Table of Content

20 February 2019, Volume 27 Issue 2

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Neurodevelopmental outcome of very preterm and extremely preterm infants

CAO Yun

2019, 27(2):  119-122.  DOI: 10.11852/zgetbjzz2019-0044

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Infants born at very preterm(VPT) and extremely preterm(EPT) are at risk for both brain injury and neurodevelopmental impairment (NDI). With advance in neonatal intensive care, the survival rate of VPT and EPT preterm infants has increased significantly. However, decreasing NDI and improving the long term outcome are currently the important issues globally. Understanding the neurodevelopmental outcomes of VPT and EPT preterm infants is important,which can guide the clinical decision and early intervention thereby improving the long term outcome.

Connotation and extension of high-risk child management in child healthcare service in China

ZHANG Yue

2019, 27(2):  123-125.  DOI: 10.11852/zgetbjzz2018-1853

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High-risk child management is an important task for child healthcare service providers in China, which includes the children with high-risk factors at birth or with growth and development problems after birth.With the development of society, the content of high-risk child management has transferred from physiological healthcare to psychological and social healthcare.The core content is to strengthen the follow-up frequency, provide anticipatory guidance, and work on early detection and intervention for growth and development problems.

Longitudinal follow-up study on catch-up growth of low birth weight preterm infants aged 0 to 2 years

LI Yun-hui, SHAN Yan-chun, YANG Zhao-chuan, FU Peng, RAN Ni

2019, 27(2):  126-128.  DOI: 10.11852/zgetbjzz2018-0920

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Objective To investigate the growth pattern and characteristics of low birth weight preterm infants within 2 years after birth, in order to promote proper physical growth in preterm infants. Methods Totally 123 low birth weight preterm infantsin the Department of Child Health Care, the Affliated Hospital of Qingdao University were enrolled in this study from January 2012 to December 2015, and were divided into small gestational age (SGA) infants and appropriate gestational age (AGA) infants.Longitudinal follow-up and intervention management of all children were performed.Weight, length and head circumference were regularly measured at 3,6,12 and 24 months after birth and WHO Anthro software was used to calculate the Z-scores of weight,length and head circumference.The growth indicators of premature infants with different characteristics were compared by repeated measures analysis of variance. Results 1) The overall weight, length and head circumference of premature infants showed an upward trend in Z score within 12 months after birth, but the increase was not obvious at the ages of 12 to 24 months.2) Comparison between SGA and AGA: the intra-group effect analysis indicated that the Z-scores of weight, length and head circumference of SGA and AGA groups generally showed an upward trend, with the fastest growth rate before the age of 6 months and slower growth after that.The Z-scores of the length of SGA group turned to a downward trend after the age of 12 months.The intergroup effect showed that Z-scores of the weight, length and head circumference at all age stages in the SGA group were significantly lower than the AGA group during the age of 3-24 months (F=5.653,5.644,7.163, P<0.05).The Z scores of weight, length and head circumference of the AGA group at 12 months and 24 months were close to the mean value of WHO standard children at the same age. Conclusions Preterm infants with low birth weight have catch-up growth in weight, length and head circumference within 24 months after birth.The catch-up growth mainly occurs within 12 months after birth, and the speed of the catch-up growth goes quickly at first, and then the increase speed slows down.Physical growth of AGA premature infants is better than that of SGA premature infants.

Role and significance of NOD-like receptor mediated inflammatory response in anti-infection immunity of preterm infants

SHU Dan-dan, YU Sheng-lin, MIAO Xin-xin, ZHANG Yu-sheng

2019, 27(2):  129-132.  DOI: 10.11852/zgetbjzz2018-0733

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Objective To compare the difference of the expression of NOD-like receptors (NOD1 and NOD2), IL-6 and TNF-α in preterm infants in different gestational age and birth weight groups, in order to analyze the relationship among gestational age, birth weight and immune function in preterm infants. Methods Blood samples of preterm infants in the neonatal department of Childerns Hospital of Soochow University were collected from April 2016 to January 2017. The peripheral blood mononuclear cells of the preterm infants were collected, and were stimulated for 24 hours by Tri-DAP and MDP.The expression levels of NOD1 and NOD2 gene in the cells and IL-6, TNF-α in the supernatant were tested. Results The expression levels of NOD1 mRNA and IL-6 in preterm infants with gestational age<32 weeks were significantly lower than those with gestational age of 34-＜36 weeks (P<0.05).The expression of NOD1 mRNA in preterm infants with birth weight<1.5 kg was significantly lower than those with birth weight over 1.5 kg.And the expression of NOD2 mRNA and IL-6 was significantly lower than that with 2.0-2.5 kg (P<0.05).Moreover, the levels of NOD1 mRNA and NOD2 mRNA were positively correlated with birth weight(r=0.352,0.306,P<0.05), but were not related to gestational age.The expression of TNF-α was positively correlated with both gestational age and birth weight(r=0.380,0.289,P<0.05). Conclusions Preterm infants with lower birth weight has lower levels of NOD-like receptor and poorer immunity to infection.Birth weight has greater influence on immune function in premature infants compared with gestational age.

Efficacy of early premature infant oral motor intervention on the prognosis of premature infants

2019, 27(2):  133-137.  DOI: 10.11852/zgetbjzz2018-0439

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Objective To analyze the efficacy of early premature infant oral motor intervention (PIOMI) on the prognosis of premature infants in neonatal intensive care unit (NICU), in order to provide evidence for the management of premature infants. Methods A total of 151 preterm infants in NICU of Liaocheng People′s Hospital were enrolled in this study, and were divided into intervention group and control group from January 2015 to January 2017.Both groups received routine treatment of preterm infants after stable vital signs, and the intervention group was given oral massage method adopted by Sandra Fucile additionally,with 1 time per day for 14 consecutive days.Chinese Version of Peterm Infant Oral Feeding Readiness Assessment Scale(PIOFRA scale-CV) was used to evaluate the preterm infant′s oral feeding ability, including the oral feeding performance, feeding process and feeding outcome, and Neonatal Behavioral Neurological Assessment(NBNA) results.Infant Neurological International Battery(Infanib) was used for early motor development evaluation at 3 and 6 months after birth respectively. Results The postmenstrual age of the intervention group was significantly smaller than the control group till the completely gastrointestinal feeding(t=3.01,P=0.04).The feeding efficiency of the intervention group was significantly higher than that in the control group (t=2.30,P=0.03).The weight of the intervention group reaching completely gastrointestinal feeding was significantly lower than that in the control group (t=3.45,P=0.01).The score of PIOFRA Scale-CV in intervention group was significantly higher than that in control group (F=5.658, P=0.02), and there were interaction effects between different time and groups (F=12.60, P<0.001).Infanib was used to evaluate early motor development at 3 months of age in both groups, and the proportion of normal results in intervention group was significantly higher than that of control group(χ²=4.00,P=0.03).At 6 months of age, the proportion of abnormal results in intervention group was significantly lower than that in the control group, and the proportion of normal results was significantly higher than that in the control group (χ²=10.52,12.10,P<0.01). Conclusions Oral feeding in preterm infants is a systematical and complex process.Early oral exercise intervention scheme can shorten the transition time from tube feeding to complete oral feeding, and can improve the performance of feeding in premature infants.

Study on the correlation between general movements assessment results and developmental outcome in preterm infants without cerebral palsy

LI Yun,ZHANG Yue,HUANG Jun,ZHANG Ying,YANG Hong,JIANG Chun-hua,ZHONG Ping-li,JIANG Yuan

2019, 27(2):  138-141.  DOI: 10.11852/zgetbjzz2018-0866

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Objective To analyze the difference on the overall developmental outcomes measured by Development Screening Test (DST) in children with abnormal and normal results of general movements (GMs), in order to explore the correlation between GMs assessment mild neurologic dysfunction. Methods Participants were recorded with GMs assessment results during writhing and fidgety movement period from 2009 to 2017.And the developmental quotient (DQ) and mental index (MI) were assessed by DST at 9,12 and 24 months old. Results Single factor analysis showed that there was no significant differences on DQ and MI results between children with normal and abnormal GMs assessment results among 9,12 and 24-month-old infants.After adjusting confounding factors, abnormal results of GMs fidgety movement indicated high risk of abnormal developmental outcomes(9 months old:OR=3.075,95%CI:1.013-9.331;12 months old:OR=3.638,95%CI:1.552-8.527;24 months old:OR=2.750,95%CI:1.213-6.242).The sensibility of GMs assessment to predict later outcome was low(8.82%~18.60%), while the specificity was high(＞95%). Conclusion GMs assessment has limitation to predict later development outcome of infants, and can not replace other development assessments.

Effects of oral motor intervention on the feeding performance of preterm infants with oral feeding disorder and the analysis of high risk factors influencing the number of interventions

ZHU Xiao-yun,HE Min-si,LU Chun-mei,YIN Huan-huan,SHI Xiao-juan,ZHU Mo

2019, 27(2):  142-145.  DOI: 10.11852/zgetbjzz2018-0818

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Objective To observe the improvement of feeding ability of the preterm infants with oral feeding disorders after oral motor intervention (OMI), to explore the correlation between gestational age, general movements (GMs) results and OMI times, and to determine the risk factors influencing OMI times. Methods Totally 89 preterm infants who completed camera shooting of GMs and received self-feeding through their mouths after OMI were enrolled from March 2015 to February 2016, and were divided into two groups according to their birth gestational age, including group of<34 weeks and group of ≥ 34 weeks.At the same time, the results of GMs assessment were classified into three categories, the OMI times between the two groups and different groups were statistically compared.OMI times was set as dependent variable, gestational age, birth weight and the age at the beginning of treatment, GMs results, complications of the digestive, respiratory, blood, nerves, and other system obstacles, and the total number of the symptoms were included as independent variables, and multiple stepwise regression analysis was used to determine the high risk factors influencing the OMI times. Results The OMI times before reaching the feeding capacity required by the doctor, in gestational age<34 weeks group were more than those in the ≥34 week group (P<0.05).The OMI times of preterm infants with the better GMs result were fewer.On the contrary, the OMI times with poor GMs result were more frequent.According to the analysis of clinical manifestations, the worse results of GMs assessment, the smaller gestational weeks and the symptoms of the digestive system were high risk factors for the increase of OMI times in preterm infants(R²=0.34). Conclusions Birth gestational age is one of the factors affecting the feeding disorder of preterm infants, and the poor result of GMs assessment in preterm infants may indicate the existence of feeding disorder at the same time.The symptoms of the digestive system are also the high risk factor for increasing times of OMI in preterm infants, suggesting that digestive disorders may affect the improvement of oral function.

Spatial distribution of poor vision among children and adolescents aged 6 to 18 years in Shandong province

HAN Li-zhen, FU Mao-sun, XIE Hong, LIU Yi-hua

2019, 27(2):  146-150.  DOI: 10.11852/zgetbjzz2018-0328

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Objective To analyze the spatial distribution characteristics of poor vision in children and adolescents in Shandong province, in order to provide scientific basis for the prevention and control of poor vision. Methods Data were from the database of physical examination of 9.39 million children and adolescents aged 6 to 18 years in Shandong province in 2015.The data of left and right eye vision were acquired, and Arc GIS 9.3 software was used to present the spatial distribution of poor vision of 6 to 18-year-old children and adolescents in Shandong province, and their regional distribution characteristics were described. Results The total poor vision rate among children aged 6 to 18 in Shandong province was 38.7% in 2015, and the rates of mildly, moderately and severely poor vision were 7.5%,14.2% and 17.1%, respectively.The rate of poor vision in urban areas was higher than that in rural areas (47.9% vs.33.3%), and it was higher in girls than boys (42.3% vs.35.7%)(P＜0.05).The rate of poor vision in central and northeastern areas of Shandong province was higher, so were the distribution of poor vision in boys and girls.And mildly poor vision showed scattering distribution. Conclusions There are obvious spatial differences on the distribution of poor vision among children and adolescents aged 6 to 18 years in Shandong province.Thus spatial ingredients should be considered when the local departments make relevant strategies

Study on the status and influencing factors of health literacy among middle school students in three provinces, China

WANG Yu-qing, YU Xiao-ming, HUANG Si-zhe, GUO Shuai-jun, WANG Lu

2019, 27(2):  151-155.  DOI: 10.11852/zgetbjzz2018-0454

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Objective To comprehensively understand the status and problem of health literacy among middle school students in three provinces, China, in order to provide suggestions for further health education. Methods Multistage sampling method was used to select 5 000 students from 22 junior high schools or senior high schools in Guangdong province, Jilin province and Hebei province from January 2015 to February 2017.The participants were surveyed by questionnaires which consist of basic data, health knowledge, health attitude, health skills and health behaviors. Results The average score of health literacy was 69.67±10.04, and the proportion of having basic health literacy was 11.5% among middle school students in Guangdong, Jilin, Hebei provinces.Binary Logistic analysis showed that students from Jilin(OR=4.15,95%CI:3.03-5.69) and Hebei(OR=2.18,95%CI:1.61-2.96), living in suburb areas(OR=1.25,95%CI:1.01-1.56), with maternal education of high school(OR=1.26,95%CI:0.99-1.60) or college and above(OR=1.98,95%CI:1.53-2.57), enjoying in accepting health education(OR=1.99,95%CI:1.45-2.71) had higher proportion of basic health literacy.And the students in senior high school(OR=0.50,95%CI:0.40-0.63), who only accepted health education from school (OR=0.62,95%CI:0.45-0.85)or family(OR=0.73,95%CI:0.53-1.01) had lower proportion of basic health literacy. Conclusions The health literacy level of middle school students in China is relatively low, so families and schools need to assume the same responsibilities in health education.Also, health education should be carried out in the forms students love to see and hear.

Effect of adrenocorticotropic hormone on the expression of stress proteins in infantile spasm model induced by N-methyl-D-aspartate

HONG Ke, ZHANG Hong, LI Ya-kun, CHEN Jian-zhong

2019, 27(2):  156-159.  DOI: 10.11852/zgetbjzz2018-1097

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Objective To analyze the effect of adrenocorticotropic hormone(ACTH) on the expression of stress proteins in infantile spasm model induced by N-methyl-D-aspartate(NMDA), in order to provide theoretical evidence for the treatment of infantile spasm. Methods Totally 60 neonatal rats were randomly divided into control group, NMDA group and ACTH group, with 20 rats in each group. On the 11th day of birth, ACTH group was injected with 10 mg/(kg·d) ACTH intraperitoneally, and the other two groups were injected with the same amount of saline. On the 15th day of birth, 15 mg/(kg·d) NMDA was intraperitoneally injected into NMDA group and ACTH group, and the same amount of saline was injected into control group. Spasticity score was used to score the spasticity symptoms of three groups. The mRNA transcription levels of interleukin 1 beta (IL-1β), interleukin 6 (IL-6) and ACTH in hippocampus were measured by q-PCR. The expressions of corticotropin releasing hormone (CRH) and corticotropin releasing hormone type 1 receptor (CRHR1) in hippocampus were measured by Western Blot method. Results The score of spasticity in NMDA group was significantly higher than that in control group (t=11.236, P<0.001). The score of spasmodic symptoms in ACTH group was lower than that in NMDA group (t=-6.347, P<0.001). Compared with the control group, the transcription levels of IL-1β and IL-6 in the hippocampus of NMDA group increased (IL-1β:t=6.237, P<0.001; IL-6: t=6.553, P<0.001). The transcriptional levels of IL-1βand IL-6 in the hippocampus of ACTH group were lower than those of NMDA group (IL-1β: t=-7.669, P<0.001; IL-6: t=-8.125, P<0.001). The transcription level of ACTH mRNA in hippocampus of group ACTH was higher than that of NMDA group (t=7.758, P<0.001). Compared with the control group, the expression levels of CRH and CRHR1 protein in hippocampus of NMDA group were up-regulated (CRH: t=7.517, P<0.001; CRHR1: t=7.745, P<0.001). While the expression of CRH and CRHR1 protein in ACTH group was lower than that in NMDA group (CRH: t=-6.120,P=0.003; CRHR 1: t=-6.050, P=0.005 ). Conclusions ACTH could relieve spasm symptom induced by NMDA in neonatal rats. It is speculated that ACTH may help decrease the mRNA expressions of IL-1β and IL-6 in the hippocampal tissues of neonatal rats, up-regulate the mRNA expression of ACTH, and inhibit the protein expressions of CRH and CRHR1.

Research progress on the influence of vitamin D deficiency during pregnancy on pregnant women and their offsprings

ZHANG Ying-kuan,YANG Shu-fen

2019, 27(2):  160-163.  DOI: 10.11852/zgetbjzz2018-0560

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Vitamin D (Vit D) deficiency is a common public health problem worldwide, especially in pregnant women and their offsprings.Vit D deficiency can not only cause diseases in bone, but also correlate with allergic diseases, type 1 diabetes, cardiovascular diseases, tumors, autoimmune diseases and neurobehavioral diseases.So there are increasing concerns that maternal Vit D deficiency could adversely affect the life and health of pregnant women and their offsprings.This review summarizes the impact of Vit D deficiency on the health of pregnant women and their offsprings, in order to improve maternal awareness of Vit D supplementation and achieve eugenics.

Research progress on the roles of vitamin A and vitamin D in the adjuvant treatment of children with pneumonia

WANG Shan-shan, GU Lian-jie, LIU Hong, ZHENG Min,SONG Jia-le

2019, 27(2):  164-167.  DOI: 10.11852/zgetbjzz2018-1035

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Pneumonia is a common infectious disease in children.Its main pathogens are viruses, bacteria, chlamydia and mycoplasma, which seriously affect children′s health.Antibiotics are mainly used in clinical treatment, but a variety of drug-resistant strains have appeared in the application of broad-spectrum antibiotics in recent years, resulting in poor treatment efficacy.With the deepening of clinical and basic medical research, vitamin A(Vit A) and vitamin D(Vit D) play an important role in improving the body′s immunity.Therefore, this paper reviews the roles of Vit A and Vit D in the adjuvant treatment of children′s pneumonia and related research progress.

Research progress on the effects of lactoferrin supplementation on newborns and infants

SUN Rui-ying,QU Shu-qiang

2019, 27(2):  168-170.  DOI: 10.11852/zgetbjzz2018-0656

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With the development of economy and society, people have paid more and more attention to immune nutrition in recent years, such as vitamins, probiotics, polyunsaturated fatty acids, nucleotides, lactoferrin (LF) and so on.These nutritions can promote the growth, maintain the balance of metabolism, regulate the immunity of the body, and maintain the homeostasis of the human body.As a multifunctional protein, lactoferrin is the first line of defense in the non-specific immune system of mammals.Lactoferrin also has functions and properties of microbe resistance, immunomodulation, regulating intestinal flora, promoting the proliferation and differentiation of intestinal cells.This review summarizes the related researches on lactoferrin supplementation in neonates and infants.

Predictive value of cord blood markers in neonatal early-onset sepsis

2019, 27(2):  171-174.  DOI: 10.11852/zgetbjzz2018-0998

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Neonatal mortality has become one of the important indicators for measuring the level of health development in a country.Because of the low immunity, newborns are prone to developing various infectious diseases after birth, and the infection is difficult to control.Early detection, as well as timely and rational use of antibiotics to treat infections have become an urgent problem to be solved.This review describes the predictive value of C-reactive protein, procalcitonin, interleukin 6, and hepcidin in cord blood for early-onset sepsis in neonates, and illustrates the action and mechanism of various factors, as well as the interaction of maternity, placenta and fetus.

Research progress on the relationship of vitamin A and immune function and lung disease in children

CAO Hai-yan,LIU Shi-ping,LEI Yuan

2019, 27(2):  175-177.  DOI: 10.11852/zgetbjzz2018-0602

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Vitamin A(Vit A) is a micronutrient that plays an important role in organism, and it is closely related to the maintenance of the normal function of the body.In China, the typical Vit A deficiency has been rare, but the prevalence of atypical lack is still high.Vitamin A deficiency would lead to infectious diseases, particularly respiratory infections.In recent years, there have been many researches on the relationship between Vit A and infectious diseases,most in the aspect of immunity.This review summarizes the effects of Vit A on immunity and the lungs.

Bibliometric analysis of the researches on air pollution and childhood asthma

FU Ling-ling, HUANG Feng-yan, GAO Han, WANG Zhi-ping

2019, 27(2):  178-182.  DOI: 10.11852/zgetbjzz2018-0902

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Objective To analyze the researches on air pollution and childhood asthma bibliometricly, in order to provide implications and guidance for further studies. Method Bibliometrics and data map visualization analysis methods were used, and papers from 2000 to 2017 in the Science Citation Index Expanded database were collected, and were statistically analyzed from five aspects,including published and cited time series, countries, disciplines and periodicals, research institutions and authors, paper keywords. Results The number of papers published and the number of citations rose rapidly over time,80% of high quality magazines and 60% of research institutes came from the United States.There was no statistically significant linear correlation between the number of published journals and the impact factors (r=0.39, P=0.221).And 91% of papers were from environmental science and allergy, birth cohorts and fine particles were hot topics in recent years. Conclusions Researches on air pollution and childhood asthma are on the rise, and the United States has led research in this area.Meanwhile,the research focuses have changed from the relationship between single pollutants and childhood asthma to complex air pollution and epidemiology of life history.

Analysis of neurobehavioral development of 3-month-old children with neonatal hyperbilirubinemia

LIU Qiu-ju

2019, 27(2):  183-185.  DOI: 10.11852/zgetbjzz2018-0411

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Objective To investigate the influence of neonatal pathological jaundice on the neurobehavioral development of 3-month-old infants,in order to provide evidence for early clinical treatment and early evaluation of prognosis. Methods Totally 114 neonates with pathological jaundice treated in the Affiliated Hospital of Guilin Medical College from August 2014 to April 2016 were enrolled in this study, and were divided into three groups according to different levels of serum bilirubin concentration, including low level group(46 case, Sb<257 μmol/L),moderate level group(31 cases, Sb 257-342 μmol/L)and high level group(37 cases, Sb> 342 μmol/L).Infants received brainstem auditory evoked potentials (BAEP) test on admission and the abnormal cases would be retested BAEP at the age of 3 months old. Intelligent tests were conducted in all infants at their age of 3 months old. Results The abnormality rates of first BAEP test at admission in low level group, moderate level group and high level group were 34.8%(16/46), 51.6%(16/31) and 64.9%(24/37),respectively. And the difference was significant among three groups(P＜0.05).The scores of (mental development index,MDI) and (psychomotor development mdex,PDI) increased with the decrease of Sb level, and were negatively correlated with Sb level(r＝-0.583,-0.574,P＜0.001). And there was significant delay in the cases with abnormal BAEP results for the primary screening compared with normal ones. However, only three cases were abnormal in BAEP test at the age of 3 months old. Conclusions BAEP is a sensitive index of cerebral injury in children with neonatal pathological jaundice, but not an indicator for the recovery of patients′ nervous system independently. So it is suggested that together with regular neurobehavioral development test, BAEP warrants timely abnormal condition of nervous system for pediatricians in order to give early intervention and improve the prognosis.

Prevalence and influencing factors of diarrhea in rural children under 7 years old in five counties of Ningxia

LIU Xiao-juan, PENG Juan-xia, HE Shu-lan, LIU Lan

2019, 27(2):  186-189.  DOI: 10.11852/zgetbjzz2018-0397

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Objective To explore the prevalence and influencing factors of diarrhea in rural children under 7 years old in five counties of Ningxia Hui Autonomous region,in order to provide scientific references for taking corresponding intervention measures and optimally allocating of health resources. Methods Data of 10 318 rural children were collected by Health Survey Questionnaire on Rural Residents program performed collaboratively by Ningxia Health Bureau and Harvard/Oxford University Research Team in 2009,2011,2012 and 2015 in five counties (Haiyuan, Yanchi, Tongxin, Pengyang and Xiji) of Ningxia.Influencing factors of diarrhea in children were determined by unconditioned binary Logistic regression analysis. Results Totally 558(5.4%) rural children under 7 years old in five counties of Ningxia suffered from diarrhea over the last two weeks.Single factor analysis showed that children with different ages, nationalities and vaccine experiences had significantly different prevalence rates of diarrhea (P<0.05).Logistic regression analysis results showed that hui ethnic group (OR=1.351,95%CI:1.090-1.671), younger ages(0-＜2 years old OR=10.515,95%CI:7.308-15.129; 2-＜4 years old OR=3.319,95%CI:2.285-4.821) and low family income per year (OR=1.555,95%CI:1.229-1.966) were risk factors for childhood diarrhea in this area. Conclusions The prevalence rate of diarrhea in children under 7 years old in rural areas of Ningxia is still high.Nationality, age and family income may be the main influencing factors for childhood diarrhea.

Analysis of the results of the deafness gene in 52 deaf children from special school in Hubei province

WANG Hong-mei, LI Bin, ZHOU Jiao

2019, 27(2):  190-193.  DOI: 10.11852/zgetbjzz2018-0475

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Objective To screen 13 sites of the genes GJB2, GJB3, SLC26A4 and mitochondrial DNA(mtDNA) susceptible to deafness in deaf children from a special school, and to compare with hearing normal children, in order to know about the mutation gene and sites. Methods The peripheral blood of 52 deaf children and 1 131 children with normal hearing were collected, and genomic DNA was extracted from March to September 2017.And 13 mutation sites of GJB2, SLC26A4, mtDNA and GJB3 genes were detected by using the hereditary deafness gene chip detection kit. Results Totally 18(34.63%) mutation carriers were detected in 52 deaf patients who carried different mutation genes.And 13 cases with GJB2 gene mutations(25.00％),including 3(5.77%) cases of homozygous mutation,6(11.54%) cases of single heterozygous mutation and 4(7.69%) cases of complex heterozygous mutation.Also,3(5.77％) cases with SLC26A4 gene mutations, including 2 (3.85%) cases of homozygous mutation and 1 (1.92%) cases of single heterozygous mutation.And 2 cases with mtDNA gene mutations(3.85%), which were 1555A>G homogenous mutations.No GJB3 gene mutation was detected.Finally 125 (11.05%) mutation carriers were detected carrying different mutated genes in 1 131 children with normal hearing, of whom 79(6.99%) cases with GJB2 gene mutations,35(3.09%)cases with SLC26A4 gene mutations,11 cases with mtDNA gene mutations(0.97%).No GJB3 gene mutation was detected.There were significant differences on gene distribution between deaf children and normal children(χ²=25.98, P<0.001). Conclusions The hotspot gene of deafness mutation mainly are GJB2 and SLC26A4 in this special school, and GJB2 235delC(19.23%) is the most common mutation site.And genetic testing of deafness provides evidence for reducing birth defects.

Effect of individualized breast milk fortifier on the growth and development of breastfed premature infants

WANG Shu-huan, LIU Ge-li, LIU Yang, HAN Yuan-yuan, WANG Yan

2019, 27(2):  194-196.  DOI: 10.11852/zgetbjzz2018-0804

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Objective To investigate the effect of individualized breast milk fortifier in breastfed premature infants, in order to provide reference for the appropriate feeding of premature infants. Methods A total of 120 premature infants were selected from January 2016 to December 2017 in Tanggu Obstetrics and Gynecology Hospital of Binhai District, Tianjin, who were hospitalized in pediatrics department and monitored their growth and development in Tianjin Binhai New Area Women and Children Health and Family Planning Service Center regularly. The participants were randomly divided into two groups, with 60 cases in each group. The control group was fed with standard breast milk fortifier, while the observation group was fed with individualized breast milk fortifier according to the protein intake of premature infants. The weight, length and head circumference, and feeding complications of the two groups were compared. Results The body weight, body length and head circumference of premature infants in two groups were higher in 1 month, 2 months and 3 months after feeding, with significant time influence(P<0.05). And these indicators in the observation group were higher than those in the control group, with significant intervention influence(P<0.05). The incidence rates of feeding intolerance and necrotizing enterocolitis in the observation group were significantly lower than those in the control group (χ²=4.821、5.217,P<0.05). Conclusions Compared with the standard breast-feeding agent, individualized breast milk fortifying agent can promote the physical growth of premature infants better. And the individualized breast milk fortifying is safer than standard breastfeeding fortifier, because it can reduce the incidence of feeding complications.

Clinical trial and effect of Bi-level continuous positive airway pressure on early pulmonary function in preterm infants with mild respiratory distress syndrome

ZHANG Hui-jie, WEN Xiao-hong, HUANG Hui-zhi, PAN Jun-ping, SHEN Pei-ting, WU Wan-yun

2019, 27(2):  197-201.  DOI: 10.11852/zgetbjzz2018-0332

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Objective To explore the efficacy and effect of Bi-level continuous positive airway pressure (BiPAP) on early pulmonary function in the treatment of premature infants with mild respiratory distress syndrome (RDS). Methods Totally 76 preterm infants with mild RDS in Neonatal Intensive Care Unit (NICU) of the Third Affiliated Hospital of Anhui Medical University were selected as participants from June 2016 to January 2018 and given non-invasive ventilation after birth. The infants were randomly divided into BiPAP group(38 cases) and CPAP group (38 cases). The therapeutic effect and early pulmonary function of the two groups were compared. Results 1) The endotracheal intubation rate of the BiPAP group was significantly lower than that of the CPAP group(5.26% vs. 26.32%, P<0.05),but the average duration for noninvasive respiratory support ,the average time of complementary oxygen need, repeated application of pulmonary surfactant, other complications, the death rate and the average hospitalization days between the two groups were not significantly different (P>0.05). 2) The BiPAP group had significantly lower respiratory rate[(42.98±4.26)times/min vs. (46.13±4.58)times/min], higher tidal volume[(6.50±1.29)ml/kg vs. (5.55±1.03)ml/kg] and minute ventilation [(0.50±0.66)L/(min·kg) vs. (0.45±0.47)L/(min·kg)]( P<0.05), while the differences on the ratio of time to peak tidal expiratory flow to total expiratory time, ratio of volume to peak tidal expiratory flow to total expiratory volume, peak expiratory flow, and breathing flow at 75%, 50%, and 25% of tidal volume were not significant in both groups (P>0.05) . Conclusion Compared with CPAP, BiPAP is safer and more effective in the treatment of mild RDS in preterm infants, and can also improve lung compliance and early lung function in preterm infants with RDS.

Clinical study of myelin basic protein and neuron-specific enolase in children with mycoplasmal pneumouniae pneumounia complicated with encephalitis

LI Qin, WANG Ya-kun, TIAN Li-yuan, ZHANG Man, WANG Yan-yan, LI Qing-tao, CHANG Hai-xia

2019, 27(2):  202-204.  DOI: 10.11852/zgetbjzz2018-0204

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Objective To test the levels of myelin basic protein (MBP) and neuron-specific enolase(NSE) in the cerebrospinal fluid (CSF) of children with mycoplasmal pneumonia complicated with encephalitis, in order to explore the clinical value of MBP and NSE in the assessment of mycoplasmal pneumonia complicated with encephalitis. Methods Totally 68 cases with mycoplasmal pneumonia complicated with encephalitis were selected as experimental group (including 36 cases of non-convulsion group,32 cases of convulsion group) and 30 cases of mycoplasmal pneumonia in control group from April 2016 to October 2017.The contents of MBP and NSE in the cerebrospinal fluid (CSF) were tested by enzyme linked immunosorbent assay (ELISA). Result The levels of MBP and NSE in the cerebrospinal fluid of the convulsive group and the non-convulsive group were significantly higher than those in control group (P<0.05), and were also higher in convulsive group than non-convulsive group (P<0.05). Conclusion The content of MBP and NSE in CSF can be used as an index to evaluate the central nervous system injury and injury degree of children with mycoplasmal pneumonia complicated with encephalitis, which is helpful for clinicians to predict the condition and make reasonable diagnosis and treatment as soon as possible.

Study on the correlation between endothelial nitric oxide synthase polymorphism and encephalopathy of prematurity

CHANG Shao-hong,LUAN Bin,ZHANG Wei-xing

2019, 27(2):  205-207.  DOI: 10.11852/zgetbjzz2018-0104

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Objective To analyze the correlation between endothelial nitric oxide synthase (eNOS) polymorphism (AGT M235T, ACE I/D, eNOS G894T, eNOS T-786C) and encephalopathy of prematurity, in order to provide reference for assessing the patients′ condition comprehensively. Methods Preterm infants with gestational age under 34 weeks in neonatal intensive care unit (NICU) of Xinxiang Central Hospital were enrolled in this study from June 2014 to September 2017. Head ultrasound and magnetic resonance imaging of the patients were conducted, and gene polymorphisms were tested. Clinical data of the participants were retrospectively collected. The correlation among AGT M235T, ACE I/D, eNOS G894T, eNOS T-786C and encephalopathy of prematurity was analyzed. Result It was found that eNOS T-786C TC+CC polymorphism was an independent risk factors for encephalopathy of prematurity (OR＝3.206,95%CI:1.850~7.652). Conclusions There is genetic susceptibility in encephalopathy of prematurity. And gene polymorphism test is helpful to assess the prognosis of preterm infants.

Application of neutrophils to lymphocytes ratio for influenza diagnosis of children aged not more than six years old

YUAN Xiao-hong,LI Peng

2019, 27(2):  208-211.  DOI: 10.11852/zgetbjzz2018-0599

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Objective To analyze the prevalence of influenza A/B in preschool children and neutrophils to lymphocytes ratio (NLR) of influenza A/B positive patients and patients with influenza-like illness, in order to provide more ideas and basis for the prevention, diagnosis and treatment of influenza-like illness. Methods Children who were not more than 6 years old, and screened for antigen of influenza viruses in the Second Affiliated Hospital of Xi′an Jiaotong University, were enrolled in this study from November 2017 to February 2018.The venous blood or finger tip blood of the participants were collected for blood routine test.SPSS 19.0 software was used to analyze data. Results Totally 99(26.19%) cases with positive influenza A were observed in 378 children with influenza-like illness,44 (11.64%) cases with positive influenza B, and the 225 cases were not infected.There was significant difference on the value of NLR between patients with influenza A infection and children without infection(P＜0.05).When NLR was 0.42, the sensitivity for the prognosis was 86.1%, the specificity was 93.2%, and the area under curve (AUC) was 0.594. Conclusion NLR has certain clinical value for the diagnosis of H1N1 influenza, and can be helpful to diagnose influenza A virus infection by influenza virus antigen screening.

Effects of nasal intermittent positive pressure ventilation compared with continuous positive airway pressure on preterm infants with different degrees of respiratory distress syndrome

NIU Jun-hong,CHEN Xing

2019, 27(2):  212-215.  DOI: 10.11852/zgetbjzz2018-0352

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Objective To compare the clinical effects of nasal intermittent positive pressure ventilation (NIPPV) and nasal continuous positive airway pressure (NCPAP) on the treatment of different degrees of neonatal respiratory distress syndrome (NRDS) in preterm infants,in order to provide evidence for clinical treatment of NRDS. Methods A randomized, controlled, single-center study was performed on 221 premature infants with NRDS in Liaocheng Women and Children Health Care Hospital from March 2012 to June 2017.And these premature infants were classified into Ⅰ,Ⅱ,Ⅲ,Ⅳ grades according to X-ray results, then randomly assigned to receive NIPPV and NCPAP.Effect and complications were compared between the two groups. Results The effective rates of Ⅱ,Ⅲ grades in NIPPV group were higher than those in NCPAP group(P＜0.05).The proportion of pulmonary surfactant use, mechanical intubation, apnea in the NIPPV group among Ⅱ,Ⅲ grades was significantly lower than those in NCPAP group(P＜0.05).However, no significant differences were found on the incidence of patent ductus arteriosus, intracranial hemorrhage,air leak syndrome between the two groups.There was no significant difference on therapeutic effect of NRDS children among Ⅰ,Ⅱ grades(P>0.05). Conclusions As an initial respiratory support for the treatment of NRDS preterm infants, NIPPV has similar efficacy with in the treatment of I-grade NRDS.In terms of Ⅱ and Ⅲ grade of RDS, NIPPV has an advantage over NCPAP.Neither NIPPV nor NCPAP is effective for Ⅳ grade of NRDS.

Case report and review of literature on osteogenesis imperfecta caused by a new mutation of COL1A2 in neonates

CHENG Fei, ZHOU Jun-min

2019, 27(2):  216-218.  DOI: 10.11852/zgetbjzz2018-0351

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Objective To analyze and summarize the clinical phenotype and gene mutation characteristics of a de novo COL1A2 gene mutation in a newborn with osteogenesis imperfecta (OI),in order to improve the diagnosis and understanding of OI. Methods Clinical data and test results were reviewed from a newborn diagnosed with OI in the department of Pediatrics of the Third Hospital of Xiamen Affiliated Hospital in August 2017. In addition, the newborn and her parents′ peripheral blood genomic DNA were extracted, and the genes related to OI were analyzed and reviewed by using the whole-sequence exon gene detection technology. Results The patient′s COL1A1 gene was not found with pathogenicity variation, while the COL1A2 gene was detected with a new hybrid missense mutation (c.G2882A, p.G961D). The mutation had not been reported in PubMed and HGMD databases, which was inherited from her mother. Conclusions According to the clinical information of the children, the genetic model of disease and comprehensive evaluation of Exomiser software, it is predicted that the new mutation of COL1A2 gene (c.G2882A, p.G961D) is the cause of OI in this case.

Prevalence and influencing factors of iron-deficiency anemia among preschool left-behind children in Kirgiz ethnic minority in Xinjiang

2019, 27(2):  219-221.  DOI: 10.11852/zgetbjzz2018-0631

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Objective To understand the status and influencing factors of iron deficiency anemia in preschool left-behind children in the Kirgiz ethnic minority in Xinjiang, in order to provide support for the healthy growth of left-behind children. Methods Stratified sampling was used to investigate and test 442 left-behind children aged 3 to 6 years in the Kirgiz Autonomous Prefecture in Xinjiang from October to November 2016. Results The total prevalence of iron deficiency anemia in preschool children of Kirgiz ethnic preschool children was 18.10%(80/442).The prevalence rates of mild, moderate and severe iron deficiency anemia were 12.22%,4.30% and 1.58%, respectively, and the difference was significant(χ²=47.60, P<0.01).Regression analysis showed that no iron supplementation during pregnancy (OR=2.026,95%CI:1.038-3.944), family income under 1 000 yuan (OR=2.352,95%CI:1.111-5.011), picky eating (OR=3.997,95%CI:1.318-12.108) were risk factors for iron deficiency anemia. Conclusions The prevalence of iron-deficiency anemia among preschool children in Kirgiz ethnic minority is relatively high, and mild anemia is the main cause.Positive interventions should be adopted to reduce the prevalence of anemia.

Correlation between early childhood caries and Cariostat score of caries activity test in children aged 0 to 2 years in Beijing

LIN Xiao-hua,WANG Wen-hong,ZOU Xiao-xuan,MIAO Jiang-xia,CUI Xiu-li

2019, 27(2):  222-225.  DOI: 10.11852/zgetbjzz2018-0653

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Objective To investigate the prevalence of early childhood caries(ECC) in children aged 0 to 2 years in Beijing,and to analyze the correlation between ECC and caries activity test(Cariostat score). Methods Totally 1 123 children aged 0 to 2 years from Haidian district in Beijing were examined by a cross-sectional sampling method from March to September 2016.The plaque samples were collected from buccal surfaces and incubated in the Cariostat test medium (Beijing GangDa Medical Technology CO., Ltd, China). Meanwhile mother/primary caregivers were also surveyed by oral health questionnaires. Results The ECC prevalence of children aged 0 to 2 years was found to be 13.2% with a mean decayed missed filled teeth(dmft) score of 0.44±1.35, and caries severe index(CSI)was 1.86±6.42.ECC, dmft, CSI and Cariostat value all increased significantly with age(P＜0.001).Cariostat test showed that most of the caries-free children were at lower level while most of the ECC children were at higher level(P＜0.001). Conclusions A strong correlation between the caries activity test (Cariostat score) and ECC exists in children aged 0 to 2 years.It is clear that Cariostat score can be used as an indicator for caries risk assessment and ECC prediction, and can provide reference for individualized management of caries.

Analysis of the injury factors and clinical features of pediatric ocular traumatic children

ZHENG Ling-ling, HE Li-wen, XIAO Wei, BAI Ying-ying, TAN Jun-lian

2019, 27(2):  226-229.  DOI: 10.11852/zgetbjzz2018-0453

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Objective To explore the characteristic of pediatric ocular traumatic children, in order to explore the risk factors of pediatric post-traumatic endophthalmitis. Methods Totally 144 ocular trauma children admitted by Zhongshan Ophthalmic Center from January to October 2017 were enrolled in this study.Demographic characteristic, injury factors and clinical features were recorded.And the influencing factors of post-traumatic endophthalmitis were analyzed. Results It was observed that 28 (21.4%) patients out of 131 open ocular trauma developed endophthalmitis.For ocular traumatic children, primary repair above 8 hours increased the risk of endophthalmitis by 5.379 times.Left-behind children increased the risk of primary repair over 8 hours by 1.570 times.Primary repair within 8 hours played an intermediary role between left-behind children and endophthalmitis(Z=2.09,P=0.036). Conclusion Pediatric post-traumatic endophthalmitis is associated with primary repair within 8 hours or not, and left-behind children with delayed primary repair should be given more concern.