Table of Content

10 March 2020, Volume 28 Issue 3

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Application of motor development assessment in early childhood development

CHI Xia

2020, 28(3):  233-236.  DOI: 10.11852/zgetbjzz2019-1839

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Growth and development monitoring is an important part of early child development.Motor development assessment monitoring,as the basic content of children′s growth and development,deserves more attention.According to the milestones of children′s motor development,combined with reflexes,muscle tension,posture and motor pattern,children′s motor development level is comprehensively judged by means of inquiry,observation and examination.By judging whether children′s motor development level is delayed or abnormal,corresponding health promotion,early intervention and rehabilitation are given to these children.This paper introduces the current situation of children′s motor assessment from the aspects of comprehensive development scales,infant neuromotor development scales,special motor development scales and motor scales suitable for children with cerebral palsy.

Recommendations for graded prevention and control for children during the outbreak of corona virus disease 2019

YING Yan-qin, WEN Yu, ZHAO Jin-zhu, LIU Yan, ZHANG Jian-ling, YE Feng, TANG Li-na, HE Tian-yi, CHEN Ping, GAO Tao-zhen, WANG Bang-yan, LAN Hong-wen, ZHANG Cai, QIU Li-ru, HAO Yan, LUO Xiao-ping

2020, 28(3):  237-241.  DOI: 10.11852/zgetbjzz2020-0134

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Since December 2019,the coronavirus disease 2019 (COVID-19) associated infection/pneumonia has emerged in Wuhan,Hubei in China.The State Council has classified it into category-B infectious diseases in the list of the People′s Republic of China on the prevention and control of infectious diseases,and has regarded it as category-A infectious diseases in terms of the prevention and control measures on January 20th,2020.With the progress of the outbreak,more cases of the novel coronavirus infection/pneumonia in children have been reported.Until now,it has been generally believed that the disease can occur in people at all different ages.Infections under 3 years old are rare,but a case of 17-day-old neonate has been reported.Based on the frontier clinical experience and the characteristics of the reported cases in children,this article summarizes the strategies for graded prevention and control for children with novel coronavirus infection/pneumonia,so as to provide reference for pediatric clinic and general public.

Recommendations for delayed immunization with national immunization program vaccines based on safety and efficacy analysis during epidemic of novel coronavirus pneumonia

WANG Lin

2020, 28(3):  242-246.  DOI: 10.11852/zgetbjzz2020-0143

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Since December 2019,an outbreak of novel coronavirus pneumia (NCP) has spread across China successively.Approved by the State Council,the National Health Commission of the People′s Republic of China has classified it into category-B infectious diseases in the list of the People′s Republic of China on the prevention and control of infectious diseases,and has regarded it as category-A infectious diseases in terms of the prevention and control measures on January 20th,2020.Successive series of prevention and control measures was conducted such as isolating patients and medical observation of their close contacts.The gathering of vaccination units may increase the risk of spread and infection of the NCP,so that children and their guardians are placed under home quarantine,which will results in delayed vaccination.Children′s guardians and health care staff in primary health care institutes are in great need of knowing the immunogenicity and safety of delayed vaccination and the priority of vaccination after recovery of outpatient service.On the basis of the literature review of guidelines and a large number of literature at home and abroad,experts of Group for Disease Prevention and Vaccination,Society of Child Health,Chinese Preventive Medicine Association analyzed the influence of all kinds of different inoculum time and procedures on the safety and immunogenicity of vaccination,hoping to provide scientific evidence and professional advice in time the and eliminate anxiety panic of child guardians and confusion of vaccination workers on the front line concurrently.

Study on the correlation of preterm birth with subclinical hypothyroidism and age of pregnant women

SHAO Ya-wen, BAI Yan, LIN Ru, CHEN Ma-li, HE Wen-hua, ZHAO You-hong

2020, 28(3):  247-251.  DOI: 10.11852/zgetbjzz2019-01771

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Objective To investigate the association of preterm birth with pregnant women age and subclinical hypothyroidism (SCH), in order to provide scientific evidence for making individualized strategies for pregnant women with SCH. Methods A total of 2 868 pregnant women in Gansu Provincial Maternity and Child Care Hospital were enrolled in this study from February 2016 and June 2018. Unconditional Logistic regression model was used to evaluate the associations between age, SCH and the risk of preterm birth. Results Compared with moderate age women, women of advanced reproductive age had higher risk of preterm birth (OR=1.67,95%CI: 1.32-2.13). Younger women had higher risk for very preterm birth (OR=3.65, 95%CI: 2.21-6.05).Compared with women with normal thyroid function, women with SCH had higher risk of preterm birth and moderate preterm birth (preterm birth,OR=3.07, 95%CI:2.28-4.12; moderate preterm birth OR=2.67, 95%CI:1.86-3.83).Interaction analysis revealed a multiplier interaction between age and SCH on the risk of preterm birth. Conclusions The risk of preterm birth and its subtypes in SCH patients of different ages is not consistent. It is suggested to assess preterm risk in SCH women by different age groups and take individualized pregnancy management and medication guidance.

Analysis of the correlation between general movements assessment and NBNA results at twisting movement stage

HUANG Lei, JIAO Xiao-yan, LI Jia-yue, HUI Ze-dong, JIN Bei-yi, HE Li

2020, 28(3):  252-255.  DOI: 10.11852/zgetbjzz2019-0242

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Objective To study the consistency between general movements (GMs) assessment and neonatal behavioral neurological assessment (NBNA) results in high-risk infants. Methods Totally 706 high-risk infants born in the Gansu Provincial Maternity and Childcare Hospital from January 2017 to January 2018 and followed up in Child Healthcare Department were enrolled in this study. All infants were assessed at twisting movement stage and finished NBNA neurological assessment. Kappa value of the two methods was calculated to analyze the consistency. Results The normal detection rate of GMs in full-term and normal birth weight infants was higher than that of premature and low birth weight infants (P＜0.05). And the detection rate of cramped-synchronized GMs in preterm infants was significantly higher than that in term infants (P=0.043). With the decrease of gestational age and birth weight, the detection rate of abnormal GMs presented an increasing trend significantly (P＜0.05). There were certain correlations between NBNA result and GMs assessment at different gestational age and birth weight groups, and the Kappa values were 0.112-0.289, 0.118-0.194 (P＜0.05). Conclusions The consistency of NBNA score and GMs assessment result at different gestational age and birth weight groups still needs to be further discussed. Moreover, the two methods cannot be replaced by each other. Combined application can evaluate the brain development of high-risk infants comprehensively, and promote their motor development and social adaptability.

Study on differential expression of long non-coding RNA in peripheral blood of children with autism spectrum disorder

WEI Nian-jin, FANG Yu-dan, JIANG Lian, ZHENG Xiao-fei, HE Lin, MA Chen-huan, WANG Yu

2020, 28(3):  256-260.  DOI: 10.11852/zgetbjzz2019-0853

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Objective To investigate the expression of LncRNA in peripheral blood of children with autism spectrum disorder (ASD),So as to provide theoretical basics for further study on early biomarkers of ASD. Methods Totally 40 ASD and normal control children were recuited from Shanghai Children′s Hospital from January to September 2018,and their peripheral blood samples were collected.The difference expression of whole-genome LncRNA between children with ASD and neurotypical controls was analyzed by the LncRNA Array v2.0 chip.The expression of LncRNA and mRNA related to neurodevelopment was quantitatively analyzed by qRT-PCR. Results A total of 3 655 LncRNA differential expression in ASD peripheral blood specimens were found according to the LncRNA Array v2.0 chip display,of which 2 238 LncRNA were upregulated,and 1 417 were downregulated.Quantitative analysis on 13 LncRNAs related to neurodevelopment by qRT-PCR showed that 10 LncRNAs were upregulated in ASD group,of which 4 LncRNAs were related to HOX gene and 3 LncRNAs were downregulated,1 LncRNAwas related to HOX gene.These results were in accordance with the study of array chip.The express of HOX gene in peripheral blood of ASD group was lower that of control group. Conclusions There are significant differences on LncRNA expression related to neurodevelopment in peripheral blood of ASD group.The differential expression of LncRNA related to HOX gene are potential biomarkers for early screen and diagnosis of ASD.

Analysis of clinical and risk factors for preterm birth less than gestational age

ZHONG Qing-hua, DUAN Jiang, ZENG Jie, LIANG Kun, QI Zhi-ye, SONG Jiu-shan

2020, 28(3):  261-264.  DOI: 10.11852/zgetbjzz2019-0600

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Objective To investigate the risk factors of pretermsmall for gestational age (SGA) and appropriate for gestational age (AGA),and to provide basis for clinical intervention in preterm SGA. Methods A total of 1 370 preterm infants admitted to the First Affiliated Hospital of Kunming Medical University from January 2011 to December 2017 were enrolled. The relationship between gestational age and birth weight was divided into SGA group (675 cases) and AGA group (695 cases). The general situation of premature infants in the two groups,perinatal high risk factors and complications were compared. Results 1) Birth weight,birth length,birth head circumference,discharge weight,discharge length of SGA group were less than those of AGA group.Hospitalization days in SGA group were longer than that in AGA group,the difference was statistically significant (χ² =-11.62、-7.12、-5.25、-5.72、-2.1、4.46,P<0.05);2)There were significant differences between SGA group and AGA group in maternal age maternal,pregnancy-induced hypertension syndrome,placental abnormality,cesarean section (t=65.841,170.937,19.558,92.719,P＜0.05); 3) The incidence of asphyxia,neonatal respiratory distress syndrome,myocardial injury,feeding intolerance,pneumonia sepsis,hypoglycemia and hypothyroxinemia in preterm SGA group were signigicantly higher than that in AGA group (t=4.465、4.162、6.035、3.97、5.180、5.21、4.71、5.031,P＜0.05);4) Logistic regression analysis indicated that the mother with gestational hypertension (OR=5.64,95%CI:1.28-16.16),placental abnormality (OR=3.65,95%CI:1.16-7.69),multiple pregnancy (OR=2.89,95%CI:1.05-8.84) were independent risk factors for the occurrence of premature SGA. Conclusion Strengthening pregnancy health care,intrauterine monitoring,timely detection of intrauterine growth retardation,active treatment of pregnant mothers can help reduce the incidence of premature SGA; strengthening the monitoring of premature delivery of SGA can reduce the occurrence of complications.

Association analysis based on nuclear family between orosomucoid like 3 gene polymorphism and susceptibility in preschool children with wheezing

ZHANG Yu-hong, YU Yan-yan, WANG Yi-fen, QIAN qian, MEN Shuai

2020, 28(3):  265-268.  DOI: 10.11852/zgetbjzz2019-0771

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Objective To investigate the genetic relationship between orosomucoid like 3 (ORMDL3)gene polymorphism and wheezing in preschool children by association analysis based on nuclear family,so as to provide evidence for the prevention of wheezing. Methods A total of 30 preschool wheezing children with positive result of asthma predictive index (API) and 60 biological parents were selected.The poly morphism of genetic loci gene rs7216389 and rs7216558 loci in each group were analyzed by Sanger sequencing.Then rs7216389 and rs7216558 were analyzed by transmission disequilibrium test (TDT) based on family and haplotype relative risk (HRR) for each group with the FBAT 2.0.4 software. Results The rs7216389 and rs7216558 loci of ORMDL3 gene showed exactly the same genotype.TDT analysis showed that under the additive model and stealth model,the genetic marker loci rs7216389 and rs7216558 were associated with preschool wheezing,and allele T was over-transmitted,which was a risk factor for wheezing (Z=2.268,2.250,P<0.05). Under the dominant model,allele C were associated with preschool wheezing (Z=-2.250, P<0.05),which was protection factor for wheezing.HRR analysis showed that under the additive model,the T/T of rs7216389-rs7216558 composition were associated with preschool wheezing (Z=2.000, P<0.05),while the C/C single-fold had a protective effect (Z=-2.000, P<0.05). Conclusion ORMDL3 gene is associated with the occurrence of wheezing in preschool children,and genetic polymorphism of ORMDL3 gene plays an important role in the pathogenesis of wheezing.

Correlation analysis of gross motor function, hand function and communication function in children and adolescents with cerebral palsy

WANG Xin-ying, XU Wei-jian, SHI Wei, TU Meng-juan

2020, 28(3):  269-272.  DOI: 10.11852/zgetbjzz2019-0828

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Objective To analyze the relationship between gross motor function, operation function and communication function impairment and three major functions of children and adolescents with different types and age,in oroler to proviole reference for making rehabilitation strategies. Methods The Chinese version of the cerebral palsy Gross Motor Function Classification System extended and revised version (GMFCS-ER), the Chinese version of mini-MACS and the Chinese version of Manual Ability Classification System (MACS), the Chinese version of Communication Function Classification System (CFCS) were used to perform gross motor function on 119 children and adolescents with cerebral palsy aged 2 to 18 years old.Hand function and communication ability were evaluated and graded. Results 63.9% of children and adolescents had a GMFCS grade and 54.7% had grade Ⅰ and Ⅱ CFCS,52.9% of grades were graded Ⅱ and Ⅲ, and most of the three functions of children with hemiplegia grade Ⅰ-Ⅲ.22 of the 119 subjects (18.5%) had the same levels of three functional grades.Three functional grades had a moderate correlation in assessing children with cerebral palsy (r=0.62-0.70, P<0.001). Conclusions The three grading systems complement each other and influence each other.The use of only one functional grading system does not describe the overall functional status of children and adolescents with cerebral palsy.

Reliability and validity of the Chinese Version of Hammersmith Infant Neurological Examination

LIU Zhen-huan, JIN Bing-xu, LIU Chen, ZENG Zhen, QIAN Xu-guang, ZHAO Yong, TAN Yuan, ZHOU Yuan, PANG Bi-hui

2020, 28(3):  273-276.  DOI: 10.11852/zgetbjzz2019-0856

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Objective To test the validity and reliability of the Chinese version of Hammersmith Infant Neurological Examination (HINE). Methods Totally 59 children aged 2 months to 1 year old in diagnosis of high-risk infants with cerebral palsy were selected according to Chinese guidelines for rehabilitation of cerebral palsy (2015),devided into two groups by gestational-age,premarure group (32 to 36 weeks gestational-age) and term-infant group (37 to 42 weeks gestational-age).30 normal children matched with group in age were selected.All children were evaluated with the Chinese version of HINE.The total score of HINE and each factor score among the three groups were used to discriminate validity.As the gold standard the diagnosis of high-risk children with cerebral palsy,ROC was used to determine the cutoff point,tensitivity and specificity.10 cases were randomly selected from each group and re-examined and evaluated by the same physician 1 week after the first examination to test the test-retest reliability.10 cases were randomly selected from each group.The two groups of evaluators simultaneously conducted the examination and scoring of the HINE to test the inter-rater reliability. Results The total score of scale and the scores of 5 items in the preterm and term-infant groups were lower than those in the normal control group, and the differences were statistically significant (P＜0.01).The area under the ROC curve of the preterm group was 0.95, when the limit was 21 points,the sensitivity was 0.97,and the specificity was 0.93.While the area under the ROC curve of the term-infant group was 0.93, when the limit was 26 points,the sensitivity was 0.97,and the specificity was 0.95. The sensitivity and specificity of both groups were ≥0.9.For the inter-rater reliability and the test-retest reliability,the intraclass correlation coefficient (ICC) of total score were both >0.80,the intraclass correlation coefficient (ICC) of the scores of 5 items was >0.70 and >0.80 respectively. Conclusions The Chinese version of HINE has good validity and reliability,high sensitivity and specificity.It could be used as a clinical screening instrument for high-risk cerebral palsy children aged from 2 months to 1 year.

Investigation on the status and influencing factors for depression symptom of children and adolescents with home quarantine during the prevalence of novel coronavirus pneumonia

WANG Yue, YANG Yuan-yuan, LI Shao-wen, LEI Xiao-mei, YANG Yu-feng

2020, 28(3):  277-280.  DOI: 10.11852/zgetbjzz2020-0178

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Objective To understand and explore the depression status and its influencing factors among children and adolescent students during the prevalence of the coronavirus disease 2019 (COVID-19),in order to provide reference for the psychological intervention for students in this area. Methods A self-designed general data questionnaire,Depression Self-rating Scale for Children (DSRS)and the Screen for Child Anxiety Related Emotional Disorders (SCARED) were typed in www.wjx.cn.And the questionnaire was sent out to children and adolescent aged 8 to 18 years by Wechat APP from February 6th to 8th,2020.Univariate and multivariate analysis were used to analyze the influencing factors associated with NCP by SPSS 22.0 software. Results Totally 396 valid questionnaire were returned.The average score of DSRS score was 7.35±5.10.Using 15 as the cut point of having depression symptoms,it was found that 41 students (10.4%) had depression symptoms obviously.Multivariate analysis showed that anxiety score,dwelling area,fear of the COVID-19 prevalence and age were influencing factors of DSRS score (P＜0.05).Logistic analysis indicated that anxiety (OR=4.284,95%CI:2.163~8.486,P＜0.001),dwelling in suburban and rural areas (OR=2.382,95%CI:1.120~5.069,P=0.024),and fear of COVID-19 related events (OR=3.312,95%CI:1.210~9.064,P=0.020) were risk factors for depression of children and adolescent with home quarantine. Conclusions Psychological intervention should be strengthen in children and adolescents by family,school and the society,so as to reduce the panic and anxiety in children.Moreover,it is suggested to give more concern to older children in high grade as well as child and adolescent dwelling in suburban and rural areas,thereby reducing the depression of them during the COVID-19 prevalence.

Research progress on the influencing factors and existing problems of screening results of neonatal inherited metabolic diseases

ZHANG Yue, ZHAO Jun, GAO Hua-fang, MA Xu

2020, 28(3):  281-283.  DOI: 10.11852/zgetbjzz2019-0584

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This paper summarizes the current situation of inherited metabolic disease (IMD) screening for neonates in China,combs the influencing factors for screening results and the prominent problems in the screening process,such as unreasonable neonatal blood collection time,the non-standard screening index of cut-off value and low recall rate of positive screening newborns,thereby providing reference for the standardization of IMD screening for neonates in China.

Research progress on the genetics of developmental dyslexia susceptibility gene KIAA0319 and DCDC2

ZHAO Hua, LIU Rui-fang, SHI Hong-juan, ZUO Peng-xiang

2020, 28(3):  284-287.  DOI: 10.11852/zgetbjzz2019-0437

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Developmental dyslexia (DD) in children is a polygenic genetic disease with complex etiologies,controlled by multiple genes interacting with each other.In recent years,multiple susceptible genes have been gradually identified since the researches on genetic behavior of dyslexia.This paper mainly focuses on chromosome 6 to review the common candidate genes for dyslexia,including DCDC2,KIAA0319 and their interactions,so as to provide reference for exploring the mechanism of dyslexia from the perspective of "gene-brain-behavior".

Review on the correlation among vitamin D,autophagy,immunomodulation and diseases of various body systems in children

XING Na, REN Li-hong

2020, 28(3):  288-291.  DOI: 10.11852/zgetbjzz2019-0450

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Vitamin D,as a kind of fat-soluble steroid hormones,has an extensive and complex effect to human body by interacting with specific receptors.Vitamin D receptor (VDR) is represent in a variety of tissue cells,most commonly seen in organs such as small intestine,kidney,parathyroid gland and skeleton.In addition,cardiovascular,gastrointestinal tract,central nervous system and other organs also have the expression of the vitamin D receptor.The body will appear the corresponding pathological changes when serum vitamin D level is abnormal,including respiratory diseases,digestive tract diseases,urinary system diseases,rheumatic immune diseases,autoimmune diseases,obesity and other diseases.This paper summarizes the correlation of vitamin D,autophagy;immune regulation and diseases of various systems.

Progress on the application of transcranial magnetic stimulation in neurodevelopmental disorders

MENG Tian-tian, WANG Zhao-hui

2020, 28(3):  292-294.  DOI: 10.11852/zgetbjzz2019-0175

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Neurodevelopmental disorder is a kind of mental disorder characterized by impaired or delayed functional development,which occurs in infancy.As a non-invasive physical examination and treatment method,transcranial magnetic stimulation (TMS) has been widely used in psychiatry and rehabilitation medicine with good efficacy.Now TMS has been extended to children with neurodevelopmental disorders.This review mainly focuses on the application of this technique in children with neurodevelopmental disorder.

Sleep problems and recent advances in children with epilepsy

ZHANG Gui-rong, SHAO Jie

2020, 28(3):  295-298.  DOI: 10.11852/zgetbjzz2019-0341

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Sleep problems are common behavioral problems in child health care,especially in children with epilepsy. Sleep problems or sleep disorders,such as difficulty in falling asleep,waking up at night,obstructive sleep apnea,sleepwalking and nightmares,often lead to impaired daytime function in children and families. However,children with epilepsy are more likely to have sleep problems because abnormal brain electrical activity during sleep disturbs the normal sleep structure.Sleep and epilepsy interact with each other and have complex interactions. Sleep can activate epileptiform discharge,and seizures will interfere with sleep structure. In addition,sleep problems also affect the cognition,behavior and quality of life in children with epilepsy. This article mainly discusses sleep and sleep related problems in children with epilepsy,and summarizes the epidemiology of sleep problems in children with epilepsy,the relationship between sleep problems and epilepsy,the influence of sleep on cognitive function of children with epilepsy,and sleep intervention.

Meta-analysis on the efficacy of different blue phototherapy modes on neonatal hyperbilirubinemia

SONG Jiu-shan, LUO Cheng, LIANG Kun

2020, 28(3):  299-303.  DOI: 10.11852/zgetbjzz2019-0772

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Objective To evaluate the efficacy and adverse reactions of different blue phototherapy modes on neonatal hyperbilirubinemia,in order to provide scientific evidence for clinical treatment. Methods The clinical randomized controlled study on the treatment of neonatal hyperbilirubinemia by blue phototherapy published from the database inception to May 2018,were retrieved in PubMed,EMBASE,Web of science,Cochrane library,CNKI,VIP and WanFang database. Most literature results were analyzed by RevMan 5.3,but some results were dealt by other medical statistics methods. Results Finally 8 literature containing 954 patients were selected. Meta-analysis showed that phototherapy can significantly decrease the infants′ serum bilirubin level (SMD=55.35,95%CI:50.23-60.48, P<0.001),of which both intermittent phototherapy and continuous phototherapy can also decrease the infants′ serum bilirubin concentration (SMD=58.72,95%CI:54.35～63.09, P<0.001;SMD=51.53,95%CI:41.48～ 61.59, P<0.001). However,the differences on cure rate of neonatal hyperbilirubinemia (χ²=0.00,P=1.00) and the decrease value of the serum bilirubin concentration (SMD=-1.24,95%CI:-5.62-3.15,P=0.58) between different blue phototherapy modes were not significant. Compared with continuous phototherapy,intermittent phototherapy showed lower rate of adverse reactions (RR=0.18,95%CI :0.13-0.25,P<0.001). Conclusions Both intermittent phototherapy and continuous phototherapy can effectively decrease the infants′ serum bilirubin concentration. Meanwhile,the intermittent phototherapy can better reduce the incidence of adverse reactions than continuous phototherapy.

Clinical comparative study on the feeicacy of levetiracetam and topiramate added tiapride in the treatment of refractory Tourette syndrome in children

LIN Hai-sheng, CHEN Wen-xiong, YANG Si-yuan, TAO Cong, WANG Ling, CHEN Rui-qiong

2020, 28(3):  304-307.  DOI: 10.11852/zgetbjzz2019-0509

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Objective To compare the efficacy and safety of levetiracetam and topiramate plus tiapride in the treatment of refractory Tourette syndrome (TS) in children. Methods From January 2016 to February 2019,60 TS children aged 8～12 years were randomly divided into two groups. Because of the poor therapeutic effect of tiapride alone,the two groups were additionally given levetiracetam (LEV) and topiramate (TPM) respectively.Finally 49 childrencompleted the treatment for 8 weeks,of which,24 in levetiracetam group and 25 in topiramate group.Yale Global Tic Severity Scale (YGTSS) and Treatment Emergent Symptom Scale (TESS) were used to evaluate the effects and adverse reactions before and after treatment for 2,4,8 weeks. Results At the 2nd,4th and 8th weekend after treatment,YGTSS scores in LEV group and TPM group were lower than those before treatment,but YGTSS scores in TPM group were significantly lower than those in LEV group at each time period (t=4.185,7.787,10.521,P＜0.05). The effective rates of LEV group were 50.0%,54.2% and 45.8% at the end of 2,4 and 8 weeks,and those of TPM group were 76.0%,80.0% and 80.0% respectively.The effective rates of the TPM group at 2,4,and 8 weekends were 76.0%,80.0%,and 80.0%,respectively. The effective rate of the two groups at the end of the 8th week was significantly different (χ²=6.151,P<0.05). The incidence of adverse reactions in the LEV group and the TPM group were 12.5% and 16.0%,respectively (χ²=0.130,P>0.05). Conclusions Both LEV and TPM can be effectively applied to treat refractory TS in children. The short-term (8 weeks) efficacy of TPM is better than that of LEV. Both drugs have fewer short-term adverse reactions and tolerable.

Early complications and neurological prognosis within 12 months of corrected age in twin preterms with birth weight discordance

DONG Hui-fang, WANG Yin-juan, FAN Xu-fang, LI Wen-li, XU Fa-lin

2020, 28(3):  308-311.  DOI: 10.11852/zgetbjzz2019-0780

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Objective To study the early complications and neurological prognosis within 12 months of corrected age in twin preterms with birth weight discordance,in order to provide evidence for the prevention of complications in twin preterms with birth weight discordance. Methods A prospective cohort study was conducted.a total of 67 pairs of live twin preterms with birth weight discordance≥25% but without twin to twin transfusion syndrome hospitalized in the neonatal department of the Third Affiliated Hospital of Zhengzhou University from January 1,2016 to December 31,2017 were included,and were divided into low birth weight group and high birth weight group.The early complications and neurological prognosis within 12 months of corrected age were observed. Results 1)The rates of neonatal respiratory distress syndrome (NRDS),feeding intolerance and infectious diseases were significantly higher in the low birthweight group than in the high birth weight group (t=4.418,4.251,3.983,5.858,4.733,P<0.05).2)A total of 55 pairs of twins were both cured and 43 pairs were followed up to 12 months of correct age.In different gestational age groups (＜32 weeks,32-33⁺⁶ weeks and 34-36⁺⁶weeks),neonatal behavioral neurological assessment (NBNA) scores in low birthweight group were significantly lower than that of heavy birthweight group (t=4.850,3.269,3.381,P<0.05).There was no statistical difference in mental development index (MDI) between the two groups among different gestational age groups at 6 and 12 months of correct age respectively,while psychomotor development index (PDI) in the low birth weight group was lower than that of high birth weight group with statistical difference among different gestational age groups at 6 and 12 months of correct age (6months t=3.735,2.494,2.129;12months t=4.269,3.233,2.578,P<0.05). Conclusions In the twin preterms with birth weight discordance,those with low birthweight have more complications and a higher incidence of poor prognosis.Therefore,strict follow-up should be taken to those patients,and more attention should be paid to the psychomotor development.

Characteristics of early language development in children with autism spectrum disorder, global development delay and developmental language delay

LIU Dong-mei, ZOU Shi-pu, GONG Jun, LUO Xiu, ZHONG Yun-ying, YANG Li

2020, 28(3):  312-315.  DOI: 10.11852/zgetbjzz2019-0379

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Objective To analyze the characteristics and differences of language development in children with autism spectrum disorder (ASD),global developmental delay (GDD) and developmental language delay (DLD),in order to provide evidence for early identification and intervention. Methods ASD,GDD and DLD children at the age of 18 to 36 months and diagnosed from March 2017 to December 2018 were included,and divided into ASD group (n=155),GDD group (n=92) and DLD group (n=162). The subjects and their parents completed the Early Language Development Process Scale to evaluate the language development level of children. Results 1) The median scores of ASD,GDD and DLD in P₇₅-A (speech and language expression),P₇₅-B (auditory perception and comprehension),P₇₅-C (visual-related comprehension and expression) and P₇₅-total (total score) were 17,10,3,31;16,9,1,26;14,7,0,21 respectively. 2) There was no significant difference on P₇₅-A scores between girls in the GDD and DLD groups (H=5.503,P=0.057),but the difference between ASD and DLD,GDD and DLD were statistically significant both in boys and girls (P<0.05). 3) There was no gender difference on scores of the four parts between ASD and GDD group,but there was gender difference on P₇₅-A score and P₇₅-total score in DLD group (Z=-2.117-2.010,P<0.05). Conclusions The degree of language development impairment in the three groups ranging from severe to light is ASD,GDD,and DLD.The ability of auditory perception and comprehension and vision-related comprehension and expression of ASD and GDD group perform worse than DLD group; and the language development of girls in DLD group is better than that of boys.

Relationship between the expression of miR-146a and miR-155 in peripheral blood mononuclear cells and inflammation response in infants with respiratory syncytial virus pneumonia

XU Dan-gui, CHEN Qi, WANG Rui, XIONG Tian-tian, YANG Li-xia

2020, 28(3):  316-319.  DOI: 10.11852/zgetbjzz2019-0595

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Objective To investigate the relationship between inflammation response and the expression of miR-146a and miR-155 in peripheral blood mononuclear cells (PBMCs) of infants with respiratory syncytial virus (RSV) pneumonia. Methods Totally 84 children with RSV pneumonia admitted in the Third Clinical Medical College of Three Gorges University were enrolled in this study from January 2017 to January 2019,and were divided into mild group and severe group.Meanwhile,80 healthy children who took physical examination were selected as control group.Peripheral blood was collected and monocytes were isolated,real-time fluorescent quantitative PCR was used to test the levels of miR-146a and miR-155 in monocytes.The levels of serum tumor necrosis factor-α (TNF-α),interleukin-1β (IL-1β),interleukin-6 (IL-6) and interleukin-8 (IL-8) were detected by ELISA.Pearson method was used to analyze the correlation between the levels of inflammatory factors and the expression levels of miR-146a and miR-155 in the two groups. Results The level of miR-146a in PBMCs of severe group was significantly lower than that of mild group and control group (F＝31.907,P＜0.001),but miR-146a level was not significantly different between the mild group and the control group (P>0.05).The level of miR-155 in PBMCs of severe group was significantly higher than that of mild group and control group (F=143.127,P＜0.001),and it was significantly higher in mild group than control group (P＜0.001).The levels of serum TNF-α,IL-1β,IL-6 and IL-8 in children with RSV pneumonia were significantly higher than those in the control group (t=36.627,39.350,22.743,10.617,P＜0.001).MiR-146a level was negatively correlated with the expressions of TNF-α,IL-1β,IL-6 and IL-8 in children with RSV pneumonia (r=-0.473,-0.502,-0.396,-0.337,P＜0.05),while miR-155 level was positively related to the expressions of TNF-α,IL-1β,IL-6 and IL-8 (r=0.451,0.394,0.359,0.382,P＜0.05). Conclusion The expression of miR-146a in PBMCs of children with RSV pneumonia is low,while the expression of miR-155 is high,both of which are related to the severity of disease and inflammatory reaction in children.

Spatial autocorrelation analysis on poor vision of primary school students in Beijing

WANG Ling-ling, ZANG Dan-dan, SONG Yu-zhen, LYU Ruo-ran

2020, 28(3):  320-323.  DOI: 10.11852/zgetbjzz2019-0430

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Objective To know about the spatial distribution characteristics of the poor vision of primary school students in Beijing,so as to provide scientific basis for the formulation of intervention policies and measures. Methods Logarithmic visual acuity chart was used to examine the eyesight of all pupils and the spatial distribution characteristics of the poor vision level were analyzed by Arcgis10.2 software. Results The detection rate of poor vision of primary school students in Beijing in 2017 was 46.8% (361 183/771 392),among which the poor vision rate of female students was higher than that of male students (χ²=67.721,P＜0.01),and the poor vision rate in urban areas was higher than that in rural areas (χ²=1.550,P＜0.01).The poor vision rate in low-grade students was 36.4%,mainly with mild and moderate levels.While the poor vision rate in high-grade students was 58.6%,mainly with moderate and severe levels.The overall Moran′s I index and Z value of primary schools were 0.377 and 4.191,respectively.The poor vision rate of students in Dongcheng district,Xicheng district,Haidian district and Changping district presented high-high concentration,while Huairou district and its surrounding district showed low-low concentration. Conclusions The poor vision rate of primary school students in Beijing is high,and there is a significant positive spatial autocorrelation.The poor vision rate demonstrates a higher level in core area of the city,a decreasing trend in the surrounding areas,and the lowest level in the northeastern and southwestern areas of Beijing.

Investigation on preschool children′s potentially risky behavior on unintentional injury and contributory factors in a community in Shantou

YANG Gui-tao, HUANG Bi-ling, LIN Jia-ling, LI Li-ping

2020, 28(3):  324-327.  DOI: 10.11852/zgetbjzz2019-0243

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Objective To understand the characteristics of the potential risk behavior of unintentional injury and its influencing factors in preschool children,so as to provide evidence for the formulation of related intervention measures. Methods Questionnaire was self-designed and the reliability and validity of the questionnaire were analyzed.A cross-sectional study on parents and preschool children in a community of Shantou was conducted by stratified cluster sampling. Results Totally 164 preschool children were investigated validly.The rates of high-risky behavior on falls and traffic injuries among preschool children were 43.9% and 30.5%,respectively.And the rates of burn,drowning and poisoning were all lower than 1%.Among the 13 kinds of high-risky behaviors,6 kinds of behaviors were more than 25%,all of which were falls and traffic injuries.And 6 kinds of behaviors were less than 3%,which included burn,drowning and poisoning.Boys,preschool children in large classes and children with more parental supervision had significantly higher scores on risky behaviors than girls,preschool children in primary and secondary classes and children with less parental supervision (Z=-2.60,-1.59,-2.60,P<0.05).Multiple linear regression analysis showed that children′s gender,grade,parental supervision,area and location of injuries were the independently influencing factors of children′s risk behavior (β=-0.18,0.20,-0.19,-0.22,-0.17,P＜0.05). Conclusions There are significant differences on high-risk behaviors of injuries among preschool children.As for the prevention of occurrence of unintentional injury in preschool children,the primary task is to prevent falls and traffic injuries with a focus on parents and children.And the following task is to prevent drowning,burn and poisoning with the key in eliminating the injury factors and strengthening the parental supervision.

Analysis of gene types and clinical phenotype in neonatal disease screening of thalassemia of 30 554 neonates in Huangshi city

KE Hai-yan, LI Sheng, ZHU Yan-ru, LEI Lin, JIANG Hong, FEI An-xing

2020, 28(3):  328-330.  DOI: 10.11852/zgetbjzz2019-0382

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Objective To investigate the distribution of thalassemia gene in Huangshi city and clinical manifestation of different genotypes,so as to provide reference for the screening and prevention of thalassemia. Method The initial screening of thalassemia was carried out by capillary electrophoresis,and the cases with positive screening results were recalled for thalassemia gene and blood routine test. Results In 2018,there were 31 140 live births in Huangshi city,of whom 30 554 newborns conducted neonatal disease screening for thalassemia,with a screening rate of 98.12% and a positive rate of 1.79% (546/30 554).α-thalassemia accounted for 73.44 %,including --^SEA/αα (54.11%),-α^3.7/αα (37.66%),and -α^4.2/αα (6.48%).Mild,stationary and middle clinical phenotypes were 221 177 and 3 cases,respectively.β-thalassemia accounted for 26.01% (142/546),and 13 types of mutations were detected,such as IVS-2-654 (50.7%),CD41-42 (19.72%) and CD17 (8.45%).In terms of clinical phenotype,133 cases were mild and 9 cases were moderate.There were 3 cases of αβ-thalassemia,and 2 cases of Southeast Asian missing α-thalassemia type combined with Hong Kong type HK αα.The incidence of anemia in thalassemia gene carriers were 27.29%,and 71.81% cases were slight anemia type.Moreover,the incidence of anemia in α-thalassemia and β-thalassemia gene carriers were 21.95% and 42.25%,and mild anemia type accounted for 78.41% and 63.33%,respectively. Conclusions The thalassemia in Huangshi city is mainly seen in α-thalassemia with --^SEA/αα genotype.β-thalassemia is most common with IVS-2-654 genotypes,mainly with static and mild clinical phonotypes.Compared with α-thalassemia gene carriers,β-thalassemia gene carriers lare more likely to develop anemia.All in all,it is necessary to conduct thalassemia screening in order to provide reference for preventing thalassemia and decreasing birth defects.

Effects of valproic acid,oxcarbazepine and levetiracetam monotherapy on the efficacy and bone metabolism of school-age children with epilepsy

ZHANG Xiao-long, ZHANG Yuan-da, HE Hua-fen, JI Chao-yu, YANG Xu, REN Shu-hong

2020, 28(3):  331-334.  DOI: 10.11852/zgetbjzz2019-0451

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Objective To investigate the efficacy of three antiepileptic drugs on epilepsy,including valproic acid,oxcarbazepine and levetiracetam,and to analyze their effects on bone metabolism of children with school-age children. Methods A total of 150 school-age children with epilepsy admitted to Baoding Children′s Hospital were enrolled in this study from June 2015 to June 2018,and were randomly divided into three groups,with 50 cases in each group.Group A received oxcarbazepine,group B received levetiracetam,while group C was given valproic acid for monotherapy.After 6 months of treatment,the efficacy of three drugs was evaluated.The changes in bone metabolic markers before and after intervention were compared. Results After treatment,the levels of Ca and 25- (OH) D in group A significantly decreased,while ALP level significantly increased (t=21.125,4.037,4.976,P＜0.001).ALP level in group B was significantly higher after treatment (t=2.321,P＜0.05).Moreover,the levels of Ca,25- (OH)D and BMD in group C significantly decreased after treatment,while the levels of ALP and BAP significantly increased after treatment (t=31.596,5.991,3.591,3.239,4.643,P＜0.001).The total effective rates of three groups were significantly different (P＜0.05). Conclusions For children with epilepsy,the efficacy of levetiracetam is superior to that of valproic acid,and the adverse reaction of levetiracetam is less than oxcarbazepine.It is worth noting that levetiracetam has the least impact on bone metabolism indicators in school-age children.Because of its safety and effectiveness,levetiracetam is worth of clinical application.

Study on the intervention effect of collective language training on language retardation in children

LIN Xiao-miao, ZOU Lin-xia, LAN Ying, CHEN Wei-hua

2020, 28(3):  335-337.  DOI: 10.11852/zgetbjzz2019-0618

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Objective To analyze the effect of collective language training on language retardation of children,in order to provide reference for making intervention measures. Methods Totally 80 children with language retardation in Guangxi Maternal and Child Health Hospital were enrolled in this study from January 2017 to May 2018,and were divided into observation group (n=40) and control group (n=40).All patients received language training one by one,and the observation group was given collective language training additionally.The adaptive behavior,language and personal social behavior were assessed with Gesell Developmental Scale before treatment and 3 months after treatment. Results After three-month intervention,the scores of adaptive behavior,language and personal social behavior in observation group were significantly higher than those in control group (t=3.348,3.188,2.105,P＜0.05). Conclusion Collective language training can improve the development of adaptive behavior,language and personal social behavior in children with language retardation.

Practical research on brain-strengthening and intelligence-benefiting acupuncture combined with sensory integration training in children of cerebral palsy with mental retardation

ZHOU Hong-tao, QIN Rong, LIU Zhi-xiong, ZUO Wen-jing

2020, 28(3):  338-340.  DOI: 10.11852/zgetbjzz2019-0153

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Objective To analyze the role of brain-strengthening and intelligence-benefiting acupuncture combined with sensory integration training in children of cerebral palsy with mental retardation,So as to provide scientific evidence for clinical treatment. Methods A total of 184 children with cerebral palsy and mental retardation admitted to Hunan Children′s Hospital from November 2015 to March 2018 were randomly divided into A,B,C and D group,with 46 cases in each group.Group A received routine rehabilitation training,and group B and C were given sensory integration training,and brain-strengthening and intelligence-benefiting acupuncture additionally.While the group D was given routine rehabilitation,brain-strengthening and intelligence-benefiting acupuncture treatment combined with sensory integration training. The scores of developmental quotient (DQ),intelligence quotient (IQ),Children Sensory Integration Rating Scale (CSIRS) and Infants-junior and Middle School Students Social-life Ability Scale were compared,and the occurrence of adverse events was observed. Results The scores of DQ,IQ,CSIRS and Infants-Junior and Middle School Students Social-Life Ability Scale of the 4 groups after treatment were higher than those before treatment,with significant differences (t=2.234,4.157,4.019,7.281,3.782,5.499,5.263,8.002,5.519,7.988,8.121,11.756,11.591,23.327,24.886,39.339,5.305,8.013,8.113,11.490,P＜0.05 or <0.01),and the scores of DQ,IQ,CSIRS and Infants-Junior and Middle School Students Social-Life ability Scale of the group D after treatment were higher than group B,C and A,with significant differences (t=2.579,2.821,4.439,2.108,2.282,3.849,3.176,3.352,5.758,19.829,17.666,33.204,2.863,3.053,5.305,P＜0.05 or 0.01). There was no significant difference on the incidence rates of total adverse events among the 4 groups (χ²=0.748,P=0.852). Conclusion Brain-strengthening and intelligence-benefiting acupuncture combined with sensory integration training can significantly improve the DQ and IQ of children of cerebral palsy with mental retardation,as well as their sensory integration ability and social life ability with good safety.

Correlation of serum ghrelin with the severity of disease and gastrointestinal dysfunction in children with hand-foot-and-mouth disease

JIANG Cheng, XU Miao, WU Guo-rong, ZHANG Jian, WANG Qiong

2020, 28(3):  341-344.  DOI: 10.11852/zgetbjzz2019-0456

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Objective To investigate the relationship between serum ghrelin and gastrointestinal dysfunction in children with different severity of hand-foot-mouth disease (HFMD),in order to provide reference for clinical treatment of HFMD. Methods A total of 130 children with HFMD admitted to Wuxi Children′s Hospital from September 2016 to October 2018 were selected as the study group,and 60 healthy children who took physical examination at the same period were selected as healthy group.The venous blood of the participants was collected in the morning,the levels of serum ghrelin,D-lactate,endotoxin and procalcitonin (PCT) were tested,and the gastrointestinal failure (GIF) score was evaluated.Pearson correlation analysis was used to analyze the correlations of ghrelin,D-lactate and endotoxin with PCT.And the values of ghrelin,D-lactate,endotoxin and PCT in the diagnosis of HFMD were analyzed by receiver operating curve (ROC).Logistic regression analysis was conducted to determine the factors that might affect the occurrence of HFMD. Results Serum level of ghrelin of the study group was significantly lower than that of the healthy group (t=17.764,P＜0.05),while the GIF score and the serum D-lactate,endotoxin and PCT levels were significantly higher than those of healthy group (t=26.112,14.324,15.491,23.433,P<0.05).Serum ghrelin level in critical HFMD children and severe HFMD children was significantly lower than that of typical HFMD children,and serum level of ghrelin was significantly lower in critical HFMD children than severe HFMD children (F=105.761, P<0.05).Moreover,GIF score,the levels of serum D-lactate,endotoxin and PCT in critical HFMD children and severe HFMD children were significantly higher than typical HFMD children,and those indexes were higher in critical HFMD children than severe HFMD children (P<0.05).Pearson correlation analysis showed that serum ghrelin level was negatively correlated with GIF score,serum D-lactic acid,endotoxin and PCT in HFMD children (r=-0.549,-0.563,-0.667,-0.581, P<0.05).The areas under the curve (AUC) for ghrelin,D-lactake endotoxin and PCT were 0.868,0.867,0.750 and 0.846.Logistic regression analysis showed that ghrelin,D-lactate,endotoxin and PCT were all risk factors for HFMD. Conclusion Serum ghrelin level is closely related to the severity of HFMD and gastrointestinal function,and decreases with the increasing of severity of HFMD.

Clinical analysis of vitamin D and respiratory distress syndrome in preterm infants

GENG Jia-qing, FANG Cheng-zhi, ZHANG Bing-hong

2020, 28(3):  345-348.  DOI: 10.11852/zgetbjzz2019-0725

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Objective To analyze the relationship between serum vitamin D [25- (OH)D₃] levels at birth and respiratory distress syndrome (RDS) in preterm infants,in order to provide scientific basis for the treatment of RDS in preterm infant. Methods A total of 131 premature infants with RDS admitted to the Wuhan University People′s Hospital were selected as the experimental group,and 29 non-RDS premature infants were used as control group.The clinical data (such as gender,mode of delivery,maternal pregnancy and Apgar score)and the results of serum 25- (OH) D₃ were collected,and the association between serum 25- (OH)D₃ level and RDS was analyzed. Results 25- (OH)D₃ levels in the RDS group was lower than that in control group (t=2.682,P＜0.05),and CPAP time,oxygen therapy days,intravenous nutrition days,hospitalization time were significantly longer than those in control group (t=2.969,2.380,2.571,1.999,P＜0.05).Binary logistic regression analysis showed that vitamin D deficiency was risk factors for RDS in preterm infants (OR=0.050,95%CI:0.013-0.186). Conclusions Preterm infants with low vitamin D level may increase the incidence of RDS.So it is of great significance for prevention of vitamin D deficiency.

Effect of sling exercise training on core stability of children with spastic cerebral palsy

JIN Guo-sheng, DING Jie, HOU Mei, SUN Dian-rong, HUAN Sai, LI Jun, WANG Shu-ting

2020, 28(3):  349-351.  DOI: 10.11852/zgetbjzz2019-0689

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Objective To explore the effect of sling exercise training on the core stability of children with spastic cerebral palsy,So as to provide scientific basics for the rehabilitation treatment of children with cerebrd palsy. Methods Sixty patients with spastic cerebral palsy treated in Qingdao Women and Children′s Hospital were randomly divided into control group and experimental group from October 2016 to March 2018 with 30 cases in each group.The control group was giver routine rehabilitation training,and the experimental group received sling exercise training additionally.Both groups were treated for 3 months,and were assessed with core stability assessment,D and E domains of Gross Motor Function Measure 88 (GMFM-88),Berg Balance Scale (BBS) and the timed 10 meters walk test (10MWT) before and after 3 months of treatment. Result After 3 months of treatment,flat support time,supine legs raised angle,supine static belly support time,the scores of GMFM-88 D、E,BBS,time and steps of 10MWT in two groups were both improved than before (P＜0.05),and the experimental group was significantly better than the control group (t=2.95、3.78、3.46、3.37、2.89、4.52、7.33、3.96,P＜0.01). Conclusion The sling exercise training could effectively improve the core stability and the motion function of children with spastic cerebral palsy.