Table of Content

10 March 2021, Volume 29 Issue 3

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Professional Forum

Endocrine function and growth and development of preterm infants

YANG Fan, XIE Hua

2021, 29(3):  233-237.  DOI: 10.11852/zgetbjzz2020-2048

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Endocrine function plays an important role in regulating normal growth and development of the body.Due to the immaturity of the hypothalamic-pituitary axis and abnormal levels of various endocrine hormones, premature infants often develop a series of recent and long-term complications that affect growth and development, and some of them may also develop metabolic syndrome in adulthood.

Original Articles

Study on the correlation between serum thyroid hormone level and severity of disease in preterm infants

WANG Qiao-fang, YAN Chang-hong, LUO Ding-zhen, CHEN Li-ping, YANG Li

2021, 29(3):  238-242.  DOI: 10.11852/zgetbjzz2020-0661

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Objective To analyze the correlation between serum thyroid hormone level and disease severity of preterm infants, so as to provide reference for early screening of critically ill infants. Methods A total of 209 preterm infants in Children's Hospital of Jiangxi Province from March 2018 to June 2019 were selected as study objects, and were divided into critically-ill group(n=23), recovery group (n=60) and non-critical group(n=126) according to the severity of disease.Serum levels of FT3, FT4 and TSH on the 7th and 14th day after birth were tested, and the difference of thyroid hormone concentrations on the 7th and 14th day(△FT3、△FT4、△TSH) was calculated.The association of disease with FT3, FT4, TSH, △FT3, △FT4 and △TSH was analyzed. Results There were no differences in gestational age, weight and gender among the three groups of premature infants(P＞0.05).The concentrations of FT3 and FT4 in the critically ill group and recovery group on the 14th day after birth were higher than those on the 7th day after birth, but the concentrations of FT3 in the critically ill premature infants on the 7th day and 14th day were lower than those in the recovery group and non-critically ill group(P＜0.05).△FT3 of the critically-ill group was lower than that of the recovery group and the non-critical group, △FT4 of the non-critical group was significantly lower than that of the other two groups(F=3.727, 11.860, P＜0.05).And △TSH was not significantly different among the three groups(F=1.082, P＞0.05). Conclusions The concentration of FT3 is closely related to the severity of the disease.And the more severe the disease, the lower the concentration of FT3.

Follow-up study on catch-up growth of premature infants within 2 years old in Chengdu area

LIU Yang, LIU Huan

2021, 29(3):  243-248.  DOI: 10.11852/zgetbjzz2020-1279

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Objective To observe the growth and development, as well as catch-up growth of premature infants within corrected age of 24 months, and to determine the catch-up growth period. Methods A total of 270 premature infants and 105 full-term infants, who took physical examination in Maternal and Child Health Care Hospital of Shuangliu District, Chengdu during December 2016 to December 2017, were enrolled in this study.These infants were divided into non-premature infant group, low-risk premature infant group and high-risk premature infant group.The Z-score method was used to assess body weight, body length, head circumference and body weight for height, thus to analyze the catch-up growth within 24 months of correct age. Results The body length, body weight, head circumference and body weight for height in both premature infants and full-term infants showed catch-up growth within 24 months of correct age.The incidence of catch-up growth in weight was high within 2 months of correct age, and the peak of catch-up growth lasted longer in height.After 5 months of corrected age, the incidence of catch-up growth leveled off, and the groups diverged in terms of height by weight after 6 months old.At 24 months of corrected age, the incidence rates of catch-up growth in weight, length, head circumference and length-by-weight were 83.2%, 66.27%, 37.73%, and 89.7% for the low-risk group and 89.0%, 70.21%, 49.7%, and 98.98% for the high-risk group. Conclusions The growth trajectories of preterm and full-term infants are inconsistent, and the low-risk preterm infants show greater growth potential.The premature infants basically complete catch-up growth within 5 months of correct age, and the catch-up growth of body weight, body length and head circumference is unbalanced.

Investigation of the growth and neurobehavioral development of very low/extremely low birth weight infants in the first year after birth

ZHANG Min, LI Meng-meng, YANG Lei, YU Zhang-bin, CHI Xia, HAN Shu-ping, CHEN Yu-lin

2021, 29(3):  249-252.  DOI: 10.11852/zgetbjzz2020-1452

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Objective To evaluate the growth and neurobehavioral development of very low/extremely low birth weight infants in the first year after birth, so as to provide evidence for early intervention. Methods A total of 222 very low/extremely low birth weight infants admitted to Nanjing Maternal and Child Health Care Hospital from August 2014 to July 2017 were followed up.Their growth and neurobehavioral development at 3, 6 and 12 months of corrected gestational age were evaluated.The infants were divided into different groups according to birth weight(≤1 000 g, 1 000<-1 500 g) and gestational age(≤28 weeks,＞28 weeks). T test and chi-square test were used for statistical analysis. Results The height, weight and head circumference increased with the increasing of age (40 weeks and 3, 6 and 12 months).There were no statistically significant differences in height, weight and head circumference in different birth weight groups and gestational age groups(P＞0.05).In terms of Gesell Scale, scores of each dimension increased gradually with age.And there were no statistically significant differences in five regions of the Gesell Scale in different birth weight groups and gestational age groups in infants at the age of 6 and 12 months old(P＞0.05). Conclusions Intrauterine retardation and neurobehavioral development lag in very low/extremely low birth weight infants can gradually catch up with age.And it is necessary to build up a standardized follow-up system.

Evaluation of lactic acid and lactate clearance in brain injury of asphyxia neonates

HUANG Xun-bin, ZHOU Qiu-jing, FU Qing-song, CHENG Guo-qiang, QIU Hui-xian

2021, 29(3):  253-257.  DOI: 10.11852/zgetbjzz2020-1266

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Objective To explore the value of arterial blood lactate and lactate clearance in early evaluation of brain injury in asphyxia neonates, in order to provide reference for the early identification of brain injury in neonates. Methods A total of 129 cases of neonatal asphyxia admitted to Neonatology Department, Longgang District Central Hospital of Shenzhen from May 2016 to May 2019 were retrospectively analyzed.According to whether the children had neurological symptoms or abnormal amplitude integrated electroencephalogram monitoring results, the neonates were divided into brain injury group (n=83 cases) and non-brain injury group (n=46).The differences in arterial blood pH, base excess (BE), lactate and lactate clearance between the two groups were analyzed.The rates of brain injury, poor prognosis and fatality of children were compared between children with high and low lactic acid level and lactate clearance.Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of arterial blood lactic acid and lactate clearance in brain injury of asphyxia neonates. Results There were 9 deaths brain injury group, 26 with poor prognosis and 48 with good prognosis among survivors.The pH and BE of arterial blood in the brain injury group were significantly lower than those in non-brain injury group within 1 hour after birth, while the lactic acid level was significantly higher than that in the non-brain injury group (t=10.159, 9.023, 9.917, P<0.01).The pH of arterial blood and the lactate clearance of lactic acid in the brain injury group were lower than those in the non-brain injury group at 6 hours after treatment, while the lactic acid level was higher than that in the non-brain injury group (t=4.869, 9.708, 9.917, P<0.05).There was no statistically significant difference in the BE value within 6 hours after treatment (t=1.732, P>0.05).The brain damage rate, poor prognosis rate and fatality rate of children in the high lactic acid group were significantly higher than those in the low lactic acid group(χ²=54.692, 11.790, 5.926, P<0.05), which were also significantly higher in high lactate clearance group than those in low lactate clearance group(χ²=71.816, 15.016, 6.966, P<0.05).ROC curve analysis showed that joint monitoring of arterial blood lactic acid and lactate clearance predicted brain injury ability best, with sensitivity of 100% and specificity of 98.6%. Conclusion The joint monitoring of arterial blood lactic acid and lactate clearance has certain clinical value in early screening of brain injury and prognosis judgment in asphyxia neonates.

Effects of early parenting ideas and behavior intervention on feeding and growth of infants

WANG Wei, ZHANG Yue-fang, HE Hong-ru, YANG Li-fang, ZHANG Huan, FAN Hong-ge, JU Xi-chi

2021, 29(3):  258-261.  DOI: 10.11852/zgetbjzz2020-1930

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Objective To explore the effects of early parenting ideas and behavior intervention on feeding and neurobehavioral development during infant period, so as to provide basis for medical institutions to popularize parenting care knowledge to parents. Methods From January to August 2019, a total of 120 healthy children at the age of 1 month old, who took physical examination in Department of Child Health Care, Shaanxi Provincial People's Hospital, were selected in this study, with 60 infants in the intervention group and 60 infants in the control group.The control group received regular physical examination and health guidance, while the intervention group received early parenting philosophy and behaviors intervention additionally.At the age of 12 months, the family environment, infant feeding index, complementary feeding behavior, physical and mental development indicators were compared between the two groups. Results Compared with the control group, children in the intervention group had better family nurturing environment(χ²=34.48,P<0.001), higher feeding index scores(t=5.23, P<0.001) and feeding behavior level(χ²=18.23,P<0.001).The measured values of weight (male:Z=-2.12; female:Z=-2.11), body length (male:Z=-2.50; female:Z=-2.13) and head circumference (male:t=2.19; female:Z=-2.16) in the intervention group were all significantly higher than those in the control group (P<0.05).In the intervention group, the gross motor function (Z=-2.49), fine motor function (t=3.02), adaptive ability (Z=-4.75), language (Z=-2.81), social ability (Z=-3.06) and total developmental quotient (DQ) (Z=-4.28) were significantly higher than those in the control group (P<0.05). Conclusion Early parenting ideas and behaviors intervention can create a good family nurturing environment and feeding conditions for infants, which is beneficial to the physical growth of infants and to promote their intellectual development.

Prevalence of smoking behavior among high school students in Beijing and gender difference in the association between family factors and smoking behavior

LIU Yun-fei, YAN Xiao-jin, ZHANG Jing-shu, LYU Ruo-ran, DUAN Jia-li, LUO Dong-mei, MA Ning, SONG Yi

2021, 29(3):  262-267.  DOI: 10.11852/zgetbjzz2020-1296

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Objective To describe the prevalence of smoking behavior and compare the gender difference in the association between family factors and smoking behavior among high school students in Beijing, in order to provide reference for interventions. Methods A stratified cluster random sampling method was used to conduct a questionnaire survey among 16 669 high school students from April to May in 2014.Chi-square and Logistic regression were used to analyze the association between family factors and smoking behavior. Results Totally 40.7% of boys and 20.6% of girls tried smoking, 16.1% of boys and 4.6% of girls started smoking before 13 years old, 24.3% of boys and 6.2% of girls had smoked at least one day within 30 days before the survey, 7.2% of boys and 1.0% of girls had smoked more than 5 cigarettes each day within 30 days before the survey, and the gender difference was significant(χ²=799.71, 601.33, 1 078.60, 423.79, P＜0.05).The associations between father's job and trying cigarettes smoking, father's job and smoking before 13 years old, maternal education and smoking before 13 years old were stronger in boys.While the associations between maternal education and smoking more than 5 cigarettes each day within 30 days before the survey, family structure and trying cigarettes smoking, family structure and smoking cigarettes at least one day within 30 days before the survey, family structure and smoking more than 5 cigarettes each day within 30 days were stronger in girls. Conclusions There are gender differences in smoking behaviors among high school students in Beijing.Father's job has stronger association with boys' smoking behavior in than that girls', while family structure had stronger association with girl's smoking than boys'.It is supposed to provide early health education of tobacco control to boys and girls.

Study on the occurrence and relationship of overweight and obesity in three generations

BAI Jing, ZHU Li-jun, CHEN Ling

2021, 29(3):  268-271.  DOI: 10.11852/zgetbjzz2020-1673

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Objective To explore the occurrence of overweight and obesity in preschoolers and their immediate relatives (parents, grandparents and maternal grandparents), as well as the relationship between them, so as to provide scientific basis for preventing and reducing overweight and obesity in preschoolers. Methods A stratified random cluster sampling method was adopted to select 2 217 preschoolers in Yuhua district of Nanjing from May to June in 2019.The information of children, such as age, gender, birth weight and the anthropometric data of their immediate family members were collected by questionnaire survey.The anthropometric indexes of children were measured by standard way in kindergarten.The relationship between overweight and obesity in preschoolers and their immediate relatives was analyzed. Results The rates of overweight and obesity in preschoolers were 7.80% and 2.75%, respectively.The incidence of obesity in boys was significantly higher than that of girls (3.4% vs.2.0%, P＜0.05).In the middle-aged parental generation, the prevalence of overweight and obesity was 36.1% and 11.1% in men, respectively, both significantly higher than those in women (13.6%, 3.3%) (P<0.001).Whereas in the grandparental generation, the prevalence of obesity was significantly higher in women than that in men (grandparents:10.1% vs.5.9%, P<0.001; maternal grandparents:7.5% vs.6.2%, P<0.05).According to the ordered Logistic regression model, it was found that maternal overweight(OR=1.614, 95%CI:1.132-2.301, P＜0.01) and paternal obesity (OR=2.584, 95%CI:1.773-3.765, P＜0.001) were independent risk factors for childhood overweight and obesity.Obesity of grandparents and maternal grandparents had no significant relationship with childhood obesity. Conclusions The prevalence of overweight and obesity in middle-aged men is highest among three generations.Parents' overweight or obesity could significantly increase the risk of obesity in preschoolers.

Study on the related factors of physical injury fears in preschool children

XIE Bing-jie, WU Guo-lian, JIA Ya-ya, WEI Xiao-juan, ZHANG Jin-jin, WANG Hui-mei

2021, 29(3):  272-276.  DOI: 10.11852/zgetbjzz2020-1790

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Objective To study the basic situation and related factors of physical injury fears in preschool children, in order to provide scientific basis for their early detection and timely intervention. Methods A total of 969 healthy children aged 3 to 6 years were selected from 3 representative kindergartens in Taiyuan city by stratified cluster sampling, including 504 males and 465 females.The research tools included self-designed children basic information questionnaire, Spence Preschool Anxiety Scale, Normal Development of Social Skill from Infant to Junior High School Children(S-M), Family Nurturing Environment Scale and Self-rating Anxiety Scale(SAS). Results There were 75 positive cases detected with physical injury fears (7.73%), including 33 males (6.5%) and 42 females (9.0%), with no statistically significant difference (χ²=2.091, P>0.05).Female scored higher in physical injury fears than males (t=-2.200, P=0.028).Multivariate analysis showed that non-cesarean section(OR=2.063, 95%CI:1.128—3.772, P=0.019), maternal anxiety score (OR=1.074, 95%CI:1.024—1.125, P=0.003) were the risk factors for the physical injury fear of preschool children, and the language cognition factor score(OR=0.912,95%CI:0.873—0.952, P＜0.001,)and the total score of social life ability (OR=0.961,95%CI:0.936-0.988,P=0.004)were the protective factors. Conclusions Physical injury fears is more common in preschool children and is related to maternal anxiety, family nurturing environment and children's social life ability.Therefore, early family parenting intervention can prevent children's fear of physical injury and promote their physical and mental health.

Review

Progress on the influencing factors and prevention of neonatal diaper dermatitis

CHEN Yu-shuang, YANG Si-yu, HUANG Yu-ting, JIN Meng, ZHOU Le-shan

2021, 29(3):  277-280.  DOI: 10.11852/zgetbjzz2020-0964

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This article reviews the research progress on the risk factors and prevention of neonatal diaper dermatitis from three aspects, including the improvement of neonatal skin monitoring system, the implementation of ABCDE skin care program and the adoption of parental participation nursing model, thereby providing reference and guidance for for reducing the incidence of neonatal diaper dermatitis and medical expenses, improving infants comfort and ensuring the nursing safety of newborns

Research progress on intestinal barrier dysfunction in necrotizing enterocolitis

YANG Meng-yang, JIANG Min

2021, 29(3):  281-284.  DOI: 10.11852/zgetbjzz2020-0115

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Necrotizing enterocolitis (NEC) is a common and serious disease of digestive system during neonatal period, which is one of the main cause of premature death. Intestinal barrier function is underdeveloped in preterm infants, and many pathogenic factors may induce intestinal barrier dysfunction, causing the intestinal mechanical barrier damage, the delay of microbial barrier establishment, the immature of immune barriers, thereby inducing inflammatory cascade reaction and the occurrence of NEC. Early diagnosis of NEC is extremely important for its treatment and prognosis, and the researches on intestinal barrier dysfunction markers are expected to improve the specificity and sensitivity of early diagnosis of NEC. This paper reviews the research progress on intestinal barrier dysfunction in NEC, in order to deepen the understanding of the role of intestinal barrier in the pathogenesis of NEC, and to provide more ideas for the prevention and treatment of NEC.

Research progress on the preventive application of glutamine in necrotizing enterocolitis in premature infants

ZHANG Hai-jian, ZHU Ming-zhe

2021, 29(3):  285-288.  DOI: 10.11852/zgetbjzz2020-0213

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Necrotizing enterocolitis (NEC) is one of the most common acute and fatal gastrointestinal emergencies in premature infants,mainly manifested as abdominal distension,hematochetia,etc.In severe cases,intestinal perforation and even septicemia may occur.The etiology and pathogenesis is unclear,some studies have found that intestinal mucosa barrier damage may be related to its pathogenesis,glutamine (Gln),the essential amino acid for human body,plays an irreplaceable role in maintaining intestinal mucosal integrity and reducing intestinal mucosal damage and ischemic necrosis.This paper reviews the preventive application of glutamine in NEC in premature infants.

Research progress on the effects of pulmonary microbiota on the lung development of premature infants

PENG Qian, QU Shu-qiang

2021, 29(3):  289-291.  DOI: 10.11852/zgetbjzz2020-0362

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Pulmonary function is not only the most important determinant of the life of premature infants,but also an important factor affecting their long-term prognosis.The microbial communities in the lungs and intestines are complex,and play an important role in the regulation of pulmonary diseases through the intestinal-pulmonary axis.This review summarizes the aspects of the midgut-lung axis and its pathophysiology in respiratory diseases characterized by bronchopulmonary dysplasia of premature infants,and explores the existing and innovative approaches to prevention and treatment.

Research progress on hypothermia in the treatment of neonatal hypoxic-ischemic encephalopathy

TIAN Zhi-chen, ZHANG Xuan, YIN Xiao-juan

2021, 29(3):  292-295.  DOI: 10.11852/zgetbjzz2020-0360

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Hypoxic-ischemic encephalopathy (HIE) is the main cause of neonatal death and disability.Mild hypothermia treatment can significantly reduce the mortality and disability rate of HIE.However, there are still some newborns with lifelong disability in movement, sensation and cognition.Therefore, the implementation conditions of mild hypothermia treatment need to be optimized.This article reviews the pathophysiology of HIE, the neuroprotective effect of hypothermia treatment on HIE, and the influence of various parameters of hypothermia treatment on the neuroprotective effect, so as to provide the basis for better clinical application of hypothermia treatment on HIE.

Meta Analysis

Systematic review and Meta-analysis of the prevalence of stunting among children in China

GUO Bing-bing, JIANG Xin-ye, WEI Ya-rong, PEI Jing-jing, XU Yin

2021, 29(3):  296-300.  DOI: 10.11852/zgetbjzz2020-0215

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Objective To understand the prevalence of growth retardation among children and adolescents in China through Meta analysis, in order to provide scientific basis for early prevention and treatment of growth retardation in children. Methods Literatures about the prevalence of growth retardation among children in China were retrieved from CNKI, Wanfang data, CBM, VIP and PubMed databases up to March 30th, 2020.Literature quality was evaluated according to the cross-sectional study evaluation criteria in STROBE statement.The prevalence rate was combined with Stata 12.0 software.Subgroup analysis was carried out on factors such as gender, age, regional distribution, year of investigation and residence.Egger test and funnel plot were used to evaluate the publication bias of each literature.The sensitivity analysis was completed by eliminating any one of low-quality articles. Results A total of 23 articles were included, with a total sample size of 699 974, ranging from 6 082 to 99 542(M=17 329).The overall prevalence of growth retardation in Chinese children was 6.0% (95%CI:5.0%-7.0%).Subgroup analysis showed that the prevalence rates of growth retardation in children aged 0-7 years and 7-18 years were 8.1%(95%CI:6.0%-10.2%) and 3.3%(95%CI:2.7%-3.9%), and the difference was significant(t＝4.12,P<0.05).The prevalence rate of growth retardation was 9.9%(95%CI:7.5%-12.2%) in 2005—2010, and 3.0%(95%CI:2.2%-3.7%) in 2011-2019, the difference was significant (t＝6.49,P<0.05).The prevalence rate of growth retardation was 4.5% (95%CI:3.4%-5.7%) in rural area and 2.5%(95%CI:1.9%-3.1%) in urban area,the defference was significant(t＝2.94,P<0.05).But the difference was not significant between different genders and regional distribution. Conclusion The prevalence rate of children's growth retardation is decreasing in China, and there are differences among different age groups and residence.

Clinical Research

Investigation and analysis of sleep status in preschool children with epilepsy

JIA Tian, YANG Lin, LEI Xiao-mei

2021, 29(3):  301-304.  DOI: 10.11852/zgetbjzz2020-2004

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Objective To analyze the sleep status of preschool children with epilepsy,and to explore the prevalence and influencing factors of the sleep problems. Methods From June 2018 to June 2019,a total of 96 children with epilepsy aged 3 to 5 in the Department of Pediatrics of the Second Affiliated Hospital of Xi'an Jiaotong University were selected as the epilepsy group,and 97 healthy children matched by age and gender were as controls. The Children's Sleep Habits Questionnaire (CSHQ) was used to investigate and analyze their sleep status,and the total score of CSHQ over 54 points was considered as poor sleep quality. Univariate analysis and Logistic regression analysis were used to determine the related factors that may lead to poor sleep quality in children with epilepsy. Results 1) The incidence of poor sleep quality in epilepsy group was higher than that in control group (33.33% vs. 10.20%,P＜0.001). 2) Univariate analysis showed that seizure types (χ²=7.200,P=0.007),seizure frequency (χ²=14.189,P=0.001) and the time periods of seizure(χ²=6.667,P =0.036)may relate to the occurrence of poor sleep quality. 3) Logistic regression analysis showed that generalized seizure (OR=4.996),seizures concentrated in the sleep period (OR=4.320),frequency≥4 times/month (OR=7.740) were risk factors for poor sleep quality in children with epilepsy. Conclusions Children with epilepsy have shorter sleep duration,and are more likely to have sleep problems than normal preschoolers. It is supposed to give early identification and intervention for epilepsy children with high-risk factors for poor sleep quality.

Clinical analysis of coinfection of hBov in children with lower respiratory infection

HE Xiang-ping, WANG Yu-qing, FU Yan-ping, CAI Chun-mei, JIA Hai-xiang, ZHANG Li-ping, LU Wei-yi

2021, 29(3):  305-308.  DOI: 10.11852/zgetbjzz2020-1070

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Objective To analyze the impacts of polyinfection on clinical characteristics of children with acute lower respiratory tract infection due to hBoV, and to analyze the high risk factors of the polyinfection. Method From November 2017 to October 2019, totally 3 350 samples of nasopharyngeal aspirates were collected for respiratory tract multi-pathogen detection from children with lower respiratory tract infection in the Respiratory Department of Children's Hospital Affiliated to Soochow University. Results Among the 3 350 samples, hBoV was found positive in 167 samples (5.0%), of which 102 (61.1%) were hBoV mono-infected and 65 (38.9%) poly-infected.In the polyinfected samples, the main pathogens included the virus (26, 15.6%), mycoplasma pneumonia (16, 9.6%) and bacteria (11, 6.6%), 12 samples (7.2%) were poly-infected with two or more pathogens.In terms of cough, wheezing, fever, dyspnea, lung rales and hospitalization stay, there was no statistically significant difference among the groups of mono-hBoV infected samples, poly-virus infected samples, poly-mycoplasma infected samples, poly-bacteria infected samples, and poly-infected samples with two or more of the pathogens(P＞0.05).The proportion of severe pneumonia in poly-bacteria infected samples was significantly higher than that in poly-virus and poly-mycoplasma infected samples(χ²=15.648, P<0.05).Logistic regression analysis indicated that pre-admission course exceeded 7 days was a risk factor for hBoV polyinfection (OR=1.040, 95%CI:1.002-1.079). Conclusions hBoV has a higher polyinfection rate.AND hBoV poly-bacterial infection may aggravate the disease.Children with pre-admission course ＞7 days should be alerted for hBoV polyinfection.

Reliability and validity of four square step test in children with balance dysfunction

LIANG Xian-rong, TAN Zhu-jiang, CAO Jian-guo, PENG Kang-long, CHEN Tu-rong, GONG Rong, CHEN Qin-er

2021, 29(3):  309-312.  DOI: 10.11852/zgetbjzz2020-1401

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Objective To study the reliability and validity of four square step test (FSST) in children with balance dysfunction, so as to provide experimental evidences for clinical evaluation of children with balance dysfunction. Methods A total of 129 children with impaired balance function treated in Shenzhen Children's Hospital between January 2018 and February 2019 were selected as the study subjects.All participants were evaluated by two assessors (A, B) 3 times a week.A was responsible for the first and third evaluation, while B was responsible for the second evaluation.The content of the first evaluation included FSST, Berg Balance Scale (BBS), time up and go test (TUG) and 10-meter walking test (10MWT), with an interval of 3-5 minutes between every two test.The content of the second and third evaluation only included FSST.During the evaluation, the assessors did not discuss with each other and record their own data.Pearson correlation analysis was performed to test the correlation of FSST, BBS, TUG and 10MWT results so as to reflect the reliability of FSST.The inter-rater reliability and re-test reliability of FSST were analyzed, and CDM packet was used to detect the discrimination. Results The correlation coefficients of FSST with BBS, TUG and 10MWT were -0.985 (-0.782--0.605), 0.678 (0.572-0.761) and 0.721 (0.626-0.795) (P<0.001).The reliability and test-retest reliability of FSST were 0.957 and 0.979.The validity value was 0.801-0.989 for differentiating children at different ages, which was 0.707-0.824 for differentiating children with different etiologies. Conclusion FSST has high parallel validity, inter-evaluator consistency reliability and test-retest reliability in evaluating children's balance function, and is worth for clinical application.

Effects of parental participation in developmental care combined with kangaroointervention on growth and development, neurobehavior and Ghrelin level in very low birth weight infants

WANG Xue-qin, HE Jing, HE Min, XIAO Yi-wei

2021, 29(3):  313-317.  DOI: 10.11852/zgetbjzz2020-0913

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Objective To analyze the effects of parental participation in developmental care combined with kangaroo intervention on growth and development, neuro-behavior and Ghrelin level in very low birth weight (VLBW) infants. Methods A total of 106 extremely low birth weight infants treated in Sichuan Maternal and Child Health Hospital from May 2017 to June 2019 were enrolled in this study.Forty-nine cases whose parents participated in developmental care on the basis of conventional intervention were selected as the control group, and 57 infants in the observation group were given kangaroo intervention additionally.The clinical conditions, developmental conditions, complications, neurobehavioral development, and Ghrelin level in infants were compared between the two groups. Results The infants in the observation group had shorter enteral feeding time and time to return to normal weight than the control group, and the daily sleep time in the observation group was significantly longer than that in the control group (t=7.200, 6.284,14.995, P<0.05).There was no significant difference in the weight, head circumference and length of the two groups before intervention (P> 0.05).The weight, head circumference and length of the infants in the observation group were larger than those in the control group after intervention (t=10.257,2.155,3.559, P<0.05).The total incidence of complications in the observation group was 8.77%, significantly lower than that in the control group (24.49%) (χ²=4.834, P<0.05).There was no significant difference in NBNA score and Ghrelin level between the two groups of infants before intervention (P>0.05), but the score of NBNA and Ghrelin in the observation group were significantly higher than those in the control group after intervention (t=6.284,2.893, P<0.05). Conclusion Compared with kangaroo intervention alone, parents' participation in developmental care combined with kangaroo intervention can significantly shorten the time for VLBW infants to reach total enteral feeding, recover normal body weight and sleep every day, improve their weight, head circumference and body length, and facilitate their neurobehavioral development and improve the level of Ghrelin.

Study on the clinicalpoor outcomes of premature infants born by early-onset severe-preeclampsia

ZHONG Mei-zhen, LI Xiao-zhong, WANG Li-zhou, CHEN xian-rui

2021, 29(3):  318-322.  DOI: 10.11852/zgetbjzz2020-1518

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Objective To discuss the impact of early-onset severe-preeclampsia(ES-PE) on the clinical outcomes of premature infants. Methods All the live-birth preterm infants with gestational age ≤34 weeks, delivered by women with early-onset severe-preeclampsia in the First Affiliated Hospital of Xiamen University from January 2016 to December 2017, were recruited prospectively in this study.Premature infants were divided into study group and control group according to whether their mother had ES-PE during pregnancy or not.The clinical outcomes of the preterm infants were observed, and the related clinical data were collected for analysis. Results Totally 814 live-birth preterm infants with gestational age ≤34 weeks were delivered during this study period, with 107 in study group and 707 in control group.Finally infants who met the follow-up criteria in the study group and control group were 101 and 640 cases, respectively.Compared with control group, the incidence rates of cesarean section, neonatal birth asphyxia, neutropenia, thrombocytopenia, nosocomial infections, feeding intolerance, neonatal respiratory distress syndrome (NRDS) and bronchopulmonary dysplasia (BPD) increased significantly in study group(χ²=68.722, 13.073, 15.759, 14.910, 5.221, 4.515, 8.117, 4.192, P＜0.05).The average birth weight of the study group was less than that of control group (t=-2.120, P＜0.05), while the average hospitalization day of the study group was longer than that of the control group (t=2.862, P＜0.05) between the two groups(P＞0.05). Conclusion ES-PE affects the birth way and birth weight of preterm infants, increases adverse events rate, hospitalization day in preterm infants, but has no impact on neonatal mortality.

Study on the association of platelet parameters and the risk of moderate/severe bronchopulmonary dysplasia

JI Wei-hua, WANG Jin-yuan, DIAO Jing-jun

2021, 29(3):  323-327.  DOI: 10.11852/zgetbjzz2020-1403

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Objective To explore the association between platelet parameters at birth and the risk of moderate/severe bronchopulmonary dysplasia (BPD) in a cohort of extremely preterm infants. Methods The data of premature infants with gestational age ≤28 weeks and birth weight<1 500 g admitted to the Neonatal Intensive Care Unit, Dalian Maternal and Child Health Care Hospital of Dalian Medical University from September 2014 to December 2019 were retrospectively collected.The preterm infants were divided into non-BPD, mild BPD and moderate/severe BPD groups.The differences in platelet parameters in 24 hours after birth among the three groups were compared, including platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and platelet mass.Receiver operating characteristic (ROC) curve was used to evaluate the early predictive value of platelet parameters for moderate/severe BPD. Results A total of 147 premature infants were enrolled, including 71 non-BPD infants,35 mild BPD infants and 41 infants with moderate/severe BPD.The value of MPV in 24 hours after birth was significantly higher in moderate/severe BPD group than that in non-BPD group and mild BPD group(F=8.048,P<0.001).But there were no significant differences in PLT, PDW and platelet mass among the three groups (P>0.05).Multivariate Logistic regression analysis indicated that with the increase of gestational age, the risk of moderate/severe BPD decreased (OR=0.466, 95%CI:0.247-0.880).The increasing MPV(OR=2.522, 95%CI:1.313-4.847), higher number of blood transfusions(OR=2.177, 95%CI:1.135-4.177), and longer duration of mechanical ventilation(OR=3.296, 95%CI:1.071-10.144).ROC curve analysis showed that the best diagnostic cut-off value of MPV was 10.55 fl,and the sensitivity and specificity of early prediction of moderate/severe BPD was about 62.2% and 76.8%, respectively. Conclusions A higher level of MPV in the first 24 hours of life may increase the risk of moderate/severe BPD after extremely premature birth.The change of MPV is likely to be related to the onset of BPD in preterm infants.

Experience Exchange

Effect of integrated oral motor intervention on feeding performance and complications in premature infants

ZHANG Ling-li, YU Xiao-liang, TIAN Xi-wen, CHEN Na

2021, 29(3):  328-331.  DOI: 10.11852/zgetbjzz2020-1405

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Objective To analyze the effect of integrated oral exercise intervention on feeding performance and complications in preterm infants. Methods From January 2018 to January 2020, 80 premature infants were randomly divided into two groups, with 40 infants in each group.The control group received routine intervention, and the observation group was given comprehensive oral exercise.The neurobehavioral development, feeding performance and the incidence of complications were compared between the two groups. Results After 7 days of intervention, the total score of neurobehavioral development in both the observation group and the control group increased, and the neurobehavioral development score in the observation group changed greater (t=11.670, P<0.001).After intervention, the feeding performance in the observation group was better than that in the control group.The total complication rate in the observation group after intervention was significantly lower than that in the control group (χ²=5.591,P＜0.05). Conclusion Comprehensive oral exercise intervention can effectively promote children's neurobehavioral development, improve feeding performance, and significantly reduce the incidence of related complications.

Expression of IL-33/ST2 in peripheral blood of children with Mycoplasma pneumoniae pneumonia

LI Jiu-ying, LI Ping-zhen, QIU Ya-ming

2021, 29(3):  332-334.  DOI: 10.11852/zgetbjzz2020-1092

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Objective To investigate the expression of interleukin-33/tumor suppressor protein 2 (IL-33/ST2) in peripheral blood of children with mycoplasma pneumonia (MPP) and its clinical significance. Methods From June 2017 to October 2018, 100 children with MPP in Kaifeng Children's Hospital were selected as the study subjects (MPP group), and another 100 healthy children in the same period were selected as the control group.Peripheral venous blood was collected from two groups of children, peripheral blood mononuclear cells (PBMC) and plasma were isolated.The expression of IL-33 was detected by enzyme-linked immunosorbent assay (ELISA), the expression of ST2 protein was detected by immunoblotting (WB), COSMED PFT4 instrument was used to detect pulmonary function in two groups of children.Pearson method was used to analyze the correlation between IL-33 and ST2 protein levels in peripheral blood of MPP children and pulmonary function. Results Compared with the control group, the levels of IL-33 and IL-4, ST2 protein in peripheral blood of MPP children increased significantly (t=9.749, 33.783, 43.890, P<0.05), while the levels of INF-γ, PEF%, FEV1% and FEV1/FVC decreased significantly (t=12.014, 19.860, 20.258, 21.006, P<0.05).Pearson analysis showed that IL-33 and ST2 protein levels in peripheral blood of MPP children were positively correlated with IL-4 level(r=0.537, 0.511), and negatively correlated with INF-γ level, PEF%, FEV1%, FEV1/FVC level (r=-0.660—-0.431, P <0.05). Conclusions IL-33 and ST2 are highly expressed in peripheral blood of MPP children.It may be involved in airway inflammation of MPP by mediating Th2 dominant immune response.

Study on the changes of serum vitamin D level and T lymphocyte immunity in children with asthma at different stages

LI Min, YANG Guo-jian, PENG Qin-mei

2021, 29(3):  335-338.  DOI: 10.11852/zgetbjzz2020-1321

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Objective To analyze the changes and correlation of serum 25-hydroxyvitamin D₃ [25-(OH)D₃], the number of T lymphocytes and related cytokines in children with asthma at different stages, and to explore the possible mechanism of 25-(OH)D₃ involved in the pathogenesis and progression of asthma. Methods From January 2018 to December 2019, a total of 105 children with asthma and 30 healthy children in Sichuan Provincial People's Hospital were selected into this study, including 25 cases of acute attack, 40 cases of chronic duration and 40 cases of remission.The level of 25-(OH)D₃ were detected by electrochemical stripping voltammetry and the levels of T lymphocyte subsets and their cytokines IFN- γ, IL-4 and IL-10 were detected by flow cytometry. Results In children with asthma, serum 25-(OH)D₃ level decreased significantly, the number of CD3, CD4/CD8 cells as well as the secretion level of IFN-γ and IL-10 decreased, while the level of IL-4 secretion increased.Changes were most pronounced during acute episodes, followed by chronic persistence, and closest to normal during remission.The level of serum 25-(OH) D₃ in children with asthma at different stages was positively correlated with the level of IFN-γ and IL-10, and negatively correlated with the level of IL-4. Conclusions Vitamin D, as an immunomodulatory hormone, is closely related to the onset and disease control of asthma.Monitoring serum 25-(OH) D₃ level of asthmatic patients is helpful for the judgment and the treatment of the disease condition, providing a new monitoring method for the clinical practice.

Expressions and clinical significance of serum microRNA-155 and chemokine 8 in children with cough variant asthma

YANG Ying, LIU Ya-kun

2021, 29(3):  339-342.  DOI: 10.11852/zgetbjzz2020-1418

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Objective To investigate the expression levels of serum microRNA-155 (miR-155) and chemokine 8 (CXCL8) in children with cough variant asthma (CVA), and to discuss the clinical significance of these indicators. Methods A total of 86 CVA patients treated in Daxing Maternal and Child Health Hospital of Beijing from March 2017 to February 2019 were selected as study objects (experiment group), and 90 healthy children who underwent physical examination at the same time were selected as the control group.The general clinical data were collected, sputum eosinophil (EOS) count, exhaled nitric oxide (FeNO) and pulmonary function indexes including forced expiratory volume in one second (FEV₁), peak expiratory flow rate (PEF) and forced expiratory volume in one second/forced vital capacity (FEV₁/FVC) were measured.Pearson method was used to analyze the correlation between miR-155, CXCL8 levels and EOS, FeNO, lung function.In addition, receiver operating characteristic curve (ROC) was used to analyze the predictive value of serum miR-155 and CXCL8 levels for CVA. Results Compared with the control group, the levels of EOS, FeNO, miR-155 and CXCL8 in the experiment group were significantly higher(t=11.606, 27.562, 19.721, 10.754, P＜0.05), while the levels of FEV₁, PEF and FEV₁/FVC were significantly lower (t=17.471, 10.975, 33.605, P<0.05).Pearson analysis showed that miR-155 and CXCL8 were positively correlated with EOS and FeNO (P<0.05), and negatively correlated with FEV₁, PEF and FEV₁/FVC (P<0.05).The area under the curve of miR-155 and CXCL8 was 0.821 (95% CI:0.675-0.967) and 0.851 (95% CI:0.741-0.961), respectively.The area under the curve of combined detection in predicting CVA was 0.935 (95% CI:0.914-0.975). Conclusion The levels of serum miR-155 and CXCL8 in children with CVA are increasing, which has certain predictive value for CVA, and may be used as potential serological markers for the diagnosis of CVA.

Appropriate Technology

Comparison of the effects of different stretching methods on the muscle tension and tolerance of children with spastic cerebral palsy

LI Kai-dong, ZHOU Wen-zhi, TIAN Ping, YANG Xia, ZOU Pin-fang

2021, 29(3):  343-346.  DOI: 10.11852/zgetbjzz2020-1487

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Objective To compare the effect of different stretching methods on the muscle tension of children with spastic cerebral palsy (CP) and the differences in their tolerance. Methods A total of 53 CP patients, who were treated in Chengdu Women's and Children's Central Hospital from September 2019 to May 2020 and met the inclusion criteria, were randomly divided into observation group (n=27) and control group (n=26).The observation group was given a small range of progressive drafting method, while control group received a large range of static drafting method.Both groups received routine rehabilitation treatment, and were intervened for 12 weeks with the frequency of 30 minutes/time,1 time/day, 5 times/week.The changes of muscle tension in the children were observed by Modified Ashworth Scale(MAS), joint range of motion (ROM) and other indicators before and after the training.The modified CHEOPS pain scoring method was used to observe the changes in children's tolerance. Results After treatment, the muscular tension (MAS) scores of the two groups were lower than those before treatment (control group:t=2.121, 4.947, 2.476; observation group:t=3.422, 5.322, 2.933), the measurement of joint mobility improved compared with that before treatment (control group: t=2.061, 2.017, 2.053; observation group:t=4.357, 3.936, 3.349), and the modified CHEOPS pain score was significantly higher than that before treatment (t=39.817, 16.908,P＜0.05).After treatment, the muscle tension of adductor femoris, hamstrings and ankle plantar flexor of children in the observation group was significantly higher than that in control group (t=2.230, 2.133, 2.173, P＜0.05).The adductor angle, the popliteal angle and the dorsiflexion angle of the foot in the observation group improved more than the control group (t=2.059, 2.119, 2.105,P＜0.05 ),while the improvement of CHEOPS pain score during stretching treatment was more significant in control group(t=13.157, P<0.001). Conclusion Progressive stretching therapy is more effective in improving the muscle tension of children with spastic cerebral palsy, and is more easily accepted by children with high tolerance, so it is suitable for application and promotion in the rehabilitation of children with cerebral palsy.