Table of Content

10 April 2021, Volume 29 Issue 4

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Professional Forum

Correlation of maternal cholesterol and oxysterols during pregnancy with cognitive development in the offspring

YU Huan-ling

2021, 29(4):  349-351.  DOI: 10.11852/zgetbjzz2021-0285

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Cholesterol, the essential material for brain development, is transported continuously from mothers to fetus during the gestation stage to meet the need of embryonic and fetal development. Oxysterols are oxygenated derivatives of cholesterol or its sterol precursors, and may be closely related to brain function. Population studies have found that the serum/plasma cholesterol levels of pregnant women are correlated with the risk of developing attention-deficit hyperactivity disorder and autism spectrum disorders in offspring, but the research evidence needs to be improved.

Original Articles

Expression and clinical value of miR-138 and miR-338 in peripheral blood of children with spastic cerebral palsy

LIU Hong-xing, NIU Guo-hui, CUI Bo, ZHANG Guang-yu, WANG Xin

2021, 29(4):  352-356.  DOI: 10.11852/zgetbjzz2020-1979

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Objective To detect the expression levels of microRNA-138 (miR-138) and microRNA-338 (miR-338) in children with spastic cerebral palsy and explore the clinical value. Methods A total of 64 children with spastic cerebral palsy who were treated in the Third Affiliated Hospital of Zhengzhou University from March 2018 to April 2020 were selected into spastic cerebral palsy group. Meanwhile,62 healthy children were selected as healthy control group. The expression levels of miR-138 and miR-338 were detected by real-time quantitative PCR (qRT-PCR),the serum levels of tumor necrosis factor-α (TNF-α),C-reactive protein (CRP),nerve growth factor (NGF) and endothelin (ET) were detected by enzyme-linked immunosorbent assay (ELISA). Pearson method was used to analyze the correlation between serum miR-138,miR-338 and TNF-α,CRP,NGF,ET expression levels in children with spastic cerebral palsy Receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of serum miR-138 and miR-338 in spastic cerebral palsy. Multivariate Logistic regression analysis was used to analyze the influencing factors of spastic cerebral palsy. Results The expression levels of miR-138,miR-338,TNF-α,CRP and ET in serum in spastic cerebral palsy group were higher than those in healthy control group,while NGF expression level was lower than that in control group(t=9.598,9.592,11.039,42.397,14.172,5.744,P＜0.05). There was a positive correlation between serum miR-138 and miR-338 in children with spastic cerebral palsy (r = 0.687,P < 0.05),and they were positively correlated with TNF-α,CRP,ET levels (miR-138:r=0.519,0.483,0.494;miR-338:r=0.506,0.492,0.516,P＜0.05),and negatively correlated with NGF level (r=-0.522,-0.496,P＜0.05). The area under the curve (AUC) of serum miR-138 and miR-338 in the diagnosis of spastic cerebral palsy was 0.882 and 0.858,the cut-off value was 1.189 and 1.406,the specificity was 75.8%,93.5%,and the sensitivity was 87.5% and 67.2%,respectively.The AUC of the combined diagnosis was 0.950,the specificity was 90.3%,and the sensitivity was 93.8%. Logistic regression analysis that miR-138,miR-338 and NGF were protective factors of spastic cerebral palsy [OR (95%CI):2.280 (1.742-2.983),2.222 (1.637-3.016),P<0.05],and NGF was risk factor of spastic cerebral palsy [OR (95%CI):0.720 (0.527-0.984),P＜0.05]. Conclusions The serum expression levels of miR-138 and miR-338 in children with spastic cerebral palsy are significantly up-regulated,and they may play an important role in the occurrence and development of spastic cerebral palsy.

Correlation between frequent nocturnal enuresis and birth asphyxia in children

SHEN Jia-yao, ZHENG Xiang-yu, JIN Xing-ming, MA Jun

2021, 29(4):  357-361.  DOI: 10.11852/zgetbjzz2020-0921

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Objective To explore the correlation between frequent nocturnal enuresis and birth asphyxia, in order to provide empirical evidence for clinical analysis of the etiology of frequent nocturnal enuresis. Methods A total of 62 290 children aged 5-12 years were selected in this study in Shanghai from June 2014 to June 2015 by a stratified cluster random sampling method. The correlation between frequent nocturnal enuresis and birth asphyxia was analyzed by multivariate Logistic regression. Results The incidence of frequent nocturnal enuresis in children aged 5-12 years was 0.5%(327/62 290). Univariate Logistic regression analysis showed that frequent nocturnal enuresis was significantly correlated with birth asphyxia (OR=4.127,95%CI:2.994-5.690,P<0.001). Multivariate Logistic regression analysis indicated that children with birth asphyxia still had a high risk of developing frequent nocturnal enuresis (OR=3.001,95%CI=2.054—4.385,P<0.001). In addition, the correlation between frequent nocturnal enuresis and birth asphyxia was closer in boys (OR=3.518, 95%CI:2.275—5.438,P<0.001) than that in girls (OR=2.293, 95%CI:1.041—5.051,P=0.039). Conclusion Frequent nocturnal enuresis is significantly associated with birth asphyxia, and the correlation is more closer in boys, indicating that birth asphyxia is a high risk factor for frequent nocturnal enuresis.

Cross-sectional study and relative factors analysis of sensory abnormalities in children with autism spectrum disorder

HU Jin-ming, LIU Xing-hua, ZHAN Guo-dong, XING Yi-pei, ZOU Xiao-bing

2021, 29(4):  362-366.  DOI: 10.11852/zgetbjzz2020-1393

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Objective To investigate the sensory abnormalities in children with autism spectrum disorder (ASD) and the factors correlated with sensory abnormalities,so as to provide theoretical reference for the clinical diagnosis and behavior modification of ASD children. Methods A total of 121 ASD children were enrolled in this study from August,2015 to January,2016. The sensory abnormalities were evaluated by the Autism Diagnostic Interview-Revised (ADI-R). Psycho-Educational Profile-version 3 (PEP-3),WISC,Gesell test,Brief Autism Mealtime Behaviors Inventory (BAMBI) were used to assess other characteristics of ASD children. The correlation between sensory abnormalities and related factors was analyzed by spearman correlation analysis. Results Totally 19.0% (23/121) of ASD children had no-sensory abnormalities,mild- and severe-sensory abnormalities was detected in 64(52.9%) and 34(28.1%) children,respectively. The kinds of sensory abnormalities in mild- and severe-sensory abnormalities group were more than those in no-sensory abnormalities group (χ²=88.042,P<0.01),which were also much more in severe-sensory abnormalities group than that in mild-sensory abnormalities group (P<0.01). Part-A (scocial interaction) and B(communication) scores of ADI-R in severe-sensory abnormalities group with no language ability (19.59±4.67,12.36±1.76) were significantly higher than those in no-sensory abnormalities group (15.79±1.94,9.86±3.34,F=3.032,5.190,P＜0.05).Additionally,Part-B of ADI-R scored higher in severe-sensory abnormalities group than in mild-sensory abnormalities group (10.79±2.32,P<0.05). In PEP-3,the percentage of personal self-care in mild and severe-sensory abnormalities group was lower than that in no-sensory abnormalities group (χ²=8.641,P<0.01). As for full intelligence quotient(FIQ) and developmental quotient (DQ),there was no significant difference among three groups(P＞0.05). In BAMBI,mild- and severe-sensory abnormalities group had higher score on limited variety of food than no-sensory abnormalities group (χ²=6.806,P＜0.05). In non-verbal ASD children,sensory abnormalities were positively related to the part-A and B scores of ADI-R (r_s=0.260,0.359,P<0.01).Moreover,sensory abnormalities of ASD children were negatively related with the percentage of personal self-care in PEP-3 (r_s=-0.252,P=0.005),and positively related to the scores of food refusal in BAMBI (r_s=0.224,P=0.013). Conclusions Sensory abnormalities are existed in 81.0% of ASD children,with a greater variety of sensory abnormalities in the severe group. ASD children with severe-sensory abnormalities are less socially competent and had more eating problems. Sensory abnormalities are not associated with intelligence test and Gesell assessment result. Sensory abnormalities may be a predictor of social competence in children with ASD.

Prevalence of negative affect and its association with physical activity among junior high school students in Beijing

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

2021, 29(4):  367-371.  DOI: 10.11852/zgetbjzz2020-1718

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Objective To analyze the current situation of negative affect among junior high school students in Beijing and its association with physical activity, so as to provide evidence for improving students' negative affect and promoting their mental health. Methods Using stratified multistage cluster sampling, a self-administered questionnaire survey was conducted among 12 338 students from 63 junior high schools in 18 counties/districts of Beijing from March to May in 2014.The prevalence of negative affect and its association with physical activity were analyzed. Results In the past 12 months, 1 517 (12.30%) students often/always felt lonely, 3 337 (27.05%) students often/always felt unhappy due to academic pressure or performance problems, 1 514 (12.27%) students often/ always had insomnia because of worrying about something, and 1 354 (10.97%) students stopped their usual activities because of sadness and despair for 2 weeks or more.The trend χ² test showed that the increased frequency of physical activity was closely associated with the decrease of self-reported negative affect.After adjusting for sex, area, school type, grade and academic performance, the Log-binomial models showed that students who were physically active for 60 minutes or more generally had a lower risk of negative affect compared with those who were never physically active for 1 week.And having physical activity for 3 days or more weekly could significantly reduce the risk of all four kinds of negative affect, especially for those students with loneliness.When stratified by sex, area, school type, grade or academic performance, the associations between physical activity and one or more negative affect were observed in varying degrees at almost all subgroups excepted for students at the ninth grade. Conclusions The junior high school students in Beijing have relatively high prevalence of negative affect.Actively participating in physical activity for more than 3 days per week helps to improve the mental health for most students, and has the most significant effect on loneliness.

Screening and mutation analysis of methylmalonic acidemia in newborns in Heze area

LIU Chang, MENG Cui-ping, FANG Zhen-nan, ZHAO Fen, WANG Qing-hua

2021, 29(4):  372-376.  DOI: 10.11852/zgetbjzz2020-0923

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Objective To analyze the clinical phenotype, gene mutation type and different types of treatment effects of children with methylmalonic acidemia (MMA). Methods A total of 210 319 newborns born in Heze City from May 2015 to December 2019 were screened by using tandem mass spectrometry technology combined with urine gas chromatography mass spectrometry and second-generation sequencing technology. And 88 diagnosed patients were divided into simple MMA children and MMA children combined with homocysteine, and were given responding treatment accordingly. Paired sample t test was used to compare and analyze the data before and after treatment. Results Of the 88 children with MMA, 79 were MMA with homocysteine, 9 were simple MMA. And 49 children performed genetically sequencing, indicating 13 mutation sites of MUT gene and 20 mutation sites of MMACHA gene. Finally 3 unreported mutations were found in MUT gene, including c.389G>A:1963C>T, c.2009G>T, c.1233_1235delCAT. And 5 unreported mutations were found in MMACHA gene, including c.481C>T, c.568dupT, c.57delT, c .471G>A, c.IVS2+149C>T. After treatment, 78 children with MMA combined with homocysteine had significantly lower blood propionylcarnitine (C3) value and urine methylmalonic acid value(P<0.05). Conclusions Newborn genetic metabolic disease screening can detect, diagnose, and treat MMA children early, and reduce the mortality and disability rate of MMA children. Genetic testing is helpful for the diagnosis of MMA typing and treatment plans. The clinical phenotype of different genotypes and the response to treatment are different. And the new mutation sites not only enrich the gene mutation spectrum of children with MMA, but also provide prenatal diagnosis for proband families.

Correlation between the levels of plasma adrenocorticotropic hormone,cortisol and glycosylated hemoglobin level in children with type 1 diabetes mellitus

JIAO Li-hua, LI Hong, LIU Jian-li

2021, 29(4):  377-380.  DOI: 10.11852/zgetbjzz2020-1466

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Objective To Analyze the correlation between adrenocorticotropic hormone(ACTH),cortisol(CORT) and glycated hemoglobin(HbA1c) levels in children with type 1 diabetes mellitus(T1DM),so as to provide scientific evidence for the clinical diagnosis of T1DM. Methods A total of 105 T1DM children hospitalized in the Department of Endocrinology of Tangshan Maternal and Child Health Hospital from January 2014 to December 2018 were selected as the T1DM group,and meanwhile 105 healthy children were selected as the control group. The levels of plasma ACTH and CORT at different time points (8:00,16:00 and 24:00) were measured by enzyme-linked immunosorbent assay (ELISA). Pearson method was used to analyze the correlation between the daily average levels of ACTH,CORT and fasting blood glucose (FPG),HbA1c and other indicators. In addition,Logistic regression analysis was used to analyze the risk factors of T1DM. Results Compared with those in the control group,the levels of triglyceride (TG),total cholesterol (TC),low density lipoprotein (LDL-C),FPG and HbA1c were significantly increased in T1DM group(P＜0.05),while the level of high-density lipoprotein (HDL-C) was decreased (P＜0.05). The expression level of ACTH and CORT at 8:00,16:00 and 24:00,and the daily average levels in plasma of T1DM group were significantly higher than those in control group (P＜0.05). Correlation analysis showed that the daily average expression levels of ACTH and CORT were positively correlated with FPG and HbA1c (r_ACTH=0.717,0.585, r_CORT=0.636,0.696,P<0.01). Logistic regression analysis showed that ACTH and CORT were independent risk factors of T1DM. Conclusions ACTH and CORT are highly expressed in plasma of T1DM children,which are correlated with HbA1c. As independent risk factors for the onset of T1DM,ACTH and CORT may be used as potential markers for glycemic control of T1DM.

Mutation characteristics of phenylalanine hydroxylase gene in children with phenylketonuria in Heze

XU Long-fang, LI Mu-qi, WANG Yu-feng, REN Hui-ping, LIU Shuo, WANG Qing-hua

2021, 29(4):  381-384.  DOI: 10.11852/zgetbjzz2020-1653

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Objective To analyze the mutation characteristics of phenylalanine hydroxylase (PAH) gene in children with phenylketonuria (PKU) in Heze,Shandong,in order to provide scientific reference for further diagnosis and gene treatment of PKU. Methods For children with PKU who were clinically diagnosed and voluntarily underwent genetic testing,high-throughput sequencing technology was used to detect genes related to genetic metabolic diseases in patients,and the detected loci were verified by sanger sequencing and parental verification. Results A total of 53 pathogenic variants were detected in 28 children,of which 25 children were detected with 2 definite pathogenic alleles (89.3%),and 3 patients was detected with 1 variant allele gene (10.7%). Among the 53 mutation types,there were 38 missense mutations (71.7%),4 splicing mutations (7.5%) and 11 nonsense mutations (20.8%). The mutation sites were distributed in the 2^nd,3^rd,6^th,7^th,9^th-11^th and 4^th intron regions of PAH gene. There were 50 (94.3%) variation sites in the exon region and 3 (5.7%) variation sites in the intron region. In children with typical PKU,c.1068C>A was the predominant variation site. While the variation sites of children with mild PKU mainly included c.158G＞A,c.728G>A,and children with mild HPA were presented with variation sites of c.158G>A and c.1068C>A. The detection of c.158G＞A,c.728G＞A and c.1068c＞A was high. c.158G＞A was detected in children with mild PKU and mild HPA,with a mean Phe concentration of 860.74 μmol/L. And c.728G＞A was detected in children with typical PKU and mild PKU,with a mean Phe concentration of 879.51 μmol/L. c.1068C＞A was detected in children with typical PKU and mild HPA,with a mean Phe concentration of 1 098.44 μmol/L. Conclusion The main mutations of PAH gene in children with PKU in Heze include c.158G>A,c.728G>A and c.1068C>A.

Basic Experimental Articles

Effect of 2-arachidonoylglycerol level on hippocampal neuroinflammatory response in autistic model rats

LIU Yu, LIU Ze-hui, XIE Shu, LI Ling, SHI Mei, ZOU Ming-yang, SUN Cai-hong

2021, 29(4):  385-388.  DOI: 10.11852/zgetbjzz2020-1372

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Objective To analyze the effect of regulating 2-arachidonoylglycerol(2-AG) level on the expression of cytokines in hippocampus of autistic model rats,in order to provide a theoretical basis for the etiology research of autism spectrum disorders (ASD). Methods Autistic model rats induced by sodium valproate (VPA) were chosen as objects,and were divided into control group (CON group),VPA group,VPA + 1 mg/kg JZL184 group (VPA + 1RJ group),VPA + 3 mg/kg JZL184 group (VPA + 3RJ group),VPA + 10 mg/kg JZL184 group (VPA + 10RJ group). Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used to detect the level of 2-AG in the hippocampus. Real-time fluorescent quantitative PCR (RT-PCR) and enzyme-linked immuno sorbent assay (ELISA) were used to measure the mRNA expression levels and tissue contents in the hippocampus,including pro-inflammatory cytokines TNF-α,iNOS,IL-1β and anti-inflammatory cytokines Arg-1,IL-4,IL-10 and IL-13. Results LC-MS/MS results showed that the level of 2-AG decreased in hippocampus of VPA rats than that in the CON group (P<0.05),which was significantly higher in VPA+10RJ group than that in VPA group (P<0.05). RT-PCR results showed that compared with the CON group,the expression level of iNOS was increased in the VPA group (P<0.05). Compared with the VPA group,the expression levels of IL-1β,Arg-1,IL-10,IL-13 increased,while the expression level of iNOS decreased in the VPA + 1RJ group. In the VPA+3RJ group,TNF-α and iNOS expression levels decreased than those in VPA group. iNOS expression decreased,and IL-10 expression increased in the VPA + 10RJ group (P<0.05). ELISA results showed that compared with CON group,the expression of iNOS in VPA group was up-regulated,and the expression of Arg-1 and IL-10 was decreased (P<0.05). Compared with the VPA group,the expression of IL-4 in the VPA + 1RJ group was up-regulated,the expression of iNOS was reduced and the expression of IL-10 was up-regulated in the VPA + 3RJ group. In the VPA + 10RJ group,the expression of iNOS was reduced,and the expression of Arg-1 and IL-10 was up-regulated compared with VPA group (P<0.05). Conclusion Elevating 2-AG level could relieve the abnormal neuroinflammation in hippocampus of autistic model rats.

Review

Relationship between playful parenting and brain function development in children aged 3 to 8 years

DANG Jia-jia, MA Ning, SONG Yi

2021, 29(4):  389-392.  DOI: 10.11852/zgetbjzz2020-1276

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It is an important period for brain development during the childhood of ages 3 to 8 years when the brain function has strong plasticity. The deprivation of early experience often leads to the developmental retardation of the central nervous system,or even atrophy and permanent damage. Most of children's early experiences are acquired through play,which cannot be carried out without the participation of adults. More and more studies have revealed the important role of playing parenting on brain function. This review aims to summarize the role of playing parenting on children's brain function development,such as sensation and movement,attention and awareness,learning and memory. What's more,this review also briefly discusses the effects of play types on brain function and existing challenges,with the aim of promoting healthy brain function in children from the perspective of parents,teachers,and other adults involved in play.

Research progressin vitamin D and brain development

QIN Ying, YANG Shu-fen

2021, 29(4):  393-396.  DOI: 10.11852/zgetbjzz2020-1036

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In recent years, research on vitamin D has been progressing rapidly, and the relationship between vitamin D and brain development has received increasing attention. Vitamin D is a steroid hormone that can participate in the regulation of cell proliferation, differentiation and apoptosis. In addition to promoting calcium and phosphorus absorption, bone development and immune regulation, a large number of studies have shown that vitamin D can also affect nerves as a type of neurohormone for the development and function of the system. This article will focus on the vitamin D and vitamin D receptor (VDR) in the brain, the possible regulation of vitamin D on brain development, and the correlation between vitamin D and neuropsychiatric disorders in children.

Application of noninvasive brain stimulation in children with psychological disorders treatment

BAI Hai-ping, YUAN Yuan

2021, 29(4):  397-400.  DOI: 10.11852/zgetbjzz2020-1257

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With regard to the psychological disorders of adolescents, noninvasive brain stimulation (NIBS) technique is one of the most advanced physical therapy, and its clinical effects have attracted much attention in the recent years. The NIBS techniques consist of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). Therefore, this article mainly focuses on the working principles of the two techniques and their therapeutic application in major depressive disorder in youth, attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), respectively. Furthermore, the article emphasizes that NIBS technique has potential in the treatment of children's psychological disorders, and the artificial intelligence is critical to its development.

Application of constraint-induced movement therapy and hand-arm bimanual intensive training in upper limb function intervention of children with spastic hemiplegia

WU Yun

2021, 29(4):  401-404.  DOI: 10.11852/zgetbjzz2020-0063

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Children with spastic hemiplegia suffer from upper limb motor dysfunction,which affects the independence of daily life.In recent years,the rehabilitation of children with hemiplegia has attracted much attention.Traditional neurodevelopmental treatment models focus on reducing tension and promoting normalization of upper limb movement patterns,hoping to improve functional levels.With the advancement of the ICF concept,improving upper limb activity and participation in children with hemiplegia has become the main guide for current intervention.And the constraint-induced movement therapy (CIMT) and hand-arm bimanual intensive training (HABIT) are widely used in clinical practice.This review makes a comparative analysis and review from the perspective of theoretical basis,population adaptation,intervention methods and clinical efficacy,in order to provide a basis for the selection of clinical intervention methods for children with hemiplegia.

Research progress on the growth and development of small for gestational age children

LAN Hong-yan, CHEN Jin-jin

2021, 29(4):  405-408.  DOI: 10.11852/zgetbjzz2020-0381

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In recent years, with the full opening of the “second child” policy and the continuous improvement of treatment level for high-risk newborns, the proportion of pregnant women of advanced reproductive age and defective fetuses in China has increased year by year, and the increasing growth and development problems faced by gestational age children are gradually revealed. Small for gestational age (SGA) infants usually have birth weight below the 10th percentile for infants of the same gestational age, or 2 standard deviations below the average body weight of the same gestational age. Studies have shown that there are many differences in physical growth and neurodevelopment between the SGA and appropriate for gestational age (AGA) infants. So this review aims to summarize the recent research progress in the growth and development patterns of SGA in recent years, thus to provide a reference for the assessment of growth and development and early clinical intervention of SGA children.

Research advances in missed diagnosis and misdiagnosis of autism spectrum disorder in children and adolescents

ZHOU Yu-hang, ZHAO Hong-bo, GUO Lan-min, JIANG Zhi-mei

2021, 29(4):  409-413.  DOI: 10.11852/zgetbjzz2020-0161

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Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders characterized by social communication disorders of varying severity,repetitive behaviors and a narrow range of interests.ASD has become one of the important causes of mental disability in children and adolescents in China,and early intervention is beneficial to the prognosis of children.However,there are often missed diagnosis and misdiagnosis phenomena in the diagnosis of ASD.Based on previous studies,this review combs the manifestation types and causes of missed diagnosis and misdiagnosis of ASD,and discusses possible countermeasures.

Clinical Research

Researchon the influence of kindergarten curriculum on the intelligence development of preschool children with cerebral palsy from the perspective of whole person development

FAN Tao-lin, FAN Min, TONG Yin, XIE Shuang-xi, FU Lei-min, WANG Chun-hua

2021, 29(4):  414-417.  DOI: 10.11852/zgetbjzz2020-1538

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Objective To study the impact of kindergarten curriculum on the intellectual development of preschool cerebral palsy (CP) children based on the perspective of holistic development,in order to provide a new method for facilitating the rehabilitation of CP children. Methods A total of 79 preschool CP children in Xiangya Boai Rehabilitation Hospital from February to July 2019 were divided into control group (n=39) and intervention group (n=40) by digital table method. The control group received routine rehabilitation treatment,while the education group was given kindergarten curriculum additionally. The Gesell Developmental Diagnostic Scale (GDDS),Webster Infant Intelligence Scale (WPPSI) were adopted to evaluate developmental age (DA) of the five energy zones and full intelligence quotient (FIQ) before and after treatment. Results After four-month treatment,the total effective rate of intervention group (92.5%) was significantly higher than that of control group(66.7%)(χ²=13.403,P＜0.01). The difference in DA of gross and fine motor between the two groups was not significant (t=0.283,0.414,P>0.05). The adaptability/language/personal social DA and WPPSI FIQ scores were significantly better than the control group (t=2.280,2.005,2.020,2.010,P<0.05). Conclusion Kindergarten curriculum can effectively promote the development of adaptability/language/personal social ability of preschool-age CP children and improve their intellectual development level.

Relationship between sedentary behavior time and physical activity level, mental health status of preschool children

LIU Min, WANG Ying, LIU Qi-fen

2021, 29(4):  418-420.  DOI: 10.11852/zgetbjzz2020-1565

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Objective To explore the relationship between sedentary behavior time and physical activity level,mental health status of preschool children,so as to provide reference for making intervention strategies of physical activity and mental health. Methods From January to December 2019,145 preschool children from kindergartens in this region were selected as the objects. Strengths and Difficulties Questionnaire (SDQ) (parent version),triaxial accelerometer and supporting ActiLife software were used to investigate all the children. The detection rate of mental health status abnormality,sedentary behavior time and physical activity level were summarized. Pearson/Spearman correlation test was used to analyze the correlation between sedentary behavior time and physical activity level,mental health status of preschool children. Results Preschool children in this region had a long sedentary behavior [(26.49±7.58)min/h],and it was mainly concentrated in 12:00-15:59 a day. The overall physical activity level of preschool children in this region was mainly low intensity. Boys had the highest proportion of moderate intensity physical activity,while girls had the highest proportion of low intensity physical activity,and the difference was statistically significant(χ²=10.504,P=0.005). The detection rate of abnormal mental health status of preschool children was 50.34% (73/145). Correlation analysis showed that sedentary behavior time was negatively related to physical activity level in preschool children (r=-0.418,P＜0.001),and positively related to the mental health status(r=0.341,P＜0.001). Conclusions The sedentary behavior time of preschool children is closely related to physical activity level and mental health status. It is suggested to improve the physical activity level of preschool children,shorten the sedentary behavior time so as to promote mental health.

Study on the status and influencing factors for urine lead level of primary and middle school students in Liuzhou city

ZHOU Zhou, DENG Liang-qiong, LIU Ping, HUANG Ting, ZENG Ting

2021, 29(4):  421-424.  DOI: 10.11852/zgetbjzz2020-1143

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Objective To explore the status and influencing factors for urine lead level of primary and middle school students in Liuzhou city. Methods A stratified cluster random sampling method was used to select 2 047 primary and middle school students from 12 schools of 4 areas as participants from October 2018 to November 2018. Urine samples were collected and the urine levels were tested by inductively coupled plasma-mass spectrometer (ICP-MS). Multiple linear regression model was used to analyze related risk factors affecting urine lead levels. Results The detection rate of urine lead was 99.80%, and the geometrical mean of urinary lead level was 2.147 μg/g creatinine. The level of serum lead in children at the age of 6—11 years old was significantly higher than other groups (H=270.003, P<0.001), and the urine lead level of girls was significantly higher than that of boys (Z＝-2.046, P=0.041). Multivariate analysis showed that often having freshwater fish, street food and snacks, and playing electronics were positively correlated with urinary lead level(β=0.947、1.250、1.056、1.262,P<0.05), while often eating vegetables and fruits were negatively related to urinary lead level(β=-0.866、-0.951,P<0.05). Conclusions Urine lead level of children in Liuzhou is influenced by many factors, such as age, the house dwelling, children's behavior habit and dieting habit. Relevant health education should be widely provided to children and parents, so as to reduce the hazard of lead for children.

Application of auto regressive integrated moving average model in predicting the incidence of congenital hypothyroidism in Guangzhou

JIANG Xiang, XU Ai-jing, TANG Fang, JIA Xue-fang, TANG Cheng-fang, CHEN Qian-yu, ZHENG Rui-dan, LIU Ji-lian, HUANG Yong-lan

2021, 29(4):  425-429.  DOI: 10.11852/zgetbjzz2020-0103

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Objective To analyze the feasibility of applying auto regressive integrated moving average model (ARIMA) to predict the incidence of congenital hypothyroidism (CH) in Guangzhou,so as to provide references for the prevention and control of congenital hypothyroidism. Methods The incidence rate of CH in Guangzhou from 1991 to 2018 was collected,and the ARIMA model was established according to the CH incidence rate from 1991 to 2016.The ARIMA model was tested by comparing the predicted incidence and actual incidence in 2017-2018,and the trend of CH incidence in the next three years was predicted. Results The overall incidence of CH showed an upward trend from 1991 to 2018.ARIMA (0,1,0) was the optimal model based on 1991-2016 CH incidence rate,which was better fit the time trend of CH incidence.The maximum relative error between the predicted and actual incidence of CH in 2017-2018 was 7.9% in the model fitting,providing a relatively accurate prediction.The predicted CH incidence in 2019-2021 was 86.1 per 100 000 births,90.7 per 100 000 births and 94.3 per 100 000 births,respectively. Conclusion ARIMA (0,1,0) model has a good fitting effect on the trend of CH incidence and can be used for the prediction and dynamic analysis of CH incidence in Guangzhou.

Study on the risk prediction of chronic kidney disease in premature infants and low birth weight infants

CHEN Hai-dan, ZHANG Hua, ZENG Fan-juan

2021, 29(4):  430-434.  DOI: 10.11852/zgetbjzz2020-1112

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Objective To explore the risk factors of chronic kidney disease (CDK) in premature infants and low birth weight infants. Methods Cases of low birth weight and premature infants from three key hospitals in Sanya, Hainan Province were collected in this study from January 2005 to January 2019. All traceable children were followed up for 18 months to observe the screening rate of CKD. The clinical data after birth, the laboratory examination data after enrollment and the results of follow-up data were analyzed. Logistic regression analysis was used to observe the risk factors of CKD in preterm and low birth weight infants. ROC curve analysis was used to observe the effectiveness of each risk factor in evaluating CKD. Results A total of 1 269 subjects were included in the study, of whom 39(3.07%) cases were diagnosed with CKD. Binary Logistic regression analysis showed that gestational age ≥29.37 weeks, endogenous creatinine clearance (Ccr)≤36.53 ml/(min·1.73 m²), serum albumin≥39.43 g/L, and exercise behavior index≥10.17 were the protective factors for preterm infants and low birth weight infants from CKD (β=-0.290,-0.117,-0.038,-0.559,P<0.05), serum creatinine (Scr)≥47.58 μmol/L, diastolic blood pressure≥85.69 mmHg, urine albumin≥12.16 mg/L, fasting blood glucose≥5.61 mmol/L were risk factors for CKD in preterm infants and low birth weight infants (β=0.047,0.069,0.315,1.510,P＜0.05). ROC analysis showed that Ccr, serum albumin, diastolic blood pressure, blood creatinine, urine albumin, fasting blood glucose, and exercise behavior index had certain value in predicting CKD in preterm infants and low birth weight infants (P<0.05), and Ccr and Scr had better predictive performance (AUC =0.794,0.738). Conclusions Scr diastolic blood pressure, urine albumin, and fasting blood glucose are risk factors for CKD in preterm infants and low birth weight infants. High exercise index, high serum albumin, and high gestational age are beneficial to reduce CKD in premature and low birth weight infants. Ccr and Scr can predict the occurrence of CKD in preterm infants and low birth weight infants, but attention should be paid to the identification of false positive cases.

Analysis of birth defects of 101 children in Linhe district,Bayannur city, Inner Mongolia from 2017 to 2018

ZHAO Jing, GAO Yu-min, SU Xiong, LIU Ying, GUO Cui-lan, LI Hai-ling

2021, 29(4):  435-438.  DOI: 10.11852/zgetbjzz2020-1366

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Objective To analyze the detection and epidemiological characteristics of birth defects in Bayannur City Hospital and Maternal and Child Health Hospital,in order to provide a basis for the formulation of preventive measures. Methods A total of 209 cases of adverse pregnancy (including live birth,stillbirth and death within 7 days after birth) from 2017 to 2018 were selected to analyze the general situation of birth defects. Maternal childbearing ages,complications during pregnancy,adverse pregnancy history,medication history during pregnancy,previous chronic disease history and number of births and parities were analyzed and compared. Results Among the 11 145 cases of delivery,there were 101 cases of birth defects,with the incidence of birth defects of 90.62/10⁴,and the incidence of unexplained stillbirth (108 cases) of 96.60/10⁴. The top ten birth defects included congenital heart disease,cleft lip and palate,Down syndrome,spina bifida,finger (toe) deformity,congenital hydrocephalus,congenital abdominal wall malformation,renal dysplasia (including duplicate kidney,absence of kidney),equinovarus and external ear malformation. Most (37.62%) of the mothers whose children had birth defects lived in Linhe district. Compared with the 273 pregnant women in the control group,the proportion of pregnancy complications in the birth defect group (21.78%) was lower (χ²=15.391,P<0.001),and the proportion of taking medicine during pregnancy (10.89%) was also significantly lower than that in the control group (χ²=5.254,P=0.022). Conclusions The incidence of birth defects in Linhe district of Bayannur city is lower than that in Inner Mongolia Autonomous region and the whole country. Congenital heart disease,polydactyly (toe),cleft lip and palate and congenital hydrocephalus are the types of defects that need to be paid more attention to. Whether the excessive arsenic content in the water in this region is related to birth defects still needs to be further explored and analyzed.

Multi-center study on complications and consequences of premature infants in Henan province

DUAN Wen-li, XU Fa-lin, LIU Ya-xuan, DONG Hui-fang, WANG Yin-juan, ZHANG Yi, ZHANG Ru

2021, 29(4):  439-442.  DOI: 10.11852/zgetbjzz2020-1955

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Objective To investigate the complications and consequences of preterm infants in Henan province, so as to provide basis for improving the poor prognosis of preterm infants. Methods A total of 12 406 live premature infants from 53 hospitals in 17 cities of Henan province, born from January 1st, 2019 to December 31st, 2019, were selected into this study, and their complications and consequences were retrospectively collected and analyzed. Results 1) The most common complication was pneumonia(39.3%), followed by respiratory distress syndrome (34.7%), asphyxia (17.0%), patent ductus arteriosus (13.5%), septicemia (5.6%), intraventricular hemorrhage (5.5%), necrotizing enterocolitis (2.2%), bronchial pulmonary dysplasia (1.7%), periventricular leukomalacia (1.6%), retinopathy of prematurity (1.2%).And the incidence of the above complications except pneumothorax of premature infants was statistically significant among different gestational age groups (P＜0.05).The complication incidence of premature infants in different grades of hospitals was statistically significant (P＜0.05) except the incidence of cholestasis, intracranial infections and persistent pulmonary hypertension of the newborn.2) In terms of treatment outcome, the incidence rates of improvement, abandonment, death and transferring to another hospital of premature infants were 93.4%, 2.6%, 0.8% and 3.2%.The treatment consequences except death rate of premature infants differed significantly in different grades of hospitals(P＜0.01).3) Premature infants most (63.2%) died within 1 week of birth, and the main causes included infectious diseases, respiratory distress syndrome, asphyxia, congenital malformations and pulmonary hemorrhage. Conclusions The complications of premature infants mainly include pneumonia, respiratory distress syndrome, asphyxia, patent ductus arteriosus, septicemia and intraventricular hemorrhage.Gestational age is closely related to the complications and consequences of premature infants.Therefore, it is necessary to further improve the treatment network of all grades, to strengthen prenatal screening and perinatal health care, and to prevent and cure complications positively, thereby improving the prognosis of premature infant.

Effects of overweight and obesity on tidal lung function of infants with recurrent wheezing

ZHOU Zhen, LI Li-yun, TAN Yan-fang, GUO Su-hua , LIN Ying , ZHAO Hui, LI Zeng-qing

2021, 29(4):  443-446.  DOI: 10.11852/zgetbjzz2020-1558

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Objective To investigate the effect of overweight and obesity on tidal lung function of infants with recurrent wheezing,in order to provide evidence for the prevention and control of asthma. Methods A total of 100 children aged 0 to 3 years with recurrent wheezing were selected in this study from Child Respiratory Department in Guangdong Women and Children Hospital. According to body mass index (BMI),wheezing children were divided into non-overweight group (n=70) and overweight/obesity group (n=30). And 80 children aged 0 to 3 years without respiratory diseases were selected as control group and divided into non-overweight group (n=50) and overweight/obesity group(n=30) according to BMI. The tidal breathing parameters and flow-volume loop of infants in each group were recorded and compared. Results The values oftime to peak tidal expiratory flow as a proportion of expiratory time(TPTEF/TE),volume to peak expiratory flow as a proportion of exhaled volume(VPTEF/VE),inspiratory time/expiratory time(TI∶TE),tidal expiratory flow when 25% of tidal volune remain in the lung/peak tidal expiratory flow(25/PF) of the wheezing infants with non-overweight significantly decreased compared with the control group without wheezing (t=8.518,7.767,3.142,7.860,P<0.05),while peak tidal expiratory flow(PTEF),tidal expiratory flow when 75% of tidal volume remains in the lung(TEF75) increased (t=6.728,8.540,P<0.05). In the control group and the wheezing group,compared with the non-overweight infants,tidal volume/kg(VT/kg) of infants with overweight and obesity decreased (t=2.872,3.048,P<0.05). Conclusion Overweight and obesity have impacts on VT/kg of tidal lung function,but did not affect airway obstruction indicators.

Experience Exchange

Effect of early assisted physical exercise and active exercise on physical and neuropsychological development of preterm and/or low birth weight infants

CAI Chuan-lan, LI Rui, SHEN Ping, HU Xue-qin

2021, 29(4):  447-450.  DOI: 10.11852/zgetbjzz2020-1269

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Objective To explore the effect of early assisted physical exercise and active exercise on physical and neuropsychological development of premature infants and low weight infants,so as to provide evidence for its role in facilitating the development of premature infants and low weight infants. Methods A total of 218 premature infants and low weight infants with gestational age less than 36 weeks or birth weight lower than 2 500 g were enrolled in this study from Maternal and Child Health Hospital,Jin'an District. Infants were divided into different groups according to the frequency and duration of the passive and active motor training based on the willing of their parents. The Gesell Development Scale was used to evaluate the neuropsychological development of the study subjects,and the Gesell scores of the three groups were compared at the corrected age of 6 and 12 months. Results The higher frequency and duration of early assisted physical exercise and active motor training tended to significantly increase the physical measurements and intelligence development quotients of preterm/low weight infants at corrected age of 6 and 12 months (P< 0.05). Compared with the group with training frequency ≤1 d/week,preterm/low weight infants in the 2—3 d/week and ≥4 d/week groups had higher weight,length,and head circumference measurements and higher developmental quotients in the adaptive,gross motor,and fine motor energy areas at the corrected age of 6 and 12 months,except for the head circumference at corrected age 6 months (P<0.05). Compared with the preterm/low birth weight infants who took training for 0—2 months,those who took training for 5—6 months had higher weight and length measurements and higher developmental quotients in the adaptive,fine motor,and social behavioral domains at the corrected age of 6 and 12 months (P<0.05). Conclusion Early assisted physical exercise and active motor training can effectively promote the physical and neuropsychological development of premature infants and low weight infants.

Analysis of early intervention guided by the general movements assessment in very premature and extremely premature infants

WU Fu-rong, LIANG Shu-yi, GAN Ming-xia

2021, 29(4):  451-454.  DOI: 10.11852/zgetbjzz2020-1132

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Objective To explore the feasibility of early intervention using the general movements (GMs) assessment results as grouping guidance in very premature and extremely premature infants,in order to provide basis for clinic application. Methods From May 2016 to May 2019, 76 premature infants (51 very premature infants and 25 extremely premature infants) who received early intervention in the rehabilitation department of Xiamen Children's Hospital were enrolled in the study. Regular follow-up protocol was conducted to these infants. The gross motor developmental outcome was evaluated at corrected age of 12 months old. Results According to GMs results, 76 premature infants were divided into group A (high risk), group B (medium risk) and group C (low risk) for early intervention till corrected age of 12 months old. Altogether 16 cases (21.1%) had abnormal motor development outcomes, among whom there were 11 cases (14.5%) with cerebral palsy and 5 cases (6.6%) with motor development retardation. Conclusion It is feasible to apply GMs results to guide early intervention in grouping of very early and extremely premature infants, so as to reasonably allocate rehabilitation medical resources, indicating that GMs assessment can be further applied in clinical work.

Research on the combined predictors of refractory mycoplasma pneumonia in children

FU Shuai, QIN Xuan-guang

2021, 29(4):  455-457.  DOI: 10.11852/zgetbjzz2020-1536

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Objective To study the risk factors that can be used to distinguish children's refractory mycoplasma pneumonia (RMPP) from mycoplasma pneumonia (MPP),thus to determine the combined predictors for predicting RMPP,so as to provide basis for customizing accurate treatment and medication plan for RMPP children. Methods A total of 141 children with MPP admitted to Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 1st,2016 to December 31st,2018 were included,and clinical data and laboratory examination data were collected. The patients were divided into MPP group and RMPP group according to the therapeutic efficacy of the first 3 days. The risk factors related to RMPP were preliminarily screened out by univariate analysis,and a multivariate Logistic regression model was established and independent risk factors were selected through stepwise regression. Finally,the receiver operating characteristic curve (ROC) of combined factors was drawn for prediction efficiency analysis. Results There were 85 cases of MPP and 56 cases of RMPP among 141 children.Age,pleural effusion,cough duration,C-creactive protein (CRP),erythrocyte sedimentation rate (ESR),lymphocyte count (LY)and percentage of lymphocytes (LY%) were significantly different between MPP group and RMPP group (P<0.05). Pleural effusion,fever duration,cough duration,CRP and LY% finally entered the prediction model of RMPP,with AUC of 0.834(95%CI:0.768—0.900),Youden index of 0.522 at the maximum. And the sensitivity and specificity were 80.4% and 71.8%,respectively. Conclusion This study constructs a combined model for predicting RMPP with pleural effusion,fever duration,cough duration,CRP,LY%,which has clinical guiding significance for the predictive diagnosis of RMPP and the use of glucocorticoids.

Appropriate Technology

Study on the effect of sling exercise training on the walking ability of children with spastic diplegia cerebral palsy after selective posterior rhizotomy

ZHOU Wen-ying, FAN Tao-lin, HU Bi-nong, XU Long, DENG Ning, ZHANG Na, WANG Chun-hua, ZHANG Hong

2021, 29(4):  458-462.  DOI: 10.11852/zgetbjzz2020-1131

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Objective To analyze the effect of children's sling exercise training (SET) on walking ability in children with spastic diplegia cerebral palsy after selective posterior rhizotomy (SPR),in order to provide clinical basis for the rehabilitation of children with spastic diplegia cerebral palsy. Methods A total of 69 children with spastic diplegia cerebral palsy in Xiangya Boai Rehabilitation Hospital from May to December 2018 were enrolled in this study,and were randomly divided into control group(n＝35) and experiment group(n=34). The control group received routine rehabilitation training after SPR,while the experimental group was given SET additionally. Gross Motor Function Measurement E zone (GMFM-E),Gross Motor Function Classification System(GMFCS),10 m Maximum Walking Speed (10 mMWS) and walking parameter (step length and step width) were used to assess the gross motor function and classification,walking ability and the gait situation before the operation,1 month,3 months and 6 months after the operation. Results There were no significant differences on GMFM-E area,10m MWS,step length and step width scores between the two groups before operation and 1 month after treatment. The above indexes of two groups were all improved in 3 and 6 months after treatment(t_3月＝-2.727、-2.468、-2.595、2.597,t_6月＝-3.218、-3.479、-5.132、4.677,P<0.05).And the indexes of walking ability of the two group in 6 months of treatment were better than those in 1 month and 3 months of treatment. Additionally,improvement of walking ability in the experiment group was more significant than that in the control group (P＜0.05). The total rate of change in GMFCS of the experiment group (32.35%) was higher than that in the control group(14.29%). Conclusion Sling exercise training after SPR play a crucial role in improving the gross motor function,walking ability and gait performance of children with spastic diplegia cerebral palsy.