Chinese Journal of Child Health Care

Sleep nurturing care behaviors and children's health

WANG Hui-shan

2021, 29(5): 465-467. DOI: 10.11852/zgetbjzz2021-0497

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Early childhood is a process of rapid changes in sleep/wake patterns development.Inappropriate sleep nurturing care will lead to a high incidence of sleep problems in infants and young children.And sleep problems will have adverse effects on children's physical growth, cognitive development, emotional behavior and others.In order to improve the sleep quality and prevent sleep problems of infants and young children, it is suggested that health care workers should provide sleep health knowledge and predictive guidance for parents, guide the caregivers to adopt appropriate sleep nurturing care behaviors, and promote early childhood development.

Development and evaluation of the Chinese Infants Sleep Assessment Scales

FENG Wei-wei, PAN Xiao-ping, WANG Hui-shan, ZHANG Yue, JIN Xi, HUANG Xiao-na, XU Tao, ZHANG Tong, Provincial Working Group for Study on the Development of Chinese Infants and Todders Sleep Assessment Scales

2021, 29(5): 468-472. DOI: 10.11852/zgetbjzz2020-1376

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Objective To develop Chinese Infants Sleep Assessment Scales (ISAS) suitable for Chinese infants under the age of 1 year old, and to evaluate the reliability, validity and feasibility of the scales. Methods The scale was divided into two ages, 0—3 months and 4—11 months, according to the infants' sleep development characteristics.Firstly, an item pool with 4 dimensions of sleep rhythm, bedtime arrangement, night wakings and sleep disordered breathing was constructed.Then, the scales were compiled and evaluated through preliminary screening, modification, item analysis, validity analysis, reliability analysis and confirmatory factor analysis. Results The ISAS (0—3 months) and ISAS (4-11 months) both had 14 items, including 4 factors of sleep rhythm, bedtime arrangement, night wakings and sleep disordered breathing with total variance explained of 56.61% and 55.02%, respectively.The items of the two scales were slightly different.The item-level content validity of all items in both scales ranged from 0.83 to 1.00.The two scales were positively correlated with Brief Infant Sleep Questionnaires (BISQ) in terms of sleep latency, number of night wakings and sleep duration, with correlation coefficients of 0.31,0.41,0.39 and 0.32,0.66 and 0.38, respectively.There were statistically significant differences between community sample and clinical sample in the total scores of the two scales and most of the factors (except the sleep disordered breathing factors of the 0-3 months) (P<0.05).The Cronbach's α coefficients of the two scales were 0.681 and 0.673, and the test-retest reliability were 0.75 and 0.74. Conclusion The two scales have relatively stable factor structures and good reliability and validity, which can be used for early screening of infants' sleep problems.

Comparative analysis of the clinical features and sleep structures of obstructive sleep apnea-hypopnea syndrome in preschool-age and school-age children

XU Xue-yun, WANG Yu-qing, HAO Chuang-li, HE Yan-yu, GENG Ya-xuan, JIANG Yu-ting, LYU Meng, LU Min, HAN Jun, WANG Jing, DOU Xun-wu, ZHU Hui-e, YIN De-pei

2021, 29(5): 473-478. DOI: 10.11852/zgetbjzz2020-2071

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Objective To analyze the clinical features and sleep structure characteristics of obstructive sleep apnea-hypopnea syndrome (OSAHS) in preschool-age and school-age children, in order to provide evidence for sleep assessment and interventions of children. Methods A total of 123 children diagnosed with OSAHS through polysomnography(PSG) from December 2016 to November 2019 in the Department of Respiratory of Children's Hospital of Soochow University were enrolled in this study.Meanwhile, 313 children diagnosed with primary snoring(PS) during the same period were selected into the control group.According to their ages, children were divided into preschool age group and school age group.Clinical data and PSG results were collected. Results The night and day symptoms of OSAHS preschool-age and school-age children were more significant than those in the control group (P<0.05).The proportion of rapid eye movement (REM) stage in preschool children with OSAHS was significantly higher than that in control group (Z=2.467,P＜0.05).The total sleep time (TST) and sleep efficiency of school-age children with OSAHS were lower than those of preschool children with OSHAS (t=2.518, Z=1.527, P<0.05).The proportion of non-rapid eye movement 2(NREM 2) stage in school-age OSAHS children was higher than that in the control group, while the proportion of stage NREM 3 was lower in school-age OSAHS children (t=4.080, Z=1.832, P<0.05), and oxygen desaturation index(ODI) increased(Z=1.653, P<0.05).Apnea-hypopnea index (AHI) was positively correlated with the proportion of NREM 1 stage sleep in preschool children (r=0.217), and negatively correlated with the proportion of REM stage (r=-0.220).Body mass index (BMI) was negatively related to the proportion of NREM3 stage in school-age children (r=-0.429, P<0.05). Conclusions The clinical manifestations of children with OSAHS are different from those of PS children, and vary by age.The changes of sleep structure in school-age OSAHS children are more obvious than those in pre-school children.The changes of sleep structure in preschool-age and school-age OSAHS children are related to AHI and BMI, respectively.

Investigation on sleep problems and related factors in preschool children during home quarantine

WANG Pei-yao, LI Wen, HU Ya-bin, WANG Guang-hai, JIANG Fan, CHEN Jie

2021, 29(5): 479-483. DOI: 10.11852/zgetbjzz2021-0037

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Objective To investigate sleep problems and the associated factors among preschool children during home quarantine, so as to provide scientific basis for minimizing the impact of restricted activities and home isolation resulting from public health emergency on children's health. Methods An online survey was conducted from March 15th to 28th, 2020 among 16 094 children aged 3 to 6 years.The parents of children completed the Children's Sleep Habits Questionnaire (CSHQ), the Children Strengths and Difficulties Questionnaire (SDQ) (edition for parents).The data together with their demographic information were collected and analyzed. Results The prevalence of sleep problems (CSHQ score>41) was 76.8%, which was significantly correlated with socio-demographic factors including age, parents' education level, family structure and so on (χ²=66.98, 36.51, 11.01, P<0.05).After controlling for socio-demographic factors, children with more severe emotional/behavioral problems were at higher risk of sleep disturbance. Conclusions Sleep problems among preschoolers are common during home quarantine caused by public health emergency, and are associated with emotional/behavioral problems.Targeted interventions are needed to minimize the impact of restricted activities and home quarantine on children's health.

Detection of nutrition and immune factors in children with cerebral palsy and the effect of individualized nutritional intervention

WANG Jun, XU Wen-jing, LIU Bi-bo, ZHU Deng-na, XIONG Hua-chun, YUAN Jun-ying, ZHANG Yong

2021, 29(5): 484-487. DOI: 10.11852/zgetbjzz2020-1497

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Objective To evaluate the nutritional status of children with cerebral palsy by anthropometry,and to test the levels of humoral immune factors and analyze the correlation with nutritional status,so as to provide reference for clinical implementation of individualized nutrition services. Methods Children with cerebral palsy aged 1 to 5 years and hospitalized in the Department of Child Rehabilitation of the Third Affiliated Hospital of Zhengzhou University were selected as the study objects. The nutritional status of the children was evaluated by Z-score method,and the levels of humoral immune factors were measured. All children were given nutritional treatment intervention,and the improvement of nutritional indicators was detected after intervention. Results A total of 90 children with cerebral palsy were included for nutritional assessment and were given individualized nutrition intervention. The incidence of malnutrition was 53.3%(48/90),including 33.3% of low weight,54.2% of growth retardation,20.8% of weight loss and 16.7% of overweight or obesity. There were significant differences in weight,WAZ,IgG and IgM levels among children with mild,moderate and severe cerebral palsy (F=3.321,3.964,16.955,5.596, P<0.05). After intervention,the weight and WAZ were higher than those before intervention,and the difference was significant (t=2.236,2.280,P<0.05). Conclusions There is a high prevalence rate of malnutrition and nutritional diseases in children with cerebral palsy. The more serious the disease is,the worse the nutritional status is,and the lower the levels of humoral immune factors IgG and IgM will be. And individualized nutritional intervention plays a positive role in improving recent nutritional status of children with cerebral palsy.

Prospective cohort study on the relationship between sleep patterns and nighttime awakenings of infants aged 0 to 6 months old in Shunyi District

LIU Ya-jing, LIU Chao, CHEN Tong-ying

2021, 29(5): 488-491. DOI: 10.11852/zgetbjzz2020-1584

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Objective To examine infants sleep patterns in Shunyi District, in order to provide reference for giving early sleep guidance to parents. Methods The prospective cohort study enrolled 220 healthy infants from China Longitudinal Environmental, Genetic and Economic Cohort (CHALLENGE) in Shunyi District of Beijing, and the infants were followed up at the age of 42 days, 3 and 6 months old.The demographic data of infants were collected, and the Brief Infant Sleep Questionnaire (BISQ) was used to evaluate the sleep patterns and sleep disorders of infants. Results 0- to 6-month-old infants changed significantly in sleep duration time of day and night.The daytime sleep duration decreased significantly from (6.0±2.3)h on 42 days old to (3.8±1.5)h on 6 months old.Nocturnal sleep duration increased significantly from (6.9±2.2)h on 42 days old to(8.1±2.3)h on 6 months old.Multiple linear regression analysis showed nighttime awakenings of 42-day and 6-month-old infants were positively correlated with feeding asleep patterns (β=0.69,0.80,P<0.001). Conclusions The sleep patterns of infants changes significantly at 6 months old after birth, and the way of feeding asleep is significantly related to the number of nighttime awakenings.Parents should make appropriate response to reduce the occurrence of infant sleep problems.

Health-related quality of life in children with functional single ventricle

WANG Ting-ting, YE Xiu-xia, CHEN Wei-min, HE Yong-rui, QIN Rong, HONG Hai-fa

2021, 29(5): 492-496. DOI: 10.11852/zgetbjzz2020-2114

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Objective To investigate health-related quality of life (HRQOL) in pediatric patients with functional single ventricle (FSV), and to compare HRQOL between children with FSV and healthy pediatric population. Methods A cross-sectional survey was conducted to recruit 113 pediatric patients with FSV aged 2 to 18 years and their parents from 2002 to 2018 in Shanghai Children's Medical Center.Patients and their parents completed the Chinese version of the Pediatric Quality of Life Inventory (PedsQL) 4.0 generic core scales and 3.0 cardiac module.Independent t-test was used to compare generic PedsQL scores between patients with FSV and healthy population.Generic PedsQL scores for parent proxy-report by age group were compared by ANOVA.Kruskal-Wallis H test was used to compare HRQOL by age group in the cardiac module. Results By self-report and parent proxy-report, generic PedsQL scores for patients with FSV were significantly lower than healthy population in the total scores, physical, psychosocial, emotional, social and school domains (self-report:t=6.823, 7.850, 5.825, 4.260, 4.817, 7.621; parent proxy-report:t=7.641, 8.589, 6.459, 5.823, 6.206, 7.381, P＜0.05).The PedsQL scores in preschool patients with FSV were significantly lower (F=4.090, P＜0.05).In the cardiac module, patients ≥8 years old reported lower scores for physical appearance (H=8.812, P＜0.05).Self-report and parent proxy-report PedsQL scores for treatment anxiety were significantly lower in patients ≤ 8 years old (H=6.045, 14.702, P＜0.05). Conclusions Overall, pediatric patients with FSV perceive poorer quality of life than healthy population.Assessment and interventions on pediatric patients' HRQOL are needed.

Comparison of the effects of swaddle bathing and tub bathing on physiological parameters and stress of mid-late preterm infants during bathing

SUN Li, YANG Jing-hua, CHEN Ying, WU Qiong-qiong, CAO Yue-rong

2021, 29(5): 497-501. DOI: 10.11852/zgetbjzz2020-1591

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Objective To compare the effects of swaddle bathing and tub bathing on the physiological measurements and behavioral stress of mid-late preterm infants in neonatal intensive care unit (NICU), in order to provide reference for providing better care for preterm infants. Methods Totally 80 mid-late premature infants hospitalized in NICU in Jiangyin People's Hospital from April to September 2019 were enrolled in this prospective study.The participants were randomly assigned into control group (n=40) and experiment group (n=40).The control received conventional tub bathing, while the experiment group was given swaddled bathing with single layer of towel.The bath duration time, procedure and care were the same in the two groups.The physiological parameters of body temperature,heart rate (HR), respiration, SPO₂ and crying time before and after bath between the two groups were recorded and compared.Pre-bath and post-bath stress levels in both groups were compared by using the Newborn Infant Pain Scale (NIPS). Results Body temperature and SPO₂ value of the premature infants in experiment group just after the bath were significantly higher than those in control group (t=8.538, 3.180,P<0.05).Either HR or respiratory frequency in the control group was significantly higher than those in experiment group (t=6.335, 3.328,P<0.05).Crying time was significantly shorter in the experiment group than that in the control group [(17.45±4.91)s vs.(59.03±24.93)s, t=10.349, P<0.05).And NIPS scores of the premature infants in experiment group after bath decreased at a statistically significant level compared with the control group (0.98±0.92 vs.1.83±1.08,t=3.783, P<0.05). Conclusion Given the positive effect of swaddled bathing in maintaining physiological condition and reducing stress, it can be used as an appropriate bathing method in NICU.

Influence of adolescents' actual weight and perceived weight on their self-esteem

WANG Xiang-lan, LIU Jun, ZHONG Heng-heng, WU Yun-xing, WANG Qing, LUO Zi

2021, 29(5): 502-505. DOI: 10.11852/zgetbjzz2020-0820

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Objective To investigate the actual weight, perceived weight among adolescents, and to analyze its relationship with self-esteem, thus to provide reference for the development of mental and physical health. Methods A total of 1 534 adolescents from two middle schools in Shandong province were randomly selected as participants.A self-designed general information questionnaire and Self-Esteem Scale (SES) were used to survey the adolescents, and their height and weight of the adolescents were also measured.Kappa test, t test, analysis of variance and multiple linear regression analysis were used for statistical analysis. Results The detection rates of wasting, overweight and obesity of adolescents in this study were 9.1%, 12.7%, and 10.1%, respectively.There was a lack of consistency between the actual weight status of adolescents and their perceived weight status (Kappa=0.325, P＜0.001).Only 19.4% of obese adolescents correctly assessed their weight status, which were lower than the other three groups (P<0.001).And 41.3% of adolescents misidentified their actual weight status.Boys, the only child, good family economic condition and perceived school performance had positive effect on the youth self-esteem level (P<0.01).The perceived weight of adolescents, rather than the actual weight, was closely related to self-esteem.Adolescents with perceived obesity had lower self-esteem (P<0.001). Conclusions There is a lack of consistency between adolescents' actual weight status and their perceived weight status.Adolescents' perceived weight, rather than actual weight, is closely related to self-esteem.Schools and parents should consider how adolescents perceive their own obesity to improve their self-esteem and help them grow healthily and happily.

Application of melatonin in children's sleep research and its measurement methods

JIN Wei-qi, HAN Dong-mei, WANG Guang-hai, LI Gui-pu, JIANG Fan

2021, 29(5): 506-509. DOI: 10.11852/zgetbjzz2020-0707

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Melatonin is an indoleamine hormone with various physiological functions.In recent years,it has attracted much attention in evaluating circadian rhythm and improving sleep.Melatonin research in children has also gradually increased,but there is currently a lack of sensitive and accurate melanin detection methods.Therefore,this article mainly reviews the changes in melatonin's characteristics in early life,the application of children's sleep research,as well as the collection and detection methods,in order to provide a certain reference value for clinical treatment of sleep problems such as sleep rhythm disorders in children.

Sleep disorders in children with epilepsy

ZHAO Fen, WANG Guang-hai, WANG Ji-wen

2021, 29(5): 510-514. DOI: 10.11852/zgetbjzz2020-1867

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Epilepsy is a common neurological disease in children, caused by highly synchronized abnormal discharges of brain neurons and characterized by a persistent tendency to cause epilepsy.Pediatric epilepsy and sleep disorders can affect each other and form a vicious circle.However, clinicians pay insufficient attention to sleep disorders in children with epilepsy and lack effective diagnosis and treatment.Therefore, this article discusses the interaction between epilepsy and sleep in children, common sleep disorders in children with epilepsy, and assessment and treatment methods, hoping to provide references for early identification and comprehensive diagnosis and treatment of sleep disorders in children with epilepsy.

Research advances on pathogenesis and treatment of sleep disorders for children with cerebral palsy

ZHANG Yue-hua, YU Zhi-hua, KONG Mian

2021, 29(5): 515-517. DOI: 10.11852/zgetbjzz2020-0248

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Sleep disorders are increasingly prevalent in children.As one of the most common neurological diseases, children with cerebral palsy suffer serious and higher incidences of sleep disorders due to its persistent brain damage and comorbidities.It will seriously affect the growth and development of children with cerebral palsy and the rehabilitation effects.The mechanism of cerebral palsy with sleep disorders is not clear and there is no specific treatment.This review will focus on the epidemiological study, pathogenesis, diagnosis and treatment of sleep disorders in children with cerebral palsy.

Effects of disinfectants and the by-products on asthma in children

JIA Yuan-yuan, WU Cheng, WU Hua-jie, SUN Xin

2021, 29(5): 518-522. DOI: 10.11852/zgetbjzz2020-1265

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Asthma is the most common chronic respiratory disease in children.In recent years, the cumulative prevalence rate of asthma has been on the rise.There are many factors contributing to asthma, among which environmental factors play an important role.Children spend most of their time indoors, so the effects of exposure to disinfectants in indoor environments on childhood asthma deserve great attention.Recent studies have found that exposure to disinfectants and their by-products is associated with airway inflammation, symptoms of asthma and the onset of asthma.With the pandemic of novel coronavirus (COVID-19) pneumonia, disinfection has become a crucial part of prevention and control, and the consumption of disinfectants has been increasing significantly.Therefore, this review summarizes the effects of disinfectants and their products on childhood asthma, discusses the possible pathogenesis, and puts forward suggestions on the rational use of disinfectants according to the current situation, thereby helping control childhood asthma.

Research progress on the association between vitamin A and neonatal respiratory diseases

LI Qian-qian, JIANG Hong

2021, 29(5): 523-526. DOI: 10.11852/zgetbjzz2020-1454

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Vitamin A is a fat-soluble vitamin that participates in a wide range of physiological processes, such as embryonic development, visual development, cell differentiation and proliferation.Retinoic acid (RA) is the main active form of vitamin A, which regulates the development of multiple organs.Sufficient vitamin A is needed during early lung development.Chronic vitamin A deficiency is related to the histopathological changes of the lungs, which can disrupt normal lung physiology, leading to severe respiratory diseases.This review mainly summarizes the relationship between vitamin A and neonatal respiratory diseases, thus to provide guidance for clinical treatment.

CiteSpace-based visualization analysis of the researches on the first 1 000 days of early life in China

YANG Yu-cheng, HONG Qian, ZHOU Rong-Jun, DENG Yu-chen, DUAN Shu-pei, WANG Yan-hong

2021, 29(5): 527-531. DOI: 10.11852/zgetbjzz2020-0698

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Objective To understand the research status of the first 1 000 days of early life in China, and to grasp the research hotspots and frontiers in this field, so as to provide reference for further researches in the future. Method Relevant literature on the first 1 000 days of early life in the CNKI full-text database from 1993 to 2018 was retrieved, and CiteSpace was used to draw a scientific knowledge map for visual analysis. Results The number of articles published in the field of researches on the first 1 000 days of early life in China showed an overall upward trend.There were few research authors and simple cooperative relations, and HONG Jian-guo had the most publications.The distribution of research institutions was scattered, and there was a lack of academic communications and cooperation between research institutions.Publications on the first 1 000 days in life from Chongqing Medical University and the Affiliated Institutions were the most.Terms including "early life" and "malnutrition" were the research hotspots in this field, "insulin resistance", "nutrition", "malnutrition", "children" and "famine" were the research frontiers in this field.Finally the timeline chart on the development process of this field can be divided into 1993—2005, 2006—2012, 2013—2018 three stages by combining the keyword co-occurrence map with clustering. Conclusions Researches on the first 1 000 days of early life in China is booming, but the research strength is weak.It is recommended to strengthen the input of scientific researchers and academic cooperation among different institutions.And related researches on malnutrition in early life need to be further developed.

Demand,utilization and supply of early childhood education and care service for children aged 0 to 3 years in Shanghai

ZHANG Hai-feng, HUANG Ying, TONG Lian, QIAN Xu

2021, 29(5): 532-536. DOI: 10.11852/zgetbjzz2020-1630

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Objective To clarify the demand, utilization and supply of early childhood education and care (ECEC) services for children aged 0 to 3 years in Shanghai, in order to provide evidence for giving related suggestions. Methods Departments of Children Health Care in community in health care centers of Shanghai were selected by stratified multi-stage sampling method.The outpatient doctors asked parents of children aged 0 to 3 years who came to the clinic to fill out an online questionnaire.A total of 2 101 parents of children aged 0 to 3 years were recruited and completed the questionnaire survey. Results The demand rate of ECEC services for children aged 0 to 3 years in Shanghai was 44.5% (750/1 686).Over 90% of families preferred to community-based ECEC service and early education services offered by ECEC institutions.And 61.8% (463/750) of families had a maximum affordable cost ≤3 000 yuan per month.The utilization rate of ECEC services for children aged 0 to 3 years in Shanghai was 19.8%.There were 737 institutions in Shanghai that could provide ECEC services, including 204 institutions with notification of ECEC services, 496 kindergartens offered ECEC service for children under 3 years old, and 37 nurseries.Only 21.4% (89/415) of parents reported monthly fee of ECEC institutions ≤3 000 yuan, and 72.8%(89/415) of parents reported fee between 3 001—7 000 yuan per month.The finding showed that the mean fee for the institutions obtained official permission of establishment was 7 536 yuan per month, and only 27.6% of those kind institutions charged ≤3 000 yuan a month per month. Conclusions The utilization and supply of ECEC services have been increased by offering various forms of services in Shanghai.However, the gap still exists between demand and supply, and the cost of ECEC services is higher than what parents expected, suggesting that developing assessable community-based and affordable services may increase the effective supply of ECEC in Shanghai.

Evaluation of overweight, obesity by different methods and analysis differences on body composition among children and adolescents in new urban area of Urumqi

YANG Yan, ZHANG Lu-lu, JIAZILA· Ai-shan-jiang, GUO Ni -ya, ZHENG Lan, CAI Wen-ping

2021, 29(5): 537-541. DOI: 10.11852/zgetbjzz2020-0379

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Objective To explore the developmental regularity and characteristics of body composition of children and adolescents aged 6~15 years in Urumqi, and to analyze its difference among normal, overweight and obese in children and adolescents, so as to explore the difference on evaluating obesity between body mass index(BMI) and body fat, in order to early detection of overweight and obesity in children and provide basis for developing improvement measures. Methods A total of 907 children and teenagers in Urumqi were enrolled in this study in January 2019.All body composition indicators were tested by body composition analyzer, and BMI-Z score was calculated.Overweight and obesity assessment referred to WS/t586-2018. Results Except for the body fat rate of boys, the body composition indexes of boys and girls had linear trends with age (P<0.05).BMI-Z scores of boys in different age groups were significantly higher than those of girls (P<0.05).Body fat percentage (BFP) in boys increased firstly and then decreased with age, while BFP in girls increased with age, and outpaced boys at the age of 11 years old.The overweight rate and obesity rate assessed by BMI and PBF were 11.5% and 9.0%, 14.1% and 20.5%, respectively.Among children with normal BMI, 7.6% and 3.1% were assessed as overweight and obesity by BFP.And 49.5% of children in BMI overweight group were assessed as obesity by BFP.The body composition indexes were significantly higher in overweight and obesity group than those in normal group (P<0.05). Conclusions The body composition of children and adolescents increases with age and has gender differences.The rate of overweight and obesity is slightly different by different methods, indicating that BMI is likely to underestimate the BFP of obese children.

Study on the relationship between children's physical fitness evaluation and coordination disorder evaluation index

CHEN Yan-jie, WANG Huan, LIANG Ai-min

2021, 29(5): 542-544. DOI: 10.11852/zgetbjzz2020-1433

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Objective To analyze the correlation between the national physique evaluation and the indicators of children's coordination disorder in 3- to 6-year-old children in Beijing, so as to provide theoretical basis for further screening of developmental coordination disorders(DCD) in nurseries and kindergartens. Methods From March to April 2019, 253 children aged 3 to 6 years in three kindergartens in Beijing were selected into this study.The Children's Motor Coordination Ability Assessment Scale (Second Edition) (MABC-2) was used to evaluate the prevalence of children's DCD.Children's physical fitness was evaluated by using the early childhood section of the National Physical Fitness Measurement Standards Manual as the standard.Multiple linear regression method was used to analyze the relationship between children's physical fitness and DCD. Results Some indexes in the evaluation of 3- to 6-year-old children's physical fitness had certain correlation with the prevalence of DCD (P<0.05).The total score on physical fitness of DCD children was lower than that of non DCD children.For 3-to 6-year-old children, the risk of DCD decreased when the items of jumping on both feet and the tennis throw scored higher(OR=0.501, 0.507, P＜0.05). Conclusions There is a correlation between physical fitness scores and DCD in children aged 3—6 years.Physical fitness tests may play a supplementary role in screening children with DCD, and further studies with larger samples are warranted.

Correlation of leukotriene C4 synthase gene polymorphism with susceptibility and efficacy of respiratory syncytial virus bronchiolitis

DONG Ming-ying, TAO Bing-tong

2021, 29(5): 545-549. DOI: 10.11852/zgetbjzz2020-1972

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Objective To investigate the relationship between polymorphism of leukotriene C4 synthase (LTC4S) gene rs730012 and susceptibility of respiratory syncytial virus (RSV) bronchiolitis and the efficacy of montelukast sodium. Methods A total of 120 children diagnosed with RSV bronchiolitis in Nanyang Second General Hospital were selected as case group,and 80 healthy children were selected as control group. Genotypes of LTC4S rs730012 in two groups were detected. The case group was treated with Montelulast sodium orally for 2 weeks based on the routine treatment. The differences in clinical manifestations of children in the case group with different genotypes were analyzed,and the changes in serum cysteamine leukotriene (CysLTs),urinary leukotriene E4(LTE4),eosinophi cationic protein (ECP) levels and moisture respiratory pulmonary function parameters were detected before and after treatment. Results The distribution of genotype and allele frequency of LTC4S rs730012 showed no significant difference between the case group and control group (χ²=0.797,0.624,P>0.05). After treatment,the clinical symptom score after one week,the duration of cough,breathing and wheezing and the hospitalization days in AC/CC group were significantly lower than those in AA group(t=3.552,2.284,3.446,2.716,2.871,P<0.05).After one week of treatment,the levels of serum CysLTs,urine LTE4 and ECP in the AC/CC group were significantly lower than those in AA group(t=4.653,5.917,9.933,P<0.001).Additionally, the lung function indexes like tidal volume,TPTEE/TE and VPEE/VE were also significantly higher than those of AA group(t=2.090,2.104,2.312,P<0.05). Conclusions There was no correlation between LTC4S gene polymorphism and susceptibility in children with RSV bronchiolitis,but it may be related to the efficacy of montelulast sodium. The efficacy of RSV children with AC/CC genotype is relatively better than that of RSV children with AA genotype.

Analysis of monitoring neonatal jaundice detected by smartphone image-based bilirubin

HAN Mei, ZHU Shang-pin, TONG Shi, QIU Su-hong, GONG Li, GAO Xiang-yu

2021, 29(5): 550-554. DOI: 10.11852/zgetbjzz2020-1229

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Objective To evaluate the clinical application value of image-based bilirubin (IBB) detection of neonatal jaundice by smartphones. Methods The neonates with jaundice and birth weight > 2 500 g and without phototherapy were selected from the Neonatology Department of Suining County People's Hospital from December 2019 to April 2020.The total serum bilirubin (TSB), transcutaneous bilirubin (TcB) and IBB of infants were tested simultaneously.TSB and IBB were re-tested at the end of phototherapy and in 24 hours.The glabella of forehead was selected as detection sites of TcB and IBB.Sex, age, gestational age, birth weight, TSB and the mean value of three consecutive tests of TcB and IBB were recorded.The t test, paired t test, Pearson's correlation analysis and Bland-Altman plots consistency analysis were used. Results A total of 86 neonates were enrolled, including 46 males and 40 females.The median age was 7 days, the gestational age was (37.7±1.2) weeks, the birth weight was (3 197±396) g, and 57 cases were treated with blue light.Compared with TSB, the accuracy of IBB was similar to that of TcB [(0.32±1.11) mg/dl vs.(0.19±1.08) mg/dl, t=0.740, P=0.461].The accuracy of IBB and TcB in the subgroup with age ≤ 2 days was worse than that in the subgroup with age ＞ 2 days (t=-4.258,-3.617, P＜0.05).There was a good correlation (r=0.973) and a strong consistency (95.3% of the samples fell within the 95% consistency interval) between IBB and TSB.The accuracy of IBB at 0 hour after phototherapy was significantly inferior to that of IBB at 24 hours after phototherapy (t=-6.311, P＜0.001), and there is a moderate correlation (r=0.750) and poor consistency (only 91.2% of the samples fall within the 95% consistency interval) between IBB and TSB.At 24 hours after phototherapy, the correlation between IBB and TSB was still moderate (r=0.724), and the consistency improved (94.7% of the samples fell within the 95% consistency interval) between IBB and TSB. Conclusions The accuracy of IBB is similar to that of TcB, and there is a good correlation and a strong consistency between IBB and TcB.IBB is suitable for newborns with birth weight >2 500 g.It is a simple, quick and relatively accurate way to monitor neonatal jaundice dynamically at home after the mother is discharged from the hospital 2-3 days after delivery.

Association between serum 25(OH)D level in cord blood and respiratory distress syndrome among preterm neonates

ZHANG Cheng-qiang, LU Cheng-qiu, QIAN Bei-qian, ZHANG Bin, WANG Ji-mei

2021, 29(5): 555-559. DOI: 10.11852/zgetbjzz2020-1570

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Objective To investigate the relationship between serum 25 hydroxy vitamin D [25(OH) D] level and respiratory distress syndrome (RDS) in preterm infants,in order to provide new ideas for clinical prevention of RDS. Methods A total of 179 preterm infants admitted to NICU, Obstetrics and Gynecology Hospital Affiliated to Fudan University from March 2018 to May 2020 were included in the analysis.Cord blood was collected at birth, and the serum 25(OH)D level in cord blood was determined by chemiluminescent microparticle immunoassay.The infants were divided into RDS group and control group according to the diagnosis of RDS.According to whether serum 25(OH)D level was lower than 20 ng/ml, the infants were divided into vitamin D reduction group and normal group.The differences on the influencing factors between the two groups were analyzed and compared. Results Among all preterm infants, 25.1% were deficient in 25(OH)D level (<10 ng /ml), 42.5% were deficient (10—<20 ng/ml), and 32.4% were normal (≥20 ng/ml).The level of 25(OH)D in cord blood of RDS group [(11.3±7.2) ng/ml] was significantly lower than that of the control group [(15.88±8.4) nmol/L, t=3.469, P<0.01)].The prevalence of 25(OH)D decrease in RDS group was 89.0% (121/136), which was significantly higher than that in control group [46.5% (20/43), χ²= 35.221, P <0.01)].Multivariate analysis result indicated that gestational age and decreasing serum 25(OH)D level in cord blood were independent risk factors for RDS in preterm infants(OR=39.694, 5.696, P＜0.05). Conclusion The prevalence of vitamin D deficiency in preterm infants is high, and it may increase the incidences of RDS.

Observation on the curative effect of personalized comprehensive intervention on feeding difficulties of premature infants

PEI Ya, YANG Zhao-hui, WANG Shuang, WU Yi-pin

2021, 29(5): 560-564. DOI: 10.11852/zgetbjzz2020-1337

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Objective To observe the effect of personalized comprehensive intervention on feeding difficulties in premature infants, so as to provide evidence for effective intervention. Methods A total of 106 premature infants with feeding difficulties admitted to the Department of Neonatal Medicine, Affiliated Union Hospital, Tongji Medical College of Huazhong University of Science and Technology from January 2015 to June 2019, were enrolled in this study.And the infants were divided into control group (n=52) and observation group (n=54) according to whether personalized comprehensive intervention was performed.Both groups received non-nutritive sucking training, while the observation group received personalized comprehensive intervention additionally.The duration of oral transition feeding, the Prepare Infant Oral Feeding Readiness Assessment (PIOFRA) score on the third and the 7th day after treatment, and the number of cases reaching 30 points on the 7th day of treatment were compared between the two groups. Results After treatment, the duration of oral transitional feeding in the observation group was shorter than that in the control group (t=11.282).The PIOFRA score of the observation group was higher than that of the control group on the third day 3 and the 7th day (t=9.561, 9.617).And the number of cases with PIOFRA score ＞30 points on the 7th day after treatment in the observation group was significantly more than that in the control group(χ²=5.270,P＜0.05). Conclusions Personalized comprehensive interventions for preterm infants with feeding difficulties can effectively shorten the duration for oral transitional feeding, improve the ability of preterm infants to prepare oral feeding faster, and reduce the risk of malnutrition.

Effect of prolonging mother-infant skin-contact time on breastfeeding

YANG Jing, WEI Na, LIU Xiao-ya, ZHAO Dian, XU Yin

2021, 29(5): 565-568. DOI: 10.11852/zgetbjzz2020-1294

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Objective To explore the influence of mother-infant skin-contact time on breastfeeding at discharge, 1 month or 3 months after delivery, in order to facilitate implementation of newborn safety project in pilot hospitals in Guizhou. Methods A total of 368 pregnant women were selected from pilot hospitals in the designated areas (Guizhou Province) of WHO/China CDC newborn safety project, and were divided into four groups according to mother-infant skin-contact time[＜30 min(n=49), 30-<60 min(n=59), 60-<90 min(n=54), ≥90 min(n=206)].The exclusive breastfeeding rate, difficulty of breastfeeding and long-term breastfeeding risk of the four groups were analyzed. Results There was no statistical difference in the exclusive breastfeeding rate among the four groups (χ²=2.026, P>0.05),but the rate of exclusive breastfeeding in the group of mother-infant skin-contact time ≥90 min was significantly higher than that in the three groups in the first month after delivery(χ²=8.755, P＜0.05).With the increasing time of mother-infant skin-contact time, the rate of moderate/severe difficulty of breastfeeding was significantly reduced, while the mild difficulty of breastfeeding significantly increased(χ²=19.627, P＜0.001) .In 3 months after birth, with the increasing of mother-infant skin-contact time, the scores of maternal and infant satisfaction and lifestyle, as well as the total score of Maternal Breastfeeding Evaluation Scale(MBFES) significantly increased(F=9.758,15.201,9.025,16.360, P<0.001). Conclusion Prolonging mother-infant skin-contact time is helpful to improve the key link of breastfeeding, the rate of exclusive breastfeeding and the long-term outcome of breastfeeding.

Analysis of the characteristics and risk factors of bronchial asthma in 142 preschool children

LIU Li, XIAN Rong-hua, SHEN Yu-hui, ZHANG Yuan, ZHANG Hong

2021, 29(5): 569-572. DOI: 10.11852/zgetbjzz2020-1434

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Objective To analyze the characteristics and risk factors of bronchial asthma in 142 preschool children, in order to provide reference for preventing asthma. Methods A total of 142 preschool children with bronchial asthma hospitalized in Nanchong Central Hospital from January 2018 to December 2019 were selected as case group.Meanwhile, 142 non-asthmatic hospitalized children in the respiratory department, who were matched by gender and sex, were selected as control group.The basic information of the surveyed objects was obtained by questionnaire survey.And the risk factors for bronchial asthma were analyzed by Logistic regression analysis. Results There were 83 males and 59 females in the case group, of whom 129 were caused by respiratory tract infection, including 46 cases of mycoplasma, 37 cases of respiratory syncytial virus, 33 cases of influenza virus, 14 cases of adenovirus and 5 cases of parainfluenza virus.Univariate analysis showed that gestational age ≥37 weeks (OR=0.792, 95%CI:0.357-0.948), exclusive breastfeeding within 6 months old (OR=0.320, 95% CI:0.107-0.479) were the protective factors for the onset of bronchial asthma in preschool children, while the risk factors included family history of allergic disease (OR=1.513, 95% CI:1.206-1.742) and allergic rhinitis (OR=1.304, 95% CI:1.182-1.549), history of food allergy (OR=1.815, 95% CI:1.492-2.203), family decoration within one year (OR=1.328, 95% CI:1.102-1.591), family members smoking (OR=2.115, 95% CI:1.628-2.499), long-term contact with fluffy or foam products (OR=1.480, 95% CI:1.173-1.772), school or family near the main road (OR=1.815, 95% CI:1.692-2.203) were the risk factors (P<0.05). Conclusion Bronchial asthma in preschool children is mostly caused by respiratory tract infections and is mainly influenced by factors such as gestational age at birth and family history of allergies, which can be intervened targetedly to reduce the incidence of bronchial asthma in preschool children.

Effects of oral muscle training on language development and salivation in children with cerebral palsy

ZHANG Jing, TAN Li-jin, HUANG Mei-mao

2021, 29(5): 573-577. DOI: 10.11852/zgetbjzz2020-0951

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Objective To observe the effects of oral muscle exercise training combined with comprehensive rehabilitation training on the language development and salivation of children with cerebral palsy, so as to provide reference for the rehabilitation training of children with cerebral palsy. Methods A total of 62 children with cerebral palsy who received treatment in Liuzhou Maternal and Child Health Hospital from August 2018 to December 2019 were selected as the study subjects.According to the random number table method, the participants were divided into study group and control group, with 31 cases in each group.The control group was given comprehensive rehabilitation training, while the intervention group received oral muscle exercise training additionally. The language development, salivation grading and swallowing function of all children were analyzed and compared before treatment, after 1 course of treatment and 2 courses of treatment.And the clinical effect after treatment was compared. Results Before treatment, there were no significant differences in language development scores, articulation and speech development scores, salivation grading and swallowing function scores between study group and control groups (P＞0.05).After 1 and 2 courses of treatment, the assessment score of language development and articulation development obviously improved in both groups, the swallowing function score in both groups was significantly decreased, the proportion of mild salivate cases significantly increased.Moreover, the clinical efficacy(χ²=7.381, 7.123), language development(t=5.624, 4.361) and articulation development(t=4.911, 4.202), swallowing function(t=8.493, 6.262) of the study group were significantly better than those in control group after 1 and 2 courses of treatment, and the proportion of mild salivate cases was significantly higher in study group(H=4.381, 7.715, P＜0.05). Conclusion Oral muscle exercise training combined with comprehensive rehabilitation training in children with cerebral palsy can effectively improve the clinical efficacy, improve language development, salivation status and swallowing function, and is worthy of clinical popularization.

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