Table of Content

10 July 2021, Volume 29 Issue 7

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Professional Forum

Genome editing and inherited metabolic disease

LUO Xiao-ping, YING Yan-qin

2021, 29(7):  697-700.  DOI: 10.11852/zgetbjzz2021-0965

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With the development and popularization of the newborn screening and second-generation sequencing techniques, more and more patients with inherited disorders were diagnosed in their early stage. For such patients, the treatment is quite limited. However, the gene therapy has been proved to be a great option to correct the mutation directly via transferring DNA to their cells. Gene editing techniques have advantages and disadvantages in their application, and related ethical issues should be strictly followed.

Original Articles

Research on the correlation among vitamin D,bone morphogenetic protein-2 and osteoblast function in growth hormone deficiency children

YI Xiao-qing, HAN Tian-tian, LIU Hong-hong, WANG Si-si, ZHANG Rong, WANG Ai-rong, XIAO Yan-feng

2021, 29(7):  701-704.  DOI: 10.11852/zgetbjzz2020-1685

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Objective To clarify the correlation among vitamin D,bone morphogenetic protein-2(BMP-2) and osteoblast function in children with growth hormone deficiency(GHD),in order to provide theoretical reference for the complementary treatment of short stature in children. Methods A total of 83 GHD children and 40 normal children admitted in the Pediatrics Department of the Second Affiliated Hospital of Xi'an Jiaotong University from March 2012 to March 2013 were enrolled in this study. According to the Tanner staging and age,GHD children were divided into 2 sub-groups,prepuberty group and puberty group. Their body height,body height standard deviation (HtSDS),bone age were measured. Serum levels of 25(OH)D₃,BMP-2,osteocalcin (OC) and procollagen Ⅰ N-terminal propeptide (PINP) were tested by enzyme linked immunosorbent assay (ELISA) in GHD children,and the results were compared with healthy control. The relationship among 25(OH)D₃,BMP-2,OC,PINP,GH,HtSDS,the difference between bone age and age were analyzed by Pearson correlation analysis. Results The prepubertal GHD and the pubertal GHD children had significant lower levels of 25(OH)D₃,BMP-2,OC and PINP than the controls(t=4.282,7.162,3.940,4.832,P＜0.05). It was significant in the correlation between 25(OH)D₃ and bone formation markers (OC,PINP,BMP-2 and GH) in GHD children (r=0.481,0.473,0.324,0.545, P＜0.05),as well as the correlation between BMP-2and bone formation markers (OC,PINP and GH) in GHD children(r=0.322,0.415,0.619, P＜0.05).But the correlation among 25(OH)D₃,BMP-2 and HtSDS and the difference betweenbone age and age were not significant in GHD children(P＞0.05). Conclusions Bone formation in GHD children is lower than healthy controls. The low levels of osteogenic markers in GHD children,like OC and PINP,are related to its low vitamin D and BMP-2 levels. The low level of GH has an impact on the levels of vitamin D and BMP-2.

Effects of growth rate during infancy and childhood on glucose and lipid metabolism at 6 years old

LI Nan, ZHANG Shuang, LIU Hui-kun, ZHANG Tao, QIAO Yi-juan, LENG Jun-hong

2021, 29(7):  705-709.  DOI: 10.11852/zgetbjzz2020-1087

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Objective To assess the impact of rapid growth during infancy or childhood on serum levels of glucose and lipids at the age of 6 years old,to provide theoretical basis for the effective prevention of metabolic disease in childhood and adulthood. Methods From March 1st, 2017 to June 30th, 2018, a total of 9 719 children aged six years in senior class of 50 municipal kindergartens in Tianjin were selected by a cross-sectional survey. Body weight, height, serum levels of glucose, total cholesterol and triglycerides were measured. The anthropometry data at birth and at 1 year old was retrospectively collected. Rapid growth was defined as standard deviation higher than 0.67 of weight gain from two measurements. Then the correlations of rapid growth at 0- to 2-year-old, 2-to 5-year-old with blood glucose and lipids levels were analyzed. Results Compared with children with non-rapid growth, children with rapid growth during infancy (from birth up to 2 years old) and childhood (2 to 5 years old) had higher serum levels of glucose [(4.78±0.45)mmol/L vs. (4.66±0.51)mmol/L] and triglycerides [(0.96±0.44)mmol/L vs. (0.83±0.34)mmol/L] at 6 years old (P<0.05). Logistics regression analysis indicated that children with rapid growth during infancy(OR=1.343, 95%CI: 1.040—1.733) and childhood(OR=2.697, 95%CI: 2.038—3.570) increased the risk for higher level of triglycerides(P<0.05). Conclusions Rapid growth in early childhood is associated with both serum glucose and lipids levels at 6 years old. Thus appropriate weight gain should be emphasized to children.

Survey on the levels of arm circumference and arm-to-height ratio of children under 7 years old in Nanjing

DA Li, BAO Ye-lin, LI Lu, TONG Mei-ling, ZHANG Min, CHEN Ling

2021, 29(7):  710-712.  DOI: 10.11852/zgetbjzz2019-0660

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Objective To analyze the levels of arm circumference and arm-to-height ratio (AHtR) of children under 7 years old in Nanjing in 2015,and to discuss the significance of arm circumference and AHtR in children's growth and development. Methods A total of 8 682 children under 7 years old was enrolled in this study by using stratified random cluster sampling method. Children were divided into 21 groups by age for both males and females. The arm circumference was measured and the correlation with physical development indexes was analyzed. Results The growth rate of arm circumference was faster between 1 and 3 months old,and slower after 3 months old. The mean arm circumference of boys in different age groups was larger than that of girls,among which the arm circumference of boys was significantly different with that of girls in 1 month—,3—21 months,2—<2.5 years old,3—<4.5 years old and 5.5—<7 years old groups(P<0.05).The AHtR increased with age in the first 3 months,and then decreased. The average AHtR of children from 1 month to 3 years old was 0.169—0.237 for boys and 0.169—0.230 for girls. The P₅₀ value of AHtR of children from 3 to 7 years old was 0.150—0.160 for boys and 0.140—0.160 for girls. The arm circumference was positively correlated with body weight,but not associated with body mass index (BMI). Conclusions There were age and sex differences in arm circumference,age differences in AHtR in children under 7 years old in Nanjing.Additionally,arm circumference is related to body weight.

Analysis of body composition of children with different genders, ages and nutritional status

SU Yue-yue, WANG Hong, LI Qing, ZHANG Xiao-qiong, QIU Ming-hui

2021, 29(7):  713-716.  DOI: 10.11852/zgetbjzz2020-1286

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Objective To analyze the differences in body composition of children with different genders,age and nutritional status,so as to provide basis for children's health evaluation. Methods A total of 1 185 children aged 3 to 8 years who took physical examination in Shenzhen Maternal ＆ Child Healthcare Hospital from January to December 2019 were enrolled in this study. All participants were measured for height and weight,and multi-frequency bioelectrical impedance analysis (MF-BIA) was used to measure body composition indicators. The correlations among gender,age and nutritional status with children's body composition were analyzed. Results The weight,body mass index(BMI),fat-free mass(FFM),total body water(TBW) and basal metabolic rate(BMR) of boys were higher than those of girls,while PBF was lower in girls (t=2.94,5.05,5.21,4.67,2.88,5.27,P<0.05). The height and body fat (BF) changed little between different boys and girls,and the difference was not statistically significant (P>0.05). BF,FFM of boys and girls all increased with age,while BMI decreased with age firstly but turned to an increasing trend from 6—years old (P<0.05). The age of adiposity rebound (AR) in children was about 5 years old. BF,PBF and FFM of boys and girls all gradually increased with the increasing of BMI (boys:F=33.28、29.81、33.02;girls:F=28.57、13.38、24.55,P<0.05). There was a high consistency between PBF and BMI in the evaluation of overweight and obesity in children (χ²=143.28、99.02,P<0.05),but the detection rate of overweight and obesity in PBF was higher (P<0.05). Conclusions There are obvious differences in body composition among children with different genders,age and nutritional status. Body composition has a good early warning effect on the occurrence of overweight and obesity in children,and is a beneficial supplement to the health evaluation of children.

Correlation between gestational diabetes mellitus exposure and offspring obesity

JIA Zhao-xia, ZHAO Yong-xian, HUANG Li-li, WANG Jun-hua, WANG Zhao, WU Ming-hui

2021, 29(7):  717-720.  DOI: 10.11852/zgetbjzz2020-1060

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Objective To investigate the risk of overweight/obesity during 3 years old in children exposed to gestational diabetes mellitus (GDM), in order to provide scientific basis for prevention of childhood obesity. Methods Totally 2 275 eligible children were enrolled in this prospective cohort study from September 2014 to August 2015 in 16 communities of Beijing, and were followed up to 3 years old. Their height and weight were measured at each regular physical examination. Results The body mass index(BMI) of children exposed to GDM was higher than that in the non-exposure group at 1, 2 and 3 years old, but the differences were not significant (P>0.05). The factors that increased the risk of children being overweight and obese within 1 year old included macrosomia (OR=2.01, 95%CI:1.40—2.89), mother with high BMI before pregnancy (OR=1.09, 95%CI:1.06—1.13) and excessive weight gain during pregnancy (OR=1.01, 95%CI:0.99—1.03), while high family income was a protective factor(OR=0.83, 95%CI:0.71—0.98). The factors increasing the risk of children being overweight and obese within 2 years old were macrosomia (OR=1.66, 95%CI:1.07—2.58), mother with high BMI before pregnancy(OR=1.14, 95%CI:1.09—1.18) and excessive weight gain during pregnancy(OR=1.02, 95%CI:1.00—1.04), while factors decreased the risk included higher level of family incomes (OR=0.61, 95%CI:0.49—0.75) and exclusive breastfeeding for 6 months (OR=0.61, 95%CI:0.45—0.84). Factors increasing the risk of children being overweight and obese within 3 years old were macrosomia (OR=1.89, 95%CI:1.23—2.91) and mother with high BMI before pregnancy (OR=1.14, 95%CI:1.09—1.18),while high family incomes (OR=0.66, 95%CI: 0.54—0.81) and exclusive breastfeeding for 6 months (OR=0.55, 95%CI:0.40—0.75) were protective factors for overweight and obese within 3 years old. Conclusion In order to reduce the overweight and obesity of children within 3 years old, the weight of pregnant women before and during pregnancy should be strictly controlled, and exclusive breastfeeding should be adhered to 6 months old as much as possible.

Epidemiological investigation on the detection rate of childhood obesity under 7 years old in Nanjing from 1986 to 2016

YANG Lei, HUANG Fang-yan, CHEN Yi-qing, TONG Mei-ling, CHI Xia, ZHANG Min

2021, 29(7):  721-725.  DOI: 10.11852/zgetbjzz2020-1190

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Objective To obtain the epidemiological characteristics of childhood obesity in Nanjing by analyzing the data of childhood obesity under 7 years old in the previous study "Physical Development survey of children under 7 years old in Nine Chinese cities". Methods In 1986, 1996, 2006 and 2016, the stratified cluster random sampling method was adopted to select 10 000 children under 7 years old from Qinhuai District and Jiangning District of Nanjing, and physical data were collected to calculate the detection rate of obesity and overweight in different age groups and genders in previous surveys. Results 1) The detection rate of obesity was 0.308% in 1986, 1.76% in 1996, 4.83% in 2006 and 4.42% in 2016.The detection rate of obesity in 2006 was the highest, which was slightly lower in 2016. 2) In 1996, 2006 and 2016, the detection rate of obesity in children under 7 years old showed a trend of first decreasing and then gradually increasing with the increase of age. The detection rate of obesity in 1-year-old and 2-year-old children was lowest, which gradually increased with age from 3 years old. 3) In 2016, the overall detection rate of overweight among children under 7 years old and the detection rate in children at all age groups were all higher than that in 2006. 4) In 2006 and 2016, the overall detection rate of obesity in boys under 7 years old was higher than that of girls. Conclusion Childhood obesity is still a major problem in children's health, and the intervention of childhood obesity is a long-term and arduous work.

Study on the correlation among large muscle group movement development, children's growth and development and perception of movement ability

LIU Wen-jing, LI Dong-mei, SUN Yue-hong, ZHAO Xiao-juan, FANG Yi-qin

2021, 29(7):  726-729.  DOI: 10.11852/zgetbjzz2020-1287

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Objective To explore the correlation among children's large muscle group movement development,growth and development and perception of movement ability,so as to provide scientific reference for the comprehensive assessment of children's physical and mental health. Methods A total of 178 children aged 7—8 years between May 2018 and October 2019 were selected into this study. All children completed height and weight measurement after admission. The third version of the Large Muscle Movement Development Test (TGMD-3) was used to evaluate the development of large muscle groups in children,and the Children's Perception and Social Adaptation Scale (PSPC-P) to test children's physical perception capabilities. Pearson correlation analysis was used to evaluate the relationship among motor development of large muscle groups,growth and development,and operational capabilities. Results Among the 7- to 8-year-old children,the mobility score in the TGMD-3 of boys was lower than that of girls,while the scores of control and the total score of TGMD-3 of boys were significantly higher(t=7.391,5.327,6.481,P<0.05).The scores of mobility,control and the total score of TGMD-3in 8-year-old children were significantly higher than those in 7-year-old children (t=6.035,7.121,6.092,P<0.05). The height and weight of boys aged 7—8 were slightly higher than those of girls (t=7.091,6.436, P<0.05). PSPC-P score was not statistically significant between boys and girls (P>0.05). The height,weight and PSPC-P score of 8-year-old children were all higher than those of 7-year-old children (t=6.093,7.163,5.992, P<0.05).Pearson correlation analysis showed that the mobility,control and total score of large muscle group were positively related to children's height,weight and PSPC-P score(mobility r=0.745,0.737,0.762;control r=0.698,0.794,0.751;total score r=0.711,0.721,0.745,P<0.05). Conclusions There is a close correlation among the movement development of the large muscle groups,growth and development,and the perception of movement ability in children aged 7—8 years. Children's movement measurement should be added to comprehensively evaluate the overall physical and psychological development of children.

Basic Experimental Article

Role of Orexin-A in the initiation of hypothalamic-pituitary-gonadal axis

YANG Mei, LI Hai-yan, HOU Hui-dan, HAN Jing, TAO Yue-hong

2021, 29(7):  730-733.  DOI: 10.11852/zgetbjzz2020-0917

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Objective To analyze the effects of Orexin-A on sexual development, serum levels of luteinizing hormone(LH), follicle stimulating hormone(FSH), estradiol(E2), Leptin and Kisspeptin, in order to explore the role of energy metabolism in the initiation of hypothalamic- pituitary-gonadal axis (HPGA). Methods In June 2018, 100 five-days-old female SPF SD rats were randomly divided into 4 groups: the control group, the precocious puberty group, the Orexin-A group, the Orexin-A+Orexin-1 receptor (OX1R) antagonist group, with 25 rats in each group. Each rat in the later three groups was subcutaneously injected with a mixture (25μl) of ethanol and ethylene glycol with 300μg of danazol to establish the precocious puberty model, while rats in the control group were injected with the same volume of danazol-free ethanol and ethylene glycol. Rats in the Orexin-A group were injected with 0.5 nmol/L Orexin-A 5μl once daily via lateral ventricle at 15 days old, and rats in the Orexin-A+OX1R antagonist group were injected with 0.5 nmol/L Orexin-A 5μl and 30 nmol/L OX1R antagonist 5μl once daily via lateral ventricle at 15 days old. The levels of serum sex hormones, Kisspeptin and Leptin at prepuberty, onset puberty and post puberty stage were tested. The vaginal opening time in different groups was compared, and the levels of serum sex hormones, Kisspeptin and Leptin were compared in different groups and periods. Results 1) The first vaginal opening time in the precocious puberty group was earlier than that in the control group (H=3.092,P=0.012,P＜0.05). 2) It was found that the LH, E2, Kisspeptin and Leptin levels of the Orexin-A group were lower than those of the precocious puberty group at prepuberty stage (t=-3.082,-2.476,-3.732,-3.289,P＜0.05). However, there were no significant differences on other hormone level except Kisspeptin(t=-4.486,P<0.05) between the precocious puberty group and the Orexin-A+OX1R antagonist group((t=-2.469,-2.771,P＞0.05). During puberty onset stage, the LH and Leptin levels in the Orexin-A group was lower than those in the precocious puberty group(P＜0.05). However, there were no significant differences between the precocious puberty group and the Orexin-A+OX1R antagonist group(P＞0.05). At post puberty stage, the leptin level in the Orexin-A group was lower than that in the precocious puberty group(t=3.674,P＜0.05). Conclusion Orexin-A can inhibit the initiation and progress of the HPGA by inhibiting Kisspeptin expression in the hypothalamus. Energy metabolism is related to the initiation of HPGA.

Review

Research progress on the undernutrition and growth hormone/insulin-like growth factor-1 with children

ZHANG Tian, SUN Hai-ling, ZHANG Mei, BAN Bo, SUN Bing

2021, 29(7):  734-737.  DOI: 10.11852/zgetbjzz2020-1118

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At present, undernutrition is still common among children and adolescents in our country, especially in remote and rural areas of the western China. Children in remote areas often suffer from inadequate intake of protein and trace elements such as zinc and iron due to economic reasons, resulting in growth retardation, low weight and anemia. The growth hormone (GH)/insulin-like growth factor-1 (IGF-1) axis is the main regulator of growth and development in children and adolescents. This review summarizes the effects of undernutrition on the GH/IGF-1 axis and discusses the importance of nutritional status of children in assessing the GH/IGF-1 axis.

Research advances in feeding difficulties of infants and toddlers

YUE Xiao-jing, DU Lin, JIA Fei-yong

2021, 29(7):  738-741.  DOI: 10.11852/zgetbjzz2020-0975

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Feeding difficulty is a common feeding problem in infants and toddlers. The causes are complicated and the symptoms are various. However, feeding difficulty has a far-reaching impact, thus early reasonable feeding is of great significance. At present, there is a lack of consensus on the diagnostic criteria and intervention measures. In this paper, the influencing factors, evaluation and intervention of infants and toddlers feeding difficulties are reviewed in order to clarify the research status.

Research advances on vitamin K and bone health in children

CHEN Shu-ling, ZHAO Jin-zhu, HAO Yan

2021, 29(7):  742-745.  DOI: 10.11852/zgetbjzz2020-1085

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The positive effect of vitamin K on bone metabolism has been confirmed in adults, but its effect on bone metabolism in children has not been further studied. Therefore, based on the existing literature, this paper reviews the biological characteristics and functions of vitamin K, the mechanism of vitamin K regulating bone metabolism, and the current studies related to bone health in children, so as to provide evidence for further research and application of vitamin K in children's bone health.

Research advances on the relation between vitamin A deficiency and infectious diseases in children

ZHANG Li-li, LI Yuan-xia

2021, 29(7):  746-750.  DOI: 10.11852/zgetbjzz2020-1142

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Vitamin A is one of the important nutrients for human growth and development. It not only participates in body's metabolism, maintains the body's normal visual response, but also maintains the integrity of the mucosal epithelium. Additionally, vitamin A plays an auxiliary anti-infection role in intestinal infections and respiratory infections. This review will briefly summarize the correlation between vitamin A deficiency and infectious diseases in children.

Research advances in the effects of rare earth exposure on children's health

WANG Shuai, DING Ye-chun, ZHANG Zhi-qian, FAN Xiao-na

2021, 29(7):  751-754.  DOI: 10.11852/zgetbjzz2020-1196

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With the extensive exploitation and application of rare earths, a large number of rare earths enter the environment and the food chain, people have more and more opportunities to contact rare earths at high or low concentrations, and suffer from the health problems caused by the accumulation of rare earths in their bodies. Children are the hope of the country and the future of the nation, and are in the critical period of growth and development. The impact of rare earth exposure on children's health has been the focus of domestic and foreign scholars, but there are few relevant summary reviews at present. In order to provide scientific basis for early prevention, early detection or clinical treatment of rare earth related diseases in children, this paper reviews the accumulation and distribution of rare earth in children and the health effects caused by exposure.

Clinical Research

Study on the efficacy and safety of long-acting growth hormones in treating pediatric growth hormone deficiency patients

WAN Nai-jun, ZHANG Tian, ZHANG Jin, SUN Hui-hui, SHANG Ran, SHI Wei-jia

2021, 29(7):  755-758.  DOI: 10.11852/zgetbjzz2020-1392

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Objective To compare the efficacy and safety betwen a weekly PEGylated human growth hormone (PEG-rhGH,Jintrolong) and a daily growth hormone in children with growth hormone deficiency (GHD),in order to provide evidence for clinical application. Methods Totally 50 GHD children were enrolled in this study,of whom 20 cases were treated with weekly PEG-rhGH [0.2 mg/(kg·week)],and the other 30 cases were treated with daily rhGH [0.03 mg/(kg·week)]. Both treatments last for 56 weeks. The height,height velocity (HV),height standard deviation score(HTSDS),serum insulin-like growth factor-1(IGF-1),thyroid function,fasting blood glucose,fasting insulin,glycated hemoglobin (HbAlc),lipids and insulin resistance(IR) of the participants was measured before treatment,16,28 and 56 weeks after treatment initiation,respectively. Results Among the patient groups receiving weekly PEG-rhGH and daily rhGH,HVs were significantly increased from (3.67±0.81)cm/year and (3.39±1.36)cm/year before treatment to (14.05±2.30)cm/year and (13.63±2.32)cm/year in 28 weeks after treatment initiation (TI) (P<0.05). A significantly greater HV increase was observed in weekly PEG-rhGH group (P<0.05). At the end of treatment (56 weeks post TI),the HVs were (10.98±1.01)cm/year and (10.77±1.48)cm/year for the groups receiving weekly PEG-rhGH and daily rhGH treatment,respectively,but with no statistically significant difference between the two groups(P>0.05). Additionally,there was significant improvement in HTSDS compared with baseline from 16 weeks after TI in two groups,and HTSDS gradually reached to normal level (P<0.05). A more significant increase was observed in the weekly PEG-rhGH group than that in the daily rhGH group in 4 weeks after TI and through the whole treatment period (P<0.05). IGF-1SDS gradually increased for both groups after TI,and showed significant differences from 16 weeks after TI compared with baseline(P<0.05). Additionally,IGF-1SDS was significantly higher in weekly PEG-rhGH group than that in daily rhGH group from 28 weeks after TI. Neither the weekly PEG-rhGH group nor the daily rhGH group experienced severe adverse event throughout the treatment period. Conclusions Weekly PEG-rhGH is effective and safe for GHD treatment,and its efficacy is superior to daily rhGH. No severe side effect is observed.

Consistency analysis of ASQ-3 and DDST Scales in infant developmental screening

HUANG Hong-mei, TANG Yan-ling, WANG Xiao-rong, LI Ting-yu

2021, 29(7):  759-762.  DOI: 10.11852/zgetbjzz2020-1460

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Objective To explore and analyze the consistency of the subjective and objective evaluation scale-Ages and Stages Questionnaire-Third Edition (ASQ-3) and Denver Development Screening Test (DDST),in order to provide reference for the clinical assessment of children's developmental disorders. Methods A total of 355 children in Children's Health Clinic of Chongqing Youyou Baobei Children and Women's Hospital from April 1st,2019 to April 30th,2020 were selected in this study. Their record of ASQ-3 and DDST evaluation results was retrospectively collected. The screening positive rates of two assessment tools were compared,and the consistency of the two tools in gross motor function,fine motor function,language and personal-social function was analyzed. Results The screening positive rate of ASQ-3 was higher than that of DDST. Except for the motor function,the differences on the screening positive rate of fine motor,language,and personal-social function between the two tools were significant (χ²=28.942,6.424,60.634,P＜0.05). The consistency of the two screening methods was analyzed by the Kappa test. All Kappa values of the four function zones were lower than 0.4,suggesting very low consistency between ASQ-3 and DDST. The Kappa value of the motor function was relatively high compared with other zones(Kappa=0.317,P<0.001). Conclusions The consistency between ASQ-3 and DDST is low in developmental screening of children aged 3—60 months. Further researches are warranted to improve the accuracy and consistency of the infant development screening scale.

Study on efficacy of lower limb motor function of sling exercise therapy combined with kinesio taping on dyskinetic cerebral palsy

WANG Chun-hua, FAN Tao-lin, ZHOU Wen-ying, CHEN Dong-dong, XU Long, YANG Yan-wen

2021, 29(7):  763-766.  DOI: 10.11852/zgetbjzz2020-1877

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Objective To investigate efficacy of lower limb motor function of sling exercise therapy (SET) combined with kinesio taping on lower limb motor function of children with dyskinetic cerebral palsy,in order to provide clinical evidence for the treatment of these children. Methods A total of 59 children with dyskinetic cerebral palsy in Children's Rehabilitation Department of Xiangya Boai Rehabilitation Hospital were enrolled in this study from March 2018 to December 2019,and were randomly divided into 3 groups,including control group(n=20),SET group(n=20) and study group(n=19). The control group was given routine rehabilitation,SET group received sling exercise therapy additionally,and the study group was treated with kinesio taping based on SET group. The three groups were treated for 4 months. 10m maximum walking speed (10 mMWS),Berg Balance Scale (BBS) and Gross Motor Function Measure (GMFM) were used to evaluate the walking ability,balance and gross motor function of children before treatment and in 4 months after treatment. Results After 4 months of treatment,the scores of 10 mMWS (t=3.249,4.042,7.761),GMFM (t=5.297,13.128,20.982) and BBS(t=4.025,7.289,6.394) of three groups were all better than those before treatment(P<0.01). Additionally,the improvements of 10 mMWS,GMFM and BBS scores in study group were significantly higher than those in control group and SET group(F=7.071,4.787,4.093,P<0.05). Conclusions Sling exercise therapy combined with kinesio taping can strengthen the clinical treatment efficacy of children with dyskinetic cerebral palsy,effectively improve the children's balance function,gross motor function and walking ability.

Correlation of bone age with overweight and obesity in children

GAO Hai-tao, WANG Xi, XU Qi, WANG Xiao-yan, WANG Jian-hong, ZHANG Li-li, LI Xiao-meng, LI Na, JIN Na, JIN Chun-hua, WANG Lin

2021, 29(7):  767-771.  DOI: 10.11852/zgetbjzz2021-0435

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Objective To observe the distribution of difference between bone age and age (BAD) in children at different age stages, and to explore the correlation betweenoverweight and obese children with abnormal bone age development. Methods Totally 21 699 children and adolescents aged 6 to 18 years, who took physical examination in the Affiliated Children's Hospital Capital Institute of Pediatrics from January 2010 to December 2020, were enrolled. The bone age was evaluated by CHN method on left hand radiographs. According to the cut-off point recommended by WHO, the subjects were classified into normal group, overweight and obesity groups. The distribution characteristics of BAD in children with different ages and nutritional status were analyzed. The key time point of bone age advance in overweight and obese children was evaluated. Results The children were mainly school-age children aged 6—12 years, of whom 48.6% were boys and 51.4% were girls. The detection rate of BAD >1 in normal, overweight and obese children was statistically significant (χ²=1 703.70, P<0.05). The average value of BAD in overweight and obese children was higher than that in normal children among most age groups, and the average value of BAD was higher than 1 in 6- to 11-year-old obese boys and 6- to 10-year-old obese girls. There was significant difference in average value of BAD between 6- to 12-year-old boys and 13- to 15-year-old boys in obesity groups (t= 9.47, P<0.05), and the average BAD of 6- to 12-year-old boys was higher than 1. There were significant differences in BAD between girls aged 6 to 12 years and 13 to15 years in overweight and obese group (t=9.695, 13.118, P<0.05), and the average BAD of 6—12 years old girls in overweight and obesity group were higher than 1. Conclusion The BAD of overweight and obese children is significantly obvious than that of normal children, and the BAD of 6- to 12-year-old children is the most obvious. Early bone age has a strong influence on children's normal growth and final height, which should be paid more attention and intervention.

Functional near-infrared spectroscopy study in children with developmental delay

QUAN Yan, LUO Li, CHEN Ling, WEI Wen-xi, CHEN Ying-rui, LIU Ping, ZHANG Yu, LI Hong-hui, ZENG Ting

2021, 29(7):  772-774.  DOI: 10.11852/zgetbjzz2021-0208

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Objective To study the characteristics of children with developmental delay (DD) by using functional near infrared spectroscopy (fNIRS), so as to provide reference for the individual diagnosis and treatment of DD. Methods A total of 13 children with DD(DD group) and 19 normal children (NC group) were selected in this study, whose brain function was tested by 8-channel fNIRS. Multiscale entropy (MSE) of each channel and the mean MSE of the frontal region between DD group and NC group were compared by t test. Results The mean MSE of DD group (1.570±0.491) was significantly lower than that of NC group (2.075±0.791) (t=2.228, P＝0.034). The MSE values in channel 3 and 8 were significantly different between DD group and NC group(t=2.513, 2.868, P＜0.01). Conclusions Compared with the normal control group, the complexity of frontal lobe spontaneous brain signals in children with DD is significantly lower, indicating that children with DD have bilateral prefrontal brain function impairment.

Research on the brainstem auditory evoked potential in 788 children with autism spectrum disorders in South China

NING Shu-yao, CHEN Wen-xiong, YANG Si-yuan, LI Jia-ling, LIANG Hua-bing, HU You-xiu

2021, 29(7):  775-778.  DOI: 10.11852/zgetbjzz2020-1812

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Objective To investigate the characteristics of brainstem auditory evoked potential (BAEP) in children with autism spectrum disorder (ASD) and normal hearing threshold in South China. Methods The BAEP records of ASD children in Guangzhou Women and Children's Medical Center between 2013 and 2018 were retrospectively reviewed. Healthy controls matched by age and gender were also recruited. The thresholds,wave absolute latencies (AL),wave inter peak intervals (IPL),Ⅰ-Ⅲ/Ⅲ-Ⅴ inter peak interval ratio and Ⅴ/Ⅰ amplitude ratio of BAEP between both groups were analyzed and compared. And the BAEP data of the children would be excluded from both groups if the hearing threshold of his/her ear exceeded 30 dB nHL. Results A total of 788 ASD children and 150 healthy controls were included. BAEP data of 1 530 ears in ASD group and 300 ears in control group were included in final analysis. All participants in the two groups could differentiate into well-defined waveforms of BAEP at 90 dB nHL sound stimulation. 1) The absolute latencies of wave Ⅰ,wave Ⅲ,wave V and inter peak intervals of Ⅰ-Ⅲ of ASD children were significantly longer than those of children in control group (Z=-2.006,-3.986,-2.552,-2.405,P<0.05).2) The abnormal ratio of Ⅰ-Ⅲ/Ⅲ-Ⅴ inter peak interval of ASD group (3.14%) was significantly higher than that of the control group(P<0.001). Conclusions There are distinct changes in BAEP in ASD children,especially the abnormal prolongation of brainstem conduction time,suggesting that ASD children may have brainstem dysfunction,which may lead to the damage of related information transmission.

Prevalence of high blood pressure and its influencing factors among adolescents in Benxi, Liaoning province

CHEN Yong-gang, GAO Qing, PIAO Tai-hong, CHENG Ming, YE Qian-wen, WU Ming

2021, 29(7):  779-782.  DOI: 10.11852/zgetbjzz2020-0999

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Objective To understand the prevalence of high blood pressure among adolescents in Benxi in 2019, and to analyze its influencing factors, so as to provide basis for formulating the corresponding strategy and measure to prevent and control the high blood pressure of teenagers. Methods From September to October 2019, 3 669 adolescents aged 9 to 24 years in Benxi were selected as study subjects by using a multi-stage stratified random cluster sampling method. Logistic analysis was used to analyze the influencing factors for high blood pressure. Results Totally 3 489 adolescents finished the survey, and it was found that high blood pressure rate in Benxi was 19.00%. Multivariate analysis showed that age, overweight and obesity, living in school and moderate-to-high intensity exercise were the main factors for high blood pressure in adolescents. The risk factors for high blood pressure included 14 to 18 years old (OR=1.272, 95%CI:1.041—1.555),overweight and obesity(OR=2.126, 95%CI: 1.671—2.706; OR=4.444, 95%CI: 3.626—5.445), not living in school (OR=1.514,95%CI: 1.099—2.085), moderate and high intensity exercise (moderate to high intensity exercise for 1-2 days per week OR=1.371, 95%CI:1.039—1.808;moderate to high intensity exercise for more than 3 days per week OR=1.437, 95%CI: 1.110—1.861). Conclusion The prevalence rate of high blood pressure is relatively high in Benxi, thus effective prevention and control measures should be taken to reduce the occurrence of high blood pressure.

Experience Exchange

Expression and significance of serum leptin,omentum-1 and adiponectin in girls with idiopathic central precocious puberty

YAN Song, LIU Fang

2021, 29(7):  783-786.  DOI: 10.11852/zgetbjzz2020-1299

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Objective To investigate the diagnostic value of serum leptin,omentin-1 and adiponectin in girls with idiopathic central precocious puberty (ICPP),in order to provide evidence for the clinical application. Methods From April 2017 to August 2019,124 girls with ICPP,86 girls with premature thelarche (PT) and 100 healthy girls were selected as the study objects. The levels of serum leptin,omentin-1 and adiponectin were tested by enzyme-linked immunosorbent assay. ROC curve was used to analyze the value of each index in diagnosis and differential diagnosis,and AUC was calculated. Results Compared with the control group,the level of leptin was higher,omentin-1 and adiponectin were lower in ICPP group (P<0.05). Leptin level was higher and omentin-1 level was lower in PT group than that in control group (P<0.05). Compared with PT group,the level of leptin was higher and omentin-1 was lower in ICPP group (P<0.05). The AUC of leptin,omentin-1 and adiponectin in the diagnosis of ICPP was 0.898,0.842 and 0.799,respectively. The combined detection of the three indicators increased AUC to 0.920. The AUC of leptin,omentin-1 and adiponectin in the differential diagnosis of ICPP and PT were 0.761,0.604 and 0.572,respectively. The combined detection of the three indicators increased AUC to 0.775. Conclusion Serum adipokine leptin,adiponectin and omentum-1 have certain clinical value in the diagnosis of ICPP and the differential diagnosis between ICPP and PT.

Risk factors of overweight and obesity among the infants

CHEN Xiao-zheng, LI Yi-chen

2021, 29(7):  787-790.  DOI: 10.11852/zgetbjzz2020-1440

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Objective To explore the prevalence and risk factors associated with overweight and obesity among infants,so as to provide basis for the early prevention of childhood obesity. Methods Infants born from September to December 2018 in Beijing Obstetrics and Gynecology Hospital,Capital Medical University were enrolled in this study,and the maternal factors and infant growth characteristics were collected. Overweight and obesity were defined by the WHO sex-age based body mass index(BMI). Chi-square test,t-test and multivariate Logistic regression were used to analyze the data. Results A total of 3 018 infants were investigated,including 1 566(51.89%) boys and 1 452(48.11%) girls. The rates of overweight and obesity among 6-month-old infants were 10.80% (326/3 018) and 3.48%(105/3 018),respectively,while 10.11% (305/3 018) and 2.85%(86/3 018) in 12-month-old infants. Multivariate Logistic regression analysis showed that maternal pre-pregnancy BMI≥25 kg/m²(OR=1.297),gestational diabetes mellitus(OR=1.215),cesarean section(OR=1.617),macrosomia(OR=1.154),non-exclusive breastfeeding within 6 months old(OR=1.586) and excessive weight gain within 6 months old (OR=1.845) were risk factors of overweight or obesity in 12-month-old infants(P＜0.05). Conclusion Maintenance of appropriate body weight before pregnancy,reducing the incidence of gestational diabetes mellitus,cesarean section and macrosomia,increasing the rate of breastfeeding,and avoiding rapid weight gain from birth to 6 months old are of great significance to prevent the occurrence of overweight and obesity among 12-month-old infants.

Association between serum levels of fat-soluble vitamins and severity of atopic dermatitis in children

XIAO Chuan-liu

2021, 29(7):  791-793.  DOI: 10.11852/zgetbjzz2020-1467

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Objective To investigate the relationship between fat-soluble vitamins (vitamin A,D,E) and the incidence and severity of atopic dermatitis (AD) in children,so as to provide theoretical reference for prevention and treatment of AD in children. Methods A total of 64 AD children diagnosed in the Second Affiliated Hospital of Hainan Medical College were selected as AD group,and 64 healthy children in the same period were recruited into control group.The severity of AD was assessed by the Scoring Atopic Dermatitis (SCORAD).The levels of vitamin A (Vit A) and vitamin E (Vit E) were tested by high performance liquid chromatography,and the level of 25-hydroxy vitamin D₃ [25(OH)D_3] was determined by liquid chromatography tandem mass spectrometry. Results Compared with control group,the AD group had significantly lower levels of Vit A and Vit E (t=3.986,4.312,P＜0.05).The mean SCORAD score of AD children was 37.8±15.3.The difference in serum 25(OH)D₃ level among mild,moderate and severe AD groups was significantly different(F=9.405, P＜0.05).Among AD children,the SCORAD score was negatively correlated with serum 25(OH)D₃ level (r=-0.389,P=0.001),but not related to Vit A and Vit E levels (P>0.05). Conclusion Vit A and Vit D deficiency or insufficiency exists in AD children,and the serum Vit D level is negatively correlated with the severity of AD.

Comparison of milk components between Han and Hui nationalities in Lanzhou based on propensity score matching

ZHANG Yong-hua, WANG Ke-ling, SHI Ying, WANG Chun-ping

2021, 29(7):  794-797.  DOI: 10.11852/zgetbjzz2020-1459

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Objective To know about the differences in breast milk composition among Han and Hui nationalities of Chinese females,in order to provide basic data for promoting breastfeeding,growth and development of infants. Methods Lactating women were voluntarily recruited in this study June 2019 to May 2020 and their breast milk was collected. Human Milk Analyzer was used to detect the fat,protein,lactose and dry matter content,while the titration method was used to measure the calcium level. Propensity score was used to match the potential confounders before comparing the breast milk composition between Han and Hui groups. Results Total of 1 030 women were enrolled in this study,of whom 43 were Hui people. After matching by propensity score,40 Han and Hui lactating women were paired. There were no significant differences in breast milk energy,protein,lactose,fat,calcium,dry matter between Han and Hui lactating women(t=0.832,-0.629,-1.058,0.783,-0.758,1.217,P＞0.05). A positive correlation was observed between lactation days and protein only in Han women(r=-0.191,r'=-0.193,P<0.001). But this correlation was not observed in breast milk of Hui women(P＞0.05). Conclusions There were no significant differences in breast milk composition between Han and Hui women. However,breast milk protein significantly decreased in Han lactating women.

Analysis of physical examination for entering kindergartens of 944 children in Shannan,Tibet

XUE Han, LI Long, CHEN Jun, CIREN Qu-zhen, DU Yun-qing, GUO Shuang, LI Jin, HU Han-ning, LI Yi-rong

2021, 29(7):  798-801.  DOI: 10.11852/zgetbjzz2020-1126

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Objective To analyze the data of physical examination for entering kindergartens of children in Shannan City in 2019,to understand the physical health of children in Shannan City,in order to provide scientific basis for local child healthcare. Methods Physical examination data of 944 children aged 2 to 6 years in the Department of Pediatric Care of the Maternal and Child Health Hospital of Shannan City in 2019 were enrolled in this study. The growth and development of children at different age and gender groups,the prevalence rates of dental caries,poor vision and anemia were analyzed. Results In 2019,the detection rate of malnutrition among children admitted to the hospital in Shannan City was 8.90% (84/944). The difference in growth retardation at different age groups was significant (χ²=16.519,P=0.01). The detection rate of overnutrition was 4.45% (421/944),and the difference in obesity rate was significant (χ²=8.200,P=0.042). The detection rates of caries,anemia and poor vision were 48.52% (458/944),17.76% (167/944) and 47.56% (449/944),respectively. There were statistical differences in the detection rates of caries and anemia at different age groups(χ²=54.271,14.031,P＜0.05). However,the rate of poor vision was not found significant different among different age and gender groups (P＞0.05). Conclusions The prevalence rates of growth retardation,dental caries,anemia,and poor vision in preschool children in Shannan City are relatively high. It is suggested that parents and related agencies should work together in preventive health care and strengthen crowd intervention.

Efficacy of rhGH combined with letrozole in the clinical treatment of adolescent idiopathic short stature in male children

ZHANG Qiang, LIU Li-jun, LI Jin-ying, CUI Hai-jing, WANG Yi-jing

2021, 29(7):  802-805.  DOI: 10.11852/zgetbjzz2020-1507

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Objective To study the efficacy of recombinant human growth hormone (rhGH) combined with letrozole on the improvement of the predicted final height in male children with adolescent idiopathic short stature (ISS). Methods Totally 60 male children diagnosed with adolescent idiopathic short stature admitted in Children's Hospital of Hebei Province from May 2015 to May 2019 were enrolled in this study and were divided into two groups by simple grouping method,with 30 cases in each group. The control group was treated with rhGH,while the experiment group was treated with rhGH and letrozole. Both groups were treated for one year. The improvement of physical development,growth rate,bone metabolism index and occurrence of adverse events were collected and analyzed. Results There were no significant differences in bone age,height and bone metabolism indexes between the two groups before treatment (P>0.05). After 1 year of treatment,the bone age and bone alkaline phosphatase(BALP) level of the experiment group were lower than those of the control group (t=6.537,9.290,P<0.05),and the levels of bone glaprotein(BGP),procollagen Ⅰ N-terminal peptide(PINP) and vitamin D of the experimental group were significantly higher than those of the control group (t=4.501,4.269,9.230,P<0.05). The predicted final height value was significantly higher in experiment group (t=2.833,P<0.05). There were no significant differences in growth rate and adverse reactions between the two groups (P<0.05). Conclusion Letrozole can improve the predicted final height of male children with adolescent idiopathic short stature.