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Table of Content

    10 October 2021, Volume 29 Issue 10
    Professional Forum
    Feeding practice and gut health during infancy
    HU Yan
    2021, 29(10):  1041-1043.  DOI: 10.11852/zgetbjzz2021-1303
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    Gut health largely depends on stable intestinal microbiota and mature immune status. Dietary factors play an important role in maintaining gut health. Good feeding practice in infants,such as breast-feeding,introduction of solid food on time,increasing food diversity and healthy eating habits,can promote gut health by establishing normal intestinal microbiota and effective immune function.
    Original Articles
    Differences in feeding behaviors between grandparents and parents and its correlations with preschool children′s eating behaviors
    WU Ru-xing, WANG Jian, WEI Xiao-xue, GUO Yi-bin, CHENG Xu-wen, WU Bao-jin, CHEN Jin-jin, WU Ying-hui, CHEN Ru-nan, ZHU Da-qiao
    2021, 29(10):  1044-1048.  DOI: 10.11852/zgetbjzz2021-0923
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    Objective To explore the differences in feeding behaviors between grandparents and parents, and to analyze its correlation with preschoolers′ eating behaviors, so as to further clarify the possible influence of caregivers′ identity and feeding behaviors on eating behaviors. Methods From May 2020 to January 2021, a survey was conducted among primary caregivers of preschoolers from 8 kindergartens and 2 community health service centers in Pudong New Area, Shanghai.The propensity score matching with a ratio of 1∶2 was used to form the grandparents group (n=72) and the parents group (n=144) according to primary caregivers′ identity. Results There were statistically significant differences between grandparents and parents in content-restricted feeding (t=4.72, P<0.001), behavior-restricted feeding (t=2.13, P=0.036), children′s initiative eating (t=-4.76, P<0.001), exogenous eating (t=-5.07, P<0.001) and emotional eating (t=1.99, P=0.050).Multivariate analysis of variance (MANOVA) showed that behavior-restricted feeding (F=1.82,P=0.086), encouraging healthy eating (F=2.46,P=0.019) and content-restricted feeding (F=3.69,P=0.001) had significant predictive effects on eating behaviors.There was no statistical correlation between primary caregivers′ identity and eating behaviors of preschoolers (P>0.10). Conclusions Parents use content-restricted feeding and behavior-restricted feeding more frequently than grandparents.Primary caregivers′ feeding behaviors, rather than their identity, are significantly related to eating behaviors of preschoolers.
    Effect of different feeding patterns on the intellectual development and immune function of infants
    CUI Yi-fan, DONG Ming-ming, HU Dan, XIAO Xu-wu
    2021, 29(10):  1049-1052.  DOI: 10.11852/zgetbjzz2021-0716
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    Objective To investigate the effects of different feeding patterns on the intellectual development and immune function of infants, so as to provide evidence for scientific feeding of infants. Methods Totally 87 healthy full-term infants born in Dalian Maternal and Child Health Hospital from May 2019 to June 2020 were enrolled in this study, and were divided into breast feeding group and artificial feeding group.Serum IgG, IgM and IgA tests were performed at 3, 6 and 12 months of age.Intellectual development was assessed at 6 and 12 months of age. Results At 6 months old, the developmental quotient, the scores of fine movement, language and social behavior of infants in the breastfeeding group were significantly higher than those of the artificial feeding group (t=2.035,3.814, 2.075, 2.229, P<0.001 or <0.05).At the age of 12 months old, the developmental quotient, the scores of fine movement and language of infants in the breastfeeding group were significantly higher than those of the artificial feeding group (t=2.062, 2.271, 2.066, P<0.05).Serum IgG level of infants in the breastfeeding group was significantly higher at 6 months old than that of the artificial feeding group(t=4.920, P<0.001),but there was no significant difference between the two groups at 3 and 12 months old(t=0.316,0.708, P>0.05).Serum IgM level of infants in the breastfeeding group was significantly higher at 6 and 12 months old than that of the artificial feeding group (t=2.700, 4.757, P<0.01), while there was no significant difference between the two groups at 3 months old (t=1.797, P=0.076).Serum IgA level of infants in the breastfeeding group were higher than that of the artificial group at 3, 6 and 12 months old (t=6.441, 6.115, 6.765, P<0.001). Conclusions There are differences in intellectual development and immune function in infants with different feeding patterns.Breastfeeding is beneficial to the intellectual development and immune function of infants, and should be strongly supported and promoted.
    Cross-sectional survey on the effects of different types of obesity on high blood pressure in children and adolescents from seven provinces in China
    CHEN Man-man, HUO Jia-kang, MA Ying, MA Tao, LI Yan-hui, GAO Di, CHEN Li, DONG Yan-hui, MA Jun
    2021, 29(10):  1053-1057.  DOI: 10.11852/zgetbjzz2021-0282
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    Objective To investigate the additive interaction of different types of obesity on high blood pressure in children and adolescents,in order to provide basis for controlling blood pressure level effectively. Methods Data were collected from a cross-sectional survey of children and adolescents with a multi-stage cluster sampling in seven provinces and cities in China in 2012. T test and chi-square test were used to analyze the differences between continuous variables and classified variables,respectively. Logistics regression was used to analyze the correlation between different types of obesity and high blood pressure,and the interaction between general obesity and simple abdominal obesity was analyzed. Results A total of 40 015 children and adolescents were included in this study. The proportion of children with general obesity,simple abdominal obesity and compound obesity with high blood pressure was 17.7%,12.0% and 23.2%,respectively. Compound obesity had a greater effect on high blood pressure in boys and urban children and adolescents (boys OR=2.80,95%CI: 2.55—3.07; urban OR=2.95,95%CI: 2.69-3.24),the same results were found for the high systolic and diastolic blood pressure. In children and adolescents with high blood pressure,the additive interaction of general obesity and simple abdominal obesity caused the high blood pressure in 22% of the population. Conclusions General obesity has a greater effect on blood pressure than simple abdominal obesity. Among different types of obesity,compound obesity is still the most risk factor leading to high blood pressure. In children and adolescents with high blood pressure,general obesity and simple abdominal obesity have additive interaction.
    Study on physical development and nutritional status of children with autism spectrum disorders aged 3-7 years in Tianjin
    YANG Rui-bo, LIU Jia-xue, HAN Yu, QU Zhi-yi, LI Yao, XIONG Wen-juan, ZHANG Xin
    2021, 29(10):  1058-1062.  DOI: 10.11852/zgetbjzz2021-0543
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    Objective To understand the growth and development status of children with autism spectrum disorders (ASD) aged 3-7 years in Tianjin, in order to provide reference for improving their growth and development. Methods A total of 221 ASD children aged 3—7 years were selected to take physical examination by cluster sampling in Tianjin.All indicator values were converted to Z-scores using the physical growth and development of children under seven years of age in nine cities of China in 2015 and WHO child growth standard.The Childhood Autism Rating Scale (CARS) was used to assess the severity of ASD. Results The overweight and obesity rate of ASD children in Tianjin was 19.0%.The distribution curves of weight for age Z-score (WAZ), height for age Z-score(HAZ),BMI for age Z-score(BAZ) all shifted to the right side.The Z-score distribution curves of chest circumference and waist circumference extended beyond +3s, and the Z-score distribution curve of sitting height shifted to the left side, showing a growth deviation in ASD children.The WAZ (Z=2.053, P<0.05) and the ratio of overweight and obesity (χ2=6.572,P<0.05) in boys was higher than those of girls.The overweight and obesity rate of 6- to 7-year-old group was significantly higher than that of 3-year-old and 4-year-old group(P<0.05).But there was no significant difference in the level of nutritional status among different severity groups of ASD children (χ2=5.321,P>0.05). Conclusions The detection rate of overweight and obesity in ASD children in Tianjin is relatively high, and the deviation of physical growth exists in ASD children.So it is necessary to strengthen the growth and development monitoring and the intervention of obesity.
    Study on the combined influence of parental screen time and restrictive behaviors on screen time of children and adolescents aged 6 to 17 years from 7 provinces in China
    MA Ying, SU Bin-bin, HUO Jia-kang, CHEN Man-man, LI Yan-hui, GAO Di, DONG Yan-hui, MA Jun
    2021, 29(10):  1063-1067.  DOI: 10.11852/zgetbjzz2020-2213
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    Objective To analyze the combined influence of parental screen time and restrictive behaviors on screen time of children and adolescents,and to understand whether decreasing parental screen time combined with restrictive behaviors on screen time of children and adolescents will help control the screen time of children and adolescents within two hours more effectively,so as to provide reference for developing healthy lifestyle. Methods Students aged 6—17 years were selected from 93 schools in 7 provinces and cities in China,with a stratified cluster sampling method. Parental screen time,restrictive behaviors on children′s screen time and children′s screen time were measured by structured questionnaires. A multivariable Logistic regression model was used to analyze the combined influence of parental screen time and restrictive behaviors on screen time of children and adolescents. Results A total of 37 984 students were enrolled into this study with an average age of (10.7±3.2) years old. There were 8 543 students(22.5%) whose daily screen time exceeded 2 hours.Compared with control group,the odds ratio of children′s screen time >2 h/d in the group without parental restriction on screen time and parental screen time >2 h/d group were 1.25(95%CI: 1.09—1.43,P=0.002) and 1.52(95%CI: 1.44—1.60,P<0.001),respectively. And the odds ratio of children′s screen time >2 h/d in the group of parental screen time>2 h/d without restrictive behaviors on children was 1.93 times higher than that in control group(95%CI: 1.72—2.17,P<0.001). After adjusting for confounding factors such as gender,residence place,age and parental education level with stratified analysis,there was also a consistent result with the overall. Conclusions Parental screen time <2 h/d and restrictive behaviors on screen time of children and adolescents are both the protective factors of controlling children′s screen time,and there is a combined influence of the two factors. In order to further reduce the obesity and other health problems of children and adolescents caused by too long screen time,parents should not only limit the children′s screen time,but also need to control their own screen time.
    Longitudinal analysis of physical growth of term small for gestational age infants at 0 to 24 months old from communities in Guangzhou
    LIU Hui-yan, LIN Sui-fang, LI Wei-dong, WEN Yu-qi, XIAO Wan-qi, SONG Yan-yan
    2021, 29(10):  1068-1071.  DOI: 10.11852/zgetbjzz2020-2084
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    Objective To investigate the physical growth of small for gestational age(SGA) 24 months after birth,so as to provide the scientific basis for making growth and development intervention strategies for SGA. Methods A prospective study was used to select SGA born from January 2016 to April 2018,receiving regular physical examination in community health-care service centers within 2 years after birth. Full-term appropriate for gestational age(AGA) infants during the same period were selected as controls. The weight and length of the infants were measured continuously. And after standardization,the growth level and growth rates were compared between the two groups. Results 1) The weight and length for age Z-scores in the SGA group were lower than those in the AGA group. In the SGA group,the weight and length for age Z-scores both showed an increasing trend in the 12 months after birth. But the weight gain(△Z: 1.17±1.10) and length growth(△Z: 0.65±1.23) of the SGA group were higher than those of the AGA group during infancy. 2) Totally 67.65% of the infants showed catch-up growth in weight and 50.98% of infants showed catch-up growth in height. Weight and height growth rate at 0 to 12 months old was positively correlated with the nutritional status at 2 years old(P<0.01). 3) The incidence rates of underweight,stunting and wasting were higher than those of the AGA group,and the incidence at 2 years old was 8%—15%. The incidence of overweight and obesity of SGA group was lower than that of the AGA group,the incidence of overweight at 2 years old was 2.94%. The differences in the incidence rates of underweight,stunting and overweight were significant between SGA group and AGA group(χ2=4.40,4.18,5.38,P<0.05). The incidence of anemia of SGA group at 6 months old was 43.63%. Conclusions Small full-term infants have catch-up growth in weight and length within one year after birth. The occurrence of malnutrition should not be ignored,and attention should be paid to prevent malnutrition and anemia at 6 months of age in full-term infants.
    Study on the development characteristics of 3- to 6-year-old children′s gross movements
    WEN Rui-xiang, JIANG Gui-ping, ZHAO Pan-chao, LI Jia-hui
    2021, 29(10):  1072-1076.  DOI: 10.11852/zgetbjzz2021-0211
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    Objective To explore the developmental characteristics of 3- to 6-year-old children′s gross movements,so as to provide data support for clinical diagnosis,treatment and educational intervention. Methods From April to July 2019,640 children aged 3—6 were randomly selected from two public kindergartens in Beijing,and Gross Motor Development Test(TGMD-3) was used for gross motor development test. Two-way ANOVA method was used to compare the differences in gross movement scores among children among different age and gender groups. Results There was no significant interaction effect between sex and age in the development of gross movements of 3- to 6-year-old children(P>0.05). There was a significant age main effect on the total score of gross movement,locomotor skills,object control skills and 13 sub-items(P<0.001). The score of rough movements increased with the increase of age. There was a significant gender main effect on the total score of locomotor skills,hop and skip in the 4- to 6-year-old group(P<0.05),which were better in girls than those in boys. The gender main effect also appeared in the score of object control skills,two-hand strike,forehand strike,kick and dribble(P<0.001),and which were better in boys than those in girls. Conclusions The scores of gross movements of 3- to 6-year-old children continue to increase with the increase of age. The locomotor skills of girls are better than those of boys,and the object control skills of boys are better than those of girls. It is suggested to give differential teaching according to the age and gender characteristics of the rough movements development at the age of 3 to 6 years old.
    Application of nocturnal lowest oxygen saturation combined with sleep-related scales in screening obstructive sleep apnea in children
    SHAO Na, ZHAO Bing-jie, MA Li-na, CHEN Xi, SHE Ning-ning, SI Chao, LIU Na, YUAN Yu-qi, LIU Hai-qin, REN Xiao-yong
    2021, 29(10):  1077-1081.  DOI: 10.11852/zgetbjzz2021-0864
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    Objective To evaluate the accuracy of nocturnal lowest oxygen saturation (LSaO2 ) at night combined with OSA-18 scale and modified Epworth Sleepiness Scale for Children (ESS-CHAD ) in primary screening of obstructive sleep apnea (OSA ) in children, so as to explore a simpler, faster and feasible method for primary screening of suspected OSA in children. Methods A total of 139 children who completed overnight polysomnography (PSG) in the Department of Otolaryngology Head and Neck Surgery of Second Affiliated Hospital of Xi′an Jiaotong University were enrolled in this study from 13rd, August 2020 to 8th February 2021. Their parents completed OSA-18 and ESS-CHAD with the assistance of doctors. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and ROC curve of the serial tests were calculated, respectively. Results According to the ROC curve, the optimal cut-off value of nocturnal LSaO2 for predicting OSA in children was 90.5% (P<0.001, AUC=0.82). The highest sensitivity of OSA-18 and ESS-CHAD for diagnosing OSA was 74.8% and 22.7%, respectively. The highest sensitivity of LSaO2/OSA-18, LSaO2/ESS-CHAD, OSA-18/ESS-CHAD in the diagnosis of OSA in children was 88.2 %, 68.1% and 77.3%, respectively. Conclusions The nocturnal LSaO2 has clinical value in the diagnosis of OSA in children. OSA-18 has higher sensitivity but lower specificity than ESS-CHAD. The sensitivity and specificity of LSaO2 combined with OSA-18 in diagnosing OSA are higher than the remaining serial tests, which could be used in primary screening OSA in children at grassroots hospitals where sleep monitoring is impossible.
    Review
    Research progress on intestinal absorption mechanism and interaction of nutrient trace metal elements
    WANG Hai-wa, YAN Chong-huai
    2021, 29(10):  1082-1086.  DOI: 10.11852/zgetbjzz2021-0476
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    The nutritive trace metal elements in the human body are mainly absorbed by the intestine and play a very important role in various life activities.This article summarizes the recent research progress in the intestinal absorption mechanism of common trace elements, such as iron, zinc, copper, manganese, molybdenum, chromium and cobalt, and explores the forms of interaction between element absorption.Metal elements in the body maintain a steady state through absorption, distribution and excretion, and the whole process requires the body′s overall metabolic regulation.Therefore, the factors that affect the absorption of trace metal elements in the intestine are not only the interference between the metal elements in the diet, but also the chemical form of the metal elements, the ratio of metal elements, other coexisting components in the food, and the intestinal flora, etc.More important is the state of the body.This article will propose clinical nutritional supplement strategies on this basis.
    Progress on food selectivity in children with autism spectrum disorder
    AI Nü-tian, LI Ting-yu
    2021, 29(10):  1087-1090.  DOI: 10.11852/zgetbjzz2020-1951
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    Autism spectrum disorder (ASD) is a kind of neurodevelopmental disorder. In addition to the core symptoms, food selectivity is also common in children with ASD. However, clinicians pay less attention to it. Thus,the medical staff need to know more about the food selectivity of ASD children in order to guide clinical work. In this paper, the status quo, related factors, influence and treatment progress of food selectivity in ASD children are reviewed.
    Research progress in polyunsaturated fatty acids and food allergy in children
    ZHOU Zi-bei, LI Zai-ling
    2021, 29(10):  1091-1095.  DOI: 10.11852/zgetbjzz2020-2224
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    Over the past 20 years,food allergy has become more and more common globally. So there is an urgent need for effective preventive treatment. Polyunsaturated fatty acids,especially n-3 polyunsaturated fatty acids,can affect the immune response of the body and prevent the development of immune disorders by suppressing inflammation. This review discusses the relationship between polyunsaturated fatty acids and food allergy based on the influencing factors of food allergy,summarizes the current research results on the relationship between polyunsaturated fatty acids and food allergy,aiming to provide new ideas for the prevention and treatment of food allergy in children.
    Research progress on the influence of family nurturing environment on early childhood development
    LI Jia, WANG Xue-na, DU Wen-wen, ZHANG Meng, YU Li-ping
    2021, 29(10):  1096-1099.  DOI: 10.11852/zgetbjzz2020-1280
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    Early childhood development is of great significance to individual, family and society. Improving the parental competence and family nurturing environment is the key and core to promote the early development of children. This paper focuses on the family nurturing environment and early childhood development from the perspective of related concepts, theories, influence and intervention practice, aimed to provide the basis for the relevant empirical research in China, and to provide reference for the improvement of children′s health care work, so as to promote the comprehensive development of early childhood.
    Research progress on the assessment tools of responsive feeding among infants and toddlers
    AN Mei-jing, LIU Xi-yao, LONG Chao, ZHOU Qian-ling
    2021, 29(10):  1100-1104.  DOI: 10.11852/zgetbjzz2021-0026
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    Responsive feeding emphasizes the interaction between caregivers and infants and toddlers during the feeding process. Caregivers are encouraged to respond the child′s hunger and satiety signals in a prompt and appropriate manner. Responsive feeding is recommended by relevant organizations around the world. Good assessment tools of responsive feeding not only improve the comparability of results among different studies,but also contribute to assess the invariance of caregiver′s responsive feeding practices over time. In order to provide references for health workers,this paper reviews the assessment tools of responsive feeding,including scales and video observation.
    Research progress on growth retardation of infants and toddlers
    WU Hua-hong, LI Yang, LI Hui
    2021, 29(10):  1105-1108.  DOI: 10.11852/zgetbjzz2020-2173
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    In recent years,the children′s growth retardation rate has been decreased worldwide,but the regional difference is still prominent. The growth retardation rate of children in poor areas of China is still almost 10%. Growth retardation has an impact on children′s physical growth,cognitive development,increases the risk of chronic diseases,decreases their income level in adulthood,and impairs social and economic productivity. The infant and toddler stage is the most prone ages of growth retardation,and also the key window period of intervention for growth retardation. So this review focuses on this stage,analyzes the causes,prevention and intervention methods and common clinical problems of growth retardation in this stage,in order to contribute to the understanding,prevention and intervention of growth retardation.
    Meta Analysis
    Meta-analysis of vitamin D level in healthy Chinese children over the past 10 years
    AN Na, ZHAO Yi-le, ZHANG Gu-ying, AN Zhi-hua
    2021, 29(10):  1109-1114.  DOI: 10.11852/zgetbjzz2020-1798
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    Objective To systematically review the prevalence of vitamin D deficiency in healthy Chinese children for nearly 10 years, in order to provide data for public health strategies for children. Methods PubMed, EMbase, CNKI, WanFang Data and VIP database were searched for observational studies over the past 10 years on prevalence of vitamin D deficiency in healthy Chinese children. Stata 14.0 software was used to perform a Meta analysis on the prevalence rate. Results A total of 21 articles were reviewed, with a sample size of 129 283 children aged 0 to 18 years old. Among them, the constituent ratios of sever lacking, deficiency, insufficient, adequate, excess, intoxication were 2.46%(1.03%—4.47%), 21.57%(13.65%—30.72%), 28.71%(20.83%—37.35%), 55.80%(42.19%—68.97%), 0.30%(0.17%—0.46%) and 0.11%(0.07%—0.17%), respectively. The deficiency rate gradually increased with the increasing of age, with the lowest rate of 11.06% in the infant group and the highest rate of 56.14% in the adolescent group, the difference was statistically significant(P=0.003). The deficiency rate of children were higher in North China than in South China(P=0.249). The rate of Vitamin D deficiency in Spring and Winter were higher than that in Summer and Fall(P=0.168),but the difference was not significant(P>0.05). Conclusion Vitamin D level in Chinese healthy children are not optimistic, and active efforts should be made to improve the overall vitamin D level of Chinese children.
    Development and evaluation of Child Eating Behavior Scale
    YIN Ke, ZHANG Ting, SONG Zhi-xiao, ZHANG Li, QIAO Xiu-yun, LI Yan
    2021, 29(10):  1115-1119.  DOI: 10.11852/zgetbjzz2020-2099LB
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    Objective To develop Eating Behavior Scale for children with high reliability and validity,so as to provide a scientific and reliable tool for the evaluation of children′s eating behavior in China. Methods A total of 349 parents of children aged 1—3 years were investigated. Then the initial questionnaires were formed. Factor analysis,discriminant analysis,Cronbach′s α coefficient and Spearman correlation analysis were used to screen the initial items. And 1 021 parents of children aged 1—3 years were asked to fill out primary questionnaire. Finally the formal questionnaire was formed. The reliability and validity of the formal questionnaire was tested by Guttman split-half reliability analysis,retest reliability analysis,exploratory factor analysis and confirmatory factor analysis. Results 1) Finally the Eating Behavior Scale of children consisted of 39 items with 7 dimensions was formulated. The Cronbach′s α coefficient of scale was 0.889,Guttman split-half reliability was 0.922,the retest reliability of the scale was 0.735,and the correlation coefficient between each factor and the scale ranged from 0.455 to 0.817. Confirmatory factor analysis showed that the values of x2/df,GFI,CFI,RFI and RMSEA of the scale were 2.980,0.815,0.802,0.708 and 0.062,respectively. 2) Children′s weight was related to birth weight,family structure and bad eating habits(P<0.05). The length was related to family structure and low salt diet(P<0.05). The education level of parents had a significant effect on children′s eating behaviors(P<0.05). Family income had a significant effect on children′s food preference(P<0.05). The effects of different family structures on food response,satiety response and common meal opportunity were significantly different(P<0.05). Conclusion Children′s Eating Behavior Scale is a scientific and reliable tool with good reliability and validity,which can objectively evaluate the dietary behavior problems of 1- to 3- year-old children in China.
    Study on vitamin D level of 603 adolescent children in Harbin
    LI Qiu-shi, LI Shu-wei, LI Dan, LIU Yang-yang, WANG Di, YANG Shu-fen
    2021, 29(10):  1120-1124.  DOI: 10.11852/zgetbjzz2021-0027
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    Objective To know about serum vitamin D (VD) level of the adolescence children and the its influencing factors, and to analyze the causes of VD insufficiency, so as to provide scientific reference for further research. Methods A total of 603 healthy adolescence children aged 11 to 17 years were enrolled in this study, and were taken physical examination, questionnaire survey from 2015 to 2016. Serum levels of 25(OH)D, parathyroid hormone (PTH), calcium (Ca), phosphorus (P) and alkaline phosphatase (ALP) of the participants were tested. Results Serum 25(OH)D level of 603 adolescence children were 14.16 (10.68, 18.46) ng/ml, and 81.1% adolescent children had VD deficiency and insufficiency. Serum levels of PTH, Ca, P and ALP were 42.7(31.90, 60.70) pg/ml, (2.47±0.13) nmol/L, (1.57±0.21) nmol/ L and (275.23±127.60) U/L. Serum 25(OH)D level was negatively correlated with PTH level and ALP level(r=-0.039,-0.141,P<0.01), positively related to serum Ca level(r=0.312,P<0.001). There was a logarithmic correlation between PTH and 25(OH)D, and no 25(OH)D inflection point appeared when PTH reached the maximum inhibition state.Outdoor activities time, VD supplementation was positively related to serum 25(OH)D level(P trend<0.01). Conclusions Vitamin D deficiency and insufficiency among adolescents is common. Indicators like serum PTH,ALP and Ca levels would help to assessing VD level of children. So it is suggested to encourage outdoor activities, take VD supplementation to improve 25(OH)D level of children.
    perinatal factors and the short-term adverse outcomes larger gestational age infants and gestational diabetes mellitus mothers
    YANG Yun, ZHANG Shi-fa
    2021, 29(10):  1125-1129.  DOI: 10.11852/zgetbjzz2021-0382
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    Objective To analyze the perinatal factors and the short-term adverse outcomes of large gestational age (LGA) infants delivered by gestational diabetes mellitus (GDM) mothers, so as to provide scientific reference for clinical management of LGA. Methods The clinical data of 817 cases in the obstetrical department of Ma'anshan Maternal and Child Health Hospital from January to May 2019 were collected. Logistic regression was used to analyze the association between perinatal factors and LGA infants in mothers with GDM. The relationship of short outcome between LGA infants and appropriate for gestational age (AGA) infants was analyzed by χ2 test. Results Multivariate analysis of LGA infants revealed the following risk factors: Maternal body mass index (BMI)>23.9 kg/m2(OR=1.139, 95%CI:1.082—1.198, P<0.001), maternal triglyceride(TG)≥2.3 mmol/L (OR=1.115, 95%CI: 1.020-1.219, P=0.016), male neonates (OR=1.089, 95%CI: 1.050-1.129,P<0.001) and neonatal gestational age (OR=1.403,95%CI:1.205-1.634, P<0.001) were the risk factors for LGA infants. There was no significant difference of hospitalization between LGA infants and AGA infants (11.2% vs. 12.4%, χ2=0.239, P>0.05). Conclusions It is supposed to strictly control maternal BMI and TG levels of GDM, and to pay more attention to the long-term adverse of LGA infants in order to promoting mother-infant health. The short-term outcomes of LGA and AGA infants are not distinctly different, so the long-term outcome should be further monitored.
    Association between family nurture environment and neuropsychological development in children with autism spectrum disorder
    WENG Ting-ting, WANG Qiong-yao
    2021, 29(10):  1130-1132.  DOI: 10.11852/zgetbjzz2020-1884
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    Objective To describe the differences in parenting environment in children with autism spectrum disorders(ASD)and development delay,and to analyze the association between the family nurturing environment and developmental assessment result among autistic children. Methods From January 2018 to August 2020,totally 42 ASD children and 48 children with development delay were enrolled in this study from Ma′anshan Maternal and Child Health Hospital.Both groups were assessed by Gesell Developmental Scale and the family rearing environment completed by parents. Results There were 33(36.7%)children whose rearing environment rated as poor,of whom 12(28.6%)children was in ASD group,and 21(43.8%)children in developmental delay group.The detection rate of poor emotional warmth in ASD group was significantly higher than that in children with developmental delay(Z=2.490,P<0.05), but the difference on other dimensions between the two groups was not significant(P>0.05).In addition,ASD children living in poor parenting environment had lower score in adaptive behavior(F=3.662,P<0.05). Conclusion More attention should be paid to promoting the family rearing environment of ASD children,family-oriented intervention and education may promote the rehabilitation effect.
    Analysis on the intestinal flora of infants with neonatal respiratory distress syndrome
    ZHANG Ya-min, BI Mei-rong, HE Xue-jia, WANG Ying, ZHANG Nan, ZHU Wei-wei
    2021, 29(10):  1133-1136.  DOI: 10.11852/zgetbjzz2020-1827
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    Objective To analyze the characteristics of structural changes of intestinal flora in infants with neonatal respiratory distress syndrome (NRDS), in order to provide theoretical basis for the clinical application of probiotics for NRDS assisted therapy. Methods A total of 15 premature infants with NRDS who were hospitalized in the Neonatology Department of Jinan Central Hospital from January to May 2020 were selected into the NRDS group in this study. Meanwhile, 15 non-NRDS hospitalized premature infants were selected as the control group.The clinical data, blood sample, stool sample of the participants were collected. The stool DNA was extracted, high-throughput 16S rRNA gene sequencing was conducted, and bioinformatics analysis was conducted to compare the differences of intestinal flora between the two groups. Results 1) Compared with the control group, the OTU number of intestinal flora in the NRDS group was lower in each level of bacteria classification, including species, genus, family, order, class and phylum.2) The β diversity analysis showed that there were significant differences in intestinal flora structure between NRDS group and control group. 3) At the level of "family", Enterobacteriaceae was enriched in the NRDS group (Z=2.78, P=0.009). At the level of "phylum", Firmicutes were enriched in the control group (Z=2.18, P=0.021) and Proteobacteria were enriched in the NRDS group (Z=2.02,P=0.014). Conclusions The ecological imbalance of intestinal flora is found in NRDS infants, and the richness and diversity of flora species are decreasing. The structural distribution of intestinal flora in infants with NRDS is significantly different from that of normal preterm infants.
    Clinical Research
    Appropriate complementary feeding practice and associated factors among caregivers of children aged 6 to 23 months in rural areas of Hunan province
    LIAO Ming-hui, HUANG Qun, LI Hui-xia, LIAO Yi, HUANG Guang-wen
    2021, 29(10):  1137-1141.  DOI: 10.11852/zgetbjzz2021-0645
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    Objective To evaluate the quality and associated factors that potentially affect complementary feeding practice in rural areas of Hunan, in order to provide reference for scientific nutritional intervention and guidance for infant feeding. Methods Three indicators minimum dietary diversity(MDD), minimum meal frequency(MMF) and minimum acceptable diet(MAD) were used to evaluate the rationality of complementary feeding.Multivariate Logistic regression model was used to analyze the relevant factors. Results The eligibility rates of MDD, MMF and MAD for children aged 6—23 months were 62.3%, 75.1% and 44.0%.Compared with children aged 6—11 months, children aged 12—17 and 18—23 months had a lower risk for ineligible MDD(OR=0.234, 0.105) and ineligible MAD(OR=0.429, 0.400).Compared with parents who scored less than 60 in knowledge and attitude towards nutrition and health, parents who scored 60—79(OR=0.691, 0.648, 0.662) and 80—100(OR=0.560, 0.400, 0.480) had a lower risk for ineligible MDD, MMF and MAD.Poor economic condition was a risk factor for complementary feeding of infants. Conclusions The complementary feeding of infants and young children in rural areas of Hunan needs to be improved.Younger month-age, lack of parental knowledge about nutrition and health and low regional economic level are high-risk factors for improper complementary feeding.
    Application of different doses of vitamin D supplementation in premature infants
    LIU Yi-rong, ZENG Chun-ying, ZHANG Wen-jing, LIU Dong, CAI Yue-ju
    2021, 29(10):  1142-1144.  DOI: 10.11852/zgetbjzz2020-1807
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    Objective To evaluate the effect of different doses of vitamin D supplementation on vitamin D level of preterm infants with gestational age ≤34 weeks at discharge,in order to provide evidence for the post-natal vitamin supplementation of premature infants. Methods A total of 67 premature infants with gestational age 34 weeks or less in Boluo Maternal and Child Care Hospital from January 2019 and June 2020 were randomly divided into low-dose group(32 cases) and high-dose group(n=35) after full enteral feeding. Then the discharge level of 25(OH)D,vitamin D insufficiency and related adverse reactions were compared. Results There was no statistically significant difference in the level of 25 (OH) D of umbilical cord blood at birth between low-dose group and high-dose group (P>0.05). The serum 25 (OH) D level of infants in the high-dose group was significantly higher than that of the low-dose group(t=2.872,P<0.05). The incidence of vitamin D deficiency/insufficiency at discharge in the high-dose group was significantly lower than that in the low-dose group (χ2=4.189,P<0.05). However,the incidence of vitamin D deficiency/deficiency in the high-dose group still reached to 28.6%. Conclusions For premature infants with gestational age ≤34 weeks,supplementing vitamin D at 800 U/d can significantly improve the deficiency or insufficiency of vitamin D at discharge. However,for ultra-low birthweight infants with lower gestational age and lower birth weight,a larger dose of vitamin D supplementation may be required.
    Analysis on influencing factors of adolescent health-related behavior in Xi′an urban and rural area
    YANG Feng, LIU Jing, WANG Jian-bang, LIJie, ZHANG Jun, PENG Yin-jie, LIU Li-ping, YANG Huan
    2021, 29(10):  1145-1149.  DOI: 10.11852/zgetbjzz2021-0448
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    Objective To understand the health-related behavior status of Xi ′an urban and rural area adolescents and its influencing factors, so as to provide reference for adolescent health education. Methods By using random cluster sampling method, 748 adolescents were surveyed from September to October 2019 with questionnaires about exercise, diet, internet use, smoking, drinking, suicidal ideation and sex-related behaviors.Binary Logistic regression analysis was used to analyze the influencing factors. Results The reported rates of lack of exercise, dietary bias, smoking, drinking, excessive internet use, suicidal ideation and sex-related behaviors were 52.1%, 40.7%, 14.3%, 30.8%, 22.0%, 14.6% and 19.3%, respectively.Logistic regression analysis showed that the risk factors for lack of exercise included female, high school students, weight, parents′ relaxed requirements, loneliness; risk factors for partial eating behavior included more monthly living expenses and heavy learning stress; risk factors for smoking included male, age, poor academic record, loneliness; risk factors for included male, age, more monthly living expenses, loneliness; risk factors for excessive online time included male, junior school students, parents′ relaxed requirements, poor academic performance; risk factors for suicidal ideation included living in town, only child, poor parental relationship, heavy learning stress, loneliness; sex-related behaviors included male, high school students, parents′ relaxed requirements and loneliness. Conclusions The rate of self-reported health-related behaviors is still high, especially the partial eating behavior.Boys are more prone to excessive internet use, smoking, drinking and sex-related behaviors.Loneliness and study stress affect multiple health-related behaviors.So it is supposed to strengthen the emotional guidance for teenagers and help the boys to establish healthy behavior.
    Effect of early breast milk and breast milk fortifier feeding on the growth and development as well as nutritional status of very low birth weight infants
    ZHU Xiao-bing, HU Xiao-su, ZOU Dan, RUAN Hong
    2021, 29(10):  1150-1153.  DOI: 10.11852/zgetbjzz2020-2009
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    Objective To investigate the effect of early breast milk and breast milk fortifiers on the growth and development as well as nutritional status of very low birth weight infants(VLBWI),so as to provide evidence for clinical application. Methods A total of 300 cases of VLBWI admitted to the neonatal intensive care unit of People′s Hospital of Kaizhou District from January 2016 to May 2019 were selected as the study objects. According to different feeding methods,the infants were divided into breast milk group,breast milk combined with breast milk fortifier group,premature formula milk group,breast milk combined with premature formula milk group,with 75 cases in each group. The growth and development,nutritional status and complications of the four groups were compared. Results There was no significant difference in average weight growth rate,average body length growth rate,average head circumference growth rate and time taken to recover to birth weight among the four groups(F=0.083,1.217,1.225,1.512,P>0.05).The rates of feeding intolerance and necrotizing enterocolitis in the breast milk combined with breast milk fortifier group were significantly lower than those in the preterm formula milk group,breast milk combined with preterm formula milk group(x2=14.620,10.170, 6.996,5.042,P<0.05).In terms of the rates of bronchopulmonary dysplasia,nosocomial infection and retinopathy,the difference was not statistically significant among the four groups(x2=1.542,0.896,0.779,P>0.05). Conclusions The growth,development and nutritional status of very low birth weight infants fed with early breast milk and breast milk fortifiers will not be impacted. Meanwhile,early breast milk and breast milk fortifiers can reduce the incidence of feeding intolerance and complications of necrotizing enterocolitis,which can be promoted in clinical practice.