Table of Content

10 November 2021, Volume 29 Issue 11

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Professional Forum

Current status of the rehabilitation assessment system for children with brain injury in China

PANG Wei

2021, 29(11):  1157-1160.  DOI: 10.11852/zgetbjzz2021-1600

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Accurate assessment is crucial to the diagnosis, determination of severity and prognosis, development of rehabilitation plans and evaluation of rehabilitation outcomes in children with brain injury. This paper briefly reviews the development of rehabilitation assessment tools for children with brain injury in China in terms of brain imaging technology, developmental screening and diagnosis, motor ability, language and intelligence assessment, and makes suggestions for future development, aiming to promote the development of a comprehensive rehabilitation assessment system for children with brain injury in China.

Original Articles

Effect of biomechanics correction insole on lower limb function and gait of spastic cerebral palsy children with hallux valgus

KONG Ya-min, LI Hua-wei, XIE Ke-gong, MA Bing-xiang

2021, 29(11):  1161-1166.  DOI: 10.11852/zgetbjzz2021-0488

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Objective To investigate the effect of biomechanics orthopedic correction of insole(ICB insole) on lower limb function and gait in spastic cerebral palsy children with hallux valgus, in order to provide effective treatment and clinical basis for the treatment of spastic cerebral palsy children with hallux valgus. Methods From January 2017 to December 2019,80 children with spastic cerebral palsy were enrolled in this study and were randomly divided into control group (n=40) and observation group (n=40).The control group received rehabilitation training, while the observation group was given ICB orthopedic insole additionally.After 6 months of treatment, medial longitudinal arch (MLA), each stage of support phase, arch index (AI), step length, step frequency, step speed, Gross Motor Function Measure-88 (GMFM-88) and Berg Balance Scale (BBS) scores were measured. Results 1) After treatment, MLA, each stage of support phase, AI, step length, stride frequency, stride speed, GMFM-88 and BBS scores in control group and observation group showed a significant downward trend (P<0.01).2) After treatment, there were significant differences in right MLA, each stage of support phase, AI, step length, stride frequency, stride speed, BBS GMFM-88 and D.E region of scores between control group and observation group (t=2.571、0.827、1.449、1.670、3.512、3.202、5.828.5.585、2.675、4.721、2.345,P< 0.05).3) After treatment, there was no significant difference in the left inner arch angle between control group and observation group (P>0.05), but the downward trend of observation group was better than that of control group. Conclusions ICB orthopedic insole combined with rehabilitation training can improve the valgus foot of children with spastic cerebral palsy, improve the motor function and walking ability of both lower limbs, and can be used as an auxiliary method for the clinical treatment of valgus foot in children with spastic cerebral palsy.

Frequency-dependent changes in the degree centrality in children with nocturnal enuresis

ZHENG Xiang-yu, SUN Jia-wei, JIA Xi-ze, LYU Ya-ting, WANG Meng-xing, MA Jun

2021, 29(11):  1167-1171.  DOI: 10.11852/zgetbjzz2021-0003

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Objective To explore the characteristics of brain network signal transmission in children with nocturnal enuresis (NE) in different frequency bands, and to find abnormal brain areas, so as to provide theoretical basis for follow-up precision treatment. Methods A case-control study was adopted. According to the criteria of the International Children′s Continence Society (ICCS), 129 children with NE and 37 children without enuresis in Shanghai Children′s Medical Center were enrolled in this study from 2016 to 2018. Degree centrality (DC) was analyzed in the typical band (0.01-0.08 Hz) and in slow 5 (0.010-0.027 Hz). T test were used to compare the differences between the two groups in the different frequency bands. Results were corrected using Gaussian random field (GRF) theory (P<0.05 for voxels and P<0.05 for clusters). Results In the typical frequency band, children with enuresis had significantly higher DCs in the left rolandic operculum (t=4.469 9, GRF corrected P<0.05 for voxel, P<0.05 for clusters), right rolandic operculum(t=4.351 6, GRF corrected P<0.05 for voxel, P<0.05 for clusters) and left middle cingulate gyrus (t=4.139 7, GRF corrected P<0.05 for voxel, P<0.05 for clusters), while lower DCs in the right gyrus rectus (t＝-4.127 2, GRF corrected P<0.05 for voxel, P<0.05 for clusters) and the left middle frontal gyrus (t＝-4.835 5, GRF corrected P<0.05 for voxel, P<0.05 for clusters). In sub-bands, DC values of children with nocturnal enuresis were increased in the left thalamus (t=3.905 4, GRF corrected P<0.05 for voxel, P<0.05 for clusters) and decreased in the right superior frontal gyrus, orbital part (t＝-4.509 6, GRF corrected P<0.05 for voxel, P<0.05 for clusters). Conclusions Brain regions with abnormal DC values in band 5 are directly related to the regulation of voiding function in children, according to previous study. And the function of brain regions in the typical band needs to be further investigated. Increased DC values in the left thalamus and decreased DC values in the frontal middle gyrus may affect the transmission of information in the voiding network of children, which may contribute to the occurrence of nocturnal enuresis.

Investigation and clinical phenotypic analysis of gene copy number variation in 120 children with intellectual disability/developmental delay in Anhui province

CHEN Lu-lu, TONG Guang-lei, ZHOU Tao-cheng, LI Hong, XU Yan-hong, SU Wei, LUO Yuan-yuan, LIANG Dong

2021, 29(11):  1172-1175.  DOI: 10.11852/zgetbjzz2020-1808

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Objective To investigate the detection of pathogenic and likely pathogenic copy number variations (CNVs) in 120 children with intellectual disability (ID)/developmental delay (DD) in Anhui province, and to analyze the clinical phenotype of the children, so as to clarify the genetic etiology of ID/DD children. Methods A total of 120 children with unexplained ID/DD who were treated in the Department of Pediatric Rehabilitation of Anhui Children′s Hospital from May 2019 to June 2020 were selected and tested for the presence of pathogenic and likely pathogenic CNVs by chromosome microarray analysis (CMA).The clinical phenotype and characteristics of pathogenic and likely pathogenic CNVs were analyzed. Results Among 120 children with ID/DD, pathogenic CNVs were detected in 18 cases (15.00%), likely pathogenic CNVs in 2 cases (1.67%), variation of uncertain significance CNVs in 39 cases (32.50%), and likely benign and benign CNVs in 61 cases (50.83%). Among 20 children with pathogenic and likely pathogenic CNVs, 5 had congenital malformations/special faces, and 14 had one or more other diseases. There were 3 cases, 12 cases and 5 cases with mild, moderate and severe mental retardation, respectively. There were 21 pathogenic and likely pathogenic CNVs in 20 children with ID/DD, including 13 microdeletion fragments (61.90%) and 8 microduplication fragments (38.10%) with a ratio of 1.63∶1. The average fragment size was 6.34 Mb. Twenty one pathogenic and possibly pathogenic CNVs were detected most on chromosomes 2 and 22 (3 locations).Among the 20 children with ID/DD, 10 cases (50.00%) had known syndromes, and 10 cases (50.00%) had still undefined syndromes or disease areas in the database. Conclusion For children with unexplained ID/DD, CMA detection can clarify the genetic etiology, which is of great significance for the treatment of children and guidance for their parents to reproduce.

Associations of sleep duration with overweight and obesity in school-age children

ZHANG Xue-rong, CHEN Tian-jiao, MA Jun

2021, 29(11):  1176-1180.  DOI: 10.11852/zgetbjzz2020-1604

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Objective To investigate the influencing factors of night sleep time and its relationship with overweight and obesity in children, so as to provide scientific reference for taking interventions of overweight and obesity. Methods A total of 1 175 students from 8 schools(4 primary schools in urban and rural areas, respectively) in Fangshan District, Beijing, were recruited by a stratified cluster random sampling method in October 2012. The distribution characteristics of sleep time and its relationship with overweight and obesity were analyzed by using multivariate binary Logistic regression model. Results The sleep insufficiency rate of school-age children(<10 h/d) reached 68.5%. Demographic characteristics affected the sleep time of children, and urban students and boys had less sleep time (P<0.001).Body mass index(BMI) and the rates of obesity and overweight increased with the decreasing of sleep duration (P<0.01).The average daily sleep duration <9 h/d was a risk factor for overweight and obesity of school-age children. After the adjustment of gender, residence, family income, parents′ educational level, physical activity and sedentary behavior time, only the average daily sleep duration <9 h/d on weekends was associated with overweight and obesity of school-age children[OR=1.570 (1.074-2.295),P=0.02]. Conclusions Sleep insufficiency may be a risk factor for overweight and obesity in children, especially the average daily sleep duration of weekends. The prevalence of overweight and obesity should be prevented and controlled through targeted improvement of children′s sleep duration and lifestyle.

Epidemiologic status and influencing factors of overweight and obesity in children and adolescents aged 6 to 17 years in Henan province

ZHANG Yao-dong, WANG Yi-ran, HUANG Xiao-pei, WEI Hai-yan

2021, 29(11):  1181-1185.  DOI: 10.11852/zgetbjzz2020-1326

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Objective To understand the epidemiologic status of overweight and obesity among children and adolescents aged 6 to 17 years in Henan Province, and to explore the influencing factors, in order to provide reference for developing effective intervention measures. Methods Questionnaire survey and physical examination were conducted among 6- to 17-year-old students with a stratified cluster sampling method in seven cities of Henan Province in 2019. Chi-square, one-way analysis of variance and Logistic regression model were used to data analysis. Results A total of 19 390 children and adolescents were included in this study. The detection rate of overweight and obesity was 42.3%, of which 4 415 (22.8%) weredetected with overweight and 3 790 (19.5%) were detected with obesity. The detection rates of overweight and obesity in the 10 390 boys were 23.0% and 20.8%, respectively. The detection rates of overweight and obesity in the 9 000 girls were 22.5% and 18.1%, respectively, which were significantly lower than those of boys. The detection rates of overweight and obesity in elementary school students were higher than those of high school students and junior high school students. Multivariate Logistic regression analysis showed that risk factors of overweight and obesity included paternal overweight (OR=1.842), maternal overweight (OR=2.586), preferring to eat sweets and puffed food (OR=3.161), eating too fast (OR=3.268), eating out frequently (OR=1.882), watching TV and playing mobile phone for more than 2 hours everyday (OR=2.376) and insufficient sleep time everyday (OR=2.640). Conclusion The detection rates of overweight and obesity among children and adolescents are relatively high in Henan Province, so targeted intervention measures should be implemented to reduce the prevalence of overweight and obesity effectively.

Association between fatty liver and sleep quality among adolescents in Shanghai

ZHOU Hui-qing, YAO Min

2021, 29(11):  1186-1188.  DOI: 10.11852/zgetbjzz2021-0135

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Objective To preliminarily explore the correlation between fatty liver and sleep quality in adolescents in Shanghai. Method A total of 1 121 students from Shanghai completed Adolescent Sleep Quality Questionnaire and had their liver fatty content measured with FibroScan. Results The detection rate of fatty liver in all adolescents was 9.01% (101/1 121), with no significant difference between genders [male:8.84%(49/554), female:9.17%(52/567), χ²=0.03, P>0.05].The detection rate of poor sleep quality in all adolescents was 21.05% (236/1 121), with no significant gender difference [(male:21.48%(119/554), female:20.63%(117/567),χ²=0.07, P>0.05)].The detection rate of poor sleep quality was 25.74% in 101 students with fatty liver and 20.59% in 1 020 students without fatty liver, but it was not significantly different (χ²=0.93, P>0.05). Moreover, there were no significant differences on subjective sleep quality, sleep duration, sleep effect and daytime dysfunction between students with and without fatty liver(P>0.05). Conclusion The inter-relationship between fatty liver and sleep quality in adolescents in Shanghai needs to be further studied.

Effect of autologous umbilical cord blood infusion combined with rehabilitation on children with brain injury

ZHANG Yi-wen, CAO Jian-guo, LIU Qing, YUN Guo-jun, WANG Jing-gang

2021, 29(11):  1189-1192.  DOI: 10.11852/zgetbjzz2020-2185

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Objective To explore the safety, feasibility and effectiveness of autologous umbilical cord blood (UCB) therapy combined with rehabilitation on children with brain injury, in order to provide a new idea and approach for the treatment of children with brain injury in clinic. Methods A total of 11 children with brain injury who underwent autologous UCB infusion treatment and adhered to rehabilitation in Shenzhen Children′s Hospital from July 2018 to May 2020 were selectedinto observation group, and 11 brain injury children with no significant difference in functional status from observation group were selected as control group. The observation group received rehabilitation treatment for half a year since UCB infusion, while the control group only received conventional rehabilitation treatment for half a year. Both groups were evaluated for their functional level before and half a year after treatment. Paired-sample t-test was used to compare the levels of neurone specific enolase (NSE) and inflammatory factors before treatment and 2 weeks after UCB therapy. Results The gross and fine motor skill, rough intelligence scores of the observation and the control group significantly improved after treatment in both observation group and control group. Besides, the above index scores were significantly higher in observation group (t=7.214, 3.310, 3.641, P<0.05). Two weeks after treatment, the pro-inflammatory cytokines(IL-2, IL-6) and NSE levels of the children in observation group were significantly decreased(t=3.304, 3.206, 3.709, P<0.05), while the anti-inflammatory cytokines(IL-4, IL-10) level was significantly increased(t=3.937, 4.316, P<0.05). In addition, no obvious side effects and complications were found during the treatment and long-term follow-up. Conclusion Autologous UCB infusion is a safe and feasible method, and has a significant effect in improving the functional level of children with brain injury when combined with rehabilitation training.

Basic Experimental Articles

Effect and mechanism of long non-coding RNAnuclear-enriched abundant transcript 1 on hippocampal neuronal apoptosis in epilepsy model

QU Hui-xia, YUAN Xiao-feng, QU Xin

2021, 29(11):  1193-1197.  DOI: 10.11852/zgetbjzz2021-0402

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Objective To investigate the effect and mechanism of long non-coding RNA (lncRNA) nuclear-enriched abundant transcript 1(NEAT1)on hippocampal neuron apoptosis in epilepsy cell model, in order to provide evidence for NEAT1 being the new target of epilepsy treatment. Methods The rat hippocampal neuron cells were cultured in vitro and induced without magnesium to prepare epileptic hippocampal neuron models.The experiment included control group (normal extracellular fluid), model group (magnesium-free extracellular fluid), transfection control group (transfection non-specific siRNA+magnesium-free extracellular fluid) and transfection group(transfected with NEAT1 specific siRNA+ magnesium-free extracellular fluid).The expression changes of NEAT1 and miR-29b-3p were detected by real-time fluorescent quantitative PCR (qPCR).The dual luciferase reporter gene experiment detected whether NEAT1 targets miR-29b-3p, and interleukins-1(IL-1), interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) content were tested by enzyme-linked immunosorbent assay(ELISA) .AnnexinV-FITC/PI double staining method was used to detect hippocampal neuronal cell apoptosis, protein Western blot was used to detect the expression levels of B cell lymphoma/lewkmia-2 (Bcl-2), Bcl-2 Associated X Protein (Bax), toll-like receptor-4(TLR4) and nuclear factor-κB(NF-κB) in cells of each group. Results Compared with the control group, the apoptosis rate of hippocampal neurons and the expression levels of NEAT1, Bax, TLR4 and NF-κB in the model group increased (F=50.980, 73.668, 65.635, 13.203, 10.292, P<0.05), the contents of IL-1, IL-6 and TNF-α increased (F=33.107, 33.857, 51.129, P<0.05), the expression levels of miR-29b-3p and Bcl-2 decreased (F=145.023, 67.655, P<0.05).While inhibiting the expression of NEAT1 can reduce neuronal apoptosis, inhibit the expression of Bax, TLR4 and NF-κB, promote the expression of miR-29b-3p and Bcl-2, and reduce the secretion of IL-1, IL-6 and TNF-α.The dual luciferase reporter gene experiment confirmed the targeting relationship between NEAT1 and miR-29b-3p. Conclusion lncRNA NEAT1 targets to down-regulate the expression of miR-29b-3p and block the TLR4/NF-κB signaling pathway to inhibit the apoptosis of hippocampal neurons in epilepsy models.

Review

Research progress on the serious games in the intervention of the children′s developmental coordination disorder

XU Zi-han, HOU Shi-lun

2021, 29(11):  1198-1202.  DOI: 10.11852/zgetbjzz2020-1288

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Exercise therapy is one of the treatment methods of children′s developmental coordination disorder(DCD),while the traditional exercise approach has many limits,including the boring experience of training and the relatively low compliance of patients. Serious games,whichcombine electronic games with exercise therapy to build the oriented task form of intervention for DCD,has better performance in the flexibility of treatment,the richness of content,and the patient′s compliance. Recent researches in home and abroad indicate that serious games play a positive role in the intervention for children with DCD.

Research progress on the influencing factors of nutritional status of children with cerebral palsy

LI Ying-yan, LI Xin, HUANG Xin-ping, XU Hai-lan, PANG Wei

2021, 29(11):  1203-1207.  DOI: 10.11852/zgetbjzz2020-1304

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Cerebral palsy is a kind of postural and motor developmental disorder secondary to early central nervous system injury in infants. In recent 20 years,people not only pay attention to the physical disability of children with cerebral palsy,but also give more concern to their nutrition and health. Previous studies have found that children with cerebral palsy have many nutritional problems, which will not only affect the prognosis of cerebral palsy,but also affect the growth and even life expectancy of children with cerebral palsy. Nutrition problems of children with cerebral palsy have been paid attention to by the rehabilitation clinic. In this paper,literature at home and abroad in recent years is reviewed and the factors affecting the nutritional status of children with cerebral palsy are analyzed from multiple dimensions,hoping to provide a breakthrough point for the implementation of clinical nutritional intervention for children with cerebral palsy.

Research progress on the indicators of cardiometabolic risk in obese children

HAN Yan, PENG Lu-ting, LI Xiao-nan

2021, 29(11):  1208-1212.  DOI: 10.11852/zgetbjzz2020-1285

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Childhood obesity increases the cardiometabolic risks (CMR) such as dyslipidemia,hypertension,and hyperglycemia,and usually persists into adulthood,leading to younger age trend of metabolic diseases. At present,a large number of studies have found that uric acid,retinol-binding protein 4,vitamin D and other factors are related to the CMR in obese children,which can be used as a marker of CMR and provide new ideas for the prevention and treatment of cardiovascular metabolic diseases. Therefore,it is of great importance to understand the relationship and mechanism between indicators and CMR,which is beneficial for early identification and intervention of high-risk groups of cardiovascular and metabolic diseases.

Research advances on the diagnosis and treatment of hypophosphatemic rickets in children

XU Yu-yan, ZHU Liu-yan, SHAO Jie

2021, 29(11):  1213-1217.  DOI: 10.11852/zgetbjzz2020-1413

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Hypophosphatemic rickets(HR),also known as familial hypophosphatemia,is a hereditary disease characterized by hypophosphatemia and renal phosphate loss,mainly manifested as bone mineralization disorders. It includes a group of diseases with similar phenotypes but different genotypes,hereditary patterns and etiologies. The most common HR is X-linked dominant hypophosphatemic rickets(XLH). Uncommon HR may be caused by autosomal dominant or recessive inheritance. Activation mutation of fibroblast growth factor 23(FGF23) gene and inactivation mutation of regulation gene involved in FGF-23 regulation have been confirmed and proved to be related to the pathogenesis of these disorders. The pathophysiology,pathogenesis,clinical manifestations,diagnosis and treatment of HR will be reviewed in this paper reviews.

Literature review on coparenting and related scales or questionnaires commonly used

WU Ru-xing, CHENG Xu-wen, CHEN Jin-jin, CHEN Ru-nan, ZHU Da-qiao

2021, 29(11):  1218-1222.  DOI: 10.11852/zgetbjzz2020-1410

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Coparenting was firstly proposed by American scholars,and its conceptual definition has not been completely consistent. Although the research on coparenting started relatively late in China,domestic scholars discovered new dimensions with cultural characteristics (such as red/white face) in the process of introducing and cross-cultural adjustment of coparenting assessment scales and questionnaires. This paper attempts to carry out a conceptual analysis of coparenting and to sort out the commonly used scales and questionnaires systematically,so as to provide reference for domestic scholars to select reasonable and effective assessment tools.

Current situation and prospect of X-linked hypophosphatemia rickets

LI Wen-xin, REN Li-hong

2021, 29(11):  1223-1227.  DOI: 10.11852/zgetbjzz2020-1919

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X-linked hypophosphatemia rickets(XLH) is a hereditary metabolic bone disease with a complex pathogenesis and is relatively rare clinically. Its main clinical manifestations are skeletal malformation and short stature with a high disability rate. Therefore, early diagnosis and treatment of XLH is of great significance to the rehabilitation of patients. Traditional treatment mainly focuses on supplementing phosphate and vitamin D analogue. With the gradual deepening of scholars′ research on the pathological mechanism of XLH, new therapeutic methods such as molecular targeted therapy have emerged, bringing good news to patients through multidisciplinary joint diagnosis and treatment. In this paper, the clinical characteristics, pathogenesis, treatment status and future development trend of XLH will be reviewed.

Clinical Research

Longitudinal follow-up study on neuropsychiatric development of low birth weight infants at different gestational ages within two years old

JIANG Chun-hua, HUANG Jun, LI Yun, ZHANG Ying, ZHONG Ping-li, CHEN Min, YU Wen-xian, XU Lan, ZHAO Li-ping, PENG Yong-Mei, ZHOU Ting-ting, JIANG Hong

2021, 29(11):  1228-1232.  DOI: 10.11852/zgetbjzz2020-2016

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Objective To analyze the neuropsychological development of low birth weight infants (LBWI) with different gestational ages within the age of two years, so as to provide basis for targeted early intervention. Methods From January 2016 to February 2017, a total of 280 low birth weight infants (LBWI) who completed neuropsychological development follow-up within the age of two years in Minhang District of Shanghai were collected. According to gestational age, children were divided into three groups: early preterm (28-33⁺⁶ weeks, EPT), late preterm (34-36⁺⁶ weeks, LPT) and term infants (37-41⁺⁶ weeks, T). General movements(GMs) assessment and Gesell scale were adopted to evaluate the children′s neurobehavioral development. Results The abnormal rate of GMs in preterm birth or torsion stage was found higherin the lower gestational age group (χ²=7.36,P＜0.05), while no significant difference existed in the restless movement stageamong EPT group, LPT group and T group(χ²=4.36, P>0.05). Gesell results indicated that except for the five domains at 9 months old and the language, individual-social domains at 18 months old in EPT group, all of the development quotient (DQ) of the five domains of Gesell scale reached the normal level(DQ≥86). The DQ of the five domains scored lower in the lower gestational age group (P<0.05), except for the domains of language and individual-social at 24 months old. The higher rate of developmental delay(DQ＜86) was found in the lower gestational age group, with statistically significant difference among EPT group, LPT group and T group in the five domains at 9 months old and in the domains of fine motor, adaptability and individual-social at 18 months old (P<0.01). Multiple linear regression analysis indicated that a significantly positively correlation existed between gestational age and the DQ of all the domains in different age groupsexcept for the domain of individual-social at 24 months oldafter adjustment for confounding factors, including children, parents and families(β: 0.612-2.382, P<0.01). Conclusions Gestational age at birth is an important and independent factor for the neuropsychological development of LBWI within 2 years old, and children with lower gestational age have the worse development. Preterm infants have a catch-up in neuropsychological development, which can reach the normal level until 2 years old. But the DQ of the domains of gross motor, fine motor and adaptability are still lower than the full-term infants. Thus it is supposed to strengthen the early systematic healthcare of LBWI, especially for the preterm children, in order to realize the early detection and personalized intervention of the developmental delay and to promote the early reasonable catch-up and all-around balanced development.

Analysis of the influencing factors for congenital hypothyroidism in 45 infants

ZHANG Xue-mei, XIE Bang-gui, CHEN Xiao-bing, PAN Cai-qin, LU Yu-zhu, LI Jun-ke, CHEN Qiu-ning

2021, 29(11):  1233-1236.  DOI: 10.11852/zgetbjzz2020-1959

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Objective To investigate the incidence and influencing factors of congenital hypothyroidism (CH), so as to provide basis for the prevention and treatment of CH. Methods From January 2015 to December 2019, the newborns undergoing neonatal disease screening in local region were enrolled in this study, and the incidence rate and distribution of CH were analyzed. Univariate and multivariate Logistic regression analysis methods were used to analyze the related factors of CH. Results The total number of neonatal screening from 2015 to 2019 was 127 524, of whom 45 cases were diagnosed with CH, and the overall incidence rates of CH in 5 years was 35.29/10⁵. The incidence rate of CH in winter and spring were higher than that in summer and autumn, but the difference was not statistically significant (χ²=0.884, P=0.347). The incidence rates of CH in preterm infants was the highest (251.68/10⁵), significantly higher than that of full-term infants(20.93/10⁵,χ²=105.839, P＜0.001).Multivariate Logistic regression analysis showed that low birth weight(OR=3.172, 95%CI: 2.185-8.116, P=0.012), premature delivery(OR=2.662, 95%CI: 1.904-7.115, P=0.008), gestational diabetes mellitus(OR=1.973, 95%CI:1.362-4.950, P=0.037), pregnancy induced hypertension(OR=1.892, 95%CI: 1.207-4.216, P=0.024),medication history(OR=2.350, 95%CI: 1.802-6.713, P=0.016), radiation exposure history(OR=2.712, 95%CI:1.938-7.346, P=0.028) and iodine deficiency during pregnancy(OR=4.120, 95%CI: 2.713-9.150, P＜0.001) were the risk factors of CH (P<0.05). Conclusions The incidence rate of CH is high in local region, and there are many risk factors that affect the incidence rates of CH. So it is supposed to make preventive measures based on these factors to reduce the incidence of CH.

Characteristics of neurodevelopment in 18- to 36-month-old children with language delay

ZHAO Li, CAI Shi-zhong, WU Ying, ZHANG Li-jun, JI Yi-ting, CHEN Yan

2021, 29(11):  1237-1241.  DOI: 10.11852/zgetbjzz2020-2031

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Objective To retrospectively analyze the characteristics of neurodevelopment in children with language developmental delay aged 18 to 36 months, so as to provide theoretical evidence for further assessment and intervention. Methods Children with language problems aged 18 to 36 months from 2018 to 2019 were enrolled in this study from Children′s Hospital of Soochow University. Children′s neurodevelopment was assessed by Chinese Children Development Scale and Early Language Milestone Scale, which divided them into two groups according to the results: simple language delay and global developmental delay. The development quotients(DQ) of each dimension and early language development were compared within two groups. Positive detection rate of autism was analyzed. Results A total of 700 children were included. There were no significant differences in age(t＝-1.73,P=0.09) and gender(χ²=2.06,P=0.15)between the two groups. The development of language areas, gross motor, fine motor, adaptability and social interaction in global developmental delay group was significantly worse than that in simple language delay group(t=15.08, 20.26, 25.68, 18.76, 39.79,P＜0.001). In addition, early language development in general language development, language understanding, expression and auditory perception, and visual-related language decreased significantly in global developmental delay group compared with simple language delay group (t=8.20, 10.23, 9.18. 11.39,P<0.001). Language delay was related to the DQ of fine motor, adaptability and social interaction in simple developmental delay group (r=0.127, 0.146, 0.238, P<0.001), while it was associated with the DQ of each dimension in global developmental delay group(r=0.154, 0.392, 0.390, 0.435, P<0.001). The positive detection rate of autism screening in global developmental delay group was significantly higher (χ²=61.69, 105.17, P<0.05). Conclusion Children with early language delay combined with backwardness in multiple dimensions have a significant lag in language development and should be further examined to identify neurodevelopmental disorders.

Differences in blood amino acids and acyl carnitine between full-term small for gestational age newborns and full-term suitable for gestational age newborns

FANG Qiao-yan

2021, 29(11):  1242-1244.  DOI: 10.11852/zgetbjzz2021-0294

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Objective To study the difference of blood amino acids and acyl carnitine between full-term small for gestational age newborns and their matched full-term suitable for gestational age newborns, so as to provide reference for the supplementation of amino acids in full-term small for gestational age newborns. Methods From April 2019 to July 2020, a total of 57 cases of full-term small for gestational age newborns in Hunan Provincial Maternal and Child Health Hospital were selected into study group, and meanwhile 57 cases of matched full-term suitable for gestational age newborns born in this hospital were selected as the control group.The levels of blood amino acids and acyl carnitine between the two groups were measured respectively, and their differences were analyzed. Results There were no significant differences in butyryl carnitine, 3-hydroxy isoamyl carnitine, isoamyl carnitine, sunoyl carnitine, leucine and methionine between study group and control group (t=1.707, 1.122, 1.122, 1.638, 1.855, 1.638, P>0.05), but significant differences existed in propionyl carnitine, free carnitine, myristoyl carnitine, octanoyl carnitine, tyramine and valine between the two groups (t=5.524, 3.392, 4.530, 4.716, 4.530, 3.547, P<0.05). Conclusions There are significant differences in blood amino acids and acyl carnitine between full-term small for gestational age newborns and full-term suitable for gestational age newborns, so full-term small for gestational age newborns are given critical attention from clinicians.It is supposed to supplement amino acids for full-term small for gestational age newborns as soon as possible, and to encourage early mobilization of medium and long chain fatty acids to stabilize energy metabolism.

Correlation between quality of life and mental health of left-behind children and influencing factors of their quality of life

WANG Wen, CHEN Dan-dan, ZHANG Xin-hui

2021, 29(11):  1245-1248.  DOI: 10.11852/zgetbjzz2021-0612

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Objective To analyze the correlation between quality of life (QOL) of left-behind children and their mental health, and to explore its influencing factors, so as to provide theoretical evidence for improving their QOL. Methods From September 2017 to September 2020, 208 left-behind children in the fourth grade to sixth grade of a primary school in this area were selected for investigation.The Universal Core Scale of Quality of Life for Children (PedsQL4.0) was used to evaluate the QOL of left-behind children, the Mental Health Diagnostic Test (MHT) was used to evaluate their mental health.Pearson correlation analysis method was adopted to analyze the correlation between the QOL of left-behind children and mental health, and the multiple linear stepwise regression model was used to analyze the influencing factors affecting QOL of left-behind children. Results The total score of PedSQL4.0 scale for left-behind children was (80.52±9.58) points, and the MHT test was (8.27±0.99) points.The QOL scores of left-behind children were negatively correlated with their mental health scores (P<0.05).Multivariate analysis showed that the factors influencing the total score of the QOL of left-behind children were education level of caregivers, interest and hobbies, frequency of contact with parents, and parents′ working time (β=3.122, 4.057, 2.524,-2.018, P<0.05). Conclusions Left-behind children′s QOL is closely related to their mental health.Factors such as the education level of caregivers, whether children have hobbies, the frequency of contact with their parents, and duration for their parents going out to work can significantly affect the quality of life of left-behind children.

Effects of transcranial direct current stimulation intervention on fine motor function in children with cerebral palsy

CHEN Yan, XIANG Xi, XIE Hui, SUN Wei, HU Jin-lu

2021, 29(11):  1249-1252.  DOI: 10.11852/zgetbjzz2020-1893

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Objective To analyze the effect of transcranial direct current stimulation (tDCS) intervention on fine motor function in children with cerebral palsy, in order to provide theoretical reference for clinical application. Methods A total of 60 children with cerebral palsy aged 4 to 6 years were selected in the rehabilitation department of Chenzhou First People′s Hospital from June to December 2019, and were randomly divided into 2 groups. The control group (n=30) was treated with conventional rehabilitation, while the observation group (n=30) was given tDCS additionally. Both groups were treated for 6 weeks, with a frequency of 1 time/day, 5 days/week. The Peabody Fine Motor Development Scale (PDMS-FM) and Fine Motor Function Evaluation Scale (FMFM) were used to evaluate the changes of the two groups. Then the effect of intervention was compared. Results There was no significant difference in total effective rate between observation group and control group (92.9%vs.82.5%,χ²=0.74, P>0.05). However, difference in recovery rate between the two groups was found significant (67.9%vs.37.3%,χ²=5.24, P<0.01). After treatment, PDMS-FM scores of grasping, visual motor integration, fine motor quotient (t/t′=4.71, 2.54, 2.67) and each item in FMFM scale index (t/t′=4.35, 2.74, 3.31, 2.52, 2.15, 2.58) in observation group was significantly higher than those in control group (P<0.01 or <0.05). In both observation group and control group, PDMS-FM scale index (observation group t=16.67,23.13,6.59 and control group t=7.42, 14.81, 2.71) and each item in FMFM scale index (observation group t/t′=12.10, 13.51, 16.16, 12.62, 9.64, 14.28 and control group t/t′=8.46, 12.11, 9.26, 19.95, 12.97, 15.79) after treatment scored higher than that before treatment (P<0.01 or <0.05). Conclusion Both treatments can effectively improve fine motor function of children with cerebral palsy, but rehabilitation combined tDCS intervention therapy has a better overall efficacy than conventional rehabilitation therapy alone.

Experience Exchange

Expression and clinical significance of serum microRNA-155 in children with recurrent wheezing

SHEN Ren, YANG Shan-pu, WU Yue-chao, ZHOU Yan, ZHANG Lin-tao

2021, 29(11):  1253-1256.  DOI: 10.11852/zgetbjzz2020-2198

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Objective To analyze the expression level of microRNA-155(miRNA-155) in asthmatic predictive index (API) positive and negative children with recurrent wheezing, and to explore the relationship between miRNA-155 and wheezing as well as eosinophil count. Methods A total of 40 children with recurrent wheezing in Yuhuan People′s Hospital from January 2019 to October 2020 were enrolled in the wheezing group, including 27 API positive children and 13 API negative children. Meanwhile, 40 healthy children were selected into the control group. The levels of miRNA-155, eosinophils, IFN-γ and IL-4 in peripheral blood of wheezing group and control group were tested. Results The levels of miRNA-155 and IFN-γ/IL-4 in wheezing group were significantly lower than those in control group(t=2.307, 3.839, P<0.05), while the number of eosinophils in wheezing group was significantly higher than that in the control group(t =5.278, P＜0.05). The miRNA-155 level and the IFN-γ/IL-4 value of API positive children in the wheezing group were significantly lower than those of API negative and control children (H=13.580, F=9.731,P<0.05). In the wheezing group, the number of eosinophils of API positivechildren was significantly higher than that of API negative and control children(F=22.303, P＜0.05). In the wheezing group, the level of miRNA-155 in API positive children was negatively correlated with the number of wheezing(r＝-0.566, P<0.05).The level of miRNA-155 was negatively related to eosinophil count in the wheezing group(r＝-0.630, P<0.05). Conclusion The decrease of miRNA-155 level may be a risk factor for wheezing, and the role of miRNA-155 in wheezing development may be related to eosinophils.

Expressions of serum microRNA-155 and interferon-γ inducible protein 10 in children with bronchial asthma and its clinical significance

QU Meng-ting, FENG Hui-min

2021, 29(11):  1257-1260.  DOI: 10.11852/zgetbjzz2020-2212

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Objective To test the expression levels of serum microRNA-155(miR-155) and interferon-γ inducible protein 10(IP-10) in children with bronchial asthma, and to analyze their correlation with prognosis of children, in order to provide reference for clinical treatment. Methods A total of 72 children with bronchial asthma who were treated in the First Affiliated Hospital of Xinjiang Medical from January 2018 to March 2019 were selected as the study subjects, and 75 healthy children who took physical examination were selected into the control group.Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression of serum miR-155, the levels of serum IP-10, interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) were detected by enzyme-linked immunosorbent assay (ELISA).Pearson method was used to analyze the correlation among miR-155, IP-10, IL-6 and TNF-α.Children with bronchial asthma were followed up within one year after treatment, the number of asthma attacks, average hospitalization times, average hospitalization time and peak expiration flow(PEE) were recorded, and the relationship between the expressions of miR-155 and IP-10 and the prognosis of children was analyzed. Results Compared with those in control group, the expression level of serum miR-155 in children with bronchial asthma was significantly lower (t=13.852, P<0.05), while the expression levels of IP-10, IL-6 and TNF-α were significantly higher in children with bronchial asthma (t=7.317, 10.170, 13.772, P<0.05).Pearson correlation analysis showed that the expression level of serum miR-155 was negatively correlated with IL-6 and TNF-α (r=-0.489,-0.579, P<0.05), the expression level of IP-10 was positively related to IL-6 and TNF-α (r=0.546, 0.599, P<0.05), and serum miR-155 level was negatively correlated with IP-10 level (r=-0.512, P<0.05).The attack times, hospitalization times, hospitalization duration in children with high expression of serum miR-155 within one year were significantly lower than low expression of serum miR-155, and PEE was significantly higher in high expression group of serum miR-155 (t=8.442, 8.933, 10.413, 10.204, P<0.05).While the levels of the above indicators except PEE in children with high expression of serum IP-10 were significantly higher than low expression of serum IP-10, and PEE was significantly lower in high expression group of serum IP-10 (t=7.272, 7.189, 11.589, 9.789, P<0.05). Conclusion miR-155 and IP-10 may be related to airway inflammation in asthma, which are likely to be involved in the pathogenesis and prognosis of bronchial asthma, and the specific mechanism needs be further studied.

Appropriate Technology

Effect of suspension technique combined with acupuncture treatment on the gross motor function and activities of daily living in children with spastic cerebral palsy

WANG Shao-feng, TONG Guang-lei, ZHANG Qing-qing, HOU fang, WU Shan-shan, XU Jin-bo

2021, 29(11):  1261-1264.  DOI: 10.11852/zgetbjzz2021-0033

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Objective To analyze the effect of suspension technique combined with acupuncture on gross motor function and activities of daily living (ADL) in children with spastic cerebral palsy,and to provide theoretical basis for clinical application. Methods A total of 84 children with spastic cerebral palsy were enrolled in this study from 476 children admitted to Anhui Children′s Hospital from January 2018 to December 2019.The random number method was used to divide the participants into control group(n=28), acupuncture group(n=28) and experimental group(n=28).The control group was given routine rehabilitation training, the acupuncture group received acupuncture treatment additionally, and the experimental group was given suspension technique treatment based on the acupuncture group.Before and after treatment, the gross motor function of the children was evaluated in C, D and E domains of the Gross Motor Function Measure (GMFM-88) scale, the cerebral palsy children′s Activities of Daily Living (ADL) scale was used to assess children′s ADL. Results The indicators of each group after treatment were better than those before treatment among three groups(P＜0.05).The GMFM-C, GMFM-D, GMFM-E, ADL scores among the three groups were different after treatment(H=14.044, 16.874, 13.246, 14.590, P＜0.05), and the scores of experimental group were better than those of the control group(P<0.05). Conclusion Suspension technique combined with acupuncture can further promote the improvement of gross motor function and activities of daily living in children with spastic cerebral palsy.

Clinical effect of repetitive transcranial magnetic stimulation combined with extracorporeal shock ware treatment on lower limb function in children with hemiplegia

YUN Guo-jun, WANG Jing-gang, LI Rui-hao, TONG Nan, CAO Jian-guo, GUO Ying-ying

2021, 29(11):  1265-1268.  DOI: 10.11852/zgetbjzz2021-0987

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Objective To observe the clinical effect of repetitive transcranial magnetic stimulation (rTMS) combined with extracorporeal shock wave (ESW) treatment on the lower limb function of children with hemiplegia, so as to provide scientific reference for the rehabilitation of these children. Methods A total of 60 children with hemiplegic cerebral palsy were randomly assigned to the study group and control group.Both groups received conventional rehabilitation therapy and extracorporeal shock wave therapy, while participants in the intervention group underwent rTMS treatment additionally.Muscle tone, plantar pressure, plantar area and GMFM-88 of the children in two groups were evaluated before and after treatment. Results After treatment, muscle tone (t=4.521,3.789), plantar pressure (t=8.412,7.354), plantar area (t=4.585,10.251)and GMFM-88 D and E scores (t=11.247,9.254,8.738,6.254) in both groups were significantly improved compared with baseline (P<0.05).After treatment, muscle tone of children in the study group was significantly lower than that of the control group, plantar pressure, plantar area, GMFM-88 D and E scores of study group were significantly higher than those in control group (t=7.213, 5.134, 4.233, 8.646, 7.463, P<0.05). Conclusion rTMS combined with ESW therapy can effectively improve the lower limb motor function and gait performance in children with hemiplegia.