Table of Content

10 January 2022, Volume 30 Issue 1

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Professional Forum

Food sweeteners and childhood obesity

JI Chen-bo

2022, 30(1):  7-10.  DOI: 10.11852/zgetbjzz2021-1858

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Childhood obesity seriously endangers children's physical and mental health, and is increasingly prevalent. Most childhood obesity is still simple obesity, which is closely related to poor eating behaviors, especially excessive energy intake or dietary structure disorders (such as high sugar and high fat). With the prevalence of ultra-processed foods in recent decades, food sweeteners have become more diverse, have a more comprehensive application range, and have a sharply increased consumption. Food sweeteners have a long history, and are considered safe.However, growing evidence showed that excessive intake would interfere with the metabolism, whether it is natural sweeteners or artificial sweeteners.Therefore, long-term excessive intake of food sweeteners in children can significantly increase the risk of childhood obesity. This article mainly summarizes related researches on the influence of food sweeteners on metabolism,so as to provide reference for pediatricians.

Nutrition and metabolism level of children with attention deficit hyperactivity disorder and its correlation with brain function

LAN Hong-yan, HUO Yan-yan, WU Dan, ZHANG Yuan-yuan, LI Yi-cheng, REN Yu-qian, WANG Xiu-lian, CHEN Jin-jin

2022, 30(1):  11-14.  DOI: 10.11852/zgetbjzz2021-0778

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Objective To assess nutrient level and body fat metabolism of children with attention deficit hyperactivity disorder (ADHD), and to analyze the correlation between nutrient metabolism and cerebral cortex function, thus to provide reference for clinical diagnosis and treatment of ADHD. Methods Children diagnosed with ADHD in theDepartment ofChild Health Care in Shanghai Children's Hospital were enrolled in this study from January to December 2020. Children who had regular physical examinations during the same period were recruited. Demographic data were collected from parents, then clinicians conducted interviews and assessments with children using body composition analyzers and brain function quantitative imaging devices to test body fat metabolism and brain function indicators. Venous blood tests were performed on all participants to obtain vitamins, trace elements, 25-hydroxyl vitamin D [25(OH)D] and other nutrients levels. Results Totally 60 effective samples were selected after screening, including 30 children in ADHD group and 30 children in control group. Vitamin B12 levelsof children in ADHD group and control group were (375.45±69.25) pm/ml and (421.68±103.72) pm/ml, respectively,and the difference was significant(t=2.031,P<0.05).Compared with children in control group, the body mass index (BMI) and body fat rate of ADHD children increased significantly (t=2.026, 2.106, P<0.05). The impairment of cerebral cortex function of ADHD was most prominent in the dorsolateral right prefrontal lobe. The levels of 25(OH)D and vitamin E were related to the degree of cerebral cortex activation (r=0.695, -0.571, P<0.05). Conclusions ADHD children have a higher risk of obesity. 25(OH)D is positively correlated with the degree of cerebral cortex activation,which may provide reference for auxiliary treatment of ADHD.

Original Articles

Relationship between bone mineral content and obesity in children and adolescents in Yinchuan

ZHOU Jin-yu, BAI Ling, DONG Yang-yang, CAI Rong-rong, JIA Lei-na, DING Wen-qing

2022, 30(1):  15-19.  DOI: 10.11852/zgetbjzz2021-0822

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Objective To analyze the relationship between body mineral content (BMC) and obesity in children and adolescents, so as to provide more powerful basis for preventing osteoporosis in children and adolescents. Methods A total of 1 578 children and adolescents were randomly selected from Yinchuan city by cluster sampling from 2017 to 2020, and conducted questionnaire survey. Their physical examination and bone mineral content were measured. The relationship between obesity of different definitions and bone mineral content was analyzed by binary Logistic regression. Results BMC of obese children at different body mass index (BMI), waist circumference (WC), waist height ratio (WHtR) and percentage of body fat (FMP) groups were significantly higher than that of normal group (P<0.01). There was a positive correlation between BMC and different obesity indicators in boys and girls (P <0.01). WC in boys and BMI in girls had the highest correlation with BMC (r=0.749, 0.684). Binary Logistic regression analysis showed that after adjusting for age, it was found that obesity defined by FMP and WHtR was significantly associated with the increase of BMC in boys (FMP:OR=1.53, 95%CI:1.04 - 2.27; WHtR:OR=4.39, 95%CI:1.55 - 12.44). For girls, obesity defined by FMP was significantly associated with the increase of BMC (OR=3.46, 95%CI:1.59 - 7.51). Conclusion Obesity defined by FMP and WHtR have a certain public health value for children and adolescents to prevent osteoporosis, but excessive obesity may cause bone injury.

Relationship between weight status, obesity type and body composition among seven-year-old children in a community of Shandong

LU Zhen-ping, SHI Rong, ZHANG Yan, GAO Yu, TIAN Ying, LEI Xiao-ning

2022, 30(1):  20-24.  DOI: 10.11852/zgetbjzz2021-0810

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Objective To analyze the differences in body composition among school-age children with different genders, weight status or obesity types, and to explore the influence of weight status or obesity types on muscle to fat ratio (MFR) and fat mass percentage (FMP). Methods A total of 440 seven-year-old children from Laizhou Wan Birth Cohort were followed up from 2019 to 2020.Twelve kinds of body composition indexes related to the total body composition, fat free mass and fat mass were measured and calculated by human component analyzer.Weight status was divided into three types based on body mass index (BMI).BMI and waist-to-height ratio were used to divide the participants into four obesity types.Then the correlations of weight status and obesity type with body composition were analyzed. Results No significant gender difference in MFR and FMP was found (t=1.16, 0.39, P>0.05).MFR showed a decreased trend among the normal, overweight and obesity groups, and it also decreased in non-obesity, abdominal obesity, general obesity and compound obesity (F=141.65, 63.96, P<0.05).But other body composition indexes increased gradually among groups (P<0.05).The results of multiple linear regression showed that MFR was 3.28 (95%CI:-3.69 - -2.87,P<0.001) lower and FMP was 17.25% (95%CI:16.07 - 18.43,P<0.001) higher in the obese group than that in the normal group.MFR was 3.18 (95%CI:-3.65 - -2.71, P<0.001) lower and FMP was 17.55% (95%CI:16.15 - 18.95, P<0.001) higher in the compound obesity group than that in the non-obesity group. Conclusions The weight gain of obese children is mainly attributed to the increase of body fat.The imbalance of muscle and fat in children with compound obesity suggests that the prevention and control of compound obesity in childhood has important public health significance to reduce its health risk.

Correlation of family feeding mode and parents'negative emotion with childhood malnutrition

WU Wei-lan, JIANG Hui-yun, LUO Yu-yang, ZHU Cai-rong, LIU Xin, MENG Xiao-mei

2022, 30(1):  25-29.  DOI: 10.11852/zgetbjzz2021-0926

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Objective To analyze the correlation of family feeding style and negative emotion of parents with childhood malnutrition, in order to guide family scientific feeding and to prevent the occurrence of malnutrition in children. Methods A total of 75 malnourished children in Maternal Child Health Hospital of Guangxi Autonomous Region from April to October 2020 were enrolled in this study. And 77 healthy children during the same period were selected into the control group. The parents of children in two groups were investigated by questionnaire. The difference in children's eating behavior was compared, and the correlation of family feeding pattern and negative emotions of parents with childhood malnutrition was analyzed. Results In terms of eating behavior, the scores of oversatiation response (t=2.104), food response (t=4.206), food preference (t=9.099) and craving for drinks (t=4.435) of malnourished children were lower than those of children in the control group (P<0.05). There were statistically significant differences between the malnutrition group and control group in the parents'perception of children's weight (t=3.167), forced eating (t=3.354) and supervised eating (t=3.726) in terms of family feeding pattern (P<0.05). In the emotion of parents, the incidence of anxiety in the malnutrition group was higher than that in the control group (χ²=8.660, P=0.003). Parents'perception of their children's weight (r_s=0.246), worry (r_s=0.213), forced eating (r_s=0.254), supervised eating (r_s=0.284), anxiety of parents (r_s =0.218), depression (r_s =0.334) were positively correlated with the occurrence of malnutrition (P<0.05). After adjusting for confounding factors, parents'perception of children's weight, forced eating, supervised eating and depression were independently influencing factors for the occurrence of malnutrition (P<0.05). ROC curve analysis showed that the AUC values of parents'perception of children's weight, forced eating, supervised eating and depression in predicting the occurrence of child malnutrition were 0.639, 0.645, 0.669 and 0.692, respectively(P<0.05). Conclusions Family feeding patterns and anxiety of parents are associated with malnutrition of children. It is supposed to adjust family feeding patterns, relieve negative emotions of parents, and assist children to correct their bad diet behavior, thereby reducing the risk of malnutrition.

Status of physical activity outside kindergarten among Beijing urban preschoolers as well as family and community environment

XU Meng-xue, WANG Xiao-juan, WANG Bo, JIANG Yuan-yuan, ZHU Zong-han, ZHANG Ting, GUAN Hong-yan

2022, 30(1):  30-33.  DOI: 10.11852/zgetbjzz2021-1060

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Objective To know about the status of physical activity outside kindergarten among Beijing urban preschoolers, and to explore related influencing factors in family and community, so as to provide evidence for assessment and intervention of preschooler's physical activity. Methods A convenient cluster sampling method was utilized to select 527 preschoolers from three kindergartens in Dongcheng district, Beijing from May to June, 2018. Caregivers were asked to fill out a self-designed questionnaire targeting daily physical activity time, outdoor activity time, screen time and sleep time. The compliance rate of each category mentioned above was analyzed referring to physical activity guideline for Chinese preschoolers aged 3-6 years. Results The time for physical time on school day and weekend was as follows, total activity:(86.39±59.75) min vs. (155.67±81.56) min, moderate to vigorous activity:(57.58±55.16) min vs. (83.14±61.22) min, outdoor activity time:(67.77±46.26) min vs. (181.31±96.11) min. The screen time and sleep time on school day and weekend were (30.42±23.52) min vs. (51.06±41.25) min, (10.94±0.83) h vs. (10.47±1.05) h, respectively. The compliance rate of total physical activity time on weekend, moderate to vigorous physical activity time, outdoor activity, screen time and sleep time were 30.9%, 65.1%, 81.7%, 83.5% and 80.2%, respectively. Family and community environmentscores were positively related to children's sleep and outdoor time (r=0.110 - 0.270, P<0.05). Conclusions Preschoolers lack physical activity and moderate to vigorous intensity activity, but have excessive screen time outside kindergarten. Improving family and community environment may have a positive effect on outdoor activity and sleep time.

Effects of seasonal factors on sleep severity and structure of children with obstructive sleep apnea hypopnea syndrome in Suzhou area

JIANG Yu-ting, WANG Yu-qing, XU Xue-yun, HE Yan-yu, GENG Ya-xuan, LYU Meng, WANG Zhi-hui, HAN Jun, WANG Jing

2022, 30(1):  34-38.  DOI: 10.11852/zgetbjzz2021-0951

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Objective To analyze the clinical and polysomnography (PSG) data ofchildren with obstructive sleep apnea hypopnea syndrome (OSAHS) in different seasons, and to explore the influence of seasonal factors on children with OSAHSin Suzhou area. Methods From March 2017 to February 2019, children with snoring, mouth breathing and other symptoms who visited Respiratory Medicine Department of Children's Hospital of Soochow University and had PSG examination were selected into this study. Then the participants were divided into two groups:≤6 years old and ＞6 years old. The differences in diagnosis, sleep structure, obstructive apnea hypopnea index (OAHI), oxygen desaturation index (ODI), the lowest oxygen saturation(LSAO2) among different seasons between the two groups were compared. Results 1) Among 227 OSAHS cases, the lowest OSAHS detection rate was in summer (χ²=8.964, P=0.03). 2) There was no significantly seasonal difference in diagnosis rates of children with mild, moderate and severe OSAHS (P>0.05). 3)The proportion of non-rapid movement 2 (NREM2) of OSAHS in spring was lower than in summer and winter (P＜0.05).The proportion of rapid eye movement (REM) in spring was higher than that in summer and winter (P＜0.05).The proportion of non-rapid movement 3 (NREM3) in summer was lower than that in spring and winter (P＜0.05). 4) LSaO2 in spring was lower than that in summer (P＜0.001). REM-apnea index(REM-AI) in spring was higher than that in autumn and winter (P＜0.05). 5) The proportion of NREM2 stage in OSAHS children ≤6 years old in spring was lower than that in summer (P＜0.001). The proportion of NREM3 in summer was lower than that in spring and winter (P＜0.05), and the proportion of REM in spring was higher than that in winter (P=0.048). Respiratory events and oxygen saturation analysis showed that LSaO2 (%) in spring was lower than that in summer (P=0.004). REM-AI in spring was higher than that in winter (P<0.01). Conclusions Seasonal factors have no significant effect on the severity of OSAHS in children. Sleep structure and respiratory events of OSAHS are different in seasons, such changes are mainly in children at the age of 6 years old and younger.

Growth and development of preterm children during the follow-up of child nutrition clinic and its associated factors

HE Xiao-ying, WU Cui-ling, QI Mei-jiao, ZENG Ling-yan, SUN Ya-lian, ZHU Yan-na

2022, 30(1):  39-43.  DOI: 10.11852/zgetbjzz2021-1094

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Objective To investigate the growth of the preterm children and to find out the associated factors, in order to provide more targeted nutritional advice for reducing the prevalence of extra-uterine growth retardation (EUGR). Methods From August 2020 to May 2021, 1 839 preterm infants were enrolled in this study by convenient sampling in Foshan Women and Children Hospital. Feeding practice of the preterm infants were investigated, body weight and length were measured. Ultimately, the prevalence of underweight, stunting, insufficient energy intake and feeding difficulty were calculated. Results 1) The prevalence rates of underweight, EUGR, possibly insufficient energy intake, insufficient energy intake and feeding difficulty in preterm infants were 5.7%, 4.6%, 44.4%, 6.3% and 25.3%, respectively. 2) Totally 56.9% of preterm infants with fetal underweight remained underweight after birth. Simultaneously, 39.1% with fetal stunting maintained stunting. 3) Risk factors of underweight included gestational age<32 weeks (OR=2.396, 95%CI: 1.338 - 4.293, P=0.003), fetal underweight (OR=9.895, 95%CI: 4.472 - 21.895, P＜0.001), fetal stunting(OR=12.550, 95%CI: 6.836 - 23.041,P<0.001) and feeding difficulty(OR=2.368, 95%CI: 1.409 - 3.978, P=0.001). Risk factors of stunting after birth were fetal underweight (OR=13.950, 95%CI: 6.38 8 - 30.464, P<0.001), fetal stunting (OR=5.920, 95%CI: 2.957 - 11.855, P<0.001) and feeding difficulty (OR =2.666, 95%CI: 1.527 - 4.654, P=0.001). Conclusions The prevalence of EUGR in preterm children is relatively low during follow-up in child nutrition clinic. Meanwhile, feeding difficulty is an independent risk factor for EUGR. Therefore, besides emphasizing sufficient nutrients intake, measures to improve feeding difficulty should also be provided when giving nutritional advice to the preterm children.

Review

Effects of maternal dietary nutrition during pregnancy on obesity and metabolism in children

WAN Ning-yu, HU Jia-jin, LIU Yang, MA Ya-nan, WEN De-liang

2022, 30(1):  44-48.  DOI: 10.11852/zgetbjzz2021-0952

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Childhood obesity is a global public health problem, and its causes are closely related to exposure to adverse environments in early life. Dietary nutrition during pregnancy can affect the intrauterine environment of the fetus, which has an important influence on the morbidity of obesity and metabolic diseases in the offspring. This review focuses on the existing research evidence on the association of the energy intake, various dietary nutrients intake and the dietary patterns during pregnancy with childhood obesity and metabolic diseases, summarizes the effects of dietary nutrition during pregnancy on the metabolism of offspring, and put forward suggestions on rational dietary intake during pregnancy, so as to provide reference for the prevention and control of obesity and metabolic diseases in early life.

Dietary nutrition and the onset time of puberty

QIN Yu-jie, XIAO Yan-feng

2022, 30(1):  49-52.  DOI: 10.11852/zgetbjzz2021-0359

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Puberty is a crucial stage of development in life.Early onset of puberty can affect children's physical and mental health.Many studies have found that diet and nutrition are related to the onset of puberty.Meat, high-fat diet and intake of sugar may promote the earlier onset of puberty, but the roles of soybean products and milk are controversial, and dietary fiber may avoid it.There is relation between micronutrients and puberty.Out-of-season vegetables and fruits, nutritional supplements may also increase the risk of precocious puberty.This article will review the related researches.

Research progress in cold executive dysfunction in adolescents with depression

CHEN Hai-si, GAO Jing-fang, WANG Xiao-le, HU Xi-wen

2022, 30(1):  53-56.  DOI: 10.11852/zgetbjzz2021-0532

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Depression always onsets in adolescence and early recognition is the basis of early intervention.Studies have found persistent cognitive impairment in many different cognitive domains such as attention and executive functions, including working memory and inhibition.This review mainly focuses on the neuropsychological and neuroimaging advances in inhibition and working memory as well as the cognitive flexibility in adolescent depression, in order to explore the characteristics of cold executive functions in adolescent depression.

Progress in the influence of obesity on motor competence of children

ZHOU Lin, HE Yu-xiu, LIANG Yu

2022, 30(1):  57-61.  DOI: 10.11852/zgetbjzz2021-0175

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Motor competence (MC) is the cornerstone of promoting children's physical activity and enhancing their physical fitness. MC plays an important role in the development of children's special sports skills in the future and the cultivation of lifelong sports thoughts. Studies have shown that obesity is correlated with MC of children. The gross and fine motor skills,balance and coordination of obese children were significantly lower than those of their peers with healthy weight. However,in the process of children's motor development,the diversity of influencing factors and individual differences in neural development lead to the complexity of the relationship between obesity and MC. This paper will focus on the relationship between obesity and MC,and discuss the possible mechanism of obesity affecting children's MC,aiming to better guide the MC promotion and weight prevention and control of obese children through the in-depth understanding of the relationship between the two.

Research progress on the influence of electronic screen exposure on children's movement

LIU Ming-xia, HUA Jing

2022, 30(1):  62-66.  DOI: 10.11852/zgetbjzz2020-2214

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Adequate physical activity is an important guarantee for healthy growth and is beneficial to children's physical and mental health and cognitive development. Persistent screen exposure during childhood has been reported in an increasing number to have a negative impact on children's physical activity. This study reviews the specific effects and mechanisms of electronic screen exposure on children's physical activity, and summarizes the methods for early detection and intervention of motion problems related to electronic screen exposure, thus providing clues for further clinical and basic research into the effects of electronic screens on motor coordination in Chinese children.

Meta Analysis

Meta analysis of the association between breastfeeding and childhood deleterious oral habits

ZHOU Jie, LI Da-wei, LIU Ri-hui

2022, 30(1):  67-71.  DOI: 10.11852/zgetbjzz2020-1628

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Objective To evaluate the association between breastfeeding and deleterious oral habits in children,so as to provide reference for preventing deleterious oral habits. Methods Databases of CNKI,VIP,WANFANG,PubMed were searched to collect literatures regarding breastfeeding and deleterious oral habits from 2000 to 2020 in home and abroad.A meta-analysis was conducted to synthesize the evidence by Stata14.0.The combined odds ratio(OR)and 95% confidence interval(CI)were calculated. Results Totally 17 articles were enrolled,including 7 579 subjects from 8 countries.Meta-analysis showed that exclusive breastfeeding was a protective factor for mouth breathing(OR=0.498,95% CI:0.364 - 0.681),non-nutritive sucking(OR=0.327,95%CI:0.152 - 0.704),pacifier-sucking(OR=0.362,95%CI:0.181 - 0.724).Compared with mixed breastfeeding ≥ 6 months,mixed breastfeeding<6 months was a risk factor for oral breathing(OR=1.596,95% CI:1.298 - 1.962),non-nutritive sucking(OR=2.939,95%CI:1.651 - 5.232),pacifier-sucking(OR=4.378,95% CI:2.607 - 7.353). Conclusions Breastfeeding can prevent the occurrence of deleterious oral habits.Due to the limitation of the quantity and quality of the included literature,more prospective studies are needed to support this conclusion.

Clinical Research

Serum polyunsaturated fatty acid levels in children with autism spectrum disorders

PAN Li-zhu, HU Shao-hua, MA Chen-huan, ZHU Pei-ying, CHU Li-ting, WANG Yu

2022, 30(1):  72-75.  DOI: 10.11852/zgetbjzz2021-1121

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Objective To investigate the expression level of serum polyunsaturated fatty acids (PUFAs) in children with autism spectrum disorder (ASD), in order to provide theoretical basis for the diagnosis and treatment of ASD. Methods From December 2020 to June 2021, 45 ASD children and 30 typically developed children were selected in the Department of Children Health Care of Shanghai Children's Hospital. The content of PUFAs in their peripheral blood serum was determined by liquid chromatography-tandem mass spectrometry. The Brief Autism Mealtime Behavior Inventory (BAMBI) and a self-designed dietary questionnaire were used to understand the differences in dietary behavior and dietary structure between ASD children and the control group. Then the influencing factors of serum PUFAs expression level in ASD children were further analyzed. Results Serum levels of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arachidonic acid (AA), linoleic acid (LA), total n-3 PUFAs and total n-6 PUFAs in ASD group were decreased (t=2.81,2.04,2.94,2.33,2.11,2.63, P<0.05), especially EPA and AA were significantly decreased (P<0.01). Diet and behavioral problems (including food refusal, ASD related feeding problems, limited variety of foods) and total score of children in the ASD group were higher than those in the control group (t=2.93, 13.42, 2.22, 8.40, P<0.05). The overall interest in diet of children in ASD group was lower than that in the control group(t=2.70, P＜0.05), especially in fish (t=5.03, P<0.05). Conclusions The content of serum PUFAs in ASD children is lower than that in healthy children, which may be related to dietary behavior and dietary preference. Supplement of PUFAs may be one of the auxiliary methods for the treatment of ASD children.

Current status and influencing factors of screen exposure in children with global developmental delay

YAN Wen-jie, LIN Yuan-yuan, ZHANG Yi-wen, YU Jun-chun, SHEN Zhi-min

2022, 30(1):  76-79.  DOI: 10.11852/zgetbjzz2021-1146

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Objective To investigate the current status of screen exposure in children with global developmental delay, and to explore the related factors affecting screen time. Methods From November 2019 to June 2021, 217 children with global developmental delay aged 2 to 5 years in the Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center were enrolled in this study. Their parents completed the screen exposure questionnaire. Then the screen exposure status was described, and the risk factors of screen exposure of children with global developmental delay were analyzed by Logistic regression. Results Totally 80.2% of the children with global developmental delay had their onset age of screen use before 18 months old, and 51.6% of them use screen＞1 h/d. And 37.3% primary caregivers chose to accompany children more than half of the time during screen exposure. Logistic regression analysis showed that high frequency of reading between primary caregivers and children (> 3 days per week) was a protective factor of screen time＞1 h/d in children with global developmental delay (OR=0.246,95%CI:0.129 - 0.469). Not having mother as the primary caregiver(OR=2.055, 95%CI: 1.138 - 3.710) and having screen exposure while eating (OR=2.067, 95%CI: 1.161 - 3.680) were independent risk factors of screen time＞1 h/d in children with global developmental delay. Conclusions A higher percentage of children with developmental delays have more screen time than the guideline recommendations. And the screen time of children is influenced by the primary caregiver and their behaviors. Pediatricians should strengthen the propaganda of proper use of screens so as to prevent children from early and excessive exposure to screen.

Association of family socioeconomic status with growth, development and nutritional status of children under 3 years old

LI Jing, DANG Shao-nong, XIANG Xiao-mei

2022, 30(1):  80-83.  DOI: 10.11852/zgetbjzz2021-0953

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Objective To explore the association of family socioeconomic status (SES) with growth, development and nutritional status of children under 3 years old, so as to provide scientific basis for the prevention and health care of children in China. Methods Data were from the database of Xi'an based on the physical development survey of children under 7 years old in nine cities of China in 2015. Socioeconomic status comprehensive indicators included parents'education level, parents'occupation and annual family income. The outcome variables included physical measurement (length and weight) and nutritional status.After adjusting children's gender and month agelinear regression models and Logistic regression models were established to analyze the association between SES and children growth and nutritional outcomes. Results A total of 12 017 children under 3 years old were included in this study, among which 281 (2.3%) children were assessed with malnutrition and 531 (4.4%) children were assessed with overnutrition. After adjusting children's gender and month age, compared with children with low levels of SES, children with moderate levels of SES increased in length by 0.32 cm (95% CI: 0.16 - 0.47) and had a 20% lower risk of overnutrition (OR=0.80, 95%CI: 0.65 - 0.98). Children with high levels of SES increased in length by 0.77 cm (95%CI: 0.61 - 0.92) and weight by 0.06 kg (95% CI: 0.006 - 0.12) and a 33% reduction in the risk of overnutrition (OR=0.67, 95% CI: 0.53 - 0.83). Conclusions Better SES may reduce the risk of overnutrition in children, and contribute to children's physical development and nutritional health. Efforts should be made to improve the family parenting environment, as well as to strengthen the propaganda and education of children's health care in low SES families, thus improving the health level of children.

Trends in the prevalence of overweight and obesity among children and adolescents aged 6 to 17 years from 2009 to 2018 in Shanghai

YAN Qiong, ZHANG Zhe, YANG Dong-ling, SUN Li-jing, LUO Chun-yan

2022, 30(1):  84-87.  DOI: 10.11852/zgetbjzz2021-0626

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Objective To analyze the trends of overweight and obesity among children and adolescents aged 6 to 17 years from 2009 to 2018 in Shanghai, in order to provide evidence for the prevention and control of overweight and obesity in children and adolescents. Methods A total of 523 112 children and adolescents aged 6 to 17 years with complete data were selected from students' common diseases surveillance program in Shanghai from 2009 to 2018.Overweight and obesity were defined using the growth reference for school-age children and adolescents established by the World Health Organization in 2007 (here in after referred to as WHO standard).Multivariate linear regression model was used to examine the trends in body mass index(BMI), and multivariate Logistic regression model was used to examine the trends in the prevalence of overweight and obesity. Results The total detection rates of overweight and obesity among children and adolescents aged 6 to 17 years in Shanghai in 2018 were 19.37% and 10.78%.The detection rates of overweight and obesity were 22.33% and 16.27% for boys, and 16.31% and 5.13% for girls, respectively, which were significantly higher in boys than those in girls (χ²=253.26, 1 404.73, P<0.001).After adjusting for the age and sex, the rate of overweight and obesity increased from 16.94% and 9.22% in 2009 to 19.37% and 10.78% in 2018, respectively (P_trend<0.001). Conclusions BMI and the rate of overweight and obesity of children and adolescents aged 6 to 17 years in Shanghai show an increasing trend from 2009 to 2018.The growth rate of overweight and obesity tends to be flat, but it is still prevalent.

Analysis on physical fitness development of 3- to 6-year-old children in Kunming from 2017 to 2019

GUO Bi-zhou, PU Hong, XIE Lu, HUANG Tian, DING Xiao-yan, ZHENG Jia-yun, LIU Dong-jiao

2022, 30(1):  88-92.  DOI: 10.11852/zgetbjzz2021-0740

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Objective To analyze the results of physical fitness test of 3- to 6-year-old children for three consecutive years, and to find out the imbalance in the development of children's physical fitness, so as to provide suggestions for the development of children's physical exercise and the comprehensive improvement of preschool children's physical fitness. Methods Data of 38 kindergartens in Kunming City from 2017 to 2019 were analyzed by SPSS 20.0 statistical software.The related indexes included height,weight,10 meter turn back run, standing long jump, tennis throw, two feet continuous jump, sitting forward bending, walking balance beam eight physical fitness items, as well as three growth and development evaluation results(age-specific height, age-specific weight, height specific weight). Results The excellent rate of physical fitness increased from 32.5% in 2018 to 35.7% in 2019(χ²=62.512, P<0.05).The 0-point ratio of sitting forward flexion increased from 1.7% in 2018 to 3% in 2019.Except 10 meter turn back run, the 5-point ratio of the other five items increased by 1.8%—8.8% in 2019 compared with 2018.Compared with the six items of normal children, the average score of children with low height was 1.855 points lower (t=-16.416, P<0.05), and that of children with low weight was 1.856 points lower (t=-17.346, P<0.05).Compared with the six items of normal children, the average score of overweight children was 0.277 points lower (t=-2.798, P<0.05), the average score of emaciated children was 0.917 points lower (t=-6.073, P<0.05).The average score of obese children was 0.571 points lower (t=-5.490, P<0.05), and the average score of height abnormal children was 0.812 points higher (t=7.123, P<0.05).Moreover, in the six physical items of children with abnormal growth and development, the ratio of low score (0-2 points) of most items was higher than that of normal children. Conclusions It is supposed to emphasize children's flexibility and balance exercise, strengthen health education for parents, improve their understanding, do a good job in children's health management, prevent and early treat growth and development diseases, so as to continuously promote healthy development of physique and protect children's health.

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Effect of nasal hormone and montelukast sodium in the treatment of children with adenoid hypertrophy on sleep quality and clinical efficacy

CHEN Yi-hui, YANG Ai-ye, CHEN Peng, YANG Yin-tong

2022, 30(1):  93-96.  DOI: 10.11852/zgetbjzz2021-1377

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Objective To analyze the effects of nasal hormones and montelukast sodium in the treatment of children with adenoid hypertrophy on sleep quality and clinical efficacy, so as to provide reference for clinical diagnosis and treatment. Methods A total of 400 cases of children with adenoid hypertrophy admitted to the Department of Otolaryngology, the Fourth Hospital of Xi'an from December 2019 to December 2020 were selected into this study, and were randomly divided into two groups according to the random number table method, with 200 cases in each group. The control group was treated with nasal hormones, and the observation group received nasal hormones and montelukast sodium treatment. The clinical efficacy, sleep quality of the two groups were observed in 8 weeks. Results After 8 weeks of treatment, the total effective rate of children in the observation group was significantly higher than that in the control group (92.5% vs. 85.00%, χ²=5.634,P<0.05). The score of sleep disorder was 5.17±1.05 and the A/N value was 0.60±0.05, significantly lower than those of the control group (6.60±1.38, 0.70±0.06, t=11.662, 18.107, P<0.05). Moreover, serum levels of IL-6, IL-4 and IL-1β, the EOS count,the expression levels of sIgE andeosinophil cationic protein(ECP) were significantly lower than those of the control group (t=30.936, 13.248, 19.718, 23.190, 10.304, 39.316, P<0.05). Conclusion The combination of nasal hormone and montelukast sodium has a significant effect in children with adenoid hypertrophy, which helps to improve the sleep quality and curative effect of children, and is worth in promoting clinically.

Assessment of amplitude-integrated electroencephalogram scoring system in asphyxia neonates

LU Jun-jie, ZHU Jin-gai, ZHANG Jun, HU Xiao-shan, CHEN Xiao-hui

2022, 30(1):  97-101.  DOI: 10.11852/zgetbjzz2021-0834

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Objective To perform the amplitude integrated electroencephalogram (aEEG) for neonates with asphyxia, and to analyze the correlation between aEEG score and hypoxic-ischemic encephalopathy (HIE) severity, so as to provide reference for early clinical diagnosis of HIE and severity assessment. Methods A retrospective analysis was conducted on 88 cases of asphyxia neonates with gestational age ＞35 weeks who were admitted to the Neonatal Department of Nanjing Maternity and Child Health Hospital from July 2014 to December 2020 and underwent bedside Cerebral Function Monitor(CFM) examination within 12 hours after birth.The neonates were divided into normal group (n=10), mild HIE group (n=30), moderate HIE group (n=32) and severe HIE group (n=16).The risk factors of severe HIE were analyzed.Compressed aEEG recordings were obtained by CFM examination and four parameters of aEEG patterns were evaluated and scored, including continuity(Co), cycling(Cy), amplitude of lower border(LB), bandwidth span and amplitude of lower border(B), and the total score(T) was added up.The correlation between each parameter and HIE severity was analyzed.After HIE cases were treated with hypothermia, cerebral function was reviewed and the aEEG scores of each group were compared again.Fifty-five babies completed cranial MRI examination, and the difference of MRI severity among HIE groups was compared. Results There were significant differences in gestational age, pH value of the first postnatal blood gas analysis between the severe HIE group and other HIE groups(H=11.104, F=3.725, P＜0.05).The cesarean section rate in normal group was higher than that in other groups (Fisher's exact probability, P=0.031).The lower scores of Co, Cy, LB, B and T of aEEG indicated more severe HIE, and the negative correlation was significant (r=-0.531, -0.529, -0.423, -0.468, -0.487, P＜0.05).After HIE cases were treated with hypothermia, aEEG scores among each group were significantly improved.But the aEEG total score of the severe HIE group was still significantly different from that of the mild and moderate HIE groups (F=5.972, P<0.001).There was no significant difference in MRI severity among different HIE groups(P＞0.05). Conclusions aEEG scoring system can early diagnose and predict the severity of HIE in asphyxia neonates with brain function monitoring, which can be used as a tool to evaluate the severity of HIE.Hypothermia therapy can improve the cerebral function of HIE patients.

Follow-up analysis of type B 293 high-risk infants with information management

HUA Yi, WANG Yi, WANG Ying-ying, HUANG Qian, SHEN Hui-juan, CHEN Hua-qin, CHEN Yu, LI Hong-xin

2022, 30(1):  102-105.  DOI: 10.11852/zgetbjzz2020-2039

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Objective To summarize and analyze the follow-up data of high-risk infants, and to understand the results of nutrition and nervous system development of high-risk infants after discharge, so as to better guide the follow-up work. Methods A total of 293 high-risk infants were selected from type B high-risk children who were followed up in the combined outpatient department of Changzhou Children's Hospital from June 1st, 2019 to July 1st, 2020.The follow-up data of high-risk diseases, follow-up compliance, exclusive breastfeeding rate, nutritional development and nervous system development were analyzed. Results Preterm birth, pneumonia and severe jaundice were the top three diseases in the follow-up of high-risk children.Follow-up compliance was only 43.0%.The follow-up rate of exclusive breast-feeding was 32.8%.The prevalence rates of malnutrition and overnutrition were 14.0% and 9.2%, respectively.In addition, 49 of the 293 type B high-risk children were at risk of brain injury or had abnormal nervous system development, and were assessed by Gesell at 3 months after birth.Among the five areas, the largest gap between Gesell score and the corresponding age was in the aspect of adaptive area, accounted for 55.1%.The highest number of days behind was in fine motor activities, with an average lag of 41.8 days than normal children.There were eight children assessed entirely abnormal by Gesell, of whom six were preterm infants.Compared with the full-term high-risk infants, the preterm high-risk infants had statistically significant differences in the exclusive breastfeeding rate, the days of fine motor delay, the days of delayed response ability and the days of delayed speech ability (χ²=32.47, 2.46, 2.23, 2.19,P＜0.05). Conclusions It is suggested that information management should be carried out for the follow-up data of type B high-risk infants, and timely analysis should be made to obtain the relevant follow-up results, which has a certain guiding role in improving the follow-up compliance, breastfeeding rate and strengthening the fine motor exercise of children with brain injury, especially the premature high-risk infants.

Study on the correlation between video electroencephalogram and Gesell Developmental Scale test in neonates with convulsion

SONG Cai-hong, LIU Zeng-fang, HE Zhao-ping, MEI Ling-hua, LIU Yuan, ZHANG Yu

2022, 30(1):  106-109.  DOI: 10.11852/zgetbjzz2021-0008

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Objective To investigate the correlation between video electroencephalogram (VEEG) and Gesell Developmental Scale (GDS) in neonates with convulsion, in order to provide theoretical reference for predicting the prognosis of neonates with convulsion. Methods From July 2015 to August 2019, newborns who were hospitalized with neonatal convulsion and underwent VEEG examination in Yulin Second Hospital were collected as study subjects.VEEG characteristics in the neonatal period was analyzed, GDS test was performed 3 months after birth. Results 1) A total of 43 eligible newborns were included, including 20 cases of mild VEEG abnormality, 10 cases of moderate abnormality and 13 cases of severe abnormality.2) Mild VEEG abnormalities were mainly paroxysmal abnormalities (50%), and the moderate abnormality was mainly paroxysmal abnormality (40.0%) and mature abnormality (30%).Background activity (61.5%) was the main abnormal condition.3) A total of 38 children were followed up, including 6 lost in follow-up.The results of GDS test showed that the prognosis of 15 patients was poor(DQ＜85), with the poor prognosis rate of 40.5%(15/37).4) The prognosis rate of mild, moderate and severe VEEG patients was about 11.1%, 60.0% and 77.8%, respectively.The consistency test of Kappa between the degree of VEEG abnormality and GDS was 0.60.The sensitivity and specificity of predicting the degree of VEEG abnormality were 86.7%, 72.7%, positive predictive value of 68.4% and negative predictive value of 88.9%. Conclusions The predictive value of VEEG and GDS test in neonatal convulsions is not completely consistent.VEEG has high sensitivity and negative predictive value in predicting prognosis, but low specificity and positive predictive value.Clinically, it often takes a long time for comprehensive evaluation to make a more accurate judgment on the neurodevelopment of children with seizures.