Table of Content

10 May 2023, Volume 31 Issue 5

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Professional Forum

Development andapplication of assessment system for children's physical activity and early development in China

YANG Yufeng

2023, 31(5):  465-469.  DOI: 10.11852/zgetbjzz2023-0399

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The ultimate goal of early childhood development is to help children achieve their maximum potential, and to improve the overall quality of the population, thereby achieving the goals of national development and human health. Physical activity in children is the main form and means for early development. With the renewal of the times and the improvement of life quality, there has been a general decrease in physical activity and movement and an accelerated emergence of physical, psychological and behavioral problems in children. Scientific monitoring and assessment is particularly important in order to better promote early development by increasing children's physical activity and movement. This article will introduce the importance of establishing children's physical activity and early development assessment system of China and the common methods of monitoring and assessing children's physical activity and early development.

Original Articles

Mediating effect of body mass index between screen behavior and physical activity enjoyment among school-age children

WU Shukun>, SUN Xiaoyu>, LIANG Ruihua>, ZUO Qun>

2023, 31(5):  470-474.  DOI: 10.11852/zgetbjzz2022-0819

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Objectives To analyze the relationship between screen behavior and physical activity enjoyment in school-age children, and to explore the mediating effect of body mass index (BMI), so as to provide evidence for formulating strategies to promote physical activity enjoyment in school-age children. Methods A total of 973 students from Grade 1 to 6 were selected from a primary school in Liupanshui city of Guizhou province in June 2021. Screen time on study days and weekends was collected by a self-designed questionnaire, were used to assess the screen behaviors, and the Physical Activity Enjoyment Scale was adopted to investigate physical activity enjoyment. The mediating effect was analyzed by Bootstrap method. Results The average scores of physical activity enjoyment of the 927 students was 18.42±4.01, and their average BMI was (16.90±0.13)kg/m². The proportion of screen time ≤2h/d on study days and weekends was 88.46% and 59.87%, respectively, and the difference was significant(χ²=197.680, P<0.001). Score of screen behaviors on study days and weekends were found to be negatively correlated with physical activity enjoyment(r=-0.286, -0.393, P<0.05), and positively correlated with BMI(r=0.359, 0.462, P<0.01), while there was a negative correlation between BMI and physical activity enjoyment (r=-0.362, P<0.01). The mediating test showed that in addition to directly affecting physical activity enjoyment, screen behavior also had an indirect influence on it through the mediation of BMI with 33.84% of the total effect. Conclusions BMI partially mediates the negative effect of screen behavior on physical activity enjoyment in school-age children. It is recommended that interventions to increase physical activity enjoyment in school-age children need to focus on reducing their screen time and also on enhancing management of their BMI.

Association between 24-hour movements and negative emotions in adolescents in Shanghai

MIAO Yuling>, LIN Qingmin>, JIANG Yanrui>, ZHAO Jin>, ZHANG Yunting>, WANG Guanghai>, JIANG Fan>

2023, 31(5):  475-480.  DOI: 10.11852/zgetbjzz2022-1132

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Objective To examine the association of 24-hour movements with negative emotions in adolescents in Shanghai, in order to provide theoretical reference for the integration of medical-educational practice in 24-hour activity interventions for adolescent mental health. Methods Middle school students from 6 sample districts in Shanghai were selected by multi-stage stratified random cluster sampling method during November 2017 and January 2018. Standardized questionnaires were used to assess meeting 24-hour movement guidelines on nightly sleep duration, screen exposure time, and moderate-to-vigorous physical activity as well as negative emotions of depression, anxiety and stress. The association between 24-hour movements and negative emotions was analyzed by Logistic regression. Results Overall, 2 312 students were enrolled in this study, of whom 1 113(48.1%) were female students and 1 267 (54.8%) were junior-middle school students, with an average age of (14.84±2.09) years old. The prevalence rates of junior-middle school students and senior-middle school students meeting all the 24-hour movement guidelines were 14.4% and 3.5%, while the prevalence of negative emotions in junior-middle school students and senior-middle school students was 11.4% - 35.8% and 19.5% - 51.6%, respectively. There was a dose-dependent association between the number of meeting the 24-hour movement guidelines and negative emotions. Meeting more 24-hour movement guidelines was related to a lower risk of negative emotions. Compared with those meeting none of the guidelines, the risk of negative emotions decreased by 78% to 79% for junior-middle school students who met all 24-hour of activity (anxiety OR=0.21, 95%CI:0.11 - 0.39; depression OR=0.22, 95%CI:0.17 - 0.51), and by 49% to 50% for senior-middle school students (stress OR=0.50, 95%CI:0.29 - 0.86; depression OR=0.51, 95%CI:0.30 - 0.87). Conclusions The prevalence of Shanghai adolescents meeting the 24-hour movement guidelines is low and meeting more 24-hour movement guidelines is associated with lower risk of negative emotions. This study highlights the importance of enhancing 24-hour movement intervention for supporting mental health in adolescents.

Influencing factors of the home-based outdoor activities time among preschoolers

ZHANG Hong>, WANG Xinyao>, YAO Chunhua>, YE Sunyue>

2023, 31(5):  481-485.  DOI: 10.11852/zgetbjzz2022-0519

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Objective To explore the influencing factors of time for preschooler home-based outdoor activities, especially the interaction between parents and children and grandparental care, so as to provide theoretical basis for the intervention on preschool-aged children's home-based outdoor activities. Methods A questionnaire survey was conducted using a convenience group sampling method among 1 431 parents of preschool-aged children from four kindergartens in Pinghu City, Zhejiang Province. Statistical analysis was carried out by multivariate Logistic regression model. Results The outdoor activity time ≥1h/d of father (OR=3.87, 95% CI:1.74 - 8.59), mother (OR=12.82, 95%CI:7.12 - 23.08) and grandparents (OR=3.39, 95% CI:2.08 - 5.53), the accessibility of outdoor activity fields (OR=1.61, 95% CI:1.25 - 2.07) and boys (OR=2.83, 95%CI:1.30 - 6.16) were the influencing factors of outdoor activity time (≥2h/d vs. <1h/d) among preschoolers. The interaction was observed between fathers' outdoor activity and preschoolers' gender. The statistically significant dose-effect relationship between fathers' outdoor activity [OR (95%CI):1.89(1.19 - 3.00), 4.50(1.94 - 10.42)] and girls' outdoor activity was also observed (P<0.001). Conclusions The outdoor activity time of parents and grandparents, the accessibility of outdoor activity fields are crucial changeable factors affecting the outdoor activity time of preschool-aged children at home. Strengthening health education and lifestyle management in non-parental caregivers, as well as paying attention to the important influence of the role of father, may be an important way to promote home-based outdoor activities of preschool-aged children.

Effect of aquatic motor therapy combined with routine rehabilitation therapy on motor function among children with spastic cerebral palsy

ZHONG Chen>, HU Shanshan>, ZHANG Hengshuo>, ZHANG Cui>, YAO Chuanlei>, SONG Qipeng>

2023, 31(5):  486-490.  DOI: 10.11852/zgetbjzz2022-0596

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Objective To study the influence of aquatic motor therapy (AT) combined with conventional rehabilitation therapy (CRT) on the motor function of preschool children with spastic cerebral palsy, in order to provide theoretical basis for improving the motor function of preschool children with spastic cerebral palsy. Methods A total of 25 preschoolers with spastic cerebral palsy who were admitted to Qilu Children's Hospital of Shandong University from January 2020 to August 2020 were enrolled in this study and were randomly divided into AT+CRT group (n=12) and CRT group(n=13).Children in CRT group were given CRT for 12 weeks, while children in AT+CRT received AT additionally, with the frequency of 5 times/week.The range of lower extremity joint motion, calf muscle tone, plantar contact area and gross motor function were compared before and after intervention. Results After intervention, triceps muscle tension, joint motion of lower extremity and plantar contact area in both AT+CRT group and CRT group were all significantly better than those before intervention (AT+CRT group: t=2.803, 7.197, 3.550, 3.730, 3.541; CRT group:t=2.941, 6.921, 4.335, 3.199, 4.554, P<0.05).After intervention, the scores in the D area of the Gross Motor Function Rating Scale (GMFM-88) in both AT+CRT and CRT groups were significantly higher than those before intervention (t=4.979, 3.750, P<0.05), and the improvement in the AT+CRT group was greater than that in the CRT group (t=0.757, P<0.05).After intervention, the score of GMFM-88E in the AT+CRT group was significantly higher than that before intervention (t=5.244, P<0.05), while there was no significant difference in the CRT group (P>0.05).The improvement amplitude in the AT+CRT group was greater than that in the CRT group, with statistical significance (t=2.305, P<0.05). Conclusion Both AT+CRT and CRT can effectively improve the range of motion, calf muscle tone and plantar contact area of lower extremity in children with spastic cerebral palsy, but AT+CRT can improve the gross motion function better than CRT.

Effect of whole body vibration training on fine motor ability of children with cerebral palsy with the assistance of digital OT system

WANG Man, XIAO Yingying, ZHANG Yuanyuan, ZHANG Lixin

2023, 31(5):  491-496.  DOI: 10.11852/zgetbjzz2022-1142

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Objective To explore the effect of whole body vibration training on the fine motor function of children with spastic hemiplegia, so as to provide clinical reference for occupational therapy of hemiplegic cerebral palsy. Methods A total of 68 children with spastic hemiplegia in Shengjing Hospital were enrolled in this study from October 2020 to October 2022, and were randomly divided into control group (n=34) and study group (n=34).Both groups were given conventional occupational therapy, while the study group was additionally provided with whole body vibration (WBV) training.Scores in fine motor function measurement-D (FMFM-D) (upper limb operation) and FMFM-E (hand-eye coordination) of FMFM before training, 4 weeks, 8 weeks and 12 weeks after training and the results of the Motion Control Report in the digital OT assessment system were compared between the two groups. Results Repeated-measures analysis of variance showed that FMFM-D score changed over time (F_time=76.017, P＜0.001), while grouping effect and interaction effect were not significant(F_{group/interaction}=1.173, 0.470, P＞0.05).The change of FMFM-E score was influenced by both the time effect and group effect (F_{time/group/interaction}=783.275, 4.209, 50.233, P＜0.05).After 8 and 12 weeks of training, the study group scored higher in FMFM-E than the control group(F=9.375,9.207, P＜0.05).The coincidence degree of motion trajectory was affected by both time effect and group effect (F_{time/group/interaction}=567.166, 4.720, 47.497, P＜0.05).After 4, 8 and 12 weeks of training, the movement performance of the study group was better than that of the control group(F=8.783, 7.583, 8.937, P＜0.05).Movement speed was affected by both time effect and group effect (F_{time/group/interaction}=351.375, 16.538, 73.909, P＜0.05).After 8 weeks and 12 weeks of training, the movement speed of the study group was higher than that of the control group (F=69.764, 60.557, P＜0.05). Conclusion Whole-body vibration training can improve the fine motor function, movement speed and hand-eye coordination of children with spastic hemiplegia.

Correlation between gutmicrobiota and symptom severity in children with autism spectrum disorder

LI Dexin>, CHEN Qiang>, ZHUANG Zhicheng>, CHEN Hong>, YANG Bingjiao>, JIANG Shunxiang>, ZHOU Xiang>

2023, 31(5):  497-501.  DOI: 10.11852/zgetbjzz2022-1252

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Objective To analyze structural characteristics of gut microbiota and its correlation with symptom severity in children with autism spectrum disorder (ASD), in order to provide new ideas for exploring pathogeny and targeted therapy. Methods A total of 107 ASD children in the Child Mental Health Department of Zhuhai Maternal and Child Health Hospital from March 2021 to September 2021 were selected as the ASD group, and 30 normal preschool children in a kindergarten were included as the control group.The severity of ASD symptoms was assessed using the Childhood Autism Rating Scale (CARS).Sample DNA was extracted after collecting fresh stools from both groups of children, and then the 16S rDNA V4 region of the bacteria was amplified and sequenced in high throughput. Results There was no significant difference between the alpha diversity index and beta diversity of the gut microbiota between children in ASD group and control group (P>0.05).At the phylum level, the relative abundance of the Proteobacteria in the ASD group was significantly lower than that in the control group (t=-3.103, P<0.05).At the family level, the dominant gut microbiota of children in ASD group included Tannerellaceae, Eggerthellaceae, Desulfovibrionales, Selenomonadaceae, Moraxellaceae, Bifidobacterium, while the dominant gut microbiota in normal group included Barnesiellaceae, Streptococcus, Barnesiella.At the genus level, the differences in the relative abundance of Anaerostipes, Collinsella, Blautia, and Megamonas in children with different severity of symptoms were statistically significant (P<0.05).Spearman correlation analysis showed a positive correlation of Blautia and Megamonas with CARS score in ASD children (r=0.213, 0.288, P<0.05). Conclusion Gut microbiota of ASD children is disturbed and its structure is strongly related to the severity of behavioral symptoms.

Review

Research advances on the relationship between motor competence and physical activity and its influencing factors for children

LIANG Yu, HE Yuxiu, ZHOU Lin

2023, 31(5):  502-506.  DOI: 10.11852/zgetbjzz2022-0020

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This article gives an overview of the representative researches in the last 20 years, and analyzes the relationship between motor competence(MC) and physical activity(PA), and discusses the influences of age, gender, health and related fitness(HRF), perceptual competence, cultural background and geographical environment on the above-mentioned relationship. There is an interaction between MC and PA, the characteristics of MC of children with different ages, genders, HRF levels and perceptual competence, as well as its correlation with PA still needs to be further clarified. It is suggested that further studies focus on the moderating variables of the relationship between MC and PA, take the influence of cultural and geographical environment characteristics on the types and patterns of children's PA in to consideration, so as to improve the MC assessment tools. Furthermore, studies are warranted on how to design interventions that effectively enhance children's.

Molecular mechanism of childhood obesity related cardiomyopathy

NIU Wanxia, LIANG Shuang, WANG Yibiao

2023, 31(5):  507-511.  DOI: 10.11852/zgetbjzz2022-0978

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Childhood obesity complications are increasing year by year with the continuous growth of obesity incidence rate.Studies have shown that the increased risk of cardiovascular disease (coronary atherosclerosis, heart failure and arrhythmia) is closely related to obesity.Additionally, obesity is also related to the occurrence and development of myocardial hypertrophy, ventricular systolic dysfunction and reduced diastolic compliance.The diastolic function of simple obese children is significantly lower than that of normal weight children.There are many pathological mechanisms of cardiomyopathy caused by obesity, including insulin resistance, inflammation, oxidative stress, lipotoxicity, apoptosis and mitochondrial autophagy.However, the precise molecular mechanism by which obesity leads to changes in cardiac structure and function remains unclear.This article briefly reviews the possible molecular mechanisms of obesity-induced myocardial remodeling, and provides theoretical basis for the prevention and treatment of obesity related cardiomyopathy in children.

Effects of sleep deprivation during pregnancy on the offspring

JIN Qingqing, LYU Jing, ZHOU Jie, XIAO Jing, FANG Wei, LUO Xianghong

2023, 31(5):  512-515.  DOI: 10.11852/zgetbjzz2022-1367

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Sleep deprivation is a state in which the body does not get enough sleep due to various reasons.There is growing evidence that pregnancy is a special physiological period when sleep deprivation is more likely to occur to varying degrees than in non-pregnant women, and that it may have serious adverse consequences for the offspring.This article summarizes and reviews the effects of sleep deprivation during pregnancy on the offspring and may provide some clinical ideas to promote maternal health and improve offspring outcomes.

Research advances on the correlation of gene polymorphisms of vitamin D receptor and vitamin D level with neurodevelopmental disorders in children

LI Jia, ZHANG Yanchi

2023, 31(5):  516-520.  DOI: 10.11852/zgetbjzz2022-1081

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Vitamin D and its receptors (VDR) are widely expressed in various regions of human body.VDR mediates all molecular effects of active vitamin D, and its gene polymorphisms have been linked to a variety of neurodevelopmental disease.This article reviews the association of vitamin D and VDR gene polymorphisms with childhood neurodevelopmental disorders, providing theoretical reference for early prevention, intervention and treatment in children.

Research advance on exosomes and neuropsychiatric disorders in children

LIU Jiamin, ZHAO Sha, ZHONG Yan

2023, 31(5):  521-525.  DOI: 10.11852/zgetbjzz2022-1082

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Exosomes are a bridge for intercellular information exchange and material transfer, and contain a variety of bioactive components that play an important role in neurodevelopment, immunity, tissue homeostasis, cancer, neurodegenerative diseases and neuropsychiatric disorders in children.This paper summarizes the biological characteristics and biological production of exosomes, points out the mechanism intervention or influencing factors of exosomes in children with common neuropsychiatric disorders such as autism spectrum disorder, epilepsy, schizophrenia, Tourette syndrome, and discusses the potential role of exosomes in the diagnosis, treatment and prognosis of children with neuropsychiatric disorders.The future treatment of children with neuropsychiatric disorders is prospected.

Research progress on risk factors for developmental language disorders

LI Huimei, LIU Xiao

2023, 31(5):  526-528.  DOI: 10.11852/zgetbjzz2022-1208

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Developmental language disorder (DLD) is one of the most common developmental disorders.Symptoms of DLD often occur in early childhood, affecting children's studies, social communication, behavior and other aspects, and also bring negative impacts to parents and society.This paper reviews the research progress in the risk factors for DLD, in order to provide reference for early detection, early diagnosis and selection of interventions for DLD.

Meta Analysis

Dose-response Meta-analysis of the influencing factors and fractures in school-age children and youth

YIN Cuiping, WANG Nan, LIU Ran

2023, 31(5):  529-534.  DOI: 10.11852/zgetbjzz2022-1058

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Objective To systematically evaluate the influencing factors of fractures (FR) in school-age children and adolescents, and to assess the association based on a dose-response Meta-analysis. Methods Observational studies on the FR in school-age children and adolescents published from Jan.2000 to Jan.2022 were retrived from the databases of CBM, CNKI, Wanfang Data, and VIP.The articles were screened strictly to extract valid data.Stata 16.0 was applied to combine the odds ratio (OR) of effect sizes, Q-test and I² test were used to evaluate the heterogeneity of outcome indicators in the literature, and Begg's test was used to detect publication bias.Finally, the dose-response relationship between FR and influencing factors was performed. Results A total of 14 articles (2 cohort studies, 3 case-control studies and 9 cross-sectional studies) involving 30 769 cases and 45 857 controls were included.Meta-analysis showed that boys (OR=2.91, 95%CI: 2.76 - 3.06), moderate-to-vigorous physical activities (OR=1.55, 95%CI: 1.33 - 1.77), FR history (OR=3.56, 95%CI: 2.18 - 4.94), July/August (OR=4.19, 95% CI: 3.30 - 5.08) and rural area (OR=2.17, 95%CI: 1.02 - 3.32) were risk factors for the developing of FR, while high secondary school (OR=0.39, 95%CI: 0.11 - 0.67) was a protective factor for FR.The dose-response analysis showed a non-linear correlation between age and FR risks (χ²=13.26, P<0.01).The correlations of body mass index (χ²=6.71, P=0.082), physical activity time (χ²=3.18, P=0.107) and household income (χ²=1.47, P=0.690) with FR risks were linear. Conclusion Gender, physical activity time, fracture history, month, and urban/rural area may lead to the differences in the incidence of FR in school-age children and adolescents, and the effect of age on FR showed a non-linear relationship of "increasing and then decreasing", which needs to be confirmed by further clinical studies and epidemiological surveys.

Systematic review of the effects of motion sensing game on upper limb function in children with cerebral palsy

YANG Tingting>, LI Xin>, YU Xinlu>, ZHANG Bo>, PANG Wei>

2023, 31(5):  535-540.  DOI: 10.11852/zgetbjzz2022-1103

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Objective To systematically review the effects of motion sensing game on upper limb function in children with cerebral palsy. Methods The relevant articles from CNKI, Wanfang Database, VIP Database, PubMed, and Web of Sciences Database up to September 9th, 2022 were retrieved by thematic retrieval. The information including study subjects, age, intervention equipment and methods, intervention time, intervention frequency, evaluation index and intervention results included in the literature were retrived, and the literature quality was evaluated using the modified Jadad Scale. Results A total of 7 articles were included, mainly focusing on the upper limb function, hand function, hand dexterity and grip strength of children with cerebral palsy. Six studies showed improvements in upper limb function, upper limb speed, hand function, grip strength, spasticity, and independence in activities of daily living and reduced parental stress after motion sensing game intervention. One study showed no improvement in upper limb coordination or hand function after the intervention, but grip strength and caregiver perception of hand function improved. Conclusion Motion sensing game has a positive effect on improving the upper limb function of children with cerebral palsy, but there is still controversy about the improvement of upper limb coordination and hand function, which needs further discussion.

Clinical Research

Correlation of serum 25-(OH)D level with calf skeletal muscle development and gross motor function measure score in children with cerebral palsy

LIU Jin>, ZHANG Fang>, WANG Jianzhong>

2023, 31(5):  541-545.  DOI: 10.11852/zgetbjzz2022-0617

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Objective To investigate the correlation of serum 25-hydroxyvitamin D [25-(OH)D] level with calf skeletal muscle development and gross motor function measure (GMFM) score in children with cerebral palsy(CP), in order to further provide reliable medical evidence to confirm the importance of adequate vitamin D level on the normal development of skeletal muscle system in CP children. Methods From December 2019 to January 2022, a total of 48 CP children with hemiplegia (n=24) and diplegia (n=24) who received rehabilitation treatment in Qinhuangdao Maternal and Child Health Hospital were enrolled in this study, and 24 typically developed children with the same age were selected as the control group. Calf muscle structure was measured by ultrasound at rest. GMFM scores were used to assess the standing and walking ability of children with CP. Serum 25-(OH)D level was determined by enzyme-linked immunosorbent assay. Results Serum 25-(OH)D level in hemiplegia group [(21.62±5.89)ng/ml] and diplegia group [(20.85±4.73)ng/ml] was significantly lower than that in control group [(27.93±5.20)ng/ml, P＜0.05]. For children with CP, the lateral gastrocnemius muscle fascicle length (FL) and soleus muscle thickness (MT) were correlated with GMFM score(r=0.414, 0.402, P＜0.05). Serum 25-(OH)D level of CP children was positively correlated with MT of tibialis anterior muscle (r=0.511, P＜0.001), MT of medial gastrocnemius muscle (r=0.394, P=0.006), MT of lateral gastrocnemius muscle (r=0.483, P=0.001), MT of soleus muscle (r=0.287, P=0.048) and GMFM (r=0.436, P=0.002). Further multivariate linear regression analysis showed that serum 25-(OH)D level was positively correlated with MT of tibialis anterior muscle (β=0.556, 95%CI:0.610 - 2.641, P=0.002), MT of lateral gastrocnemius muscle (β=0.492,95%CI:0.007 - 2.795,P=0.049) and GMFM (β=0.056, 95%CI:0.000 - 0.112, P=0.049). Conclusions The decrease of serum 25-(OH)D level in CP children is related to the dysplasia of calf muscle structure and the impairment of standing/walking ability. Therefore, vitamin D should be supplemented appropriately for CP children and targeted activities should be carried out in the early stage to optimize the adaptive changes of muscle structure and function.

An 8-year follow-up study on the changing trend of overweight and obesity among primary and secondary school students in Longkou City from 2015 to 2022

YAO Lijuan, HU Xiao, JIANG Weiwei

2023, 31(5):  546-550.  DOI: 10.11852/zgetbjzz2022-1303

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Objective To analyze the trajectory changes of body mass index(BMI) and its association with further overweight and obesity among non-overweight and non-obesity primary and secondary school students at baseline, in order to provide basis for controlling the incidence of overweight and obesity among children and adolescents in China. Methods The physical examination data of primary and secondary school students were collected from a cohort study designed in Longkou City from 2015 to 2022, and 7 346 non-overweight and non-obesity students at baseline were included in thus study. The Generalized linear model was used to analyze the effect of baseline BMI level on further BMI level after 8 years of follow-up, and stratified analysis was performed according to age groups. Linear trend test was used to analyze the influence of baseline BMI level on end-stage BMI change trend. Results During the follow-up period, the detection rates of overweight and obesity were 14.6%, 17.9%, 17.7%, 17.7%, 18.3%, 20.4%, and 18.3% from 2016 to 2022, respectively. Among these, the detection rate of overweight and obesity in 2021 was highest. At different baseline ages, changes with follow-up years followed the same pattern, with overweight and obesity rate trend firstly up and then down with age, with the rate of increase peaking at around 10 years old. After 8 years of follow-up, compared with the baseline, the further new-onset overweight and obesity rate was 18.3%, and boys(21.5%) were higher than girls(15.8%). Compared with the baseline BMI-Z level＜-2, the correlation of primary BMI-Z with final BMI-Z level was stronger (P_trend <0.001) in baseline BMI-Z＞-1 group (β=1.191, 95%CI:0.853 - 1.529). When baseline BMI level was 1 - 2, it had a greater impact on the final BMI level for students agded 9 - 11 than students agde 6 - 8 (β=1.600, 95%CI:1.360 - 1.839). Conclusions The new-onset overweight and obesity rate of boys in Longkou City was higher than girls. The incidence of overweight and obesity in the age group of 9 - 11 years increases rapidly, and it was closely correlated with the level of further BMI. Comprehensive prevention and control strategies should be implemented to focus on prevention and control, and to reduce the risk of overweight and obesity effectively.

Investigation on the effect of nutrition and exercise quality of school-age children on physical development in Nanyang

DONG Zhenghang, LI Yangyang, HUANG Fang, GAO Yanan

2023, 31(5):  551-554.  DOI: 10.11852/zgetbjzz2022-1321

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Objective To explore the influence of school-age children's nutrition and exercise quality on their physical development. Methods A total of 4 032 primary school students were selected into this study by random stratified sampling method in September 2020. Their height, body quality, exercise quality (50m running time, grip strength, standing long jump, stereo forward flexion) were measured, and nutrition intake was assessed, the detection rates of obesity, overweight and malnutrition were analyzed in different nutrition level and sports quality. Results The detection rates of overweight, obesity and low body weight were 12.28%, 7.74%, and 9.42%, respectively, which were 13.01%, 8.50% and 9.47% in boys and 11.51%, 6.95% and 9.38% in girls. Among all the students, the detection rates of overweight and obesity among students with outstanding exercise quality were significantly lower than those in students with poor exercise quality (χ²=216.790, 219.578, 107.187, 102.776, P<0.05). There was no significant difference in the detection rate of malnutrition between students with excellent exercise quality and poor exercise quality (P>0.05). Among all the students, compared with the detection rates of overweight and obesity in students with overnutrition were significantly higher than those in students with inadequate nutrition and balanced nutrition (χ²=727.945, 918.773, P<0.05). The detection rate of low body weight in students with malnutrition was significantly lower than that in students with overnutrition and balanced nutrition (χ²=869.875, 933.032, P<0.05). Conclusion Adequate nutrition intake and high exercise quality can reduce the occurrence of obesity, overweight and malnutrition in school-age children, and maintaining a balanced nutrition and persistent exercise can have a positive significance to the physical development and health of school-age children.

Effects of nutrition support team management mode on growth development and immune function in premature infants

ZHENG Tingyu, ZHANG Chunyu, YANG Fei, ZHENG Fang, ZHANG Mengxia, XIA Luping, XU Sunchao

2023, 31(5):  555-558.  DOI: 10.11852/zgetbjzz2022-1153

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Objective To analyze the effects of nutrition support team (NST) management mode on growth development and immune function in premature infants, in order to provide reference for early nutritional support of premature infants. Methods A total of 98 premature infants treated in Hangzhou Obstetrics and Gynecology Hospital were enrolled in this study from January 2019 and December 2021.According to random number table method, infants were divided into observation group (n=49) and control group (n=49).The observation group was given NST management, while the control group received comprehensive nutrition support management.All infants were continuously intervened till 6 months of corrected month age.The growth rates of body mass, length and head circumference, catch-up growth rate, scores of mental development index (MDI) and psycho-motor development index (PDI) after 6 months of corrected age, levels of immunoglobulin A (IgA), immunoglobulin M (IgM) and immunoglobulin G (IgG) within 1h after birth and after 6 months of corrected age, as well as incidence of common complications suring intervention were compared between the two groups. Results After 6 months of corrected age, growth rates of body mass, head circumference and length in the observation group were significantly higher than those in the control group (t=6.773, 9.859, 4.831, P<0.05).The catch-up growth rate, scores of MDI and PDI in observation group were significantly higher than those in control group (t=4.947, 12.572, 4.495, P<0.05), and levels of IgA, IgM and IgG were significantly higher than those in control group (t=3.062, 7.617, 9.185, P<0.05).During intervention, the incidence of feeding intolerance in observation group was significantly lower than that in control group (8.16% vs.26.53%, χ²=5.763, P<0.05). Conclusion NST management mode can promote growth development and enhance immune function in premature infants, which has some application value in clinic practice.

Investigation on the current situation of one-day physical activity arrangement in kindergartens in Chongqing

LIU Xia>, WANG Nianrong>, GUAN Hongyan>, XIAO Guiyuan>

2023, 31(5):  559-563.  DOI: 10.11852/zgetbjzz2022-0658

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Objective To investigate the current situation of one-day physical activities of children in the kindergartens in each county and district of Chongqing, and to compare the activity types and time arrangements of preschool children at different ages in the kindergartens of different counties and districts in Chongqing, so as to provide basis for guiding preschool children to carry out scientific activities. Methods In January 2022, 4 714 kindergarten classes (including large, middle, small and mixed-age classes) from 1 798 kindergartens (including first-level, second-level, third-level, and unrated kindergartens) in 40 counties/districts in Chongqing were randomly selected in this study by stratified cluster sampling. Questionnaire survey was conducted to investigate the physical activities arrangement of each kindergarten class from Monday to Friday, including static activities time (electronic screen time and non-screen time), low-intensity physical activity time, moderate- to high-intensity physical activity time and total physical activity time. The rates of standard-obtained time for various activities were compared. Results Electronic screen time, non-electronic screen time, time for low-intensity physical activity, moderate- to high-intensity physical activity, and total exercise time was 29.6min, 93.9min, 19.0min, 123.3min and 142.3min, respectively. The compliance rates of time for electronic screen, moderate- to high-intensity physical activity and total physical activity were 71.8%, 95.7%and 57.9%, respectively, which were significantly different among the first, the second, the third level and unrated kindergartens(χ²=66.877, 9.854, 10.083, P<0.05), and among the large, the middle, the small and mixed-age classes(χ²=208.440, 53.749, 152.336, P<0.001). Conclusions The time and types of one-day physical activity are insufficient and imbalanced among kindergartens with different levels and grades from Chongqing. It is necessary to adjust the arrangement of physical activity in kindergartens.

Appropriate Technology

Effect of group training based on the treatment and education of autistic and communication handicapped children on preschool children with autism spectrum disorder

ZENG Hongling, ZHOU Yi, XIE Jun, DAI Lisha, TANG Jun

2023, 31(5):  564-569.  DOI: 10.11852/zgetbjzz2022-0839

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Objective To explore the effect of treatment and education of autistic and communication handicapped children (TEACCH) group training in preschool children with autism spectrum disorder (ASD), in order to provide reference for localization of the training mode of TEACCH. Methods Totally 60 preschool children with ASD in Children's Rehabilitation Department of Wuhan Mental Health Center from January 2018 to October 2021 were enrolled in this study, and were randomly assigned to the TEACCH group (n=30) and the control group (n=30).The Chinese version of Psycho-Educational Profile, 3rd ed(PEP-3) was used to assess treatment effects at baseline, posttest, 6-month follow-up and 1-year follow-up after training. Results No significant difference was found between the two groups at baseline (P>0.05). Time effect was significant for all indicators (P＜0.001). The scores of expressive language, receptive language, fine motor, social reciprocity, problem behavior, personal self-care and adaptive behavior in the TEACCH group were significantly improved than those of the control group (F=4.159, 10.447, 4.556, 4.666, 12.922, 4.199, 8.484, P<0.05). The interaction effects between time and group were significant in affective expression, problem behavior and personal self-care scores (F=3.919, 5.071, 9.689, P<0.05). The change scores of expressive language, problem behavior and personal self-care in the TEACCH group were significantly higher than those of the control group at posttest, 6-month follow-up and 1-year follow-up (P<0.05). The change scores of emotional expression and social interaction in the TEACCH group were significantly higher than those of the control group only at posttest and 6-month follow-up (P<0.05). The change scores of receptive language, fine motor and adaptive behavior in the TEACCH group were significantly higher than those of the control group only at posttest and 1-year follow-up (P<0.05). Conclusion Group training based on TEACCH can promote the language, fine motor, emotion, social interaction and behavior of preschool ASD children.

Consensus Statement

Interpretation of "Females with ADHD:An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women (2020) "

ZHANG Jie, AN Yingping, YANG Yi, ZHANG Yannan, TIAN Lin

2023, 31(5):  570-575.  DOI: 10.11852/zgetbjzz2022-0909

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Attention deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children. Since most girls and women with ADHD do not have externalized behavioral problems and the public has a stereotype of ADHD symptoms, a considerable number of girls and women with ADHD do not receive timely diagnosis and scientific treatment, resulting in a variety of social function impairment and increased health risks in adulthood. In 2020, The United Kingdom ADHD Partnership published "Females with ADHD:An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women", which for the first time addresses the diagnosis and treatment of women with ADHD from a lifespan management perspective and provides recommendations. This paper interprets the expert consensus in order to provide relevant help for the identification, evaluation, diagnosis, treatment and management of ADHD in girls and women and improve their long-term health status and clinical prognosis.