Table of Content

10 July 2023, Volume 31 Issue 7

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Expert Commentary

Early prevention of dyslipidemia in children and adolescents as well as cardiovascular health in adulthood

XIANG Wei

2023, 31(7):  697-702.  DOI: 10.11852/zgetbjzz2023-0538

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In our country, cardiovascular disease (CVD) now ranks the first among independent risk factors for atherosclerosis(AS) and CVD, and it is now the leading cause of mortality in both urban and rural populations. Numerous studies have demonstrated that AS-related CVD begins with AS lesions in early childhood, and this process is correlated with increased plasma cholesterol levels. The prevalence of dyslipidemia among children and adolescents is increasing in China. The definition, latest categorization, diagnosis, and treatment of dyslipidemia in children and adolescents are presented in this article. Primary prevention places a focus on lifestyle prevention, genetic counseling, and avoiding harmful impacts of variables connected to the developmental genesis hypothesis of health and illness on fetuses and offspring. When it comes to secondary prevention, the focus is on the value of screening and the promotion of dyslipidemia screening in children at high/medium risk or with a positive family history. For children with moderate to severe dyslipidemia, tertiary prevention means careful dietary restriction and medication intervention. It is advised to refer patients to a multidisciplinary team of experts in tertiary prevention. Finally, the development of researches on adult cardiovascular health and early dyslipidemia prevention in children and adolescents is presented.

Professional Forum

Adverse factors in early life and the development and prevention of chronic diseases

WU Ting, LI Fei

2023, 31(7):  703-706.  DOI: 10.11852/zgetbjzz2023-0616

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The theory of developmental origins of health and disease(DOHaD) that evolved from a series of epidemiological studies of infants and adults states that many chronic diseases in adulthood can be traced back to early life development. Changes in fetal metabolism and developmental processes induced by adverse factors in early life permanently reshape the structure, function and metabolism of the body, ultimately leading to the onset of disease in adulthood. This review focuses on the factors that affect the occurrence of chronic diseases in childhood and adulthood in early life, and puts forward suggestions to reduce the risk of diseases, aiming for providing clues for the early prevention of chronic diseases and promoting long-term health.

Basic Experimental Articles

Association of abdominal obesity and pre-abdominal obesity with hyperuricemia in children

LIU Haodong, LI Cheng, ZHAO Min, XI Bo

2023, 31(7):  707-712.  DOI: 10.11852/zgetbjzz2022-1360

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Objective To examine the relationship of abdominal obesity and pre-abdominal obesity with hyperuricemia among children, in order to provide scientific basis for the prevention and treatment of hyperuricemia in children. Methods Data were from the baseline survey of the Huantai Childhood Cardiovascular Health Cohort Study conducted in Huantai County, Zibo City, Shandong Province from November 2017 to January 2018. A total of 1 202 children with complete data were included in this study. Covariance analysis was used to compare the difference in uric acid levels between children with normal waist circumference (WC), pre-abdominal obesity and abdominal obesity, and multivariate Logistic regression model was used to analyze the relationship of abdominal obesity and pre-abdominal obesity with hyperuricemia among children, using normal WC as reference. Results After adjusting for all potential covariates, uric acid levels in children with pre-abdominal obesity [(289.7±80.6)μmol/L] and abdominal obesity [(332.2±87.8)μmol/L] were significantly higher than those with normal WC [(268.6±71.3)μmol/L] (F=88.51, P<0.05). Compared with children with normal WC, children with pre-abdominal obesity (OR=2.71, 95%CI:1.38-5.31) and abdominal obesity (OR=7.97, 95%CI:4.61-13.76) were at an increased risk of hyperuricemia(P<0.01). The results were similar when using waist-to-height ratio to determine abdominal obesity. Conclusion There is a positive relationship of abdominal obesity and pre-abdominal obesity with hyperuricemia in children, suggesting that more efforts should be made to reduce childhood abdominal obesity, in order to prevent the occurrence of childhood hyperuricemia.

Multi-center survey on serum folic acid in preschool children in China

LIU Min, ZHANG Qian, YANG Ting, CHEN Jie, CHEN Li, DAI Ying, JIA Feiyong, WU Lijie, HAO Yan, LI Ling, ZHANG Jie, KE Xiaoyan, YI Mingji, HONG Qi, CHEN Jinjin, FANG Shuanfeng, WANG Yichao, WANG Qi, JIN Chunhua, LI Tingyu

2023, 31(7):  713-717.  DOI: 10.11852/zgetbjzz2022-1527

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Objective To understand the situation of the serum folic acid level and folic acid deficiency in Chinese preschool children, and to compare them with the current reference range of serum folic acid provided by WHO and the United States US Centers for Disease Control and Prevention (CDC), so as to provide basis and suggestions for the establishment of the reference value of serum folic acid for Chinese preschool children. Methods From May 2018 to December 2019, children were recruited from 13 cities across five geographical regions in China, and finally a sample of 1 373 healthy children under 7 years old was obtained. Serum folic acid level was quantitatively determined by automatic chemiluminescence immunoassay (mindray, CL-1000i, China). Results The overall serum folic acid level was 12.46 (10.08~15.35)ng/mL, and the reference interval (P₅-P₉₅) ranged from 6.89 to 21.00ng/mL. Taking serum folic acid level <2ng/mL (CDC standard), ＜4ng/mL (WHO standard) and <6.89ng/mL(P₅ in this study) as the threshold values for serum folic acid deficiency, the number of folic acid deficiency in this population was 0, 3 (0.22%) and 66 (4.81%), respectively. The difference in serum folic acid level between different age groups was statistically significant (F=1.244, P<0.05). Serum folic acid level was negatively correlated with age (β=-0.998), and has no significant correlation with WAZ, HAZ and BMI. There was no statistical difference in serum folic acid level between boys and girls among children in different age groups (P＞0.05). Conclusion The determination of serum folic acid deficiency at a single threshold point is not applicable to preschool children, and the reference value of serum folic acid level should be set according to age.

Status quo and risk factors for different body proportions of children under 2 years old in the real world

HUO Yanyan, LIU Zhongling, MA Ling, WU Dan, WANG Xiulian, QIU Xiaoyan, DOU Jiaying, REN Yuqian, LI Yicheng, HONG Xia, CHEN Jinjin

2023, 31(7):  718-723.  DOI: 10.11852/zgetbjzz2022-1163

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Objective To identify the prevalence and the risk factors of different body proportions in children under 2 years of age, so as to provide theoretical basis for making related prevention and control measures. Methods Cross-sectional data of 8 474 children under 2 years old (0~<2 years) from May 2020 to May 2022 were retrieved through the Children′s Growth and Development Assessment and Follow-up System of the Department of Child Health Care, Shanghai Children′s Hospital for a retrospective study according to real-world research methods. Physical data were measured by medical professionals, and the children′s birth and parents′ conditions were collected retrospectively. A numerical table was constructed and the SPSS 26.0 software was used to analyze the prevalence and risk factors of different body proportions. χ² test was used for comparison between groups and multi-factor Logistic regression analysis was used for regression. Results The study included 3 813 boys and 4 661 girls under 2 years of age in routine health check-ups, of whom the overall detection rates for emaciation, overweight and obesity were 1.5%, 19.0% and 7.8% respectively. The detection rates of overweight and obesity in boys were higher than those in girls(χ²=17.597, 12.653, P＜0.01). The risk of overweight and obesity was increased in children with birth weight > 4 000g, larger for gestational age and larger head circumference, and the risk of obesity was higher in children with birth weight <2 500g than that in the normal group(P＜0.01). Children with smaller head circumference and small for gestational age were more likely to emaciation(P＜0.05).Children with overweight or obese parents were at a higher risk of developing overweight and obesity than the normal population, and caesarean section was also a risk factor for obesity in childhood(RR=1.33, 95%CI:1.15-1.53, P＜0.01). Logistic regression analysis showed that boys, head circumference, birth weight in relation to gestational age and parental BMI were valid early warning indicators of overweight and obesity in children (P＜0.01). Conclusion With a high detection rate of overweight and obesity in children under 2 years of age and the persistence of emaciation, early prevention and intervention are needed for the healthy development of children′s physical fitness.

Status quo and related factors of Chinese vocabulary and grammar development in children aged 2 to 6 years

LIU Huijuan, SONG Zhixiao, GAO Nannan, ZHANG Li, SUN Jin, QIAO Xiuyun, KE Jiamei, LI Yan

2023, 31(7):  724-730.  DOI: 10.11852/zgetbjzz2022-0715

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Objective To assess Chinese vocabulary and grammar development of children aged 2 to 6 years, and to analyze its development process and related influencing factors. Methods From July 2021 to February 2022, 198 children aged 2 to 6 years were included in the outpatient physical examination of Shandong Province Qianfoshan Hospital, who were divided into 8 groups by age with 0.5 years intervals. The enrolled children were assessed for vocabulary and grammar development, and the influencing factors were analyzed. Results 1) Vocabulary comprehension was partially not up to standard at 2 to 4 years old and up to standard at 4 to 6 years old. Children over 4 years old performed better than those under 4 years old in vocabulary expression. 2) There were more substandard items of grammar at the age of 2 to 3.5 years old than the age of 3.5 to 6 years old. Simple sentence patterns and noun phrases were acquired first, then the patterns of calculus and complex sentences. The semantics of action events were acquired first, followed by the characters, and finally the semantics of the orientation of the characters. 3) The main caregivers [grandmother (Z=-2.96), primary school education (H=10.96), housewife(H=16.55)] and the use of dialect communication(H=20.53), short interaction in the past week (H=9.14), holding food in mouth(Z=-2.08), semi-liquid diet(H=10.07), eating solid food too late (H=13.71) were associated with higher rate of vocabulary comprehension errors (P＜0.05). The main caregivers [grandmother (Z=-2.25), primary school education (H=15.28), housewife (H=17.08)], the use of dialect communication (H＝13.65), short interaction in the past week (H=8.03) and holding food in mouth (Z=-2.59) were associated with higher vocabulary expression error rate (P＜0.05). The main caregivers [grandmother(Z=-3.08), primary school education(H=17.10), housewife(H=23.64)], the use of dialect communication(H＝25.56), early exposure to electronic screens(H=9.21) and long screen time(H=14.70), and eating behavior [holding food in mouth(Z=-2.98), dislike chewing food(Z=-2.81), prefer porridge or rotten noodles (Z=-1.99), late eating solid food (H=12.56), picky eating (Z=-2.18)] were associated with higher grammar error rates (P＜0.05). Conclusions There is a significant correlation of age with the development of vocabulary and grammar. Vocabulary comprehension is learned by the age of 4, while vocabulary expression and grammar are gradually mastered after 4 years old. Main caregivers, family parenting, language environment, screen time and dietary behavior are related to vocabulary and grammar development.

Effect of methylphenidate hydrochloride prolonged-release tablets on the growth of children with attention deficit hyperactivity disorder

LI Rong, LI Nian, WU Dandan, HUANG Rong, CHEN Yinhua

2023, 31(7):  731-735.  DOI: 10.11852/zgetbjzz2022-1339

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Objective To analyze the effect of methylphenidate hydrochloride prolonged-release tablets on the growth and nutritionl intake of children with attention deficit hyperactivity disorder (ADHD), in order to provide scientific reference for drug therapy of ADHD. Methods ADHD children in Children′s Hospital of Nanjing Medical University were selected as study subjects, and were divided into treatment group and control group. The treatment group was given methylphenidate hydrochloride sustained release tablets, while the control group received behavior management. Height, weight, body composition measurement and 24 hour dietary survey analysis were monitored regularly. Results The Z scores of weigh-for-age(W/A-Z) (t= 5.815, 6.708, 5.003, 2.234, P<0.001) andthe Z scores of body mass index-for-age(BMI/A-Z) (t=3.776, 4.666, 6.431, 7.467, P<0.001), body composition measurement of protein content (t=3.789, 4.087, 3.098, 2.889, P=0.001), skeletal musclecontent (t=3.112, 2.890, 4.765, 5.221, P<0.001),fat content (t=4.329, 3.879, 2.998, 2.567, P<0.001); 24-hour dietary assessment of energy (t=11.657, 12.887, 5.091, 3.765, P<0.001), protein (t=12.987, 14.098, 13.777, 12.987, P<0.001), fat (t= 12.889, 12.012, 14.887, 13.987, P<0.001) and carbohydrate intake (t= 13.889, 14.889, 15.098, 14.889, P<0.001)after 3-month,6-month,9-month,and 12-month treatmentwere lower than those in control group. The Z scrores of height-for-age (H/A-Z) of children in the treatment groupafter 6-month, 9-month and 12-month treatment were lower than those in control group(t=1.752, 2.625,5.961,P＜0.001). Repeated measurement anova analysis showed that the time effect, intragroup effect and interaction effect of physical assessment, body composition (except for inorganic salts) and 24-hour dietary assessment between the treatment group and control group were statistically significant (P<0.05). Conclusion The medication of methylphenidate hydrochloride prolonged-release tablets on ADHD children, with the treatment duration increasing, will have an impact on the height, weight, BMI and nutritionl intake of children.

Application of early start Denver model in the rehabilitation of children with autism spectrum disorder of different conditions

ZHANG Chao

2023, 31(7):  736-740.  DOI: 10.11852/zgetbjzz2022-0971

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Objective To analyze the effect of Early Start Denver Model (ESDM) in the rehabilitation of children with autism spectrum disorder (ASD) with different degrees of condition. Methods A total of 120 ASD patients treated in Xinzheng Hospital of Traditional Chinese Medicine from February 2018 to April 2019 were enrolled in this study, and were randomly divided into experimental group (n=60) and control group(n=60).Children in each group was divided into grade Ⅰ, Ⅱ, and Ⅲ according to the fifth edition of Diagnostic and Statistical Manual of Mental Disorders(DSM-5).The experimental group was treated with ESDM, while the control group was given traditional rehabilitation.Childhood Autism Rating Scale(CARS) and the Psychoeducational Profile-Third Edition(PEP-3) were used to evaluate the rehabilitation effect before intervention and six months after intervention. Results After 6 months of intervention, the CARS score of children with grade Ⅰ andⅡ ASD in the experimental group was significantly lower than that in the control group(t=4.447, 6.280, P＜0.05).There was no statistically significant difference between the test group and the control group in the grade Ⅲ CARS scores (t=0.159, P=0.875).The scores of imitation, emotional expression, social interaction and nonverbal behavior in the PEP-3 score of children in experimental group of grade Ⅰ and Ⅱ were significantly different from those of the control group (χ²=3.908, 4.910, 6.112, 4.185, P＜0.05), butthere were no significant differences the PEP-3 scores in grade Ⅲ children between the two groups (P＞0.05). Conclusion The ESDM model was more effective in children with mild to moderate autism compared to the conventional intervention model, especially in improving imitation, emotional expression, social activities and nonverbal behavior in children with autism, but no significant advantage is found in children with severe autism.

Status quo and related factors of parental nurturing care ability of children aged 0-3 in Beijing

KONG Wenrui, XU Mengxue, JIA Ni, MU Lijuan, HAN Ying, LI Qiuju, MENG Zhaoxue, WANG Shulan, ZHU Zonghan, GUAN Hongyan

2023, 31(7):  741-745.  DOI: 10.11852/zgetbjzz2022-0929

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Objective To investigate the status quo and related factors of parental nurturing care ability of children aged 0-3 in Beijing, in order to provide evidence-based reference for further scientific and targeted guidance on nurturing care. Methods From July to November 2020, a self-administered questionnaire survey was conducted among 1 514 parents of children aged 0-3 years in 5 districts of Beijing. A self-designed Caregiver′s Nurturing Care Practice Self-report Questionnaire was used to assess the ability of nurturing care, including nurturing concept and style, health care, nutrition and feeding, responsive caregiving, early learning opportunities, security and safety. Univariate and multivatiate linear regression analysis were used to examine the influence of children, parents and family environment factors on nurturing care ability. Results The total score of the Caregiver′s Nurturing Care Practice Self-report Questionnaire was 77.81±10.31. The scores of nurturing concept and style, health care, nutrition and feeding, responsive caregiving, play experience, security and safety were 78.81±13.84, 69.43±11.17, 78.51±13.06, 84.00±13.66, 73.35±18.84 and 82.77±12.80, respectively.Multivariate linear analysis showed that children′s age (1 year old:β=-2.09,95%CI:-3.17- -1.02; 2-3 years old: β=-3.95, 95%CI:-5.27--2.62), annual household income (β=1.39, 95%CI:1.16-3.95), number of picture books (β=2.55, 95%CI:0.25-2.53), early learning support (β=7.20, 95%CI:6.09-8.31), and availability of a regular playground (β=5.48, 95%CI:4.33-6.63) were factors influencing the total parental nurturing ability score (P＜0.05). Conclusions Parents of 0- to 3-year-old infants and toddlers have good nurturing care ability overall, but there is still room for further improvement in health care and early learning opportunity. Relative support or intervention is needed to better promote early childhood development.

Association between bone development and vitamin K in children aged 0 to 14 years

YANG Yuru, WANG Hong, XU Shuhong, CAO Yanmei, MENG Xian, GE Dongmei

2023, 31(7):  746-750.  DOI: 10.11852/zgetbjzz2022-1274

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Objective To explore the association between bone development and vitamin K in 6 335 children aged 0 to 14 years, in order to provide a theoretical basis for future clinical intervention of abnormal bone development in children. Methods From January 2020 to April 2022, 6 335 children aged 0 to 14 years who took physical examination in the child health department of several maternal and child health hospitals in Sichuan Province were selected in this study. Serum levels of vitaminK₁ and K₂ were tested by liquid tandem mass spectrometry, meanwhile, the conditions of bone development was recorded. The children were divided into normal group (n=5 040) and abnormal group (n=1 295) according to the bone development result. Then the differences between the two groups were analyzed, andthe influencing factors of bone development in children,especillythe relationship between abnormal bone development and vitamin K was analyzed by Logistic regression. Results There were significant differences in gender(χ²=6.03), age(Z=14.32), height(Z=16.35), weight(Z=16.70), serum vitamin D(Z=8.26),K₁(Z=5.70) and K₂(χ²=13.88) between normal bone development group and abnormal bone development (P＜0.05). The detection rate of skeletal dysplasia in children at different age groups was statistically significant (χ²=158.66, P<0.05). There was no significant difference in the proportion of vitamin K₂<0.10ng/mL among different age groups (P>0.05), but the level of vitamin K1 among different age groups was statistically significant (Z=36.5, P<0.05). The levels of vitamin K₂ and K₁ in children among different ages in the normal group were compared, and the difference was statistically significant (χ²=47.58, Z=582.65, P<0.05).Logistic regression analysis showed that female(OR=0.857,95%CI:0.755-0.973) and weight (OR=0.949,95%CI:0.931-0.968) were protective factors of bone development in children (P<0.05) , height (OR=1.044,95%CI:1.034-1.054) , and vitamin K₂<0.1ng/mL(OR=1.153,95%CI:1.006-1.320) were risk factors for bone development in children(P<0.05). Conclusions The development of children's bones is influenced by various factors.Among vitamin K, it is mainly vitamin K₂ that affects children′s bone development, and children with vitamin K₂< 0.1ng/mL are more likely to have abnormal bone development than children with vitamin K₂≥0.1ng/mL. Monitoring and intervening vitamin K₂ level in children is of certain clinical significance for the early prevention of abnormal bone development diseases.

Review

Research progress in the relationship between rapid catch-up growth and childhood obesity in small for gestational age infants

LI Mingzhu, WANG Jing, XIE Duoshuang

2023, 31(7):  751-755.  DOI: 10.11852/zgetbjzz2022-0757

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Because of the lifting of intrauterine growth restriction and the altered nutritional environment after birth, most small for gestational age (SGA) would have catch-up growth.Catch-up growth can promote the physical development and improve the quality of survival of SGA.Recently, there is much evidence that rapid catch-up growth is associated with childhood obesity, while breastfeeding can reduce the incidence of obesity.This article reviews the progress in the relationship between rapid catch-up growth of SGA and childhood obesity, and discusses possible mechanisms.

Research advances on the correlation of gut microbiota with brain development and neurocognitive behavior in preterm infants

ZHANG Dan, ZHANG Jun, YANG Yurong, CAO Mi, YAN Jingmin, ZHU Luyang

2023, 31(7):  756-759.  DOI: 10.11852/zgetbjzz2022-0872

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Gut microbiota is an important determinant of health and disease at all stages of life.Understanding how gut microbiota shapes infant brain structure, function and neurocognitive behavior in infants is an important current research frontier.Premature infants are a special group of infants with a high risk of abnormal brain development and poor neurobehavioral development.This paper aims to summarize the characteristics of gut microbiota colonization in preterm infants and explore the potential associations of gut microbiota with brain development and neurocognitive behavior, so as to provide theoretical evidence for optimizing neurodevelopmental outcomes and making intervention strategies in preterm infants.

Research progress in growth and development of twins small for gestational age infants and its influencing factors

PAN Ting, ZHANG Xuan

2023, 31(7):  760-765.  DOI: 10.11852/zgetbjzz2022-1233

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With the opening of "the three-child" policy and the development of obstetrics and neonatal technology, the birth rate of twins is rising year by year. The incidence of twins small for gestational age is increasing as a result of limited intrauterine environment, more complex umbilical cord and placental relationships and increased maternal complications, etc. At present, there are few researches on the growth and development of twins small for gestational age. Therefore, this review summarizes the growth and development of twins small for gestational age after birth and related factors.

Research progress of gut microbiota and respiratory virus infection in children

YE Zhixu, YU Fuxun

2023, 31(7):  766-769.  DOI: 10.11852/zgetbjzz2022-0424

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Gut microbiota plays an important role in maintaining human health.Viruses are the most common cause of acute respiratory tract infection in children.The relationship between gut microbiota and disease has become a hot topic of current research.There is increasing evidence that gut microbiota can remotely influence the host immune response, which is crucial to host defense against infection.This paper summarizes the research progress in the effect of gut microbiota on children′s respiratory tract immunity, focusing on the relationship between gut microbiota and defense against respiratory tract virus infection in children, so as to provide a new idea for the prevention and treatment of respiratory viral diseases in children.

Influence of parent-child interaction on early childhood development outcome

CAO Hui, YAN Shuangqin, GUAN Hongyan

2023, 31(7):  770-774.  DOI: 10.11852/zgetbjzz2022-0811

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Family environment plays a central role in children′s health, growth and development.Parent child interaction is an important indicator to evaluate the quality of parenting care, and high quality parent-child interaction is a key determinant of cognitive and psycho-social development.However, so far, there is still a lack of comprehensive discussion on the relationship between parent-child interaction and early childhood development outcomes in China.By searching the previous literature and analyzing researches related to parent-child interaction, this paper finds that parent-child interaction can have a positive impact on children′s cognitive function, emotional sociality, language ability and common children′s developmental behavior disorders, and parent-child interaction therapy can also produce a good intervention effect, so as to provide a new intervention path and evidence-based basis for promoting children′s early development based on parent-child interaction.In addition, it is also pointed out that more evaluation and guidance of parent-child interaction, intervention practice research of children with special developmental behavior problems need to be carried out in China in the future, so as to further promote the development of new service technologies for early childhood development in China.

Meta Analysis

Qualitative evidence-based study on the association between eating out of/at home and obesity in children

ZHANG Rong, WU Xiangyi, ZHU Yimin, ZHU Wenli, the Committee of Guidelines for Childhood Obesity Prevention and Control

2023, 31(7):  775-780.  DOI: 10.11852/zgetbjzz2022-1192

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Objective To systematically evaluate the relation between eating out of/at home and overweight risk in children, in order to provide evidence-based reference for the development of guidelines and policies. Methods Related literature published in Cochrane library, PubMed, EMBASE, China Biomedical Literature Database (CBM), China National Knowledge Network (CNKI) and Wanfang Data Knowledge Service platform from January 1st, 1998 to December 31st, 2021 was systematically searched. Data were extracted and included articles were evaluated according to GRADE standards. Results A total of 10 cross-sectional studies and 3 cohort studies were included. The results showed that children tended to choose healthy food when eating at home. However, eating out, especially for western fast food, was associated with high fat, high sugar and high energy food intake. Frequently eating out increased the risk of overweight and obesity in children, which was related to children′s age, gender and weight status. Conclusions Eating out of/at home might be related to childhood obesity, which needs to be supported by more evidence from high-quality researches. In order to prevent and control childhood obesity, it is recommended that children eat at home more often.

Clinical Research

Application of long-term management mode based on Internet technology in children with intractable epilepsy

LI Weiwei, ZHANG Dandan, LIU Xiaoming, CHEN Jiao, XIA Lu

2023, 31(7):  781-784.  DOI: 10.11852/zgetbjzz2022-1035

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Objective To explore the application effect of long-term management mode based on Internet technology in children with intractable epilepsy. Methods From February 2019 to April 2020, a total of 81 children with intractable epilepsy were enrolled in this study, and were randomly divided into study group (n=41) and control group (n=40).Long-term management mode based on Internet technology was implemented for the study group, whilethe control group was given routine management for one year. The compliance behavior, seizure frequency during the management period and quality of life before and after management were compared between the two groups. Results There were significant differences in the distribution of compliance behaviors of diet, medication, follow-up and emotional management during the management period between the two groups (Z=7.400, 4.830, 5.014, 5.694, P<0.05). The complete compliance rates of diet, medication, follow-up and emotional management during the management period in the study group were 82.93%, 87.80%, 80.49% and 75.61%, significantly higher than those of 55.00%, 67.50%, 57.50% and 50.00% in the control group (χ²=7.125, 4.761, 4.889, 5.420, P＜0.05). The number of epileptic seizures during the management period in the study group was (16.83±2.59) times/year, lower than that of (25.35±4.74) times/year in the control group (t=10.072, P＜0.05). After management, the scores of quality of life in terms of fear of attack, experience, emotion and social function of the two groups were higher than those before management (P＜0.05), which were higher in the study group than those in the control group (t=9.453, 8.792, 7.080, 9.558, P＜0.05). Conclusion The application of long-term management mode based on Internet technology for children with intractable epilepsy can improve their compliance behavior, control seizures, and improve their quality of life.

Trends and influencing factors of low birth weight of newborns in Xixiangtang District, Nanning City from 2015 to 2021

WEI Jufang, CHEN Jijian

2023, 31(7):  785-789.  DOI: 10.11852/zgetbjzz2022-1013

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Objective To analyze the trend and influencing factors of low birth weight (LBW) in Xixiangtang district of Nanning from 2015 to 2021,in order to provide evidence for reducing the incidence of LBW. Methods Birth data of live births in Xixiangtang, Nanning from 2015 to 2021 collected by "Guangxi Gui Women′s and Children′s Health Management Information System" were analyed.The χ² test for trend was used to test the difference of LBW among years.Time series analysis was adopted to predict the incidence of LBW in 5 years.Multivariate Logistic regression analysis was used to analyze the influencing factors of LBW. Results A total of 14 075 live births were delivered, including 875 low birth weight infants.The incidence of LBW increased from 4.9% in 2015 to 7.3% in 2021(χ²_trend=4.352, P=0.037).Time sersis ananlysis predicted that the incidence of LBW in this district was 8.3% in 2026.Multivariate Logistic regression analysis showed that maternal aged ≥35 years (OR=1.556, 95%CI:1.095-2.209), premature delivery(OR=37.601, 95%CI:31.446-44.962), multiple pregnancy(OR=10.290, 95%CI:7.588-13.955) were risk factors of LBW.Parity of 2(OR=0.602, 95%CI:0.474-0.764),antenatal examinations of 8 or more(OR=0.496, 95%CI:0.322-0.763), newborn sex of male (OR=0.603, 95%CI:0.508-0.716) were protective factors of LBW. Conclusions The incidence of LBW in Xixiangtang District of Nanning shows an increasing trend from 2015 to 2021, higher than the national average level, and may continue to increase in the next 5 years.Preventive measures should be taken among pregnant women with high-risk factors to reduce the incidence of LBW.

Disease burden of low body weight in children under 5 years old in China from 1990 to 2019

ZHU Lijun, LI Biaozhang, ZHOU Jiawen, WU Baixin, LI Weidong

2023, 31(7):  790-793.  DOI: 10.11852/zgetbjzz2022-1480

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Objective To analyze the current situation and trends of the disease burden due to low weight in Chinese children under 5 years old from 1990 to 2019, in order to provide reference for the prevention and control of the disease burden caused by low weight in children. Method Disability-adjusted life year (DALY) indicators attributable to low weight in children under 5 years of age from 1990—2019 were extracted from global burden of disease(GBD) 2019, and trends in mortality and DALY rates for diseases associated with low weight were analyzed using Joinpoint linear regression models. Results In 2019, the number of deaths due to low weight in children under 5 years of age in China was 34 400, the mortality rate was 42.27/10⁵, the DALY was 3.145 million person-years, and the DALY rate was 3 859.31/10⁵. Compared to 1990, the number of deaths decreased by 86.40%, mortality rate decreased by 80.74%, DALY decreased by 86.08% and DALY rate decreased by 80.29% in 2019. The burden of disease due to low weight was higher in boys than that in girls. The mortality rates for respiratory infections and tuberculosis, intestinal infections, and sudden infant death syndrome due to low weight in children under 5 years of age were 2.73/10⁵, 0.07/10⁵, and 0.07/10⁵, respectively. Respiratory tract infection and tuberculosis maintained the highest mortality and DALY rates among the three related diseases caused by low body weight. Conclusion Although the mortality and DALY of children under 5 years of age due to low body weight have shown a decreasing trend from 1990 to 2019, there are still many challenges in the prevention and treatment, indicating that the disease burden of children under 5 years of age attributed to low body weight cannot be ignored.

Effects of different ways of umbilical cord milking on the outcome of very preterm infants

FENG Xiao, CHEN Ling, ZHAO Hongying, HUANG Rui, LIN Chenxi, ZHUANG Lijuan

2023, 31(7):  794-798.  DOI: 10.11852/zgetbjzz2021-1602

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Objective To investigate the effect of different ways of umbilical cord milking(UCM) on the hemoglobin level and complication incidences in very preterm infants, so as to provide reference for choosing appropriate way of UCM in clinic. Methods From May 2018 to May 2021,a total of 262 cases of very preterm infants delivered via vagina in Zhongshan Hospital Affiliated to Xiamen University with gestational age of 28 to 31⁺⁶ weeks were divided into intact umbilical cord milking(I-UCM) group(n=87), cut-umbilical cord milking(C-UCM) group(n=88), immediate cord milking(ICC) group(n=87) according to different umbilical cord clamping methods. The hemoglobin level, hematocrit, serum total bilirubin level, phototherapy rate and transfusion rate during hospitalization of very preterm infants were compared among three groups. Besides, peri/intraventricular hemorrhage, neonatal necrotizing enterocolitis(NEC), retinopathy of prematurity(ROP), bronchopulmonary dysplasia(BPD), neonatal hypoglycemia and neonatal hypothermia were also compared among three groups. Results The levels of hemoglobin and hematocritin 1 hour after birth in I-UCM group and C-UCM group were significantly higher than those in ICC group(F=26.754, 29.147, P＜0.001), which were even higher in I-UCM group than C-UCM group(P<0.001). Serum total bilirubin level in the third and fifth day after birth in both groups of I-UCM and C-UCM were higher than those in group ICC(F=4.319,7.117, P=0.014). The incidence rates of peri/intraventricular hemorrhage(χ²=10.261), NEC(χ²=6.512), hypoglycemia and hypothermia(χ²=13.198) in both I-UCM group and C-UCM group were significantly lower than those in ICC group(P<0.05). There were no significant differences in the incidence rates of ROP, BPD and the proportion of phototherapyduring hospitalization in very preterm among the three groups(P>0.05). Conclusions Both I-UCM and C-UCM can effectively increase the blood volume of very preterm infants. The two UCM methods have similar effects on reducing the incidence of peri/ventricular hemorrhage, NEC, neonatal hypoglycemia, neonatal hypothermia and blood transfusion rate of very preterm infants.

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Prevalence of overweight and obesity among primary school students in Tai′an in 2021

WANG Xiaoli, DONG Qing, SUN Fengyan, CHEN Liping, YAO Guo, SHI Baohai

2023, 31(7):  799-803.  DOI: 10.11852/zgetbjzz2022-0696

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Objective To investigate the current prevalence of overweight and obesity of primary school students, in order to provide scientific reference for the developing targeted and effective strategies. Methods A total of 10 644 primary school students aged 6 to 13 years were randomly selected from urban and rural areas in Tai′an in this study in 2021. The overweight and obesity were defined according to body mass index (BMI) criteria, then the detection rates of overweight and obesity were analyzed. Results The total detection rate of overweight in children aged 6 to 13 years was 23.03%, which was 26.14%, 19.35% for boys and girls, respectively. The total detection rate of obesity in primary school students aged 6 to 13 years was 20.77%, which was 24.50%, 16.35% for boys and girls, respectively. The detection rates of overweight and obesity in boys were higher than those in girls. For children from urban and rural areas, the detection rates of overweight were 21.86% and 24.15%, respectively; and the detection rates of obesity were 22.07% and 19.52%, respectively. The detection rates of overweight and obesity in primary school students aged 6 to 13 years were higher than those in 2018(17.58%, 19.03%),the growth rates in the three years were 33% and 9.14% respectively. Conclusions The detection rates of overweight and obesity among primary school students in Tai′an area are high, with boys significantly higher than girls, and there is a significant increasing trend from 2018 to 2021. It is urgent to raise social awareness of the prevention and treatment of overweight and obesity in primary school students, and it is imperative to develop an effective weight loss program.

Current status quo and influencing factors of sugar-sweetened beverage intake among 919 pupils in Luzhou

LIANG Yi, ZHANG Jielan, WANG Fang, GAO Yunfei, JU Mei

2023, 31(7):  804-808.  DOI: 10.11852/zgetbjzz2022-0697

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Objective To analyze the current status and influencing factors of the intake of sugar-sweetened beverages (SSB), so as to provide scientific basis for effectively reducing SSB intake in pupils and promoting children′s health. Methods From September to November 2021, a total of 919 students aged 9-13 years in grade four to grade six were selected to fill out the questionnaire from four primary schools in Luzhou by random cluster sampling. SSB intake status was descriptively analyzed. Kruskal-Wallis H test, and ordinal multiclass Logistic regression analysis were used to analyze the influencing factors of SSB intake. Results Among 919 pupils surveyed, 67.9% reported that they consumed less than 1 bottle of sugar-sweetened beverages per week, 27.3% for 1-2 bottles per week, and 4.8% for ≥3 bottles per week. Multivariate analysis showed that the high frequency of friends around drinking SSB (always:OR=3.00, 95%CI:1.21-7.47), buying SSB at school (always:OR=9.46, 95%CI:2.71-32.97), parents offering SSB (always:OR=6.32, 95%CI:1.60-24.98), buying SSB at home (always:OR=18.23, 95%CI:5.92-56.21) and average daily TV/video time (≥2 hours:OR=2.14, 95%CI:1.35-3.39) were positively correlated with SSB intake. Conclusions The intake level of SSB among pupils in Luzhou is relatively high, with 32.1% of primary school students consuming more than 1 bottle (230ml) of SSB per week. It is mainly affected by friends around, the availability of SSB at school and home, and the average daily TV/video time. The available access to sugary drinks for elementary school students should be reduced, peer education should be emphasized, and a supportive environment should be actively constructed to foster good diatary habits and promote healthy growth of children.

Correlation of lipid metabolism with left ventricular hypertrophy and left ventricular remodeling in obese children

CAO Yachuan, DOU Jijuan, MA Yaping, REN Jindong, CHEN Xinyan

2023, 31(7):  809-812.  DOI: 10.11852/zgetbjzz2022-0719

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Objective To analyze the correlation of lipid metabolism with left ventricular hypertrophy (LVH) and left ventricular remodeling (LVR) in obese children, so as to provide reference for early clinical intervention of obese children. Methods A total of 86 cases of obese children who visited Affiliated Hospital of Jiangnan University from January 2018 to December 2021were enrolled in this study, meanwhile 80 cases of non-obese children were taken as the non-obese group in the same period. The levels of lipid metabolism indicators [including low density lipoprotein (LDL), triglyceride (TG), total cholesterol (TC), and high density lipoprotein (HDL)] and the incidence rates of LVH and LVR were compared between the two groups. The correlation of lipid metabolism with LVH and LVR was analyzed by Spearman correlation. The lipid metabolism indicators which could predict the risk of LVH and LVR were analyzed by a non-conditional Logistic regression model. Results The levels of LDL, TG and TC of children in obese group were significantly higher than those in non-obese group (t=5.604, 6.018, 5.273, P<0.001), while the level of HDL of children in obese group was significantly lower than that in non-obese group (t=6.437, P<0.001). The incidence rates of LVH and LVR in obese group was significantly higher than those in non-obese group (χ²=15.472, 13.079, P<0.001). The levels of LDL(r=0.506, 0.430), TG(r=0.547, 0.429) and TC(r=0.528, 0.475) were positively correlated with LVH and LVR (P<0.05 or <0.001), while thelevels of HDL were negatively correlated with LVH and LVR(r=-0.490, -0.411,P<0.05 or <0.01). Logistic regression analysis indicated that the levels of TG(OR=1.268, 1.183, 95%CI:1.107-1.468, 1.017-1.290), LDL(OR=1.280, 1.271, 95%CI:1.105-1.392, 1.136-1.385), HDL(OR=0.816, 0.847, 95%CI:0.705-0.987, 0.763-0.992)could predict the risk of LVH and LVR in obese children. Conclusion The lipid metabolism is correlated with LVH and LVR in obese children, and the lipid metabolism indicators are expected to be risk predictors of LVH and LVR in obese children