Chinese Journal of Child Health Care

Screening and intervention for birth defects and common inherited metabolic diseases

MA Hong-wei

2013, 21(4): 337-338.

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Analysis of the curative effect of congenital hypothyroidism children.

JIANG Xue-jin,WANG Xiao-rong,WANG Jing,GU Xue-zhu,GAO Jing,WANG You-jie.

2013, 21(4): 342-344.

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Objective To analyze the neural and psychological development of congenital hypothyroidism (CH) children from the newborn screening for CH,and provide evidences for estimating prognosis and exploring more perfect treatment. Method The DQ,motor,fine movement,adaption,language and social behavior of congenital hypothyroidism children were evaluated using neural and psychological development diagnosis scale for 0~6 years old children. Results Intelligence level of most CH children was in normal range,average scores of DQ were higher than 85 but in low-to-normal level in each age group.Neural and psychological development of CH children of different diagnosis age were not significantly different.The correlations between pretreatment FT₃ and fine movement,adaption,language,social behavior were significant (P<0.05),and the correlation coefficients were -0.282,-0.280,-0.276,-0.192,respectively.The correlation between pretreatment FT₄ and motor was significant (r=0.198,P<0.05). Conclusion Intelligence level of most CH children can achieve normal range.Both high FT₃ level and low FT₄ level can affect the neural and psychological developments of CH children.

Results analysis of external quality assessment program in newborn screening laboratories during 2003-2012 in China.

WANG Wei,ZHONG Kun,HE Fa-lin,WANG Zhi-guo.

2013, 21(4): 345-347.

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Objective To summarize and analyze the results of external quality assessment (EQA) of phenylalanine (Phe) and thyroid stimulating hormone (TSH) during 2003-2012 in China and then provide a benchmark for the neonatal screening testing. Methods Referring to Newborn Screening Quality Assurance Program of Centers for Disease Control And Prevention and GB/T 20470-2006:Requirements of external quality assessment for clinical laboratories.With 3 times one year,5 controls were distributed to the participated laboratories each time.Then the laboratories were asked to measure and report the results back in a specified time.With appropriate statistical analysis,the performance of each laboratory was evaluated. Results During 2003-2012,the percent of each method used for Phe was from 54.9% to 85.2% for Fluorescence Analysis,from 12.6% to 6.2% for Quantitative Enzymatic Method,and from 35.4% to 4.6% for Guthrie Test.The percent of each method used for TSH was from 44.8% to 70.7% for Time Resolved Fluoroimmunoassay(TRFIA),from 36.0% to 11.2% for Enzyme-Linked Immunosorbent Assay(ELISA),and from 17.5% to 13.0% for Fluorescent-Enzyme immunoassay(FEIA).The inter-laboratory coefficient of variation(CV) during the 10 years were 12.13%,17.15%,and 12.14%~12.97% for each method of Phe.And for TSH,the inter-laboratory CV were 14.14%,14.88%~27.20%,and 17.07%~34.98% for each method,respectively.The average acceptable rates of Phe and TSH were 95.3% and 89.4% for quantitative testing,97.8% and 98.0% for qualitative clinical judgment. Conclusion The CV of Fluorescence Analysis and TRFIA are less than others,thus the TRFIA is the first choice for TSH testing in China.The external quality assessment of Phe and TSH for newborn screening is helpful to discover the problem in this area and promote the national quality level.

Discussions of clinical characteristics and genotype and clinical phenotype relationship in methylmalonic acidemia.

LI Fang,MA Hong-wei,SONG Ying,HU Man,REN Shuang.

2013, 21(4): 348-350.

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Objective To discuss the clinical characteristics,blood amino acid and urinary organic acid changes,the relationship between clinical phenotype and genotype in methylmalonic acidemia(MMA). Method The clinical data,blood amino acid,urinary organic acid and gene results of the 10 patients diagnosed with MMA were analyzed,which were from the developmental pediatrics department of Shengjing Hospital of China Medical University during August 2011 to December 2012. Results 10 patients,age of onset ranged from 5 days to 2 years and 5 months.The main clinical manifestations included poor feeding (2 cases),poor weight gain(1 case),repeated vomiting (2 cases),repeated convulsions (1 case),developmental retardation (3 cases),developmental degradation (1 case) and musclar dystonia (3 cases).The laboratry findings showed metabolic acidosis in three cases,hyperammonemia in seven cases and hyperhomocysteinemia in six cases.The typical MRI changes were found in 3 cases,nonspecific change were found in 4 cases.4 cases were detected related gene mutation,diagnosed three cases of cblC subtype,one case of mut-subtype.In patients reactive to VitB12 treatment,urinary MMA average decreased rate was 6.45,which of the blood C3 was 2.05,and C3/C2 was 1.64. Conclusions Except for the nonspecific clinical features,it is vulnerable to have metabolic acidosis,hyperammonemia and hyperhomocysteinemia; the brain MRI appears both typical changes and non-specific changes;the decline level of urinary MMA is a sensitive index in patients reactive to VitB12 treatment;genetic testing is used for clinical parting,estimating prognosis and prenatal diagnosis.

Analysis of the mutations of phenylalanine hydroxylase gene in Han ethnic group of Ningxia.

MAO Xin-mei,HE Jiang,LIU Yuan,LI Hong-yan,YU Wu-zhong.

2013, 21(4): 351-354.

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Objective To understand the structure and characteristics of the mutations of phenylalanine hydroxylase (PAH) gene in Han ethnic group of Ningxia. Method All of the exons and promoters of PAH gene of 12 phenylketonuria (PKU) cases in children of Han were determined by using the method of PCR direct sequencing. Results 18 mutations were detected in 24 PAH alleles.The detection rate of mutations was 75% (18/24).There were 11 kinds of mutations,including 9 of missense mutations,1 of nonsense mutations and 1 of splice site mutations. Conclusion According to the research,the mutations of PAH gene in Han group of Ningxia show diversity,complexity,and significant ethnic characteristics.

Comparing of prechtl's qualitative general movements assessment and electroencephalogram of children with different motor development outcomes.

GONG Chun-dan,PENG Yong-mei,MA De-jun,SHI Wei,LI Hui,HOU Fang-hua,SU Yi,LI Yun,YANG Hong.

2013, 21(4): 355-357.

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Objective To analyze prechtl's qualitative general movements assessment(GMs) and electroencephalogram(EEG) of children with different motor development outcomes retrospectively and investigate the GMs value in predicting of cerebral palsy. Methods The GMs and EEG reports of children more than one-year-old who had been hospitalized in neonatal intensive care unit were collected.The diagnosis of cerebral palsy was made according to the international cerebral palsy diagnostic definition published in 2006.Stata 11.0 was used to analyze GMs positive predictive values,negative predictive values,specificity and sensitivity among different groups and the difference of EEG. Results A total of sixty-two children were enrolled,28 of them were diagnosed as cerebral palsy,11 were motor retardation and 23 were normal.The predictive validity of GMs was as following:sensitivity 96.4%,specificity 73.9%,positive predictive value 81.8% and negative predictive value 94.4%.The rate of abnormal GMs in children of cerebral palsy was significantly higher than that in motor retardation and normal children.The rate of abnormal EEG in children of cerebral palsy and motor retardation were 78.6% and 81.8% respectively,higher than that in normal children(53.3%).The abnormalities of EEG mainly were sharp wave,sharp slow wave,high voltage and slow basic activities. Conclusions GMs assessment could be used in high risk infants within 4 to 5 months to give a reliable and valid prediction for later motor development outcome,especially for cerebral palsy.Application of GMs and EEG would help comprehensive assessment of patients' function status.

Developmental effects on children's false memory of materials presentation way.

SHI Bei-bei,NIU Yu-bai.

2013, 21(4): 358-360.

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Objective To research the impact on children's false and true memory of the presentation way of learning materials. Method The study set integral and individual presentation as two different conditions,90 children aged 8~,10~,and 12-year-old,took part in the experiment,in which the DRM paradigm was used. Results Both true and false memory increased with age.The presentation way of learning materials influenced both true and false memory,especially when the lists were presented simultaneously;it evoked the increase in both true memory and false memory.The integral presentation had a negative effect on children's false memory,with a significant effect on 8-year-old,and with no significant difference between the false alarm rates of critical lures of 10 years old and 12 years old children. Conclusion The integral presentation way of learning materials could increase children's false and true memory significantly.

Study on the developmental disparities of adolescents' core self-evaluation and its relationship with multidimensional life satisfaction.

HU Bing-zheng.

2013, 21(4): 361-363.

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Objective To explore the disparities of adolescents' core self-evaluation and its relationship with multidimensional life satisfaction. Method A stratified random sample of 300 adolescent students completed the Core Self-evaluation Scale(CSES),Multidimensional Students' Life Satisfaction Scale(MSLSS) and basic circumstance questionnaire. Results The averages of CSES and MSLSS were both significantly higher than theoretical mid-value(P<0.001).There were no significant differences in adolescents' core self-evaluation score in respect to different grade,sex,area and being only-child or not(P>0.05).CSES predicted 24.6% of total variances of MSLSS,and predictive powers to each subscale of MSLSS were between 10.5% to 19.9%. Conclusion Core self-evaluation is an important factor to preserve adolescents' multidimensional life satisfaction.

Developmental characteristics of children with autism.

ZHOU Xiang,CHEN Qiang,ZENG Cai-xia,CHEN Hong,JIANG Zhen-feng,ZHUANG Zhi-cheng,ZENG Shu-ping.

2013, 21(4): 364-366.

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Objective To study the natural characteristics of natural developing on the autistic children. Method Developmental characteristics of individuals were evaluated by the psycho educational profile-revised(PEP-R) with 300 untreated cases (boys 270,girls 30,aged from 12 to 96 months) with autism. Results The developmental quotient of less than 70 of children with autism was 89.33%,and the developmental quotient was gradually decreased with increase of age (P<0.01).In the same age,each development quotient was not balanced (P<0.01),the scores of both the imitation and the cognitive performance were worst (P<0.01),and the scores of cognition performance and cognitive verbal were deviation (P<0.01),and the gross motor development was normal. Conclusion Developmental characteristics of autistic children without treatment have the presence of abnormal progress and order,and the situation would be worse and worse as increase of age.

Investigation on asthma in 0~14 years old children in Baoji city.

LV Ju-hong,LI Wen-jun,WEI Sheng-yun,TANG Shu-bin,LI Wu-jun,GAO Gai-lan,WANG Yu,LIU Wen-jing,HAN Li-hua,DENG Feng.

2013, 21(4): 367-369.

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Objective To understand asthma prevalence in 0~14 years old children in Baoji city. Method The cluster sampling method was used to select randomly 0~14 years old Baoji children for investigation. Results Morbidity of asthma was 4.82% in 0~14 year-old children in Baoji,the morbidity of boys' and girls' were 5.68% and 3.82% respectivily,the difference of morbidity between different gender was statistically significant (χ²=19.965,P<0.001).In terms of patients who had asthma attack in near 2 years,predisposing factors were mainly respiratory infections(98.96%) and changes in the weather (87.08%),the seasons of asthma onset were autumn (42.71%) and winter (21.55%)primarily.An major hour of asthma onset were midnight (43.13%) and mane primo (29.38%).The age of the first asthma onset was under 3 years old accounted for 71.04%;rate of using antibiotic was 85.21%.Multivariate unconditional logistic regression analysis presented that in the case of no cold or flu,children had sneezing,runny nose,nasal congestion,nasal itching or eye itching phenomenon were independent risk factors for asthma(P<0.05),and repeated skin itching or joint flexor side rash,allergic rhinitis,allergic symptoms or similar allergies after eating some foods,caesarean,plus protein food within six months,history of using antibiotics,room wall using paint,doors and windows were made from plastic steel,coolingwith natural ventilation in summer,silkworm sand pillow were independent risk factors for asthma (P<0.05);Heater using in winter heating,ventilation or cooling using fans in summer and down duvets were protective factors of asthma (P<0.05). Conclusion Compared to 2000,the morbidity of asthma in 0~14 years of children in Baoji markedly rise,there are many risk factors of childhood asthma,and it is necessary to strengthen the prevention and control of children asthma.

Protection of bifidobacterium from damage to neonatal rat model of necrotizing enterocolitis.

LIN Xiao-pei,GU Zhi-cheng.

2013, 21(4): 370-373.

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Objective To research bifidobacterium's effects on tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) in intestinal tissue of neonatal SD rat model of necrotizing enterocolitis (NEC) and to investigate the protective effects of bifidobacterium against NEC. Methods 128 neonate Sprague-Dewley (SD) rats aged 2 days were divided into four groups at random:LPS group(A),LPS+bifidobacterium group(B),normal saline group (C) and bifidobacterium group(D).After received injection of LPS for a week,eight rats,which were selected form each group at random,were killed quickly respectively at 2,6,12 and 24 hours through decollation.The intestinal tissue obtained,the ileocecal junction was for histological analysis,and the remains was used to measure the level of TNF-α and IL-10 through ELISA method. Results Compared to group A,the scores of intestinal histologic pathological injury of group B at 2,6,12,24 hours were significantly lower (P<0.05) and the levels of TNF-α in ileal tissue of group B at 2,6,12 hours were significantly lower(P<0.05).Also compared to group A,the levels of IL-10 in ileal tissue of group B at 2,6,12,24 hours were significantly higher (P<0.05).Statistics showed that TNF-α level had positive correlation with the scores of neonatal rats of intestinal histologic injury (r=0.646) and IL-10 level had negative correlation with the scores of neonatal rats of intestinal histologic injury (r=-0.598). Conclusion Bifidobacterium could reduce the level of TNF- α and increase the level of IL-10 of NEC model,bifidobacterium provides protection from NEC.

Effect of phycocyanin on the expression of IGF-1 in coxsackievirus B3 mice myocarditis.

CAO Mi,HUANG Xing-yuan,ZHANG Jing.

2013, 21(4): 374-376.

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Objective To investigate the effect of phycocyanin on the expression of insulin like growth factor-1 (IGF-1) in coxsackievirus B3(CVB3) mice myocarditis. Methods A total of 55 BalB/c mice were assigned into three groups:normal control group (group A,n=15),virus control group (group B,n=20),phycocyanin intervention group (group C,n=20).Mice were killed on the 15th day after inoculated,and the samples of blood and myocardium were obtained.Optical microscope was used to detect the inflammation and necrosis in myocardium.The level of ICF-1 in plasma was measured using ELISA.The expression of IGF-1 in myocardium was determined by RT-PCR and Real-time PCR. Results The survival rate of group C was higher than that of group B (P<0.05).Compare to group A,group B had higher level of ICF-1 in plasma and the higher expression of IGF-1 in myocardium.The level of ICF-1 in plasma,the histopathologic score and the higher expression of IGF-1 in myocardium of group C were lower than those of group B,but higher than group A (P<0.05). Conclusion Phycocyanin may influence the expression of ICF-1 and possibly thus providing protective effects on myocardium.

Establishment the cut-off value of congenital hypothyroidism on newborn in Guangzhou city.

JIANG Xiang,JIANG Jian-hui,LI Bei,WU Jia,CHEN Qian-yu,CAO Wei-feng,JIA Xue-fang,LI Hui.

2013, 21(4): 385-387.

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Objective To get the distribution of thyroid stimulating hormone (TSH) and cut-off value in Guangzhou city. Method The results of 209 534 newborns were analysed from September 2011 to August 2012,which was described by percentiles and ROC curve,and determined the reasonable cut-off value combined with the actual screening results. 【Result】 The distribution of newborn screen was deflection,P₉₉ was 9.63 mU/L,the optimal cut-off value was 14 mU/L by ROC curve,the low cut-off value of our lab was 9 mU/L and the high cut-off value was 25 mU/L. Conclusion It is necessary to establish the reasonable cut-off value before carring out the neonatal screening.The determination of low and high cut-off value and establishment of recall-back methods are effective mode for neonatal screening.

Investigation of the extremely low birth weight infant living condition.

LU Dan-fang,TONG Xiao-mei.

2013, 21(4): 388-391.

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Objective To investigate the extremely low birth weight infant's (ELBWI) quality of life and related intervention measures through review of ELBWI's living condition from a single centre NICU in recently years. Method It was retrospectively analyzed about the clinical data of 32 patients of ELBWI from February 2000 to January 2012. Results The ELBWI suvival rate,mortality rate,abandon rate were 34.4%,25.0%,and 40.6%respectively.The Assisted Reproductive Technologies (ART) ELBWI suvival rate was 75.0%.Female suvival rate(72.7%) was higer than male's in all suvival patients.The common direct causes of death were pulmonary haemorrhage(62.5%),hyaline membrane disease (12.5%),intracranial haemorrhage(12.5%) and gastrointestinal bleeding(12.5%).The data were divided into two stages(February 2000~January 2006 vs February 2006~January 2012).Compared with the former group,the abandon rate of the later was obviously lower(28.0% vs 85.7%) and suvival rate was significantly higher (44% vs 0%).There was significant diffrence of ART between survival group and mortality/abandon group(P<0.05) with single factor analysis and logistic regression analysis. 【Conclutions】 Positive treatment and timely processing of complications can improve ELBWI survival rate and reduce mortality.The treatment of survival limits ELBWI should weigh up pros and cons,and should elevated the living quality of ELBWI.

Effect of cerebral palsy children's disability on mental health status of parents.

GUO Lan-min,LV Zhi-hai,XIAO Feng-ming,JIANG Zhi-mei,ZHANG Shi-ling.

2013, 21(4): 391-394.

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Objective To study the effects of children's disability on their parents' mental health status. Methods 128 children with cerebral palsy were selected and tested with gross motor function classification system (GMFCS),mental health conditions of their parents and 128 normal children's parents were tested with the Symptom Check-List 90(SCL-90).Data were analyzed by t-test and multiple regression analysis. Results Compared with the parents of normal children,the parents of cerebral palsy children had much higher SCL-90 total score and seven positive factors scores such as somatization,interpersonal relations,obsession,depression,anxiety,hostilityand paranoid(P＜0.01).Expense and newly diagnosed age of cerebral palsy children had relationship with their parents' anxiety and depression scores respectively,course of disease had an effect on total score and each factors. Conclusion Mental health status of cerebral palsy children' parents lags behind that of normal children' parents.Severity of children's disability, newly diagnosed age,course of disease and expense could affect their parents' mental health.

Relationship between behavior problems and family environment in pre-school-age children in Zhongshan city.

YE Chun-hong,GU Li-ping,LI Jing,HE Shu-hua,DENG Cheng,GAO Jian-hui.

2013, 21(4): 394-396.

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Objective To study the relationship between behavior problems and family environment in pre-school-age children and to provide the epidemiological information for making comprehensive intervention plan. Method Simplified Conners Scale and Familiy Environment Scale-Chinese Version were applied to 152 kindergarten students aged 3~6 years old in Zhongshan city,and the date were collected and analyzed by statistic softwares. Results 30 children showed behavior problems.Higher scores in family conflict and independence showed in children with behavior problems than those in normal children (P<0.05);while lower scores in family intimacy,feeling expression,parents' educational level,recreation time,religional morality belief and organization showed in children with behavior problems (P<0.05). Conclusion Behavior problems in pre-school-age children are related closely to family environment,which needs to gain more attention.

Clinical significance of serum cystatin C for early diagnosis of renal injury induced by asphyxia in neonates.

SONG Yu-tong,REN Li-hong.

2013, 21(4): 396-398.

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Objective To study the clinical significance of serum cystatin C(Cys-C) for early diagnosis of renal injury induced by asphyxia in neonates. Methods Neonates with asphyxia were divided into mildly asphyxiated group(192 cases)and seriously asphyxiated group(34 cases) by Apgar scores of 1 minute after birth,meanwhile 39 cases of no asphyxia of newborn as control group.The peripheral vein blood samples of neonates were collected,and serum Cys-C was detected.It was compared with serum creatinine( Cr) and urea ( BUN) with Kruskal-Wallis H Test.The related factors of Apgar score such as Cys-C,Cr,BUN and so on were analyzed by Logistic regression analysis. Results 1)The level of Cys-C was (2.54±0.48)mg/L,(2.16±0.45)mg/L,and (1.53±0.27)mg/L in seriously asphyxiated group,mildly asphyxiated group and control group,respectively.The level of Cr was (102.32±32.64)μmol/L,(89.35±26.24)μmol /L and (69.03±22.00)μmol /L respectively.The levels of BUN was (9.26±4.29)μmol/L,(8.31±4.50)μmol /L and (5.31±3.01)μmol/L,respectively.Kruskal-Wallis H tests indicated that there were significant differences between seriously asphyxiated group,mildly asphyxiated group and control group(P<0.01).2)Logistic analysis indicated that the level of serum Cys-C had the least OR value. Conclusions The less Apgar score is,the higher levels of serum Cys-C,Cr and BUN are.There is a best relationship between the Apgar score and the level of serum Cys-C in early examination of asphyxiated neonates.

Comparison of the development of desire-belief system between typical children and autism children.

SHAO Zhi,ZHANG Ting,YAO Li,TAO Hong-mei.

2013, 21(4): 399-401.

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Objective To explore the development of desire-belief system of autism children and compare with typical children. Methods Autism children with mental age from 3~5-year-old (n=18) and typical children from 3~5-year-old (n=18) were tested by diverse desire,diverse belief and false belief tasks.The two groups of participants were matched well on mental age and gender. Results It was shown that both two types of children could complete divers desire task; however autism children failed on diverse belief and false belief tasks(P<0.05). Conclusion The results implied that autism children with mental age from 3~5-year-old could understand desire but not belief.

Structural family therapy research on family environment of children with attention deficit hyperactivity disorder.

MEI Zhu.

2013, 21(4): 401-404.

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Objective To explore structural family therapy on children with attention deficit hyperactivity disorder (ADHD) in the influence of family environment and its clinical significance. Methods It was improved ADHD children suffering from within the family environment by applicating structure-based family therapy theory and skills,through the restructuring of family roles,tasks,and boundaries. 【Result】 After structural family therapy,family cohesion,emotional expression and the successful scores of study group were significantly higher,and contradictions and control scores were significantly reduced,compared with the control group(P<0.01). Conclusion Structural family therapy for the improvement of ADHD children family environment has a positive,effective role,in order to improve children's ADHD clinical comprehensive treatment and intervention effect.

Study on mental health of guarded students in rural area.

ZHOU Li.

2013, 21(4): 404-407.

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Objective To investigate the mental health of the guarded students and personality differences between the guarded students and the non-guarded students. Methods Stratified sampling method was used to draw 278 secondary school students in Chongqing city.They were investigated with MHT,Eysenck Personality Questionnaire (child). Results 1) Among the 278 students in rural area,the detection rate of mental disorder was 6.5%.2) The guarded students had significant higher scores than the non-guarded students over MHT and the factors of self-blame(42.8±1.4,33.4±1.7,t=3.52;6.1±0.2,4.5±0.3,t=3.58,all P<0.01).3) The guarded students scored significantly higher than the non-guarded students over the factors of EPQ related to psychoticism(P),neuroticism(N) (5.64±3.21,3.29±2.68,t=4.307;15.61±4.53,8.73±4.71,t=7.355,all P<0.01),The guarded students scored significantly lower than the non-guarded students on the factors of EPQ related to lie(L) (10.50±4.29,13.04±4.54,t=-2.828,P<0.01).4) The factors in MHT positive correlated with the factors of psychoticism and neuroticism.The factors in MHT had negative correlation with the factors of EPQ related to lie(L).5)The factors of Personality explained 21%~49% difference of the scores of MHT,study anxiety,hostility,interpersonal sensitivity,body symptom,hypersensitiveness.The neuroticism(N) best forecasted and explained the score of MHT. Conclusions Mental health problems of the guarded students in rural areas are serious.There are personality differences between the guarded students and the non-guarded students.Personality is the important factor on mental health of guarded students,and these differences call for special attention.

Study of the refractive status and analysis of the risk factors in 3 to 6 years old children in Jinjiang city.

SU Cui-min,WANG Hong-fei,SU Li-hui,CAI Geng-yao,CHEN Fu-chi,CHEN Chang-ya.

2013, 21(4): 407-410.

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Objective To investigate the abnormal refractive status and the risk factors in 3 to 6 years old children in Jinjiang city,and to provide information for the intervention of preschool children's abnormal refractive. Method A sample of 3 346 children aged 3 to 6 years old were selected randomly,examined the refractive status of the children with SureSight autorefractor,surveyed the relevant factors,and analyzed on the results. Results The abnormal rate of refractive status in 3 346 children(6 692 eyes,3 to 6 years old)was 38.5%,the difference among 3-year-old,4-year-old,5-year-old and 6-year-old group was statistically significant (χ²=854.88,P<0.001),there was no significant difference between the boys and girls (χ²=7.773,P>0.05).Analysis of risk factors:myopia in 3 to 6 years old children was associated with the average time watching TV one day;hyperopia was associated with mother's vision,father's vision and children's nutrition; astigmatism was associated with the father's vision and children's nutrition. Conclusion It is very important to screen refractive early and eliminate the adverse factors in the preschool children,so as to promote children's vision.

Study of the result of tympanometry to 4 028 preschool children in Shenyang.

ZHANG Dong-hong,WANG Yu-jing,MA Xiu-lan.

2013, 21(4): 410-411.

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Objective To investigate the percentage of abnormal data tympanomery to preschool children. Methods Hearing screening by tympanomery was conducted to 4 028 children in Shenyang. Results The percentage of abnormal data (B was 4.11%,C was 15.46%)was 19.57%.There was significant difference of abnormal data between male and female.The percentage of abnormal data of 2~4 years old was higher than that of 5~6 years old.Abnormal middle ear function in male was higher than female. Conclusion Tympanometry is an sensitive diagnostic test to the middle ear dysfunction for preschool children.

Study on neonatal screening in Xicheng district of Beijing.

WANG Bing,YAN Xue-ming.

2013, 21(4): 412-414.

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Objective To summarize recall of suspected patients from the neonatal screening for congenital hypothyroidism(CH) and phenylketonuria(PKU) in Xicheng district of Beijing,and to further improve the management quality of neonatal screening. Method The data of recall for neonatal screening in Xicheng District of Beijing during 2007 to 2011 was analyzed retrospectively. Results 43 264 newborns were tested and analyzed from 2007 to 2011.The average screening rate was 98.75%.The screening test of 406 cases were positive and 98.28% were recalled to take diagnostic test. Conclusion Adjust management methods and strengthen link management can improve the rate of screening and the recall and reduce the disability.

Development status of social expectation in urban pupils from Dezhou city.

DU Lei.

2013, 21(4): 416-419.

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Objective To explore the developmental status of pupils' social expectation so as to improve pupils' development in family and school. Method An investigation was executed on 784 pupils coming from several Dezhou city primary school using Cradall & Katkovsky' s CSD. Results The results revealed that 1) the overall level of urban pupils' social expectation was above average;2) The social expectation gradually declined along with grade,in which the grade three and grade five composed two sharply declining stage;3)The social expectation of primary school girls was higher than that of boys,and showed distinct developmental mode:the girls' social expectation declined linearly while the boys' social expectation declined in a ladder way. Conclusions The development of pupils' social expectation shows remarkable characteristics in grade and gender dimensions.Thus both parents and teachers should adjust their educational methods according to the developmental characteristics of pupils' social expectation.

Analysis of the brainstem auditory evoked potential in the children with autism.

YAN Hua,ZHANG Hui-jia,GUO Chun-guang,ZHOU Ping-qiu,HE Jin-hua,SU Zhen-hui,YANG Wei-hong,WANG Yi-mei.

2013, 21(4): 419-421.

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Objective To investigate the characteristics of brainstem auditory evoked potential (BAEP) in children with autism. Method The data of BAEP in the children with autism was analysed. Results BAEP of 33 children among 78 cases were normal,the rest were abnormal,mainly including changed wave amplitude,the prolonged wave latency,long interpeak latency,poor wave form differentiation and increased hearing threshold level. Conclusion Acouesthesia of autistic children is almost normal,but the brainstem transmission time of BAEP is prolonged,which indicate that auditory brainstem dysfunction may lead to the dysplasia of cognitive and language development.

Investigation on behavioral problem of children aged 4~16 years old in Foshan district.

MO Wen-hui,ZHOU Jie,CHEN Xiao-qiang,LI Yi,LIN Xiu-wen,ZHU Xiao-ling.

2013, 21(4): 421-423.

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Objective To investigate the occurrence condition and characteristics of children's behavior problems,and to study the influencing factors about childen's behavior problems. Method By using the Achenbach's Child Behavior Checklist standardized in China(for parents),self-made children's mental health questionnaire,1 800 children aged 4~16 years old in Chancheng,Nanhai,Shunde district of Foshan city were surveyed. Results The prevalence of behavior problems of children was 11.8%.The difference of the prevalence of behavior problems between sexes was not significant.The difference of the prevalence of behavior problems among different regions were not significant.The main factors affecting behavior problem in children were education of parents,family breeding method,relations between parents,community environment. Conclusion Comprehensive measures should be adopted to reduce the prevalence of behavior problems.

Analysis of atypical pathogen in children with respiratory tract infection in Haikou region.

HUANG Yu-min,TU Zhi-hua,WANG Jie,WU Wei-xue.

2013, 21(4): 425-428.

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Objective To investigate the respiratory tract infection of suffering children by 9 atypical pathogens in Haikou region,and definite the distribution of atypical pathogen. Methods Based on indirect immunofluorescence assay,blood IgM levels had been simultaneously detected of 9 atypical pathogens,which isolated from＜1 year old,1~2 years old,2~3 years old,≥3 years old children with respiratory tract infection from July 2011 to June 2012.And then the positive cases had been epidemiological clinical analysed. Results The total positive rate of atypical pathogen was 34.69%(417/1 202),the mixed infection positive rate was 4.58%(55/1 202),all most the mixed infection cases were infected by MP and other 1 or 2 pathogens together.The positive rates 31.53%,5.41%,1.16% of MP,INFB,RSV respectively were the frist,second,third highest rate,the cases infected by COX or CP were the least in 9 atypical pathogens.In April (March of lunar calendar),the total positive rate was 47.57%,it was the highest,and the total positive rate of winter and spring was higher than that of summer and autumn.The total positive rate increased as the age increased.In ＜1 year old group,the positive rate of MP was the highest,and the second highest was the RSV's,but in the other group,the first and the second highest positive rate were MP's and INFB's.The positive rate of MP in female was higher than that in male. Conclusion The distribution,the peak onset season and the positive rates of 9 atypical pathogens in respiratory tract infection children in Haikou are different to the other region.

Relationship between intellectual development and changes of serum brain-derived neurotrophic factor in children with febrile seizures.

ZHOU Ju-hua,FANG Su-zhen,ZHOU Xi-zhong,DU Jiang,ZHAO Qian,LI Hong.

2013, 21(4): 428-431.

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Objective To investigate the pathophysiological effects of serum brain-derived neurotrophic factor (BDNF) level and analyse the relationship with the electroencephalogram (EEG) and mental development in the process of febrile seizures (FS). Methods All cases were divided into three groups.Experimental group was the children with FS(n=73);Control group was the children with acute upper respiratory infection(n=51) and healthy children(n=43).The serum BDNF levels of all groups were detected by ELISA;The brain activity was examined by EEG;The mental development index(DQ) was assessed by development scale. Results The serum BDNF levels in experimental group were greatly higher than those of the control groups(P<0.01).The serum BDNF levels were significantly increased in children with abnormal EEG(P＜0.01 or ＜0.05),especially the children with seizure abnormal EEG.There was no significant correlation between DQ and the serum BDNF(P=0.144). Conclusions The serum BDNF levels in experimental group is significantly increased and might be involved in the development process of FS.BDNF is expected to be a sensitive index for evaluating the degrees of brain damage.There was no significant correlation between serum BDNF and DQ.

Hepatitis B virus infection survey and analysis after using hepatitis B vaccine 20 years.

LUO Hong-wei,ZHOU Yu-lei,MENG Guang-hui.

2013, 21(4): 431-433.

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Objective To understand hepatitis B virus surface antigen carrying case after 20 years using of hepatitis B vaccine in Zhoukou,in order to improve the prevention and control measures for hepatitis B. Method In Zhoukou city,children aged 1~19 were chosen as the research object,using the enzyme-linked immunosorbent assay for the detection of the crowd with HBsAg. 【Result】 In Zhoukou city investigation group,the positive rate of HBsAg (2.30% in 2011 and 7.97% in 1999) had 71.14% decline,children aged <5 HBsAg had prevalence <1%. Conclusion It is effective of hepatitis B vaccine immunization.Neonatal hepatitis B vaccination is made availably,students and adults of the hepatitis B vaccine immunization should be strengthened.

Effects of life quality on autistic disorder children's parents.

LIU Zhen-huan,XIE Qiao-ling,ZHANG Yong.

2013, 21(4): 433-435.

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Objective To investigate the quality of life and related factors in parents of children with autism. Methods 90 parents of autistic children and 120 parents of normal children were participated.SF-36 was employed to evaluate both groups by questionnaire.Parents of autistic children also completed Clancy Autism Behavior Scale (CABS),Autistic Behavior Checklist (ABC),the Children Autistic Rating Scale (CARS)and Autistic children checked with the Gesell development diagnosis scale. Results 1)Parents of autistic children reported substantially lower scores of SF-36 than that of parents with normal group(P＜0.01).2)The quality of life of parents in low functioning intelligence group was worse than high functioning intelligence group(P＜0.01).3) The quality of life of parents was positively correlated with intelligence of autistic children,and negative correlated with symptom of autistic children. Conclusions Children with autistic disorder took grievous influence on parent's quality of life.Compared with high functioning intelligence group,the low functioning intelligence children's parents had even worse quality of life.

Radio frequency ultrasound technology to quantitatively assess of normal children in Shaanxi.

LI An-mao,FENG Xiao-lei,LIU Ting,ZHANG Jie,BAI Qiang,LI Hua,CHEN Guang-sheng.

2013, 21(4): 436-438.

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Objective To quantitative evaluat the normal children carotid artery intima-media thickness(IMT) and wall elastic various parameters of the salary range,and provide normal reference data for atherosclerosis early diagnosis and childhood intervention in Shaanxi. Methods The quality intima-media thickness (QIMT)and quality arterial stiffness(QAS)of ultrasound radio frequency(RF)technology were applied for 150 normal children volunteer to obtain bilateral carotid intima-media thickness IMT,compliance index (distend compliance DC,conform compliance CC) and stiffness index (augmentation index AIX,a coefficient,βcoefficient,pulse wave velocity PWV),parameters childhood range. Results 1)Normal children aged 7~15 in Shaanxi had IMT(441.483±85.126)μm,DC(0.077±0.030)mm²/kPa,CC(2.290±0.952)mm²/kPa,AIX(-2.804±2.449),α(1.453±0.519),β(3.002±1.050),PWV(3.650±0.558) m/s.2)Carotid artery between the right and left sides,between the different gender carotid parameters showed no significant differences. Conclusion Application of radio frequency ultrasound technology can accurately provide normal childhood common carotid artery intima-media thickness IMT,vascular elastic parameter,and scientific basis for intervention in the prevention of arteriosclerosis in Shaanxi area.

Study on neonatal disease screening for a total of 133 866 neonates of Laiwu city.

WU Hong-bo,LV Wei-feng,WANG Yun-xia.

2013, 21(4): 442-443.

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Objective To summarize neonatal screening for congenital hypothyroidism(CH),phenylketonuria(PKU),in Laiwu in the past 13 years to present the morbidity of the two kinds of diseases. Methods A retrospective study was employed to study the screening results of CH and PKU. For PKU to detect serum phenylalanine concentrationby fluorometric methods and for CH to detect serum thyroid stimulating homone levels by time-resolved fulorometry. Results A total of 133 866 cases (form May,1999 to Ocotober 2012 ) were screened,with the rate of screening 86.74%.The incidences of deficiency of PKU were 1/1 02 97 and that of CH 1/1,673,with 13 cases and 80 cases respectively. Conclusion The prevalence of CH and PKU can be reduced by neonatal screening and early-goal directed therapying.

Application guidance of general movements assessment for high risk infants in Minhang district of Shanghai.

LI Yun,YANG Hong,XIAO Li-ping,SHI Wei,HUANG Jun,SUN Mei-mei,FENG Yu-ying,JIANG Liang-hua,ZHANG Ying,HOU Fang-hua,WANG Yi,SHAO Xiao-mei.

2013, 21(4): 444-446.

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Objective To study the application guidance of GMs assessment for high risk infants in the maternal & child healthcare network to promote the abilities of early screening for developmental motor disorders such as cerebral palsy. Method The management guidance was formed after reviewing the experiences of using GMs assessment. Results The management guidance included the following four parts:establishing the network,dividing the responsibilities of involved organizations,training of staff and working guarantee measures.The clinical guidance included ten parts:working objectives,service users,time of GMs assessment,equipments,video recording,video assessment,results of GMs assessment,rechecking of difficult cases,referring to rehabilitation and follow-up,manning levels. Conclusion By setting-up the application guidance of GMs assessment,competence of healthcare for neurological development of high risk infants is promoted and early rehabilitation is available for motor disabilities such as infants with cerebral pasly.

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