Table of Content

10 April 2018, Volume 26 Issue 4

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Analysis of intelligence structure and characteristics in children with high autistic trait

LIN Li-zi, ZHANG Zhe-qing, DAI Mei-xia, LUO Mei-fang, LIANG Jing-jing, LI Xiu-hong, JING Jin

2018, 26(4):  352-356.  DOI: 10.11852/zgetbjzz2018-26-04-02

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Objective To explore the differences of intelligence levels,intelligence structures and characteristics of cognitive processing among children with different autistic traits (AT). Methods A total of 423 normal children were recruited,and were divided into three groups (low AT,medial AT and high AT) according to the total score of Autism Spectrum Quotient from December 2015 to January 2017.Intelligence was assessed by the Chinese version of Wechsler Intelligence Scale for Children-Fourth Edition (WISC-Ⅳ) for children in different AT groups.After adjusted for covariates including gender,age,parents' educational levels and monthly family income,the full scale intelligence quotient (FIQ) and other composite indices of WISC-Ⅳ were compared among three AT groups. Results Children with high AT showed lower FIQ and composite indices of WISC-Ⅳ compared with other two groups,except for the processing speed index (PSI).After adjusted for covariates,the differences of verbal comprehension index (VCI) and cognitive proficiency index (CPI) remained statistically significant among three groups (P=0.025 and 0.033).Post hoc multiple comparisons suggested that only the VCI were higher in children with low AT than in those with medial AT,while other comparisons showed no differences.Significant strengths of children with high AT were observed on PSI compared with VCI (P=0.007). Conclusions The verbal comprehension is lower and the verbal working memory is relatively intact in children with high AT,which show the similar cognitive features with ASD children.Children with high AT show strengths on PSI when compared with VCI.

Preliminary study on multiple cognitive processing characteristics in Chinese children with developmental dyslexia

HU Xiao-yun, WANG Qi, CHEN Yu-xia, GUO Yang-feng, WU Jing, LI Xiu-hong

2018, 26(4):  357-360.  DOI: 10.11852/zgetbjzz2018-26-04-03

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Objective To study eight cognitive processing abilities in Chinese children with developmental dyslexia (DD),and to initially explore the main characteristics of cognitive processing defects and its causal relationship with DD. Methods A total of 28 DD children were enrolled in case group,and 28 normal children with matched reading-level (RL) and 28 normal children with equivalent chronological age(CA) were selected as control group.The Dyslexia Checklist for Chinese Children (DCCC) was used to compare the multiple of cognitive processing characteristics in children of three groups. Results The T scores of DCCC(F=8.05),written expression disorder(F=12.20),unhealthy reading habits(F=4.14),attention deficits(F=4.57),visual perception deficits(F=12.29),writing disorder(F=7.26),auditory perceptual deficits(F=5.56)and meaning comprehension disorder(F=4.79)in DD children were significantly higher than those of the controls (P<0.05).But the scores of spoken language barriers(F=1.55)among three groups were not significantly different (P>0.05).Logistic regression analysis showed that compared with reading level,visual impairment (OR=0.915,95%CI:0.838~0.999) was the main defect in Chinese DD children;Compared with chronological age,visual impairment (OR=0.908,95%CI:0.828~0.996) and written expression disorder (OR=0.818,95%CI:0.695~0.963) were the main defects of Chinese DD children. Conclusions Multiple cognitive deficits exist in Chinese DD children.The core defect of Chinese DD is visual impairment,and written expression disorder may be greatly influenced by reading level.

Research on the relationship between speech-evoked auditory brainstem responses and language proficiency in children with autism

CUI Zi-tian, PENG Zi-wen, WAN Guo-bin

2018, 26(4):  361-364.  DOI: 10.11852/zgetbjzz2018-26-04-04

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Objective To explore the characteristics and differences on speech-evoked auditory brainstem responses (speech-ABR) between children with autism spectrum disorder (ASD) and healthy children,and to investigate the relationship between speech-ABR and language development level. Methods Totally 18 healthy children and 15 children with ASD were enrolled in this study.The children's ability assessment was performed by specialists by using the Childhood Autism Rating Scale (CARS),the Autism Diagnostic Observation Schedule (ADOS),and the Gesell Development Diagnosis Scale (GDDS).All participants were tested by speech-ABR examinations.The latency,duration and amplitude of each wave were recorded. Results All waves latency of transient responses of speech-ABR in ASD children were delayed.Latency of sustained responses of E wave and F wave were significantly delayed.The language scores in GDDS were negatively correlated with the wave V,wave A and wave F latency in ASD(r=-0.525,-0.563,-0.580,P=0.04,0.029,0.024). Conclusion Brainstem deficits in ASD are manifested in the reduction of nerve synchronization.Brainstem and cortical encoding of speech sounds dysfunction may contribute to the language and social communication impairment in ASD.

Status of positive psychological traits in rural orphans and its impact on health risk behaviors

LIU Xian-hua

2018, 26(4):  365-367.  DOI: 10.11852/zgetbjzz2018-26-04-05

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Objective To explore the status of positive psychological traits in rural orphans and its relationships with health risk behaviors,iin order to provide scientific basis of prevention and intervention. Methods A total of 56 orphans and 56 non-orphans in rural middle school were surveyed with the Positive Mental Characters Scale for Chinese School Students (PMCSCSS) and the Adolescent Health Related Risky Behavior Inventory (AHRBI) from October 2015 to April 2016. Results 1) Orphans performed significantly lower scores than non-orphans in the positive traits of creativity,craving for knowledge,thinking & insight,persistence,kindness,leadship,teamwork and spirituality (P<0.05);2) Orphans' positive traits of craving for knowledge,thinking & insight,persistence,kindness,prudence,faith & hope and spirituality were significantly negatively related to the six types of health risk behaviors (P<0.05);3) Orphans' positive traits of thinking & insight,craving for knowledge,persistence,kindness and faith &hope significantly could predict the six types of health risk behaviors reversely (P<0.05). Conclusion The current study suggests that the positive psychological traits of rural orphans are at low level,and positive psychological traits are the important protective factors of health risk behaviors in rural orphans.

Study on behavior problems in children with abnormal language development

ZOU Qiu-yan, JIANG Yan-rui, MA Xi-rui, ZHANG Yi-wen

2018, 26(4):  368-371.  DOI: 10.11852/zgetbjzz2018-26-04-06

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Objective To explore the relationship between language development and behavioral problems in children,and to provide evidence for children's language promotion and intervention. Methods By comparative experimental study,80 children with language disorders were recruited according to age,sex matched control group from October to November 2014.Conners Parents Questionnaire and Dream Standardized Language Test were used to evaluate 3~8-year-old children's behavior and language. Results 1)The standardized test results of Dream language in children with language problems were significantly lower than those of the control group (P<0.001).2)Children with language problems had more behavior problems,learning problems,impulsivity,hyperactivity,hyperactivity and so on (P<0.05).3)Children with better overall language condition had lower scores of behavior problems,learning problems,impulsivity,hyperactivity and hyperactivity index,the less behavioral problems,and there was no significant correlation between language condition and psychosomatic disorders and anxiety (P>0.05). Conclusions There is significant correlation between the status of children's language and behavior problems.Medical staff in the developmental behavioral pediatric need to not only pay attention to behavior problems in children with language deficit,but also deliver more concern to the language problems in children with behavior problem,thereby clarifying diagnosis and taking intervention.

Comparison of the early screening results for autism spectrum disorder in Grade Ⅲ level A hospitals and community health services

GUO Cui-hua, LUO Mei-fang, WANG Xu-xiang, DAI Mei-xia, JING Jin

2018, 26(4):  372-375.  DOI: 10.11852/zgetbjzz2018-26-04-07

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Objective To compare the screening results for autism spectrum disorder (ASD) between Grade Ⅲ level A hospitals and community health services,and to provide clues for future screening work. Methods A total of 7 381 toddlers aged 16~30 months were involved in the ASD screening,including 4 930 toddlers from Grade Ⅲ level A hospitals and 2 451 from communities.By using propensity score matching (PSM) method,2 451 pairs of toddlers with comparable basic information were used to compare the screening results between Grade Ⅲ level A hospitals and communities. Results The positive rate of Grade Ⅲ level A hospitals (17.7%) was higher than that of the communities (8.2%).The positive rate of follow-up interview(42.5%) was also higher than that of the communities (2.8%)(P<0.001).But the lost rate of diagnosis (11.7%) was lower than that in the communities (47.0%) (P＜0.001).The lost rates of follow-up interview in two kinds of samples were close(49.2% vs 47.0%,P=0.611). Conclusions The false positive rate in both Grade Ⅲ level A hospitals and communities is so high that the accuracy should be improved and follow-up interview should be taken seriously.Those failed to be followed up in communities are more likely to increase the risk of delayed diagnosis and treatment.An active monitoring,referral and follow-up system may help to improve early screening and diagnosis in primary health care services.

Association between sleep habits and mental health problems among adolescents

LEI Jie, ZHANG Jin-wen, LI Sheng-hui

2018, 26(4):  376-380.  DOI: 10.11852/zgetbjzz2018-26-04-08

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Objective To examine the association between mental health problems and sleep habits among Chinese adolescents,including sleep duration,bed time,wake time on weekdays and weekends,and sleep stability,in order to provide reference for prevention and improving mental health of adolescents. Methods A method of stratified,cluster random sample was conducted,and totally 4 966 adolescents aged 11~20 years were enrolled in this cross-sectional survey.The Modified Adolescent Sleep Hygiene Scale (M-ASHS) was used to assess sleep habits.The Strengths and Difficulties Questionnaire (SDQ) was used to evaluate mental health problems. Results Among adolescents involved in the survey,of whom 46.4% had a sleep duration less than 8 hours on weekdays,7.6% had a sleep duration less than 8 hours on weekends,47.5% had bed time later than 22:00 on weekdays,39.8% had bed time later than 22:30 on weekends,45.2% had awakening time later than 8:00 on weekends,22.55% had irregular sleep schedule;8.7% of the sampled adolescents had mental health problems.After controlling for confounders,five sleep variables were found to be associated with adolescents' mental health.The five factors covered three sleep domains:sleep duration less than 8 hours on weekdays and weekends (OR=1.77,1.65,95%CI:1.13~2.76,1.12~2.43,P=0.012,0.011),bed time later on weekdays and weekends (OR=1.73,1.37,95%CI:1.30~2.31,1.07~1.77,P<0.001,P=0.014),and irregular sleep schedule (OR=1.48,95%CI:1.08~2.02,P=0.014). Conclusion It is suggested that sleep hygiene education should be strengthened to help adolescents develop good sleep habits,including enough sleep duration,early to bed and wake up earlier,and regular sleep schedule,in order to promote prevention and intervention of mental health problems.

Effect of rhEPO treatment on MOG expression in brain tissue of newborn rats with intrauterine inflammation of remyelination and its correlation with myelin repair

SUN Meng-ya, LUO Gang, WANG Qian, JIANG Hong

2018, 26(4):  381-385.  DOI: 10.11852/zgetbjzz2018-26-04-09

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Objective To study the neuroprotective effect of rhEPO on brain tissue of newborn rats with intrauterine infection by detecting the changes of MOG expression,in order to provide reference for clinical intervention. Methods 1)Wistar rats that had been pregnant for 15 days were selected and divided into LPS infection group and control group through intraperitoneal injection of LPS (0.3 mg/kg) and equivalent stroke-physiological saline solution.Totally 64 newborn rats in the same fetus of the LPS infection group with brain inflammatory injury proved by HE staining were randomly selected and were divided into rhEPO treatment group (n=32) and infection control group(n=32).Meantime,32 newborn rats in the control group were randomly enrolled as the blank control group.Three groups of rats were conducted intraperitoneal injection of rhEPO (5000IU/kg) or equivalent saline solution simultaneously promptly every day after the birth.2) Brain tissues of three groups were took out by perfusing formaldehyde on 0h,the 3rd,7th and 14th of their birth respectively.And the levels of MOG mRNA and MOG protein were tested by RT-PCR and western blot respectively. Results 1)The levels of MOG mRNA of blank control group were significantly higher on the 3rd (2.05±0.75),7th (2.37±0.57) and 14th (3.36±0.81) day than those on 0 hour (1.01±0.16)(P＜0.05).2)The levels of MOG mRNA on 0 hour,the 3rd,7th and 14th day of infection control group were lower than those of blank control group,and the differences were significant on the 3rd and 7th day.3)The levels of MOG mRNA on the 3rd(2.18±0.89),7th(3.53±1.55) and 14th(3.30±1.12) were significantly higher in rhEPO treatment group than those in infection control group(P＜0.05).4)The level of MOG protein in rhEPO treatment group was significantly higher than that in the infection control group with the same age on the 3rd(18.23±0.37 vs12.63±0.65),7th(22.72±2.77 vs 13.59±1.10),and 14th day(25.85±2.70 vs15.63±1.32). Conclusion The mechanism of inhibiting the expression of MOG gene and protein in the myelin sheath was found in the brain tissue damage induced by intrauterine inflammation in neonatal rats.Early application of rhEPO can promote the expression of MOG gene and protein,to play a protective role in nerve repairment.The best treatment may last for 14 days.

Research progress on characteristics and clinical intervention and theory of mind for children with autism spectrum disorder

ZHANG Ting, SHAO Zhi

2018, 26(4):  386-388.  DOI: 10.11852/zgetbjzz2018-26-04-10

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The delayed development or deficiency of theory of mind of autism children is an important reason of their social impairment,which causes autism children lack adequate social skills,including inability to properly communicate with persons in family,and difficulty in blending in school and community.Intervention of the theory of mind can promote the development of social ability of children with autism.The contents of existing training generally include the following items:the intervention of false belief understanding,the intervention followed the developmental order of theory of mind in typical children,the intervention combining theory of mind intervention with social skills.Based on existing studies,further intervention training should focus on the generalization of the intervention of theory of mind and different levels of autistm children to set up different intervention plans.

Review on the effects and mechanisms of food allergy on autism spectrum disorders

LU Ming-yue, HU Yan

2018, 26(4):  389-391.  DOI: 10.11852/zgetbjzz2018-26-04-11

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Autism spectrum disorder (ASD) and allergic diseases have been increasing in recent years.Currently,existed research have shown that there was a close relation in mechanism between autism spectrum disorders and allergic diseases,including food allergy.This article reviews recent progress on the effects and mechanisms of food allergy on autism spectrum disorders.

Research progress on the relationship between environmental factors and autism spectrum disorder

WEI Ya-min, JIANG Zhi-mei, GUO Lan-min, WANG Ya-nan

2018, 26(4):  392-395.  DOI: 10.11852/zgetbjzz2018-26-04-12

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Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders that cause onset in early childhood and is the result of a combination of genetics,immunology,epigenetics and the environment.In recent years,environmental factors have become research highlights in the study of pathogenesis of ASD at home and abroad.Therefore,this review summarizes the environmental factors related to the pathogenesis of ASD.

Research progress on cognitive neural mechanisms of attention deficit/hyperactivity disorder based on the studies of magnetic resonance imaging

ZHAO Jun-xiu, XU Wen, SUN Jin-hua

2018, 26(4):  396-398.  DOI: 10.11852/zgetbjzz2018-26-04-13

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Attention deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with high incidence rate,characterized by unsustainable attention and/or hyperactive/impulsive behavior causing much trouble and pain to the study,life,interpersonal relationship and family of the patients.Therefore,studying the pathogenesis of ADHD is of great significance for exploring new therapies,improving clinical prognosis and alleviating patient's pain caused by the disease.Neuroimaging studies have developed rapidly in recent years,and with the aid of techniques and approaches of brain imaging,exploring the neural mechanism of ADHD has been explored thereby showing varieties of interesting results.This paper reviews the ADHD literatures on the functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI),in order to deepen the knowledge and understanding of the neural mechanisms of ADHD,and to provide evidence for clinical practice.

Functions and regulation of brain renin-angiotensin system in early development

WU Ling-ling, ZHAO Zheng-yan

2018, 26(4):  399-401.  DOI: 10.11852/zgetbjzz2018-26-04-14

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The classic renin-angiotensin system (RAS) plays an important role in the regulation of blood pressure and body fluid.Recently,major advance in the field of the RAS is the discovery of a complete local RAS in the brain.Brain RAS has all active components of RAS and it is involved in the brain functioning.Brain RAS develops from fetal period and it is easily disturbed by various factors.This review summarizes the articles about the functions and regulation of brain RAS in early development,in order to provide references for further research.

Prevalence of autism spectrum disorders among children in China:a systematic review and meta-analysis

LIU Xian, LIN Sui-fang, CHEN Wen-xiong, CHAN Fan-fan, SHEN Song-ying, QIU Xiu

2018, 26(4):  402-406.  DOI: 10.11852/zgetbjzz2018-26-04-15

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Objective To systematically review the findings of Chinese epidemiological studies in the past 16 years by a meta-analysis,to estimate the prevalence for autism spectrum disorder (ASD) in Chinese,and to extract its epidemiological characteristics as well as to further explore the differences of the prevalence of ASD between China and foreign countries. Method Databases such as Chinese Web of Knowledge,WeiPu,WanFang were searched for literatures published from January,2000 to December,2016 about the prevalence of ASD/autism in China. Results Totally thirty studies were included in meta-analysis.The prevalence of ASD was 26.50/10 000,and prevalence of autism was 14.00/10 000.There was a significant difference on the ASD prevalence among the following sub-factors including gender,age,screening criteria and so on except northern and southern China. Conclusions Although prevalence of ASD in Chinese children showed an increasing trend,it is still lower than that in foreign countries.The prevalence of ASD in China is clearly underestimated due to the limitation of the following influential factors,such as investigation population,monitoring methods,screening and diagnostic tools.

Factors affecting the early diagnosis of autism spectrum disorders

HUANG Min-shi, LIN Yan, WEI Zhen, ZHANG Shi, WAN Guo-bin

2018, 26(4):  407-410.  DOI: 10.11852/zgetbjzz2018-26-04-16

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Objective To investigate factors affecting the early diagnosis of autism spectrum disorders (ASD) in order to provide evidence for further research and policy. Methods Totally 207 ASD cases under six years old diagnosed at Shenzhen Maternity and Child Health care Hospital were recruited,and their caregivers were asked to finish a field survey or telephone survey.According to the diagnostic months,participants were divided into early diagnosis group(n=48,23.19%) and later diagnosis group(n=159,76.81%).Univariate analysis and stepwise Logistic regression analysis were used to compare the influencing factors on questionnaire,results of Gesell Development Diagnosis Scales (GDDS) and Baby-junior high school students ability of social life scale(S-M) between the two groups. Results The two groups were different in 11 factors,such as an early screening of ASD,the main caregivers.Multivarite Logistic analysis showed that early screening of ASD was an favorable factor(OR=4.296,95%CI:1.959~9.423).The more seriously disabled degree of ability for social life(OR=0.380,95%CI:0.207~0.698)and gross motor skill(OR=0.323,95%CI:0.185~0.564),the worse it was for early diagnosis. Conclusion Since the early screening plays a crucial role at early diagnosis,the process of early screening for ASD should be improved.

Diagnostic validity of the integrated audio-visual continuous operation test for attention deficit hyperactivity disorder

LIANG Yan, DU Song-mei, CHEN Hong, DONG Fei-rong, WANG Wei-qian, LIN Hai-xi, YANG Chuang

2018, 26(4):  411-414.  DOI: 10.11852/zgetbjzz2018-26-04-17

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Objective To preliminarily test the diagnostic efficacy of integrated visual and auditory continuous performance test (IVA-CPT) in attention deficit hyperactivity disorder (ADHD),in order to provide a pathway for better clinical diagnosis of ADHD. Methods The diagnostic and statistical manual of mental disorders fourth edition (DSM-Ⅳ) was used as diagnosis standard,73 cases with clinical diagnosis of ADHD by Conners Parent Symptom Questionnaire(PSQ),Chinese Wechsler intelligence scale for children and IVA-CPT and 41 healthy children were tested;Then the result of IVA-CPT between the two groups and the differences between IVA-CPT type and DSM-IV type in the case group were compared. Results The difference on IVA-CPT result between the case group and the control group was statistically significant (P<0.05).The differences of IVA-CPT type and DSM-IV type in the case group were not statistically significant (P>0.05). Conclusion IVA-CPT may be an affective tool to help clinical doctor to auxiliarily diagnose ADHD.

Analysis of follow-up outcome and early development characterists in 301 children with language development delay

SUN Dian-rong, LI Xin, ZHANG Lei-hong, WANG Qiang, HOU Mei

2018, 26(4):  415-417.  DOI: 10.11852/zgetbjzz2018-26-04-18

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Objective To monitor the clinical outcome of children with language development delay through long-term follow-up,and to analyze development features in children with different diseases,in order to provide evidence for early diagnosis. Methods Children with language development delay treated in the Rehabilitation Department of Qingdao Women and Children Hospital from July,2009 to July,2014 were assessed by Gesell Development Scale and were given training intervention,then were followed up for at least 1 to 2.5 years to make diagnosis and monitor the outcome.And retrospective analysis was made to know the features of children's early development. Results A total of 301 children were included,and 64 children were diagnosed with developmental language delay,57 cases with functional articulation disorder,51 cases with specific language impairment,68 cases with autism spectrum disorder and 61 cases with intellectual disability.The area development of Gesell scale showed unbanlanced results among different diseases.And the developmental quotients (DQ)of speech area were lower than the other four areas.And the difference between speech area and another area showed disparities in different diseases. Conclusions Outcome of language development delay children aged 2~3 years is different.The early development levels of every areas in Gesell development scale show their own features,and it is of benefit to early identificaion and intervention.

Pedigree analysis on three cases with short stature due to neurofibromatosis type Ⅰ

PAN Dan-ping, LU Xiang-peng, DUAN Feng-yang, WANG Zhi-ru, YAO Xian-hua, MA Bing-xiang, YANG Yan-ling, ZHENG Hong

2018, 26(4):  418-420.  DOI: 10.11852/zgetbjzz2018-26-04-19

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Objective To analyze the possible mechanism and prevention of short stature caused by NFⅠthrough the analysis of a pedigree of neurofibromatosis type Ⅰ (NF Ⅰ). Method The clinical data and gene test data of 3 cases of NFⅠwith short stature in a pedigree were retrospectively analyzed. Results The height of two cases of children and their mother were less than 2 standard deviations,all with typical skin changes and varying degrees of skeletal deformity.The bone age of two children lagged behind over 1 year and the level of IGF-1 was lower,with normal thyroid function and no tumor-related abnormalities.Genetic sequencing showed that there was a heterozygous mutation(c.4267A>G) in mother and 2 children diagnosed with NF Ⅰ. Conclusions NFⅠ,one of the special causes of short stature should be given high priority.It is an autosomal dominant disease,and there is no effective treatment for NFⅠ.Therefore,prenatal diagnosis is the most important prerequisite for preemptive families to prevent NF Ⅰ.

Clinical study of repetitive transcranial magnetic stimulation on the brain injury in infants

CHEN Yan-juan, DONG Shang-sheng, KE Chun-hua, DENG Yi-guang

2018, 26(4):  421-423.  DOI: 10.11852/zgetbjzz2018-26-04-20

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Objective To explore the application value of repetitive transcranial magnetic stimulation (rTMS) on the children with brain injury. Methods Through prospective randomized controlled trials,46 cases of brain injury infants were randomly divided into treatment group and control group.The two groups were both given basic intervention,and the observation group were added with rTMS,and the related function were evaluated before and after the trial. Results After treatment,GMFM-88 and Peabody scale GMQ and GMQ score in two groups were significantly improved than those before treatment (P<0.05);After treatment,GMFM-88,GMQ and FMQ score in Peabody Scale of the observation group increased obviously than those of the control group,and there were significant differences on the scores of GMQ (P<0.05).After treatment,the overall sleep and waking up or crying at night were better than the those before treatment (P<0.05).Nap time,difficulty in falling asleep at night,sleep time at night,waking up crying in the morning did not change significantly (P>0.05). Conclusion rTMS therapy has a certain effect on the recovery of brain function in children with brain injury.

Study on neuropsychological development of preterm infants at the age of 24 months old after birth

HUANG Hai-yan, LU An-feng, HUANG Guo-sheng, Bi Xue-lan

2018, 26(4):  424-426.  DOI: 10.11852/zgetbjzz2018-26-04-21

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Objective To explore the neuropsychological development of 24-month-old preterm infants by analysing the results of Gesell Developmental Scale,and to provide evidence for improving neuropsychological development of preterm infants. Methods A total of 278 preterm infants admitted to the Neonatology Department of Qinzhou Maternal and Child Health Care Hospital and regularly followed up after discharge were selected as the preterm group,and were divided into two subgroups according to gestational age (GA).A total of 113 full-term infants admitted during the same period were selected as the term group.Gesell developmental quotients (DQs) of all infants at their 24 months old were collected and the results of Gesell Developmental Scale were compared among all the groups to find out the differences in their neuropsychological development. Results 1) There was no significant difference on the incidences of abnormal gross motor movement and abnormal fine movement between preterm group and term group (P>0.05).No significant difference had been found in the DQs of those functional areas between the two groups.Compared with the term group,the preterm group had higher incidences of abnormality in language,adaptability and social contact,and lower DQs of those functional areas.2) There was no significant difference in the incidence of abnormality in gross motor movement,fine motor movement,language,adaptability and social contact between preterm infants with GA≥32 weeks and term infants.However,the DQs of the three functional areas(language,adaptability and social contact) were lower in preterm infants with GA≥32 weeks.3) Compared with term infants,preterm infants with GA less than 32 weeks had higher incidences of abnormality in all functional areas and lower DQs of all functional areas. Conclusions The majority of 24-month-old preterm infants have catched up with the term infants in gross motor movement and fine movement,however,the development of language,adaptability and social contact is still delayed.The neuropsychological development of preterm infants with GA less than 32 weeks is not balanced with that of term infants.Therefore,it is necessary to extend the length of follow-up time and strengthen the intervention.

Analysis of catch-up growth during infancy in preterm and low birth weight infants

KE Hai-jin, WU Jie-ling, GUO Yong, LUO Xian-qiong

2018, 26(4):  427-429.  DOI: 10.11852/zgetbjzz2018-26-04-22

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Objective To examine the catch-up growth during infancy in preterm and low birth weight infants. Methods A total of 252 preterm and low birth weight infants who received physical examination in children's health clinic during Jan. 2013 to Dec.2016 were enrolled in this study.Weight and length of infants at birth and 1 year old expressed as standard deviation scores and catch-up growth was defined as an increase of 0.67 in the Z scores between birth and the age of 1 year old.The difference of catch-up growth between boys and girls was evaluated. Results Among 252 preterm and low birth weight infants,there were 118 male infants(46.8%) and 134 female infants(53.2%).The rapid growth of weight[Z:(1.41±0.83)kg] and length[Z:(0.82±0.76)cm] occurred infants during infancy.The rates of catch-up growth for weight and length were 80.5% and 62.7%,respectively;There were no differences on catch-up growth for weight and length between male and female infants (χ²=1.583,1.082,P>0.05).The rate of catch-up growth for weight of children born appropriate for gestational age was higher than that of small or large for gestational age (χ²=8.552,P=0.014). Conclusions Catch-up growth occurs during infancy in most of preterm and low birth weight infants.Correctly nutritional support and growth monitoring are essential for growth development.

Analysis of mortality evaluation and study on intervention countermeasure of neonatal death in Shaanxi province

ZHANG Juan, YU Xi-ping, LI Zhan-kui, CAI Wen-juan

2018, 26(4):  430-432.  DOI: 10.11852/zgetbjzz2018-26-04-23

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Objective To understand the current status and influencing factors of neonatal mortality in Shaanxi Province,to explore the problems of policy implementation,and to give suggestion on improvements and policies to reduce neonatal death. Method Data of the neonatal death monitoring and death review from 2010 to 2016 in Shaanxi Province were analyzed retrospectively. Results The neonatal mortality rate of Shaanxi province declined from 8.94‰ in 2010 to 3.87‰ in 2016.The rural decline rate (5.77‰) was greater than that of the city (1.8‰).The main causes of the neonatal death were premature/low birth weight,birth asphyxia,accidental suffocation,congenital heart disease,pneumonia and congenital anomaly.In 2010,2011 and 2013,birth asphyxia ranked in the first of the death causes;In 2012,congenital heart disease was the first; Since 2015,premature /low birth weight has been the first cause of neonatal death.A total of 66 cases were reviewed,11(16.7%) were inevitable death; 37(56.0%) were avoided death by creating conditions,18(27.3%)were avoided death. Conclusions Neonatal recovery skills training is suggested to be powered in order to minimize neonatal motality.And it is crucial to standardize the management of the premature and neonatal critical disease treatment technology and to establish the network of emergency transion in critical newborns.

Clinical and chromosome analysis of 92 cases of children with unexplained global developmental delay

ZHANG Duan-Xiu, PENG Gui-lan, HU Shu-Xiang

2018, 26(4):  433-436.  DOI: 10.11852/zgetbjzz2018-26-04-24

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Objective To explore the clinical and genetic etiology in children with global developmental delay(GDD),and to provide theoretical basis for the genetic counseling,recurrence risk assessment of sibling and prenatal diagnosis. Methods A total of 92 cases of unexplained GDD were selected and analyzed by routine G banding karyotype analysis.If the result of routine G banding karyotype analysis was normal,further lines of chromosomal microarray analysis(CMA) for genome-wide copy number variations (CNVs) detection,analysis of pathogenesis of copy number variation would be conducted.And the correlation between CNVs and GDD was analyzed. Results In this study,there were 18 cases (19.6%) with abnormal chromosomal results of 92 patients with unexplained GDD.Among them,11 cases (12.0%) showed abnormal karyotype analysis results by routine G banding.Seven cases (7.6%) of abnormality in chromosome microarray analysis were detected.7 pCNVs were found in these 7 cases including 4 known syndromes like 1p36 deletion comprehensive syndrome,2q37 microdeletion syndrome,18q deletion syndrome,and lq21.1 microdeletion syndrome. Conclusions Gene CNVs related microdeletion/repetition is one of the main genetic causes of unknown GDD patients.Routine G banding karyotype analysis combined with CMA for patients with unexplained GDD will be helpful for the etiology diagnosis,thereby providing evidence for genetic counseling of their families,recurrence risk assessment and prenatal diagnosis.

Characteristics of language development in early childhood

CAO Li, RAN Yu-chen, MENG Xian

2018, 26(4):  437-439.  DOI: 10.11852/zgetbjzz2018-26-04-25

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Objective To understand the characteristics of children's normal language development process and the situation of language development retardation,and to provide scientific basis for the correct assessment of children's language development. Methods A total of 1 016 children aged 18~36 months from the Department of Child Health Care in Sichuan Provinicial Hospital of Women and Children were enrolled as subjects in the study,and the Language Development Screening Scale for infants and young children was used as the investigation tool. Results Boys aged 18～30 months had significantly lower scores than girls in the same age group (P<0.05),and the incidence of language development retardation of boys was significantly higher than that of girls (P<0.05).The rapid growth of language in boys and girls appeared in their 24 months,but the language development had no significant gender difference between from 30 months to 36 months (P>0.05). Conclusions Differences in the development of boys and girls should be correctly understood,and more attention such as language stimulation and evaluation should be paid in early stage.Also,children with language development retardation should get positive intervention.

Development of resilience model index on preschool children

MA Hong-xia, CHEN Yi-yi, ZHANG Xiao-lei, HUANG Gang, WANG Ya-jing

2018, 26(4):  440-443.  DOI: 10.11852/zgetbjzz2018-26-04-26

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Objective To explore related factors of preschool children's psychological resilience model construction,in order to develop the resilience model index of preschool children's resilience. Methods The teachers were investigated by《The Questionnaire on Children's Adaptation at the Kindergarten》 in 2011.Then a total of 121 cases were selected as research subjects by the survey,which contained well-adjusted group and maladaptive group.Through the interviews with 50 teachers to 121 cases,resilience model index of preschool children were constructed by word coding and factor analysis combined with literature review. Results A total of 43 indexes of psychological resilience were constructed using the word coding.23 indexes of resilience were constructed by factor analysis.Through the combination and reduction of indexes content,61 resilience model indexes of preschool children were constructed. Conclusion Resilience model index on preschool children are developed using qualitative and quantitative research,thereby providing the theoretical support for the construction of resilience model of preschool children.

Risk factors for isolated premature thelarche and idiopathic central precocious puberty in girls of Tianjin

WANG Yan-hua, ZHAO Xin, LIU Ji-qin

2018, 26(4):  444-447.  DOI: 10.11852/zgetbjzz2018-26-04-27

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Objective To investigate the risk factors for isolated premature thelarche (IPT) and idiopathic central precocious puberty (ICPP) of girls in Tianjin. Methods A total of 110 cases of simple early breast development and 127 cases of girls with idiopathic central precocious puberty in the Affiliated Hospital of Logistic University of PAP Hospital were selected from February 2016 to May 2017,1∶2 pairs were matched according to age,and 220 normal girls and 254 normal controls were selected as controls,questionnaire survey was conducted among all subjects. Results Logistic regression analysis showed that pollution factory near the address,mother's menarche age ≤13 years old,frequency of use of plastic products,animal food or high protein diet and pigment food containing preservatives were risk factors for IPT (OR=9.061,22.220,2.980,6.508 and 14.069,P＜0.05);Taking nutrition supplements,using adult wash skin care products,food containing hormones,mother's menarche age ≤13 years old and seafood diet were risk factors for ICPP (OR=3.071,2.445,4.063,2.809 and 2.849,P＜0.05). Conclusion The risk factors of IPT and ICPP in girls in Tianjin city are complex,which are related to maternal age at menarche,diet habits and so on.

Analysis on the viruses in 578 children with acute respiratory tract infection

CAO Huan-zhen, ZHAO Yang-yang, YAN Jian-hua, JIAN Shao-xia, DU Bao-yuan, KOU Xiao-hui, GUO Lian, YANG Xiao-lin, LIU Hong-li

2018, 26(4):  448-450.  DOI: 10.11852/zgetbjzz2018-26-04-28

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Objective To understand the viral pathogen of children with acute respiratory infection(ARI) in Sanmenxia,and to provide guidance for direct clinical diagnosis and treatment. Methods Nasopharyngeal swabs were collected from 578 inpatient children diagnosed with ARI,and respiratory syncytial virus (RSV),adenovirus(ADV),parainfluenza virus Ⅰ,Ⅱ,Ⅲ (PIV Ⅰ～Ⅲ),influenza virus A,B (IVA,IVB) were detected by direct immunofluorescence. Results The total positive rate of virus pathogen of children with ARI was 61.59%.45.22% of the positive specimens were mixed infection.The total positive rate of virus pathogen was the highest in winter (77.35%) and the lowest in summer(25.0%).The total virus detection rate of lower respiratory tract infection was higher than that of upper respiratory tract infection.The detection rates of RSV,PIV Ⅲ and IVA ranked the top three,with 30.62%,28.89% and 21.97%,respectively.The detection rates of RSV and PIV Ⅲ were higher in lower respiratory tract infections in children under 3 years of age during the fall and winter.IVA had a higher detection rate in children with upper respiratory tract infection in winter. Conclusions RSV,PIV Ⅲ,IVA are main pathogens of acute respiratory tract infections in children from Sanmenxia area.RSV and PIV Ⅲ are the main pathogens of lower respiratory tract infections in children under 3 years old in autumn and winter.IVA is the main pathogen of upper respiratory tract infection in children of all ages in winter.It is of great significance to early diagnose virus pathogen and to avoid antibiotics abuse to detect viral pathogens in ARI children.

Research on the dose of growth hormone in prepubertal children with idiopathic short stature

GUI Lin-yan, WANG Pu

2018, 26(4):  451-452.  DOI: 10.11852/zgetbjzz2018-26-04-29

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Objective To explore the clinical efficacy of recombinant human growth hormone (rhGH) in children with prepubertal idiopathic short stature (ISS). Methods A total of 68 children with ISS treated in Zhengzhou Maternal and Child Health Care Hospital from March 2014 to June 2016 were enrolled in this study,and the study was approved by ethics committee unanimously.According to the random number table,the participants were divided into two groups,of which 34 cases were treated with subcutaneous injection of low-dose rhGH 0.25 mg/(kg·week) as the low dose group,the other 34 cases with high-dose subcutaneous injection of rhGH 0.40 mg/(kg·week) as the high dose group,and the course of treatment was 14 months.Growth relovity (GV),height standard deviation integral (HtSDS),bone age and incidence of adverse reactions were compared between the two groups after treatment. Results The differences of height(107.4±6.85 vs. 126.7±7.15),GV (7.45±1.09 vs. 11.68±1.37)and HtSDS(-0.96±0.43 vs. -0.64±0.52) index between high dose group and low dose group were significant (P<0.05);There were no significant differences on bone age,the number of cases of redness and swelling,and pain between the two groups (all P>0.05),and the symptoms counld resolve spontaneously. Conclusion RhGH has significant effect on the treatment of ISS,and the efficacy of high-dose rhGH is better than that of low-dose rhGH.

Evaluation on dental filling efficacy of deciduous anterior teeth caries by 15%EDTA gel

TONG Xue-mei, ZHOU Lan, ZHOU Lin

2018, 26(4):  453-455.  DOI: 10.11852/zgetbjzz2018-26-04-30

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Objective To evaluate the filling efficacy of maxillary deciduous anterior teeth with 15% ethylene diamine teraacetic acid(EDTA) gel as chemical way to remove the decay. Methods A total of 120 patients were selected and divided into experiment group and control group with 60 patients in each group.Carisolv^TM gel was used in control group and 15%EDTA gel was used to remove the decay in experiment group.Then,one step self-etching-adhesives and Filtek Z350 (3M ESPE) flowable resin was used to fill the teeth defect.During one-year follow-up period,filling efficacy were assessed in one-year follow-up period.The data recorded were analyzed by chi-square test with SPSS 19.0 software. Results No significant difference on baseline data was observed(P＞0.05).After one-year follow-up period,no patients dropped out.The success rate of dental filling in the experiment group and the control group was separately 99% and 98%.No statistically significant difference was observed with respect to dental filling efficacy(P ＞0.05). Conclusion 15%EDTA gel could be used to remove decayed tissue in the treatment of deciduous decay,with self-etching-adhesives and Filtek Z350 (3M ESPE) as dental filling.

Epidemiological status of dental caries among children aged 8 in Pingdingshan city

SONG Qiu-kun, LI Ai-jun, WANG Ya-tao, MA Hong-mei, WANG Xiao-wen

2018, 26(4):  456-458.  DOI: 10.11852/zgetbjzz2018-26-04-31

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Objective To understand the epidemic status of dental caries among 8-year-old school-aged children in Pingdingshan city. Method A total of 1 762 children aged 8 (grade two students) in five counties and three districts of Pingdingshan were interviewed by stratified cluster sampling method. Results The incidence of caries among 8-year-old school-aged children in Pingdingshan was 84.68%,with an average DMFT of 4.79.There was significant difference of caries prevalence between rural and urban areas (P＜0.05).The rate of six or more dental caries on rural and urban areas was 35.61% and 44.20% respectively,the difference was statistically significant (P＜0.05).The rate of dental caries on deciduous teeth and permanent teeth was 83.65% and 25.77% respectively.There was a direct correlation between breast teeth and constant molar (r=0.236,OR=11.24). Conclusion The caries prevalence rate of permanent teeth is relatively high.Oral health education of children and control dental caries should be strengthened to reduce the prevalence of dental caries among children.

Clinical observation on the value of early intervention of traditional Chinese medical massage on high-risk infants

WANG Chun-hua, WANG Cui-ping, FENG Jiao-mei

2018, 26(4):  459-461.  DOI: 10.11852/zgetbjzz2018-26-04-32

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Objective To explore the application value of massage therapy in early intervention exercise of high-risk infants in order to provide evidence for clinical treatment. Methods Children with movement of growth retardation who visited in Maternal and Child Health Hospital of Shouguang City from July 2015 to June 2016 were selected as the research objects,and then were randomly divided into control group and intervention group.The intervention group was given massage combined with conventional treatment,while the control group only received conventional treatment.The intervention effects of the two groups were observed,and the differences on Gesell exercise score and development quotient between the two groups before and after intervention were compared. Results The effective rate of the intervention group was 93.3%,higher than that of the control group; After the intervention,Gesell exercise score of the intervention group was higher than that of the control group (t=-12.524,P<0.001).Development quotient of the intervention group was higher than that of the control group.The levels of IL-6,hs-CRP and TNF-α of the intervention group were lower than those of the control group (P<0.05). Conclusion Early intervention of massage therapy is effective on high-risk children with sports retardation,and early intervention can produce better results.