Table of Content

20 April 2019, Volume 27 Issue 4

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Orginal Article

Early intervention of neurodevelopmental disorders in children

HAN Ying

2019, 27(4):  349-350.  DOI: 10.11852/zgetbjzz2019-0347

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With advances in the ability to identify neurodevelopmental disorders in children at younger ages, doctors' information need for early intervention is increasing. This review summarizes the neurodevelopmental background, timing of initiating intervention, primary intervention approaches and predictors of treatment outcomes. And it is suggested that the combination of parent-mediated and direct clinician-implemented intervention can help improve children's prognosis.

Diagnosis, treatment and management of epilepsy in children with autism spectrum disorder

CHEN Wen-xiong

2019, 27(4):  351-354.  DOI: 10.11852/zgetbjzz2019-0373

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Although comorbidity between autism spectrum disorder (ASD) and epilepsy has been recognized for several years, the exact mechanism of the interaction is still not clear.There are few studies on the impact of epilepsy on mental and behavioral disorders in ASD children, but it is reported that ASD children comorbid with epilepsy are prone to having difficulty in growth and development, social communication as well as self-care.So it is required to give comprehensive assessment before treatment, including etiological investigation, cognitive, linguistic, emotional, social and behavioral functions.And the treatment is mainly based on psychosocial intervention combined with drugs.Antiepileptic drugs are selected according to the type of epilepsy and drug tolerance, taking into account the behavioral side effects of drugs.Seizures-like behaviors are common in children with ASD and need to be carefully identified.Suspected epileptic seizures should be promptly diagnosed and treated or referred.There is some evidence that ASD is associated with increasing refractory epilepsy and mortality.Therefore, strengthening multidisciplinary communication is an important link to improve the early identification and long-term management of ASD comorbidity epilepsy.

Evaluation and influencing factors analysis of the visual-motor integration of preschool children in Nanjing

XU Qu, OU Jia-xin, ZHANG Qing-yu, JIANG Bei, WANG Jing, YANG Lei, HONG Qin, TONG Mei-ling, GUO Xi-rong, CHI Xia

2019, 27(4):  355-357.  DOI: 10.11852/zgetbjzz2018-0673

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Objective To investigate the performance of visual-motor integration (VMI) of preschool children in Nanjing,and to analysis the related influencing factors,in order to provide reference for clinical work on VMI development at early childhood education. Methods Totally 483 preschool children from 6 kindergartens in the main city of Nanjing were selected in this study by stratified random sampling method from March to May 2017. And the general data and visual-motor integration development were assessed. Results 1) Visual-motor integration capability improved and the original score of VMI was increased in older children. 2) There was no significant gender difference on VMI standard scores among all age groups (P>0.05). 3) Scores of VMI in all age groups except group aged six years old and eight months to nine months were significantly higher than the norm of the United States (P<0.01). 4) There were low correlations between VMI standard score and the basic information,including learning experience of dance,learning instrument,education level of parents(r=0.11-0.13,P<0.05). Conclusions Visual motor integration improves with the age getting older,but no significant gender differences on VMI is observed. Education level of parents,learning experience of dance and musical instruments at early childhood is correlated with the development of children's visual motor integration ability.

Prospective cohort study on neurodevelopmental outcomes at the age of 18-24 months in small for gestational age preterm infants with gestational age of 30-34 weeks

HE Long-kai, SONG Yan-yan, ZHANG Teng-wei, TANG Liang, CAI Yue-ju

2019, 27(4):  358-361.  DOI: 10.11852/zgetbjzz2018-0502

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Objective To study neurodevelopmental outcomes at the age of 18-24 months in small for gestational age preterm infants with gestational age of 30-34 weeks,in order to provide theoretical basis for clinical improvement of diagnosis,treatment and early intervention in preterm infants. Methods A prospective cohort study was adopted. Premature infants,who were born at gestational age of 30-34 weeks and received regular follow-up management at high-risk infant outpatient clinic in Guangzhou Women and Children's Medical Center,were enrolled in this study from January 2015 to December 2017. And the participants were divided into small for gestational age (SGA) group and appropriate for gestational age (AGA) group. Birth data,perinatal factors,early complications,physical growth and neurodevelopmental outcomes between SGA group and AGA group were compared,also the effect of early complications of SGA infants on neurodevelopmental outcomes was observed. Results A total of 122 follow-up preterm infants were included in the study,with 58 in SGA group and 64 in AGA group. There was no significant differences on perinatal and postnatal complications between the two groups (P>0.05).Theadaptability,gross motor,fine motor and language in SGA group at the adjusted age of 6-12 months old were inferior to those of control group(P<0.05),while individual social development was not significantly different between the two groups (P>0.05). The gross motor and fine motor in SGA group at the adjusted age of 18-24 months old were inferior to those of control group(P<0.05),while the adaptability,language and individual social development were not significantly different between the two groups (P>0.05). Preterm infants with bronchopulmonary dysplasia were more likely to develop neurodevelopmental retardation (DQ≤75),and the difference was significant (P<0.05). Conclusions The gross motor and fine motor in SGA infants at the adjusted age of 18-24 months old lag behind AGA infants at the same age. And bronchopulmonary dysplasial(BPD) may be a potential risk factor for neurodevelopmental retardation.

Study on the status quo of early child development in eight provinces of China

SHAN Wen-jie, ZHANG Yun-ting, LIN Qing-min, JIANG Yan-rui, ZHU Qi, JIANG Fan

2019, 27(4):  362-365.  DOI: 10.11852/zgetbjzz2018-1442

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Objective To assess the cognitive and motor development of young children in China, and to evaluate the status quo of early childhood development in China. Methods A total of 1 026 full-term healthy children at the age of 2-30 months old were selected by convenience sampling from 8 provinces in China from October 2012 to March 2013.Demographic and social economic status data were investigated by parent report questionnaire.Bayley Scales of Infant Development were used to assess the development of young children.Multiple regression analysis was conducted to explore risk factors of cognitive development and motor development in young children. Results The average cognitive development index of infants aged 2-30 months in China was 102.38±17.58,and the average motor development index was 101.39±16.38.Cognitive retardation rate was 7.70%, and motor development retardation rate was 8.28%.After adjusting for confounders, compared with those with maternal education higher than junior college, children with maternal education under middle school appeared to have significantly lower cognitive development index (β=-8.51, 95%CI:-11.23--5.78) and motor development index (β=-4.17, 95%CI:-6.79--1.55). Conclusions Early child development in China has improved since 20 years ago.Maternal education is significantly associated with young child's cognition and motor development.

Analysis of the neurodevelopment and its influencing factors of high-risk infants in Shanghai

SHEN Li, TIAN Yuan, YU Guang-jun, HU Xiang-ying, MA Li-yu, PU Zheng

2019, 27(4):  366-369.  DOI: 10.11852/zgetbjzz2018-0752

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Objective To investigate the current status and influencing factors for neurodevelopment of high-risk infants,in order to provide implications for pregnancy education and improving the diagnosis and treatment of high-risk infants. Methods A cross-sectional survey with cluster sampling was adopted from March 2016 to October 2017. Totally 603 high-risk infants and caregivers from three Maternal and Child Health (MCH) hospitals in Shanghai were selected as participants,questionnaire surveys and Gesell Development Diagnostic Tests were carried out. Logistic regression was used to analyze the influencing factors of neuropsychological development. Results A total of 603 high-risk infants were investigated in this study,with an average age of (6.69±3.53) months,of which 305 (50.6%) were boys and 298 (49.4%) were girls. The abnormal rates of motor development,cognition development,language development and person-skills development were 10.0%,14.9%,12.1%,and 8.5%,respectively. Logistic regression analysis showed that premature birth,low birth weight infants,neonatal pneumonia,occasional alcohol intake during pregnancy and maternal emotional stress during pregnancy were risk factors for motor development. Low birth weight infants,occasional alcohol intake during pregnancy were risk factors for cognition development. Premature birth,occasional alcohol intake during pregnancy and father's emotional stress were risk factors for language development. Premature birth and occasional alcohol intake during mother's pregnancy were risk factors for person-skills development. Conclusions Preterm infants and low birth weight infants should be given more concern on their neurodevelopment. Occasional alcohol and parents' emotional stress have negative effect on neurodevelopment.

Research on the characteristics of noun development in children aged 1 to 6 years in Jiangsu province

ZHANG Qing-yu, XIE Ya-chun, OU Jia-xin, XU Qu, WANG Jing, JIANG Bei, XU Ya-qin, ZHANG Xin, CHI Xia, TONG Mei-ling

2019, 27(4):  370-373.  DOI: 10.11852/zgetbjzz2018-1077

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Objective To investigate the status of language nouns development, in order to know about the general rules of noun comprehension and expression in children aged 1~6 years in Jiangsu province. Method A random sample of 1 121 children was tested using the noun test section of the “language development assessment scale for children aged 1~6”. Results 1) Children learnt the name of the body part firstly, followed by the name of the item and the toy, and finally acquired the abstract nouns such as the upper word; 2) The development of children's noun understanding existed age threshold, the equivalent age of P₇₅ was 2 years old, and the equivalent age of P₉₀ was 2.5 years old; 3) The development of children's noun expression existed age threshold, the equivalent age of P₇₅ was 2.5 years old, and the equivalent age of P₉₀ percentile was 3 years old; 4) The average score on the noun test of girls was significantly higher than that of boys (P<0.005). Conclusion The development of nouns in children aged 1~6 years has specific characteristics such as acquisition order, age boundary value and gender difference, which are important for promoting early development and early intervention of children's language.

Analysis of correlation between maternal anemia during pregnancy and developmental delay among children in 8 counties in central and western China

YANG Chen-lu, LIU Xiao-li, SONG Qi-ying, ZHOU Hong, WANG Yan

2019, 27(4):  374-377.  DOI: 10.11852/zgetbjzz2018-0367

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Objective To understand the status of maternal anemia during pregnancy,and to explore its correlation with developmental delay among children in 8 counties in central and western China,in order to provide evidence for intervention. Methods A cross-sectional study with probability proportional to size (PPS) sampling method was conducted in 8 counties in central and western China from October 2016 to January 2017. Data of maternal anemia during pregnancy of 1 100 children aged 1-59 months were obtained. Ages and Stages Questionnaires (ASQ) were used to evaluate the developmental outcomes of children. Multivariate Logistic regression model was applied to estimate the odds ratios (OR) and 95% confidence intervals (95%CI) after adjustment for potential confounding variables. Results Totally 419(38.1%) mothers had maternal anemia during pregnancy in surveyed areas. Maternal anemia during pregnancy was a risk factor for suspected developmental delay in communication domain (OR=2.02,95%CI:1.09-3.75,P=0.025) and overall ASQ (OR=1.63,95%CI:1.12-2.38,P=0.011) after adjustment for children's gender,children's age,parity,delivery mode,gestational age,birth weight,malnutrition,anemia in children,annual per capita net income of the family and maternal education. Conclusion Maternal anemia during pregnancy is correlated with suspected developmental delay among children in in central and western China.

Research on reliability and clinical application of the Family-Video-Feedback Scale

CAO Jia-yan, SHI Wei, SHEN Xiu-shu, YANG Hong, ZHU Xiao-yun, SU Yi

2019, 27(4):  378-380.  DOI: 10.11852/zgetbjzz2018-1028

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Objective To study the reliability of Family-Video-Feedback Scale (FVFS), and to explore the clinical application of the scale in early intervention for high-risk infants at 0 to 6 months old. Methods 1) Internal consistency reliability:Totally 130 videos and clinical materials were collected from 130 families accepting intervention guidance in Rehabilitation Department of Children's Hospital from May, 2017 to March, 2018.2) Inter-raters reliability and test-retest reliability:30 high-risk infants and their 60 videos (30 pre-videos and 30 post-videos) were included into study.Two raters evaluated the 30 pre-videos with FVFS and evaluated again after 7 days.The inter-raters reliability and test-retest reliability were represented by interclass correlation coefficient (ICC).3) Clinical application:After evaluated the pre-videos, therapist delivered to parents, and then parents took videos again after adjustment.The score of the pre-videos and post-videos were compared. Results The internal consistency reliability of subscale 1(video quality assessment) was 0.603.The inter-rater reliability (ICC values) of the total score of subscale 1(video quality assessment) was 0.970,and subgroups' ICC values ranged from 0.903 to 0.983.The test-retest reliability of subscale 1(video quality assessment) was 0.966,and subgroups' ICC values ranged from 0.840 to 0.966.The internal consistency reliability of subscale 1(intervention quality assessment) was 0.519.The inter-rater reliability (ICC values) of the total score of subscale 2(intervention quality assessment) was 0.909,and subgroups' ICC values ranged from 0.697 to 1.000.The test-retest reliability of subscale 1(intervention quality assessment) was 0.988,and subgroups' ICC values ranged from 0.869 to 1.000.The mean score of the 30 pre-videos and post-videos on the total score of video quality assessment, intervention quality assessment and the whole scale were 6.57 vs.7.37,12.30 vs.15.79,18.87 vs.23.33,respectively, and the differences were significant(P<0.05). Conclusions The FVFS has high inter-raters reliability and test-retest reliability, with good internal consistency reliability of the video quality assessment and acceptable internal consistency reliability of the intervention quality assessment.It is valuable for clinic to evaluate videos with FVFS to improve the quality of family early intervention.

Incidence rates of birth defects within 2 years after birth based on the maternal population cohort in Jiangbei District, Ningbo during 2010-2015

ZHAO Yi-ming, SHI Hui-jing, YUAN Fang

2019, 27(4):  381-384.  DOI: 10.11852/zgetbjzz2018-1353

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Objective To investigate incidence rates of birth defects and diagnosed defect composition during pregnancy and different time period after birth, in order to explore more appropriate time period of birth defects monitoring. Methods The population-based surveillance data were retrived from reginal birth defects monitoring network, where all defects cases reported within 13 weeks of pregnancy to 2 years after birth were selected from 23 054 pregnant women who gave birth within 2010 to 2015 in Jiangbei district, Ningbo city.The incidence rates, the diagonozed defect types and the diagnosed time were descriptively analyzed. Results Totally 1 040 cases of birth defects were found from 2010 to 2015 for all registed pregnant women in the study area.From early pregnancy to 2 years after delivery, the cumulative reporting rate of birth defects was 4.51%, and there existed a year-by-year increasing trend.The incidences rate of birth defects was significantly higher in those of stillbirths.Congenital heart disease ranked the first in all types of birth defects.Calculated by different time (age) point of diagnose, the incidence rate of congenital heart disease was 2.7% from early pregnancy to 7 days after birth, 3.61% before 42 days after birth, 4.42% before 1 year old, and 4.51% before 2 years old.The detection rate of birth defects from gestation age of 13 weeks to 2 years after delivery was 1.7 times higher than that from early pregnancy to 7 days after birth.And nearly 97.88% of birth defects were found within 1 year after birth. Conclusions Prolonging the time period for birth defects surveillance would make data close to the real rate.So it is suggested that the monitoring period of birth defect should be expended to 2 years after birth.

Establishment of early warning score of detailed assessment of general movements on cerebral palsy

WANG Yu-qing, ZHU Ping, YANG Zhong-xiu, GU Gui-xiong

2019, 27(4):  385-387.  DOI: 10.11852/zgetbjzz2018-1019

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Objective To establish the early warning score of cerebral palsy in twist-movements infants based on detailed assessment of general movements the study of high-risk infants. Methods The high-risk children who established archives in the department of rehabilitation in Xuzhou Children's Hospital were selected as participants from January 2016 to January 2017.The general movements feature evaluation and refinement score were conducted at corrected age of 4-6 weeks.And 52 neurological exercises were tested for infants at corrected age of 4-8 weeks.At 12 months old (corrected age of 44-52 weeks), different developmental outcomes were determined according to the diagnostic criteria for cerebral palsy.According to the research of health statistics, the early warning score of twist movements detailed assessment was established. Results The detailed assessment scores of twist-movements were significantly different among normal group, poor repertoire group, and synchronous exercise group (F=208.186,P<0.001).It was also positively correlated with 52 items scores(r=0.968, P<0.001).The normal motor development group ("green area") ranged from 27 to 42 points, which was equivalent to more than 27 points.The range of mild abnormalities ("yellow area") ranged from 18 to 26 points.The range of severe abnormalities ("red area") ranged from 5 to 17 points, which was equivalent to 17 points or less.The cerebral palsy warning score of this data showed that the predictive validity was 92.11%, the sensitivity was 100%, the specificity was 90.00%, the positive predictive value was 72.73%, the negative predictive value was 100%, the false positive rate was 10%, and the false negative rate was 0. Conclusion The establishment of warning score on cerebral palsy has higher sensitivity and specificity, lower false positive/negative rates, which can be used by medical personnel in clinical practice.

Study on qualitative assessment of general movements to guide early intervention of high risk children

DIAO Ying-ying, YUE Bao-zhu, CHEN Jian-gui, MA Zong-yan, WANG Cun-juan

2019, 27(4):  388-391.  DOI: 10.11852/zgetbjzz2019-1003

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Objective To compare the prognosis of simple family rehabilitation training and family rehabilitation training combined with medicine intervention in high-risk infants with normal general movements (GMs) assessment, in order to analyze the guidance significance of GMs on the early intervention of high-risk infants. Methods A total of 183 high-risk infants with normal GMs assessment were recruited at the Rehabilitation Department of Weifang Maternal and Child Health Hospital from February 2016 to February 2017.Infants were randomly assigned to observation group and control group.The observation group (n=89) received simple family rehabilitation training, whereas the control group received family rehabilitation training combined with medicinal interventions (n=94).Infants were assessed at corrected age of 6,9 and 12 months using the Peabody Development Motor Scales (PDMS).Statistical analysis of measurements of the PDMS was performed with SPSS 21.0. Results After intervention, there was no significant difference on the scores of gross movement quotient (GMQ), fine motor quotient (FMQ), and total sports quotient (TMQ) between observation group and control group at the corrected age of 6,9 and 12 months (P>0.05).Repeated analysis of variance showed that the difference on the GMQ, FMQ, and TMQ scores between observation group and control group was not significant (P>0.05), while the time influence on the GMQ, FMQ, and TMQ scores was significant(P<0.05).There were no interactions between the effect of family rehabilitation training combined with medicinal interventions and time on the GMQ, FMQ, and TMQ scores (P>0.05). Conclusions GMs assessment is of great guiding significance for the early intervention of high-risk infants.For high-risk infants with normal GMs assessment results, family rehabilitation without medicinal interventions may well be as effective as that with medicinal interventions, so excessive intervention should be avoided.

Effect of remote ischemic postconditioning on calcium sensing receptor and Akt/Pi3k pathway in hypoxic-ischemic encephalopathy rats

YAN Min, GUO Jin, SONG Lin, NIE Yin-yue

2019, 27(4):  392-396.  DOI: 10.11852/zgetbjzz2018-1775

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Objective To explore the effect of remote ischemic postconditioning (RIPC) on calcium sensing receptorl(CaSR) expression and Akt/Pi3k pathway in brain tissue of neonatal rats with hypoxic-ischemic encephalopathy(HIE), in order to provide theoretical evidence for the treatment of HIE in neonates. Methods Totally 120 newborn Wistar rats aged 7 days were randomly divided into sham operation group (S group), hypoxic-ischemic encephalopathy group (HIE group), RIPC for 5 minutes group (R1 group) and RIPC for 10 minutes group (R2 group).The behaviors of rats in each group were observed and the body weight was measured.The morphological changes were observed by HE staining, and the ultrastructure of cells was observed by electron microscopy.The expressions of CaSR, Bax, Bcl-2,p-Akt and Akt protein were detected by immunohistochemistry, and the expression of p-Akt, Bax and Bcl-2 protein was detected by western blotting. Results Compared with HIE group, rats in R1 group and R2 group showed reduced abnormal behaviors, and the growth rate of body weight increased significantly (P<0.05).The number of CaSR positive cells in R1 group (22.00 ±1.79) and R2 group (20.83 ±2.04) was significantly lower than that in HIE group (25.67±1.21) (P < 0.05).The number of p-Akt positive cells in R1 group (25.00±1.41) and R2 group (27.3 3±1.86) was significantly more than that in HIE group (14.33 ±2.16) (P<0.05).The p-Akt optical density value of R1 group (328.33 ±24.86) and R2 group (339.67± 23.77) was significantly higher than that of HIE group (120.83 ±17.43) (P<0.05).Compared with HIE group, Bax expression level was decreased in R1 group and R2 group (P<0.05), while Bcl-2 expression level was increased (P<0.05).However, there were no significant differences on the indexes between R1 group and R2 group (P>0.05).And the Akt expression level was not significantly different among the four groups (P>0.05). Conclusion RIPC plays a protective role in neonatal rat brain tissue injury, probably because of the decreasing expression of CaSR in brain tissue and the activation of Akt/Pi3k pathway.

Discussion on the necessity of routine screening for inborn errors of metabolism in children with autism spectrum disorder

REN Shuang, LI Chen-yang, QIAO Chong, LI Jing

2019, 27(4):  397-399.  DOI: 10.11852/zgetbjzz2018-1367

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Autism spectrum disorder(ASD) is a group of neurodevelopmental disorders,and its etiology is very complicated.Some children with inborn errors of metabolism (IEM) accompanied by ASD or autistic symptoms, can relieve ASD to a certain extent by the treatment of IEM, so IEM is probably one of the causes of ASD.This review discusses whether IEM screening should be routinely carried out in ASD children.

Effects of early nutritional intervention on the development of nervous system in premature infants

CHEN Mei-hui, LI Xiao-jie, LIANG Yu-qiong

2019, 27(4):  400-403.  DOI: 10.11852/zgetbjzz2018-1409

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With the continuous improvement of medical standards and the continuous development of perinatal medicine recently, the survival rate of premature infants has significantly improved.At the same time, the incidence of neurological diseases such as cerebral palsy, epilepsy and mental retardation has increased significantly.Studies have shown that early adequate nutrition is an important factor in the developmental outcomes of preterm infants' neurodevelopment and later cognitive abilities.This review summarizes the effect of early nutritional interventions to preterm infants on brain development and nervous system development,in order to analyze the relationship between nutrients, nutritional supplements and the development of premature infants' brain and nervous system.

Research progress on the influencing factors of sibling relationship

BIAN Si-qian, HU You-fang

2019, 27(4):  404-406.  DOI: 10.11852/zgetbjzz2018-0241

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Sibling relationship is the longest-lasting interpersonal relationship in an individual's life,which has great influence on physical and mental health and socialized development of both generations. Factors that affect the sibling relationship mainly include family,individual and social level. This review summarizes the progress of influencing factors of sibling relationship at home and abroad in recent years.

Research progress on the correlation between intestinal flora and autism spectrum disorder

KUNG Wei-yen, WANG Yu

2019, 27(4):  407-410.  DOI: 10.11852/zgetbjzz2018-1166

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder mainly characterized by social communication disorders, repetitive behaviors and narrow interests.The etiology of ASD is complex, and it focuses on the genetic and environmental factors.As the pathogenesis is unknown, there is no effective treatment.It is found that gastrointestinal diseases and changes of intestinal flora are common in ASD children.Recent studies have shown a two-way interaction between the gut nervous system and the central nervous system, called the microbiota-gut-brain axis.Gut flora regulates brain function through neuroendocrine, immune and intestinal nervous systems and thus affects brain development and behavior.Therefore, the imbalance of intestinal flora may be related to the occurrence of ASD.This article will summarize the effect of intestinal flora on ASD and the progress of related treatment.

Meta analysis of the influence of living environment factors on birth defects

TI Xin-jing, LIN Meng-meng, LIU Yang, FU Ling-ling, WANG Zhi-ping

2019, 27(4):  411-413.  DOI: 10.11852/zgetbjzz2018-1020

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Objective To explore the relationship between three living environment factors(living near pollution source, prenatal bedroom decoration and indoor pet raising)and birth defects through Meta?analysis. Methods Published researches on birth defects were retrieved by searching CNKI, Wanfang database and VIP online between January 1st,1977 and July 30th, 2018.Studies were screened according to strict inclusion criteria.Heterogeneity test and effect value combination were performed on the included literature.Sensitivity analysis, publication bias test and correction were performed on the results. Results Finally 21 articles were included in this Meta?analysis.The adjusted merger OR values of living near pollution source, bedroom decoration during pregnancy, pets raising indoors were 2.474(1.659-3.688), 2.149(1.807-2.555) and 2.721(2.006-3.693) through random effects model. Conclusion Living near pollution source, prenatal bedroom decoration and pets raising indoors will increase the risk of birth defects.

Effect of early intervention of nerve development on longitudinal development of premature infants

LIU Li-rui, WU Yan-qiu, LIU Xia, WANG Wei-wei, XU Dong-mei, ZHOU Qi-li, MENG Lan-si, HUANG Hui-jie

2019, 27(4):  414-417.  DOI: 10.11852/zgetbjzz2018-1549

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Objective To analyze the role of early intervention of nerve development on longitudinal development of premature infants, in order to provide evidence for improving prognosis. Methods Totally 60 premature infants born in Affiliated Hospital of Chengde Medical University were divided into intervention group and control group according to the willing of the family, and 30 full-term infants were selected as the term group from October 2014 to October 2015.The clinical data of preterm infants and their mothers were retrospectively collected.And the neurodevelopmental evaluation was performed with Gessel Development Scale at the age of 3 months old, 1 year old, 2 years old and 3 years old and the results were compared longitudinally. Results The neurobehavioral development of preterm infants in intervention group was superior to that in control group at the age of 1 year old(P<0.05), but there was no significant difference on gross motor movement development between intervention group and the term infants (P>0.05).There was no difference between the intervention group and the term infants on neurobehavioral development at 3 years old (P>0.05).But the language and the fine movement in control group still lagged behind the intervention group and term group(P<0.05).The longitudinal comparison indicated that the preterm infants in the intervention group had earlier neurodevelopmental catch-up and faster catch-up speed. Conclusion Early intervention of nerve development can improve the nerve development of premature infants as early as possible and realize the catch-up growth of nerve development.

Influence of different reading ways on the narrative ability of middle school children

LIANG Hao, ZHANG Min, CHEN Sui-qing

2019, 27(4):  418-421.  DOI: 10.11852/zgetbjzz2018-1287

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Objective To analyze the influences of independent reading and shared reading on the narrative ability of children, in order to provide scientific basis for effectively promoting the development of children's narrative ability. Method A kindergarten was selected and divided into two groups to receive intervention for 4 weeks, including experimental group (shared reading group) and control group (independent reading group)from March to May 2017. Results The variance analysis showed that the main effects of pretest and posttest, reading style, story element were significant (F=40.44,28.60,39.67,P<0.001).Simple effect analysis showed that the performance of shared reading group was significantly better than that of independent reading group in the posttest, and the story background in the posttest, the results of attempted action and story results were significantly higher than those of the story cause and internal reaction(P<0.05).But there was no significant difference on the story cause dimension between shared reading group and independent reading group. Conclusions Different reading styles play a positive role in promoting the development of children's narrative ability, but the effect is different.Shared reading is more effective on the development of children's narrative ability than independent reading.However, the two groups have no significant effects on the cause of the story.

Comparison on the effect of caffeine citrate and aminophylline on neurological development in preterm infants

WANG Chang-yan

2019, 27(4):  421-424.  DOI: 10.11852/zgetbjzz2018-1478

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Objective To compare the effect of caffeine citrate and aminophylline on neurological development in preterm infants, in order to provide reference for the early intervention of preterm infants. Methods Totally 62 infants with apnea of prematurity (AOP) treated with caffeine citrate was enrolled as study group from June 2014 to June 2018,and 69 AOP infants treated with aminophylline were selected as control group from December 2011 to May 2014.Brain magnetic resonance image(MRI)scanning was conducted to compare white matter disease(WMD) between caffeine citrate group and aminophylline group at 3 to 8 days after birth and corrected gestational age of 40 weeks.Neurological development was assessed by Gessell Scales of Infant Development in 6 months and 12 months and was compared between the two groups. Results There were no significant differences on sex, gestational age at birth, birth weight, glucocorticoids use before birth and delivery mode, Apgar score at 5 minutes, assisted ventilation, as well as surfactant therapy between caffeine citrate and aminophylline group(P>0.05).Difference on WMD between the two groups was not found at 3 to 8 days after birth(P>0.05), but it was significant at corrected gestational age of 40 weeks(P<0.05).After following up to corrected age of 6 months, the scores of gross motor, fine motor, personal-social contact in caffeine citrate group were significantly higher than those in aminophylline group(P<0.05).And after following up to corrected age of 12 months, the scores of gross motor, fine motor, language and adaptability in caffeine citrate group were significantly higher than those in aminophylline group(P<0.05). Conclusion Caffeine citrate can potentially improve the neurological development outcome of AOP infants at 6 and 12 month old.

Study on the current status and related influencing factors for neuropsychological development among 6 to 36-month-old infants in Kunming

YANG Shu, ZHANG Jun-xia, WANG Ruo-si

2019, 27(4):  425-428.  DOI: 10.11852/zgetbjzz2018-0350

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Objective To explore the current situation and related influencing factors of neuropsychological development among 6 to 36-month-old infants in Kunming,in order to provide reference for facilitating neurodevelopment of children. Methods A total of 310 infants aged 6-36 months were selected as participants in the department of preventive healthcare,Yan'an Hospital Affiliated to Kunming Medical University from August 2016 to July 2017. Data on history of delivery/disease,pregnancy complications,family status and main caregiver were collected through questionnaire survey. Developmental Screening Test for children under six (DST) was used to conduct neuropsychological test among these infants. The weight-for-age,length-for-age,head circumference-for-age were used to evaluate physical development. Multi-factor ordinal logistic regression analysis was used to screen the influencing factors for neuropsychological development among infants. Results The rates of "normal(DQ≥85)","suspicious(70≤DQ≤84)","abnormal(DQ<70)" on development quotient (DQ) in 310 infants were 51.0%,40.3% and 8.7%,respectively,while 75.2%,18.7% and 6.1% on MI (mental index). And 61.3% of infants had gross motor delays. Multi-factor ordinal Logistic regression analysis showed those DQ delays were significantly associated with gender (OR=0.453,95%CI:0.245-0.839),low birth weight (OR=0.150,95%CI:0.019-0.968),elderly childbirth (OR=0.216,95%CI:0.055-0.852),without siblings (OR=0.459,95%CI:0.237-0.887).Maternal unemployed (OR=2.487,95%CI:1.247-4.963) were protective factor to DQ delay. Conclusion It is suggested to pay more attention to influencing factors and take measures to improve the neuropsychological development of infants.

Study on the development of intelligence in preterm infants with different gestational ages

ZHOU Feng-juan, TU Si, LIU Xian, LU Jin-hua, QIU Xiu

2019, 27(4):  429-432.  DOI: 10.11852/zgetbjzz2018-08891

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Objective To analyze the intelligence development of preterm with different gestational ages,in order to provide suggestions for healthcare of premature infants. Methods A total of 2 579 children aged 6-24 months in Guangzhou Women and Children's Medical Center were enrolled in this study from February 2012 to December 2015. And the participants were divided into four groups according to gestational age,including moderate preterm (MPT) (32^+0/7-33^+6/7weeks),late preterm (LPT)(34^+0/7-36⁺⁶ weeks),early term (ET)(37^+0/7-38⁺⁶ weeks) and full-term (FT)(39^+0/7-41⁺⁶ weeks) infants. Gesell development Scale was used to assess the neurodevelopment of participants,and the difference among four groups were compared. Results Compared with those born full term,the risk of neurodevelopmental delay in MPT(OR=2.38,95%CI:1.18-4.78),LPT(OR=1.63,95%CI:1.07-2.48) and ET(OR=1.42,95%CI:1.12-1.81) infants were much higher. Conclusions Moderate,late and early preterm increase the risk of delayed neurodevelopment proportion compared with full term infants. And an inverse dose-response relationship between gestational age and risk of developmental delay is found in the tested children.

Prediction of neuropsychological development in infants by continuous brainstem evoked potential abnormalities

WANG Xiao-yan, ZHANG Ping, WANG Hong, ZHAO Zhi-wei

2019, 27(4):  433-435.  DOI: 10.11852/zgetbjzz2018-0756

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Objective To analyze the predictive validity of brainstem auditory evoked potential(BAEP) or auditory brainstem response(ABR) on neuropsychological development in infants and young children,in order to provide scientific evidence for the effect of persistent BAEP abnormality on neuropsychological development in infants aged 2 years. Methods Totally 95 premature babies born in Hubei Maternal and Child Health Hospital from June 2014 to October 2015 were selected as participants. The average gestational age was (34.3±1.7) weeks and the weight was (2.457±0.268) kg. There were 100 full-term infants with an average gestational age of (38.3±1.9) weeks with a weight of (3.457±0.328) kg. Bayley Infant Development Scale was followed up to 2 years old,and BAEP was monitored at the age of 1,3 and 6 months. The relationship between normal and abnormal BAEP results at the age of 6 months old and neuropsychological development at 2 years old was observed. Results The mental development indexes (MDI) at the age of 2 years old in preterm infants with abnormal BAEP aged 28-32 weeks,32-34 weeks,35-36 weeks and full-term infants were 80.63±5.216,83.43±3.563,86.36±7.658 and 90.12±5.658,respectively. While the MDIs at the age of 2 years old in infants with normal BEAP results in those children were 89.75±5.249,94.30±7.740,94.44±7.570 and 93.89±9.752,respectively. The differences were significant among the groups (P<0.05). Conclusion BAEP monitoring at the age of 6 months old is a sensitive index for predicting the level of neuropsychological development at 2 years old.

Analysis of influencing factors influencing the quality of general movements in infants during the period of fidgety movements

ZHOU Xue, LI Xin-xin, LI Ke-meng, JIA Fei-yong, LI Hong-hua

2019, 27(4):  436-439.  DOI: 10.11852/zgetbjzz2018-0940

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Objective To analyze the risk factors influencing the quality of general movements (GMs) in infants during the period of fidgety movements, in order to provide scientific basis for clinical treatment. Methods A total of 719 high-risk infants receiving GMs assessment from July 2015 to April 2018 and at the stage of fidgety movements were enrolled in this study, including 571 cases of normal group and 148 cases of abnormal group by GMs assessment.Data on risk factors of antenatal, intrapartum and postpartum that may affect the quality of GMs in infants were investigated and collected. Results Single factor analysis showed that the birth weight of the abnormal group was significantly lower than that of the normal group (P<0.01), while the rates of gestational age (<30 weeks), neonatal asphyxia, hypoxic ischemic encephalopathy, neonatal hyperbilirubinemia, intracranial bleeding, and neonatal convulsions of the abnormal group were significantly higher than those of the normal group(P<0.05).Bivariate Logistic regression analysis indicated that birth weight(OR=0.645,95%CI:0.474-0.878)、gestational age(<30 weeks) (OR=4.05,95%CI:1.565-10.484)、hypoxic ischemic encephalopathy (OR=3.152,95% CI:1.765-5.629)、neonatal hyperbilirubinemia (OR=5.07,95%CI:3.161-8.132)、neonatal convulsions (OR=3.579,95%CI:1.572-8.146) were influencing factors for low quality of GMs in the stage of fidgety movements. Conclusions Gestational age under 30 weeks, hypoxic ischemic encephalopathy, neonatal hyperbilirubinemia and neonatal convulsions are risk factors for abnormal GMs results in infants during the period of fidgety movements, and tow birth weight is protective factor.Early screening and intervention should be performed to the infants with such high risk factors.

Analysis on clinical characteristics and gene mutation of children with X-linked severe combined immunodeficiency

TAN Jian-qiang, YAN Ti-zhen, HUANG Jun, TANG Ning, YUAN De-jian, CAI Ren

2019, 27(4):  439-442.  DOI: 10.11852/zgetbjzz2018-1134

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Objective To analyze the gene mutations of three male children clinically diagnosed with X-linked severe combined deficiency syndrome(X-SCID), in order to provide evidence for genetic counseling and prenatal diagnosis. Methods Interleukin-2 receptor gene (IL2RG) mutation was detected by whole exome sequencing and direct sequencing in children and family members, and prenatal diagnosis was performed in one of the families. Results The mutation of c.202G>A(p.Glu68Lys)was detected in the IL2RG gene in family 1and family 2,and the mutation of c.676C > T (p.Arg226Cys) was found in IL2RG gene of family 3.The mother of the proband found the fetus as female through prenatal diagnosis, carrying the same pathogenic gene with the proband, but this couple chose to continue the pregnancy. Conclusion Totally 3 cases of X-SCID are diagnosed by IL2RG gene detection, and successful prenatal diagnosis is given to one X-SCID family, thereby giving guidance for pregnancy of family 3.

Effects of early intervention on the intellectual development of low birth weight infants and maternal emotion

GONG Jian-mei, WANG Jie, WANG Fang, ZHU Qiong, ZHANG Jin-song, PENG Yong-mei

2019, 27(4):  443-446.  DOI: 10.11852/zgetbjzz2018-1031

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Objective To analyze the effect of early intervention on the intellectual development of low birth weight infants and maternal emotion. Methods A cohort of 135 low birth weight infants and their mothers was selected from January 2016 to June 2018, and the participants were randomly divided into intervention group and control group.The control group was given routine physical examination, and the intervention group was given family intervention training additionally.At the age of 3,9,18 months old, infants received Gesell intellectual development check, and the mothers filled out the Self-rating Depression Scale (SDS) and the Self-rating Anxiety Scale (SAS) to assess their emotion status at the same time. Results At 9 months old, there were significant differences on the gross motor, adaptive behavior and the language area between intervention group and control group (t=2.514,2.32,3.266,P<0.05).And at the 18 months old, there were statistically significant on the all five major functional areas (t=2.453、3.063、2.743、2.828、2.853,P<0.05). Repeated analysis of variance showed that the time influence on five major functional areas of developmental quotient (DQ) was significant(P<0.05).And the differences on the major functional areas of DQ except the gross motor area between intervention group and control group were significant (P<0.05).There were interactions only on the language areas between the intervention effect and time.In terms of maternal emotion, SDS score of mothers in intervention group was significantly lower than that in control group at the age of 9 months old (P<0.05).The scores of SDS, SAS at the age of 3,9,18 months old in two groups showed a decreasing trend, and the time influence on the scores of SDS and SAS was significant(P<0.05), while the intervention effect was not significantly different(P>0.05). Conclusions Early intervention can promote the intellectual development of low birth weight infants, but has limited influence on improving maternal emotion to some extent.

Report of childhood cancer incidence and mortality from Anhui registries in 2014

DAI Dan, LI Rui, ZHA Zhen-qiu, CHEN Ye-ji, LIU Zhi-rong

2019, 27(4):  447-450.  DOI: 10.11852/zgetbjzz2018-0939

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Objective To analyze the incidence and mortality of childhood cancer (0-14 years old) of Anhui registries in 2014. Methods The incidence and mortality of childhood cancer from Anhui registries in 2014 were analyzed,the crude rate and standardized rate were calculated, and the difference between the urban and rural group or sex group were compared. Results The crude incidence of childhood cancer was 9.46/10⁵,incidence standardized by Chinese standard population was 8.90/10⁵ .The crude mortality of childhood cancer was 4.02/10⁵,incidence standardized by Chinese standard population was 3.87/10⁵ .The main malignant tumors in incidence and mortality were leukemia,malignant tumor of brain and central nervous system,bone cancer and lymphoma.The incidence and mortalit y of tumor in urban areas and male group were higher than those in rural areas and female group, respectively. Conclusion The prevention of leukemia,malignant tumor of brain and central nervous system,bone cancer and lymphoma need to be given more concern, and the risk factors need to be intervened to avoid the big burden of childhood cancer.

Analysis of intellectual structure in children with functional articulation disorder

GAO Tie-ying, ZHAO Chan-juan, HAO Shu-hong

2019, 27(4):  451-453.  DOI: 10.11852/zgetbjzz2018-0505

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Objective To understand the development of intellectual structure in children with functional articulation disorder(FAD)and to research the basis for their Comprehensive rehabilitation of cognitive function. Methods A total of 30 children with FAD diagnosed in Dalian Children's Hospital and 30 normal children were tested by the Peabody picture vocabulary testl(PPVT) and the Neuropsychological Development Scale for 0-6-year-old children in the first half of 2017.To compare the children's language IQ and developmental quotient (DQ), their abilities of gross & fine movement, their language level, their adaptability and social communication with each other. Results The development of fine movement & language and adaptability of children with FAD were much inferior to normal children (t=5.241,4.100,3.256,P<0.05). The development of gross movement and social communication in FAD group were in accordance with the normal control(t=1.594,2.058,P>0.05).In the comparison of five abilities , the development of fine movement and adaptive ability of children with FAD were also lagging behind the gross movement and social communication of their own. The above differences were statistically significant (t=-2.847,-2.794,-4.268,-2.398,P<0.05) . Conclusions The intellectual structure of children with FAD may have developmental imbalance. It is necessary to assess their development level as early as possible in order to help their overall recovery.

Analysis of hearing screening results of 268 187 newborns in Jiaxing from 2013 to 2017

SUN Xiao-yan, DING Jie, ZHANG Ying, XU Yan

2019, 27(4):  453-456.  DOI: 10.11852/zgetbjzz2018-0999

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Objective To analyze the hearing screening results of newborns in Jiaxing, in order to provide scientific reference for early diagnosis, intervention and treatment. Methods All newborns in Jiaxing who have performed hearing screening were selected in this study from January 2013 to December 2017.The relevant data were collected through screening institutions, maternal and child health institutions in city (county) district and city-level newborn hearing screening management center.Transient evoked otoacoustic emissions (TEOAE) and automatic auditory brainstem response (AABR) were used to screen high-risk neonates.Those who did not pass the test were screened again at the age of one month old.Those who had abnormal re-screening results were assessed by auditory brainstem response (ABR) in time. Results There were totally 268 187 live births in the five years from 2013 to 2017,among which 266 802 newborns were screened for hearing loss.The initial screening rate was 99.48% (266 802/268 187), and the failure rate was 8.91% (23 776/268 187).The actual re-screening rate was 94.89% (22 561/23 776), 2 269 cases should be referred, 2 167 cases received audiological diagnosis actually, and finally the referral rate was 95.50% (2 167/2 269).Totally 715 cases were diagnosed with hearing loss, and the detection rate of hearing loss was 2.68 ‰, of which 202 cases were mild, moderate, severe and extremely severe hearing loss cases were 202,372,127 and 57,respectively. Conclusion The rate of primary screening, re-screening and referral of newborn hearing screening in Jiaxing city is gradually increasing, which is of great help to the early diagnosis, follow-up and intervention of hearing impairment in infants.

Effect of mesh intensive suspension training on gross motor function in children with developmental delay

ZHANG Yi-wen, CAO Jian-guo, GUO Jin, YUN Guo-jun, LIU Qing, DAI Meng-ying

2019, 27(4):  457-460.  DOI: 10.11852/zgetbjzz2018-0889

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Objective To investigate the effect of mesh intensive suspension training on gross motor function in children with developmental delay,in order to provide new ideas for early intervention in clinical. Methods Totally 50 children with developmental delay in the Affiliated Hospital of Jiamusi University were randomly divided into control group and treatment group 25 children in each group from June 2017 to June 2018. The control group was given routine rehabilitation,while the treatment group received mesh intensive suspension training for three months additionally.The gross motor function was assessed through Alberta Infant Motor Scale(AIMS) and Peabody Developmental Measure Scale-Gross Motor(PDMS-GM). Results The scores of gross motor function in control group and treatment group significantly increased (AIMS:t=-2.983,-7.157,P<0.05;PDMS-GM:t=-2.733,-6.517,P<0.05),and the gross motor function in treatment group improved more obviously (AIMS:t=-2.400,PDMS-GM:t=-6.099,P<0.05). Conclusion The mesh intensive suspension training combined with routine rehabilitation training can effectively improve the gross motor function in children with developmental delay.