Table of Content

10 November 2019, Volume 27 Issue 11

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Longitudinal cohort study on the correlation between growth rate and obesity risk of small for gestational age infants

WU Dan, WANG Xiu-lian, HUO Yan-yan, GUO Qian-wen, SUN Fan-fan, LIU Mei-yan, CHEN Jin-jin

2019, 27(11):  1163-1166.  DOI: 10.11852/zgetbjzz2018-1752

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Objective To explore the correlation between growth rate of small for gestational age(SGA) infants and the risk of obesity in school-age children by longitudinal cohort study,so as to provide theoretical basis for making corresponding prevention and control measures. Methods A cohort study including 2 079 SGA infants was conducted from 2004 to 2011,who were followed up to 6 years old from birth.Height,weight and head circumference of SGA infants were measured,and their physical conditions were assessed by the World Health Organization (WHO) standards. Results According to Z score (ΔWAZ) of body weight change in the first four months after birth,the participants were divided into 4 groups,including slow growth rate (ΔWAZ<-0.67),moderate growth rate (ΔWAZ-0.67-0.67),rapid growth rate (ΔWAZ 0.67-1.28),and extremely rapid growth rate (ΔWAZ＞1.28).The overweight and obesity risks increased with the increasing of growth rate.Compared with children with moderate growth rate,the risk of overweight and obesity in rapid growth rate and extremely rapid growth rate groups were 11.91 times and 2.34 times higher than those in the moderate growth rate group,respectively(OR=11.91,95%CI:9.04-15.76,P<0.001;OR=2.34,95%CI:1.80-3.03,P<0.001).And the risk for emaciation significantly increased in slow growth rate group(OR=2.48,95%CI:1.81-3.39,P<0.001).However,the extremely rapid growth rate could not reduce the risk for emaciation/growth retardation(OR=0.68,95%CI:0.48-0.95,P>0.05). Conclusions Rapid growth rate of SGA infants will increase the risk of overweight and obesity in school-age children significantly.Early monitoring of physical development of SGA infants should be thought highly of,so that whether the growth rate of SGA children is too fast could be determined as early as possible.Thus,related prevention strategies could be made,thereby reducing the long-term risk of adverse metabolism associated with excessive growth.

Association between screen time and left ventricular hypertrophy in childhood

WANG Ming-ming, ZHANG Yan-qing, ZHANG Yun-fei, ZHANG Qian, ZHAO Min, XI Bo

2019, 27(11):  1167-1170.  DOI: 10.11852/zgetbjzz2019-0103

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Objective To examine the association between screen time and left ventricular hypertrophy (LVH) among children,so as to provide evidence for the prevention of LVH. Methods A convenience cluster sampling method was adopted from Nov.2017 to Jan. 2018,and totally 1 319 students aged 6-11 years from an elementary school in Huantai county,Zibo city were recruited.The participants filled out questionnaires,conducted anthropometric and ultrasonography test.LVH was defined as left ventricular mass index (LVMI) ≥90th (P₉₀) percentile values by age and sex of the present population.Multiple Logistic regression model was used to examine the association between screen time and LVH in children. Results The average screen time for weekdays,weekend days and all days were (0.42±0.65)h/d,(1.83±1.32)h/d and (0.83±0.71)h/d,respectively.The proportions of children with average screen time over 2 h/d for weekdays,weekend days and all days were 0.6% (8/1 319),23.4% (308/1 319) and 4.6%(61/1 319),respectively.Logistic regression analysis showed that after controlling sex,age,consumption of vegetables and fruits,and carbonated drinks,physical activity,sleep duration and blood pressure,compared with children with screen time less than 2 h/d,those with screen time over 2 h/d had increased risk of LVH (OR=2.16,95%CI:1.08-4.32,P=0.03).After additional adjustment for body mass index (BMI),the significant association disappeared (OR=1.45,95%CI:0.63-3.33,P=0.388).However,there were no significant differences on the association between screen time on weekdays and weekend days and risk of LVH (P>0.05). Conclusion Screen time over 2 h/d is associated with increased risk of LVH in childhood,and BMI may play a mediating effect on the association between screen time and LVH risk.

Effect of unhealthy eating behavior and dietary patterns on body mass index among preschool children

SU Ting-juan, CHEN Rui-mei, ZUO Xiao-yu, CHEN Qiu, TAO Fang-biao, ZHANG Jing-li

2019, 27(11):  1171-1174.  DOI: 10.11852/zgetbjzz2018-1706

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Objective To analyze the rate of unhealthy dietary patterns and eating behavior in preschool children in Yangzhou,and to explore the effect on children′s body mass index(BMI). Methods Totally 2 531 preschool children from 7 nurseries in Yangzhou were enrolled in this study from April to May, 2015,and were assessed by questionnaire survey to collect basic information,dietary patterns and eating behaviors of children over the past week. Results The rate of unhealthy dietary patterns was 7.8%,and the rate of picky eating was the highest (25.2%,637/2 531) among unhealthy eating behaviors,followed by fast eating (18.8%,477/2 531).Moreover,the rates of picky eating and fast eating in boys were significantly higher than those in girls(picky eating:27.5% vs. 22.5%,fast eating:20.9% vs. 16.5%,P<0.05). Multivariate Logistic regression analysis found that preference to salty food(OR=2.05,95%CI:1.26—3.34) and greasy food(OR=1.96,95%CI:1.22—3.16) were risk factors and slow eating(OR=0.31,95%CI:0.23—0.42) was a protective factor for childhood obesity(P＜0.001). However,there was no significant difference on the body weight in preschool children with different dietary patterns(P＞0.05). Conclusions Unhealthy eating behaviors and dietary patterns are prevalent among preschool children in Yangzhou,and unhealthy eating behaviors are related to children′s obesity. So it is suggested to take comprehensive intervention measures,such as controlling family′s unhealthy eating behavior,so as to reduce childhood overweight and obesity.

Study on the relationship between serum Hcy and the risk of diabetes mellitus and cardiovascular disease in simple obese children

CHEN Wei, HE Tao

2019, 27(11):  1175-1178.  DOI: 10.11852/zgetbjzz2018-1677

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Objectives To investigate the relationship between serum Hcy and the risk of diabetes mellitus and cardiovascular disease in simple obese children,in order to provide reference for clinical diagnosis and treatment of simple obesity in chidren. Methods Totally 53 simple obese children who visited in Shenzhen children′s Hospital were enrolled in obesity group from August 2016 to December 2017,and 82 healthy children who underwent physical examination in this hospital during the same period were selected as normal group. Serum homocysteine(Hcy) level was determined by chemiluminescence. Height,weight,hip circumference,waist circumference,body mass index(BMI),waist-hip ratio(WHR),total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),fasting blood glucose(FBG) and fasting insulin(FINS) were measured,and insulin secretion function index(HOMA-β),homeostasis model insulin resistance index(HOMA-IR) were calculated. Also,the correlation between Hcy and other indicators was analyzed. Results The level of serum Hcy in obesity group was significantly higher than that in normal group(t=3.136,P<0.05). There was no significant difference in height between the two groups(P>0.05),while the body weight,hip circumference,waist circumference,BMI and WHR in obesity group were higher than those of the normal group(P<0.05). Moreover,the levles of FBG,FINS and HOMA-IR in simple obese children were significantly higher than those of normal group,while the level of HOMA-β was significantly lower in simple obese children(P<0.05). Serum Hcy level was positively correlated with BMI,WHR,FBG,FINS,HOMA-IR,TG,TC and LDL-C levels(r=0.473—0.732,P< 0.05),and negatively related to HOMA-beta and HDL-C levels(r=-0.774,-0.725,P<0.05). Conclusion Serum homocysteine level is increasing in simple obese children,which is closely correlated with diabetes mellitus and cardiovascular disease.So it is suggested that serum homocysteine level should be monitored regularly in simple obese children.

Evaluation and revision of School-age Children′s Eating Behavior Scale based on the generalizability theory

ZHANG Hao, TANG Qing-xia, JIANG Xun, YUAN Jing, XU Tong, SHANG Lei

2019, 27(11):  1179-1182.  DOI: 10.11852/zgetbjzz2019-0325

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Objective To reassess the reliability of the School-age Children′s Eating Behavior Scale developed by the research group by the generalizability theory,and then to revise the original scale. Methods Totally 700 parents of children aged 6 to 12 years were randomly selected from two primary schools in urban and suburb of Xi′an from March to June 2018,and were asked to filled out School-age Children′s Eating Behavior Scale.Then the scale was evaluated and revised based on generalizability theory. Results The generalized coefficients of the 8 dimensions were 0.74-0.85,and the reliability indexes were 0.73-0.84,which were greater than 0.70 and reaching the good level.The performance of dimensions of ill-balanced eating,food responsiveness,satiety responsiveness,craving for junk food were relatively good,while those of worse eating habit,external factor eating,dietary restriction,food preference were relatively worse.According to experts and GT analysis results,the final revision scale,including 46 items and 8 dimensions,had good reliability and validity. Conclusions The School-age Children′s Eating Behavior Scale revised and improved based on the generalizability theory,is prove to be of good test accuracy and reliability.Therefore,it could be used to measure and evaluate the eating behaviors of school-age children in China.

Analysis of the status and related factors for complementary feeding of 6 to 23-month-old infants in Xinjiang

ZHANG Hui, ZHANG Hong, CHEN Hui, DONG Ju

2019, 27(11):  1183-1187.  DOI: 10.11852/zgetbjzz2018-1623

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Objective To understand the status and related factors for complementary feeding of 6 to 23-month-old infants in Xinjiang,in order to provide relevant basis for scientific feeding of infants. Methods A stratified multi-stage sampling method was used to investigate infants aged 6 to 23 months old and main caregivers from Hotan Prefecture and Kashgar area in southern Xinjiang and Changji Hui Autonomous Prefecture in Northern Xinjiang from July 2017 to May 2018. Results 1) The pass rate of minimum diet diversity(MDD) was 63.22%(887/1 403),the pass rate of minimum meal frequency(MMF) was 57.95%(813/1 403),and the pass rate of minimum acceptable diet(MAD) was 42.69%(599/1 403). The eligible rates of MDD,MMF and MAD in urban infants aged 6 to 11 months old were lower than those in rural infants(P<0.05). The eligible rates of MDD and MAD in urban infants aged 12 to 17 months were significantly higher than those in rural infants(P<0.05),and the eligible rates of MMF and MAD in urban infants aged 18 to 23 months were significantly higher than those in rural infants(P<0.05). 2) The unqualified MMF of infants and young children in northern Xinjiang was 1.947 times higher than that in southern Xinjiang. The unqualified MMF of children with normal weight was 2.715 times higher than that in children with low birth weight. The unqualified MDD and unqualified MAD of families with children more than three were 1.709 and 1.571 times higher than those of families with children not more than two. Conclusions The eligible rate of MDD,MMF and MAD of 6 to 23-month-old infants in Xinjiang is relatively low. Infants living in the northern Xinjiang,with normal birth weight and with siblings more than two are high-risk population for unqualified feeding. It is suggested that health education and correct guidance on infant feeding should be given and strengthened,caregivers′ feeding habits and behaviors should be changed,thereby improving the status of infant feeding.

Analysis of the current status and influencing factors for eating behavior characteristicsof preschool children in Xincheng district of Xi′an community

TAN Jiao, ZHENG Xing-rong, MA Yong-hong, SHI Ming-juan, LEI Jing, SONG Zhen-zhong

2019, 27(11):  1188-1191.  DOI: 10.11852/zgetbjzz2019-0606

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Objectives To investigate the characteristics of unhealthy eating behaviors of preschool children in Xi′an,and to systematically analyze the influencing factors,so as to provide basis for regulating good eating behavior and promoting reasonable diet for preschool children. Methods A total of 306 preschool children were selected in 6 community health service centers from August to December 2017,and were investigated by the Preschool Children′s Dietary Behavior Scale with high reliability and validity.The influencing factors for eating behaviors of children were analyzed by multiple linear regression method. Results The most common unhealthy eating behaviors of preschool children in Xi′an community included picky eating,active eating ability,poor eating habits and so on.There were significant differences on picky eating,poor eating habits and satiety response scores between boys and girls (t=3.650,2.024,3.707,P<0.05).The main caregivers and their educational backgrounds had significant effects on picky eating behavior of preschool children (F=3.126,P=0.026).The score of active eating ability in children whose caregivers had different health conditions was significantly different (F=5.052,P=0.007).Also,significant difference existed on the scores of picky eating behavior and bad eating habits of preschool children with different family members (t=6.442,3.515,P<0.05).Multiple linear regression method indicated that influencing factors for eating behavior of preschool children included the only child,the number of resident population in family,body mass index and education background of caregivers. Conclusion The key interventions for developing healthy eating behaviors and promoting physical and mental health include strengthening the establishment of the knowledge and the concept of health support for the caregivers,unifying parenting concept of the family members,and reducing the bad eating habits of obese/overweight children.

Research progress on motor development in infants with prenatal iron deficiency

LI Ming-yan, ZHAO Zheng-yan

2019, 27(11):  1192-1195.  DOI: 10.11852/zgetbjzz2019-0158

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Iron deficiency (ID) and iron deficiency anemia (IDA) are the most common nutrient deficiency worldwide.Pregnant women and infants are the high-risk population of ID.Maternal ID,to a certain extent,may affect fetal/neonatal iron status.ID in early life affects motor development of individual mainly through alteration of myelination,striatal and dopamine neurotransmitter system.Early postnatal iron supplementation can correct ID in circulation and tissue,but can not completely reverse the behavioral changes caused by ID during pregnancy.Therefore,it is of great significance to further study the effect of prenatal ID and its reversibility on motor development in infancy,and to clarify the critical time window of iron therapy for improving children′s quality of life and long-term prognosis.

Progress on the developmental physiology of digestive system in children

XU Xiao-fei, CHEN Hui-ping, YANG Ji-guo

2019, 27(11):  1196-1200.  DOI: 10.11852/zgetbjzz2019-0285

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The requirements of nutrients for children are different from adults′,and the digestive functions in children are immature.In the present review,the progress on developmental physiology of children in digestive system related to oral,gastric motility,and enzymes secretions were summarized.The main features include a higher pH in gastric fluid,a lower enzymes output and activities in secretions in stomach and pancreas,a slower gastric empty rate and intestinal motility,and the immature of intestinal barrier than those in adults.This review aims to provide knowledge for health care,nutrients supply,development of food and in vitro digestive models for children,thereby proposing future directions in related fields.

Correlations among lactose intolerance,calcium intake and bone health

WU Hai-lin, ZHAN Xue

2019, 27(11):  1201-1203.  DOI: 10.11852/zgetbjzz2019-0099

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Lactose intolerance is considered to be concerned with calcium intake and bone health.It is generally believed that lactose intolerance can reduce calcium intake,but its effect on calcium absorption rate is still controversial.Lactose appears to be an important factor of calcium absorption among lactose intolerant populations,and different doses of lactose in earlier study designs may also be responsible for different results.In recent decades,lactase related gene types have been found to be an important factor affecting calcium intake and bone health.However,being limited by knowledge and technology,the heterogeneity among previous studies is large,which contributes to the contradictory data aggregation in related studies.So more reliable and larger samples of control studies are warranted in order to explore the correlation among lactose intolerance,calcium intake and bone health.

Research progress on vitamin A in breast milk

DENG Jing, LI Ting-yu

2019, 27(11):  1204-1207.  DOI: 10.11852/zgetbjzz2019-0106

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Vitamin A (VA) is an essential micronutrient,which plays an important role in epithelial integrity,visual development,immunity,reproductive function,growth and development as well as brain development.Although the public health policy of supplementing VA has been widely implemented,vitamin A deficiency (VAD) remains a significant public health concern in developing countries worldwide.For exclusively breastfed infants,breast milk is the only source of VA intake.However,there are currently some controversies about the level of VA in breast milk,whether it meets the needs of infants,and how to supplement vitamin AD in clinic.Therefore,it is important to know the level of VA in breast milk,the factors affecting VA level in breast milk and the reasonable supplementary dose of VA.To this end,this paper reviews the research progress on VA research in breast milk.

Research progress on influencing factors of body composition in children and adolescents

LI Hui-yi, YANG Shu-fen

2019, 27(11):  1208-1210.  DOI: 10.11852/zgetbjzz2018-1767

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Childhood and adolescence are the key period of an individual′s bodybuilding. Having a good physical condition at this stage lays the foundation for the whole life. Many factors,such as environment,behavior and so on,can affect the growth development of children and adolescents. So it is important to clarify the role of these factors in the process of children′s and adolescents′ composition forming. This review summarizes the effects of age and sex,physical activity,sleep,sedentary behavior,maternal nutrition status during pregnancy and feeding patterns on their body composition.

Analysis of the influencing factors for anemia of infants and young children aged 6 to 23 months in Yingyangbao intervention areas

WANG Ou, WANG Li-juan, HUANG Jian, HUO Jun-sheng, SUN Jing

2019, 27(11):  1211-1214.  DOI: 10.11852/zgetbjzz2018-1691

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Objective To analyze the influencing factors of anemia among infants and young children in complementary food supplement(Yingyangbao,YYB) intervention areas,so as to provide scientific reference for the improvement of anemia. Methods A total of 19 522 infants and young children aged 6 to 23 months were selected in this study in 2015 by multistage sampling,probability proportional to size sampling and random equidistant sampling methods from the YYB intervention areas. Anemia was determined by hemoglobin measurement. Information about caregivers,nutrition knowledge,YYB intake situation and feeding during the last 24 hours were investigated by questionnaire. The indicators to assess feeding practice were calculated. Multi non-conditional Logistic regression model was used to analyze factors associated with anemia. Results The anemia rate of surveyed children was 30.0%(5 883/19 552). In the non-anemic group,about 81.9% of the infant caregivers received junior high school education or above,and the nutritional knowledge accuracy rate was 42.4%,which were both significantly higher than those of the anemic group(P<0.05). For the non-anemic infants and young children,the duration of YYB intake was approximately(7.37±4.76) months,which was significantly longer than that of the anemic group. Besides,the minimum dietary diversity rate,the minimum meal frequency rate and the minimum acceptable diet rate were 69.2%,68.0% and 41.9%,respectively,significantly better than those of the anemic children. Logistic regression analysis showed that infants′ gender(OR= 0.918,95% CI:0.856-0.985,P=0.017),age(OR=0.947,95%CI:0.936-0.958,P＜0.001),education level of caregivers(OR=0.772,95%CI:0.742-0.804,P＜0.001),correct nutrition knowledge(OR=0.995,95%CI:0.993-0.997,P＜0.001),minimum dietary diversity(OR=1.128,95%CI:1.044-1.219,P=0.002),minimum dietary frequency(OR=0.984,95%CI:0.973-0.995,P＜0.005),and YYB intake duration(OR=0.984,95%CI:0.973-0.995,P＜0.001) were all associated factors with anemia. Conclusion Continuous and effective YYB intake,popularization of nutrition knowledge and improvement of education and feeding practice would contribute to control the prevalence of anemia among infants and young children in poor areas of China.

Cross-sectional study on serum vitamin A level in children aged 0 to 16 years in different ages

ZHANG Xu-guang, CHEN Yan-ping, CHEN Dong-kai, ZHANG Dong-mei, LIU Li, JING Hong, HOU Shao-ying

2019, 27(11):  1215-1218.  DOI: 10.11852/zgetbjzz2018-1314

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Objective To investigate vitamin A level of children,in order to provide theoretical basis for scientific supplement of vitamin A. Methods A cross-sectional study was conducted. Totally 3 163 individuals aged 0 to 16 years who took physical examination in Child Care Clinic of Harbin Children′s Hospital from September,2017 to August,2018 were enrolled in this study. Information of participants such as gender and age were recorded. Serum level of vitamin A was determined by high performance liquid chromatography. Results The average level of serum vitamin A was(0.30±0.08) mg/L for all participants,and were(0.20±0.04),(0.23±0.04),(0.33±0.06),(0.30±0.05),(0.35±0.06)mg/L and(0.44±0.08) mg/L for 0—,0.5—,1—,3—,6— and 6—12 years old groups,respectively. The overall incidences of vitamin A abnormal in children aged over 6 months were 52.2%(1 572/3 012),in which the incidence of vitamin A deficiency and insufficiency were 5.7 %(172/3 012) and 46.5%(1 400/3 012),respectively. The prevalence of abnormal level of vitamin A was 98.8 % in children more than 6 months old. There was significant difference on the rate of abnormal level of vitamin A among children in different age groups(χ²=998.70,P＜0.001). Conclusion Vitamin A malnutrition is still a serious public health problem and more attention is supposed to be paid to children with high rate of vitamin A deficiency and insufficiency.

Analysis of the current status and related factors for anemia among students in Ningxia Hui and Han Nationality

WANG Jun-yi, SONG Yi, HU Pei-jin, ZHANG Bing, DONG Bin, MA Jun

2019, 27(11):  1219-1222.  DOI: 10.11852/zgetbjzz2018-1425

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Objective To explore the ethnic differences and influencing factors of anemia in primary and middle school students in Ningxia,in order to provide a straightforward basis for improving the intervention policies and measures for anemia in Ningxia students. Method A stratified random cluster sampling method was used to select 3 747 students from the four age groups(7,9,12 and 14 years old) of Ningxia Hui and Han nationality as participants. Results The prevalence of total anemia among primary and middle school students in Ningxia was 8.1%. And the prevalence of anemia among Hui was 8.7%(140/1 615),slightly higher than that of Han(7.7%,165/2 132)(χ²=1.06,P=0.01). The detection rates of mild and moderate/severe anemia among Hui students were 7.2% and 1.4%,respectively,while 6.4% and 1.3% in Han students. The prevalence of anemia was higher in Han students at younger age group. Logistic regression analysis demonstrated that age(9 years old OR=0.53,95%CI:0.33-0.85;12 years old OR=0.51,95%CI:0.32-0.82),malnutrition(OR=0.63,95%CI=0.45-0.87) were related to anemia in Han students. While gender(OR=1.65,95%CI:1.15-2.36) and age(9 years old OR=0.35,95%CI:0.21-0.58;12 years old OR=0.54,95%CI:0.32-0.92) were correlated with anemia in Hui students(P<0.05). Interaction analysis found that there were interaction effects between ethnicity and gender,areas,as well as age(P＜0.05). Conclusions To formulate measures for prevention and treatment of anemia according to different ethnic differences between Hui and Han,it is recommended to increase the iron-rich foods intake in the diet of Hui students. Moreover,more attention should be paid to gender and urban-rural differences on anemia, so as to improve the health status of Ningxia Hui and Han students.

Clinical value of N-terminal pro-brain natriuretic peptide and cardiac troponin Ⅰ in evaluatingthe prognosis of neonatal respiratory distress syndrome

WU Ting-ting, HE Qiao-feng, CAO Ling

2019, 27(11):  1223-1227.  DOI: 10.11852/zgetbjzz2019-0641

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Objective To explore the clinical value of N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin Ⅰ(cTnⅠ) in evaluating the prognosis of neonatal respiratory distress syndrome (NRDS),in order to provide reference for clinical practice. Methods Totally 110 children with NRDS hospitalized in Yulin First Hospital from April 2015 to April 2018 were enrolled in this study as the case group,and 60 infants without NRDS in the meantime were selected as control.Children with NRDS were divided into survival group and death group according to the prognosis.Differences on general clinical data among each group were compared.Logistic regression equation was used to analyze the relationship between the death of NRDS children and the levels of NT-proBNP and cTnⅠ.And ROC curve was used to evaluate the predictive value of NRDS. Results Plasma levels of NT-proBNP and cTnⅠ in case group were significantly higher than those in control group(t=24.329,51.075,P＜0.05).Compared with survival group,birth weight,oxygen index (PaO₂/FiO₂) were lower and the levels of creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) were significantly higher in the death group(P＜0.05).Plasma levels of NT-proBNP and cTnⅠ in death group were significantly higher than those in survival group (P<0.05).NT-proBNP and cTnⅠ levels in children with grade Ⅳ NRDS were significantly higher than those in children with grade Ⅰ-Ⅲ NRDS,so was in grade Ⅲ NRDS than those in grade Ⅰ-Ⅱ NRDS (P<0.05).Spearman rank correlation analysis indicated that the levels of NT-proBNP and cTnⅠ were positively correlated with NRDS severity respectively (r=0.329,0.287,P<0.05).Multiple Logistic regression equation suggested that NT-proBNP (OR=3.115,95%CI:2.249-7.184) and cTnⅠ(OR=2.376,95%CI:1.582-6.110) were risk factors of death (P<0.05).The area under ROC curve of NT-proBNP and cTnⅠ in predicting death of NRDS children was 0.769 and 0.691,respectively.The area under the ROC curve predicted by the two groups was significantly higher than that predicted by the two groups alone (Z=2.854,P<0.05). Conclusions The levels of NT-proBNP and cTnⅠ are positively correlated with the severity of NRDS,which may be risk factors for the death of NRDS children.Moreover,the combined detection of NT-proBNP and cTnⅠ levels has a high clinical value in predicting the prognosis.

Dose- and time-effect relationship of recombinant human growth hormone on growth velocity and bone age in preadolescent children with idiopathic short stature

PENG Yan-song, ZOU Fu-rong

2019, 27(11):  1228-1231.  DOI: 10.11852/zgetbjzz2018-1526

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Objectives To explore the dose-time effect of recombinant human growth hormone(rhGH) on growth velocity(GV) and bone age(BA) in preadolescent children with idiopathic short stature(ISS),in order to provide guidance of rational rhGH use in treating ISS. Methods A total of 108 preadolescent children with ISS were enrolled in this study from January 2011 to June 2016,and were randomly divided into three groups,including low-dose rhGH group [0.12 U/(kg·d),n=36],middle-dose rhGH group [0.18 U/(kg·d),n=36] and high-dose rhGH group [0.24 U/(kg·d),n=36]. All children were given rhGH by subcutaneous injection before sleep every day for 2 years. The chronological age(CA),height(Ht),GV,BA,predicted adult height(PAH) and height standard deviation score(HtSDS) of the children before and after treatment were evaluated. Results At 6,12,18 and 24 months after rhGH treatment,the BA of the three groups significantly increased(P<0.05),while the BA/CA showed no significant changes among three groups(P>0.05),and there were no significant differences on BA and BA/CA among three groups(P>0.05). The Ht,GV,PAH and HtSDS of the three groups at 6,12,18 and 24 months after rhGH treatment were significantly higher than those before treatment(P<0.05),the Ht,PAH and HtSDS all gradually increased with time,and the GV reached the peak at 6 months. The Ht,GV,PAH and HtSDS in the middle-dose and high-dose rhGH groups were significantly higher than those in the low-dose rhGH group at all time points(P<0.05),while the GV in high-dose rhGH group was significantly higher than that in the middle-dose rhGH group only at 6 months after treatment(P<0.05). The rates of adverse reaction in three groups were 2.78%,2.78% and 8.33%,respectively,and there was no significant difference among three groups(P>0.05). In high-dose rhGH group,thyroid-stimulating hormone(TSH) level in one case increased,and relieved after treatment with levothyroxine. Conclusions To a certain degree,rhGH is effective in promoting GV growth for preadolescent children with ISS. There may be dose- and time- dependence manner in short-term catch-up growth,and it has little influence on the growth potential of children. However,excessive doses may not be significantly synergistic,and long-term medication may have a risk of thyroid dysfunction.

Association between interleukin-8 gene polymorphism and occurrence and development of acute bronchitis induced by respiratory syncytial virus

DU Lin-bo, WANG Hong-bing, LIAO Fan-da, LIU Dan-hong, WANG Xuan

2019, 27(11):  1232-1235.  DOI: 10.11852/zgetbjzz2018-1045

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Objective To investigate the association between interleukin-8 gene polymorphism and occurrence and development of acute bronchitis induced by respiratory syncytial virus,in order to provide scientific reference for predicting the development of acute bronchitis. Methods Totally 80 children with acute bronchitis induced by respiratory syncytial virus(case group) and 30 healthy children (control group) who underwent physical examination were selected as the participants from March to September in 2017.According to the severity of the disease,children in case group were divided into mild group (n=52) and moderate to severe group (n=28).The expression of IL-8 in three groups was tested by enzyme linked immunosorbent assay (ELISA),and the genotype frequencies of-251 and 781 polymorphic loci of three groups of IL-8 genes were measured by PCR-RFLP. Results The serum expression of IL-8 in control group [(4.35±0.84)pg/ml] was lower than that in the other two groups.The expression of IL-8 in mild group was lower than that in moderate and severe group [(7.63±1.31)pg/ml vs.(10.22±1.85)pg/ml,P<0.05)].The AA genotype frequency of IL-8 gene-251 locus in control group (6.67%) was lower than that in the other two cases (23.08%,28.57%) (P<0.05).Likewise,the frequency of allele A of IL-8 gene-251 locus in control group (33.33%) was lower than that in the other two groups (51.92%,55.38%) (P<0.05).Linkage analysis indicated that the A allele of the IL-8 gene-251 loci was closely linked to the 781 locus C allele,and the common AC haplotype was associated with the susceptibility to acute bronchitis caused by respiratory syncytial virus and the severity of the disease. Conclusion The AC haplotype of-251 and 781 loci of IL-8 gene is associated with the occurrence and development of acute bronchitis induced by respiratory syncytial virus.

Analysis of the influencing factors of breast milk expression and investigation on maternal-infantile satisfaction

WAN Yan-Nan, CHENG Qian

2019, 27(11):  1236-1239.  DOI: 10.11852/zgetbjzz2018-1502

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Objective To know about the breastfeeding patterns of infants within 1 year old,and to investigate its influencing factors and maternal-infantile satisfaction,so as to provide scientific evidence for promoting breastfeeding. Methods Infants under one year old receiving breastfeeding in the Department of Child Health Care,Children′s Hospital of Chongqing Medical University were enrolled in this study from July to August in 2018.And a self-designed questionnaire and the Maternal Breastfeeding Evaluation Scale were filled out by mothers of infants.The current situation and influencing factors of breast milk expression,as well as maternal-infantile satisfaction under different breastfeeding patterns were analyzed. Results Totally 240 valid questionnaires were collected.And 95(39.6%) were totally or partially fed by expressed breastmilk,among which 82.1% were due to working factors.Also,39.6% of 240 participants were in support of breast milk expression,while 13.3% were against,and 47.1% thought that direct feeding and breast milk expression were both acceptable.Mothers with longer time for commuting (OR=1.893,95%CI:1.139-3.146),and with less involvement in infant care (OR=0.256,95%CI:0.112-0.583) were more likely to choose breast milk expression.There were no significant differences on the total score and the score of three subscales of Maternal Breastfeeding Evaluation Scale between direct feeding group and breast milk expression group(P＞0.05). Conclusions Breast milk expression is common and is widely supported by lactating women.Returning to work is the main reason for breast milk expression.And feeding infants expressed breast milk does not impact maternal-infantile satisfaction.

Analysis on the influencing factors of infantile eczema

ZHOU Qin, GU Gui-xiong, YE Kan, SONG Yuan, KONG Rui, LI Bei-quan

2019, 27(11):  1240-1242.  DOI: 10.11852/zgetbjzz2017-0780

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Objective To understand the present situation of infantile eczema,and to explore the influencing factors of infantile eczema. Methods According to the principle of "informed consent and voluntary",a total of 1 135 infants,at the age of 1 month,6 months and 12 months,were selected randomly from Suzhou Municipal Hospital from March to September 2016.The questionnaires were conducted to infants′ parents,recording the potential related factors of infantile eczema.Chi-square test and Logistic regression analysis were used to analyze the related factors of infantile eczema. Results 1) The prevalence rates of infantile eczema at the age of 1 month,6 months and 12 months old were 59.1%,41.7% and 19.8% respectively with significant difference(P<0.05).2) Single factor analysis showed that infantile eczema was related to feeding pattern,baby care products and outdoor activity time (P＜0.05).Logistic regression analysis showed that artificial feeding (OR=2.695,95% CI:1.826-3.976) and mixed feeding (OR=1.530,95% CI:1.179-1.986) were risk factors of infantile eczema(P<0.01).Outdoor activities for 1 to 2 hours (OR=0.475,95% CI:0.343-0.658),outdoor activities for more than 2 hours (OR=0.273,95% CI:0.162-0.460) and the use of baby care products (OR=0.755,95% CI:0.592-0.964) were protective factors of infantile eczema(P<0.05). Conclusions 1) The prevalence of infantile eczema decreases with age,and the balance of Th1/Th2 tends to ease eczema.2) Breastfeeding,appropriate outdoor activities and usage of proper baby care products may reduce the occurrence of infantile eczema.

Comparative study on nutrition-related indicators in preterm infants with different follow-up    patterns from 6 to 12 months after birth

LYU Kui-lin, YU Xiu-mei, YANG Zhang-ya, YANG Wang, ZHANG Yu-ping

2019, 27(11):  1243-1246.  DOI: 10.11852/zgetbjzz2019-0282

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Objective To monitor serum 25-hydroxyvitamin D₃ [25-(OH)D₃],calcium(Ca),phosphorus (P),alkaline phosphatase (ALP),urea(UREA),prealbumin (PA) of regular and irregular follow-up model of premature infants from corrected age of 6 to 12 months after birth,so as to explore the effect of two follow-up models on nutritional status of premature infants and the safety. Methods A retrospective analysis of 143 premature infants in the Second Affiliated Hospital of Army Medical University from January 2015 to December 2017 was conducted.Totally 79 premature infants undergoing regular follow-up were assigned to group A,and 64 premature infants undergoing unscheduled follow-up were selected as group B.In the meantime,253 full-term healthy infants followed up in the pediatric care clinic were assigned to group C.Serum level of 25-(OH)D₃, Ca,ALP,P,UREA and PA were tested at the corrected age of 6 months to 12 months. Results 1) Serum 25-(OH) D₃,Ca and PA in group A and group C of premature infants were significantly higher than those in group B (P<0.05).Serum 25-(OH) D₃ in group A was significantly higher than that in group C (P<0.05).But there were no significant differences on serum ALP,P and UREA among group A,B and C.2) There were no poisoning cases of 25-(OH)D₃ in three groups.The most suitable 25-(OH)D₃ levels were found in group A and the least in group B. Conclusion 1) The incidence rates of serum 25-(OH)D₃ deficiency and hypoprealbuminemia are lower in preterm infants regularly followed up and fed according to the recommendation of child care.2) The feeding scheme for premature infants is supposed to be individualized.3) Some nutritional indicators of premature infants,such as alkaline phosphatase,lack reference criteria and need to be improved.

Evaluation of Z-score of growth and development as well as nutritional status of preschool children    aged 3 to 6 years in Jinnan district,Tianjin

GUO Xuan, LIU Zhi-jia, MAN Ying-ying, LI Shuang

2019, 27(11):  1247-1250.  DOI: 10.11852/zgetbjzz2019-0126

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Objective To understand the growth and nutritional status of preschool children in Jinnan district of Tianjin,in order to provide reference for children′s health nutrition guidance work in this region. Methods A stratified random sampling method was used to retrieve the physical examination data in spring of children aged 3 to 6 years in the public kindergartens in Jinnan district of Tianjin.Children were divided into four groups,including 3-,4-,5-,6-7 years old groups,and the participants were randomly selected according to 1∶1 of the sex ratio in different groups.Finally data of 2 172 children were collected.Z-score method recommended by the World Health Organization (WHO) was used for evaluation. Results Among all age groups,the height and weight of boys were higher than girls from the same age group.The differences on WHZ and HAZ value among different age groups in boys and girls were statistically significant (boys F_WHZ=11.966,girls F_WHZ=28.291,boys F_HAZ=40.474,girls F_HAZ=22.520,P<0.05).The differences on WAZ values were statistically significant among all age groups for boys (F_WAZ=3.258,P<0.05).The WAZ and HAZ values for boys were significantly higher than those of girls (t_WAZ=6.426,t_HAZ=8.913,P<0.05).The prevalence of emaciation in boys decreased with age significantly (χ²_trend=22.550,P<0.05).The prevalence of overweight among male and female girls both increased with age significantly (χ²_trend=119.876,87.316,P<0.05).In addition,the prevalence of obesity in boys and girls also increased with age (χ²_trend=22.550,68.397,P<0.05). Conclusion The problem of overweight and obesity among preschool children in Jinnan district of Tianjin is very prominent,meanwhile malnutrition cannot be ignored.

Analysis of the status and influencing factors of serum 25-hydroxy vitamin D in 687 children

LIU Juan, LIU Yong-lin

2019, 27(11):  1251-1254.  DOI: 10.11852/zgetbjzz2019-0101

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Objective To understand the serum level of 25-hydroxy vitamin D [25-(OH)D] in children from Shenmu,to evaluate the risk degree and to find out the influencing factors,thereby providing theoretical basis for the prevention and treatment of vitamin D deficiency in this area. Methods A total of 687 children were selected for health examination in child health clinic from January 2016 to December 2017.Serum 25-(OH)D₃ concentrations of children was tested by chemiluminescence immunoassay,and the influencing factors were analyzed. Results The maximum value of 25-(OH)D in 687 children was 96.9 ng/ml,and the minimum value was 2 ng/ml,with the average level of (32.59±13.14) ng/ml.The number of children with vitamin D deficiency,insufficiency,appropriate level of vitamin D was 120(17.5%),169(24.6%) and 398(57.9%),respectively.No children existed excessive vitamin D level or vitamin D intoxication.Single factor analysis indicated that vitamin D level was related to age,season,daily time for outdoor activity,previous supplementation of vitamin D,duration of vitamin D supplementation,vitamin D supplementation over the past three months(P＜0.05).Logistic regression analysis showed that daily outdoor activity time for 30 min to 2 hours (OR=0.43,95%CI:0.22-0.84,P=0.03) and vitamin D supplementation for 3 months to one year (OR=0.12,95%CI:0.05-0.28,P<0.001) were protective factors for vitamin D deficiency. Conclusion The protective factor of vitamin D deficiency is the duration of outdoor activities and vitamin D supplementation.The key to reduce vitamin D deficiency is prevention,and health education is supposed to be strengthened.

Analysis on the development of infant skinfold thickness and its correlation with body weight,chest    circumference and upper arm circumference in Daxing district,Beijing

REN Jun-shuang, BAO Ling, WANG He-ru, ZUO Han-xiao, LIU Guang-li, LIU Jin, LYU Yan-yu

2019, 27(11):  1255-1259.  DOI: 10.11852/zgetbjzz2019-0317

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Objective To understand the development pattern of skinfold thickness and its correlations with body weight,chest circumference and upper arm circumference of infants aged 0 to 12 months in Daxing district,Beijing,in order to provide reference for infants health care. Methods A total of 465 infants admitted to the child health care clinic were enrolled in this study from January 2017 to August 2018,and were divided into 5 groups by age.Their body weight,chest circumference,upper arm circumference and the thickness of the pleats at four parts were measured,including biceps brachii,triceps brachii,inferior angle of scapula and anterior superior iliac spine. Results The average body weight,upper arm circumference and the thickness of skinfolds at all age groups were significantly higher than those recommended by WHO in 2006 for children with the same sex and age.The increase of chest circumference in all age groups was greater than that of head circumference,the upper arm circumference increased rapidly within 0 to 12 months,and reached to the peak at 9 months.The development trend of skinfold thickness of male and female infants was consistent.The difference on skinfold thickness of triceps humerus between male and female infants aged 12 months was statistically significant (P<0.05),while the differences were not significant between different genders among other age groups (P＞0.05).The thickness of the pleats at the four parts had a significant effect on the weight and chest circumference of the male infants,of which the anterior superior iliac spine,triceps brachii and inferior angle of scapula had significant effects on the circumference of the male upper arm.The anterior superior iliac spine,triceps humerus and inferior angle of scapula had significant effects on the body weight and chest circumference of the female infants,and triceps humerus had a significant effect on the arm circumference of the female. Conclusions The average thickness of skinfolds in infants aged 0 to 12 months are higher than the reference index recommended by WHO.Chest circumference and upper arm circumference develop rapidly,among which the cross time of chest circumference and head circumference is significantly earlier.It is indicated that infants are likely to have good or excessive nutrition,positive exploration for the influencing factors is needed,thereby improving nutritional status in early life.

Causes and prevention of corrosive esophageal burn of 32 children

WANG Ying, WANG Wei-jia, LUO Chen-chen, MIAO Jing, YAN Ni, ZHANG Xiao-lan

2019, 27(11):  1260-1262.  DOI: 10.11852/zgetbjzz2019-1290

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Objective To analyze the causes of corrosive esophageal burn in children, the pre-hospital cares and family members′ knowledge about the safety of corrosive substances, so as to afford standardized prevention. Methods A total of 32 cases of pediatric corrosive esophageal burn admitted by the Pediatric Surgery Department of the Second Affiliated Hospital of Xi ′an Jiaotong University from January 2001 to January 2019 were reviewed, and were grouped by rural areas and urban areas, the families′ educational level and the knowledge about the safety of corrosive substances. The results were analysed using the software SPSS 24.0. Results There were 24 cases (75.0%) in rural areas, 8 cases (25.0%) in urban areas of 32 cases. The family members of 11 cases said they had known about the knowledge of corrosive substances, including 4 in rural areas and 7 in urban areas, the family members of 9 cases said that they had taken relevant pre-hospital cares, including 3 in rural areas and 6 in urban areas, both of the percentage of family members in rural areas who had knowledge about corrosive substances and adopted pre-hospital cares were significantly lower than those in urban areas, with 16.7%, 12.5% and 87.5%, 75.0%, respectively (P<0.05). The prognosis of the children who received pre-hospital cares was significantly better than that of the children who did not receive pre-hospital cares, with fewer balloon dilation times and shorter hospitalization days [(6.00±2.89)times and (9.00±2.94)times respectively, t=2.61, P<0.05; (56.00±3.65)d and 65.00±9.53)d respectively, t=2.73,P<0.05). Conclusions Children corrosive esophageal burns occurs is not only related to the characteristics of the children themselves, but also is closely related to the geography, family, society, etc. The certain pre-hospital cares have obvious positive effect to the prognosis, reminding that relevant departments should strengthen the educational propaganda work on the safety knowledge of corrosive substance, especially focusing on the vast rural areas.

Survey on nutritional status as well as knowledge,attitude and behaviors among school-age children in Wuhan

WANG Pei, PAN Xin-yun, WANG Xiao, LIU Hua-niu, HE Zhen-yu

2019, 27(11):  1263-1265.  DOI: 10.11852/zgetbjzz2019-0216

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Objective To investigate nutritional status,as well as knowledge,attitude and behaviors regarding nutrition among school-age children in Wuhan,so as to provide scientific basis for improving nutritional status of school-aged children. Methods A questionnaire survey on knowledge,attitude and behaviors regarding nutrition and height measurement were conducted among 1 348 school-age children from 5 primary schools and 7 middle schools in Wuhan in May 2018 by using the multi-stratified cluster sampling method. Results The detection rates of wasting,overweight and obesity in students were 9.57% (129/1 348),9.72% (131/1 348),and 5.27% (71/1 348),respectively.Only 57.72% (778/1 348) students could evaluate nutrition status appropriately.Most students had poor nutrition knowledge,proper nutrition attitude and behavior. Conclusion It is supposed to strengthen nutrition health education,to develop healthy nutritional attitude and to foster healthy eating habits.

Establishment of reference intervals for serum iron,magnesium,zinc and copper in    infants aged 0 to 12 months in Changchun

JIA Ya-nan, GUO Wen-jia, ZHU Xue-tong, ZHOU Qi, XU Jian-cheng

2019, 27(11):  1266-1268.  DOI: 10.11852/zgetbjzz2018-0769

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Objective To establish reference intervals of serum iron,magnesium,zinc and copper in healthy infants aged 0 to 12 months in Changchun,in order to provide reference for clinical diagnosis and treatment. Methods According to industry standards of health WS/T 402-2012 and after screening by clinical and laboratory standards,8 905 infants aged 0 to 12 months who took physical examination in the First Hospital of Jilin University were enrolled from January 2014 to December 2017.Serum iron,magnesium,zinc and copper were tested by Hitachi 7600-210 automatic biochemical analyzer and were classified according to age and gender.Data were analyzed by SPSS 21.0 and then the reference intervals for age and gender were obtained. Results Serum iron levels gradually decreased with months and serum magnesium concentration gradually increased with months.After gradually increasing with months,serum zinc level in boys and girls trended to peak at 7 to 8 months old and 5 to 6 months old,respectively,and then gradually declined.Serum copper level increased with months,peaking at 11 to 12 months old.There were age differences on the reference intervals of the four trace elements,and serum copper began to show gender differences from 4 to 12 months old. Conclusion It is of great significance to establish age-and sex-related reference intervals for serum trace elements in infants for the correct assessment of infant development.