Table of Content

10 November 2023, Volume 31 Issue 11

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Professional Forum

Early intervention of emotionalization and socialization on high-risk children

XIONG Zhonggui, ZHENG Xiaoyun, BIAN Xiaoyan, XU Haiqing

2023, 31(11):  1161-1164.  DOI: 10.11852/zgetbjzz2023-0985

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High-risk children are confronted with a serial of medical issues, such as early development of emotionalization and socialization, in which there were significant difference in neurobehavioral development between high-risk children and normal children. Early intervention could promote healthy development of high-risk children. This study is aimed at early development of emotionalization and socialization to achieve the optimal potential development on high-risk children.

Premature infants need to be vigilant about spastic cerebral palsy

CUI Hong

2023, 31(11):  1165-1167.  DOI: 10.11852/zgetbjzz2023-1040

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Preterm birth is the leading cause of death among newborns and infants. Compared with full-term infants, preterm infants has a significantly higher risk of motor abnormalities and even cerebral palsy, which seriously affects the future survival and quality of life of preterm infants. Cerebral palsy is characterized by abnormalities in movement, muscle tone, and posture, with spastic cerebral palsy being the most common type of cerebral palsy. Most causes of cerebral palsy can be traced back to the perinatal period, with premature birth being an important risk factor for it. Although there is currently no recognized assessment tool to accurately predict cerebral palsy in preterm infants, standardized motor assessment tools, such asGeneral Movement Assessment, Hammersmith Infant Neurological Examination and neuromotor examination 15, are still important tools for early identification and assessment of cerebral palsy. The accuracy of early prediction of cerebral palsy can be further improved by the combination of early sequential cranial ultrasound and cranial magnetic imaging.

Original Articles

Influence of family support on the effect of early intervention on motor function in high-risk children

QIN Yueyi, TIAN Tian, LU Xiao

2023, 31(11):  1168-1173.  DOI: 10.11852/zgetbjzz2022-1419

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Objective To explore the relationship between the involvement degree of family intervention and the effect of motor function intervention on high-risk infants aged 0 to 3 years, in order to provide ideas for early intervention strategies for high-risk infants. Methods From June 2020 to April 2022, 81 high-risk infants with motor development retardation were included in this study for follow-up. All children received regular intervention in hospital and family guidance, and were divided into group with intervention frequency of <15min/d and group with intervention frequency of ≥15min/d according to the average length of daily family intervention. The level of children′s motor function was evaluated with Peabody Developmental Motor Scale (PDMS-2) before and 3 months after the intervention, and the intervention effect was compared. Results After intervention, gross motor development quotient (GMQ), fine motor development quotient (FMQ) and total motor development quotient (TMQ) of all children were significantly higher than those before intervention (t=5.250, 5.601, 5.705, P<0.05). Further group comparison showed that the GMQ, FMQ and TMQ both in children aged 0 - 12 months and 13 - 36 months were significantly higher than those before intervention in group with intervention frequency of <15min/d and group with intervention frequency of ≥15min/d (P<0.05), but the GMQ, FMQ and TMQ of children aged 0 - 12 months after intervention were significantly higher than those of children aged 13 - 36 months (P<0.05). Families of children with abnormal cranial MRI were more likely to devote more time to the intervention each day than families of children without abnormalities (χ²=4.516, P=0.034), and GMQ, FMQ and TMQ all improved significantly more in families of children with abnormal cranial MRI after the intervention (t=2.104,2.264,2.757,P<0.05). Conclusions The early intervention training mode of hospital rehabilitation intervention combined with family intervention has a good promotion effect on improving the motor function of high-risk children with motor retardation aged 0 - 3 years. Family interventions that involve a higher level of investment and an early start are more likely to improve children′s motor development. The findings of the child′s cranial MRI have a certain influence on the family motivation and the effectiveness of the intervention.

Interaction of maternal pre-pregnancy body mass index and gestational weight gain on macrosomia

YU Chengdong, ZHANG Yaqin, WU Huahong, ZONG Xinnan, LI Hui

2023, 31(11):  1174-1179.  DOI: 10.11852/zgetbjzz2023-0110

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Objective To explore the effects of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) during pregnancy and their additive interaction on macrosomia, and provide evidence for maternal weight management before and during pregnancy. Methods This study was based on the data of 12 040 pregnant women and full-term newborns surveyed in 13 cities of China from June 2015 to November 2018. According to China′s standards for overweight, obesity, and GWG, unconditional multivariate Logistic regression was performed to estimate the independent effect and additive interaction of pre-pregnancy BMI and GWG on macrosomia. Results With the increase of pre-pregnancy BMI category, the mean GWG decreased gradually (P_trend<0.001). After adjusting for other confounding factors, the results showed that pre-pregnancy overweight/obesity (OR=1.67, 95%CI: 1.35 - 2.05) and excessive GWG (OR=1.78, 95%CI: 1.48 - 2.16) increased the risk of macrosomia. The coexistence of pre-pregnancy overweight/obesity and excessive GWG further increased the risk of macrosomia, but the additive interaction between them was not found. Conclusions Pre-pregnancy overweight/obesity and excessive GWG are independent risk factors for macrosomia, but the interaction between them is not statistically significant. It is suggested that pregnant woman should keep normal weight before pregnancy and gain appropriate weight during pregnancy, especially those who are overweight/obese before pregnancy should keep lower GWG to reduce the risk of macrosomia in offspring.

Nutritional status and its influencing factors of children aged 1 - 5 years with cerebral palsy in Shenzhen

WANG Jinggang, LI Qingyun, YU Chunyu, YUN Guojun, TONG Nan, CAO Jianguo

2023, 31(11):  1180-1184.  DOI: 10.11852/zgetbjzz2023-0070

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Objective To investigate the nutritional status of children aged 1 - 5 years with cerebral palsy in Shenzhen, and to determine its influencing factors, in order to provide evidence for clinical nutritional intervention. Methods This multicenter study was performed in ten maternal and child healthcare hospitals from October 2020 to August 2022. A total of 1 094 1- to 5-year-old children with cerebral palsy were involved in the survey. General data of the children were collected, meanwhile body weight, height/body length were measured. Nutritional status was evaluated according to the child growth and development standards issued by WHO. Multivariate Logistic regression analysis was performed to test factors that may affect nutritional status. Results The prevalence of malnutrition among children with cerebral palsy aged 1 - 5 years was 17.91%. GMFCS level, feeding difficulty and parental knowledge level of nutrition were the factors significantly influencing the nutritional status of children with cerebral palsy (P<0.05). Higher GMFCS score and feeding difficulty were the risk factors for malnutrition with cerebral palsy, while parental knowledge level of nutrition was a protective factor. There was no significant difference in the prevalence of malnutrition among children with different clinical classification, constipation or not, same educational background of parents (P >0.05). Conclusions The malnutrition prevalence rate in children with cerebral palsy aged 1 - 5 years appears to be low in Shenzhen, China. GMFCS levels, the severity of feeding difficulties, and parental knowledge level of nutrition are factors that affect the nutrition status of this population.

Prevalence and influencing factors of hyperuricemia in children and adolescents aged 6 - 17 years in northeastern Sichuan province

GUO Xuemei, XIAO Ningting, JING Xueming, ZHU Zhennan, ZHANG Heping

2023, 31(11):  1185-1190.  DOI: 10.11852/zgetbjzz2023-0156

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Objective To investigate the prevalence of hyperuricemia (HUA) and its related factors in children and adolescents aged 6 - 17 years in Northeast Sichuan Province, so as to provide scientific basis for early prevention and treatment. Methods A retrospective study was conducted to collect the clinical data of 15 739 children and adolescents aged 6 - 17 years from January 1st, 2017 to December 31st, 2021 in the Affiliated Hospital of North Sichuan Medical College to analyze the prevalence of HUA. According to the diagnostic criteria of hyperuricemia, the participants were divided into no hyperuricemia group (n=12 565) and hyperuricemia group (n=3 174). Multivariate Logistic regression was used to analyze the influencing factors of HUA prevalence. Results The overall prevalence of HUA among children and adolescents aged 6 - 17 years in northeast Sichuan Province was 20.17% (3 174/15 739), with 26.53% (2 492/9 392) among boys and 10.75% (682/6347) among girls. The prevalence of HUA has shown an overall increasing trend in the past 5 years, with a faster increase in 2019—2020; the prevalence tended to increase with age, with 12 years old as the cut-off point, the prevalence of HUA increased significantly in boys aged 12 years or order. Multifactorial Logistic regression analysis showed that males (OR＝2.308, 95%CI:1.310 - 4.065, P=0.004), increasing age(OR＝1.129, 95%CI:1.019 - 1.251, P=0.020), overweight/obesity (OR＝1.080, 95%CI: 1.014 - 1.150, P=0.016), higher serum creatinine level(OR＝1.028, 95%CI:1.008 - 1.049,P=0.006), higher triglycerides level(OR＝1.546, 95%CI: 1.133 - 2.108,P=0.006), and higher serum calcium level(OR＝12.723, 95%CI:1.783 - 90.801,P=0.011) were risk factors for the development of HUA. Conclusions The prevalence of HUA in children and adolescents aged 6 - 17 years in Northeast Sichuan is higher in boys than in girls, and the prevalence increases with age. HUA is closely related to gender, age, body mass index, serum creatinine, triglyceride and serum calcium levels.

Comparative study on the development level of children with autism spectrum disorder and developmental language disorder in different genders aged 2 - 5 years

SHEN Shihui, MA Chenhuan, LI Mengfan, DONG Chuanfei, WANG Yu, CHEN Jinjin

2023, 31(11):  1191-1195.  DOI: 10.11852/zgetbjzz2022-1169

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Objective To compare the differences in developmental levels between children with autism spectrum disorder (ASD) and children with developmental language disorder (DLD) of different genders, so as to provide theoretical basis for individualized educational interventions for preschool ASD children. Methods A total of 116 ASD children aged 2 - 5 years and 97 DLD children from October 2021 to June 2022 were evaluated by using the Griffiths Developmental Scale, and the evaluation results of the two groups were analyzed and compared. Results Except for motor development, personal-social,language, hand-eye coordination, performance dimension and practical reasoning DQs of ASD chilren were all significantly lower than those of DLD children(t=4.45, 3.69, 5.88, 5.60, 5.76, P＜0.001). ASD children had significantly lower scores in personal-social, language, hand-eye coordination, performance dimension and practical reasoning DQs than DLD children(boys: t=3.28、2.57、2.85、2.52、3.92; girls: t=3.29、2.79、8.62、9.07、6.86, P＜0.01). Girls with ASD had lower hand-eye coordination and performance DQs than boys with ASD(t=3.51, 4.84, P＜0.01). Conclusions Except for motor development, DQs of ASD children are all significantly lower than DLD children. DQs of some developmental areas in ASD girls lag behind those of ASD boys. Therefore, it is necessary to provide high-intensity individualized interventions for ASD children of different genders.

Status quo and influencing factors for language development in children aged 18 months

XIA Bin, WANG Jie, LIU Qiaoyun, CHEN Siqi, LI Luanluan, YU Xiaodan

2023, 31(11):  1196-1201.  DOI: 10.11852/zgetbjzz2023-0241

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Objective To know about current status and influencing factors of language development among 18-month-old children, so as to provide guidance for early intervention. Methods A total of 362 children aged 18 months who took routine physical examination in the Department of Child Health Center of Changning Maternal and Infant Health Care Hospital in Shanghai from October 2021 to March 2022 were selected into this study, including 176 boys and 186 girls. Children were screened for language development by using the Early Language Milestone Scale, with the total score≤P₁₀ as abnormal. The demographic information, family conditions, behavior habits and feeding behaviors were collected using questionnaire. Univariate analysis and multiple regression analysis were performed to analyze influencing factors of language development. Results The prevalence of language development delay among 18-month-old children was 9.9%, with 11.9% in boys and 8.1% in girls. The score of voice and speech (11.14±2.62 vs. 12.45 ± 3.20) and the total score of language development (35.19±3.90 vs. 36.68 ± 4.02) in boys were significantly lower than those of girls (t=-4.244, -3.591, P＜0.05). Multiple regression analysis showed that mother or (maternal) grandparents as the major caregiver (β＝1.188, 0.279, 0.217, 1.735, P<0.05) and higher education level of caregivers (β = 1.027, 0.267, 0.161, 1.485, P<0.05) had positive effects on the scores of voice and speech, auditory perception and understanding, visual related understanding and expression and total score of language development. However, longer screen time (β =-0.452, -0.612, P<0.05) and delayed timing to introducing solid food (β =-0.515, -0.613, P<0.05) are negatively correlated with voice and speech development and overall language development of children. Conclusion Children at 18 months of age have a higher rate of abnormal language development, especially in boys; this can be facilitated by choosing an appropriate caregiver, controlling screen time and adding solid foods to the diet at the right time.

Construction and effectiveness of a remote home rehabilitation model based on internet technology for children with cerebral palsy

FAN Taolin, JIANG Ying, DAI Jin′e, ZHANG Xiaoding, YANG Guihua, XU Yaxiong, WANG Chunhua

2023, 31(11):  1202-1207.  DOI: 10.11852/zgetbjzz2023-0125

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Objective To construct a remote home rehabilitation model based on Internet technology, and to observe the effect of this rehabilitation model on motor function and functional independence of children with cerebral palsy (CP), in order to provide clinical evidence for home rehabilitation training of children with cerebral palsy. Methods A total of 65 children with cerebral palsy who had recovered from Xiangya Bo′ai Rehabilitation Hospital from June to November 2022 were selected into this study and were divided into remote intervention group (n=31) and conventional intervention group (n=34) according to the wishes of their caregivers.Children in conventional intervention group were given home rehabilitation training according to the home training program, while children in remote intervention group received an individualized remote home rehabilitation model, including remote rehabilitation training and quality control. Children in the two groups received intervention for 12 weeks with frequency of ≥1.5h/d, 5d/week. Gross Motor Function Measure (GMFM), Fine Motor Function Measure (FMFM), and Functional Independence Measure Children′s Edition (WeeFIM) were used to evaluate the gross motor function, fine motor function, and daily living ability of children before treatment and 12 weeks after treatment. Results After 12 weeks of treatment, the total satisfaction rate of the remote intervention group was 90.32%, significantly higher than that of the conventional intervention group (70.59%) (χ²=7.651, P<0.05). After 12 weeks of treatment, GMFM, FMFM and WeeFIM scores in the two groups were significantly improved compared with those before treatment (remote intervention group: t=16.736、36.772、18.858; conventional intervention group: t=7.354、18.495、8.895, P<0.05). The scores of the above indicators in the remote intervention group after 12 weeks of treatment were significantly higher than those in the conventional intervention group (t =2.014, 2.106, 2.137, P<0.05). Conclusion The remote home rehabilitation model based on Internet technology can effectively improve the gross motor function, fine motor function and daily living ability of children with cerebral palsy.

Basic Experimental Articles

Effects of ferulic acid on the behavior and expression of interleukin-1β, interleukin-6 and tumor necrosis factor-α in autistic model rats

ZHANG Xiaoyue, GUO Lanmin, LI Qinghong, WANG Sijia, XING Xiao, LI Wenxia, WANG Jinfeng

2023, 31(11):  1208-1213.  DOI: 10.11852/zgetbjzz2022-0612

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Objective To investigate the effects of ferulic acid on behavior, activation of microglia in hippocampus and expression of interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in autistic model rats, in order to explore a new approach for ASD drug therapy. Methods The autism model was prepared by referring to the Schneider autism model rat method. Forty 7-day-old model rats were randomly divided into valproate(VPA) group and ferulic acid (FA) group. Control rats 20 were randomly selected into NS group. FA group was intraperitoneally injected with ferulic acid 50mg/kg for 21 consecutive days from the 7th day, VPA group and NS group were injected with normal saline. The model was identified by developmental and behavioral tests. After the intervention, the morphological changes of hippocampus were observed by HE staining, the expression levels of IBA-1 were detected by immunofluorescence staining, and the expression levels of IL-1β, IL-6 and TNF-α were detected by enzyme-linked immunosorbent assay. Results Compared with NS group, VPA group had lower body weight, curvy tail or short tail, decreased "sociability" and "social novelty", decreased ability to distinguish social odor, and increased repetitive and stereotypical behavior (P<0.05). The nerve cells in the hippocampus were arranged in disorder, with large space, unclear structure, cell degeneration and inflammatory cell infiltration. The number of activated microglia in hippocampus increased, and the expression levels of IL-1β, IL-6 and TNF-α increased (P < 0.05). After ferulic acid intervention, the pathological damage of hippocampus in FA group was improved compared with VPA group. The number of IBA-1 positive cells and the expression levels of IL-1β and IL-6 decreased (P < 0.05). Conclusion The intervention of ferulic acid can improve the learning and memory ability of the autism model mice, and improve the abnormal development and behavioral performance of the autism model mice to a certain extent, such as impairment of social interaction. Ferulic acid can reduce the number of activated microglia and the expression levels of pro-inflammatory cytokines IL-1β and IL-6 in the hippocampus of autism model rats, thus playing a neuroprotective role.

Review

Research advance in the relationship between hyperoxia and immature brain injury

WU Tong, JI Hong

2023, 31(11):  1214-1218.  DOI: 10.11852/zgetbjzz2023-0268

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With significant progress being made in neonatal intensive care, the survival rate of premature infants has been substantially increased. Hyperoxia therapy plays a key role in the early treatment of neonates, especially in premature infants. However, supraphysiological concentration of oxygen has toxic effects on the developing lung and retina. Moreover, permanent neurological impairments caused by oxidative stress induced by hyperoxia have been paid more and more attention, especially in premature infants with incomplete brain development, which brings heavy burden to children and their families. This article reviews the mechanism of hyperoxia on immature brain injury and its potential treatment strategies.

Protective effect and mechanism of insulin-like growth factor 1 in preterm infants with white matter damage

MA Hongfang, XUE Jiang, LIANG Shuang

2023, 31(11):  1219-1224.  DOI: 10.11852/zgetbjzz2022-1285

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White matter damage (WMD) in preterm infants, as a demyelinating disease, has a variety of pathogenesis and forms of damage. Due to the lack of specific treatment, it is the main cause of long-term sequelae such asperceptual disability, cognitive impairment and emotional disorder in preterm infants. Ithas been reported that the fine-tuning of insulin-like growth factor-1(IGF-1) levels by upstream events of WMD may lead to myelination disorders, and targeted supplementation of recombinant human insulin-like growth factor-1(rh-IGF-1) can not only promote the development of oligodendrocytes(OLs) and myelin maturation in WMD, but also reverse the neurobehavioral abnormalities caused by WMD. In view of this, this article reviews the progress of IGF-1 in WMD.

Effects of maternal anesthesia exposure during pregnancy on pregnancy outcome and neurodevelopment of offspring

PENG Rui, YUAN Hongmei

2023, 31(11):  1225-1229.  DOI: 10.11852/zgetbjzz2023-0109

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With the improvement of medical technology, an increasing number of women need to receive anesthesia during pregnancy because of surgery, and medical workers gradually pay attention to the impact of anesthesia exposure during pregnancy on the neurodevelopment of offspring. Much of exploration of the neurotoxicity of anesthetics comes from preclinical studies in rodents and nonhuman primates, which are different from the data of these animal studies and previous retrospective cohort studies in humans. Human studies in this field are limited and currently inconclusive. In 2016, the United States Food and Drug Administration issued a warning regarding impaired brain development after exposure to certain anesthetic agents used for general anesthesia in the third trimester of pregnancy. Furthermore, it is also recommended that healthcare professionals balance the benefits and potential risks of anesthesia in infants and pregnant women. However, women may be exposed to narcotic drugs at any stage of pregnancy. Therefore, this paper summarizes the effects of maternal exposure to general anesthesia during early (<14 weeks), mid(14 - 27 weeks), and late pregnancy(≥28 weeks) on the neurodevelopment and cognitive function of their offspring.

Circadian clock and attention deficit hyperactivity disorder

HUANG Huifang, CHEN Yanhui, HUANG Yuxian

2023, 31(11):  1230-1234.  DOI: 10.11852/zgetbjzz2022-1546

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The circadian clock produces a stable 24-hour circadian rhythm, which plays a crucial role in sleep, attention, learning, memory and cognition. Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children. Circadian rhythm system dysfunction and sleep problems are found to be more common in ADHD compared to healthy children these years, which can worsen the symptoms of ADHD in turn. The circadian clock can regulate various physiological and biochemical processes related to ADHD, including hypothalamus-pituitary-adrenal axis, monoaminergic neurotransmitter system. This review will address the interaction between circadian system and processes above as well as their potential role in the development of ADHD.

Research progress on the placental exposure to microplastics and the impact of microplastics on fetus

XU Anqi, ZHAI Lingling

2023, 31(11):  1235-1240.  DOI: 10.11852/zgetbjzz2023-0227

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Microplastics are harmful to the environment and human, which has been receiving high attention in recent decades. The fetal period is a very vulnerable stage throughout the life course. However, maternal exposure to microplastics is likely to influence fetus through placenta. The study provides an overview of global microplastic exposure and maternal exposure during pregnancy, and details placental exposure, potential adverse effects on the fetus, and possible mechanisms, with the aim of providing some ideas for further studies.

Meta Analysis

Meta-analysis of the efficacy of lower robot-assisted gait training on lower limb function in children with cerebral palsy

HUANG Xinping, WU Juanmei, WU Yingying, XIE Hongxiang, CHEN Fangchuan

2023, 31(11):  1241-1247.  DOI: 10.11852/zgetbjzz2022-1326

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Objective To study the efficacy of robot-assisted gait training (RAGT) on lower limb function in children with cerebral palsy through systematic review, in order to provide evidence-based reference for the application of lower robot-assisted gait training. Methods The randomized controlled trials on robotic gait training for lower limb rehabilitation in children with cerebral palsy were retrieved through CNKI, VIP, Wanfang, PubMed, Embase, and Cochrane Library, which were published from inception to September 2022. Two researchers independently screened the literature according to the inclusion and exclusion criteria, and completed the process of data extraction, checking the data and quality evaluation. RevMan5.3 was used to perform Meta-analysis and present the related results for gross motor functions, including standing, walking, running and jumping (GMFM-D, GMFM-E), muscle tone (MAS), balance function (BBS), step speed, and step length. Results A total of 16 randomized controlled trials with 759 children with cerebral palsy were included in this study. The control group received conventional rehabilitation therapy, while the experimental group was given RAGT/RAGT additionally. Compared with the control group, after RAGT, the GMFM-D raw score (MD=5.53, 95%CI:4.47 - 6.60, P<0.01), GMFM-D percentage (MD=11.46, 95%CI:6.75 - 16.17,P<0.01), and GMFM-E raw score (MD=8.41, 95%CI:5.31 - 11.51, P<0.01), GMFM-E percentage (MD=11.20, 95%CI:6.14 - 16.26, P<0.01), GMFM D+E total score (MD=9.93, 95%CI:5.78 - 14.08, P<0.01), MAS score (MD=-0.45, 95%CI:―0.51 - ―0.38, P<0.01), BBS score (MD=5.90, 95%CI:3.60 - 8.20, P<0.01), and stride speed (MD=4.03, 95%CI:0.94 - 7.11, P=0.01) of children in the experimental group all improved with significant differences (P>0.05), but there was no statistically significant difference in step length (MD=0.40, 95%CI:-0.02 - 0.82, P=0.06) between the two groups. Conclusions RAGT has a positive effect on lower limb function in children with cerebral palsy, but there is heterogeneity in the existing studies. Therefore, randomized controlled trials with large samples and rigorous intervention protocols are warranted in the future.

Clinical Research

Therapeutic effect of low frequency repetitive transcranial magnetic stimulation combined with task oriented training on lower extremity gross motor function and gait function of children with spastic hemiplegic cerebral palsy

ZHANG Qiu, LI Weiping, YU Jihua, DU Xinping, LING Yunqi, XU Fangyuan

2023, 31(11):  1248-1253.  DOI: 10.11852/zgetbjzz2023-0103

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Objective To analyze the effect of low frequency repetitive transcranial magnetic stimulation (rTMS) combined with task oriented training (TOT) on lower extremity gross motor and gait function of children with spastic hemiplegic cerebral palsy, in order to provide new ideas for improving the motor function of spastic hemiplegic cerebral palsy. Methods From August 2021 to September 2022, 75 children aged 3 - 6 years with spastic hemiplegic cerebral palsy were selected into this study from the Outpatient and Inpatient Departments of Rehabilitation Medicine in the Affiliated Southwest Medical University, and were randomly divided into routine group (n=25), TOT group (n=25) and rTMS+TOT group (n=25). Children in the three groups all received conventional rehabilitation. Additionally, children in TOT group received TOT, children in rTMS+TOT group received TOT combined with low frequency rTMS. Children in the three groups were assessed with Modified Ashworth Scale (MAS), D and E domains of Gross Motor Function Measure-88(GMFM-88) and footprint analysis before and after treatment. Results After 6-week intervention, scores of the above indicators in the three groups improved significantly than those before intervention (P<0.05). Intergroup comparison showed that performance of MAS (H=20.995), D and E domains of GMFM-88 (F=12.348, 19.428), turnover step length (F=2.137), step width (F=12.160) and 1 minute walk test (1MWT) distance assessment (F=8.705) were significantly better than those in TOT group and routine group (P<0.05). Conclusion Low frequency rTMS combined with TOT could decrease the gastrocnemius muscle tone and improve the lower extremity gross motor and gait function in children with spastic hemiplegic cerebral palsy, and the effect is better than TOT alone.

Effects of air pollutants and meteorological factors on childhood asthma in Hohhot urban area

LIANG Xiaoping, ZHANG Yuling, ZHANG Qiaoling, HAN Fang

2023, 31(11):  1260-1264.  DOI: 10.11852/zgetbjzz2023-0211

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Objective To investigate the correlation of childhood asthma with air pollutants and meteorological factors in Hohhot urban area, and to determine the main environmental factors affecting the incidence of asthma in children of all ages, so as to provide reference for formulating targeted prevention and emergency measures. Methods The treatment information of childhood asthma in Hohhot urban area from 2015 to 2019 was retrospectively analyzed, and the concentration data of main air pollutants and meteorological data in the same period were statistically collected. The correlations of childhood asthma at all ages with air pollutants and meteorological factors were analyzed to clarify the effects of air pollutants and meteorological factors on childhood asthma. Results During the infant period, the number of asthma patients in spring was positively correlated with NO₂ concentration (r=0.351, P=0.049), and the number of asthma patients in summer was negatively correlated with concentrations of PM_2.5 (r=-0.445, P=0.010) and CO (r=-0.441,P=0.010), and the number of asthma patients in winter was positively correlated with CO concentration (r=0.544,P=0.011). The number of school-age children with asthma in winter was positively correlated with the concentrations of CO (r=0.690, P=0.003) and SO₂ (r=0.808, P＜0.001). There were significant correlations between air pollutants and meteorological factors. Conclusions Meteorological factors play an important role in the diffusion of air pollutants. In the prevention of asthma in children, it is important to keep abreast of air pollution and climate change and to implement targeted prevention and control measures in different seasons.

Appropriate Technology

Clinical efficacy of digital OT training system combined with MOTOmed intelligent exercise training in the treatment of children with spastic hemiplegia

ZHANG Hongmin, GAO Jing, WANG Lina

2023, 31(11):  1265-1269.  DOI: 10.11852/zgetbjzz2023-0140

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Objective To analyze the effect of digital OT training system combined with MOTOmed intelligent exercise training system on the fine motor function of upper limbs and activities of daily living in children with spastic hemiplegia, so as to provide clinical reference for improving fine motor function in children with hemiplegia. Methods A retrospective study was conducted. Totally 60 children with spastic hemiplegia who received rehabilitation treatment in the Outpatient Department of Huai′an Maternal and Child Healthcare Hospital from January 1st, 2018 to December 31st, 2021 were enrolled in this study, and were divided into conventional group(n=20), MOTOmed group(n=20) and combined treatment group(n=20). Children in the conventional group were given occupational therapy and biofeedback, while children in the MOTOmed group received MOTOmed intelligent motion training additionally, children in the combined treatment group received digital OT training in addition to MOTomed intelligent motion training. Before treatment and 3 months after treatment, fine motor function measure FMFM), activity of daily living (ADL) and manual ability classification system (MACS) were used for evaluation. Results The differences in the scores of FMFM-D, FMFM-E, ADL before and after treatment was significant among three groups(H=11.972, 13.511, 17.188, P<0.05), which in the combined treatment group were significantly higher than those in MOTOmed group (H=2.954, 2.784, 3.803) and the conventional group(H=3.037, 3.470, 3.331, P<0.05). After treatment, the difference in MACS grade was significantly different among three groups (χ²=17.250, P<0.05), which in the combined treatment group was significantly different from that in MOTOmed group (χ²=10.733, P<0.05) and the conventional group (χ²=10.092, P<0.05). Conclusion In addition to conventional rehabilitation treatment, the combination of digital OT training system and MOTOmed intelligent motor training system can significantly improve the fine motor function and daily living activities of upper limbs in children with spastic hemiplegia.

Case Report

Case report of GAND syndrome caused by GATAD2B gene mutation and literature review 

LUO Guangjin, ZHANG Xuan, LI Xiaoping, Yuan Aiyun, Hou Mei, Chen Jun

2023, 31(11):  1270-1272.  DOI: 10.11852/zgetbjzz2022-0998

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Genetic characteristics and clinical phenotype analysis of a case with 3q distal microdeletion syndrome

ZULIHUMAER·Rixiati, LUO Yanfei, SUN Guanghui, MIREGULI·Maimati

2023, 31(11):  1273-1276.  DOI: 10.11852/zgetbjzz2022-1327

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