Table of Content

10 September 2025, Volume 33 Issue 9

Previous Issue   

Professional Forum

Educational assessment and intervention of dyslexia

LI Hong

2025, 33(9):  929-933.  DOI: 10.11852/zgetbjzz2025-0907

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Dyslexia is the most common type of specific learning difficulty, affecting approximately 5% to 10% of school-age children.From the perspective of cognitive psychology, this paper systematically reviews the cognitive mechanisms, assessment tools, diagnostic criteria, and intervention research on dyslexia, and highlights that the primary focus of its assessment and intervention is decoding ability (character recognition).Future efforts should integrate advances in artificial intelligence and educational technology to promote the establishment of early screening and evidence-based intervention systems.

Fundamental skills of child reading development

HAO Ying, SONG Yixuan

2025, 33(9):  934-938.  DOI: 10.11852/zgetbjzz2025-0940

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Reading is a cornerstone of children′s cognitive, reasoning, and socio-emotional development.In the Simple View of Reading, reading is regarded as coordinated development of two components, decoding and language comprehension.Based on this framework, this article summarizes fundamental skills and developmental trajectories relevant to each of the two components.Decoding mainly depends on children′s orthographic knowledge, phonological awareness, and efficient grapheme-phoneme correspondences.Language comprehension mostly draws on vocabulary knowledge, grammar, discourse cohesion, inferencing skills, working memory, and narrative skills.Clarifying these fundamental skills helps parents, teachers, and clinicians identify children′s specific areas of difficulties and form more targeted, effective intervention plans.

Multidimensional mechanisms of Chinese dyslexia from cognitive, neurobiological, and genetic perspectives

SONG Ranran, ZHANG Jiao

2025, 33(9):  939-943.  DOI: 10.11852/zgetbjzz2025-0902

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This review summarizes recent advances in Chinese developmental dyslexia across cognitive functions, neurophysiological, and etiology.Phonological, morphological awareness, orthographic, and rapid automatized naming constitute core deficits in Chinese dyslexia.Chinese children with dyslexia exhibit reduced activation in the left inferior frontal gyrus and increased activation in the right precentral/middle temporal gyrus, suggesting impaired phonological processing and potential compensatory mechanisms.Genetic research has identified novel susceptibility genes (e.g., SEMA3F, AUTS2, EVC).Furthermore, significant roles of environmental factors and gene-environment interactions were explored.Further prospective studies are warranted to elucidate both the universal and specific cognitive functions, neurophysiological, and etiology underlying Chinese developmental dyslexia.

Original Articles

Association between different types of after-school physical activity and sleep problems among preschool children

ZHANG Lili, MIAO Xueqing, SHEN Yi, FAN Mingyuan, SHI Huijing, HU Yanqi

2025, 33(9):  944-948.  DOI: 10.11852/zgetbjzz2025-0117

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Objective To examine the association between different types of after-school physical activities and sleep problems in preschool children, providing theoretical support for sleep interventions based on exercise modalities. Methods A cross-sectional study was conducted.From April to June 2024, a total of 2 683 children from four public kindergartens in Minhang district were enrolled to participate in the survey.Parents were invited to complete the basic sociodemographic information, after-school physical exercise information and the Children′s Sleep Habits Questionnaire (CSHQ).A total CSHQ score>41 indicated positive for overall sleep problems.Based on the event-group training theory, after-school physical activities were categorized and statistically analyzed. Results Of 2 683 distributed electronic questionnaires, 2 491(92.84%) were completed and 2 460(98.75%)were valid.The mean age was (4.97±0.91) years with a male-to-female ratio of 1.05∶1.The prevalence of overall sleep problems was 82.07%.One-way ANOVA revealed statistically significant differences in bedtime resistance (F=7.98) and sleep anxiety scores (F=5.99) across activity types (P<0.01).After adjusting for age, gender, singleton status, primary caregiver, and parental education/occupation, mixed-effects linear regression showed that participation in multiple types of after-school physical activities was negatively associated with bedtime resistance (β=-0.347, Z=-2.63, 95%CI: -0.605 to -0.088, P=0.008) and sleep anxiety scores (β=-0.241, Z=-2.00, 95%CI: -0.478 to -0.004, P=0.045). Conclusions The variety of after-school physical activities is associated with sleep outcomes in preschool children.Engagement in diverse physical activities serves as a protective factor against bedtime resistance and sleep anxiety.These findings highlight the importance of cultivating varied physical activity habits in preschool children to promote healthy sleep patterns.

Mediating role of parenting confidence in the relationship between household income and responsive caregiving for high-risk infants aged 0 - 3 years

LIU Panting, ZHANG Lei, PAN Lichao, MA Yun, XU Xin, HONG Qin, CHI Xia, TONG Meiling, QIAN Jun

2025, 33(9):  949-953.  DOI: 10.11852/zgetbjzz2024-1114

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Objective To examine the relationships between household income, parenting confidence, and responsive caregiving among caregivers of high-risk infants aged 0 - 3 years, in order to provide evidence to support rehabilitation interventions for this population. Methods A cross-sectional survey was conducted among 361 high-risk infants (aged 0 - 3 years) who attended the early intervention clinic at Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University between October 2023 and February 2024.Data were collected using a general information questionnaire, the Karitane Parenting Confidence Scale (KPCS), and the Infant-Toddler Responsive Caregiving Scale (IT-RCS).The relationships among household income, parenting confidence, and responsive caregiving were analyzed, and a structural equation model (SEM) was employed to test the mediating role of parenting confidence in the association between household income and responsive caregiving. Results 1) The total score for parenting confidence in high-risk children is 40.20±3.93, and the total score for responsive care is 66.56±12.33.2) Household income was significantly positively correlated with total parenting confidence scores (r=0.119, P<0.05) and total responsive caregiving scores (r=0.215, P<0.01). Parenting confidence scores was also significantly positively correlated with responsive caregiving scores (r=0.451, P<0.01).3) Household income significantly predicted responsive caregiving (β=0.398, P=0.006).Parenting confidence partially mediated the relationship between household income and responsive caregiving (β=0.154, P=0.021), accounting for 27.90% of the total effect. Conclusions Parenting confidence partially mediates the association between household income and responsive caregiving in caregivers of high-risk children aged 0 - 3 years.Healthcare professionals should focus on enhancing caregivers′ parenting confidence to improve responsive caregiving practices.

Causal relationship between circulating amino acids and autism spectrum disorder based on Mendelian randomization

ZHU Bingquan, LYU Lina, QI Ye, CHEN Saijing, LIU Dan

2025, 33(9):  954-958.  DOI: 10.11852/zgetbjzz2025-0503

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Objective To analyze the causal relationship between circulating amino acid levels and autism spectrum disorder (ASD), in order to provide genetic evidence for precision intervention strategies in ASD. Methods Based on summary data from genome-wide association studies (GWAS) in European populations, a two-sample Mendelian randomization (MR) framework was employed, incorporating 18 381 ASD cases and 27 969 controls.A total of 441 genetic instrumental variables (SNPs) were selected, covering 20 circulating amino acids.The inverse-variance weighted (IVW) method was used as the primary analysis, supplemented by weighted median (WME), MR-Egger regression, and weighted mode (WM) methods to assess causal effects.Sensitivity and pleiotropy were evaluated using Cochran′s Q test and MR-PRESSO. Results The causal analysis revealed no significant association between genetically predicted circulating amino acid levels and ASD risk (IVW P>0.05), this finding was consistent across MR-Egger regression, WME, and WM analysis.This conclusion remained robust after outlier correction via MR-PRESSO.However, Cochran′s Q test indicated significant heterogeneity for lysine (Q=24.037, P=0.045) and leucine (Q=23.713, P=0.049).MR-PRESSO detected horizontal pleiotropy for tryptophan (global P =0.001) and lysine (global P =0.046), but no significant causal associations persisted after outlier correction (corrected tryptophan β=-0.07, P=0.21, lysine β=0.12,P=0.09).The 95% confidence intervals for tryptophan, lysine, methionine, arginine, and threonine were exceptionally wide in MR-Egger regression or WM analysis. Conclusions Genetically predicted circulating amino acid levels show no direct causal relationship with ASD.However, the robustness of results for tryptophan, lysine, methionine, arginine, threonine, and leucine was limited, warranting cautious interpretation.

Neural activation patterns of visuospatial working memory and its clinical correlations in children with developmental dyslexia

XIAO Xinyu, YIN Feifei, GAO Shan, LI Juan, JI Chun, ZUO Pengxiang

2025, 33(9):  959-963.  DOI: 10.11852/zgetbjzz2025-0248

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Objective To analyze the prefrontal cortex (PFC) activation patterns during visuospatial working memory tasks in children with developmental dyslexia (DD) and their correlation with dyslexic symptoms, so as to provide neuroimaging evidence for the differential diagnosis of DD. Methods From May to June 2024, a screening for DD was conducted among all third- to fifth-grade students at a primary school in Xinjiang.Based on parental consent and handedness, 33 children with DD were enrolled and matched 1∶1 with typically developed (TD) controls by grade, age, and sex.Functional near-infrared spectroscopy (fNIRS) was employed to measure concentration changes of oxygenated hemoglobin (HbO₂) in the PFC during visuospatial working memory tasks to reflect cortical activation.Dyslexic symptoms were assessed using the Diagnostic Checklist for Chinese Children (DCCC).Group differences in HbO₂ β-values were analyzed using independent samples t-tests or Mann-Whitney U tests, while Spearman correlation examined relationships between prefrontal cortex activation and dyslexic symptoms in DD children. Results The fNIRS results revealed significantly lower HbO₂ β-values in the DD group compared to controls in the dorsolateral prefrontal cortex (channel 8: t=2.134), orbitofrontal cortex (channel 13: Z=2.860), and frontopolar cortex (channel 14: t=2.212) (P<0.05).Additionally, the total score of the DCCC scale and the scores of its 8 factors were significantly higher in the DD group than those in the normal control group (Z=6.983, 6.626, 6.986, 6.941, 6.358, 6.915, 6.710, 6.864, 6.876, P<0.001).Negative correlations were observed between HbO₂ β-values in the frontopolar cortex (channel 14) and scores on visual perception (r=-0.430) and writing impairment (r=-0.438) subscales (P<0.05). Conclusions Children with DD have deficits in visuospatial working memory, mainly manifested in insufficient activation of the dorsolateral prefrontal cortex, orbito frontal cortex and fronto polar cortex.The frontopolar cortex may serve as a potential biomarker for auxiliary DD diagnosis.

Latent profile analysis of family nurturing environment and child neglect differences among urban preschool children

XU Xiaohan, KOU Zhiru, ZHANG Xi, YU Tengfei, FENG Xueying, JIN Yanchun, YANG Xiuling

2025, 33(9):  964-969.  DOI: 10.11852/zgetbjzz2024-1047

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Objective To analyze the latent classes of family nurturing environments among urban preschool children and their association with child neglect, in order to provide evidence for targeted interventions to prevent child neglect. Methods From July to December 2023, a convenience cluster sampling method was used to select 425 parents of urban preschool children in Qingdao, Shandong Province. Data were collected using a general information questionnaire, the Chinese Urban Neglect Scale for 3 - 6-year-old children, the Parenting Stress Index-Short Form, the Preschool Parents′ Rearing Attitudes Questionnaire, and the Family Adaptability and Cohesion Scale. Latent profile analysis (LPA) was performed to classify family rearing environments. Multivariate logistic regression was used to identify influencing factors, and mixed-effects regression models were employed to analyze the association between different rearing environment classes and child neglect. Results The family rearing environments of urban preschool children were categorized into three latent classes: low stress - high resilience (47.8%), moderate stress - moderate resilience (46.3%), and high stress - low resilience (5.9%). Significant differences in child neglect severity were observed across these classes (χ²＝207.694, P<0.001).Compared to the low stress - high resilience group, families with less father-child interaction time were more likely to fall into the moderate stress - moderate resilience group (OR＝0.745, 95%CI: 0.635 - 0.874, P<0.001), while those with less mother-child interaction time were more likely to belong to the high stress - low resilience group(OR＝0.707, 95%CI: 0.510 - 0.981,P<0.05) and lower maternal education levels were less likely to belong to the high stress - low resilience group(OR＝0.345, 95%CI: 0.121 - 0.984,P<0.05). Conclusions Family nurturing environments of urban preschool children can be classified into three distinct categories, with varying degrees of child neglect. Community healthcare providers should develop tailored interventions to enhance parent-child interaction time and improve nurturing environments, thereby reducing the risk of child neglect.

Physical activity status and determinants among junior high school students in Shanxi Province, China

WANG Siji, LIN Yanmin, CHEN Jiu, WANG Yibing, KONG Zhe, XIE Jun

2025, 33(9):  970-975.  DOI: 10.11852/zgetbjzz2024-1121

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Objective To investigate the current status of physical activity (PA) and its influencing factors among junior high school students in Shanxi Province, China, in order to provide evidence for promoting PA participation. Methods From February to July 2024, a stratified random sampling method was used to recruit 532 junior high school students from 8 secondary schools in Taiyuan, Lyuliang, Yuncheng, Jincheng, and Datong cities of Shanxi Province.PA levels were objectively measured using ActiGraph wGT3X-BT accelerometers, and data were processed using ActiLife software (version 6.13.6).Chi-square tests were used to compare PA compliance rates across different demographic groups, and binary logistic regression was employed to identify factors associated with meeting PA recommendations. Results The compliance rate with PA recommendations among junior high school students in Shanxi Province was 17.1%.Binary logistic regression analysis revealed that male gender (OR=8.58, 95%CI: 4.73 - 15.57, P<0.05) and non-boarding school status (OR=1.95, 95%CI: 1.11 - 3.43, P<0.05) were significant positive predictors of meeting PA recommendations. Conclusions The compliance rate with PA recommendations among junior high school students in Shanxi Province remains suboptimal.Gender and boarding school status are identified as key determinants of PA participation.Targeted interventions should be implemented to enhance overall PA engagement, particularly for female students and boarding school students.

Basic Experimental Articles

Hypoxia-preconditioned human dental pulp stem cells attenuatehypoxic-ischemic brain damage in neonatal rats by regulating ferroptosis

HUO Qixiao, GAO Shujun, XU Kang, FANG Xiangyan, XIAO Peilun, WANG Xiaoli, WANG Fantao

2025, 33(9):  976-981.  DOI: 10.11852/zgetbjzz2024-1254

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Objective To investigate the effects of hypoxia-preconditioned human dental pulp stem cells (H-hDPSCs) transplantation on neuronal ferroptosis in neonatal rats with hypoxic-ischemic brain damage (HIBD), in order to provide novel therapeutic insights for neonatal HIBD. Methods A total of 64 7-day-old Sprague Dawley rats were randomly assigned to four groups: sham-operated (Sham), HIBD, normoxic-cultured hDPSCs (N-hDPSCs), and hypoxia-preconditioned hDPSCs (H-hDPSCs), with 16 rats in each group.The HIBD model was established using the Rice-Vannucci method.N-hDPSCs or H-hDPSCs were transplanted into the lateral ventricle 24 hours post-modeling.At 72 hours post-transplantation, histopathological changes were assessed by hematoxylin-eosin (HE) and Nissl staining, serum and cortical iron levels were measured by ELISA.Expression levels of ACSL4, GPX4, and SLC7A11 mRNA in the cerebral cortex detected by real-time quantitative fluorescence polymerase chain reaction (qRT-PCR). Results The results of HE and Nissl staining showed that compared with the Sham group, HIBD group showed neuronal disarray, pyknotic nuclei, and reduced Nissl bodies, while both hDPSCs groups exhibited attenuated damage.Compared with the Sham group, serum iron and iron content of the cortical tissue on the injured side were as the followings in the remaining three groups: HIBD>N-hDPSCs>Sham (F=79.565, 121.065, P<0.001).In terms of ferroptosis markers: GPX4+/SLC7A11+ neurons were as the followings: Sham>H-hDPSCs>HIBD (F=30.896, 75.089, P<0.001), ACSL4+ neurons were as the followings: HIBD>N-hDPSCs>Sham (F=87.724, P<0.001).H-hDPSCs showed higher GPX4 or SLC7A11 and lower ACSL4 expression than N-hDPSCs at both mRNA (qRT-PCR) and protein (Western blot) levels (P<0.001). Conclusions Transplantation of hDPSCs mitigates HIBD by suppressing neuronal ferroptosis, with hypoxia-preconditioned cells demonstrating superior therapeutic effects through regulation of ferroptosis-related pathways (GPX4/SLC7A11 upregulation and ACSL4 downregulation).

Review

Effects of nurturing care on early language learning in children

WANG Shutong, CHEN Mengying

2025, 33(9):  982-986.  DOI: 10.11852/zgetbjzz2024-1120

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Early childhood is the period when the brain development is the most critical and easily influenced by environmental factors.Nurturing care framework includes five areas: health, nutrition, responsive care giving, safety, and opportunities for early learning, which can guarantee and promote the healthy growth of children.Based on the critical period of children′s brain and the sensitive period of language learning, this paper summarizes nurturing care as meeting the physiological and psychological needs of children, separately explores their impact on early language learning and elaborates on the significance of focusing on early language development in children.

Advances in early intervention for language and social development in children with global developmental delay

GUO Cheng, YU Xiaodan

2025, 33(9):  987-991.  DOI: 10.11852/zgetbjzz2024-1159

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Global developmental delay (GDD) is a common neurodevelopmental disorder characterized by delays in two or more developmental domains in children under 5 years of age.Among these children, most exhibit impairments in the language domain, and closely related social skills are also typically delayed.The period from 0 to 5 years is a critical stage for brain development and a key window for language and social intervention.With appropriate supportive interventions during this stage, some GDD children can progress to within the normal functional range.However, current research on intervention methods and outcomes for GDD remains limited, both domestically and internationally.Therefore, this article will summarize the developmental characteristics of GDD children in language and social domains and review the current progress in early intervention practices and research.

Relationship between branched-chain amino acids and mother-offspring overweight/obesity transmission

FANG Chunli, ZHANG Zhihong, LIU Mengjiao

2025, 33(9):  992-996.  DOI: 10.11852/zgetbjzz2024-0937

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The escalating prevalence of childhood overweight and obesity may stem from the intergenerational transmission of maternal overweight and obesity.Branched-chain amino acids (BCAAs), including leucine, isoleucine, and valine, are essential amino acids involved in energy metabolism and protein synthesis.While BCAAs are closely associated with the risk of overweight and obesity, their role in mother-offspring intergenerational transmission remains unclear. Studies indicate that obese pregnant women exhibit elevated BCAA levels, which can be transferred to the fetus via placental transport.This process activates the mammalian target of rapamycin complex 1 (mTORC1), upregulating the expression of amino acid transporters and further facilitating fetal BCAAs uptake.Excessive BCAAs may disrupt glucose and lipid metabolism by promoting lipogenesis and impairing insulin signaling, thereby increasing offspring obesity risk.Given the critical role of BCAAs in the intergenerational transmission of obesity, this review synthesizes current evidence and mechanistic insights into the relationship between BCAAs and mother-offspring overweight/obesity transmission, in order to explore their potential as an intervention target and provide a scientific foundation for childhood obesity prevention strategies.

Current situation of the diagnosis and treatment of sleep disorders in children

ZENG Xiangdong, HU Wenguang

2025, 33(9):  997-1002.  DOI: 10.11852/zgetbjzz2024-0208

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Sleep refers to a natural, reversible, periodic physiological and behavioral state that has significant impacts on health. It plays a critical role in the growth and development, learning and memory, emotional and behavioral regulation, as well as immune modulation in children. The field of pediatric sleep medicine encompasses various specialties such as neurology, psychiatry, pulmonology, otolaryngology, stomatology, and endocrinology. With growing attention to children′s sleep, assisting children in improving their sleep, learning, daily living, and family functioning is a shared goal among all pediatricians.This review aims to summarize the current classification, assessment, and interventions for pediatric sleep disorders,in order to improve the diagnosis and treatment of sleep disorders in children.

Meta Analysis

Visual analysis of hotspots and trends in cerebral palsy rehabilitation research from 2004 to 2024

DANG Xue, XIONG Ziyi, ZHANG Hongyu, CAO Yinuo, SONG Wenjun, LIU Wei, YING Zhenhao

2025, 33(9):  1003-1009.  DOI: 10.11852/zgetbjzz2024-0858

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Objective To explore research frontiers and emerging trends in cerebral palsy (CP) rehabilitation over the past two decades, in order to provide insights for clinical rehabilitation research. Methods Publications related to CP rehabilitation (2004—2024) were retrieved from the Web of Science Core Collection from 2004 to 2024.CiteSpace 6.2.R6 was employed to analyze country/region contributions, institutional affiliations, authors, keywords, and reference co-citations. Results A total of 2 336 articles were included, with annual publications demonstrating an upward trajectory.The United States (563 publications) and the University of Queensland (97 publications) ranked as the most productive country and institution, respectively.Boyd achieved the highest academic influence (h-index: 24).Keyword burst analysis identified 20 emergent terms, while reference co-citation clustering yielded 17 thematic clusters, highlighting artificial intelligence (AI)-augmented CP rehabilitation and early intervention as current research frontiers. Conclusions Cerebral palsy rehabilitation research themes show a trend from traditional motor rehabilitation modes to artificial intelligence-assisted rehabilitation.Rehabilitation robotics, virtual reality-assisted cerebral palsy rehabilitation and early intervention are research hotspots in this field, CP rehabilitation research has evolved from traditional motor-based modes toward AI-assisted approaches.Rehabilitation robotics, virtual reality-assisted therapy, and early intervention represent key hotspots, which may bring breakthroughs in CP rehabilitation, and related research should be prioritized.

Clinical Research

Clinical application and efficacy of oral exercise intervention combined with music therapy in feeding disorder of premature infants

ZHOU Xin, QIN Xian, MENG Pingping, MAO Shigang, LIU Wendong, XING Jingsong

2025, 33(9):  1010-1014.  DOI: 10.11852/zgetbjzz2024-0885

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Objective To investigate the efficacy of oral motor intervention combined with music therapy in preterm infants with feeding difficulties, in order to provide evidence for establishing standardized clinical protocols. Methods A prospective study was conducted involving 68 preterm infants with feeding disorders admitted to the Neonatal Intensive Care Unit (NICU) of Qingdao Municipal Hospital between August 2022 and August 2023. Participants were randomly assigned using a random number table to either the control group (n=34) or the intervention group (n=34). The control group received standard touch by the nursing team, while the intervention group received additional oral motor intervention combined with music therapy. Both groups underwent a two-week treatment period. Outcome measures included daily weight gain, duration of gastric tube retention, total hospitalization length, incidence of complications, nutritional indicators, initiation of oral feeding, and Neonatal Oral Motor Assessment Scale (NOMAS) scores before and after intervention. Results Post-intervention, the intervention group exhibited significantly greater daily weight gain (t=3.180), shorter gastric tube retention time (t=3.549), reduced hospitalization duration (t=3.238), and lower incidence of feeding complications (χ²=4.802) compared to the control group (P<0.05). Nutritional markers, including albumin (t=3.388), globulin (t=3.128), and prealbumin (t=3.105) levels, were also significantly higher in the intervention group (P<0.05). NOMAS assessment revealed that the intervention group demonstrated significantly higher scores for normal sucking (t=5.274, 3.338, P<0.05) and lower scores for sucking disorganization and dysfunction (t=5.559, 7.102, 3.462, 3.217, P<0.05) compared to both baseline and the control group. Conclusion The combination of oral motor intervention and music therapy significantly reduces gastric tube dependence and hospitalization duration, decreases feeding-related complications, improves nutritional status, and demonstrates notable clinical efficacy in managing feeding difficulties in preterm infants, suggesting strong potential for widespread clinical application.

Effect of low-frequency repetitive transcranial magnetic stimulation combined with sling exercise training on children with spastic hemiplegic cerebral palsy

JIN Guosheng, WANG Shuting, LI Jianfei, HUAN Sai, WEI Ran, YUAN Aiyun, HOU Mei, BAI Guangtao

2025, 33(9):  1015-1019.  DOI: 10.11852/zgetbjzz2025-0094

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Objective To investigate the therapeutic effects of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) combined with suspension exercise therapy (SET) in children with spastic hemiplegic cerebral palsy (CP), in order to provide evidence for rehabilitation strategies. Methods Sixty children with spastic hemiplegic CP treated at Women′s and Children′s Hospital, Qingdao University between January and November 2024 were enrolled in this study, and were randomly assigned to control group (conventional rehabilitation, n=20), SET group (control treatment+SET, n=20), or combined group (SET treatment+LF-rTMS, n=20).All groups received 4 weeks of intervention.Outcomes were assessed pre- and post-treatment using Gross Motor Function Measure-88 (GMFM-88) domains D (standing) and E (walking/running/jumping), Peabody Developmental Motor Scales-2 Fine Motor (PDMS-2 FM), Berg Balance Scale (BBS).Besides, the root mean square value (RMS) of the biceps brachii, triceps brachii, rectus femoris, tibialis anterior and transversus abdominis muscles was used as the main observation index of surface electromyography (sEMG). Results After 4 weeks, all groups showed significant improvements inGMFM-88 domain D and E, BBS scores, and RMS of all target muscles (P<0.01), the PDMS-2 FM scores in the combined group and the SET group were higher than those before treatment (P<0.01).Comparisons between groups revealed that the combined group had superior GMFM-88 domain D (F=9.124) and E (F=9.422) scores, PDMS-2 FM (F=9.835), and BBS (F=9.019) compared to both other groups (P<0.05), significantly greater RMS improvements in biceps (F=10.855), triceps (F=11.341), rectus femoris (F=29.272), and tibialis anterior (F=27.940) versus controls and SET group (P<0.05), and the combined group and SET group had greater improvements in transversus abdominis RMS (F=43.100) versus controls (P<0.01). Conclusion LF-rTMS combined with SET can effectively improve the gross motor function and fine motor function, and balance function of children with spastic hemiplegic cerebral palsy, and try to promote in clinical practice.

Association of cognitive-behavioral impairment with urinary levels of epinephrine, norepinephrine, γ-aminobutyric acid and taurine in children with obstructive sleep apnea

JI Jiapeng, WANG Yuqing, CHEN Bolin, XU Xueyun, LYU Meng

2025, 33(9):  1020-1024.  DOI: 10.11852/zgetbjzz2024-0527

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Objective To investigate the association of urinary levels of epinephrine, norepinephrine, γ-aminobutyric acid (GABA), and taurine with cognitive-behavioral impairment in children with obstructive sleep apnea (OSA), in order to provide scientific evidence for predicting cognitive-behavioral impairment in these patients. Methods A total of 74 children diagnosed with OSA by polysomnography (PSG) at the Respiratory Department of Children′s Hospital of Soochow University between February 2023 and February 2024 were selected as study subjects, along with 30 children with primary snoring (PS) as controls.The Pediatric Quality of Life Inventory (PedsQL) scores and urinary levels of epinephrine, norepinephrine, GABA, and taurine were compared between groups. Results Compared to the PS group, children with OSA exhibited significantly lower PedsQL scores in school functioning (t=2.596, P=0.011) and social functioning (Z=2.506, P=0.012).The OSA group with cognitive-behavioral impairment demonstrated higher urinary epinephrine (F=25.725, P<0.001) and lower taurine levels (F=9.515, P<0.001) than both the PS group and OSA group without cognitive-behavioral impairment.Logistic regression analysis identified urinary epinephrine (OR=1.023, 95%CI: 1.001 - 1.046, P=0.041) and taurine (OR=0.985, 95%CI: 0.974 - 0.997, P=0.014) as significant independent predictors of cognitive-behavioral impairment in children with OSA. Conclusion Urinary epinephrine and taurine levels are dysregulated in children with OSA, with taurine demonstrating a potential protective effect against cognitive-behavioral impairment.

Status and influencing factors of iron deficiency anemia in 14 458 children aged 6 - 72 months in Haikou City

ZHUO Qiuling, LIN Bailang, HUANG Lihong, LIU Ying, FU Liying, SHI Liangsun, ZOU Binjun, CHEN Dan, ZHOU Jie, ZHOU Xiaomei

2025, 33(9):  1025-1029.  DOI: 10.11852/zgetbjzz2025-0083

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Objective To analyze the detection rate and influencing factors of iron deficiency anemia (IDA) in children aged 6 - 72 months in Haikou city, and provide reference for clinical diagnosis and treatment. Method A retrospective cross-sectional survey was conducted on the clinical data of 14 458 children aged 6 - 72 months with iron deficiency anemia who had finished physical examinations at Haikou Maternal and Child Health Hospital from October 2020 to July 2024. To know the prevalence and influencing factors of IDA in children aged 6 - 72 months through univariate analysis and logistic regression analysis. Results The detection rate of IDA in children aged 6 - 72 months in the past 5 years was 15.5%, and the overall IDA detection rate showed a slow upward trend over the 5 years (χ²_trend=9.19, P=0.002, Pearson r=0.025). Univariate analysis revealed that there were statistically significant differences (P<0.05) in birth age (t=193.04), preterm birth (χ²=14.380), recurrent respiratory infections (χ²=27.513), first pregnancy (χ²=40.809), and first pregnancy (χ²=40.809) between the anemic and non anemic groups. The results of multiple logistic regression analysis showed that recurrent respiratory infections were a high-risk factor for IDA (OR=1.451, 95%CI: 1.258 - 1.681, P<0.01). Conclusions The overall detection rate of IDA in children aged 6 - 72 months in Haikou City shows a slow upward trend. Recurrent respiratory infections are a high-risk factor for IDA, and active prevention and timely treatment of respiratory infections in children should be carried out.

Life quality and influencing factors of obstructive sleep apnea children

LIU Haiqin, MA Lina, NIU Xiaoxin, FENG Yani, SHI Yewen, ZHANG Yitong, ZHOU Yanuo, FAN Linjie, REN Xiaoyong, SHE Ningning

2025, 33(9):  1030-1034.  DOI: 10.11852/zgetbjzz2025-0077

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Objective To evaluate the quality of life (QoL) and its influencing factors in children with obstructive sleep apnea (OSA), providing a reference for clinical intervention. Methods A total of 527 children who underwent overnight polysomnography (PSG) at the Second Affiliated Hospital of Xi′an Jiaotong University between 2021 and 2023 were enrolled.Under the guidance of professional technicians, participants completed the Pediatric Sleep Questionnaire, the Epworth Sleepiness Scale for Children and Adolescents, and the OSA-18 quality of life survey.Based on PSG results, children were categorized into groups to assess QoL.Further stratification was performed according to OSA-18 scores into mild, moderate, and severe impact groups.Statistical analysis was conducted using univariate analysis and ordered multivariate logistic regression. Results Among the 527 children, 116 (22.0%) were in the primary snoring group, 310 (58.8%) in the mild OSA group, and 101 (19.2%) in the moderate-to-severe OSA group.As OSA severity increased, the proportion of children with snoring and apnea significantly rose (both P<0.05).Additionally, the percentage of children falling asleep within 20 minutes of bedtime (χ²=6.599, P=0.037) and requiring prolonged wakefulness after rising (χ²=25.617, P<0.001) also increased significantly.OSA-18 scores indicated a progressive deterioration in QoL with disease severity (χ²=17.74, P=0.001).When stratified by QoL impact, significant differences were observed among groups in N3 sleep proportion, total obstructive event count, longest obstructive event duration, total mixed event count, longest mixed event duration, total hypopnea count, longest hypopnea duration, lowest oxygen saturation (SaO₂), apnea-hypopnea index, and oxygen desaturation index (all P<0.05).Ordered multivariate logistic regression identified lowest SaO₂ as an independent influencing factor for reduced QoL (OR=0.861, 95%CI:0.746~0.993,P=0.040). Conclusions Compared with primary snoring, OSA exerts a progressively greater impact on children′s QoL as disease severity increases.Furthermore, lowest SaO₂ is an independent protective factor for diminished QoL, warranting clinical attention.

Appropriate Technology

Application of whole genome sequencing technology in infant genetic disease screening

ZHAO Chunjuan, LU Bohua, WANG Xian, LIU Ye, CUI Liru

2025, 33(9):  1035-1040.  DOI: 10.11852/zgetbjzz2024-0820

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Objective To explore the significance of whole genome sequencing(WGS) technology in the screening of genetic diseases in infants under 3 months old, in order to provide a new direction for precise diagnosis of genetic diseases. Methods Infants with clinically undiagnosed suspected genetic diseases who underwent WGS analysis in the neonatal ward of Baoding Hospital of Beijing Children′s Hospital Affiliated to Capital Medical University from April 2019 to April 2024, were selected as study subjects. Clinical data were collected to assess the significance of WGS technology in genetic diseases. Results A total of 82 infants were included, and genetic abnormalities were detected in 38 cases, with a detection rate of 46.34%(38/82). Among them, there were 3 cases of Gilbert syndrome, 2 cases of epidermolysis bullosa, 2 cases of Coffin-Siris syndrome, 2 cases of Prader Willi/Angelman syndrome, 2 cases of methylmalonic acidemia mut(0) type, 2 cases of methylmalonic acidemia with homocystinuria CblC type, and 1 case each of Sjogren-Larsson syndrome, maple syrup urine disease type 2, central gigantism syndrome type 2, Neurofibromatosis-Noonan syndrome/neurofibromatosis type 1, Marshall syndrome, X-linked congenital adrenal hypoplasia, Treacher Collins syndrome type 1, multiple congenital anomalies-hypotonia-seizure syndrome, autosomal dominant cutis laxa type 1, congenital central hypoventilation syndrome, spinal muscular atrophy type 2, 16p11.2 deletion syndrome with a 220kb deletion, dilated cardiomyopathy 1CC type, 11q23.3q25 copy number duplication, Kabuki syndrome type 2, Menkes disease, mitochondrial DNA mutation, xeroderma pigmentosum, immunodeficiency type 104, hypohidrotic ectodermal dysplasia, idiopathic infantile arterial calcification, neonatal severe encephalopathy, G6PD-deficient hemolytic anemia, CHARGE syndrome, and Niemann-Pick disease type C1. Conclusion As a precision medical tool, WGS enables a definitive diagnosis for some infants with genetic diseases and allows for early access to personalized treatment plans, thereby holding significant importance in the screening of genetic diseases.