OBJECTIVETo investigate the risk factors for asthma in children in Hefei, China and to provide a strategy for asthma control in this region.

METHODSA total of 400 children with a confirmed diagnosis of asthma, as well as 400 children of comparable age, sex, living environment, and family background, who had no respiratory diseases, were selected for a case-control study. A survey questionnaire survey was completed for all children. The obtained data were subjected to univariate and multivariate logistic regression analysis to determine the risk factors for asthma.

RESULTSThe logistic regression analysis showed that a family history of allergy, allergic rhinitis, infantile eczema, no breastfeeding, air-conditioning and passive smoking were the risk factors for asthma in children, with odds ratios of 9.63, 7.56, 4.58, 2.16, 1.73, and 1.55 respectively.

CONCLUSIONSIn order to reduce the incidence of asthma, we should advocate breast feeding, promote outdoor activities, keep ventilation natural, prevent passive smoking and cure allergic rhinitis.

Adolescent ; Asthma ; etiology ; prevention & control ; Case-Control Studies ; Child ; Child, Preschool ; China ; Female ; Humans ; Infant ; Infant, Newborn ; Logistic Models ; Male ; Risk Factors

OBJECTIVETo investigate how to establish good eating behavior and correct bad eating habits in infants by means of the child health care outpatient clinic and to promote the growth and development of infants.

METHODSInfants aged 0-3 months, who were randomly selected from the urban area of Chongqing, were divided into intervention and control groups. The infants in the intervention group received all intervention measures in the study, while those in the control group received conventional health care. Both groups were subjected to regular monitoring of eating behavior indices including time of introduction of foods, frequency of adding complementary foods and intake frequency of unhealthy foods to analyze the effect of intervention.

RESULTSIn the intervention group, foods were introduced at a reasonable time (P<0.01). Compared with those in the control group, the children aged 9 and 12 months in the intervention group had a significantly higher intake frequency of meat, vegetables and fruits (P<0.01) and a significantly lower intake frequency of sweet drinks (P<0.05), children aged 18 and 24 months in the intervention group had a significantly lower intake frequency of sweet drinks (P<0.01), and the children aged 24 months in the intervention group had a significantly lower intake frequency of ice cream (P<0.01).

CONCLUSIONSEating behavior intervention can promote the proper introduction of foods and regular addition of supplementary foods, as well as decrease the intake frequency of unhealthy foods such as sweet drinks and ice cream, thus improving the eating behavior of infants.

China ; Feeding Behavior ; Female ; Humans ; Infant ; Infant, Newborn ; Male

OBJECTIVETo investigate the role of non-high density lipoprotein cholesterol (non-HDL-C) in the assessment of cardiovascular disease (CVD) risk factors such as hypertension, pre-diabetes and diabetes in obese children.

METHODSAccording to the presence of complications (hypertension, pre-diabetes and diabetes), 810 children with central obesity were divided into two groups: one group with complications (n=499) and one group without complications (n=311). One hundred and sixty-four age- and sex-matched children served as the control group. Logistic regression analysis and receiver operating characteristic (ROC) curves were used to analyze the detection of non-lipid CVD risk factors by seven lipid markers.

RESULTSThe prevalence rates of hypertension and pre-diabetes were significantly higher in obese children with high non-HDL-C concentrations (≥3.76 mmol/L). After adjusting for waist circumference Z-scores, the area under the ROC curve for non-HDL-C was 0.680 to detect non-lipid CVD risk factors, while the areas for low-density lipoprotein cholesterol, total cholesterol and apoprotein B were 0.659, 0.669 and 0.647 respectively.

CONCLUSIONSCompared with the other lipid markers, non-HDL-C is a better predictor for non-lipid CVD risk factors in obese children. Measurement of non-HDL-C concentations is recommended for obese children.

Adolescent ; Cardiovascular Diseases ; etiology ; Child ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Female ; Humans ; Logistic Models ; Male ; Obesity ; blood ; complications ; Risk Factors

OBJECTIVETo study the application of umbilical venous catheter (UVC) combined with peripherally inserted central catheter (PICC) in very low birth weight infants (VLBWIs).

METHODSA retrospective analysis was performed on the VLBWIs in the neonatal intensive care unit who received UVC combined with PICC (catheter group, n=63) or did not receive the catheter treatment (non-catheter group, n=38) to compare the differences in nosocomial infection, weight gain, and length of hospital stay between the two groups.

RESULTSThe rate of nosocomial infection was 17% in the catheter group and 24% in the non-catheter group (P>0.05). Compared with the non-catheter group, the catheter group had a significantly higher weight gain (11.7±2.0 g/kg•d vs 10.6±2.3 g/kg•d; P<0.05) and a significantly shorter length of hospital stay (40±11 days vs 45±14 days; P<0.05). There was no significant difference in the incidence of complications between the two groups.

CONCLUSIONSCompared with those not receiving catheter treatment, the VLBWIs receiving UVC combined with PICC have a markedly higher weight gain and a markedly shorter length of hospital stay and show a declining trend in the rate of nosocomial infection.

Catheterization, Peripheral ; adverse effects ; Central Venous Catheters ; Cross Infection ; epidemiology ; Humans ; Infant, Newborn ; Infant, Very Low Birth Weight ; Retrospective Studies ; Umbilical Veins

OBJECTIVETo study the value of the Vanderbilt ADHD Parent Rating Scale (VADPRS) in the diagnosis of attention deficit hyperactivity disorder (ADHD).

METHODSVADPRS were completed by parents of 319 children with suspected ADHD. The children were then evaluated by a specialist based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) and 196 of them were diagnosed with ADHD. The value of VADPRS in the diagnosis of attention deficit and hyperactivity was evaluated using ROC curves. Diagnostic evaluation indexes at best operating point were calculated. Kappa values were calculated to explore the consistency of items in VADPRS and corresponding items in the DSM-IV criteria.

RESULTSThe area under the ROC curve for the diagnosis of attention deficit by VADPRS was 0.791. At the best operating point, its sensitivity was 0.83, specificity was 0.63, positive predictive value was 0.69 and negative predictive value was 0.79. The area under the ROC curve for the diagnosis of hyperactivity by VADPRS was 0.855. At the best operating point, its sensitivity was 0.82, specificity was 0.76, positive predictive value was 0.65, and negative predictive value was 0.88. The negative predictive value of VADPRS in general population screen was 0.99, based on the results of this study. The consistency of items in the VADPRS and corresponding items in DSM-Ⅳ criteria was poor, with the Kappa value of most items being less than 0.40.

CONCLUSIONSVADPRS is suitable for a general population screen for ADHD and it is helpful in the clinical diagnosis of ADHD, but its results can be influenced by parents' awareness and perception of children's behavior, and cannot replace the interview and judgment of professionals.

Adolescent ; Attention Deficit Disorder with Hyperactivity ; diagnosis ; psychology ; Child ; Child, Preschool ; Female ; Humans ; Male ; Parents ; Psychiatric Status Rating Scales

OBJECTIVETo investigate influential factors for the tendency to medicate and medication compliance in children with attention deficit hyperactivity disorder (ADHD).

METHODSA total of 188 children aged from 5 to 16 years, who were initially diagnosed with ADHD according to DSM-IV criteria, were included in the study. They underwent symptom assessment and cognitive function test. The compliance of methylphenidate treatment was evaluated.

RESULTSPatients with better emotional state, and fewer oppositional and hyperactive behaviors and those who had a family history of psychiatric diseases and who obtained lower scores in the number cancellation test (NCT), were more prone to medication and/or exhibited better medication compliance. Logistic regression analysis showed that fewer oppositional and hyperactive behaviors and lower NCT scores were the predictive factors for a higher tendency to medicate, and a better emotional state was the predictive factor for better medication compliance. Patients of predominantly inattentive type were more prone to medication and showed better medication compliance, as compared with those of combined type. Gender, age and symptom severity were not associated with the tendency to medicate and/or medication compliance.

CONCLUSIONSThere is a need to enhance medication compliance in children with ADHD who have hyperactive, impulsive and oppositional behaviors, and to improve their long-term social functions.

Adolescent ; Attention Deficit Disorder with Hyperactivity ; drug therapy ; psychology ; Central Nervous System Stimulants ; therapeutic use ; Child ; Child, Preschool ; Emotions ; Female ; Humans ; Logistic Models ; Male ; Medication Adherence ; Methylphenidate ; therapeutic use

OBJECTIVETo investigate the clinical efficacy and safety of oxcarbazepine (OXC) suspension in children with focal epilepsy.

METHODSA total of 118 children aged 2-14 years, who were newly diagnosed with focal epilepsy between October 2009 and December 2011, were randomly divided into experimental group (n=60) and control group (n=58). The experimental group was treated with an orally suspension of OXC and the control group was orally administered with carbamazepine (CBZ) tablets. The two treatment regimens were compared in terms of clinical efficacy and safety.

RESULTSAfter 13 and 26 weeks of treatment, the experimental group had response rates of 75% and 72% respectively and seizure-free rates of 53% and 50%, and the control group had response rates of 71% and 66% and seizure-free rates of 50% and 43% respectively. There were no significant differences in the clinical efficacy between the two groups (P>0.05). After 26 weeks of treatment, the adverse event rates of the experimental and control groups were 18% and 40% respectively, with a significant difference between the two groups (P<0.05).

CONCLUSIONSOXC suspension has a comparable clinical efficacy to that of CBZ tablets in children aged 2-14 years who are newly diagnosed with focal epilepsy, but OXC suspension causes fewer adverse events and has higher safety.

Adolescent ; Anticonvulsants ; therapeutic use ; Carbamazepine ; adverse effects ; analogs & derivatives ; therapeutic use ; Child ; Child, Preschool ; Epilepsies, Partial ; drug therapy ; Female ; Humans ; Male ; Suspensions

OBJECTIVETo investigate pathological changes in the epileptogenic foci of children with intractable epilepsy and their clinical significance.

METHODSThirty children with intractable epilepsy were included in the study. The epileptogenic foci were surgically resected and pathological changes in the obtained specimens were observed under a light microscope (LM) and a transmission electron microscope (TEM).

RESULTSUnder the LM, cortical dysplasia was found in 14 cases (47%), hippocampal sclerosis in 11 cases (37%), dysembryoplastic neuroepithelial tumor in 1 case (3%), ganglioglioma in 1 case (3%), and encephalomalacia in 3 cases (10%). The TEM observation revealed pathological changes in the ultrastructure of the hippocampus and extra-hippocampal cortex, such as changes in the number of synapses and synaptic structure, decrease in neurons and karyopyknosis, swelling and degeneration of astrocytes, and changes in mitochondrial structures.

CONCLUSIONSPathological changes in the hippocampus and extra-hippocampal cortex, especially synaptic remodeling, may be the morphological basis for spontaneous recurrent seizures in children with intractable epilepsy. The pathological changes and epileptiform activity are related to an imbalance between excitatory and inhibitory neurotransmission.

Adolescent ; Brain ; pathology ; ultrastructure ; Cerebral Cortex ; pathology ; ultrastructure ; Child ; Child, Preschool ; Epilepsy ; pathology ; surgery ; Female ; Hippocampus ; pathology ; ultrastructure ; Humans ; Infant ; Intelligence ; Male ; Microscopy, Electron, Transmission

OBJECTIVETo investigate the relationship of bilirubin/albumin (B/A) ratio and acidosis with abnormal brainstem auditory evoked potentials (BAEPs) in neonates with severe hyperbilirubinemia and its clinical significance.

METHODSA total of 967 neonates with severe hyperbilirubinemia between November 2008 and October 2009 were enrolled in the study. They were divided into two groups according to their BAEPs: normal BAEP group (n=799) and abnormal BAEP group (n=168). Univariate analysis and age-stratified Chi-square test were used to determine the relationship of B/A ratio and acidosis with BAEP.

RESULTSThe univariate analysis showed that the abnormal BAEP group had significantly lower pH and base excess values and a significantly higher B/A ratio compared with the normal BAEP group (P<0.05). The age-stratified Chi-square test showed that neonates with acidosis or with a B/A ratio greater than 1.0 had a significantly higher incidence of abnormal BAEPs than those without acidosis or with a B/A ratio less than 1.0 in any age (days) group of neonates with severe hyperbilirubinemia (P<0.05).

CONCLUSIONSHigh B/A ratio and acidosis are the risk factors for abnormal BAEPs in neonates with severe hyperbilirubinemia, which is the case for those in any age group. In order to reduce the incidence of hearing loss in any age group of neonates with severe hyperbilirubinemia, we should correct the acidosis and lower the B/A ratio as soon as possible.

Acidosis ; physiopathology ; Bilirubin ; blood ; Evoked Potentials, Auditory, Brain Stem ; Humans ; Hyperbilirubinemia ; blood ; physiopathology ; Infant, Newborn ; Serum Albumin ; analysis

OBJECTIVETo observe the therapeutic effect of Ommaya reservoir implantation on hydrocephalus in premature infants following intraventricular hemorrhage (IVH) and to investigate factors influencing the therapeutic effect.

METHODSAn ambispective cohort study was conducted on the clinical and follow-up data of 20 premature infants (gestational age <32 weeks, birth weight <1500 g) who received Ommaya reservoir implantation because of hydrocephalus following IVH. The therapeutic effect of Ommaya reservoir implantation was observed. These patients were divided into cure and treatment failure groups according to their treatment outcomes. The factors influencing therapeutic effects were investigated by univariate analysis.

RESULTSHydrocephalus was relieved significantly at 30 days after Ommaya reservoir implantation. However, some patients showed significantly decreased therapeutic effects since 3 months after operation: during 3-6 months after operation, 7 cases underwent ventriculoperitoneal shunt, 4 cases discontinued treatment because of economic reasons, and 1 case underwent endoscopic third ventriculostomy due to scalp hematoma with skin necrosis. The ventricles of the remaining 8 cases returned to normal size at 12-18 months after operation. As for postoperative complications, secondary IVH was seen in 8 cases, intracranial infection in 2 cases, and scalp hematoma with skin necrosis in 1 case. The univariate analysis revealed significant differences in gestational age, birth weight and duration of hydrocephalus before Ommaya reservoir implantation between the cure and the treatment failure groups (P<0.05).

CONCLUSIONSOmmaya reservoir implantation has a remarkable short-term therapeutic effect on hydrocephalus in premature infants following IVH, but later the effect decreases in some patients. Low gestational age, low birth weight and long duration of hydrocephalus may be the main factors influencing therapeutic effects of Ommaya reservoir implantation.

Cerebral Hemorrhage ; complications ; Cerebrospinal Fluid Shunts ; instrumentation ; Cohort Studies ; Female ; Humans ; Hydrocephalus ; surgery ; Infant, Newborn ; Infant, Premature ; Male