Application of TMS technology in newborn screening has resulted in major expansion of disorder panel for metabolic diseases in recent years. This automated, multiplex testing methodology detects multiple analytes from single analysis of one blood spot, which leads to detection of 30-35 disorders of amino acids, organic acids, and fatty acids metabolism. The early identification of persons affected with inborn errors of metabolism has led to unexpected discoveries related to the natural history of the disorder or options for therapy. This article summarized (1) the basic principles of this technology and methodology. (2) Current status of application of this methodology in the United States, European countries and in China. (3) The positive impacts on the public health and advances in medical genetics. Finally (4) Challenges, issues and possible solutions. The purpose of this article aimed at introducing new technology and exploring the possibilities of implementing into developing countries where medical genetics is not developed and foreseeing the possible problems and obstacles.

BACKGROUND:Studies have shown that bone loss can lead to a series of diseases, such as osteoporotic fractures, thus seeking to increase bone mass has become a goal of the majority of researchers.
OBJECTIVE:To summarize the current studies of improving bone mass by using stem cel transplantation, hoping to the extensive application of stem cel transplantation in the clinical treatment of osteoporosis as early as possible.
METHODS:A computer-based search of PubMed and CNKI was performed by the first author to retrieve articles relevant to stem cel therapy for osteoporosis published from January 1997 to October 2014. The keywords were“to improve bone mass, regenerative medicine, bone marrow mesenchymal stem cel transplantation, stem cel therapy”in Chinese and English, respectively, which appeared in the title, abstract or keywords. Articles published recently or in authoritative journals were preferred, and final y 28 articles were included in result analysis.
RESULTS AND CONCLUSION:Bone marrow mesenchymal stem cel s which are isolated and cultured easily can proliferate rapidly and have multi-lineage differentiation potential. Studies have shown that the osteogenic differentiation of bone marrow mesenchymal stem cel s can real y improve bone mass, and obtain more achievements in the treatment of orthopedic disorders. This new cel therapy can help to accelerate bone healing and reduce treatment time, offering a new therapeutic choice for orthopedic surgery, plastic surgery, oral and maxil ofacial surgery, and therefore, it has broad application prospects.

Objective: To investigate the coverage of rotavirus vaccination among children under five years in Xiuzhou District of Jiaxing City, so as to provide insights into rotaviral diarrhea control. Methods: The rotavirus vaccination data of children aged two months to five years were extracted from the vaccination clinics of eight township hospitals and community health service centers through the Zhejiang vaccination information system. The coverage of rotavirus vaccination was analyzed among children with different genders, ages, types of vaccines and doses of vaccination. Results: Totally 32 752 children were included, and the coverage of rotavirus vaccination was 47.09%. The coverage of rotavirus vaccination was significantly higher in boys than in girls ( 47.65% vs. 46.46%, P<0.05 ), and a higher vaccination rate was seen in children with local household registration than in those without ( 56.76% vs. 38.75%, P<0.05 ). The vaccination rates of monovalent and pentavalent rotavirus vaccines were 36.90% and 10.18%, respectively. Totally 26 982 doses of rotavirus vaccines were vaccinated, with a mean dose of ( 0.84±1.02 ) per capita, and the vaccination rates of one, two and three doses were 20.75%, 17.37% and 8.96%, respectively. The median age was 6.00 months ( interquartile range, 3.00 months ) among children vaccinated with the first dose. Conclusions The coverage of rotavirus vaccination and full-dose vaccination are low among children under five in Xiuzhou District, with monovalent rotavirus vaccines predominant. Intensified rotavirus vaccination is therefore recommended.

Objective:To explore the characteristics of cerebral blood flow changes in MRI perfusion imaging in patients with Parkinson disease (PD) cognition disorders and its correlation with serum epidermal growth factor (EGF) level.Methods:One hundred and twenty PD patients diagnosed and treated from September 2017 to September 2020 in Hangzhou Third People′s Hospital were selected. According to the presence of mild cognitive impairment (MCI), they were divided into PD-MCI group (60 cases) and PD without cognition impairment (PD-NCI) group (60 cases). Another 60 cases of healthy physical examination during the same period were selected as the normal control group. MRI perfusion imaging was used to evaluate the cerebral vascular perfusion in each group, and the EGF level of each group was determined by enzyme-linked immunosorbent assay and compared.Results:The CBF and CBV in the PD-MCI group and PD-NCI group were lower than those in the normal control group, while the MTT was longer than that in the normal control group:(14.78 ± 2.49), (18.21 ± 2.84) ml/(100 g·min) vs. (18.21 ± 2.84) ml/(100g·min); (1.42 ± 0.29), (1.83 ± 0.31) ml/100 g vs. (2.87 ± 0.54) ml/100 g; (10.53 ± 2.18), (7.85 ± 1.39) s vs. (4.29 ± 1.05) s, and the differences were statistically significant ( P<0.05). The CBF and CBV in the PD-MCI group were lower than those in the PD-NCI group, while MTT was longer than that in the PD-NCI group, and the differences were statistically significant ( P<0.05). The level of serum EGF in the PD-MCI group and PD-NCI group were lower than those in the normal control group: (146.25 ± 30.12), (208.17 ± 21.25) ng/L vs. (242.38 ± 25.46) ng/L; the level of serum EGF in the PD-MCI group was lower than that in the PD-NCI group, and the differences were statistically significant ( P<0.05). CBF, CBV and EGF were linearly positively correlated with Montreal Cognitive Assessment Scale (MoCA) scores ( r1 = 0.810, r2 = 0.732, r3 = 0.825, P<0.05), while MTT was linearly negatively correlated with MoCA scores ( r4 = -0.756, P<0.05). Conclusions:PD-MCI patients have abnormal cerebral blood flow, and serum EGF level decrease. In PD-MCI patients, CBF, CBV and EGF are linearly positively correlated with MoCA scores, while MTT is linearly negatively correlated with MoCA scores.

Objective:To investigate the change in serum epidermal growth factor (EGF) level in patients with Parkinson's disease (PD) and correlate it with cognitive impairment.Methods:A total of 154 patients with early PD who received treatment in Hangzhou Third People's Hospital between July 2017 and June 2018 were included in this study. They were randomly divided into mild cognitive impairment (observation group) and no cognitive impairment (control group) according to the severity of cognitive impairment. Cognitive impairment was graded using Montreal cognitive assessment scale. Motor function was assessed using Unified Parkinson's Disease Rating Scale Part III formulated by International Parkinson and Movement Disorder Society. All these assessments were performed at enrollment and at the end of 2-year follow-up. Serum EGF level was measured by double antibody sandwich enzyme-linked immunosorbent assays. Patients without cognitive impairment were divided into four groups according to quartiles of serum EGF levels. The conversion rate of PD-MCI was calculated at 2 years of follow-up and compared between groups.Results:Among 154 patients, 68 (44.16%) patients developed PD-MCI, and 86 (55.84%) patients had no cognitive impairment. Montreal cognitive assessment scale score and serum EGF level in the observation group were (20.01 ± 3.15) points and (267.79 ± 63.18) ng/L, respectively, which were significantly lower than those in the control group [(28.21 ± 2.84) points, (491.53 ± 67.38) ng/L, t = 8.11, 9.03, both P < 0.001]. Unified Parkinson's Disease Rating Scale Part III score in the observation group was significantly higher than that in the control group [(23.47 ± 5.33) points vs. (18.69 ± 4.37) points, t = 5.18, P < 0.001]. Among the first quartile group, 14 (63.64%) patients converted to PD-MCI; while among the fourth quartile group, 2 (9.52%) patients converted to PD-MCI. The conversion rate of PD-MCI in the second, third and fourth quartile groups was significantly lower than that in the first quartile group (χ 2 = 9.73, 14.48, 33.47, all P < 0.05). Conclusion:Cognitive impairment in patients with PD is closely related to serum EGF level. Serum EGF level is a hematological index to predict cognitive impairment in patients with PD. This study is innovative and scientific.

OBJECTIVETo examine the effect of parents' occupational and life exposure during six months before pregnancy on executive function of preschool children.

METHODSPregnant women involved in the study came from the Ma'anshan Birth Cohort Study,a part of the China-Anhui Birth Cohort Study. Between October 2008 and October 2010, pregnant women who accepted pregnancy care in four municipal medical and health institutions in Ma'anshan city were recruited as study objects. A total of 5,084 pregnant women and 4,669 singleton live births entered in this cohort. Between April 2014 and April 2015, a total of 3,803 pre-school children were followed up. Finally, except 32 preschool children did not have EF evaluation result, there were 3,771 children included in this study. By using self-designed " Maternal health handbook", we researched parents' general demographic characteristics, and life and occupational exposure during six months before pregnancy. To research preschool children's executive function, we used the Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P). Univariate and multivariate statistical method was used to analyze the association of parents' life and occupational exposure during six months before pregnancy and preschool children's EF.

RESULTS3,771 preschool children's detected rate of inhibitory self-control index (ISCI), flexibility index (FI), emergent metacognition index (EMI) and global executive composite (GEC) dysplasia were 4.8% (182), 2.3% (88), 16.5% (623) and 8.6% (324) respectively. During six months before pregnancy, children whose parents were lived in a noise environment (OR=1.86, 95% CI: 1.36-2.54), whose maternal were exposed to pesticides were the risk of ISCI dysplasia(OR=3.60, 95% CI: 1.45-8.95). During six months before pregnancy, children whose maternal were exposed to pesticides (OR=6.72, 95% CI: 2.50-18.07) and whose father were exposed to occupational lead (OR=2.10, 95% CI: 1.25-3.54) were the risk of FI dysplasia. During six months before pregnancy, children whose parents were lived in a noise environment (OR=1.42, 95%CI: 1.18-1.71) and whose father were exposed to occupational lead (OR=1.30, 95%CI: 1.02-1.65) were the risk of EMI dysplasia. During six months before pregnancy, children whose parents were lived in a noise environment (OR=1.58, 95% CI: 1.24-2.01) and whose maternal were exposed to pesticides (OR=2.39, 95% CI: 1.02-5.58) were the risk of GEC dysplasia.

CONCLUSIONThe development of executive function is worse among preschool children whose parents live in noise environment, mother exposed to pesticides, and father exposed to occupational lead during six months before pregnancy.

Child ; Child, Preschool ; China ; Cohort Studies ; Environmental Exposure ; adverse effects ; Executive Function ; Family Characteristics ; Female ; Humans ; Lead ; adverse effects ; Male ; Occupational Exposure ; adverse effects ; Parents ; Pesticides ; adverse effects ; Pregnancy ; Prenatal Exposure Delayed Effects ; epidemiology ; psychology

OBJECTIVETo investigate the related influencing factors of preschool children's emotional and behavioral problems in early life and explore the associations between the symptoms of depression or anxiety during pregnancy and emotional and behavioral problems in preschool children.

METHODSBased on the Ma'anshan Birth Cohort Study of the China-Anhui Birth Cohort Study (C-ABCS), women were recruited at their first clinical visit between October 2008 and October 2010 in four municipal medical and health institutions of Ma'anshan City, a total of 5 084 pregnant women and 4 669 singletons live births were included in the birth cohort. Women completed measures of depressive (Self-Rating Anxiety scale) and anxious (Center for Epidemiologic Studies Depression) symptoms in pregnancy. By the age of 3-6 follow-up, 3 653 children were followed with completed information between April 2014 and April 2015, strengths and difficulties questionnaires were used to assessed offspring emotional and behavioral problems. Logistics regression was used to investigate the relationship between the symptoms of depression or anxiety during pregnancy and emotional and behavioral problems in preschool children.

RESULTSThe detected rates of emotional symptoms, conduct problems, hyperactivity and peer problems in preschool children were 6.3% (229/3 653), 7.5% (274/3 653), 7.6% (278/3 653) and 2.8% (103/3 653), while 7.6% (277/3 653) for total difficulties, 10.9%(398/3 653) for prosocial behavior and 27.4%(981/3 557) for impact respectively. Prevalence of anxiety and depression in the first trimester was 2.7%(100/3 653) and 4.7%(171/3 653) respectively, and in the second trimester was 2.0%(66/3 375) and 3.6%(122/3 375) respectively. After we controlled the confoundings of gestation age, place of residence, family income, maternal education, paternal education, premature birth and folic acid supplement before pregnancy, multinomial logistic regression analysis showed that the risk of children's emotional symptoms in maternal anxiety in both first-trimester and second-trimester group was higher than the group of no depression and anxiety symptoms, and OR(95%CI) was 5.90(2.00-17.48). Compared with whose mother no depression in both first-trimester and second-trimester, the risk of children's emotional symptoms in maternal depression in both first-trimester and second-trimester group was higher, and OR(95% CI) was 3.07 (1.30-7.28). And the risk of children's total difficulties of maternal anxiety in second-trimester was 2.27 (95%CI: 1.10-4.71) times of no anxiety in second-trimester. While the risk of children's total difficulties of maternal depression in second-trimester was 2.20 (95%CI: 1.24-3.93) times of no depression in second-trimester. Maternal emotional symptoms were not significant associations with conduct problems, hyperactivity, peer problems and prosocial behaviors (P> 0.05).

CONCLUSIONThere was a negative impact of maternal anxiety and depression symptoms during pregnancy on emotional and behavioral problems in preschool children. These findings highlight the need for additional clinical and research attention to both maternal depression and anxiety in pregnancy, which may be helpful to reduce the incidence of children's emotional and behavioral problems and act as an important measure in prevention.

Anxiety ; epidemiology ; Child ; Child, Preschool ; China ; Cohort Studies ; Depression ; epidemiology ; Female ; Humans ; Logistic Models ; Mothers ; psychology ; Pregnancy ; Prevalence ; Problem Behavior ; psychology ; Surveys and Questionnaires

OBJECTIVETo examine the effect of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with childhood overweight and adiposity, and to explore possible early life risk factors for obesity in preschool children.

METHODSBasic information of pregnant women and gestation period came from the Ma'anshan Birth Cohort Study, a part of the China-Anhui Birth Cohort Study (C-ABCS). Pregnant women in routine health care from four municipal medical and health institutions were enrolled voluntarily during October 2008 and October 2010 in Ma'anshan City. A total of 5 084 pregnant women and 4 669 singleton live births were included in this study. Between April 2014 and April 2015, 3 797 children were followed up. Children whose BMI were >85th percentiles for age and genders of World Health Organization (WHO) reference were considered as overweight, and >95th percentiles for age and genders cut-off values were considered as obesity (pathological and secondary causes of obesity were excluded). Gestational weight gain was defined according to the Institute of Medicine (IOM) guidelines. Univariate and binary regression model analysis was used to examine the effect of pre-pregnancy BMI and GWG with childhood overweight and adiposity.

RESULTSOf the 3 797 pregnant women, the prevalence of underweight, normal weight, overweight and obesity were respectively 22.6% (n=858), 70.3% (n=2 671), 6.2% (n=234) and 0.9% (n=34). There were 3 563 pregnant women who were obtained gestational weight gain data, the prevalence of inadequate GWG, appropriate GWG, excessive GWG were respectively 12.4% (n=443), 25.9% (n=922) and 61.7% (n=2 198). The prevalence of overweight and obesity were 11.5% (n=437) and 10.8% (n= 411) in preschool children, respectively. After adjusting confounding factors including age at delivery, genders of children, children age, birth weight, breastfeeding and household economic status, binary logistic regression analysis showed that pre-pregnancy overweight and obesity(OR=2.01, 95% CI: 1.53-2.65), excessive GWG(OR=1.65, 95% CI: 1.35-2.03) were risk factors for overweight and obesity, and pre-pregnancy underweight was protective factor for childhood overweight and obesity (OR=0.49, 95% CI: 0.39-0.62). Joint associations of pre-pregnancy BMI and inappropriate GWG were also noticed in the study: compared to only pre-pregnancy higher BMI or excessive GWG or indequate GWG, combination of high pre-pregnancy BMI and excessive GWG or high pre-pregnancy BMI and inadequate GWG, adverse effects on childhood overweight and obesity were much higher,OR (95%CI) values were 2.90(1.97-4.28), 3.17(1.44-6.97) respectively.

CONCLUSIONBoth high pre-pregnancy BMI and inappropriate GWG are associated with greater offspring BMI. Pregnant women should achieve appropriate weight gain and help prevent obesity in their children.

Body Mass Index ; Child ; Child, Preschool ; China ; Cohort Studies ; Female ; Humans ; Overweight ; epidemiology ; Pediatric Obesity ; epidemiology ; Pregnancy ; Prevalence ; Regression Analysis ; Risk Factors ; Weight Gain

OBJECTIVETo analyze the associations between pregnancy-related anxiety and the prevalence of subthreshold autism trait (SAT) in preschool children.

METHODSBaseline data came from the Ma'anshan Birth Cohort Study, a part of the China-Anhui Birth Cohort Study (C-ABCS). All the participants were enrolled among pregnant women who received prenatal health care in 4 municipal medical centers during Oct. 2008 to Oct. 2010. A total of 5 084 pregnant women were recruited at the beginning and 4 669 singleton live births were included until childbirth. The situation about pregnancy-specific anxiety during trimester and third trimester of women were evaluated by Pregnancy-specific Anxiety Questionnaire (PAQ). Between April 2014 and April 2015, the cohort was followed up again, and the Clancy Autism Behavior Scale (CABRS) filled out by parents was used for telling the SAT children from the healthy children among 3 663 preschool children. Univariate and binary regression model was used to estimate associations between the pregnancy-related anxiety during trimester and third trimester and the subthreshold autism trait in children.

RESULTSDuring the pregnancy, the detected rates of women with pregnancy-specific anxiety in trimester and the third trimester were 25.5%(935/3 663), 13.9%(501/3 592) respectively, and the detected rate of maternal pregnancy-specific anxiety in both periods was 7.7%(278/3 592). There were 290 positive children with SAT and the detection rate was 7.9%. After controlling possible confounding factors including children's genders, place of residence, supplement folic acid during pregnancy, preterm birth, exposure to second-hand smoke during pregnancy, the father (mother) cultural levels, the father (mother) nature of work and family income, the results of multinomial logistic regression analysis showed that maternal pregnancy-specific anxiety in trimester was the risk factor for SAT in preschool children (OR=1.51, 95% CI: 1.11-2.04), and there was no association between maternal pregnancy-specific anxiety in the third trimester and SAT in preschool children (OR=1.36, 95% CI: 0.82-2.22). Compared with the single function of maternal pregnancy-specific anxiety in trimester or the third trimester for SAT in preschool children, maternal pregnancy-specific anxiety in both periods presented a joint action that increasing the risk for SAT (OR=2.02, 95% CI: 1.36-2.98).

CONCLUSIONMaternal pregnancy-related anxiety was a risk factor for subthreshold autism trait in preschooler children. Pregnant women should try to keep a good mental state to create a good environment for fetal growth.

Anxiety ; epidemiology ; Autistic Disorder ; epidemiology ; Child ; Child, Preschool ; China ; Cohort Studies ; Dietary Supplements ; Female ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Complications ; psychology ; Pregnancy Trimester, Third ; psychology

Objective: To understand the epidemiological characteristics and relevant factors on the comorbidity of hyperactivity behavior and allergic disease among preschool children in urban areas of Ma'anshan city. Methods: During April 2014 to April 2015, 91 kindergartens over 3 years old were investigated. In the investigation, 16 439 questionnaires were distributed to parents, and 15 291 valid questionnaires were collected. Conners abbreviated symptom questionnaire (brief symptom questionnaire) was filled out by parents to assess the children's hyperactive behaviors. Information of allergic disease history was reported by parents, including allergic dermatitis/eczema, food/drug allergy, allergic rhinitis and asthma. Multivariate unconditional logistic regression was used to analyze the relevant factors of comorbidity of hyperactivity behavior and allergy diseases. Results: The average age of the 15 291 children were (4.5±1.0) years old, among which 53.7% (8 218/15 291) were boys. The prevalence of hyperactive behaviors was 8.6%(1 317/15 291), and the comorbidity rate of hyperactivity and allergic deseases was 1.7% (258/15 291). After confounding factors including gender, age, delivery mode, father's age and pregnancy complications adjusted, poor sleep quality (OR=4.45, 95%CI: 2.85-6.94), long duration of watching TV at weekend (OR=1.39, 95%CI: 1.00-1.94) and poor eating behavior (OR=1.78, 95%CI: 1.07-2.98) were relevant factors of the comorbidity of hyperactivity and allergic diseases. Conclusion The prevalence of comorbidity of hyperactivity behavior and allergic disease among preschool children in urban areas of Ma'anshan city was not high. Poor night sleep quality, long duration of watching TV and frequently picky eating were relevant factors of the comorbidity of hyperactive behaviors and allergic diseases.