Objective: To understand the serum vitamin A level of children aged 0-16 years in Nantong City, and to provide reference for scientific supplement of vitamin A for children and prevention of related diseases. Methods: A cross-sectional survey method was used to detect the serum vitamin A level of 3 271 children aged 0-16 years old by using high performance liquid chromatography (HPLC) in Nantong Maternal and Child Health hospital from January 2017 to December 2018, and the general information of children was collected. Results: The results showed that the average serum vitamin A concentration of 0-16 years old children was(0.31±0.08)mg/L, boys was(0.31±0.08)mg/L, which was lower than that of girls(0.32±0.09)mg/L. The proportion of insufficient and deficient vitamin A in boys was higher than that in girls(P<0.01); The levels of serum vitamin A were different by age groups, from high to low were >12~16, >6~12, >3~6, >1~3, ≤1 years old, the difference was statistically significant(F=3.48，P<0.05). The results showed that the proportion of normal, insufficient and deficient vitamin A in rural children were 51.2%, 43.5% and 5.3%, respectively. The proportion of vitamin A deficiency and deficiency in rural children was higher than that in urban areas(χ2=18.86，P<0.01). Conclusion The proportion of vitamin A insufficieng and deficiency among children in Nantong is higher, boys show worse vitamin A status compared of girls. More attention should be paid to these children and prevention of related diseases.

Objective: To understand the relationship between serum 25 hydroxyvitamin D [25(OH)D] levels and social emotional functions in children with autism spectrum disorder (ASD), in order to provide the reference for comprehensive interventions in ASD children. Methods: From January to June 2024, 124 ASD children aged 1-3 who received rehabilitation training at designated rehabilitation institutions in Nantong City, China were selected as the case group, while 124 healthy gender and age matched children who underwent health examinations at the same time were selected as the control group. The study used liquid chromatography-mass spectrometry to measure serum 25(OH)D levels in both groups of children. The Chinese Infant-Toddler Social and Emotional Assessment (CITSEA) was used to evaluate the emotional and socialization functioning of children with ASD, and to explore the relationship between serum 25(OH)D levels and their emotional and social functioning. Results: The serum 25(OH)D levels were lower in the case group [(59.22±19.96)nmol/L] compared to the control group [(85.50±21.59)nmol/L], and the rate of 25(OH)D deficiency or insufficiency (21.77%) was higher than that of the control group (7.26%), with statistically significant differences ( t/χ 2=-7.75, 8.91, P <0.01). The CITSEA evaluation results showed that the scores of the explicit behavior domain, implicit behavior domain, dysregulation domain, and ability domain in children with ASD were (63.37±10.44, 56.29± 9.36 , 57.04±10.65, 38.92±17.91) points, and the abnormal detection rates were 50.81%, 35.48%, 41.13%, and 45.16%, respectively. Among them, the abnormal detection rates of the explicit behavior domain and ability domain were higher in boys ( 57.14 %, 51.02%) compared to girls (34.62%, 23.08%), and the differences were statistically significant ( χ 2=4.18, 6.48, P < 0.05 ). The abnormal detection rates of explicit behavioral domains and dysregulated domains in ASD children with insufficient or deficient serum 25(OH)D (77.78%, 59.26%) were higher than those in the normal serum 25(OH)D group (37.11%, 18.56%), and the differences were statistically significant ( χ 2=14.06, 17.58, P <0.01). Conclusion The serum 25(OH)D levels in children with ASD are significantly lower compared to levels in healthy children, and developmental abnormalities in social emotional functioning are common concurrent problems.

Objective: To understand sensory characteristics and its correlation with behavioral problems among children with autism spectrum disorder (ASD), so as to provide reference basis for early diagnosis and comprehensive intervention of ASD children. Methods: Using cross sectional survey, 193 ASD children trained by Nantong rehabilitation institutions were recruited from September 2021 to February 2022. All children were investigated with the Short Sensory Profile (SSP) and Parent Symptom Questionnaire (PSQ). Results: Among the 193 ASD children, 106 (54.9%) children had abnormal sensory characteristics, including 45 (23.3%) with possible abnormalities and 61 (31.6%) with obvious abnormalities. The abnormal rate of auditory filtering was the highest in the seven dimensions, reaching 85.0%, followed by low strength/weakness, motor sensitivity, taste/smell sensitivity, low response/seeking sensation, vision/hearing sensitivity and tactile sensitivity. The total incidence of sensory abnormalities was 93.3%. There were significant differences in six dimensions of PSQ scale scores of ASD children with different degrees of sensory abnormalities, including conduct problems, learning problems, psychosomatic disorders, impulsive hyperactivity, anxiety and hyperactivity index ( H =38.89, 38.90, 19.53, 46.34, 34.54, 54.90, P <0.01). With the aggravation of sensory abnormalities in children with ASD, the scores of all dimensions of the PSQ scale increased significantly. The total score of SSP was negatively correlated with the six dimensions of conduct problems, learning problems, psychosomatic disorders, impulsive hyperactivity, anxiety and hyperactivity index in PSQ ( r =-0.53, -0.50, -0.32, -0.55, -0.43, -0.61, P <0.01). Conclusion ASD children generally have sensory abnormalities, which coincide with severity of behavioral problems. There is a positive correlation between sensory abnormalities and behavioral problems in ASD children. More attention should be paid to the abnormal sensory characteristics of children with ASD in the future diagnosis and treatment process.

Objective:To understand the sensory characteristics of children with autism spectrum disorder (ASD), and to explore its relationship with the clinical symptoms and to provide a reference basis for early diagnosis and intervention treatment of ASD.Methods:A cross-sectional survey was conducted to collect 216 children diagnosed with ASD according to DSM-5 from September 2021 to December 2021.All children were investigated with short sensory profile (SSP), autism behavior checklist (ABC) and social response scale (SRS). SPSS 21.0 was used for statistical analysis and the correlation between sensory characteristics and clinical symptoms of ASD children was analyzed by Pearson correlation.Results:The results showed that 120 of 216 with ASD children had abnormal SSP total score, with an abnormal rate of 55.6%.Among the seven dimensions, the abnormal rate of auditory filtering was the highest, reaching 83.8%, followed by low strength/weakness(60.2%), motor sensitivity(43.5%), low response/sensation seeking(39.8%), taste/smell sensitivity(37.5%), vision / hearing sensitivity(27.8%) and tactile sensitivity(17.6%), and the total incidence of paresthesia was 92.1%.There were significant differences in the total score of ABC and the five dimensions of sensation, communication, body movement, language and life self-care of ASD children with different sensory characteristics ( F=39.15, 39.99, 46.02, 29.18, 50.98, 51.76 respectively, all P<0.01). There were significant differences in the total score of SRS and social perception, social cognition, social communication, social motivation among ASD children with different sensory characteristics ( F=19.33, 29.47, 24.82, 29.68, 31.48, 39.86 respectively, all P<0.01). With the aggravation of sensory abnormalities, the total scores of ABC and SRS and the scores of each dimension increased.The total score of SSP was negatively correlated with the scores of sensation, communication, body movement, language, self-care and the total score of ABC ( r=-0.613, -0.631, -0.643, -0.558, -0.657, -0.679 respectively, all P<0.01). The total score of SSP was negatively correlated with social perception, social cognition, social communication, social motivation, autism behavior and the total score of SRS ( r=-0.440, -0.527, -0.504, -0.522, -0.542, -0.595 respectively, all P<0.01). Conclusion:Sensory abnormalities are common in ASD children, and with the aggravation of sensory abnormalities, the core symptoms and behavioral performance of ASD children are more obvious and positively correlated.

Objective: To explore the impact of maternal anxiety during pregnancy on social emotional development of toddlers aged 1-3 year old, so as to provide references for scientific early parenting and early intervention for toddlers with social emotional difficulties. Methods: From September 2022 to March 2023, a total of 815 toddlers aged 1-3 who underwent physical examinations and their mothers at Nantong Maternal and Child Health Hospital were enrolled. The Chinese Infant Toddler Social and Emotional Assessment (CITSEA) was used to evaluate the social emotional ability among toddlers. Maternal anxiety evaluated using the Self rating Anxiety Scale (SAS) during prenatal visit was collected. Results: The average scores on the externalizing, internalizing, dysregulation and competence domains of the CITSEA were (49.40±9.48,47.42±9.60,48.67± 10.15 , 50.07± 10.20), respectively. Among boys, the score of externalizing domain (50.89±9.45) was higher than that of girls (48.76± 9.50 ), while the score of competence domain (49.22±10.30) was lower than that of girls (51.17±9.84), and the differences were statistically significant( t =2.10, -3.03, P <0.05). The detection rates of abnormalities in the externalizing, internalizing, dysregulation, and competence domains were 7.36%, 7.12%, 7.61%, and 7.24%, respectively. Among them, boys (8.43%,6.32%, 7.96 %,7.49%) and girls (6.19%, 7.99 %,7.22%,6.96%) showed no statistical differences ( χ 2=1.50, 0.85, 0.16, 0.09, P >0.05). There were significant differences in externalizing domain scores（47.77±9.52，49.56±8.95，52.51±9.77） and competence domain scores（51.70±10.38，49.65±10.05，46.68±10.03） among toddlers of different maternal anxiety（normal, mild, moderate to severe） （ F =7.05,7.10, P <0.01）. There were significant differences in the abnormal detection rate of externalizing domain （4.81%，7.54%，11.17%） and competence domain（4.81%，6.96%，11.73%）（ χ 2=6.60，7.98， P ＜0.05）. Conclusion Maternal anxiety during pregnancy has a negative impact on the social emotional development among toddlers. In order to improve social emotional development of toddlers, multidimensional social support and education during pregnancy should be carried out.

Objective: To understand the neglect status among preschool non-only-child in Nantong, and to provide theoretical basis for the prevention and intervention of non-only child neglect. Methods: Using the method of random cluster sampling, a total of 1 141 parents of children from 9 kindergartens in the main urban area of Nantong were investigated with National Neglect Norm Scale for Children aged 3 to 6 years. Results: The neglect rate of preschool children in Nantong City was 28.6%, with neglect score being (40.21±6.67). The neglect rate of non-only-child was 32.6%, with neglect score being (41.14±6.73). The total and physical neglect rate of non-only-child were higher than that of only child, and the total neglect score and physical, emotional, educational, safety, medical neglect dimensional scores were higher than that of only-child, the difference were all statistically significant ( χ 2/ t = 6.21, 17.57; 3.95, 4.98, 3.45, 2.70, 2.01, 3.11, P <0.05). In non-only-child, univariate analysis showed that there were no significant differences in neglect rate and scores among children by gender and family types ( P >0.05); There was no significant difference in the child neglect rate between different age groups and children in different families ( χ 2 =3.59, 2.99, P >0.05), but there was a statistically significant difference in the degree of neglect ( t=2.79, 3.04, P <0.05). The neglect rate and score of non-only-child with high level of family income, parental education and parental relationship was relatively low, while the neglect rate and score in non-only-child whose grandparents serving as primary caregiver were higher ( P <0.05). Multivariate Logistic regression analysis showed that family monthly income less than 5 000 yuan was associated with 2.73 times higher risk of neglect compared to children with family monthly income more than 12 000 yuan. The risk of neglect among children whose grandparents serving as caregivers was associated with 2.17 times higher than children with parental care. The risk of neglect of children with poor parental relationship was 2.29 times higher than that of children with good parental relationship ( P <0.05). Conclusion The neglect among preschool non-only-child in Nantong City is common. Improvement in family economic status, parental care and parent relationship might help reduce neglect among preschool non-only-child.

Objective:To observe the effect of speech training based on mirror neuron theory on children with functional articulation disorder (FAD).Methods:Fifty children with FAD were randomly divided into a training group and a control group, each of 25. Both groups received 30 minutes of conventional speech training 5 times a week for 24 weeks, while the training group was additionally given 20 minutes of speech training based on mirror neuron theory simultaneously. Before and after the intervention, both groups were evaluated using the articulation speech ability assessment scale and the oral motor ability assessment scale.Results:Before the treatment, there were no significant differences between the 2 groups in any of the measurements. After the treatment, significant improvement was observed in all of the measurements for both groups, but at that point the training group′s articulation, motor ability of the lower jaw, tongue and lips were all significantly superior to the control group′s averages.Conclusions:Speech training based on mirror neuron theory can significantly improve the articulation, intelligibility and oral motor functioning of children with functional articulation disorder.

Objective:To investigate the efficacy of TiRobot navigation combined with ankle arthroscopy in the reduction and internal fixation of Hawkins type Ⅱ talus neck fracture.Methods:From January 2019 to September 2020, a total of 13 patients with Hawkins type Ⅱ talus neck fracture were admitted to Department of Foot and Ankle Surgery, Xuzhou Renci Hospital. They were 8 males and 5 females, with a mean age of 35.8 years (from 22 to 61 years). All fractures were reduced and fixated using TiRobot navigation combined with ankle arthroscopy. Time for fracture reduction assisted by intraoperative arthroscopy, time for internal fixation assisted by TiRobotic navigation, fracture union time and complications were recorded. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was used at the last follow-up to evaluate the functional outcomes.Results:All the operations were finished within 2 hour. The primary screw placement succeeded in all. The time for fracture reduction assisted by intraoperative arthroscopy averaged 52.8 min (from 43 to 66 min) and the time for internal fixation assisted by TiRobotic navigation 43.6 min (from 33 to 55 min). All the patients were followed up for an average 13.3 months(from 12 to 15 monhs). They obtained bony union within 3 months. One patient developed traumatic subtalar arthritis with mild pain and was treated conservatively. None of the patients had complications like incision infection or talus necrosis. The average AOFAS ankle-hindfoot score was 91.0 points (from 83 to 94 points) at the last follow-up.Conclusion:In the reduction and internal fixation of Hawkins type Ⅱ talus neck fracture, TiRobot navigation combined with ankle arthroscopy shows advantages of minimal invasion, accurate reduction and screw placement, and limited complications, leading to fine short-term functional outcomes.

Objective:To investigate the current status of prevention and treatment of esophagogastric variceal bleeding (EVB) in cirrhotic portal hypertension patients in Ningxia region.Methods:The retrospective and descriptive study was conducted. The clinical data of 820 cirrhotic portal hypertension patients who were admitted to 21 medical centers in Niangxia region from January 2018 to December 2020 were collected, including 85 cases in Ningxia Hui Autonomous Region People′s Hospital, 73 cases in the Fifth People′s Hospital of Ningxia Hui Autonomous Region, 59 cases in the Wuzhong People′s Hospital, 52 cases in the Qingtongxia People′s Hospital, 50 cases in the Guyuan People′s Hospital, 47 cases in the Yuanzhou District People′s Hospital of Guyuan City, 47 cases in the Yinchuan Second People′s Hospital, 40 cases in the General Hospital of Ningxia Medical University, 40 cases in the Tongxin People′s Hospital, 35 cases in the Yinchuan First People′s Hospital, 34 cases in the Third People′s Hospital of Ningxia Hui Autonomous Region, 32 cases in the Zhongwei People′s Hospital, 30 cases in the Lingwu People′s Hospital, 30 cases in the Wuzhong New District Hospital, 30 cases in the Yanchi People′s Hospital, 29 cases in the Ningxia Hui Autonomous Region Academy of Traditional Chinese Medicine, 28 cases in the Shizuishan Second People′s Hospital, 25 cases in the Shizuishan First People′s Hospital, 21 cases in the Haiyuan People′s Hospital, 20 cases in the Pengyang People′s Hospital, 13 cases in the Longde People′s Hospital. There were 538 males and 282 females, aged (56±13)years. Observation indicators: (1) clinical charac-teristics of cirrhotic portal hypertension patients; (2) overall prevention and treatment of EVB in cirrhotic portal hypertension patients; (3) prevention and treatment of EVB in cirrhotic portal hypertension patients from different grade hospitals. Measurement data with normal distribution were represented as Mean± SD. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. Results:(1) Clinical characteristics of cirrhotic portal hypertension patients: of 820 cirrhotic portal hypertension patients, 271 cases were in compensated stage and 549 cases were in decompensated stage. Of the 271 cases in compensated stage, there were 183 maels and 88 females, aged (53±12)years. There were 185 Han people, 85 Hui people and 1 case of other ethic group. The etiological data of liver cirrhosis showed 211 cases of viral hepatitis B, 4 cases of alcoholic liver disease, 8 cases of viral hepatitis C, and 48 cases of other etiology. There were 235 cases of Child-Pugh grade A and 36 cases lack of data. Of the 549 cases in decompensated stage, there were 355 males and 194 females, aged (57±14) years. There were 373 Han people, 174 Hui people and 2 cases of other ethic group. The etiological data of liver cirrhosis showed 392 cases of viral hepatitis B, 33 cases of alcoholic liver disease, 10 cases of viral hepatitis C, and 114 cases of other etiology. There were 80 cases of Child-Pugh grade A, 289 cases of grade B, 170 cases of grade C and 10 cases lack of data. (2) Overall prevention and treatment of EVB in cirrhotic portal hypertension patients: of 271 patients in compensated stage, 38 cases received non-selective β-blocker (NSBB) therapy, 16 cases received endoscopic treatment, 6 cases received interventional therapy. Of 549 patients in decompensated stage, 68 cases received NSBB therapy, 46 cases received endoscopic treatment, 28 cases received interventional therapy. (3) Prevention and treatment of EVB in cirrhotic portal hypertension patients from different grade hospitals: of 271 patients in compensated stage, 181 cases came from tertiary hospitals, of which 28 cases received NSBB therapy, 15 cases received endoscopic treatment, 6 cases received interventional therapy. Ninety cases came from secondary hospitals, of which 10 cases received NSBB therapy, 1 cases received endoscopic treatment. There was no significant difference in NSBB for prevention of EVB between tertiary and secondary hospitals ( χ2=0.947, P>0.05), while there was a significant difference in endoscopic treatment for prevention of EVB between tertiary and secondary hospitals ( χ2=5.572, P<0.05). Of 549 patients in decompensated stage, 309 cases came from tertiary hospitals, of which 22 cases received NSBB therapy, 29 cases received endoscopic treatment, 22 cases received interventional therapy. Two hundreds and fourty cases came from secondary hospitals, of which 46 cases received NSBB therapy, 17 cases received endoscopic treatment, 6 cases received interven-tional therapy. There were significant differences in NSBB and interventional therapy for prevention of EVB between tertiary and secondary hospitals ( χ2=18.065, 5.956, P<0.05). Conclusions:The proportion of receiving EUB prevention in cirrhotic portal hypertension in Ningxia is relatively low. For patients with compensated liver cirrhosis, the proportion of NSBB therapy and endoscopic treatment in the secondary hospitals was lower than that in tertiary hospitals. For patients with decompensated liver cirrhosis, the proportion of interventional treatment in secondary hospitals is lower than that of tertiary hospitals, but the proportion of NSBB in secondary hospitals taking is higher than that of tertiary hospitals.