Objective:To analyze the vaccination recommendations and follow-up for children with special health status.Methods:In this retrospective cohort study, 509 children who attended the Consultation Clinic of Vaccination for Special Health Children in Beijing Children′s Hospital from August 2020 to February 2023 were selected, the children were given vaccination planning advice after the assessment. The clinical data were collected, including the general situation, special health conditions, vaccination recommendations and implementation status, occurrence and outcomes of suspected adverse events following immunization (AEFI) after vaccination. The vaccination situation and safety in these children were evaluated.Results:Among the 509 children, the most common special health conditions were cardiovascular system diseases (103 cases), followed by neurological diseases (88 cases) and neonatal problems (82 cases). After comprehensive evaluation and multidisciplinary collaboration, 399 children (78.4%) were recommended to receive vaccination/catch-up vaccination according to the immunization program, 63 children (12.4%) were recommended to receive some vaccines but temporarily suspend others, and 47 children (9.2%) were recommended to temporarily suspend vaccination. A total of 449 children (88.2%) were actually vaccinated, AEFI occurred in 49 children and 45 cases were considered as general reactions.Conclusions:The majority of children with special health status can be vaccinated, and the overall compliance and safety are high. The individualized immunization evaluation model of multidisciplinary collaboration is conducive to the completion of the immunization program of children with special health status.

Objective:To explore the effectiveness of the comprehensive healthcare management model for children with bacterial meningitis after discharge.Methods:This study was a retrospective cohort study that included 268 children with bacterial meningitis who were discharged from the infectious medicine ward of Beijing Children′s Hospital from September 2018 to September 2023. The children were managed with a multidisciplinary collaborative comprehensive healthcare management model after discharge. Outpatient data at 1 month and 6, 12 and 24 months after discharge were collected, including (height, weight, body mass index, nutritional feeding status, hearing and vision screening results, Gesell developmental assessment results and intervention guidance services. The follow-up interval or frequency was dynamically adjusted or increased according to the child′s situation. The paired sample t-test and chi square test were applied to compare the differences in Gesell developmental quotient (DQ) and developmental delay rate between the first and last assessments to preliminarily explore the effectiveness of the comprehensive healthcare management model for children with bacterial meningitis after discharge. Results:All the 268 children completed their first assessment one month after discharge, and 37 children were found to have abnormal physical growth, mainly obesity (28 children), and another 9 children were malnutrition. Nutritional intervention and feeding guidance services were provided to all the 37 children, and as of the last follow-up, 20 children′s physical growth evaluations had turned normal. A total of 188 children completed at least 2 developmental assessments, with an interval of (14.2±9.4) months between the first and last assessments (range: 3.1-49.5 months). The DQ values of in the energy region of adaptability, gross motor skills, fine motor skills, language, and personal social skills at the last assessment were significantly higher than those at the first assessment [(91.93±13.28) vs (80.73±15.96) points, (91.69±12.96) vs (78.31±16.58) points, (89.32±16.11) vs (80.68±15.63) points, (90.10±16.65) vs (82.04±18.43) points, (92.01±14.05) vs (77.82±17.42) points]; moreover, the rates of developmental delay in each energy region were significantly lower than those at the initial assessment (9.6% vs 35.1%, 9.6% vs 42.0%, 18.1% vs 33.0%, 13.3% vs 31.9%, 9.6% vs 42.0%) (all P<0.05). Among the 200 children who completed the hearing screening, 18 were found with hearing abnormalities, and 2 were diagnosed with hearing loss in the Otolaryngology Department. Among 217 children who completed vision screening, 23 had abnormalities, and 5 were diagnosed with ophthalmic abnormalities in Ophthalmology Department (2 with strabismus, 2 with refractive errors, and 1 with optic nerve injury). Two children were found to have autism-like behavior during monitoring, and were referred to a developmental behavior clinic to be diagnosed with autism spectrum disorder and were given early diagnosis and intervention guidance. Conclusion:The comprehensive healthcare management model for children with bacterial meningitis after discharge can integrate clinical and healthcare resources, which is beneficial for improving the prognosis and enhancing the quality of life for children with special health status.

Objective:To explore the situation and influencing factors of online health information seeking behavior of older patients with coronary heart disease.Methods:From July to November 2021, a cross-sectional survey was conducted on 451 older patients with coronary heart disease in four districts of Qingdao City using the general information questionnaire, Patient Activation Scale, Social Support Scale and Online Health Information Seeking Behavior Scale.Results:Olderpatients with coronary heart disease had a score of (70.69 ± 9.19) for online health information seeking behavior. The results of multiple linear regression analysis showed that gender, education, internet use frequency, social support and patient activation were the main influencing factors of online health information seeking behavior ( R2=0.639, F=31.58, all P<0.05). Conclusions:Older patients with coronary heart disease have a moderate level of online health information seeking behavior, and is influenced by multiple factors. Targeted measures should be taken to make patients actively search for disease information online to prevent disease deterioration and promote healthy aging.

Objective:To understand the identification value of pointing gestures in children with autism spectrum disorder(ASD) and its relationship with functional development.Methods:From December 2020 to November 2021, 1 099 children from Children’s Health Care Center of Beijing Children’s Hospital were tested by pointing gestures test, including 942 ASD children and 157 typical developed children.And the data of children's neuropsychological development scale from 800 children aged 1.0-5.9 were collected.SPSS 20.0 was used for statistical analysis. Trend test was used to analyze the distribution of pointing gestures test sensitivity in autistic children, and ANOVA was used to analyze the relationship between pointing gestures test scores and functional development fields.Results:The sensitivity of pointing gestures was 83.5% in children aged 1.0-10.0 years, 76.3%-93.1% in children aged 1.0-4.9 years, and 93.1%-95.1% in children aged 1.0-2.9.With the increase of age, the sensitivity of pointing gestures in autistic children (linear-by-linear association =164.889, P<0.001) and the Yoden index had a decreasing trend. The positive predictive value (91.53%-100.00%) and negative predictive value (75.36%-91.84%) were found in the children aged 1.0-10.0 years.The sensitivity of pointing gestures test was 44.9% in children with mild autism aged 1.0-10.0 years and 46.5%-65.9% in children with mild autism aged from 1.0-3.9 years. The sensitivity of pointing gestures test was 81.5% in children with moderate autism aged from 1.0-10.0 years and 87.3%-97.8% in children with moderate autism aged 1.0-3.9 years. The sensitivity of the pointing gestures test was 97.2% in children with severe autism aged 1.0-10.0 years, and 100.0% in children with severe autism aged 1.0-3.9 years. The sensitivity of the pointing gestures in mild, moderate and severe autism children decreased with age (linear-by-linear association values were 16.725, 64.232, 66.732 respectively, all P<0.001). The children with severe autism mainly scored 2 points (80.3%, 419/522) on the pointing gestures test , and children with moderate autism mainly scored 1 point(64.2%, 170/265) on the pointing gestures test. There were significant differences in functional development among different pointing gestures test groups.Functional development score in the autism children with 0 score of pointing gestures test was significantly higher than those with 1 score and 2 scores of pointing gestures test (all P<0.05). Conclusion:Pointing gestures has good sensitivity in children with autism (especially 1.0-4.9 years of age), and may serve as an objectively observable screening method. The better children with autism score on the pointing gestures, the better their functional development.

Objective:To identify the relationship between exposure to mobile phones and other electronic products and the ability development in children.Methods:Retrospective study.A total of 218 children aged 0.5-6.0 years presented to the Department of Health Care, Beijing Children′s Hospital, Capital Medical University form September 2019 to June 2020 for developmental examination were included.Those with nervous system, mental system diseases, endocrine system diseases and premature children were excluded.Their development was evaluated and the information about exposure to mobiles phones and other electronic products were collected. Chi- square test and Fisher′ s exact probability method were used to analyze the relationship between the exposure to mobile phones and other electronic products and the ability development in children.The influencing factors of children′s development in various fields were analyzed by the binary Logistic regression. Results:Abnormal fine movements of children aged 0.5-0.9 years were related to the latest time every night of exposure ( P<0.05). Abnormalities of adaptability, language and social self-care in children aged 1.0-2.9 years and abnormality of language in children aged 3.0-5.9 years were correlated with the number of hours of daily exposure (all P<0.05). Abnormalities of language and social self-care in children aged 1.0-2.9 years and abnormalities of adaptability, language and social self-care in children aged 3.0-5.9 years were correlated with the purposes of exposure (all P<0.05). Binary Logistic regression analysis indicated that the children′s gross motor was affected by the number of hours of daily exposure ( OR=1.868, P<0.05). The children′s fine motor movements were affected by mother′s educational level and the latest time every night of exposure ( OR=1.722, 2.355, all P<0.05). The children′s adaptability was affected by mother′s educational level, child caregivers, the number of hours of daily exposure and the latest time every night of exposure ( OR=1.711, 2.866, 1.895, 1.650, all P<0.05). The children′s speech was affected by the number of hours of daily exposure, the latest time every night of exposure, and the purposes of exposure (telephone or video phone, early education or study)( OR=2.348, 1.806, 0.328/0.350, all P<0.05). The children′s social interaction and self-care delay were affected by mother′s educational level, the number of hours of daily exposure and the purposes of exposure (telephone or video phone, early education or study)( OR=1.647, 2.678, 0.307/0.363, all P<0.05). Conclusions:The adverse effects of exposure to mobile phones and other electronic products on children should be well concerned.The exposure time of developing young children should be strictly controlled to prevent the adverse effects on the nervous system and development in children.For children who were already affected, relevant habits and behaviors should be timely corrected to avoid irreversible damages.

Objective:To explore the correlation between psychological resilience, self-neglect and depression among community empty-nest elderly people, and to analyze the mediating role of depression between psychological resilience and self-neglect.Methods:This study was a cross-sectional study. From July to October 2020, a stratified multi-stage sampling was used to select 560 community empty-nest elderly people from 6 community health service centers in Qingdao as the research object. The survey was carried out using the General Information Questionnaire, the Chinese version of the Connor-Davidson Resilience Scale (CD-RISC) , the simplified version of the Geriatric Depression Scale, and the Geriatric Self-neglect Scale. Pearson correlation was used to analyze the correlation between variables. The structural equation model was constructed using AMOS 24.0. A total of 560 questionnaires were distributed, and 549 valid questionnaires were recovered, with the valid recovery rate of 98.04%.Results:Among 549 empty-nest elderly people, the total score of Chinese version of CD-RISC was (64.30±14.57) , and the average score of the Geriatric Self-neglect Scale was (3.72±2.67) . There were 174 elderly people (31.70%) with depressive symptoms. The total score and the scores of each dimension of the Chinese version of the CD-RISC in the community empty-nest elderly people were negatively correlated with the total score of the simplified version of the Geriatric Depression Scale ( P<0.01) . Except for the dimension of safety self-neglect, the scores of other dimensions and the total score of the Geriatric Self-neglect Scale were negatively correlated with the total score and the scores of each dimension of the Chinese version of the CD-RISC ( P<0.01) , and were positively correlated with the total score of the simplified version of the Geriatric Depression Scale ( P<0.01) . Depression played a mediating role between the psychological resilience and self-neglect of empty-nest elderly in the community, and the mediating effect accounted for 53.85% of the total effect. Conclusions:Psychological resilience of community empty-nest elderly can directly affect self-neglect, and can also indirectly affect self-neglect through depression. Attention should be paid to the improvement of the psychological resilience of the empty-nest elderly in the community, to reduce the occurrence of self-neglect, and to promote their healthy aging.

ObjectiveTo investigate the efficacy and safety of sequential lenvatinib therapy after stereotactic body radiotherapy (SBRT) in the treatment of advanced primary liver cancer. MethodsA total of 18 patients with advanced primary liver cancer who were admitted to The Fifth Medical Center of Chinese PLA General Hospital from October 2018 to May 2019 were enrolled, among whom there were 4 patients with BCLC stage B liver cancer and 14 patients with BCLC stage C liver cancer. The prescribed dose of planning target volume was 48-55 Gy (median 50 Gy) in 6-9 fractions, and the median of single dose was 6 (5-9) Gy per fraction. Oral administration of lenvatinib was given since 1 week after SBRT was finished, with a median medication time of 9.5 (3.6-25.8) months. Follow-up was performed once a month for the first 3 months after treatment and once every 3 months after 3 months of treatment. The Kaplan-Meier method was used to calculate overall survival (OS) rate, progression-free survival (PFS) rate, and local control (LC) rate, and the incidence rates of adverse reactions and complications were also observed. ResultsUp to the follow-up on November 30, 2020, a total of 8 patients died, among whom 3 died of liver failure, 3 died due to tumor progression, 1 died of perforation of gallbladder, and 1 died of gastrointestinal bleeding. At 3, 6, 9, 12, and 18 months of treatment, the OS rates were 100%, 94%, 83%, 72%, and 67%, respectively, the PFS rates were 100%, 67%, 50%, 22%, and 17%, respectively, and the LC rates were 100%, 94%, 94%, 94%, and 94%, respectively; the median OS time was ＞18 months, and the median PFS time was 9 months. Of all patients, 1 (6%) had a grade 3 adverse reaction during SBRT and 2 (11%) experienced a grade 3 adverse reaction during lenvatinib treatment, and no fatal adverse reaction was observed. ConclusionIt is preliminarily proved that sequential lenvatinib therapy after SBRT is an effective and safe treatment method for advanced primary liver cancer.

Objective:To investigate the correlation between social and linguistic parenting behaviors and developing capability of children with autism.Methods:From August 2020 to December 2020, the social and linguistic parenting behaviors of 302 parents of children diagnosed with autism were investigated in the outpatient department of the hospital.Meanwhile, the data of Gesell scale for children, the social life competence scale for infant and junior middle school students, the autism behavior checklist and the Cancy autism behavior scale were collected.SPSS 20.0 software was used for statistical analysis.Independent sample t test and analysis of variance were used to compare the social and linguistic parenting behaviors of different parents.Pearson correlation analysis was used to analyze the correlation between the social and linguistic parenting behaviors of parents and children's developmental ability and symptom severity. Results:There were no statistically significant differences in children's social and language development parenting behavior between father and mother ( t=1.033, P=0.303; t=-0.312, P=0.756). There were no statistically significant differences in children's social and linguistic parenting behaviors between fathers of different age groups ( F=1.425, P=0.244; F=1.127, P=0.345). Among mothers of different age groups, the social parenting behaviors of <30 years old and 30-34 years old groups were significantly better than those of 35-39 years old group ( F=3.374, P=0.019; LSD: P=0.010, P=0.006). Among fathers, the social parenting behavior( F=4.346, P=0.008; LSD: P=0.020, P=0.001) and social + linguistic parenting behavior in the graduate group and college group were significantly better than those in the high school/vocational group( F=3.965, P=0.012; LSD: P=0.020, P=0.002). Among mothers, the social parenting behavior ( F=2.812, P=0.040; LSD: P=0.008, P=0.023, P=0.009), linguistic parenting behavior ( F=3.769, P=0.011; LSD: P=0.010, P=0.025, P=0.001), social + linguistic parenting behavior ( F=3.654, P=0.013; LSD: P=0.005, P=0.015, P=0.002) in graduate and above groups were significantly better than those in college group, high school/vocational group, junior high school and below groups.The scores of social parenting behavior(40.72±6.80), linguistic parenting behavior(27.20±5.22), and social + linguistic parenting behavior(67.92±11.10) were significantly correlated with children’s fine motor(61.75±16.41)( r=0.193, P=0.001; r=0.153, P=0.009; r=0.190, P=0.001), cognition(68.28±16.83)( r=0.231, P=0.000; r=0.186, P=0.001; r=0.229, P=0.000), language(53.01±18.55) ( r=0.262, P=0.000; r=0.305, P=0.000; r=0.304, P=0.000) and social self-care(61.44±17.85) ( r=0.264, P=0.000; r=0.238, P=0.000; r=0.274, P=0.000). The scores of linguistic parenting behavior and social + linguistic parenting behavior were correlated with children's social life ability (8.65±0.89) ( r=0.142, P=0.046; r=0.140, P=0.049). There was no significant correlation between social parenting behavior, linguistic parenting behavior, social + linguistic parenting behavior and the scores of ABC scale (50.53±21.39) ( r=-0.089, P=0.336; r=-0.115, P=0.215; r=-0.107, P=0.250) and CABS scale (13.96±4.54) ( r=-0.050, P=0.490; r=-0.059, P=0.411; r=-0.058, P=0.421). Conclusions:The social and linguistic parenting behaviors are related to their age and educational level, and are significantly correlated to developing capability of children with autism, but have nothing to do with the severity of children's symptoms.

Objective:To explore the mediating effects of resilience and depression on the relationship between social support and self-neglect.Methods:From July to October 2020, a cross-sectional survey was conducted among 549 empty-nest community-dwelling elderly in the community using the social support rating scale, Connor and Davidson resilience scale, geriatric depression scale and elderly self-neglect scale. SPSS 22.0 and AMOS 24.0 were used for data analysis, including descriptive analysis, correlation analysis and structural equation modeling.Results:The scores of social support, resilience and self-neglect of the empty-nest elderly were (38.63±7.47), (64.30±14.57) and (3.72±2.67) respectively, and 31.70% (174/549) of the subjects had depressive symptoms. The score of self-neglect was negatively correlated with the score of social support ( r=-0.597, P<0.01) and resilience ( r=-0.557, P<0.01), and positively correlated with depression score ( r=0.675, P<0.01). The score of social support was positively correlated with resilience score ( r=0.531, P<0.01) and negatively correlated with depression ( r=-0.597, P<0.01). Social support could affect self-neglect directly ( β=-0.485, P<0.05), and it could also influence self-neglect indirectly through the partial mediating effect of resilience ( β=-0.451, P<0.05). The mediating effect of resilience and depression accounted for 12.18% and 36.00% of the total effects respectively. Conclusion:Social support could influence self-neglect directly or indirectly through resilience and depression. The empty-nesters should be encouraged to participate more in social activities so as to improve their resilience, reduce the occurrence of self-neglect.

Objective:To understand the health status of children in an organization in the urban area of Beijing.Methods:From October to November 2019, 558 children aged from 0 to 13 of employees in an organization in Beijing received physical examination, including height, weight, ophthalmology and otorhinolaryngology, heart and lung examination, etc.Statistical analysis was conducted on the items related to physical status and with higher detection rate. Body mass index (BMI)≥P 85(P is the percentile compared to the standardized growth curve) was defined as overweight and BMI≥P 95 as obese. The rate and composition ratio were used to describe the relevant data of each item in children′s physical examination. The differences between different age groups and gender groups were compared with the chi-square test. Results:The items with high detection rate were overweight, obesity, rhinitis, caries, phimosis, etc. The ratio of children′s weight and height ≤P 10 were 3.4% and 2.7%, ≥P 97 were 12.0% and 7.0%respectively; the rates of overweight (BMI≥P 85) and obesity (BMI≥P 95) in children were 13.8% and 13.3% respectively, the ratio of weight ≥P 97, height ≥P 97 and BMI≥P 95all increased with age in all children and in boys (all P<0.05), the ratio of BMI≤P 5 increased with age ( P<0.05), and the ratio of body weight ≥P 75 decreased with age in boys ( P<0.05); the ratio of weight ≥P 75 in boys was significantly higher than that in girls ( P<0.05). The prevalence of rhinitis in children was 39.8%, among which the prevalence of allergic rhinitis was 14.9%.The prevalence of allergic rhinitis in the 3.0-5.9 age group of all children was significantly higher than that in 0.0-0.9 age group and 6.0-9.9 age group (both P<0.05), the prevalence of total rhinitis in the 3.0-5.9 age group of girls was significantly higher than that in 0.0-0.9 age group, 1.0-2.9 age group and 10.0-13.9 age group (all P<0.05). The prevalence of dental caries in children (excluding the group of 0.0-0.9 years old) was 26.0%, the prevalence of dental caries in the 3.0-5.9 age group of all children was significantly higher than that in 1.0-2.9 age group and 10.0-13.9 age group (both P<0.05), the prevalence of dental caries in 3.0-5.9 age group and 6.0-9.9 age group of boys and girls were both significantly higher than that in 1.0-2.9 age group (all P<0.05). The prevalence of phimosis in boyswas 31.5%, the phimosis rates were significantly higher in the 1.0-2.9 age group and 3.0-5.9 age group than that in 6.0-9.9 age group and 10.0-13.9 age group (all P<0.05). No statistical differences were found in the prevalence of allergic rhinitis and dental caries between obese and non-obese children ( P>0.05). Conclusion:The severity of overweight and obesity in children is beyond our expectation, the allergenicity problem is becoming more and more prominent, the prevention and treatment of dental caries needs to be improved urgently, and the phimosis problem in boys needs to be paid attention to.