Objective: To explore the effects of grandparent involvement in parenting on health related behaviors among urban preschool children, so as to provide a basis for the development of interventions for unhealthy behaviors among preschool children with different parenting pattern. Methods: A total of 5 431 preschool children aged 3-6 years old in Xinbei District, Changzhou City, were selected by census method during January to October, 2022. General household characteristics and health related behaviors of children were investigated by questionnaires, and the differences in health related behaviors with different parenting pattern involving grandparents were explored by the χ 2 test. A multifactorial Logistic regression model was used to analyze the effects of grandparenting on preschool children s health behaviors. Results: About 51.2% of preschoolers were raised by both parents, 46.1 % were co parented by grandparents, and 2.7% were raised by grandparents. After multifactorial Logistic regression analysis controlling for age, gender, annual household income, and family structure, children co parented by grandparents had a reduced risk of screen exposure time>1 h/d ( OR =0.79, P <0.05), with increased risks of outdoor activity time<2 h/d ( OR =1.30, P < 0.05 ), sleep duration <10 h/d ( OR =1.31, P <0.05), sleep difficulties ( OR =1.39, P <0.05) and adverse eating behaviors ( OR =1.20， P < 0.05), compared with children parented by both parents. Children raised by grandparents were at increased risk for outdoor activity time<2 h/d ( OR =2.19) and unhealthy eating behaviors ( OR =1.39) ( P <0.05). Conclusions Compared with children raised by both parents, the incidence of unhealthy behaviors is increased in children raised by parents and grandparents and in children raised by full grandparents. Active intervention should be focused on unhealthy behaviors of preschool children with pareting involving grandparents to promote the physical and mental health of preschool children.

Objective:To compare the efficacy and adverse events of induction chemotherapy combined with radiotherapy alone (IC+ RT) and induction chemotherapy combined with concurrent chemoradiotherapy (IC+ CCRT) for nasopharyngeal carcinoma in the era of intensity-modulated radiation therapy in this Meta-analysis.Methods:Retrospective or randomized controlled clinical studies published between 2010 and 2020 were searched from the Cochrane Library, PubMed, and Web of Science databases. The selected studies included nasopharyngeal carcinoma patients treated with IC+ CCRT or IC+ RT. STATA 12 software was used to combine the hazard ratio (HR), risk ratio (RR) and 95% confidence interval (CI), and random or fixed effect models were used for statistical analysis.Results:A total of 2483 patients from eight retrospective studies were included. The overall survival in the IC+ CCRT group was similar to that in the IC+ RT group ( HR=0.78, 95% CI: 0.58-1.04, P=0.091). However, the distant metastasis-free survival ( HR=0.56, 95% CI: 0.42-0.74, P<0.001) and progression-free survival ( HR=0.65, 95% CI: 0.54-0.77, P<0.001) were improved in the IC+ CCRT group compared with those in the IC+ RT group. In terms of adverse reactions, the acute adverse reactions in the IC+ CCRT group were increased significantly compared with those in the IC+ RT group. Conclusions:In the treatment of nasopharyngeal carcinoma, the overall survival of two treatment modes is similar, but the distant metastasis-free survival and progression-free survival in the IC+ CCRT group are better than those in the IC+ RT group, whereas the incidence of adverse reactions is also increased. IC+ CCRT may be a recommended treatment for nasopharyngeal carcinoma patients, but more research is needed.

Objective To investigate the characteristics of cognitive development of children with attention deficit hyperactivity disorder (ADHD) by using resting-state functional magnetic resonance imaging (fMRI) degree centrality (DC) from the view of neuro-imaging.Methods Forty-five ADHD children were diagnosed at specialist clinic of Changzhou Children's Hospital,Nantong University from June 2015 to December 2016,and they were divided into 3 groups according to their ages (children aged 7-8 years old,9-10 years old and 11-12 years old,15 children in each group) and received the resting-state fMRI scans.DC value was used to analyze fMRI data.Comparative analysis was done pairwise between the three groups.Results Compared with 7-8 years old group,9-10 years old group showed lower DC value in cerebellum posterior lobe (t =-4.36) and higher DC in inferior parietal lobe (t =-5.86),and the differences were statistically significant (all P ＜ 0.05,after correction).Compared with 7-8 years old group,11-12 years old group showed lower DC value in cerebellum posterior lobe (t =-4.99) and higher DC in left superior temporal gyrus (t =5.18) and superior frontal gyrus (t =4.58),and the differences were statistically significant (all P ＜ 0.05,after correction).Compared with 9-10 years old group,11-12 years old group showed lower DC value in inferior parietal lobe (t =-5.71) and higher DC value in left superior temporal gyrus (t =5.05) and superior frontal gyrus (t =4.36),and all the differences were statistically significant (all P ＜ 0.05,after correction).Conclusion Children with ADHD at different ages had different characteristics of brain regions of fMRI.It can offer objective evidence for early cognitive intervention of children with ADHD at different ages.

Objective To investigate the semantic priming of boy with attention deficit hyperactivity disorder( ADHD) and explore whether the semantic priming deficits was associated with behavioral problems by event-related potential(ERP). Methods Thirty boy with and without ADHD aged from 7 to 13 years were asked to finish the semantic Semantic judgment task. The study took advantage of t-test ( independent-samples) to compare the amplitude and latency of the N400 in both groups,as well as behavioral data.Behav-ioral problems were assessed by the Achenbach child behavior checklist( CBCL) ,and Pearson correlation a-nalysis were used to explore the relationship between behavioral problems and semantic priming. Result-s Under the condition of semantic correlation,the hyperactive factor of CBCL in ADHA group was positively correlated with ERP N400 amplitude ( r=0.44,P<0.05) and negatively correlated with reaction accuracy ( r=-0.48,P<0.05).Under the semantic irrelevant condition,the latency of ERP N400 in ADHA group was pos-itively correlated with hyperactivity factor (r=0.53,P<0.05)and aggression factor of CBCL(r=0.62,P<0.05).The N400 amplitude of the ADHD group was significant higher than that in the control group under se-mantic related conditions((-11.36±4.77)μV vs (-7.66±5.24)μV,P=0.006),and the latency of the N400 in ADHD was more delay((369.6±44.09)ms vs (341.27±24.54)ms,P=0.004),and the reaction times (RT) was much longer((936.18±135.03)ms vs (857.78±103.45)ms,P=0.014).The latency of the N400 in ADHD was more delay than that in the control group under semantic irrelevant conditions ( ( 383. 93 ±29.66)ms vs (362.33±29.66)ms,P=0.012),and accuracies of ADHD group was lower than that of control group(0.43±0.39 vs 0.81±0.23,P<0.01).Conclusion The present result indicates that children with ADHD exhibit a deficit in the semantic priming mechanism,and the deficit is positively correlated with hy-peractivity and impulsiveness.

Objective To explore the functional properties of the brain's resting state networks in neonates with hypoxic ischemic encephalopathy.Methods Use the methods of functional MRI probabilistic tractography and graph theory to compare the global and local functional properties of the brain's resting state network between 12 cases of children with mild HIE and 14 cases of children with moderate/severe HIE.Results In terms of global topological properties,both the mild and moderate/severe group showed small-world properties.The γ and λ in the mild group were 2.450± 1.642 and 1.542±0.564 and in the moderate/severe group were 2.331± 1.554 and 1.353±0.672,respectively,which were in line with the characteristics of small-world properties (γ＞ 1 and λ ≈ 1).As far as local topological properties were concerned,the distribution of hub regions in the functional networks had smaller number of nodes in the moderate/severe group (8 nodes) than the mild group (14 nodes).The comparison of nodal efficiencies showed that the moderate/severe group had significantly reduced nodal efficiency in the left insula opercula,left supramarginal gyrus,left and right temporal pole and right middle temporal gyrus(the nodal efficiencies of the moderate/severe group:0.4089±0.0865,0.3377±0.1223,0.3842±0.0898,0.3508±0.1295,0.3564±0.0843;the nodal efficiencies of the mild group:0.4801±0.0762,0.4465±0.0898,0.4655 ±0.0812,0.4640±0.0690,0.4271±0.0636,all P＜0.05).Conclusion The topological structure of resting state functional network in children with moderate and severe hypoxic-ischemic encephalopathy is obviously backward than that in children with mild hypoxic-ischemic encephalopathy,which may be related to abnormal language,movement and cognitive function in the late stage.

Objective To compare and analyze the event related potential ( ERP ) and behavioral characteristics of sleep disordered breathing ( SDB ) and normal children by the persistent operating test ( CPT-AX) task,and to explore the characteristics and neural mechanism of the cognitive deficits in the left and right brain of school age SDB children. Methods SDB children( n=20) and normal children( n=20) aged 6-8 were selected. All subjects were tested by CPT-AX ( Go/Nogo task) . The ERP behavior of SDB and normal children was recorded,and the N2,P3 amplitude and latency of F3,Fz,F4 lead were compared. Re-sults ( 1) There was no significant difference between SDB group and normal group in behavioral correct number (36. 45±4. 69 vs 35. 00±3. 46),the reaction time ((516. 84±54. 14)ms vs (496. 94±78. 89)ms) and false alarm number( 1. 0 ( 0. 25,3. 75) vs 0. 5 ( 0. 00,3. 00) ) ( all P>0. 05) . ( 2) Comparison of F3,Fz and F4 lead:(1) SDB group:there was no significant difference in Go-N2 amplitude (-7. 75(-12. 03,-1. 09)μV vs (-8. 69±5. 72) μV vs ( -7. 12±4,68)μV) and Nogo-N2 amplitude((-10. 72±4. 49)μV vs (-12. 16±4. 60) μV vs (-11. 78±4. 44) μV) in the left,middle,and right of frontal regions. (2) Control group:there was no statistical difference between F3 and Fz ((-7. 26±3. 18)μV vs (-9. 09±3. 11)μV)(P>0. 05) in N2 amplitude and there was no statistical difference between F3 and F4((-7. 26±3. 18) μV vs (-6. 10±3. 36)μV) in N2 amplitude (P>0. 05). The N2 amplitude difference of Fz and F4 ((-9. 09± 3. 11) μV vs (-6. 10±3. 36)μV ) was statistically significant (P<0. 05). The Nogo-N2 amplitude differ-ence between F3 and Fz((-14. 05±3. 31) μV vs (-15. 50±3. 52) μV) was no statistically significant (P>0. 05) . The left frontal lobe Nogo-N2 amplitude was significantly higher than that of the right frontal lobe ((-14. 05±3. 31) μV vs-11. 75(-12. 68,-10. 43) μV) (P<0. 05),and the center of the frontal lobe No-go-N2 was significantly higher than that in the right frontal lobe((-15. 50±3. 52) μV vs -11. 75(-12. 68,-10. 43) ) ,and the difference was statistically significant (P<0. 05) . ( 3) There was no significant difference in N2 latency,P3 amplitude and latency between F3,Fz and F4 leads (P>0. 05). Conclusion Compared with normal children,SDB children showed no left dominant brain region while dealing with the same conflict monitoring tasks. It is suggested that left hemisphere activation is poor and function is incompatible. Left fron-tal lobe injury in SDB is more obvious than that in the right side.

Objective To explore the characteristics of functional connectivity based on cerebellum at resting state and the brain functions related to cognitive function on attention deficit hyperactivity disorder (ADHD).Methods Thirty ADHD children (ADHD group) were diagnosed at ADHD Specialist Clinic of Changzhou Children's Hospital,Nantong University from June 2015 to July 2017,and 33 healthy children (healthy control group) were selected from a normal school in Changzhou.Then,they received the functional and structural magnetic resonance imaging (MRI)scans.Finally,the differences of the characteristics of functional connectivity were compared between the 2 groups based on cerebellum which had been found with dysfunction on the previous study of amplitude of low-frequency fluctuation.Results It all showed positive activated brain regions when comparing ADHD group and healthy control group based on left cerebellum (-49.5,-58.5,-18.5) as ADHD children's functional connectivity scores were higher in left middle frontal gyrus [volume =835 mm3,coordinate (-27,-21,51)],right middle frontal gyrus [volume =755 mm3,coordinate(45,-3,6)],right superior temporal gyrus [volume =256 mm3,coordinate (45,-24,-6)],left limbic lobe[volume =513 mm3,coordinate (-15,-3,-18)],and there were statistically significant differences between the 2 groups (t =4.10,4.38,3.97,3.32,all P ＜ 0.05).Conclusions There exist abnormal functional connectivity between cerebellum and left middle frontal gyrus,right middle frontal gyrus,right superior temporal gyrus and left limbic lobe.It may be one of the brain mechanisms of the main clinical manifestations of the decreasing of attention,hyperactivity and impulsiveness and the dysfunction of cognitive function.

Objective To discuss the prognostic evaluation of magnetic resonance diffusion tensor imaging (DTI) in term neonates with mild and severe asphyxia.Methods Eleven neonates with mild asphyxia,14 neonates with severe asphyxia and 10 control neonates were studied.All the neonates were examined by conventional magnetic resonance imaging(MRI) and DTI.Fraction anisotropy (FA) values,apparent diffusion coefficient (ADC) values,voxel numbers and fiber numbers were calculated in seven regions of interest(ROI) and compared among the 3 groups.The correlation between FA values and neonatal behavioral neurological assessment (NBNA) scores were analyzed.Results (1) FA values in the left and the right thalamus were 0.54 ± 0.08 and 0.56 ± 0.15 in control group,0.45 ±0.03 and 0.44 ± 0.10 in mild group,and 0.21 ± 0.11 and 0.25 ± 0.13,respectively in severe group.FA values in posterior limbs of internal capsule were 0.49 ± 0.09 and 0.48 ± 0.08 in control group,0.37 ± 0.08 and 0.38 ± 0.03 in mild group,and 0.20 ± 0.04,0.19 ± 0.13 in severe group;FA values in thalamus and posterior limbs of internal capsule had statistical differences among the 3 groups (F =9.12,9.11,8.18,8.55,all P ＜ 0.05).Voxel numbers in the left and the right superior longitudinal fasciculus were 1 094 ± 112 and 1 123 ± 113 in control group,986 ± 111 and 1 009 ± 144 in mild group,450 ± 116 and 671 ± 126 in severe group.Voxel numbers in anterior limbs of internal capsule were 947 ± 104 and 1 237 ± 184 in control group,854 ± 118 and 799 ± 114 in mild group,324 ± 110 and 311 ± 126 in severe group.Voxel numbers in posterior limbs of internal capsule were 2 047 ± 129 and 2 137 ± 238 in control group,1 843 ± 233 and 1 753 ± 247 in mild group,867 ± 118 and 999 ± 167 in severe group.Voxel numbers in superior longitudinal fasciculus,anterior and posterior limbs of internal capsule had statistical differences among the 3 groups (F =10.11,9.45,7.33,8.45,12.65,11.23,all P ＜ 0.05);Fiber numbers in the left and the right cingulate gyrus were 245 ±72 and 405 ±94 in control group,225 ±52 and 365 ± 114 in mild group,145 ±62 and 185 ±84 in severe group.Fiber numbers in inferior front-occipital fasciculus were 56 ± 19 and 212 ± 33 in control group,49 ±22 and 197 ± 33 in mild group,33 ± 12 and 156 ± 39 in severe group.Fiber numbers in posterior limbs of internal capsule were 284 ± 112 and 988 ± 233 in control group,234 ± 67 and 678 ± 234 in mild group,114 ± 67 and 188 ± 84 in severe group.Fiber numbers in cingulate gyrus,inferior front-occipital fasciculus and posterior limbs of internal capsule had statistical differences among the 3 groups (F =3.11,3.45,9.88,9.12,7.45,8.88,all P ＜ 0.05).(2) The correlation between FA value and NBNA scores was analyzed:the correlation coefficient in posterior limbs of internal capsule was 0.666 which was higher than those of the other areas.The area under the ROC curve of FA values in anterior limbs of internal capsule was 0.816 (P =0.005),used NBNA scores ≥ 35 as a good outcome.FA values (≥ 0.375) in the posterior limbs of the internal capsules predicted a good outcome and the corresponding sensitivity and specificity was 73.1％ and 77.8％,respectively.Conclusion In some ROIs,FA values,voxel numbers,and fiber numbers can quantitatively reflect the degree of white matter injury in neonates with asphyxia.Furthermore,the FA values in the posterior limbs of the internal capsules are closely correlated with NBNA scores,so it has more important clinical significance,and can accurately and objectively assess the prognosis in neonates with asphyxia.

ObjectiveTo explore the neural mechanism of attention impairment in children with primary nocturnal enuresis.MethodsERPs elicited by performing the continuous operation test(CPT) were assessed in 20 children with primary nocturnal enuresis and 20 normal children.The Go/Nogo measurements of enuretic group at central scalp(Cz) were compared with the normal children and analyzed.Results1.Behavior results: there was no significant difference in the reaction time,the correct number and the false number between primary nocturnal enuresis and control group(P>0.05).2.ERP:(1)Go stimulate:the latency of Go-N2 and P3 of the children with primary nocturnal enuresis were longer than the normal control group(Go-N2:(326.80±46.40)ms vs (295.90±38.27)ms,P3:(438.80±62.60)ms vs (402.60±39.74)ms),and the difference had statistic significance(P<0.05).(2)Nogo stimulate:①Amplitude: the amplitude of Nogo-N2 of the children with primary nocturnal enuresis were lower than that of the normal control group((-10.55±3.30)μV vs (-14.12±5.99)μV),and the difference had statistic significance(P<0.05).There was no significant difference in the amplitude of Nogo-P2 and Nogo-P3(P>0.05).②Latency: the latency of Nogo-P2 of the children with primary nocturnal enuresis was longer than that of the normal control group((214.10±27.85)ms vs (198.30±19.16)ms),and the difference had statistic significance(P<0.05).There was no significant difference in the latency of Nogo-N2 and Nogo-P3(P>0.05).ConclusionAttention impairment in children with primary nocturnal enuresis might be caused by the information processing speed and conflict monitoring function obstacle,but it is not because the reactive inhibition dysfunction,thus result in the lack of arousal function and bedwetting.