CJCP
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2022 Vol.  24 No.  2
Published: 2022-02-24

STUDY PROTOCOL
STANDARD·PROTOCOL·GUIDELINE
CLINICAL RESEARCH
REVIEW
STANDARD·PROTOCOL·GUIDELINE
115 Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association; Chinese Journal of Contemporary Pediatrics; National Health Commission Key Laboratory of Neonatal Diseases
Expert consensus on grading management of electroencephalogram monitoring in neonates Hot!
Neonatal electroencephalogram (EEG) monitoring guidelines have been published by American Clinical Neurophysiology Society, and the expert consensus on neonatal amplitude-integrated EEG (aEEG) has also been published in China. It is difficult to strictly follow the guidelines or consensus for EEG monitoring in different levels of neonatal units due to a lack of EEG monitoring equipment and professional interpreters. The Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association, established an expert group composed of professionals in neonatology, pediatric neurology, and brain electrophysiology to review published guidelines and consensuses and the articles in related fields and propose grading management recommendations for EEG monitoring in different levels of neonatal units. Based on the characteristics of video EEG and aEEG, local medical resources, and disease features, the expert group recommends that video EEG and aEEG can complement each other and can be used in different levels of neonatal units. The consensus also gives recommendations for promoting collaboration between professionals in neonatology, pediatric neurology, and brain electrophysiology and implementing remote EEG monitoring.
2022 Vol. 24 (2): 115-123 [Abstract] ( 2765 ) [HTML 1KB] [PDF 648KB] ( 2256 )
124 Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association; Chinese Journal of Contemporary Pediatrics; National Health Commission Key Laboratory of Neonatal Diseases
Expert consensus on minimum technical standards for neonatal electroencephalography operation and report writing
Electroencephalography (EEG) monitoring is an important examination method in the management of critically ill neonates, which can be used to evaluate brain function and developmental status, severity of encephalopathy, and seizures and predict the long-term neurodevelopmental outcome of high-risk neonates with brain injury. EEG monitoring for neonates is different from that for adults and children, and its operation and interpretation are easily affected by the number of recording electrodes, electrode montage, and monitoring quality. Therefore, standard operation must be followed to ensure the quality of signal acquisition and correct interpretation, thereby ensuring proper management of critically ill neonates. The Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association established an expert group composed of professionals in neonatology and brain electrophysiology to perform a literature review, summarize the minimum technical standards for neonatal EEG monitoring, and develop the expert consensus on minimum technical standards for neonatal EEG operation and report writing. This consensus will provide guidance for neonatal EEG operation, including technical parameters of EEG monitoring device, operation procedures of EEG monitoring, and specifications for report writing.
2022 Vol. 24 (2): 124-131 [Abstract] ( 3136 ) [HTML 1KB] [PDF 1138KB] ( 2037 )
CLINICAL RESEARCH
132 SHEN Wei, ZHENG Zhi, LIN Xin-Zhu, WU Fan, TIAN Qian-Xin, CUI Qi-Liang, YUAN Yuan, REN Ling, MAO Jian, SHI Bi-Zhen, WANG Yu-Mei, LIU Ling, ZHANG Jing-Hui, CHANG Yan-Mei, TONG Xiao-Mei, ZHU Yan, ZHANG R
Incidence of extrauterine growth retardation and its risk factors in very preterm infants during hospitalization: a multicenter prospective study
Objective To investigate the incidence of extrauterine growth retardation (EUGR) and its risk factors in very preterm infants (VPIs) during hospitalization in China. Methods A prospective multicenter study was performed on the medical data of 2 514 VPIs who were hospitalized in the department of neonatology in 28 hospitals from 7 areas of China between September 2019 and December 2020. According to the presence or absence of EUGR based on the evaluation of body weight at the corrected gestational age of 36 weeks or at discharge, the VPIs were classified to two groups: EUGR group (n=1 189) and non-EUGR (n=1 325). The clinical features were compared between the two groups, and the incidence of EUGR and risk factors for EUGR were examined. Results The incidence of EUGR was 47.30% (1 189/2 514) evaluated by weight. The multivariate logistic regression analysis showed that higher weight growth velocity after regaining birth weight and higher cumulative calorie intake during the first week of hospitalization were protective factors against EUGR (P<0.05), while small-for-gestational-age birth, prolonged time to the initiation of total enteral feeding, prolonged cumulative fasting time, lower breast milk intake before starting human milk fortifiers, prolonged time to the initiation of full fortified feeding, and moderate-to-severe bronchopulmonary dysplasia were risk factors for EUGR (P<0.05). Conclusions It is crucial to reduce the incidence of EUGR by achieving total enteral feeding as early as possible, strengthening breastfeeding, increasing calorie intake in the first week after birth, improving the velocity of weight gain, and preventing moderate-severe bronchopulmonary dysplasia in VPIs.
2022 Vol. 24 (2): 132-140 [Abstract] ( 2778 ) [HTML 155KB] [PDF 1228KB] ( 1079 )
132 SHEN Wei, ZHENG Zhi, LIN Xin-Zhu, WU Fan, TIAN Qian-Xin, CUI Qi-Liang, YUAN Yuan, REN Ling, MAO Jian, SHI Bi-Zhen, WANG Yu-Mei, LIU Ling, ZHANG Jing-Hui, CHANG Yan-Mei, TONG Xiao-Mei, ZHU Yan, ZHANG Rong, YE Xiu-Zhen, ZOU Jing-Jing, LI Huai-Yu, ZHAO Bao-Yin, QIU Yin-Ping, LIU Shu-Hua, MA Li, XU Ying, CHENG Rui, ZHOU Wen-Li, WU Hui, LIU Zhi-Yong, CHEN Dong-Mei, GAO Jin-Zhi, LIU Jing, CHEN Ling, LI Cong, YANG Chun-Yan, XU Ping, ZHANG Ya-Yu, HU Si-Le, MEI Hua, YANG Zu-Ming, FENG Zong-Tai, WANG San-Nan, MENG Er-Yan, SHANG Li-Hong, XU Fa-Lin, OU Shao-Ping, JU Rong
Incidence of extrauterine growth retardation and its risk factors in very preterm infants during hospitalization: a multicenter prospective study
Objective To investigate the incidence of extrauterine growth retardation (EUGR) and its risk factors in very preterm infants (VPIs) during hospitalization in China. Methods A prospective multicenter study was performed on the medical data of 2 514 VPIs who were hospitalized in the department of neonatology in 28 hospitals from 7 areas of China between September 2019 and December 2020. According to the presence or absence of EUGR based on the evaluation of body weight at the corrected gestational age of 36 weeks or at discharge, the VPIs were classified to two groups: EUGR group (n=1 189) and non-EUGR (n=1 325). The clinical features were compared between the two groups, and the incidence of EUGR and risk factors for EUGR were examined. Results The incidence of EUGR was 47.30% (1 189/2 514) evaluated by weight. The multivariate logistic regression analysis showed that higher weight growth velocity after regaining birth weight and higher cumulative calorie intake during the first week of hospitalization were protective factors against EUGR (P<0.05), while small-for-gestational-age birth, prolonged time to the initiation of total enteral feeding, prolonged cumulative fasting time, lower breast milk intake before starting human milk fortifiers, prolonged time to the initiation of full fortified feeding, and moderate-to-severe bronchopulmonary dysplasia were risk factors for EUGR (P<0.05). Conclusions It is crucial to reduce the incidence of EUGR by achieving total enteral feeding as early as possible, strengthening breastfeeding, increasing calorie intake in the first week after birth, improving the velocity of weight gain, and preventing moderate-severe bronchopulmonary dysplasia in VPIs.
2022 Vol. 24 (2): 132-140 [Abstract] ( 1724 ) [HTML 1KB] [PDF 674KB] ( 1443 )
141 XU Yan-Ping, SHANG Zhen-Ru, Dorazio Robert M., SHI Li-Ping
Risk factors for peripherally inserted central catheterization-associated bloodstream infection in neonates
Objective To study the features of catheter-related bloodstream infection (CRBSI) or central line-associated bloodstream infection (CLABSI) after peripherally inserted central catheterization (PICC) in neonates admitted to the neonatal intensive care unit (NICU) and the risk factors for CRBSI or CLABSI. Methods A retrospective analysis was performed on the medical data of the neonates who were treated and required PICC in the NICU of the Children's Hospital, Zhejiang University School of Medicine from June 1, 2018 to May 1, 2020. The catheterization-related data were collected, including placement time, insertion site, removal time, and antimicrobial lock of PICC. The multivariate logistic regression model was used to investigate the risk factors for CRBSI or CLABSI in the neonates. Results A total of 446 neonates were enrolled, with a mean gestational age of (30.8±4.0) weeks, a mean birth weight of (1 580±810) g, a median age of 9 days, and a median duration of PICC of 18 days. The incidence rates of CLABSI and CRBSI were 5.6 and 1.46 per 1 000 catheter days, respectively. Common pathogens for CLABSI caused by PICC included Staphylococcus epidermidis (n=19) and Klebsiella pneumoniae (n=11), and those for CRBSI caused by PICC included Klebsiella pneumoniae (n=6). The risk of CLABSI caused by PICC increased significantly with prolonged durations of PICC and antibiotic use, and the PICC-related infection probability at head and neck was significantly lower than that in the upper and low limbs (P<0.05), while the above conditions were more obvious in neonates with a birth weight of <1 500 g. The risk of CRBSI caused by PICC decreased with the increase in gestational age (P<0.05). Conclusions CRBSI and CLABSI remain serious issues in NICU nosocomial infection. The identification of the risk factors for CRBSI and CLABSI provides a basis for improving the quality of clinical care and management.
2022 Vol. 24 (2): 141-146 [Abstract] ( 2863 ) [HTML 1KB] [PDF 587KB] ( 1079 )
147 LIU Jing-Ting, ZHOU Ya-Wei, WANG Wen-Di, MAO Bao-Hong, HU Ya-Guang
Association of the levels of heavy metals and trace elements during pregnancy with congenital heart defects in offspring: a prospective cohort study
Objective To study the association of the levels of heavy metals and trace elements during pregnancy with congenital heart defects (CHD) in offspring, and to establish a model for predicting the probability of CHD based on the levels of heavy metals and trace elements during pregnancy. Methods Based on the prospective birth cohort study in Gansu Provincial Maternal and Child Health Hospital in 2010-2012, a nested case-control study was conducted for the follow-up observation of 14 359 pregnant women. Among the pregnant women, 97 pregnant women whose offspring were diagnosed with CHD during follow-up were enrolled as the CHD group, and 194 pregnant women whose offspring had no CHD were selected as the control group. Inductively coupled plasma mass spectrometry was used to measure the levels of heavy metals and trace elements in maternal blood samples and fetal umbilical cord blood samples. A multivariate logistic regression analysis was used to evaluate the association between heavy metal and trace elements and CHD in offspring. A nomogram model for predicting the probability of CHD in offspring was established based on the levels of heavy metals and trace elements during pregnancy. Results Compared with the control group, the CHD group had significantly higher levels of aluminum (Al), natrium (Na), calcium (Ca), titanium (Ti), selenium (Se), strontium (Sr), stannum (Sn), stibium (Sb), barium (Ba), and thorium (Th) in maternal blood samples (P<0.05), as well as significantly higher levels of Al, zinc (Zn), magnesium (Mg), kalium (K), Ca, Ti, chromium (Cr), copper (Cu), arsenic (As), Se, Sr, argentum (Ag), cadmium (Cd), Sn, and plumbum (Pb) in umbilical cord blood (P<0.05). The multivariate logistic regression analysis showed that the increase in the Sb level in maternal blood was associated with the increase in the risk of CHD in offspring [adjusted odds ratio (aOR)=4.81, 95% confidence interval (CI): 1.65-14.07, P=0.004], while in umbilical cord blood, the high levels of Al (aOR=4.22, 95%CI: 1.35-13.16, P=0.013), Mg (aOR=8.00, 95%CI: 1.52-42.08, P=0.014), and Pb (aOR=3.82, 95%CI: 0.96-15.23, P=0.049) were significantly associated with the risk of CHD in offspring. The levels of Al, Th, and Sb in maternal blood and levels of Al, Mg, and Pb in umbilical cord blood were included in the predictive model for CHD in offspring based on the levels of heavy metals and trace elements during pregnancy, and the calibration curve of the nomogram predictive model was close to the ideal curve. Conclusions Increases in the levels of Al, Th, Sb, Mg, and Pb during pregnancy may indicate the increase in the risk of CHD in offspring, and the nomogram predictive model based on these indices can be used to predict the probability of CHD in offspring.
2022 Vol. 24 (2): 147-154 [Abstract] ( 2763 ) [HTML 1KB] [PDF 745KB] ( 984 )
155 CHEN Hui-Yun, PAN Tao, LI Hong, XU Qiu-Qin, SUN Fang-Can, HAN Bing, GU Xin-Xian
Assessment of myocardial injury in neonates born to pregnant women with pregnancy complicated by severe preeclampsia by myocardial work indices: a prospective study
Objectives To evaluate myocardial injury in neonates born to pregnant women with pregnancy complicated by severe preeclampsia by myocardial work indices. Methods A prospective cohort study was performed on 25 preterm infants born to the pregnant women with severe preeclampsia from June 2020 to April 2021 (severe preeclampsia group), and 25 preterm infants born to the pregnant women without severe complications in pregnancy were enrolled as the control group. Echocardiography was performed within 24 hours and at 48-72 hours and 14-28 days after birth to measure conventional parameters. Two-dimensional speckle-tracking echocardiography was performed to construct a noninvasive left ventricular pressure-strain loop based on two-dimensional myocardial strain and left ventricular systolic pressure noninvasively measured, so as to calculate myocardial work indices. Results Compared with the control group, the severe preeclampsia group had significant reductions in left ventricular global work index and global constructive work within 24 hours after birth (P<0.05), a significant reduction in left ventricular global work efficiency and a significant increase in global waste work at 48-72 hours after birth (P<0.05), and a significant reduction in left ventricular global work efficiency at 14-28 days after birth (P<0.05). Conclusions Subclinical myocardial injury persists in the neonatal period in preterm infants born to pregnant women with severe preeclampsia.
2022 Vol. 24 (2): 155-161 [Abstract] ( 2369 ) [HTML 1KB] [PDF 580KB] ( 1264 )
162 LIN Cai-Juan, GENG Guo-Xing, PENG Zhen-Ren, HUANG Xiao-Tao, WU Liu-Lin, XU Yu-Qi, LI Wei, QIAN Jia-Le, LUO Jing-Si
Characteristics of amino acid metabolism in preterm infants in Guangxi, China
Objective To study the characteristics of amino acid metabolism in preterm infants in Guangxi, China. Methods A retrospective analysis was performed on the medical data of 30 757 neonates who underwent the screening for inherited metabolic diseases and had negative results in Guangxi Neonatal Disease Screening Center from 2018 to 2020. Among these neonates, there were 28 611 normal full-term infants (control group) and 2 146 preterm infants (preterm birth group). According to gestational age, the preterm infants were further divided into four groups: very preterm (n=209), moderately preterm (n=307), and late preterm group (n=1 630). According to birth weight, they were divided into three groups: very low birth weight group (n=161), low birth weight group (n=1 085), and normal birth weight group (n=900). According to blood collection time, they were divided into three groups: 3-7 days group (n=1 664), 8-14 days group (n=314) and 15-28 days group (n=168). Tandem mass spectrometry was performed to measure the levels of 11 amino acids in dried blood spots, which were then compared between groups. Results After adjustment for confounding factors, there were significant differences in the levels of 11 amino acids among different gestational age groups (P<0.05), and significant differences were observed in the levels of the 11 amino acids between the control group and the various preterm groups (except for citrulline and methionine in the late preterm group). There were significant differences in the levels of 11 amino acids among different birth weight groups (P<0.05). Except for ornithine, there were significant differences in the levels of other amino acids among the different blood collection time groups (P<0.05). Conclusions Gestational age, birth weight and blood collection time all affect amino acid metabolism in preterm infants in Guangxi, China. This provides a basis for the laboratory to establish the reference standard and clinical interpretation of blood amino acid levels in preterm infants, and to improve the nutritional metabolism of preterm infants.
2022 Vol. 24 (2): 162-168 [Abstract] ( 2367 ) [HTML 1KB] [PDF 751KB] ( 981 )
169 XIANG Ling-Ling, HU Yuan-Yuan, XIA Xu-Hua, HUA Zi-Yu
Effect of prophylactic use of hydrolyzed protein formula on gastrointestinal diseases and physical growth in preterm infants: a Meta analysis
Objective To systematically evaluate the effect of prophylactic use of hydrolyzed protein formula on gastrointestinal diseases and physical development in preterm infants. Methods A computerized search was performed in the databases including China National Knowledge Infrastructure, Wanfang Data, Weipu, PubMed, Embase, and the Cochrane Library to identify randomized controlled trials of the effect of prophylactic use of hydrolyzed protein formula on gastrointestinal diseases and physical growth in preterm infants. RevMan 5.3 software was used to perform a Meta analysis for the included studies. Results A total of 7 randomized controlled studies were included. The results of Meta analysis showed that compared with the whole protein formula, the prophylactic use of hydrolyzed protein formula could reduce the risk of neonatal necrotizing enterocolitis (RR=0.40, P=0.04) and feeding intolerance (RR=0.40, P=0.005), and had no significant effect on the growth of weight, length and head circumference (P>0.05). Conclusions Compared with the whole protein formula, the prophylactic use of hydrolyzed protein formula in preterm infants may reduce the occurrence of necrotizing enterocolitis and feeding intolerance, and can meet the nutrient requirement of physical development. However, the evidence is limited, and the results of this study cannot support the routine prophylactic use of hydrolyzed protein formula in preterm infants.
2022 Vol. 24 (2): 169-175 [Abstract] ( 2505 ) [HTML 1KB] [PDF 845KB] ( 968 )
176 ZHAN Yu-Xiao, ZHANG Jian, FAN Cai-Fang, FAN Wen-Juan, XU Min
Distribution and drug resistance profiles of pathogens causing bloodstream infection after chemotherapy in children with acute lymphoblastic leukemia
Objective To study the changes in the distribution and drug resistance profiles of pathogens causing bloodstream infection after chemotherapy in children with acute lymphoblastic leukemia. Methods The medical data were collected from the children with acute lymphoblastic leukemia who were admitted to the First Affiliated Hospital of Zhengzhou University between January 2015 and December 2020 and developed bloodstream infection after chemotherapy. The samples were divided into the first three years group and the next three years group according to the time of testing to investigate the differences in the distribution and drug resistance profiles of pathogens as time. Results A total of 235 strains of pathogens were isolated, among which there were 159 Gram-negative strains (67.7%; mainly Escherichia coli and Klebsiella pneumoniae), 61 Gram-positive strains (26.0%; mainly Staphylococcus epidermidis), and 15 strains of fungi (6.4%; mainly Candida albicans). There were no significant differences between the first three years group and the next three years group in the detection rate of Gram-negative bacteria (68.8% vs 66.9%, P>0.05) or Gram-positive bacteria (29.2% vs 23.7%, P>0.05). Compared with the first three years group, the next three years group had significant increases in the detection rate of Streptococcus mitis (5.8% vs 0.0%, P<0.05) and fungi (9.4% vs 2.1%, P<0.05). There was no significant difference in the drug resistance rate of Gram-negative or Gram-positive bacteria between the two groups (P>0.05). Conclusions Enterobacteriaceae bacteria are the main pathogens of bloodstream infection after chemotherapy in children with acute lymphoblastic leukemia, while the detection rates of Streptococcus mitis and fungi tend to increase as time, which needs to be taken seriously in clinical practice.
2022 Vol. 24 (2): 176-181 [Abstract] ( 2750 ) [HTML 1KB] [PDF 552KB] ( 726 )
182 LI Jian-Yun, LI Li, LIU Jun, LIU Xiao-Lan, LIU Ji-Wen
Efficacy of intermittent iron supplementation in children with mild iron-deficiency anemia
Objective To study the efficacy of intermittent iron supplementation in children with mild iron-deficiency anemia. Methods A total of 147 children with mild iron-deficiency anemia were enrolled in this prospective study. They were divided into an intermittent iron supplementation group (n=83) and a conventional iron supplementation group (n=64). The levels of hemoglobin were measured before treatment and after 1 and 3 months of treatment. The treat response rate and the incidence rate of adverse drug reactions were compared between the two groups. Results Both groups had a significant increase in the level of hemoglobin after iron supplementation (P<0.05). After 1 month of treatment, the conventional iron supplementation group had a significantly higher treatment response rate than the intermittent iron supplementation group (61% vs 42%, P<0.05). After 3 months of treatment, there was no significant difference in the treatment response between the two groups (86% vs 78%, P>0.05). The incidence rate of adverse drug reactions in the conventional iron supplementation group was significantly higher than that in the intermittent iron supplementation group (25% vs 8%, P<0.05). Conclusions For children with mild iron-deficiency anemia, although intermittent iron supplementation is inferior to conventional iron supplementation in the short-term efficacy, there is no significant difference in the long-term efficacy between the two methods, and compared with conventional iron supplementation, intermittent iron supplementation can reduce the incidence of adverse drug reactions, alleviate family financial burdens, and improve treatment compliance of children, thus holding promise for clinical application.
2022 Vol. 24 (2): 182-185 [Abstract] ( 2842 ) [HTML 1KB] [PDF 479KB] ( 1576 )
186 LI Zheng, XIAO Gui-Yuan, HE Chun-Yan, LIU Xia, FAN Xin, ZHAO Yan, WANG Nian-Rong
Serum levels of insulin-like growth factor-1 and insulin-like growth factor binding protein-3 in children with autism spectrum disorder
Objectives To study the serum levels of insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) in children with autism spectrum disorder (ASD) and their association with the core symptoms of ASD. Methods A total of 150 ASD children aged 2-7 years (ASD group) and 165 healthy children matched for age and sex (control group) who were recruited at the outpatient service of Chongqing Health Center for Women and Children were enrolled as subjects. Autism Behavior Checklist (ABC) and Childhood Autism Rating Scale (CARS) were used to evaluate the core symptoms of the ASD children. Chemiluminescence was used to measure the serum levels of IGF-1 and IGFBP-3 in both groups. Results The ASD group had a significantly lower serum level of IGF-1 than the control group (P<0.05). The children with severe ASD had significantly lower serum levels of IGF-1 and IGFBP-3 than those with mild-to-moderate ASD (P<0.001). For the children aged 2-3 years, the ASD group had a significantly lower serum level of IGF-1 than the control group (P<0.05). Boys had a significantly lower serum level of IGF-1 than girls in both ASD and control groups (P<0.05). The serum levels of IGF-1 and IGFBP-3 were negatively correlated with the total score of CARS (r=-0.32 and -0.40 respectively, P<0.001). Conclusions The reduction in serum IGF-1 level in early childhood may be associated with the development of ASD, and the serum levels of IGF-1 and IGFBP-3 are associated with the core symptoms of ASD children.
2022 Vol. 24 (2): 186-191 [Abstract] ( 2135 ) [HTML 1KB] [PDF 640KB] ( 760 )
192 LUO Yan-Fei, LI Jun-Kang, MAYILA·Abudoureyimu, DILIHUMA·Julaiti, REYILANMU·Baoerhan, SUN Guang-Hui, LUAN Lei-Xin, MIREGULI·Maimaiti
Prevalence of diabetes mellitus among Uygur children in Hotan Prefecture of Xinjiang, China
Objective To investigate the prevalence of diabetes mellitus (DM) among Uygur children in Hotan Prefecture of Xinjiang, China, as well as the factors influencing the development of DM. Methods The cluster random sampling method was used to select 5 308 children, aged 4-18 years, from the middle and primary schools and kindergartens in Hotan Prefecture of Xinjiang. The survey methods included questionnaire survey and the measurement of height and weight. All subjects were tested for fasting fingertip blood glucose to investigate the prevalence of DM and impaired fasting glucose (IFG). Results A total of 5 184 valid questionnaires were collected. Fourteen children (0.27%) were found to have DM, among whom 8 had type 1 DM, 2 had type 2 DM, and 4 had unclassified DM. Twenty-nine children (0.56%) were found to have IFG. There was no significant difference in the prevalence rate of DM and IFG between boys and girls (P>0.05). The prevalence rate of DM was 0.18% in the 4-<10 years group, 0.47% in the 10-<15 years group, and 0.07% in the 15-18 years group (P=0.072).The prevalence rate of IFG in the above three age groups was 0.18%, 0.94%, and 0.42%, respectively, with a significant difference among groups (P=0.007). The proportion of family history of DM and the proportion of overweight/obesity in children with DM were significantly higher than those in children without DM (P<0.05), while the proportion of children with DM who preferred coarse grains was significantly lower than that in children without DM (P<0.05). Conclusions The prevalence of DM and IFG in Uyghur children in Hotan Prefecture of Xinjiang is relatively low. There is no significant difference in the prevalence of DM among children of different genders or age groups, but the prevalence of IFG in children of different age groups is different. A family history of DM, overweight or obesity, and low intake of coarse grains might be associated with the development of DM.
2022 Vol. 24 (2): 192-196 [Abstract] ( 2788 ) [HTML 1KB] [PDF 546KB] ( 823 )
STUDY PROTOCOL
197 XIAO Tian-Tian, DOU Ya-Lan, ZHUANG De-Yi, HU Xu-Hong, KANG Wen-Qing, GUO Lin, ZHAO Xiao-Fen, ZHANG Peng, YAN Kai, YAN Wei-Li, CHENG Guo-Qiang, ZHOU Wen-Hao
Evaluation of the clinical effect of an artificial intelligence-assisted diagnosis and treatment system for neonatal seizures in the real world: a multicenter clinical study protocol
Neonatal seizures are the most common clinical manifestations of critically ill neonates and often suggest serious diseases and complicated etiologies. The precise diagnosis of this disease can optimize the use of anti-seizure medication, reduce hospital costs, and improve the long-term neurodevelopmental outcomes. Currently, a few artificial intelligence-assisted diagnosis and treatment systems have been developed for neonatal seizures, but there is still a lack of high-level evidence for the diagnosis and treatment value in the real world. Based on an artificial intelligence-assisted diagnosis and treatment systems that has been developed for neonatal seizures, this study plans to recruit 370 neonates at a high risk of seizures from 6 neonatal intensive care units (NICUs) in China, in order to evaluate the effect of the system on the diagnosis, treatment, and prognosis of neonatal seizures in neonates with different gestational ages in the NICU. In this study, a diagnostic study protocol is used to evaluate the diagnostic value of the system, and a randomized parallel-controlled trial is designed to evaluate the effect of the system on the treatment and prognosis of neonates at a high risk of seizures. This multicenter prospective study will provide high-level evidence for the clinical application of artificial intelligence-assisted diagnosis and treatment systems for neonatal seizures in the real world.
2022 Vol. 24 (2): 197-203 [Abstract] ( 2989 ) [HTML 1KB] [PDF 887KB] ( 1087 )
REVIEW
204 YANG Dong-Ling
Recent research on the treatment of spinal muscular atrophy
Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disease characterized by progressive muscular weakness and atrophy. SMA, as an inherited disease, is the leading cause of death in infants and young children. Rapid progress has been made in the research field of SMA in recent years, and some related treatment drugs have been successfully approved for marketing. This article reviews the recent research advances in the treatment of SMA.
2022 Vol. 24 (2): 204-209 [Abstract] ( 3720 ) [HTML 1KB] [PDF 562KB] ( 1230 )
210 HAN Si-Yu
Clinical value of metagenomic next-generation sequencing in complicated infectious diseases
Infectious diseases are commonly seen in clinical practice, and pathogen diagnosis is the key link in diagnosis and treatment; however, conventional pathogen detection methods cannot meet clinical needs due to time-consuming operation and low positive rate. As a new pathogen detection method, metagenomic next-generation sequencing (mNGS) has a wide detection range and can detect bacteria, viruses, fungi, parasites, rare pathogens, and even unknown pathogens. The technique of mNGS is unbiased and can rapidly, efficiently, and accurately obtain all nucleic acid information in test samples, analyze pathogens, and guide clinical diagnosis and treatment, thereby playing an important role in complicated infectious diseases. This article reviews the diagnostic advantages and clinical value of mNGS in bacterial, fungal, viral, and parasitic infections.
2022 Vol. 24 (2): 210-215 [Abstract] ( 2857 ) [HTML 1KB] [PDF 515KB] ( 982 )
216 CUI Han-Yu, HU Chang-Ping
Recent research on the application of biologics in the treatment of multisystem inflammatory syndrome in children after SARS-CoV-2 infection
Multisystem inflammatory syndrome in children (MIS-C) is a type of hyperinflammatory symptoms similar to Kawasaki disease after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and is commonly observed in children aged 8-10 years. Primary therapeutic medications for MIS-C are intravenous immunoglobulins and glucocorticoids. It has been reported that biologics, such as IL-1 receptor antagonist anakinra, IL-6 receptor antagonist tocilizumab, and TNF-α receptor antagonist infliximab, can be used as an option for critically ill patients. This article elaborates on the mechanism of action of the above biologics and discusses the efficacy and safety biologics in the treatment of MIS-C after SARS-CoV-2 infection, in order to provide methods for the treatment of MIS-C with severe symptoms.
2022 Vol. 24 (2): 216-222 [Abstract] ( 2754 ) [HTML 1KB] [PDF 564KB] ( 679 )
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