Objective To study the subject domain knowledge of discipline development of children health care in our country using multiple statistical and social network analysis, build visualized knowledge-mapping, and then predict the development trends in the future. Methods Search had been done according to the journal's name of Chinese Journal of Pediatrics, Journal of Clinical Pediatrics, Chinese Journal of Practical Pediatrics and Chinese Journal of Children Health Care. Two individual investigators then selected articles out about children health care from the entire searching results respectively. According to the native per capita GDP, the whole period was divided into three stages, 1978-1994, -2003 and -2011. After core keywords had been characterized by Endnote X4 software in each stage, the co-occurrence matrix was built. Transformation, dimensionality reduction and clustering of the co-occurrence matrix were finished by SPSS 17.0 software, leading to the strategic plot to be built. The visualized network images were drawn using Ucinet 6.0 software. Results Totally 5 771 articles about children health care were included. The visualized domain knowledge-mapping was successfully built, and it directly reflected the structure of knowledge-mapping of the discipline development, and the key clusters were formed as well. Totally 162 articles were identified in the first 17 years (1978-1994, average 9.5 articles per year), and 5 618 articles were enrolled in the second 17 years (1995-2011, average 330.0 articles per year), which was 34.8 times of the number of articles in the previous period. It took 14 years (1978-1991) for the number of the articles accumulating to 100, and another more 7 years (1992-1998) to accumulate the number to 1 000. Then about 1 000 articles were published in every 3 years. In 1978-1994, the development of children health care headed slowly with fragmented directions, and the cluster results were poor, except the research of rickets, which revealed a relatively highlight. In the time period of 1995-2003, the research directions surrounded children nutrition disorders, and cluster analysis developed fully. But the emerging research topics needed further expanded and paid more attention and contribution to blossom them. In 2004-2011, psychosocial behavior of children became the core of whole subject, and the research network went more balanced and scientifically with great knowledge updated. Conclusions The analysis demonstrated that the subjects' research of child health care started in the early 1990s, and had made great progress in new century. The network of child health care had a long process to become mature and completed, and the research hotspots were closely linked with the pace of the times and the national policy. Eight clusters made up the main structure of the research of children health care in China, such as the methodology of the research of children health care and the development of children psychological and social behavior, and epidemiology and children development were the most centric keywords in this visualized subject knowledge-mapping study.
Objective To describe and analyze the trends and determinants of birthweight in Beijing from 1996 to 2010. Methods 63 661 babies born in two hospitals in Beijing in 1996, 1997, 1998, 1999, 2000, 2005, 2010 were included to describe the trend of birthweight. The 11 006 birth records of those babies born in Beijing obstetric and gynecologic hospital in 2010 were collected to analyze the determinants of birthweight. The chi-square test and chi-square test for trend were used to estimate the distribution of categorical variables between groups, analysis of variance was used to test the difference of birthweight among years, linear regression analysis was applied to analyze the determinants of birthweight. Results The birthweight increased from 1996 to 2000 rapidly, and then decreased slowly. The mean value of birthweight in 2010 was 3 331 g, and it was higher than the national level. The linear regression analysis suggested that maternal age, body mass index, gestational weight gain, gravidity, parity, gestational weeks and gestational diabetes mellitus were positively correlated with birthweight, the gender of neonate (female), degree of maternal education, oligohydramnios, multiple gestation and gestational hypertension were negatively associated with birthweight. According to the American Institution of Medicine (IOM) guidelines on maternal health weight gain, more than half of the women had excessive gestational weight gain from 2000. Conclusions The birthweight increased rapidly before 2000, and then decreased slowly. Maintaining a normal maternal body mass index and an appropriate gestational weight gain, avoiding preterm birth and prevention of gestational diabetes mellitus and hypertension will be helpful to get normal birthweight.
Objective To investigate the clinical features and pathological characteristics as well as their associations with secular trend of the disease of 1 579 pediatric renal biopsies. Methods The clinical and pathological data were retrospectively analyzed in 1 579 children with renal diseases with biopsy performed from 1989 to 2012 in our hospital. The changes of clinical and pathological type distribution were characterized in every 5 years historically in different age groups ( -1, -3, -6, -12, -18 years) and genders. Results ①The mean age of 1 579 children was (9.3±3.2) years (4 months to 18 years). The ratio of males to females was 1.92. Primary glomerulonephritis (PGN), secondary glomerulonephritis (SGN) and inherited nephropathy accounted for 60.1%, 31.2% and 8.3% of the total cases. The PGN and SGN mainly included nephritic syndrome (NS), isolated hematuria, acute glomerulonephritis(AGN) and Henoch-schonlein purpura nephritis(HSPN), HBV-associatied glomerulonephritis(HBVGN), lupus nephritis(LN), respectively. The pathological classification of PGN mainly included minimal change disease/mild disease (MCD/ML), IgAN and mesangial proliferative glomerulonephritis(MsPGN). ②Male patients dominated in NS, HBVGN and Alport syndrome, however, female dominated in isolated hematuria, rapidly progressive glomerulonephritis(RPGN), LN, ANCA-associated glomerulonephritis and thin basement membrane disease. The proportions of NS, isolated hematuria, AGN, CGN, HBVGN, LN and hemolytic uremic syndrome significantly changed with age. ③The clinical patterns of PGN were significantly correlated with the distribution of pathological types. The main pathological patterns of NS were MCD/ML, IgMN and IgAN. The main pathological patterns of hematuria were MCD/ML, IgAN and MsPGN. The main pathological patterns of hematuria with proteinuria were IgAN and MsPGN. The main pathological patterns of RPGN and chronic glomerulonephritis(CGN) were crescentic glomerulonephritis(CreGN) and sclerosing glomerulonephritis(SGN), respectively. ④The spectrum of NS, HSPN, HBVGN, IgAN was changed in 23 years. Conclusions There were some relationships between the clinical and pathological features to gender and age in children. Renal biopsy is valuable in the diagnosis and treatment in children with renal diseases.
Abstract Objective The purpose of this study was to analyze the features of radiographic and CT findings of pulmonary tuberculosis in infants. Methods Clinical data of infants diagnosed as pulmonary tuberculosis in chongqing medical university affiliated children's hospital from January 2001 to December 2011 were retrospectively collected, and chest X-ray and CT imaging data were analyzed. Results A total of 203 cases were diagnosed as infantile pulmonary tuberculosis in study period , 188 finished chest X-ray or CT examination cases in our hospital were brought into the analysis, 132 finished chest X-ray examination, 144 finished chest CT examination and 88 cases finished both of them. Chest radiographs showed pulmonary parenchymal infiltration in 115 cases（115/132,87.1%）, mediastinum broadness in 33 cases （33/132,25.0%）and hilum pulmonisenlargement in 9 cases (9/132,6.8%）.②Thorax CT showed pulmonary parenchymal infiltration in 143 cases （143/144，99.3%）, and mediastinal or hilar lymphadenopathy in 120 cases （120/144，83.3%）. Pulmonary parenchymal lesions were bilateral in 109 patients(109/143,) and involving the right upper lobe(n = 132), left upper lobe (n=118), left lower lobe(n=118), right lower lobe (n=124), and right middle lobe (n = 124)；Mediastinal or hilar lymphadenopathies were observed in all 120 patients,the most frequently involved nodes in proper sequence were right hilar nodes（n=72）, postcaval nodes（n=58）, left hilar nodes（n=49）,subcarinal nodes（n=44), hilar and mediastinal nodes were involved simultaneously (88,73.3%).③Thorax CT took great advantage of detecting lesions in pulmonary parenchymal infiltration, cavity, lymph nodes and bronchus, pleural disease,and calcification than chest radiography. Conclusions Pulmonary parenchymal infiltration and mediastinal/hilar lymphadenopathies were the radiologic hallmark of infantile pulmonary tuberculosis. CT was superior to chest radiographs in the diagnosis of infantile pulmonary tuberculosis.
Objective This study was conducted to explore the correlation of infants' and toddlers' responsiveness with language and cognitive development in families speaking Chinese. Methods 22 families/children(children aged 4 to 30 months) were enrolled into the study. Children received 3 times day-long audio recordings to collect naturalistically at home with Language Environment Analysis system(LENA). Three major components including child words counts, adult-child conversational turns (including adult-initiated conversational turns and child-initiated conversational turns) and adult word counts were obtained. The scales of “Infant Language Development Screening Scales” and “Bayley Scales of Infant Development-Ⅰ” were respectively used to assess language and cognitive development of children. Data were analyzed by the software of SPSS 17.0. Results The children were divided into 3 groups, aged 4-12 months (7 children)，-24 months (9 children) and -30 months (6 children) groups. There were no differences in adult word counts, adult-child conversational turns and adult-initiated conversational turns among 3 groups, but child word counts and child-initiated conversational turns differed among 3 groups and the difference increased with age. When controlled child age, child language development was correlated with child word counts and child-initiated conversational turns and adult-child conversational turns correlated with adult word counts and child word counts. There were significant association in child language expression and Bayley Psychomotor Development Index (PDI) with adult-child conversational turns. PDI was also correlated with adult word counts and adult-initiated conversational turns. Conclusions LENA as an evaluation tool could reflect child family responsiveness objectively. The infants' and toddlers' responsiveness had a certain age effect and was directly correlated with language and cognitive development in Han-language families.
Objective To explore the evaluation value of the 6-minute walk test (6MWT) on cardiac function in children with postoperative congenital heart disease during follow-up. Methods Children after CHD surgery (complicated or simple CHD) and followed up over 6 months from Children's Hospital of Fudan University were enrolled as CHD group, and healthy children were enrolled for control group, both groups were subgrouped by age at testing: 3-5, -8, -12 and -15 years age-subgroups.The 6MWT and treadmill test (TET) were performed on the same day. The 6-minute walk distance (6MWD), 6-minute walk work (weight multiplied 6MWD), and breath rate (RR), heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) before and after 6 MWT were studied. The relationship between 6MWD, 6MWT work and METs was examined. Results ① RR, HR and SBP increased markedly at the termination of the test（P<0.05）, but DBP did not change significantly（P>0.05）in CHD and control groups by all age-groups. No significant difference was observed between CHD and control groups after 6MWT（P>0.05）. ② The 6MWD was shorter in CHD group than that in control group by all age-groups, of them in CHD 3-5 ［(383.7±52.8) vs (404.4±59.0)m］, -8 years age-subgroup ［(383.7±52.8) vs (404.4±59.0) m］ the 6MWD was significantly shorter than that in control age sub-groups (P<0.05), but no difference was found in -12 ［(510.2±78.9) vs (557.6±66.8)m］ and -15 years age-subgroups ［(595.4±89.6) vs (561.9±75.9) m］ between CHD and control subgroups (P>0.05). In the complicated CHD group the 6MWD was shorter than that in the simple CHD subgroup, (405.3±61.3) vs (465.1±109.4) m, P<0.01. The 6-minute walk work was smaller in CHD group than that in control group. In 3-5, -8, -12 and -15 years age-subgroups no difference was found between CHD and control groups (P>0.05). ③ The METs in CHD 3-5 , -8 and -12 years age subgroups were lower than those in the control age subgroups (P<0.05), but no difference was found in -15 age subgroup (P>0.05). In the complicated CHD subgroup the METs were lower but no difference was found between complex and simple CHD subgroup (P>0.05). The 6MWD (r＝0.486, r=0.543，P<0.01）and 6MWT work (r=0.601, r=0.404, P<0.01) had a positive correlation with METs in CHD group and control group, respectively. Conclusions The 6MWT can reflect daily activity ability of the children with postoperative congenital heart disease. Compared to treadmill test it is the one of more effective method in evaluating the cardiac function and more easily be performed, and cost-effective.
Objective The prevalence of obesity and related cardiometabolic comorbidities increased dramatically in Chinese populations at all ages. This study aimed at investigating the prevalence of metabolic syndrome (MS) and components among pregnant women in early gestation and evaluating the associations with macrosomia. Methods A population-based routine data from Kunshan Maternal and Child Health Care Hospital from 2009 to 2010 were retrospectively analyzed. The prenatal informations were analyzed among pregnant women who received the first prenatal examination less than 20 gestation weeks, including maternal anthropometrics and blood pressure at the first prenatal visit, fasting plasma glucose and serum lipids examined in the first trimester. Birth weight and gestational age were obtained from neonates' medical records in the hospital. MS was defined according to the International Diabetes Federation (IDF) criteria 2005. Owing to waist circumferences during pregnancy was imprecise, body mass index (BMI) ≥24 kg·m-2 in first prenatal visit was used to define overweight. Results Statistical analyses were performed among 1 405 subjects with complete prenatal data. The mean of maternal age and BMI at the first prenatal visit was (26.5±3.2) years and (20.8±2.7) kg·m-2, respectively. The mean of triglyceride, HDL-C and fasting glucose was (2.4±1.0), (2.0±0.4) and (4.5±0.5) mmol·L-1, respectively. The mean of SBP and DBP was (107.7±10.0) and (69.3±7.0) mmHg. The overall prevalence of MS, overweight, elevated triglyceride, reduced HDL-C, raised blood pressure and raised glucose among pregnant women in early gestation was 1.8%, 12.0%, 76.2%, 2.8%, 2.6% and 2.3%, respectively. The mean of the birth weight and gestational age was (3 365.0±418.6) g and (39.0±1.4) weeks with the incidence of macrosomia being 7.0%. Stepwise multiple logistic regressions for 497 subjects with the first prenatal visit within 20 gestational weeks and complete prenatal and neonatal birth weight showed in early gestation maternal overweight/obesity (OR=2.4, 95%CI: 1.0~5.5) significantly increased the risk of macrosomia. There was no significant difference in the proportion of maternal overweight in early gestation between analyzed subjects and those missing birth weight data by using Person's chi-square tests. Conclusions About 1.8% of Chinese pregnant women met the criteria of MS in early gestation. The commonest components of MS including raised triglyceride (76.2%) and overweight (12.0%), were the most important risk factors for macrosomia. The findings call for the urgent need for early and throughout management of metabolic risks among pregnant women in order to control the adverse gestation outcomes.
Objective To investigate the serological epidemiology of Epstein-Barr virus( EBV) infection in children in Beijing. Methods Seven hundred and thirty three children without symptoms and signs of infection from the surgical department of Beijing Children's Hospital were enrolled into this study. Three antibodies against EBV including CA-IgG, NA-IgG and CA-IgM were examined by using enzyme linked immunosorbent assay(ELISA). Results 733 children were included (414 males, 319 females). Children in <1, -5, -10 and -17 years groups were 306, 193, 147 and 87 cases respectively. The total seropositive rate was 70.4% of CA-IgG, 68.4% of NA-IgG and 0.7% of CA-IgM respectively. The positive rates of CA-IgG and of NA-IgG were 54.2% and 51.3% in <1 year group respectively, and increased with the age. The highest positive rates of CA-IgG and NA-IgG both were 90.8% in -17 years group. The CA-IgM was only detected in five sera samples. The cumulative infection rate of EBV in <1, -5, -10 and -17 years groups were 54.2%, 74.6%, 86.4%, 90.8% and recent infection rates were 2.1%, 20%, 0%, 11.1%. The cumulative infection rate significantly differed between males and females in -17 years group. Conclusions The primary infection of EBV in children occurs at their childhood. The seropositive rate of EBV is about 90% at the age of 10 years in children. Compared with the age of EBV seroconversion in 1980's, the age has delayed with the improvement of social economic status.
Objective To evaluate the applied meaning of Ig/TCR gene rearrangements by RQ-PCR for minimal residual disease(MRD) detection in childhood acute lymphoblastic leukemia （ALL）. Methods ①PCR detection of Ig/TCR gene rearrangements of ALL children was performed at diagnosis. ②The clonality of Ig/TCR gene rearrangements was analyzed by GeneScan. ③The sequence of monoclonal PCR products was checked to determine the patient-specific sequence as MRD detection target followed by the design of patient-specific primers and probes, and RQ-PCR quantification at different therapy phases. Results Eighty six children diagnosed as ALL were included. ①At least one type of Ig/TCR rearrangement was found in 96.5% (83/86) ALL children. ②91.8% (56/61) ALL children were detected to have at least one monoclonal Ig/TCR gene rearrangement. The detection rates for monoclonal, oligoclonal and polyclonal Ig/TCR rearrangement were 58.1%, 30.8% and 11.0% with significant difference(P<0.001). ③For 22 continuous complete remission(CCR) cases, the Ig/TCR gene rearrangement expression consistently decreased as therapy continued, and before maintaining therapy, all tested MRD cases were detected to be MRD negative; For 4 relapse cases, MRD was persistently positive from beginning of induced remission to relapse, and clinically the average relapse time was 3.75 months (ranging from 2 to 8 months) since the relative expression of Ig/TCR rearrangement started increasing. Conclusions Surveillance of ALL children's MRD level detected by RQ-PCR with Ig/TCR gene rearrangement as targets, is a potentially useful assay for evaluation and assessment of therapy effect and relapse prediction.
Objective:To study the protective effects of glutamine(Gln) on intestinal mucosa in lipopolysaccharide-induced newborn rats. Methods:Four broods of mother and infant rats were randomized into four groups: methionine sulfoximine(MS)+Gln group: Gln-deprived pups + Gln supplementation ;MS+NS group: Gln-deprived pups without Gln supplementation; Normally fed and Gln group: normally fed pups + Gln supplementation; Normally fed and NS group: normally fed pups without Gln supplementation; MS,NS and Gln were given by intraperitoneal injection for 6 days. All pups received lipopolysaccharide (LPS) on D7 and were sacrificed 6 hours later. Small intestine was harvested for studies. Plasma Gln concentration was detected by high efficiency liquid chromatography. IL-1, TNF-α and MCP-1 levels were determined with homogenate by ELISA. The intestines were examined under both light, transmission and scanning electron microscopy (EM) and membrane fluidity was determined with fluorescent polarization, using a DPH probe. Results:①The number of pups in 4 groups was 11, 11, 10 and 11 respectively, but when the experiment was finished,the number was 9, 5, 10 and 11 respectively. ②Pups weight gain (g), plasma Gln concentration(μmol·L-1), IEC membrane fluorescence polarization and cytokine expression (MCP-1, TNF-α, IL-1β pg·mL-1)of four groups were（1.52±0.64）,（0.58±0.77）,（11.72±1.03）and （11.80±1.45）,（394.3±92.5）,（105.9±379）,（774.6±143.7）and （676.8±113.6），（0.241±0.046）,（0.297±0.033）,（0.215±0.052）and （0.211±0.049）,（8.0±1.6）、（5.8±0.8）、（8.5±1.3）and（8.7±1.2），（2.2±0.8）,（1.3±0.4）,（2.8±1.0）and （2.5±1.1），（28.5±155）,（16.8±11.0）,（31.4±15.1）and（32.3±13.9）. Overall, the between-group differences were statistically significant（P<0.05）.③Under light microscopy，the intestinal structure of MS+NS group pups was not intact, small intestine villi were the shortest and badly destroyed under optical microscopy. In MS+Gln group，the intestinal structure was also not intact, small intestine villi were shortened and destroyed, but some of them were restored. In normal+Gln and normal+NS group, small intestine villi were slightly destroyed. ④Under transmission EM and scanning EM, the small intestine microvilli of MS+NS group pups were shortest, badly abrupt and disorderly arranged, the membranes were destroyed and mitochondria were obviously ruptured. In MS+Gln group, small intestine microvilli were shorter and disorderly arranged, the membranes were destroyed and mitochondria were obviously swollen. In normal+Gln and normal+NS group, small intestine microvilli were normally arranged and not obviously ruptured, the membranes were not destroyed. Conclusions:Gln deprivation adversely affected gastrointestinal structure and function of newborn rats. Glutamine supplementation was protective against the damage of the gastrointestinal tract caused by endotoxemia.
