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??Objective Through the comparative analysis of influencing factor differences in the autistic spectrum disorders??ASD?? children and healthy children?? to further explore child autism factors and to provide reference for prevention and control of autism. Methods A retrospective investigation with 1??1 case-control study was conducted in 196 cases of ASD children and normal children diagnosed and treated in Jinzhou Women and Children’s Hospital between May 2014 and May 2015??through the home-made questionnaire for health factors??the differences between the two groups concerning development indicators and health influencing factors were compared. Results There was no statistical difference in the average height and weight between the two groups??P??0.05????but the size of head circumference of ASD group was greater than the control group??and the difference was statistically significant??t??2.41?? P??0.02??.Conditional logistic regression analysis revealed there was statistical difference??all P??0.05?? in children’s ability of a glimpse of recognition and understanding ??β??-3.077?? and head circumference ??β??0.341??. The test of regression coefficient of some variables showed that mother’s age older than 35 years old??family relationship??family history of neurological disorder and father engaged in manual labour had statistical significance??and were significantly correlated with the occurrence of diseases??all P??0.05??. Some factors had positive relationship with the happening of the disease??all P??0.05????namely irritable mood during pregnancy ??β??1.966?? OR??7.144????mental stimulation ??β??2.067?? OR??7.902?? and pregnancy vomiting ??β?? 2.576?? OR??13.138???? but supplements ??β??
-2.435?? OR??0.088?? and the normal quickening ??β??-2.008?? OR??0.134?? were negatively associated with ASD ??all P??0.05??. Conclusion The factors such as mother's age more than 35 years old?? father engaged in mental labour?? family tensions?? family history of nervous disorders?? mental stimulation?? emotional irritability and pregnancy vomiting?? may be the risk factors for ASD. If mother is pregnant before the age of 35?? has supplements timely and keep happy during pregnancy??and in the process of children’s growth??parents pay attention to development of language and head circumference?? and ofen accompany children?? the occurrence of ASD can be reduced to a certain extant.     

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??Objective??To find the difference in growth and development of children between full-term symmetric growth restriction??FSGR?? and full-term asymmetric growth restriction??FAGR?? through a general investigation of children born small for gestational age in Shanghai. Methods??This general investigation covered all children under 6 years old in Shanghai. Data on growth were retrospectively obtained from medical records. The P10 of birth head circumference/birthweight of the same gestational age and gender was used to distinguish FSGR and FAGR. Results??The sample contained 10 188 full-term SGA children among whom 8049 were FAGR and 2139 were FSGR. Up to 3 years old??both FSGR and FAGR failed to catch up in weight??height??head circumference and chest circumference. Growth restriction in FAGR was more serious. Significant difference could be seen in weight??t??-3.412??P??0.001?? and chest circumference??t??-2.526??P??0.012?? between FSGR and FAGR at 3 years old. Regarding growth speed??the growth rate of weight ??t??6.272??P??0.001????height ??t??9.143??P??0.001????head circumference ??t??6.063??P??0.001?? and chest circumference ??t??6.617??P??0.001?? were higher in FAGR 6 months after birth??while there was no difference after that. The BMI of FAGR was significantly lower than FSGR before 2 years old. The proportion of children in danger of being overweight was significantly higher in FSGR ??P??0.001??. Conclusion??Both FSGR and FAGR experience catch-up growth after birth??but not enough to catch up with normal children at 3 years old??especially in head circumference. In spite of severer growth restriction??the cath-up growth model of FAGR is superior to FSGR. The proportion of children in danger of being overweight is significantly higher in FSGR.     

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??Objective To analyze the correlation of heart rate variability??HRV?? parameters with troponin??cTn?? and N-terminal pro-B-type natriuretic peptide??NT-proBNP?? in children with Kawasaki disease??KD??. Methods According to presence or absence of coronary artery lesion??CAL????the enrolled 118 children with KD as KD group were divided into CAL group??n??43?? and non-CAL??NCAL?? group??n??75??. Meanwhile??32 children without cardiovascular disease in convalescent period and 106 healthy children at the same term were respectively selected as non-KD group and control group. Long-term HRV parameters were detected in each group??and levels of cTn?? and NT-proBNP were detected in KD group and non-KD group. Results HRV parameters in KD group were all higher during recovery phase than those during acute phase??except for LF/HF value lower than that during acute phase ??P??0.05 or P??0.01??. HRV parameters in KD group were all lower than those in control group??except for LF/HF value higher than that in control group ??P??0.05 or P??0.01??. Each index in time domain of HRV and high frequency ??HF????low frequency ??LF?? and very low frequency ??VLF?? in CAL group were all lower than those in control group and non-KD group ??P??0.05 or P??0.01????and SDANN??SDNN and PNN50 were also lower than those in NCAL group ??P??0.01??. Besides??the LF/HF value in CAL group was higher than that in control group??non-KD group and NCAL group ??P??0.05 or P??0.01??. The levels of cTn?? and NT-proBNP in CAL group and NCAL group were significantly higher than those in non-KD group??in which the level of cTn?? in CAL group was also higher than that in NCAL group ??P??0.01??. The level of cTn?? was negatively correlated with SDNN and HF in children with KD??while positively correlated with LF/HF value ??P??0.01??. The level of NT-proBNP had a significantly negative correlation with SDANN??SDNN and HF ??P??0.01??. Conclusion The heart autonomic nervous function is damaged in children with KD. HRV parameters have a certain clinical value for assessment of CAL in children with KD.     

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??Objective??To investigate the correlations between plasma monocyte /macrophage chemoattractant protein and related parameters of insulin resisitance in children with simple obesity. Methods??70 children with simple obesity were enrolled as study group??30 healthy children as control group. Body mass index??BMI ??and waist circumference ??WC??were detected as indices of obesity .Plasma levels of macrophage inflammatory protein-1????MIP-1??????monocyte chemoattractant protein-1??MCP-1 ??were measured by ELISA.The rate of CD68 positive cells in blood were detected by flow cytometry??FCM???? Plasma levels of insulin ??adiponectin were measured by RIA?? Insulin resisitance index ??InRI?? were caculated by homeostasis model assessment of insulin resistance ??HOMA-IR??. The associations between MIP-1????MCP-1 levels and adiponectin and related parameters were analyzed with Pearson correlation analysis or partial correlation analysis??Results??The concentration of MIP-1?? and MCP-1 in plasma in children with simple obesity were higher than that in control group. There was a significant difference between the two groups ??P < 0. 05??. The rate of CD68 positive cells in blood of simple obesity had no significant difference between that in control group ??P > 0.05??.The concentration of MIP-1?? and MCP-1 in plasma had positive correlations with BMI and WC and InRI??P < 0. 05??. The concentration of adiponectin in plasma had negetive correlations with BMI and WC and InRI ??P < 0. 05??. The rate of CD68+ cell in blood had no correlation with BMI and WC and InRI??P < 0. 05??.Conclusion??We found that a differential low-grade inflammation is associated with obesity of children .The levels of MIP-1????MCP-1 in blood of obesity were associated with insulin resistance and abdominal obesity. The levels of plasma MIP-1????MCP-1??adiponectin may predict the onset of obesity related complications.     

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??Objective??To explore the correlation between FeNO levels and airway reversibility and its clinical significance in assessment of children with asthma. Methods??A total of 161 children at 5 to14 years old with asthma admitted to pediatric respiratory outpatient of Shengjing Hospital Affiliated to China Medical University from November 2014 to November 2015 were divided into allergic group and non-allergic group according to the allergic condition. FeNO and bronchial dilatation tests were made in the two groups. The correlation between FeNO levels and improvement rate after bronchodilator in two groups was analyzed. Results????1??FeNO level in allergy group was obviously higher than that in non-allergic group??P??0.002??. ??2?? FeNO level of children in allergic group was positively correlated with improvent of bronchial improvement??P??0.05????and negatively correlated with FEV1%?? FEV1/FVC%?? FEF50%?? FEF25% and FEF75/25% of basic lung function??P??0.05????but was irrelevant to FVC%?? PEF% and FEF75% of basic lung function??P??0.05??.??3??FeNO level of children in non-allergic group was irrelevant to improvement rates of bronchial dilation and basic lung function??P??0.05??. Conclusion??For asthmatic children with allergic constitution??FeNO level is positively correlated with airway reversibility. It may be a good noninvasive predictor for evaluating asthma and airway reversibility in children with asthma. While for children without allergic constitution??FeNO level cannot indicate the airway reversibility effectively.     

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??Objective??To investigate the correlation between different levels of proteinuria and renal pathological lesion in children with primary IgA nephropathy??in order to provide references for the treatment and condition assessment. Methods??A total of 32 IgAN patients with a renal biopsy from the Pediatric Department of the First Affiliated Hospital of China Medical University from August 2005 to July 2015 were chosen. According to the level of 24 h urinary protein??UP????the 32 cases were separated into 3 groups??mild group??UP??0.5 g??n??17????moderate group??0.5-2.0 g??n??9?? and severe group??UP??2 g??n??6??. Their clinical and pathological data were studied retrospectively. Results??The proportion of patients with mild??moderate and severe proteinuria were 53.1%?? 28.1% and 18.8% respectively. Proteinuria was positively correlated with glomerular integral and tubular interstitial integral??P??0.05??. The majority of pathological changes of IgAN were grade ??and grade ??each with 14 cases??43.8%??. With the increasing level of albuminuria??the degree of pathological damage increased??P??0.05??. Crescentic lesions were found in 13 cases??40.6%????and with the increasing degree of the proteinuria??the incidence of crescent lesions had an increasing tendency??P??0.05??. Conclusion??There is correlation between proteinuria and renal pathological changes in children with IgA nephropathy. The level of proteinuria can reflect the pathological damage of glomerular and renal tubule to a certain extent. Children with mild proteinuria??who have IgA nephropathy??also have the potential to progress to ESRD. They need to be treated actively to reduce urinary protein and delay the progression of the disease.     

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??Abstract??Objective??To explore the changes and implications of serum orexin-A levels in childrens with obstructive sleep apnea-hypopnea syndrome ??OSAHS??. Methods??Polysomnography was performed in 30 OSAHS children ??OSAHS group???? 20 normal healthy children ??control group??and 30 obese subjects ??obese group??. Serum orexin-A concentration was measured with EIA kit. Results??Serum orexin-A level in the OSAHS group ???0.49±0.10?? μg/mL?? was significantly higher than that in the obese group ???0.29±0.07?? μg/mL??P < 0.01??and the control group???0.30±0.12?? μg/mL??P < 0.01??respectively?? serum orexin-A level in children with OSAHS correlated positively with the AHI??r = 0.427?? P < 0.05??and MAI ??r = 0.468?? P < 0.05???? but correlated negatively with the lowest oxygen saturation ??LSaO2?? ??r = -0.527?? P < 0.01?? and the mean oxygen saturation ??MSaO2?? ??r = -0.541?? P < 0.01????but not correlated significantly with the BMI ??r = -0.212?? P > 0.05??. Conclusion??Serum orexin-A level in OSAHS children is increased?? which may be caused by frequent awaking and hypoxia. The serum level of orexin-A should be used as a predictor in screening OSAHS children.     

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目的探讨儿童紫癜性肾炎(HSPN)的临床、病理分型分级与预后的关系。方法回顾性分析2000年1月至2008年10月在新疆维吾尔自治区人民医院儿科住院的55例HSPN患儿的临床、病理特点,分析对远期预后影响的因素。结果临床表现为血尿和蛋白尿者22例(40.0%),肾病综合征16例(29.1%),单纯性血尿或蛋白尿、急性肾炎和急进性肾炎者分别为12例(21.8%)、4例(7.3%)和1例(1.8%)。肾脏病理表现为系膜增生、肾小球硬化、新月体形成,国际小儿肾脏病研究组分级多见Ⅱ级和Ⅲ级,分别为27例(49.1%)和16例(29.1%)。临床分型与病理分级有相关性(P<0.05),临床分型越严重,肾脏病理损害越重,预后不佳。病理分级与预后有相关性(P<0.05),病理分级越重,预后越不佳。肾小管-间质病理分型与病理分级有相关性(P<0.01),随着肾小管-间质病变程度加重,肾脏病理损伤的程度越重,患儿预后不良。结论儿童紫癜性肾炎的临床表现、病理分级与远期预后密切相关,临床表现重,病理分级高,预后差。     

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??Objective To observe the changes of red cell distribution width ??RDW?? in children with heart failure secondary to dilated cardiomyopathy??DCM????and to explore the correlations between RDW and the common parameters of cardiac function. Methods Totally 68 children with heart failure secondary to DCM were enrolled. According to the modified Ross scoring system??the children were divided into 3 subgroups?? mild??moderate and severe heart failure subgroups. Fifty healthy children were selected as control group. RDW levels were compared among the groups. The correlation analysis was performed between RDW and plasma N-terminal brain natriuretic peptide ??NT-proBNP??as well as left ventricular ejection fraction??LVEF??. Results RDW levels in children with heart failure secondary to DCM were significantly higher than the control group ??P??0.01??.With increasing heart failure grade??NT-proBNP levels were elevated gradually and LVEF were decreased gradually ??both P??0.01????RDW levels had no significant difference among the heart failure groups??P??0.05??. RDM was not correlated with NT-proBNP or LVEF??r??0.144??r??-0.158??P??0.05??. Conclusion In children with DCM??RDW can be used as a new diagnostic marker of heart failure??but it can not reflect the severity of heart failure.     

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??Objective To identify variables that might interfere with near final height??NFH?? of patients with congenital adrenal hyperplasia??CAH?? due to classic 21-hydroxylase deficiency??21-OHD??. Methods Eight-two patients with CAH due to classic 21-OHD achieved the NFH were followed up from March 1989 to May 2015 in Child Growth Center of the First Affiliated Hospital of SUN Yat-sen University. The NFH were compared with the standard height for the population and the target height??TH????and associated factors were analyzed. Results Eighty-two patients were followed up for approximately 10.6 yrs??0.5 to 25.5 yrs??. NFH SDS??-1.9±1.1?? was significantly lower than the normal population??P??0.001??. The treated group was significantly taller than the untreated group??P??0.01????early diagnosis group appeared to be taller than those with late diagnosis??P??0.019??. A better height outcome was observed in patients with advantage in TH??good compliance??and low HC dose by multivariate Cox regression analysis in 62 treatment patients. NFH and HC dose were negatively correlated??r??-0.23??P??0.078?? in treated group. For uncontrolled patients??patients with original HC does+letrozole had a better improvement than those receiving HC enhanced dose??P??0.064??. NFH SDS of patients with central precocious puberty who received GnRHa+letrozole was significantly higher than no-intervention group??P??0.005??. Conclusion Whether receiving treatment or not NFH of the classic 21-OHD children is below expectation??as compared with both the reference population and the target height??and is even lower in non-treatment group. Early diagnosis??early treatment??good compliance and lower dose of HC have a major impact on 21-OHD NFH. Associated adjuvant therapy of inhibiting bone maturation can somewhat improve NFH.