北京城乡结合部地区6个月~3岁儿童营养性缺铁性贫血的现况调查及相关因素分析

目的 探究北京城乡结合部地区6月~3岁儿童营养性缺铁性贫血的情况,分析造成儿童贫血的影响因素,营养性缺铁性贫血的防治工作提供科学指导。方法 将2016年10月~2017年10月在天通西苑社区儿保门诊系统管理的6月~3岁儿童,共2053例作为研究对象,对其性别、年龄、血红蛋白值、贫血程度进行调查,分析不同年龄段、不同性别儿童的贫血情况。结果 2053例儿童中,存在贫血的儿童共266例（12.96%）。男孩1074例,贫血145例（13.51%）,女孩979例,贫血121例（13.36%）;6~12个月儿童701例,贫血191例（27.25%）,13~24个月儿童650例,贫血43例（6.62%）,25~36个月儿童702例,贫血32例（4.56%）。6月~3岁儿童中,贫血患病率比较高,年龄越小,患者贫血的几率越高。纯母乳喂养的儿童贫血患病率较低;辅食添加时间越晚,患病率越高;少食动物性食物的儿童患病率越高。结论 应当定期对婴幼儿进行体验,尽早发现营养性缺铁性贫血,并给予有效的干预和治疗,促进儿童的健康发展。儿童贫血与喂养行为具有密切的关系,应当形成正确的喂养方式。     

The effects of feeding on the electroencephalogram in 3- and 6-month-old infants

The human infant's neurophysiological responses to feeding are poorly understood. We found recently a significant increase of EEG amplitude in the newborn during nutritive feeding, but not during pacifier sucking. In this study, we report EEG responses to feeding in 13 infants at the ages of 3 and 6 months. The undifferentiated response of the newborn was found to wane until the age of 3 months, whereas in 6-month-old infants, relatively abundant rhythmic 3-5 Hz theta activity was recorded during feeding with an amplitude maximum in right posterior areas. Cessation of feeding was followed by cessation of theta activity. The rhythmic 3-5 Hz theta response to feeding is likely to represent emotional arousal, as it is similar to previous findings showing posterior theta increase in other settings connected with emotional arousal in infants.     

贫困农村和富裕城市6月龄婴儿粪钙卫蛋白水平的差异及其影响因素

目的比较贫困农村与富裕城市6月龄婴儿粪钙卫蛋白（FC）水平的差异及喂养对婴儿FC水平的影响。方法 2009年10月至2010年6月收集云南贫困农村以及上海城区6月龄婴儿的粪便样品,采用ELISA法检测FC水平;同时获得婴儿母乳喂养和辅助食品添加的信息。比较两地婴儿FC水平差异,母乳喂养与辅助食品添加对婴儿FC水平的影响。非正态分布数据以中位数（全距）表示。结果共调查145名婴儿,剔除10名部分资料缺失的婴儿。135名婴儿进入分析,其中96名来自贫困农村,39名来自富裕城市。富裕城市婴儿在生后前6个月的体重增长显著高于贫困农村婴儿,（5.0±0.9）kgvs（4.3±0.9）kg,P〈0.01。135名婴儿中有36名婴儿的FC水平〉600μg.g-1,其中贫困农村婴儿34/96名（35.4%）,富裕城市婴儿2/39名（5.1%）,差异有统计学意义（P〈0.01）。FC水平≤600μg.g-1的99名婴儿中,FC水平的中位数为172.0（24.5～595.9）μg.g-1,明显高于成人正常水平上限（50μg.g-1）。不同性别婴儿的FC水平差异无统计学意义（P=0.828）。富裕城市37名FC水平≤600μg.g-1婴儿的FC水平中位数为138.8μg.g-1（26.2～557.2μg.g-1）;贫困农村62名FC水平≤600μg.g-1婴儿的FC水平中位数为196.4μg.g-1（24.5～595.9μg.g-1）,差异有统计学意义（P〈0.05）。母乳喂养以及不同辅助食品添加对婴儿的FC水平无显著影响。结论 6月龄婴儿的FC水平显著高于成人。贫困农村6月龄婴儿的FC水平明显高于富裕城市婴儿,该现象是否预示着贫困农村婴儿中存在肠道隐性感染,是否因此而影响婴儿生长发育,值得进一步的研究。     

Using the WHO 2006 child growth standard to assess the growth and nutritional status of rural south Indian infants

Background: The WHO 2006 child growth standard is advocated in India, although the conformity of the growth of Indian infants to the WHO standard has only been assessed at cross-sectional points.

Aim: To assess the implications of using the WHO standard in rural India and to investigate the factors responsible for any departure from optimal growth, as shown in the WHO standard.

Subjects and methods: Mixed-effects models were applied to serial weight and length data from 384 rural south Indian infants. Unadjusted and adjusted (for, among other things, breastfeeding and maternal education) estimates were converted to Z-scores and the risks of underweight, wasting and stunting using the WHO standard compared to the NCHS 1977 child growth reference were calculated.

Results: Weight growth was more similar to the WHO standard than the NCHS reference and in late infancy the WHO standard was less likely to classify underweight (RR at 15 months = 0.45; 95% CI = 0.31–0.65). Adjusting the serial data shifted the curves 0.25 Z-scores closer to the median of either chart; variations in household socioeconomic status and morbidity were largely responsible for this shift.

Conclusion: In late infancy, the WHO standard will allow a more focused intervention effort and use of resources for targeting programmes at infants most at risk of malnutrition.     

The effect of growth hormone treatment in a child with tricho-rhino-phalangeal syndrome: A case report and review of the literature

Tricho-rhino-phalangeal syndrome (TRPS) is characterized by craniofacial and skeletal malformations including short stature, cone-shaped phalangeal epiphyses and Perthes-like changes of the hip. We describe the response to growth hormone (GH) treatment in a boy with TRPS. The patient presented at age 3.5 years for evaluation of short stature (−3.2SD). On physical examination, the characteristic facial phenotype of TRPS was noted. Radiographs showed cone-shaped phalangeal epiphyses and bilateral small and fragmented femoral heads. The diagnosis was confirmed by Sanger sequencing of the TRPS1 gene. Two GH stimulation tests revealed GH deficiency, and GH treatment was initiated. Subsequently, growth velocity improved, as did the radiographic appearance of the femoral epiphyses, as seen on sequential pelvis radiographs.This observation suggests the possibility of a beneficial effect of GH treatment on both height and epiphyses status in TRPS patient with GH deficiency. Further studies are needed to support the observation.     

中国小儿体格生长发育的研究——示指同身寸的研究

本文测量了180例小儿(初生到身长为150cm)示指同身寸的长度,分六个身长组统计其均数及标准差,并计算了示指同身寸与身长、头颈、躯干、四肢间的比值及直线相关和回归,讨论了以同身寸为参照系机体各部生长发育的规律。     

Nasal asymmetry changes during growth and development in 6- to 12-year-old children with repaired unilateral cleft lip and palate: A 3D computed tomography analysis

Repaired unilateral cleft lip and palate (UCLP) is often accompanied by the deformity and asymmetry of the nasal region. Three-dimensional analysis was performed to investigate the relationship between nasal soft- and hard-tissue asymmetries, as well as the changes in nasal asymmetry with age, among children with repaired UCLP (age: 6–12 years). Forty-seven patients were included in this study. Their computed tomography records were retrieved for analysis of the 3D asymmetry of 10 landmarks of the nasal soft and hard tissues. We observed that asymmetry was more severe in nasal hard tissues than in soft tissues, particularly in the sagittal dimension. Compared with patients aged 6–9 years old, patients aged 10 to 12 years old had significantly increased vertical asymmetry at the base of the alar groove (Gbase, p = 0.027) and the lateral point of the piriform aperture (LPA), (p < 0.001). The correlation between the LPA and the alar region was weak to moderate (r = 0.290 to 0.488). In conclusion, we found no evidence of growth and development in nasal hard-tissue asymmetry among 6- to 12-year-old children with repaired UCLP, except for the vertical dimension. Nasal soft tissue exhibited a more preferable symmetry than hard tissue, and this could be attributed to the compensatory growth of nasal soft tissue, particularly in the vertical and sagittal dimensions. The weak to moderate correlations between nasal soft-tissue asymmetry and hard-tissue asymmetry were observed in the three dimensions. Surgeons should consider these factors when repositioning the nasal alar and controlling the size of the nostrils.