Duchenne型假肥大肌营养不良症患儿的主要生活事件发生规律

目的分析Duchenne型假肥大肌营养不良症(DMD)患儿主要生活事件发生时间,了解DMD进展规律及主要临床特征。方法选取临床确诊436例DMD患者(经基因检测或肌肉活检证实),详细记录患者临床资料,分析患者的主要临床特点、进展情况、智力情况。检测其血清肌酸激酶(CK)水平,并分析CK的演变规律。结果 DMD患儿就诊时年龄为(6.37±2.88)岁,病程为(4.46±3.02)a,走路无力易摔倒和上楼困难是患者就诊的主要原因。学走路月龄在18个月以上的患儿约占59.86%。96.56%的患儿小腿腓肠肌假性肥大;5～7岁DMD患儿中93.59%存在Gower’s征阳性。血清CK水平在2～5岁逐渐升高,6～7岁达到高峰,其后逐年下降,15岁时仍然明显高于健康人。结论 DMD患者病程进展遵循一定规律,一般出生时正常,然后依次出现习步延迟、上楼困难和步行一小段距离的能力衰退,直至不能行走。     

6例杜氏肌营养不良回顾性分析

目的分析6例杜氏肌营养不良(DMD)患儿的临床特点,并结合文献复习,为早期诊断该病及采取有效治疗措施进行归纳总结。方法收集2010年1月至2015年10月收治的6例DMD患儿的临床资料,进行回顾性分析。结果 6例均为男性,确诊年龄1.2~11.5岁,均无家族史。起病隐匿,均有谷丙转氨酶、谷草转氨酶、乳酸脱氢酶、α-羟丁酸脱氢酶、肌酸激酶、肌酸激酶同工酶同步升高,以肌酸激酶升高最显著、为正常的3.7~107.2倍。基因检测均提示DMD基因突变;其中2例患儿的母亲行基因检测,提示携带相同突变基因。1例行肌肉活检,病理结果符合DMD改变。1例患儿行脐血间充质干细胞移植,5 d后肌酸激酶下降77.0%。结论对血清肌酶异常、运动功能异常的男童,应高度警惕DMD,尽早行CK及基因检测确诊,尽早干预,保护尚存的正常肌纤维,延缓疾病进展。     

先天性心脏病心肌损害临床分析

目的 探讨先天性心脏病(先心病)患儿心肌损害程度与缺氧及心功能的关系,为心肌保护提供理论依据。方法 测定115例先心病患儿心肌酶谱和58例先心病心肌肌钙蛋白I(CTnI)。结果 115例中A、D、E组心肌酶谱改变以乳酸脱氢酶(LDH)、乳酸脱氢酶同工酶1(LDH1)、肌酸激酶同工酶(CK-MB)、α-羟丁酸脱氢酶(α-HBDH)增高明显,在各组心肌酶谱结果比较及与正常值比较中,两组有显著差异或非常显著差异(P<0.05或P<0.01);CK-MB／CK>0.05。先心病患儿58例中A、D、E组cTnI检出阳性率明显升高(P<0.05),且A、D、E组中cTnI与LDH、LDH1、CK、α-HBDH阳性率比较,各组间有显著差异(P<0.05),与CK-MB比较,无显著差异(P>0.05)。结论 LDH、LDH1、CK-MB、CK-MB／CK、α-HBDH、cTnI是判断先心病患儿心肌损害重要指标;CK-MB与cTnI是诊断心肌损害的血清金标准。     

1,6-二磷酸果糖治疗新生儿窒息并心肌损害

目的探讨1,6-二磷酸果糖治疗新生儿窒息后心肌损害的效果。方法新生儿窒息并血清心肌酶谱变化85例患儿,随机分为治疗组45例和对照组40例;二组患儿均采用综合治疗。治疗组予1,6-二磷酸果糖0.10~0.25g/(kg.次),2次/d,快速静脉滴注(10min内滴完),疗程7~10d,入院12h内及治疗后查血清心肌酶谱。结果治疗与对照组治疗后肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、α-羟丁酸脱氢酶(HBDH)比较差异均具有显著性意义(Pa<0.05)。结论1,6-二磷酸果糖对新生儿窒息心肌损害有一定预防及治疗作用。     

Duchenne型进行性肌营养不良临床和基因变异97例分析

目的分析Duchenne型进行性肌营养不良(DMD)患儿的临床和基因突变特点,总结并分析97例DMD病例的基因突变热点。方法收集2014年1月至2018年1月上海交通大学医学院附属上海儿童医学中心通过基因检查随访确诊为DMD的患儿97例,对其临床表现,生化检查和基因突变结果进行分析。结果 97例中男96例,主要以喂养困难、肌酶增高和肢体无力为主要临床表现。肌酸激酶(CK)、乳酸脱氢酶(LDH)和天冬氨酸转移酶(AST)等肌酶均明显升高。通过组合的高通量检测技术检查DMD基因多为大缺失,共62例(63.92%),大重复突变11例(11.34%),24例(24.74%)发生点突变。所有的突变可发生在基因的任何位置,但是有两个缺失的热点区域:位于基因的中央区外显子45～55区共45例,占大缺失突变的72.58%;位于5’端外显子2～19区12例,占大缺失突变的19.35%。结论喂养困难、肌酶增高和肢体无力为DMD患儿的主要临床表现。肌酶明显增高者DMD基因应及时检测。     

兰州市小于18岁健康儿童心肌酶谱参考值趋势性分析

目的 通过对兰州市区婴幼儿、中小学生进行体检,检测10 d～18岁健康儿童心肌酶谱参考值,分析健康儿童与成人心肌酶谱参考值的趋势性差异,确定本地区健康儿童心肌酶谱的正常值范围.方法 将234名10 d～18岁健康儿童分为婴幼儿组、学龄前组、学龄组及青少年组.男118例,女116例.采集其外周静脉血3 mL,用速率法测定其血清中AST、LDH、α-羟丁酸脱氢酶(α-HBDH)、CK、CK-MB水平,并对检测结果进行统计学分析.结果 (1)4个年龄组血清中AST、LDH、a-HBDH、CK、CK-MB水平均较成人高,年龄越小,水平越高,随着年龄的增长,其水平逐渐接近成人.(2)这4个年龄组的指标测值与成人组比较,婴幼儿组、学龄前组及学龄组有统计学意义(Pa＜0.01);青少年组无统计学意义(P＞0.05).(3)各年龄组男、女童血清心肌酶谱水平比较差异均无统计学意义(Pa＞0.05).结论 ＜18岁健康儿童各年龄组心肌酶谱参考值有随年龄增长逐渐递减的趋势,各项指标高于成人参考值水平,故在诊断儿童病毒性心肌炎时应参考本地区儿童心肌酶谱的正常值.     

有无疫苗接种史麻疹患儿心肌酶谱变化的意义

目的了解有无麻疹疫苗接种史麻疹患儿急性期心肌酶谱变化及临床意义,探讨疫苗接种对麻疹患儿心肌的保护作用。方法对71例住院麻疹患儿按有无麻疹疫苗接种史分为有疫苗接种史组23例（有接种组）和无疫苗接种史组48例（无接种组）,并设健康对照组30例。分别检测各组血清肌酸激酶（CK）及其同工酶（CK-MB）,乳酸脱氢酶（LDH）及其同工酶1（LDH1）,α-羟丁酸脱氢酶（α-HBD）水平,同时行心电图检查。结果无接种组与有接种组比较,CK-MB、LDH1及α-HBD明显升高（Pa〈0.05）,并肺炎增多（P〈0.05）,平均住院天数增加（P〈0.01）。二组分别与健康对照组比较,CK-MB、LDH、LDH1及α-HBD均明显升高（Pa〈0.01）。结论麻疹患儿急性期存在心肌酶谱升高,接种麻疹疫苗对急性期麻疹患儿心肌有一定保护作用,可减少合并症。     

肺炎支原体肺炎患儿心肌酶谱动态分析

目的 对婴幼儿与儿童肺炎支原体(MP)肺炎的心肌酶谱的动态变化进行检测,了解二者在发病早期与恢复期的不同。方法 婴幼儿组和儿童组MP肺炎均在发病后1周和3周早晨取空腹血测定血清心肌酶谱及其同工酶。结果 心肌酶谱在发病第1周时儿童组血清门冬氨酸氨基转氨酶(AST)、肌酸激酶(CK)、肌酸磷酸激酶同工酶(CK-MB)、α-羟丁酸脱氢酶(α-HBD)均高于婴幼儿组,两组比较有显著性差异(P<0.01)。发病后3周经治疗血清心肌酶和同工酶婴幼儿组均高于儿童组,差异有显著性(P<0.01)。婴幼儿组中2次测定乳酸脱氢酶(LDH),均高于儿童组,且差异有显著性(P<0.01)。结论 MP肺炎感染早期儿童组心肌损害较婴幼儿组明显。发病后3周经治疗婴幼儿心肌损害较儿童组明显且迁延。婴幼儿组病程中LDH均高于儿童组,可能与LDH敏感性高、恢复慢、特异性差及婴幼儿肺部表现较儿童严重、且缺氧也更明显有关。     

Duchenne型进行性肌营养不良40例临床分析

目的 探讨Duchenne型进行性肌营养不良(DMD)的临床特点及肌酶、肌电图、肌肉活检的诊断价值.方法 对40例经dystrophin蛋白检测确诊的DMD患儿的临床特征及实验室检查资料进行分析.结果 40例患儿平均年龄7.2岁,平均发病年龄4.5岁,15%患儿有家族史.40例患儿均有典型的临床症状和体征,肌酶升高以肌酸磷酸激酶(CPK)升高为主,≤8岁年龄组CPK值高于＞8岁组.所有患儿肌肉活检均有肌纤维变性和坏死,12.5%的患儿尚伴炎性细胞浸润.在有肌源性损害同时,15%的患儿肌电图尚有神经源性损害.结论 血清肌酶、肌电图及肌活检是DMD重要的辅助诊断指标,对于肌电图有神经源性损害和肌活检病理检查有炎性细胞浸润者,应进行基因检测和(或)dystrophin蛋白检测.     

病毒性脑炎患儿血清心肌肌钙蛋白的临床意义

目的　研究血清心肌肌钙蛋白I(CTnI)水平对病毒性脑炎 (病脑 )并心肌炎或心肌损害患儿的诊断价值。方法　用酶联免疫吸附试验 (ELISA)测定 4 0例病脑患儿 (意识障碍组 12例 ,无意识障碍组 2 8例 ;惊厥组18例 ,无惊厥组 2 2例 )及 4 0例对照组血清心肌酶谱及CTnI水平。结果　病脑组血清心肌酶谱及CTnI阳性率明显高于对照组 (P <0 .0 5 ) ,同时有意识障碍组血清心肌酶谱及CTnI阳性率明显高于无意识障碍组 (P <0 .0 5 ) ,有惊厥组血清心肌酶谱和CTnI阳性率高于无惊厥组 (P均 <0 .0 5 )。结论　CTnI对病脑并心肌损害诊断有较高的特异性、敏感性 ,是治疗及预后判断的指标之一     

假肥大型肌营养不良患者血清肌酸激酶变化规律

目的：假肥大型肌营养不良患者血清肌酸激酶随病程进展而不断变化。该研究旨在分析假肥大型肌营养不良患者血清肌酸激酶的变化规律。方法：收集临床已确诊的假肥大型肌营养不良患者的血清,其中男性39例,女性1例,通过连续监测法测定血清肌酸激酶。结果：假肥大型肌营养不良患者血清肌酸激酶在3～5岁达到峰值,以后随病程进展和年龄增加逐年下降,年均下降率为8.7%。结论：假肥大型肌营养不良患者的血清肌酸激酶在3～5岁达到峰值,以后随年龄增加而逐年下降,这种变化规律可以反映肌纤维坏死速率和病程进展速度,评估治疗效果。     

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目的了解不同初治年龄对先天性肾上腺皮质增生症(CAH)患儿身高、骨龄、性早熟等方面的影响。方法将1982～2004年在上海新华医院和上海市儿科医学研究所内分泌、遗传代谢病专科诊治的32例CAH患儿(年龄:女≥8岁,男≥9岁),按初治年龄分为≤3岁组(14例)和>3岁组(18例),观察两组间末次复诊时骨龄与身高龄之差、性早熟例数及男女患儿发生性早熟的不同。结果14例初治年龄≤3岁患儿末次复诊时骨龄与身高龄之差[(3.0±2.0)岁]与18例>3岁组[(4.6±1.6)岁]比较差异有显著性(P<0.05),初治年龄>3岁组发生真性性早熟(9例)与≤3岁组(2例)比较差异有显著性(χ2=4.453,P<0.05)。男性患儿发生真性性早熟(9例)与女性患儿(2例)比较差异有显著性(χ2=4.794,P<0.05)。结论CAH患儿≤3岁得到诊治者其预测终身高较>3岁方诊治者明显改善,其性早熟发生率明显减少,男性CAH患儿较女性CAH患儿更易发生性早熟。     

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??Objective??To explore the value of clinical manifestations and routine examinations for the diagnosis of intrathoracic tuberculosis in children. Methods??The medical records of children under 16 years of age due to intrathoracic diseases in Shanghai Pulmonary Hospital affiliated to Tongji University School of Medicine from January 2009 to December 2011 were collected. According to the final diagnosis??the patients were divided into 2 groups??intrathoracic tuberculosis and non tuberculosis. The clinical manifestations and routine auxiliary examination results of the 2 groups were retrospectively analyzed. The children were divided according to age??10 years and over 10 years old in 2 groups??and the clinical data were also compared. Results????1??Pathological diagnoses were confirmed at 72.30% of proportion at whole patients??70.73% in TB group. The positive rate of tuberculosis bacteriology was 21.85% in TB group. ??2??The middle course of history accounted for 56.30% in TB children. At the onset of illess??the proportion of fever and predisposition to tuberculosis??positivity of tuberculin skin test??TST?? and serumal tuberculosis antibody??and average value of ESR??CRP??PLT and D-Dier in blood were significantly higher in TB group than those in non-TB group. ??3??About 59% of patients in the non-TB group were cured or were markedly improved by antibiotic treatment??which was effective in 10% of the TB group. ??4??Diagnostic accordance rate by radiology was 53.36% and the rate of misdiagnosis as tuberculosis accounted for 11.71% in non-TB group. Conclusion??Clinical features combined with medical history and laboratory results are helpful for the identification of tuberculosis in children under 16 years old.     

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目的探讨性早熟对2~10岁女童骨密度的影响。方法选择2003-01—2006-01在湖南省儿童医院内分泌专科就诊的2~10岁性早熟(明确诊断、并排除影响骨代谢性疾病)女童237例,根据真、假性性早熟(CPP、PPP)分为2组,各组再按年龄组分层,采用单光子骨矿物质密度测定仪测量左手桡骨中远1/3处桡、尺骨密度(BMD),并与同龄健康女童进行对比和分析。结果CPP、PPP和健康组BMD均随年龄增长而增加,3组各年龄桡骨BMD均高于尺骨;CPP桡、尺骨BMD均相对较高,8~10岁组中CPP较对照组约高6.4%~8.6%;3组桡、尺骨BMD均在8~10岁增长加速,特别是尺骨(P<0.05),分别较6~7岁组增长20.4%、17.8%和14.3%;以CPP组增幅最大,明显高于健康组,与健康组(6~7岁)增长比较差异有显著性(桡骨P<0.05、尺骨P<0.001)。PPP组则与健康女童差异不显著。结论健康女童骨矿化自9岁起开始青春期加速,CPP女童青春期尺骨生长加速的年龄提早,BMD相应增加,而PPP不像CPP那样明显影响女童的正常骨骼发育。     

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??To observe the dynamic changes of serum TNF-α??IL-18 and IL-10 in children with primary nephrotic syndrome??PNS?? and the effect of Huaiqihuang particles on these inflammatory factors ??infection and relapse of the patients. Methods??Totally 67 patients first diagnosed with PNS were randomly divided into group A ??35 cases?? and group B ??32 cases??. Group A was treated with prednisone and Huaiqihuang particles??while group B was treated with prednisone only. Observe the serum TNF-α??IL-18 and IL-10 level before the treatment?? 0.5 month??1 month??3 months and 6 months after treatment. Record the infection and relapse patients within 1 year. Group C was control group ??25 healthy children??. Serum TNF-α??IL-18 and IL-10 level was detected by ELISA. Results????1??The infection times of group A??0.54 time each patient??were significantly fewer than group B??1.81 time each patient???? and the relapse cases of group A??7??37.5%?? were fewer than group B??12??37.5%??.??2??TNF-α?? Before treatment?? the serum level was higher than group C??P < 0.05???? 0.5 month after treatment?? it decreased to normal in both group A and B??P < 0.05???? then maintained at normal level??there were no differences between the two groups. ?? 3??IL-18??Before treatment?? the serum level of groups A and B was higher than group C??P < 0.05???? it decreased significantly after 3 months’treatment ??P < 0.05??in group A?? which was lower than that of group B but still higher than that of group C??P < 0.05??. ??4??IL-10 ??Before treatment?? the serum level of the gwo groups was higher than group C??P < 0.05???? 0.5 month after treatment?? it decreased in both group A and B??P < 0.05???? there were no differences between the two groups. Six months after treatment?? it increased significantly in group A ?? higher than group B??P < 0.05???? but still did not reach the normal level. ??5??Relapse cases?? Serum TNF-αlevel in group A was lower than that of group B??P < 0.05??. There were no differences between the two groups in IL-18 and IL-10 level. Conclusion??TNF-α??IL-18 and IL-10 participate in the pathogenesis of PNS. The imbalance of inflammatory factors and inhibited factors may be one of the pathogenesis of PNS. Huaiqihuang particles can prevent the infection and relapse of PNS children??by reducing the inflammatory effects of IL-18 and enhancing the inhibitory effects of IL-10.     

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??Objective To detect the concentrations of serum anti-Mullerian hormone??AMH?? and inhibin B??INHB?? in healthy children aged from 0 to 5 years??in order to help provide the basis for early clinical assessment of gonadal function. Methods A total of 1400 children were included. The children included 700 healthy boys and 700 girls aged from at birth to 5 years old from 5 Hospitals. They were divided into seven groups??0-1 month??m????1-6 m????6 m-1 year??yr??????1-2 yr????2-3 yr????3-4 yr and ??4-5 yr??100 children in each group. The concentrations of serum AMH and inhibin B were detected by ELISA. Results In 0-5 years old healthy boys?? serum AMH concentrations reached the peak of 210.70??55.37-439.45?? μg/L from 1 to 6 month??and maintained the relatively stable level of 147.1??17.69-321.88?? μg/L during 1-5 years of age??while in 1 to 6 month healthy girls??it reached a small peak of 1.77??0.06-7.68?? μg/L and tended to be stable at ??1.98??0.19-7.31?? μg/L?? during 2-5 years of age. Serum inhibin B concentrations were 274.23??0.00-602.34?? ng/L??with the highest during 1-6 months of birth in boys??which appeared small peak of 36.83??0.00-226.32?? ng/L in girls. Conclusion It is the first large sample research of serum AMH and inhibinB concentration range in healthy children aged 0 to 5??and the peak concentration appears at one to six months after birth.     

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??Objective??To study the gender and age distribution of bone metabolic markers in healthy children and adolescents??5-14 years old??. Methods??Detailed clinical documents were collected??and morning fasting 5 mL venous blood samples were drawn from 273 cases of the healthy volunteers and healthy school children. Automatic electrochemiluminescence immunoassay analyzer was applied for the tests of bone formation markers??Procollagen type 1 nitrogenous propeptides??P1NP????Osteocalcin??OC???? and bone resorption marker??β-Cross-linked C-terminal telopeptide of type 1 collagen??β-CTx????. The bone metabolic markers were used to calculate percentile values for the 5th?? 10th?? 25th?? 50th?? 75th?? 90th?? and 95th percentiles in the 3 age groups respectively. Results??The variation trends of bone formation markers??P1NP??OC?? and bone resorption marker ??β-CTx?? in two gender groups were similar??being relatively low in preschool age and school age period??gradually increasing during preadolescence??reaching peak in adolescence and declining rapidly after adolescence. There were no significant differences in bone formation markers P1NP??P??0.404?? and OC ??P??0.766?? between male and female groups??but there was significant difference in bone resorption marker β-CTx??P??0.01??. Conclusion??There are no statistically significant differences in the serum levels of P1NP or OC between male and female groups in the bone formation markers of healthy children aged 5-14 years. There is significant difference in bone resorption marker β-CTx between the two groups??the level of the boys being higher than the girls. According to the age distribution of the reference values?? the increasing trend of bone metabolic parameters of the female group will appear 1 or 2 years earlier??the peak value being lower.     

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??Abstract??Objective??To understand the prevalence of Epstein-Barr virus in hospitalized children. Methods??All results of anti-VCA-IgM and anti-VCA-IgG to Epstein-Barr virus detected by ELISA in Chongqing Children’s Hospital from January to December in 2009 were collected. The data was counted using statistical analysis of Chi-Square Test by gender?? age group and season. Results??The total infection rate of Epstein-Barr virus for hoapitalized children under 18 years old was 35.27% in 2009 and the recent infection rate was 12.66%.The accumulation infection rate gradually increased with ages?? and nearly half of children had been infected by Epstein-Barr virus in pre-school age group. The period from 3 to 5 years old was the peak age of infection. The accumulation rate among 0??3 months?? 3??6 months?? 6??12 months?? 1??2 years?? 3??5 years?? 6??12 years and 13??18 years old was 27.70%?? 10.48%?? 14.13%?? 27.69%?? 44.61%?? 51.99% and 57.34%?? respectively. And the recent infection rate was 1.15%?? 1.25%?? 2.52%?? 12.55%?? 22.21%?? 18.55% and 20.3%?? respectively. The recent infection rates in March?? September and October were higher than those of others in 2009?? and the difference was statistically significant ??P < 0.05??. Except the 1??2 years group ??P < 0.05???? there was no difference in other age groups about the cumulative and the recent infection rate by gender ??P > 0.05??. Conclusion??1. The infection rate of Epstein-Barr virus for childen is lower than that reported before in China. Nearly half of children have been infected by Epstein-Barr virus in pre-school age group?? the peak period of infection being 3??5 years old.2. There is no gender difference of cumulative and recent infection rate in Chongqing in 2009?? the infection rate in March and September-October were higher than those of others.     

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??Objective??To describe height velocity in pre-pubertal Growth Hormone Deficiency??GHD?? children without recombinant human growth hormone??rhGH?? treatment and explore the height velocity targets for the first year in response to rhGH treatment. Methods??Analyze retrospectively the height velocity data without??HV0?? and one year after ??HV1?? rhGH treatment in physiologic dose??0.7 U/??kg·w???? in pre-pubertal GHD children above 3 years old who were diagnosed from Jan??2000 to Dec??2009 in our hospital. The GHD patients who were included for calculation of HV0 had peak GH value in GH provocative test less than 7 ng/ml. HV0 was calculated according to age??HV0-CA??342 patients?? and bone age??HV0-BA??257 patients?? respectively. According to the peak GH value in GH provocative test??the patients who were included for calculation of HV1 were divided into GHD-1 group????0.33 nmol/L??140 patients?? and GHD-2 group??7.0??9.9 μg/L??33 patients??. Results??Within every bone age group??GHD-1 group had significantly higher HV1 than GHD-2 group??P??0.05????11.0??10.5-11.5?? cm/a??n??34?? vs. 9.9??9.1-10.8?? cm/a??n??6?? when bone age was less than 3 years??10.4??9.8-10.9?? cm/a??n??48?? vs. 8.8??8.3??9.2?? cm/a??n??8?? when bone age was between 3 to 5 years??and 9.5??9.1-9.9?? cm/a??n??58?? vs. 8.5??8.0-9.1?? cm/a??n??19?? when bone age was between 6 to 10 years. The mean HV1 of GHD-2 was very close to the 25th percentile??P25?? of GHD-1 group. They both were significantly higher than HV0-BA. Conclusion??The recommended height velocity target for the first year after rhGH treatment in pre-
pubertal GHD children is the P25 of HV1 of GHD-1 group. It should be at least 9.9 cm/a??8.7 cm/a and 8.3 cm/a when the bone age is less than 3 years??3 to 5 years and 6 to 10 years?? respectively.     

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??Objective??To study and analyze the serum 25-hydroxyvitamin D level in children aged from 0 to 14 years old in Shenyang. Methods??A total of 2416 cases of health children were chosen during January 2016 to December 2016. The level of 25??OH??D was determined by high-performance liquid chromatography tandem mass spectrometry. The data were dealt with SPSS19.0. Results??The level of 25??OH??D in 2416 children was??24.63±10.74?? μg/L??in whom the deficiency rate was 18.6%??the insufficiency rate was 16.7%??the sufficiency rate was 64.7%. With the increasing of the age??the level of 25??OH??D had a decreasing tendency. The total abnormal rate of 25??OH??D was 62.5% in??5-year-old group. The serum 25??OH??D level reached the highest in August and September and the lowest in March and April. Conclusion??The nutrition status of 25??OH??D is great in children aged 0 to 5 years old in Shenyang area. However??it is not optimistic in??5-year-old group. Therefore it is necessary to raise the awareness of the nutrition status of 25??OH??D in??5-year-old group. Thus the serum 25-??OH??D level changes significantly with seasons??and should be supplied scientifically and reasonably.