Scientific assessment of physical growth and development in children / 中国实用儿科杂志

The weight development can be used to indicate children's nutritional status. But the assessment of stature development in children is more complicated,which involves genetics,endocrine,nutrition and bone metabolism. Parents should regularly follow up on the growth and development of children. At the same time,the growth data of children should be kept by parents. Pediatricians can obtain important information from the child's development history to help assessment and diagnosis. Before dealing with this thorny problems of social and medical confusion,primary care pediatricians(PCP)should learn the knowledge of height growth during childhood,including the normal range and rules of height growth. Meanwhile,PCP need to understand the factors affecting the height growth in order to make proper management.

Research advance in assessment of nutritional status of children / 中国当代儿科杂志

Malnutrition is not a simple disease, which occurs in the condition when the body does not get the right amount of nutrients to maintain healthy tissues and organ functions. Malnutrition generally refers both to undernutrition and overnutrition, but usually it is used to refer solely to a deficiency of nutrition. Infants and young children are the most vulnerable because of their high nutritional requirements for growth and development. Growth is an important indicator of health and nutritional status of a child. Generally, underweight, studding and wasting are used as the indicators of malnutrition. In fact, a gain in height is a better indicator of the adequacy of a diet than a gain in weight. Rates of weight gain needs to accompany accelerated height gain to maintain normal body proportions (weight-for-height). Now therefore WHO recommends using weight-for-height as the indicator of malnutrition of epidemic intensity in communities and of nutritional condition evaluation, including treatment assessment. The assessment of nutritional status is commonly summarized by the mnemonic "ABCD," which stands for anthropometric measurement (A), biochemical or laboratory tests (B), clinical indicators (C) and dietary assessment (D). Children with malnutrition are required to ingest more than 30 essential nutrients including both functional, protective nutrients (type I) and growth nutrients (type II), in order to have a catch-up growth in weight and height.

Seasonal influence on the diagnosis of food allergy in children less than 3 years of age / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the seasonal influence on the diagnosis of food allergy in children under 3 years of age.</p><p><b>METHOD</b>The data of epidemiological studies about food allergy of children under 3 years of age attending routine well-baby checks at the Department of Primary Child Care, Children's Hospital of Chongqing Medical University in the winter and summer, 2009, including questionnaires, results of skin prick test (SPT), food elimination and oral food challenge (OFC) were analyzed. All the data were analyzed by SPSS 17.0.</p><p><b>RESULT</b>The age and sex distribution, and both the rates of the drop-out in two studies were similar. Ninety infants were positive for SPT, 40 infants were positive for OFC, and 31 infants dropped out in winter; while 65 infants were positive for SPT, 25 positive for OFC, and 31 dropped out in summer. The percentage of positive SPT in the children performed in winter was higher than that in summer (14.9%, 90/603 vs 10.7%, 65/607) (P = 0.028). Skin prick test accuracy was similar when the studies were performed in winter and in summer [sensitivity 0.85 and 0.84, positive predictive value (PPV) 0.54 and 0.47, negative predictive value (NPV) 0.99 and 0.99]. The prevalence of food allergy in the children studied in winter was higher than that in summer (7.0% vs 4.3%), but the difference was not significant. After correcting the prevalence for dropout children, the prevalence of food allergy (FA) investigated in winter was significantly higher than that in summer (9.3% vs 5.9%). The results of circular distribution analysis showed the date of birth corresponding to estimated value of peak point of SPT in winter were not consistent with it in summer, so was OFC. Either the results of skin prick test or oral food challenge in two studies were not correlated with the seasons of birth.</p><p><b>CONCLUSION</b>Our data showed that the rates of positive SPT and the prevalence of food allergy were correlated with the seasons, but the seasons of birth did not influence the results of skin prick test or oral food challenge in children, while the real age of children were related to them.</p>

Prevalence of food allergy in children under 2 years of age in three cities in China / 中华儿科杂志

<p><b>OBJECTIVE</b>To estimate the prevalence and clinical features of food allergy in children aged 0 - 2 years.</p><p><b>METHOD</b>From January to February, 2009 and January to May, 2010, all well-infants and young children between the age of 0 and 2 years attending routine health visits at the Department of Primary Child Care, in Chongqing, Zhuhai and Hangzhou were invited to participate in the study. Parents completed questionnaires and all children were skin prick tested (SPT) to a panel of 10 foods (egg white, egg yolk, cow's milk, soybean, peanut, wheat, fish, shrimp, orange and carrot). Based on the results of SPT and medical history, the subjects under went the suspected food elimination and oral food challenge under medical supervision. Food allergy was confirmed by the food challenge test.</p><p><b>RESULT</b>Totally 1687 children were recruited by the consent of their parents. Of 1687 children approached, 1604 (550 of Chongqing, 573 of Zhuhai and 481 of Hangzhou) fulfilled the study criteria for diagnosing food allergy. One hundred children were confirmed to have challenge-proven food allergy in 3 cities (40 of Chongqing, 33 of Zhuhai and 27 of Hangzhou). The prevalence of food allergy in 0-2 years old children in Chongqing was 7.3%, in Zhuhai was 5.8% and in Hangzhou was 5.5%. There was no significant difference in the prevalence of food allergy in children under 2 years among the three cities, and the average prevalence for food allergy in children under 2 years was 6.2%. Egg (3.0% - 4.4%) was the most common allergen, followed by cow's milk (0.83% - 3.5%), shrimp (0.17% - 0.42%) and fish (0.17% - 0.21%).</p><p><b>CONCLUSION</b>The prevalence of food allergy in 0 - 2 years old children in China was 5.5% - 7.3%. There was no significant difference in the prevalence of food allergy in children under 2 years of age among the three cities. Egg was the most common allergen, followed by cow's milk, shrimp and fish.</p>

Changes of anterior fontanel size in children aged 0 - 2 years / 中华儿科杂志

<p><b>OBJECTIVE</b>To study the development of anterior fontanel(AF) in children less than 2 years of age.</p><p><b>METHOD</b>The size of AF of the children under 2 years of age was measured. The criteria were: (1) All the children were singletons and term (37 weeks ≤ gestational age ≤ 40 weeks) at birth, birth weight > 2500 g. (3) Those with intracranial diseases (included trauma and asphyxia) and scalp hematoma were ruled out. (3) Healthy children (without intracranial disease, growth retardation, congenital syndrome or bone metabolic diseases such as rickets).</p><p><b>RESULT</b>(1) The mean value of AF in neonates was 1.5 (0.3 - 2.5) cm, and the average of the AF at 1 month after birth was 2.2 cm, which was the largest one. The size of AF was 1.0 (0.3 - 2.0) cm at age 12 months, and 0.5 (0.3 - 0.7) cm at 24 months. (2) The percentage for the closure of the AF was 3% at 6 months, 26.5% at 12 months, and 93.0% at 24 months. (3) There were no gender differences in the size of the AF (P > 0.05). And the size of AF was not correlated with the development levels of weight, length, and head circumference (P > 0.05).</p><p><b>CONCLUSION</b>(1) The size of AF at 1 month was maximum (2.2 cm), and then decreased by years. The AF was almost closed (93%) at 24 months. (2) There were no gender differences in anterior fontanel (P > 0.05). The size of AF was not correlated with the growth of weight, length, and head circumferences (P > 0.05). (3) The fontanel dimensions should be represented by oblique diameters of the fontanel in clinical pediatrics. (4) The AF closure time needs to be further evaluated in normal children.</p>

Immune state in lung of BALB/c mice with ovalbumin allergy and the effects of fulvotomentoside on lungs of mice / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate immune state in lung of BALB/c mice with ovalbumin (OVA) allergy and the effects of fulvotomentoside (Ful) on lungs of the mice and provide some clues for the mechanism that patients with food allergies were prone to asthma and observe the effects of the treatment with traditional Chinese medicine.</p><p><b>METHOD</b>Ninety-six female BALB/c mice were randomly divided into 6 groups. Mice in group 1 and group 2 were sensitized intraperitoneally and challenged intragastrically with OVA and were exposed to phosphate buffer solution and OVA respectively by nebulized inhalation. Mice in group 3 and group 4 were treated with Ful, other processes were the same as the mice in group 1 and group 2, respectively. Mice in group 5 were not challenged intragastrically with OVA and other processes were the same as the mice in group 2. Group 6 was the control group. The number of total leukocytes and cell classification in bronchoalveolar lavage (BALF) were counted, and inflammatory characteristic of lung was scored by staining with hematoxylin and eosin. The protein expressions of transforming growth factor (TGF-β1), interleukin-6 (IL-6), interleukin-17 (IL-17A) in lung of the mice were detected by immunohistochemical method. The activation of neutrophils in lung was assayed by the level of myeloroxidase (MPO).</p><p><b>RESULT</b>There was no inflammatory cells infiltration in lung of the mice in group 1. Compared with group 6, numbers of total leukocytes and erythrocytes as well as the percentage of neutrophils and lymphocytes were increased in group 2. Inflammatory score and protein expressions of TGF-β1 [(75 437 ± 3 638) vs. (6 118 ± 1 978)], IL-6 [(121 650 ± 25 389) vs. (15 726 ± 9 360)], IL-17A [(252 105 ± 31 651)vs. (72 644 ± 12 285)] in lung were increased, too. Inflammatory score and TGF-β1 (11 054 ± 1 468), IL-6 (50 877 ± 11 744), IL-17A (137 864 ± 28 986) expressions in group 5 were lower than those in group 2. Eosinophils infiltration was significant in group 5. After the treatment with Ful, TGF-β1 expression did not change and IL-6, IL-17A expressions were decreased in lung of the mice that inhaled OVA. It was not enough for Ful to relieve the neutrophil aggregation and improve inflammatory reaction in lung.</p><p><b>CONCLUSION</b>The expressions of TGF-β1, IL-6, IL-17A in lung of the mice with OVA allergy were increased markedly after they inhaled specific antigen, which caused serious inflammation that was induced by neutrophil infiltration in lung. Ful could decrease the expressions of IL-6, IL-17A to some extent, but it was not enough to improve pathologic state in lung.</p>

Evaluation of therapeutic effects of three hypoallergenic formulae in infants with cow's milk protein allergy / 中华儿科杂志

<p><b>OBJECTIVE</b>To compare the growth and symptom remission of infants with cow's milk protein allergy, who were fed with an amino acid formula, an extensively hydrolyzed formula or soy formula.</p><p><b>METHOD</b>Infants who were diagnosed as cow's milk protein allergy and can not be breastfed were enrolled in the intervention group, and were assigned to three special formulae (amino acid formula, extensively hydrolyzed formula or soy formula ) according to the will of parents from March 2009 to March 2010 (n = 74). A non-randomized control group was made up of age-matched healthy children (n = 21). Anthropometric measurements and symptoms were evaluated after 30, 60, 90, and 180 days. The differences of physical growth and the therapeutic effects among each group were calculated by SPSS 13.0 package.</p><p><b>RESULT</b>After 180 days follow-up, the weight for age Z score and length for weight Z score were -0.43 +/- 0.88 and -0.31 +/- 0.78 in patients fed with soy formula substitute, which were significantly lower than those of patients fed with amino acid formula (0.11 +/- 0.77, 0.20 +/- 0.69) , extensively hydrolyzed formula (0.10 +/- 0.62, 0.18 +/- 0.70) and control group (0.22 +/- 0.54, 0.22 +/- 0.64) (P<0.05). However, there were no significant differences in physical growth among patients fed with amino acid formula, extensively hydrolyzed formula and control group (P>0.05). Moreover, no significant difference was found in length for age and head circumference for age among four groups (P>0.05). All hypoallergenic formulae were much helpful in remission of the symptoms of eczema (P<0.05). However, amino acid formula and extensively hydrolyzed formula were more effective and rapid in relieving symptoms than soy formula (1 mo vs 2 mo) (P = 0.003).</p><p><b>CONCLUSION</b>Both amino acid formula and extensively hydrolyzed formula can maintain the normal growth of infants with cow's milk protein allergy. While, the growth of patients fed with soy formula was significantly slower than that of the other three groups. All hypoallergenic formulae can be effective in relieving allergy symptoms, and amino acid formula or extensively hydrolyzed formula seems to be superior to soy formula.</p>

Assessment and management of rotation and angulation of lower limbs in children / 中国当代儿科杂志

Most rotational and angulational variations in young children are benign and resolved spontaneously. However, they may cause great concerns to parents. In order to provide a deliberate assessment and management of lower limb rotational and angulational problems, it is necessary for pediatricians to understand the normal variations of lower limb development in healthy children combined with the features of child growth and development and detail physical examinations.

Diagnostic capacity of skin prick test in egg and cow's milk allergic infants / 中华儿科杂志

<p><b>OBJECTIVE</b>Mean diameter is the most common used parameter for wheal response assessment after skin prick test. This study aimed to investigate the diagnostic capacity of mean diameter according to the outcome of oral food challenge, and to determine the cut-off points that could render food challenges unnecessary.</p><p><b>METHOD</b>Data of 173 children referred to the Division of Primary Child Health Care for the evaluation of suspected food allergy were prospectively studied. All children underwent skin prick test and open food challenge to the relevant food(s) in clinic. The mean wheal diameter of skin prick test was measured, and open food challenge was performed to confirm food allergy. The SPSS software package version 13.0 for windows (SPSS, Chicago, IL, USA) was used for all statistical analysis. Open food challenge was taken as the gold standard for diagnosis. Diagnostic capacity of skin prick test, including the sensitivity, specificity, positive predictive value, negative predictive value, was calculated by cross-table. In addition, receiver operating characteristic curve (ROC) was plotted and area under the curve (AUC) was calculated to quantify the accuracy of the parameter.</p><p><b>RESULT</b>For the 173 children, 271 open food challenges were performed with egg white, egg yolk and cow's milk, In which 123 were positive, 99 children were diagnosed as food allergy. Cutaneous symptoms (87.0%) were most common, followed by gastrointestinal symptoms (9.8%). The AUC of mean diameter was 0.794 for egg white, 0.804 for egg yolk and 0.904 for cow's milk. The sensitivity of skin prick test with a cut-off value of ≥ 3 mm was ranged from 71% to 87%, while the specificity was between 31% and 57%. The authors also defined food specific skin prick test mean diameters that were 100% diagnostic for allergy to egg white (≥ 8.5 mm), egg yolk (≥ 5.5 mm), cow's milk (≥ 5.5 mm).</p><p><b>CONCLUSION</b>Predictive decision points for a positive outcome of food challenges can be calculated for egg and cow's milk using mean diameter. It may help to simplify the diagnostic procedure of food allergy.</p>

Analysis of influential factors of infant acceptance of new complementary food / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the process to accept the new complementary food, by infants and to analyze the influential factors.</p><p><b>METHOD</b>A total of 105 infants were enrolled in this study. Early infant temperament questionnaires were answered by the mothers. The infants were given 10 times to touch new food (carrot mud), and each of their mealtime score of a 5 degrees system was recorded. The distinctions of the food acceptance were analyzed by using chi-square test. The relations between feeding patterns, sex, maternal parity, education and favor of carrot were analyzed by ANOVA and multivariate correlation analysis respectively.</p><p><b>RESULT</b>The infants showed a certain degree of rejection to taste the new food carrot and begin to accept after tasting for several times. By the 5(th) taste the carrot mud was accepted by most infants (87.7%). The breastfed infants were easier to accept the carrot than the formula-fed infants. There was certain degree of difference in accepting the new food between the genders. The male infants were more difficult to accept carrot than female infants. Mother's education level did not affect the baby's acceptance.</p><p><b>CONCLUSION</b>Many factors affect the infant's acceptance of new food. Repeatedly tasting new foods will help the infant's acceptance. Infants need at least 5 times of tasting, preferably more than 10 times, to accept new food. Attention should be paid to increase the infant's early experience on the new food. Further research should explore whether the effects of food on the early formation of the picky eating behavior of children.</p>

Effects of fulvotomentoside on inflammatory factors and antiinflammatory factors in intestine of ovalbumin-sensitized BALB/c mice / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the effects of fulvotomentoside (Ful) on inflammatory factors and antiinflammatory factors in intestine of ovalbumin (OVA)-sensitized BALB/c mice, and to explore the mechanisms of its anti-food allergy effect.</p><p><b>METHOD</b>Twenty-four female BALB/c mice aged 6 weeks fed with ovalbumin-free feed were randomly divided into 3 groups, food allergy (FA) group, Ful group and normal saline (NS) group. Mice in FA and Ful groups were sensitized intraperitoneally two times with OVA and challenged intragastrically with OVA. Mice in Ful group were treated with 200 mg/kg of Ful by subcutaneous injection once daily for 22 days. The mice in FA and NS groups were used as positive control and negative control, respectively, and were treated with normal saline solution by subcutaneous injection for 22 days. Just 48 hours after the last challenge, the mice in each group were sacrificed and specimens of jejunum were taken. The mRNA expressions of transforming growth factor β1 (TGF-β1), interleukin-6 (IL-6), interleukin-17A (IL-17A) and forkhead box P3 (Foxp3) in jejunum were detected by reverse transcription-PCR (RT-PCR). The protein expressions of TGF-β1, IL-6, and IL-17A in jejunum were detected by immunohistochemical method. The activation of neutrophils in jejunum was assayed by the levels of MPO.</p><p><b>RESULT</b>The expressions of TGF-β1, IL-6, IL-17A mRNA [(0.370 ± 0.013), (0.475 ± 0.015), (0.541 ± 0.013)] and related protein [(53,075.70 ± 20,727.06), (256,881.66 ± 36,561.79), (435,064.25 ± 69,911.48)] in jejunum were increased and the Foxp3 mRNA [(0.231 ± 0.014) vs. (0.365 ± 0.015)] expression was decreased in group FA. After the treatment with Ful, IL-6 and IL-17A mRNA [(0.196 ± 0.005), (0.204 ± 0.008)] and protein [(114,040.30 ± 20,295.25), (218,200.74 ± 30,077.69)] expressions were decreased and Foxp3 mRNA (0.578 ± 0.021) expression was increased, and no change of TGF-β1 expression was unchanged. There were no significant differences of the levels of MPO among the three groups.</p><p><b>CONCLUSION</b>Inflammatory reaction which was characterized by the increase of IL-6 and IL-17A expressions was found in intestine of ovalbumin-sensitized BALB/c mice. Ful could decrease overexpression of IL-6 and IL-17A, and increase the expression of specific transcription factor Foxp3 of regulatory T cells significantly in intestine. It may be one of the mechanisms that Ful improved intestinal inflammation.</p>

Effect of maternal iron status on infant's iron level: a prospective study / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the effect of maternal iron levels in second trimester of pregnancy on the infants' early iron status, explore the relationship between maternal and infant's iron status, and analyze the main factor influencing anemia of the infants.</p><p><b>METHODS</b>Totally 100 couples of mother-baby were followed up from the second trimester of the mothers' pregnancy till the babies were 3 - 5 months old in the Department of Primary Child Care from March 2006 to February 2007. The maternal venous blood samples were collected in the second and the third trimesters and were analyzed for Hb at the same time. The infants' venous blood samples were collected at the end of the follow-up visit and were analyzed for Hb. The values of sTfR of the infants were compared with the maternal iron status diagnostic criteria. The infant's weight was measured during the visits by two professional staff members. The physical growth was assessed with CDC2000 reference.</p><p><b>RESULTS</b>(1) Among 100 couples of mother-baby, none of the Hb values was lower than 90 g/L during the whole period of survey. The prevalence of ID in the babies at the ages of 3-5 months was 39%. Among them 36 cases (36/39, 92.31%) were born to the mother with ID during pregnancy; 26 couples of mother-infant had normal iron status during the following study. (2) The ID' prevalence in the infants born to the mothers with ID was higher than in the babies born to the healthy mothers (chi(2) = 11.567, P < 0.005). The ID' prevalence in the infants born to the mothers with IDA was higher than in the babies born to the mothers with LID (chi(2) = 7.356, P < 0.01). (3) The sTfR values of infants born to the mother with ID during pregnancy were increased significantly (P < 0.01); the iron nutritional status did not show any significant difference between babies whose mothers were IDA and LID (P > 0.05). (4) The SF value of maternal venous blood was negatively correlated with the sTfR value of infant (r = -0.7552, P < 0.01).</p><p><b>CONCLUSIONS</b>(1) The anemia of the infants aged 3 - 5 months was correlated with the iron shortage during the fetal stage. (2) The mild iron deficiency in the pregnant women during the second trimester could decrease the iron storage of fetus and then also could affect the iron status of the early infancy and cause anemia.</p>

Energy intake of infants at the age of 4-12 months / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the total energy intake, the energy from milk and other foods in the infants aged 4 to 12 months and analyze the factors related to the energy intake.</p><p><b>METHODS</b>Totally 132 infants aged 4 months, who were brought for serial measurements to the Department of Primary Child Care, from November 2004 to March 2005 were enrolled into this study and were serially followed up until 12 months of age. The infants were divided into 3 groups, group A, age 4-5 months; group B, age 6-8 months; group C, age 9-12 months. The weights and the recumbent body lengths were measured by two professional staff members. The assessment of physical growth of the infants was done by using the CDC2000 reference. As the changes of Z score on weight for age (Delta WAZ) were < -0.67 during the two visits, the participation of the infants to this study was discontinued. The dietary intakes of the infants were calculated according to 24 h dietary records or after weighing foods for sequential 3 days,</p><p><b>RESULTS</b>(1) When the Delta WAZs of the participated infants were between 0.67 and -0.67, the food intakes among three groups were 119-128 g/(kg.d), the protein intakes were 1.82 g/(kg x d), 2.76 g/(kg x d) and 3.52 g/(kg x d), respectively. The milk intakes were 76-114 g/(kg x d), which accounted for 93% of energy intakes in group A, 64% in group B and 56% in group C. The energy intakes of the 3 groups were 83.9 kcal/(kg x d), 81.6 kcal/(kg x d), and 85.8 kcal/(kg x d), respectively, which were almost similar to WHO 2003 recommendations, and lower than that of Chinese RNI. (2) The data from multiple linear regression analysis showed that the food intakes and the energy density were the most important factors related to energy intakes. The energy density of all foods was 0.6-0.8 kcal/g.</p><p><b>CONCLUSIONS</b>(1) The growth of the infants was within the normal range as the energy intakes were 82-86 kcal/(kg x d). (2) The infants may need 900-750 g/d of milk to meet the basic requirements of energy and protein. (3) The food intakes and the energy density were the most important factors related to the energy intakes, the appropriate energy density for infants is 0.6-0.8 kcal/g.</p>

Experimental study on the intestinal mucosal secretary IgA responses to the ovalbumin-induced allergy in mice / 中华儿科杂志

<p><b>OBJECTIVE</b>To valuate the intestinal mucosal secretary IgA (sIgA) responses to the ovalbumin-induced allergy in mice, to provide some clues for the exploration of mechanisms and therapeutic methods in the children's food allergy.</p><p><b>METHODS</b>Female BALB/c mice aged 6 weeks fed on the ovalbulmin-free diet, were randomly divided into 2 groups with 8 mice in each. The mice in group Ch were sensitized with ovalbumin (OVA) intraperitoneal injection two times and challenged intragastrically 3 times. Two days after the last challenge with oral OVA, the mice were sacrificed and the samples were collected. The mice in group Ns were given intraperitoneal and intragastrical normal saline as control. The levels of total IgA and OVA-specific IgA in the intestinal mucus of the mice were determined by ELISA; the immunohistochemical methods were adopted to observe IgA(+) plasmacytes in lamina propria (LP) and surface membrane IgA (smIgA)(+) lymphocytes in peyer's patch (PP); the IL-4 mRNA expression in LP was assessed by RT-PCR. The IL-4 mRNA expression in PP was evaluated by in situ hybridization.</p><p><b>RESULTS</b>After the mice in Ch group were sensitized and challenged with OVA, the levels of the total IgA and the OVA-specific IgA in mucus remarkably increased (P < 0.01 respectively), the amounts of the IgA(+) plasmacytes in LP and the smIgA(+) lymphocytes in PP significantly increased (P < 0.01 respectively); a significantly positive correlation was found among the total IgA levels, the OVA-specific IgA levels, the IgA(+) plasmacyte counts in LP and the smIgA(+) lymphocyte counts in PP (P < 0.01 respectively); the mRNA expressions of IL-4 in LP and in PP were significantly augmented (P < 0.01 respectively); significantly positive correlations were found either between the IL-4 mRNA expression and the IgA(+) plasmacyte counts in LP (P < 0.01) or between the IL-4 mRNA expression and the smIgA(+) lymphocyte counts in PP (P < 0.01).</p><p><b>CONCLUSIONS</b>The intestinal mucosal sIgA responses are abnormally augmented in the ovalbumine-induced allergic mice, which may be partly due to the increased expression of IL-4 mRNA in gut.</p>

Assessment of taste development in 62 newborn infants / 中华儿科杂志

<p><b>OBJECTIVE</b>To study the differential facial responses to four basic tastes of the newborns and the gender-related different taste sensitivity.</p><p><b>METHODS</b>Sixty-two newborns (31 females and 31 males) born in the Department of Obstetrics, First Hospital of the Chongqing University of Medical Sciences were tested for responses to four solutions, including 25% sucrose (sweet), 5% sodium chloride (salt), 1.43% citric acid (sour), and 0.025% berberine (bitter) 90 minutes after birth. The inclusion criteria were: (1) medically uncomplicated full-term pregnancy; (2) medically uncomplicated spontaneous vaginal delivery; (3) Apgar score of at least 8 at 1 and 5 min. All the infants were found to be normal and healthy on pediatric examination. The facial responses of the newborns were recorded by video. The facial responses were divided into nine facial action units and expressions from A1 to C3, which are also expressed as the 1 - 9 grades of intensity, crying was included as grade 9 and nausea was defined as grade 10 intensity. The distinctions of the facial responses were analyzed by chi-square test. The distinctions of sex in the facial responses were analyzed by the Wilcoxon test.</p><p><b>RESULTS</b>All the newborns were full term, excluding the medical conditions. The average birth weight of the newborns was 3324.3 g. The data from the study indicated that absence of distinctive mouth action or sucking was the major facial response of the infants to sucrose solution (P < 0.01). There were no special expressions when the newborns were given the salt solution (P > 0.01). The lip pursing with negative brow and middle face actions were major response of the infants to the sour solution (citric acid) (P < 0.01). The expressions in response to the bitter solution of the infants were the mouth gaping with negative brow and middle face actions (P < 0.01). The facial responses to the sweet and bitter solutions in the boys were more sensitive than those in the girls (P < 0.01). There was no sex difference in the intensities of the facial responses to the salt and sour solutions (P > 0.05).</p><p><b>CONCLUSIONS</b>The newborns had distinct responses to the four solutions shortly after birth. The facial expression to sweet and bitter solutions in the boys were more sensitive than in the girls.</p>

Vitamin B12 nutritional status in preschool children in Chongqing / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore the levels of serum vitamin B(12) (VB(12)) in preschool children, determine the relationship between the levels of serum VB(12) and anemia, and analyze the effects of several factors related to the level of serum VB(12).</p><p><b>METHODS</b>From March 2005 to July 2005, the weight, height and complete blood count (CBC) were studied in 351 children aged 2 to 7 years from 4 kindergartens of Chongqing. The concentrations of serum VB(12) and the dietary survey of 177 of the children were evaluated.</p><p><b>RESULTS</b>The average level of serum VB(12) for the preschool children was 552 pg/ml. The levels of serum VB(12) in 4.5% (8/177) of the children were below 200 pg/ml (defined as VB(12) deficiency), in 10.7% (19/177) of the children were 200 - 300 pg/ml (called marginal deficiency). There were no significant differences in the levels of serum VB(12) between boys and girls. And there was no correlation between the levels of serum VB(12) and hemoglobin. The results of multivariate stepwise regression analysis showed that the concentrations of serum VB(12) were mainly influenced by the contents of VB(12) in the foods (P = 0.03). Eight of the children with normal growth and development were diagnosed as VB(12) deficiency, only one of them was diagnosed microcytic hypochromatic anemia. The ranges of Hb, MCV and MHC were normal in the other 7 children.</p><p><b>CONCLUSIONS</b>The levels of serum VB(12) of preschool children were higher than that of adults, suggesting that the levels of serum VB(12) change with age. There were no significant differences in the levels of serum VB(12) in 2-7 years old children between sex and ages. The levels of serum VB(12) were not correlated with the concentrations of hemoglobin. Macrocytic anemia may not occur in preschool children with VB(12) deficiency. The intake of VB(12) from the diets was one of the important factors for preschool children to keep the normal ranges of serum VB(12). It is beneficial for children to consume foods enriched with VB(12) to keep the normal level of serum VB(12).</p>

Prognoses of food allergy in infancy / 中华儿科杂志

<p><b>OBJECTIVE</b>Food allergy as one of social health problems has gained more attention of people. However, few reports on prognosis of food allergy, the relation between infant food allergy and other allergic diseases, and factors affecting prognoses of infant food allergy in China. The present study was designed to investigate the evolution of infancy food allergy and to explore predicting factors of the tolerance to these foods and factors of other allergic diseases to provide a clue for managing children with food allergy reasonably and to improve their prognoses.</p><p><b>METHODS</b>Totally 119 children with food allergy during infancy, who were diagnosed in the Department of Primary Child Care, Children's Hospital, Chongqing University of Medical Sciences from January 2000 to June 2003, were studied retrospectively by analyzing the follow-up data before March 2004. The occurrence of food tolerance and other allergic diseases were counted. Kaplan-Meier methods were used to calculate the cumulative tolerance probability. And the predicting factors of persistent food allergy and influential factors of other allergic diseases were analyzed by unconditional Logistic regression models.</p><p><b>RESULTS</b>The cumulative tolerance probabilities of cow's milk and egg were 42% and 31% one year after diagnosis respectively, 63% and 62% 2 years later, 77% and 80% 3 years later, and 100% after 4 years. And the severity of skin prick test reactions to cow's milk and egg was the predicting factor for persisting hypersensitivity to cow's milk and egg (OR = 2.535, 95% CI: 1.159-5.543; OR = 2.654, 95% CI: 1.302-5.410, P < 0.05). Thirteen cases presented with hypersensitivity to other foods (15.6 +/- 6.1) months after the diagnosis was confirmed, and the risk factor was the long-lasting hypersensitivity to egg (OR = 6.109, 95% CI: 1.818-20.527, P < 0.05). After 4 cases and 15 cases were diagnosed as allergic rhinitis and asthma, respectively, (16.8 +/- 8.3) months after diagnoses and the risk factors were the long-lasting hypersensitivity to egg and the respiratory symptoms (OR = 3.596, 95% CI: 1.429-9.045; OR = 4.235, 95% CI: 1.152-15.563, P < 0.05).</p><p><b>CONCLUSION</b>At least 75% of children with egg or cow's milk allergy could develop tolerance to egg or cow's milk within 3 years after diagnoses; 10.9%, 12.6% and 3.4% of children with food allergy suffered from other food allergy, asthma and allergic rhinitis. Strengthening the screening and management of children at high risk for persistent food allergy will contribute to improvement of the prognoses of food allergy.</p>

Immunoregulatory effects of the Lonicera aquatic extract in the ovalbulmin-sensitized BALB/c mice / 中华儿科杂志

<p><b>OBJECTIVE</b>To evaluate the immunoregulatory effects of the Lonicera water extract in the ovalbulmin (OVA)-sensitized BALB/c mice and to explore feasibility of treating food allergy with the traditional Chinese medicine (TCM).</p><p><b>METHODS</b>Forty female BALB/c mice aged 6 weeks fed with ovalbulmin-free feed, were randomly divided into 5 groups with 8 mice in each. Four groups were sensitized with OVA intraperitoneally two times and challenged intragastrically four times. Groups H, M and L were treated respectively with high (100 mg/100 ml), medium (50 mg/100ml) and low (25 mg/100 ml) concentration of the Lonicera water extract at a dose of 0.3 ml/10 g body weight just 4 hours after the first challenge and then twice daily for 10 consecutive days. The mice in group Ch were used as positive control and were sensitized intraperitoneally and treated with normal saline solution intragastrically daily. The mice in NS group were used as negative control without sensitization and challenge. Just 1 hour after the last challenge, the mice in each group were sacrificed and specimens of jejunum were taken. Histological examinations on the jejunum specimens were performed after either HE or toluidine blue staining, the levels of histamine in gut of the mice were assayed with a fluorescent method; the IFN-gamma and IL-4 production in peripheral lymph node mononuclear cell (PLNMC) and the OVA-specific IgE levels in serum were measured by using ELISA; the mRNA expression of IL-12p40 in PLNMC of the mice was evaluated by RT-PCR; the footpad swelling reactions were assessed for the OVA-induced delayed hypersensitivity.</p><p><b>RESULTS</b>(1) The inflammatory reactions were significantly inhibited in the mice of group H and M; the accumulated and degranulated mast cells in lamina propria were significantly reduced in the mice by gavage with 100% or 50% of the Lonicera extract, concomitant with the increased percentage of the intact mast cells. (2) The release of histamine in gut in the mice of group H and M was significantly reduced. (3) Either the IL-4 production and the ratio of IL-4/IFN-gamma in PLNMC or the IFN-gamma generation was significantly reduced in group H and M. (4) IL-12p40 mRNA expression in PLNMC was significantly reduced in group H and M. (5) The levels of OVA-specific IgE in serum were reduced in the mice of group H and M. (6) The footpad swelling reactions induced in the allergic mice were significantly inhibited after giving the Lonicera extract of the three different concentrations.</p><p><b>CONCLUSION</b>The Lonicera extract showed significant immunoregulatory effects in OVA-induced allergic mice model in this study. Lonicera extract may be of potential research value in treatment of both IgE and none IgE mediated food allergy.</p>

Study on the current situation and influential factors of child neglect among aged 3-6 year-olds in the urban areas of China / 中华流行病学杂志

<p><b>OBJECTIVE</b>Children aged 3 - 6 years in the urban areas of China were surveyed for the first time to find out the state of child neglect (CN) as well as the major relevant risk factors so as to provide evidence for developing intervention measures.</p><p><b>METHODS</b>1163 children (of whom 49.6% were males and 4.5% were minority nationality) were randomly sampled under multistage stratification, from 25 cities which representing 15 provinces of China. Based on the Child Neglect Norms used by China, prevalence of CN was identified and SPSS-Windows 11.0 was employed for statistical analysis. Scores, frequency/degrees, age, sex and 5 types (physical, emotional, educational, medical and safety) of CN on every group of the regions, were calculated. Multifactorial analysis was conducted through Binary Logistic Regression and multiple linear regression to determine the relevant risk factors.</p><p><b>RESULTS</b>(1) The average degree of CN for the 3 - 6 year-olds was 42.2, with its prevalence as 28.0%. Degrees of CN for the groups of 3, 4, 5, 6-year-olds were 41.7, 42.2, 42.1 and 43.1 (F = 0.988, P > 0.05), with frequencies of 25.0%, 25.3%, 27.9% and 35.4% (chi(2) = 4.798, P > 0.05), respectively. Degrees for CN in males and females were 42.7 and 41.8 (F = 2.502, P > 0.05) with the frequencies as 32.6% and 23.7% (chi(2) = 6.585, P < 0.05), respectively. Degrees of CN for the five types were 39.4-43.4 with the frequencies as 5.1%-12.9%, respectively. No significant difference was found in the frequency of the types (with an exception on 'physical neglect') between males and females (P > 0.05). The highest frequency (42.9%) of CN was seen in the single-parent families and the lowest in large family with three generations (25.5%). (2) According to monofactorial chi(2) test, the possible risk factors of CN would include: educational background, occupation and decrease of income of the parents during last year, etc. (3) Binary Logistic regression analysis showed that the influential factors to the occurrence of CN would include: father's educational background, sex of the child and mother's occupation, etc. (4) Multiple linear regression showed that the influential factors to the degree of CN were: family structure, number of supporting family members, relationship between parents and children, etc.</p><p><b>CONCLUSION</b>The degree and frequency of CN among children aged 3 to 6 in the urban areas of China were high but similar among the four age groups. Male children had a higher frequency of neglect than females, but with similar degree. Children in single-parent families had the highest frequency. The major influential factors of CN would include: educational background, occupation, family structure, family income of the parents which were similar to the results reported from foreign literature.</p>

Prediction of food allergy by using cord blood IgE levels / 中华儿科杂志

<p><b>OBJECTIVE</b>As more attention is paid to food allergy which is already regarded as a public health problem, there is still a lot of uncertainty as to the mechanisms and there are limited therapeutic methods for this problem. It is of importance to screen the susceptible infants as early as possible. The present study was conducted to learn whether cord blood IgE levels (CBIgE) could be used as a predictor of food allergy, and to find out factors which influence the predictive accuracy of CBIgE.</p><p><b>METHODS</b>The present study enrolled 118 infants born between April 2001and July 2001, and the authors followed up the infants until they were 4 months old. At the end of follow up, 105 infants had complete data for evaluation. Paper radioimmunosorbent tests (PRIST) were used for CBIgE assay, and parents were required to answer the standard questionnaires and the food skin prick tests (SPT) were taken for all infants.</p><p><b>RESULTS</b>At the end of follow-up, the infants were divided into 3 groups based on food allergy status: FA group with obvious food allergy, SFA group with suspected food allergy and NFA group without allergy. The median values of CBIgE levels in FA group were higher than those in SFA and NFA groups (4.80 IU/L, 0.55 IU/L, 0.87 IU/L, P < 0.01). When the cutoff value for CBIgE was set at 0.9 IU/L (CBIgE(0.9)), 42.9% of infants were found to have food allergy in the higher CBIgE group, 6.7% in the lower CBIgE group (P < 0.01, RR 95% CI = 2.715 approximately 15.221); when the cutoff value was set at 0.5 IU/L (CBIgE(0.5)), 30.9% in the higher CBIgE group and 5.00% in the lower CBIgE group (P < 0.01, RR 95% CI = 1.954 approximately 19.552). In addition, the sensitivity of CBIgE(0.9).as a predictor of food allergy, was 78.95% and the specificity, efficiency and odd product were 73.68%, 74.74%, and 10.50, generally better than CBIgE(0.5) of which the sensitivity, specificity, efficiency, odd product were 89.47%, 5.00%, 57.89%, 8.5 (P < 0.01). With the multi-factor stepwise regression analysis, our study indicated that exposure to cigarette smoke (OR 95%CI = 4.3340 approximately 71.2432), animal fur (OR 95% CI = 1.9869 approximately 30.7472), and egg supplement (OR 95% CI = 1.9340 approximately 25.8885) before 4 months of age might be the risk factors which may result in the predictive uncertainty of CBIgE.</p><p><b>CONCLUSIONS</b>Increased CBIgE levels might be the risk factor which result in food allergy; CBIgE(0.9), as a predictor of food allergy, is superior to CBIgE(0.5). However, some environmental factors, such as early exposure to cigarette smoke, animal fur and too early egg supplement would lead to predictive uncertainty of CBIgE.</p>