Changes of peripheral perfusion index in very low birth weight infants with late-onset sepsis / 中国小儿急救医学

Objective:To analyze the changes of peripheral perfusion index (PPI) with late-onset sepsis (LOS) in very low birth weight infants during hospitalization.Methods:Very low birth weight infants admitted to the neonatal intensive care unit of Children′s Hospital of Fudan University from August 1, 2021 to August 31, 2022 were consecutively included.Infants with admission age ≥three days and unstable circulation, or positive blood culture within three days after birth were excluded.From the day of admission, the PPI values of the right hand and either foot of the infants were measured with Masimo SET Radical-7 everyday while whether LOS occurred during hospitalization was observed.The mean PPI curve of very and extremely low birth weight infants without LOS was plotted.For those with LOS confirmed by blood culture, the PPI change trajectory three days before and after the occurrence of LOS was drawn, and the change trend of PPI before the occurrence of LOS was analyzed by trend chi-square test.Non-parametric test was used to analyze the effect of LOS on pre- and post-ductal PPI values.Results:A total of 107 very low birth weight infants were included in the final analysis.Among them, there were 11 infants confirmed as LOS by blood culture, 37 infants diagnosed as clinical LOS, and 59 infants without LOS.Pre-and post-ductal PPI values of very low birth weight infants without LOS were 2.06±1.30 and 1.72±0.92, respectively; those with clinical LOS were 1.90±0.94 and 1.58±0.83, respectively; those with LOS confirmed by blood culture were 1.92±1.11 and 1.62±0.82, respectively.For infants with LOS confirmed by blood culture, the pre-and post-ductal PPI values showed a continuous downward trend during three days before the onset of disease, with the lowest PPI values on the first day before the diagnosis of blood culture.The downtrend of pre-ductal PPI was statistically significant ( χtrend2=5.57, P<0.05). Conclusion:The PPI value of very low birth weight infants show a downward trend when LOS occurs.It should be observed dynamically in clinical practice, which is helpful to suspect or identify LOS as early as possible.

Clinical analysis of 103 children with Angelman syndrome / 中华实用儿科临床杂志

Objective@#To investigate the correlation between clinical phenotype, electroencephalogram (EEG) characteristics and genotype in children with Angelman syndrome(AS).@*Methods@#A total of 103 children with AS at Department of Neurology, Children′s Hospital of Fudan University from June 2017 to June 2018, were included in this study.The information of clinical characteristics, EEG manifestations, genotypes as well as the epileptic outcome were collected retrospectively.The correlations between clinical phenotype, genotype, and epileptic outcome were evaluated.@*Results@#(1) Of the 103 cases, 48 were male (46.6%) and 55 were female (53.4%). (2) Genotypes on AS critical region were maternal chromosome 15q11.2-q13 [86.4%(89/103 cases)], paternal uniparental disomy [3.9%(4/103 cases)], imprinting defects [1.9%(2/103 cases)], and mutations in the maternal copy of UBE3A [7.8%(8/103 cases)]. (3) Apparent happy demeanor or smile and general developmental delay were observed in all AS children.Dyskinesia accounted for 98.1% (101/103 cases), followed by oral movement or suck disorders [97.1%(100/103 cases)] and abnormal posture [67.0%(69/103 cases)]. The proportion of acquired small head circumfe-rence or microcephaly, flat occiput or occipital groove and wide-spaced teeth were 61.2%(63/103 cases), 85.4%(88/103 cases) and 44.7%(46/103 cases), respectively.(4) Behavioral problems like fascination with water, sleep problems and feeding difficulties were found in 86.4%(89/103 cases), 89.3%(92/103 cases) and 85.5%(88/103 cases) of the children, respectively.Sleep disorders [94.4%(84/89 cases) vs.57.1%(8/14 cases)] and feeding difficulties [93.3%(83/89 cases) vs.35.7%(5/14 cases)] were more frequently seen in children with maternal absence group, compared those with no absence, and the differences were statistically significant (all P<0.05). (5) Epilepsy was present in 77.7% (80/103 cases) of children with onset age varying from 8 to 72 months and 80.8% (59/73 cases) were developing seizures prior to 3 years old.Children with maternal absence showed more multiple seizure types than those with no absence[41.7%(32/68 cases) vs.0(0 case)], and the difference was statistically significant(P<0.05). Children with well-controlled epilepsy had more atonic seizure, compared with those with poorly controlled seizure [48.3%(14/29 cases) vs.18.5%(4/27 cases)], and the difference was statistically significant(P<0.05).@*Conclusions@#Sleep disorders, feeding difficulties in infancy and multiple seizure types are more commonly seen in AS children with maternal absence.Atonic seizure is easier to be controlled over other types of seizures.

Clinical analysis of 103 children with Angelman syndrome / 中华实用儿科临床杂志

Objective To investigate the correlation between clinical phenotype,electroencephalogram(EEG) characteristics and genotype in children with Angelman syndrome(AS). Methods A total of 103 children with AS at Department of Neurology,Children′s Hospital of Fudan University from June 2017 to June 2018,were included in this study. The information of clinical characteristics,EEG manifestations,genotypes as well as the epileptic outcome were collected retrospectively. The correlations between clinical phenotype,genotype,and epileptic outcome were evaluated. Results (1)Of the 103 cases,48 were male(46. 6﹪)and 55 were female(53. 4﹪).(2)Genotypes on AS criti﹣cal region were maternal chromosome 15q11. 2－q13[86. 4﹪(89/103 cases)],paternal uniparental disomy[3. 9﹪(4/103 cases)],imprinting defects[1. 9﹪(2/103 cases)],and mutations in the maternal copy of UBE3A[7. 8﹪(8/103 cases)].(3)Apparent happy demeanor or smile and general developmental delay were observed in all AS children. Dyskinesia accounted for 98. 1﹪(101/103 cases),followed by oral movement or suck disorders[97. 1﹪(100/103 cases)]and abnormal posture[67. 0﹪(69/103 cases)]. The proportion of acquired small head circumfe﹣rence or microcephaly,flat occiput or occipital groove and wide－spaced teeth were 61. 2﹪(63/103 cases),85. 4﹪(88/103 cases)and 44. 7﹪(46/103 cases),respectively.(4)Behavioral problems like fascination with water,sleep problems and feeding difficulties were found in 86. 4﹪(89/103 cases),89. 3﹪(92/103 cases)and 85. 5﹪(88/103 cases)of the children,respectively. Sleep disorders[94. 4﹪(84/89 cases)νs. 57. 1﹪(8/14 cases)]and feeding difficulties[93. 3﹪(83/89 cases)νs. 35. 7﹪(5/14 cases)]were more frequently seen in children with maternal ab﹣sence group,compared those with no absence,and the differences were statistically significant(all P＜0. 05).(5)Epi﹣lepsy was present in 77. 7﹪(80/103 cases)of children with onset age varying from 8 to 72 months and 80. 8﹪(59/73 cases)were developing seizures prior to 3 years old. Children with maternal absence showed more multiple seizure types than those with no absence[41. 7﹪(32/68 cases)νs. 0(0 case)],and the difference was statistically significant (P＜0. 05). Children with well－controlled epilepsy had more atonic seizure,compared with those with poorly con﹣ trolled seizure[48. 3﹪(14/29 cases)νs. 18. 5﹪(4/27 cases)],and the difference was statistically significant( P＜0. 05). Conclusions Sleep disorders,feeding difficulties in infancy and multiple seizure types are more commonly seen in AS children with maternal absence. Atonic seizure is easier to be controlled over other types of seizures.

Distribution of waist circumference and waist-to-height ratio and their values in obesity screening among 3-9 years old Han and Uygur ethnic children in Xinjiang Uygur Autonomous Region of China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the distributions of waist circumference and waist-to-height ratio (WHtR) in Han and Uygur ethnic children aged 3-9 years in Xinjiang Uygur Autonomous Region (Xinjiang) and discuss their values in obesity screening in children.</p><p><b>METHODS</b>Stratified cluster random sampling was conducted to select Han and Uygur ethnic children from kindergartens and primary schools in four areas of Xinjiang in April 2014. The children's standing height, body weight and waist circumference were measured by trained investigators according to standard protocol. WC>or=P80 and WHtR>or=0.48 were used as the cutoff value for abdominal obesity screening in children with normal BMI. The association between overweight/obese prevalence rate and obesity related indicators, such as BMI, WC, WHtR, were analyzed.</p><p><b>RESULTS</b>A total of 4024 Han and Uygur ethnic children were investigated, in which 2461 were in Han ethnic group, 1563 were in Uygur ethnic group. The WC and WHtR at P50 and P80 were differed significantly. In both Han and Uygur ethnic groups, there were some children with WC>or=P80 or WHtR>or=0.48, although they had normal BMI. This proportion decreased with age.</p><p><b>CONCLUSIONS</b>The WC and WHtR are similar in Han and Uygur ethnic children aged 3-9 years. WC and WHtR have values in obesity screening for children with normal BMI which suggested to use it as the supplementation of BMI in obesity screening in preschool aged children.</p>

Study on HIV prevention related knowledge-motivation-psychological model in men who have sex with men, based on a structural equation model / 中华流行病学杂志

Objective Knowledge-motivation-psychological model was set up and tested through structural equation model to provide evidence on HIV prevention related strategy in Men who have Sex with Men (MSM).Methods Snowball sampling method was used to recruit a total of 550 MSM volunteers from two MSM Non-Governmental Organizations in Urumqi,Xinjiang province.HIV prevention related information on MSM was collected through a questionnaire survey.A total of 477 volunteers showed with complete information.HIV prevention related Knowledge-motivationpsychological model was built under related experience and literature.Relations between knowledge,motivation and psychological was studied,using a ‘structural equation model’ with data from the fitting questionnaires and modification of the model.Results Structural equation model presented good fitting results.After revising the fitting index:RMSEA was 0.035,NFI was 0.965 and RFI was 0.920.Thereafter the exogenous latent variables would include knowledge,motivation and psychological effects.The endogenous latent variable appeared as prevention related behaviors.The standardized total effects of motivation,knowledge,psychological on prevention behavior were 0.44,0.41 and 0.17 respectively.Correlation coefficient of motivation and psychological effects was 0.16.Correlation coefficient on knowledge and psychological effects was-0.17 (P＜0.05).Correlation coefficient of knowledge and motivation did not show statistical significance.Conclusion Knowledge of HIV and motivation of HIV prevention did not show any accordance in MSM population.It was necessary to increase the awareness and to improve the motivation of HIV prevention in MSM population.

Study on HIV prevention related knowledge-motivation-psychological model in men who have sex with men, based on a structural equation model / 中华流行病学杂志

Objective Knowledge-motivation-psychological model was set up and tested through structural equation model to provide evidence on HIV prevention related strategy in Men who have Sex with Men (MSM).Methods Snowball sampling method was used to recruit a total of 550 MSM volunteers from two MSM Non-Governmental Organizations in Urumqi,Xinjiang province.HIV prevention related information on MSM was collected through a questionnaire survey.A total of 477 volunteers showed with complete information.HIV prevention related Knowledge-motivationpsychological model was built under related experience and literature.Relations between knowledge,motivation and psychological was studied,using a ‘structural equation model’ with data from the fitting questionnaires and modification of the model.Results Structural equation model presented good fitting results.After revising the fitting index:RMSEA was 0.035,NFI was 0.965 and RFI was 0.920.Thereafter the exogenous latent variables would include knowledge,motivation and psychological effects.The endogenous latent variable appeared as prevention related behaviors.The standardized total effects of motivation,knowledge,psychological on prevention behavior were 0.44,0.41 and 0.17 respectively.Correlation coefficient of motivation and psychological effects was 0.16.Correlation coefficient on knowledge and psychological effects was-0.17 (P＜0.05).Correlation coefficient of knowledge and motivation did not show statistical significance.Conclusion Knowledge of HIV and motivation of HIV prevention did not show any accordance in MSM population.It was necessary to increase the awareness and to improve the motivation of HIV prevention in MSM population.