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ObjectiveTo understand the physical development level of 3-7 years old children in Zhag′yab， and to provide reference for local health decision-making. MethodsA cross-sectional study was conducted between June 2021 and July 2021， with a sample of 1 247 Tibetan children aged 3-7 years from kindergartens in 13 districts of Zhag′yab. Their height and weight were measured and the hemoglobin was detected by a unified method. Standard statistical method was adopted （Z-score method）. Z-scores of length /height-for-age （HAZ）， Z-scores of weight-for-age （WAZ）， Z-scores of body mass index （BMI）-for-age （BAZ） and Z-scores of weight-for-height （WHZ） were calculated by WHO Anthro v3.2.2 and WHO Anthro Plus. The nutritional status of children was evaluated according to WHO diagnostic criteria for malnutrition and anemia. ResultsThe average WAZ and HAZ of children aged 3 to 7 in Zhag′yab were lower than the WHO standards，except for the WAZ of 4-year old， the differences were statistically significant （P<0.05）. The overall detection rate of malnutrition was 25.7%， stunting， underweight， wasting， overweight， obesity and anemia were 11.6%， 11.8%， 10.8%， 3.3%， 1.8% and 29.3%， respectively. The detection rates of all indicators in boys were higher than those in girls， and the differences were not statistically significant （P>0.05）. The overweight rate and obesity rate of rural children were lower than those of urban children， and the other detection rates were higher than those of urban children. The differences of underweight rate， obesity rate and anemia rate were statistically significant between urban and rural children （P<0.05）. Among the detection rates of all indicators in different age groups， there were statistically significant differences in the overweight rate and the anemia rate （P<0.05）. The overweight rate of children aged 4 and the anemia rate of children aged 5 were the highest. ConclusionsThe physical development of children aged 3 to 7 in Zhag′yab is poor， and the prevalence of malnutrition and anemia is high. Underweight and anemia are more serious in rural children， and the overweight and obesity problem of urban children is emerging. More attention should be paid to promote their nutritional status. The prevention and intervention of children’s malnutrition should be strengthened in Zhag′yab.
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@#【Objective】 To guide the nutritional intervention of children in the clinical practice ，by exploring the effect of over-nutrition in postnatal life on growth of the female SD rats.【Methods】We established the rat model of intra? uterine growth retardation（IUGR）through diet restriction in pregnant rats and selected female newborn rats that met the criteria as the experimental group（group I）. Group I was randomly divided into control group（group IC）and small group（group IS）. Fifty-eight female newborn rats with normal diet in pregnant period（group C）were also divided into control group（group CC）and small group（group CS）. After 21-days-lactation，group IC and group CC were randomly subdivided into 4 rats per cage，and then fed with normal diet，while group IS and group CS were fed with high fat diet. We measured the body weight and the body length of each rat every week. Serum fasting insulin，fasting blood glucose，IGF-1，IGF- BP3 levels，and rat insulin sensitivity index（ISI）were measured at different growth and development stages.【Results】 The body weight and body length of group IS were higher than those of group IC（P<0.05）；the same was true for group CS and group CC. In the different growth and development stages，the FINS，FBG，IGF- 1 and IGF- BP3 of group IS were higher than those of group IC（P < 0.05），the ISI was lower than that of group IC（P < 0.05）. Besides，the FINS，FBG of group CS were higher than those of group CC and the ISI of group CS was lower than that of group CC in the 75 days after birth（P < 0.05）.【Conclusions】We found that those small for gestational age infants can be added nutrition appropriately for rapid catch-up，but it is necessary to evaluate the growth index closely and adjust the nutrition on time. Children with normal intrauterine development also need to prevent over-nutrition.
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@#【Objective】To investigate the effects of different nutritional status in early life on weight catch-up，puberty initiation and obesity in rats with intrauterine growth retardation（IUGR）.【Methods】IUGR model of newborn rats was established by limiting diet during pregnancy in SPF rats. Female newborn rats were used in the experiment. IUGR rats were divided into two groups：small litter IUGR group（SL-IUGR）and common feeding IUGR group（CF-IUGR）. Rats of normal birth weight served as normal control group（NC）. The SL-IUGR group was used to simulate overfeeding in lactation period. After weaning，the rats in the three groups were fed with basic diet. The weights were measured at postnatal 1，7，14，21，35，42 and 75 days. The time of vaginal orifice opening（VO）was recorded. The levels of estradiol（E2），luteinizing hormone（LH）and follicle estrogen（FSH）were examined on the 21 d and the 35 d.【Results】The birth weight of IUGR rats was（4.92±0.18）g，which was significantly lower than that in the control group（6.00±0.29 g，P < 0.001）. IUGR rats showed weight growth catch- up on the 14th day. The body weight of SL- IUGR group was higher than that of control group from 14 to 75 d. The body weight of CF-IUGR group lagged behind that of control group from 1 to 75 d，the difference was statistically significant（P < 0.05）. The vaginal opening time of female IUGR rats in SL- IUGR group was （29.88 ± 1.81）d，which was significantly earlier than that of CF- IUGR group（32.03 ± 2.11）days（P = 0.044）. There was a correlation between body weight of the 21 d and vaginal opening time in IUGR rats，Rs = -0.174，P = 0.039. The besity rates of puberty and adulthood of IUGR rats in SL-IUGR group were 28.33% and 21.67%，which were significantly higher than those in CF-IUGR group（7.5%，6.25%；P = 0.001，0.007）. The weight growth rate of adolescent obese IUGR rats at 7 and 21 d was higher than that of non-adolescent obese rats，and the weight growth rate of adult obese IUGR rats at 7 and 35 d was higher than that of non-adolescent obese rats. The difference was statistically significant（P < 0.05）. Binary Logistic regression analysis of vaginal opening time and adult obesity in IUGR rats′ group OR = 0.419，P = 0.24. The time of vaginal orifice opening was not an independent factor of adult obesity. 【Conclusions】The improvement of nutrition level in the early stage of life is beneficial to weight catch-up of IUGR，and the overweight catch-up during lactation can lead to puberty and adulthood obesity of IUGR rats，as well as the advance of vaginal opening time.
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[Objective] We explore the diagnosis of Smith-Magenis syndrome and its clinical features of children,to raise the domestic awareness of this disease.[Methods] In this study,the child received peripheral blood chromosome microarray analysis,blood routine and urine routine,growth hormone provocation test,insulin-like growth factor Ⅰ and insulin-like growth factor binding protein Ⅲ test,cortisol (8a) test,prolactin test,adrenocorticotropic hormone test,thyroid function test,liver and kidney function test,blood biochemistry test,fasting insulin test,2-hour plasma glucose test,the antibodies and antigens test of hepatitis B.The bone age measurement and the pituitary gland MRI were also performed.We use the above figures to diagnose Smith-Magenis syndrome,assess and observe the condition of the child in Smith-Magenis syndrome.[Results] In this case,the chromosomal microarray analysis revealed a deletion of about 3.6Mb fragments in the chr17p11.2 region,including main functional gene RAI1,which was associated with Smith-Magenis syndrome.According to the clinical manifestations and the result of chromosome microarray analysis,the diagnosis of children with Smith-Magenis syndrome was made clear.[Conclusion] Genetic tests are the standard for diagnosing Smith-Magenis syndrome.When children have special facial features combined with multiple system disorders,early genetic examination is conducive to early diagnosis,and can reduce the time and economic cost.