Well-child care delivery in the community in China: Related factors and quality analysis of services.

Well-child health care services are essential for maintaining optimum child health and development. This study's aim was to evaluate the quality of such services and identify factors affecting service quality from the perspective of well-child health care providers located in China's Hunan Province. To achieve this, a qualitative descriptive method was employed, with 22 well-child health care providers being recruited, using purposive sampling, from among the provinces' government community health centers. The participants completed individual semi-structured interviews lasting approximately 25-30 minutes that were designed to obtain their views on well-child health care administration in the province. Then, the interview transcripts were analyzed thematically. The main finding was that participants felt that the delivery of well-child health care services in Hunan Province is insufficient. Factors they mentioned as negatively affecting the delivery of such services included the region's fragmented primary health care system, inadequate attention to this issue from parents and community health care center managers, and a lack of specialized well-child care knowledge. Thus, currently, well-child health care is not being successfully implemented in Hunan Province; consequently, in order to successfully implement well-child health care in this region, community health care centers should invest more resources and funding, particularly into education programs for well-child health care providers.

[Effects of inhaled corticosteroids on bone age and growth in children with asthma].

OBJECTIVE: Long-term inhaled corticosteroids are the preferred treatment for asthma, but their safety still controversial. The aim of the present study was to explore the effects of inhaled corticosteroids on bone age and growth in children with asthma. METHODS: Seventy-three children with asthma received inhaled fluticasone treatment at a starting dosage of 250 µg/d for 3 months, when the dosage was reduced by a third. Three months later, the patients were treated with fluticasone at a dosage of 125 µg/d for 6 months. Bone age, heights and weights were measured before and one year of treatment. RESULTS: The increase in the heights, weights and RUS (radius, ulna and short finger bones) bone age of the children with asthma after one year of treatment was not significantly different from healthy children. There were no significant differences in body mass index (BMI) before and after one year of treatment, however the level of carpal bone age [-0.2(-0.6,0.8) years] was delayed after therapy compared to before treatment [-0.5(-1.0,0.6) years] (P<0.05). CONCLUSIONS: Treatment with inhaled corticosteroids for 1 year may suppress the level of carpal bone age, but the level of RUS bone age, heights, weights and BMI are not affected. It is necessary to monitor the growth of children with asthma who receive long-term inhaled corticosteroid treatment.

[A mutation in TGF beta1 gene encoding the latency-associated peptide in a Chinese patient with Camurati-Engelmann disease].

OBJECTIVE: To identify the mutation in transforming growth factor-beta1 gene (TGF beta1) in a Chinese patient with Camurati-Engelmann disease(CED). METHODS: Denaturing high-performance liquid chromatography (DHPLC) analysis was performed on the whole seven coding exons and exon-intron boundaries, then the mutation was identified by direct sequencing. RESULTS: Mutation screening of TGF beta1 in this patient revealed a heterozygous missense mutation R218H in exon 4. CONCLUSION: The identification of the mutation could provide essential data for subsequent therapy and genetic counseling.