Abstract Background We aimed to analyze the characteristics of the body composition of children and adolescents aged 3–17 in Suzhou, China. Methods A cross-sectional study between January 2020 and June 2022 using bioelectrical impedance was conducted to determine the fat mass (FM), fat-free mass (FFM), skeletal muscle mass, and protein and mineral contents of 24,845 children aged 3–17 who attended the Department of Child and Adolescent Healthcare, Children’s Hospital of Soochow University, China. Measurement data was presented in tables as mean ± SD, and groups were compared using the independent samples t-test. Results FM and fat-free mass increased with age in both boys and girls. The fat-free mass of girls aged 14–15 decreased after reaching a peak, and that of boys in the same age group was higher than that of the girls (p < 0.05). There were no significant differences in FM between boys and girls younger than 9- and 10-years old. The percentage body fat (PBF) and FM index of girls increased rapidly between 11 and 15 years of age (p < 0.05), and those of boys aged 11–14 were significantly lower (p < 0.05), suggesting that the increase in body mass index (BMI) was mainly contributed by muscle mass (MM) in boys. Conclusions The body composition of children and adolescents varies according to their age and sex. A misdiagnosis of obesity made on the basis of BMI alone can be avoided if BMI is used in combination with FM index, percentage body fat, and other indexes.

Abstract Background Short stature is defined as height below 2 standard deviations of the population with the same age, gender. This study is aimed to assess the characteristics of body composition in preschool children with short stature. Methods Anthropometric measurements and body composition were assessed in 68 preschool children aged 3 to 6 years old with short stature and 68 normal controls matched on age and gender. Height, weight and body composition (total body water, protein, minerals, body fat mass, fat-free mass, soft lean mass, skeletal muscle mass, and bone mineral contents) in the two groups were measured and compared. Results The total body water, protein, minerals, body fat mass, fat-free mass, soft lean mass, skeletal muscle mass, and bone mineral contents were lower in preschool children with short stature than controls (P < 0.05). Body mass index and fat mass index did not differ between groups. Fat-free mass index was significantly lower in short stature group than controls (t = 2.17, P = 0.03). Linear regression analysis showed that there was a positive correlation between height and fat-free mass index [β, 1.99 (0.59, 3.39), P = 0.01], a negative correlation between height and body fat percentage [β, − 0.20 (− 0.38, − 0.01), P = 0.04]. The proportions of fat-free mass in the upper limbs were significantly lower (Right,t = − 2.78,Left t = − 2.76, P < 0.05, respectively) in short stature, although body fat distribution was not. Conclusions The fat-free mass such as protein and bone minerals is lower in preschool children with short stature, suggesting the monitoring of fat-free mass for early identification and intervention.

Transforming acidic coiled coil containing protein 3 (TACC3) is emerging as an attractive anticancer target in recent years, however, few TACC3 small-molecular inhibitors have been reported up to now. In this study, fifteen compounds were designed and synthesized based on the lead compound KHS101 to find more potent TACC3 inhibitors. Among them, the most potent compound 7g exhibited about 10-folds more potent antiproliferative activities than KHS101 in various cancer cell lines. Two different protein-drug binding assays including DARTS, and CETSA revealed TACC3 as a biologically relevant target of compound 7g. In addition, compound 7g induced cell cycle arrest at the G2/M phase and induced cell apoptosis. Furthermore, compound 7g depolarized the MMP and induced ROS generation in a dose-dependent manner in U87 cells. More importantly, 7g reduced tumor weight by 72.7% in U87 xenograft model at a dose of 20 mg/kg/day without obvious toxicity. Altogether, compound 7g deserved further investigations as a novel, safe and efficacious TACC3 inhibitor for the treatment of GBM.

目的 比较分析2015年及2020年胎龄＜32周小胎龄(VLGA)早产儿人口学特征、疾病谱、临床结局、生长结局的变化.方法 选择扬州大学医学院附属淮安市妇幼保健院新生儿医学中心2015年1月1日至12月31日(174例)及2020年1月1日至12月31日(157例)收治住院的VLGA早产儿的资料.分析其临床结局;分析达出院标准出院的VLGA早产儿的人口学信息、疾病谱及治疗情况.结果 不同年份出生早产儿临床结局比较,差异有统计学意义(P＜0.05).2015年达出院标准出院的VLGA早产儿135例,2020年125例.2020年出生早产儿出生胎龄、出生体重低于2015年;剖宫产率、出院胎龄、出院体重高于2015年,住院天数长于2015年(P＜0.05).2020年新生儿呼吸窘迫综合征、败血症、中重度脑室内出血、支气管肺发育不良、动脉导管未闭发生率高于2015年(P＜0.05).达出院标准出院的不同年份出生早产儿生长结局比较,差异无统计学意义(P＞0.05).结论 关注更低出生体重、更小出生胎龄、合并更危重并发症的VLGA早产儿,可以获得更好的临床结局和生长结局.

目的 分析学龄期注意缺陷/多动障碍(ADHD)儿童环境铅暴露情况,并进一步分析各年份、各亚型ADHD儿童铅暴露水平以及不同血铅水平下的社会功能情况.方法 招募2016年1月-2019年12月至苏州大学附属儿童医院儿童保健科就诊的4590例ADHD儿童(ADHD组),并选取同期以注意力不集中和/或多动、冲动就诊但未达到诊断标准的2264名儿童(非ADHD组).对所有儿童采集清晨空腹静脉血,采用原子吸收光谱法进行测定血铅水平.应用Weiss' s功能性缺陷程度评定量表(WFIRS-P)对所有儿童社会功能进行评价.结果 20162019年学龄期ADHD患儿血铅整体水平呈逐年下降趋势.ADHD组儿童血铅水平高于非ADHD组,差异具有统计学意义(t=2.659,P=0.008).混合型ADHD患儿血铅水平≥50 μg/L的比例最高.混合型组ADHD患儿血铅水平高于注意缺陷型组和多动冲动型组(H=14.629,P=0.001).ADHD儿童在不同血铅水平下社会功能差异无统计学意义(P＞0.05).非ADHD儿童在不同血铅水平下社会活动维度差异有统计学意义(P=0.044).结论 近年来儿童铅暴露水平呈下降趋势,对于以注意力不集中和/或冲动多动为主诉就诊的儿童来讲,低水平铅暴露仍需引起重视.

目的 探讨伴有语言障碍的孤独症谱系障碍(ASD)儿童与特发性语言障碍(SLI)儿童发育水平的差异及语言发展进程的特点,为早期诊断、早期干预及提供科学的个性化的干预措施提供依据.方法 从2018年1月-2019年12月在苏州大学附属儿童医院儿童保健科因语言迟缓就诊的儿童中选择年龄在24～48个月之间,经过一系列检查最终确诊为ASD儿童293例及SLI儿童261例,对这些患儿进一步应用0～6岁儿童神经心理发育量表及语言发展进程量表进行评估.结果 ASD组和SLI组在粗大运动、精细动作、适应能力、语言能力及个人-社会能力方面均有差异,差异有统计学意义(P ＜0.001).ASD组在语言表达能力、听觉感受和理解能力、与视觉相关的理解和表达能力3个方面得分均低于SLI组,差异有统计学意义(P＜0.001).结论 ASD儿童与SLI儿童相比各能区发育水平均有落后,临床过程中对语言发育迟缓儿童应增加语言理解及表达能力的评估,这样更有利于制定出个性化的康复方案进而针对性的干预.

目的 初步分析注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童血清D族维生素水平,以及不同亚型ADHD儿童之间血清维生素D水平是否存在差异.方法 选取2019年1月—2019年12月于苏州大学附属儿童医院儿童保健科就诊,经过一系列检查评估并最终确诊为ADHD的儿童295例,并进行分型.另选取同期在儿童保健科进行健康体检的同年龄段儿童271例,作为正常对照组.采用电化学法测定两组儿童血清中维生素D水平.结果 ADHD组中血清维生素D水平均低于正常对照组,差异具有统计学意义(P<0.05).ADHD组维生素D缺乏的比例较高,差异具有统计学意义(P<0.01).不同类型ADHD儿童血清维生素D水平差异无统计学意义(P>0.05).结论 ADHD儿童血清维生素D水平低于正常对照组.对于ADHD患儿应注重血清维生素D水平的监测并及时补充,也许对ADHD预防及病情恢复能够起到促进作用.

Naturally occurring polyphenol curcumin (4) or demethoxycurcumin (5) and their synthetic derivatives display promising anticancer activities. However, their further development is limited by low bioavailability and poor selectivity. Thus, a mitochondria-targeted compound 14 (DMC-TPP) was prepared in the present study by conjugating a triphenylphosphine moiety to the phenolic hydroxyl group of demethoxycurcumin to enhance its bioavailability and treatment efficacy. The in vitro biological experiments of DMC-TPP showed that it not only displayed higher cytotoxicity as compared with its parent compound 5, but also exhibited superior mitochondria accumulation ability. Glioma cells were more sensitive to DMC-TPP, which inhibited the proliferation of U251 cells with an IC50 of 0.42 μM. The mechanism studies showed that DMC-TPP triggers mitochondria-dependent apoptosis, caused by caspase activation, production of reactive oxygen species (ROS) and decrease of mitochondrial membrane potential (MMP). In addition, DMC-TPP efficiently inhibited cellular thioredoxin reductase, which contributed to its cytotoxicity. Significantly, DMC-TPP delayed tumor progression in a mouse xenograft model of human glioma cancer. Taken together, the potent in vitro and in vivo antitumor activity of DMC-TPP warrant further comprehensive evaluation as a novel anti-glioma agent.

目的 回顾性分析18～36月龄语言发育迟缓儿童神经发育特点,为后期评估、干预提供理论依据.方法 选取苏州大学附属儿童医院2018-2019年因语言问题首次就诊的18～36月龄婴幼儿,根据"0～6岁儿童神经心理发育量表"及"早期语言发育进程量表"结果分为单纯语言发育迟缓组与多能区发育迟缓组,比较两组儿童各能区发育、早期语言水平,以及孤独症筛查阳性检出率.结果 共有700例婴幼儿入选,两组间月龄(t=-1.73,P=0.09)、性别(x2=2.06,P=0.15)差异无统计学意义;两组间年龄构成比存在差异(x2=9.124,P=0.01).多能区发育迟缓组在语言、大运动、精细运动、适应性及社交能区均更为落后(t=15.08,20.26,25.68,18.76,39.79,P＜0.001).在早期语言水平方面,多能区发育迟缓组在总的早期语言发展水平、语音和语言表达、听觉感受理解、视觉相关语言方面较单纯语言发育迟缓组均更低(t=8.20,10.23,9.18,11.39,P＜0.001).单纯语言迟缓组语言能区的落后与精细运动、适应性及社交DQ存在相关性(r=0.127,0.146,0.238,P＜0.001),而多能区发育迟缓组语言能区的落后与各能区DQ均存在相关性(r=0.154,0.392,0.390,0.435,P＜0.001);多能区发育迟缓组孤独症筛查阳性检出率更高(x2=61.69,105.17,P＜0.05).结论 早期语言发育迟缓儿童合并多能区落后时存在语言发育的显著落后,应进一步完善检查,注意识别神经发育障碍性疾病.

Objective:To analyze the associations between attention deficit hyperactivity disorder (ADHD) and serum vitamin B levels in children.Methods:A total of 103 ADHD children who were diagnosed in the Department of Child and Adolescent Healthcare of Children′s Hospital of Soochow University from September 2018 to April 2019 were selected as the ADHD group, and 89 children of the same age who underwent routine physical examinations served as the healthy control group.The serum levels of vitamin B, including vitamin B 1, vitamin B 2, vitamin B 6, vitamin B 9, and vitamin B 12, were measured by the methods of electrochemistry.Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P) was applied to analyze the correlation between social function scores and vitamin B levels in ADHD children. Results:The levels of vitamin B 9[(12.55±2.22) nmol/L vs.(13.26±2.54) nmol/L] and vitamin B 12 [(278.54±32.00) ng/L vs.(288.90±31.32) ng/L] in ADHD children were significantly lower than those in healthy children( t=-2.064, -2.261, all P<0.05). No significant difference was observed in serum levels of vitamin B 1, vitamin B 2 and vitamin B 6 between the 2 groups (all P>0.05). Correlation analysis displayed that only vitamin B 12 level was significantly and negatively correlated with social function in the learning/school dimension ( r=-0.208, P=0.035), and no significant correlation was found between other vitamin B levels and social function (all P>0.05). Conclusions:The serum levels of vitamin B 9 and B 12 in ADHD children were obviously lower than those in healthy children of the same age.Serum vitamin B 12 deficiency had an influence on the social function of the learning/school in ADHD children.Attention to the monitoring and timely supplementation of vitamin B in childhood, especially vitamin B 9 and B 12, may be of positive significance in the prevention of the occurrence and development of ADHD to some extent.

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder among children and adolescents, and it is commonly accompanied with other developmental and psychological disorders.The prevalence of obesity in children continues to rise, and it is also a major social public concern that threatens human health.As a somatic comorbidity with ADHD, obesity is characterized by a high incidence.In this paper, the focus would be placed on the underlying mechanisms of ADHD accompanied with obesity from the aspects of genetics, perinatal period, environmental and neurobiological factors, which could provide a theoretical basis and intervention strategies for the early identification, rational treatment and long-term comprehensive management, as well as prevention and treatment effects of ADHD and its comorbidities.

目的 探讨技能模块化培训在儿科住院医师规范化培训中的应用.方法 该院创造性地建立了一套比较完整的模块培训体系.将基础临床技能归纳为15个模块,包括心肺复苏、气管插管、四大穿刺、测量血压、神经体格查体、四肢淋巴结查体、胸腹部查体、影像学检查、心电图判读、团队协作、系统评估.将同质化培训、督导督查、团队协作、认证理念、模拟教学、医学人文等理念,全面融汇其中.结果 住院医师规范化培训学员经过模块技能培训后,技能操作能力较培训前得显著提升,临床业务能力也得到了锻炼.结论 儿科模块化基本操作技能培训能够规范、标准、科学、高效、针对性提高基础技能培训质量,为儿科住院医师更好地完成规范化培训打下了良好的基础.

[目的]了解3～18月龄婴幼儿神经心理发育现状,分析不同出生季节对其神经心理发育状况的影响.[方法]采用方便抽样法,选取2018年1月—2018年12月某三级甲等儿童医院儿童保健科门诊就诊的3～18月龄婴幼儿1613例,采用首都儿科研究所编制的0～6岁小儿神经心理发育量表进行测试,比较不同季节出生儿童的总发育商(DQ)以及神经发育大运动、精细动作、适应性、语言、社交各方面发育情况.[结果]4月龄、5月龄、6月龄、16月龄婴幼儿的神经心理发育DQ值与出生季节间的相关性有统计学意义(P<0.05);4月龄婴幼儿的神经心理发育迟缓率与出生季节间的相关性有统计学意义(P<0.05).[结论]出生季节与婴幼儿神经心理发育有关,临床儿童保健工作者应指导家长根据季节差异给予婴幼儿动作、语言、适应力、社交等多方面的均衡训练.

目的 探讨问题教学法(PBL)+传统教学法(LBL)双轨教学法在小儿外科临床见习中的实际应用效果.方法 抽取2017年1月-2019年12月在苏州大学儿科临床医学院进行临床见习的76名本科学生,随机分组,对照组采用LBL教学法进行教学,观察组采用PBL+LBL的双轨教学法,比较两组实习生的考核成绩以及教学满意度.结果 两组实习生的理论知识考核成绩差异无统计学意义(P＞0.05);观察组实习医学生教学满意度为97.37％,对照组为84.21％,观察组实习生的临床实践考核成绩显著高于对照组,差异有统计学意义(P＜0.05).结论 在小儿外科临床见习中采用PBL+LBL双轨教学法可显著提升教学效果和实习生的教学满意度.

目的 评估儿童饮食行为干预工具对儿童饮食行为问题及抚养人对儿童饮食行为认知态度的干预效果.方法 以苏州市200名1～5岁饮食行为问题儿童为研究对象,随机分成干预组100名和对照组100名,分别采用爱饭达(IMFeD)工具,即儿童饮食行为干预计划(identification and management of feeding difficulties,IMFeD),及常规门诊指导进行干预.随访为期9个月,共随访4次,每次随访需要对儿童进行体格测量,同时通过让抚养人填写问卷,评估儿童各阶段的饮食行为状况及抚养人的认知状况.结果 在儿童6类饮食行为问题中,抚养人报告最严重的是“胃口差”和“不良进食习惯”,而未报告“潜在疾病状态”.干预组儿童在“胃口差”(P ＜0.001)和“父母过度关心”(P =0.049)这两项目的基线评分高于对照组.经过9个月的干预,两组儿童的饮食行为评分较干预前均呈下降趋势,干预组在“胃口差”的改善程度较对照组更明显(P=0.003).干预组儿童的身高和体质量增长幅度均高于对照组,且身高的差异有统计学意义(P =0.030).随干预时间的延长,干预组在“胃口差”“对某种食物特别偏好”“不良进食习惯”“父母过度关心”四类评分及饮食行为总评分均呈现逐渐递减趋势,且各项组间比较差异均有统计学意义(P＜0.001).干预组抚养人在干预后“认为孩子吃饭存在问题”的比例、“对孩子吃饭的担忧程度”以及对医生的疗效和满意度评价有明显改善(P ＜0.001).结论 综合系统的饮食行为干预可以较好地改善儿童的饮食行为问题,促进儿童体格生长,同时可以改善抚养人对儿童饮食行为的认知态度.

OBJECTIVE:The effects of lead exposure on cognitive function have been studied intensively over the past decade, but less attention has focused on its impact on auditory function. This study is aimed at investigating the effect of lead on the cochlea and the molecular mechanisms responsible for its actions.METHODS:0.2% lead acetate was administered to rats in drinking water for 30, 60, and 90 days. Brainstem auditory evoked responses (ABR) were recorded, and morphological changes in the hair cells were observed. We also measured glutathione (GSH) and malondialdehyde (MDA) concentrations and antioxidant enzyme activities such as catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and glutathione reductase (GR) activities in the cochlea.RESULTS:Lead exposure increased the ABR threshold and slightly prolonged the latencies of wave II and wave IV in rats. Abnormally shaped hair cells and loss of hair cells were found in the cochlea basilar membrane, together with degenerative changes in spiral ganglion neurons following lead exposure. The activities of some antioxidant enzymes were also reduced in association with upregulation of MDA expression. These effects may be caused by impaired catalytic function of the enzymes as a result of lead interaction.CONCLUSION:The antioxidant system of the cochlea in the immature rat brain is highly vulnerable to developmental lead exposure. Oxidative stress may therefore represent a possible mechanism for lead-induced auditory deficits.

目的 了解苏州市区部分6～12岁儿童BMI指数分布情况,为儿童营养问题的有效防控提供科学依据.方法 采用2017年苏州市区部分小学健康监测的数据,共16754名(男9018名,女7736名),计算BMI,分析不同年龄组BMI的百分位分布情况,计算男女生不同年龄组的超重和肥胖率.结果 6～12岁儿童的BMI均值随着年龄增加逐渐增加,男童大于女童;与中国BMI标准曲线比较,本组研究对象除了在P 3位有几个年龄段略低以外,其余均大于中国标准,在P 97位更为明显;与美国CDC标准比较,女童差别不大,男童在P 3位略低,而P 97位明显高于CDC标准;男童的超重比率为18.9％,肥胖比率为16.32％,女童的超重比率为16.53％,肥胖比率为10.61％,均为男童高于女童,差异有统计学意义.结论 苏州市区部分6～12岁儿童营养状况存在一定的不平衡性,肥胖的问题相当突出,尤其是男童的肥胖问题更为明显.

目的 探讨视屏暴露环境与儿童语言发育迟缓的相关性.方法 设计问卷调查语言发育迟缓儿童的视屏暴露信息及家庭环境信息,通过多元线性回归分析视屏暴露因素对儿童语言发育的影响.结果 134例16-48月龄的语言发育迟缓儿童,视屏暴露的起始月龄为(11.57±5.32)月,儿童每日视屏暴露总时长达(118.79±99.89)min.多元线性回归分析发现,视屏暴露起始月龄越小(t=3.743,P<0.001),每日视屏暴露总时间越长(t=-3.547,P=0.001),母子间对话时间越短(t=2.877,P=0.005),儿童的语言DQ值越低.结论 过早、过久的视屏暴露及母子间缺乏对话交流,是儿童语言发育迟缓的重要危险因素.减少视屏暴露,并增加亲子对话交流,有助于预防语言发育迟缓的发生.

The hematopoietic system is one of the potential targets of lead intoxication. Recognition of the lead-related deleterious outcomes promotes us to explore the potential therapeutic intervention. Here, we show that ginsenoside Rg1 (Rg1), extracted from the Chinese herb Panax ginseng, remarkably ameliorates the lead acetate-caused hematological index distortion as well as advanced hematopoietic stem cells (HSCs) aging and aging associated inflammation response. Specifically, Rg1 administration alleviated the increment of aging associated p53-p21-Rb signaling in aged HSCs induced by lead acetate. It also led a reduction of the lead acetate-induced increased inflammation level in blood plasma, which also partly contribute the aged HSCs rejuvenation. In conclusion, our results indicate that ginsenoside Rg1 therapeutically alleviated the essential blood deficits and advanced HSCs aging by lead acetate exposure, by which it could be viewed as a potential candidate for lead acetate-caused blood toxicity treatment.

Background: We investigated the clinical characteristics of a 3-month-old infant with acute mercury vapor poisoning. Clinical symptoms of acute mercury poisoning in infants include acute onset, rapid progression, severe illness with respiratory symptoms that may result in pneumothoraces and aspiration pneumonias.Case presentation: A 3-month-old girl presented with pneumothoraces and respiratory failure to the hospital. Two days before hospitalization, the girl had stayed in a room containing mercury vapor for several hours. She was hospitalized for acute mercury poisoning. We used sodium dimercaptosulphonate (DMPS) for treatment.Conclusion: Pulmonary disease was mainly induced by the inhalation of mercury vapor. The disease was characterized by acute respiratory distress, pneumothorax and acute chemical pneumonitis. It responded to chelation therapy with the agent DMPS. (C) 2016 Published by Elsevier B.V.