Children In Southern China Research Articles

Epidemiology, genetic characteristics, and association with meteorological factors of human metapneumovirus infection in children in southern China: A 10-year retrospective study

ObjectivesThis study aimed to determine the epidemiological and genetic features of human metapneumovirus (HMPV) infection in children in southern China, and the effect of meteorological factors on infection. Methods14,817 children (≤14 years) with acute respiratory tract infections from 2010 to 2019 were examined for HMPV and other respiratory viruses by real-time quantitative polymerase chain reaction. Full-length F gene of 54 positive samples were sequenced and subjected to phylogenetic analysis. The correlation between the HMPV-positive rate and meteorological factors was analyzed by linear regression analysis. ResultsHMPV was detected in 524 (3.5%) children, who were mostly younger than 1 year. The seasonal peak of HMPV prevalence mainly occurred in spring. Respiratory syncytial virus was the most common virus coinfected with HMPV (5.3%). Phylogenetic analysis revealed that the sequenced HMPV strains belonged to four sublineages, including A2b (1.9%), A2c (31.5%), B1 (50.0%), and B2 (16.7%). After adjusting for all meteorological factors, sunshine duration was inversely correlated with the HMPV-positive rate. ConclusionHMPV is an important respiratory pathogen that causes acute respiratory tract infections in children in southern China, particularly in children ≤5 years old. The prevalence peak of HMPV in this area appeared in spring, and the predominant subtype was B1. Meteorological factors, especially long sunshine duration, might decrease the HMPV prevalence.

Bacterium detected by gram stain and drug sensitivity in Chinese children with acute sinusitis

BackgroundAcute rhinosinusitis (ARS) is one of the common diseases of upper respiratory tract infection in children. Bacterial infection is a significant aggravating factor in pediatric ARS. In this research, our goal was to detected the bacterial flora and antibiotic sensitivity of ARS in Chinese children.MethodsWe recruited 133 children with ARS between January 2020 and January 2022 from our hospital. Sinus secretion were collected and cultured for Gram stain as well as antimicrobial susceptibility tests.ResultsMoraxella catarrhalis, Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae and Pseudomonas aeruginosa were detected in order in children with ARS, of which 25% were negative for bacterial culture and 10% were positive for two strains. Amoxicillin and clavulanate potassium were useful for Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis. Quinolones are useful for Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae and Pseudomonas aeruginosa.ConclusionsThis research updates the proportion of ARS bacterial infection in children in southern China and the antibiotic sensitivity.

Estimation of indoor soil/dust-skin adherence factors and health risks for adults and children in two typical cities in southern China

Soil/dust (SD) skin adherence is key dermal exposure parameter used for calculating the health risk of dermal exposure to contaminants. However, few studies of this parameter have been conducted in Chinese populations. In this study, forearm SD samples were randomly collected using the wipe method from population in two typical cities in southern China as well as office staff in a fixed indoor environment. SD samples from the corresponding areas were also sampled. The wipes and SD were analyzed for tracer elements (aluminum, barium, manganese, titanium, and vanadium). The SD-skin adherence factors were 14.31 μg/cm2 for adults in Changzhou, 7.25 μg/cm2 for adults in Shantou, and 9.37 μg/cm2 for children in Shantou, respectively. Further, the recommended values for indoor SD-skin adherence factors for adults and children in Southern China were calculated to be 11.50 μg/cm2 and 9.37 μg/cm2, respectively, which were lower than the U.S. Environmental Protection Agency (USEPA) recommended values. And the SD-skin adherence factor value for the office staff was small (1.79 μg/cm2), but the data were more stable. In addition, PBDEs and PCBs in dust samples from industrial and residential area in Shantou were also determined, and health risks were assessed using the dermal exposure parameters measured in this study. None of the organic pollutants posed a health risk to adults and children via dermal contact. These studies emphasized the importance of localized dermal exposure parameters, and further studies should be conducted in the future.

Fecal carriage and molecular epidemiology of mcr-1-harboring Escherichia coli from children in southern China

BackgroundThe increase of multidrug-resistant Enterobacteriaceae bacteria has led to the reintroduction of colistin for clinical treatments, and colistin has become a last resort for infections caused by multidrug-resistant bacteria. Enterobacteriaceae bacteria carrying the mcr-1 gene are majorly related to colistin resistance, which may be the main reason for the continued increase in the colistin resistance rate of Enterobacteriaceae. The study aimed to investigate the sequence type and prevalence of Escherichia coli (E. coli) harboring the mcr-1 gene in the gut flora of children in southern China. MethodsFecal samples (n = 2632) of children from three medical centers in Guangzhou were cultured for E. coli. The mcr-1-harboring isolates were screened via polymerase chain reaction (PCR). The colistin resistance transfer frequency was studied by conjugation experiments. DNA sequencing data of seven housekeeping genes were used for multi-locus sequence typing analysis (MLST). ResultsPCR indicated that 21 of the 2632 E. coli (0.80%) isolates were positive for mcr-1; these strains were resistant to colistin. Conjugation experiments indicated that 18 mcr-1-harboring isolates could transfer colistin resistance phenotypes to E. coli J53. MLST analysis revealed that the 21 isolates were divided into 18 sequence types (STs); E. coli ST69 was the most common (14.3%), followed by E. coli ST58 (9.5%). ConclusionThese results demonstrate the colonization dynamics and molecular epidemiology of E. coli harboring mcr-1 in the gut flora of children in southern China. The mcr-1 gene can be horizontally transmitted within species; hence, it is necessary to monitor bacteria that harbor mcr-1 in children.

Preliminary study on genetic factors related to Demirjian's tooth age estimation method based on genome-wide association analysis.

The age determination of individuals, especially minors, is critical in forensic research. In forensic practice, dental age estimation is one of the most commonly used methods for determining age as teeth are easy to preserve and relatively resistant to environmental factors. Tooth development is affected and regulated by genetic factors; however, these are not incorporated into current commonly used tooth age inference methods, leading to unreliable results. Here, we established a Demirjian and a Cameriere tooth age estimation-based methods suitable for use in children in southern China. By using the difference between the inferred age and the actual age (MD) as the phenotype, we identified 65 and 49 SNPs related to tooth age estimation from 743,722 loci among 171 children in southern China through a genome-wide association analysis (p<0.0001). We also conducted a genome-wide association study on dental development stage (DD) using the Demirjian tooth age estimation method and screened two sets of SNP sites (52 and 26) based on whether age difference was considered. The gene function enrichment analysis of these SNPs found that they were related to bone development and mineralization. Although SNP sites screened based on MD seem to improve the accuracy of tooth age estimation, there is little correlation between these SNPs and an individual's Demirjian morphological stage. In conclusion, we found that individual genotypes can affect tooth age estimation, and based on different phenotypic analysis models, we have identified some novel SNP sites related to tooth age inference and Demirjian's tooth development stage. These studies provide a reference for subsequent phenotypic selection based on tooth age inference analysis, and the results could possibly be used in the future to make forensic age estimation more accurate.

Association between the PPARGC1A Gly482Ser polymorphism and muscle fitness in Chinese schoolchildren.

Muscle health is essential for children's physical development and future health. PPARGC1A gene encode the peroxisome proliferator-activated receptor coactivator 1α which coactivates transcription factors that control mediating skeletal muscle fiber type conversion and skeletal muscle fiber formation. The PPARGC1A rs8192678 Gly/Ser (Gly482Ser) polymorphism was associated with the regulation of skeletal muscle fibre type. This paper aims to explore the association between the PPARGC1A rs8192678 (Gly482Ser) polymorphism and muscle fitness in Chinese schoolchildren. We detected the distribution of the PPARGC1A rs8192678 (Gly482Ser) polymorphism by DNA typing of saliva samples from untrained Southern Chinese Han children aged 7-12 years. Considering that muscle studies in children cannot use invasive sampling, we analyzed the association between alleles and genotypes with high validity tests of muscle fitness assesment in children(handgrip strength, standing long jump, sit-ups and push-ups). The results showed no significant differences in height, weight or body mass index between the sexes. The grip strength indicators were correlated with age in boys and height and weight in girls. Sit-ups were significantly higher in girls with the PPARGC1A Gly/Gly genotype than in boys, and handgrip strength and standing long jump were significantly lower in girls with the PPARGC1A rs8192678 (Gly482Ser) genotype than in boys. Genetic model analysis showed that the Gly482 allele had a dominant genetic effect on the Gly482 allele is hypothesized to influence the expression of type I fibers in skeletal muscle in girls, while the Ser482 allele affects on type II fibers in girls. The two alleles had little genetic effect on boys. The results suggested the possible association of the PPARGC1A rs8192678 (Gly482Ser) polymorphism on myofibril type-related phenotypes in Han Chinese children in southern China, with a particular impact on girls.

Component-Resolved Analyses for Diagnosis of Food Allergies in Infants and Young Children in Southern China

Introduction: Chicken eggs and cow’s milk are two of the most common foods that cause allergic reactions in infants and young children, and there is a lack of precise diagnostic methods to identify the allergic state of these patients. The recently developed food allergen component-resolved diagnosis (CRD) may be a more accurate diagnosis method for food allergies. Methods: One hundred children sensitized to egg white and milk crude extracts and diagnosed with or suspected allergic disease were included. The specific immunoglobulin E (sIgE) (s) of animal food allergen crude extracts (egg yolk, milk, shrimp, crab, cod, beef) and the main components of egg white and milk were tested. The sensitization characteristics, cross-reactivity, and clinical relevance were analyzed. Results: The results of egg white-sensitized patients showed that ovalbumin (Gal d 2) had the highest positive rate of 100%. Compared with other pairwise combinations of egg allergens, the combination of egg white and Gal d 2 had higher diagnostic accuracy, with an AUC of 0.876 (95% CI: 0.801–0.951), a sensitivity of 88.9%, and a specificity of 75.9%. The positive rates of beta-lactoglobulin (Bos d 5) and alpha-lactoglobulin (Bos d 4) in the milk-sensitized children were comparable, 92% and 91%, respectively. The combination of crude milk extract and Bos d 4 had the highest diagnostic accuracy, with an AUC of 0.969 (95% CI: 0.938–0.999), a sensitivity of 100%, and a specificity of 82.7%. Conclusion: Among these subjects, our study found the main allergenic component of egg white was Gal d 2, and the main allergenic components of milk were Bos d 4 and Bos d 5. CRD may help identify egg/milk allergies and non-allergies.

Associations of PART1 and DEFB1 polymorphisms with Dental Caries in twelve-year-old children in Southern China: a cross-sectional study

Objective:The aim of this study was to assess associations of PART1 rs27565 and DEFB1 rs11362 polymorphisms with the prevalence of dental caries in twelve-year-old children in Nandan County, Guangxi, China.Methods:A total of 1,061 children were included in this cross-sectional study and divided into two groups based on the Decayed, Missing and Filled teeth (DMFT) index: caries-free children (DMFT score = 0) and children with caries (DMFT score ≥ 1). Demographic characteristics, oral hygiene behaviour and dietary habits were collected through household records and questionnaires. Genomic DNA was extracted from buccal cells, and PART1 rs27565 and DEFB1 rs11362 polymorphisms were genotyped using a custom-designed 48-Plex single nucleotide polymorphism-scan kit.Results:Carriers of the PART1 rs27565 C allele (odds ratio [OR] = 1.338, 95% confidence interval (CI) = 1.015–1.764, P value = 0.039) and carriers of the DEFB1 rs11362 T allele (OR = 1.364, 95% CI = 1.056–1.762, P value = 0.017) had a higher risk of caries. Carriers of the PART1 rs27565 TC or CC genotype who ate sugary food more than once a week had a 1.6-fold higher risk of caries than TT carriers who ate sugary food at most once a week (OR = 1.579, 95% CI = 1.032–2.414, P value = 0.035). Carriers of the DEFB1 rs11362 CT or TT genotype who ate sugary food more than once a week had a 2.1-fold higher risk of caries than CC carriers who ate sugary food at most once a week (OR = 2.057, 95% CI = 1.438–2.940, P value < 0.001).Conclusion:PART1 rs27565 and DEFB1 rs11362 polymorphisms were associated with caries in 12-year-old children in Nandan County, Guangxi, China. Carriers of the PART1 rs27565 TC or CC genotype and the DEFB1 rs11362 CT or TT genotype who ate sugary food more than once a week had a high probability of having caries.

Seroepidemiology of enterovirus A71 infection in prospective cohort studies of children in southern China, 2013-2018

Enterovirus A71 (EV-A71)–related hand, foot, and mouth disease (HFMD) imposes a substantial clinical burden in the Asia Pacific region. To inform policy on the introduction of the EV-A71 vaccine into the National Immunization Programme, we investigated the seroepidemiological characteristics of EV-A71 in two prospective cohorts of children in southern China conducted between 2013 and 2018. Our results show that maternal antibody titres declined rapidly in neonates, with over half becoming susceptible to EV-A71 at 1 month of age. Between 6 months and 2 years of age, over 80% of study participants were susceptible, while one third remained susceptible at 5 years old. The highest incidence of EV-A71 infections was observed in children aged 5-6 months. Our findings support EV-A71 vaccination before 6 months for birth cohorts in southern China, potentially with a one-time catch-up vaccination for children 6 months-5 years old. More regionally representative longitudinal seroepidemiological studies are needed to further validate these findings.

Clinical characteristics and long-term outcomes of 12 children with vitamin D-dependent rickets type 1A: A retrospective study.

Vitamin D-dependent rickets type 1A (VDDR1A) is a rare autosomal recessive disorder caused by deficiency of the CYP27B1 gene. This study aims to investigate the phenotypic and genotypic features of VDDR1A children in southern China and evaluate the long-term therapeutic effects. Twelve children from southern China with VDDR1A were enrolled in this study. Their clinical, radiological, biochemical, and molecular findings were analyzed retrospectively. The rickets severity score (RSS), biochemical parameters, and height standard deviation score (HtSDS) were used to evaluate clinical outcomes. Six males and six females were included in this VDDR1A cohort. The age of onset was from 6 months to 1.8 years, and the age at diagnosis was 2.1 ± 0.8 years. The most common clinical symptoms at diagnosis were delayed walking (10/12) and severe growth retardation (9/12). HtSDS at diagnosis was negatively associated with age (p < 0.05). All patients presented with hypocalcemia, hypophosphatemia, increased serum alkaline phosphatase and parathyroid hormone, and high RSS at diagnosis. Two allelic variants of the CYP27B1 gene were identified in all patients, including nine different variants, four known and five novel, with c.1319_1325dupCCCACCC(p.Phe443Profs*24) being the most frequent. All patients were treated with calcitriol and calcium after diagnosis, and all patients but one were followed-up from 6 months to 15.6 years. HtSDS, RSS, and biochemical parameters were found to be improved during the first few years of the treatment. However, only five patients had good compliance. Although RSS and biochemical parameters were significantly improved, the HtSDS change was not significant from the time of diagnosis to the last visit, and seven patients remained of a short stature (HtSDS < -2). Our study extends the mutational spectrum of VDDR1A and finds a hotspot variant of the CYP27B1 gene in southern China. The results reconfirm the importance of early diagnosis and treatment compliance and reveal the challenge of height improvement in VDDR1A patients.

Human adenovirus (HAdV) infection in children with acute respiratory tract infections in Guangzhou, China, 2010–2021: a molecular epidemiology study

BackgroundHuman adenovirus (HAdV) infection can cause a variety of diseases. It is a major pathogen of pediatric acute respiratory tract infections (ARIs) and can be life-threatening in younger children. We described the epidemiology and subtypes shifting of HAdV among children with ARI in Guangzhou, China.MethodsWe conducted a retrospective study of 161,079 children diagnosed with acute respiratory illness at the Guangzhou Women and Children’s Medical Center between 2010 and 2021. HAdV specimens were detected by real-time PCR and the hexon gene was used for phylogenetic analysis.ResultsBefore the COVID-19 outbreak in Guangzhou, the annual frequency of adenovirus infection detected during this period ranged from 3.92% to 13.58%, with an epidemic peak every four to five years. HAdV demonstrated a clear seasonal distribution, with the lowest positivity in March and peaking during summer (July or August) every year. A significant increase in HAdV cases was recorded for 2018 and 2019, which coincided with a shift in the dominant HAdV subtype from HAdV-3 to HAdV-7. The latter was associated with a more severe disease compared to HAdV-3. The average mortality proportion for children infected with HAdV from 2016 to 2019 was 0.38% but increased to 20% in severe cases. After COVID-19 emerged, HAdV cases dropped to 2.68%, suggesting that non-pharmaceutical interventions probably reduced the transmission of HAdV in the community.ConclusionOur study provides the foundation for the understanding of the epidemiology of HAdV and its associated risks in children in Southern China.

Urinary metabolites and handwipe phthalate levels among adults and children in southern China: Implication for dermal exposure

Paired handwipe and urine samples were collected from adult (n = 130) and child (n = 82) residents of a typical urban community in southern China to examine relationships between external and internal exposure as well as the contribution of dermal absorption to the exposure of phthalates. The concentrations and composition profiles of phthalates were similar in handwipes from both adults and children, and contained mainly di-2-ethylhexyl phthalate (DEHP), di-n-butyl phthalate (DnBP) and di-iso-butyl phthalate (DiBP), consistent with profiles of phthalates in air and dust. The major metabolites of these phthalates, i.e., mono-n-butyl phthalate (mnBP) from DnBP, mono-iso-butyl phthalate (miBP) from DiBP and three metabolites of DEHP (namely mEHP, mEHHP and mEOHP) were widely detected in paired urine samples. Positive correlations were found between contamination levels of DiBP and DnBP in handwipes and their corresponding urinary metabolites, whereas no significant correlation was observed for DEHP. This suggests that dermal absorption might be an important exposure pathway particularly for low molecular weight phthalates. Our study shows that dermal absorption is a non-negligible exposure pathway for phthalates, to which children are particularly sensitive since the contribution of dermal uptake to the internal exposure of phthalates was higher in children than adults.

Prevalence of Visual Impairment in Preschool Children in Southern China.

PurposeThe goal of this study is to assess the prevalence and distribution of visual impairment in preschool children in southern China.MethodsPreschool children aged 36–83 months were enrolled in a vision screening program in Shantou City. Visual acuity test and non-cycloplegic refraction were conducted. According to the American Academy of Ophthalmology (AAO) guidelines, visual impairment was defined as uncorrected visual acuity (UCVA) in either eye <20/50, 20/40, and 20/32 in children aged 36–47, 48–59, and 60–83 months, respectively, as well as an interocular difference (IOD) of ≥ two lines of UCVA.ResultsThe UCVA test was successfully performed on 7,880 children (94.6% of the enrolled population). A total of 938 (11.9%; 95% CI 11.2–12.6) children were found to have reduced UCVA in the worse eye, and 393 (5%; 95% CI 4.5–5.5) of the children had an IOD of two or more lines. Combining the reduced UCVA with the IOD criteria identified 1,032 (13.1%; 95% CI 12.4–13.8) children with visual impairment. UCVA in preschool children improves with age naturally and boys have slightly better age-adjusted UCVA than girls. Causes of reduced visual acuity included uncorrected refractive error, amblyopia, congenital cataract, and others. The cylindrical diopter in the right eye of children with reduced vison was higher than that of children with normal vision (1.19 ± 1.05 vs. 0.52 ± 0.49, P < 0.001). A total of 146 (1.9%, 95% CI 1.6–2.2) of the preschool children wore spectacles. The proportion of wearing spectacles increased with age (χ2 = 35.714, P < 0.001), but with IOD increasing by.1 logMAR, the odds of wearing spectacles decreased by 44.8%.ConclusionThis study provided data on the prevalence of visual impairment in preschool children in China by large-scale school-based vision screening. Further studies should be conducted to verify the benefit from vision screening.

Characteristics and Prognosis of Talaromyces marneffei Infection in HIV-positive Children in Southern China.

Knowledge about the clinical characteristics and prognostic factors of Talaromyces marneffei infection in children is limited, especially in HIV-positive children. We performed a retrospective study of all HIV-positive pediatric inpatients with T. marneffei infection in a tertiary hospital in Southern China between 2014 and 2019 and analyzed the related risk factors of poor prognosis using logistic regression. Overall, 28 cases were enrolled and the prevalence of talaromycosis in AIDS children was 15.3% (28/183). The median age of the onset was 8years (range: 1-14years). The typical manifestation of skin lesion with central umbilication was not common (21.4%). All the children had very low CD4+ cell counts (median 13.5 cells/μL, range: 3-137 cells/μL) on admission. 92.9% children were misdiagnosed and talaromycosis was only noted after positivity for HIV infection. 89.3% diagnoses of T. marneffei infections were based on positive blood cultures, with a long culture time (median 7days, range from 3-14days). The sensitivity of fungus 1,3-β-D-glucan assay was 63.2%. Amphotericin B was superior to itraconazole in the induction antifungal therapy of talaromycosis in HIV-positive children. A six-month follow-up revealed a 28.6% mortality. Lower ratio of CD4+/CD8+ and amphotericin B treatment not over 7days predicted poor prognosis. Our retrospective study provided an overview and update on the current knowledge of talaromycosis in HIV-positive children. Pediatricians in endemic areas should be aware of mycoses to prevent misdiagnosis. 1,3-β-D-glucan assay did not show optimal sensitivity. Amphotericin B treatment over 7days can improve poor prognosis.

Early Diagnosis of Wilson's Disease in Children in Southern China by Using Common Parameters.

Objective: The aim of the study was to develop the early diagnostic criteria for Wilson’s disease (WD) in young children in southern China by using alanine aminotransferase (ALT) elevation as the first manifestation. Methods: A cross-sectional retrospective analysis of the clinical data and genetic test results of children with WD in southern China in the past 4 years and the follow-up of their short-term prognosis were performed in this study. Results: A total of 30 children (5.08 ± 2.06 years old) with elevated ALT as the first manifestation of WD in southern China were enrolled in this study, including 14 females and 16 males. Specifically, in all of the 30 cases (100%), the serum ceruloplasmin (CP) level was decreased, whereas the 24-h urinary copper level was increased. The genetic mutation test of the ATP7B gene was used to confirm the diagnosis. In particular, the two mutation sites, including p.R778L and p.I1148T, had the highest mutation frequencies, approximately 23.0 and 10.7%, respectively. Through follow-up, most of the children had good recovery. Conclusion: Early diagnosis and treatment of WD would substantially increase the survival rate and have a better prognosis. In addition, in 5-year-old children from southern China, early diagnosis could be performed quickly by referring to the following three parameters: elevated ALT, decreased ceruloplasmin level, and increased 24-h urinary copper level. It lays a foundation for further studies with a larger sample size.

Anemia of School-Age Children in Primary Schools in Southern China Should Be Paid More Attention despite the Significant Improvement at National Level: Based on Chinese Nutrition and Health Surveillance Data (2016-2017).

Globally, anemia among school-age children (SAC) remains a serious public health problem, impacting their growth, development, educational attainment and future learning potential. National and subnational anemia prevalence among SAC in China has not been assessed recently. Based on data from Chinese Nutrition and Health Surveillance (2016–2017), the current anemia status of SAC in primary schools in China was investigated. Anemia prevalence of SAC in primary schools in China was 4.4%, dropping 63.6% compared with that in 2002. Even though anemia was no longer a significant public health problem at the national level, there were significant spatial disparities of anemia prevalence in different areas: anemia prevalence in 63% of provinces of northern and eastern China has lowered to below 5%, while in provinces of southern China, it was still ranging from 5% to 11.0%, about 3 times of other areas. For those children in southern China, mother’s education level (OR = 1.24, p = 0.04) and father’s education level (OR = 1.27, p = 0.01) below senior high school, eating meat less than 3 times per week (OR = 1.18, p = 0.01) were risk factors of anemia. Older age (OR = 0.35–0.72, p < 0.01) was a protective factor. Targeted interventions should be taken to improve SAC anemia in Southern China, despite anemia of SAC in primary schools no longer being a significant public health problem.

Unintentional injuries and risk behaviours of internal migrant children in southern China: A cross-sectional study.

The purpose of this study was to estimate the prevalence of unintentional injuries and to identify factors mediating the risk of unintentional injuries among internal migrant children in southern China using self-reported data collected between April 2016 and March 2017. Logistic regression models were used to identify significant risk factors for unintentional injuries among the internal migrant children. The prevalence of self-reported unintentional injuries among internal migrant children in this study was 19.15%. Internal migrant children exhibiting antisocial (antisocial behaviour vs. no behaviour problems, OR=2.162, 95% CI: 1.194-3.915, p=.011) and neurotic behaviours (neurotic behaviour vs. no behaviour problems, OR=2.064, 95% CI: 1.098-3.880, p=.024) were more likely to report unintentional injuries. There was a positive correlation between the number of risk behaviours and the prevalence of unintentional injuries among non-migrant and internal migrant children. Children's behavioural problems were closely related to unintentional injuries and may be useful as predictors of unintentional injuries in children.

Parvovirus B19 associated autoantibodies upregulation in women and children in Southern China

Abstract Objectives Human parvovirus B19, the cause of fifth disease in children and transient arthropathy in adults, could induce autoimmunity and the production of autoantibodies. The aim of this study is to explore the relationship between B19 infection and autoantibodies upregulation in women and children. Methods Of 512 women and children in our hospital between 2016 and 2018, all cases simultaneously test anti-B19 IgM and autoantibodies like anti-nuclear antibody, anti-Sm and anti-double stranded DNA antibody were included in this study. Results Parvovirus B19 infection could significantly upregulate anti-nuclear antibody and anti-Sm, but not anti-double stranded DNA, the titer of autoantibodies is associated with the content of anti-B19 IgM, and the infection in children is accompanied with more obvious autoantibodies upregulation. Conclusions Our data shows that parvovirus B19 infection is related to autoantibodies production in both women and children, and the status of infection may associate with the titer of autoantibodies in parvovirus B19 infected patients.

DNA Methylation Biomarkers of IQ Reduction are Associated with Long-term Lead Exposure in School Aged Children in Southern China.

Although lead associated with intelligence decline in children has long been reported, studies combining intelligence determination, molecular mechanisms exploration, and biomarker screen are quite rare. In this study, based on 333 children aged 9-11, we determined the role of DNA methylation (DNAm) in the relationship of lead exposure with children's intelligence. DNAm was measured from children's blood DNA specimens, and mediation analysis was performed to identify DNAm biomarkers mediating the lead-intelligence relationship. We identified forty-three differentially methylated regions (DMRs), and two fragments (FAM50B1 and PTCHD3) significantly mediated the lead-intelligence relationship, with contribution rates of 30.36% (p = 0.010) and 60.36% (p < 0.001), respectively. In addition, blood lead levels (BLLs) lower than 100 μg/L still adversely affected children's IQs and DNAm of the two fragments. Our data suggests that DNAm mediates lead-associated cognitive delay in children and blood lead reference value for school-aged children (100 μg/L) should be revised, and the candidate biomarkers can be used in related neurological diseases in future.

Breakfast preferences and consumption location among children at a median age of 7 in Shenzhen: Implications for managing overweight and obesity

BackgroundBreakfast is commonly described as the most important meal of the day; however, we have little information regarding its relevance for childhood overweight and obesity in southern mainland China. This study aimed to assess the association between breakfast preferences, consumption location and overweight and obesity for children in Shenzhen. MethodsAmong 6126 children (median age 7.2 years) at primary schools, 3504 were finally included after a questionnaire survey and physical examination. Ten commonly consumed foods/beverages for breakfast in southern China were exposure variables, and consumption location, total energy demographic and other dietary characteristics were covariates in logistic regression to determine the effect of breakfast preferences on overweight and obesity, estimating odds ratios (ORs) and 95% confidence intervals (CIs). ResultsProbability of overweight/general obesity was inversely associated with children eating plain congee for breakfast (adjusted OR 0.689, 95% CI 0.566–0.838), restricted to boys after stratification. Probability of overweight/general obesity and central obesity was positively associated with usually eating steamed rice roll for breakfast (OR 1.309, 95% CI 1.090–1.571 and OR 1.351, 95% CI 1.064–1.717, respectively), but the effect on overweight/obesity remained statistically significant for only boys after stratification. Eating steamed rice roll for breakfast and eating out for breakfast had an additive interaction on overweight/obesity. Additionally, eating bread for breakfast had a mild favorable effect on overweight/obesity but only for girls. ConclusionsKeeping a healthy weight might benefit children who eat plain congee or bread for breakfast in China. However, frequent consumption of steamed rice roll for breakfast and especially eating out could contribute to overweight and obesity. Thus, we need to promote a healthier breakfast pattern among children in southern China to reduce the odds of obesity.