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Background: Since publication in 2006, the Bayley-III scale has been used widely in pediatric populations worldwide; however, there have been very few studies which examined the usefulness and the potential sex differences in a Chinese context.\ud \ud Aims: To assess the reliability and validity of the Bayley-III cognitive scale, and detect possible sex differences in term children so as to provide evidence for clinical and research use in China.\ud \ud Study design: Cross-sectional study.\ud \ud Participants and outcome measures: Of the 1589 children from 3 healthcare institutions that were initially recruited, a total of 1444 children were included in the final analysis. We randomly selected 5-10% children from the total sample to evaluate the test–retest, inter-rater and criteria-related reliability in order to meet the psychometric criteria of Bayley-III scale. Inter-item consistency, test-retest and inter-rater reliability of the scale were estimated using Split-half method and Intra-class Correlation Coefficient (ICC). The content validity was evaluated by the Item-level Content Validity Index (I-CVI). The Mann-Kendall trend test was performed to assess trends of cognitive development, and post-hos Least Significant Difference test was used to detect age-appropriateness of items.\ud \ud Results: Six developmental pediatricians were trained to administer the Bayley-III cognitive scale. Inter-item consistency (n=1444) with Guttman split-half coefficient was above 0.8, while test-retest (n=144) and inter-rater reliability (n=74) had good to excellent ICCs of over 0.9. The criteria-related validity (n=74) of Bayley-III was acceptable, and associations with Gesell Developmental Schedules (GDS) were mainly above 0.8. The raw score of Bayley-III scale in total subjects (n=1444) showed an increased trend across all months of age (p

Runx3, a member of the Runt-related transcription factor family, has attracted extensive attention due to its important role in the development of immune systems, especially in the differentiation of T cells. Accumulated evidence indicated that altered expression of Runx3 regulates a variety of target genes in different tissues/cells. Studies in animal models suggested that Runx3 may regulate the development of T cell lineage including those of innate lymphoid cells, Treg cells and dendritic cells, which may contribute to the development of hypersensitivity and asthma. Specifically, Runx3 modulates Th1/Th2 balance and hence, the production of interleukins, which induce inflammatory responses. Understanding the roles and mechanisms of Runx3 in the regulation of immune function provides a basis for the design of novel preventive and treatment models for bronchial asthma. This article reviews published data from cell lines, animal models, and patients, concerning the relationship between Runx3 expression alteration and asthma. Epigenetic regulation of Runx3 by DNA hypermethylation and microRNA, and the implication of these pathways in asthma are also discussed.

Supplemental material, IMR902579 Supplemental Material for Establishing an early identification score system for cerebral palsy based on detailed assessment of general movements by Yuqing Wang, Ping Zhu, Zhongxiu Yang and Guixiong Gu in Journal of International Medical Research

The present study aimed to explore the function of miR‑34b promoter methylation in cell proliferation in children's acute leukemia. Quantitative PCR and methylation‑specific PCR were performed to measure the levels of miR‑34b and its promoter methylation in normal cells, eight leukemia cell lines as well as primary leukemic cells isolated from patients newly diagnosed with acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML) and mixed lymphocytic lymphoma. miR‑34b levels in leukemia cell lines and primary leukemic cells were significantly lower than those in normal cells. The miR‑34b promoter was found to be methylated in all leukemia cell lines, 24 of 31 ALL patients and 8 of 19 AML patients, but not in the 23 normal controls. miR‑34b expression and methylation of its promoter were not associated with most clinical parameters assessed; however, miR‑34b levels in prednisone‑sensitive ALL were significantly different from those in insensitive ALL. A cell counting kit‑8 assay showed that transfection of miR‑34b mimics into K562 cells inhibited their proliferation. Furthermore, treatment with the demethylating agent 5‑aza‑2‑deoxycytidine significantly enhanced miR‑34b expression levels and decreased the methylation status of its promoter in HL‑60 and K562 cells. In conclusion, the results of the present study indicated that in pediatric leukemia cells and leukemia cell lines, the expression of miR‑34b is inhibited by methylation of its promoter, which impairs the restraining effects of miR‑34b on cell proliferation. It was also indicated that the expression of miR‑34b in ALL patients may affect their response to early treatments.

Objective This retrospective study aimed to establish an early identification score system of cerebral palsy (CP) in the writhing movement period of high-risk infants by detailed assessment of general movements (GMs). Methods High-risk infants from our hospital during January 2016 to January 2017 were included. GMs were assessed and a detailed score was calculated. The 52-neuromotor examination for 0- to 1-year-olds was performed and follow-up outcome was determined at the 12th month according to CP diagnostic criteria. An early identification score of detailed assessment was established in the writhing movement period of infants. Results The detailed score during the writhing movement period was significantly different among the normal, poor repertoire, and cramped-synchronized groups of GMs ( F = 208.186). Detailed scores were positively related to 52-neuromotor examination scores, with a correlation coefficient of 0.218. The predictive validity of the early identification score was 92.11%, sensitivity was 100%, specificity was 90.00%, the positive predictive value was 72.73%, the negative predictive value was 100%, the false positive rate was 10, and the false negative rate was 0. Conclusion The detailed GM score in the writhing movement period is correlated with 52-neuromotor examination results. The CP early identification score could be useful in clinical practice.

To explore advantages and challenges for exclusive breastfeeding (EBF), compared to non-exclusive breastfeeding (nEBF).Mothers from 7 cities in China were visited at 3, 10, 60, 120, and 180 days postpartum. Data about feeding practices, infant growth, and the macronutrient contents of human milk (HM) were collected.130 lactating mothers attended 5 visits. 59 mothers (45.4%) exclusively breastfed infants for 0-4 month. Frequencies of breastfeeding per day were higher in the EBF group than the nEBF group at day 3, 10, 120 and 180, and were less than 8 times per day in the nEBF group. For Weight-for-age z scores, there were no differences between the two groups. Length-for-age z score was greater in the nEBF group at day 180 (0.74±1.05 vs 0.33±1.28). Weight-for-length z scores were greater in the EBF group at day 120 and 180 (day 120: 0.88±1.08 vs 0.36±1.1, day 180: 1.1±0.94 vs 0.54±1.07). The average protein and lactose contents of HM in the nEBF group were higher than in the EBF group at day 10.For nEBF infants, intake of formula replaced intake of breastmilk, due to lack of breastfeeding frequency, which did not bring weight gain for nEBF infants. During the introduction of complementary foods, EBF infants needed complementary nutrients to support growth. Therefore, lactating mothers may need to provide appropriate complementary feeding and maternal leave extension to attend to their infant's nutritional requirements. The criteria for linear growth may also need to be more commensurate with breastfeeding and relevant to later health outcomes.

Ghrelin is an endogenous ligand of growth hormone (GH) secretagogue receptor (GHSR) and has a number of biological effects, including heart protection. The present study aimed to reveal the positive effect of ghrelin on myocardium with hypoxia/reoxygenation (H/R) treatment and the involved molecular mechanisms. Successful construction of lentiviral expression vector (ghrelin-pLVX-Puro) was confirmed by colony polymerase chain reaction (PCR) verification. Primary rat cardiac myocytes were isolated and identified by immunofluorescence staining. Existence of red fluorescence of α-sarcomeric actinin indicated the successful isolation. Following ghrelin transfection and H/R treatment, primary cells were divided into four groups: Control, H/R, empty (empty pLVX-Puro + H/R) and ghrelin (ghrelin-pLVX-Puro + H/R). Cell viability and apoptosis were evaluated by Cell Counting Kit-8 (CCK-8) and Hoechst staining, respectively. The cell viability in the ghrelin group was significantly higher than that in the empty control group (P

Background Urine is a good alternative body fluid for gonadotropin studies. There was limited information about the effects of different storage conditions on urinary gonadotropin measurement by using immunochemiluminometric assay (ICMA). Methods ICMA was used to determine gonadotropin in urine stored under different conditions, such as different pH, storage time, and cycles of freeze-thaw. Results Luteinizing hormone (LH) level was not significantly affected at pH 2.5 to 10.5 or being stored at 4°C for 3 days. Follicular stimulating hormone (FSH) level was not significantly changed at pH 3.5 to 10.5 or throughout 49-day storage at 4°C in the absence of glycerol. LH was significantly decreased after freeze-thawing twice, while FSH was resistant to freeze-thaw procedures. Conclusions LH and FSH can be determined by ICMA in normal urine pH range (4.6 ~ 8.0). Urine LH is more sensitive to long-term storage and multiple freeze-thaw procedures than FSH.

ObjectivesThis study aimed to explore the cognitive development of low-risk children during early childhood for early-term births at 37 and 38 weeks of gestation compared with full term births at 39–41 weeks of gestation.Setting and participantsWe conducted a cross-sectional study in Shanghai, one of the largest cities in China. A total of 1444 children from singleton pregnancies born at term gestation were included in the study.MeasuresThe cognitive outcomes of the subjects were measured using the cognitive subtest of Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) across three cities in China. We analysed the association between gestational age and cognitive development during infancy and toddler stages using multivariate linear modelling.ResultsThe cognitive development scores for infants born at 37 gestational weeks were significantly lower than those born at 39–41 gestational weeks (β=−2.257, 95% CI −4.280 to −0.235; p0.05). Moreover, these effects were not found in toddlers (between 17 and 48 months of age) after adjusting for the possible confounders (p>0.05).ConclusionsInfants born at 37 weeks of gestation exhibited weaker cognitive ability compared with those born at 39–41 weeks of gestation. Our findings provide evidences for the close monitoring of potential developmental problems in early-term children, especially those born at 37 gestational weeks.

Inappropriate inflammatory response in children with M. pneumoniae infection might be associated with disease severity. The role of Granulocyte macrophage colony stimulating factor (GM-CSF) in hospitalized children with Mycoplasma pneumoniae pneumonia (MPP) has not been fully discussed.Clinical and laboratory data of a total 40 children with MPP were collected. GM-CSF and myeloperoxidase (MPO) were detected by ELISAs. Meanwhile, normal human bronchial epithelium was infected by M. pneumoniae and neutrophils were stimulated by GM-CSF to explore GM-CSF and MPO release in supernatant, respectively.Compared to control group, a significant increased percentage of neutrophils and decreased percentage of macrophages in bronchoalveolar lavage fluid of children with MPP was observed (P 0.05). Children with MPP had significantly higher levels of GM-CSF (P = 0.0047) and MPO (P = 0.0002) in BALF compared to the controls. Level of GM-CSF in BALF was associated with duration of fever (r = 0.42, P = 0.007) and strongly correlated with level of MPO (r = 0.075, P = 0.0005). Levels of GM-CSF and MPO significantly decreased (both P 0.05) after treatment. In vitro, M. pneumoniae induced GM-CSF expression in a time-dependent manner during a 72-h period (P 0.05) and MPO secretion significantly increased by recombinant human GM-CSF stimulation at 24h (P 0.05).GM-CSF could be induced by M. pneumoniae infection in vivo and vitro. Childen with high level GM-CSF had longer duration of fever. GM-CSF probably plays a vital role in neutrophil inflammation in M. pneumoniae infection.

Background: Although poor health conditions and decreased developmental levels have been investigated in migrant children, no study in China has focused on these children’s individual motor development. Objectives: This study aims to explore the prevalence of motor impairment in Chinese migrant children and to determine the contributory factors. Patients and Methods: In this cross-sectional study, a structured questionnaire was administered to primary caregivers of preschool children aged 3 - 6 (n = 2,976) in ten kindergartens from two districts of Suzhou, China, to assess the children’s home socioeconomic status and motor environment, that is, the presence of affordances for motor development. Motor ability was assessed using the Movement Assessment battery for children-second edition (MABC-2). Multiple logistic regression analysis was used to determine the risk factors for motor impairment in migrant children. Results: Migrant children showed correlations with impairment in manual dexterity, aiming and catching, and motor development (odds ratios [ORs] = 1.320, 1.255, 1.260, respectively; P < 0.05). Outdoor movement affordances and toys for fine motor development were significantly associated with motor impairment in migrant children (ORs = 0.834 [movement affordances, 0.843 [toys], P < 0.05). Conclusions: Chinese migrant children are at a high risk of motor impairment, which is associated with a lack of outdoor movement affordances and toys for fine motor development. Future prevention and intervention should focus on the motor environment of the home.

To analyze pupils' neglect status aged 6-11 years in China's rural.According to the principle of multi-stage stratified cluster sampling, to extract 7,943 pupils aged 6-11 years for the survey from 56 primary schools in 28 counties in nine provinces, from December 2012 to March 2013. Proceed questionnaire survey by the scale from "Neglect Evaluation Norms for pupils aged 6-8 years in Rural Areas of China" and "Neglect Evaluation Norms for pupils aged 9-11 years in Rural Areas of China". And analyze neglect rates and neglect degrees of the different grades, gender, family types and different levels of neglect.The total neglect rate of China's rural pupils aged 6-8 and 9-11 years was 40.2% (1,258/3,130) and 42.5% (1,498/3,526) respectively, which differences had no statistical significant (χ2=3.59, P=0.058); the total neglect degree was 46.04±8.87 and 44.78±10.43 respectively, which differences had statistical significant (t=5.01, P0.001); the differences of neglect rates and neglect degrees between male (41.4% (657/1,587) and 46.28±8.76) and female (39.0% (601/1,543) and 45.78±8.97) of aged 6-8 were all no statistical significant (χ2=1.87, P=0.171; t=1.49, P=0.136); the neglect rates and neglect degrees of male (46.3% (816/1,763) and 45.53±10.11) were higher than female (38.7% (682/1,763) and 44.06±10.69) in the group of aged 9-11, which differences were all statistical significant (χ2=20.84, t=3.97, P0.001); the male neglect rate in the group of aged 6-8 in social neglect (11.7% (198/1,691)) and the neglect degree in educational neglect (48.09±9.70) were higher than female (9.4% (155/1,648) and 47.37±9.89), which differences were all statistical significance (χ2=14.55, P0.001, t=2.22, P=0.026), the male neglect rate in the group of aged 9-11 in physical neglect (20.4% (398/1,954)) was higher than female (16.7% (326/1 957)), which differences had statistical significance (χ2=8.92, P=0.003).The neglect status of Chinese pupils aged 6-11 years in rural was serious, and we should find out risk factors and provide efficient prevention measures.

To investigate the major influence factors of child neglect among rural areas children aged 3-6 years in China.According to multi-stage stratified cluster sampling, distribution characteristics and the level of economic development, we randomly sampled 10 provinces, 26 cities (8 capital cities, 16 prefecture-level cities and 2 municipalities) using lottery method. Depending on the different level of economic and cultural, we sampled one medium county from each city (municipalities sampled two counties), a total of 28 counties. All towns were divided into high, medium and low three levels in accordance with economic and cultural, each level sampled one town, each conty sampled three towns, a total of 84 towns were sampled. Each town sampled 40 children, including 20 boys and 20 girls (including each 10 children aged 3 to 6, half and half boys and girls). 4 096 rural children aged 3-6 years old were sampled and surveyed of China. Based on "the Neglect Norms for Children Aged 3 to 6 Years Old in Rural Areas of China" explored the risk factors of child neglect. SPSS 18. 0 for windows was employed for statistics analysis. Multifactorial analysis was conducted through multivariate Logistic Regression.The total neglected rate of the rural children aged 3 to 6 was 53.7% (2,047/3,810), and the total neglected degree was 44.42±7.57. The multivariate logistic regression analysis showed that, neglected risk of the boys was higher than the girls (OR=1.30, 95% CI: 1.13-1.49), neglected risk of children were higher, when their mothers were migrant workers (OR=2.18, 95% CI: 1.59-3.00); the lower educational level of mothers, the higher neglected risk of children, the children in families that mothers only received primary education or was uneducated were most likely to be neglected (OR=2.92, 95% CI: 1.91-4.47), the second was the families that mothers received primary education (OR=1.86, 95% CI: 1.29-2.69); the lower the household income, the easier to be neglected the children, the easiest one was the household income less than 5000 RMB (OR=2.85, 95% CI: 2.14-3.79), the second was 5000-9,999 RMB (OR=1.76, 95% CI: 1.40-2.20); the relationship between children and mothers was distanced, neglect risk of children was higher (OR=3.88, 95% CI: 1.31-11.52); left behind children were easier to be neglected (OR=1.30, 95% CI: 1.09-1.54).The influence factors among children aged 3-6 years in the rural areas of China were boys, mother's occupation, maternal education level, the relationship between children and mothers, household income and left-behind children.

Aim The aim of this study was to examine the effects of home and educational environments on children's motor performance in China. Method We conducted a cross-sectional study of 4001 preschool children selected from 160 classes. The children's motor performance was assessed using the Movement Assessment Battery for Children, 2nd edition (MABC-2). Home and educational environments were evaluated using validated checklists. The effects of home and educational environments on motor performance were analysed using mixed and multilevel logistic regression models. Results The results showed that one score increase in the outside space of the family home was positively associated with the increase in total test score (0.104) subtest score of aiming and catching (0.037), and balance (0.034) of the MABC-2, after adjusting for potential confounders (each p

Long non-coding RNA (lncRNA) plays a role in gene transcription, protein expression and epigenetic regulation; and altered expression results in cancer development. Acute myeloid leukemia (AML) is rare in children; and thus, this study profiled lncRNA expression in bone marrow samples from pediatric AML patients. Arraystar Human LncRNA Array V3.0 was used to profile differentially expressed lncRNAs in three bone marrow samples obtained from each pediatric AML patient and normal controls. Quantitative polymerase chain reaction (qRT-PCR) was performed to confirm dysregulated lncRNA expressions in 22 AML bone marrow samples. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed to construct the lncRNA-mRNA co-expression network. A total of 372 dysregulated lncRNAs (difference ≥10-fold) were found in pediatric AML patients compared to normal controls. Fifty-one mRNA levels were significantly upregulated, while 85 mRNA levels were significantly downregulated by >10-fold in pediatric AML, compared to normal controls. GO terms and KEGG pathway annotation data revealed that cell cycle pathway-related genes were significantly associated with pediatric AML. As confirmed by qRT-PCR, expression of 24 of 97 lncRNA was altered in pediatric AML compared to normal controls. In pediatric AML, ENST00000435695 was the most upregulated lncRNA, while ENST00000415964 was the most downregulated lncRNA. Data from this study revealed dysregulated lncRNAs and mRNAs in pediatric AML versus normal controls that could form gene pathways to regulate cell cycle progression and immunoresponse. Further studies are required to determine whether these lncRNAs could serve as novel therapeutic targets and bbdiagnostic biomarkers in pediatric AML.

To study the expression level and CpG island methylation status of miR-34b in leukemia cell lines and to research the effect of DNA methylation on the proliferation of leukemia cells regulated by miR-34b.Taqman real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was carried out to detect the relative expression of miR-34b in control group (bone marrow cells of 20 children without blood disease) and 8 leukemia cell lines (U937, HL-60, MV4-11, M2R, K562, Raji, CCRF, DAMI). Methylation-specific polymerase chain reaction (MSP) was carried out to detect the methylation differences of miR-34b in control group (Bone marrow cells of 23 children without blood disease), 8 leukemia cell lines. HL-60 and K562 were treated with methyltransferase inhibitor (5-aza-2-dC) for further detection of its methylation status and expression of miR-34b. Hsa-miR-34b mimics was transfected into K562 cell by liposome, the transfection efficiency was detected by flow cytometry. The cell proliferation of hsa-miR-34b transfected group in each stage was measured with CCK-8 assay, and then compared with non-transfected group and negative control group.The relative expression level of miR-34b in the group of children without blood disease and the group of leukemia cell lines were 5.22 ± 1.15, 0.03 ± 0.03. The results showed that, the group of leukemia cell lines was significantly different from the control group (t = 4.538, P0.01) . Eight leukemia cell lines showed methylation, the positive rate of the methyl was 100%. There was no methylation in the 23 cases of control group. After leukemia cell lines HL-60 and K562 were treated with 5-aza-2-dC, the methylated bands became obviously weakened, and the relative expression levels of miR-34b substantially increased 49.5 times and 18.8 times respectively. After hsa-miR-34b mimics was transfected into K562 cell by liposome, its transfection efficiency detected by flow cytometry was 61% and the cell proliferation was measured with CCK-8 assay from which it was found that the cell proliferation was significantly suppressed compared with the control group at 48 h (t = 9.303, P0.01), 72 h (t = 65.617, P0.01), 96 h (t = 36.878, P0.01) and 120 h (t = 18.748, P0.01) in hsa-miR-34b transfected group, with the inhibition rate of 12.2% (48 h), 45.7% (72 h), 32.5% (96 h) and 22.9% (120 h).The hypermethylation of promoter leads to decrease in the expression levels of miR-34b in leukemia cell lines, which attenuate mechanism of proliferative inhibition may be one of the reasons of occurrence or development of childhood leukemia.