Association of Breastfeeding Duration with Body Composition in Children Aged 3–5 Years

Objective This study aimed to assess the relationship between the body composition of children aged 3–5 years and breastfeeding status and duration.Methods The study was conducted using data from the National Nutrition and Health Systematic Survey for children 0–17 years of age in China(CNHSC),a nationwide cross-sectional study.Breastfeeding information and potential confounders were collected using standardized questionnaires administered through face-to-face interviews.The body composition of preschool children was measured using bioelectrical impedance analysis.A multivariate linear regression model was used to assess the relationship between breastfeeding duration and body composition after adjusting for potential confounders.Results In total,2,008 participants were included in the study.Of these,89.2%were ever breastfed and the median duration of breastfeeding was 12 months(IQR 7–15 months).Among children aged 3 years,the height-for-age Z-score(HAZ)for the ever breastfed group was lower than that for never breastfed group(0.12 vs.0.42,P=0.043).In addition,the weight-for-age Z-score(WAZ)of the ever breastfed group was lower than that of the never breastfed group(0.31 vs.0.65,P=0.026),and the WAZ was lower in children aged 4 years who breastfed between 12 and 23 months than in those who never breastfed.Compared to the formula-fed children,the fat-free mass of breastfed infants was higher for children aged 3 years(12.84 kg vs.12.52 kg,P=0.015)and lower for those aged 4 years(14.31 kg vs.14.64 kg,P=0.048),but no difference was detected for children aged 5 years(16.40 kg vs.16.42 kg,P=0.910)after adjusting for potential confounders.No significant difference was detected in the weight-for-height Z-score(WHZ),body mass index(BMI)-for-age Z-score(BAZ),fat-free mass index,and body fat indicators in the ever breastfed and never breastfed groups and among various breastfeeding duration groups for children aged 3–5 years.Conclusion No obvious associations were detected between breastfeeding duration,BMI,and fat mass indicators.Future prospective studies should explore the relationship between breastfeeding status and fat-free mass.

Characterization of CircRNA-Associated CeRNA Networks in Folate Deficiency-Induced Neural Tube Defects

Objective Circular RNAs(circRNAs)participate in several important pathological processes and have been used in the diagnosis and treatment of various diseases.This study aimed to investigate the role of circRNAs in neural tube defects(NTDs).Method We characterized circRNA-associated competitive endogenous RNA(ceRNA)networks in brain tissue of low folate-induced NTDs mouse at embryonic day 13.5 by high-throughput sequencing.The expression levels of Circzfp644,miR-20-5p and Gas7 were detected by RT-PCR.Gas7 and Circzfp644functions were determined by miRNA-mimics and inhibitors in mouse teratocarcinoma cells(F9 cells),and luciferase gene reporter assay was assessed in the F9 cells.In addition,the expression levels of Circzfp644,miR-20-5p and Gas7 were determined by Nanostring in human NTDs tissues.Results We detected 57 circRNA transcripts,16 miRNAs,and 148 mRNAs that were significantly dysregulated in NTDs brain tissues compared with their expression levels in control(normal)tissues.Circzfp644 shared miRNA response elements with the growth arrest specific 7(Gas7)gene and competitively bound with miR-20-5p to increase the expression of Gas7.Downregulation of Circzfp644and Gas7 and upregulation of miR-20-5p were found in human NTD tissue.Conclusion This study provides new perspectives on the role of circRNAs in nervous system development and the pathogenesis of NTDs.

Clinical application of SARS-CoV-2 antibody detection and monoclonal antibody therapies against COVID-19

The purpose of this study was to investigate the clinical application of severe acute respiratory distress syndrome coronavirus-2(SARS-CoV-2)specific antibody detection and anti-SARS-CoV-2 specific monoclonal antibodies(mAbs)in the treatment of coronavirus infectious disease 2019(COVID-19).The dynamic changes of SARS-CoV-2 specific antibodies during COVID-19 were studied.Immunoglobulin M(IgM)appeared earlier and lasted for a short time,while immunoglobulin G(IgG)appeared later and lasted longer.IgM tests can be used for early diagnosis of COVID-19,and IgG tests can be used for late diagnosis of COVID-19 and identification of asymptomatic infected persons.The combination of antibody testing and nucleic acid testing,which complement each other,can improve the diagnosis rate of COVID-19.Monoclonal anti-SARS-CoV-2 specific antibodies can be used to treat hospitalized severe and critically ill patients and non-hospitalized mild to moderate COVID-19 patients.COVID-19 convalescent plasma,highly concentrated immunoglobulin,and anti-SARS-CoV-2 specific mAbs are examples of anti-SARS-CoV-2 antibody products.Due to the continuous emergence of mutated strains of the novel coronavirus,especially omicron,its immune escape ability and infectivity are enhanced,making the effects of authorized products reduced or invalid.Therefore,the optimal application of anti-SARS-CoV-2 antibody products(especially anti-SARS-CoV-2 specific mAbs)is more effective in the treatment of COVID-19 and more conducive to patient recovery.

Impact of Novel Coronavirus Vaccination on the Clinical Characteristics and Parental Care Needs of Infected Children During a High-Intensity Epidemic Period

Objective:This study aimed to investigate the impact of COVID-19 vaccination on the clinical characteristics and care needs of infected children during a high-intensity pandemic and to measure the potential effects of vaccination on children's health status and healthcare utilization.Methods:A sample of 903 children who had recently been infected with the novel coronavirus and came to our hospital's emergency department from January 11 to January 30,2023,was used as the research object in this retrospective study.The questionnaire on unknown coronavirus infection was filled out anonymously,and SPSS20.0 software was used for statistical data analysis.Results:The baseline conditions of 903 subjects were studied,including 505 males,accounting for 55.92%,and 398 females,accounting for 44.08%.The age of infection was mainly concentrated in preschool children(26.02%)and school-age children(38.76%).Regarding vaccination,561 cases were vaccinated,accounting for 62.13%.Among them,37 children received one dose of vaccine,accounting for 4.1%,463 children received two doses,accounting for 51.27%,and 61 children received three doses,accounting for 6.76%.For previous allergic diseases,180 children had a history of allergic diseases,accounting for 19.93%.Regarding sources of infection,the most common source was someone at home,accounting for 82.61%.Vaccination can effectively reduce the fever of children infected with the new coronavirus,the number of outpatient and emergency doctor visits,and the risk of hospitalization.In addition,regarding treatment,children in the vaccinated group were more likely to be treated at home,and the types of drugs used also differed from those in the non-vaccinated group.However,the vaccination group has a relatively high incidence of symptoms such as sore throat,cough,abnormal sense of smell and taste,muscle soreness,and headache.However,these are mild clinical symptoms and do not affect children's physical health and development.Parental care needs for children infected with COVID-19 are disparate,and parents of vaccinated children have lower proportions of needs for child care.Conclusion:Vaccination positively impacts the clinical outcomes of children infected with COVID-19 and their parents'well-being.

Hepatic recompensation according to the Baveno VII criteria via a transjugular intrahepatic portosystemic shunt: Is this true?

Hepatic recompensation is firstly described in the Baveno VII criteria,which requires the fulfillment of strict criteria.First,a primary cause of cirrhosis must be addressed,suppressed,or cured.Second,complications of liver cirrhosis,inclu-ding ascites,encephalopathy,and variceal hemorrhage,must disappear without any intervention.Finally,liver function indicators must be improved.Moreover,without addressing/suppressing/curing cirrhosis and improvement in liver syn-thetic function,complications,including ascites and variceal hemorrhage can be improved by a transjugular intrahepatic portosystemic shunt(TIPS),which is not evidence of hepatic recompensation.Therefore,on the basis of the definition of hepatic recompensation,TIPS does not achieve hepatic recompensation.

Current Trends of the Prevalence of Childhood Asthma in Three Chinese Cities: A Multicenter Epidemiological Survey

Objective To analyze the prevalence of asthma and asthma related symptoms among children aged 0-14 years in three Chinese cities and to obtain a crude estimation of the trend of childhood asthma prevalence in China. Methods A cross-sectional, population-based survey of prevalence of asthrna was conducted in children aged from 0 to 14 years in 3 major cities of China （Beijing, Chongqing, and Guangzhou） with different geographic locations. All the subjects were randomly selected by a multi-stage sampling method. Three to five schools and kindergartens in 2 urban districts in each city were randomly selected for the survey, and a validated questionnaire that included the core questions of the International Study of Asthma and Allergies in Childhood, Phase III questionnaire and several additional questions were used. All questionnaires were completed by parents or guardians of the selected children. Children whose parents responded affirmatively to the question＂ Has your child ever been diagnosed as asthma by a doctor＂ were recognized as victims of asthma. Results The prevalence of asthma in Beijing, Chongqing, and Guangzhou was 3.15%, 7.45%, and 2.09%, respectively. These values were significantly higher than those obtained 10 years ago in the national epidemiological survey in 2000 which used the same method of investigation and the same diagnotic criteria （x^2=3.938, P=-0.047; 22=73.506, P≤0.001; x^2=11.956, P=0.001, in each city）. Of the asthmatic children 57.21%, 69.91%, and 60.00% had their first attack before the age of 3 in Beijing, Chongqing, and Guangzhou, respectively. Wheezing was the primary clinical manifestation for all asthmatic children, followed by persistent cough and repeated respiratory infections. Both the prevalence of asthma and asthma-related symptoms were statistically higher in males than in females. Conclusion The prevalence of childhood asthma is statistically higher than that 10 years ago in the three Chinese cities.

Impacts of Types and Degree of Obesity on Non-Alcoholic Fatty Liver Disease and Related Dyslipidemia in Chinese School-Age Children?

Objective To explore the impacts of types and degree of obesity on non‐alcoholic fatty liver disease （NAFLD） and related lipids disturbance in Chinese school‐age children. Methods A total of 1 452 school‐age Children of 7 to 17 years were recruited in Beijing with representative cluster sampling method. Data of anthropometric measurements including weight, height and waist circumference were collected from March to May of 2007. Body mass index（BMI）was calculated. Blood samples were obtained and lipid profiles including triglyceride （TG）, total cholesterol （TC）, high‐density lipoprotein cholesterol （HDL‐C） and low‐density lipoprotein cholesterol （LDL‐C） were measured, while glutamate‐pyruvate transaminase （ALT） and glutamic‐oxalacetic transaminase （AST） were determined to evaluate liver function. The liver was also scanned by sonography, and abnormal hepatic sonograms were documented. NAFLD was diagnosed according to the criteria recommended by the Fatty Liver and Alcoholic Liver Disease Study Group under the Chinese Liver Disease Association. Analysis of covariance （ANOVA）, Chi‐square test for trend and binary logistic regression analysis were performed. Results The dyslipidemia and ultrasonographic fatty liver deteriorated with the degree of obesity defined either by BMI or waist circumference. Compared with BMI, waist circumference contributed more to the development of dyslipidemia, fatty liver and NAFLD. The highest levels of TG, TC, LDL‐C, and lowest level of HDL‐C were seen in the mixed obese group followed by abdominal obese, peripheral obese and non‐obese ones. Adjusted for gender and age, the odds ratios （ORs） and their 95% confidence intervals of peripheral obesity, abdominal obesity and mixed obesity were 0, 10.93 （0.98‐121.96） and 79.16 （10.95‐572.44） for predicting NAFLD; 12.61 （1.24‐127.78）, 19.39 （5.23‐71.85）, and 93.21 （29.56‐293.90） for predicting ultrasonographic fatty liver; 1.78 （0.59‐5.44）, 3.01 （1.91‐4.77）, and 4.64 （3.52‐6.12） for predicting dyslipidemia, respectively compared with the non‐obese control group. The trend of hazards over groups was statistically significant （P0.01）. Conclusion The levels of lipid profile and the prevalence of NAFLD and dyslipidemia increased in parallel with the degree of obesity; As compared with the non‐obese control, the mixed obesity had the strongest association with NAFLD and dyslipidemia, followed by abdominal obesity and peripheral obesity in Chinese school‐age Children.

Pubertal Hypertension is a Strong Predictor for the Risk of Adult Hypertension

Objective To assess and compare the predictive effects of hypertension before puberty and during puberty on adult hypertension.Methods A total of 412 adults from the ＂Beijing children and adolescents blood pressure （BP） study＂ cohort were followed up in a clinical examination in 2005.Systolic and diastolic BP,height,and weight in childhood were measured at a baseline survey in 1987.The participants were divided into pre‐puberty and puberty sub‐cohorts according to their pubertal development stage at baseline.Information on adult BP,anthropometric indices and life style were collected through questionnaire and physical examination.BP changes and the predictive effect on adult hypertension were compared between the two sub‐cohorts.Correlation of BP levels between 1987 and 2005 was examined through linear regression models.Results From childhood to adulthood,the regression coefficients of systolic BP were similar in the two sub‐cohorts （both β=0.34,P0.001）,while the coefficient of diastolic BP was larger in the pubertal cohort （β=0.31,P0.001） compared with the pre‐pubertal cohort （β=0.12,P=0.017）.Fifty percent of children with pubertal hypertension became hypertensive adults,while pre‐pubertal hypertension resulted in 34.3%.After adjustment for sex,age,family history of hypertension,obesity in childhood,and adulthood,pubertal hypertension predicted a higher risk of adult hypertension than pre‐pubertal hypertension,with odds ratios （95% confidence intervals） of 10.00 （3.03‐33.07） and 2.71 （0.83‐8.85）,respectively.Conclusion Our results suggest that hypertension during pubertyis likely to result in adult hypertension.

Coxsackievirus B3 Infection Triggers Autophagy through 3 Pathways of Endoplasmic Reticulum Stress

Objective Autophagy is a highly conserved intracellular degradation pathway. Many picornaviruses induce autophagy to benefit viral replication, but an understanding of how autophagy occurs remains incomplete. In this study, we explored whether coxsackievirus B3(CVB3) infection induced autophagy through endoplasmic reticulum(ER) stress. Methods In CVB3-infected HeLa cells, the specific molecules of ER stress and autophagy were detected using Western blotting, reverse transcription polymerase chain reaction(RT-PCR), and confocal microscopy. Then PKR-like ER protein kinase(PERK) inhibitor, inositol-requiring protein-1(IRE1) inhibitor, or activating transcription factor-6(ATF6) inhibitor worked on CVB3-infected cells, their effect on autophagy was assessed by Western blotting for detecting microtubule-associated protein light chain 3(LC3). Results CVB3 infection induced ER stress, and ER stress sensors PERK/eIF2α, IRE1/XBP1, and ATF6 were activated. CVB3 infection increased the accumulation of green fluorescent protein(GFP)-LC3 punctuation and induced the conversion from LC3-Ⅰ to phosphatidylethanolamine-conjugated LC3-1(LC3-Ⅱ). CVB3 infection still decreased the expression of mammalian target of rapamycin(mTOR) and p-mTOR. Inhibition of PERK, IRE1, or ATF6 significantly decreased the ratio of LC3-Ⅱ to LC3-Ⅰ in CVB3-infected HeLa cells. Conclusion CVB3 infection induced autophagy through ER stress in HeL a cells, and PERK, IRE1, and ATF6 a pathways participated in the regulation of autophagy. Our data suggested that ER stress may inhibit mTOR signaling pathway to induce autophagy during CVB3 infection.

Correlation Between Birth Defects and Dietary Nutrition Status in a High Incidence Area of China

Objective To investigate the association between birth defects and dietary nutrient intake in a high risk area of China. Methods A dietary survey was performed and serum folic acid was measured in women whose pregnancy was affected by neural tube defects （NTDs） or unaffected by any birth defects （BDs） in Zhongyang and Jiaokou Counties in Shanxi Province of China. ResuIts The local average consumption of foods including dark green vegetables, fruits, fat and meat, and nutrient intake （e.g. energy, protein, retinol, riboflavin, vitamin E, and selenium） were lower than the national average level. In women of childbearing age, these regions, the intake of nutrients was much lower than the recommended nutrient intake （9%-77%）. The case-control dietary nutrition study of women whose pregnancy was affected by BDs （including NTDs and congenital heart defects） demonstrated that, in early pregnancy, adequate nutrition （i.e. eating meat, fresh vegetables, fruit more than once a week） was a protective factor, while eating germinated potatoes was a risk factor. The geometrical mean （pS- p95） of serum folic acid in women with NTD birth defects was 9.6 nmol/L （3.6, 23.03）, which was significantly lower than that in normal women （14.03 nmol/L）. Conclusion Women of childbearing age in the two counties of Shanxi Province, China, have a marked insufficient intake of some nutrients, especially folic acid, zinc, vitamins A and B12. This nutrient deficiency may be an important risk factor for the high prevalence of birth defects in these regions. Therefore, adequate dietary nutrition in early pregnancy can prevent BDs.

Understanding the Choice of Sleep Arrangements and Soothing Methods and Their Associations with Sleep Problems among Children Under 3 Years Old:A Chinese Population Based Study

Objective This study aimed to examine the sleep arrangements and soothing methods and to assess their associations with sleep problems among children aged<3 years in China.Methods A cross-sectional survey was conducted in 2019 from six provinces in China.A total of 1,195 caregivers of children aged 0–35 months were included in the study.Data on sleep arrangements,soothing methods,and sleep problems(i.e.,frequent night awakenings and difficulty falling asleep)were assessed using the Brief Infant Sleep Questionnaire.The reasons for bed-sharing in sleep arrangements were recorded using a self-designed questionnaire.Results The bed-sharing practice was very prevalent at any age,which ranged from 69.9%to 78.3%.Most infants fell asleep while feeding or being rocked/held before age 12 months.By age 35 months,62.4%of the children fell asleep in bed near parents.The most common reasons for bed-sharing were breastfeeding/feeding and convenience.Parental involvement when falling asleep was significantly related with frequent night awakenings and difficulty falling asleep.No association was found between bed-sharing and sleep.Conclusion Bed-sharing and parental involvement were very common among Chinese children aged<3 years.Children who fall asleep with parental involvement were more likely to have sleep problems.

Coagulopathy in a subtype of choledochal cyst and management strategy

AIM: To evaluated our management algorithm of the coagulopathy. We evaluated our management algorithm of the coagulopathy.

Joint Association of Metabolic Health and Obesity with Ten-Year Risk of Cardiovascular Disease among Chinese Adults

Objective This study aims to investigate the association of metabolic phenotypes that are jointly determined by body mass index(BMI)or fat mass percentage and metabolic health status with the tenyear risk of cardiovascular disease(CVD)among Chinese adults.Methods Data were obtained from a cross-sectional study.BMI and body fat mass percentage(FMP)combined with the metabolic status were used to define metabolic phenotypes.Multiple linear regression and logistic regression were used to examine the effects of metabolic phenotypes on CVD risk.Results A total of 13,239 adults aged 34-75 years were included in this study.Compared with the metabolically healthy non-obese(MHNO)phenotype,the metabolically unhealthy non-obese(MUNO)and metabolically unhealthy obese(MUO)phenotypes defined by BMI showed a higher CVD risk[odds ratio,OR(95% confidence interval,CI):2.34(1.89-2.89),3.45(2.50-4.75),respectively],after adjusting for the covariates.The MUNO and MUO phenotypes defined by FMP showed a higher CVD risk[OR(95%CI):2.31(1.85-2.88),2.63(1.98-3.48),respectively]than the MHNO phenotype.The metabolically healthy obese phenotype,regardless of being defined by BMI or FMP,showed no CVD risk compared with the MHNO phenotype.Conclusion General obesity without central obesity does not increase CVD risk in metabolically healthy individuals.FMP might be a more meaningful factor for the evaluation of the association of obesity with CVD risk.Obesity and metabolic status have a synergistic effect on CVD risk.

Molecular and Epidemiological Characterization of Infant Botulism in Beijing, China

Laboratory-based pathogen isolation, identification, and toxicity determination were performed on samples from a suspected case of infant botulism. Mice injected with cultures generated from the enema sample and ingested Powered infant formula （PIF） presented typical signs of botulism. Antitoxins to polyvalent botulinum neurotoxins （BoNTs） and monovalent BoNT type B antitoxin had protective effects. Clostridium botulinum isolated from the enema and residual PIF samples were positive for type B toxin. Pulsed-field gel electrophoresis （PFGE） revealed that the two strains of C. botulinum isolated from the two samples produced indistinguishable pulsotypes. These findings confirmed this case of type B infant botulism associated with the ingestion of PIF contaminated bv type B C. botulinum spores.

Follicle-stimulating hormone is expressed in ovarian follicles of chickens and promotes ovarian granulosa cell proliferation

Follicle-stimulating hormone(FSH),an important hypothalamic-pituitary-gonadal axis(HPG)hormone,is secreted by the pituitary gland.This study confirms that FSH is expressed in chicken follicles at different stages,and positive FSHβ mRNA signals were stronger(P<0.05)in granulosa cells than in oocytes.The 369 bp coding sequence of FSHβ in ovaries is 100%identical to that in the pituitary gland.The experiment in vitro revealed that the ovary possessed FSH secretory capacity.Further,FSHβ mRNA was significantly upregulated(P<0.05)in follicles and significantly higher(P<0.05)than that in the pituitary gland by approximately 2–23 times with the development.The number of granulosa cells decreased significantly(P<0.05)in the cells with siRNA treatment,confirming that the ovarian FSH could promote granulosa cell proliferation.This view was supported by cell cycle analysis and CCND2 and CCNE2 expression.Further research indicated that no difference(P>0.05)was observed between the number of granulosa cells treated with FSHβ siRNA and in exogenous FSH.However,the number of granulosa cells without FSHβ siRNA transfection was significantly higher(P<0.05)for exogenous FSH.This finding suggests that the proliferative effect of exogenous FSH on ovarian granulosa cells depend on endogenous FSH.This study demonstrated that the FSH gene was expressed in chicken follicles and promoted ovarian granulosa cell proliferation,which enriched the theory on HPG axis.

Abnormal Adipokines Associated with Various Types of Obesity in Chinese Children and Adolescents

Objective To explore the role of adipokines including insulin, resistin, leptin, adiponectin, acylation stimulating protein （ASP） and complement C3 （C3） in various types of obesity （peripheral obesity, abdominal obesity and mixed obesity） in Chinese children and adolescents, and their relationships with body size and pubertal development. Methods Children and adolescents （n=3 508） aged 6 to 18 years, with 1 788 boys and 1 720 girls were assessed for body mass index, waist circumference, pubertal development, blood insulin, resistin, leptin, adiponectin, ASP and C3 levels. Three types of obesity [peripheral obesity （n=43）, abdominal obesity （n=473）, mixed obesity （n=1 187）] and non‐obese control （n=1 805） were defined with combined use of Chinese body mass index and waist circumference criteria. Results Serum resistin, leptin and adiponectin levels were higher in girls than those in boys （all P0.01）. Insulin and leptin increased and adiponectin decreased across five Tanner stages in both girls and boys （all P0.001）, while ASP changed only in girls （P0.001） and C3 only in boys （P0.001）. Insulin, leptin and ASP were higher, but adiponectin was lower in all three types of obesity vs. the non‐obese control （all P0.05）. The greatest abnormalities of all six adipokines were found in the mixed obesity group. With inclusion of body mass index and waist circumference in simultaneous regression analyses, both body size indices were independently and significantly correlated with insulin, leptin and adiponectin after age and gender adjustment. Compared with waist circumference, the body mass index was stronger in interpreting insulin, leptin, adiponectin and ASP levels, whereas it was weaker in explaining variance of plasma C3. Conclusions Obese children have a worse metabolic profile with high insulin, resistin, leptin, ASP and C3, and low adiponectin levels. The adipokine profile in mixed obesity is worse than that in peripheral or abdominal obesity. Identification of obese subjects with a malignant adipokine profile using a combination of body mass index and waist circumference is important for the prevention of obesity‐related disease.

National Nutrition and Health Systematic Survey for Children 0–17 Years of Age in China

The main purpose of the National Nutrition and Health Systematic Survey for children 0-17 years of age in China(CNHSC)was to collect basic data on the nutrition,development,and health status for children in different regions across China using evidence-based,reliable,and cost-effective approaches.Children and their parents or guardians from seven regions(south,southwest,north,northwest,eastern,central,and northeast China)in China were recruited.A multi-stage stratified randomized sampling method was used.Two provinces were randomly sampled from each of the seven regions,from which one urban district and one rural country were also randomly sampled,resulting in a total of 28 survey counties/districts.Dietary surveys,health examinations,laboratory testing,and questionnaires were used to collect dietary intake,nutritional status,child development,and health status information.Nutrition,health,and lifestyle assessment of children and their parents was determined using the Knowledge Attitude Practice(KAP)survey.Greater than 100,000 children(38,000 children<6 years of age and 66,000 children6-17 years of age)completed the survey.The survey provided comprehensive data on child nutrition and health status for future studies and will serve as the basis for an integrated nutrition and health improvement strategies proposal for children in China.

Unusual Patterns of Neural Tube Defects in a High Risk Region of Northern China

Objective To study the prevalence of different types of neural tube defects （NTDs） in Luliang Prefecture, Shanxi province, where the prevalence of NTDs is unusually high and the correlation between NTDs prevalence and patterns. Methods A surveillance population-based birth defects was performed in Luliang Prefecture, Shanxi province. Results The results of our study showed that the prevalence of NTDs was 2-fold higher in Luliang Prefecture than in other areas of Shanxi province. Unusual patterns of NTDs were found, however, multiple NTDs were relatively common in Luliang Prefecture, accounting for over 13% of all NTDs cases in China. Conclusion The prevalence of NTDs is associated with its patterns.

Physical Growth of Children in Urban,Suburban and Rural China's Mainland:A Study of 20 Years' Change

Objective To describe secular trends on physical growth of children in China during the year of 1985‐2005 and to analyze the urban‐suburban‐rural difference and its change. Methods The measurements of height, weight and chest circumference obtained from two serial national cross‐sectional surveys for children aged 0 to 7 years in China were used to analyze the secular trends, and the growth differences among urban, suburban and rural children were compared. Results The average weight and height for both boys and girls from urban, suburban and rural areas have significantly increased in most age groups during the past 20 years; The average chest circumference increased slightly, ranging from 0.0 to 2.0 cm. From 1985 to 2005, the urban‐suburban difference in height had become smaller, and that in weight showed similar trend for children under 3 years old but became larger after 3 years old; the suburban‐rural difference both in height and weight became larger after 6 months old. The increment per decade in height was the greatest in the suburban group while the greatest increment in weight was the urban group. Conclusion Positive secular trends were observed among urban, suburban and rural areas in Chinese children under 7 years old during the 1980s and the 2000s, reflecting a rapid socio‐economic development in China.

Epidemiological Features of Severe Acute Respiratory Syndrome in Beijing Urban and Suburb Areas in 2003

To describe the epidemiologic features of an outbreak of severe acute respiratory syndrome （SARS） in urban and suburb areas in Beijing and to explore their differences between these two areas. Methods Data of SARS cases were collected from daily notification of China Ministry of Health and a database of infectious diseases was established by the Beijing Municipal Center for Disease Prevention and Control （BCDC）. All the data were put into dataset files by Microsoft Exeel-2000 and analyzed with SPSS version 10.0 software. Results The respective urban incidence and mortality rate were 29.06 and 2.21 per 100 000, while the case fatality rate was 7.62%. In contrast, the respective suburb incidence and mortality rate were 10.61 and 0.78 per 100 000, and the case fatality rate was 7.32%. No significant differences were found in demographic characteristics between the urban and suburb areas. Conclusion Beijing urban area suffered a more serious SARS epidemic than the suburb area in 2003.