Sex-specific effects of organophosphate ester exposure on child growth trajectories in the first two years

The connections between urinary organophosphate ester(OPE)metabolites and child growth have been identified in prior research,but there is currently a dearth of epidemiological evidence regarding the sex-specific impact of OPEs on child growth trajectories.This study enrolled 804 maternal-child pairs,and five OPE congeners were quantified in maternal serum during pregnancy.In this study,the impact of prenatal OPE exposure on child growth trajectories was assessed using linear mixed-effect models and a group-based trajectory model(GBTM),with consideration given to sex-specific effects.Fetuses were frequently exposed to OPEs in utero,and tris(2-butoxyethel)phosphate(TBEP)exhibited the highest concentration levels in maternal serum.Among male children,an increase of 2.72 ng/g lipid in TBEP concentration was associated with a 0.11-unit increase in head circumference-for-age z-score(HCAZ),and the effect was mainly concentrated at 1 and 2 months of age.Among female children,an increase of 2.72 ng/g lipid in tris(2-chloro-1-(chloromethyl)ethyl)phosphate(TDCPP)concentration was associated with a 0.15-unit increase in length-for-age z-score(LAZ)and a 0.14-unit increase in weight-for-age z-score(WAZ),and the effects were mainly concentrated at 9 months of age.For HCAZ trajectories,higher prenatal TBEP exposure was associated with higher odds for the fast growth group in male children.For the LAZ and WAZ trajectories,higher prenatal TDCPP exposure was associated with higher odds for the fast growth group in female children.The trajectory analysis approach provided insight into the complex associations between OPE exposure and child growth.

Eradication of Helicobacter pylori increases childhood growth and serum acylated ghrelin levels

AIM: To determine whether Helicobacter pylori (H. pylori)infected children have reduced body weight (BW) and height (BH) growth, and if H. pylori eradication may restore growth while improving serum acylated ghrelin. METHODS: This longitudinal cohort study with oneyear follow-up enrolled 1222 children aged 4 to 12 years old into an observation cohort (18 with and 318 without H. pylori ) and intervention cohort (75 with and 811 without). The 7-d triple therapy was used for eradication in the intervention cohort. The net increases of BW and BH as well serum acylated ghrelin after oneyear follow-up were compared between successful eradicated H. pylori-infected children and controls. RESULTS: In the observation cohort, the H. pylori - infected children had lower z score of BW (-1.11 ± 0.47 vs 0.35 ± 0.69, P = 0.01) and body mass index (BMI) (0.06 ± 0.45 vs 0.44 ± 0.73, P = 0.02) at enrollment and lower net BW gain after one-year follow-up (3.3 ± 2.1 kg vs 4.5 ± 2.4 kg, P = 0.04) than the non-infected controls. In the intervention cohort, the H. pylori - infected children had lower z score of BMI (0.25 ± 1.09 vs 0.68 ± 0.87, P = 0.009) and serum acylated ghrelin levels (41.8 ± 35.6 pg/mL vs 83.6 ± 24.2 pg/mL, P < 0.001) than the non-infected controls. In addition to restoring decreased serum ghrelin levels (87.7 ± 38.0 pg/mL vs 44.2 ± 39.0 pg/mL, P < 0.001), the H. pylori - infected children with successful eradication had higher net gains (P < 0.05) and increase of z scores (P < 0.05) of both BW and BH as compared with non-infected controls after one-year follow-up. CONCLUSION:H. pylori-infected children are associated with low serum acylated ghrelin and growth retardation. Successful eradication of H. pylori restores ghrelin levels and increases growth in children.

THE ANALYSIS OF CHILD′S GROWTH TREND DURING 1958～1995 IN XI′AN CITY

The paper analyzed the growth level and velocity to find the growth trend with the data collected in 8 investigations on growth of children aged 7～17 years in 1958～1995 in Xi′an. The results showed that child′s growth level was elevated with the passage of years and was the lowest in 1962, the highest in 1995 during the 38 years. The height of boy of the same age in 1995 has average increased by 9 59 cm over 1958 and girl 8 38 cm. The weight of boy of the same age in 1995 has averagely increased by 8 35 kg over 1958 and girl 5 90 kg. The chest girth of boy of the same age in 1995 has average increased by 5 69 cm over 1958 and girl 4 66 cm. The growth level of children aged 9～15 years had greater increase than others in 7～17 years of age. The average increment per 10 years of boy's height was 2 57 cm and girl's 2 26 cm. The average increment of per 10 years of boy's weight was 2 17 kg and girl's 1 56 kg. The average increment of per 10 years of boy's chest girth was 1 50 cm and girl's 1 23 cm. The analysis of the growth velocity in different period during 38 years showed the velocity in 1958～1962 was a negative value and indicated a growth retard, but the velocity in 1962～1964 was the fastest and indicated a catch up growth. And then, growth velocities of height, weight and chest girth were different in different period. The analysis of the growth curves of height, weight and chest girth showed that the 2 cross ages were 1～3 years of age ahead of time and menarche and emission also were ahead of time that during the 38 years indicated there is a child's growth acceleration in Xi′an and the trend of child's growth acceleration could continue if there are more and better nourishment, sports requisites, health care and housing conditions.

Growth and Associated Factors in Children and Adolescents Living with HIV/AIDS Followed at the Mother and Child Centre of the Chantal Biya Foundation, Yaoundé-Cameroon: A Case Control Study

Background: HIV/AIDS has a negative impact on child growth. Assessing the growth of infected children is an important part of the overall care of these children which in turn improves the monitoring and prognosis of the disease. The purpose of the study was to describe and compare the growth of children living with HIV with those not infected and to identify the associated factors. Method: This was an analytical case control study conducted in a pediatric hospital, Yaoundé from January 25th to June 20th 2019. Our study population consisted of 164 children with an age range from 06 weeks to 19 years old of which we had 41 HIV-infected cases and 123 uninfected controls matched by sex and age plus or minus 02 months. Anthropometric parameters were measured according to the standards described by the WHO. The data was entered and analyzed using Epi info 3.5.4, WHO Anthro and WHO Anthropoplus softwares. The chi-square and the Fisher’s exact tests were used to compare qualitative variables, with a significance threshold set at P less than 5%. Results: Of the 41 cases, 15 (36.6%) had at least one anthropometric index (weight for age, height for age, weight for height) -2 Z score versus 05 for controls (4.1%). 36.6% of cases had growth retardation (Height for age -2 Z score) compared to 4.1% in controls with a significant difference (p = 0.000). In 18.2% of cases, underweight was found (Weight for age -2 Z score) with a significant difference compared to controls (p = 0.000). Wasting was present in 10% of infected children (P = 0.240). We found 7.3% obesity/overweight in cases and 25.2% in controls (P = 0.003). We did not find any associated factor with growth disorders in our study. Conclusion: Infected children are smaller in weight and size. After multivariate analysis, there remained a significant difference between cases and controls regarding stunting, obesity and overweight. No factors studied were associated with the growth disorders detected, which suggests that growth disorders in children and adolescents living with HIV are due to the disease itself. Hence the need for health workers is to strengthen the prevention of mother and child transmission and the monitoring of the growth of HIV-infected children in order to improve the long-term prognosis.

儿童慢性粒细胞白血病慢性期红细胞参数及血清bFGF、TGF-β1、VEGF表达变化分析

目的探究儿童慢性粒细胞白血病(CML)慢性期红细胞参数及血清碱性成纤维细胞生长因子(bFGF)、转化生长因子β1(TGF-β1)及血管内皮生长因子(VEGF)表达变化。方法前瞻性选取2020年1月至2023年1月在首都医科大学附属北京儿童医院进行治疗的54例CML慢性期患儿为研究组,另随机抽取46名同期在本院进行体检的健康儿童为健康对照组。研究组给予酪氨酸激酶抑制剂治疗。比较两组间红细胞参数及血清bFGF、TGF-β1、VEGF表达变化,并比较研究组治疗前后红细胞参数及血清bFGF、TGF-β1、VEGF表达水平。结果研究组的RBC、血红蛋白、红细胞压积(HCT)及平均红细胞血红蛋白浓度(MCHC)水平分别为(3.45±0.04)×10^(12)/L、(102.33±1.15)g/L、(32.03±0.61)%、322.15±2.58,均显著低于对照组[(4.98±0.03)×10^(12)/L、(149.78±1.88)g/L、(44.33±0.31)%、334.12±0.77],平均红细胞体积(MCV)、平均红细胞血红蛋白含量(MCH)及红细胞体积分布宽度(RDW)水平分别为(91.44±0.77)fL、(33.15±2.55)pg、(17.55±0.12)%,均显著高于对照组[(89.88±0.34)fL、(30.24±0.16)pg、(12.66±0.11)%],差异均有统计学意义(P<0.05)。研究组的血清bFGF、VEGF水平分别为(30.66±9.66)、(128.68±30.58)pg/mL,均显著高于对照组[(5.26±1.54)、(70.66±11.26)pg/mL],TGF-β1水平为(38.22±8.06)μg/L,显著低于对照组[(78.66±8.13)μg/L],差异均有统计学意义(P<0.05)。治疗后,研究组患儿的RBC、血红蛋白、HCT、MCV及MCH水平均较治疗前显著降低,MCHC及RDW水平均较治疗前显著升高,差异均有统计学意义(P<0.05)。研究组治疗后的血清bFGF、VEGF水平均较治疗前显著降低,TGF-β1水平较治疗前显著升高,差异均有统计学意义(P<0.05)。结论在儿童CML慢性期患儿中可见血细胞参数明显异常,血清bFGF、VEGF水平显著升高,TGF-β1水平显著降低。酪氨酸激酶抑制剂治疗CML慢性期能有效改善患儿红细胞形态及功能,抑制肿瘤细胞生长,临床疗效显著,值得临床推广使用。

Corneal properties in children with congenital isolated growth hormone deficiency

AIM:To compare the corneal parameters of children with congenital isolated growth hormone deficiency and healthy subjects.METHODS:In this cross-sectional,prospective study,50 cases with growth hormone(GH)deficiency treated with recombinant GH and 71 healthy children underwent a complete ophthalmic examination.The corneal hysteresis(CH),corneal resistance factor(CRF),Goldmann-correlated intraocular pressure(IOPg)and corneal-compensated intraocular pressure(IOPcc)were measured with the Ocular Response Analyzer(ORA).Central corneal thickness(CCT)was measured by a ultrasonic pachymeter.RESULTS:The mean age was 13.0±3.0 years in the GH deficiency group consisting of 21 females and 29 males and 13.4±2.4 years in the healthy children group consisting of 41 females and 30 males.There was no statistically significant difference between the groups for gender or age(Chi-square test,P=0.09;independent ttest,P=0.28,respectively).The mean duration of recombinant GH therapy was 3.8±2.4y in the study group.The mean CH,CRF,IOPg and IOPcc values were 11.0±2.0,10.9±1.9,15.1±3.3,and 15.1±3.2 mm Hg respectively in the study group.The same values were 10.7±1.7,10.5±1.7,15.2±3.3,and 15.3±3.4 mm Hg respectively in the control group.The mean CCT values were 555.7±40.6,545.1±32.5μm in the study and control groups respectively.There was no statistically significant difference between the two groups for CH,CRF,IOPg,IOPcc measurements or CCT values(independent t-test,P=0.315,0.286,0.145,0.747,0.13 respectively).CONCLUSION:Our study suggests that GH deficiency does not have an effect on the corneal parameters and CCT values.This observation could be because of the duration between the beginning of disease and the diagnosis and beginning of GH therapy.

关于改善中枢性性早熟患儿身高获益的思考

随着遗传和环境等多种因素的改变,儿童性早熟的发病率逐渐增加,以改善身高为目的的性早熟治疗是临床关注的重点问题之一。目前,促性腺激素释放激素类似物(gonadotropin-releasing hormone analogs,GnRHa)仍是首选治疗药物,但其对身高的改善作用受多种因素影响,可能导致身高获益低于预期。联合重组人生长激素(recombinant human growth hormone,rhGH)治疗是提高GnRHa疗效的可选治疗策略,然而联用时机等尚无明确推荐。基于性早熟治疗现状,重新审视单用GnRHa及联合rhGH治疗对身高的改善作用至关重要。该文探索了联合治疗适应证等策略,以期指导临床用药,帮助性早熟患儿实现更理想的身高获益。

关注矮身材儿童的规范化诊疗

矮身材对儿童的身心健康具有深远的影响,是儿童内分泌专科常见的疾病。儿童处于生长发育的快速变化时期,且矮身材的病因繁杂,漏诊、误诊、干预不足或过度干预等现象始终存在,需要强化规范化诊疗。本文讨论了儿童矮身材临床诊疗中面临的挑战,特别强调矮身材的诊疗一方面要做到精准诊断,寻找病因,另一方面治疗上要严格把握适应证,做到个体化治疗。与此同时,对未来矮身材的诊疗方向进行展望,对进一步规范化矮身材的诊疗行为提出建议,以期为临床医生和决策者提供有益的参考。

一孩感染乙肝孕妇二孩妊娠的母婴阻断研究

目的探讨乙肝孕妇一孩母婴阻断失败的原因及二孩妊娠阻断效果和母婴结局,评价妊娠期抗病毒治疗阻断乙型肝炎母婴传播对儿童生长发育的影响。方法选取2017年2月至2019年2月南京中医药大学附属南京医院产科常规产检的34例HBV感染经产妇。HBV感染孕妇一孩妊娠时均未抗病毒治疗为一孩组;二孩妊娠时均在妊娠中晚期开始抗病毒治疗为二孩组,比较两次妊娠期合并症及并发症的发生率。两次分娩新生儿分为新生儿一孩组及新生儿二孩组,比较一般情况、患病情况及生长发育。结果34例孕妇两次妊娠期间均为HBeAg阳性,分娩一孩前平均HBV-DNA为(2.27±1.95)×10^(8)IU/mL,二孩妊娠后孕妇平均HBV-DNA水平为(2.43±2.15)×10^(8)IU/mL。二孩组分娩前口服抗病毒药物孕妇病毒载量均下降,平均下降至(1.98±6.23)×10^(3)IU/mL。二孩组孕妇剖宫产率高于一孩组孕妇(P=0.005)。一孩组孕妇出现妊娠合并症、产时并发症发生率与二孩组差异无统计学意义(P>0.05)。新生儿一孩组新生儿出生后规范的乙肝疫苗接种率为70.59%(24/34),规范的乙肝免疫球蛋白接种率为50%(17/34)。新生儿二孩组新生儿乙肝疫苗及免疫球蛋白接种率和及时率高于新生儿一孩组(P<0.05)。两组新生儿出生缺陷、生长发育差异没有统计学意义(P>0.05)。结论高病毒载量孕妇孕期抗病毒治疗可有效降低病毒载量,联合新生儿免疫接种可以减少新生儿乙肝病毒感染的发生。妊娠期抗病毒治疗不会增加围生期不良事件和产时并发症的发病率,也不影响新生儿的生长发育。

儿童生长发育智慧管理平台设计与应用

目的:按照智慧医院建设标准,结合儿童生长发育专科特点,设计融合线上线下一体化的儿童生长发育智慧管理平台。方法:利用互联网、人工智能和大数据的创新应用,实现儿童生长发育的“互联网+”儿童保健服务、人工智能的骨龄测评、大数据生长发育智能评估。结果:提供了动态监测、精准识别、个性化指导,实现了儿童生长发育偏离的早发现、早干预、早诊断、早治疗。结论:该平台的建立,提高了诊疗效率和质量,提升了患者就医体验,为促进儿童健康发展、提高儿童健康管理水平等提供了借鉴和启示。

合并间脑综合征的儿童视路胶质瘤化疗后体重增长及生存观察

目的 探讨伴有间脑综合征(DS)的视路胶质瘤(OPG)患儿化疗后的体重增长及生存状况。方法 回顾性分析2018年5月—2020年12月儿科收治的6例伴有DS的OPG患儿临床资料。患儿确诊中位年龄13.5(3~43)个月,化疗前中位体重为6.9(6~8)kg,所有患儿在确诊OPG之前均出现消瘦或体重不增,化疗前均呈极度消瘦状态,其年龄别体重Z评分(WAZ)均<-2。化疗过程中动态监测患儿的体重变化,评估化疗后1、3、6、9、12个月的WAZ,采用重复测量方差分析比较患儿化疗前后WAZ并对其生存状况进行观察随访。结果 中位随访时间46(29~59)个月,2例视力消失的患儿,经手术或放化疗后视力仍无明显改善,4例患儿起病时伴有眼震,化疗后眼震均消失,1例患儿出现中枢性性早熟。结束化疗后1例失访,3例停止化疗后肿瘤进展,予化疗维持肿瘤稳定,无死亡病例。所有患儿体重较化疗前明显增长,随着化疗时间延长,体重及WAZ增加明显(P<0.05)。结论 伴有DS的儿童OPG,术后化疗有助于改善眼震、增加体重。

特纳综合征临床诊疗管理的现状思考

特纳综合征(Turner syndrome,TS)的临床诊断存在延迟,尤其对于嵌合核型患者,诊断延迟将阻碍与年龄相适应的相关治疗,导致不良的健康结局。因此,有必要基于临床现状探索早期诊断和治疗方案的改善措施。此外,随着研究深入,TS的临床诊治重点逐渐扩展至心血管、生育力、过渡期等多方面,以提高患者的预后和生存质量。该文探讨了TS诊疗的临床现状和管理要点,旨在为改善TS诊疗管理提供思考。

幼儿行为自我调节能力的发展:母亲、同伴、教师的作用

本研究测查了120名幼儿三个时期(4岁,5岁,6岁)的行为自我调节能力以及4岁时的社会关系(母子关系、同伴关系、师幼关系),采用分层线性模型估计行为自我调节能力的起始水平和发展速率,考察社会关系的作用。结果表明:4岁时师幼亲密性越高,行为自我调节能力起始水平越高,5~6岁时的增长速率越低;4岁时同伴拒绝越高,4~5岁时行为自我调节能力的发展速率越低。

二甲双胍对妊娠期高血糖孕妇后代远期影响的研究进展

妊娠期高血糖是指孕前或孕期发生的不同程度的糖代谢紊乱,严重影响母婴结局。近些年来,妊娠期高血糖的发病率不断增加,妊娠期高血糖的孕妇在饮食及运动管理控制不佳时通常采用胰岛素及口服药物治疗。二甲双胍作为一种口服降糖药物,在降低孕妇血糖的同时,还能降低新生儿低血糖、巨大儿等不良事件的发生率,有效控制孕妇孕期体质量增长。二甲双胍治疗对母体是安全的,但与胰岛素治疗不同的是,二甲双胍能够通过胎盘进入胎儿体内,因此仍然存在二甲双胍治疗对胎儿远期预后影响的担忧。目前国内外对二甲双胍治疗的产妇后代长期生长发育影响程度尚不明确,本综述就二甲双胍作用机制及后代远期生长发育影响进行总结,并为妊娠期高血糖临床指南标准后期制定提供借鉴内容。

基于FGF23/Klotho稳态观察口服糖皮质激素致生长障碍的临床研究

目的观察长期口服糖皮质激素(glucocorticosteroid,GC)抑制原发性肾病综合征(primarynephrotic syndrome,PNS)儿童生长与FGF23/Klotho比值变化的相关性。方法前瞻性选取已停用GC 3个月以上,于2022年6—12月至河南中医药大学第一附属医院儿科医院复查的56例激素敏感型PNS儿童为研究对象。入院监测尿蛋白定性及定量后,尿蛋白复发者加用GC治疗,为GC组(n=29);尿蛋白未复发者不加用GC治疗,为无GC组(n=27)。同期选取29例3岁至青春期前年龄的健康体检儿童作为对照组。比较各组身高、骨龄、增长速度及FGF23/Klotho比值等指标,并进行相关性分析。结果GC组加用GC 1个月后的FGF23/Klotho比值高于无GC组(P<0.05),半年内的身高增长速度、骨龄增长速度均低于无GC组(P<0.05)。相关性分析显示PNS儿童治疗1个月后的FGF23/Klotho比值与治疗半年内的身高增长速度、骨龄增长速度均呈显著负相关(分别r=-0.356、-0.436,P<0.05)。结论FGF23/Klotho稳态失衡是长期口服GC导致生长障碍的机制之一。

短肽型全肠内营养疗法对克罗恩病患儿体格生长及营养状态的影响

目的探讨短肽型全肠内营养疗法对活动期克罗恩病(Crohn's disease,CD)患儿的临床诱导缓解作用,以及治疗前后体格生长和营养学指标的变化。方法前瞻性纳入2017年1月—2024年1月入住南京医科大学附属儿童医院消化科的43例活动性CD患儿为研究对象,随机分为药物治疗组(13例)和短肽+药物治疗组(30例),分析两组CD患儿治疗前后儿童CD活动指数、体格生长和营养学指标的变化。结果短肽+药物治疗组CD患儿治疗后儿童CD活动指数评分低于药物治疗组(P<0.05),年龄别体重Z评分、体重指数和白蛋白水平高于药物治疗组(P<0.05)。中重度活动短肽+药物治疗亚组患儿总蛋白水平高于中重度活动药物治疗亚组(P<0.05)。结论短肽型全肠内营养疗法可诱导活动期CD患儿的临床缓解,且能促进其体格生长,改善其营养状态。

综合儿童保健管理对早产儿生长发育和智力发育的影响分析

目的:分析综合儿童保健管理对早产儿生长发育和智力发育的影响。方法:选取2021年1月—2022年1月泰安市妇幼保健院收治的有保健管理干预需求的早产儿120例为研究对象,按照随机表数字表法分为参照组和试验组,各60例。参照组实施常规儿童保健管理,试验组实施综合儿童保健管理。比较两组身体发育指标、智力发育指标、营养性疾病发生率。结果:干预前,两组身长、体质量、头围对比,差异无统计学意义(P>0.05);干预后,两组身长、体质量、头围均增长,且试验组增长幅度大于参照组(P<0.05)。干预前,两组大运动、语言运动、社交能力、适应性、精细运动评分比较,差异均无统计学意义(P>0.05);干预后,两组大运动、语言运动、社交能力、适应性、精细运动评分均升高,且试验组高于参照组(P<0.05)。试验组营养性疾病总发生率较参照组低(P<0.05)。结论:早产儿实施综合儿童保健管理能够促进身体发育、智力发育,降低营养性疾病发生率。

维生素D在儿童保健中促进身高增长的效果

目的探讨维生素D对儿童保健身高促进的干预成效。方法选取2021年12月至2022年12月菏泽市妇幼保健院接受儿童保健的儿童140例。以随机数字表法将其纳入不同的组别,每组记录样本量为70例。对照组采用常规儿童保健治疗方案,研究组在此基础上服用维生素D,强化维生素D、身高的监测。对比分析组间骨代谢指标、生长发育结果等。结果治疗后,两组相关骨代谢指标测定结果均有较治疗前上升的趋势,研究组高于对照组(P<0.05);在骨龄、生长速率、身高、超声骨密度等方面,两组均比治疗前增长,且研究组高于对照组(P<0.05)。结论在儿童保健身高促进的治疗期间,应用维生素D可收益良好效果,除能够提高儿童身高外,还可促进其生长发育,增加其骨密度。同时,此种治疗方案对提高患儿骨代谢水平作用突出,利于改善其预后。

针对性儿童保健护理对儿童生长发育的影响研究

分析针对性儿童保健护理对于促进儿童生长发育的影响。选取2022年2月—2022年9月滨州医学院附属医院收治的80例保健儿童为研究对象,采用随机数字表法将其分为对照组和观察组,每组各40例。对照组儿童接受常规保健护理,观察组儿童接受针对性儿童保健护理,比较两组儿童的体格发育情况、疾病患病情况、生长发育情况以及儿童家长的护理满意度。结果显示,施护后,观察组儿童身高、体重和头围等各项体格发育指标均优于对照组(P<0.05);观察组总患病率为7.50%,对照组总患病率为45.00%,观察组总患病率低于对照组(P<0.05);观察组Gesell发育量表各项指标评分均高于对照组(P<0.05);观察组儿童家长护理总满意度高于对照组(P<0.05)。研究发现,针对性儿童保健护理能够有效促进儿童的健康生长发育,降低其患病率,家长对护理服务的满意度较高。

浅谈万全“育婴四法”对小儿生长发育的影响

万全提出“预养以培其元,胎养以保其真,蓐养以防其变,鞠养以慎其疾”的“育婴四法”。其中,预养以培其元包括做好备孕,避免伤害、确保健康生育;胎养以保其真则需小儿父母注意精神调摄、品德修养、饮食起居,运动、胎教等以确保胎儿健康发育;蓐养以防其变包括小儿从新生儿期到婴儿期的调护、防治疾病,调护蓐母身体等;鞠养以慎其疾包括小儿从幼儿期到学龄前期的日常调护、饮食营养、疾病防治及早期教育等方面。充分挖掘万全“育婴四法”学说的内涵,将“育婴四法”学说与小儿的生长发育联系起来,对当今小儿的生长发育具有一定的借鉴意义。