[Effects of chelation therapy with succimer in young rabbits of moderate lead poisoning].

OBJECTIVE: To explore the effect of chelation therapy with succimer (DMSA) in male rabbits of moderate lead poisoning during juvenile stage. METHODS: Twenty-four 45-day-old male New Zealand rabbits were randomly divided into three groups (therapy group, TG; positive control group, PG and negative control group, NG, n=8). The TG and PG were orally exposed to lead acetate (5 mg x kg(-1) x d(-1)) for 6 weeks. Rabbits in TG were orally supplied DMSA 1050 mg/m2 in the first week and 700 mg/m2 in the next two weeks, while the other two groups wren't blood and urinary samples of all rabbits were collected per week. The tissues and organs of all rabbits were collected after 12 weeks. The blood lead levels (BLLs) were determined by atomic absorption spectrometer. The urine lead levels and the lead contents of tissue and organ were determined by inductively coupled plasma-mass spectrometry. Histopathology of tissue and organ was observed by light microscope. RESULTS: Compared with PG, the lead level in the morning urine of TG with DMSA chelating was increased significantly. The level was peaked at (1246.96 +/- 157.91) microg/L on the first day after chelating. While the base line was (40.97 +/- 1.77) microg/L before chelating. Meanwhile, the BLLs were sharply declined from (429.63 +/- 10.82) microg/L to (238.50 +/- 11.82) microg/L. The urine lead levels of TG decreased through the 3-week chelating and 3-week discontinuation. The urine lead levels of these two groups were significantly different (F=2934.35, P<0.01). Compared to each two groups in these three groups, there were significant difference (P<0.01). The authors found the reversion of BLLs in first week after stop chelating. The BLLs of PG presented the slow course of declining in the same time, were (135.50 +/- 7.09) microg/L, very close to the level of TG for (149.88 +/- 11.39) microg/L. Compared with treatment discontinuation for 3 weeks, the urine lead levels and the body weight gain of the therapy group increased more than that of PG, and the BLLs and the lead concentrations in tissues and organs decreased more than that of PG, and histopathology in the liver tissues and testicle tissues were improved. CONCLUSION: DMSA chelating for the rodent models of moderate lead poisoning might reduce the BLLs and soft tissue lead contents quickly and effectively, decrease toxic effects of lead in a short period of time, thus alleviate the impairment of lead poisoning on tissues and organs by decreasing lead burden, and bring out improvement on the growth retardation caused by lead poisoning.

[Effects of moderate lead poisoning on the hippocampus tissue of rabbits in juvenile stage].

OBJECTIVE: To understand the effects of moderate lead poisoning on the hippocampus tissue of rabbits in juvenile stage. METHODS: Sixteen 45-day-old male New Zealand rabbits were randomly divided into blank group and lead-exposed group,8 for each group. Rabbits in the lead-exposed group were treated with 5 mg x kg(-1) x d(-1) lead acetate in their forage for 6 weeks to establish a moderate lead poisoning animal model. The blood lead levels and the lead contents in the hippocampus were determined by atomic absorption spectrometer and inductively coupled plasma-mass spectrometry respectively. Histopathology and ultra-microstructure in the hippocampus tissue were observed by light microscope and electron microscope. The NR1, NR2A and NR2B protein expressions in the CA1 hippocampal region were analyzed through immunohistochemical method. RESULTS: Compared with those of blank group, the blood lead levels of lead-exposed group were significant increased, (428.63 +/- 9.46) vs (66.38+/-3.93) microg/L (t = 100.08, P<0.01); and lead contents of hippocampus was significantly increased, (44.57+/-2.03) vs (21.20+/-1.53) ng/g, (t = 26.05, P<0.01); the hippocampus wet weight were significant decreased, (0.735 +/-0.012) vs (0.808+/-0.010), (t =12.97, P<0.01); the coefficient of hippocampus wet weight, was (0.458 +/-0.004) vs (0.476+/-0.005), (t =7.87, P<0.01). The significant declines in both the positive rate of NR1 and NR2A in the CA1 hippocampal region for NR1: (37.44 +/- 2.05)% vs (41.81+/-2.50)% (t = 3.82, P<0.01) and for NR2A: 21.97+/-1.08 vs 25.48+/-1.30 (t =5.89, P<0.01) were also observed. With light microscope and electron microscope, the histopathology and ultra-microstructure of neuron and glial cell in the hippocampus tissue were changed. CONCLUSION: The impairment of hippocampus of rabbits in juvenile stage with chronic moderate lead poisoning were observed, and the histopathology and N-methyl-D-aspartate receptor protein expressions in the hippocampus tissue were changed.

Developmental lead exposure alters gene expression of metabotropic glutamate receptors in rat hippocampal neurons.

Exposure to lead in utero and in infancy is associated with a risk of impaired cognitive development. Increasing evidence suggests that the family of metabotropic glutamate receptors (mGluRs) plays an important role in synaptic plasticity and memory formation. We determined whether mGluRs subtypes 1, 3, and 7 (mGluR1, mGluR3, and mGluR7) were involved in developmental neurotoxicity due to lead. Embryonic rat hippocampal neurons were cultured for 21 days and exposed to lead chloride beginning on the fourth day of incubation. We investigated levels of mGluR1, mGluR3, and mGluR7 mRNA expression by using quantitative real-time reverse-transcription polymerase chain reaction (RT-PCR) with lead exposure at 10 nM, 1 microM, and 100 microM. Lead exposure in vitro downregulated the expression of mGluR1 mRNA and upregulated the expression of mGluR3 and mGluR7 mRNA in a dose-dependent manner. We speculate that mGluRs may be involved in lead neurotoxicity. Pathways that likely contribute to lead neurotoxicity by means of mGluRs are impairment of long-term potentiation, effects on N-methyl-D-aspartate (NMDA) receptor functions, and depotentiation.

Exploratory analysis of early treatment discontinuation and clinical outcomes of patients with attention-deficit/hyperactivity disorder.

INTRODUCTION: This post-hoc analysis was to investigate the impact of treatment discontinuation on clinical outcomes in patients with attention-deficit/hyperactivity disorder (ADHD). METHODS: Data are from a 12-month, observational, multinational study that included outpatients aged 6-17 years who were diagnosed with ADHD and treated with atomoxetine, methylphenidate, or nootropic agents. Treatment effectiveness and proportions of patients who discontinued treatment were compared between China and the other non-Western countries/regions combined. Propensity score matching was used to further estimate the association between treatment discontinuation and effectiveness. RESULTS: Of the 546 patients who entered the study, 337 patients had complete data and were included in the analyses. Compared with the other countries/regions, China subgroup had a higher treatment discontinuation rate (odds ratio = 25.80; P < 0.0001) and poorer treatment effectiveness: least-squares (LS) mean changes were 5.74 versus 8.56 (P = 0.0225) for the Child Health and Illness Profile-Child Edition (CHIP-CE) Achievement domain and -1.87 versus -2.13 (P = 0.0401) for Clinical Global Impressions-ADHD-Severity (CGI-ADHD-S). Further analyses of matched discontinuer-maintainer pairs showed that discontinuers demonstrated poorer effectiveness: LS mean changes for the CHIP-CE Achievement domain and CGI-ADHD-S (discontinuer versus maintainer) were 5.36 versus 9.10 (P = 0.0255) and -1.32 versus -1.96 (P = 0.0179) for overall population, respectively, and 4.40 versus 10.17 (P = 0.0065) and -1.48 versus -2.45 (P = 0.0089), respectively, for China subgroup. DISCUSSION: This analysis found that early treatment discontinuation was associated with worse clinical outcomes for patients with ADHD. China subgroup had substantially higher discontinuation rates and poorer effectiveness outcomes. Strategies to improve medication persistence have the potential to improve outcomes for ADHD patients in China.

[Effects of perinatal exposure to methylmercury on the structure of hippocampus and cerebellum in young rats].

OBJECTIVE: To evaluate the effects of perinatal exposure to methylmercury on the structure of hippocampus and cerebellum in young pups. METHODS: Divided the 9 pregnant SD rats into three groups randomly: group I, II and III After exposing the rats of the three groups from day 7 in pregnancy through lactation with methylmercury (the dose were 0, 0.1 and 1mg/(kg x d) respectively), examined the early physiology development and the structure of hippocampus and cerebellum of day-21-offspring rats. RESULTS: Except for changes in body weight on 21 day, the offspring showed no apparent changes in appearance and physiology. Pyknosis in several neurons and disturbance arrangement of pyramidal cells in CA3 and CA4 region of the hippocampus were observed in hippocampus and cerebellum of the rats in group III under the microscope, while no pathological changes were observed in group II. Testing the positive expression of immunohistochemistry, we found out that the NF expression of hippocampus in II and III groups were lower than group I (F = 7.94, P < 0.01), while that of GFAP were increased significantly (F = 10.10, P < 0.01). NF expression of cerebellum in group III was lower than group II and group I (F = 6.85, P < 0.05). while that of GFAP was higher than the other two groups (F = 6.85, P < 0.05). The ultrastructure changes happened in both II and III groups examined through electron microscope, including irregular form in nucleus of neurons, pyknosis of soma, degeneration of mitochondria, lysis of dendrite and axon, et al. CONCLUSION: Perinatal low-level methylmercury exposure affected the ultrastructure and expressions of the neural cells in cerebellum and hippocampus of the young rats.

[Association between vitamin D receptor gene polymorphism and vitamin D deficiency rickets].

OBJECTIVE: To explore the genetic susceptibility of children to vitamin D deficiency rickets through studying the association between Vitamin D receptor (VDR) gene polymorphism and vitamin D deficiency rickets. METHODS: One hundred and fifty-nine children (100 boys and 59 girls, aged 0 to 2 years), with new-onset vitamin D deficiency rickets were enrolled. The patients sampled from a community of Jiamusi City, Heilongjiang Province. Seventy-eight healthy age-matched children (46 boys and 32 girls) were used as the controls. VDR gene polymorphism (cleaved by restriction endonuclease Fok I) was analyzed by polymerase chase reaction-restriction fragment length polymorphism (PCR-RFLP). The frequencies of the VDR genotype and allele were compared between the two groups. RESULTS: The frequencies of FF, Ff and ff genotypes were 37%, 51% and 12% in the Rickets group, and 18%, 55% and 27% in the Control group. A significant difference was found in the frequency distribution of the VDR genotype between the two groups (chi(2)(0.01(2))=9.210, chi(2)=13.3880, P < 0.01). In the Rickets group, f allele frequency was lower (37% vs 54%), while the F allele was more common than the Control group (63% vs 46%). CONCLUSIONS: There is an association between the VDR gene Fok I polymorphism and vitamin D deficiency rickets. The individuals with the F allele are more susceptible to vitamin D deficiency rickets.

Efficacy and safety of olanzapine for treatment of patients with bipolar depression: Chinese subpopulation analysis of a double-blind, randomized, placebo-controlled study.

BACKGROUND: Depression in bipolar I disorder responds to the atypical antipsychotic olanzapine. This subpopulation analysis assessed whether olanzapine is superior to placebo specifically in the treatment of Chinese patients with bipolar I depression. METHODS: This was a subpopulation analysis of a 6-week, multicenter, double-blind, parallel, randomized, placebo-controlled trial among 12 Chinese study centers. Eligible inpatients and outpatients were randomized to olanzapine (5 to 20 mg/day) or placebo. Patients were primarily assessed by the Montgomery-Åsberg Depression Rating Scale total score. Secondary assessments used a range of other efficacy and safety measures. This subpopulation analysis was underpowered to show statistically significant differences between treatment groups. RESULTS: In total, 210 patients (mean age 32.9 years at baseline, 54.3% females) were random-ized. Similar proportions of patients treated with olanzapine (75.0%) and placebo (72.9%) completed the double-blind phase. Baseline-to-endpoint least-squares mean ± standard error decrease in the Montgomery-Åsberg Depression Rating Scale total score in the olanzapine group (-13.55±0.80) was similar to that noted in the parent trial (-13.82±0.65). However, the difference between olanzapine and placebo groups was not statistically significant (P=0.44); this finding was also true for the secondary efficacy measures. A post hoc analysis showed a greater emergence of mania in the placebo group, which likely reduced the treatment difference between olanzapine and placebo in the primary efficacy measure. Safety data were consistent with the known safety profile of olanzapine, including a higher incidence of weight gain (≥7%) in the olanzapine group (24.1% vs 1.4%, P<0.001). CONCLUSION: Olanzapine provides similar improvement in depression among Chinese and non-Chinese bipolar I patients. The lack of a statistically significant difference between the olanzapine and placebo groups in this Chinese subpopulation analysis may relate to an a priori lack of study power, and underestimation of the effect of olanzapine because of a greater emergence of mania in placebo-treated patients and missing data associated with a high early discontinuation rate.

Differential response profiles in children and adolescents with attention-deficit/hyperactivity disorder: treatment with atomoxetine.

Atomoxetine has been shown to be safe and effective in the treatment of attention-deficit/hyperactivity disorder (ADHD). The purpose of this post hoc analysis was to examine response trajectories of pediatric patients treated with atomoxetine. Data were pooled from 7 atomoxetine double-blind, placebo-controlled clinical trials conducted in pediatric patients between November 1998 and June 2004. Growth mixture modeling was applied to the investigator-rated ADHD rating scale (ADHDRS-Inv) and Clinical Global Impressions-ADHD-Severity (CGI-ADHD-S) scores in the randomized acute phase (6-9 weeks) to explore whether there were groups of patients who differed in their response to atomoxetine. Classification and regression tree analyses were performed to identify predictors that can help categorize subjects to different response profiles. Patients (N = 925) were mostly male (73%) and of the combined subtype (74%). Most patients had a response pattern characterized by gradual, modest improvement, while a smaller group experienced early, robust improvement.

Applicability of a filter paper method to measure blood lead levels in large populations of Chinese children.

BACKGROUND: Capillary filter paper can be useful for screening blood lead concentrations in large populations of geographically dispersed Chinese children. METHODS: A total of 159 at 0-6 years of age were enrolled in the study when they came for routine pediatric care. Paired venous and capillary filter paper samples were collected from all subjects. Graphite furnace atomic absorption spectrophotometry was used to measure blood lead concentrations. Comparability of the lead assay methods was assessed. The concordance coefficient between these two methods was 0.87 (p < 0.01). The values of blood lead concentrations measured by the different methods were comparable statistically. The sensitivity of the filter paper method was 85%, 73% and 75%; specificity was 92%, 99% and 100%; the positive predictive value was 86%, 89% and 100%, and negative predictive value was 91%, 98% and 99% at cut-offs of 10, 15 and 20 microg/dl, respectively. The Youden's index was 77, 71 and 75 at those cut-offs. Values obtained via the filter paper method appeared to be relatively stable up to 4 weeks post-collection. CONCLUSIONS: The filter paper method for lead determinations has a sufficiently high sensitivity and specificity and correlates well with venous sampling. The ease with which this technique can be performed and screened samples can be sent to a centralized laboratory by regular mail indicates that it is a promising and attractive reference method, particularly in large populations of widely dispersed young children in China and other countries.

[Hearing screening for high-risk newborns].

OBJECTIVE: To investigate the morbidity of congenital hearing impairment among high-risk newborns and the relevant pathogenic factors. METHODS: Initial screening of hearing by otoacoustic emission (OAE) was conducted among 208 high-risk newborns, 130 males and 78 females after they were born and the second screening was conducted by OAE was conducted 42 days after those with positive results were examined by auditary brainstem response (ABR). RESULTS: All of the 208 newborns received the initial screening with a screening rate of 100%, and 130 newborns received the second screening with a screening rate of 62.5%. The positive rates in the initial screening and second screening were 34.61% and 7.14% respectively. Six newborns were examined by ABR and 2 of them were diagnoses as with hearing impairment with a prevalence rate of 1.78%. The factors, such as sex, age, and Apgar score affected the initial screening results. CONCLUSION: The most proper time for initial hearing screening is around the 42nd day after birth. High-risk newborns should receive regular test even though they pass the initial screening. A special follow-up system should be constructed for the high-risk newborns.

[An epidemiological study on sleep problems in children aged 1 to 23 months in Shanghai].

OBJECTIVE: To understand prevalence of sleep problems and presence of improper sleep habit of children aged one to 23 months in Shanghai, and to identify their related factors. METHODS: Totally, 1 252 normal children, without severe illness and abnormal delivery history, aged one to 23 months were randomly selected from five districts of Shanghai. Under strict quality control system, their parents were interviewed with questionnaire to look into their familial and social environment, as well as sleep-related factors. RESULTS: Fully-completed information was obtained in 1 129 of 1 252 children, with a response rate of 90.18%. Prevalence of sleep problems in children was 65.90% in Shanghai, remarkably higher than in the other areas. Prevalence of nightmare, level of fright at night, snore and sleep apnea in boys were significantly higher than those in girls. Prevalence of improper sleep habit in children was also higher, including sleeping with their parents, parental presence at sleep onset and irregular sleep time. Main risk factors related to children's sleep problems were maternal anxiety, children's irregular sleep time, parental presence at sleep onset, difficulty-type temperament and maternal poor sleep during pregnancy. CONCLUSIONS: In Shanghai, prevalence of sleep problems in children aged one to 23 months was relatively higher and main risk factors for them were social, cultural and familial environment, especially negligence of cultivating proper sleep habit and parental improper response to children's poor sleep behavior.

Does participation in a weight control program also improve clinical and functional outcomes for Chinese patients with schizophrenia treated with olanzapine?

OBJECTIVES: This study examined whether participation in a weight control program (WCP) by patients with schizophrenia treated with olanzapine was also associated with improvements in clinical and functional outcomes. METHODS: A post-hoc analysis was conducted using data from the Chinese subgroup (n=330) of a multi-country, 6-month, prospective, observational study of outpatients with schizophrenia who initiated or switched to oral olanzapine. At study entry and monthly visits, participants were assessed with the Clinical Global Impression of Severity, and measures of patient insight, social activities, and work impairment. The primary comparison was between the 153 patients who participated in a WCP at study entry (n=93) or during the study (n=60) and the 177 patients who did not participate in a weight control program (non-WCP). Mixed Models for Repeated Measures with baseline covariates were used to compare outcomes over time. Kaplan-Meier survival analysis was used to assess time to response. RESULTS: Participants had a mean age of 29.0 years and 29.3 years, and 51.0% and 57.6% were female for WCP and non-WCP groups, respectively. Average initiated daily dose for olanzapine was 9.5±5.4 mg. WCP participants gained less weight than non-participants (3.9 kg vs 4.9 kg, P=0.03) and showed statistically significant better clinical and functional outcomes: greater improvement in illness severity (-2.8 vs -2.1, P<0.001), higher treatment response rates (94.1% vs 80.9%, P<0.001), shorter time to response (P<0.001), and greater improvement in patients' insight (P<0.001). Patients who enrolled in a WCP during the study had greater initial weight gain than those who enrolled at baseline (P<0.05), but similar total weight gain. CONCLUSION: Participation in a WCP may not only lower the risk of clinically significant weight gain in olanzapine-treated patients, but may also be associated with additional clinical and functional benefits.

[Sleep habits and sleep disturbance in school-age children of China].

OBJECTIVE: To survey the sleep habits (bedtime, wake time), sleep duration, and sleep problems in school-age children of China. METHOD: From November to December, 2005, a total of 19,299 school-age children from 55 elementary schools of 9 cities entered the study by a cross-sectional survey. A parent-administered questionnaire and the Chinese version of the Children's Sleep Habits Questionnaire were applied to investigate children's sociodemographic characteristics and sleep behaviors, respectively. RESULTS: The mean sleep duration was 9 hours and 10 minutes (9:10, SD:48 min) during the weekdays and 9:48 (SD: 63 min) during the weekends. In about 71.4% and 41.8% school-aged children the sleep duration per day did not reach the lowest criterion of 10 hours recommended by the Ministry of Education of China during weekdays and weekends, respectively. Sleep problems were common with prevalence ranging from 14.5% for sleep-disordered breathing to 75.3% for daytime sleepiness. Parasomnia (chi(2) = 13.76, P < 0.01) and sleep-disordered breathing (chi(2) = 119.83, P < 0.01) were more prevalent in boys than in girls; however, sleep anxiety was more prevalent in girls than in boys (chi(2) = 19.42, P < 0.01). Except for night waking, other types of sleep problems were significantly associated with age. CONCLUSIONS: Inadequate sleep duration and sleep problems prevail among school-age children, which indicates that children's sleep health may be a major public health concern in China.

[Development and psychometric properties of the Chinese version of Children's Sleep Habits Questionnaire].

OBJECTIVE: To develop the Chinese version of Children's Sleep Habits Questionnaire (CSHQ) by translating and retranslating the English version of CSHQ and to examine the reliability, content validity, construct validity of the Chinese version in a general population of school-age children. METHODS: During November and December 2005, a total of 20 457 school-age children from 55 primary schools of 9 cities were recruited through cluster-stratified selection, using geographic location, economic standard, and population density as criteria. A parent-administered questionnaire and the Chinese version of CSHQ were completed to quantify sociodemographic characteristics and to characterize sleep patterns and sleep disturbances, respectively. RESULTS: The internal consistency of overall questionnaire and the eight subscales of the Chinese version of CSHQ was good (Cronbach's alpha coefficient was 0.73 and ranged from 0.42 to 0.69, respectively). The consistency between mother and father was ICCs = 0.89 for overall questionnaire and ranged from ICCs = 0.83 to ICCs = 0.92 for subscales. The test-retest reliability was ICCs = 0.85 for overall questionnaire and range from ICCs = 0.60 to ICCs = 0.88 for subscales. Factor analysis revealed a three-factor structure, which could represent bedtime behavior problems, sleep disturbance, sleep duration and daytime sleepiness, respectively, and the three factors could be used to explain 58.63% of the total variance. The factor loading was above 0.5 for the corresponding subscale. CONCLUSIONS: Reliability, content validity and construct validity of the Chinese version of CSHQ in a general population of school-age children are good. It appears to be a suitable instrument for measuring sleep patterns and screening for sleep problems in school-aged children.

[Parental education to reduce blood lead levels in children with mild and moderate lead poisoning: a randomized controlled study].

OBJECTIVE: To evaluate the effectiveness of parental education on reducing lead exposure of children by examining the changes in blood lead levels of children whose parents receiving or not receiving educational intervention. METHODS: Two hundred children with confirmed blood lead levels beyond 100 microg/L were selected. They were randomized into two groups, 107 children in study group and 93 in control. At the beginning of the study, parents of both study and control groups were called for interview to complete KABP questionnaire and lead study questionnaire. The study group was provided with interventional measures while control group was not contacted until the end of study. Intervention of parental education was undertaken by means of a TV program, a set of slides and a brochure, and focused on the questions regarding harmful effects of lead poisoning, the sources of environmental lead and prevention of this preventable disease. Tests for blood lead level were repeated for both study and control groups 3 months after the determination of the initial blood lead level. RESULTS: All the relevant knowledge of health effect, lead sources and prevention of childhood lead poisoning of participating parents of study group were improved significantly (chi(2) = 14.06, 13.07, 10.08, 28.26, P < 0.01) after educational intervention while parents control group also were significantly improved in the sub-catalogs of concept and prevention (chi(2) = 7.69, 8.64, P < 0.01), but not the health effect and sources of childhood lead poisoning. Children and parents' behavior in study group was improved accordingly and significantly. Less children ate popcorn (chi(2) = 4.08, P < 0.05), less children drank tap-water in the morning (chi(2) = 23.04, P < 0.01), more kids washed their hands before eating (chi(2) = 5.82, P < 0.05), less kids played on road side (chi(2) = 9.60, P < 0.01), and more parents changed their coat or took shower or washed hands before going home after work (chi(2) = 4.00, P < 0.05). But in the control group only the number of kids playing on road side was decreased significantly (chi(2) = 9.60, P < 0.01). A general decline in blood lead levels was detected in both groups with statistical significance at P < 0.01. However, the decrease in blood lead levels was more remarkable in the study group. There was average reduction of 55 microg/L (35%) in blood lead levels for study group (t = 4.979, P < 0.01) and an almost 33 microg/L (20%) for control (t = 3.398, P < 0.01). The reduction in blood lead level was 22 microg/L greater in study group (t = 3.531, P < 0.01). The study also showed that the effectiveness of the educational interventions depended upon various aspects. Fourteen variables were included in the stepwise multiple regression equation of blood lead level changes. Such as parents' occupational exposure to lead, the improvement of knowledge about prevention of childhood lead poisoning, the chang of habit of snacks intake, parents' education levels, the change of attitude of parents for the childhood lead poisoning, etc. CONCLUSION: Educating parents is proved to be an effective approach for children with mild and moderate lead poisoning.

[The parents' opinions on screening program regarding newborn hearing].

OBJECTIVE: To investigate opinions on screening of newborn hearing from parent's and its influence to parents and their families. METHODS: Parents were divided into two groups and were given the same questionnaire. Those parents whose babies had passed the first test were in the first group, and those parents whose babies failed the test were in the second group. RESULTS: Most of the parents showed their ignorance to hearing screening with about 97.5% of parents admitted they had little knowledge of hearing screening. 93.06% of the parents showed positive attitude to the screening after being informed of the test. 59.73% of the parents thought the test results were reliable. 73.12% of the parents whose babies showed negative result at the first-test, thought the results were accurate. There were only 38.19% of the parents whose babies failed the first test held the same opinion. We also found that there were some disagreement among 78% of the parents who believed that the positive screening results might cause additional psychological stress on them and therefore affecting their normal family life. CONCLUSIONS: Being informed of the screening, parents showed awareness of the test and were willing to cooperate. They believed the test was beneficial to their babies. Some parents whose babies did not pass the first screening test were often doubtful to the results and refused to be followed up. Therefore, we should improve our diagnostic technology to reduce the negative effects of the test. The results of our investigation suggested that the newborn hearing screening was applicable in our country.