ABSTRACT
Children with infantile cholestatic liver disease are often accompanied by malnutrition, which in turn can affect its progression and prognosis. There are many factors causing malnutrition and various methods for malnutrition assessment, but there is still a lack of uniform standard for nutritional assessment in patients with liver diseases, and a variety of indicators and methods are required for comprehensive analysis and assessment. This article analyzes the common causes of malnutrition in children with cholestatic liver disease, introduces the different methods for nutritional assessment, including anthropometric measurements, laboratory examination, and nutritional assessment tools, and elaborates on nutritional intervention treatment, so as to improve the understanding of nutritional problems in children with cholestatic liver disease. Early identification and rational interventions can help to improve the quality of life and prognosis of children.
ABSTRACT
Objective:To analyze the characteristics of body composition, dietary intake and vitamin D status of school-age wasting children, and to provide evidence for individual dietary intervention and nutrient supplement.Methods:From September to December 2019, we chose wasting children aged 6-10 years old in the nutrition clinic of Beijing Children's Hospital affiliated to Capital Medical University, and a retrospective case-control study was adopted. To detect body composition and vitamin D level, and conduct dietary survey and assessment. The measurement data of normal distribution were compared by independent sample t-test. The relationship between the two variables was analyzed by Pearson correlation analysis. Rank sum test was used to compare rank data.Results:A total of 60 subjects were studied, including 30 boys and 30 girls. The percentage of inorganic salt in boys (6.81±0.37)% is higher than that in girls (6.37±0.59)%, the difference was statistically significant ( t=7.75, P=0.009). Compared with the target values of normal children of the same age and gender, the contents of fat in boys ((2.39±1.25) kg and (4.20±0.95) kg, t=43.05, P<0.001), in girls ((2.66±1.20) kg and (4.91±1.41) kg, t=59.87, P<0.001); muscle in boys ((17.35±3.23) kg and (21.57±4.94) kg, t=16.89, P<0.001), in girls ((17.69±3.03) kg and (21.79±4.36) kg, t=20.97, P<0.001); total water in boys ((13.54±2.52) kg and (16.80±3.86) kg, t=16.51, P<0.001), in girls ((13.82±2.36) kg and (16.96±3.40) kg, t=20.20, P<0.001); protein in boys ((3.58±0.67) kg and (4.51±1.04) kg, t=18.68, P<0.001), in girls ((3.65±0.63) kg and (4.55±0.92) kg, t=24.55, P<0.001); inorganic salt in boys ((1.42±0.25) kg and (1.56±0.36) kg, t=4.28, P=0.036), in girls ((1.37±0.27) kg and (1.56±0.30) kg, t=8.24, P=0.006) were all significantly reduced. The total energy intake of all the children were lower than the recommended intake for children of the same age and gender. Among them, 70.00%(42/60) of children had insufficient energy intake for breakfast, 50.00% (30/60) for lunch and 40.00%(24/60) for dinner. In terms of energy intake of three macronutrients, 53.33%(32/60) of children were deficient in carbohydrate, 50.00%(30/60) in protein and 58.33%(35/60) in fat. The mean content of 25-hydroxyvitamin D was (46.95±14.53) nmol/L in male and (46.41±14.51) nmol/L in female, all of them had Vitamin Dinsufficiency. Conclusion:Wasting children should be tested for body composition and vitamin D levels, to get individualized dietary instruction and nutrient supplementation, and improve nutritional status.
ABSTRACT
OBJECTIVE:To explore the feasibility of question-and-answer practice teaching in the pharmacy department of our hospital. METHODS:The practice teaching of pharmacy department was taken as a pilot,and the question-and-answer practice teaching was used in emergency and outpatient pharmacies,inpatient pharmacy,PIVAS,drug warehouse,clinical pharmaceutics room,preparation room and drug testing laboratory. The effects of the practice teaching on internships,teachers,pharmacy depart-ments and patients were excavated. RESULTS & CONCLUSIONS:Satisfaction of teachers,pharmacy,patients and clinics for the question-and-answer practice teaching was 100%,and satisfaction of internships was 94.5%. The question-and-answer practice teaching has improved their professional knowledge and competence,resolved difficulty of patients about drug counseling and helped the improvement of overall business level in department.