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Breastfeeding plays a crucial role in the early and even later health of offspring.Epidermal growth factor(EGF)in breast milk is one of growth factor family members, which can regulate energy balance and is closely related to the growth and development of infants.In recent years, researchers at home and abroad have paid close attention to the research of EGF in breast milk.The paper summarizes the basic situation of EGF, and the content, the influencing factors, the main functions of EGF in breast milk and the risk relationship between EGF in breast milk and diseases, in order to point out the direction for further research of EGF in breast milk.
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Objective:To monitor iodine nutrition of women during late pregnancy and examine the correlation between maternal urine iodine concentration and newborn physical development.Methods:Prospective cohort study was conducted in 151 pregnant women at 28-34 weeks' gestation who accepted nutrition follow-up between December 2014 and August 2015. Participants were surveyed twice at enrollment and hospitalization for delivery respectively by iodine related food frequency method and 24 h diet diary and dietary nutrition software was used to calculate diet iodine consumption amount. Spot urine samples were taken three times totally every two weeks and data of antenatal care was recorded and the participants were divided into groups during this period. The physical development indexes and neonatal thyroid stimulating hormone (TSH) levels were obtained.Results:Maternal median urinary iodine concentration was 100.0 μg/L. Using urinary iodine levels 150 μg/L and 249 μg/L as cut-off points, participants were divided into three subgroups as iodine-insufficient, iodine-adequate and iodine-over, with incidences of 76.8% ( n=116), 19.2% ( n=29), and 4.0% ( n=6), respectively. Subgroup analysis showed no significant differences between the iodine-insufficient group ( n=116) and the iodine-sufficient group ( n=35) in neonatal weight [(3 295±370) vs (3 395±450)g, P=0.183], neonatal length [50.0(48.0, 50.0) vs 50.0(49.0, 51.0)cm, P=0.171], neonatal head circumference [34.5 (34.0, 35.0) vs 34.5(34.0, 35.0)cm, P=0.691], or neonatal thyroid stimulating hormone levels [(4.0±1.9) vs (4.2±2.5)mIU/L, P=0.438]. Conclusions:According to World Health Organization criteria, iodine deficiency rate in women during late pregnancy reaches 76.8%. In this study there is no significant difference in newborn physical development indexes among various pregnancy iodine nutrition statuses.
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Objective@#To investigate the levels of vitamin D and the correlation between DPN and vitamin D in elderly patients with diabetic peripheral neuropathy(DPN).@*Methods@#A total of 849 patients aged 60 years and over admitted into endocrinology department from June 2016 to September 2017 were enrolled in this retrospective case-control study.According to DPN diagnostic criteria, patients were divided into the non-DPN group(n=542)and the DPN group(n=307). The 25(OH)-vitamin D[25(OH)D]level and blood biochemical parameters were determined and compared between the two groups.The risk factors for DPN were analyzed using logistic regression analysis and plotting receiver operating characteristic(ROC)curves.@*Results@#The mean of serum 25(OH)D level in the 849 patients was 43.9±19.4 nmol/L.Serum 25(OH)D level was lower in the DPN patients than in the non-DPN patients[(40.9±20.4)nmol/L vs.(45.7±18.6)nmol/L, P<0.05]. The incidence of 25(OH)D deficiency was higher in the DPN group than in the non-DPN group(72.3% or 222/307 vs. 64.6% or 350/542, P<0.05). Binary logistic regression analysis indicated that 25(OH)D was a protective factor for DPN(OR=0.980, 95% CI: 0.964~0.995, P<0.05)and the disease duration was a risk factor for DPN(OR=1.048, 95% CI: 1.027~1.070, P<0.001). ROC analysis indicated that the diagnostic cut-off value of serum 25(OH)D for predicting DPN was 37.5nmol/L, with a Youden index of 0.17, sensitivity of 0.65 and specificity of 0.52.@*Conclusions@#The 25(OH)D level is much lower in diabetic patients, especially in DPN patients.Higher 25(OH)VD level might be a protective factor for DPN, and vitamin D might be one of potential biomarkers for DPN in diabetic patients.
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Objective To investigate the levels of vitamin D and the correlation between DPN and vitamin D in elderly patients with diabetic peripheral neuropathy(DPN).Methods A total of 849 patients aged 60 years and over admitted into endocrinology department from June 2016 to September 2017 were enrolled in this retrospective case-control study.According to DPN diagnostic criteria,patients were divided into the non-DPN group(n=542)and the DPN group(n=307).The 25 (OH)-vitamin D[25(OH)D]level and blood biochemical parameters were determined and compared between the two groups.The risk factors for DPN were analyzed using logistic regression analysis and plotting receiver operating characteristic(ROC)curves.Results The mean of serum 25(OH)D level in the 849 patients was 43.9± 19.4 nmol/L.Serum 25(OH)D level was lower in the DPN patients than in the non-DPN patients [(40.9 ± 20.4) nmol/L vs.(45.7 ± 18.6) nmol/L,P ＜ 0.05].The incidence of 25(OH)D deficiency was higher in the DPN group than in the non-DPN group(72.3％ or 222/307 vs.64.6％ or 350/542,P＜0.05).Binary logistic regression analysis indicated that 25(OH) D was a protective factor for DPN(OR =0.980,95％ CI:0.964～0.995,P ＜0.05)and the disease duration was a risk factor for DPN(OR =1.048,95％ CI:1.027～1.070,P＜0.001).ROC analysis indicated that the diagnostic cut-off value of serum 25(OH)D for predicting DPN was 37.5nmol/L,with a Youden index of 0.17,sensitivity of 0.65 and specificity of 0.52.Conclusions The 25 (OH)D level is much lower in diabetic patients,especially in DPN patients.Higher 25(OH)VD level might be a protective factor for DPN,and vitamin D might be one of potential biomarkers for DPN in diabetic patients.
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Objective To investigate the vitamin B 12 status of vegetarians in Shanghai.Methods A total of 282 adult vegetarians and 282 omnivores matching by gender and age were recruited in Shanghai.Their dietary intakes were collected.The serum concentrations of vitamin B12,folate and homocysteine were tested.The red blood cell,hematocrit value,mean corpuscular volume and mean erythrocyte width were also examined.Results The daily average intake of dietary vitamin B12 was (0.46± 1.01) μg/d in vegetarians and only (0.1±0.46) μg/d in vegans,which was lower than that of omnivores [(3.91±6.92) μg/d,F=50.57,P＜0.01].137 omnivores and 274 vegetarians had less dietary vitamin B12 level than recommended nutrient intake (RNI) and the difference was statistically significant (x2 =114.77,P＜ 0.01).54.26％ of vegetarians,68.92％ vegans,49.04％ ovo-lacto vegetarians and 15.60％ omnivores had hyperhomocysteinemia and the differences between vegetarians and omnivores were statistically significant (all P＜0.01).After adjusting the confounding factors the hematocrit value was higher in vegetarians,vegans and ovo-lacto vegetarians than in omnivores (27.42％± 18.32％,28.73％± 18.19％,26.95％± 18.38％ vs.8.96％± 16.59％,P＜0.01).Vegans had lower red blood cell counts and higher hematocrit value and mean corpuscular volume than omnivores.Conclusion Vitamin B12 deficiency combined with an elevated level of homocysteine and red blood cell volume growth are common but serious issue in vegetarians,especially in vegans.
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Objective To investigate the impact of an infant formula supplemented with 1.34 g/L oligosaccharides mixture (galactooligosaccharides and fructooligosaccharides,GOS+FOS) on growth,stool characteristics and fecal beneficial bacteria content in healthy infants.Methods 25 formula-fed (FF) infants and 29 breast-fed (BF) infants within 3 weeks after birth were included and followed up.FF infants were exclusively fed with GOS+FOS supplemented formula at the median age of 13d (1-27d).Body weight and head circumference at 6 and 12 weeks were measured.The frequency,consistency,and color of the infant's stool,and occurrences of spit-up or vomiting during the study period were recorded daily by the parents.Stool samples were collected at 6 and 12 weeks of age,and then subjected to quantitative real-time polymerase chain reaction assays for the enumeration of lactobacillus,bifidobacteria,Bifidobacterium longum,Bifidobacterium breve and Bifidobacterium adolescentis.Results No difference in daily weight gain was detected between the two groups (33.56 ± 7.03g vs.31.18 + 6.91g,P=0.22)during the observation phase from 6 to 12 weeks.FF infants had less frequent and firmer stools at 6 weeks than BF infants,and they both had similar stool frequency,color and consistency at the end of study.FF infants had less fecal Bifidobacterium,B.longum and B.breve at 6 weeks,but those differences became less significant at 12 weeks with more increase in fecal B.longum and B.breve levels in FF infants during the follow up.Conclusions The GOS+FOS supplemented formula provides adequate nutrition for growth,and promotes soft stools and intestinal bifidogenic effects in healthy infants.
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Objective To investigate the association between choline intake during pregnancy and choline metabolism in parturients and infants,and to analyze the difference in plasma choline level between premature and healthy full-term infants at birth.Methods Neonates who were born in the Department of Obstetrics of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from September 2014 to May 2016 were enrolled.Demographic and clinical information of these neonates and their mothers were recorded.Dietary choline intake during pregnancy was determined on the second day after delivery using food frequency questionnaires.Free choline levels in plasma of all parturients and neonates were measured.Then,data were collected and analyzed by independent samples t-test,trend Chi-square test,Chi-square test and linear regression methods.Results (1) A total of 134 parturients and their neonates were enrolled in this study including 80 full-term infants and 54 premature infants.Compared with the full term group,the parturients in the premature group had higher pregestational BMI (22.7±3.2 vs 20.8±2.3,t=-3.720) and lesseducation background (trendx2=4.020) (both P＜0.05).(2) The food frequency questionnaires showed that 30.0％(24/80) of pregnant women in the full-term group reached adequate intake (AI) of choline during pregnancy,while only 11.1％ (6/54) in the premature group did.(3) Plasma choline level in maternal peripheral blood was positively associated with maternal dietary choline intake during pregnancy (r=0.882,r2=0.778,P＜0.001).Moreover,plasma choline level in the umbilical artery was closely related to maternal plasma choline level (r=0.965,r2=0.931,P＜0.001).(4) The dietary choline intake during pregnancy,maternal plasma choline level and plasma choline level in umbilical artery in premature infant group were all lower than those of full-term group [(305.24± 102.17) vs (386.16± 121.36) rmg/d,t=4.026;(5.23±0.79) vs (7.18± 1.51) μmol/L,t=9.783;(20.68±3.52) vs (27.96±3.94) μmol/L,t=10.930;all P＜0.01].Conclusions Insufficient dietary intake of choline during pregnancy is common.The dietary choline intake during pregnancy in parturients of preterm delivery group is lower than that in full-term group.Dietary choline intake during pregnancy is related to plasma choline level in umbilical artery.Therefore,dietary guidance should be emphasized for pregnant and lactating women to increase the intake of foods rich in choline.It is also important to provide premature infants with choline in time to meets the needs of their development.
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Objective To understand the effectiveness of peroral endoscopic myotomy(POEM)for achalasia and secondary severe malnutrition in children and the effectiveness of nutrition support before and after POEM.Method Treatment of POEM,nutrition support(tube feeding by percutaneous endoscopic gastrostomy three months before operation)in one case were recorded and analyzed.Results POEM was successful without any complication such as perforation,bleeding,and pneumoderm.The child suffered from fever after surgery,which was dissolved after symptomatic treatment three days later.Chest pain was relieved after changing position.The diet was changed from liquid to semifluid,and then to normal diet.The child did not have dysphagia.During the 6-month follow-up,the patient had normal diets by oral route.The weight was 32 kg before achalasia and decreased to 18 kg after 9 months(at admission);it then increased to 29 kg after short-time(12 days)parenteral nutrition and long-time(3 months)enteral nutrition by percutaneous endoscopic gastrostomy,and then the patient received POEM.His weight was 30,31,31,29,and 31 kg 1,4,6,9,and 13 months,respectively,after POEM.Conclusion POEM can effectively cure achalasia in pediatric patients and improve the quality of life.Rational enteral nutrition can improve nutrition status and facilitate a successful POEM.
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Objective To assess the enteral iron and energy intake of premature neonates during hospitalization in neonatal intensive care unit(NICU).Methods This retrospective study enrolled 208 premature neonates admitted in the NICU of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine within 48 hours after birth from January 2012 to December 2013.The following data were recorded for all infants:clinical basic information,the amount of formula iron intake in milk,enteral and parenteral nutrition intake as well as oral iron supplementation.Results The amount of enteral iron intake in the 1st,2nd,3rd,4th week after birth and at discharge was (0.2 ± 0.3) mg/(kg · d),(0.9 ±0.7) mg/(kg · d),(1.2 ±1.0) mg/(kg · d),(1.5 ± 1.1) mg/(kg · d),and (2.2 ± 1.1) mg/(kg · d),respectively,which accounted for 10％,45 ％,60％,75 ％ and 110％ of the recommended iron intake.The energy intake in the 1st,2nd,3rd,4th week after birth and at discharge was (13.2 ± 14.8) kcal/(kg · d) (1 kcal =4.184 kJ),(46.0 ± 32.6) kcal/(kg · d),(62.2 ± 38.1) kcal/(kg · d),(71.3 ± 38.2) kca]/(kg · d) and (105.3 ± 32.1) kcal/(kg · d),which accounted for 11.0％,38.3％,51.8％,59.4％ and 87.8％ of the recommended intake,respectively.Lower enteral iron and energy intake after birth occurred in the premature infants with lower birth weight,especially those with anemia who had significantly lower enteral iron intake than the normal neonates in the first 2 weeks after birth.Conclusions Enteral iron and energy intake among premature neonates were insufficient,especially during the first 2 weeks after birth.It is necessary to develop and implement more effective nutritional support to improve the nutritional status of premature infants.
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Objective To investigate urinary iodine and dietary iodine intake in adults, and to ana-lyze the relationship of urinary iodine and daily dietary iodine intakes with thyroid nodules.Methods To-tally 30 participants with nutritional background were enrolled prospectively from January to March 2015 in Shanghai.The 3-day survey of 24-hour's diet record was made using weighting method to evaluate the daily nutrient intakes.On the second and third days of dietary records, urine samples in fasting status and 2 hours after meals were collected from all the participants (n=240).The levels of urine iodine were meas-ured, and dietary iodine intake calculated.3-month food frequency questionnaire was completed and thy-roid ultrasonography performed.Results The median urinary iodine ( MUI) of fasting and 2 h postprandi-al urine samples was 137.56 μg/L ( 91.4-211.5 μg/L) .The portions of participants with iodine insuf-ficiency, iodine adequate, and iodine above requirements or excess were 20.2%, 56.7%, and 23.3%, respectively.Inter-individual MUI varied from 36.31 μg/L to 359.20 μg/L.No significant difference was found between the fasting urinary iodine and 2 h postprandial urinary iodine ( P=0.389 ) .The average di-etary iodine intake was (197.2 ±74.2) μg/d, and the proportions from iodine salt and drinking water were 70.2% and 5.4%, respectively.There was a significant positive correlation between dietary iodine intake and urinary iodine value of the same day (r=0.426, P=0.019).Participants with thyroid nod-ules had higher urinary iodine than participants without thyroid nodules [ ( 194.0 ±101.5 ) μg/L vs. (135.7 ±72.9) μg/L, P<0.001].Conclusions Inter-individual iodine nutritional status are signifi-cantly different under natural living status.Increased urinary iodine may be related with thyroid nodules. Repeat random urine iodine test combined dietary assessment may reduce the error in evaluating individual iodine nutritional status.
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Objective To investigate the association between activity energy expenditure ( AEE ) and body composition in school-age children.Methods A total of 62 students ( Grades 3 and 4, aged 8 -10 years) from a primary school in Shanghai were enrolled in this study .AEE was estimated with a metabolic cart (energy metabolism determination system ).Body composition (body mass, body mass index, fat percentage, fat mass, fat-free mass, fat mass index, fat-free mass index, obesity degree) was evaluated by bioelectrical im-pedance analysis .The above indicators were compared between obese and non-obese students .Results There were no statistically significant differences in exercise time , total AEE and relative AEE between obese and non-obese boys [ (9.70 ±1.91) min vs.(10.00 ±1.97) min, t=0.336, P=0.739; (198.74 ±53.33) kJ vs.(171.54 ±41.75) kJ, t =-1.422, P =0.165; (0.46 ±0.09) kJ/(min· kg) vs.(0.51 ± 0.04) kJ/(min· kg), t=2.043, P=0.051], while obese boys had higher absolute AEE than non-obese boys [(20.06 ±3.14) kJ/min vs.(16.93 ±1.85) kJ/min, t=-2.910, P=0.007].Obese girls had shor-ter exercise time and lower relative AEE than non-obese girls [ (7.35 ±3.05) min vs.(9.98 ±1.82) min, t=2.509, P=0.027;(0.41 ±0.09) kJ/(min· kg) vs.(0.51 ±0.07) kJ/(min· kg), t=3.244, P=0.003 ] , whereas there were no statistically significant differences in total AEE and absolute AEE between obese and non-obese girls [ (129.29 ±71.13) kJ vs.(161.50 ±35.38) kJ, t =1.351, P =0.203; (16.82 ± 3.26) kJ/min vs.(16.17 ±2.00) kJ/min, t=-0.676, P=0.504].After controlling for age and gender, absolute AEE was significantly positively correlated with body mass index ( P=0.015 ) , obesity degree ( P=0.010), fat mass (P=0.047), fat-free mass (P=0.010), and fat-free mass index (P=0.003) in boys, but not in girls.Relative AEE was significantly negatively correlated with body mass index ( boys: P =0.000, girls: P=0.000), obesity degree (boys: P=0.002, girls: P=0.000), fat percentage (boys:P=0.000, girls:P=0.001), fat mass (boys:P=0.000, girls:P=0.000), fat-free mass (boys: P=0.002 , girls: P=0.022 ) , and fat mass index ( boys: P=0.000 , girls: P =0.000 ) in both boys and girls.Conclusions In obese children, AEE is correlated with body composition, with relative AEE reducing as obesity degree increasing.There may be complex relationships among body size , body composition, and energy metabolism in children.
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Extrauterine growth restriction (EUGR) in premature infant is a common problem in the world. The reasons for high EUGR rate, such as declining gestational age and birth weight, getting more medical treatment and examination or interruption of nutritional support, had been profoundly studied. However, there are few reports about the limited ability of intakes of energy and various nutrients and the updating of the growth standard curve . Research suggested that the average time taken to reach the recommended fat intake in preterm infants is proximately day 6 after birth, protein day 4 after birth, carbohydrate one-week after birth. Vitamins and trace elements are usually not able to or take a long time to reach the recommended nutrient intake. Without enough intake of energy and nutrients to maintain the need of intrauterine growth rate and catch-up growth in preterm infants, EUGR cannot be improved. In this paper, the EUGR and the intake of important nutrients, such as energy, fat, protein, vitamins and minerals, etc., during hospitalization were reviewed in hope to achieve more rational and standardized management for preterm infant,and provide more reasonable advise to control EUGR.
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Objective To investigate the effect of nutritional therapy for an infant with short bowel syndrome (SBS) who had jejuno-colostomy. Methods An individualized nutritional support before and after the closure of jejunum colostomy was provided to a 3-month-old girl with SBS who had jejuno-colostomy so as to find out its influence on prognosis. Results Paren-teral nutrition is a life-saving therapy for infants with SBS. The proper enteral nutrition can improve intestinal tolerance and re-duce the incidence of postoperative complications, and improve outcomes of SBS infants. Conclusions Appropriate nutrition therapy is important to reduce the complications and improve the prognosis of SBS infants.
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Objective To describe aerobic capacity and body composition of school-aged children in Shanghai and explore the potential relationship between body composition and aerobic capacity.Methods Totally 63 school-aged children in Shanghai were measured for height,weight,fat percentage (FAT％),and fat-free mass (FFM).Body composition was estimated from bioelectrical impedance analysis (BIA).Body mass index (BMI),fat mass index (FMI),and fat-free mass index (FFMI) were calculated.Aerobic capacity (VO2max and the maximum oxygen pulse) were measured using the COSMED fitmate metabolic systems (combined heart rate and cycling test).Results The boys who were obese or overweight had both higher absolute value of VO2max and lower relative values of VO2max than other boys [(1 038.50 ± 157.93) ml/min vs (923.90±82.03) ml/min,F=4.812,P=0.005; (23.62±4.22) ml/ (kg· min) vs (27.75 ±2.41) ml/ (kg · min),F =5.633,P =0.002].The girls who were obese or overweight tended to have higher absolute value of VO2max [(966.70 ± 131.22) ml/min vs (892.55 ± 108.71) ml/min] and lower relative values of VO2 max [(23.84 ± 4.30) ml/ (kg · min) vs (28.09 ± 4.52) ml/ (kg · min)] than other girls.After controlling for age,the relative VO2max values were negatively associated with body mass index (BMI),degree of obesity,FAT％,FM,FFM,FMI,FFMI (boys:r =-0.675,P ＜ 0.000 1 ; r =-0.634,P＜0.000 1; r=-0.667,P＜0.000 1; r=-0.726,P＜0.000 1; r=-0.594,P＜0.000 1;r=-0.686,P＜0.000 1; r=-0.456,P=0.010; girls:r=-0.651,P ＜0.000 1; r=-0.552,P=0.002; r=-0.527,P=0.003; r=-0.633,P＜0.000 1; r=-0.520,P=0.004; r=-0.579,P=0.001 ; r =-0.597,P =0.001).In boys,the maximum oxygen pulse was positively correlated with BMI,FFM,and FFMI (r =0.358,P=0.048; r =0.543,P=0.002; r =0.554,P=0.001); in girls,the maximum oxygen pulse was positively correlated with FFM and FFMI (r =0.378,P =0.043 ; r =0.449,P =0.014).Conclusions Aerobic capacity is associated with body composition in school-aged children.Higher degree of obesity is associated with poorer aerobic capacity.Maximum oxygen pulse is also associated with FFM.
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Anemia is one of the most common disease in premature infants,it not only affects growth and development,but also have long-term impact on the future movement,cognition,learning ability and behavioral development,and most of mental harms nor reversible even though after iron supplementation.So,supplementation with intravenous iron will be a good approach to prevent and treatment with anemia for oral iron supplementations invalid or intolerant infants.Currently,safety and start time for iron supplementation in preterm infants remains controversial.This review focuses on the efficacy and safety of intravenous iron for prevent and treatment of iron deficiency anemia in preterm infants.
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Objective To survey the nutritional status and nutritional knowledge,attitude and practice (KAP) of primary and middle school teachers in Shanghai,and to study the possible correlation of nutritional KAP with overweight/obesity and obesity-related complications.Method Using stratified cluster random sampling,a questionnaire survey was conducted among 544 hygiene teachers and 150 non-hygiene teachers selected from all primary and middle schools in all districts in Shanghai,investigating the nutritional status and nutritional KAP in this population.Results The prevalence of overweight/obesity and obesity-related complications were significantly lower in hygiene teachers than in non-hygiene teachers (19.81％ vs.38.15％,t =22.303,P=0.000; 18.6％ vs.26.39％,t =4.156,P=0.047).The attitude score was the highest among the 3 surveyed parts,significantly higher than the lowest,which was practice score (hygiece teachers:91.76 ±13.66 vs.74.42±11.61,t=14.595,P=0.000; non-hygiene teachers:85.67 ±18.77 vs.69.88 ±13.30,t =25.400,P =0.000).Hygiene teachers scored significantly higher than non-hygiene teachers in all the 3 parts of KAP (knowledge:84.43 ± 11.98 vs.75.73 ± 16.82,t =5.822,P =0.000; attitude:91.76 ± 13.66 vs.85.67±18.77,t =3.640,P=0.000; practice:74.42 ±11.61 vs.69.88 ±13.30,t =4.030,P=0.000).There was no correlation between the teachers' body mass index and KAP scores,nor between obesityrelated complications and knowledge or attitude scores,while obesity-related complications was found correlated with practice score and KAP score (t =-0.146,P =0.005 ; t =-0.105,P =0.043).Conclusions The nutritional status of teachers in Shanghai primary and middle schools is associated with their nutritional KAP.There is a correlation between obesity-related complications and practice score.Hygiene teachers have better nutritional KAP compared with non-hygiene teachers.
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Objective To evaluate the effects of iron dextran or iron sucrose on the stability of fat emulsion in total nutrient admixture (TNA) in pediatric settings.Methods TNA with different intravenous doses of iron sucrose or iron dextran (0.25,0.5,0.75,or 1.00 mg) were prepared,and each dose was prepared 10 bags.The TNAs were stored at 25 ℃ for 3 days,and the stability of fat emulsion was observed by electron scanning microscopy.Meanwhile,the pH and osmolality were also measured.Results The particle sizes of fat emulsions in TNA with different concentrations of iron sucrose or iron dextran at different time points were not significantly different (F =0.32,P =0.7836 ; F =1.73,P =0.1321,respectively).The mean particle size of the fat emulsion in each group was ＜ 0.5 μm within 72 hours.For TNA containing different concentrations of iron,the percentage of particles ＞ 0.5 μm,pH,and osmotic pressure showed no significant difference at different time points (percentage:F =1.47,P =0.3467 ; F =1.04,P =0.4758.pH:F =0.63,P =0.5942 ; F =0.46,P =0.6825.osmotic pressure:F =1.37,P =0.3648 ; F =0.65,P =0.6023).Conclusion The TNA addeded with iron sucrose or iron dextran with an concentrations of ＜ 1％ is stable.
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Objective To compare and analyse four references for assessment of obesity in Chinese children. Methods The height and weight of 2347 children(1175 boys and 1172 girls) aged 7 to 8 years in Shanghai were measured,and their body mass indexes (BMI) were calculated.The prevalences of overweight and obesity were evaluated and compared among reference of Weight for Height 1985(WFH 1985 reference),BMI reference of Working Group on Obesity in China (WGOC reference),BMI reference of Europe International Obesity Task Force(IOTF reference) and BMI reference of Centers for Disease Control and Prevention of American 2000 (CDC reference). Results The prevalence of overweiight in boys evaluated by IOTF reference was significantly higher than those by the other three references(P<0.05),and the prevalence of overweight in girls evaluated by IOTF reference was significantly higher than those by WGOC and CDC references (P<0.05).The prevalence of obesity in boys evaluated by IOTF reference was significantly lower than those by the other three references (P<0.01),and the prevalence of obesity in girls evaluated by IOTF reference was significantly lower than those by WGOC and WFH 1985 references(P<0.01).There was no significant difference in the evaluation findings of obesity and overweight between WFH 1985 and WGOC references(P>0.05). Conclusion WFH 1985 and WGOC references are more suitable than IOTF and CDC references for assessment of overweight and obesity in Chinese children.
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Objective To gather observational data on resting energy expenditure(REE)of children with newly diagnosed malignant solid tumor, and to examine factors that might be relevant to their energy expenditure change. Methods It is a retrospective study. Data from sixty-one patients with newly diagnosed malignant tumor admitted to department of pediatric surgery in Xinhua Hospital were reviewed in this study. Resting energy expenditure was measured by indirect calorimetry. Patients with benign tumor admitted during the same period were used as the control group. Results The difference of percentage of patients with normal, decreased, or increased REE between benign and malignant groups was not significant(χ2 = 0.466, P = 0.792). Patients with one or more gastrointestinal symptoms had higher percent of Pre-REE compared with patients without any gastrointestinal symptoms, but no significant difference existed(119.8±80.4 vs 91.1±27.2, Z = 0.746, P = 0.456). Different tumor types were associated with different effects on REE. There was no significant difference in REE levels between patients with decreased diet intake and those without(Z = 0.528, P = 0.598). Conclusions It is confirmed that not all patients with malignant tumor have an increased REE. Moreover, the tumor site might be an independent factor affecting patients' REE level.
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Objective To evaluate the effect of iron on the stability of fat emulsion in total nutrient admixture (TNA) in pediatrics. Methods Based on intravenous nutrition preparation and handling protocols, 0,0.25, 0.50, 0.75, and 1.00 mg iron sucrose was added in each 100 ml TNA, respectively, and each dose was prepared for 10 bags. The stability of fat emulsion was observed by electron scanning microscopy. The pH and osmolality were determined at different time points (0, 24, 48, and 72 h). Results The fat particle size, percentages of particles ＞ 0.5 μm, pH value, and osmolality were not significantly different among all the groups at different time points (all P ＞ 0.05). The mean particle sizes of the fat emulsion were ＜ 0.5 μm in all groups within 72 h.No fat particle with diameter ＞ 5 μm was seen in each group. Conclusion TNA containing iron sucrose with concentrations range 0.25-1.00 mg per 100 ml is stable.