Effects of enteral nutrition starting time on digestive function and growth rate in very low birth weight infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the appropriate time of starting enteral nutrition and observe the effects of different enteral nutrition starting times on the digestive function, growth rate, and nosocomial infection rate in very low birth weight infants (VLBWI).</p><p><b>METHODS</b>All the VLBWI admitted to the neonatal intensive care unit between February and December, 2012 were selected. Depending on different times of starting enteral nutrition, these infants were divided into three groups: ≤ 3 days (n=116), 4-6 days (n=36), and ≥ 7 days (n=26). The effects of different enteral nutrition starting times on digestive function, growth rate and nosocomial infection rate were analyzed.</p><p><b>RESULTS</b>The ≤ 3 days group had significantly higher milk intake than the other two groups at one week after birth; the ≤ 3 days and 4-6 days group had significantly higher milk intake than the ≥ 7 days group at two and three weeks after birth. The growth rate showed no significant differences between the three groups. The ≤ 3 days group had a significantly shorter time of central venous catheterization than the other two groups, and the ≥ 7 days group had a significantly longer time to full enteral feeding than the other two groups. The nosocomial infection rate of the ≤ 3 days group (13.8%) was significantly lower than that of the ≥ 7 days group (46.2%).</p><p><b>CONCLUSIONS</b>For VLBWI, the time of starting enteral nutrition has no impact on growth rate, but starting enteral nutrition early can promote the development of gastrointestinal function, increase milk intake, shorten the time to full enteral feeding, reduce the time of central venous catheterization, and significantly reduce nosocomial infection rate.</p>

Juvenile psoriatic arthritis / 中国当代儿科杂志

A case of juvenile psoriatic arthritis in a 12 year-old boy was reported. The patient had a history of one and half a year of bilateral heel pain, followed by pain in the right knee and ankle and right hip joint. He developed psoriatic lesions affecting his nails and skin. He had increased erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) contents. Human leukocyte antigen (HLA) B27 was detected but serum rheumatoid factor was not in the patient. A skin biopsy revealed psoriasis and ultrasonography demonstrated synovitis in right knee and ankle. Juvenile psoriatic arthritis was diagnosed based on his physical, laboratory and skin biopsy findings. A treatment with nonsteroidal anti-inflammatory drugs and sulfasalazine produced no effect. Leflunomide in conjunction with anti-TNF biologic agents (Etanercept) was administered, followed by symptomatic improvement 2 weeks later.