Effects of Nutrient Fortified Complementary Food Supplements on Anemia of Infants and Young Children in Poor Rural of Gansu

Objective To assess the effectiveness of complementary food supplements with protein and multi-micronutrients on hemoglobin and anemia in infants and young children. Methods In 5 poor counties of Gansu, 984 children aged 6-12 months were enrolled and divided into two groups. In addition to the usual home-made complementary food, all the children were fed one sachet of either Formula Ⅰ or Formula Ⅱ supplements each day. Protein and micronutrients were provided in Formula Ⅰ, while the same energy intake was secured in Formula Ⅱ as in Formula Ⅰ. A massive dose of vitamin A was supplemented to all the children every 6 months. Hemoglobin test was done at the same time. Results Prevalence of anemia was about 35% in both Formula Ⅰ and Formula Ⅱ group at baseline, and there were no differences in hemoglobin concentration between the two groups, During the 6-month and 12-month supplementation, hemoglobin of children in Formula Ⅰ group was higher than that in Formula Ⅱ group （P〈0.05）, and hemoglobin increase in Formula Ⅰ group was significantly higher than that in Formula Ⅱ group （P〈0.001）. After 6- and 12-mouth supplementation, the prevalence of anemia in Formula Ⅰ group dropped to 19.1% and 8.2% respectively, and it was 28.0% and 12.4% in Formula 2 group. The prevalence of anemia in Formula Ⅰ group was significantly lower than that in Formula Ⅱ group （P〈0.05）. After adjusting age and hemoglobin level at baseline, the hemoglobin increase at age of 24 months in formula 1 group was higher （10.7 g/L vs 7.9 g/L, P〈0.0001）. Conclusion Micronutrient fortified complementary food supplements, with large-dose vitamin A, is effective for children aged 6-12 months in terms of iron deficiency prevention.

The effect of zinc supplementation on diarrheal diseases in children in the Niger Delta Sub-Region of Nigeria

This study evaluated the trend of diarrheal diseases managed with zinc supplementation by comparing it with diarrheal diseases managed without zinc supplementation at the University of Port Harcourt Teaching hospital (UPTH), Nigeria. The study was a descriptive retrospective study done at the Diarrhea Training Unit (DTU) of UPTH to determine the effect of zinc supplementation in the management of diarrhea in children under 5 years. Out of the 134 case records studied, of children aged 0 to 59 months who presented with diarrhea at the DTU, 57 children did not receive zinc supplementation between October and December, 2007 and 77 children received zinc supplementation between October and December 2009. The results showed that (74) 96.1% of patients who received zinc supplementation, and (48) 84.2% of those who did not, had no repeat diarrheal episodes when seen at the follow up clinic. On the other hand, 1.3% of those who received zinc supplementation and 1.8% of those who did not, had increased episodes of diarrhea when seen at the follow up clinic. Of those who received, and those who did not receive zinc supplementation, 2.6% and 14% respectively, had reduced episodes of diarrhea. These findings clearly demonstrate the effectiveness of zinc supplementation in halting the course of diarrheal diseases in children aged 0 to 59 months. We therefore advocate for the use of zinc supplementation in the management of diarrhea in

History of Vitamin A Supplementation Reduces Severity of Diarrhea in Young Children Admitted to Hospital with Diarrhea and Pneumonia

Background: Although the role of vitamin A in childhood pneumonia in association with diarrhea is not fully proven, we did not find any published data demonstrating the impact of lack of vitamin A supplementation in under-five children who present with the co-morbidities of pneumonia and diarrhea. This study examined whether previous vitamin A supplementation was associated with reduced severity and duration of diarrhea and pneumonia for children presenting with both illnesses. Methods: All admitted children (n = 189) aged 0 - 59 months to the Special Care Ward of the Dhaka Hospital of icddr,b with diarrhea and radiological pneumonia from September-December 2007 were enrolled. We compared clinical features of the children who received (n = 96) and did not receive (n = 93) high potency capsule vitamin A supplementation during previous immunization according to EPI schedule. Results: In logistic regression analysis, after adjusting for potential confounders such as respiratory rate, lower chest wall in-drawing, severe wasting and systolic blood pressure, vitamin A non-supplemented children with pneumonia and diarrhea more often presented in their early infancy (95% CI 1.01 - 1.09), had duration of diarrhea for >4 days (95% CI 1.79 - 11.88), had clinical dehydration (95% CI 1.2 - 5.63), and more often required hospitalization for >7 days (95% CI 1.03 - 8.87). But, there was no significant difference in the clinical features of pneumonia, such as history of cough, respiratory rate, lower chest wall in-drawing, nasal flaring, head nodding, grunting respiration, cyanosis, and inability to drink between the groups. Conclusion: Lack of vitamin A supplementation in under-five children with radiological pneumonia and diarrhea is independently associated with young infancy, duration of diarrhea for >4 days, dehydration and hospitalization for >7 days which underscores the importance of routine supplementation of vitamin A in young infancy. However, lack of vitamin A supplementation did not influence any clinical signs of pneumonia.

TREATMENT OF IRON DEFICIENCY ANEMIA IN CHILDREN BY IRONSUPPLEMENTATION TWICE WEEKLY AND WEEKLY

Objective The effect of intermittent iron supplementation weekly and twice weekly was studied in children with iron deficiency anemia(IDA). Methods Subjects were 58 children who were randomly divided into two groups. One group received a dosage of 2mg/kg Fe every 3d for 9 weeks. The other group received the same dose Fe once a week for 12 weeks. Results Hemoglobin and serum ferrltin increased significantly after treatment in both groups (P <o.o5), and zinc protoporphyrin decreased significantly (P <o. o5). But serum rerrltin of both groups was different after 6 weeks of treatment (P<o. o1). The side effect of the group supplemented once every 3d was higher than that of the group once a week, but there was no statistically significant difference. Conclusion Iron supplementation every 3d has a similar effect to once a week for treatment of IDA. The former should be used for the serious patients for 6 weeks. The later should be used for infants and the patients whose resistance of intestines and stomach are not good.

Effect of Vitamin C Supplementations on Iron Deficiency Anemia in Chinese Children

A total of 65 children with mild iron deficiency anemia (IDA) were divided into 5 groups, and received 0, 25, 50, 100 and 150 mg/day of vitamin C (VC) respectively every day for 8 weeks. Hemoglobin, serum ferritin, free erythrocyte and hematocrit were determined every week. At a daily average intake of about 30 mg of VC and 7.5 mg of Fe, the results of the study indicate that: (1) VC supplement alone could effectively control children's IDA, and a dose-dependant relationship was observed. (2) 50 mg/day of VC is the most efficient dosage and 6 weeks is the shortest time for an effective therapy. (3) With a diet predominately comprised of plant foods, it is suggested that appropriate dose of VC should be supplemented for the children during winter and spring in northeastern areas of China.

国医大师禤国维治疗儿童特应性皮炎用药规律的挖掘

【目的】采用数据挖掘技术挖掘国医大师禤国维教授治疗儿童特应性皮炎的组方用药规律。【方法】收集禤国维教授门诊治疗儿童特应性皮炎的有效病例的病案资料,采用频数统计、关联规则分析、聚类分析等方法对录入的病案数据进行统计分析。【结果】共收录处方242首,涉及中药101味。常用药物为23味,高频药物(频数>100次)共16味,分别为甘草、防风、北沙参、紫苏叶、麦冬、徐长卿、布渣叶、白鲜皮、玄参、薏苡仁、蝉蜕、百合、生地黄、地肤子、茯神、芡实。药物的性味归经分析显示,药物大多偏甘寒,主要归脾、胃、肝经。关联规则分析得到常用药物组合24个,关联规则20条。聚类分析得到2个核心药物组合。【结论】禤国维治疗儿童特应性皮炎以“清、补、和”三法为主,“扶正御邪,平调阴阳”的用药原则贯穿治疗始终。

口服营养补充对急性淋巴细胞白血病儿童诱导化疗期血液系统并发症等的影响——随机对照研究的中期结果

目的探讨口服营养补充(ONS)对急性淋巴细胞白血病(ALL)儿童诱导化疗期间血液系统并发症及感染的影响。方法2022年1月—2022年12月年龄<16岁ALL儿童36例符合入组条件且完成诱导治疗,按1∶1比例随机分为干预组和对照组各18例。对照组给予低脂饮食(膳食脂肪供能≤每日总能量的20%),干预组给予低脂饮食及高中链甘油三酯、高蛋白、高热卡的短肽型ONS 20mL/(kg·d),食用时间为诱导化疗VDLD阶段。比较两组诱导化疗期间血液系统并发症、输血制品和感染的发生情况。结果干预组与对照组比较,中性粒细胞缺乏持续时间更短(12.50±9.38d和19.11±10.06d,P=0.049)、恢复时间更早(25.39±4.5d和30.06±3.80d,P=0.002);血小板最低值水平较高(P=0.048),Ⅳ度血小板减少的出现时间更晚(P=0.009)、持续时间更短(P=0.024)和恢复时间更早(P=0.012),输血小板的例数和次数均低于对照组(P<0.05);发热天数、抗菌药的使用、总体感染均倾向于较少,但差异未显出统计学意义(P>0.05)。结论ALL儿童在诱导化疗期间使用短肽型ONS有助于提高血液系统对化疗的耐受性。终期研究结果将会得出更确切的结论。

维生素D在儿童原发性肾病综合征中的保护作用及应用策略研究进展

原发性肾病综合征是儿童最常见的肾小球疾病之一,其病理生理的改变和长期的糖皮质激素治疗影响维生素D代谢。本文对儿童原发性肾病综合征与维生素D缺乏的关系、维生素D补充与骨保护及肾脏保护作用,以及原发性肾病综合征儿童维生素D营养状态的临床评估、筛查、预防、治疗和安全性的应用进行综述,为原发性肾病综合征儿童科学、安全、有效应用维生素D提供参考。

陈健教授从“伏火”论治儿童周期性发热综合征经验

[目的]总结陈健教授从“伏火”论治儿童周期性发热综合征的临床经验。[方法]通过门诊跟诊学习、病案收集整理及查阅相关文献,探讨儿童周期性发热综合征的病因病机,总结陈教授从“伏火”论治该病的治疗经验,并举验案一则加以验证。[结果]陈教授认为,儿童周期性发热综合征的核心病机为“伏火”,“伏火”为发病之本,痰、毒、瘀既是病理产物,也是贯穿病程始终的重要致病因素,郁为存在于发病全过程的病理状态。治疗上以益气除热或养阴清热与调气之法并行,并以自拟方药为治疗儿童周期性发热综合征的有效验方。所举验案以周期性发热为主要症状,辨为阴虚发热证,投以养阴清热、行气解郁之法,取得了较好的疗效。[结论]陈教授从“伏火”论治儿童周期性发热综合征,疗效显著,具有一定的指导意义,值得临床参考借鉴。

Assessment of Diarrheal Disease Management Practice in Under-Five-Year Children According to WHO Guideline in Health Facilities of Hawassa City, SNNPR, Ethiopia

Objective: To explore the practice of management of diarrhea in under-5-year children at health facilities found in Hawassa town, and associated factors with malpractice in comparison. Methodology: Cross Sectional study was conducted in 2 hospitals, 2 health centers and 2 private clinics that are found in Hawassa city which is found in Southern Nations, Nationalities and peoples (SNNP), 275 KM to south from Addis Ababa, capital city of Ethiopia from august 2017-October 2017. Structured checklist was used to retrieve the required information from the patients on arrival and stay in pediatrics OPDs and wards. The data analysis carried out using SPSS version 20.0. Logistic regression was carried out to analyze the association between the independent and dependent variables. Statistically significant associations were declared at p-values of less than or equal to 0.05. Results: Out of 420, about 397 (94.5%) children with diarrheal disease between the ages of 3 - 59 months were studied. The study subjects were from governmental hospitals (35.5%), health centers (34.5%) and private clinics (30%) that are found in Hawassa City. Sign of dehydration was 66 (17%) of which majority 59 (83%) of them were rehydrated. As to Zink supplementation, only 180 (45%) received it;antibiotics were the commonly (59.1%) prescribed drugs. Only 43.3% of children were appropriately managed. Hospitals had higher odds of inappropriate management of diarrhea with AOR = 1.61 (95% CI: 1.04 - 2.5) and children one year or younger were more inappropriately managed for diarrhea at the health facilities with AOR of 2.3 (95% CI: 1.57 - 4.41). Conclusions: In the current study the management of diarrhea at the health facilities is unsatisfactory as only less than half of children with diarrhea were properly managed. Treatment of diarrhea at hospital level and the patient’s age being less than 1 year were found to significantly affect the level of mismanagement of the diarrheal disease. Therefore, orientation and trainings for health care providers especially GPs and Residents should be given to adhere to recommended zinc therapy, Oral Rehydration Salts (ORS) replacement therapy and rational antibiotics prescription.

Management of HIV in Children Using a Bovine Colostrum-Based Food Product— An Observational Field Study

Aim: Malnutrition increases the severity and mortality of HIV infection. Therefore, this field study was started and aimed to provide a major cohort of HIV-infected children with the colostrum-based food product ColoPlus (ColoPlus AB, Malm&ouml;, Sweden) and to investigate the effects of ColoPlus on the nutritional status and immunological capacity of children including tolerability and safety of the product. Methods: In this major field program comprising 850 malnourished HIV positive children, 50 grams of ColoPlus was administrated for 4 weeks as the first meal in selected health facilities in Northern Uganda. Forty-eight of these children (8 months - 14 years of age) were recruited into a descriptive prospective study and were followed for 12 weeks. At the start (week 0) and at weeks 4, 8 and 12, CD4+ cell counts, serum albumin and hemoglobin were analyzed. The remaining 802 patients were observed to register safety and tolerability of ColoPlus. Results: There was a general improvement of wellbeing of the children with increased body weight and decreased fatigue. In the descriptive study of the 48 children, there was a significant rise of the CD4+ values at week 4 (+15.4% ± 2.8%, p = 0.0001) compared to week 0, and at week 8 (+39.1% ± 3.9%, p < 0.0001), but a return towards the 0-values at week 12 (+2.1%, ±2.8%, NS). Hemoglobin and serum albumin showed an almost similar trend. ColoPlus was well tolerated by all the 850 children and no side effects or adverse events were seen. Conclusion: These results show that addition of a colostrum-based food product to the daily diet is beneficial in HIV-positive malnourished children. An improvement in nutritional status as well as in immune capacity was seen. These effects were prolonged and remained at least 4 weeks after cessation of ColoPlus administration.

Vegetarian Diets in Children—Some Thoughts on Restricted Diets and Allergy

Vegetarianism is a common diet worldwide. For a large proportion of people, meat or fish is not available at all or not regularly as a meal. But also in the industrialised countries, vegetarian nutrition is becoming more and more popular for various reasons. Many vegetarian parents also want a suitable diet for their children. But are restrictive diets beneficial or potentially harmful in certain situations, such as a predisposition to severe atopy? Are vegetarian diets equally suitable for pregnant women, nursing mothers, infants, children, and adolescents? What critical nutrients should parents, children, pediatricians, and nutritionists pay particular attention to? This article is focused on questions like these and discusses scientifically based concepts of nutrition. Main findings are that exposure to a variety of food antigens during early life may play a role in the development of healthy eating habits and that restrictive diets have not been found in studies to prevent allergic disease.

补锌在小儿腹泻治疗中的疗效观察

目的 探讨在小儿腹泻治疗中补锌对患儿治疗效果的影响。方法 74例腹泻患儿,按照随机数字表法分为观察组与对照组,每组37例。对照组采用常规药物(蒙脱石散+枯草杆菌活性二联活性颗粒)治疗,观察组在常规治疗的基础上采用补锌治疗。比较两组治疗效果、治疗指标、家属满意度。结果 观察组治疗总有效率94.59%高于对照组的72.97%,差异有统计学意义(P<0.05)。观察组退热时间、止泻时间、住院时间分别为(4.28±0.57)、(2.44±1.43)、(5.14±1.13)d,均短于对照组的(5.96±0.63)、(6.49±1.41)、(7.22±1.20)d,差异有统计学意义(P<0.05)。观察组患儿家属满意度91.89%高于对照组的67.57%,差异有统计学意义(P<0.05)。结论 对小儿腹泻患儿采取补锌治疗的效果显著,可提升患儿的治疗效果,缩短患儿的退热时间、止泻时间以及住院时间,并提升患儿家属的治疗满意度,值得临床推广应用。

复方嗜酸乳杆菌联合补锌治疗应用于小儿腹泻的价值评价

目的 探讨在小儿腹泻治疗过程中复方嗜酸乳杆菌联合补锌的临床治疗效果。方法 选取2019年3月-2021年3月入院就诊的小儿腹泻患者100例作为研究对象,临床设置研究组50例,对照组50例,对照组患者采用复方嗜酸乳杆菌治疗方式,研究组患者在此治疗基础上联合使用补锌治疗方式,组间对比两组患者的营养效果以及临床时间指标。结果 治疗前,组间对比研究组患者与对照组患者,营养状况、免疫功能以及症状评分差异不显著,显示组间差异无统计学意义(P>0.05);治疗后,研究组患者组间清蛋白为(36.67±5.20)g/L,血红蛋白(96.20±4.20)g/L,IgG(9.11±2.21)g/L、IgA(1.98±0.81)g/L、症状评分(0.52±0.02)分,对照组清蛋白为(32.44±4.55)g/L,血红蛋白(92.02±4.33)g/L,IgG(8.20±2.20)g/L、IgA(1.68±0.31)g/L、症状评分(1.24±0.04)分,差异显著(P<0.05)。治疗后,组间对比两组患者临床时间指标,研究组显示排便频率恢复正常时间(2.02±0.20)d、水样便消失时间(2.02±0.11)d、发热消失时间(1.20±0.12)d、住院时间(6.34±1.02)d,对照组显示排便频率恢复正常时间(5.71±1.12)d、水样便消失时间(4.40±1.15)d、发热消失时间(1.97±0.31)d、住院时间(3.34±1.02)d,差异显著(P<0.05)。治疗后,研究组患者治疗效果明显高于对照组,差异显著(P<0.05)。结论 在小儿腹泻患者治疗中,使用复方嗜酸乳杆菌联合补锌方式,对患者预后效果进行改善,治疗时间有所缩短,营养情况改善后,免疫功能得到优化,值得临床推广。

入托入学儿童预防接种证查验及疫苗补种情况分析

目的研究分析入托入学儿童预防接种证查验及疫苗补种情况。方法收集整理2019年9月入托入学儿童预防接种证查验及疫苗补种资料,了解辖区内入托入学儿童持证及疫苗补种情况。结果本次共调查入托入学儿童2014名(入托儿童404名,入学儿童1610名),其中持证儿童1936名(入托儿童398名,入学儿童1538名),持证率为96.13%(入托儿童持证率为98.51%,入学儿童持证率为95.53%),应补证儿童78名,实补证儿童78名(入托儿童6名,入学儿童72名),补证合格率100%;应补种儿童262名(入托儿童16名,入学儿童246名),实补种合格儿童164名(入托儿童12名,入学儿童152名),补种合格率为62.60%(入托儿童合格率为75.00%,入学儿童合格率61.79%)。结论本辖区卫健、教育部门配合密切,入托入学儿童预防接种证查验工作落实到位。同时,应加强健康教育,规范预防接种,进一步提高疫苗补种合格率。

学龄前儿童长期补充碳酸钙制剂效果的研究

目的 研究碳酸钙长期补充对学龄前儿童骨量、钙、铁代谢的影响。 方法 以成都市幼儿园 12 3名 3～ 6岁儿童为研究对象。将入选的儿童随机分成试验组与对照组。试验组每日服用 30 0mg钙 (6日 /周 ) ,对照组不给任何钙剂。试验前后观测右足跟骨骨量 ,检验血清铁蛋白、钙。在试验前、试验 1个月、3个月 ,6个月后检验尿钙。 结果 (1)成都市学龄前儿童膳食钙摄入量低 ,试验前血钙、尿钙水平低 ;补钙后试验组升至正常水平。 (2 )碳酸钙剂补充对跟骨骨量发育有促进作用。 (3)补充钙剂 6个月对血清铁蛋白无明显影响。 结论 钙补充对学龄前儿童的骨量提高有促进作用 ,对铁代谢无明显影响。学龄前儿童钙摄入少 ,建议每日补充 30 0mg元素钙。

儿童补锌与生长发育相关性研究

目的：探讨儿童补锌对血锌水平的影响及与儿童体重、身高、智商等发育的相关关系。方法：用分层加单纯随机抽样的方法对抽取的168例儿童进行体格检查、血锌浓度测定、智商测定,并问卷调查儿童饮食、补锌等情况,采用SPSS10.0版统计软件进行多元线性回归分析。结果：①本组168例儿童血锌平均浓度为58.98μmol/L,正常血锌儿童占75.0%,低血锌儿童占25.0%。②儿童血锌水平与性别无关,与年龄有高度显著性差异（χ^2=20.08,P〈0.01）,3~6岁儿童缺锌比例较7-12岁儿童高。③血锌水平影响儿童体重、身高发育,低血锌儿童体重、身高发育指标低于正常的比例高（χ^2=24.52,P〈0.01,χ^2=29.03,P〈0.01,）。④影响血锌水平的因素主要为饮食与补锌情况。⑤影响智商的因素为血锌水平与补锌情况。结论：正常饮食儿童低血锌比例低,偏食、挑食、厌食是引起血锌偏低的主要因素,血锌水平影响智商高低。科学对待儿童缺锌与补锌,理性对待广告宣传,纠正不良饮食习惯是保障儿童锌营养的关键。

3—12岁儿童膳食补充剂摄入现状及影响因素分析

目的:通过横断面调查,描述中国3—12岁儿童膳食补充剂的摄入现状,并讨论其相关因素。方法:采用多阶段随机整群抽样抽取中国7城市2农村3—12岁儿童1 806名,通过问卷调查获得其一般情况,通过膳食补充剂频率调查获得其摄入情况。结果:家庭人均月经济收入高(P=0.001)、喂养人认为孩子体重偏低(P=0.024)、认为孩子营养状况不好(P=0.023)、每周外出就餐多(P<0.001)、父亲文化程度高(P<0.001)、母亲文化程度高(P<0.001)的儿童更容易使用补充剂。结论:补充剂使用与儿童年龄、父母文化程度、家庭经济状况,生活习惯和喂养人对儿童健康的认知有关。应加强健康教育,建立对儿童健康和对营养素补充剂的正确认识。

周日补铁治疗儿童缺铁性贫血疗效观察

目的观察每周一次补铁治疗缺铁性贫血（ＩＤＡ）的疗效。方法采用设未治疗的病例对照组和正常对照组的方法，对 ５０例 ＩＤＡ患儿每周一次性补充元素铁 ２ｍｇ／ｋｇ，共 １２周。在治疗前、中、后观察 Ｈｂ，ＺＰＰ，ＳＦ三项指标的变化。［结果］治疗组治疗１２周后Ｈｂ、ＳＦ均极显著性升高（Ｐ＜０．０１），ＺＰＰ极显著性降低（Ｐ＜０．０１），病例对照组各指标仅略有改善，不能达到正常水平。［结论］ ７日补铁法对７～１３岁缺铁性贫血儿童的治疗疗效显著，铁营养指标均恢复正常，且副作用小，服用方便。

《食品安全国家标准 辅食营养补充品》的修订

《辅食营养补充品通用标准》(GB/T22570-2008)颁布后,营养包产品在我国早期儿童营养改善项目得到广泛应用。但由于存在标准适应性、我国标准体系的变化、营养科学的发展以及国际标准的进步等问题,需要修订。本文对该标准深入研究并进行修订。通过汇集结合相关进展和数据,包括国际相关标准、我国婴幼儿营养状况、膳食营养素摄入量、营养包应用干预效果及干预项目需求建议,对比研究CAC/GL8辅食营养补充品指南、我国基础性食品安全国家标准,采用我国2013年版DRIs进行有效性和安全性的评估分析,进行专家意见征求和社会意见广泛征求,进行本标准的修订。主要修订内容为:标准名称由推荐性标准变更为强制性食品安全国家标准;适宜人群扩展扩大至60月龄儿童;调整蛋白质含量要求为不低于25g/100g;调整锌、叶酸、烟酸的每日份含量要求;可选择成分增加二十二碳六烯酸;调整污染物、微生物限量及脲酶活性;修订标识要求。修订后的《食品安全国家标准辅食营养补充品》(GB 22570-2014)已于2014年11月01日正式实施。