There are various causes of cholestatic liver disease in infants that include extrahepatic biliary tract diseases, liver diseases, anatomical abnormality, metabolic or endocrine diseases, poisoning, infection, and so on. The causes leads to re-duction or interruption in bile lfow and thus results in nutrients malabsorption and comprehensive metabolic disorder. The aims of nutritional therapy for cholestatic liver disease are to reduce the risk of cholestasis related complications, to promote recov-ery of liver diseases, to restore bile flow, to promote growth and improve the comprehensive metabolic disorders, to improve quality of life and to prepare children for liver transplantation.

Chronic diarrhea in children is often accompanied by malnutrition,growth disorders,immune dis-function and repeated infection due to deferment diarrhea and malabsorption of nutrients, which could influence the physical and mental development of children. The etiology and pathogenesis of chronic diarrhea are complex. The causes of chronic diarrhea are different in children with different ages,different regions and countries.

Objective To analyze the effect of calcitonin combined with alfacalcidol on clinical outcome,lumbar vertebrae bone mineral density and safety in patients undergoing internal fixation of humeral shaft fracture.Methods 80 patients with humeral shaft fracture treated with internal fixation in Xunwu county people's hospital from June 2010 to June 2016 were selected,and randomly divided into control group and observation group,40 cases in each groups.The control group was given calcium carbonate D3 tablets and functional exercise therapy,the observation group treated calcitonin combined with alfacalcidol on the basis of control group,analysis and comparison the clinical effects,lumbar spine BMD and safety.Results Compared with before treatment,serum calcium level of two groups increased significantly at treatment 2 weeks and 3 weeks(P<0.05);The control group BMD of lumbar spine was significantly increased in treatment 12 weeks(P<0.05),the observation group BMD of lumbar spine was significantly increased in treatment 4 weeks and 12 weeks(P<0.05).Compared with control group,the level of serum calcium in observation group was higher at treatment 2 weeks and 3 weeks (P<0.05),BMD of lumbar spine was higher at treatment 4 weeks and 12 weeks(P<0.05);The total adverse reaction rate of observation group was 10%,the difference was not statistically significant to control group 15%.Conclusion The combination of calcitonin and alfacalcidol treatment of internal fixation of humeral shaft fractures in patients with significant results, can improve serum calcium levels in patients with and improve bone mineral density, and less adverse reactions.

In recent years,gastrointestinal microbiota and fecal microbiota transplantation(FMT)has gained rapidly development.The recent studies demonstrated that FMT has obvious clinical efficacy and safety on the treatment of clostridium difficile infection,inflammatory bowel disease and other diseases in adult.The present article will discuss the efficacy of FMT in treating digestive diseases in children.This review summarizes therapeutic advances in FMT,latest FMT therapies and presents the potential of FMT therapeutics in gastrointestinal and extra-intestinal conditions in children.

Fecal microbiota transplantation(FMT)is a method to recover the gut microbiota and treat the intestinal or non-intestinal diseases through transplanting the fecal liquid from healthy population into patients' gastrointestinal tract.There are limited data about the FMT in children.The clinical practice needs professional workgroups,strict indications,normalized and precise procedures.

Objective On the basis of previous experiments ,we try further to seek the new evidences of α7nAChR participating in 100 Hz electroacupuncture (EA ) regulating natural killer (NK ) cells activity .Methods α7nAChR antibody and the specificα7nAChR antagonist α-bungarotoxin (α-Bgt) were used to study the effect of α7nAChR on NK cell activity in 100 Hz EA mice .Re-sults Compared with 100 Hz EA group ,100 Hz EA plus α7nAChR-Ab group showed a significant enhanced in NK cell activity (P<0 .05) .100 Hz EA treated with 1 .5 or 3 .0 μg α-Bgt groups had higher NK cell activity than 100 Hz EA group(P<0 .01) . Conclusion α7nAChR is involved in 100 Hz EA modulation for immune function ,which provide the theoretical and practical basis for further clarifying and expanding the clinical application of EA .

Biliary infection in children includes acute and chronic cholecystitis and cholangitis.The main dinical manifestations of acute cholecystitis are right upper-quadrant abdominal pain which is persistent with nausea and vomiting,Murphy's sign positive.Some of patients have high fever,chills,jaundice,and some severe patients have coma.Acute cholangitis has rapid onset.The most common manifestations are abdominal pain,fever,chills and jaundice which are known as Charcot's triad.A few children's main manifestation is septic shock which has a high mortality.This article described the diagnosis and treatment of biliary inflammation in children.

Objective To observe the application of angiotensin Ⅱ receptor antagonist valsartan in reducing minim albuminuria in earlier period of the diabetes and kidney disease.Methotis 36 patients Who administered angiotenain Ⅱ receptor antagonist valsartan 80～160nag,qd,for 8 weeks.Compared with symptoms before the treatment,the blood pressure,the amount of the urinary albuminufia,and observed the change of the empty stomach blood sugar,the saccharified hemoglobin,the triglyceride,the total cholesterol,the endogenous creatinine clearance rate,etc.Results After the treatment,the urinary albumin drops obviously(P＜0.01),While the blood pressure,the empty stomach blood sugar,the saccharified hemoglobin,the triglyceride,the total cholesterol and the endogenous creatinine clearance rate have no obvious change.There is no obvious side effect during therapeutic process.Conclusion The application of angiotenain Ⅱ receptor antagonist valsartan can reduce the amount of the urinary albumin,is the effective way in treating the earlier period of the diabetes and kidney disease.

Objective To explore the early diagnosis and standard treatment of autoimmune hepatitis (AIH).Methods The process of clinical diagnosis and treatment in 2 children with AIH was retrospectively analyzed.The related literatures were reviewed.Results Two males were 6 years and 1 month old and 6 monthes and 18 days old,respectively.Both of them had the symptom of jaundice at onset,accompanied with the elevate aminotransferase and positive autoantibodies.One case showed elevated serum IgG and interface hepatitis in liver pathology,and all other causes were excluded.He had a good response to the treatment of hormone combined with azathioprine.The other case had a poor response to the treatment of single hormone.Conclusions Childhood AIH is rare in clinic.Its response to the therapy of glucocorticoid and immune inhibitors is good.So it should be diagnosised and treated early.

Objectives To study the clinical characteristics and early diagnosis of infant with both alpha 1 antitrypin deficiency (α1-ATD) and biliary atresia (BA). Methods The clinical characteristics, serum biochemical parameters, gene mutations and treatment of one infant with both α1-ATD and BA was reported. Related literatures about liver disease caused by α1-ATD were reviewed and analyzed. Results The infant was characterised with neonatal cholestasis, hepatomegaly, elevated serum ALT, AST, total bilirubin (TB), direct bilirubin (DB) and γ-glutamyltransferase (γ-GT) and absence of bile secretion from the duodenal drainage tube. BA was conifrmed by laparotomy and pathological examination and Kasai′s operation was performed. Further, the infant was confirmed by SERPINA 1 gene mutation analysis, which leads to the diagnosis of α1-ATD. The case of infant with both alpha 1 ATD and BA has not yet been reported at home and abroad. According to the literatures, children with α1-ATD were characterized with cholestasis, hepatomegaly, hypoproteinemia, high serum ALT and AST, coagulation disorders caused by vitamin K 1 deifciency and hepatic dysfunction. Prognosis was poor without early diagnosis and treatment. Conclusions For infant cholestasis, a lot of auxiliary examinations should be performed to identify the etiology of cholestasis. Gene analysis could help differential diagnosis. Prompt diagnosis and early treatment are the key to improve the survival rate and prognosis.