Obesity is a common cause of nonalcoholic fatty liver disease(NAFLD).Recently,the morbidity of NAFLD has increased rapidly worldwide,associated with obesity prevalence.NAFLD,metabolic syndrome(MS)and insulin resistance are closely related.The increase in weight,especially in visceral fat tissue,was the highest risk factor to cause NAFLD and MS,and for their progress.To NAFLD patients,the only effective measure is weight reduction,including reasonable diet and aerobic exercise.Moreover,a sound mentality and behavior are the key factors of the treatment of NAFLD.On the other hand,the literature lacks well-designed,randomized control trials that assess the efficacy of anti-obesity drug and weight-loss surgery on the long-term outcomes of NAFLD.

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.

n admixtures are summarized.

More studies have shown that dietary calcium intake can decrease the incidence of metabolic syndrome. Milk consumption in childhood and the habit of milk drinking are positively correlated with bone mineral density in adult-hood. This article summarizes the relationship between dietary calcium and bone mineral density and obesity-related metabolic disorder in children.

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.

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.

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.

Objectives To assess the clinical value of ultrasonography (US) and bioelectrical impedance analysis (BIA) in analyzing abdominal fat contents of obese children and adolescents through comparison with MRI. A correlation with other obese related metabolic parameters was conducted. Methods Ninety 7-17-y-old obese children and adolescents (60 boys and 30 girls with mean age of 9.6 ± 2.9 y and mean BMI of 24.5 ± 4.5 kg/m2) were recruited. Metabolic parameters were measured, and insulin resistance was estimated according to homeostasis model assess-ment (HOMA-IR). On the same day abdomen subcutaneous fat thickness (SFTUS) was measured by US. Body fat mass (FMBIA) and abdominal visceral fat area (VFABIA) were analyzed by bioelectrical impedance analysis (BIA). After obtaining informed consent, abdominal MRI was performed in 20 subjects. Each section of umbilicus level was analyzed by image threshold value segmentation using SigmaScan Pro 5 and abdominal subcutaneous fat area (SFAMRI) and visceral fat area (VFAMRI) were calculated. Results (1) A strong positive association was found between SFTUS and SFAMRI (P< 0.05), VFABIA and VFAMRI (P < 0.01) respectively. (2) FMBIA and SFAMRI, VFAMRI, SFTUS also showed significant correlations (P < 0.05). (3) VFAMRI showed extremely significant positive correlations with TG, Insulin,C-peptide and HOMA-IR (P < 0.01 ) ; SFAMRI was also correlated positively with them (P < 0.05). (4) SFTUS was correlated positively with UA (uric acid), Insulin, 2HIns (insulin measured at 2 hours after meal), C-peptide,2HC-peptide (C-peptide measured at 2 hours after meal) and HOMA-IR (P < 0.01). (5) VFABIA was correlated significant positively with UA, insulin, TG, 2HIns and HOMA-IR. FMBIA showed positive correlation with UA, Insulin,2HIns, C-peptide, 2HC-peptide and HOMA-IR. Conclusions abdominal subcutaneous and visceral fat of obese children and adolescents evaluated by US and BIA are correlated well with those assessed by MRI, and also correlated well with TG, insulin, C-peptide and other metabolic biochemical parameters. Our data support the value of using cost effective, simple and convenient methods such as BIA and US to evaluate the obese and related metabolic risk of children and adolescents in clinical practice.

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.

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.