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06 October 2023, Volume 38 Issue 10 Previous Issue   

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Interpretation of the 2022 International Consensus Recommendations for Eosinophilic Gastrointestinal Disease Nomenclature and implications for pediatric research in China LI Jing, NIE Xiao-lu, WU Jie 2023, 38(10): 721-725.  DOI: 10.19538/j.ek2023100601 Abstract ( )   The incidence of eosinophilic gastrointestinal diseases（EGIDs）is increasing.However，except for eosinophilic esophagitis（EoE），the guidelines or consensus on non-EoE EGIDs are still lacking. In 2022，the “International Consensus Recommendations for Eosinophilic Gastrointestinal Disease Nomenclature” was published to establish a naming system and standardize the diagnostic terms for EGIDs. This article introduces the background，process，and main contents of “International Consensus Recommendations for Eosinophilic Gastrointestinal Disease Nomenclature”，and briefly introduces the possible problems in the diagnosis and treatment of children with EGIDs in China so that clinicians can understand the contents of the Consensus and achieve a standardized diagnosis.

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Ketogenic diet：A classical nutritional therapeutic strategy of food as medicine for the prevention and treatment of metabolic diseases ZHANG Jie, LIANG Liang-liang, YANG Yan-ling 2023, 38(10): 726-730.  DOI: 10.19538/j.ek2023100602 Abstract ( )   Ketogenic diet is a classical nutritional therapeutic strategy of food as medicine for disease prevention and treatment. It is a kind of diet composed of high fat，low carbohydrate，appropriate protein and nutrients. Under general condition，the source of energy for the human body is sugar，followed by fat and protein. The therapeutic principle of ketogenic diet mimics energy metabolism under starvation. The source of energy is supplied by ketone bodies produced by fat metabolism，not relying on carbohydrates. Decades of clinical and scientific research have confirmed the good curative effect of ketogenic diet in the treatment of some patients with drug-resistant epilepsy. Its value in the prevention and treatment of many metabolic diseases has also been verified. For patients with different diseases，it is necessary to design individual ketogenic diet plans according to their nutritional and metabolic status，in order to reduce the risk and try to attain the best effect. This review describes the concept，scheme，mechanism，indications，contraindications and adverse reactions of ketogenic diet， aiming to further understand the ketogenic diet and better guide the practice of ketogenic diet to prevent and treat disease.

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Vitamins B and the prevention and treatment of inherited metabolic disorders CHONG He-meng, ZHANG Ya-nan, MA Xin-yu, et al 2023, 38(10): 731-735.  DOI: 10.19538/j.ek2023100603 Abstract ( )   Impaired transport or biotransformation of vitamins B can lead to a variety of inherited metabolic diseases. Vitamins B are important nutrients in the human body，acting as coenzymes for many enzymes and participating in the body's energy and material metabolism. The main physiolo-gical function of vitamin B1 is to constitute the coenzymes of decarboxylase and other enzymes，participate in material metabolism and energy metabolism，and is necessary for the metabolism of branched-chain amino acids. Vitamin B2 is mainly derived as bioflavin nucleotides and flavin adenine dinucleotides，which are involved in biological oxidation and energy generation in the body. The bioactive form of vitamin B6 is a coenzyme of amino acid decarboxylase，aminotransferase，etc. It is involved in the synthesis of hemoglobin and certain neurotransmitters，as well as the conversion of sulfur-containing amino acids and other physiological functions.

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Evaluation and nutritional management of child and adolsecent obesity with hyperuricemia WEI Hai-yan, LIN Yi-fan, YUAN Shu-xian 2023, 38(10): 735-740.  DOI: 10.19538/j.ek2023100604 Abstract ( )   Obesity is an important risk factor for secondary hyperuricemia. With the increase of the prevalence of obesity，hyperuricemia has also increased significantly and showed a trend of younger age. Hyperuricemia in children and adolesc-ents is called early-onset hyperuricemia. Compared with adult patients，early-onset hyperuricemia is more prone to renal insufficiency and gout，which is closely associated with hypertension，hyperlipidemia and insulin resistance，leading to the increase of cardiocerebrovascular diseases. Therefore，pediatricians should pay more attention to hyperuricemia. The etiology of hyperuricemia is complex. The cut-off value of blood uric acid for the diagnos of hyperuricemiais is different at home and abroad，and it is related to age and gender，which needs to be evaluated carefully. Nutritional management is the cornerstone of the prevention and treatment of hyperuricemia.The diet of low purine，low fat，low salt，low fructose，high fruits and vegetables and moderate grain and active lifestyle are important means to prevent and treat adolescent obesity and hyperuricemia.

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Value of Omega-3 polyunsaturated fatty acids in brain development and function LIU Yu-peng, XIA Jia, QIN Jiong 2023, 38(10): 741-745.  DOI: 10.19538/j.ek2023100605 Abstract ( )   Fatty acids are essential components of body growth and development，playing various roles in maintaining health and preventing diseases. Among them，dietary polyunsaturated fatty acids，especially Omega-3 polyunsa-turated fatty acids，are indispensable to neurodevelopment. In the process of child development，a deficiency of Omega-3 polyunsaturated fatty acids can lead to damage to the nervous system，resulting in various neurodevelopmental disorders such as schizophrenia，attention deficit hyperactivity disorder（ADHD），and autism spectrum disorders. If Omega-3 polyun-saturated fatty acids are lacking during pregnancy，it can result in preterm birth，neonatal mortality and maternal depression during the perinatal period，and fetal abnormal brain development. This review summarizes the recent research progress on Omega-3 fatty acids at home and abroad，highlighting the importance of Omega-3 fatty acids in the human body and their role in neurodevelopment. For the patients with neuropsychiatric diseases such as ADHD，the potential nutritional metalolic abnormality should be paid attention to and metabolic analysis should be performed to identify macro-nutrient structural problems. Appropriate supplementation of Omega-3 polyunsaturated fatty acids can improve the neuropsychiatric status of patients.

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Value of zinc in the prevention and treatment of childhood diseases LI Dong-dan, YAN Jie, YANG Yan-ling 2023, 38(10): 745-750.  DOI: 10.19538/j.ek2023100606 Abstract ( )   Zinc is a very important micronutrient in the body，which plays an important role in children's growth，development and immunity. Zinc deficiency is common in children. It is more common in the children with developmental delay，infectious diseases，immune deficiency，dermatitis and some inherited metabolic disorders. Zinc supplementation is not only an effective measure to correct zinc deficiency bus also important for prevention and treatment of some severe diseases. This review will expound the value of zinc in the prevention and treatment of children's various diseases and research progress at home and abroad.

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Dietary fibre as a key nutrient to improve the gastrointestinal function DONG Hui, ZHANG Hui-ting, YANG Yan-ling, et al 2023, 38(10): 751-754.  DOI: 10.19538/j.ek2023100607 Abstract ( )   Dietary fibre，also known as the seventh nutrient，is a kind of carbohydrate that cannot be digested by the human gastrointestinal tract，but can be fermented by intestinal microbiota to produce short chain fatty acids，which plays an important role in improving intestinal function and maintaining body metabolism and health. At present，there is a lack of understanding of dietary fibre in the public and the amount of intake is significantly lower than the international recommended intakes. This article reviews the definition of dietary fiber，recommended intake，and the impact on human gastrointestinal tract and health，aiming to improve the understanding of dietary fiber and its role.

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Nucleotides and their application in the treatment of mitochondrial disorders LI Min, YANG Yan-ling 2023, 38(10): 754-758.  DOI: 10.19538/j.ek2023100608 Abstract ( )   Nucleotides，a group of important nutrients，involve in many reactions of human physiological metabolism，including energy metabolism，cell expression and signal transduction. As one of the important carriers of ATP production，nucleotides may provide more energy carriers and raw materials for mitochondria. Nucleotides may have excellent therapeutic potential in most mitochondrial diseases secondary to ATP synthesis defects. The review focuses on the physiological effects of nucleotides in order to further explore the pharmacological and clinical value of nucleotides.

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Use of taurine in the treatment of inherited metabolic disorders  CHEN Zhe-hui, LU Mei, YANG Yan-ling 2023, 38(10): 758-761.  DOI: 10.19538/j.ek2023100609 Abstract ( )   Taurine is an important nutrient. It is a conditio-nally essential amino acid. The human body needs large amounts of taurine to maintain organ function. While some taurine is synthesized internally，the majority is obtained through dietary intake. Taurine serves various physiological functions，including lowering blood cholesterol levels，improving insulin resistance，reducing blood pressure，enhancing mitochondrial function，andpromoting development of organs，especially brain，liver，and heart. Taurine has been studied both in vitro and in vivo for its therapeutic potential in the treatment of inherited metabolic disorders such as mitochondrial diseases，metabolic syndrome，and neurodevelopmental disorders， which has confirmed the significant value of taurine in these treatments.

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Application of probiotics in the treatment of inherited metabolic disorders CHEN Jing-yu, DONG Yu-meng, WANG Li 2023, 38(10): 761-765.  DOI: 10.19538/j.ek2023100610 Abstract ( )   The inherited metabolic disorders are caused by the gene mutation in the human body. The gene mutation leads to the functional defects in the enzymes，coenzymes，transporters，membranes and receptors，which cause the corresponding pathological damage to many systems of the body. To reduce the morbidity and mortality，the patients with inherited metabolic disorders should get early screening，early diagnosis，and early treatment. Probiotics，as a living microorganism beneficial to human health，can be used either directly or indirectly to treat the patients with inherited metabolic disorders. In clinical practice，it is appropriate and effective to utilize probiotics in conjunction with other forms of therapy.

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Bombyx mori oil in the treatment of inherited metabolic disorders  ZHENG Hong, YANG Yan-ling 2023, 38(10): 765-768.  DOI: 10.19538/j.ek2023100611 Abstract ( )   Inherited metabolic disorders have complex clinical manifestations with high rate of disability and mortality. The symptoms of the patients are usually non-specific，which results in difficult diagnosis. Biochemical and genetic examination should be performed as early as possible to confirm the diagnosis and save time for treatment. Dietary and nutritional interventions are important measures for the prevention and treatment of inherited metabolic disorders.Unsaturated fatty acids are essential nutrients in neurodevelopment and functional maintenance. Conventional diets cannot provide enough unsaturated fatty acids for children. Supplementation of unsaturated fatty acids is necessary as a main or supportive treatment. Bombyx mori oil is rich in α-linolenic acid and can be used as medicine and food. Traditional medical research has proved that bombyx mori oil has good nutritional and medicinal value，having the effect of anti-inflammation，anti-allergy，anti-cancer，lowering blood sugar，regulating lipid，scavenging free radicals，antioxidation，and improving memory and other efficacy. This review summarizes the characteristics of bombyx mori oil and α-linolenic acid to provides reference for the application of bombyx mori oil in the treatment of inherited metabolic disorders from the perspective of nutritional intervention.

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Study on atypical social look in 40 toddlers with high-risk autism spectrum disorders  SHAO Huan, JIANG Ji-ying, DING Ning, et al 2023, 38(10): 769-774.  DOI: 10.19538/j.ek2023100612 Abstract ( )   Objective    To study the social look characteristics of high risk toddlers with autism spectrum disorder（ASD）and their feasibility as an early screening marker of ASD. Methods    A total of 88 toddlers aged 12-18 months including 40 high-risk ASD toddlers（HR-ASD group）and 48 typical development toddlers（TD group）were recruited to the Child Mental Health Center of Nanjing Brain Hospital for social reference test from June 2020 to June 2021.Independent samples t-test was used to compare the difference in social look time and gaze switch between the two groups under different informant（caregiver/stranger）and different information（positive information/negative information）.Use the Autism Diagnostic Observation Scale-2（ADOS-2）to evaluate ASD symptoms（social interaction deficits）in the HR-ASD group and use multiple regression to analyze the relationship between HR-ASD children’s social look and ASD symptoms. Results    Regardless of the informant（caregivers or strangers），the HR-ASD group had a greater percentage of gaze ambiguity stimuli than the TD group，the percentage of gaze information providers was less than that of the TD group，and the gaze switch frequency was lower than that of the TD group（all P<0.01）. Regression analysis found that the percentage of gaze information providers and the gaze switch frequency were negative predictors of the social interaction dimension of ADOS-2（both P<0.05）. Conclusion    HR-ASD toddlers have deficits in social gaze maintenance and switch， which can predict social interaction deficits.

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Retrospective analysis of 756 cases of ingested foreign bodies in the upper gastrointestinal tract in children treated with electronic endoscopy FANG Gao-chao, HUANG Kai-yu 2023, 38(10): 775-778.  DOI: 10.19538/j.ek2023100613 Abstract ( )   Objective    To explore the clinical characteristics of chidren with foreign bodies in the upper gastrointestinal tract，and to investigate the influencing factors of complications and endoscopic removal failure. Methods    Data of 756 cases of children with foreign bodies in upper gastrointestinal tract were collected retrospectively at the Second Affiliated Hospital of Wenzhou Medical University from January 2015 to February 2020.Gender，age，the location and duration of foreign body ingestion and the types of foreign bodies were analyzed to study their influence on occurrence of complications and endoscopic removal failure. Results    A total of 756 cases（468 males and 288 females）were enrolled. The median age was 3 years，with peak age being 1-3 years（57.9%）. About 1.1% of patients had esophageal diseases. The most common foreign body ingested was coin（n=543，71.8%）. Foreign bodies were most commonly located in the entrance of esophagus（n=376，49.7%）.The duration of foreign body ingestion ranged from 1 hour to 1 month. There were 7.8% of children who developed complications. Long time of foreign body ingestion， esophageal foreign body and sharp foreign body were risk factors of complications（P<0.05）. The success rate of endoscopic removal of foreign body was 96.3% The influencing factors of endoscopic foreign body removal had no influence on the result of operation（P>0.05）. Conclusion    Coin is the most common foreign body in upper gastrointestinal tract in childhood.Foreign bodies are most commonly located in the entrance of esophagus.Endoscopic removal of foreign bodies from the upper gastrointestinal tract in children has a high success rate. Long time of foreign body ingestion， esophageal foreign body and sharp foreign body increase the risk of complications.

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Research progress of GABAA-receptor gene related epilepsy YANG Ying, ZHANG Yue-hua 2023, 38(10): 779-784.  DOI: 10.19538/j.ek2023100614 Abstract ( )   Chloride ion channels are one of the important ion channels that maintain homeostasis in the body. The binding of γ-aminobutyric acid （GABA） to GABA receptors can activate chloride ion channels， resulting in the influx of chloride ions， hyperpolarization of the postsynaptic membrane， and inhibition of neuronal electrical activity. According to the differences in sensitivity of GABA receptors to agonists and antagonists， GABA receptors can be divided into three pharmacological subtypes: GABAA， GABAB， and GABAC. GABAA receptors are the most important inhibitory receptors in the central nervous system and serve as targets for many antiepileptic drugs. This article provides an overview of the research progress on epilepsy caused by genetic variations related to GABAA receptors.

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Advances in research on the treatment for spinal muscular atrophy ZHANG Bo-han, XU Xiang-ping 2023, 38(10): 785-794.  DOI: 10.19538/j.ek2023100615 Abstract ( )   Spinal muscular atrophy（SMA）is an autosomal recessive neuromuscular disease characterized by progressive muscular weakness and atrophy，which seriously affects the lifespan and health of infants and children. Revolutionary progress has been made in research on the treatment of SMA In recent years，some related drugs have been successfully approved for marketing. This article illustrates a review from approved therapies to future therapeutic targets，and provides relevant insights.

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Application and evaluation of food thickeners in gastroesophageal reflux disease ZHANG Ting, MA Ming, JIANG Mi-zu 2023, 38(10): 795-800.  DOI: 10.19538/j.ek2023100616 Abstract ( )   Review the clinical evidence of the application of food thickeners in children with gastroesophageal reflux disease， discuss the types and clinical choices of thickeners， evaluate the benefits and risks of using thickeners in children with gastroesophageal reflux disease， and understand the application of food thickeners in the treatment of children with gastroesophageal reflux disease. Given that children usually have good tolerance to food thickeners， although there have been reports on adverse reactions， careful selection of appropriate types of thickeners and close follow-up with nutrition experts can achieve good therapeutic effects in most patients.