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The digestive system is the largest immune organ of the human body, the intestinal microecology is the second brain of the human body, the function of the entire digestive system is closely related to food digestion, nutrient absorption, detoxification, immunity, nutritional metabolism and neuropsychiatric state, to some extent, the health of the digestive system represents the health of the human body, so the way to understand the "royal gastrointestinal tract" is more conducive to protecting children's physical and mental health.
On December 11th, the Henan Provincial Continuing Medical Education Project "Pediatric Digestion and Nutrition New Knowledge Forum" was successfully held in the Fifth Affiliated Hospital of Zhengzhou University. In view of the current epidemic prevention and control situation, the conference was held online throughout the conference, and pediatric experts at home and abroad started from their own areas of expertise to provide advice for protecting children's physical and mental health, and more than 30,000 people watched this pediatric knowledge event online.
Enhanced communication benefits children associated with digestive diseases
The academic conference was hosted by the Fifth Affiliated Hospital of Zhengzhou University, with the theme of "Royal Children's Gastrointestinal, Child Health", and in-depth implementation of the strategic deployment of Healthy Central Plains. Professor Jeffrey Teckman, Director of the Cardinal Glennon Children's Medical Center of St. Louis University, Professor Liu Yufeng, Doctoral Supervisor of the First Affiliated Hospital of Zhengzhou University, Professor Lv Quanjun, Professor Li Xiaoqin of Henan Children's Hospital, Tang Youcai, Vice President of the Fifth Affiliated Hospital of Zhengzhou University, and other well-known experts and scholars at home and abroad discussed the concept of children's health, promoted academic and technical exchanges in the field of children's digestive system, and benefited children with digestive diseases and related diseases in Henan Province.
Professor Jeffrey Teckman began to study the relationship between Alpha-1 antitrypsin deficiency and liver disease in children and lung disease in adults since 1993, and in the forum, he shared some new treatment methods and research progress in basic clinical practices recently, and proposed the theory of gene precision treatment of liver disease in children.
According to reports, Professor Tang Youcai and Professor Jeffrey Teckman have been collaborating on a number of international topics such as childhood liver disease since 2014. In addition, zhengda fifth affiliated hospital has also declared international joint laboratories and a number of medical projects approved by the Henan Provincial Bureau of Foreign Experts Affairs, and has achieved fruitful results. At present, it is applying for the Outstanding Foreign Scientist Studio, trying to escort the health of children with well-known experts inside and outside the United Nations.
Several experts support children's health issues
Tang Youcai made relevant analysis from the research status of NAFLD (non-alcoholic fatty liver) and the related research of Plin5.
"NAFLD and metabolic syndrome, type II diabetes, arteriosclerotic cardiovascular disease, etc. are mutually causal, and jointly promote the high incidence of extrahepatic malignant tumors such as cirrhosis, liver cancer, colorectal tumors, etc.; and there are differences in drug choice and lifestyle intervention in domestic and foreign guidelines, and the prevention and treatment of NAFLD in China is facing great challenges." Tang Youcai introduced that the research on the progress mechanism of NAFLD-related liver disease and its scientific research output can lay a theoretical foundation for clinical treatment, which is conducive to strengthening the health management of the whole process of NAFLD disease, effectively preventing the progression of the disease to the terminal stage of cirrhosis and liver cancer, reducing liver disease-related deaths, and reducing the economic burden of public health.
Liu Yufeng, doctoral supervisor of Children's Hospital of zhengda First Affiliated Hospital, made an in-depth analysis of the malnutrition factors of children's tumors, commonly used malnutrition diagnostic indicators, nutritional risk screening methods, the impact of malnutrition in tumor patients, and the nutritional treatment of tumor patients with the theme of "Nutritional Support for Children's Malignant Tumors". He said that STRONG is a common nutritional risk screening method for pediatric tumor patients, and nutritional support for tumor patients should follow the principle of five-step treatment, first choose nutrition education, and then choose oral nutrition supplementation, whole enteral nutrition, partial parenteral nutrition, and total parenteral nutrition.
Li Xiaoqin reminded that different bowel diseases have similar clinical manifestations, colonoscopic manifestations, and even the same bowel disease has different colonoscopic manifestations, medical workers should combine the child's medical history and clinical manifestations, excavate the pathological value, attach importance to CTE (CT small bowel imaging), colonoscopy auxiliary examination, and then make preliminary diagnosis and treatment.
Lu Quanjun interpreted the relevant knowledge of "nutritional screening and evaluation of pediatric hospitalized patients" for everyone. He mentioned that the incidence of malnutrition among hospitalized children was as high as 15 to 30 per cent. Malnutrition is a serious pathological condition that increases the risk of infection and postoperative complications, delays wound healing, and leads to childhood neurodevelopment, behavioral habits, and birth defects. Nutritional risk screening is the first step in nutrition management, which can detect malnutrition and children with the potential for deterioration during hospitalization early, which is conducive to timely and comprehensive nutritional assessment and early and reasonable nutritional intervention.
Childhood obesity needs to be given high priority
Childhood obesity is also an important topic at this forum. Childhood obesity is a disease in which excessive energy is stored in the form of fat in children, and the weight of body fat exceeds the standard and is associated with an increased risk of hyperlipidemia, hypertension, diabetes and cardiovascular disease. In recent years, the incidence of childhood obesity has increased year by year, becoming one of the killers of children and adolescents in the 21st century.
"China's childhood obesity rate shows the characteristics of urban higher than rural areas, especially in large cities with rapid economic development, and the overweight and obesity rate of school-age children in developed cities has increased by 4 times to 6 times in the past 20 years." Liu Liu, deputy chief physician of Zhengda Fifth Affiliated Hospital, said that childhood obesity is becoming a serious public health problem, obesity is showing a rapid epidemic trend in children between 5 and 6 years old and around adolescence, and foreign fast food and sweet drinks are important risk factors.
Liu Liu said that for children and adolescents with obesity, adhering to the idea of prevention-oriented, structured weight management, multidisciplinary comprehensive management, and level 3 medical management. Strengthening the comprehensive treatment of exercise, dietary adjustment and behavioral psychological correction is the first choice for the treatment of childhood obesity.
Liu Hua, deputy chief physician of Zhengda Fifth Affiliated Hospital, said that childhood obesity is closely related to precocious puberty, and excessive obesity may affect all aspects of pubertal development, such as the timing of puberty initiation and the levels of various hormones in puberty. It is generally believed that precocious puberty is judged by girls developing secondary sexual characteristics before the age of 8, boys developing secondary sexual characteristics before the age of 9, or girls developing menarche before the age of 10.
"Adolescent sexual development in children is a transitional stage from naïve to mature, marked by an increase in pulsed GnRH secretion in the hypothalamus, which is initiated by genetic, nutritional, environmental, and socioeconomic factors." Liu Hua said that the current research believes that obesity has a promoting effect on female sexual development, and the role of male sexual development is controversial, which may be related to the small correlation between BMI and male body fat, and the alternative indicators that can more sensitively reflect body fat in clinical practice need to be further improved.
Meng Yan, deputy chief physician of the Department of Pediatrics of the Fifth Affiliated Hospital of Zhengda University, believes that childhood and puberty are important periods for bone growth, and a 10% increase in peak bone mass can delay the occurrence of osteoporosis by 13 years, so bone mass and bone density in adolescence are particularly important. The effect of diabetes on adolescents or the peak period of bone mass deposition reduces the bone formation process, and adolescents with simple obesity and type II diabetes mellitus are more normal, and visceral fat is inversely correlated with bone mass and bone density, resulting in less bone mass is difficult to support weight, which may bring higher risk of fall and fracture. At present, there is clear evidence for the increased risk of type II diabetes fractures in adults, and there is an urgent need for longer-term longitudinal studies to explore the long-term effects of diabetes and obesity on bone growth in adolescents.