The second edition of the expert consensus on pediatric nutrition was formed based on a global update of pedia-tric nutrition guidelines or consensus worldwide,the management of congenital heart disease,and the result...The second edition of the expert consensus on pediatric nutrition was formed based on a global update of pedia-tric nutrition guidelines or consensus worldwide,the management of congenital heart disease,and the results of multi-center clinical nutrition research for congenital heart disease following thefirst Chinese consensus edition of 2016.The consensus was also shaped by the results of three discussion sessions and two questionnaires con-ducted by the 13-member collaboration group.This process was informed by both clinical guidelines and expert consensus.The quality of literature,both in English and Chinese,and the level of recommendations were evaluated using the Grading of Recommendations Assessment,Development,and Evaluations(GRADE)system.展开更多
Congenital heart disease(CHD),the most prevalent congenital ailment,has seen advancements in the“dual indi-cator”screening program.This facilitates the early-stage diagnosis and treatment of children with CHD,subse-...Congenital heart disease(CHD),the most prevalent congenital ailment,has seen advancements in the“dual indi-cator”screening program.This facilitates the early-stage diagnosis and treatment of children with CHD,subse-quently enhancing their survival rates.While cardiac auscultation offers an objective reflection of cardiac abnormalities and function,its evaluation is significantly influenced by personal experience and external factors,rendering it susceptible to misdiagnosis and omission.In recent years,continuous progress in artificial intelli-gence(AI)has enabled the digital acquisition,storage,and analysis of heart sound signals,paving the way for intelligent CHD auscultation-assisted diagnostic technology.Although there has been a surge in studies based on machine learning(ML)within CHD auscultation and diagnostic technology,most remain in the algorithmic research phase,relying on the implementation of specific datasets that still await verification in the clinical envir-onment.This paper provides an overview of the current stage of AI-assisted cardiac sounds(CS)auscultation technology,outlining the applications and limitations of AI auscultation technology in the CHD domain.The aim is to foster further development and refinement of AI auscultation technology for enhanced applications in CHD.展开更多
Background Vitamin E is the most abundant lipid-soluble antioxidants present in plasma;however,the relationship between serum vitamin E and change in body mass index(BMI)-for-age Z scores in adolescents has not been w...Background Vitamin E is the most abundant lipid-soluble antioxidants present in plasma;however,the relationship between serum vitamin E and change in body mass index(BMI)-for-age Z scores in adolescents has not been well described.Methods This study is a cross-sectional study.Data were analyzed from 4014 adolescents who participated in the National Health and Nutrition Examination Survey.The nutritional status was calculated by BMI Z scores and was classifed into nor-mal weight,overweight,and obese.Multivariable-adjusted logistic regression was used to examine the association between serum vitamin E levels with overweight/obesity.Besides,the interaction effects between potential confounders and vitamin E on obesity were further evaluated.Results After adjusting potential confounders,serum vitamin E levels were negatively associated with overweight/obesity in girls but not in boys.Per standard deviation increment in vitamin E concentrations was associated with a 92%decreased risk of obesity in females.Besides,lower quartiles of serum vitamin E were associated with a higher risk of overweight/obesity in girls.Moreover,the inverse association between serum vitamin E levels and obesity was also found in most subgroups through subgroup analysis.Conclusions Our study supports the negative association between serum vitamin E levels and overweight/obesity in ado-lescents.A higher serum vitamin E level may be associated with a reduced probability of obesity in girls,but not in boys.展开更多
Background Tetralogy of Fallot(TOF)is the most common cyanotic congenital heart disease.Children with TOF would be confronted with neurological impairment across their lifetime.Our study aimed to identify the risk fac...Background Tetralogy of Fallot(TOF)is the most common cyanotic congenital heart disease.Children with TOF would be confronted with neurological impairment across their lifetime.Our study aimed to identify the risk factors for cerebral morphology changes and cognition in postoperative preschool-aged children with TOF.Methods We used mass spectrometry(MS)technology to assess the levels of serum metabolites,Wechsler preschool and primary scale of intelligence-Fourth edition(WPPSI-Ⅳ)index scores to evaluate neurodevelopmental levels and multimodal magnetic resonance imaging(MRI)to detect cortical morphological changes.Results Multiple linear regression showed that preoperative levels of serum cortisone were positively correlated with the gyrification index of the left inferior parietal gyrus in children with TOF and negatively related to their lower visual spaces index and nonverbal index.Meanwhile,preoperative SpO_(2) was negatively correlated with levels of serum cortisone after adjusting for all covariates.Furthermore,after intervening levels of cortisone in chronic hypoxic model mice,total brain volumes were reduced at both postnatal(P)11.5 and P30 days.Conclusions Our results suggest that preoperative serum cortisone levels could be used as a biomarker of neurodevelopmental impairment in children with TOF.Our study findings emphasized that preoperative levels of cortisone could influence cerebral development and cognition abilities in children with TOF.展开更多
基金supported by the National Natural Science Foundation of China(81970265,82270310)a Sub-Project of the National Key R&D Program“The recognition and Identification of Genetic Pathogenic Genes for Structural Birth Defects”(2021YFC2701002)+1 种基金Nanjing Science and Technology Development Project(2019060007)Jiangsu Provincial Key Research and Development Program(BE2023662).
文摘The second edition of the expert consensus on pediatric nutrition was formed based on a global update of pedia-tric nutrition guidelines or consensus worldwide,the management of congenital heart disease,and the results of multi-center clinical nutrition research for congenital heart disease following thefirst Chinese consensus edition of 2016.The consensus was also shaped by the results of three discussion sessions and two questionnaires con-ducted by the 13-member collaboration group.This process was informed by both clinical guidelines and expert consensus.The quality of literature,both in English and Chinese,and the level of recommendations were evaluated using the Grading of Recommendations Assessment,Development,and Evaluations(GRADE)system.
基金supported by Jiangsu Provincial Health Commission(Grant No.K2023036).
文摘Congenital heart disease(CHD),the most prevalent congenital ailment,has seen advancements in the“dual indi-cator”screening program.This facilitates the early-stage diagnosis and treatment of children with CHD,subse-quently enhancing their survival rates.While cardiac auscultation offers an objective reflection of cardiac abnormalities and function,its evaluation is significantly influenced by personal experience and external factors,rendering it susceptible to misdiagnosis and omission.In recent years,continuous progress in artificial intelli-gence(AI)has enabled the digital acquisition,storage,and analysis of heart sound signals,paving the way for intelligent CHD auscultation-assisted diagnostic technology.Although there has been a surge in studies based on machine learning(ML)within CHD auscultation and diagnostic technology,most remain in the algorithmic research phase,relying on the implementation of specific datasets that still await verification in the clinical envir-onment.This paper provides an overview of the current stage of AI-assisted cardiac sounds(CS)auscultation technology,outlining the applications and limitations of AI auscultation technology in the CHD domain.The aim is to foster further development and refinement of AI auscultation technology for enhanced applications in CHD.
基金supported by the China Postdoctoral Science Foundation(2019M651904)the Key Project supported by the Medical Science and Technology Development Foundation,Nanjing Municipality Health Bureau(ZKX19039)+1 种基金the National Key Research and Development Program of China(2017YFC1308105,2016YFC1101001)the National Natural Science Foundation of China(81970265,82000303).
文摘Background Vitamin E is the most abundant lipid-soluble antioxidants present in plasma;however,the relationship between serum vitamin E and change in body mass index(BMI)-for-age Z scores in adolescents has not been well described.Methods This study is a cross-sectional study.Data were analyzed from 4014 adolescents who participated in the National Health and Nutrition Examination Survey.The nutritional status was calculated by BMI Z scores and was classifed into nor-mal weight,overweight,and obese.Multivariable-adjusted logistic regression was used to examine the association between serum vitamin E levels with overweight/obesity.Besides,the interaction effects between potential confounders and vitamin E on obesity were further evaluated.Results After adjusting potential confounders,serum vitamin E levels were negatively associated with overweight/obesity in girls but not in boys.Per standard deviation increment in vitamin E concentrations was associated with a 92%decreased risk of obesity in females.Besides,lower quartiles of serum vitamin E were associated with a higher risk of overweight/obesity in girls.Moreover,the inverse association between serum vitamin E levels and obesity was also found in most subgroups through subgroup analysis.Conclusions Our study supports the negative association between serum vitamin E levels and overweight/obesity in ado-lescents.A higher serum vitamin E level may be associated with a reduced probability of obesity in girls,but not in boys.
基金supported by the National Natural Science Foundation of China(82270310,81970265).
文摘Background Tetralogy of Fallot(TOF)is the most common cyanotic congenital heart disease.Children with TOF would be confronted with neurological impairment across their lifetime.Our study aimed to identify the risk factors for cerebral morphology changes and cognition in postoperative preschool-aged children with TOF.Methods We used mass spectrometry(MS)technology to assess the levels of serum metabolites,Wechsler preschool and primary scale of intelligence-Fourth edition(WPPSI-Ⅳ)index scores to evaluate neurodevelopmental levels and multimodal magnetic resonance imaging(MRI)to detect cortical morphological changes.Results Multiple linear regression showed that preoperative levels of serum cortisone were positively correlated with the gyrification index of the left inferior parietal gyrus in children with TOF and negatively related to their lower visual spaces index and nonverbal index.Meanwhile,preoperative SpO_(2) was negatively correlated with levels of serum cortisone after adjusting for all covariates.Furthermore,after intervening levels of cortisone in chronic hypoxic model mice,total brain volumes were reduced at both postnatal(P)11.5 and P30 days.Conclusions Our results suggest that preoperative serum cortisone levels could be used as a biomarker of neurodevelopmental impairment in children with TOF.Our study findings emphasized that preoperative levels of cortisone could influence cerebral development and cognition abilities in children with TOF.
