I. Pediatric mesenteric lymph node enlargement – is it related to the child’s abdominal pain? 1. Ultrasound examination of the abdomen: there are large mesenteric lymph nodes, large ones even 25 mm in diameter. Lymph nodes have nothing to do with your child’s abdominal pain. This indicates that your child’s immune function is normal. 2, mesenteric lymphadenitis: there is abdominal pain, but most of it is constant pain, not relieved after the stool, there must be high fever, because it is caused by inflammation? There is pressure pain or even rebound pain in the abdomen, especially like acute appendicitis, only the pressure pain point is not fixed like appendicitis with the right lower abdomen, mostly after the cold. Is it meaningful to check the trace elements? Check the trace elements to see if your baby is deficient in any trace elements so that you can always find out what your child needs to “supplement”. The serum level of trace elements does not represent the functional status of trace elements in the body, nor can it be used as a diagnostic basis for electrolyte disorders and trace element deficiencies or high blood lead in the body. Even the micronutrient values obtained from venous blood sampling are only blood levels and do not represent the content in the corresponding tissues. For example, calcium is mainly deposited in the bones, and blood calcium levels do not represent calcium levels in the bones. Iron is mainly found in red blood cells and is involved in oxygen-carrying hemoglobin, while blood tests show serum free iron levels, which are not representative of the condition of red blood cells. Copper is mainly stored in the liver. Even if venous blood is collected to measure trace elements, it is not meaningful for assessing the nutritional status of infants and children. While foods contain more than 20 trace elements, there are generally only five or six trace element tests available for children. Growth abnormalities are also not only due to micronutrient deficiencies. Parents are advised to focus their feeding on balanced nutrition, focusing on macronutrients such as carbohydrates, fats and proteins. If a child is growing normally, there is no need to test for micronutrients. Only micronutrient testing through venous blood can reflect serum levels; blood taken through the fingers will have tissue fluid mixed in and results will be low; hair testing is absolutely meaningless. During balanced nutrition, there is no need for additional micronutrient supplementation as long as you eat normally. During breastfeeding, only vitamin D supplementation is needed, and the first complementary food should be iron-rich infant nutrition rice powder. Generally, children with normal growth and development do not need to do trace element testing. Third, can fever-reducing patches reduce fever? How do fever-reducing patches reduce fever? The instructions say that it relies on the evaporation of water vapor from the hydrogel to take away heat, which is actually a physical cooling method. In fact, the effect of physical cooling is very poor, even if the whole body bath such a way, but only a short time to reduce a little and a very short duration, and will lead to chills, so many authoritative medical institutions have clearly said not warm water bath. Some fever patches have added ice chips, peppermint, eucalyptus oil and other substances, which, like cool oil, make the local skin feel cool, but not really lower the temperature. If your child just likes to put them on, it’s not impossible, but not all children can express that, and sometimes he just can’t say no to you. You also need to know that some children are allergic to fever patches. Fourth, stop listening to foolishness, there is no such thing as growing pains! In children 3-5 years old, pain in the evening or at night on the front side of the calf or around the knee joint with no obvious cause is often attributed to growing pains or due to calcium deficiency. In fact, “growing pains” is a false proposition and there is no such thing as “growing pains” in medicine. The so-called “growing pains” are usually the result of children not releasing their waste products after a day of playing and exercising, and these pains do not require any treatment and can be relieved by themselves after a night’s rest. Pain in an indeterminate location (i.e., pain that can occur in different areas) and pain that can be relieved with rest is usually not a disease. Usually, if the pain is caused by a disease or swelling or inflammation, it will usually manifest as pain in a fixed location. Persistent pain and paroxysmal aggravation at a fixed location may be temporarily relieved by medication, but the pain will continue, and the pain will increase in intensity and duration, especially at night, and the first symptom of many malignant tumors is persistent night pain. Similar to “growing pains”, the rotundity of the baby at birth does not require treatment, Guo Yuan said, all children are born with rotundity, which is because the baby is not weight-bearing in the womb. This is a process that every child will go through, only the severity of the difference, generally without treatment, as long as the child’s legs are symmetrical, without any other symptoms, are normal. V. Late teething, occipital baldness, night sweating caused by calcium deficiency? The time of teething is usually from 6 to 8 months, but it is normal for teeth to appear as early as 4 months or as late as 12 months. There are individual differences in the early and late teething, and the age at which teething begins is related to family genetics. 1. Severe vitamin D deficiency rickets can also be late in teething. If an infant takes 400 units of vitamin D every day from 2 weeks of life, has a good nutritional status and normal growth and development, late teething cannot be considered to be caused by calcium deficiency due to vitamin D deficiency. If you do not take vitamin D, you should take 400 units of vitamin D every day as soon as possible. 2. Many normal babies can also suffer from occipital baldness. Some children with more excited types of neural activity move more when lying on their backs, and fatter children sweat a lot, are uncomfortable in the occipital area, and like to rub back and forth, all of which are prone to occipital baldness. The back of the head and occipital area are places that are easily rubbed and sweat during sleep. The hair here becomes yellow, thin and soft, and sometimes even loses its hair, which is called occipital baldness. 3. Children with vitamin D deficiency rickets have occipital baldness. Vitamin D deficiency is related to calcium and phosphorus metabolism, so parents misidentify occipital baldness as being caused by calcium deficiency. If your child takes vitamin 400ID every day, you can rule out calcium deficiency as the cause. 4. A child who sweats a lot does not necessarily have a calcium deficiency. The vast majority of children’s excessive sweating is physiological. Because the sweat glands and sympathetic nervous system of children are not fully developed, the body metabolism is vigorous, and the skin vascular distribution is large, the body water content is large. In addition to active, more sweating than adults, so easy sweating is a normal physiological phenomenon. In addition, too much clothing, too thick covers, and too high room temperature can make children sweat more, and giving children overheated milk or other diets can also cause sweating. Sweating when you just fall asleep may be due to the need to release excess energy in your body. 5. Pathological sweating is common in children with vitamin D deficiency rickets, because vitamin D is related to calcium and phosphorus metabolism. If an infant has been taking a preventive amount of vitamin D (400 units per day) or has been outdoors regularly, the child’s motor development is normal and no abnormalities are seen in the bones, there is no need to worry about this disease. Other diseases with symptoms other than sweating should be seen by a doctor if necessary. Inflammation = infection? Inflammation is a local tissue response that occurs in living tissues with a vascular system that is primarily defensive in nature to injury factors. The basic local lesions of inflammation are metaplasia, exudation and hyperplasia, where metaplasia is the injury and exudation and hyperplasia are the resistance to injury. The inflammatory process is a three-way contest of injury, resistance to injury, and repair. So what are the factors that can cause inflammation? ① Inflammation caused by microorganisms: bacteria, viruses, rickettsia, mycoplasma, fungi, spirochetes and parasites are the most common causes of inflammation. ② Inflammation caused by physical factors: high temperature, low temperature, radioactive substances and ultraviolet light, etc. and mechanical injury. All of these diseases have obvious physical or chemical factors causing the disease, such as esophagitis caused by esophageal burns, pancreatitis induced by overeating, and ophthalmia caused by ultraviolet light. ③ Inflammation caused by chemical factors: exogenous chemicals such as strong acids, strong bases and turpentine, mustard gas, etc. Endogenous toxic substances such as decomposition products of necrotic tissues and metabolites that accumulate in the body under certain pathological conditions, such as urea, etc. ④ Foreign body-induced inflammation: Foreign bodies that enter the body through various routes, such as various metals, wood debris, dust particles, and surgical sutures, can cause different degrees of inflammatory reactions due to their different antigenic properties. ⑤ Inflammation caused by ischemic necrosis: this type of disease, usually sterile, is caused by tissue necrosis caused by vasospasm and embolism. Examples include thrombo-occlusive vasculitis, nodular arteritis, nodular vasculitis, phlebitis, etc. (6) Inflammation caused by allergy: This type of disease is often dominated by tissue edema, usually caused by allergic reactions to pollen, drugs, cosmetics, certain foods, etc. For example, allergic rhinitis, allergic conjunctivitis, etc. (7) Inflammation caused by tissue hyperplasia: These diseases are all caused by tissue hyperplasia or atrophy resulting in dysfunction. For example, hypertrophic rhinitis, hypertrophic gastritis, arthritis caused by osteophytes, atrophic rhinitis, atrophic gastritis, etc. (8) Inflammation due to neurological causes: these diseases are often due to trauma . Hyperplasia, poisoning, infection, nutritional deficiency, etc. lead to nerve dysfunction, such as sciatica caused by trauma or osteophyte compression of the sciatic nerve, polyneuritis caused by vitamin deficiency, but also optic neuritis and radiculitis caused by infection. From the above, it is clear that inflammation is a big concept, which includes microorganisms, physicochemical factors, metabolic reactions …… and other causes. However, infection is only one type of inflammation, which is a pathological change caused by the invasion of biological pathogens into the body. So we can’t exactly equate them, and by extension, we know how to use the terms anti-inflammatory and anti-infective. This “misconception” can harm children with asthma for the rest of their lives: stopping medication for fear that hormones are harmful! According to the developmental pattern of childhood asthma, 60% of patients will improve by the time they reach puberty if they are well controlled, especially in the years after age 11 and before puberty, which is the golden period for treatment. The reason why so many asthma patients, especially children, do not have good control of their asthma is, on the one hand, because the children themselves have poor compliance, do not adhere to the treatment for a period of time, or take the medicine, but go back to not adhere to eat; another very important reason is that parents are concerned about the side effects of drugs. Inhaled glucocorticoids: Budesonide belongs to inhaled glucocorticoids, about 10% of the drug enters the lungs when inhaled, and the rest is swallowed into the digestive tract, and is inactivated through the first pass metabolism of the liver, basically not showing systemic adverse reactions. The bioavailability of budesonide is low, ranging from 6-10%, and the clearance rate is the highest among inhaled glucocorticoids (1.4L/min). Inhaled glucocorticosteroids enter the respiratory tract in the form of micro-particles and act directly on the airway mucosa, the dosage is small, the amount of drug absorbed into the blood is small, and after inactivation by the liver, they are quickly metabolized in the body, so there are generally no systemic adverse reactions. The adverse reactions are mainly caused by the deposition of hormone in the oropharynx and the dumbness of the throat and Candida infection in the oropharynx, so the occurrence of adverse reactions can be reduced by paying attention to the timely rinsing of the mouth after each use.