Gonadotropin-releasing hormone (GnRH) dependent precocious puberty/central precocious puberty (GDPP/CPP) is one of the common diseases of the pediatric endocrine system.CPP is mainly treated with gonadotropin-releasing hormone analogues (GnRHa) internationally.They slow the progression of bone age and improve adult height in children with CPP by inhibiting the activity of the hypothalamic-pituitary-gonadal axis and the secretion of sex hormones.In clinical practice, the populations who benefit from GnRHa treatment and the best GnRHa treatment plan still need to be investigated, and the long-term efficacy and safety evidence of GnRHa should be further improved.

Timing of puberty showed a dramatic decrease in the past decades,and it depends on the gene,nutrition,environment,social economics,and so on.Childhood obesity affects both the timing of puberty and sex hormone levels.However,the influence of obesity on the timing of puberty has gender differences.Current studies show that childhood obesity accelerates the onset of puberty in girls,but it still has controversy in boys.Mechanisms of concrete have not clear,may be related to the subjectivity of standard of male sexual development and the correlation of body mass index as a substitute for male obesity is poor.Through literature review at home and abroad,this article will explain the influence of obesity on the timing of puberty,sex hormone levels and its gender differences,further explore the possible mechanisms of body fat participate in starting the gonad axis,and provide new research direction on the switch for the gonad axis.

Islet β cell secretion deficiency and( or) the decreased insulin sensitivity of target tissue are the important pathophysiological mechanisms of diabetes. So,detection and assessment of isletβcell function in the early stages,could be of great significance for disease severity evaluation,early intervention and prognosis of the disease. At present,the main methods of the testing and assessment ofβcell function includeβcell function evaluating indexes,pulsatile insulin secretion,insulin secretion by glucose or non-glucose secretagogues and func-tion testing by other secretions of isletβcells. Among of them,βcell functional assessment methods by detecting C-peptide( especially aspects such as 90 minutes of C-peptide testing in mixed-meal tolerance test,urinary C-pep-tide creatinine ratio) have experienced some progress in recent years.

Objective To establish the specific 16S 23S rRNA gene spacer regions map of different bacteria by PCR, RFLP(restriction fragment length polymorphism ),DNA clone and sequences analysis. Methods A pair of primer was selected from highly conserved sequences adjacent to the 16S 23S rRNA spacer region. The farget rRNA regions from 61 strains of standard bacteria and corresponding clinical isolates representing for 20 genera and 26 species were amplified by PCR,and thereafter analyzed RFLP, DNA clone and sequences analysis.Meanwhile, all the specimens were examined by bacterial culture and PCR RFLP analysis. Results 26 different standard strains presented one band,two bands,three bands and more than three bands respectively, the sensitivity of which reached 2.5 CFU and had no cross reaction to the human genomic DNA,fungus and virus.14 species could be distinguished immediately by PCR, other 10 species must be identified by further Hinf I or Alu I digestion. K.pneumoniae and E.durans differentiate only at the site of 779 th nucleotide according to the sequence analysis, and only one enzyme Xma III could discriminate them.15 specimens from 42 septicemic neonates were blood culture positive and the positive rate was 35.7%. However, 27 specimens were positive by PCR and the positive rate was 64.2%,which was significantly higher than that of the blood culture( P

To report the process of diagnosis and treatment of 1 case with SRY gene mutation of 46, XY complete gonadal dysplasia, and to discuss the clinical characteristics, diagnosis and treatment of the disease.Due to clitoral enlargement for 8 months, a 9 years old girl was admitted to the Children′s Hospital Affiliated to Zhejiang University School of Medicine.Previously, she had early breast development, and suffered from high gonadotropin expression when she was 6 years and 4 months old.Physical examination: breast B3 stage, female vulva, clitoris hypertrophy, normal urethra, normal vaginal opening, slightly thick hymen ring, the development of pubic hair was 2 stages, and Prader score level 1.Laboratory data showed elevated levels of estradiol, testosterone, and human chorionic gonadotrophin.Genetic examination revealed that the chromosome karyotype was 46, XY and SRY gene detection was positive.Therefore, the patient was diagnosed with 46, XY complete gonadal dysplasia.Bilateral gonadectomy was performed, and the posto-perative pathological diagnosis was bilateral gonadoblastoma with left dysgerminoma.The tumor did not recur after che-motherapy.The etiology of early breast development needs to be carefully identified.Patients with sexual characteristics dysplasia need to accept the chromosome karyotype analysis and gene detection, and surgical exploration should be performed when necessary for a correct diagnosis as soon as possible.

Objective To analyze the relationship between dynamic change of GPI-80 and disease severity and prognosis of childhood anaphylactoid purpura. Methods Patients were collected and divided into three groups according to their clinical features: purpura group (purpura only), mixed group (purpura + arthritis + gastrointestinal bleeding) and nephritis group. There were 20 patients in each group. GPI-80 expression on the neutrophils was detected by flow cytometry during acute and regressive phases of the disease. GPI-80 expression was compared among different groups and different phases. Renal biopsies were performed in 20 nephritis patients. Results GPI-80 expression was significantly increased in all patient groups compared with that in the normal control (P 0.05). No significant difference of GPI-80 expression was found among 20 nephritis patients with different pathological patterns. Forty-two patients (10 in purpura group, 15 in mixed group, and 17 in nephritis groups) were followed up and GPI-80 expression was detected at the time of discharge and 2 weeks after discharge, the results showed that GPI-80 expression was decreased from 93.26% (?7.89%) at acute phase to 91.37% (?6.9%) at regressive phase with an average interval of 13.5 days. Most of them (35/42) further decreased to 38.44% (?7.8%) in 2 weeks after discharge. GPI-80 expression remained high in 7 patients for 2 weeks after discharge and relapsed in 5 patients within 1 month after discharge. Conclusions High GPI-80 expression is related to the severity of the disease. The decrease of GPI-80 takes place later than the improvement of clinical symptoms. Children with persistently high GPI-80 expression are likely to relapse. It seems that there is no correlation between GPI-80 expression and different pathological patterns of nephritis.

Objective To explore the relationship between obese children with benign acanthosis ni-gricans and insulin-resistant and type 2 diabetes mellitus. Methods Levels of glucose, insulin, and glucose/ insulin ratio were measured on fasting blood specimens, and anthropometric parameters including waist/hip ratio, fat mass, body fat percentage and body mass index were examined in 42 obese children with benign acanthosis nigricans, 60 cases of simple obesity and 20 healthy children controls. Glucose tolerance tests were performed in groups of obese children with benign acanthosis nigricans and simple obesity, respectively. Results Two of 42 obese children with benign acanthosis nigricans were diagnosed as type 2 diabetes mellitus. The rate of abnormal glucose tolerance and levels of blood sugar during 60 min and 120 min after glucose tolerance were significantly higher in acanthosis nigricans children than those in simple obesity (P

Objective: To establish a prediction model of herpangina epidemic trend based on Baidu index and hand, foot and mouth disease, so as to provide insights into analyses of communicable disease epidemics with limited or missing surveillance data. Methods: The incidence of hand, foot and mouth disease in Zhejiang Province during the period from the first week of 2015 through the 39th week of 2021 was retrieved from the China Information System for Disease Control and Prevention, and the Baidu index of hand, foot and mouth disease and herpangina was collected via the Baidu search engine during the same period. The correlation between the Baidu index and time series of hand, foot and mouth disease was examined using wavelet analysis. In addition, a random forest training model was created based on the Baidu index and incidence of hand, foot and mouth disease, and the fitting effectiveness was evaluated using the mean percentage error, while the Baidu index of herpangina was included in the model to predict the epidemic trend of herpangina during the study period. Results: The Baidu index of herpangina and hand, foot and mouth disease, and the Baidu index and incidence of hand, foot and mouth disease all appeared two peaks at the 26th and 52th week. The phase difference was less than 0.1 week between the Baidu index and time series of hand, foot and mouth disease, and the mean percentage error of the training model was 13.07%, with high concordance between the predicted number and actual report number of cases with hand, foot and mouth disease. The numbers of herpangina cases were predicted to be 28 822, 27 341, 28 422, 51 782, 52 457 and 5 691 from 2015 to 2020, and there were totally 48 702 herpangina cases reported until the 39th week of 2021. Like hand, foot and mouth disease, the incidence of herpangina peaked between May and July. Conclusion The random forest training model based on the Baidu index and incidence of hand, foot and mouth disease is feasible to predict the epidemic trend of herpangina.

Nonalcoholic fatty liver disease(NAFLD)has become one of the great risks for children′s development and health, while its pathogenesis and progression characteristics are still not clear.The establishment of NAFLD specific research model can help to explore and reveal the role of related pathways in the occurrence and development of NAFLD.The existing models for the study of NAFLD in children mainly include diet-induced animal models and in vitro hepatocyte culture models.In recent years, organoids cultured from stem cells have similar spatial tissues of corresponding organs and can reproduce some functions of corresponding organs, which can be used to simulate liver inflammation and fibrosis process.In this paper, we will introduce these models and methods, focus on the construction and application of organoids, and look forward to the application of models for children NAFLD in the future.

Objective: To investigate epidemiological characteristics of notifiable infectious diseases in Zhejiang Province in 2023, so as to provide the evidence for strengthening prevention and control of infectious diseases. Methods: Data pertaining to notifiable infectious diseases reported in Zhejiang Province in 2023 were retrieved from the Infectious Disease Surveillance System of Chinese Disease Prevention and Control Information System. The incidence and mortality were analyzed according to the classification of notifiable infectious diseases and transmission routes, and epidemiological characteristics of infectious diseases were descriptively analyzed. Results: Thirty types of notifiable infectious diseases with 2 955 699 cases and 427 deaths were reported in Zhejiang Province in 2023, with a reported incidence rate of 4 493.93/105 and a reported mortality rate of 0.649 2/105. A total of 679 notifiable infectious disease emergencies were reported, with 26 514 cases and 1 case death (rabies). The emergencies mainly occurred in schools and preschool institutions, with 621 cases accounting for 91.46%. There were 1 case of cholera reported in class A notifiable infectious diseases and no death, 22 types of class B notifiable infectious diseases, with a reported incidence rate of 552.46/105 and a reported mortality rate of 0.644 7/105, and 8 types of class C notifiable infectious diseases, with a reported incidence rate of 3 941.48/105 and a reported mortality rate of 0.004 6/105. The incidence rates of respiratory, intestinal, blood-borne and sexually transmitted, natural and insect-borne infectious diseases were 4 028.67/105, 381.59/105, 81.15/105 and 1.35/105, respectively, according to transmission routes. Influenza (3 561.78/105) and COVID-19 (423.77/105) reported the highest incidence, and AIDS (0.477 4/105) and tuberculosis (0.130 8/105) reported the highest mortality. Conclusion The incidence rates of respiratory and intestinal infectious diseases were high in Zhejiang Province in 2023, and schools and preschool institutions were the main places of diseases occurred.