This paper meticulously traces the discovery of congenital hypothyroidism. Throughout the history of medical science, civilizations around the world have documented cases of iodine deficiency goiter and cretinism. However, the relationship between iodine and goiter was not recognized until the early 19th century in Europe. Anatomical knowledge and clinical practice concerning the thyroid gland deepened, by the end of the 19th century, European physicians confirmed that a malfunction in thyroid could lead to cretinism. Following discussions and studies by doctors from various European countries, the modern medical term "congenital hypothyroidism" was intially used in the United Kingdom, replacing "cretinism", and then widely accepted.

This article outlines the global history of newborn screening for congenital hypothyroidism (CH), starting from the spread of medical knowledge and technology across the world. It is believed that the inception of CH screening programs greatly benefited from research linking thyroid dysfunction and intellectual impairment in the late 19th century, coupled with the discovery of thyroxine in the early 20th century. By the early 1970s, Professor Jean H. Dussault in Quebec, Canada, had conducted the first large-scale newborn CH screening program. As CH screening technologies have developed and spread globally, China has made significant progress in this area. Since the initial efforts in the early 1980s, there has been substantial increase in the national screening rate in recent years. However, China still confronts challenges due to regional disparities.

This paper delves into the evolution of the Apgar score, a globally utilized clinical tool in medical practice, and the debates and challenges it faced across different historical periods. In the 1950s, Virginia Apgar innovatively introduced a new method for assessing newborns based on five clinical indicators: heart rate, respiratory effort, response to stimulation, muscle tone, and skin color. Subsequently, her research team focused on improving and perfecting the scoring system. The Apgar score has been widely used to diagnose the presence and severity of asphyxia in newborns, evaluate the need for and the effectiveness of resuscitation, and predict adverse outcomes in newborns. Since the 1980s, the medical field has continuously emphasized on preventing misuse and overuse of the Apgar score, during which its applicability and predictive value have become more and more clarified.

This article provides a detailed review of Virginia Apgar's life experience, medical education, and career development, as well as her outstanding achievements in medicine. Apgar promoted the independent and specialized development of anesthesiology. She was concerned about maternal and neonatal health for a long time, created a neonatal scoring system based on clinical experience, the Apgar Score, and was committed to scientific research and dissemination of birth defects.

Preeclampsia is one of the most important types among hypertensive disorders during pregnancy, characterized by a high incidence, multi-organ involvement, and severe threats to maternal and fetal health. This paper reviews the historical understanding of eclampsia, explores the development of the concept of "preeclampsia" alongside advancements in blood pressure measurement and urinalysis technologies, and examines the historical explanations of the etiology of eclampsia and preeclampsia. From abnormal fetal positioning to placental dysfunction and endothelial cell dysfunction, although the exact pathogenesis of eclampsia-preeclampsia remains unclear, reviewing this historical progression provides a deeper understanding of the evolution of this field and its essence. This, in turn, helps to grasp the cognitive foundations of current practices and the potential limitations.

Objective To investigate the correlation between the expression of serum 25hydroxyvitamin D[25(OH)D]and growth differentiation factor 15(GDF-15)levels and the risk of malignancy in patients with metabolic syndrome(MS)and the development of combined thyroid nodules(TN).Methods From August 2019 to August 2023,185 MS patients who visited the First Affiliated Hospital of Xinjiang Medical University were regarded as the study subjects,according to the results of thyroid ultrasound examination,they were separated into MS group(n=73)and MS+TN group(n=112).According to the malignant grading of thyroid nodules,MS+TN patients were separated into benign group(n=89)and malignant group(n=23).Another 68 healthy individuals who underwent physical examinations were regarded as control group.Enzyme-linked immunosorbent assay(ELISA)was applied to determine the levels of serum 25(OH)D and GDF-15 in each group.Pearson was applied to analyze the correlation between serum 25(OH)D and GDF-15 levels and clinical indicators in MS in TN patients.Multivariate Logistic regression was applied to analyze the influencing factors of malignant TN in patients with MS combined with TN.Receiver operating characteristic(ROC)curve was plotted to evaluate the diagnostic value of serum 25(OH)D and GDF-15 levels in MS with malignant TN.Results Comparison of serum 25(OH)D(30.41±6.73 ng/ml,27.23±6.15 ng/ml,24.67±4.38 ng/ml)and GDF-15(167.99±22.56 ng/L,239.75±25.92 ng/L,286.63±26.04 ng/L)levels in control,MS and MS+TN groups,the differences were statistically significant(F=22.219,472.113,all P<0.05).Compared with the benign group,the serum 25(OH)D(26.28±4.53 ng/ml vs 18.44±3.79 ng/ml)level in the malignant group was obviously reduced,while the GDF-15(276.93±24.53 ng/L vs 324.17±31.89 ng/L)level was obviously increased,the differences were statistically significant(t=7.631,7.718,all P＜0.05).The BMI,age,FPG,TG,TSH and TGAb levels of patients in the malignant group were obviously higher than those in the benign group,the difference were statistically significant(t=2.868,3.523,3.542,3.603,4.581,5.516,all P＜0.05).Pearson correlation analysis,and the serum 25(OH)D level in MS patients with TN was negatively correlated with FPG,TSH,TG and TGAb levels(r=-0.302,-0.482,-0.524,-0.546,all P<0.001),while GDF-15 level was positively correlated with TG,TSH,TGAb and FPG levels(r=0.467,0.541,0.578,0.623,all P<0.05).Multivariate logistic regression analysis,GDF-15(OR=1.673,95%CI:1.146～2.442)was a risk factor for the occurrence of malignant TN in MS patients(P<0.05),and 25(OH)D(OR=0.744,95%CI:0.604～0.916)was a protective factor for the occurrence of malignant TN,the AUC values of serum 25(OH)D and GDF-15 levels in the diagnosis of MS combined with malignant TN were 0.813,0.799 and 0.930,respectively,and the combination was superior to the single diagnosis(Z=2.088,2.021,P=0.037,0.043).Conclusion The levels of serum 25(OH)D and GDF-15 in patients with MS combined with TN are obviously correlated with nodular nature.The decrease in serum 25(OH)D level and the increase in GDF-15 level are risk factors for malignant TN in MS patients.

Objective:To investigate the prognosis and risk factors of IgA vasculitis nephritis (IgAVN) in children.Methods:A retrospective cohort study was conducted. Clinical data were collected from 264 children who were pathologically diagnosed with IgAVN at Department of Pediatric Nephrology, Tongji Hospital, affiliated with Tongji Medical College, Huazhong University of Science and Technology, between January 2011 and December 2017. All patients had a follow-up period of more than 3 years. Clinical characteristics, renal pathology, 3-year and 5-year prognosis were analyzed. The patients were grouped based on gender, age of onset (≤6 years, >6-9 years, and >9 years), pathological classification (≤Ⅲ and>Ⅲ),whether the prognosis was complete remission at 3 and 5 years. Independent sample t-tests, ANOVA or chi-squared test were used for intergroup comparisons. Spearman correlation analysis was applied for ordinal data, and multivariate Logistic regression was used to analyze factors affecting the prognosis. Receiver operating characteristic (ROC) curve was utilized to evaluate the predictive value of these factors. Results:Of the 264 children with IgAVN, 153 were male and 111 were female, the age of onset was 8.3 (6.7, 10.3) years, 118 patients (45%) with onset age >6-9 years accounted for the highest proportion. All patients presented with skin purpura and renal involvement, primarily manifesting as hematuria and/or proteinuria. Microscopic hematuria was observed in 253 patients (95.8%), while 246 patients (93.2%) showed proteinuria. In 256 patients (97.0%), hematuria or proteinuria urinalysis was detected within 6 months of skin purpura onset, and 243 patients (92.0%) underwent renal biopsy within 6 months of renal involvement. The most common clinical subtype in 264 IgAVN children was hematuria and proteinuria (204 cases, 77.3%), with grade Ⅲ being the predominant pathological classification (181 cases, 68.6%). Among children ≤6 years old, the 3-year complete remission rate was higher in males than in females (83.9% (26/31) vs. 7/16, χ2=8.12, P=0.012). Factors independently associated with poor 5-year prognosis included time from hematuria or proteinuria urinalysis to renal biopsy >6 months, elevated serum cholesterol levels, and incomplete remission 3 years post-biopsy ( OR=5.41, 1.39, 6.02, 95% CI 1.40-20.86, 1.04-1.84, 2.61-13.88, all P<0.05). The serum cholesterol has a predictive value for 5-year prognosis ( P=0.020, AUC=0.62, 95% CI 0.52-0.71, Youden index=0.27, cutoff=4.37). Conclusions:For children with IgAVN aged≤6 years, the 3-year prognosis is better in males than in females. Time from hematuria or proteinuria urinalysis to renal biopsy >6 months, elevated serum cholesterol levels, and incomplete remission at 3 years post-biopsy may be independent risk factors for poor 5-year prognosis in children with IgAVN.