1.A New Model for Diagnosis and Treatment of Growth and Development-related Diseases from the Perspective of the Integration of Exercise, Medicine, and Education
Jiaqi QIANG ; Yutong WANG ; Jiaxuan LIU ; Yingjing WANG ; Shi CHEN ; Hui PAN
Medical Journal of Peking Union Medical College Hospital 2025;16(3):537-544
Growth and development-related diseases result from the interplay of biological, psychological, and social factors. The collaboration between healthcare, sports, and education sectors integrates multidisciplinary resources and strengths to promote standardized diagnostic and therapeutic processes. This approach establishes a comprehensive closed-loop system encompassing early screening and referral, diagnosis and comprehensive evaluation, intervention and support plan formulation, as well as long-term management andoutcome assessment. It provides systematic scientific support for the healthy growth of children and adolescents, shifting disease intervention to the subclinical stage. Against the backdrop of societal informatization and intelligent development, this diagnostic and therapeutic model not only safeguards the holistic health of children and adolescents but also offers novel perspectives and feasible pathways for managing growth and development-related diseases. The implementation of this systematic diagnostic and therapeutic paradigm presents an innovative solution with Chinese characteristics for addressing such conditions, while injecting new vitality into the advancement of national health initiatives.
2.Association Between Vitamin D Status and Insulin Resistance in Adolescents: A Cross-sectional Observational Study
Xiaoyuan GUO ; Yutong WANG ; Zhibo ZHOU ; Shi CHEN ; Mei ZHANG ; Bo BAN ; Ping LI ; Xinran ZHANG ; Qiuping ZHANG ; Kai YANG ; Hongbo YANG ; Hanze DU ; Hui PAN
Medical Journal of Peking Union Medical College Hospital 2025;16(3):577-583
To investigate the correlation between vitamin D nutritional status and insulin resistance in pubertal adolescents. This cross-sectional observational study employed convenience sampling to recruit 2021-grade(8th grade) students from Jining No.7 Middle School in Shandong Province on June 5, 2023. Data collection included questionnaires, physical examinations, and imaging assessments to obtain general information, secondary sexual characteristics development, and bone age. Venous blood samples were collected to measure fasting blood glucose(FBG), fasting insulin(FINS), homeostasis model assessment of insulin resistance(HOMA-IR), and 25-hydroxyvitamin D[25(OH)D] levels. Spearman correlation analysis and multivariate linear regression models were used to examine the associations between serum vitamin D levels and FBG, FINS, and HOMA-IR. The study included 168 pubertal adolescents[69 females(41.1%), 99 males(58.9%); mean age(13.27±0.46) years]. All participants had entered puberty based on sexual development assessment. Vitamin D deficiency was observed in 41 participants(24.4%), insufficiency in 109(64.9%), and sufficiency in 18(10.7%). The median HOMA-IR was 3.49(2.57, 5.14).Significant differences were found across vitamin D status groups for HOMA-IR [4.45(2.54, 6.62) Vitamin D deficiency/insufficiency is prevalent among pubertal adolescents, and serum vitamin D levels show a significant inverse association with insulin resistance. These findings suggest the potential importance of vitamin D status in metabolic health during puberty.
3.The Mediating Effect of Vitamin D on the Association Between Exercise and Triglyceride in Adolescents: A Prospective Cross-sectional Study
Bochuan HUANG ; Xiaoyuan GUO ; Yutong WANG ; Jiaxuan LIU ; Hui PAN ; Shi CHEN
Medical Journal of Peking Union Medical College Hospital 2025;16(3):584-590
To investigate the mediating role of vitamin D in the association between exerciseand triglyceride among adolescents, as well as its potential molecular mechanisms. This prospective cross-sectional study utilized convenience sampling, enrolling 2021-grade students from Jining No. 7 Middle School on June 5, 2023. Moderate-intensity exercise frequency was assessed via standardized questionnaires, serum 25-hydroxyvitamin D levels were measured using chemiluminescence, and triglyceride levels were determined via fully automated biochemical analysis. Spearman's rank correlation analysis was employed to examine the relationships among moderate-intensity exercise, triglyceride, and vitamin D. A mediation model was constructed using the Baron & Kenny causal steps approach, adjusting for confounders including age, sex, body mass index (BMI), dairy intake, sweet food consumption, and fast-food intake. Subgroup analyses were performed based on BMI. The significance of the mediation effect was confirmed using both the Bootstrap and Sobel tests. A total of 354 adolescents meeting the inclusion criteria were enrolled, including 142 females (40.11%) and 212 males (59.89%), with a median age of 13.25(12.83, 13.83)years. Spearman's analysis revealed a significant negative correlation between moderate-intensity exercise and triglyceride levels ( Vitamin D serves as a key mediator in the triglyceride-lowering effect of exercise among adolescents, independent of age, sex, and dietary habits. This mediation effect is particularly pronounced in adolescents with BMI < 24 kg/m2. The underlying mechanism may involve vitamin D-regulated lipid metabolism-related gene expression and suppression of inflammatory pathways, suggesting that targeting vitamin D signaling could be a potential molecular strategy for early intervention in adolescent dyslipidemia.
4.Body Composition Profiles and Associated Factors in Adolescents UndergoingLong-term Regular Exercise
Yutong WANG ; Xiaoyuan GUO ; Hanze DU ; Hui PAN ; Wei WANG ; Mei ZHANG ; Bo BAN ; Ping LI ; Xinran ZHANG ; Qiuping ZHANG ; Hongshuang SUN ; Rong LI ; Shi CHEN
Medical Journal of Peking Union Medical College Hospital 2025;16(3):591-597
To investigate body composition and associated factors in adolescents undergoing long-term regular sports training. This prospective longitudinal cohort study employed convenience sampling to recruit adolescents receiving structured athletic training at Jining Sports Training Center in June 2023. Baseline measurements included height, weight, body mass index (BMI), blood pressure, heart rate, waist circumference, and hip circumference. Questionnaires assessed sleep duration, screen time, and household income. Follow-up measurements in June 2024 repeated these assessments while adding bioelectrical impedance analysis for body composition (lean mass, skeletal muscle mass, fat mass, and body fat percentage). Linear regression models examined associations between training type (direct-contact vs. non-contact sports) and follow-up body fat percentage, BMI, and waist circumference as dependent variables, adjusting for covariates. The study included 110 adolescents (39 female, 71 male) with median age 13.21 years (IQR: 12.46-14.33). Participants comprised 65 direct-contact and 45 non-contact athletes. Baseline prevalence rates were 27.27% for overweight/obesity, 24.55% for elevated waist circumference, and 16.36% for elevated blood pressure. At follow-up, corresponding rates were 24.55%, 26.36%, and 13.64% respectively. The elevated blood pressure subgroup showed significantly higher waist circumference ( Despite regular athletic training, substantial proportions of adolescents exhibited overweight/obesity, abdominal obesity, and elevated blood pressure, warranting clinical attention. Training modality appears to influence body composition changes, with direct-contact sports associated with more favorable adiposity-related outcomes.
5.Effect of Acupuncture Combined with Bloodletting and Cupping on the Expression of Coagulation-Complement-Mast Cell Activation Axis-Related Factors in Patients with Chronic Spontaneous Urticaria:Randomize-controlled Study
Yuzhu DU ; Yuqiang XUE ; Xiang LIU ; Yu SHI ; Hongkun LI ; Wenshan LIU ; Zan TIAN ; Yutong HU ; Yanjun WANG
Journal of Traditional Chinese Medicine 2025;66(2):150-156
ObjectiveTo observe the clinical efficacy of acupuncture combined with bloodletting and cupping in the treatment of chronic spontaneous urticaria(CSU) and to explore its potential mechanisms of action. MethodsSeventy CSU patients were randomly divided into loratadine group and acupuncture + bloodletting group, with 35 patients in each group. The loratadine group received oral loratadine tablets, 10 mg once daily in the evening. The acupuncture + bloodletting group received acupuncture at Zhongwan (CV 12), Guanyuan (CV 4), Tianshu (ST 25), Zusanli (ST 36), Sanyinjiao (SP 6), Xuehai (SP 10), Quchi (LI 11), Hegu (LI 4), Taichong (LR 3), Baihui (GV 20), and Shenting (GV 24), once daily,along with bloodletting and cupping at Dazhui (GV 14) and Geshu (BL 17), every other day. Both groups were treated for 4 weeks. The 7-day urticaria activity score(UAS7) was assessed before and after the treatment, and levels of serum immunoglobulin E (IgE), interleukin-4 (IL-4), interleukin-5 (IL-5), eosinophil cationic protein (ECP), plasma tissue factor (TF), activated factor Ⅶ (FⅦa), prothrombin fragment 1+2 (F1+2), D-dimer (D-D) and complement component 5a (C5a) were detected. ResultsA total of 65 patients were included in the final analysis, 32 in the loratadine group and 33 in the acupuncture + bloodletting group. Before treatment, there was no significant difference in UAS7 score, serum IgE, IL-4, IL-5, ECP levels, or plasma TF, FⅦa, F1+2, D-D, C5a levels between groups (P> 0.05). After treatment, both groups showed significant reductions in UAS7 score, serum IgE, IL-4, IL-5, and plasma TF, FⅦa, F1+2, D-D, and C5a levels compared to those before treatment (P<0.01). However, after treatment, there was no significant difference in UAS7 score and serum ECP, IgE, IL-4, IL-5 levels between groups (P>0.05). The acupuncture + bloodletting group showed lower plasma TF, FⅦa, F1+2, D-D and C5a levels compared to the loratadine group (P<0.05 or P<0.01). ConclusionAcupuncture combined with bloodletting and cupping can effectively improve the skin symptoms of CSU patients and reduce the levels of inflammatory factors. The potential mechanism of action may involve the regulation of the coagulation-complement-mast cell activation axis, thereby inhibiting mast cell degranulation.
6.Reflection and recommendation on the current status of acupuncture direction selection and reporting.
Hongbo JIA ; Yibing LI ; Kangchen LEI ; Wenyi GE ; Wei LIU ; Songjiao LI ; Shuwen SHI ; Yutong DONG ; Congcong MA ; Li LI ; Jian LIU ; Xiaonong FAN
Chinese Acupuncture & Moxibustion 2025;45(8):1187-1194
The randomized controlled trials (RCTs) regarding acupuncture direction published from January 1st, 2013, to November 7th, 2023 were searched in China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, and VIP Chinese Journal Database. As a result, 21 RCTs were included. The problems identified included conceptual misunderstandings regarding acupuncture direction, incomplete selection strategies, confounding research factors, and inaccuracies in reporting. Based on the findings, four strategic approaches for enhancing therapeutic efficacy through acupuncture direction were summarized: aligning needle direction with the meridian pathway, directing the needle toward the lesion site, orienting the needle toward adjacent acupoints, and targeting special anatomical structures. Two additional strategies were proposed for optimizing the procedure: simplifying acupuncture operations and directing the needle toward safe anatomical sites. Recommendations were made to improve the rationality of research factor settings and the completeness of acupuncture operation reporting. Furthermore, three methods for reporting acupuncture direction were discussed: reporting the tip-pointed position, reporting the insertion angle and orientation, and reporting azimuth and polar angles, aiming to promote greater standardization and completeness in acupuncture practice and reporting.
Acupuncture Therapy/standards*
;
Humans
;
Acupuncture Points
;
Randomized Controlled Trials as Topic
;
Meridians
7.Evaluation of micro crestal flap-alveolar ridge preservation following extraction of mandibular molars with severe periodontitis.
Yutong SHI ; Yiping WEI ; Wenjie HU ; Tao XU ; Haoyun ZHANG
Journal of Peking University(Health Sciences) 2025;57(1):33-41
OBJECTIVE:
To evaluate the clinical and radiographic efficacy of micro crestal flap-alveolar ridge preservation following extraction of mandibular molars with severe periodontitis compared with natural healing, and to preliminarily propose the surgical indication.
METHODS:
A retrospective analysis was conducted on clinical data from patients with mandibular molars with severe periodontitis either receiving micro crestal flap-alveolar ridge preservation (MCF-ARP group) or undergoing natural healing in department of periodontology, Peking University School and Hospital of Stomatology from September 2013 to June 2021. Cone-beam computed tomography scannings performed before/immediately after extraction (as baseline) and repeated before implantation (after the extraction socket healing) were used to measure the ridge width, height and volumetric changes of the sockets, and the proportion of guided bone regeneration (GBR) during implant therapy were compared between the two groups.
RESULTS:
Between baseline and healing, significant differences in changes of MCF-ARP group [(8.34±2.81) mm] and natural healing group [(3.82±3.58) mm] in the distances from mandibular canal to center of the tooth socket were recorded (P < 0.001). The ridge width at 1 mm below the most coronal aspect of the crest increased by (3.50±4.88) mm in the MCF-ARP group but decreased by (0.16±5.70) mm in the natural healing group, respectively (P=0.019). After healing, the MCF-ARP group showed the distances from mandibular canal to center of the tooth socket >8 mm in all the cases, with 97.1% exceeding 10 mm. Natural healing group displayed 23.1% of the cases with center bone height < 8 mm and 61.5% exceeding 10 mm. Volume changes at the buccal and lingual aspect as well as the total socket were significantly greater in the MCF-ARP group compared with natural healing group (P < 0.001).At the time of implantation, GBR was performed in 5 out of 68 subjects (8.3%) in the MCF-ARP group, whereas 8 out of 26 subjects (30.8%) in the natural healing group required GBR, reflecting significant difference (P=0.003).
CONCLUSION
In the sites of mandibular molars with severe periodontitis, when the distances from mandibular canal to center of the tooth socket was not enough (less than 7 mm), clinicians could consider performing the micro crestal flap-alveolar ridge preservation to achieve augmentation for alveolar ridge and reduce the proportion of guided bone regeneration during implant therapy to reduce the difficulty and risk of injuries during implant therapy.
Humans
;
Tooth Extraction
;
Retrospective Studies
;
Surgical Flaps
;
Molar/surgery*
;
Mandible/surgery*
;
Female
;
Periodontitis/surgery*
;
Male
;
Adult
;
Middle Aged
;
Cone-Beam Computed Tomography
;
Alveolar Ridge Augmentation/methods*
;
Alveolar Process/surgery*
;
Tooth Socket/diagnostic imaging*
;
Dental Implantation, Endosseous/methods*
8.Survey of mosquito species and analysis of genetic structure of important mosquito species populations in Wuyi Mountain Nature Reserve
WANG Ming ; XIE Jingwen ; DU Yutong ; WANG Gang ; YIN Zige ; CAI Jinghong ; LIU Qing ; ZHANG Hengduan ; ZHAO Tongyan ; SHI Li
China Tropical Medicine 2024;24(5):499-
bstract: Objective To elucidate the distribution characteristics of mosquito species and the population genetic
diversity of important mosquito species in the Wuyi Mountain Nature Reserve, with the aim of providing a scientific basis for
the prevention and control of mosquito-borne diseases in the region. Methods Within Wuyi Mountain Nature Reserve 2022-
2023, 16 sampling sites were selected, where larvae were collected using the pipette method and adult mosquitoes were
collected using the mosquito trap lamp method. Mosquito species identification was accomplished by integrating morphological
characteristics and molecular identification techniques based on CO Ⅰ and CO Ⅱ gene sequences. Software tools such as
ClustalX, DnaSP v5.0, and Network v4.6.1.0 were utilized to analyze the genetic differentiation (Fst), gene flow (Nm) among
populations of Aedes japonicus, Aedes albopictus and Armigeres subalbatus. Results The mosquito specimens collected from
the Wuyi Mountain Nature Reserve were identified as 30 species belonging to 8 genera within the Culicidae family. Among
them, there were 10 species of Aedes, 13 species of Culex, 1 species each of Armigeres, Orthopodomyia, Uranotaenia,
Tripyeroides, and Anopheles, and 2 species of Toxorhynchites. Analysis of the genetic structure of important mosquito
populations showed that the haplotype diversity index (Hd) of Ae. japonicus was 0.994 7, with a generally moderate degree of
differentiation between populations and a higher degree of genetic differentiation between populations 6 and 12; Aedeslbopictus had a haplotype diversity index of 0.634 0, with significant genetic differentiation between populations 1 and 2
compared to other groups; Armigeres subalbatus had a haplotype diversity index of 0.703 3, with substantial genetic
differentiation and limited gene flow between population 2 and populations 3, 4, 6, and 7. Conclusions The mosquito species
are rich in Wuyi Mountain Nature Reserve. A comprehensive survey of the composition and distribution of mosquito populations
was carried out, and the characteristics of the population genetic structure of the important species of Ae. japonicus, Ae.
Albopictus, and Ar. subalbatus populations were analyzed, providing valuable scientific data reference for local mosquito-borne
ecological research and disease prevention and control.
9.Analysis of early nutritional status and prognosis of patients during extracorporeal membrane oxygenation
Tao DING ; Wei LI ; Yi ZHU ; Zhongman ZHANG ; Yutong SHI ; Tianshi LI ; Xielun LI ; Weixiao XU ; Peng ZHOU ; Di AN ; Xufeng CHEN
Chinese Journal of Emergency Medicine 2024;33(7):939-945
Objective:To observe the effects of early energy intake and early enteral nutrition on prognosis of patients during extracorporeal membrane oxygenation (ECMO).Methods:Patients who received ECMO treatment in the emergency intensive care unit (EICU) of the Jiangsu Provincial Hospital (First Affiliated Hospital of Nanjing Medical University) from January 2021 to June 2022 were selected as subjects to summarize the early energy intake of ECMO patients. Logistic regression analysis and restricted cubic spline (RCS) analysis were used to determine the relationship between early energy intake and prognosis of ECMO patients. According to the results of RCS analysis, the patients were divided into energy-deficient group and energy-sufficient group. And according to whether early enteral nutrition (EEN) was initiated, the patients were divided into EEN group and non-EEN group. The differences of clinical outcomes between energy-deficient group and energy-sufficient group, EEN group and non-EEN group were compared.Results:There was no significant difference in age, sex, BMI, primary disease and ECMO pattern between energy-deficient group and energy-sufficient group, EEN group and non-EEN group. The ECMO conversion time (days) and hospitalization time (days) in the energy-deficient group were significantly lower than those in the energy-sufficient group, and the survival rate in the energy-deficient group was significantly lower than that in the energy-sufficient group [43.2% (19/44) vs. 66.0% (31/47), P=0.029]. Kaplan-Meier survival analysis showed that the 28-day survival rate in the energy-deficient group was significantly lower than that in the energy-sufficient group, and the risk of death was 2.595 times higher than that in the energy-sufficient group. The conversion time (days), hospital stay (days) and average daily energy intake [kcal/(kg·d)] in the EEN group were higher than those in the non-EEN group ( P<0.05), and the survival rate in the non-EEN group was significantly higher than that in the non-EEN group [66.1% (41/62) vs. 31.0% (9/29), P<0.002]. Kaplan-Meier survival analysis showed that the 28-day survival rate in the non-EEN group was significantly lower than that in the EEN group, and the risk of death was 2.981 times higher than that in the EEN group ( P<0.001). Conclusions:The energy intake of patients with ECMO above 16.94 kcal/ (kg·d) is a protective factor for prognosis. EEN helps to increase early energy intake and improve prognosis in patients during ECMO.
10.A prospective cohort study on the effect of implant restoration following micro crestal flap-alveolar ridge preservation at molar extraction sockets with severe periodontitis
Yiping WEI ; Tao XU ; Wenjie HU ; Yunsong LIU ; Yutong SHI
Chinese Journal of Stomatology 2024;59(4):318-325
Objective:To evaluate the survival rate, success rate, soft tissue conditions and marginal bone level changes of implants following micro crestal flap-alveolar ridge preservation at molar extraction sockets with severe periodontitis, compared to natural healing.Methods:From March 2015 to January 2017, patients scheduled for molar extraction as a consequence of severe periodontitis and planned implant-retained prostheses from Department of Periodontology Peking University School and Hospital of Stomatology were selected. A total of 40 molar extraction sockets from 40 patients received implant placement following micro crestal flap-alveolar ridge preservation or natural healing. The front consecutive 20 teeth were assigned to the natural healing group, and the back ones were assigned to the micro crestal flap-alveolar ridge preservation (MCF-ARP) group. The superstructures were placed 6 months later. Within 2 weeks (baseline) and 1, 2 and 3 years after implant crown restoration, modified plaque index, probing depth, modified bleeding index and keratinized tissue width were recorded every six months. Parallel periapical radiographs were taken to evaluate the peri-implant marginal bone level and to calculate marginal bone loss. Independent sample t test or Mann-Whitney U test were used to compare the differences in the above clinical and imaging indicators between the two groups. Results:The implant survival rate and success rate of the two groups were both 100% (20/20). There were no significant differences in the modified plaque index, probing depth, modified bleeding index, buccal keratinized tissue width and marginal bone loss between two groups at 1, 2 and 3 years after implant crown restoration (all P>0.05). Marginal bone loss was 0.22 (0.14, 0.34) mm in the natural healing group and 0.21 (0.12, 0.30) mm in the MCF-ARP group at a 3-year post-loading evaluation. Conclusions:Within the limitations of the present study, implants placed at ridge preserved and naturally healed molar extraction sockets with severe periodontitis demonstrate comparable clinical outcomes at a 3-year post-loading evaluation.

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