Clinical data of a child with acromesomelic dysplasia Maroteaux type (AMDM) treated in the Department of Pediatrics, Tianjin Medical University General Hospital at November 2018 was retrospectively analyzed.The female child aged 3 years and 3 months old with 83 cm height (-3.84 SD) had clinical manifestations of disproportionate short stature, disproportionate shortening of forearms and forelegs, and stubby fingers and toes.Gene sequencing identified compound heterozygous mutations, c.1640T>A(p.Val547Asp)/c.682G>A(p.Gly228Ser), in the NPR2 gene, which have not been reported in the Human Gene Mutation Database.Their protein function was predicted harmful.The child was diagnosed as AMDM.During the follow-up until 4 years and 8 months old, the child was 90 cm tall (-4.35 SD), with a growth velocity of 4.9 cm/year.She was treated with recombinant human growth hormone (rhGH) treatment for 9 months and regularly followed up.The child was now 98.2 cm height (-3.07 SD) and she had a growth velocity of 10.9 cm/year.This case report enriched the gene mutation spectrum of AMDM.Treatment with rhGH can effectively improve the height of the child, but the long-term effect needs further follow-up and observation.

Objective: This study aims to investigate the menarcheal age of female junior middle school students in Tianjin and associated factors, providing suggestions for further development of adolescence education on physiological and mental health. Methods: A total of 4 127 junior middle school girls in Tianjin area were selected by stratified random sampling method, and investigated by the method of physical examination and questionnaire survey, results were analyzed. Results: There were 1 383 girls reported menarche. Mean age at menarche was(12.68±1.19) years old; One-way ANOVA showed that girls with higher family income, higher parental education had earlier menarcheal age(F=4.97, 9.52, 10.64, P<0.05). It showed that the tendency that obesity group and over-weight group was higher in the rate of menarche than that of normal group and marasmus group(F=4.20, P<0.05). However, different time on watching TV, computer or celephone and sleeping was found to be unrelated with age at menarche(P>0.05). Kruskal Wallis H test showed that girls whose mothers’ AAM was earlier had earlier menarcheal age(H=82.94, P<0.05). According to age, girls were divided into groups of 10-11, 11-12, 12-13 and 13-14 years old. Girls in each age group were divided into the menstruation menarche group and the non-menstruation menarche group. The results showed that the levels of height, weight, BMI, waist circumference, hip circumference, and the skin fold thickness in menstruation group were higher than those in non-menstruation group(t=2.18-10.93, P<0.05). After that, girls of each group were divided into four group：marasmus group, the normal group, the over-weight group and the obesity group according to BMI(χ2=34.66，13.37，11.09，12.60,P<0.05). Conclusion Female junior middle school students’ menarcheal age in Tianjin is related to family income, parents’education, mother’s age at menarche, obesity and physical exercise frequency.

ObjectiveTo objectively evaluate the clinical efficacy of three-step acupuncture-cupping therapy for cervicogenic headache.MethodSixty patients were randomly allocated to treatment and control groups. The treatment group received three-step acupuncture-cupping therapy and the control group, conventional acupuncture based on “Acupuncture Therapeutics”. Both groups were treated for three courses (10 days as acourse with two days of rest between two courses) and then the clinical therapeutic effects were evaluated. The evaluation included the overall therapeutic effect on the symptoms, the VASscore and the follow-up recurrence rate at six months after treatment.ResultThe total efficacy rate was 96.7% in the treatment group and 83.3% in the control group; there was a statistically significant difference between the two groups (P<0.01). A follow-up of six months after treatment in the two groups showed that the recurrence rate was 16.7% in the treatment group and 46.7% in the control group;there was a statistically significant difference between the two groups (P<0.05).ConclusionThree-step acupuncture-cupping therapy has a definite effect on cervicogenic headache. Its immediate and long-term effects are superior to those of conventional acupuncture. The recurrence rate in six months is lower in this therapy than in conventionalacupuncture.

With the obesity epidemic,children and adolescents with type 2 diabetes mellitus(T2DM)signifi-cantly increased throughout the world,screening and diagnosis of T2DM in the high - risk population is very important. In addition to lifestyle modification,the recommended optimal pharmacologic treatment of children and adolescents with T2DM is Metformin and Insulin. To reduce the risk of cardiovascular diseases,should fully understand the comorbidities and complications of T2DM,and take better assessment and management.

Objective To identify the role of autophagy‐related genes in prediction of therapeutic effect of ET regimen neoadju‐vant chemotherapy in breast cancer .Methods Breast cancer tissues were retrospectively collected from 41 cases of breast cancer pa‐tients that treated by ET regimen neoadjuvant chemotherapy with different therapeutic effects .Expressions of Atg3 and Beclin1 ,and the autophagy‐related genes ,were detected by Western blot ,Real‐time PCR and immunohistochemistry in these tissues to observe their expressions before neoadjuvant chemotherapy .Statistical test was used to analyze the relationship between Atg3 ,Beclin1 ex‐pressions and therapeutic effects of ET regimen neoadjuvant chemotherapy .Results Western blot ,Real‐time PCR and immunohis‐tochemistry revealed that expressions of Atg3 and Beclin1 were up‐regulated in 24 breast cancer tissues before neoadjuvant chemo‐therapy ,including 23 cases of complete response(CR) or partial response (PR) (95 .8% ) and 1 case of progressive disease (PD) . Atg3 and Beclin1 were not expressed or lowly expressed in the other 17 cases ,including 3 cases of CR or PR (17 .6% ) and 14 cases of no change and PD .The effective rate of ET regimen neoadjuvant chemotherapy in breast cancer patients with over expression of Atg3 and Beclin1 was significantly higher than those with low expression or without expression of Atg3 and Beclin1 (P<0 .05) . Conclusion Over expression of Atg3 and Beclin1 could be new indicators for therapeutic effect of ET regimen neoadjuvant chemo‐therapy in breast cancer .

Obesity in children and adolescents has become a public health problem of global attention.Although children obesity has less significant cardiovascular events,many obese children have early vascular lesion and endothelial dysfunction.Therefore,the risk factors of cardiovascular injury should be evaluated and intervented as soon as possible.

Objective To study the relationship between the level of serum epithelial fatty acid binding protein (E-FABP) and cardiovascular disease in obese children. Methods Thirty children with metabolic syndrome (MS), 32 obesity children with no MS and 50 healthy children were recruited. Serum E-FABP and glucose/lipid metabolic indices were measured. Results Com-pared with the healthy children, levels of serum E-FABP in MS children were signiifcantly elevated (P=0.001). Compared with obesity children, levels of serum E-FABP of MS children were elevated, but the difference was not signiifcant (P>0.05). The cor-relations of E-FABP with waist to hip ratio, waist-to-height ratio, atherogenic index, fasting insulin, insulin resistance index were positive (P<0.05). According to the multivariate stepwise regression analysis, E-FABP was the independent risk of atherogenic index (P=0.018). Conclusions E-FABP plays a role in the development of atherosclerosis in obesity and MS.

The validity of the recently recommended HbA1C criterion by the American Diabetes Association (ADA) in identification of dysglycemia in children with obesity was evaluated. 293 obese children underwent oral glucose tolerance test. Receiver operating characteristic ( ROC ) curve analysis was used to examine the sensitivity and specificity of fasting plasma glucose (FPG) and HbA1C in identifying dysglycemia. The results showed that the prevalence of type 2 diabetes mellitus (T2DM) was 3.8％ and prediabetes 16. 0％ based on plasma glucose standard. 4. 1％ and 25.6％ were categorized as T2DM and “at high risk of diabetes mellitus” based on both HbA1C and plasma glucose criteria. HbA1C was more efficacious than FPG in detecting abnormal glucose tolerance as shown by the areas under the curve in ROC of 0. 875 and 0. 713 respectively (P＜0. 01 ). The sensitivity and specificity were 60. 5％ and 86. 8％ at HbA1C ≥5.7％, and 30. 5％ and 94.0％ at FPG ≥ 5.6 mmol/L.

Objective To search for an effective acupuncture-moxibustion therapy for high fever in common cold. Methods According to the randomized and multi-central trial principle, 276 cases enrolled were randomly assigned to observation group of 138 cases and control group of 138 cases. The observation group were treated by electroacupuncture at Dazhui and the control group were treated by Antondinie injection coordinating pathogeny therapy to observe the prompt effects in 24 hours. Results After treatment, the temperature of every time point of the observation group was lower than that of the control group (P 0.05). Conclusion The method of electroacupuncturing at Dazhui has a definite therapeutic effect on high fever in common cold.