[Objective]To clarify the associations between plasma fibrinogen(Fbg)and volumetric bone mineral density(vBMD)as well as osteoporosis measured by quantitative computed tomography(QCT),and to explore the role of plasma Fbg in early screening and diagnosis of osteoporosis.[Methods]Patients with hypertension who were hospitalized in the Department of Endocrinology of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2018 to June 2022 and underwent QCT examinations were included for cross-sectional analysis.The study analyzed the correlation between plasma Fbg and osteoporosis in patients.The diagnostic efficacy of plasma Fbg for osteoporosis was evaluated by the area under the receiver operating characteristic(ROC)curve(AUC).[Results]Totally 441 subjects were included in the analysis,with an average age of 46.0±14.5 years and a prevalence of osteoporosis of 6.4%(28/441).As the level of plasma fibrinogen increased,the incidence of osteoporosis significantly increased(P<0.000 1)while the average bone mineral density of L1 and L2 were significantly decreased(P<0.05).Compared with the first quartile of plasma Fbg(1.99g/L-2.37g/L),the risk of osteoporosis in the fourth quartile of plasma Fbg(3.67g/L-4.46g/L)increased by 8.85 times after adjusting for related confounding factors.[Conclusion]This study found a negative correlation between plasma fibrinogen levels and bone density in patients with hypertension.Plasma fibrinogen levels may serve as a potential screening indicator for osteoporosis,aiding in early diagnosis and therapeutic monitoring.This discovery offers a new perspective for the study of bone metabolic diseases and warrants further investigation.

Cushing′s syndrome refers to a group of disorders caused by excessive secretion of adrenal glucocorticoid due to various underlying etiologies. Among these, ACTH-dependent Cushing′s syndrome, in which the source of ACTH-secretion remains unclear for extended periods, poses significant challenges in clinical management. This article presents a patient with ACTH-dependent Cushing′s syndrome where the ACTH-secreting source could not be definitively localized from our hospital. Additionally, the article reviews recent advancements in the diagnosis and treatment of such cases, both domestically and internationally, with the aim of enhancing clinicians′ understanding and improving the management of this condition.

Autoimmune oophoritis is a rare cause of primary ovarian insufficiency(POI), and some patients may also have concurrent adrenal insufficiency. This condition significantly impairs reproductive function and is often difficult to distinguish from common causes of POI, leading to missed or incorrect diagnoses. This paper reports a case of autoimmune oophoritis treated in our department and provides an updated summary of recent advances in the understanding of this condition, with the aim of raising clinical awareness and improving diagnostic accuracy among healthcare professionals.

Autoimmune oophoritis is a rare cause of primary ovarian insufficiency(POI), and some patients may also have concurrent adrenal insufficiency. This condition significantly impairs reproductive function and is often difficult to distinguish from common causes of POI, leading to missed or incorrect diagnoses. This paper reports a case of autoimmune oophoritis treated in our department and provides an updated summary of recent advances in the understanding of this condition, with the aim of raising clinical awareness and improving diagnostic accuracy among healthcare professionals.

Cushing′s syndrome refers to a group of disorders caused by excessive secretion of adrenal glucocorticoid due to various underlying etiologies. Among these, ACTH-dependent Cushing′s syndrome, in which the source of ACTH-secretion remains unclear for extended periods, poses significant challenges in clinical management. This article presents a patient with ACTH-dependent Cushing′s syndrome where the ACTH-secreting source could not be definitively localized from our hospital. Additionally, the article reviews recent advancements in the diagnosis and treatment of such cases, both domestically and internationally, with the aim of enhancing clinicians′ understanding and improving the management of this condition.

Objective::To build a reference fetal growth chart for the Chinese population based on fetal ultrasound measurements.Methods::This was a multicenter, population-based retrospective cohort study. Longitudinal ultrasound measurement data were collected from 24 hospitals in 18 provinces of China from 1 st September through 31 st October of 2019. The estimated fetal weight (EFW) was calculated based on head circumference, abdominal circumference, and femur length using Hadlock formula 3. Fetal growth curves were estimated using a two-level linear regression model with cubic splines. All participants were divided into two groups: the northern group ( n = 5829) and the southern group ( n = 3246) based on the geographical division of China and male fetus group ( n = 4775) and female fetus group ( n = 4300) based on fetal gender. The EFW was compared by fetal gender and geographical group. All statistical models were adjusted for maternal sociodemographic characteristics. Results::A total of 9075 participants with 31,700 ultrasound measurement records were included in this study. Male fetuses demonstrated significantly larger EFW compared to female ones starting at 16 weeks of gestation and extending to delivery (global test P < 0.01). The overall geographic difference in EFW was significant (global test P = 0.03), and week-specific comparisons showed that the northern group had a greater EFW starting at 15 weeks of gestation and extending to 29 weeks of gestation, although this difference did not extend to the time of delivery. The Z-score of EFW confirmed that our Chinese fetal growth charts differed from previously published standards. Conclusion::This study provides EFW and ultrasound biometric reference measurements for Chinese fetuses and reveals differences from other fetal growth charts. The chart is worth promoting in more regions of China but should be tested prudently before use.

Objective::To build a reference fetal growth chart for the Chinese population based on fetal ultrasound measurements.Methods::This was a multicenter, population-based retrospective cohort study. Longitudinal ultrasound measurement data were collected from 24 hospitals in 18 provinces of China from 1 st September through 31 st October of 2019. The estimated fetal weight (EFW) was calculated based on head circumference, abdominal circumference, and femur length using Hadlock formula 3. Fetal growth curves were estimated using a two-level linear regression model with cubic splines. All participants were divided into two groups: the northern group ( n = 5829) and the southern group ( n = 3246) based on the geographical division of China and male fetus group ( n = 4775) and female fetus group ( n = 4300) based on fetal gender. The EFW was compared by fetal gender and geographical group. All statistical models were adjusted for maternal sociodemographic characteristics. Results::A total of 9075 participants with 31,700 ultrasound measurement records were included in this study. Male fetuses demonstrated significantly larger EFW compared to female ones starting at 16 weeks of gestation and extending to delivery (global test P < 0.01). The overall geographic difference in EFW was significant (global test P = 0.03), and week-specific comparisons showed that the northern group had a greater EFW starting at 15 weeks of gestation and extending to 29 weeks of gestation, although this difference did not extend to the time of delivery. The Z-score of EFW confirmed that our Chinese fetal growth charts differed from previously published standards. Conclusion::This study provides EFW and ultrasound biometric reference measurements for Chinese fetuses and reveals differences from other fetal growth charts. The chart is worth promoting in more regions of China but should be tested prudently before use.

Objective:To develop a systematic and comprehensive training program focusing on infectious disease emergencies, which is suitable for continuing education of medical staff.Methods:The emergency competence index system constructed in previous study was used as the content framework. The training method was selected based on the core concept of "Lindeman's View of Adult Education". The training form was designed based on the results of the questionnaire survey. The expert group meeting was used to demonstrate and revise the concrete training items.Results:The finally formed Training Program on Infectious Diseases Emergencies for Medical Staff adopted a "small-group" training format and modular design, including a total of 3 modules and 9 items, and the training program database included portable training manuals, skills videos, scenario cases scripts, and assessment papers, etc.Conclusion:The developed training program could be applied to regular continuing education or intensive training of response team for certain infectious disease emergencies, so as to improve their response competence.

Objective To construct a core response competence index system for infectious disease emergencies,and to provide content framework for training program.Methods A draft of index system was developed based on literature review and theory study.Delphi technique was employed to revise the draft.Analytical Hierarchy Process and average distribution method were used to measure the weight of each index.Results Response rate of the two round consultations were 100％ and 77.8％,respectively.experts' authority coefficients were 0.88 and 0.87.Kendall's coefficients of concordance were 0.274 and 0.258,and both were statistically significant (P＜0.001).The final index system comprised 3 first-level indexes,11 second-level indexes,and 38 third-level indexes.Conclusion The index system could be used to evaluate response competence of medical staff towards infectious disease emergencies,and served as the content framework of future training program.

Objective:To study dynamic change of brain natriuretic peptide (BNP),left ventricular ejection fraction (LVEF)and prognosis improvement in patients with acute anterior myocardial infarction (AAMI)complicated hy-poxemia after noninvasive mechanical ventilation therapy.Methods:A total of 60 patients with AAMI complicated hypoxemia,who were hospitalized in our hospital from Mar 2011 to Oct 2013,were divided into noninvasive venti-lation group (n=28)and routine treatment group (n=32)according to number table.Dynamic change of BNP, LVEF and prognosis were observed and compared between two groups.Results:After treatment,BNP level and LVEF significantly improved in both groups (P<0.05 all),compared with routine treatment group,there was more significant reduction in BNP level [24h:(263.6±23.3)μmol/L vs.(126.2±21.9)μmol/L]and significant rise in LVEF [(40.6±13.1)% vs.(47.3±14.7)%]in noninvasive ventilation group after treatment (P<0.01 both);af-ter 30d follow-up,there were significant rise in 6min walking distance (percentage of 426~550m,59.3% vs. 75.0%),LVEF [(41.1±11.7)% vs.(49.4±12.5)%]and survival rate (90.6% vs.96.4%),and significant re-duction in rehospitalization rate (12.5% vs.7.1%)in noninvasive ventilation group,P<0.01 all.Conclusion:Ear-ly noninvasive mechanical ventilation therapy can significantly improve cardiac function,exercise tolerance and short-term prognosis in patients with acute anterior myocardial infarction complicated hypoxemia.