OBJECTIVES: To study the clinical and genetic characteristics of children with congenital adrenal hyperplasia (CAH). METHODS: Clinical data, laboratory findings, and genetic test results of 63 children diagnosed with CAH at Henan Children's Hospital from January 2017 to December 2024 were retrospectively reviewed. RESULTS: Of the 63 patients, the mean age at the first visit was (21 ± 14) days; 29 (46%) were of male sex and 34 (54%) were of female sex. The predominant clinical manifestations were poor weight gain or weight loss (92%, 58/63), poor feeding (84%, 53/63), skin hyperpigmentation (83%, 52/63), and female external genital anomalies (100%, 34/34). Laboratory abnormalities included hyponatremia (87%, 55/63), hyperkalemia (68%, 43/63), metabolic acidosis (68%, 43/63), and markedly elevated 17-hydroxyprogesterone (92%, 58/63), testosterone (89%, 56/63), and adrenocorticotropic hormone (81%, 51/63). Among 49 patients who underwent genetic testing, CYP21A2 variants were identified in 90% (44/49), with c.293-13A/C>G (33%, 30/91) and large deletions/gene conversions (29%, 26/91) being the most frequent; STAR (8%, 4/49) and HSD3B2 (2%, 1/49) variants were also detected. Following hormone replacement therapy, electrolyte disturbances were corrected in 57 cases, with significant reductions in 17-hydroxyprogesterone, adrenocorticotropic hormone, and testosterone levels (P<0.001). CONCLUSIONS CAH presenting in neonates or young infants is characterized by electrolyte imbalance, external genital anomalies, and abnormal hormone levels. Genetic testing enables definitive subtype classification; in CYP21A2-related CAH, c.293-13A/C>G is a hotspot variant. These findings underscore the clinical value of genetic testing for early diagnosis and genetic counseling in CAH. Citation:Chinese Journal of Contemporary Pediatrics, 2025, 27(11): 1367-1372.
Humans ; Adrenal Hyperplasia, Congenital/diagnosis* ; Male ; Female ; Retrospective Studies ; Infant ; Infant, Newborn

Objective:To explore the prognostic factors of seroma after endoscopic thyroidectomy by breast ap-proach,and construct a nomogram to predict the possibility of cervical seroma.Methods:Data of patients undergoing endoscopic thyroid surgery in Dongguan Tungwah Hospital from January 2022 to May 2024 and Dongguan Songshan Lake Tungwah Hospital from May 2023 to August 2024 were retrospectively analyzed,and 1493 patients meeting the in-clusion criteria were selected.Among them,there were 1048 patients in Dongguan Tungwah Hospital as the training co-hort,1015 patients without seroma group and 33 patients with seroma group.There were 445 patients in Dongguan Songshan Lake Tungwah Hospital as the verification cohort,including 424 patients without seroma and 21 patients with seroma.Multivariate logistic regression analysis was used to obtain relevant independent prognostic factors,and R soft-ware established a nomogram model.Calibration curves,Hosmer-Lemeshow goodness of fit,ROC curves were used to evaluate the calibrability of the nomogram model,and clinical utility was assessed by clinical decision curves.Results:Multivariate logistic regression analysis showed that central lymph node dissection,diabetes,hyperthyroidism,and nod-ule size were independent prognostic factors related to seroma.Based on the prognostic factors,the nomogram of se-roma after ETBA was constructed.The calibration curves of the training and the verification group were in good agree-ment with the observed results,and the Hosmer-Lemeshow goodness of fit test was good,with the training cohort P=0.244 and the verification cohort P=0.803.The ROC curve of the training cohort showed that the area under the curve was 0.810(95%CI:0.740～0.879),and the ROC curve of the verification cohort showed that the area under the curve was 0.815(95%CI:0.722～0.909).Conclusion:The nomogram model based on the relevant prognostic factors ob-tained by multivariate logistic regression analysis has a good prediction effect on the seroma after ETBA,and can provide reasonable and individualized treatment plan for patients.

Cervical spinal cord injury without fracture-dislocation (CSCIWFD) is referred to as a special type of cervical spinal cord injury characterized by traumatic spinal cord dysfunction and no significant bony structural abnormalities on imagines. Duo to the high risk of missed diagnosis during the initial consultation, CSCIWFD may lead to progressive neurological deterioration or even complete paralysis, severely impacting patients′ prognosis. Currently, there are no established consensuses over the diagnosis and treatment of CSCIWFD, such as the lack of evidence-based standards for indications of non-surgical treatment and risk of secondary neurological injury, as well as debates over the optimal timing for surgical intervention and indications for different surgical approaches. To address these issues, the Spine Trauma Group of the Orthopedic Branch of the Chinese Medical Doctor Association organized experts in the relevant fields to formulate Diagnosis and treatment guideline for acute cervical spinal cord injury without fracture- dislocation in adults ( version 2025) . Based on evidence-based medicine and the principles of scientific rigor and clinical applicability, the guidelines proposed 11 recommendations covering terminology, diagnosis, evaluation treatment, and rehabilitation, etc., aiming to standardize the management of CSCIWFD.

Medication reconciliation plays a key role in improving patient medication safety,reducing inappropriate polypharmacy,and promoting the high-quality development of pharmaceutical services.Compared to advanced international guidelines,China's medication reconciliation service standards have deficiencies in areas such as definition and process design,and multidisciplinary team building.There is a need to establish a comprehensive medication reconciliation effect evaluation index system,develop pharmacist-led multidisciplinary teams,promote the advancement of artificial intelligence and big data technologies,and strengthen outpatient and community medication reconciliation coverage,thereby contributing to the high-quality development of pharmaceutical services in China.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

A molecularly imprinted electrochemical sensor for rapid detection of tenuazonic acid(TeA)was developed based on the Au-MoS2/MOF(Fe2+/Fe3+)high-efficiency catalytic cycle amplification strategy,using p-aminobenzoic acid(PABA)as the functional monomer,and TeA as the template molecule.The molecularly imprinted polymer(MIP)was prepared on the surface of Au-MoS2/MOF(Fe2+/Fe3+)modified electrode through electropolymerization.By introducing flower-like MoS2 nanoflakes(MoS2 NFs)as a co-catalyst into a mixed-valence structured Fe-MOF(Fe2+/Fe3+),the H2O2 electrochemical signal of the MIP/Au-MoS2/MOF(Fe2+/Fe3+)/GCE was significantly enhanced.Under optimal conditions,the sensor exhibited good selectivity and high sensitivity toward TeA.A linear relationship(R2=0.992)was observed between the electrochemical response and TeA concentration in the range of 0.001-10 μg/kg,with a detection limit of 0.3 ng/kg.The developed method was successfully applied to determination of TeA in fruit samples,with recoveries ranging from 90.8%to 110.8%,and relative standard deviations from 1.9%to 8.4%.

Quantitative CT (QCT) is a method of measuring bone mineral density (BMD) of human based on a CT machine,calibrated by QCT body model and analyzed by professional software.Compared with dual-energy X-ray absorptiometry,QCT can not only assess the cortical and cancellous BMD but also exclude the influences of osteophytes and aortic/vascular calcification,thus being capable of accurately reflecting patients' bone mass.In recent years,increasing studies on QCT and osteoporosis (OP) have been carried out,and the application of QCT in the diagnosis of OP,evaluation of vertebral bone conditions,prediction of fracture risks,and assessment of anti-OP treatment is garnering increasing attention from researchers at home and abroad.This article reviews the research progress in this field,aiming to provide a reference for the research on QCT in the diagnosis and treatment of OP.
Humans ; Osteoporosis/diagnosis* ; Tomography, X-Ray Computed/methods* ; Bone Density

ObjectiveTo establish an adjusted Serfling regression model to estimate the excess cases and the excess epidemic period of hand-foot-mouth disease (HFMD) in Beijing from 2011 to 2019, so as to provide data support and decision-making basis for HFMD prevention and control. MethodsThe weekly number of HFMD cases in Beijing from 2011 to 2019 was utilized for adjusted the Serfling regression model. Then the adjusted model was used to fit the baseline and epidemic threshold of HFMD in Beijing from 2011 to 2019, calculating the excess cases and determining the excess epidemic period. ResultsA total of 279 306 cases of HFMD were reported in Beijing from 2011 to 2019, with the climax of the disease occurring in summer and autumn. After adjusting the fitting R² of the Serfling regression model to 0.773, a total of 10 excess epidemic periods totaling 92 weeks were estimated, mainly occurring in summer. The highest number of excess cases during an excess epidemic period was found in 2014 (1 272 cases, 95%CI: 990‒1 554), accounting for 65.04% of the actual cases (95%CI: 50.62%‒79.46%). ConclusionThe adjusted Serfling regression model fits well and can be utilized for early warning of HFMD and estimating the disease burden caused by HFMD.

The interstitial protein UL14 of pseudorabies virus(PRV)constitutes a crucial compo-nent for viral replication and virulence invasion.It can interact with other viral proteins to complete the infection of the host,rendering it one of the potentially important antiviral targets.In this stud-y,the PRV DX strain isolated in the laboratory was used as the parental strain.The recombinant UL14 protein was expressed and purified through the prokaryotic expression system.BALB/c mice were immunized with this protein as an antigen.After three rounds of subcloning screening,three hybridoma cell lines against the UL14 protein were obtained,named 1B4,1B5,and 1F2,respective-ly.The immunoreactivity of the antibodies was detected by immunofluorescence assay(IFA).The results showed that the antibody titers of the 1B4 and 1B5 strains were not lower than 1∶3 200,and that of the 1F2 strain was not lower than 1∶2 000.The results of western blot(WB)detection showed that the antibody titers of the three strains were all not lower than 1∶8 000.The results of indirect ELISA detection showed that the antibody titers in ascites were all not lower than 112 800.The results of the identification of the antigenic epitopes of the UL14 protein showed that the antigenic epitope recognized by 1B4 was 1 MFASDRRERRVRLAEAFQRE20,and the antigenic epitopes recognized by 1B5 and 1F2 were speculated to be 33GRADKKNPEFVRAFMAAKQAR53.After PRV infected susceptible cells,the temporal expression of the UL14 protein was detected by IF A using the prepared monoclonal antibodies.It was found that the temporal expression of UL14 was similar to that of gC,and the result of RT-qPCR of UL14 gene was consistent with IF A,indi-cating that UL14 might be a late gene during the PRV replication.The subcellular localization of UL14 after virus infection was detected by IFA,and it was found that the UL14 protein could be transferred from the cytoplasm to the nucleus and the expression of UL14 protein increased with the extension of infection time.This study provides a good research tool for further investigating on the function of the PRV UL14 protein and might contribute to the further study of the PRV replication mechanism mediated by the PRV UL14 protein.

Objective:This study implemented a pulmonary rehabilitation integrated care management model based on an Internet of things platform for patients with chronic obstructive pulmonary disease (COPD) and evaluated its effectiveness to provide evidence for clinical respiratory rehabilitation practices.Methods:A quasi-experimental design was adopted. Patients from the Department of Respiratory and Critical Care Medicine at Changsha Central Hospital Affiliated to University of South China between May and December 2023 were selected via purposive sampling. Sixty COPD patients from May to August 2023 were assigned to the control group, while 60 patients from September to December 2023 were assigned to the comprehensive management group. The control group adopted routine respiratory rehabilitation management, the comprehensive management group adopted a pulmonary rehabilitation integarted care management mode based on Internet of things platform respiratory rehabilitation. Before and after 6 months of intervention, patients were assessed for respiratory rehabilitation compliance, lung function (including the percentage of forced expiratory volume in the first second to the expected value (FEV 1% pred) and the ratio of forced expiratory volume in the first second to forced vital capacity (FEV 1/FVC), 6-minute walk test (6MWT) and COPD Assessment Test (CAT). Results:Finally, 55 cases were included in the control group and 59 cases were included in the comprehensive management group. The control group included 32 males and 23 females, aged (67.31 ± 7.14) years. The comprehensive management group included 39 males and 20 females, aged (68.15 ± 6.34) years. The respiratory rehabilitation compliance score, FEV 1% pred, FEV 1/FVC, 6MWT, and CAT score of the full management group after intervention were as follows: (26.45 ± 1.51) points, (59.21 ± 6.68)%, (78.35 ± 8.01)%, (479.63 ± 54.70) m, and (12.35 ± 4.01) points, which were all better than the control group′s (15.68 ± 1.56) points, (44.09 ± 6.31)%, (68.38 ± 6.43)%, (429.82 ± 60.50) m, and (17.03 ± 4.23) points. The difference between two groups were significant ( t values were 1.83-5.24, all P<0.05). Conclusions:The pulmonary rehabilitation integarted care management model based on Internet of things platform improves patient compliance, enhances pulmonary function, enhance their activity endurance, and improve their quality of life. It is worth promoting and using in clinical practice.