Objective: To characterize longitudinal trajectories of testicular development in boys and breast development in girls, so as to provide reference data for understanding patterns of pubertal sexual maturation. Methods: Based on the Shanghai Pudong New Area Cohort Study on Growth, Development and Health in Children and Adolescents, a baseline survey was conducted in 2020 using a mult stage cluster random sampling method. A total of 2 184 children who completed all follow ups during the primary school period from 13 elementary schools in Pudong New Area,Shanghai,with annual follow ups during 2021-2025. Testicular volume and Tanner stage of breast development were assessed by professional physicians using standardized visual inspection and palpation. The age distribution of testicular volume and breast development was fitted by using cumulative link mixed models and Turnbull s nonparametric maximum likelihood estimation method. Results: Median ages for testicular volumes of 2, 3, 4 and 5 mL in boys were 7.07, 9.24, 10.29, and 11.57 years old, respectively. Median ages for Tanner breast stages Ⅱ, Ⅲ, Ⅳ, and Ⅴ in girls were 8.55 , 10.17, 11.18, and 13.78 years old, respectively. Based on overweight and obesity, stratified analysis showed that earlier pubertal onset among overweight/obesity children, and the key milestones for pubertal initiation were testicular volume reaching 4 mL in boys and breast Tanner II in girls for 10.29, 10.83; 8.18, 9.00 years. Conclusion Overweight and obesity are associated with earlier pubertal initiation,but there are certain gender and developmental stage specific patterns.

Objective: To determine the potential genetic causal relationship between sleep related phenotypes and female pubertal onset using the two sample Mendelian randomization approach. Methods: Genetic instrumental variables for sleep and age at menarche were sourced from FinnGen, IEU Open GWAS and GWAS Catalog three publicly available Genome Wide Association Study databases. Causal effects were estimated using the inverse variance weighted method, supplemented by sensitivity analyses and tests for heterogeneity, pleiotropy, and direction. Results: Genetically predicted sleep duration was positively associated with age at menarche ( β =0.61, 95% CI =0.30-0.91, P <0.01). Conversely, overall sleep problems ( β =-0.13, 95% CI =-0.20 to -0.07 ), two specific types of sleep disorders (sleep apnea: β =-0.10, 95% CI =-0.16 to -0.03; insomnia: β =-0.40, 95% CI = -0.69 to -0.11) were causally associated with earlier age at menarche (all P <0.01). Sensitivity analyses confirmed the robustness of these findings with consistent effect directions and no evidence of significant directional pleiotropy. Conclusions The study reveales a genetic causal relationship between sleep and pubertal onset. Adequate sleep duration appears to have a protective effect. These findings suggest that sleep may have a critical regulatory role in the initiation of pubertal development.

Objective To investigate the expression of dihydrolipoamide S-acetyltransferase(DLAT)in hepatocellular carcinoma(HCC)tissues and its impact on immunotherapy efficacy,aiming to identify a new biomarker for prognosis assessment and immunotherapy response prediction.Methods Bioinformatics methods were used to analyze the transcriptomic data,clinical pathological characteristics and survival information of HCC patients from TCGA database.The expression of DLAT in HCC and its correlation with clinical features were evaluated,along with its relationship with immune infiltration,immune checkpoint-related genes,and immunotherapy response.Results DLAT was highly expressed in HCC tissues and associated with poor prognosis(HR=1.63,P=0.006).The proportion of R1&R2 residual tumors were significantly higher in the DLAT high-expression group(4.1％vs 1.2％,P=0.011).Immune infiltration analysis revealed that high DLAT expression was negatively correlated with Th 17,DC cells,B cells and T cells,while positively correlated with T helper cells,Tcm and Tem cells.Furthermore,DLAT expression showed significant positive correlations with key immune checkpoint genes(PDCD1LG2,HAVCR2,TIGIT,and PVR),and TIDE algorithm predicted poor response to immune checkpoint inhibitor therapy in the DLAT high-expression group.Conclusion High expression of DLAT in HCC tissues is a risk factor for poor prognosis and may serve as a potential biomarker for prognostic assessment and immunotherapy response prediction in HCC patients.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Objective:To evaluate the predictive value of the tricuspid annular plane systolic excursion to systolic pulmonary artery pressure ratio(TAPSE/sPAP) in identifying precapillary pulmonary hypertension(pcPH) patients requiring repeat balloon pulmonary angioplasty(BPA) within 3 months after initial intervention, and to determine independent risk factors associated with postoperative reintervention.Methods:We retrospectively collected clinical data from 215 consecutive patients with pcPH undergoing BPA. After applying exclusion criteria, 200 patients were ultimately included in the analysis. The predictive value of the TAPSE/sPAP for short-term BPA reintervention was assessed using receiver operating characteristic( ROC) curve analysis and multivariable logistic regression. Internal validation was performed through bootstrap resampling with 1 000 iterations to evaluate model stability. Results:A risk model for echocardiography was constructed using multiple logistic regression, and the results showed that systolic pulmonary artery pressure(sPAP), peak tricuspid regurgitation velocity(TRV), tricuspid regurgitation pressure gradient(PGTR), and TAPSE/sPAP ratio were predictive factors for BPA surgery in patients with pulmonary hypertension within 3 months. Multivariate regression analysis suggests that the TAPSE/sPAP ratio is an independent influencing factor for BPA after 3 months( OR=0.023, P<0.05). The predicted area under the ROC curve( AUC) for BPA after 3 months is 0.62(95% CI: 0.530-0.648), P<0.01, which is better than other cardiac ultrasound indicators. At the same time, internal bootstrap method was used for internal self-validation, and the AUC of the internal self-validation set was 0.67. Conclusion:The TAPSE/sPAP ratio serves as an independent predictor for requiring repeat BPA within 3 months postoperatively in patients with pcPH.

Objective To investigate the expression of dihydrolipoamide S-acetyltransferase(DLAT)in hepatocellular carcinoma(HCC)tissues and its impact on immunotherapy efficacy,aiming to identify a new biomarker for prognosis assessment and immunotherapy response prediction.Methods Bioinformatics methods were used to analyze the transcriptomic data,clinical pathological characteristics and survival information of HCC patients from TCGA database.The expression of DLAT in HCC and its correlation with clinical features were evaluated,along with its relationship with immune infiltration,immune checkpoint-related genes,and immunotherapy response.Results DLAT was highly expressed in HCC tissues and associated with poor prognosis(HR=1.63,P=0.006).The proportion of R1&R2 residual tumors were significantly higher in the DLAT high-expression group(4.1％vs 1.2％,P=0.011).Immune infiltration analysis revealed that high DLAT expression was negatively correlated with Th 17,DC cells,B cells and T cells,while positively correlated with T helper cells,Tcm and Tem cells.Furthermore,DLAT expression showed significant positive correlations with key immune checkpoint genes(PDCD1LG2,HAVCR2,TIGIT,and PVR),and TIDE algorithm predicted poor response to immune checkpoint inhibitor therapy in the DLAT high-expression group.Conclusion High expression of DLAT in HCC tissues is a risk factor for poor prognosis and may serve as a potential biomarker for prognostic assessment and immunotherapy response prediction in HCC patients.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Objective:To evaluate the predictive value of the tricuspid annular plane systolic excursion to systolic pulmonary artery pressure ratio(TAPSE/sPAP) in identifying precapillary pulmonary hypertension(pcPH) patients requiring repeat balloon pulmonary angioplasty(BPA) within 3 months after initial intervention, and to determine independent risk factors associated with postoperative reintervention.Methods:We retrospectively collected clinical data from 215 consecutive patients with pcPH undergoing BPA. After applying exclusion criteria, 200 patients were ultimately included in the analysis. The predictive value of the TAPSE/sPAP for short-term BPA reintervention was assessed using receiver operating characteristic( ROC) curve analysis and multivariable logistic regression. Internal validation was performed through bootstrap resampling with 1 000 iterations to evaluate model stability. Results:A risk model for echocardiography was constructed using multiple logistic regression, and the results showed that systolic pulmonary artery pressure(sPAP), peak tricuspid regurgitation velocity(TRV), tricuspid regurgitation pressure gradient(PGTR), and TAPSE/sPAP ratio were predictive factors for BPA surgery in patients with pulmonary hypertension within 3 months. Multivariate regression analysis suggests that the TAPSE/sPAP ratio is an independent influencing factor for BPA after 3 months( OR=0.023, P<0.05). The predicted area under the ROC curve( AUC) for BPA after 3 months is 0.62(95% CI: 0.530-0.648), P<0.01, which is better than other cardiac ultrasound indicators. At the same time, internal bootstrap method was used for internal self-validation, and the AUC of the internal self-validation set was 0.67. Conclusion:The TAPSE/sPAP ratio serves as an independent predictor for requiring repeat BPA within 3 months postoperatively in patients with pcPH.

Objective To cultivate and breed laboratory cats in conventional laboratory animal facilities,collect background data on laboratory cats,and compare them with purchased domestic cats to assess the feasibility of breeding laboratory cats.Methods Indigenous cat breeds were introduced for reproduction and population expansion under conventional laboratory environment,with recording of kitten survival rates and growth curves.Indicators of 20 laboratory cats of F1 generation(half male and half female),including complete blood count,blood biochemistry,organ mass,organ coefficient,heart rate,and blood pressure,were detected and comparisons between sexes were made.Blood pressure values and sensitivity to histamine of these cats were measured using depressor substance detection method in the Pharmacopoeia of the People's Republic of China-Four Parts:2020,and were compared with the data from 173 concurrently purchased domestic cats.Results Laboratory cats adapted well to the environment of conventional laboratory facilities,with a survival rate of 77.08％of kittens at 8 weeks of age.Red blood cell count,hemoglobin content,mean corpuscular hemoglobin concentration,and hematocrit in male laboratory cats were significantly higher than those in females(P＜0.01),while the mean corpuscular volume in males was significantly lower than that in females(P＜0.01).The levels of serum alanine aminotransferase,total bilirubin,creatinine,triacylglycerol,high-density lipoprotein cholesterol,and low-density lipoprotein cholesterol in male laboratory cats were significantly higher than those in females(P＜0.05 or P＜0.01),while cholesterol,globulin,total protein,and the albumin-globulin ratio were significantly lower in males(P＜0.01).The liver coefficient in male laboratory cats was significantly lower than that in female cats(P＜0.05),while the kidney coefficient was significantly higher(P＜0.05).The spleen-brain and kidney-brain ratios were significantly higher in males compared to females(P＜0.05 or P＜0.01).No significant differences were found in heart rate,systolic pressure,diastolic pressure,mean blood pressure,or sensitivity to histamine between male and female laboratory cats(P＞0.05).Compared to laboratory cats,purchased domestic cats had significantly higher heart rate,systolic pressure,and mean blood pressure(P＜0.01),and the magnitude of blood pressure changes induced by medium and high doses of histamine was significantly reduced(P＜0.05 or P＜0.01).Conclusion It is feasible to breed laboratory cats in conventional laboratory animal facilities.The accuracy of experimental results can be improved by using laboratory cats with clear and standardized background data.

Objective:To apply cardiovascular magnetic resonance (CMR) to quantitatively evaluate the morphology and tissue characteristics of thoracic skeletal muscle (TSM) in patients with Danon disease and hypertrophic cardiomyopathy (HCM), in order to provide auxiliary differential diagnostic information.Methods:A retrospective study was conducted on 15 Danon disease patients (Danon disease group) who completed CMR examination, and 15 HCM patients (HCM group) and 15 healthy volunteers (control group) who were matched by gender and age were compared. TSM (pectoralis major, pectoralis minor, erector spinae, and subscapularis) area index (TSMAi), T1 relaxation time of four groups, and extracellular volume (ECV) of skeletal muscles of two groups (pectoralis major and subscapularis) were measured for all subjects. Single factor analysis of variance and KruskalWallis test were used to compare three sets of values.Results:The total TSMAi of the Danon disease group was lower than that of the HCM group and the control group [(15.37±3.28)cm 2/m 2 vs (23.02±3.88)cm 2/m 2 vs (22.33±4.67)cm 2/m 2, P<0.001], and the TSMAi of each TSM was also lower than that of the HCM group and the control group (all P<0.05). There was no statistically significant difference in TSMAi between the HCM group and the control group (all P>0.05). The native T1 values of the pectoralis major muscle in the Danon disease group and HCM group were higher than those in the control group (all P<0.05). The ECV of the pectoralis major muscle and subscapularis muscle in the Danon disease group were higher than those in the HCM group and control group, and the enhanced T1 values were lower than those in the HCM group and control group (all P<0.05); There was no statistically significant difference in ECV and the enhanced T1 values between the HCM group and the control group ( P>0.05). Conclusions:The application of CMR can effectively evaluate the changes in TSM morphology and tissue characteristics in Danon disease patients. Compared with HCM patients, Danon disease patients showed significant atrophy of TSM with increased extracellular volume. CMR provides a quantitative reference for TSM in the differential diagnosis of the two.