In reference to the original drug diclofenac etalhyaluronate sodium (DF-HA), a graft copolymer was synthesized by covalent bonding. The structure of DF-HA was characterized by 1H NMR, UV-Vis spectrophotometry and FT-IR. The results showed that DF-HA was successfully synthesized, and the grafting rate was determined to be approximately 17% by 1H NMR and UV-Vis spectrophotometry. The in vitro release of DF-HA graft copolymer was studied by HPLC, and its release of diclofenac (DF) in phosphate buffered saline (PBS, pH 7.4) was investigated. The drug release rate of free DF was 83.6% after 6 h, and that of DF-HA was 4.8% within 1 d and 17.7% within 21 d, which were basically consistent with the release behavior of the reference listed drug. DF-HA could significantly achieve the sustained release of DF, and high molecular weight hyaluronic acid itself had the effect of treating osteoarthritis. With both advantages, DF-HA could have good application value.

Objective:To develop and validate clinical predictive models for identifying poor short-term response to recombinant human growth hormone(rhGH) treatment in children with short stature.Methods:A retrospective analysis was conducted on 118 children diagnosed with growth hormone deficiency or idiopathic short stature who were treated at the First Affiliated Hospital of Zhengzhou University and two other hospitals between January 1, 2020, and January 1, 2024. A poor response to rhGH was defined as a height increase of less than 0.2 standard deviation score(SDS) after 6 months of rhGH treatment. LASSO regression was used to identify predictive variables from baseline and follow-up data. Two logistic regression models were conducted: Model A(incorporating baseline variables only) and model B(incorporating both baseline and follow-up variables), and nomograms were created for visualization. External data and internal resampling were used for dual validation of the models, and their performance was compared.Results:A total of 118 children with short stature were included. Six baseline predictive variables(diagnosis, initial height SDS, bone age, bone age-chronological age difference, rhGH dose, and gender) and one follow-up variable(height SDS after 3 months of rhGH treatment) were identified. Area under the curve values for Model A and Model B were 0.753(95% CI 0.696-0.811) and 0.930(95% CI 0.891-0.975), respectively. Calibration curves, decision curve analysis, and other evaluation metrics demonstrated good discrimination and clinical utility for both models. Model B, incorporating the 3-month follow-up variable, showed superior predictive performance compared to Model A. Conclusions:The clinical prediction models developed in this study(Model A and Model B) are practical and reliable tools for quantitatively, conveniently, and intuitively identifying children with short stature at risk of poor response to rhGH treatment.

Objective:To develop and validate clinical predictive models for identifying poor short-term response to recombinant human growth hormone(rhGH) treatment in children with short stature.Methods:A retrospective analysis was conducted on 118 children diagnosed with growth hormone deficiency or idiopathic short stature who were treated at the First Affiliated Hospital of Zhengzhou University and two other hospitals between January 1, 2020, and January 1, 2024. A poor response to rhGH was defined as a height increase of less than 0.2 standard deviation score(SDS) after 6 months of rhGH treatment. LASSO regression was used to identify predictive variables from baseline and follow-up data. Two logistic regression models were conducted: Model A(incorporating baseline variables only) and model B(incorporating both baseline and follow-up variables), and nomograms were created for visualization. External data and internal resampling were used for dual validation of the models, and their performance was compared.Results:A total of 118 children with short stature were included. Six baseline predictive variables(diagnosis, initial height SDS, bone age, bone age-chronological age difference, rhGH dose, and gender) and one follow-up variable(height SDS after 3 months of rhGH treatment) were identified. Area under the curve values for Model A and Model B were 0.753(95% CI 0.696-0.811) and 0.930(95% CI 0.891-0.975), respectively. Calibration curves, decision curve analysis, and other evaluation metrics demonstrated good discrimination and clinical utility for both models. Model B, incorporating the 3-month follow-up variable, showed superior predictive performance compared to Model A. Conclusions:The clinical prediction models developed in this study(Model A and Model B) are practical and reliable tools for quantitatively, conveniently, and intuitively identifying children with short stature at risk of poor response to rhGH treatment.

To analyze the clinical features and genetic variants of a child with type 4 familial partial lipodystrophy (FPLD4) and the initial manifestation of diabetes.The male patient with the age of 13 years and 5 months, and the diabetes course was about 3 years, the patient was admitted to Children′s Hospital of Soochow University on November 10, 2021(4 th hospitalization at the hospital), in the course of diabetes, the children repeatedly suffered from diabetes ketoacidosis, and lipid metabolism complications gradually emerged.The gene sequencing showed that the proband and his mother carried dual gene mutations of PLIN1 c. 1325delG(p.G442Afs*99) and SPINK1 c. 194+ 2T>C(p.? ). The PLIN1 gene was the causal gene of FPLD4.The mutations of c. 1325delG in the PLIN1 gene had not been previously reported.Based on the clinical phenotype, family history and genetic testing findings, the patient was diagnosed as FPLD4.In addition, the mutation of SPINK1 c. 194+ 2T>C(p.? ) might increase the risk of chronic pancreatitis.This case report enriched the clinical characteristics and genotype data of FPLD4.Gene sequencing assisted the accurate diagnosis of the type of diabetes.The effects of dual gene mutations on disease progression should be concerned, which were of great significance to develop treatment regimen and disease management.

Objective:To assess the clinical value of helium-free magnetocardiography(MCG) in the diagnosis of coronary artery disease(CAD).Methods:A total of 213 patients with suspected CAD undergoing MCG in Beijing Anzhen Hospital were enrolled in the study. All patients underwent coronary CT angiography/invasive coronary angiography(CCTA/ICA) within 48 hours after MCG scanning. The parameters of MCG, including magnetic field multipolarization, magnetic field unipolarization, T-wave flattened, change in magnetic field distribution at TT segment, abnormal T-peak amplitude ration of maximum to minimum, significant movement of poles, magnetic field angle deviation and abnormal distribution of positive pole were used for the evaluation of the stenosis of coronary arteries.Results:Among 213 patients, MCG scanning was completed in 193 cases(90.6%), while 20 cases were excluded for various reasons. The CCTA/ICA results were taken as gold standard, the total coincidence rate of MCG with the degree of stenosis was 88.60%(95% CI: 83.25%-92.72%), the sensitivity and specificity of MCG in the diagnosis of CAD was 89.63%(95% CI: 83.21%-94.21%) and 88.23%(95% CI:78.12%-94.78%), respectively; the positive and negative predictive value were 93.80%(95% CI:88.72%-96.68%) and 81.08%(95% CI:72.15%-87.64%), respectively. Conclusion:MCG is highly accurate in the diagnosis of CAD, it may be widely used clinically as an non-invasive method free of radiation or contrast agent.

Objective:This survey aims to investigate the prevalence, distribution, and medical treatment of depressive and anxiety disorder among people aged 18 and above in Henan province.Methods:An epidemiological survey was conducted in 30 counties (cities and districts) of Henan province from November 2020 to March 2021. A total of 10 800 permanent urban and rural residents aged 18 and above were selected by the stratified multi-stage random sampling method. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7) were used for primary screening of depressive and anxiety disorders respectively. Then all participants were divided into high-, medium-, and low-risk groups based on the primary screening results. All participants in high-risk groups, 40% participants randomly selected in medium-risk groups, and 10% randomly selected in low-risk groups underwent a diagnostic procedure for depressive and anxiety disorder conducted by psychiatrists according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). The adjusted prevalence, standardized prevalence, and 95 %CI were calculated based on the number of patients diagnosed with depressive or anxiety disorders in the three risk groups in 12 months. The distribution of the prevalence of two mental disorders were compared using the chi-square test and Fisher′s exact probability test. Results:Among the 10 057 participants who completed the survey, 229 were diagnosed with depressive disorder and 412 with anxiety disorder. The 12-month standardized prevalence of depressive and anxiety disorder were 1.96% (95 %CI=1.51%-2.32%) and 3.90% (95 %CI=3.57%-4.23%), respectively. The prevalence rate was higher in populations living in rural areas, aged ≥60 years old, having a lower education level, having a lower monthly income, performing less regular exercise, having chronic disease, having poor physical health, and lack of mental health literacy. The treatment rates of patients with depressive and anxiety disorders were 32.8% (75/229) and 25.5% (105/412), respectively. The main reasons for non-seeking medical services were the unawareness that poor mental health status could be a disease and the consideration that mental health problems were not serious. Conclusion:The prevalence of depressive and anxiety disorder in urban and rural residents of Henan province is lower than that in other provinces of China and the corresponding national data. These prevalence rates vary greatly among populations with different demographic characteristics. The treatment rate is still low in the current studied population.

Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes(MELAS) is one of the most common inherited mitochondrial diseases. This paper reports a rare mutation associated with MELAS syndrome, the m. 3252 A>G mutation in the MT-TL1 gene encoding the mitochondrial tRNALeu(UUR). The 6-year-old girl suffered from recurrent convulsion and lactic acidemia. The mtDNA sequencing detected a variant m. 3252A>G(MT-TL1 gene) in the proband and her maternal relatives. The heteroplasmic levels in peripheral blood and urine sediment were 66.53% and 97.42%, respectively, which were obviously higher than those of her maternal relatives. Together with 3 previously reported cases, the variant m. 3252A>G could be classified pathogenic. All the reported pathogenic variants in MT-TL1 gene were reviewed to explore the genotype-phenotype correlations of pathogenic variants in MT-TL1 gene.

Objective:This survey aims to investigate the prevalence, distribution, and medical treatment of depressive and anxiety disorder among people aged 18 and above in Henan province.Methods:An epidemiological survey was conducted in 30 counties (cities and districts) of Henan province from November 2020 to March 2021. A total of 10 800 permanent urban and rural residents aged 18 and above were selected by the stratified multi-stage random sampling method. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7) were used for primary screening of depressive and anxiety disorders respectively. Then all participants were divided into high-, medium-, and low-risk groups based on the primary screening results. All participants in high-risk groups, 40% participants randomly selected in medium-risk groups, and 10% randomly selected in low-risk groups underwent a diagnostic procedure for depressive and anxiety disorder conducted by psychiatrists according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). The adjusted prevalence, standardized prevalence, and 95 %CI were calculated based on the number of patients diagnosed with depressive or anxiety disorders in the three risk groups in 12 months. The distribution of the prevalence of two mental disorders were compared using the chi-square test and Fisher′s exact probability test. Results:Among the 10 057 participants who completed the survey, 229 were diagnosed with depressive disorder and 412 with anxiety disorder. The 12-month standardized prevalence of depressive and anxiety disorder were 1.96% (95 %CI=1.51%-2.32%) and 3.90% (95 %CI=3.57%-4.23%), respectively. The prevalence rate was higher in populations living in rural areas, aged ≥60 years old, having a lower education level, having a lower monthly income, performing less regular exercise, having chronic disease, having poor physical health, and lack of mental health literacy. The treatment rates of patients with depressive and anxiety disorders were 32.8% (75/229) and 25.5% (105/412), respectively. The main reasons for non-seeking medical services were the unawareness that poor mental health status could be a disease and the consideration that mental health problems were not serious. Conclusion:The prevalence of depressive and anxiety disorder in urban and rural residents of Henan province is lower than that in other provinces of China and the corresponding national data. These prevalence rates vary greatly among populations with different demographic characteristics. The treatment rate is still low in the current studied population.

Objective:To investigate the value of serum insulin-like growth factor-1 (IGF-1), dehydroepiandrosterone sulphate (DHEAS), anti-Müllerian hormone (AMH) and bone morphogenetic protein 6 (BMP-6) in prediction of rapidly progressive puberty(RPP) in girls.Methods:The data of 750 girls who visited the Department of Endocrinology, Metabolism and Genetic Disorders, Children′s Hospital of Soochow University from August 2017 to October 2018 because of breast development were retrospectively analyzed.After following up these girls for 6 months to 1 year, those who were lost to follow up, received early treatment and failed to meet the inclusion criteria were excluded.The remaining 138 girls were divided into the central precocious puberty group (CPP, 32 cases), the early puberty with RPP group (EP-RPP, 33 cases), the early puberty with slow progression puberty group (EP-SPP, 32 cases) and RPP group (41 cases) according to the inclusion criteria.The healthy control group consisted of 33 undeveloped girls aged 8 to 9 who underwent physical examination in the same hospital over the same period.The serum concentrations of IGF-1, DHEAS, AMH and BMP-6 were measured.The general information, clinical manifestations, laboratory examination results and radiological features were compared among different groups.Statistical analysis was performed by using SPSS 22.0, and the receiver operating characteristic curve (ROC) was drawn to investigate the value of IGF-1, DHEAS, AMH and BMP-6 in prediction of RPP.Results:(1)The serum follicle stimulating hormone(FSH) peak value was 15.10(13.86-19.80) IU/L in the EP-SPP group, 11.99(9.18-16.16) IU/L in the EP-RPP group and 11.43(9.37-15.63) IU/L in the RPP group.The ratio of serum FSH/luteinizing hormone(LH) peak values was 3.20(2.44-4.58) in the EP-SPP group, 1.86(1.05-3.16) in the EP-RPP group and 0.76(0.49-0.99) in the RPP group.The serum FSH peak value and the ratio of serum FSH/LH peak values in the EP-SPP group were significant higher than those in the EP-RPP group(all P<0.05). There was no significant difference in the serum FSH peak value between the EP-RPP group and the RPP group( P>0.05). (2)The serum IGF-1 levels of the healthy control group, EP-SPP group, EP-RPP group, CPP group and RPP group were 166.00(126.50-188.00) μg/L, 199.00(170.50-262.50) μg/L, 252.00(233.00-291.50) μg/L, 288.00(252.00-376.00) μg/L and 382.00(264.0-499.50) μg/L, respectively.The serum IGF-1 levels of the EP-SPP group, EP-RPP group, CPP group and RPP group were all significantly higher than those in the healthy control group (all P<0.05). The serum IGF-1 levels in the EP-RPP group were higher than those in the EP-SPP group( P<0.01). As the puberty rapidly progressed, the serum IGF-1 levels gradually increased.The RPP group had the highest IGF-1 levels, and the difference in IGF-1 levels between the RPP group and EP-RPP group was statistically significant( P<0.01). (3)The serum DHEAS levels were 41.65(14.80-59.88) μg/L in the healthy control group, 42.50(30.15-79.83) μg/L in the EP-SPP group, 52.32(43.08-98.54) μg/L in the CPP group, 63.30(34.00-81.55) μg/L in the EP-RPP group and 70.89(51.85-100.02) μg/L in the RPP group.The DHEAS levels of the healthy control group, EP-RPP group and RPP group gradually increased.The RPP group had the highest DHEAS levels.There was significant difference in DHEAS levels among the healthy control group, EP-RPP group and RPP group ( P<0.05). There was no significant difference in DHEAS levels among the EP-SPP group, CPP group and EP-RPP group( P>0.05). (4)The serum AMH and BMP-6 levels in the EP-RPP group, EP-SPP group, RPP group, CPP group and healthy control group were not significantly different( P>0.05). (5)The area under the ROC curve of serum IGF-1 levels was 0.765, the cut-off value was 232.5 μg/L, the specificity for the cut-off value was 83.30%, and the sensitivity was 75.00%.The combined area under the ROC curve of the serum FSH peak value and the ratio of serum FSH/LH peak values was 0.795. Conclusions:Serum IGF-1 levels and the combination of the serum FSH peak value and the ratio of serum FSH/LH peak values can be used as effective indicators of slowly and rapidly progressive puberty in early adolescent girls.Serum DHEAS cannot be used as an early warning index of RPP, but it plays a critical role in the regulation of puberty initiation and process.Serum DHEAS levels may be related to the Tanner stage.

Cosmetic and plastic surgery of female external genitalia is a new subject which adopts surgical or non-surgical methods to rectification of vulva and vagina.With the social progress, genitalia plastic surgery has also achieved a dramatic of development, various new technologies has been applied, and women’s genitalia plastic surgery has shown a good prospect. This review focuses on new concepts and techniques of surgery and non-surgical cosmetic surgery of female external genitalia, including the surgical methods, such as mons pubic plasty, clitoral hood plasty, labia minora reduction surgery, labia majora reduction surgery, labia majora augmentation surgery, perineoplasty, vaginoplasty, and non-surgical methods like G-spot augmentation, orgasm shot therapy, photoelectricity-energy based therapy, etc. It could help plastic surgeons and gynecologists to understand the concepts and therapeutics better in this field.