Objective To explore the correlation between serum insulin-like growth factor1(IGF-1),insulin-like growth factor binding protein3(IGFBP-3),bone-specific alkaline phosphatase(BAP)and abundance of intestinal flora in children with idiopathic short stature(ISS).Methods A total of 86 children with ISS who were treated with short-acting recombinant growth hormone for the first time in Department of Endocrinology of Baoding Hospital,Beijing Children's Hospital,Capital Medical University,were enrolled from July 2021 to June 2023.Before treatment and at 6 months after treatment,physical indexes(height,weight)and bone age indexes[bone age index(BAI),bone age difference(BAD)]were detected with the same instrument at the same place.The fasting venous blood was collected to detect levels of serum IGF-1,IGFBP-3 and BAP by enzyme-linked immunosorbent assay.The abundances of intestinal floras were monitored by 16s rDNA high-throughput sequencing technology combined with bioinformation analysis technology.A total of 40 healthy children during the same period were enrolled as control group,and differences in different indexes within the same groups or between the two groups were compared by independent sample t test or paired t test.The correlation between abundances of intestinal floras and levels of serum IGF-1,IGFBP-3 and BAP was analyzed by Pearson correlation analysis.Results Compared with the control group.the height,weight,BAD,BAI,levels of serum IGF,IGFBP-3 and BAP,Chaol,Shannon and Pielou e of ISS patients decreased before treatment,and the differences were statistically significant(t=7.119～44.143,all P<0.05).After treatment,height,weight,BAD,BAI,levels of serum IGF,IGFBP-3 and BAP,Chaol,Shannon and Pielou e were increased in ISS children(t=3.145～39.188),the above indexes were still lower than those in control group(t=2.389～69.893),the differences were statistically significant(all P<0.05),respectively.In intestinal floras,dominant bacterial groups at phylum level were Firmicutes,Bacteroidetes,Actinobacteria and Proteobacteria,while dominant bacterial groups at genus level were Blautia,Bifidobacterium,Faecalibacterium and Bacteroides.Compared with the control group,before treatment,the abundances of Actinobacteria and Proteobacteria increased in the ISS group,while the abundances of Bacteroidetes,Bifidobacteria and Bacteroides decreased,and the differences were statistically significant(t=25.224～46.345,all P<0.05).After treatment,abundances of Bacteroidetes,Bifidobacterium and Bacteroides in the ISS group increased compared to before treatment,while abundance of Proteobacteria decreased,and the differences were statistically significant(t=10.055～39.245,all P<0.05).The abundances of Bacteroidetes,Bifidobacterium and Bacteroides in ISS group were lower than those in control group,while abundance of Proteobacteria was higher than that in control group,and the differences were statistically significant(t=6.290～20.540,all P<0.05).The abundances of Bacteroidetes,Bifidobacterium and Bacteroides were positively correlated with levels of serum IGF-1,IGFBP-3 and BAP(r=0.300～0.759,all P<0.05).Conclusion The abundances of intestinal floras are decreased,and the structure is abnormal in children with ISS.The abundances of beneficial bacteria in intestinal floras are related to levels of serum IGF-1,IGFBP-3 and BAP.In clinical treatment of ISS,combined treatment with intestinal flora disorders may be conducted.

In modern society, sugary foods have become an integral part of many people′s lives. However, excessive sugar consumption has adverse effects on both overall health and oral health, serving as a contributing factor to the global increasing incidence in oral diseases, cardiovascular diseases, cancers, obesity, and diabetes. In response to the health risks related to high-sugar diets, the World Health Organization (WHO) and World Dental Federation (FDI) have proposed initiatives and recommendations, with various governments implementing different policies and strategies to reduce sugar intake. Chinese government has also taken proactive measures. The "Healthy China Action (2019-2030)" initiative introduced by the State Council in 2019 established a crucial benchmark in limiting the average daily intake of added sugar to 25 g per person forward to 2030. Experts from Chinese Center for Disease Control and Prevention and the field of oral health have meticulously examined the impacts of sugar reduction on oral health, as well as strategies, methods, and practical considerations related to reducing sugar intake through several meeting and wrote the "Expert consensus: reducing free-sugar for caries prevention", which was subsequently reviewed and revised based on the feedback from multiple stakeholders. They have conducted thorough analyses of global trends in sugar reduction and best practices to provide valuable insights to China for crafting effective policies and strategies on sugar reduction. This consensus mainly includes the classification of free sugars, the latest scientific evidence on dental caries, recommendations from WHO on sugar-sweetened beverage taxes, nutrition labeling, advertising, food reform, adjusting supply systems, education, and promotion strategies, as well as sugar reduction actions taken by various governments around the world. Combining the actual situation in China, policy recommendations and authoritative popular science knowledge on sugar reduction for caries prevention to public are proposed to advocate for experts in multiple fields to focus on sugar reduction for caries prevention, promote the work process, and provide the scientific basis for oral health educators.

In modern society, sugary foods have become an integral part of many people′s lives. However, excessive sugar consumption has adverse effects on both overall health and oral health, serving as a contributing factor to the global increasing incidence in oral diseases, cardiovascular diseases, cancers, obesity, and diabetes. In response to the health risks related to high-sugar diets, the World Health Organization (WHO) and World Dental Federation (FDI) have proposed initiatives and recommendations, with various governments implementing different policies and strategies to reduce sugar intake. Chinese government has also taken proactive measures. The "Healthy China Action (2019-2030)" initiative introduced by the State Council in 2019 established a crucial benchmark in limiting the average daily intake of added sugar to 25 g per person forward to 2030. Experts from Chinese Center for Disease Control and Prevention and the field of oral health have meticulously examined the impacts of sugar reduction on oral health, as well as strategies, methods, and practical considerations related to reducing sugar intake through several meeting and wrote the "Expert consensus: reducing free-sugar for caries prevention", which was subsequently reviewed and revised based on the feedback from multiple stakeholders. They have conducted thorough analyses of global trends in sugar reduction and best practices to provide valuable insights to China for crafting effective policies and strategies on sugar reduction. This consensus mainly includes the classification of free sugars, the latest scientific evidence on dental caries, recommendations from WHO on sugar-sweetened beverage taxes, nutrition labeling, advertising, food reform, adjusting supply systems, education, and promotion strategies, as well as sugar reduction actions taken by various governments around the world. Combining the actual situation in China, policy recommendations and authoritative popular science knowledge on sugar reduction for caries prevention to public are proposed to advocate for experts in multiple fields to focus on sugar reduction for caries prevention, promote the work process, and provide the scientific basis for oral health educators.

Objective To explore the correlation between serum insulin-like growth factor1(IGF-1),insulin-like growth factor binding protein3(IGFBP-3),bone-specific alkaline phosphatase(BAP)and abundance of intestinal flora in children with idiopathic short stature(ISS).Methods A total of 86 children with ISS who were treated with short-acting recombinant growth hormone for the first time in Department of Endocrinology of Baoding Hospital,Beijing Children's Hospital,Capital Medical University,were enrolled from July 2021 to June 2023.Before treatment and at 6 months after treatment,physical indexes(height,weight)and bone age indexes[bone age index(BAI),bone age difference(BAD)]were detected with the same instrument at the same place.The fasting venous blood was collected to detect levels of serum IGF-1,IGFBP-3 and BAP by enzyme-linked immunosorbent assay.The abundances of intestinal floras were monitored by 16s rDNA high-throughput sequencing technology combined with bioinformation analysis technology.A total of 40 healthy children during the same period were enrolled as control group,and differences in different indexes within the same groups or between the two groups were compared by independent sample t test or paired t test.The correlation between abundances of intestinal floras and levels of serum IGF-1,IGFBP-3 and BAP was analyzed by Pearson correlation analysis.Results Compared with the control group.the height,weight,BAD,BAI,levels of serum IGF,IGFBP-3 and BAP,Chaol,Shannon and Pielou e of ISS patients decreased before treatment,and the differences were statistically significant(t=7.119～44.143,all P<0.05).After treatment,height,weight,BAD,BAI,levels of serum IGF,IGFBP-3 and BAP,Chaol,Shannon and Pielou e were increased in ISS children(t=3.145～39.188),the above indexes were still lower than those in control group(t=2.389～69.893),the differences were statistically significant(all P<0.05),respectively.In intestinal floras,dominant bacterial groups at phylum level were Firmicutes,Bacteroidetes,Actinobacteria and Proteobacteria,while dominant bacterial groups at genus level were Blautia,Bifidobacterium,Faecalibacterium and Bacteroides.Compared with the control group,before treatment,the abundances of Actinobacteria and Proteobacteria increased in the ISS group,while the abundances of Bacteroidetes,Bifidobacteria and Bacteroides decreased,and the differences were statistically significant(t=25.224～46.345,all P<0.05).After treatment,abundances of Bacteroidetes,Bifidobacterium and Bacteroides in the ISS group increased compared to before treatment,while abundance of Proteobacteria decreased,and the differences were statistically significant(t=10.055～39.245,all P<0.05).The abundances of Bacteroidetes,Bifidobacterium and Bacteroides in ISS group were lower than those in control group,while abundance of Proteobacteria was higher than that in control group,and the differences were statistically significant(t=6.290～20.540,all P<0.05).The abundances of Bacteroidetes,Bifidobacterium and Bacteroides were positively correlated with levels of serum IGF-1,IGFBP-3 and BAP(r=0.300～0.759,all P<0.05).Conclusion The abundances of intestinal floras are decreased,and the structure is abnormal in children with ISS.The abundances of beneficial bacteria in intestinal floras are related to levels of serum IGF-1,IGFBP-3 and BAP.In clinical treatment of ISS,combined treatment with intestinal flora disorders may be conducted.

Objective:To analyze the efficacy and feasibility of performing a new surgical procedure, tunnel esophagogastrostomy, to perform proximal gastrectomy.Methods:The study cohort comprised 10 consecutive patients who had undergone esophagogastrostomy by the tunnel technique in Jiangsu Cancer Hospital between October 2019 and July 2022. All patients were male. Their average age was (64.2±8.1) years and body mass index (25.5±3.2) kg/m2. Nine had upper gastric body adenocarcinoma, the remaining one having signet ring cell carcinoma. TNM staging of the tumors showed that seven were Stage IA, one Stage IB, one Stage IIA, and one Stage IIIA. Briefly, tunnel esophagogastrostomy is performed as follows: After performing a proximal gastrectomy, a rectangular seromuscular flap (3.0 cm × 3.5 cm) is created. The posterior esophageal wall is sutured to the gastric wall at the orad end of the seromuscular flap 5 cm from the stump with three to four stitches. Next, the stump of the esophagus is opened, the posterior esophageal wall is sutured to the gastric mucosa and submucosa, and the anterior esophageal wall is sutured to the full layer of the stomach. Finally, the caudad end of the seromuscular flap is closed. Data on surgical safety, postoperative morbidity, and postoperative reflux esophagitis were analyzed. All enrolled patients completed endoscopic follow-up 1 year and 2 years after surgery.Results:All procedures were completed. They comprised four cases of laparoscopic assisted surgery, four of DaVinci robotic surgery, and two of open surgery. The mean operation time was 212.7±33.2 mins, mean anastomosis time (51.6±5.3) minutes, mean tunnel preparation time (20.0±3.5) minutes, and mean operative blood loss (90.0±51.6) mL. The time to first postoperative passage of flatus was (64.8±11.5) hours. The mean hospital stay after surgery was (9.2±1.7) days. There were no postoperative complications above Clavien-Dindo Grade II. The mean preoperative Reflux Disease Questionnaire score was (3.3± 0.4) before the surgery, (3.8±1.0) 1 month postoperatively, and (3.3±0.4) 12 months postoperatively. All patients underwent endoscopic follow-up; no anastomotic stenoses were found. However, one patient had Grade A reflux esophagitis 1 year after surgery and another Grade B reflux esophagitis 2 years after surgery.Conclusion:Esophagogastrostomy by the tunnel technique is a safe and feasible means of performing proximal gastrectomy.

Objective:To analyze the efficacy and feasibility of performing a new surgical procedure, tunnel esophagogastrostomy, to perform proximal gastrectomy.Methods:The study cohort comprised 10 consecutive patients who had undergone esophagogastrostomy by the tunnel technique in Jiangsu Cancer Hospital between October 2019 and July 2022. All patients were male. Their average age was (64.2±8.1) years and body mass index (25.5±3.2) kg/m2. Nine had upper gastric body adenocarcinoma, the remaining one having signet ring cell carcinoma. TNM staging of the tumors showed that seven were Stage IA, one Stage IB, one Stage IIA, and one Stage IIIA. Briefly, tunnel esophagogastrostomy is performed as follows: After performing a proximal gastrectomy, a rectangular seromuscular flap (3.0 cm × 3.5 cm) is created. The posterior esophageal wall is sutured to the gastric wall at the orad end of the seromuscular flap 5 cm from the stump with three to four stitches. Next, the stump of the esophagus is opened, the posterior esophageal wall is sutured to the gastric mucosa and submucosa, and the anterior esophageal wall is sutured to the full layer of the stomach. Finally, the caudad end of the seromuscular flap is closed. Data on surgical safety, postoperative morbidity, and postoperative reflux esophagitis were analyzed. All enrolled patients completed endoscopic follow-up 1 year and 2 years after surgery.Results:All procedures were completed. They comprised four cases of laparoscopic assisted surgery, four of DaVinci robotic surgery, and two of open surgery. The mean operation time was 212.7±33.2 mins, mean anastomosis time (51.6±5.3) minutes, mean tunnel preparation time (20.0±3.5) minutes, and mean operative blood loss (90.0±51.6) mL. The time to first postoperative passage of flatus was (64.8±11.5) hours. The mean hospital stay after surgery was (9.2±1.7) days. There were no postoperative complications above Clavien-Dindo Grade II. The mean preoperative Reflux Disease Questionnaire score was (3.3± 0.4) before the surgery, (3.8±1.0) 1 month postoperatively, and (3.3±0.4) 12 months postoperatively. All patients underwent endoscopic follow-up; no anastomotic stenoses were found. However, one patient had Grade A reflux esophagitis 1 year after surgery and another Grade B reflux esophagitis 2 years after surgery.Conclusion:Esophagogastrostomy by the tunnel technique is a safe and feasible means of performing proximal gastrectomy.

A male patient aged 1 year and 8 months with type 2 spondyloepimetaphyseal dysplasia with joint laxity (SEMDJL2) was reported. The clinical characteristics included short stature, flat middle face, hypotonia, limb joint relaxation, hyperextension of metacarpophalangeal articulation, etc. In addition, the patient had a history of congenital laryngeal stridor. Thus, SEMDJL2 was determined according to the above symptoms and medical history. Sanger sequencing showed that the child carried a c.443C>T missense mutation in the KIF22 gene, which resulted in an amino acid variation namely p.Pro148Leu. This phenotype was preliminarily determined as a pathogenic mutation. Therefore, it is suggested that next-generation sequencing genetic testing could be helpful for genetic diagnosis in children with congenital laryngeal stridor, systemic joint relaxation, and excessive joint extension.

Objective:To investigate the effects of anxiety and depressive symptoms in mediation of pain catastrophizing on disability in patients with low back pain.Methods:A cross-sectional survey was conducted among 97 patients with low back pain in the Changjiang Subdistrict community health center from July to October 2021. Oswestry Disability Index, pain catastrophic subscale in Coping Strategies Questionnaire-24, Generalized Anxiety Disorder Scale-short version, Patient Health Depression Questionnaire-short version were used to evaluate the activity dysfunction, pain catastrophic cognition and anxiety and depression levels of patients,respectively. Path analysis was implemented to test the mediation model, and the indirect effects were assessed using the bootstrap procedure with bias-corrected 95 %CI. Results:Results suggested significant positive correlations among pain catastrophizing, anxiety, depressive symptoms and disability of patients. In addition, both anxiety and depressive symptoms significantly mediated the impact of pain catastrophizing on disability (standardized indirect effects were 0.183 and 0.197, P<0.05). Patients with higher levels of pain catastrophic cognition showed higher levels of anxiety and depressive symptoms (β=0.757, 0.720; P<0.01), and reported more severe motor dysfunction (β=0.241, 0.274; P<0.05). Conclusions:Our findings suggest that anxiety and depression may be the psychological pathways through which pain catastrophizing predicts disability in patients with low back pain. Effective psychological interventions, such as emotion regulation and stress reduction strategies should be considered in treatment and supportive care for patients with low back pain.

Objective:To analyze clinical characteristics and genetic characteristics of children with ATP sensitive potassium passage (K ATP-HI). Methods:Forty-five children with genetically confirmed K ATP-HI and their families admitted to Beijing Children′s Hospital of Capital Medical University between February 2002 and December 2018 were selected as the study subjects. A detailed retrospective analysis of the patient's clinical characteristics, diagnosis and treatment process, disease-causing gene carrying status and later follow-up data was performed. ABCC8/KCNJ11 gene was sequenced by second-generation sequencing technology. Results:Among 45 children with K ATP-HI, 34 cases (75.6%) were neonatal onset, the first symptoms of 21 cases (46.7%) were convulsions. 39 cases had been treated with diazoxide, including 12 cases (30.8%) with good efficacy, 16 cases (41%) with poor efficacy and 11 cases with uncertain efficacy. Octreotide was further applied in 18 patients with uncertain or ineffective efficacy after diazoxide treatment, and 13 cases (72.2%) were effective, 3 cases were ineffective, and 2 cases were uncertain. 10 CHI patients who were ineffective to drug treatment or had clearly focal lesions confirmed by 18F-dopa positron emission by computed tomography ( 18F-DOPA PET) scans had undergone surgical treatment, 8 of which underwent partial pancreatectomy and blood glucose returned to normal after the operation; the other 2 cases underwent subtotal pancreatectomy and both had secondary diabetes after operation. Among 45 children with K ATP-HI, 1 case carried both ABCC8 and KCNJ11 mutations, 10 cases carried ABCC8 compound heterozygous mutations, and the remaining 34 cases carried ABCC8/KCNJ11 single genetic mutation. Among them, 21 cases had paternal inheritance, and 3 cases had maternal inheritance, 6 cases were identified with de novo mutations. Conclusions:Diazoxide treatment was ineffective for most K ATP-HI children, but octreotide had a higher effective rate. Partial pancreatectomy for focal type patients had a higher cure rate, and there was a risk of secondary diabetes after subproximal pancreatectomy, so it was very important to clarify the histological type of children before surgery. ABCC8 gene mutations and KCNJ11 gene mutations were the main pathogenic genes of K ATP-HI. Among patients carrying mutations in single ABCC8 or KCNJ11 gene mutation, K ATP-HI inherited by paternity were the majority. Some K ATP-HI children can relieve the hypoglycemia symptoms by themselves.

Objective:To explore the influence of anxiety on the quality of life and its associated factors in patients with polycystic ovary syndrome (PCOS).Methods:PCOS patients were enrolled in this cross sectional study in Reproductive Endocrinology, Obstetrics and Gynecology Hospital of Fudan University from May 2019 to January 2022. Anxiety and quality of life were scored for patients diagnosed with PCOS. All patients were divided into PCOS with or without anxiety group. The associated factors of PCOS complicated with anxiety were screened from clinical features, endocrine, ovarian reserve function and metabolic status by logistic analysis and receiver operating characteristic (ROC).Results:Totally 125 PCOS patients were enrolled, of whom 44 were complicated with anxiety. The scores for the quality of life in patients with PCOS and anxiety related to obesity (12.7±1.4 vs. 18.8±0.9, P<0.001), abnormal menstruation (17.9±0.9 vs. 23.2±0.6, P<0.001) and PCOS itself (28.3±1.6 vs. 35.0±0.9, P<0.001) were all lower than those in PCOS patients without anxiety. The body mass index (BMI) [(25.74±0.97) kg/m 2vs. (23.46±0.45) kg/m 2, P=0.038] and area of insulin under the curve (IAUC) [(2 844.28±303.61) pmol/L vs. (1 834.28±147.89) pmol/L, P=0.001] of PCOS patients with anxiety were all higher, while sex hormone binding globulin (SHBG) levels [(33.29±6.21) nmol/L vs. (41.94±4.11) nmol/L, P=0.045] were lower than those without anxiety, and the differences were all statistically significant. Logistic regression analysis screened out the most relevant factor with anxiety in PCOS as IAUC ( OR=1.001, 95% Cl=1.000-1.001, P=0.021) and BMI ( OR=1.113, 95% CI=1.016-1.219, P=0.003). ROC analysis showed that IAUC was an associated factor for PCOS complicated with anxiety, and the area under the ROC curve were 0.701 ( P=0.020). Conclusion:The prevalence of anxiety in PCOS patients is higher than that in the general population. The quality of life is lower in PCOS patients with anxiety than those without. Anxiety may be closely related to weight gain and hyperinsulinemia/insulin resistance in PCOS patients.