Objective:To explore the clinical characteristics of neonatal necrotizing enterocolitis（NEC）and analyze the risk factors for early-onset NEC.Methods:A total of 220 children with NEC admitted to the Department of Pediatrics，Tianjin Medical University General Hospital from January 1st，2018 to February 29th，2024 were retrospectively selected as the research objects. According to the time of onset，the early-onset group（ n=120）and the late-onset group（ n=100）were established，and the clinical characteristics of the two groups were compared. Another 150 cases of normal healthy newborns born in this hospital in the same period were selected as the control group，and the clinical data of the control group were collected. The clinical characteristics of the early-onset group and the control group were compared，and the risk factors of early-onset NEC were analyzed by multivariate Logistic regression. Results:Compared with the late-onset group，the early-onset group had fever［50.0%（60/120）vs. 40%（40/100）， χ2=7.333， P=0.007］，apnea［39.17%（47/120）vs. 28%（28/100）， χ2=7.568， P=0.006］，no rise in body temperature［56.67%（68/120）vs. 39%（39/100）， χ2=6.815， P=0.009］，abdominal distension［25%（30/120）vs. 40%（40/100）， χ2=13.200， P<0.001］，vomiting［30.83%（37/120）vs. 45%（45/100）， χ2=12.797， P<0.001］was significantly different（all P<0.05）；Multivariate Logistic regression analysis：weight<1 500 g（ OR=5.871，95% CI：3.153～9.673， P<0.001），gestational age<30 weeks（ OR=4.256，95% CI：2.641～7.896， P=0.007），hemodynamically significant patent ductus arteriosus（hs-PDA）（ OR=3.113，95% CI：1.865～5.133， P=0.033），severe anemia（ OR=3.057，95% CI：2.165～4.802， P=0.001），feeding intolerance（ OR=4.215，95% CI：1.579～10.802， P=0.005），amniotic fluid pollution（ OR=2.452，95% CI：1.579～3.111， P<0.001）were the independent risk factors for early-onset NEC（all P<0.05）. Conclusion:Weight<1 500 g，gestational age<30 weeks，hs-PDA，severe anemia，feeding intolerance，and amniotic fluid contamination are independent risk factors for early-onset NEC. In clinical practice，more attention should be paid to these factors for disease prevention，early identification，and timely intervention in newborns to reduce the occurrence of NEC.

Objective:To investigate the status of height and weight of 3-18-year-old children and adolescents in urban China, and to provide a basis for establishing puberty phase specific curves for age-specific height and age-specific weight.Methods:A cross-sectional survey of 218 185 children and adolescents aged 3-18 years in urban China was conducted by using the method of stratified random cluster sampling from January 2017 to December 2019. The sampling areas included 12 provinces municipalities in China and autonomous regions in total. Data were collected on weight, height, waist circumference, hip circumference and secondary sexual characteristics. The generalized additive model for location, scale, and shape (GAMLSS) was employed to establish percentile reference values and growth curves of height and weight for boys and girls aged 3-18 years. Wilcoxon rank sum test was applied to compare the P 50 value of height and weight between children of each Tanner stage and children of the same age ignoring the different puberty phase. Results:The 3rd, 50th, and 97th percentile curves for height and weight for age were developed for boys and girls aged 3-18 years. The 3rd, 50th, and 97th percentile curves for age-specific height and age-specific weight for each puberty phase were developed for boys and girls. Compared with all children ignoring the different puberty phase, boys aged 9 and over and girls aged 7 and over who are at Tanner stage 1 showed shorter height and lighter weight than those of the same age group (all P<0.01), the difference ranges of height at P 50 are -4.0 to -0.6 cm for boys, and -4.4 to 0.5 cm for girls; the difference ranges of weight are -4.8 to 0.4 kg for boys, and -4.0 to -0.3 kg for girls; children at Tanner stage 2 & 3 initially were taller and heavier than those of the same age group; and later grew shorter and lighter than those of the same age group, the two sets of curves cross over; boys aged 16 and under and girl aged under 14 who are at Tanner stage 4 were taller and heavier than those of the same age group (all P<0.01), the difference ranges of height at P 50 are 0.2 to 10.0 cm for boys, and 0.2 to 9.4 cm for girls; the difference ranges of weight at P 50 are 0.7 to 10.9 kg for boys, and 1.0 to 11.2 kg for girls, and the differences showed narrowing trend with age. Conclusion:The puberty phase specific growth curves of age-specific height and age-specific weight for boys and girls aged 3-18 years are established, it is useful for clinical work to evaluate physical development of children at different puberty phases.

Objective To compare the efficacy of contrast-enhanced ultrasound (CEUS) and enhanced CT (CECT) in differential diagnosis of benign and malignant space-occupying lesions of gallbladder.Methods The clinical data of 68 cases of space-occupying lesions of gallbladder confirmed by surgery and biopsy were retrospectively analyzed.The diagnostic accuracy,sensitivity and specificity of CEUS and CECT were analyzed and compared.Results In a total of 68 cases of space-occupying lesions of gallbladder,31 cases were benign lesions and 37 were malignant lesions (gallbladder cancer).For the benign lesions cases,CEUS and CECT were mainly hyper-enhanced in the early stage of enhancement,which were 90.3％ and 83.9％,respectively.In the late stage of enhancement,they were mostly low-enhanced,which were 93.5％ and 87.1％,respectively.For the gallbladder cancer cases,CEUS and CECT were predominantly hyper-enhanced in the early stage of enhancement,which were 94.6％ and 89.2％,respectively,and were all low-enhanced in the late stage of enhancement.In the differential diagnosis for benign and malignant space-occupying gallbladder lesions by CEUS,the differences in peak time,extinction time,peak intensity and average transit time were statistically significant (all P＜0.01).The inhomogeneous enhancement rates were 41.9％ and 48.4％ respectively for CEUS and CECT in the benign lesions cases,and 94.6％ and 91.9％ in the gallbladder cancer cases.Besides,the incomplete gallbladder wall rates are 89.2％ and 91.9％ in the gallbladder cancer cases.However,these differences were all not statistically significant (all P＞0.05).In the diagnosis of benign and malignant lesions cases,the diagnostic accuracy of CEUS and CECT were 92.6％ and 89.7％,the sensitivity was 93.5％ and 90.3％,and the specificity was 89.2％ and 83.8％,respectively,but the differences were not statistically significant (all P＞0.05).Conclusion CEUS and CECT have comparable efficacy in differential diagnosis of benign and malignant space-occupying lesions of gallbladder.CEUS has advantages over CECT and is worthy of extensive clinical application and promotion.

Objective To study the relationship between the level of serum epithelial fatty acid binding protein (E-FABP) and cardiovascular disease in obese children. Methods Thirty children with metabolic syndrome (MS), 32 obesity children with no MS and 50 healthy children were recruited. Serum E-FABP and glucose/lipid metabolic indices were measured. Results Com-pared with the healthy children, levels of serum E-FABP in MS children were signiifcantly elevated (P=0.001). Compared with obesity children, levels of serum E-FABP of MS children were elevated, but the difference was not signiifcant (P>0.05). The cor-relations of E-FABP with waist to hip ratio, waist-to-height ratio, atherogenic index, fasting insulin, insulin resistance index were positive (P<0.05). According to the multivariate stepwise regression analysis, E-FABP was the independent risk of atherogenic index (P=0.018). Conclusions E-FABP plays a role in the development of atherosclerosis in obesity and MS.

Objective To investigate the value of the senile degenerative aortic valve calcification (AVC) and to analyze the correlative risk factors by color Doppler echocardiograph.Methods Aortic valves of 110 cases with AVC (study group) and 110 cases without AVC (control group) were observed by color Doppler echocardiograph.All the patients with AVC have been excluded of congenital and other acquired valves' diseases.The aortic valve' s shape and the diameters of aortic root were measured.At the same time,the peak systolic and diastolic velocities of aorta were detected.The different features were compared between the two groups.Results Test results showed significant differences in study group:Anteroposterior diameter of aortic annulus and the area of aortic valve were decreased by calcification; The anteroposterior diameter of aortic sinus increased and aorta transvalvular pressure gradient augmented; Detection rate of atherosclerosis (AS) of aorta and the peripheral artery stenosis of the study group were higher than that of control group; The AS increased pulse pressure and aggravated AVC; Correlative risk factors,in addition to age,included hypertension,hypercholesterolemia,osteoporosis,and so on.The correct diagnosis of the correlated diseases were on the basis of clinical examines.The rate of AVC with multi-factor was higher than that with single-factor.In addition,gender difference and the diameters of ascending aortic showed no significant difference in two groups.Relationship between diabetes of correlative factors and the rate of AVC showed no significant difference in two groups.Conclusion Morphologic abnormality and malfunction of aortic valve and the large artery in elder patients were caused by senile degenerative AVC.The more correlative risk factors,the worse showed.

ObjectiveTo explore the clinical value of ultrasound in the diagnosis of chest wall tuberculosis.Methods134 cases of chest wall tuberculosis were diagnosed with ultrasound and the correlation with CT,X-ray diagnostic results were studied.ResultsThere were solid echo type 27 cases; liquid dark area type 42 cases and combined echo type 65 cases.There was statistical significant difference between ultrasound and CT diagnosis of calcification within the lesion and the crab-like sinus(P＜0.05).The specificities of ultrasound and CT diagnosis of chest wall tuberculosis were 95.52％ and 93.28％,respectively,and the difference was not statistically significant (P＞0.05).ConclusionUltrasound diagnosis of chest wall tuberculosis has clinical value on determining the size of chest wall nodule,its range,and its relationship with the surrounding tissue.It is an effective diagnostic method of chest wall tuberculosis.

Objective To investigate the correlation of intima-media thickness (IMT) of the lower peripheral arteries and maximal shear rate (SR) in diabetic (DM) patients and to analyze the related risk factors.Methods A total of 84 diabetic patients and 46 controls were recruited in the study.Color Doppler ultrasonography technique was applied to observe the IMT,diameter(D) and hemodynamics of the lower peripheral arteries and the comparison with biochemical parameters was carried out in order to reveal their correlation to the pathological changes of vascular in DM patients.ResultsIn DM group,the SR was lower than that in control group (P＜0.05).The risk factors related to the lower peripheral arteries of DM patients also were significant difference to that of control group (P＜0.05).Conclusion The decrease of SR in diabetes patients can cause the thicker IMT,which is one of the important factors leading to atherosclerosis and is correlated to various risk factors for metabolic syndrome.

ObjectiveTo determine the parameters of caudate lobe of the normal liver by ultrasonagraphy and compare with that of fatty liver and to evaluate caudate lobe's changes in patients.Methods 250 healthy subjects and 250 fatty liver patients were randomly enlisted to undergo ultrasonography to measure three diameters of length,width and thickness of the candate lobes.The differences between sexes,normal livers and fatty livers in different age groups were compared.Results In healthy adults: The measurement value of length,width and thickness of normal liver in adults were (5.068±0.45),(1.932±0.26) and 3.840±0.40 cm,respectively.The measurement value of length,width and thickness of fatty livers in adults were (5.341±0.54),(5.341±0.54) and(4.496±0.51 ) cm,respectively.Significant differences were observed in the size of caudate lobe between normal and fatty livers.Conclusion Our investigation results shows that all three parameters of fatty livers are higher compared with that of normal livers and increased size of candate lobe can be used as one indicator to diagnose the fatty liver.

Objective: To explore the association of fetal umbilical artery (UA) Doppler blood flow parameters with umbilical vein (UV) serum sEng,nitric oxide (NO) level and the perinatal outcome in patients with preeclampsia(PE). Methods: Color ultrasonography was used to detect the resistive index (RI), pulse index (PI), the peak systolic velocity (Vs), diastolic velocity (Vd) and the peak-systolic/diastolic ratio(S/D) of UA in 39 PE patients(20 cases of mild preeclampsia, 19 cases of severe preeclampsia), 20 cases of normal full-term pregnant women and 20 gestational hypertension(GH) women. The UV serum level of sEng was analyzed using enzyme-linked immunosorbent assay (ELISA). The level of NO was determined using nitric acid recovery, and to analysis of perinatal outcome. Results: Compared with normal pregnancy and GH, levels of S/D, RI, PI and sEng were significantly higher in the mild and severe preeclampsia group(P < 0.05), and levels of Vs, Vd and NO were significantly lower(P < 0.05). There was a negative correlation between the values of PI, RI and S/D with the level of UV serum NO in the mild and severe preeclampsia group(P < 0.05). There was a positive correlation between the values of PI, RI and S/D with the level of UV serum sEng in the mild and severe PE group (P < 0.05). The incidence of perinatal disease was significantly higher in PE (P < 0.05). Compared with normal perinatal infants, the abnormal perinatal infants had obviously higher levels of S/D, RI, PI and sEng (P < 0.05), and lower levels of Vs, Vd and NO(P < 0.05) in PE. Conclusion: The umbilical artery blood flow parameters can reflect the disease condition and fetal status, which has an important clinical value.

Objective To observe the effect of diet control combined with exercise on hyperlipi-demia,hyperglycemia and high blood pressure in overweight subjects. Method One hundred and four subjects (75 men and 29 women )were chosen from 6789 persons for medical examinations at health administration centre of our hospital from August to December in 2005. All of them met the following requirements: age 35-60,BMI value 24—28,high blood lipids ,high blood glucose or high blood pressure ,never using any drugs and excluding diseases with defects of heart ,liver or renal function and osteoarthritis diseases affecting physical activities. They were required to follow the plan of diet control and exercise for 24 w. The changes of their body weights (BW) ,body mass index (BMI),waist-hip ratio (WHR),total cholesterol (TC),total triglyceride (TG),high-density lipoprotein (HDL-C),low-density lipoprotein (LDL-C),fasting plasma glucose(FPG),2 hours plasma glucose (2 hPG),glycosylated haemoglobin (HbA1c),systolic blood pressure (SBP) and diastolic blood pressure (DBP) were observed . Results After 24 w intervention by diet control and exercise ,the BW ,BMI,FPG,2hPG ,HbAlc ,TC ,TG,LDL-C and SBP of the subjects studied were decreased drastically. HDL-C and DBP were not changed. Conclusion Scientific and reasonable diet pattern and rational exercise can lower the hyperlipidemia ,hyperglycemia and hypertension in overweight subjects.