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 analyze the factors influencing the mobilization and collection of peripheral blood hematopoietic stem cells in patients with hematologic tumors,and to explore the predictive value of platelet counts in the process of autologous stem cell collection.Methods A total of 52 patients with hematologic tumors who underwent autologous hematopoietic stem cell transplantation in Affiliated Jinhua Hospital,Zhejiang University School of Medicine from September 2018 to March 2024 were selected.Binary Logistic regression analysis was used to explore the influencing factors of peripheral blood stem cell collection,and receiver operating characteristic(ROC)curve was used to determine the optimal cut-off value of platelet counts before collection.Results Among the 52 patients,36 patients had high-quality mobilization and 16 patients had non-high-quality mobilization.The number of chemotherapy cycles before collection and mobilization plan had significant effects on the number of CD34+cells collected,while age,gender,collection machine,and bone marrow involvement had no significant effects on the number of CD34+cells collected.The platelet counts in high-quality mobilization group were significantly higher than those in non-high-quality mobilization group(P＜0.05).Binary Logistic regression analysis showed that platelet counts before collection had a significant effect on the collection of peripheral blood stem cells(OR=0.975,95％CI:0.954-0.997,P=0.025).ROC curve results showed that the area under the curve of platelet counts prediction of stem cell quality collection was 0.732,the optimal cut-off value was 86×109/L,the sensitivity was 72.2％,and the specificity was 81.2％.Subgroup analysis showed that platelet transfusion had no significant effect on the number of CD34+cells.Conclusion The number of chemotherapy cycles before collection and mobilization plan can affect the number of autologous hematopoietic stem cells.The platelet counts before collection can help determine the best time for collection and improve the success rate of collection.

Objective:To explore and compare the clinical application value of 8-channel head phased-array coil, an 8-channel temporomandibular joint (TMJ)-specific surface coil, and a single-channel surface coil in TMJ MRI examinations.Methods:A total of 600 temporomandibular disorders (TMD) patients (1 200 joints) who underwent TMJ MRI examination in the First People′s Hospital of Jinzhong from June 2020 to January 2025 were retrospectively screened. Based on inclusion/exclusion criteria, 120 TMD patients (240 joints) with closed-mouth oblique sagittal proton density weighted imaging (OSag PDWI), coronal T2 fat-suppression weighted imaging (OCor fs T2WI) and open-mouth oblique sagittal proton density weighted imaging (OSag PDWI) were included. Patients were divided into groups A, B, and C, with 40 cases in each group. Group A (31female, 9male, median age 24 years old), underwent 8-channel head phased-array coil imaging. Group B (29 female, 11male, median age 23.5 years old) underwent TMJ imaging with an 8-channel surface coil. Group C (29 female, 11male, median age 22.5 years old) underwent single-channel surface coil imaging. There were no significant differences in age, gender, type or disease types among groups ( P>0.05). Six healthy volunteers without TMD (4 female, 2 male, range 19 to 45 years old) underwent imaging with all three coils as self-control. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and image quality were compared for five regions of interest (ROI) in both patients and volunteers. Results:Under the same sequence and the same parameters, SNR and CNR in group B were higher than those in group A, and SNR and CNR in group C were also higher than those in group A, the differences were statistically significant ( P<0.05). However, there were significant differences in SNR and CNR between group B and group C in the closed and open positions of ROI1, the open positions of ROI3 and the open positions of ROI5 ( P<0.05), and there were no significant differences in other positions ( P>0.05). Group B had the best image quality, followed by group C and group A had the worst image quality. There were significant differences in the visualization of OSag PDWI in the closed mouth position, OCor T2WI in the coronal position, and OSag PDWI in the open mouth position, such as condyle, anterior attachment, joint disc, double lamina area, joint cavity and lateral pterygoid muscle ( P<0.05). There were significant differences between group B and group C in showing the joint cavity in the closed mouth position and showing the structure of the bilaminar area in the open mouth position ( P<0.05). There was no significant difference in other regions of interest ( P>0.05). The subjective scores of condyle, anterior attachment, articular disc, bilaminar area, articular cavity, lateral pterygos muscle and other structures were medium to high in group A, high in group B, and high or high in group C by two radiologists independently. In the five rois, the 8-channel TMJ surface coil showed more details, especially in the articular disc, condyle and lateral pterygoid muscle regions, and had more advantages in both volunteers and patients. Conclusions:The 8-channel TMJ-specific surface coil provides significantly clearer visualization of critical anatomical details within the ROIs, demonstrating the highest clinical application value and is recommended as the preferred choice.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To investigate the clinical effect of indocyanine green angiography (ICGA)-assisted design and harvest of expanded flaps for scar reconstruction.Methods:This study was a retrospective observational study. From April 2019 to August 2023, 19 patients with scars (8 males, 11 females; aged 3-38 years) treated at the Plastic Surgery Hospital of Peking Union Medical College and Chinese Academy of Medical Sciences met the inclusion criteria. The scars were distributed on the head, face, trunk, and extremities. In stage Ⅰ surgery, skin soft tissue expanders were implanted in suitable areas around the scars for skin soft tissue expansion. In stage Ⅱ surgery, the scar tissue was excised, resulting in wound areas ranging from 100 to 210 cm 2, and expanded flaps were designed. ICGA was used to identify target perforators and their accompanying veins, and the flap design was adjusted to ensure the inclusion of complete arterial and venous axes. The expanded flap with an area of 120 to 240 cm2 was harvested using unilateral back-cut technique and transferred to the recipient site, and the donor site wound was sutured directly. The durations of the arterial and venous phases of ICGA during flap design were recorded. The length-to-width ratios of the back-cut flaps were calculated for different regions. After stage Ⅱ surgery, the blood perfusion and survival of the flap, the wound healing at the donor site, and the occurrence of complications were observed. During follow-up, the appearance, color, and texture of the patient's flap were observed. Results:The arterial phase of ICGA lasted 10-27 (18±5) s, and the venous phase lasted 78-116 (100±10) s. The length-to-width ratios of the back-cut flaps were 1.22±0.32, 1.63±0.12, and 1.15±0.21 for the head and neck, trunk, and limb regions, respectively. After stage Ⅱ surgery, one patient had a large area of insufficient blood perfusion in the flap. By comparing ICGA images before and after flap transfer, the sutures at the oral commissure were loosened, the blood flow of the flap was restored. The blood perfusion of the flaps in other patients was good. All flaps survived completely, with well-healed donor site wounds and no complications. During 0.5-14.0 months of follow-up, all flaps of patients demonstrated excellent appearance, with color and texture matching the surrounding skin.Conclusions:As a means of superficial blood flow visualization, ICGA can not only clearly show the microvascular distribution of the expanded flap before operation, assist in optimizing the design of the flap, but also evaluate the blood perfusion of the flap after operation, reduce the occurrence of complications, and provide a full-process navigation for the harvesting of expanded flaps, thereby improving the safety of flap transfer for scar reconstruction.

There is a large gap between production and demand of plant oil in China, which leads to the heavy reliance on imports. Diacylglycerol acyltransferase (DGAT) and phospholipid: diacylglycerol acyltransferase (PDAT) are two key enzymes responsible for the synthesis of triacylglycerol, thereby affecting the yield and quality of plant oil. This paper comprehensively reviews the research progress in DGAT and PDAT in terms of their biological functions in plant oil synthesis, the molecular mechanisms of regulating plant lipid metabolism, growth, and development under stress, and their roles in driving oil synthesis under the background of synthetic biology. Furthermore, future research and application of DGAT and PDAT are prospected. This review aims to provide a basis for deeply understanding the molecular mechanism of plant oil synthesis and improving the quality and productivity of oil crops by the utilization of DGAT and PDAT genes.
Diacylglycerol O-Acyltransferase/physiology* ; Plant Oils/metabolism* ; Acyltransferases/metabolism* ; Lipid Metabolism/genetics* ; Gene Expression Regulation, Plant ; Triglycerides/biosynthesis*

Objective:To analyze the risk factors for children with severe community-acquired pneumonia (CAP) being admitted to the pediatric intensive care unit (PICU),and establish a clinical prediction model,then evaluate the clinical application value of this model.Methods:A retrospective analysis was performed on children diagnosed with severe CAP at the Children's Hospital Affiliated to School of Medicine of Shanghai Jiao Tong University from January to June 2023.The children were divided into the PICU group and the non-PICU group based on whether they were admitted to PICU at admission.The differences in pediatric early warning score（PEWS），clinical characteristics，and laboratory test results between the two groups at their last visit before admission were compared. The independent risk factors for children with severe CAP admitted to PICU were analyzed,and a clinical prediction model was established,which was validated through the receiver operating characteristic (ROC) curve.Results:A total of 274 children were included,including 141 males and 133 females,with a median age of 50 (24,81) months. There were 43 cases in PICU group and 231 cases in non-PICU group.There were no statistically significant differences in gender and age between the two groups of children ( P>0.05). The PEWS score,white blood cell count,neutrophil count,neutrophil/lymphocyte ratio,procalcitonin (PCT),and lactate levels of children in the PICU group were significantly higher than those of children in the non-PICU group.While the duration of fever,peak temperature,and percutaneous arterial oxygen saturation (SpO 2) were significantly lower in the PICU group than those in the non-PICU group. All these differences were statistically significant ( P<0.05).Binary Logistic regression analysis showed that PEWS>4 points（ OR=6.583，95% CI 1.763 - 24.588， P<0.05），PCT>0.42 μg/L（ OR=19.046，95% CI 4.362-83.159， P<0.05），and SpO 2<93%（ OR=21.670，95% CI 3.843-122.184， P<0.05）were independent risk factors for children with severe CAP to be admitted to PICU.A clinical prediction model was constructed based on the above three independent risk factors.The area under ROC curve of the clinical prediction model was 0.941（95% CI 0.913-0.968， P<0.05），the sensitivity was 95.3%，the specificity was 80.5%，the positive predictive value was 83.0%，and the negative predictive value was 94.5%. Conclusion:For children with severe CAP，if they have PEWS > 4,an elevated PCT level，and a decreased SpO 2，it is recommended that they be admitted to PICU for further monitoring and treatment.The clinical prediction model for admission to the PICU for children with severe CAP，constructed by combining PEWS with commonly used clinical information in pediatric emergency，has a relatively high predictive efficacy and can provide a reference for the stratified diagnosis and treatment of children with severe CAP in the future.

Objective:To explore and compare the clinical application value of 8-channel head phased-array coil, an 8-channel temporomandibular joint (TMJ)-specific surface coil, and a single-channel surface coil in TMJ MRI examinations.Methods:A total of 600 temporomandibular disorders (TMD) patients (1 200 joints) who underwent TMJ MRI examination in the First People′s Hospital of Jinzhong from June 2020 to January 2025 were retrospectively screened. Based on inclusion/exclusion criteria, 120 TMD patients (240 joints) with closed-mouth oblique sagittal proton density weighted imaging (OSag PDWI), coronal T2 fat-suppression weighted imaging (OCor fs T2WI) and open-mouth oblique sagittal proton density weighted imaging (OSag PDWI) were included. Patients were divided into groups A, B, and C, with 40 cases in each group. Group A (31female, 9male, median age 24 years old), underwent 8-channel head phased-array coil imaging. Group B (29 female, 11male, median age 23.5 years old) underwent TMJ imaging with an 8-channel surface coil. Group C (29 female, 11male, median age 22.5 years old) underwent single-channel surface coil imaging. There were no significant differences in age, gender, type or disease types among groups ( P>0.05). Six healthy volunteers without TMD (4 female, 2 male, range 19 to 45 years old) underwent imaging with all three coils as self-control. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and image quality were compared for five regions of interest (ROI) in both patients and volunteers. Results:Under the same sequence and the same parameters, SNR and CNR in group B were higher than those in group A, and SNR and CNR in group C were also higher than those in group A, the differences were statistically significant ( P<0.05). However, there were significant differences in SNR and CNR between group B and group C in the closed and open positions of ROI1, the open positions of ROI3 and the open positions of ROI5 ( P<0.05), and there were no significant differences in other positions ( P>0.05). Group B had the best image quality, followed by group C and group A had the worst image quality. There were significant differences in the visualization of OSag PDWI in the closed mouth position, OCor T2WI in the coronal position, and OSag PDWI in the open mouth position, such as condyle, anterior attachment, joint disc, double lamina area, joint cavity and lateral pterygoid muscle ( P<0.05). There were significant differences between group B and group C in showing the joint cavity in the closed mouth position and showing the structure of the bilaminar area in the open mouth position ( P<0.05). There was no significant difference in other regions of interest ( P>0.05). The subjective scores of condyle, anterior attachment, articular disc, bilaminar area, articular cavity, lateral pterygos muscle and other structures were medium to high in group A, high in group B, and high or high in group C by two radiologists independently. In the five rois, the 8-channel TMJ surface coil showed more details, especially in the articular disc, condyle and lateral pterygoid muscle regions, and had more advantages in both volunteers and patients. Conclusions:The 8-channel TMJ-specific surface coil provides significantly clearer visualization of critical anatomical details within the ROIs, demonstrating the highest clinical application value and is recommended as the preferred choice.

Objective:To analyze the risk factors for children with severe community-acquired pneumonia (CAP) being admitted to the pediatric intensive care unit (PICU),and establish a clinical prediction model,then evaluate the clinical application value of this model.Methods:A retrospective analysis was performed on children diagnosed with severe CAP at the Children's Hospital Affiliated to School of Medicine of Shanghai Jiao Tong University from January to June 2023.The children were divided into the PICU group and the non-PICU group based on whether they were admitted to PICU at admission.The differences in pediatric early warning score（PEWS），clinical characteristics，and laboratory test results between the two groups at their last visit before admission were compared. The independent risk factors for children with severe CAP admitted to PICU were analyzed,and a clinical prediction model was established,which was validated through the receiver operating characteristic (ROC) curve.Results:A total of 274 children were included,including 141 males and 133 females,with a median age of 50 (24,81) months. There were 43 cases in PICU group and 231 cases in non-PICU group.There were no statistically significant differences in gender and age between the two groups of children ( P>0.05). The PEWS score,white blood cell count,neutrophil count,neutrophil/lymphocyte ratio,procalcitonin (PCT),and lactate levels of children in the PICU group were significantly higher than those of children in the non-PICU group.While the duration of fever,peak temperature,and percutaneous arterial oxygen saturation (SpO 2) were significantly lower in the PICU group than those in the non-PICU group. All these differences were statistically significant ( P<0.05).Binary Logistic regression analysis showed that PEWS>4 points（ OR=6.583，95% CI 1.763 - 24.588， P<0.05），PCT>0.42 μg/L（ OR=19.046，95% CI 4.362-83.159， P<0.05），and SpO 2<93%（ OR=21.670，95% CI 3.843-122.184， P<0.05）were independent risk factors for children with severe CAP to be admitted to PICU.A clinical prediction model was constructed based on the above three independent risk factors.The area under ROC curve of the clinical prediction model was 0.941（95% CI 0.913-0.968， P<0.05），the sensitivity was 95.3%，the specificity was 80.5%，the positive predictive value was 83.0%，and the negative predictive value was 94.5%. Conclusion:For children with severe CAP，if they have PEWS > 4,an elevated PCT level，and a decreased SpO 2，it is recommended that they be admitted to PICU for further monitoring and treatment.The clinical prediction model for admission to the PICU for children with severe CAP，constructed by combining PEWS with commonly used clinical information in pediatric emergency，has a relatively high predictive efficacy and can provide a reference for the stratified diagnosis and treatment of children with severe CAP in the future.

Objective To analyze the factors influencing the mobilization and collection of peripheral blood hematopoietic stem cells in patients with hematologic tumors,and to explore the predictive value of platelet counts in the process of autologous stem cell collection.Methods A total of 52 patients with hematologic tumors who underwent autologous hematopoietic stem cell transplantation in Affiliated Jinhua Hospital,Zhejiang University School of Medicine from September 2018 to March 2024 were selected.Binary Logistic regression analysis was used to explore the influencing factors of peripheral blood stem cell collection,and receiver operating characteristic(ROC)curve was used to determine the optimal cut-off value of platelet counts before collection.Results Among the 52 patients,36 patients had high-quality mobilization and 16 patients had non-high-quality mobilization.The number of chemotherapy cycles before collection and mobilization plan had significant effects on the number of CD34+cells collected,while age,gender,collection machine,and bone marrow involvement had no significant effects on the number of CD34+cells collected.The platelet counts in high-quality mobilization group were significantly higher than those in non-high-quality mobilization group(P＜0.05).Binary Logistic regression analysis showed that platelet counts before collection had a significant effect on the collection of peripheral blood stem cells(OR=0.975,95％CI:0.954-0.997,P=0.025).ROC curve results showed that the area under the curve of platelet counts prediction of stem cell quality collection was 0.732,the optimal cut-off value was 86×109/L,the sensitivity was 72.2％,and the specificity was 81.2％.Subgroup analysis showed that platelet transfusion had no significant effect on the number of CD34+cells.Conclusion The number of chemotherapy cycles before collection and mobilization plan can affect the number of autologous hematopoietic stem cells.The platelet counts before collection can help determine the best time for collection and improve the success rate of collection.