Objective:To compare the efficacy of recombinant human growth hormone (rhGH) combined with leuprorelin versus triptorelin in the treatment of girls with central precocious puberty (CPP).Methods:A total of 80 girls with CPP admitted to Wuhan No.1 Hospital from December 2020 to December 2023 were selected and divided into the control group ( n=40) and observation group ( n=40) by the balloting method (odd numbers for the control group and even numbers for the observation group). The control group was treated with triptorelin, while the observation group was treated with rhGH combined with leuprorelin. Before and after treatment, the two groups were compared in terms of growth indicators [predicted adult height (PAH), body mass index (BMI), annual average growth velocity (ΔGV), height standard deviation score for bone age (HtSDS-BA), bone age], pelvic development (ovarian volume, uterine volume, follicle diameter), bone metabolism indicators [25-hydroxyvitamin D (25(OH)D), calcitonin (CT), parathyroid hormone (PTH), osteocalcin (BGP)], mental health [Screen for Child Anxiety Related Emotional Disorders (SCARED) score, Depression Self-Rating Scale for Children (DSRSC) score], daily behavioral ability [Achenbach Child Behavior Checklist (CBCL) score], and biochemical indicators [fasting glucose, fasting insulin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E 2)]. Results:After treatment, PAH, BMI, ΔGV, and bone age increased in both groups (all P<0.05); HtSDS-BA decreased in the control group but increased in the observation group (all P<0.05). After treatment, the observation group had higher PAH, ΔGV, and HtSDS-BA, and lower bone age than the control group (all P<0.05). After treatment the ovarian volume, uterine volume, and follicle diameter were decreased. There were no statistically significant differences in ovarian volume, uterine volume, or follicle diameter between the two groups (all P>0.05). After treatment, the observation group had higher 25(OH)D level, and lower PTH and BGP levels than the control group (all P<0.05). Regarding mental health and behavioral ability, the observation group had lower SCARED and DSRSC scores, higher social competence score, and lower behavioral problem score in CBCL than the control group (all P<0.05). Additionally, the observation group had lower levels of FSH, LH, and E 2 than the control group after treatment (all P<0.05). Conclusions:Recombinant human growth hormone combined with leuprorelin in the treatment of girls with central precocious puberty can effectively improve growth indicators, mental health, daily living ability, and bone metabolism, and reduce the levels of some sex hormones.

Objective:To compare the efficacy of recombinant human growth hormone (rhGH) combined with leuprorelin versus triptorelin in the treatment of girls with central precocious puberty (CPP).Methods:A total of 80 girls with CPP admitted to Wuhan No.1 Hospital from December 2020 to December 2023 were selected and divided into the control group ( n=40) and observation group ( n=40) by the balloting method (odd numbers for the control group and even numbers for the observation group). The control group was treated with triptorelin, while the observation group was treated with rhGH combined with leuprorelin. Before and after treatment, the two groups were compared in terms of growth indicators [predicted adult height (PAH), body mass index (BMI), annual average growth velocity (ΔGV), height standard deviation score for bone age (HtSDS-BA), bone age], pelvic development (ovarian volume, uterine volume, follicle diameter), bone metabolism indicators [25-hydroxyvitamin D (25(OH)D), calcitonin (CT), parathyroid hormone (PTH), osteocalcin (BGP)], mental health [Screen for Child Anxiety Related Emotional Disorders (SCARED) score, Depression Self-Rating Scale for Children (DSRSC) score], daily behavioral ability [Achenbach Child Behavior Checklist (CBCL) score], and biochemical indicators [fasting glucose, fasting insulin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E 2)]. Results:After treatment, PAH, BMI, ΔGV, and bone age increased in both groups (all P<0.05); HtSDS-BA decreased in the control group but increased in the observation group (all P<0.05). After treatment, the observation group had higher PAH, ΔGV, and HtSDS-BA, and lower bone age than the control group (all P<0.05). After treatment the ovarian volume, uterine volume, and follicle diameter were decreased. There were no statistically significant differences in ovarian volume, uterine volume, or follicle diameter between the two groups (all P>0.05). After treatment, the observation group had higher 25(OH)D level, and lower PTH and BGP levels than the control group (all P<0.05). Regarding mental health and behavioral ability, the observation group had lower SCARED and DSRSC scores, higher social competence score, and lower behavioral problem score in CBCL than the control group (all P<0.05). Additionally, the observation group had lower levels of FSH, LH, and E 2 than the control group after treatment (all P<0.05). Conclusions:Recombinant human growth hormone combined with leuprorelin in the treatment of girls with central precocious puberty can effectively improve growth indicators, mental health, daily living ability, and bone metabolism, and reduce the levels of some sex hormones.

Objective:To analyze the relationship between plasma uranium concentration and renal injury.Methods:A case-control study was conducted in Hunan province, involving 102 renal injury cases and 102 matched controls. The association between plasma uranium concentration and renal injury was analyzed using conditional logistic regression models, and the dose-response relationship was analyzed through restricted cubic spline regression. The linear regression model and Spearman correlation were used to analyze the association between plasma uranium concentration and renal injury indicators.Results:The median of plasma uranium concentration was 8.94 ng/L in all subjects and 10.19 ng/L in the case group. The plasma uranium may be a risk factor for renal injury, with a dose-response relationship between the both representing nonlinear association ( χ2=5.15, P<0.05). The risk of renal injury was 4.21 times higher in the group exposed to highest uranium concentration than that in the group exposed to lowest uranium concentration. Plasma uranium concentration was closely related to glomerular filtration rate, serum creatinine and β 2-microglobulin ( r=0.211, -0.142, 0.195, P<0.05). Conclusions:The plasma uranium concentration is significantly associated with the renal injury, which may provide epidemiology evidence for the prevention of renal injury.

Objective:To summarize the ultrasound manifestations of submucosal cleft palate, and explore the diagnostic value of prenatal ultrasound for submucosal cleft palate.Methods:A total of 21 146 pregnant women who underwent fetal ultrasound examination in the second and third trimesters in the Affiliated Hospital of Jining Medical University from January 2013 to May 2018 were collected. They were all singleton pregnancy. The ultrasound image which was the horizontal plate of the palatine bone at the posterior border of the fetal hard palate was routinely obtained. The presence of bone loss at the posterior border of the hard palate was defined as a positive case. Then the palate targeted ultrasound examinations of the positive cases were performed to observe the continuity of the soft palate. The ultrasound images of positive cases were compared with the results of induction or delivery, and their postpartum diagnosis and treatment were tracked.Results:A total of 44 simple cleft palate were detected in 21 146 fetuses, including 23 dominant cleft palate and 21 submucosal cleft palate. Two cases of 21 submucosal cleft palate were induced because of other deformities, the other 19 cases were born. The follow-up of the 19 submucosal cleft palate cases showed that 15 cases visited to stomatology department before 3 years of age, and 2 cases of newborns with dominant cleft palate were misdiagnosed as submucosal cleft palate by prenatal ultrasound, and the other13 of them were clinically diagnosed as submucosal cleft palate. The ultrasound of the submucosal cleft palate showed there was no inverted "V" -shaped bone in the posterior edge of the hard palate which was connected by a membranous connection, and the soft palate was complete, but the center of soft palate was thinner or even present membranous hyperechoic in ultrasound.Conclusions:Submucosal cleft palate has characteristic ultrasound features, and prenatal ultrasound make a diagnosis and provide some basis for obtaining early diagnosis and treatment after birth.

Background Exposure to uranium can result in multi-organ toxicity in humans. Some experimental studies have shown that uranium presents a damaging effect on liver, but no relevant population studies have been reported. Objective To investigate a potential association of plasma uranium exposure with liver injury. Methods The inhabitants of two representative areas of heavy metal pollution in northern and southern Hunan were selected as the research subjects. A total of 740 participants were recruited through 1∶1 paired case-control design based on a pre-determined diagnostic criterion for liver injury (defined as two or more anomalies among alanine aminotransferase, aspartate aminotransferase, and total bilirubin in the health examination) and the principle of case-control comparability. Information such as general demographic characteristics and medical history were collected through questionnaires and physical examination. Plasma uranium and liver function were determined by laboratory tests. Spearman correlation was applied to assess the association between plasma uranium concentration and liver injury indexes, and restricted cubic spline model was used to evaluate the dose-response relationship between plasma uranium concentration and liver injury. The participants were divided into four groups from Q1 to Q4 according to the quartile values of plasma uranium concentration of the control group after natural logarithmic transformation (with the Q1 group as the reference group), and the association between plasma uranium concentration and liver injury was evaluated by conditional logistic regression. Results The plasma uranium level in M (P₂₅, P₇₅) of the case group was 10.89 (6.78-18.53) ng·L⁻¹, higher than that in the control group, 9.26 (5.01-14.38) ng·L⁻¹ (P<0.001). The results of Spearman correlation analysis showed that alanine aminotransferase and aspartate aminotransferase were positively correlated with plasma uranium level (r_s=0.138, r_s=0.167; P<0.001). The restricted cubic spline model showed that the risk of liver injury increased with the increase of plasma uranium concentration (overall effect P<0.001). After adjusting for confounding factors such as gender, age, smoking, alcohol consumption, and prevalence of hypertension and hyperlipidemia, the results of conditional logistic regression analysis showed that the risks of liver injury in the Q2 group, the Q3 group, and the Q4 group were 2.043 (95%CI: 1.135-3.680), 2.246 (95%CI: 1.238-4.075), and 3.536 (95%CI: 1.955-6.397) times higher than that of the Q1 group respectively. Conclusion Plasma uranium exposure is associated with liver injury. This study is the first to provide population-level evidence of such an association.