The birth weight of newborns in plateau areas was lower than that in plain areas，and showed a downward trend with the increase of altitude.The average birth weight of newborns would decrease by about 100 grams for every 1 000 meters increase in altitude.The mechanism is mainly related to maternal physiological changes caused by hypoxia at high altitude，such as reduced uterine arterial blood flow，changes in placental structure and decreased nutrient transport capacity.Studies have shown that gestational age，altitude，ethnicity，maternal age and the number of prenatal visits are the main factors affecting the birth weight of newborns.The genetic adaptation mechanism of native plateau nationalities（such as Tibetans）can partially alleviate the restriction of fetal growth caused by hypoxia，but its role in ultra-high altitude（>4 500 m）needs further study.Young or advanced maternal age（≥35 years old）and inadequate prenatal care would increase the risk of low birth weight.It is suggested to strengthen health education in plateau area，promote regular prenatal examination，and explore the genetic mechanism of plateau adaptation in order to improve pregnancy outcomes.

Objective:To assess the trends in the burden of periodontal disease among individuals aged 60 years and above in China from 1990 to 2021, thereby providing a scientific foundation for the development of targeted prevention and control strategies for periodontal disease in the elderly.Methods:Utilizing data from the Global Burden of Disease Study 2021 (GBD 2021), key indicators including incidence, prevalence, and disability-adjusted life years (DALY) rates were analyzed. Age-standardized rates were determined using the global standard population. Trends in the disease burden of periodontal disease among the elderly population in China from 1990 to 2021 were analyzed using Joinpoint regression analysis, and an autoregressive integrated moving average (ARIMA) model was applied to forecast the disease burden from 2022 to 2036.Results:The annual average percentage changes (AAPC) in the number of incident cases, prevalent cases, and DALYs due to periodontal disease among individuals aged 60 years and above in China from 1990 to 2021 were 3.215% (95% CI: 3.149%-3.281%, P<0.05), 3.161% (95% CI:3.037%-3.286%, P<0.05), and 3.091%(95% CI: 2.887%-3.296%, P<0.05), respectively. The results indicated that the average annual change trends of the number of incident cases, number of prevalent cases, and number of DALYs were real upward trends. Compared with other age groups, the number of incident cases, prevalent cases, and DALYs were the highest among the population aged 60-69 years. The AAPC for age-standardized incidence rate, prevalence, and DALY rates were -0.012% (95% CI:-0.031%-0.008%, P>0.05), 0.023% (95% CI:-0.070%-0.116%, P>0.05), and 0.013% (95% CI:-0.089%-0.115%, P>0.05), respectively. This indicated that the average annual change trends of the age-standardized incidence rate, age-standardized prevalence rate, and age-standardized DALY rate might be caused by random fluctuations. Males exhibited higher prevalence and DALY rates than females across all age groups ( P<0.05), whereas the incidence rates showed minimal differences between males and females across all age groups. The ARIMA forecast model indicated that the age-standardized incidence rate among males in the elderly population in China was relatively stable, while that among females showed a downward trend; the age-standardized prevalence and DALY rates followed a pattern of "decline-rise-decline". Conclusions:The disease burden of periodontal disease among Chinese adults aged 60 and above showed an overall upward trend from 1990 to 2021, with males and individuals aged 60-69 identified as high-risk groups. With the exacerbation of aging, the prevention and control situation remains severe, necessitating the implementation of gender-differentiated interventions to reduce the disease burden.

Objective:To analyze the gallbladder morphology in ultrasound examinations of children with biliary atresia, classify them accordingly, and compare the gallbladder size of different types of patients and healthy infants.Methods:Clinical data of 711 cases with biliary atresia treated at the Department of General Surgery at the Capital Center for Children's Health, Capital Medical University from January 2017 to July 2022 were retrospectively analyzed, including 407 males and 304 females, aged (46.5±26.9) days. Additionally, 106 healthy infants recruited from the same hospital between January 2024 and March 2024 were included in the control group, including 60 males and 46 females, aged (48.5±23.9) days. The gallbladder morphology was classified into four types (A, B, C and D) based on its size and shape on ultrasonography. The long diameter of the gallbladder gradually increased, with its shape gradually approaching normal. The proportions of gender, time of jaundice onset (calculated from birth), total bilirubin, direct bilirubin, γ-glutamyl transferase (γ-GT), gallbladder contraction rate, hepatic portal cyst, and cholangiography were compared among different types. The gallbladder length and width of type D were also compared with those of the healthy control group.Resluts:Among the 711 patients, 123(17.3%) were of type A, 330 (46.4%) were of type B, 112 (15.8%) were of type C, and 146 (20.5%) were of type D. There were no statistically significant differences in the male ratio, the timing of jaundice onset, total bilirubin levels, direct bilirubin levels, or γ-GT levels among the four types of patients (all P>0.05). However, the incidences of combined hepatic portal cysts in type C and D were higher than those in type A and B (all P<0.01). Notably, 68.5% (100/146) of type D patients had a gallbladder contraction rate of ≤25%, lower than the 91.8% (303/330) of type B and 95.5% (107/112) of type C ( χ2=42.41, 29.22, both P<0.001). The success rates of cholangiography for type C and D patients were 75.0% (84/112) and 76.7% (112/146), respectively, both higher than the 11.4% (14/123) for type A and 45.2% (149/330) for type B (all P<0.001). In the healthy control group, the length and width of gallbladder were larger than those in type D patients ( t=10.64, 11.62, both P<0.001). Conclusion:The ultrasonic gallbladder morphology in biliary atresia patients is diverse, and there are no significant clinical differences among the four types. However, there are differences in gallbladder contraction rates and the success rates of gallbladder imaging. The gallbladder length and width of type D patients, with a nearly normal gallbladder morphology, are smaller than those of healthy infants at the same age.

Objective:To assess the trends in the burden of periodontal disease among individuals aged 60 years and above in China from 1990 to 2021, thereby providing a scientific foundation for the development of targeted prevention and control strategies for periodontal disease in the elderly.Methods:Utilizing data from the Global Burden of Disease Study 2021 (GBD 2021), key indicators including incidence, prevalence, and disability-adjusted life years (DALY) rates were analyzed. Age-standardized rates were determined using the global standard population. Trends in the disease burden of periodontal disease among the elderly population in China from 1990 to 2021 were analyzed using Joinpoint regression analysis, and an autoregressive integrated moving average (ARIMA) model was applied to forecast the disease burden from 2022 to 2036.Results:The annual average percentage changes (AAPC) in the number of incident cases, prevalent cases, and DALYs due to periodontal disease among individuals aged 60 years and above in China from 1990 to 2021 were 3.215% (95% CI: 3.149%-3.281%, P<0.05), 3.161% (95% CI:3.037%-3.286%, P<0.05), and 3.091%(95% CI: 2.887%-3.296%, P<0.05), respectively. The results indicated that the average annual change trends of the number of incident cases, number of prevalent cases, and number of DALYs were real upward trends. Compared with other age groups, the number of incident cases, prevalent cases, and DALYs were the highest among the population aged 60-69 years. The AAPC for age-standardized incidence rate, prevalence, and DALY rates were -0.012% (95% CI:-0.031%-0.008%, P>0.05), 0.023% (95% CI:-0.070%-0.116%, P>0.05), and 0.013% (95% CI:-0.089%-0.115%, P>0.05), respectively. This indicated that the average annual change trends of the age-standardized incidence rate, age-standardized prevalence rate, and age-standardized DALY rate might be caused by random fluctuations. Males exhibited higher prevalence and DALY rates than females across all age groups ( P<0.05), whereas the incidence rates showed minimal differences between males and females across all age groups. The ARIMA forecast model indicated that the age-standardized incidence rate among males in the elderly population in China was relatively stable, while that among females showed a downward trend; the age-standardized prevalence and DALY rates followed a pattern of "decline-rise-decline". Conclusions:The disease burden of periodontal disease among Chinese adults aged 60 and above showed an overall upward trend from 1990 to 2021, with males and individuals aged 60-69 identified as high-risk groups. With the exacerbation of aging, the prevention and control situation remains severe, necessitating the implementation of gender-differentiated interventions to reduce the disease burden.

Objective:To analyze the gallbladder morphology in ultrasound examinations of children with biliary atresia, classify them accordingly, and compare the gallbladder size of different types of patients and healthy infants.Methods:Clinical data of 711 cases with biliary atresia treated at the Department of General Surgery at the Capital Center for Children's Health, Capital Medical University from January 2017 to July 2022 were retrospectively analyzed, including 407 males and 304 females, aged (46.5±26.9) days. Additionally, 106 healthy infants recruited from the same hospital between January 2024 and March 2024 were included in the control group, including 60 males and 46 females, aged (48.5±23.9) days. The gallbladder morphology was classified into four types (A, B, C and D) based on its size and shape on ultrasonography. The long diameter of the gallbladder gradually increased, with its shape gradually approaching normal. The proportions of gender, time of jaundice onset (calculated from birth), total bilirubin, direct bilirubin, γ-glutamyl transferase (γ-GT), gallbladder contraction rate, hepatic portal cyst, and cholangiography were compared among different types. The gallbladder length and width of type D were also compared with those of the healthy control group.Resluts:Among the 711 patients, 123(17.3%) were of type A, 330 (46.4%) were of type B, 112 (15.8%) were of type C, and 146 (20.5%) were of type D. There were no statistically significant differences in the male ratio, the timing of jaundice onset, total bilirubin levels, direct bilirubin levels, or γ-GT levels among the four types of patients (all P>0.05). However, the incidences of combined hepatic portal cysts in type C and D were higher than those in type A and B (all P<0.01). Notably, 68.5% (100/146) of type D patients had a gallbladder contraction rate of ≤25%, lower than the 91.8% (303/330) of type B and 95.5% (107/112) of type C ( χ2=42.41, 29.22, both P<0.001). The success rates of cholangiography for type C and D patients were 75.0% (84/112) and 76.7% (112/146), respectively, both higher than the 11.4% (14/123) for type A and 45.2% (149/330) for type B (all P<0.001). In the healthy control group, the length and width of gallbladder were larger than those in type D patients ( t=10.64, 11.62, both P<0.001). Conclusion:The ultrasonic gallbladder morphology in biliary atresia patients is diverse, and there are no significant clinical differences among the four types. However, there are differences in gallbladder contraction rates and the success rates of gallbladder imaging. The gallbladder length and width of type D patients, with a nearly normal gallbladder morphology, are smaller than those of healthy infants at the same age.

The birth weight of newborns in plateau areas was lower than that in plain areas，and showed a downward trend with the increase of altitude.The average birth weight of newborns would decrease by about 100 grams for every 1 000 meters increase in altitude.The mechanism is mainly related to maternal physiological changes caused by hypoxia at high altitude，such as reduced uterine arterial blood flow，changes in placental structure and decreased nutrient transport capacity.Studies have shown that gestational age，altitude，ethnicity，maternal age and the number of prenatal visits are the main factors affecting the birth weight of newborns.The genetic adaptation mechanism of native plateau nationalities（such as Tibetans）can partially alleviate the restriction of fetal growth caused by hypoxia，but its role in ultra-high altitude（>4 500 m）needs further study.Young or advanced maternal age（≥35 years old）and inadequate prenatal care would increase the risk of low birth weight.It is suggested to strengthen health education in plateau area，promote regular prenatal examination，and explore the genetic mechanism of plateau adaptation in order to improve pregnancy outcomes.

Objective To observe the characteristics of infant biliary atresia(BA)missed diagnosis by ultrasound.Methods Data of 72 BA infants missed by ultrasound(false-negative,group A),72 BA infants accurately diagnosed by ultrasound(true-positive,group B)and 72 non BA infants(controls,group C)were retrospectively analyzed.Clinical and ultrasonic features were compared between each 2 groups.Logistic regression analysis was performed to screen the impact factors for diagnosing and missed-diagnosing of BA.Results There were significant differences of total bilirubin,direct bilirubin,gamma glutamyl transpeptidase(GGT)and glutamic-oxaloacetic transaminase(GOT)between group A and C,also of total bilirubin,direct bilirubin and GGT between group B and C(all P＜0.05).Significant differences of the incidences of small gallbladder,gallbladder wall rigidity,poor gallbladder contraction function and fibrous plaques in the hepatic hilum were found between group A and B,of undetected or cystic changes in the gallbladder,gallbladder wall rigidity,poor gallbladder contraction function,fibrous plaques in the hepatic hilum and hepatic hilum cysts were noticed between group A and C(all P＜0.05),as well as of undetected or cystic changes in the gallbladder,small gallbladder,gallbladder wall rigidity,gallbladder wall thickening,poor gallbladder contraction function and fibrous plaques in the hepatic hilum were detected between group B and C(all P＜0.05).There were significant differences of display rate of common bile duct between each 2 groups(all P＜0.05).The lower incidence of fibrous plaques in the hepatic hilum and poor gallbladder contraction function were an impact factors for missed diagnosis of BA(both P＜0.05),while higher GGT,higher incidence of fibrous plaques in the hepatic hilum and poor gallbladder contraction function were all impact factors for diagnosis of BA in group A(all P＜0.05).Conclusion Infant BA missed diagnosis by ultrasound had lower incidence of fibrous plaques in the hepatic hilum and poor gallbladder contractile function.Combining with clinical data was helpful for reducing ultrasonic missed diagnosis of BA in infants.

Objective:To elucidate the current proficiency level in diagnosing pediatric biliary atresia among Chinese sonographers and to identify contributing factors that may influence their diagnostic capabilities.Methods:A cross-sectional internet-based survey was conducted from November 6, 2021, to December 12, 2021. The online questionnaire was disseminated to a national cohort of sonographers via WeChat groups. The survey encompassed three domains: demographic data of the participants, clinical and ultrasonographic knowledge pertaining to biliary atresia, and the cognitive understanding of biliary atresia. Descriptive statistics were utilized for the evaluation of demographic information and sonographers' clinical and ultrasonographic comprehension concerning biliary atresia. A generalized linear model was employed to ascertain the determinants influencing sonographers' expertise in clinical management and ultrasonographic diagnosis of biliary atresia.Results:A total of 511 valid responses were collated. Approximately 64.77% (331/511) of sonographers indicated a lack of comprehensive understanding of the essential parameters for ultrasonographic diagnosis of biliary atresia. Regression analysis revealed that sonographers affiliated with lower-tier hospitals ( β=-0.344, P=0.002), non-pediatric institutions ( β=-0.747, P=0.004), and those with less than 15 years of professional experience ( β=0.952, P<0.001) exhibited diminished proficiency in diagnosing biliary atresia. Upon encountering suspected cases, a mere 5.48% (28/511) of sonographers expressed complete confidence in their diagnostic capabilities. Lower professional grade ( β=-0.572, P<0.001) and lack of prior experience with suspected cases of biliary atresia ( β=-0.693, P<0.001) contributed to reduced diagnostic self-assurance among sonographers. Regarding the clinical and ultrasonographic intricacies associated with biliary atresia, only 3.33% (17/511) of sonographers had a full understanding of the diagnostic significance of hepatic fibrous plaques on ultrasound for biliary atresia. Conclusion:The study underscores a pervasive inadequacy in the understanding and diagnostic confidence among sonographers in relation to pediatric biliary atresia. Various pragmatic factors, including hospital tier, years of experience, and professional ranking, exert a direct impact on the sonographers' diagnostic acumen. Given these findings, there is an exigent need for targeted educational initiatives to enhance the diagnostic proficiency in biliary atresia among sonographers.