Background: We aimed to analyze the characteristics of the body composition of children and adolescents aged 3–17 in Suzhou, China. Methods: A cross-sectional study between January 2020 and June 2022 using bioelectrical impedance was conducted to determine the fat mass (FM), fat-free mass (FFM), skeletal muscle mass, and protein and mineral contents of 24,845 children aged 3–17 who attended the Department of Child and Adolescent Healthcare, Children’s Hospital of Soochow University, China. Measurement data was presented in tables as mean ± SD, and groups were compared using the independent samples t-test. Results: FM and fat-free mass increased with age in both boys and girls. The fat-free mass of girls aged 14–15 decreased after reaching a peak, and that of boys in the same age group was higher than that of the girls (p < 0.05). There were no significant differences in FM between boys and girls younger than 9- and 10-years old. The percentage body fat (PBF) and FM index of girls increased rapidly between 11 and 15 years of age (p < 0.05), and those of boys aged 11–14 were significantly lower (p < 0.05), suggesting that the increase in body mass index (BMI) was mainly contributed by muscle mass (MM) in boys. Conclusions: The body composition of children and adolescents varies according to their age and sex. A misdiagnosis of obesity made on the basis of BMI alone can be avoided if BMI is used in combination with FM index, percentage body fat, and other indexes.

Gallbladder torsion (GT), characterized by the axial rotation of the cystic duct and cystic artery, is a critical condition that predominantly affects elderly women and is infrequently observed in children. Chronic cholecystitis associated with incomplete GT is a particularly rare phenomenon. This article presents a pediatric case of chronic cholecystitis associated with incomplete GT. Ultrasonography and magnetic resonance cholangiopancreatography (MRCP) were utilized to confirm the diagnosis in the child. Laparoscopic cholecystectomy was successfully performed on the child, with no postoperative complications. For children with chronic cholecystitis associated with incomplete GT, clinical manifestations may improve. However, due to the presence of congenital anatomical abnormalities, children's symptoms may recur. Early laparoscopic cholecystectomy can prevent the acute onset of torsion and potential difficulties in diagnosis at later stages.

Background: Acute Kidney Injury (AKI) is a frequent post-operative complication following cardiac surgery in the clinical setting. Iron metabolism disorders are a key cause of kidney injury during the ischemia-reperfusion (IR) process. However, the role of iron metabolites in prediction of AKI remains unidentified. This study investigates the roles of iron metabolites ferritin, transferrin, and hepcidin in prediction of the occurrence and severity of AKI in children following cardiac surgery. Methods: Serum and urine samples were collected from 219 children with the age from 1 to 36 months undergoing cardiopulmonary bypass (CPB), both preoperatively and postoperatively at 0 h and 6 h. Serum ferritin, urinary transferrin, and urinary hepcidin levels were measured. Results: Among the included 219 children, 66 developed AKI postoperatively. Serum ferritin, urinary transferrin, and urinary hepcidin were significantly associated with the occurrence of AKI after CPB. The area under the receiver operating characteristic curve (AUC) for serum ferritin and urinary transferrin at 6 h postoperatively, and hepcidin at 0 h postoperatively achieved optimal values (serum ferritin AUC:0.804; urinary transferrin AUC:0.805; urinary hepcidin AUC:0.894). The combined analysis of the three biomarkers yielded a higher AUC than individual biomarkers alone. The combined biomarker panel demonstrated favourable predictive performance across all AKI severity stages. Conclusions: Ferritin, transferrin, and hepcidin serve as early predictive markers for AKI associated with cardiac surgery in children and are independent predictors for postoperative AKI. These biomarkers exhibit a good early predictive capacity for the severity of AKI.

We report a rare case of primary clinical presentation featuring elevated creatine kinase (CK) levels in a neonate, which is associated with the LAMA2 gene. In this case, a heterozygous mutation in exon5 of the LAMA2 gene, c.715C>G (resulting in a change of nucleotide number 715 in the coding region from cytosine to gua nine), induced an amino acid alteration p.R239G (No. 239) in the patient, repre senting a missense mutation. This observation may be elucidated by the neonatal creatine monitoring mechanism, a phenomenon not previously reported. We analysed the case of a neonate presenting solely with elevated CK levels who was eventually discharged after supportive treatment. The chief complaint was identification of increased CK levels for 15 d and higher CK values for 1 d. Ad mission occurred at 18 d of age, and despite prolonged treatment with creatine and vitamin C, the elevated CK levels showed limited improvement. Whole exo me sequencing revealed the presence of a c.715C>G mutation in LAMA2 in the newborn, correlating with a clinical phenotype. However, the available informa tion offers insufficient evidence for clinical pathogenicity. Mutations in LAMA2 are associated with the clinical phenotype of increased neonatal CK levels, for which no specific treatment exists. Whole genome sequen cing facilitates early diagnosis.