Under the guidance of the national strategy "Healthy China 2030" Planning Outline and the "Healthy Children Action Improvement Plan (2021-2025)", we have ushered in a new era of comprehensively improving children's health. Central precocious puberty (CPP) is a key endocrine disease in children, and its standardized treatment is essential to prevent lifelong high impairment and psychological problems. Initiated by the China Primary Health Care Foundation, the "Spark Project - Improving the Standardized Diagnosis and Treatment of Gonadal Diseases in Children" in China aims to improve the ability of pediatric medical professionals to standardize the diagnosis and treatment of gonadal diseases, protect the healthy growth of children, and light up the light of hope.
On September 21, 2024, under the leadership of Professor Xin Ying and Professor Yang Min, the directors and backbones of pediatric endocrinology departments from 20 hospitals across the country visited the outpatient clinics and wards of the Department of Pediatric Endocrinology, Genetics and Metabolism, and appreciated the strength of the professional team integrating medicine, teaching and research. In the academic discussion session in the afternoon, all the participating experts carried out full academic discussions and exchanges on topics such as the construction of department characteristics and the diagnosis and treatment of CPP diseases, and gained a lot. This article summarizes the essence of this conference to provide reference and reference for industry colleagues.
Figure 1 Special photo of Shengjing Hospital at the exchange meeting of the Spark Project CoE Demonstration Center
Conference coverage
Excellence in piloting
The Department of Pediatric Endocrinology, Genetics and Metabolism of Shengjing Hospital has made comprehensive progress in medical teaching and research
At the beginning of the academic seminar, Professor Xin Ying from Shengjing Hospital affiliated to China Medical University delivered an opening speech as the chairman of the conference. In her speech, Professor Xin Ying elaborated on the overall development layout of the hospital's "one body and two wings" and the scale of pediatric construction, and introduced the work of the Department of Pediatric Endocrinology and Genetics and Metabolism in clinical and teaching aspects.
Figure 2 Professor Xin Ying made an opening speech
Professor Wu Na from Shengjing Hospital Affiliated to China Medical University first shared the vigorous development and outstanding achievements of the Department of Pediatric Endocrinology, Genetics and Metabolism of Shengjing Hospital Affiliated to China Medical University. Since its establishment in 1983, the department has gone through more than 40 years of precipitation, and has now developed into the leading pediatric endocrine genetic and metabolic disease diagnosis and treatment center in Northeast China. Under the excellent leadership of Director Xin Ying, the department has brought together 11 professional doctors to become an elite team integrating medicine, teaching and research, and has carried out comprehensive diagnosis and treatment services covering common diseases such as short stature, precocious puberty, diabetes, etc., and has made remarkable achievements in the diagnosis and treatment of rare diseases. In addition, the department has established a multidisciplinary collaboration (MDT) team for pediatric endocrinology, difficult diseases and rare diseases, and has carried out a number of advanced diagnosis and treatment technologies, such as gene sequencing, continuous glucose monitoring and insulin pump integration.
Figure 3 Professor Wu Na gave a keynote speech
Precise escort
Practical benefits of long-acting formulations of GnRHa in the diagnosis and treatment of CPP
Professor Tong Yajie from Shengjing Hospital Affiliated to China Medical University gave a wonderful lecture on the interpretation of the 2022 expert consensus on central precocious puberty. The 2022 version of the expert consensus provides a comprehensive update and clarification on the diagnosis and treatment of CPP. The new consensus redefines the age cut-off value for the diagnosis of CPP, and proposes that a basal LH value greater than 0.2 U/L can be used as a screening index for sexual development initiation. GnRHa is the standard treatment for children with CPP, and the consensus recommends the use of long-acting GnRHa, and multiple studies have confirmed that triptorelin in its three-month dosage form has brought significant benefits to Chinese children with CPP. Professor Tong also emphasized the importance of individualized treatment, which should comprehensively consider the progression of bone age, the results of GnRH provocation test, developmental status, and gonadal status in the diagnosis and treatment of CPP.
Figure 4 Professor Tong Yajie gave a keynote speech
Dr. Meng Lingzhe from Shengjing Hospital Affiliated to China Medical University gave a detailed introduction to the application of triptorelin in the treatment of CPP in the third month, and shared the case of a 6-year-old and 5-month-old girl who visited the hospital for bilateral breast enlargement. After the diagnosis of CPP, the child was treated with triptorelin in three months, and the level of gonadal hormone was effectively suppressed, the development of secondary sexual characteristics was stable, and the bone age was well controlled. Dr. Meng emphasized that compared to the one-month injection form, the three-month dosage form improved patient compliance, reduced the number of injections, and reduced the medical burden. He pointed out that improving long-term patient compliance is critical to treatment outcomes, and that the effectiveness and convenience of the three-month dosage form have brought additional benefits to children and their families.
Fig.5 Dr. Meng Lingzhe gave a keynote speech
Zhou Ming, head nurse of Shengjing Hospital Affiliated to China Medical University, systematically expounded the standardized process of injection operation from the introduction of the molecular structure of triptorelin dosage form in March and the clinical application at home and abroad, and emphasized the importance of various factors to ensure efficacy and safety. Nurse Zhou gave a detailed introduction to the process from drug reconstitution to injection, including how to choose the right injection site and ensure accurate injection techniques. In addition, Nurse Manager Zhou shared effective nursing strategies such as communication with children and their parents, emotional comfort, etc., and pointed out the importance of these strategies in improving children's treatment compliance and reducing injection pain, as well as the advantages of triptorelin in optimizing patient management and improving patient satisfaction.
Figure 6 Zhou Ming, the head nurse, gave a keynote speech
Professor Yang Min from Shengjing Hospital, China Medical University, shared a special case of precocious puberty, emphasizing the importance of in-depth exploration of the possible complex etiology behind the disease in clinical diagnosis. The child had a precocious puberty case of breast development at the age of 4 years and 11 months, and the bone age of 11 years was significantly ahead of the examination. The second-generation sequencing was perfected without obvious abnormalities, and the chromosomal examination showed 47,XXX, considering that the bone age of the child was significantly ahead of time, and the lifelong height and short stature were predicted, the FISH detection of sex chromosomes was further improved, and the chimeric Turner syndrome was confirmed. Professor Yang emphasized that for patients with short stature and precocious puberty, etc., with a karyotype of 47,XXX, it is necessary to pay attention to the possibility that their karyotype is mosaic. Due to the complexity of the clinical manifestations and karyotypes of chimeric TS, careful physical examination should be paid attention to avoid misdiagnosis and missed diagnosis.
Figure 7 Professor Yang Min gave a keynote speech
In this meeting, the participating experts conducted in-depth discussions on the construction of the department and the long-acting dosage form treatment of GnRHa in children with CPP. Professor Xu Xuan from Hunan Provincial People's Hospital pointed out that the long-acting dosage form of GnRHa, especially the three-month dosage form of triptorelin, can stably inhibit the secretion of gonadotropins for a long time and effectively control the progression of CPP. In addition, she emphasized the need to comprehensively consider factors such as the child's age, bone age, weight, developmental level, and whether the child has menarche when choosing a treatment plan, and strengthen the education of the child and his family. Professor Leyuan from the First Affiliated Hospital of Jinzhou Medical University shared his experience in applying triptorelin in clinical practice for three months, and pointed out the advantages of this dosage form in reducing the number of injections, improving patient compliance, and helping to manage patients in different places. At the same time, she emphasized the importance of individualized treatment plans, drug economics considerations, and adequate doctor-patient communication. Professor Li Shujun of Anshan Central Hospital shared her more than 20 years of clinical experience in the discussion, she pointed out that triptorelin has a definite effect in the clinical diagnosis and treatment of CPP, and emphasized the importance of comprehensive evaluation and close monitoring of patients' sexual development, height growth, bone age growth and other aspects during the treatment process. Professor Zhao Yongqiang of Fukuang General Hospital of Liaoning Health Industry Group pointed out that the outstanding professional strength of the outstanding team led by Director Xin Ying in the field of pediatric endocrinology and genetic metabolism has benefited patients in the surrounding areas and is worthy of reference and learning from colleagues in the industry. At the same time, he emphasized the key role of department construction in providing high-quality medical services, and should pay more attention to the diagnosis and treatment of rare diseases and difficult diseases, establish a professional team and improve auxiliary examinations, so as to further improve the diagnosis and treatment of endocrine diseases in children.
Fig.8 In the discussion session, Prof. Xu Xuan (A), Prof. Leyuan (B), Prof. Li Shujun (C) and Prof. Zhao Yongqiang (D) delivered speeches
This event brought together many classic cases and in-depth analysis by experts and scholars, which not only improved the participants' ability to diagnose and treat pediatric endocrine and genetic metabolic diseases such as precocious puberty, but also demonstrated the hospital's professional strength and teamwork spirit in the diagnosis and treatment of rare and complex diseases. Looking forward to the future, Shengjing Hospital will continue to play a leading role in the field of pediatrics, continuously promote academic exchanges and cooperation, deepen the research and diagnosis and treatment of rare diseases and complex diseases, and is committed to promoting advanced medical technology and valuable diagnosis and treatment experience to a wider region, so as to escort the healthy growth of more children and inject new vitality and hope into the cause of children's health.
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Valid until: 29.09.2026