[Health Byte] is your insider guide to navigating Shanghai's health maze. From the labyrinth of public and private healthcare options to the pulse of cutting-edge medical services, we've got you covered. Each bite-sized article ends with a health tip, making wellness in the city more accessible than ever. Wondering about hospital features, where to find bilingual medics, or the scoop on insurance coverage? "Health Byte" breaks it down, offering clear, actionable insights.

Children's Day is coming up on June 1 – a gentle reminder that the little people in our lives are growing fast, probably eating too much sugar, and potentially developing an orthopedic condition or two. This week, we're taking a look at the usual suspects: flat feet, curved spines, and legs that don't quite point in the same direction. Local experts weighed in, because if there's one thing parents in Shanghai do better than enroll their kids in cram school, it's worry about their anatomy.

Flat Feet, Fallen Arches, and the Fear of the Orthopedic Future

There are two golden windows when your kid's feet are doing weird things, and apparently that's perfectly normal. First is around age 3 or 4, when they've just figured out how to walk without face-planting. You might notice bow-legged waddling or pancake-flat feet. The second phase comes during puberty, when everything grows too fast and often in the wrong direction.

"Physical exercise and barefoot walking are great for foot development," says Dr Ma Xin of Shanghai Sixth People's Hospital – home to the National Orthopedics Center and presumably a lot of very concerned parents. "But modern parents are bubble-wrapping their kids. No one likes sports anymore."

If your child's feet are looking suspiciously archless, don't panic. It's called pediatric flatfoot, or pes planus if you want to sound fancy at brunch. Most of the time, it's painless and harmless, no surgery required. But Dr Ma notes that if there's foot pain, uneven shoulders, or your kid suddenly starts walking like a pirate, it's worth checking in. Left unchecked, flat feet can put a twist in the spine – and not in the fun, yogic way.

"Annual screening is a good idea," Ma adds. "If there are no symptoms, don't intervene. But if your kid's in pain, don't just Google it – talk to a doctor."

When flat feet do need attention, the usual playbook starts soft: physical therapy, over-the-counter insoles, or the orthopedic Holy Grail – custom orthotics. According to Dr Ma, these often do the trick, sparing kids from the sharp end of the scalpel.

"Surgery is the last resort," he says, "but when it's needed, it works well."

Shanghai's medical community, in true hyper-efficient fashion, is leaning hard into early screening and gentle intervention. The goal? Catch the wobbly arches before they snowball into surgical cases – because nobody wants to put their teenager in a cast unless absolutely necessary.

Curved Spines and Straight Talk: When Posture Becomes a Diagnosis

In the city where kindergarteners can recite English idioms but forget to blink during iPad time, spine health has quietly elbowed its way into the top three childhood medical concerns – right behind myopia and obesity. That's right: Shanghai's kids are not just squinting and snacking their way through adolescence, they're also curving.

An estimated 3 percent of Chinese primary and middle schoolers – over five million kids – are developing scoliosis, or "curved spine" if you prefer the visual. And the numbers aren't leveling off. They're growing by 300,000 a year, mostly undetected, mostly untreated, until something starts to look visibly off or socially awkward.

Treatment depends on the angle of the curve. Under 20 degrees? Stretching and sports. Between 20 and 40? Break out the brace. Over 40? Now you're in surgery territory.

"Parents usually don't notice until it's already affecting their kid's mood, growth, or confidence," says Dr Sun Wuquan, director of the Tuina Department at Yueyang Hospital. "It's a creeping issue, and early intervention is everything."

Interestingly, Shanghai is treating this not just with Western diagnostics and spinal braces, but also with a full-throttle mix of Traditional Chinese Medicine. Tuina – the therapeutic cousin of massage – has been applied to scoliosis for over three decades at Yueyang. Their current model? A spine squad assembled from departments in rehab, imaging, surgery, acupuncture, and pediatrics, all under one roof, working in tandem like a medical Avengers team.

Integrated medicine: now with posture checks.

The Myopia Epidemic: Kids, Screens, and a City Going Nearsighted

If your child is in school in Shanghai and can still see the back of the classroom, they're officially a statistical outlier.

According to the National Health Commission, myopia is now a national epidemic among China's youth. Over half of minors are nearsighted – 52.7 percent, to be exact – and the numbers only climb with age. By high school, more than 80 percent are squinting their way through class. In Shanghai? It's worse. Of course it is.

As of 2023, nearly 87 percent of high schoolers in the city are dealing with myopia. Middle schoolers aren't far behind at 78 percent, and even half of primary school students are already in glasses. If you've been wondering why opticians seem to be multiplying like bubble tea shops – well, now you know.

Local health and education authorities aren't blind to the issue (pun intended). They've rolled out a barrage of intervention plans tailored to different risk levels, because not all eyeballs deteriorate at the same speed.

Meanwhile, the Shanghai Children's Foundation has teamed up with Shanghai Ai'er Eye Hospital on a mission to make myopia prevention a family affair. Four rounds of charity initiatives, 200-plus public events, and a lot of PowerPoint slides later, they're teaching parents to care as much about axial length as they do about math scores.

Natural Light, Cloudy Days & Balcony Staring: The Science of Seeing Straight

Turns out the best thing for your kid's eyesight isn't another round of Kumon or an iPad loaded with "educational" apps. It's sunlight – old-fashioned, UV-filtered, dopamine-stimulating daylight. Two hours a day, preferably outdoors, preferably not between 10 am and 4 pm unless you're also a fan of heatstroke.

Even cloudy skies help, says Dr Deng Dan of Shanghai Children's Medical Center. If outdoor time is off the table, even staring wistfully into the distance from a balcony window might delay the dreaded axial eye growth that leads to myopia.

Of course, with sunshine comes responsibility. "Sun-proofing" is the word of the day. Hats. Sleeves. Sunscreen applied 15-20 minutes before leaving home and reapplied every two hours like clockwork. If your kid comes back looking like a lobster, cold towels and hospital visits might be next on the itinerary.

Weapons Against Myopia: From Hard Lenses to Soft Drugs

Shanghai's defense against worsening vision doesn't stop at sunlight. There's also a full arsenal of interventions, depending on age and diopter count.

• Orthokeratology lenses (Ortho-K): hard contact lenses worn overnight that temporarily reshape the cornea – suitable for kids over 8 with moderate myopia.
  
• Defocus spectacle lenses: glasses with a clever optical trick, aimed at slowing progression for the under-7 crowd.
  
• Low-dose atropine eye drops: 0.01% concentration, a pharmaceutical whisper that works for some kids without frying their pupils.
  

When All Else Fails: Laser Beams and Artificial Lenses

For the truly committed – or truly myopic – there's always surgery. LASIK reshapes the cornea like a sculptor with a laser beam. ICL drops a micro-lens behind your iris like a high-tech contact lens that lives inside your eye rent-free.

And Shanghai? Shanghai doesn't just do these procedures. It leads the world in them. Fudan University's Eye, Ear, Nose and Throat Hospital performs more myopia surgeries than anywhere else on the planet. Recently, they debuted the SMILE Pro – the Tesla of refractive surgery tech. One eye, ten seconds. Blink and it's done. Literally.

Medical Highlight in Shanghai

Breathing Easier: Lung Biopsies Go High-Tech

If you've ever had a doctor say, "We found a spot on your lung," you know what comes next: a torturous waiting game involving CT scans, repeat appointments, and, eventually, a biopsy with all the subtlety of a dart throw. But thanks to a sleek new gadget in Shanghai's medical arsenal, that anxiety spiral might soon be obsolete.

Enter Ion Robotic Bronchoscopy – a minimally invasive lung biopsy tool that sounds like it belongs on a Mars rover but actually lives in a few local hospitals. It allows doctors to navigate deep into the lungs using an ultrathin, highly maneuverable catheter (think a bendy straw with GPS). Its job? To extract tiny pieces of tissue from suspicious nodules (small, potentially cancerous lumps), even those hiding out on the lung's outer fringes.

Previously, accessing those deep or peripheral lesions was tricky at best and sometimes downright impossible. Now, doctors can not only biopsy (take a sample for testing), but also treat some nodules on the spot using radiofrequency ablation – a method of zapping early-stage tumors with heat.

"It's the most advanced tech we have right now," says Dr Li Qiang from Shanghai East Hospital, which has teamed up with Shanghai United Family Hospital to open a precision diagnosis and minimally invasive treatment center for early-stage lung cancer. "It's efficient, accurate, and safer."

And yes, it's open to both local and international patients – no passport required. You'll find the Ion system in action at Shanghai Chest Hospital, Shanghai Pulmonary Hospital, and Shanghai United Family Hospital, where it quietly turns lung anxiety into lung clarity – one robotic arm at a time.

Health Byte Tips

Diabetes at Sea: How a Rotten Apple Smell Saved a Life

A 58-year-old Filipino marine engineer nearly didn't make it to shore. He collapsed aboard his vessel off the coast of Shanghai – pale, short of breath, and exhaling what witnesses described as a rotten apple scent. That peculiar odor turned out to be a red flag for something far more serious: diabetic ketoacidosis, or DKA.

DKA is a medical emergency that can occur when the body doesn't have enough insulin (the hormone that allows sugar to enter cells for energy). In response, the body starts breaking down fat for fuel. This process generates ketones – acidic chemical byproducts. While a small amount of ketones is normal (and even expected in some situations, like fasting or keo-diets for example), in DKA, ketone levels skyrocket. The blood becomes too acidic, and without rapid treatment, organs begin to shut down.

The ship's captain called in a helicopter evacuation. A medical team from Shanghai Seventh People's Hospital met them midair with life-saving treatment already underway. After 72 hours in critical care, the patient stabilized and walked out of the hospital 12 days later – a rare success story in what's often a grim scenario.

Doctors used the case as a wake-up call: for people with diabetes, DKA is preventable. Take insulin as prescribed. Monitor your blood sugar. And know the warning signs: intense thirst, frequent urination, fatigue, confusion, and breath that smells sweet or fruity (a sign of excess ketones in the bloodstream, not a new flavor of gum).

Ketosis – a mild elevation in ketones – can be harmless in healthy people, such as those on ketogenic diets. But in people with type 1 or insulin-dependent type 2 diabetes, it can quickly spiral into ketoacidosis, which is life-threatening. Know the difference.

In Short: If your breath smells like apples but you haven't had any, it's time to see a doctor – not a nutritionist.

Upcoming Topics: Blink. Your Eyes Might Be Thirsty.

If you've ever stared at a screen so long that blinking felt optional, you're not alone. Dry eye syndrome is quietly plaguing Shanghai's screen-bound masses – kids, adults, and probably your cat.

Next time, we'll dive into what's drying out your eyeballs, what to do about it, and whether your air conditioner is secretly your worst enemy. Stay tuned.

About the Author

Cai Wenjun is a seasoned health reporter with Shanghai Daily. With extensive experience covering the local medical system, hospitals, health officials and leading medical experts, Cai has reported on major pandemics including SARS, swine flu and COVID-19, as well as developments in the local health industry.