Insolinoma is a rare disease,but with an increased incidence in recent years.From March 2003 to October 2010,16 patients with insulinoma had been admitted to the Nanfang Hospital,and the results of imaging investigation were compared with histopathological examination after operation.All cases had typical Whipple's triad,low plasma glucose and high plasma insulin concentrations. Sixteen tumors were found in total.The detection rate of ultrasonography was 44％ (7/16),and the detection rate of enhanced computed tomography (CT)and magnetic resonance imaging (MRI) were 67％ (8/16) and 75％ (6/8) respectively.The detection rate reached 88％ by combination of CT and MRI.Two patients had no abnormal findings in ultrasonography,CT and MRI,while positive results were found in the arterial stimulation procedure with venous sampiing (ASVS) in both patients.CT or MRI is the preferred approach for localization diagnosis of insulinoma. The ASVS achieves a distinct advantage in localization of insulinoma.

Objective: To establish comprehensive laboratory reference intervals for Chinese children. Methods: This was a cross-sectional multicenter study. From June 2013 to December 2014, eligible healthy children aged from 6-month to 17-year were enrolled from 20 medical centers with informed consent. They were assessed by physical examination, questionnaire survey and abdominal ultrasound for eligibility. Fasting blood samples were collected and delivered to central laboratory. Measurements of 15 clinical laboratory parameters were performed, including estradiol (E2), testosterone(T), luteinizing hormone(LH), follicle-stimulating hormone(FSH), alanine transaminase(ALT), serum creatinine(Scr), cystatin C, immunoglobulin A(IgA), immunoglobulin G(IgG), immunoglobulin M(IgM), complement (C3, C4), alkaline phosphatase(ALP), uric acid(UA) and creatine kinase(CK). Reference intervals were established according to central 95% confidence intervals for reference population, stratified by age and sex. Results: In total, 2 259 children were enrolled. Finally, 1 648 children were eligible for this study, including 830 boys and 818 girls, at a mean age of 7.4 years. Age- and sex- specific reference intervals have been established for the parameters. Reference intervals of sex hormones increased gradually with age. Concentrations of ALT, cystatin C, ALP and CK were higher in children under 2 years old. Serum levels of sex hormones, creatinine, immunoglobin, CK, ALP and urea increased rapidly in adolescence, with significant sex difference. In addition, reference intervals were variable depending on assay methods. Concentrations of ALT detected by reagents with pyridoxal 5'-phosphate(PLP) were higher than those detected by reagents without PLP. Compared with enzymatic method, Jaffe assay always got higher results of serum creatinine, especially in children younger than 9 years old. Conclusion This study established age- and sex- specific reference intervals, for 15 clinical laboratory parameters based on defined healthy children.