Homo sapiens PDCD10(programmed cell death 10,alias,"TF-1 cell apoptosis related gene 15,TFAR15"),cloned by means of cDNA-representational differences analysis,had been initially identified associated with cell apoptosis.Recent research suggested mutations within the PDCD10 gene or deletion were responsible for cerebral cavernous malformations,and PDCD10 was the third CCM gene.On the other hand,other research demonstrated that PDCD10 was strictly modulated and up regulated in many kinds of tumors,which implicated that PDCD10 participated in tumorous signal transduction.The recent research confirmed that PDCD10 interacts with MST4,a member of Ste20-related kinases,and the interaction promoted cell proliferation and transformation via modulation of the ERK-MARK pathway.In conclusion,all these demonstrate that PDCD10 has many biological effects,which suggests that it is a novel player in vascular morphogenesis and/or remodeling,as well as tumorigenesis and cancer progression.

Objective To explore the clinical application value of multi-slice spiral CT angiography.Methods 28 patients who were suspected cerebrovascular disease were taken cerebrovascular enhanced scan by 16-slice spiral CT,and VR,MIP and MPR post -processing were uset to reconstmct the cerebrovascular image.Results In 28 patients,11 cases were normal,17 cases were abnormal,and among these patients there were 8 cases of abnormal blood vessels,4 cases of aneurysms,1 case of cerebral arteriovenous malformation,4 cases of cerebral artery stenosis.Conclusion The multi-slice CT compared with ordinary spiral CT had the advantage of faster and more secure.It had an important role in guiding the screening and clinical treatment programs in cerebral infarction patients with suspected cerebral artery stenosis.It had a lot of advantages in diagnosis vascular disease and clinical observation after treatment.

[Objective] To observe the efficacy of metformin treatment on non-alcoholic fatty liver disease (NAFLD) in obese children.[Methods] A retrospective analysis was performed of 10 patients over 10 years old with NAFLD from July 10,2013 to August 23,2016.These patients were treated with metformin in pediatric endocrinology outpatient department of the First Affiliated Hospital of Sun Yat-sen University.The changes of liver ultrasonography,hepatic enzymes,blood lipids,blood glucose,insulin,HOMA-IR,BMI,and waist circumference height ratio were compared before and after treatment with metformin.[Results] There were 10 cases of NASH,including 5 boys and 5 girls.The short-term treatment of metformin reduced the levels of ALT,AST,and HOMA-IR for all 10 patients (P ＜ 0.01).ALT,gradually decreased with the course of treatment.Fasting insulin and waist circumference to height ratio also improved with the treatment (P ＜ 0.05);the changes of TG,BMI,and fast glucose were not obvious (P ＞ 0.05).[Conclusion] Metformin can effectively reduce liver enzymes and improve insulin sensitivity in children with NASH in short term,the improvement of TG and BMI in short term is not obvious.

[Objective] We assessed in a retrospective unicenter study the state of metabolism and gonadal axis of early menarche girls and girls who treated with Gonadotropin-releasing hormone analogs (GnRHa).[Methods] Thirty-nine early menarche girls and 58 girls who had been treated with GnRHa were enrolled in our study and 19 normal menarche girls were enrolled as control group.Data were collected in height,weight,gonadal hormone,blood glucose,insulin,blood lipid,leptin,adiponectin and the size of uterus and ovary.[Results] Both BMI SDS for chronological age (CA) and for bone age (BA) of early menarche girls were significantly higher than normal menarche girls (P ＜ 0.05).The ratio of insulin resistance in early menarche girls (20.5％) was also significantly higher than normal girls (0％).No significant difference in lipid metabolism and gonadal axis between two groups.In girls treated with GnRHa,BMISDS,insulin,HOMA-IR and the ratio of insulin resistance (20.7％) were all significantly higher than normal group (P ＜ 0.05).Meanwhile,DHEAS,androstenedione and testosterone of GnRHa treated girls were significantly higher than early menache girls,and DHEAS was higher than normal girls.The size of uterus in treated group was larger than the other two groups.[Conclusion] Early menarche and GnRHa treatment may take negative effect to BMI and glucose metabolism.Androgen was higher in GnRHa treated group.Therefore,suggestion was that BMI,insulin,blood glucose and androgen should be monitored in early menarche girls and girls treated with GnRHa.

Objective To assess the vaIue of speckle tracking imaging (STI) in quantifying the regional myocardial strain in systemic lupus erythematosus (SLE) group.Methods ① Sixty subjects were divided into SLE group and normal group.High frame rate two-dimensional images were recorded from the apical two-chamber view,long-axis view and four-chamber view of the left ventricle (LV).Peak systolic strain of each view of 18 segments were measured by automated functional imaging (AFI) software of 2-DSE.All parameters were compared between the two groups.② Twenty cases were randomly taken from the normal group.The same observer at different times and two observers measure the strain of left ventricular respectively.The results of the measurement between the two groups were compared with unpaired t test and its relevance was analyzed using Pearson's correlation analysis.ResultsLeft ventricular two-dimensional longitudinal strain gradually increased from the base to apex in the normal group.There were statistically differences between the apical segments and the basal,middle segments of every left ventricular wall (P＜0.05).The same wall segment time to peak myocardial systolic peak strain was consistent.Left ventricular two-dimensional longitudinal strain gradually increased from the base to apex in the SLE group,except for the anterio-septal and anterior wall [ (-18.7±4.2)％,(-16.3±9.4)％,(-18.1±10.5)％ vs (-19.0±9.0)％,(-18.6±7.9)％,(-17.7±1.4)％ ].There was no statistically significant difference between the apical segments and the basal,middle segments of every left ventricular wall(P＞0.05).All parameters of S were significantly higher in the normal group than those of the SLE group.The difference was statistically signoficant (P＜0.05).The time to peak systolic peak strain of every segments was not consistent.The results from the same observer at different times and peak systolic myocardial strain measurements by the two observers were correlated well(P＜0.01).Conclusion The myocardial function assessment by STI technology in the SLE patients is significantly different from that of the normal control:SLE patients with left ventricular myocardial damage can be manifested as reduced regional myocardial systolic peak strain.

Objective To investigate the effects of early tracheotomy on the prognosis of patients with severe brain lesions .Methods The clinical data of 68 patients with severe brain lesions were retrospectively analyzed . According to the time of tracheotomy ,we assigned 68 patients to receive either early tracheotomy or late tracheotomy . 34 patients who were given tracheotomy within 72 hours in Intensive Care Unit were selected as the early tracheotomy group (ET group).34 patients who were given tracheotomy after 14 days in Intensive Care Unit were selected as the late tracheotomy group(LT group).The time of mechanical ventilation,length of hospital stay,and the incidence of ventilator associated pneumonia ( VAP ) , sedative drug use time , antibiotic use time , in-hospital mortality were compared between the two groups.Results In ET group,the hospitalization time,mechanical ventilation time, incidence of VAP,sedative drug use time,antibiotic use time were (4.2 ±2.4)d,(3.5 ±0.6)d,(14.5 ±3.2)%, (1.5 ±0.5)d,(3.3 ±0.3)d,those in LT group were (12.5 ±4.8)d,(8.5 ±5.6)d,(28.6 ±8.6)%,(6.3 ±1.2)d, (13.2 ±1.1) d respectively,the differences between the two groups were statistically significant ( t =3.14,2.96, 3.28,3.46,2.57,all P<0.05).The hospitalization mortality rates of ET group ,LT group were (23.8 ±4.38)%, (24.5 ±4.16)%,respectively no significant difference between the two groups ( t=1.49,P<0.05).Conclusion The use of early tracheotomy can reduce the hospitalization time ,shorten the time of mechanical ventilation ,reduce the incidence of ventilator associated pneumonia ,and reduce the time of using sedative drugs and antibiotics ,but the mor-tality has no significant effect in the severe craniocerebral injury patients .

Objective To explore the relationship between adrenarche and gonadarche.Methods Total 49 idiopathic central precocious puberty(ICPP)girls,whose serum dehydroepiandrosterone sulfate(DHEAS)Z scores for chronological age were higher than+2 s at diagnosis.were enrolled.Physical examinations during pubertal stage were repeated at 3-6 months intervals,and serum DHEAS levels were monitored yearly within an average period of 4.08 years.Of them,16 girls were followed up until more than one year after discontinuation of gonadotropin-releasing hormone analogue(GnRHa)treatment.Results Before GnRHa treatment,these49 girls presented a younger average age at attainment of pubic hair stage2(PH2)and pubic hair stage3(PH3)than normal(8.07 years vs 11.16 years,8.82 years vs 12.40 years respectively).During GnRHa treatment,the intervals between PH2 and PH3,PH3 and pubic hair stage4(PH4),breast stage 2(B2),and PH2 were longer than normal(1.69 years vs 0.83 years,1.64 years vs 0.60 years,and3.62 years vs 0.76 years respectively).The intervals between PH2 and PH3,as well as B2 and PH2 during GnRHa treatment were also longer than that before GnRHa treatment(1.69 years/35 0.88 years,3.62 years vs 1.13 years respectively).The serum DHEAS Z scores decreased during GnRHa treatment,and increased significantly after GnRHa cessation.Conclusion Gonadarche after age of 6-year-old may lead to earlier adrenarehe.GnRHa treatment might slow down the progression of adrenarche and suppress the hypothalamuspituitary-gonadal axis.

Objective To evaluate the long-term final adult height outcome of combined treatment with gonadotropin-releasing hormone analogue(GnRHa)and recombinant human growth hormone(rhGH)in girls with idiopathic central precocious puberty(ICPP).Methods Out of 49 sirls with ICPP[treated with GnRHa at a dose of 60-80 μg/kg every 4 weeks for at least 6 months,whose height velocity fell below 4 cm/year and showed no improvement of predicted adult height(PAH)in 6 months],26 received(rhGH-combined group),in addition to chronological age,and duration of GnRHa treatment,who showed the same growth pattern but refused rhGH treatment,served to evaluate the efficacy of rhGH in addition.At the conclusion of the smdy,all the girls had been followed up for(3.3±1.9)years,and(3.2±0.9)years in rhGH-combined group and control group,respectively;and had achieved adult heisht.To compare the PAH with the final adult height(FAH)before and after treatment in the two groups.Results During rhGH treatment, height velocity of the rhGH-combined girls increased significantly[(6.7±2.0 vs <4)cm/year baseline],RhGH-combined gids showed an adult height far higher than pretreatment PAH [(157.5±4.5 vs 148.1±4.6)cm,P<0.01],and target height[(154.4±4.6)cm] was,significantly excceded.The control group reached an adult heisht also significandy higher than pretreatment PAH[(154.7±5.5vs 150.3±6.0)cm,P<0.01],while target height[(155.6±4.3)cm]was just reached but not significantlyexcceded.The gain in height obtained,calculated between pretreatment PAH and final heisat,(9.4±4.9)cm in rhGH-combined group was much more than that(4.3±4.2)cm in the control group(P<0.01).Conclusion RhGH may accelerate the linear growth and improve adult height of GnRHa-treated ICPP girls.

Objective To evaluate the association between two different linear growth patterns with the levels of serum insulin in children bem small for gestational age(SGA).Methods Serum fasting glucose,fasting insulin,and insulin-like growth factor-I(IGF-I)concentrations were determined in 30 catch-up growth(CUG)children bern SGA [CUG-SGA,16 females,14males,(6.62±0.66)year],37 non-catch-up growth(NCUG)children born SGA[NCUG-SGA,15 females,22 males,(5.97±0.56)year],and42 appropriate for gestational age(AGA)children with normal height[AGA,16females,26males,(7.05±0.39)year].Results (1) Basal fasting insulin and homeostasis model assessment for insulin resistance(HOMA-IR)were significantly higher in CUG-SGA group than in NCUG-SGA and AGA group(P<0.01 or P<0.05).But there was no difference in fasting insulin between NCUG-SGA group and AGA group.IGF-I levels in CUG-SGA were significantly higher than in NCUG-SGA group[(212.61±17.81 vs 137.40±14.66)ng/ml,P=0.001],but showed no difference from AGA group(P=0.095).(2)In the SGA group,HOMA-IR showed positive correlation with age,△height SDS,and current body mass index.Fasting insulin showed positive correlation with △height SDS(r=0.500,P=0.002)in≤6 year group as well as with △weight SDS(r=0.496,P=0.030)in>6 year group.Conclusions Insulin as a growth factor may participate in postnatal catch-up growth accompanied with increased insulin resistance in SGA children.

Objective To understand how serum DHEAS levels change with sex,age and stage of sexual maturation in children and adolescents and explore the relationship between adrenarche and pubertal maturatiotL Methods Serum samples from 120 healthy boys,198 healthy girls and 152 girls with idiopathic central precocious puberty (ICPP) were examined for DHEAS.Referenee ranges for healthy children and adolescents and statistical difierences between heahhy girls and ICPP girls were analyzed with respect to sex,age and stage of sexual maturation.Results Both healthy children and ICPP girls showed extremely low levels of serum DHEAS and they were not related to sex.age or tanner stages in the individuals below age of 6 years.Serum DHEAS levels were positively related to both age (above age of 6 years)and tanner stage in healthy groups(r=0.69 and 0.71 respectively,P＜0.01).After the onset of puberty,serum DHEAS levels appeared to be higher in boys than that in girls within the same tanner stage(P＜0.05).Within the individusis in the same age group with same sex.serum DHEAS levels increased along with pubertal development.While within the individuals in same tanner stage group with salne sex after puberty onset.serum DHEAS levels showed no significant difference among different age groups.For example.there was no difference in serum DHEAS levels of healthy girls in tanner stage Ⅲ among different age subgroups(age of8-9;age of 10-11,age of 12-13)and the mean vallie of serum DHEAS was 532.0-557.8μg/L(F=0.21,P=0.98).In different age subgroups above age of 6 years,Z scores for serum DHEAS in ICPP girls were highher than them healthy ones with advanced tanner stages(0.97us-0.1 and 1.39us-0.08,JP≤0.01)In different tanner stage subgroups.Z scores for serum DHEAS showed no difierence between healthy and ICPP girls despite apparent different age ranges(0.00 us-0.31-0.18,P＞0.05).Conclusions Serum DHEAS level increased along with both age (above 6 years) and tanner stage in healthy children and adolescents.There was no gender difference until the onset of puberty.It was demonstrated that adrenache and gonadarche were related to each other.Reference ranges for adolescents should be interpreted according to sex.age and tanner stage simultaneously.