Blood glucose control is not only the key issue of diabetes management, but also one of the goals of diabetes treatment.Pain associated with self-monitoring of blood glucose(SMBG)results in poor compliance with blood glucose testing.With the advent of continuous glucose monitoring(CGM), it is more convenient to detect blood glucose and realize dynamic glucose monitoring.Continuous glucose monitoring(CGM)is widely used in adults with diabetes, and the usage among children is also increasing.Many studies have conducted clinical trials on the use of CGM in children with diabetes, initially confirming the use of CGM in children with diabetes.However, some studies still have controversies on the use of CGM in children.In this paper, the clinical studies of CGM in children′s diabetes in recent years were summarized to further understand the application of CGM and its combined insulin pump in pediatrics.

Objective To observe the serum and cerebrospinal fluid (CSF) levels of procalcitonin (PCT),matrix metalloproteinase-9 (MMP-9) in children with purulent meningitis and viral encephalitis,and evaluat the differential diagnosis value of PCT and MMP-9.Methods The clinical data of 73 patients with intracranial infection admitted to neurology of Qingdao Women and Children's Hospital from September 2014 to December 2015.Twenty-two patients with pumlent meningitis were se1ected as purulent meningitis group,51 patients with viral encephalitis as viral encephalitis group,and another 20 non-infectious convulsion children as a control group.Samples of 2 ml CSF and 3 ml venous blood from all the subjects were collected within 24 hours after admission.The levels of MMP-9 were detected by Enzymelinked immunosorbent assay (ELISA),and the PCT 1evels were measured by electrochemiluminescence immunoassay.The data in multiple groups were compared with analysis of variance,and by SNK-q test to carry on pairwise comparison among groups.The positive rate significance compared by Chi-square test.Linear correlation analysis was used for correlation analysis.Results Mean serum and CSF levels of PCT in the pumlent meningitis patients group were significantly higher than those in the viral encephalitis group as well as the control group (P ＜ 0.01),but the levels of serum or CSF there were no significant difference between the viral encephalitis group and the control group (P ＞ 0.05);Mean serum and CSF levels of MMP-9 in the pumlent meningitis patients group were significantly higher than those in the viral encephalitis group and control group (P ＜ 0.01),and the levels in patients with viral encephalitis were significantly higher than those in control group (P ＜ 0.01);The increased percentage of the serum and CSF PCT in pumlent meningitis group were significantly higher than in viral encephalitis group (P ＜ 0.01).,but there were no significant difference for MMP-9 (P ＞ 0.05);The PCT level of serum or CSF in pumlent meningitis patients was positively correlated with MMP-9 (r =0.498,P ＜ 0.01),but there was no significant correlation in viral encephalitis group (P ＞ 0.05).Conclusion Detection of PCT and MMP-9 level is valuable in differential diagnosis for the pumlent meningitis or viral encephalitis.

Objective To explore the molecular basis of the characteristics of the serum auto-fluorescent spectrum in patients with ovarian cancer and the changes that might be induced by surgery. Methods Using fluorospectrophotometer and 300nm excitation light,the serum auto-fluorescent spectrum of 84 patients with ovarian cancer before and after the surgery and 30 healthy people were detected. Meanwhile, the serum tumor signs (CEA, CA199 and CA125), hemoglobin and plasma albumin level of all patients with ovarian cancer were detected. Their correlation with the fluorescence spectral characteristic parameters were analyzed. Results Compared with healthy people, the serum auto-fluorescent spectrum in patients with ovarian cancer exhibited purple-shifted position of λ2 peak and red shift in λ4 peak,had higher peak extent inλ1, λ2, λ4 and λ6 peak, and larger peak area of λ1, λ2, λ3, λ4 and λ6. Compared with those in ovarian cancer patients before surgery, the serum auto-fluorescent spectrum in these patients after operation had red shifts in λ1, λ2 and λ3 peak, lower peak extent in λ1, λ2, λ3 and λ4, and smaller peak area in λ1, λ2, λ3,λ4 and λ6 peak. In ovarian cancer patients, the serum level of CEA was positively correlated with the λ2 peak extent and the peak area of λ2 and λ3, while the serum level of CA125 was positively correlated with the peak extent of λ1-λ4 and λ6 and the peak area of λ1-λ3. The serum level of CA199 was negatively correlated with the λ2 position and positively correlated with the peak extent of λ1-λ6 and the peak area ofλ1-λ3 and λ6 in patents with ovarian cancer. Besides, the serum albumin was positively correlated with theλ2 peak position and negatively with the peak extent of λ1-λ6 and the λ1-λ3 peak area, while the level of hemoglobin was positively correlated with λ1 peak position. Conclusions The elevated serum tumor markers and lower albumin (plasma) level lead to the changes of the serum autofluorescence spectra characteristic parametersin in patients with ovarian cancer.These changes can be modestly corrected by surgery.

The clinical data of a child with Bainbridge-Ropers syndrome in Qingdao Women and Children′s Hospital was retrospectively analyzed.A 26-day old female presented with no weight gain, more sleep, mild feeding difficulty and low muscle tension.A novel nonsense mutation (c.3464c > A) was found in ASXL3 gene through whole exon sequencing, namely a pathogenic mutation, and has not been reported at home and abroad.At the age of 6 months, special facial features were obvious, with claw-shaped hands and bilateral wrists deviated to ulnar side.Follow-up revealed that psychomotor development is retarded.

Objective:To study the effect of continuous subcutaneous insulin infusion (CSII) in the long-term treatment of type 1 diabetes mellitus (T1DM) children, to analyze the factors influencing the efficacy, and to provide theoretical guidance for the application of CSII in long-term therapy and follow-up management.Method:A total of 60 T1DM children who were under 18 years old, lived in Qingdao for a long time, had CSII for more than 6 months, and visited the Outpatient Department of Endocrinology of Qingdao Women and Children′s Hospital for a long term from January 2019 to June 2019 were followed up with questionnaires to understand their general condition and treatment-related data.Result:After the CSII therapy, the hemoglobin A1c (HbA1c) of T1DM children significantly decreased from (9.58±2.08)% to (7.12±1.11)% ( t=7.315, P<0.05), the daily insulin dosage per unit weight significantly declined from 0.91(0.86, 0.94) IU to 0.80 (0.66, 0.88) IU ( Z=-5.514, P<0.05), and the frequency of both hypoglycemia and ketoacidosis was significantly reduced.Diet control, daily exercise time, the visit frequency and the self-monitoring frequency of blood glucose affected the curative effect of CSII therapy (all P<0.05). Conclusion:CSII therapy can effectively control the blood glucose of children with T1DM in Qingdao area, significantly lower HbA1c, and reduce the insulin dosage and the incidence of hypoglycemia and ketoacidosis.Good diet control, regular exercise, regular follow-up and a high frequency of blood glucose monitoring are associated with better glycemic control.

Objective:To understand the correlation of different ultrasound characteristics with thyroid cancer, and evaluate the effect and safety of different surgical strategies in pathological suspected cancer and highly suspected cancer by pure ultrasound.Methods:The clinical data of 679 patients (787 thyroid nodules) underwent thyroid surgery from August 2016 to December 2019 in Beijing Daxing District People′s Hospital were retrospectively analyzed, including ultrasound characteristics (echo, margin, form, ratio of tall to wide, calcification), surgery data (operation time, surgical strategies, whether the second surgery), recovery process (whether combined with secondary injury, including hoarse voice and choking on drinking water; drainage tube retention time and postoperative drainage), pathological examination results (pathological types, whether included parathyroid gland in the submitted specimen and whether lymph node metastasis). The effect and safety were compared between dissection and non-dissection of central group lymph nodes in pathological suspected cancer patients and highly suspected cancer by pure ultrasound patients.Results:Among the 787 thyroid nodules, 316 nodules (40.2%) were malignant nodules, including 308 papillary carcinomas; 471 nodules (59.8%) were benign nodules. The rates of low echo, unclear margin, form irregularity, ratio of tall to wide >1 and microcalcification in malignant nodules were significantly higher than those in benign nodules: 90.5% (286/316) vs. 38.9% (183/471), 52.5% (166/316) vs. 11.5% (54/471), 53.8% (170/316) vs. 11.5% (54/471), 30.4% (96/316) vs. 5.5%(26/471) and 65.5% (207/316) vs. 8.7% (41/471), and there were statistical differences ( P<0.01). Among 26 patients with pathological suspected cancer, there were no statistical difference in operation time, drainage tube retention time, postoperative drainage, surgical complications and paraffin pathology result between patients with dissection of central group lymph nodes (17 cases) and patients without dissection of central group lymph nodes (9 cases) ( P>0.05); the patients with dissection of the central group lymph nodes were all proved to be cancer by paraffin pathology examination. The highly suspected cancer by pure ultrasound was in 57 cases, there were no statistical difference in operation time, drainage tube retention time, postoperative drainage, choking on drinking water or hoarse voice between patients with dissection of central group lymph nodes (23 cases) and patients without that dissection (34 cases) ( P>0.05); the incidence of parathyroid gland in the submitted specimen and malignant rate of paraffin pathology result in patients with dissection of central group lymph nodes were significantly higher than those without that dissection: 39.1% (9/23) vs. 2.9% (1/34) and 30.4% (7/23) vs. 8.8% (3/34), and there were statistical differences ( P<0.01 or <0.05). Conclusions:Thyroid ultrasound characteristics have important predictive value. It is recommended to clean central group lymph node in most cases of pathological suspected cancer; while when highly suspected cancer by pure ultrasound happens, it is recommended to clean lymph node only when lymph node metastasis is highly suspected.

OBJECTIVE To explore the effects and potential mechanism of evodiamine on inflammatory response and apoptosis of epithelial cells in asthma model rats. METHODS SD rats were separated into control group， model group， evodiamine low-dose group （10 mg/kg）， evodiamine high-dose group （20 mg/kg）， dexamethasone group （positive control， 0.5 mg/kg）， epidermal growth factor （EGF） group [mitogen-activated protein kinase （MAPK） activator， 10 μg]， evodiamine high-dose+EGF group （20 mg/kg evodiamine+10 μg EGF）， with 10 rats in each group. Except for the control group， the other groups were sensitized by 3-point injection of 10% ovalbumin（OVA）-aluminium hydroxide mixture and stimulated by inhalation of 2%OVA nebulized liquid to establish an asthma model. The count of inflammatory cells （macrophages and lymphocytes） in bronchoalveolar lavage fluid （BALF） was detected in each group； pathological changes of lung tissue in rats were observed； the apoptosis of airway epithelial cells， the levels of serum inflammatory factors [tumor necrosis factor-α， interleukin-6 （IL-6） and IL-4]， the expressions of pathway-related proteins p38 MAPK， phosphorylated p38 MAPK （p-p38 MAPK）， signal transduction and transcription activating factor 1 （STAT1）] and apoptosis-related proteins [B cell lymphoma-2 （Bcl-2） and Bcl-2 associated X protein （Bax）] were all detected in lung tissue. RESULTS Compared with the control group， bronchial mucosal edema， thickening of alveolar septa and extensive infiltration of inflammatory cells were observed in the lung tissue of rats in the model group； the number of inflammatory cells， apoptosis rate of airway epithelial cells， the levels of inflammatory factors， p-38 MAPK/p-38 MAPK， and the protein expressions of Bax and STAT1 were increased significantly； the expressions of Bcl-2 protein and Bcl-2/Bax were reduced significantly （P＜0.05）. Compared with the model group， the pathological changes in lung tissues were alleviated to varying degrees in evodiamine low-dose and high-dose groups， and dexamethasone groups， and the above indicators were significantly reversed. However， the change trends of corresponding indicators in the EGF group were opposite to the above （P＜0.05）. EGF could significantly attenuate the effect of high-dose evodiamine on inflammatory response in asthmatic rats （P＜0.05）. CONCLUSIONS Evodiamine can relieve inflammatory reactions and inhibit the apoptosis of airway epithelial cells in asthmatic rats， the mechanism of which may be associated with inhibiting p38 MAPK/STAT1 signaling pathway.

OBJECTIVE To explore the effects and potential mechanism of evodiamine on inflammatory response and apoptosis of epithelial cells in asthma model rats. METHODS SD rats were separated into control group， model group， evodiamine low-dose group （10 mg/kg）， evodiamine high-dose group （20 mg/kg）， dexamethasone group （positive control， 0.5 mg/kg）， epidermal growth factor （EGF） group [mitogen-activated protein kinase （MAPK） activator， 10 μg]， evodiamine high-dose+EGF group （20 mg/kg evodiamine+10 μg EGF）， with 10 rats in each group. Except for the control group， the other groups were sensitized by 3-point injection of 10% ovalbumin（OVA）-aluminium hydroxide mixture and stimulated by inhalation of 2%OVA nebulized liquid to establish an asthma model. The count of inflammatory cells （macrophages and lymphocytes） in bronchoalveolar lavage fluid （BALF） was detected in each group； pathological changes of lung tissue in rats were observed； the apoptosis of airway epithelial cells， the levels of serum inflammatory factors [tumor necrosis factor-α， interleukin-6 （IL-6） and IL-4]， the expressions of pathway-related proteins p38 MAPK， phosphorylated p38 MAPK （p-p38 MAPK）， signal transduction and transcription activating factor 1 （STAT1）] and apoptosis-related proteins [B cell lymphoma-2 （Bcl-2） and Bcl-2 associated X protein （Bax）] were all detected in lung tissue. RESULTS Compared with the control group， bronchial mucosal edema， thickening of alveolar septa and extensive infiltration of inflammatory cells were observed in the lung tissue of rats in the model group； the number of inflammatory cells， apoptosis rate of airway epithelial cells， the levels of inflammatory factors， p-38 MAPK/p-38 MAPK， and the protein expressions of Bax and STAT1 were increased significantly； the expressions of Bcl-2 protein and Bcl-2/Bax were reduced significantly （P＜0.05）. Compared with the model group， the pathological changes in lung tissues were alleviated to varying degrees in evodiamine low-dose and high-dose groups， and dexamethasone groups， and the above indicators were significantly reversed. However， the change trends of corresponding indicators in the EGF group were opposite to the above （P＜0.05）. EGF could significantly attenuate the effect of high-dose evodiamine on inflammatory response in asthmatic rats （P＜0.05）. CONCLUSIONS Evodiamine can relieve inflammatory reactions and inhibit the apoptosis of airway epithelial cells in asthmatic rats， the mechanism of which may be associated with inhibiting p38 MAPK/STAT1 signaling pathway.