Type 1 diabetes is the main type of diabetes mellitus among children and adolescents and the incidence has steadily increased worldwide in the past 20 years,so more and more people pay attention to the pediatric type 1 diabetes.This article reviews the worldwide research progresses of epidemiology,treatment and management of type 1 diabetes.By comparing the research progresses home and abroad,we can know the gaps home and abroad better,so as to indicate potential paths for future research in China.

Sepsis-associated encephalopathy is a diffuse brain dysfunction that occurs secondary to infection.It is characterized by alteration of consciousness and cognition,seizure or focal neurological signs.Sepsis-associated encephalopathy is accompanied by abnormalities of electroencephalogram and somatosensoryevoked potentials,increased biomarkers of brain injury and,frequently,by neuroradiological abnormalities.Its diagnosis relies essentially on neurologic examination.Hepatic/uremic encephalopathy,metabolic disturbances,drug overdose,withdrawal syndrome and Wernicke's encephalopathy are the main differential diagnosis of sepsis-associated encephalopathy.Currently,treatment consists mainly of controlling sepsis.Various drugs acting on septic pathophysiology have been tested in septic animals.

Objective To explore the clinical effects of hysteroscopy treatment for uterine septum guided by B Ultrasound.Methods Clinical data of 107 patients with uterine septum were retrospectively analyzed after performing transcervical hysteroscopy resection of septum with being monitored by B Ultrasound,Results All of the operat.ions were successful,and there was no uterine perforation,intestinal injury or water intoxication.Following up after operation,endometrial and uterine morphology were normal and all patients had pregnancy and delivery.Conclusion Hysteroscopy guided by B Ultrasound could make operation easier,time shorter,bleeding less,trauma smaller,safer,pregnancy rate higher,complications of pregnancy less,and it could easier be accepted.

Objective To observe the clinical effect of plasmin combined with aspirin in treating acute cerebral infarction and to explore the influence to blood rheology and nerve function.Methods 148 cases with acute cerebral infarction were randomly divided into two groups.The control group (n =74) was treated by honghua injection.The study group (n =74) was treated by plasmin combined with aspirin.After treatment,the clinical effect,blood rheology and neurological recovery were observed.Results The total effective rate of the study group was 97.2％,which was significantly higher than that of the control group(74.3％) (x2 =15.88,P ＜ 0.05).The blood rheology indexes of the two groups had improved and neural function of the two groups was restored,but those in the study group were obviously better than control group (t =3.56,3.42,4.26,3.22,4.16,all P ＜ 0.05).Conclusion Plasmin combined with aspirin in treating acute cerebral infarction has accurate clinical curative effect,can markedly improve the blood rheology and promote nerve functional recovery,is worth of clinical spreading.

Most children with Hirschsprung's disease (HD) have a satisfactory outcome after a pull-through operation.However,a small group of patients develop severe postoperative complications,and a reoperation may be necessary.The most common and serious complications after definitive surgery are as follows:anastomotic stricture,a twist of the pull-through segment,retained aganglionosis,HD-associated enterocolitis,anastomotic leak,and fistulae.Using a well-defined treatment algorithm based on the clinical status as well as precise diagnostic workup can end the long suffering of patients with postoperative complications.Pull-through surgery can be safely performed with favorable outcomes after thorough history-taking,meticulous clinical examination,a thoughtful planning,adherence to basic surgical principles and under skillful hands.

Along with improvements in the embedding materials, continual innovation of the applied technique, and further understanding of therapeutic mechanism, the application scope of negative pressure wound therapy (NPWT) becomes broader, clinical experience in its use becomes more abundant. This issue of the journal highlights 5 papers to introduce the experience and knowledge regarding NPWT technique of the authors.
Humans ; Negative-Pressure Wound Therapy ; Wound Healing

Appropriate classification and staging is the basis for the diagnosis and treatment of idiopathic macular hole (IMH).According to the appearance of vitreous and retina determined by optical coherence tomography,IMH can be classified as primary or secondary IMH,and IMH with or without vitreous attachment;Vitreous attachment can be further classified as vitreomacular adhesion or vitreomacular traction.According to the measured horizontal diameter,IMH can be classified as large,middle and small IMH.This new classification system and comprehensive parameters improve the traditional Ⅳ-stage theory,with a better description of the occurrence and development of IMH process.It should be used as the general principal to guide IMH classification,evaluation of surgical indications,selection of operative method,and estimation of surgical outcome.Ganglion cell damage caused by internal limiting membranes (ILM) peeling is the major concern in the IMH vitreoretinal surgery.For complicated and large IMH,inverted ILM flapping can improve the closure rate;ILM peeling and postoperative face-down posture are not necessary for IMH less than 250um in diameter.The current vitreoretinal surgery trend to treat IMH is personalized surgical treatment,following the existing evidence-based medical evidence,and based on the new classification information,ocular and systemic features of each patient.

Objective To investigate the clinical efficacy of pantoprazole combined with domperidone in the treatment of chronic superficial gastritis.Methods 50 patients with chronic superficial gastritis were selected,and they were randomly divided into single drug treatment group and two drugs treatment group by the random number table method,25 cases in each group.The single drug treatment group was treated with domperidone,the two drugs treatment group was given pantoprazole combined with domperidone treatment.After 3 weeks of treatment,the total effective rate,disappearing time of abdominal pain,postprandial fullness belching disappeared time,the disappearance time of patients before meals;and after treatment,fullness,belching,abdominal pain score difference;psychological function of patients before and after treatment,differences in physical function indicators of the quality of life were compared between the two groups.Results The total effective rate of the two drugs treatment group was higher than that of the single drug treatment group (96.00％ vs.76.00％,x2 =4.153,P ＜ 0.05).The disappearance time of abdominal pain,postprandial fullness disappeared time,belching disappeared time of the two drugs treatment group were shorter than those of the single drug treatment group(t =8.201,9.155,10.762,all P ＜ 0.05).Before.treatment,the postprandial fullness,belching,abdominal pain points between the two groups had no statistically significant differences(all P ＞ 0.05).After treatment,the postprandial fullness,belching,abdominal pain of the two drugs treatment group decreased more significant (t =5.255,4.923,6.245,all P ＜ 0.05).Before treatment,the psychological function,physical function and quality of life index between the two groups showed no statistically significant differences (all P ＞ 0.05).After treatment,the psychological function,physical function and quality of life index of the two drugs treatment group increased more greatly (t =5.242,4.153,4.733,4.255,4.562,4.715,all P ＜ 0.05).Conclusion The clinical efficacy of pantoprazole combined with domperidone in the treatment of chronic superficial gastritis is effective,it can effectively improve the patients’ clinical symptoms and quality of life,shorten the treatment time,it is worthy of promoting.

Objective To explore the application value of laparoscopic surgery in type 2 diabetes patients with acute cholecystitis.Methods 50 type 2 diabetic patients with acute cholecystitis were chosen as the research objects,the patients were divided into the observation group and control group according to the method of treatment, 25 cases in each group.Strict control of blood glucose levels in patients before operation,the observation group treated by laparoscopy,the control group were treated with conventional open surgery.Recorded the operation time and hemor-rhage,postoperative abdominal drainage,anal exhaust time,patient ambulation time and hospitalization time and other indicators.The patients were followed up to record the postoperative infection,occurrence of complications such as postoperative inflammation.Results There was no statistically significant differences between the two groups in oper-ation time(t =1.02,P >0.05).In the observation group,the intraoperative blood loss was (41.2 ±8.3)mL,postop-erative drainage volume was (107.5 ±16.4)mL,which were significantly lower than those in the control group,and the anal exhaust time was (1.7 ±0.3)d,total hospitalization time was (7.1 ±1.7)d,which were significantly shorter than those of the control group,the differences were statistically significant(t =3.43,3.78,3.43,4.21,all P <0.05).The observation group the complications included wound infection 1 cases,the complication rate was 4.0%, while in the control group,the complications included bile leakage,reflux esophagitis,incision infection,fat liquefac-tion,pulmonary infection and incisional hernia,the overall complication rate was 24.0%,there was statistically signifi-cant difference in the complication rate between the two groups(χ2 =4.54,P <0.05).Conclusion The laparoscopic surgery in the treatment of type 2 diabetic patients with acute cholecystitis has exact effect,and the patients recovery time is short,the complication rate is low.

Prenatal diagnosis is vitally important to control birth defects.The mature application of detecting biochemical markers in maternal serum and cytogenetic karyotype analysis of amniotic fluid cells , villi cells and umbilical cord blood cells , as well as the development of fluorescence in situ hybridization , nucleic acid amplification , gene sequencing , chips and other molecular biological techniques , have significantly improved the standards of prenatal diagnosis.The application of high-throughput sequencing , a non-invasive detection technique , ushers the development of prenatal diagnostic techniques into a new stage.In the face of a growing number of and constantly updated test items , it is necessary to assess the advantages and limitations of various prenatal diagnostic techniques , so as to realize scientific selection and combination, and utilize the techniques to their fullest potential.