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.

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

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.

Objective To explore the effect and safety of compression and distraction technique by external fixation without grafting in treatment of noninfectious nonunion of tubular fractures.Methods 43 patients were randomly divided into 2 groups by visiting sequence with random number,odd into the observation group,even into the control group.The observation group(22 cases) adopted the external fixation retractor pressure treatment,the control group(21 cases) was given extemal fixation combined with locking plate treatment.The efficacy of two groups was compared.Results 43 patients were followed up for 6 ～ 15 months,average 7.5 months.The bone healing time was 3 ～ 14 months,average 5.1 months.43 patients were all healed.The total effective rate of the observation group was 81.8％,which was significandy higher than 66.7％ in the control group (Z =9.654,P =0.001).There were no significant differences in adverse reactions and complications between the two groups (x2 =0.068,P =0.795).Conclusion The compression and distraction technique by external fixation in the treatment of noninfectious nonunion of tubular fractures has obvious curative effect,it can be widely used in clinical practice.

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 investigate effects of cemented hip arthroplasty applied to treat intertrochanteric fracture of aging patients.Methods 21 cases of clinical data of patients with intertrochanteric fracture treated with cemented hip arthroplasty were retrospectively analyzed,and hip functions were evaluated according to Harris grading.Results The mean time of surgery was (42.2 ± 8.6) main,mean blood loss was (597 ± 83) ml,mean time of hospital stay(specialist hospital stay not included) was (16.5 ± 1.7) days,all cuts were primary healing,and mean time of healing was (15.7 ± 0.2)days.After operation 5 parents had respiratory tract infection and improved by symptomatic anti-inspection therapy.3 cases had deep vein thrombosis and improved by inferior vena cava filter input and thrombolysis therapy.1 case had dislocation after cemented hip hemiarthroplasty and improved by legs brace booth outside fixed for 3month.21 cases had following up for 6 months after operation.All fractures were cured,without any osteolysis,loosening of the prosthesis or heterotopic ossification.65 ～ 89 scores by Harris hip function grading,and the mean score was 74.1.13 cases were good,7 cases less than ideal and 1 case poor.Conclusion Cemented hip arthroplasty is an effective method to treat intertrochanteric fracture of aged patients.After operation,the patients can do early activity and have long-term good function recovery.

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.

Usually,invasive prenatal diagnosis of birth defects is necessary for pregnant women with advanced age .The classic technology is evaluation of fetal chromosome karyotype which is performed by cytogenetic analysis of amniotic fluid fetal exfoliated cells through amniocentesis in the second trimester .For some pregnant women who were unfit or refused to accept invasive prenatal diagnosis ,the application of new technology makes assessment of risk of fetal abnormalities more accurate .When screening is used to assess risk of fetal abnormalities , the women should be told that the screening technologies cannot substitute for invasive diagnosis testing of fetal exfoliated cells , the reason of older pregnancy and both advantages and limitations of the prenatal diagnosis and screening technologies should be considered , and the risks of invasive prenatal diagnosis and risk of missed diagnosis of abnormal fetal in selection of prenatal diagnosis strategy for pregnant women with advanced age should be compared .

Objective To explore the effect of Buyanghuishensan plus hyperbaric oxygen and medicine in the treatment of delayed encephalopathy after acute carbon monoxide poisoning .Methods According to the digital t able,143 patients with delayed encephalopathy after acute carbon monoxide poisoning were randomly divided into two groups .70 patients in the control group were treated by hyperbaric oxygen and medicine ,while 73 patients in the treat-ment group were treated by Buyanghuishensan plus hyperbaric oxygen and medicine .They were treated for three months.After three months,MMSE and ADL were used to determine changes of the patients'neurological function. Results The total effective rate of the treatment group was 97.3%,which was significantly higher than 88.6%in the control group(χ2 =4.84,P<0.05).After treatment for 3 months,the MMES score of the two groups increased signif-icantly (t=3.096,4.725,all P<0.01),and that of the treatment group increased more significantly (t=2.466,P<0.05).After treatment for 3 months,the ADL score of the two groups decreased significantly (t=2.691,3.179,P<0.05 or P<0.01),and that of the treatment group decreased more significantly (t=2.607,P<0.05).Conclusion Buyanghuishensan plus hyperbaric oxygen and medicine can improve neurological function in patients with delayed encephalopathy after acute carbon monoxide poisoning .