Thyroid nodules in childhood are less prevalent but more often to be malignant than those in adulthood. The evaluation of thyroid nodules includes history collection, physical examination, laboratory examination, imaging and ifne-needle aspiration biopsy (FNAB). A history of neck irradiation, previous thyroid diseases and thyroid neoplasms in the family are high risk factors of malignant nodules. Thyroid ultrasonography is the ifrst choice of thyroid nodules assessment. FNAB is the best way to discriminate between benign and malignant lesions. Treatment option for benign thyroid nodules is follow-up. Surgery is the most effective treatment option for malignant or suspicious thyroid nodules.

The rise in childhood obesity has lead to an increased number of children with lipid abnormalities,and the predominance of a combined dyslipidemic pattern characterized by a moderate-to-severe elevation in triglycerides,normal-to-mild elevation in low density lipoprotein cholesterol and reduced high density lipoprotein cholesterol.Most of the published guidelines focus on managing primary dyslipidemia in pediatric patients,there is still no general consensus regarding the treatment of obesity-related lipid abnormalities in children.This article reviews screening,diagnosis and management of dyslipidemia associated with obesity in children,and emphasize lifestyle change is critical,in the rare child for whom diet and exercise interventions are insufficient,there are medication options that can be considered.

This study was aimed to reveal the effector mechanisms of Chinese medicine aconite, ginseng, astragalus and dried ginger on the intervention of adriamycin (ADR) cardiotoxicity model rats. The analysis was made on the interactive relationship between aconite and ginseng, astragalus as well as dried ginger. A total of 72 rats were randomly divided into nine groups. There were eight rats in each group. Except the normal group, rats in each group were intraperitoneally injected with 2.5 mg·kg-1 of ADR according to their body weights. The injection was given once a week and continued for four weeks. The total dosage was 10 mg·kg-1. In the aconite, dried ginger group, the intragastric administration dosage of herbal decoction was 1.75 g·kg-1. The decoction dosage in the gin-seng, astragalus group was 0.875 g·kg-1. The decoction dosage in the Shenfu, Qifu group was 2.625 g·kg-1. The decoction dosage in the Jiangfu group was 3.5 g·kg-1. The intragastric administration was given once a day and continued for four weeks. Indexes such as superoxide dismutase (SOD), cardiac troponins (cTn), cytochrome C (CytC), myocardial mitochondria of Bax, Bcl 2, caspase-3, caspase-9 were detected. The colligation score was calculated associating with the close index. One-way ANOVA was given on different indexes and colligation indi-cators among different drug groups and the factorial design variance analysis was given to reveal the drug interac-tions. The results showed that compared with the normal group there were statistical significances among different indexes in the model group (P < 0.05). Aconite, ginseng, astragalus, dried ginger had varying degrees of impact on different indicators. There were statistical significances on the interaction between aconite and ginseng, astra-galus, dried ginger (except Bax). It was concluded that herbal medicine aconite, ginseng, astragalus, dried ginger had certain protective effect to the heart of ADR model rats. The combination of aconite and ginseng, astragalus, dried ginger can enhance the effect compared with a single herb.

Objective To explore the effects of different degrees of hypoxia-ischemia(HI)on neuronal apoptosis and astrocyte proliferation in neonatal rats.Methods A total of 72 rat pups aged 7 days were randomly divided into 3 groups(n=24 each group):sham operated group,mild HI group,and severe HI group.The rats were subjected to right carotid artery occlusion and exposed to a hypoxic gas mixture (8% oxygen and 92% nitrogen)for 40 minutes at 34.5℃ in mild HI group and for 65 minutes at 35.5℃ in severe HI group.The expression of glial fibrillary acidic protein(GFAP)was detected by immunohistochemistry,and TUNEL method was performed to observe the proliferation of astrocytes and the neuronal apoptosis.Results Compared with sham operated group,the number of GFAP-positive cells signifiantly increased throughout the cortex and white matter in the ischemic hemisphere 48 hours(P＜0.01)and 1 week(P＜0.05)after mild HI,and in some areas the increase continued until week 4(P＜0.05).The number of GFAP-positive astrocytes in the cortex and white matter was signficantly higher in severe HI group than in mild HI group(P＜0.05)and sham operated group(P＜0.01)48 hours and 1 week after severe HI,but the increase was not detectable at week 4.Compared with sham operated group,the number of TUNEL-positive cells in the subcortical white matter in the ischemic hemisphere signficantly increased in mild HI group 48 hours,1 week,and 4 weeks following a mild HI insult(P＜0.05),but no signficant difference in the number of TUNEL-positive cells in the cortex was found.Following a severe HI insult,the number of TUNEL-positive cells in the cortex and white matter in the ischemic hemisphere significantly increased at 48 hours(P＜0.01),and in peri-infarct regions the number of TUNEL-positive cells increased until weeks 1 and 4(P＜0.05).Conclusion Mild HI causes neuronal apoptosis mainly in subcortical white matter and prolonged proliferation of astrocytes.Severe HI is associated with widespread neuronal apoptosis in the ischemic hemisphere,and the proliferation of astrocytes is rapid and prominent after severe HI.

Objective To investigate the expression levels of forkhead transcription factor 3 (FOXP3) and cytotoxic T lymphocyte-associated antigen-4(CTLA-4) in the peripheral blood of children with newly diagnosed type 1 diabetes mellitus(T1DM),and explore their roles in the pathogenesis of T1DM. Methods Fifty children with newly diagnosed T1DM and 30 healthy children( control group) were select-ed. FOXP3 and CTLA-4 mRNA expressions were detected using real-time PCR. Soluble FOXP3 ( sFOXP3 ) and CTLA-4(sCTLA-4) protein levels in the serum were assayed by ELISA,and the levels of diabetes anti-bodies,HbA1C and C-peptide were determined using Western blotting,high performance liquid ion-exchange chromatography,and electrochemiluminescence, respectively. Results The expressions of FOXP3 mRNA and protein in T1DM patients were lower than those in the control group[0. 95 ± 0. 48 vs. 2. 11 ± 0. 79,(6. 27 ± 1. 49) ng/ml vs. (9. 02 ± 2. 37) ng/ml,respectively,both P <0. 01],while the expressions of CTLA-4 mRNA and protein were higher than those in the control group[2. 43 ± 0. 83 vs. 1. 94 ± 0. 84,(77. 88 ± 22. 34) ng/ml vs. (65. 97 ± 12. 11) ng/ml,respectively,both P<0. 01]. In T1DM patients,the expressions of FOXP3 and CTLA-4 genes presented positive correlation with the protein expression( r=0. 758,0. 396, P<0. 05), and FOXP3 protein expression presented correlation with CTLA-4 protein expression ( r =-0. 624,P<0. 05). Conclusion There are abnormal expressions of FOXP3 and CTLA-4 genes as well as their proteins in the peripheral blood of the children with newly diagnosed T1DM,and FOXP3 regulated the expression of CTLA-4 in T regulatory cells,indicating the involvement of immune mechanisms in the devel-opment of T1DM.

Cardiovascular Diseases ; genetics ; Humans ; Polymorphism, Genetic ; Receptors, Adrenergic, beta-1 ; genetics

Objective To summarize the clinical features of diabetic ketoacidosis (DKA) in children with newly diagnosed type 1 diabetes mellitus(T1DM),and to explore the predictors of DKA by analyzing these factors in order to achieve early recognition.Methods In this retrospective study,200 children with newly-onset T1DM from January 2009 to December 2012 in Shengjing Hospital of China Medical University were chosen.These patients were divided into DKA group and non-DKA group.Clinical data including age,gender,health insurance,body shape,infection history,family history of diabetes,type of residence,income,duration of history,C peptide,glycosylated hemoglobin,blood lipids,thyroid tests,diabetes antibodies etc were collected.Results Among 200 cases of newly diagnosed T1DM,107 children had DKA,93 children had non-DKA,and the incidence of DKA was 53.5％.In the group of DKA,39 cases (36.5％) were male,68 cases were female,while in the group of non-DKA 45 cases (48.4％) were male,48 cases were female.In the group of DKA,children ranged in age from 16 months to 13 years old,and the average age was (6.53 ±3.55) years old.In the non-DKA group,children ranged in age from 1 to 14 years old,and the average age was (7.05 ± 3.55)years old.In the group of DKA,43 cases (40.2％) didn't have health insurance,while in the non-DKA group,28 cases (30.1％) didn't have medical insurance.In the DKA group,30 cases (28％) had a family history of diabetes,while in the non-DKA group,27 cases (29％) had a family history of diabetes.In the group of DKA,the duration was (30.24 ± 76.50)days,while in the group of non-DKA,the duration was (33.38 ± 49.30) days.The glycosylated hemoglobin in the DKA group was (12.38 ± 2.66)％,in the non-DKA group was (12.48 ± 2.24) ％.There were no significantly differences of the above factors between the 2 groups (all P ＞ 0.05).In the group of DKA,35 cases(32.7％) were thin,66 cases(61.7％) were of normal size,and 6 cases(5.6％) were fat.In the group of non-DKA,9 cases(9.3％) were thin,76 cases (78.6％) were of normal size,and 8 cases(12.1％) were fat.In the group of DKA,33 cases (30.8％) had infection history,77 cases (72％) lived in rural areas,and the average of C peptide was (0.25 ± 0.22) μg/L.In the group of non-DKA,17 cases (18.3％) had infection history,52 cases(55.9％) in rural areas,and the average of C peptide was (0.36 ± 0.21) μg/L.There were significant differences of the above factors between the 2 groups (all P ＜ 0.05).Conclusions Children with newly diagnosed T1DM who is thin,rural resident,and has lower C peptide level is more susceptible to DKA.More attention should be paid to the children with newly diagnosed T1DM who have above characteristics.

The traditional Chinese medicinal therapy of the eye acupuncture is one of superior microacupuncture therapies which was invented by famous acupuncture professor Peng Jing-shan. Through needling points around the eye, the treatment can treat the diseases of whole body, especially for curing apoplectic paralysis. This article expounded and analyzed the mechanism of eye acupuncture in treating apoplectic paralysis through medical theory, biological holographic theory, modern nerves anatomy and nerves physiology.

Histone deacetylase (HDAC) is a protease which regulates gene expression and modify the structure of chromosome. The balance between acetylation and deacetylation of histone plays an important role in maintaining cellular function and the process of genes expression. Overexpression of HDAC and recruitment by transcription factors inhibit the expression of certain genes, leading to tumorigenesis and other diseases. Recently, with the further research on cancer epigenetics, HDAC inhibitors have increasingly caught attention. As a novel class of antitumor agents, HDAC inhibitors are widely explored in hematological malignancies. There are several kinds of HDAC inhibitors for the treatment and clinical research of non-Hodgkin lymphoma (NHL), such as vorinostat, belinostat, chidamide, CUDC-907. This article mainly describes the development of the HDAC inhibitors in NHL.

Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cytarabine ; administration & dosage ; Daunorubicin ; administration & dosage ; Female ; Humans ; Idarubicin ; administration & dosage ; Leukemia, Myeloid, Acute ; drug therapy ; Male ; Middle Aged ; Treatment Outcome ; Young Adult