Adolescent ; Child ; Diabetes Mellitus, Type 2 ; diagnosis ; etiology ; therapy ; Diet ; Exercise ; Humans ; Self Care

Adult ; Child ; Humans ; Metabolic Syndrome ; diagnosis ; etiology ; physiopathology ; Pediatrics ; trends ; Research ; trends

Objective To explore the clinical characteristics of Gitelman syndrome in children and the difference between Gitelman syndrome and Bartter syndrome.Methods Clinical date,biochemical tests and therapy of 6 patients diagnosed as Gitelman syndrome in Beijing children′s hospital from Mar.to Dec.2006 were retrospectively analyzed.At the same time,the relative articies of Gitelman syndrome and Bartter syndrome were reviewed.Results The symptoms of 6 patients appeared early.The age of onset of Gitelman syndrome at infancy stage,the main complains were growth delay,weakness,tetany.All patients had normal blood pressure.The biochemical tests showed hypocalemic,hypomagnesium,alkalosis and hyperreninemia.But the concentration of aldosterone was normal or little higher.The manifestations of all patients were relieved after taking both potassium and magnesium.Conclusion Gitelman syndrom and Bartter syndrome have differences at clinical syndrome and machanism of onset.

Objective To explore the reasons and preventive measures of early dislocation after total hip arthroplasty in elder patients. Method A retrospective study was done to analyze dislocation time, reason and time of 168 elderly patients with early anti-dislocation after total hip arthroplasty in joint surgery. Results Only 7 patients (4.1%) had type I joint dislocation, including 2 male and 5 female patients aged 65~89 years. The dislocation happened in 4~5 weeks postoperatively, mainly resulting from hip joint over flexion when urinating in bed, sleep-turning, loaded-moving, walking and stoop and diachoresis. Conclusions For the elderly patients after total hip replacement, it is type I dislocation which happened 4 ~ 5 weeks after operation, more femal than male, reasons including over-exercrse. Effective prevention measures includes regular rehabilitation training, early precautions enhanced mental support and safety nursing.

Objective To analyze the etiology and clinical characteristics of children with tumor-associated precocity.Methods Thirty children with tumor-associated precocity hospitalized in Department of Surgery of Beijing Children's Hospital Affiliated to Capital Medical University from Jan.2006 to Mar.2012 were selected as research subjects.The causes,clinical characteristics and treatment situation of the patients were retrospectively studied.Results The group of patients included 14 boys and 16 girls,with average age of (3.74 ± 2.44) years.Twenty-two patients (73.3％) were younger than 5 years old,and their etiological distributions listed as follows:8 cases were hypothalamic hamartoma(HH),2 cases were hypothalamic germinoma,1 case was arachnoid cyst,7 cases were adrenocortical tumor (in which 1 case was adenoma and 6 cases were adenocacinoma respectively),5 cases were ovarian cyst,2 cases were ovarian tumor (in which 1 case was endodermal sinus tumor and 1 case was sex cord-stromal tumor respectively),2 cases were MuCune-Albright syndrome,and 1 case was mediastinal teratoma,1 case was penis primitive neuroectoderm tumor,and 1 case was Leydig cell proliferation accompanied with neoplasma.Eleven patients(36.7％) suffered central precocious puberty,with HH (n =8) being the most common causes.Four patients with HH presented with gelastic epilepsy.Precocious puberty caused by HH patients could be safely controlled by gonadotropin-releasing hormone agonists.Nineteen patients(63.3％) suffered peripheral precocious puberty,with adrenocortical tumor being the most common cause for the boys and ovarian cyst being the most common cause for the girls.Besides that,the onset symptom of a patient with adenocacinoma was facial acne accompanied with hypertrichiasis and another patient with ovarian tumor had intermittent abdominal pain,and the onset symptoms of all the boys were external genital development and those of the girls were mammary development or colporrhagia,respectively.Conclusions Tumors are one of the most causes of precocious puberty in children.During the process of diagnosis and treatment of precocious puberty,imaging examinations on pituitary,gonad and adrenal gland should be paid great attention to and seldom occurred tumors should also be considered.For ovarian cyst patients with precocious puberty attention shall be paid attention to the differentiation from MuCune-Albright syndrome.

OBJECTIVETo investigate the glutamate dehydrogenase 1 (GLUD1) gene mutation of three patients diagnosed as glutamate dehydrogenase congenital hyperinsulinism (GDH-HI).

METHODSThree patients diagnosed as GDH-HI and their parents were involved in the study. PCR-DNA direct sequencing was used to analyze the exons 6,7,10,11 and 12 of the GLUD1 gene.

RESULTSIn the first case, an R269H heterozygous mutation was found in the GLUD1 gene, with autosomal dominant inheritance. In the second case, there was a de novo S445L heterozygous mutation of the GLUD1 gene. No mutation was detected in the third case.

CONCLUSIONIn Chinese, R269H, S445L heterozygous mutation of the GLUD1 gene can lead to GDH-HI. Genetic analysis is necessary in making genetic diagnosis of congenital hyperinsulinsm.

Adult ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; China ; Congenital Hyperinsulinism ; enzymology ; genetics ; DNA Mutational Analysis ; Exons ; Female ; Glutamate Dehydrogenase (NADP+) ; genetics ; Humans ; Infant ; Male ; Molecular Sequence Data ; Mutation, Missense

OBJECTIVETo establish osteoblast model, primary cilla model was removed by chloral hyrate, observe effects of osteoblast primary cilla moved on enhancing ALP staining and calcified nodules staining in electromagnetic field.

METHODSThree 3-day-old male SD rats weighed between 6 and 9 g were killed, cranial osteoblast was drawed and adherencing cultured respectively. Cells were subcultured and randomly divided into 4 groups until reach to fusion states. The four groups included chloral hydrate non-involved group (control group), 2 mM, 4 mM and 8 mM chloral hydrate group, and cultured in 37 °C, 5% CO2 incubator for 72 h. Morphology of primary cilla was observed by laser confocal scanning microscope, and incidence of osteoblast primary cilia was analyzed by Image-Pro Plus 6.0 software. Cells in the correct concentration group which can removed cillia most effectively were selected and divided into 3 groups, including control group (C), Electromagnetic fields group (EMFs), and EMFs with 4 mM chloral hydrate group. DMEM nutrient solution contained 10%FBS were added into three groups and cultured for 9 days and formation of ALP were observed by histochemical staining of alkaline phosphatase. After 12 days' cultivation, formation of mineralization nodes was observed by alizarin red staining.

RESULTSCompared with control group and 2mM chloral hydrate group,4 mM chloral hydrate group could effectively remove osteoblast primary cilla (P<0.01). Removal of osteoblast primary cilla could weaken the formation of ALP and mineralization nodes in osteoblast in EMFS. Compared with EMFs group, the area of ALP and mineralization nodes in EMFs with 4 mM chloral hydrate group were decreased obviously (P<0.01).

CONCLUSION4mM chloral hydrate could effectively remove osteoblast primary cilia. Primary cilla participate in EMFs promoting formation of ALP and mineralization nodes in osteoblast and provide new ideas for exploring mechanism of EMFs promoting osteoblast maturation and mineralization.

Alkaline Phosphatase ; metabolism ; Animals ; Cell Culture Techniques ; instrumentation ; methods ; Cells, Cultured ; Chloral Hydrate ; pharmacology ; Cilia ; drug effects ; enzymology ; physiology ; Male ; Osteoblasts ; cytology ; enzymology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate osthole effect on femoral tissue resorption activity of rat in vitro.

METHODSSix SD rats weighted (80 ± 5) g were used to isolate and culture femoral tissue (diaphyses and metaphysis) in vitro. The cultured tissue were devided into control group, estradiol group and osthole group. The femoral tissue was treated with final concentration of 1 x 10(-5) mol/L osthole and 1 x 10(-8) mol/L estradiol culture in vitro at 48 hours after cultured. Tartrate-resistant acid phosphatase (StrACP) activity, glucose and Lactic acid content, StrACP, MCSF (Macrophage colony stimulating factor) and CTSK (Cathepsin K) mRNA was detected by Real-Time RT-PCR were detected.

RESULTSConcetration of Alkaline phosphatase activity were 2226 and 2498 in 1 x 10(-5) mol/L osthole and 1 x 10(-8) mol/L estradiol respectively. As compared with control group, the activity of StrACP of 1 x 10(-5) mol/L osthole and 1 x 10(-8) mol/L estradiol were inhibited at 6, 9, 12 days (P < 0.05); under treatment of in l x 10(-5) mol/L osthole, the content of Lactic acid were increased and the content of glucose were decreased at 3, 6, 9 days (P < 0.05); StrACP, MCSF and CTSK mRNA expression level were inhibited at 6, 9 days (P < 0.05).

CONCLUSIONOsthole can inhibit bone resorption and raise the level of nutrition metabolism of femurs tissue.

Acid Phosphatase ; metabolism ; Animals ; Bone Resorption ; prevention & control ; Coumarins ; pharmacology ; Estradiol ; pharmacology ; Femur ; drug effects ; Glucose ; analysis ; Lactic Acid ; analysis ; Male ; Rats ; Rats, Sprague-Dawley

Objective:To explore the clinical efficacy of single-center infant kidney donor adult dual kidney transplantation to explore the difference of different operation methods and the operation options of different donor kidney conditions so as to improve the success rate of children kidney donor adult dual kidney transplantation and reduce complications.Methods:A total of 42 cases of infant and adult dual kidney transplantations at Department of Kidney Transplantation in The Second Xiangya Hospital of Central South University from December 2012 to May 2019 were divided into two groups according to whether or not donor kidney fulfilled the criteria of three " 5" . According to different surgical approaches, they were divided into three groups of A (classical En-Bloc operation), B (separated dual kidney transplantation) and C (modified operation). The clinical data and prognoses were analyzed.Results:The median follow-up period was 55(11-92) months. The estimated glomerular filtration rate was 123.4(92.2-156.6) ml/min for operation A, 97.2(81.3-116.6) ml/min for operation B and 133.9(133.9-133.9) ml/min for operation C. In donor group not fulfilling the " 5" principle, no thrombotic event occurred for operation A/C and 3 cases of transplantation for operation B. There were single renal embolism ( n=2) and dual renal embolism ( n=1)(3/5, 60%)( P<0.05). Urinary protein was positive in the last follow-up: operation A (1/2, 50%) and operation B (3/5, 60%) ( P<0.05). The estimated glomerular filtration rate at the last follow-up was 82.4(80.9-83.9) ml/min for operation A, 71.8(46.1-114.2) ml/min for operation B and 122(83.3-142.4) ml/min for operation C. The 1-year graft survival rate was 100% and 89.5% in three " 5" donor group and 3-year graft survival rate was 100% and 84.2% respectively. Conclusions:Satisfactory outcomes might be obtained during dual kidney transplantation for infants and adults. The incidence of thrombosis, urine leakage and urinary protein is lower in improved kidney transplantation group than that in previously operated group. The problem of graft hyperperfusion injury is well solved. And the long-term follow-up outcome is excellent.

OBJECTIVEHLA-DMA and DMB are non-classical genes whose product (DM molecules) plays an important role in antigen presentation. Our present study was designed to investigate the relationship between human leukocyte antigen-DMA, -DMB and clinical status heterogeneity of type 1 diabetes.

METHODSA total of 80 children (male 36, female 44) with type 1 diabetes were selected as research subjects. Diagnosis of type 1 diabetes was made according to WHO criteria. The range of age at onset of type 1 diabetes was 2.5 - 14 years. Ninety-one healthy adult blood donors were selected as normal controls. Polymerase chain reaction and dot blot hybridization techniques were used to classify DMA and DMB alleles. Patients with type 1 diabetes were classified into different groups according to different clinical status, including sex, age of onset, ketosis onset situation on diagnosis, remained function of islet beta cell, etc. Then distribution of DM susceptive alleles and heterodimer in different clinical groups were studied.

RESULTSThe frequencies of DMA * 0103 and DMB * 0103 alleles in patients were significantly increased (50% vs. 8%, 43% vs. 22%, respectively), these two alleles confer susceptibility to type 1 diabetes in Chinese. The frequencies of DMA * 0103/DMB * 0102, DMA * 0103/DMB * 0103 and DMA * 0103/DMB * 0101 heterodimers were also increased in the patients. The above heterodimers confer predisposition to type 1 diabetes. Both DMB * 0103 allele and DM susceptive heterodimers are related to islet beta cell function on diagnosis. The patients with DMB * 0103 allele or DM susceptive heterodimers were significantly increased in the patients with lower C-peptide level on diagnosis (56% vs. 29%; 58% vs. 34% respectively). DM heterodimes were also related to onset age and ketosis-onset-situations of the patients. The patients carrying DM susceptive heterodimers had higher probability to suffer type 1 diabetes before 10 years of age and had the predisposition to ketosis or ketoacidosis on diagnosis.

CONCLUSIONHLA- class II non-classical alleles-DMA and DMB may play an important role in pathogenesis of type 1 diabetes, and clinical status heterogeneity of type 1 diabetes may be related to genetic mechanism.

Adolescent ; Alleles ; Child ; Child, Preschool ; Diabetes Mellitus, Type 1 ; genetics ; pathology ; Female ; Gene Frequency ; HLA-D Antigens ; genetics ; Humans ; Male ; Polymerase Chain Reaction