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.

Background One of the major challenges in arrhythmogenic right ventricular cardiomyopathy (ARVC) ablation is ventricular tachy-cardia (VT) non-inducibility. The study aimed to assess whether fast rate (≥ 250 beats/min) right ventricular burst stimulation was useful for VT induction in patients with ARVC.Methods Ninety-one consecutive ARVC patients with clinical sustained VT that underwent electro-physiological study were enrolled. The stimulation protocol was implemented at both right ventricular apex and outflow tract as follows: Step A, up to double extra-stimuli; Step B, incremental stimulation with low rate (< 250 beats/min); Step C, burst stimulation with fast rate (≥ 250 beats/min); Step D, repeated all steps above with intravenous infusion of isoproterenol.Results A total of 76 patients had inducible VT (83.5%), among which 49 were induced by Step C, 15 were induced by Step B, 8 and 4 by Step A and D, respectively. Clinical VTs were induced in 60 patients (65.9%). Only two spontaneously ceased ventricular fibrillations were induced by Step C. Multivariate analysis showed that a narrower baseline QRS duration under sinus rhythm was independently associated with VT non-inducibility (OR: 1.1; 95% CI: 1.0–1.1;P = 0.019).ConclusionFast rate (≥ 250 beats/min) right ventricular burst stimulation provides a useful supplemental method for VT induction in ARVC patients.