Up to 80% of type 1 diabetes melitus children present with diabetic ketoacidosis (DKA). Stroke in children with DKA children is uncommon but life-threatening. Various types of stroke, such as ischemic, cerebral venous thrombosis, and hemorrhagic stroke were observed in children with DKA. In this article, we review the literatures regarding stroke in children with DKA.

This study was aimed to discuss the influence of specific acupoint acupuncture therapy to the serum angiogenesis factor of high fat diet obese mouse models. Mice were randomly divided into the blank control group , acupuncture control group , model control group , and acupuncture treatment group . There were 6 mice in each group . Obese mouse models were induced after 15-week high fat diet . The specific acupoint acupunc-ture therapy was used as an intervention treatment method for 10 days . The enzyme-linked immunosorbent as-say (ELISA) was used in the detection of serum insulin, vascular endothelial growth factor (VEGF), soluble vascular endothelial growth factor receptor , leptin and the level of nitric oxide in mice . The results showed that the serum insulin , nitric oxide and leptin level in the obese mouse models were increased . However , there were no obvious changes on the vascular endothelial growth factor and soluble vascular endothelial growth fac-tor receptor level . The specific acupoint acupuncture therapy can obviously reduce the level of serum nitric ox-ide and leptin, and improve the content of vascular endothelial growth factor in obese mouse models. However, there were no influence on the level of blood glucose and soluble vascular endothelial growth factor receptor . It was concluded that the specific acupoint acupuncture therapy method had preferable antiobesity action . Its mechanism of action may be related to the regulation of angiogenesis .

AIM: To study cellular and molecular mechanisms of cardiac development associated genes ex- pression and its function during early stage cardiomyogenesis. METHODS: (1 ) Mouse embryonic stem cells (ESC) line D3 culture. (2) Inductive culals of ESC differentiated into cardiac myocytes in vitro.(3) Identification of ESC -derived cardiac myocytes: RNA isolation; synthesis of specific primer and RT - PCR; Label of RT - PCR products with [? - 32P] dATP as probes, purifyed by sephadex G - 50 columns, determined the yield of DNA. RNA dot hy- bridization. RESULTS: 80% of ESC differentiated into cardiomyocytes by improved conditional medium. Cardiomy- ocytes contraCted in a synchronous manner. The results of RT - PCR and RNA blot showed that cardiac genes were expressed abundantly and specifically during the early cardiomyogenesis. CONCLUSIONS: ESC were able to be dif- ferentiate into cardiomyocytes. Different concentrations and components of RA, DMSO and FCS affected ESC car- diomyogenesis in de. The optimal result obtained was from the conditional medium, a mixturce of 2 nmol/L retinoic acid (RA), 0.6% dimethyl sulfoxide (DMSO) and 20% fend calf serum (FCS).

Objective:To explore the effect of narrative medicine course on the empathy ability and comprehensive ability training of residents in the standardized residency training in municipal hospitals.Methods:A narrative medicine group was set up in a municipal hospital, and a anarrative medical course of 2 months of narrative theory teaching and 4 months of clinical practice education was carried out among 42 residents. The Chinese version of the Interpersonal Response Index Scale (IRI-C) was used to measure the empathy ability at 4 time points (before intervention, 2 months after theory education, 2 months after practice, and 4 months after practice). The effect of narrative medicine courses was evaluated through the satisfaction questionnaire survey, parallel medical record writing and the first-time pass rate of Medical Practitioner Qualification Examination. SPSS 25.0 was used to analyze the variance of one-way repeated measurement.Results:The empathy ability of 42 residents was significantly improved. The empathy score after 2 months after practice was higher than that before intervention and after the theoretical course ( P < 0.05), while the empathy score after 4 months of practice was higher than that before intervention and after the theoretical course ( P < 0.05). The most popular theoretical teaching forms among residents were interactive theoretical teaching (64.29%, 27/42), video viewing (59.52%, 25/42), and situational simulation (52.38%, 22/42). The comprehensive abilities of parallel medical record writing and podium performance among residents were improved. Passing the Medical Practitioner Qualification Examination is a necessary condition for passing the residency training program. The first-time pass rate of the Qualification Examination for the residents was 72.00% (18/25), which was higher than that of the residents who were not recruited during the same period (64.71%, 11/17). Conclusion:Carrying out narrative medicine education is helpful to improve the empathy ability and comprehensive ability of training residents in municipal hospitals.

【Objective】 To evaluate the diagnostic value of prostate specific antigen density (PSAD) and central glandular prostate specific antigen density (CGPSAD) combined with multi-parameter magnetic resonance imaging (mpMRI) in the diagnosis of prostate cancer (PCa) and prostate hyperplasia (BPH) in the gray area of prostate specific antigen (PSA) (4.0-10.0 μg/L). 【Methods】 Data of 634 patients who had received prostate biopsy in our hospital were retrospectively collected. Among them, 121 patients were selected. According to the pathological results of the biopsy, they were divided into PCa group and BPH group. The three diameters of the prostate and the central gland were measured by MRI. We calculated the prostate volume (PV) and the central gland volume (PVc), and then compared age, PSA, PV, PVc, PSAD, CGPSAD, prostate images, and PI-RADS score between PCa and BPH groups. Multifactor logistic regression analysis was performed to study the independent risk factors for PCa. Receiver operating characteristic (ROC) curves of PCa diagnosis were plotted, respectively, and the area under the curve (AUC) was calculated and compared with the reference. 【Results】 There was no significant difference in total prostate specific antigen (tPSA) between the two groups (P>0.05). However, significant differences were observed in age, PV, PVc, PSAD, CGPSAD and PI-RADS score between the two groups (P<0.05). Multifactor logistic regression analysis showed that PI-RADS score was an independent risk factors for PCa (OR=4.156, P<0.001). The AUC value of PSAD, CGPSAD, PI-RADS score, PSAD combined with PI-RADS score and CGPSAD combined with PI-RADS score were 0.744, 0.771, 0.844, 0.884, and 0.903, respectively. The AUC value of CGPSAD combined PI-RADS score was the highest. 【Conclusion】 CGPSAD is better than PSAD in diagnosing PCa in the grey area of PSA. Combined with PI-RADS score of mpMRI, it can improve the diagnosis of prostate cancer and guide clinical and prostate biopsy.

OBJECTIVE：To investiga te the effects of MEK/ERK pathway specific inhibitor PD 98059 combined with paclitaxel on the proliferation and apoptosis of human gastric signet ring cell carcinoma （SRCC）cells. METHODS ：Using human SRCC KATO Ⅲ cells as object ，CCK-8 assay was used to detect cell proliferation after treated with paclitaxel ，PD98059 and two drug combination for 48 h，and the proliferation rate was calculated. Flow cytometry ，Western blotting and Transwell assay were used to detect the cell proliferation ，the expression of apoptosis related protein （Cleaved-caspase-3）and cell migration after treated with paclitaxel，PD98059 and two drug combination for 48 or 24 h. RESULTS ：After treated with paclitaxel （1 μg/mL），PD98059（5， 20，40 μmol/L）and two drug combination （1 μg/mL+5，20，40 μmol/L），the proliferation rate of cells was increased significantly in administration groups ，and the combination groups were significantly higher than paclitaxel and PD 98059 alone groups （P＜ 0.05）. After treated with paclitaxel （1 μg/mL），PD98059（5，20，40 μmol/L）and two drug combination （1 μg/mL+40 μmol/L）， early and late apoptosis rate ，the protein expression of Cleaved-caspase- 3 were significantly increased in paclitaxel group and combination group ；combination group was significantly higher than paclitaxel and PD 98059 alone group （P＜0.05）. The number of migrated cells in administration groups were reduced significantly ，and the combination group was significantly lower than paclitaxel and PD 98059 alone group （P＜0.05）. CONCLUSIONS ：Paclitaxel and PD 98059 can inhibit the proliferation and migration of human SRCC KATO Ⅲ cells，paclitaxel can also promote the apoptosis and the expression of apoptosis related protein，which may be related to the inhibition of MEK/ERK pathway. The effect of the combination of the two drugs is better than paclitaxel or PD 98059 alone.