Henoch-Sch?nlein purpura ( HSP ) is the most common disease with small vasculitis as the main pathological changes in childhood. Gastrointestinal symptoms as the main clinical manifestations are called abdominal type allergic purpura,some children show abdominal symptoms before skin purpura,even without skin purpura during the whole course of disease,which usually leads to misdiagnose. This article summaries the clini-cal diagnosis and treatment progress of abdominal type allergic purpura.

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Objective:To explore the associations of urinary retinol binding protein (RBP) and β 2-microglobulin (β 2-MG) with urinary albumin to creatinine ratio (UACR) and renal function in hospitalized patients with type 2 diabetes mellitus (T2DM). Methods:A total of 1 030 Chinese patients with T2DM were included in this study. The subjects were divided into the UACR normal group (<30 mg/g), microalbuminuria group (30-300 mg/g) and macroalbuminuria group (>300 mg/g). Patients with normal UACR were further divided into two groups according to the estimated glomerular filtration rate (eGFR): the eGFR low group (<90 ml·min -1·1.73m -2) and the normal eGFR group (≥90 ml·min -1·1.73m -2). Urine RBP and β 2-MG levels among the groups were compared. Multiple linear regression analyses were applied to evaluate risk factors of urine RBP and β 2-MG. Results:In all patients ( n=1 030), urine RBP and β 2-MG increased gradually with the increase of UACR across the three groups, the proportions of abnormal urine RBP (>0.7 mg/L) and β 2-MG (>370 μg/L) in these groups were 3.8%, 8.5%, 39.0% ( P<0.001), and 12.9%, 26.7%, 46.8% ( P<0.001), respectively. In the UACR normal group ( n=788), 12.2% of the patients were with eGFR<90 ml·min -1·1.73m -2. The proportion of abnormal β 2-MG (>370 μg/L) was higher in the eGFR low group than that in the eGFR normal group (29.2% vs. 10.7%, P<0.001). Multivariate linear stepwise regression analyses were performed using natural logarithm of urine RBP or β 2-MG as dependent variable, and showed that urine RBP was independently associated with UACR ( β=0.0005, P<0.001), serum creatinine ( β=0.006, P<0.001) and glycosylated hemoglobin A1c ( β=0.050, P=0.001), and β 2-MG was independently correlated with UACR ( β=0.000 4, P<0.001), serum creatinine ( β=0.011, P<0.001), systolic blood pressure ( β=0.005, P=0.031) and fasting blood-glucose ( β=0.027, P=0.046). Conclusions:Urine RBP and β 2-MG are positively associated with high UACR and impaired renal function in T2DM patients, and these changes could occur before UACR and eGFR turned out to be abnormal. It is recommended that urine RBP and β 2-MG be detected as early as possible to identify diabetic kidney disease in patients with normal UACR and eGFR.

Anomalous aortic origin of a coronary artery（AAOCA）is a rare congenital malformation of the coronary artery，characterized by the coronary orifice origin from the inappropriate sinus of valsalva. Clinical presentations of this condition are occult，and different types present with various clinical manifestations，including exercise-induced angina，syncope，and even sudden death，particularly when the coronary artery follows an interarterial（intramural）course. Coronary computed comography angiography is an effective diagnostic method for precisely delineating the origin and shape of the coronary artery. Surgical correction is recommended upon evidence of myocardial ischemia and potential risk，and offers favorable long-term prognosis post-surgery. Despite low morbidity，limited experience in diagnosis and treatment，early diagnosis and timely treatment are of great importance because of the high potential risk related to the high-risk types. This paper aims to review the advances in the pathophysiology，clinical manifestations，diagnosis，and treatment of AAOCA to enhance recognition among pediatricians and reduce the incidence rate of sudden cardiac death in children with AAOCA.

ObjectiveTo explore the anhedonia level and its relationship with cognitive function in patients with first-episode psychosis， and to analyze the influencing factors of cognitive function. MethodsA total of 143 first-episode psychiatric patients who met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） in the Affiliated Brain Hospital of Guangzhou Medical University from December 2016 to March 2019 were selected. Positive and Negative Syndrome Scale （PANSS） was used to evaluate the patient’s psychiatric symptoms， in which N2 （emotional withdrawal） and N4 （passive/apathetic social withdrawal） were used to assess the anhedonia level， and patients whose （N2+N4） scores beyond 4 were classified into anhedonia group， and those with （N2+N4） scores less than or equal to 4 were classified into non-anhedonia group. Hamilton Depression Scale-24 item （HAMD-24） was used to measure the depressive symptoms， and the MATRICS Consensus Cognitive Battery （MCCB） was used to detect cognitive function. Then the clinical symptoms and cognitive function of two groups were compared， and the influencing factors of cognitive function were screened by multiple linear regression analysis. ResultsThe negative symptom score， general pathological symptom score and total score of PANSS in anhedonia group were significantly higher than those of non-anhedonia group， with statistical difference （P<0.05）. The score of working memory in adolescent subgroup， the scores of information processing speed， attention/alertness and vocabulary learning in adult subgroup of anhedonia group were lower than those of non-anhedonia group， with statistical difference （P<0.05）. Multiple linear regression analysis showed that the anhedonia score and the duration of untreated psychosis were the influencing factors of working memory in adolescent subgroup （P<0.05）. ConclusionPatients with high levels of anhedonia suffer more severe mental symptoms and cognitive impairment， moreover， anhedonia is one of the influencing factors of working memory in adolescents.