The pathogenesis of type 1 diabetes is complicated.The infection of enterovirus is closely related to this disease as one of the environmental factors.After susceptible individuals are infected by enterovirus,beta cells in pancreas islets are damaged in two ways,direct infection and autoimmune responses,then leading to the decrease of insulin secretion,clinical diabetes,finally resulting in functional failure of pancreatic islet.

Polyglandular autoimmune syndromes (PAS) comprises a wide spectrum of autoimmune disorders for autoimmune inflammatory to invade.According to age of presentation,characteristic patterns of disease combinations,and different modes of inheritance,PAS are classified into four subtypes.Actual diagnosis of PAS involves clinical syndromes,serological measurement of organ-specific autoantibodies and subsequent functional testing.Principles of treatment included comprehensive assessment,hormone replacement,general consideration.

Objective To investigate the curative effect of sodium nitroprusside in the treatment of EV71-related pneumoedema/pneumorrhagia and hypotension in this study. Methods This was a retrospective study of a total 10 children with EV71-related pneumoedema/pneumorrhagia treated with sodium nitroprusside using case-control methods. The clinical manifestations and outcomes of the 10 children (present cohort) were compared with those of 8 children (past cohort) who had EV71-related pneumoedema/pneumorrhagia without sodium nitroprusside. Results Among these 10 patients,all were at the appearance of pneumoedema/pneumorrhagia, cardiac arrhythmia and hypotension. Two patients showed severe cardiac arrhythmia, two patients showed cardiac arrest for many times. All 10 patients were treated with mechanical ventilation and other conventional treatments. At the first time of the manifest of hypotension,sodium nitroprusside were put into practice in all 10 patients. Ten patients were treated with intravenously sodium nitroprusside in the stage of hypotension by maxi30 min ～ 1 h,the patients showed an improvement in vultus,pulse and peripheral circulation and decrease of heart rate and elevation of blood pressure after 30 min ～2 h,but at least 2～6 h later,the blood pressure tended to stabilize at normal standard. Conclusion Hypotension is the intensive stage in EV71-related hand,foot and mouth disease ,and the shock syndrome caused by acute left ventricular disorder is related to sympathetic nerve activity. Sodium nitroprusside can effectively reduce the cardiac afterload,and correct shock and improve the prognosis.

The school-age boy was admitted to Tianjin Children's Hospital for "fever and cough for 6 days".After detail examinations,the diagnosis of severe Mycoplasma pneumoniae pneumonia was proved.Treatments:anti-infection with Azithromycin and Meropenem;the obstruction of air way was relieved;assisted with symptomatic and supportive treatment.During the treatment,disorder of consciousness and hemiplegia of right limbs occurred,cerebral infarction was proved later by magnetic resonance angiography(MRA).Severe Mycoplasma pneumoniae pneumonia complicated with cerebral infarction is clinically rare with a high morbidity and mortality.Attention should be paid to body examination and Laboratory test.Multi-disciplinary cooperation is helpful.

Clara cell secretory protein 16(CC16)is one of the most important secreted proteins of Clara cells in respiratory epithelium, which mainly exists in the lining fluid of lung epithelial cells.When the bronchoalveolus-capillary membrane barrier is damaged, a large amount of CC16 will enter the blood.It′s eventually excreted in the urine.In recent years, more and more studies have found that CC16 not only has anti-inflammatory, immune-modulating, anti-oxidation and anti-fibrosis effects, but also is a sensitive indicator of the integrity of the airway epithelium, which can predict the occurrence and development of many children′s pulmonary diseases.This article mainly summarizes the biological characteristics and functions of CC16, and summarizes the research progress of CC16 in the diagnosis and treatment of pediatric pulmonary diseases.