Fulminant type 1 diabetes (FT1D) is a new subtype of type 1 diabetes mellitus.It has a fulminant onset of symptoms accompanied with disturbance of consciousness or elevated trypsin,severe hyperglycemia,and severe metabolic disorders.It is a critical disease.FT1D in pregnant women,the elderly,and children and adolescents have different clinical manifestations and treatments due to their different physiological aspects in comparison with that in the adults.This article summarizes the characteristics and managements of FT1D in pregnant women,the elderly,and children and adolescents in order to further enhance the understanding of FT1 D.We call on all clinicians to be vigilant and pay attention to the early diagnosis and treatment of FT1 D in special populations.

Epithelioid hemangioendothelioma (EHE) is a rare malignant vascular tumor. Its malignancy is between benign hemangioma and highly malignant angiosarcoma. It originates from vascular endothelial cells or pre-endothelial cells. It is characterized by the proliferation of vascular endothelial cells with a skin-like or histiocyte-like appearance. The incidence of EHE is less than 1% in all vascular tumors, and it can occur in multiple parts of the body, most often in the liver, followed by simultaneous involvement of the liver and lung, the lung alone, and the bone alone. At present, there is no report of epithelioid hemangioendothelioma diagnosed by bone marrow cell morphological examination in China. In this case, abnormal cells were found through bone marrow cell morphological examination, which guided the direction of further diagnosis and treatment. And finally the patient was diagnosed as epithelioid hemangioendothelioma. The bone marrow cell morphological examination can provided an important basis for clinical diagnosis and treatment. Epithelioid hemangioendothelioma needs to be differentiated from a variety of benign and malignant angiogenic tumors, especially other types of epithelioid angiogenic tumors. At present, it has been found that the disease has characters of cytogenetic and molecular biological abnormalities. Combined with histopathological morphology and immunohistochemical examination, we can make the diagnosis and differential diagnosis.

Objective:To explore the possible mechanism of Bupiwei Xieyinhuo Shengyang Prescription on gastroesophageal reflux disease (GERD) based on network pharmacology and molecular docking technology.Methods:The main active components and target information of Bupiwei Xieyinhuo Shengyang Prescription were screened by TCMSP database, and targets were identified by GeneCards, OMIM, TTD and PharmGKB databases. The intersection of active ingredient components and disease targets was selected to construct PPI network by STRING. Cytoscape CytoNCA plug-in was used to extract core targets for analysis. GO function enrichment and KEGG pathway enrichment analysis were performed using Metascape. Cytoscape 3.7.2 was used to construct the "component-target-signal pathway" network, and Autodock was used to complete molecular docking verification. Animal experiments were further used for verification. SPF SD male rats were selected and GERD model was established by esophageal stent implantation. After 14 days of intervention, serum TNF-α and COX-2 levels of rats in each group were detected for verification.Results:A total of 215 effective compounds were screened from Bupiwei Xieyinhuo Shengyang Prescription. The main targets of GERD were TNF, IL6, CASP3, TP53 and PTGS2, which mainly focused on cancer pathway, AGE-RAGE signaling pathway, calcium signaling pathway and NF-κB signaling pathway. The results of molecular docking showed that the binding potential and activity of the key active components of Bupiwei Xieyinhuo Shengyang Prescription and the core target were better. Compared with the model group, Bupiwei Xieyinhuo Shengyang Prescription could reduce the serum expression levels of TNF-α and COX-2 ( P<0.01). Conclusions:By regulating TNF, IL6, CASP3, TP53, PTGS2 and other core targets, Bupiwei Xieyinhuo Shengyang Prescription can regulate NF-κB signaling pathway, calcium signaling pathway and other signaling pathways to play a role in the treatment of GERD.

The Gastroesophageal reflux disease(GERD)is related to the dynamic disorder of the digestive tract caused by the imbalance of the viscera and meridians.The spleen and stomach are the hub of the qi machinery,transforming the essence of water and valley into energy and regulating the Yin and Yang of all bodies.The sympathetic balance between Ren-Du and Qi is the motivity of the spleen and stomach.Interstitial cells of Cajal(ICC)are the hub of digestive motility,which can maintain mitochondrial energy metabolism through mitochondrial autophagy and improve the digestive motility.Therefore,in this paper,the molecular biological basis of GERD was discussed based on the"regulating pivot with pivot"theory that the pivots of viscera and meridians drive ICC mitochondrial energy balance.It also explains the feasibility of Qi-Shi-Sheng-Jiang-Gui-Yuan Decoction in treating GERD based on"regulating pivot with pivot",which is helpful to realize the microscopization and concretization of"regulating pivot with pivot"theory and realize the modernization of TCM theory.

Zhuye Shigaotang is one of the 100 classic prescriptions published by the National Administration of Traditional Chinese Medicine. This study used the traceability method and bibliometrics method to analyze the main applicable syndromes， efficacy and meanings， modern disease spectrum， and other aspects of Zhuye Shigaotang， so as to further promote the research and development of this prescription. The results showed that Zhuye Shigaotang originated from the Treatise on Febrile Diseases， and its ingredients included Lophatheri Herba， Gypsum Fibrosum， Pinelliae Rhizoma， Ophiopogonis Radix， Ginseng Radix et Rhizoma， Glycyrrhizae Radix et Rhizoma， and Oryza sativa. The main applicable syndromes of Zhuye Shigaotang recorded in ancient books included heatstroke， cough and asthma， sores， sweat syndrome， hiccup， insomnia， malaria， headache， blood syndrome， nasosinusitis， laryngitis， etc.， involving diseases of internal medicine， surgery， gynecology， and pediatrics. Its pathogenesis was "incomplete residual heat， both Qi and Yin injuries， and stomach-Qi disharmony". The research found that Zhuye Shigaotang could also be used to treat acne， measles， and cholera， and it was especially suitable for the treatment at the later stage of epidemic diseases. Lophatheri Herba and Gypsum Fibrosum in the prescription could clear away heat and relieve vexation. Ginseng Radix et Rhizoma，Ophiopogonis Radix， Ginseng Radix et Rhizoma， and Oryza sativa could promote body fluid production and invigorate Qi. Pinelliae Rhizoma could harmonize the stomach and stop vomiting. The prescription had stable compatibility and had the effects of clearing away heat， relieving vexation， invigorating Qi， promoting body fluid production， and harmonizing the stomach. Zhuye Shigaotang was widely applied in modern clinical practices， with high application frequency in the digestive system， pediatric-related diseases， respiratory system， infectious diseases， circulatory system， and neuropsychiatric system. The specific symptoms included recurrent aphtha， hiccup， infantile pneumonia， infantile summer fever， unexplained fever， upper respiratory tract infection， epidemic hemorrhagic fever， and late measles.