Approach to the patient with vitamin D-deficient osteomalacia due to X-linked agammaglobulinemia / 中华内分泌代谢杂志

Osteomalacia is a metabolic bone disease characterized by impaired mineralization of bone matrix. VitaminD deficiency contributes to a decrease in the efficiency of intestinal calcium and phosphorus absorption, resulting in secondary hyperparathyroidism and an inadequate calcium-phosphorus product, thereby causing osteomalacia. We present a patient who was diagnosed as vitamin D-deficient osteomalacia due to X-linked agammaglobulinemia ( XLA) , and the genetic analysis of the BTK gene revealed a missense mutation ( c.82C>T) . It should be attached great importance to etiological analysis of osteomalacia, and XLA may also be a cause of vitamin D deficiency.

Clinical value of contrast-enhanced ultrasonography in diagnosing thyroid carcinoma / 中国耳鼻咽喉头颈外科

OBJECTIVE To evaluate the clinical value of contrast-enhanced ultrasonography (CEUS) in diagnosing thyroid carcinoma.METHODS The clinical data of 129 patients with thyroid nodules,who were examined by CEUS and were operated in Xinhua Hospital between Jan 2014 and Aug 2015,were analyzed in order to compare the diagnostic results of CEUS to the postoperative pathologic findings,and to summarize its imaging features.RESULTS A total of 132 thyroid nodules in 129 patients were examined by CEUS.Among them,103 nodules were diagnosed as thyroid carcinoma,24 nodules were benign thyroid tumor and 5 nodules were thyroiditis.Compared with pathology results,the diagnostic accuracy,sensitivity and specificity of contrast-enhanced ultrasound is 88.6％,92.2％ and of 75.9％ respectively.The diagnosis of the CEUS in 31 cases was not consistent with the pathological results,in which 8 cases of thyroid carcinoma were misdiagnosed as benign tumor,3 cases of thyroiditis were misdiagnosed as thyroid carcinoma,and 20 cases of benign tumors were misdiagnosed as thyroid carcinoma.The malignant thyroid nodules mainly were papillary carcinoma,which was characterized by'low enhanced'and'slow in fast out'performance in the contrast-enhanced ultrasound examination.CONCLUSION The contrast-enhanced ultrasound examination in diagnosing thyroid carcinoma has much more specificity and sensitivity,the'low-enhanced'and'slow in fast out'signs of the CEUS were the important features of malignant thyroid nodules.

Approach to the patient with pregnancy-associated fulminant type 1 diabetes mellitus / 中华内分泌代谢杂志

One case with fulminant type 1 diabetes during the third trimester of pregnancy was reported.If a patient manifests abrupt onset of hyperglycemia,nausea,vomiting,and bellyache during pregnancy or immediately after delivery,fulminant type 1 diabetes should be considered.

Effects of advanced glycation end-products on matrix metalloproteinase 2 expression in INS-1 cells / 中华内分泌代谢杂志

Objective To explore the impact of advanced glycation end-products ( AGEs) on matrix metalloproteinase 2 ( MMP-2) expression in cultivated INS-1 cells. Method INS-1 cells were cultivated and MMP-2 expression was analyzed. Glycated serum was prepared for incubating with INS-1 cell. Reactive oxygen species (ROS) was detected by flow cytometry. The intracelluar MMP-2 expression was analyzed by RT-PCR, realtime PCR and Western blot. The MMP-2 cDNA was expressed in cultivated INS-1 cells. Result The level of ROS treated with AGEs was significantly higher than that in the control( P<0.05 ) , and the levels of MMP-2 and its protein expressions turned out as well( P<0. 05). Conclusion The results suggest that MMP-2 was expressed in INS-1 cells. Increased MMP-2 expression in ?cells may be induced by AGEs, suggesting that MMP-2 might play an important role in oxidative stress-mediated islet injury.

Analysis of new-onset malignant tumors in 1771 type 2 diabetes mellitus patients / 中国医师杂志

Objective To investigate the prevalence rate of new-onset malignant tumors in type 2 diabetes mellitus patients .Methods Type 2 diabetes mellitus patients ( 1771 cases ) over 3 years since May 2006 in Xinhua Hospital were retrospectively recruited .The prevalence and distribution of different tumors were analyzed .Results ⑴Total prevalence of malignant tumors was 2.88%, and more common in male ( P <0.05 ) .The prevalence of different malignant tumors in human systems from high to low were digestive, urinary, and respiratory .⑵Age-dependent analysis from <50, 50~, 60~, 70~,and≥80 showed that the prevalence were 0.73%,1.93%,3.27%,3.58%, and 5.02% respectively .A significant difference was found in them ( P <0.05 ) .Conclusion The prevalence of new-onset malignancies is higher in type 2 diabetes mellitus , which is associated with age and sex .Tumor screening should be strongly recommended in such a group of the patients for their earlier diagnoses and treatments due to the un -typical clinical manifestations .