Objective To evaluate the serum 25?hydroxyvitamin D3[25(OH)D3]level in type 2 diabetes mellitus patients and explore its rela?tionship with energy metabolism. Methods A total of 254 type 2 diabetes mellitus patients from Liaoning Province admitted to the Endocrinology Department of our hospital from June 2014 to June 2015 were enrolled into this study. The serum 25(OH)D3 levels of the patients were measured , and the subjects were divided into different groups as follow:the measurement time of 25(OH)D3 from January to May and December was group A,June to November was group B. The parameters of 25(OH)D3,hemoglobin A1C,fasting plasma glucose and other metabolic indicators were compared between the two groups. In addition ,the two groups were divided into four subgroups abased on the level of serum 25(OH)D3:≥30 ng/mL in subgroups A1 and B1,20?<30 ng/mL in subgroups A2 and B2,10?<20 ng/mL in subgroups A3 and B3,and<10 ng/mL in subgroups A4 and B4. The metabolic indexes of different subgroups were compared. Results Serum 25(OH)D3 in group B was higher than that in group A (P<0.001). In subgroup A3,hemoglobin A1c was lower than that in subgroup A4(P=0.043). Groups A and B and each subgroup had no statis?tical significance in serum calcium(P>0.05). Conclusion The level of serum vitamin D has a prevalently decrease in type 2 diabetes mellitus in Liaoning Province,especially in winter and spring. These patients would benefit from supplement vitamin D and outdoor exercise. Vitamin D de?ficiency in patients with type 2 diabetes is associated with blood sugar. Serum calcium can not be used as an indicator of vitamin D.

Most military hospitals lack sufficient support from medical universities and therefore are confronted with a bottle -neck in graduate education. Based on the real conditions of military hospitals, this article introduces the practice and achievement in graduate education in our hospital by expanding the enrollment access, promoting the admission publicity, stressing the disciplinary balance, improving the supervisors′abilities, and enhancing teaching quality. With considerations on the four aspects of supporting strength of scientific research, stratified design of disciplines, construction of teaching quality, and innovation of training modes, it pro-vides some experience in graduate education with a view of giving reference for other military hospitals.

BACKGROUND:Critical limb ischemia is difficult to be treated among the peripheral arterial occlusive diseases, and the application of transplanting autologous stem cells can bring a hope for the treatment of this disease.
OBJECTIVE: To review the autologous stem cells transplantation in the treatment of critical limb ischemia at present, and to study the mechanism and the existing problems.
METHODS:A computer retrieval of PubMed database, Wanfang database, and CNKI database was conducted to search the related articles with the keywords of“stem cell, transplant, critical limb ischemia”in English and Chinese. Final y, 47 articles were included in final analysis according to the inclusion criteria.
RESULTS AND CONCLUSION:Autologous stem cells transplantation for treatment of lower extremity ischemic disease is a latest and significantly effective treatment, but the mechanism is unclear and stil needs further study.

[Objective] This article mainly discussed the potential of myocardial cellregeneration and the possible mechanisms involved. [Method] To study the mechanism of cardiac regeneration ability HSCs, this review studyed the relationship of the differentiation of cardiac stem cells, hematopoietic stem cells, myocardial cells and myocardial regeneration and the possible mechanisms involved. [Result] Self-renewing, differentiation both in vitro and in vivo of the c-kit positive CSCs had been seen. No matter in physiological condition or after damage, the c-kit positive CSCs had clonality and the potential of multi-directional differentiation. Hematopoietic stem cells can generate cardiomyocytes and coronary blood vessels for human celltherapy. The ability of dedifferentiation cells to maintain and improve the ventricular function of a damaged heart is very limited. [Conclusion] CSCs and HSCs play an important role in reversing chronic ischemic and non-ischemic heart failure.

Henoch-Sch(o)nlein purpura(HSP) is one of the most common vasculitides in children with many manifestations including skin purpura,arthritis,abdominal pain and renal involvement.The renal involvement(Henoch-Sch(o)nlein purpura nephritis,HSPN) is the principal cause of morbidity and major risk factor for prognosis in HSP.The paper reviewed the updated treatment strategy for HSPN.Accordingly,steroids,cyclophosphamide,mycophenolate mofetil,mizoribine,cyclosporine,triptolide,angiotensin converting enzyme inhibitors (ACEI) / angiotensin receptor blockers(ARB),plasma apheresis and tonsillectomy are possible indicator for the further therapy of HSPN.Furthermore,prospective randomized controlled treatment studies on children with severe HSPN would be needed.

Phototherapeutic keratectomy(PTK)has been employed as a surgical tool to treat corneal disease for about 20 years.PTK made it possible to remove superficial corneal opacities and thereby restore vision by splitting molecules of biological tissue with 193 nm ultraviolet light.Recently,the development of the excimer laser technique is more rapid.It has principally focused on refractive surgery but has also benefited PTK.Anterior corneal pathology,such as elevated lesions,stromal opacities,corneal scars,corneal dystrophies and corneal degenerations etc,can be visually devastating.Over the past decade,there was a shift in the treatment of these conditions from corneal transplantation to PTK for visual restoration.PTK is a powerful tool for the management of anterior corneal pathology.In a properly selected and well-counseled patient,PTK can significantly improve vision and quality of life.This article reviews the recent literature of techniques for performing and refining PTK and also of various pathologic conditions that can be treated with PTK.

Electric field treatment of tumor technology is of great significance in the treatment of glioma,including direct current electric field and alternating electric field.Direct current electric field affects the migration of glioma cells,and can be used as a new clue for the treatment of glioma.While alternating electric field can inhibit the proliferation and invasion of glioma cells,and induce apoptosis,and can obviously prolong the survival period of patients with glioma and improve their quality of life.

Chronic hyperglycemia is often accompanied by abnormal lipid metabolism, hypertension, low-grade systemic inflammation and oxidative stress.These factors increase the risk of cardiovascular disease(CVD)in type 2 diabetes mellitus(T2DM)patients.Comprehensive treatment of T2DM should emphasize the improvement of abnormal lipid metabolism, prevention of weight gain and reduction of the CVD risk in addition to proper glycemic control.Incretin, as a new hypoglycemic drug, has more advantages in improving glucose and lipid metabolism, finally to reduce cardiovascular risk.Through possible mechanisms including direct influence on liver lipid metabolism, change of fat mobilization and delay of gastric emptying, incretin shows positive influence on the lipid metabolic markers such as low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, triglycerides, and total cholesterol, while it improves glucose control.Thus, incretin plays an important role in the comprehensive management of type 2 diabetes mellitus.

ObjectiveThis system review for the medicine of children gastroesophageal reflux disease(GERD) will provide the latest evidence based medicine evidence for pediatric clinical medication.MethodsThe documents of randomized controlled clinical trials of children GERD,which had been published in domestic and foreign journals from the year 2000 to 2010,had been retrieved and screened by the study inclusion criteria.According to the Jadad evaluation questionaire,the documents' quality had been evaluated.The efficiency rates of treatment were calculated respectively by the merger of same medicines,and the meta-analysis of different drugs had been done for evaluating the effect of different pharmacological therapeutic agents.In addition,the adverse events occurred during treatment were analyzed.ResultsThere were 31 documents fitting inclusion criteria.2 015 cases of children ( 1039 cases in treatment groups and 976 cases in control groups) had been included in these randomized controlled clinical trials.In these documents the agents included:cisapride ( 18 articles ),erythromycin ( 8 articles ),motilium ( 5 articles ).The merger efficiency rates of these medicines were cisapride (93.43％ ),erythromycin (92.86％ ),motilium (93.06％) respectively.There were no significant difference in the efficiencies of the three drugs in the treatment of GERD ( P＞0.05 ).In addition,the results of meta-analysis about treatment inefficiency,used with the postures therapy and support therapy as controls,were cisapride OR=0.15 ( OR 95％ CI0.11～0.20),erythromycin OR =0.08 ( OR 95％ CI 0.04～0.14 ),motilium OR=0.03 ( OR 95％ CI 0.01～0.07).Furthermore,their adverse effect rates were cisapride 0.72％ ( diarrhea 0.58％,somnolence 0.14％ ),erythromycin 0.96％ ( drug rashes 0.48％,slight increase of GOT 0.48％ ),motilium 1.50％ (diarrhea 1.50％ ).ConclusionThe efficiencies of smaller doses of erythromycin were better than cisapride,and not better than motilium;but the adverse effect rates were better than cisapride,and not better than motilium.In summary,smaller doses of erythromycin is better currently in the treatment of GERD.Attention should be paid in the use of erythromycin,since it accounted for slight increases in GOT or drug rashes approximately.

Objective To know the related risk behaviour and counter nursing measures for patients with schizophrenia. Methods Investigated 162 patients with schizophrenia to know their disease-related risk behaviour. Results There were 48 patients had risk behaviour, 83.33% dangerous behaviour was occurred within 2 weeks after enter the hospital. Most dangerous behaviour such as uprash damage, self damage and went astray had occurred from 8:00 to 17:00, commit suicide often occurred from 12:00 to 14:00 or 17:00 to 8:00. Conclusions Evaluation in early stage, strengthen management, build up cooperated relationship between patients and nurses, carry out proper psychological nursing and avoid risk behaviour can effective protect patients with schizophrenia.