Objective To investigate the relationship of serum level of 25 hydroxyl vitamin D3 [25(OH)D3 ] with insulin resistance (IR) and bone metabolism in diabetic patients with chronic kidney disease (CKD) . Methods From April 2012 to February 2014 ,200 diabetic patients with CKD were selected ,and they were divided into three groups according to eGFR:60 subjects in eGFR> 45 ~ 59 ml/(min?1.73 m2 ) group ,60 subjects in eGFR 30~44 ml/(min?1.73 m2 ) group and 80 subjects in eGFR 15~29 ml/(min?1.73 m2 ) group .Clinical features ,IR and indexes of bone metabolism among different groups were compared .Indexes of bone metabolism between two groups with different HOMA‐IR level were also compared . Results The difference of age ,gender ,BMI ,blood pressure and FPG among three groups had no statistical significance (P> 0 .05) .The difference of duration of diabetes mellitus ,duration of CKD ,urine protein ,blood lipid ,eGFR ,HbA1c ,FIns ,HOMA‐IR and indexes of bone metabolism had statistical significance (P< 0.05) .In 200 patients ,there were 129 patients (IR) with HOMA‐IR≥3.28 ,and 71 patients (non‐insulin resistance) with HOMA‐IR<3.28 .The difference of bone metabolism indexes between two groups had statistical significance (P<0.05) .The serum level of 25(OH)D3 was positively related to HOMA‐IR ,bone mineral density (BMD) at left proximal femur , BMD at lumbar ,P ,Ca and BSAP (P<0.05);while it was negatively related to osteoprotegerin and PTH (P<0 .05) . Conclusion The serum level of 25 (OH )D3 has relevance to IR and bone metabolism in diabetic patients with CKD .

Objective To review the domestic and international state-of-the-art technique of radiation oncology, and to suggest the direction, objective and main aim of radiotherapy in the military. Methods The latest advance in the field of radiation oncology was analyzed after retrieving the references concerned, reviews, meeting reports and treatises published in the latest decade. Results Since 80s of the 20th century, radiotherapy had evolved into a new era of the precise 3-D treatment techniques. The feature of all these modern advanced techniques was to encompass all cancer cells with sufficient high dose of radiation to raise the local tumor control rate, while simultaneously sparing the surrounding normal tissues to decrease severe complications. Imaging guiding radiotherapy might technically assure precision radiation therapy, and its clinical application and research work had been in progress in great fervor. Conclusions On the basis of developing a precise treatment, more attention should be put into research in the field of medical physics and radiobiology in the future, together with the use of new technology. Patients with cancer will be maximally benefited from a comprehensive therapy, including the combined use of precision radiotherapy, chemotherapy, hyperthermia therapy, intervention therapy and molecular target therapy, and other new treatment modality, such as heavy ion radiation therapy.

Anoctamin 1 (ANO1) is a calcium-activated chloride channel and is amplified and over-expressed in gastrointestinal stromal tumor, breast cancer, bladder cancer, head and neck squamous cell cancer, esophageal squa-mous cell cancer, prostate cancer and pancreatic cancer.The amplification and over-expression of ANO1 are associated with lymph node metastasis and poor prognosis.ANO1 promotes tumor formation and metastasis, and the drugs that inhibit the activity or expression of ANO1 show antitumor effects.Therefore, ANO1 may promote the tumorigenesis, and may be a molecular biomarker and a new target for cancer therapy.

Objective To investigate the relevant factors of hyperthyroidism complicating hyperthyroid heart disease.Method Among 48 cases,those factors including age,course of disease,condition and regular treatment were analyzed with Logistic multiple factor reg-ression analysis.Result The hyperthyroid heart disases was related with age,course of disease,condition and whether to treat regularly.Conclusions There are many factors to lead to hyperthroidism complicating hyperthyroid heart disease.It should be paid attention to in those patients with elder,longer course of disease,serious condition and no regular treatment.

Objective To analyze the results of inhaled allergens detection in children with allergic rhinitis(AR)in Changzhou ar-ea and the distribution situation of allergens in different age groups.Methods The levels of serum allergen specific IgE antibodies in 473 children cases(aged 1-12 years)of allergic rhinitis(AR)were detected by the Allergy Screen allergen screen system.The children cases were divided into the infants group(0-3 years old),preschool children(4-6 years old)and school age children(7 -12 years old)according to age.The allergen positive rates and the change tendency were compared among different age groups.Re-sults Among 473 children cases of allergic rhinitis,340 cases(71.9%)were positive.The top three allergens were house dust mite (55.6%),mixed fungi(25.8%)and house dust(18.8%).The positive rate of allergen showed the upward trend with the age in-crease.The distribution of house dust mite(χ2 =21.061,P =0.000),house dust (χ2 =15.111,P =0.000)and the cat and dog dan-der(χ2 = 7.597,P = 0.022 )was statistically significant among the three groups.Single allergen positive rate was the highest (38.5%)and the secand was double allergens(23.7%).The top three positive in single allergens was consistent with sort of total allergen positive rate.The most common double allergen was the combination of house dust mites and house dust.The multiple al-lergen positive rate had statistical significance in the distribution among groups(χ2 =13.399,P =0.001).Conclusion The inhaled allergens of AR children in Changzhou area are dominated by house dust mite,mixed fungi and house dust.The positive rate shows the increasing trend with age increase.The allergen constituents are different in different age groups.The positive single allergen is most common,followed by positive double allergens.

Objective To explore the changes of plasma catecholamines(CA)[including epinephrine(E) and norepinephrine(NE)] and atrial natriuretic peptide(ANP) in children with varying degrees of left ventricular ejection function(LVEF) in chronic heart failure(CHF),and establish natriuretic hormone factors as one of the diagnostic criteria of CHF.Methods Thirty-five patients with CHF and 35 children in good health were enrolled,and the concentration of plasma NE,E,ANP and the LVEF were determined.Results 1.The levels of plasma NE,E and ANP in 35 patients with CHF before treatment were significantly higher than those in control group(Pa

Purpose:To evaluate the different dose distribution created by three different plans on a nasopharyngeal carcinoma case with simultaneous integrated boost intensity modulated radiation therapy (SIB-IMRT). Methods:we designed three different SIB-IMRT plans on a nasopharyngeal carcinoma case, one was from anterior direction of the head, 5 non-equally spaced fields, another was from posterior direction of the head, 5 non-equally spaced fields also, third was 5 equally spaced fields around the head. Each plan had its dose distribution to the target and main critical structures.Results:No significant difference of dose distribution to the target when comparing the previous three different IMRT plans. However, dose to the parotids delivered from 5-equally spacd was obviously lower than the other plans, dose to the optic chiasm was much lower created by the plan designed from the posterior direction of the head with 5 non-equally spacea field.Conclusions:For a nasopharyngeal carcinoma case, there is no significant difference of dose distribution to the target compared with three different 5-beam orientation SIB-IMRT plans. To protect parotids, we recommend designing a plan with equal beam direction around the head. When the target is very close to the optic chiasm, plauning from posterior direction of the head should be better.

Four fractions (starches, water insoluble proteins, water soluble fractions and residue) were separated from oats by means of filtration and repeated high speed centrifugation, and the lipids were extracted by acid-hydrolysis as well. Then each group of experiment hyperlipemic mice, caused by high lipid diet, were fed with these fractions for 10 days respectively. The results showed that the effectiveness of the residue fraction which was rich in dietary celluloses and lipids was similar to the whole oats on depressing bl-ood-lipid and that the water insoluble proteins were effective too. The lip-ids, however,were important but not unique effective composition in the residue of oats.

Objective To understand the cognition of nursing undergraduate innovative talents of college nursing graduates,provide the basis for training and evaluation of nursing undergraduate innovative talents and establishing evaluation system.Methods Using the method of qualitative research,in-depth interviews were carried out in 13 nurses who had received full-time undergraduate nursing education from a comprehensive hospital.The acquired data were collected and analyzed,and the topics were put forward.Results The demands of clinical post for undergraduate nursing talents were many-sided.The explicit achievements such as specific topic submission,articles printed,patented invention,etc.were the most intuitionistic evaluation for innovative talents.Most of the nursing students during the learning period could not understand the importance of innovation ability in nursing work,and were lack of motivation to obtain related knowledge.Many undergraduate nurses chose self-development after work simply for professional title promotion,lacking the simplicity for innovation or for solving practical problems.Conclusions For cultivation of innovative talents,school should take students as the starting point,and the different competency as orientation,perfect cultivation mode of innovative talents.The hospital should provide learning,studying abroad opportunities for nurses,construct the innovation team of department.In addition to explicit results,internal innovation consciousness and innovation spirit should also be concerned in evaluation.