30 ?g/min were found to have retinopathy, but those with slightly increased UAE (15-30 ?g/min) showed a lower incidence of retinopathy similar to that of non-albuminuric diabetics. It indicates that UAE with 30 ?g/min may signal an imperative stage in preventing micro-vascular complications in diabetes.

In the present study, we observed the effects of cholinergic enhancement by pyridostigmine (PD), a cholinesterases inhibitor, on GH release in both normal (n = 13) and GH deficient children and adolescents (n = 8). Responses of GH to insulin hypoglycemia were also observed. In the normal subjects, PD-induced serum GH peak levels were significantly higher than that induced by insulin (P

Objective] The explanations of the six meridians theory in the book Shanghan Lun were always divergent, most of them explained it with medical theory of later ages.However, il ustrating it from the philosophic perspective was not commonly seen. Yi Jing, the book of changes, was the origin of traditional Chinese philosophy, and the six meridian system, which included three yin and three yang, was just derived from the four xiang(a traditional Chinese concept which refers to taiyang, shaoyin, shaoyang, taiyin). [Method] Through the eight trigrams and the images were analyzed with the Treatise on Six Classicsstate gasification combined with analysis Zhongjing Six Classics theoretical system and the principle of prescription. [Result] Found that eight trigrams can be good images of the corresponding six by the system, the difficult provisions in Tretise on Febrile Diseases were wel explained. [Conclusion]Through combining the images of Bagua(eight trigrams) in Yi Jing with six meridians in Shanghan Lun,il ustrating six meridians from philosophic aspect, and explaining the six meridians theory with philosophical ideas before Zhongjing ’s(the writer of Shanghan Lun) age, in order to provide new ways of thinking in comprehending the six meridians system.

Objective]To study the correspondence between human and universe theory in Shanghan Lun starting with Zhongjing ’s doctrine of treatment based on four seasons,analyse the influence of the changing seasons on giving names to the six meridians by Zhongjing ,research on the influence of pulse theory based on four seasons in Huangdi Neijing on the pulse system includes the six meridians system ,summarize the rules of the four seasons’ influence on the six meridians system in Shanghan Lun,and return to Zhongjing’s original viewpoint of four seasons and their yin and yang condition. [Method]By studying the Treatise on Four Seasons treatment Dafa Six Classics and veins in the school system, restore Treatise on Heavencorresponding way of thinking. [Result] It finds that seasons law is the core of six distinguished by its Zhongjing school system clock. [Conclusion] Studying the Four Seasonslaw andseasons therapy Dafa can know Treatise on Six by the corresponding season and six by the significance and reflects theTreatise onlearning system from four seasons pulse method.

Objective To investigate the pathological features,diagnosis and treatment of primary malignant melanoma in esophagus (PMME).Methods The clinical data of 3 patients with PMME who were admitted to the Beijing Friendship Hospital from January 2008 to June 2009 were retrospectively analyzed.All the patients received esophageal barium radiography,electronic fiberesophagoscopy,esophageal endoscopic ultrasonography,computed tomography,and underwent surgery.Adjuvant therapy and immunotherapy were applied postoperatively.Results The results of barium radiography showed irregular filling defect presentation in the distal esophagus.The results of endoscopy showed a purple black tumor with a length of 3-8 cm in the esophagus.The results of endoscopic ultrasonography showed that the tumor was derived from the mucosal layer with low echo density.The results of computed tomography showed thickness of the lower segment of the esophagus.All the 3 patients received left thoracic approach esophagectomy and esophagogastrostomy.Histopathology and immunohistochemistry confirmed malignant melanoma.The expressions of Mart-1,HMB-45 and S-100 antigen were positive.The survival time of 2 patients was longer than 3 years,and 1 patient died of metastasis 6 months after operation.Conclusions PMME is a kind of rare and malignant tumor with dismal prognosis.Surgical management is the first choice,adjuvant chemotherapy and immunotherapy are hopeful to increase the survival time of the patients.

Objective To investigate the application value of spiral CT spinal cord and intervertebral disk 3D recontruction in vertebra trauma.Methods 78 patients with vertebra trauma were examined by CT axial, the primal date of each were retrospectively inserted and reconstructed, all the cases use 3D,SSD and sagittal MPR, compared with routine 2DCT.Results Spinal cord was normal in 23 cases.Spinal cord was pressed in 39 cases.Spinal cord was transected in 16 cases.Intervertebral disk was damaged in 38 cases.Conclusion Spiral CT can do spinal cord and intervertebral disk 3D reconstruction , it can show vertebra trauma and display intervertebral disk damage intuitionistically,which has instruction in making reasonable cure project and judging cure effect.

Objective To construct and implement theSTARnurse training model, and discuss its application effect and the problems that should be paid attention to, and to provide operational cases and practical basis for nursing clinical education. Methods Through literature review and expert consultation, the framework and content of STAR nurse training model were set up and implemented. The questionnaire survey and semi structured in-depth interviews were conducted among the nurses in the hospital to evaluate the effect of improving the nurses′self-directed learning ability. Results After the implementation of the project, the scores of the three dimensions of self-management, desire for study and self-control were (3.67±0.57), (4.05±0.54), (3.99±0.50) points, which were higher than (3.55±0.49), (3.71± 0.52), (3.53±0.42) points before implementation. The difference was statistically significant (P<0.05 or 0.01). The semi structured in-depth interviews showed that all the nurses believed that STAR nurse training model could promote independent learning and stimulate interest in learning. 14 nurses thought it was beneficial for the nurses to find the problems. Conclusions STAR nurse training model can create a favorable learning environment for nurses, and stimulate the learning motivation. It plays a positive role in improving nurses′ability of self-directed learning.

Septic arthritis of the sternoclavicular joint(SCJ) is a rare condition and accounts for 0.5％-1.0％ of septic arthritis.SCJ infections often require surgical intervention.Diabetes mellitus,rheumatoid arthritis,intravenous drug use,intraarticular injection and immunosuppressive disorders are predisposing factors.Staphylococcus aureus and Pseudomonas aeruginosa are the most common bacteriologies.Early diagnosis of SCJ infection requires a high index of suspicion and a confirmatory CT or MRI scan.The characteristic imaging features include intramedullary and soft tissue gas,sequestra,soft tissue swelling and destruction or widening of joint space.Management strategies have ranged from conservative antibiotic therapy to en-bloc resection of the sternoclavicular joint with or without ipsilateral pectoralis major muscle transposition.The shoulder function in most patients were well preserved.

Objective To investigate the treatment of elderly dialysis patients with refractory hypertension.Methods Sixty-six patients were randomly divided into two groups of A group and B group,with 33 cases in each group.Patients in A group were treated by routine hemodialysis 3 times per week and hemoperfusion 1 time every 2 weeks.Patients in B group were treated by routine hemodialysis 2 times per week and hemodiafiltration 1 time per week plus hemoperfusion 1 time every 2 weeks.The levels of blood pressure,plasma endothelin (ET),angiotensin-Ⅱ (AT Ⅱ),renin (RA),parathyroid hormone (PTH) in two groups before and after treatment were compared.Results Before and after treatment,the levels of blood pressure,ET,AT Ⅱ,RA and PTH in A group were (183.42 ± 16.20)/(109.15 ± 7.69) and (151.45 ± 3.31)/(88.71 ±4.95) mmHg(1 mmHg =0.133 kPa),(173.45 ±41.25) and (160.38 ±25.31) ng/L,(69.21 ± 18.47)and(57.25 ± 23.34) ng/L,(1.21 ± 0.15) and (0.87 ± 0.14) μ g/L,(530.27 ± 43.28) and (272.43 ± 34.19) ng/Lrespectively.Before and after treatment,the levels of blood pressure,ET,AT Ⅱ,RA and PTH in B group were (185.34 ± 12.26)/ (112.38 ± 6.24) and (141.59 ± 4.15)/ (80.39 ± 2.73) mmHg,(178.21 ± 34.35) and (149.12 ±21.34) ng/L,(68.38 ±23.57) and (47.17 ± 15.61) ng/L,(1.19 ±0.29) and (0.69 ±0.41) μg/L,(528.62 ± 42.53) and (253.15 ± 31.62) ng/L respectively.The levels of blood pressure,ET,AT Ⅱ,RA and PTH in two groups after treatment were significantly decreased compared with those before treatment (P ＜0.05),and there were significant differences between two groups (P ＜ 0.05).Conclusion Combined with hemoperfusion in the treatment of elderly hemodialysis patients with refractory hypertension,the effect of combined hemodiafiltration is significant,and it is worthy of promotion.

0.05). CONCLUSIONS Levofloxacin is suited to prevent and treat the infection during the perioperation of appendectomy due to acute appendicitis.