Objective To observe the correlation between vitamin D and liver cirrhosis classification in hepatic diabetes.Methods Thirty-eight patients with hepatic diabetes,48 patients with type 2 diabetes and 30 cases of healthy controls were collected.The level of serum 25-(OH)D3 was determined,and the Child-Pugh score was calculated.The correlation between pathogenesis and pathogenetic condition of hepatic diabetes was analyzed.Results The levels of serum 25-(OH)D3 in hepatic diabetes patients,type 2 diabetes patients and healthy controls were (38.23 ± 12.47),(63.33 ± 13.58) and (86.14 ± 16.25) μ mol/L,and there was statistical difference (P ＜ 0.05).There was negative correlation in hepatic diabetes between serum 25-(OH)D3 level and liver cirrhosis Child-Pugh score (r =-0.363,P ＜ 0.05).Conclusion Low level of vitamin D may be one of the pathogenesis of hepatic diabetes.

[Objective]To explore the treatment method of Spinal tuberculosis with focus-healed kyphosis and compression of spinal cord in thoracolumbar region.[Method]Seventeen cases were treated surgerically by single stage procedure,including posterior fusion,posterior instrumentation,decompression of spinal canal and interbody autografting.[Result]All patients were followed up from 9 months to 7 years postoperatively.The solid fusion was showed radiologically in 2.8 months at posterior autografting and in 3.3 months at interbody autografting on the average.The anteriolateral decompression of spinal canal was performed on 6 cases,completely recovered in 1 case,partially recovered in 3 cases and bad result in 2 cases.[Conclusion]Spinal tuberculosis with focus-healed kyphosis and compression of spinal cord in thoracolumbar region may show little spinal symptom clinically.The purpose of treatment is to provide rigid fixation and good stability of spine.

Objective To investigate the effect of the operational treatment for periampullary carcinoma.Methods The data of 53 operative patients were retrospectively analyzed. Among the 24radical operations, PD was performed in 23 cases ,PPPD in 1 ;the palliative operation was performed in 29 cases. Results Among the 24 radical operaions, the overall mortality was 8.3% (2/24), no operational death. The postoperative morbidity was 15 cases,including 5 cases of pancreatic fistula. Median length of hospital stay was 26 days. Conclusion Continual improvement of operative technique and sufficient perioperative management were the keys to increasing the effect of the operational treatment.

Objective To investigate the principles of diagnosis and treatment of early postoperative inflammatory small bowel obstruction(EPISBO).Methods The clinical data of 22 patients admitted to our hospital from January 2000 to June 2009 were analysed for early postoperative inflammatory small bowel obstruction.Results 22 cases were cured in a mean period of 15 days through gastrointestinal decompression,somatostatin,TPN and other medications.There was no reoperations.Conclusion For EPISBO,conservative treatment should be adopted first,somatostatin and TPN has batter results.

Objective:To characterize the imaging distortion of the 1.5T magnetic resonance imaging-guided linear accelerator (MR-Linac) and to analyze the influence of MR-Linac and peripheral devices on the geometric distortion.Methods:Specialized MRI imaging distortion phantom and analysis software were applied. The baseline of imaging distortion within diameter spherical volume (DSV) around the center of the magnet was established. The influence of the beam generation system, mechanical system and peripheral devices on the imaging distortion was analyzed. The long-term stability of imaging distortion was tested on the MR-Linac.Results:Imaging distortion of the MR-Linac was increased with the increasing distance to the center of the magnet. Within DSV 400 mm, few test points surpassed 1 mm imaging distortion in 3D directions. However, imaging distortion surpassed 2 mm in part of region within DSV 400-500 mm, with the largest distortion over 7 mm. Imaging distortion of the MR-Linac remained unchanged within 7 months after installation. And the influence of the MR-Linac and peripheral devices on the imaging distortion was only observed in the overall largest distortion within DSV 400-500 mm.Conclusions:Cautions should be taken during the application of high-field MR-Linac in patients whose tumor location is over 20 cm from the ISO center. Imaging distortion of the MR-Linac remains stable within 7 months after installation. The influence of the MR-Linac and peripheral devices on the imaging distortion is trivial, which can be neglected in clinical practice.

Objective To study the clinical significance of intercostobrachial nerve ( ICBN) reservation in radical resection of breast cancer .Methods 42 cases with breast cancer at stageⅠ,ⅡorⅢa were randomly divided into experimental group(n=28) and control group(n=14).In the experimental group,the ICBN were preserved in the axillary lymph node dissection operation ,while in the control group ,the ICBN were resected in the operation .After the operation,both two groups were treated as breast cancer and the patients were followed up .The operation time,the number of ALND , local tumor recurrence and distant metastasis rates after operation , survival rate were compared between the two groups.Results Postoperative 14 days,3 months and 6 months,the incidence rates of the sensory disorder in the internal upper arms in the control group were 85.7%,64.3% and 50.0% respectively,those in the experimental group were 10.7%,3.5% and 0.0%.The differences were statistically significant between the two groups(P<0.05).The average operation time,average number of lymph node dissection between control group and experimental group had no significant difference [(80.0 ±12.9) min vs (88.0 ±15.6) min,(16.4 ±5.4) vs (14.8 ±6.1)](P >0.05).In the control group,the local recurrence rate,distant metastasis rate and survival rate were 0.0%,7.0%and 0.0%,those in the experimental group were 0.0%,0.0% and 0.0%.There were no statistically significant differences between the two groups .Conclusion It is feasible to preserve the ICBN in radical resection of breast cancer ,which reserves the skin sensory function of the internal upper arm and axilla ,and enhance the patients'quality of life.

Objective To explore the effect of endovenous laser treatment ( EVLT) for varicose great saphe-nous veins complicated with ulcers .Methods 40 cases ( 46 limbs ) of varicose great saphenous veins complicated with ulcers underwent EVLT .The abnormal vein branches of the base of ulcers and adjacent ulcers were burned and closed.Results Except a case suffered the secondary transplantation for skin flap necrosis ,no infection,skin necro-sis,deep vein thrombosis complications occurred in other 39 cases.All the ulcers healed ,and postoperative lower limb varicose veins were disappeared .The operation time was (65 ±11.6) min.All the ulcers healed and the hospitalization time was (21 ±4.6)d.All the patients were followed up for 6-36 months,and no recurrence was found.Conclusion EVLT for varicos e great saphenous veins complicated with ulcers has the advantages of good effect ,minimal incision , and quick recovery .

Objective To probe into the social support, coping styles, and mental health status of medical staff in a tertiary hospital in Beijing, for identifying potential mental problems. Methods Such means as the Social Support Rating Sheet (SSRS), Simple Coping Style Questionnaire (SCSQ), Symptom Checklist (SCL-90), and demographic characteristics questionnaire were called into play, to study 2460 medical staff in five tertiary hospitals in Beijing. Results Differences were identified among medical staff of different demographic characteristics, in terms of positive coping style and support dimensions. Analysis of the survey data indicates that the total SCL scores, total symptom problem index, positive symptom pain level, total average score of the factors, are positively related to passive coping style, as P<0. 01; and are negatively related to subjective/objective support, support utilization, and total support scores, as P<0. 01. Conclusions Hospital administration is expected to implement focused intervention to such medical staff as those under 40 years old, women, widows or divorcees, those with education lower than university degree, those with junior academic title or lower, those without titles, those in emergency departments and emergency intensive care units, doctors and nurses, frequent night-shift workers, those of excessively low self evaluation, and medical staff with chronic diseases. The purpose of this practice is to alleviate their mental stress.

Objective To observe the curative effect of herbal iontophoresis with rotation manipulation treating lumbar disc herniation.Methods 84 patients from July 2011 to July 2012 with lumber disc herniation in Electric Power hospital of Capital Medical University were randomly divided into two groups (a testing group n=42,a control group n=42).The testing group was treated with herbal iontophoresis and rotation manipulation,and the control group was treated with rotation manipulation only.The Visual Analogue Scale and Macnab standard for curative effect were observed before the treatment and 3 weeks later after the treatment.Results The total effective rate was 88.1％ and 66.7％ in the testing group and the control group respectively,the difference between two groups was statistically significant (chi-square=5.51,P=0.02＜0.05).The VAS before and after treatment in testing group were (7.31±1.39) and (2.41±1.62) respectively,compared with (7.19± 1.38) and (3.07± 1.28) in the control group.The VAS and curative effect indexes were both improved in the two groups,but the testing group increased more apparent,and the difference between the two groups was significant (P＜0.05).Conclusion The curative effect of herbal iontophoresis and rotation manipulation treating lumber disc herniation was sound.

Objective To explore the feasibility of application of the Monte Carlo method to simulate the whole body dose distribution in patients with total body X (γ) ray irradiation by comparing the actual measurement results.Methods A Monte Carlo model of a 6 MV Elekta Synergy Clinical linear accelerator was established by MCNPX.According to the relationship between the CT value and the density of the material,the CT of the ATOM physical phantom was converted into a voxel phantom for MCNPX calculation.The dose distribution of the whole body was simulated in the total body X (γ) ray irradiation.The simulated results were compared with the measurement values of the thermoluminescence dosimetry at different positions in the ATOM physical phantom to analyze the differences.Results The difference between the depth dose curve and the off-axis dose curve and the actual measurement values calculated by the 6 MV accelerator treatment head model in the water tank was less than 2％,with the maximum dose depth of approximately 1.5 cm and field size of 10 cm× 10 cm,which were consistent with the actual measurement values.The maximum difference between the simulated results at different locations in the body and the thermoluminescence dosimeter was approximately 4％,and the simulated results of MCNPX were almost in good agreement with the results of thermoluminescence.Conclusions The whole body dose distribution in patient with total body X (γ) ray irradiation can be accurately simulated by MCNPX.Monte Carlo simulation makes it possible to optimize the uniformity of the total body dose during the total body irradiation process.