Of 807 Cases of Diabetes mellitus, 100 were ketoacidosis with or with-ot coma(40 Cases among them with coma), 55 were males, 45 females. Therange of age was 5 to 76 years. There were 39 cases of ketonemia with ju-venile diabetes, and the incidence was 29. 5 per cent of 137 cases. 61 werefound to have ketonemia with adult dialetes, the incidence being 10. 2 percent of 594 cases. Blood glucose level was 166. 7 to 1000mg/dl. The mostcommon precipitating causcs of ketonemia were infection and the dis-continue of insulin treatment(58 per cent). According to the dosage of insu-lin, our patients were divided into two groups. One was a small dosagegroup(the total mean dose 25. 5 ? 3. 1 u), the other was a large dosage group(the first 8 hours' mean dose 121. 67 ? 102u, the fitst 24 hours' mean dose206. 62 ? 18. 01) There were on death and severe complications of insulintherapy in the small dosage group, but 13 (16 per cent) were died in thelarge dosage group, in which there took place such complications as hypo-kele mia(11 per cent), hypoglycemia (26 per cent) and encephaledema (3. 8per cent). Also, the negative acetone bodies occured faster in the smalldosage group. For this reason, we consider the effect of the treatment inthe small dosage group was better. Recently, we have controlled alkelidosage more strictly than before. 100-200ml of 4% Bicarbonate was givento the patient if the blood CO_2 combinedpower was lower than 20 Vol pe,

Objective To investigate peoples' awareness degree and attitudes about organ donation in current China.Methods A questionnaire regarding organ donation was designed,including 20 little questions distributed in 10 groups,most of which were choice questions.The major question was people's attitudes on organ donation,and the development of organ donation.The survey was held in the outpatient hall,bustling commercial district and four professional colleges.The interviewees were randomly selected,and their gender,age,education background,profession or major filed were asked to be indicated on the paper.Results 2930 valid questionnaires were acquired in all.The proportion of men to women was nearly 1 ∶ 1.2,with mean age of 38.12 years old; more than 90％ of the interviewees knew organ transplantation,and could choose.some of the transplantable organs;more than 95％ knew organ donation,but the time varied; nearly 90％ of the interviewees approved cadaveric organ donation,and 73％ of them would like to donate their organs post mortem.People who know more about organ failure and organ transplantation can give more supports to organ donation.The young students have much enthusiasm to organ donation,but much professional knowledge is also needed to firm their attitudes.The approval percentage of living organ donation was 65.3％,obviously lower than cadaveric organ donation ( P ＜ 0.05 ).85.7％ of the interviewees approved to compensate the donators family appropriately.62.9％ suggested using media and various kinds of education to increase people's knowledge about organ donation,and only 20％ chose appropriate legislation.Conclusion At present,the public are aware of some general knowledge about organ transplantation and organ donation.Most of the public approve organ donation and would like to donate their organs post mortem.The popularization of organ transplantation can give facilitation to organ donation.Most of the interviewees believe appropriate compensation is necessary for the donator's family.Media and education can promote the development of organ donation.

Objective To investigate the effect of nicotine on coagulation abnormalities in endotoxemic rats.Methods Ninety-six male SD rats weighing 200-250 g were randomly divided into 4 groups (n=24 each): group normal saline (group NS);group LPS;group nicotine(group NIC)and group α-bungarotoxin (α7 nicotinic acetylcholine receptor antagonist, group α-BGT) . Endotoxemia was induced by LPS 10 mg/kg injected via femoral vein in LPS, NIC and α-BGT groups. In group NIC nicotine 400 μg/kg was injected intraperitoneally at 30 min before LPS injection. In group α-BGT α-BGT 1 μg/kg was injected intraperitoneally at 15 min before intraperitoneal nicotine. Prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(Fib),antithrombin (AT),von Willebrand factor(vWF),plasminogen activator inhibitor-1(PAI-1),D-dimer,platelet count and TNF-α were measured before (baseline) and 2, 4 and 6 h after LPS injection.Results PT and APTT were significantly prolonged and plasma Fib and AT concentrations and platelet count were significantly decreased, while plasma PAI-1, D-dimer, vWF and TNF-α concentrations were significantly increased after LPS administration in group LPS as compared with group NS. Nitotine pretreatment significantly attenuated the LPS-induced changes in group NIC.The effect of nicotine was counteracted by α-BGT. Conclusion Nicotine can attenuate coagulation abnormalities induced by LPS by acting on α7 nicotinic acetylcholine receptor.

Objective To investigate the effects of recombinant human augmenter of liver regeneration (rhALR) on renal inflammation in acute kidney injury (AKI) induced by renal ischemia reperfusion (IR). Methods SD rats were randomly divided into sham-operated group,IR group,rhALR1 group (100 μg/kg) and rhALR2 group (200 μg/kg).Both renal pedicles of rats were identified and occluded with microvascular clamps for 60 min to induce acute kidney injury (AKI).Blood urea nitrogen and serum creatinine levels were evaluated using a Hitachi 747 automatic analyzer. For histological examination, sections were stained with HE. The activity of myeloperoxidase (MPO) was detected by spectrophotometer.Expression of TNF-α,ICAM-1,MCP-1 was determined by Western blotting. Results Blood urea nitrogen,serum creatinine levels and the injury of kidney were improved significantly in rhALR group as compared with IR group (all P＜ 0.05).They were improved more significantly in rhALR2 group as compared to in rhALR1 group (all P＜0.05).The protein levels of TNF-α,ICAM-1,MCP-1 and the activity of MPO in kidneys from the sham-operated rats were low,and increased significantly after renal ischemia reperfusion injury (all P＜0.05).After treated with rhALR,the expression of TNF-α,ICAM-1,MCP-1 and the activity of MPO were decreased significantly in kidneys as compared to those in IR group (all P＜0.05),which decreased more significantly in rhALR2 group than those in rhALR1 group (all P＜ 0.05). Conclusions nhALR can protect kidneys from ischemia reperfusion injury in rats.The mechanism may be associated with the inhibition of renal inflammatory cells infiltration and down-regulated expressions of YNF-α,ICAM-1 and MCP-1 in the kidney.

Objective To observe the clinical effect on cervicogenic headache (CEH) of pulsed radiofrequency stimulation (PRF) applied to the C2 dorsal root ganglion combined with nerve block.Methods A total of 78 cases diagnosed as CEH were randomly divided into a combined treatment group,a PRF treatment group and a nerve block group.The combined treatment group was given both PRF applied to the C2 dorsal root ganglion and blocking therapy.The other two groups were given only one treatment or the other.All the treatments were once weekly for 3 weeks.Before treatment and 1,3 and 6 months after treatment,all of the patients' headaches were evaluated using a visual analogue scale (VAS).Results At 1,3 and 6 months after treatment,the average VAS scores of all three groups had decreased significantly.The VAS ratings dropped the most in the combined treatment group,followed by the PRF group and then the nerve block group.All the intergroup differences were statistically significant.The combined treatment group's cure rate (88％) was significantly better than that of the PRF group (81％),which was significantly better than that of the nerve block group (54％).Conclusion Combining PRF applied to the C2dorsal root ganglion with nerve block therapy has a synergistic effect on CEH.The curative effect of the combined treatment was better than either PRF or blocking alone.

Abstract? AlM: To evaluate the meaning of using optical coherence tomography with enhanced depth imaging ( OCT-EDl ) to measure choroidal thickness of central serous retinopathy ( CSC) .?METHODS: With the retrospective case control study, 65 patients (65 eyes) with CSC and 50 healthy controls (50 eyes ) with age, gender and diopter - matched were recruited in this study. OCT-EDl were used to measure the subfoveal choroidal thickness ( SFCT ) in CSC eyes, the fellow eyes and also the control eyes. Of which 40 of the 65 CSC patients self-cured, 14 of them were treated with photodynamic therapy ( PDT ) , the left 11 accepted the laser photocoagulation ( LP ) . SFCT were measured 3mo after that. Compared with the previous data, the statistical analysis was carried out.?RESULTS: The SFCT value of 65 CSC eyes, 65 fellow eyes and 50 control eyes were 436. 23 ± 89. 50, 389. 45 ± 101. 03 and 329. 36 ± 95. 87μm, respectively. The SFCT of suffer and fellow eyes increased significantly compared to the control eyes ( P = 0. 008 and 0. 013, respectively). There was also significant difference in SFCT between the CSC eyes and the fellow eyes (P=0. 021). The SFCT were significantly decreased after PDT (P=0. 032), but with no significant changes after LP or self-cured ( P=0. 057 and 0. 076, respectively).?CONCLUSlON: OCT-EDl is a useful method to assess the choroidal topographic changes of CSC. The SFCT are significantly increased in the CSC eyes compared with that in the fellow eyes and the control eyes.

Objective To study the changes of blood arginine vaso-pression(AVP)levels in patients with severe brain injury after treated with mild hypotherima.Methods Seventy-eight patients with severe brain injury were divided into mild hypothermia(33～35℃)group and normothermia group.The blood AVP levels and CSF AVP levels were determined at the third and the seventh day after brain injury.Results The AVP levels in blood and CSF of mild hypothermia group were lower than those of the normothermia group at the third and seventh day after brain injury(P＜0.05).According to GOS,prognosis of the mild hypothermia group was better than that of the nonnotbcrmia group(P＜0.05).Conclusion The mild hypothermia treatment may have inhibitive effects on the production of blood AVP,CSF AVP,and brain edema.Mild hypothermia is an effective method in the treatment of acute severe brain iniury in reducing the mortality and in increasing the survival rate.

Objective To survey the status quo on response time of Emergency Medical Service System (EMSS)in Beijing and analyze the influence,factors in order to explore the existent problems upon EMSS of Beijing for 2008 Beijing Olympic game Methods The quantitative and aualitative mehods were used.The data derived from the record of Beijing Emergency Medical Center on the second half of 2005 was described and analyzed.Results At present,the median of response times in Beijing 120 Emss is 16.5 min,with 14.3 min for Quartile range.The cumulate proportion was 2.28% for less than 5 min,whereas 19.20% for over 30 min. there were statistically significant differences in term of the areas and stations respectively.Conclusion The response time of Beijing EMSS is too long,and it is not to be compared to the developed eoumtries itn terms of swift reponse,we should explore and amalyze the influence factors from various angles and make effort to resolve it.

Teacher student relationship is the most important part in educational activities.It’s quality and quantity have a significant impact on educational and teaching effectiveness.This article aims to analyze the exiting status of the relationship between the tutors and the postgraduates in Peking Union Medical College Hospital, focusing on the some main factors which affect the said relationship, including education environment factor, tutor factor, postgrad-uate factor and etc., and combining the characteristics of Medical Colleges’studying.On the basis of the concerned survey, this article initially discusses the key issues during the establishment of the harmony relationship between tutors and postgraduates.

Objective: To study the possible role and way of ALR in the immune regulation in vitro. Methods: The proliferation of spleen mononuclear cells of rat was detected with 3H-TdR method in vitro under the following different treatments:(1)the administration of the different concentration of rALR with 5 ?g/ml ConA at same time;(2)the addition of 30 ?g/ml ALR after 5 ?g/ml ConA pretreatment in 10 h and 32 h, respectively;(3)the addition of 5 ?g/ml ConA after 30 ?g/ml ALR pretreatment until 30 h. Cyclosporin A and the supernatant from cultures of yeast were used as positive and negative controls, respectively. The IL-2 levels in the supernatants from the mononuclear cells by various treatments were detected with RIA test kit. Results: rALR inhibited the proliferation and the production of IL-2 of the mononuclear cells from rat spleen stimulated by ConA dose-dependently. The mononuclear cell proliferations were still inhibited by 30 ?g/ml rALR after stimulated by ConA for 10 h or 32 h, but the pretreatment of 30 ?g/ml rALR for 30 h had no influence on the reactivity of mononuclear cell to ConA compared with control. Conclusion: rALR could inhibit in dose-dependent way the proliferation of mononuclear cells from rat spleen stimulated by ConA in vitro, but it couldn’t influence the rest mononuclear cells. This suggests that the rest mononuclear cells might not express the receptor of ALR.