Objective To investigate the influence of calcitriol in pancreatic islet β-cell function,blood glucose and blood lipids in patients with type 2 diabetes mellitus.Methods Ninety type 2 diabetes mellitus patients who had been treated with oral medications and whose treatment regimen was relatively stable were divided into calcitriol group (0.25 μ g/d) and control group (placebo) according to the treatment methods with 45 cases each,and all the patients were completed 12-week' clinical observation.Results After treatment compared with before treatment in calcitriol group,fasting plasma glucose (FPG),fasting insulin (FINS),homeostatic model assessment insulin resistance index (HOMA-IR),glycated hemoglobin (HbA1c),total cholesterol (TC),triglyceride (TG),and low density lipoprotein cholesterol (LDL-C) levels were significantly decreased,high density lipoprotein cholesterol (HDL-C) was significantly higher,and there were statistical differences (P ＜ 0.05).While there were no statistical differences in control group between before treatment and after treatment (P ＞ 0.05).Conclusion Calcitriol can improve glucose and lipid metabolism and pancreatic islet β-cell function in patients with type 2 diabetic mellitus and reduce insulin resistance.

Objective To summarize the bacterial drug susceptibility of common enterobacteriaceae in pediatric patients and the epidemic status of the extended spectrum beta‐lactamases(ESBLs) during 2013 and 2014 in our hospital in order to guide the clini‐cal application of antibacterial drugs .Methods Routine methods of isolation and culture were performed and the distribution of en‐terobacteriaceae with resistance were statistically analyzed with the software .Results A total of 530 isolates were collected in the hospital in which was 32 .08% Klebsiella pneumonia and 38 .87% Escherichia coli .The most sensitive drug of Enterobacteriaeeae was carbapenems .ESBLs positive rate in Escherichia coli and Klebsiella pneumonia were 32 .04% and 20% .The difference was sta‐tistically significant (P<0 .05) .Conclusion Escherichia coli and Klebsiella pneumonia were the common enterobacteriaceae in pedi‐atric patients .Carbapenems remained very high activity against Enterobacteriaceae .However ,the carbapenems resistance strains have been appeared that should pay attention .Antibiotic therapy should be based on the guidance of bacteriology to select sensitive drugs .

With the advancement of the health reform and development of medical services,and performance evaluation of fine management,have become a major means to regulate medical services, improve quality of medical services, and promote healthy functioning of hospitals. The Hospital Authority worked out the performance evaluation standards for municipal hospitals. Setup of such financial evaluation indices as cost control rate,basic operation and healthcare materials for 10 000 yuan medical revenue,per-capita income and expenditure balance,implementation of fiscal input,and asset turnover.Finance and asset management of municipal public hospitals were subject to a general assessment and comparative analysis. Assessment results were linked to the hospital ’s annual performance bonuses.This enables the financial indicators and assessment to play a key role for hospitals to reduce costs,improve efficiency and strengthen fine management. Hospitals were encouraged to achieve balanced income and expenditure, surpluses, asset efficiency, performance budgeting, cost controls,decent financial operations.

Objective: To analyze the equity of benefit which residents with different income get from Urban Employee Medical Insurance ( UEMI) and New Rural Cooperative Medical System (NCMS). Methods: Data used in this study is based on the forth household health service survey in Shanxi province. The indirectly standardization method and concentration index were employed to analyze the horizontal inequity index of benefit rate and benefit degree. Results:The horizontal inequity index of benefit rate and benefit degree in UEMI are 0.0524 and 0.0025, and the horizontal inequity index of benefit rate and benefit degree in NCMS are 0.2312 and 0.3228. Conclusion: The urban residents get the equal benefit from UEM, and there were pro-rich horizontal inequities of benefit rate and benefit degree in NCMS.

Objective To analyze and discuss the effect of heat preservation on the recovery time of BIS and the concentration of propofol in the recovery period of the elderly patients with general anesthesia in order to provide guidance for clinical treatment.Methods 78 elderly patients with general anesthesia were selected as the subjects, and the patients were divided into the control group and the study group with 39 cases in each group.The patients were divided into the control group and the study group.Control group, only to be liquid input and covered by drapes, research group take liquid input and peritoneal flushing fluid heating and heating blanket coverage of insulation measures, were recorded and compared between the two groups from anesthesia began to operation to complete the different time points of esophageal temperature and MAP, and to observe the recovery time of patients and effect compartment concentration differences.Results Two groups at T0, T1 esophageal temperature no significant difference, study group T2-T6 esophageal temperatures were significantly higher than those of the control group (P<0.05), maps of the other two groups at different time points had no significant difference;when two groups of patients with propofol withdrawal BIS values had no significant difference, and in the time of discontinuation BIS is more than or equal to 80 recovery time and effect compartment concentration have significant difference (P<0.05).Conclusion The surgical treatment of elderly patients with general anesthesia can help maintain the body temperature, shorten the recovery time of BIS and reduce the concentration of propofol in the recovery period.

Background and purpose:For the past few years, HPV DNA has been detected in the peripheral blood in the patients with cervical cancer and believed to be a promising tumor marker, but because the concentration in the patients' serum was extremely low, it made it difficult to detect the circulating HPV DNA. In order to find a way to improve the sensitivity of the assay, this study compared and evaluated three methods that are currently being used to measure HPV DNA in the extraction from serum of cervical cancer patients. Methods:51 patients were pathologically proved to be cervical cancer and enrolled into the study. DNA from their sera was extracted by three methods:(1) Phenol-chloroform extraction, (2) UNIQ-10 collumn virus DNA kit(SANGON,Shanghai), (3) QIAamp MinElute Virus spin kit(QIAGEN,Germany). Then the HPV DNA was quantitated by PCR using GP5+/GP6+ primers.Results:Either fresh or short-term storage sera has been used The positive rates were 14.3%, 5.7%, and 57.1% with three assays, respectively. But when long-term storage samples were used to quantitate, the positive rates were low regardless of the methods being used.Conclusions:QIAamp MinElute Virus spin kit was the most sensitive for the content of serum HPV DNA, it could improve the positive rate for the assay if the serum was not stored for long time.

Objective To compare cerebralspinal fluid acetylcholine (ACh) and choline (Ch) in patients with Alzheimer's disease (AD) and vascular dementia (VD), and their correlation with cognitive impairment.Methods First, dementia scales of 22 ADs, 22 VDs and 20 controls were scored using MMSE. Then the concentrations of CSF ACh and Ch in AD and VD were examined using the high-performance liquid chromatography with electrochemical detector (HPLC-ECD). Finally, the scores of MMSE and concentrations of ACh and Ch were compared. Results The ACh concentrations in AD[(10.7?5.1)nmol/L] and VD [(16.8?7.4)nmol/L] were found to be significantly lower than in controls [(34.5?9.0)nmol/L]( P =0.001), and showed a significant positive correlation with MMSE scores. The Ch concentration in AD CSF [(627.6?145.1)nmol/L] was approximately the same as in controls [(716.0?159.4)nmol/L], and showed no correlation with MMSE scores. The Ch concentration in VD CSF [(887.4?187.4)nmol/L] was significantly higher than in AD ( P =0.001) and controls ( P =0.002).Conclusion (1)The depression of ACh is correlated with cognitive impairment, suggesting ACh is an important neurotransmitters for memory. (2) VD may have a similar pathogenesis as AD. (3) The depression of AD ACh concentration and elevation of VD Ch concentration in CSF may be a role in their differentiation. (4) The application of acetylcholinesterase inhibitors is suitable for AD and VD.

6 hours). The APACHE Ⅱ and POSSUM scoring system during perioperative period was in positive correlation with postoperative morbidity and mortality. Conclusions Pancreatoduodenectomy for the treatment of periampullary carcinomas is with high risks. Postoperative mortality and morbidity were in close correlation with the risk factors.

ObjectiveTo evaluate the safety and efficacy o f microvascular deco mpression in the management of primary trigeminal neuralgia.Methods We review ed 13 patients with unilateral primary trigeminal neuralgia treated by microvasc ular decompression. Conventional spin-echo (SE) sequence and 3-D fast inflow wit h steady-state precession (3-D-FISP) sequence MRI scans were used preoperatively to find evidence of neurovascular compression. The operation was accessed by re trosigmoidal approach and the nerve root was separated away from pressure vessel s by artificial vascular patch.ResultsDuring operations it w as found that tr igeminal nerves were pressed on by blood vessels in all the cases (by the superi or cerebellar artery in 11 cases; by the basilar artery and the superior cerebel lar artery in 1 case; and by the vein in 1 case). Complete pain relief was achie ved in all the patients without mortality or permanent complications. Eleven pat ients were clinically followed for 6～24 months with a mean of 13 months, and no recurrence was seen. ConclusionsMicrovascular decompression is a safe and effective procedure in the treatment of primary trigeminal neuralgia.

Objective To explore the relationship between the serum neuron-specific enolase(NSE) level and stroke region and size,the degree of neurological deficit and prognosis at acute stage of stroke.Methods The level of serum NSE was detected by ELISA in 96 stroke patients at acute stage,including 58 cases of cerebral infarction (CI),27 cases of intracerebral hemorrhage(ICH),11 cases of subarachnoid hemorrhage (SAH) and 25 normal controls(NC group).The relationship between the level of serum NSE and China Stroke Score (CSS),Barthel index(BI),score of Glasgow-Pittsburgh Coma Scale,lesions region and volume were analysed among the various stroke types groups.Results The levels of serum NSE in the stroke patients at acute stage were significantly higher than that in NC group (allP