Objective To evaluate the serum 25?hydroxyvitamin D3[25(OH)D3]level in type 2 diabetes mellitus patients and explore its rela?tionship with energy metabolism. Methods A total of 254 type 2 diabetes mellitus patients from Liaoning Province admitted to the Endocrinology Department of our hospital from June 2014 to June 2015 were enrolled into this study. The serum 25(OH)D3 levels of the patients were measured , and the subjects were divided into different groups as follow:the measurement time of 25(OH)D3 from January to May and December was group A,June to November was group B. The parameters of 25(OH)D3,hemoglobin A1C,fasting plasma glucose and other metabolic indicators were compared between the two groups. In addition ,the two groups were divided into four subgroups abased on the level of serum 25(OH)D3:≥30 ng/mL in subgroups A1 and B1,20?<30 ng/mL in subgroups A2 and B2,10?<20 ng/mL in subgroups A3 and B3,and<10 ng/mL in subgroups A4 and B4. The metabolic indexes of different subgroups were compared. Results Serum 25(OH)D3 in group B was higher than that in group A (P<0.001). In subgroup A3,hemoglobin A1c was lower than that in subgroup A4(P=0.043). Groups A and B and each subgroup had no statis?tical significance in serum calcium(P>0.05). Conclusion The level of serum vitamin D has a prevalently decrease in type 2 diabetes mellitus in Liaoning Province,especially in winter and spring. These patients would benefit from supplement vitamin D and outdoor exercise. Vitamin D de?ficiency in patients with type 2 diabetes is associated with blood sugar. Serum calcium can not be used as an indicator of vitamin D.

Objective　To explore the factors related to local recurrence after resection of rectal carcinoma and the significance of reoperation. Methods　A retrospective analysis was made on the clinical date of 25 cases who had local recurrence after resection of rectal carcinoma. Results　The primary operation revealed that 19 cases were in Dukes stage B,15 in stage C.8 cases were low-differentiated adenocarcinoma,2 adenocarcinoma and 3 malignant chang of villous adenoma. The distal incision margin from the tunor was <3 cm in 16 cases, >3cm in 9. Radical operation was performed in 12 cases, palliative opration in 9; and non-resection procedure was made in 4. The median survival time in radical operation group was 30 months, in palliative opration group 12 months, and in non-resection group 2.3 months. 5-year survival rate in reopration patients was 21.7%. Conclusions　Local recurrence after resection of rectal carcinoma is closely related to the Duckes' classification, histological type of tumor, and selection of operation.Active surgical intervention is indicated for local recurrence after resection of rectal carcinoma which can prolong the patient's survival time.

Henoch-Sch(o)nlein purpura(HSP) is one of the most common vasculitides in children with many manifestations including skin purpura,arthritis,abdominal pain and renal involvement.The renal involvement(Henoch-Sch(o)nlein purpura nephritis,HSPN) is the principal cause of morbidity and major risk factor for prognosis in HSP.The paper reviewed the updated treatment strategy for HSPN.Accordingly,steroids,cyclophosphamide,mycophenolate mofetil,mizoribine,cyclosporine,triptolide,angiotensin converting enzyme inhibitors (ACEI) / angiotensin receptor blockers(ARB),plasma apheresis and tonsillectomy are possible indicator for the further therapy of HSPN.Furthermore,prospective randomized controlled treatment studies on children with severe HSPN would be needed.

OBJECTIVE:To explore the effect of Fuyuan capsule on the mRNA expression of HIF-1? in kidney of sepsis rats. METHODS:Male SD rats were randomly divided into sham group,model group and Fuyuan capsule group (low dose and high dose) with 4 rats in each group. CLP operation was done in Fuyuan capsule groups after four days of intragastric administration. RT-PCR testing was applied to determined the expression of HIF-1a in 3 h,6 h,12 h and 24 h after model induction. The level of IL-6 was measured by ELISA method. Blood of heart was sampled for detection of renal function. HE staining was used to observe pathological change of kidney. RESULTS:As compared with sham group,the mRNA expression of HIF-1? increased gradually within 3 h and reached peak at 24 h(P

Objective To explore enhanced MRI diagnostic value of CPA(cerebellopontine angle) tumors.Methods 68 cases of CPA tumors,including acoustic neuromas(n=34),trigeninal neuromas (n=5),meningiomas(n=20)and cholesteatomas(n=9),proved surgically and pathologically were studied.All patients were performed MR scans before and after contrasted-enhancement on axial,sagittal and coronal plane.Results 23 of 34 acoustic neuromas showed nodule-ring-like,wreathlike or mutilocular enhanced masses;11 were homogeneous masses.The facial-hearing nerve bundle were markedly thickened and enhanced in 34 cases and in which 15 presented "water-chestnut"sign;suggesting it was a typical appearance of acoustic neuromas.5 trigeminal neuromas manifested nodule-ring-like or multilocular enhanced masses(n=3),and dumbbell-like masses(n=2).20 meningiomas exhibited homogeneous massive enhancement,"dural tail"sign(n-11),the facial-hearing-nerve bundle on the affected side were enhanced but not thickened(n-5);which represented reactive changes to the tumors.9 cholesteatomas displayed long T 2 long T 1,no enhancement;spreaded along subarachnoid space and basilar artery encapsuled(n-5).Conclusion Enhanced MRI can reveal the characteristics of CPA tumors,it is of especial value for diagnosis of the tumors.

Objective: To investigate the relationship between undergraduates’ emotional intelligence, personality traits and self-handicapping. Methods: 1094 undergraduates were tested with Self-handicapping Questionnaires、Emotional Intelligence Scale and NEO-FFI. Results: ①Undergraduates’ self-handicapping was negatively correlated with emotional intelligence(P

The moral risk exists on various kinds of insurance markets,but more complicated on the medical insurance market.It makes hospitalization cost expand excessively,the urban resident's medical insurance level decrease relatively,and the decline of the whole social morals.Tracing to its cause,besides of the chasing benefit behavior of each participant,it's relational to personal morality and the relevant institution.The text holds that the normative and rational regulation is the fundamental guarantee to prevent morals risk.It's the core of evading morals risk that the establishment of social morals system.Relevant concrete measures are essential also.

Objective To know the related risk behaviour and counter nursing measures for patients with schizophrenia. Methods Investigated 162 patients with schizophrenia to know their disease-related risk behaviour. Results There were 48 patients had risk behaviour, 83.33% dangerous behaviour was occurred within 2 weeks after enter the hospital. Most dangerous behaviour such as uprash damage, self damage and went astray had occurred from 8:00 to 17:00, commit suicide often occurred from 12:00 to 14:00 or 17:00 to 8:00. Conclusions Evaluation in early stage, strengthen management, build up cooperated relationship between patients and nurses, carry out proper psychological nursing and avoid risk behaviour can effective protect patients with schizophrenia.

Objective To study the effects of lung recruitment maneuvers (RM)with different duration combined with low tidal volume (TV)ventilation in acute respiratory distress syndrome (ARDS) with pulmonary and extra-pulmonary origin(ARDSp / ARDSexp). Methods Twenty-six ARDS patients with ventilation were selected including 10 patients of ARDSp (ARDSp group) and 16 patients of ARDSexp(ARDSexp group). All patients were given intermittent high-positive end expiratory pressure (PEEP) combined with low tidal volume RM in the base of usual ventilation. Effects of different duration of RM were evaluated and compared in the patients of ARDSp / ARDSexp. Results MAP decreased and HR increased when sustaining time of RM was above 60 seconds. Significant differences were showed compared with that before treatment. MAP and HR returned to normal after RM stopped.Compared with the state before RM,Pplat and Crs increased immediately after RM (P<0.05). When RM lasted above 60 seconds, Pplat increased significantly compared with that when RM continue lasted 40-59 seconds.But Crs,OI and SpO2 didn't increase obviously. Treatment effects of RM in patients of group ARDSexp were more obviously than those in patients of ARDSp group. There were 1 case of pneumothorax and 3 cases of pneumoderma in ARDSp group and 2 cases of pneumoderma in ARDSexp group when RM lasted above 60 seconds. Conclusions RM with intermittent high-PEEP on low TV is effective to ARDS and best duration is 40～59 seconds. The patients of ARDSexp, with pulmonary interstitial edema as the main pathology, respond better to RM than patients in ARDSp with pulmonary consolidation.

Phototherapeutic keratectomy(PTK)has been employed as a surgical tool to treat corneal disease for about 20 years.PTK made it possible to remove superficial corneal opacities and thereby restore vision by splitting molecules of biological tissue with 193 nm ultraviolet light.Recently,the development of the excimer laser technique is more rapid.It has principally focused on refractive surgery but has also benefited PTK.Anterior corneal pathology,such as elevated lesions,stromal opacities,corneal scars,corneal dystrophies and corneal degenerations etc,can be visually devastating.Over the past decade,there was a shift in the treatment of these conditions from corneal transplantation to PTK for visual restoration.PTK is a powerful tool for the management of anterior corneal pathology.In a properly selected and well-counseled patient,PTK can significantly improve vision and quality of life.This article reviews the recent literature of techniques for performing and refining PTK and also of various pathologic conditions that can be treated with PTK.