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 analyze the current situation of applying case-based learning (CBL) to the education of acupuncture-moxibustion by investigating the published literatures involving CBL in medical education.Method The literatures published between 2001 and 2015 were retrieved from VIP, CNKI, CBM, and WanFang databases, and the manuscripts about the application of CBL in the education of acupuncture-moxibustion were classified and analyzed.Result The related literatures involving the application of CBL in the education of acupuncture-moxibustion were rather limited, not enough for revealing the action and significance of CBL in the education of acupuncture-moxibustion.Conclusion CBL accords with the strong practicality of acupuncture-moxibustion, and is worth promotion; however, there are some shortcomings in the compiling of cases, students grouping, evaluation of study results, and the capability of teachers, which expect further standardization of teaching process and comprehensive use of advanced teaching methods, for cultivating elites in acupuncture-moxibustion.

Most military hospitals lack sufficient support from medical universities and therefore are confronted with a bottle -neck in graduate education. Based on the real conditions of military hospitals, this article introduces the practice and achievement in graduate education in our hospital by expanding the enrollment access, promoting the admission publicity, stressing the disciplinary balance, improving the supervisors′abilities, and enhancing teaching quality. With considerations on the four aspects of supporting strength of scientific research, stratified design of disciplines, construction of teaching quality, and innovation of training modes, it pro-vides some experience in graduate education with a view of giving reference for other military hospitals.

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

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.

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 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.

BACKGROUND:Critical limb ischemia is difficult to be treated among the peripheral arterial occlusive diseases, and the application of transplanting autologous stem cells can bring a hope for the treatment of this disease.
OBJECTIVE: To review the autologous stem cells transplantation in the treatment of critical limb ischemia at present, and to study the mechanism and the existing problems.
METHODS:A computer retrieval of PubMed database, Wanfang database, and CNKI database was conducted to search the related articles with the keywords of“stem cell, transplant, critical limb ischemia”in English and Chinese. Final y, 47 articles were included in final analysis according to the inclusion criteria.
RESULTS AND CONCLUSION:Autologous stem cells transplantation for treatment of lower extremity ischemic disease is a latest and significantly effective treatment, but the mechanism is unclear and stil needs further study.

[Objective] This article mainly discussed the potential of myocardial cellregeneration and the possible mechanisms involved. [Method] To study the mechanism of cardiac regeneration ability HSCs, this review studyed the relationship of the differentiation of cardiac stem cells, hematopoietic stem cells, myocardial cells and myocardial regeneration and the possible mechanisms involved. [Result] Self-renewing, differentiation both in vitro and in vivo of the c-kit positive CSCs had been seen. No matter in physiological condition or after damage, the c-kit positive CSCs had clonality and the potential of multi-directional differentiation. Hematopoietic stem cells can generate cardiomyocytes and coronary blood vessels for human celltherapy. The ability of dedifferentiation cells to maintain and improve the ventricular function of a damaged heart is very limited. [Conclusion] CSCs and HSCs play an important role in reversing chronic ischemic and non-ischemic heart failure.