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.

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.

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.

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

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.

ObjectiveThis system review for the medicine of children gastroesophageal reflux disease(GERD) will provide the latest evidence based medicine evidence for pediatric clinical medication.MethodsThe documents of randomized controlled clinical trials of children GERD,which had been published in domestic and foreign journals from the year 2000 to 2010,had been retrieved and screened by the study inclusion criteria.According to the Jadad evaluation questionaire,the documents' quality had been evaluated.The efficiency rates of treatment were calculated respectively by the merger of same medicines,and the meta-analysis of different drugs had been done for evaluating the effect of different pharmacological therapeutic agents.In addition,the adverse events occurred during treatment were analyzed.ResultsThere were 31 documents fitting inclusion criteria.2 015 cases of children ( 1039 cases in treatment groups and 976 cases in control groups) had been included in these randomized controlled clinical trials.In these documents the agents included:cisapride ( 18 articles ),erythromycin ( 8 articles ),motilium ( 5 articles ).The merger efficiency rates of these medicines were cisapride (93.43％ ),erythromycin (92.86％ ),motilium (93.06％) respectively.There were no significant difference in the efficiencies of the three drugs in the treatment of GERD ( P＞0.05 ).In addition,the results of meta-analysis about treatment inefficiency,used with the postures therapy and support therapy as controls,were cisapride OR=0.15 ( OR 95％ CI0.11～0.20),erythromycin OR =0.08 ( OR 95％ CI 0.04～0.14 ),motilium OR=0.03 ( OR 95％ CI 0.01～0.07).Furthermore,their adverse effect rates were cisapride 0.72％ ( diarrhea 0.58％,somnolence 0.14％ ),erythromycin 0.96％ ( drug rashes 0.48％,slight increase of GOT 0.48％ ),motilium 1.50％ (diarrhea 1.50％ ).ConclusionThe efficiencies of smaller doses of erythromycin were better than cisapride,and not better than motilium;but the adverse effect rates were better than cisapride,and not better than motilium.In summary,smaller doses of erythromycin is better currently in the treatment of GERD.Attention should be paid in the use of erythromycin,since it accounted for slight increases in GOT or drug rashes approximately.

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.