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.

Chronic hyperglycemia is often accompanied by abnormal lipid metabolism, hypertension, low-grade systemic inflammation and oxidative stress.These factors increase the risk of cardiovascular disease(CVD)in type 2 diabetes mellitus(T2DM)patients.Comprehensive treatment of T2DM should emphasize the improvement of abnormal lipid metabolism, prevention of weight gain and reduction of the CVD risk in addition to proper glycemic control.Incretin, as a new hypoglycemic drug, has more advantages in improving glucose and lipid metabolism, finally to reduce cardiovascular risk.Through possible mechanisms including direct influence on liver lipid metabolism, change of fat mobilization and delay of gastric emptying, incretin shows positive influence on the lipid metabolic markers such as low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, triglycerides, and total cholesterol, while it improves glucose control.Thus, incretin plays an important role in the comprehensive management of type 2 diabetes mellitus.

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.

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 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 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 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.

Electric field treatment of tumor technology is of great significance in the treatment of glioma,including direct current electric field and alternating electric field.Direct current electric field affects the migration of glioma cells,and can be used as a new clue for the treatment of glioma.While alternating electric field can inhibit the proliferation and invasion of glioma cells,and induce apoptosis,and can obviously prolong the survival period of patients with glioma and improve their quality of life.

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.