Under pathologic conditions, nitric oxide causes peripheral insulin resistance by impairing key signal molecules of insulin signaling pathway and mediates dysfunction of islet ? cells caused by lipids, cytokines and hyperglycemia, which plays an important role in the pathogenesis of type 2 diabetes mellitus.

For the cultivation of medical students medical professionalism and evaluation has become a hot is-sue in the medical colleges medical education at home and abroad, but for junior medical students′professional spirit evaluation research is less.This paper introduces the basic concept of responsibility index and application by introducing foreign medical schools responsibility index for evaluation in school doctor students physician profession-alism, analysis the advantages and disadvantages of the method.Think the responsibility index is based on the spe-cific behavior evaluation, the result is more accurate, is suitable for junior medical students′professional spirit e-valuation system, compared with other evaluation system, responsibility index, pay more attention to guidance and specification in advance.But responsibility index also has some disadvantages.Such as responsibility index evalua-tion process must face some ethical challenges, lack of integrity and evaluation framework design.

Objective To discuss the change of androgen level in postmenopausal women with coronal atherosclerosis heart dis-ease,and to discuss its clinical significance.Methods According to the results of coronary angiography,218 cases of possible coro-nal atherosclerosis heart disease patients were divided into the observational group with 93 cases of coronal atherosclerosis heart disease patients,and the control group with non-coronal atherosclerosis heart disease patients.The levels of TC,TG,LDL-C,HDL-C,testostemne and andmstenedione in blood were investigated in two groups.Results The level of blood glucose was not statisti-cally different between the two groups(P >0.05),however,the levels of systolic and diastolic blood pressure,TC,TG,LDL-C and HDL-C were statistically different between the two groups (P < 0.05 ).Conclusion The level of androgen in postmenopausal women with coronal atherosclerosis heart disease are higher than postmenopausal women without coronal atherosclerosis heart dis-ease.Androgen detection is useful for the monitoring and diagnosis for postmenopausal women with coronal atherosclerosis heart disease.

Ophthalmic imaging including radiographic imaging, acoustic imaging and optical imaging,as a branch of medical imaging has developed rapidly. Optical imaging is very suitable for fundus examination because of the physiological characteristics of the eye. Ophthalmoscope and fundus fluorescein angiography are two historical stages of fundus optical imaging, which become an independent new discipline now, including infrared fundus photography, fundus autofluorescence, fundus fluorescein and indocyanine green angiography and optical coherence tomography. Comprehensive optical imaging plays an irreplaceable role in the diagnosis and treatment evaluation of ocular fundus diseases. Appropriate understanding the principles and significance of various optical imaging methods is very important for their clinical applications.

The choline acetyltransferase (CHAT) and the molecular forms of acetyl-cholinesterase (ACHE) activites in various brain regions of 20-day-old hypothyroid and hyper-thyroid rats were measured. The results provided the following information: 1) CHAT and ACHE activities were directly interrelated with thyroid hormones. 2) In both hypothyroid and hyperthyroid rats the nonextractable ACHE activity was distinctly decreased in every brain region, suggesting that both conditions were affected in the critical period of cholinergic synaptic development. 3) The ratio of membrane-bound ACHE to soluble ACHE decreased;it showed that thyroid hormone deficiency might distrub development and maturation of cholinergic neurons. 4) In most regions of the central nervous system,the CHAT seemed to be more affected than ACHE by thyroid hormones.

The Medical College of Panzhihua University has developed a series of curriculum reform based on Medical Professionalism, investigating the basic idea, curriculum design and assess-ment system of Medical Professionalism curriculum reform, emphasizing the combination of medical professionalism curriculum with clinical courses, in the hope of providing a unified and acknowledged medical professionalism curriculum.

Objective To investigate the relationship between social support,coping style and general well-bing in armymen.Methods 280 armymen were tested by General Well-Being Schedule(GWB),coping style questionnaire and social support scale.Results There was a significant difference between the common soldiers and the other armymen(P<0.05);all the factor scores of GWB were related highly with all the factors of coping style and social support(P<0.05～0.01).Conclusion Coping style and social support in armymen are related to the general well-being.

Objective To investigate the relationship between the plasma NT-pro BNP level and the hear function in children pa-tients with heart failure.Methods 30 children patients with heart failure and 30 healthy children were selected as the patients group and the control group respectively.The plasma NT-pro BNP level was detected in the patients group before and after treatment and the control group.The changes of heart functional indexes and the clinical symptoms in the patients group were detected,the detec-tion results and the plasma NT-pro BNP levels were performed the correlation retrospective analysis.Results The plasma NT-pro BNP level before treatment in the patients group was significantly higher than that in the control group,there was the statistically significant difference between them(P <0.05 ).After treatment,the clinical symptoms in the patients group were obviously im-proved,the plasma NT-pro BNP level was significantly decreased and LVEF by ultrasound was also increased,the differences were statistically significant(P <0.05).The plasma NT-pro BNP level after treatment in the patients group was obviously higher than that in the control group with statistical difference between them(P <0.05).The plasma NT-pro BNP level before and after treat-ment in the patients group demonstrated a negative correlation with LVEF(r=-1.32,r=-1.78).Conclusion Detecting the plas-ma NT-pro BNP level in children patients with heart failure has the important clinical guidance significance for the diagnosis,disease condition evaluation,prognostic evaluation and cardiac function grading in the children patients with heart failure.

OBJECTIVE:To explore the effects of dehydroepiandrosterone(DHEA)combined with Meloxicam tablets on thera-peutic efficacy of osteoarthritis and biochemical indicator. METHODS:104 patients with osteoarthritis were randomly divided into ex-perimental group and control group with 52 cases in each group. Control group only received Meloxicam tablets,7.5 mg/time,bid;ex-perimental group was additionally given DHEA,25 mg/time,qd,on the basis of control group. The treatment course of 2 groups was four weeks. The clinical efficacy,VAS score before and after treatment,joint function score,levels of IL-1β and TNF-α,cartilage thickness,synovial thickness and score of liquid aggregation of joint cavity were compared between 2 groups. RESULTS:The total ef-fective rate of experimental group(86.54%)was significantly higher than that of control group(69.23%),with statistical significance (P<0.05);compared with before treatment,VAS scores of 2 groups decreased significantly after treatment,while joint function scores increased significantly,with statistical significance(P<0.05). VAS score of experimental group was significantly lower than that of control group,while joint function score was significantly higher than control group,with statistical significance(P<0.05). Af-ter treatment,the serum levels of IL-1βand TNF-αin 2 groups significantly decreased,with statistical significance(P<0.05);those of experimental group were significantly lower than those of control group,with statistical significance(P<0.05);there was no statis-tical significance in the cartilage thickness between 2 groups before and after treatment(P>0.05). Compared with before treatment, the thickness of the synovial membrane and the score of liquid aggregation of joint cavity significantly decreased after treatment,with statistical significance(P<0.05);the thickness of synovial membrane and the score of liquid aggregation of joint cavity in experimen-tal group were significantly lower than in control group,with statistical significance(P<0.05). CONCLUSIONS:DHEA combined with Meloxicam tablets is significant in the treatment of osteoarthritis,can significantly relief the pain and decrease the levels of serum IL-1βand TNF-α.

BACKGROUND: With the continuous renewal and development of clinical repair techniques, the intraoperatie blood loss has been greatly reduced in the treatment of intertrochanteric fracture; however, no matter what kind of repair methods should be adopted, there are stil a large amount of perioperative hidden blood loss, however, there are few clinical reports for the reasons and related factors. OBJECTIVE: To study the correlation of perioperative hidden blood loss with gender and internal fixation methods in the surgery of elderly femoral intertrochanteric fractures.METHODS: Total y 121 patients with elderly femoral intertrochanteric fractures who received the treatment at Department of Orthopedics, Nanyang City Center Hospital from March 2010 to June 2013 were divided into two groups according to the condition and treatment wishes of patients, and were respectively treated with dynamic hip screw and proximal femoral anti-rotation intramedul ary nail internal fixation. The preoperative hidden blood loss, postoperative hidden blood loss, the total hidden blood loss, dominant blood loss and total blood loss of patients in these two groups were compared. The multiple linear regression analysis on the correlation of perioperative hidden blood loss with gender and internal fixation methods was conducted. RESULTS AND CONCLUSION: There was no significant difference in the preoperative hidden blood loss between these two groups (P > 0.05). The total blood loss, postoperative hidden blood loss and total hidden blood loss in the proximal femoral anti-rotation intramedul ary nail group were significantly higher than those in the dynamic hip screw group (P < 0.05), and the dominant blood loss was significantly lower than that in the dynamic hip screw group (P <0.05). There were significant differences in the preoperative, postoperative hidden blood loss and total hidden blood loss between males and females (P < 0.05), and above indexes in males were significantly lower than in females. The multiple linear regression analysis showed that gender and internal fixation methods were correlated with hidden blood loss (P < 0.05). These results suggest that the perioperative hidden blood loss in surgery for elderly femoral intertrochanteric fractures is closely related to gender and above indexes in internal fixation methods. The perioperative hidden blood loss of male patients is less than that of female patients, and the patients treated with proximal femoral anti-rotation intramedul ary nail fixation have more hidden blood loss than dynamic hip screw fixation.