Objective To investigate the relationship of serum 25-hydroxyvitamin D [25(OH)D] level and blood glucose control in patients with type 2 diabetes mellitus (T2DM).Methods The clinical data of 300 pa-tients with T2DM in the hospital were analyzed retrospectively.According to the level of glycated hemoglobin (HbA1c) ,the patients were divided into the good control of blood glucose group (＜6.5%) ,the medium con-trol of blood glucose group (6.5% -7.5%) and the poor control of blood glucose group (＞7.5%).Another 44 healthy individuals with normal glucose tolerance (NGT) confirmed by oral glucose tolerance test (OGT T) were selected as normal control group.The level of 25(OH)D in each group was compared ,and the correlation between HbA1c and 25(OH)D was analyzed.Results The level of serum 25(OH)D in the poor control of blood glucose group was significantly lower than that in the good control of blood glucose group and the con-trol group ,and the difference was statistically significant (P＜0.05) ;the levels of serum 25(OH)D in the the medium and good control of blood glucose groups were significantly lower than that in the control group (P＜0.05).HbA1c was negatively correlated with 25 (OH) D level (r= -0.212 ,P=0.000).Conclusion The level of serum 25 (OH) D is related to the development of T2DM.Proper vitamin D supplementation can be used as an adjuvant therapy for T 2DM.

ObjectiveTo investigate the clinical features of patients with Caroli disease. MethodsThe clinical data were collected from 41 patients who were diagnosed with Caroli disease in The Fifth Medical Center of Chinese PLA General Hospital from April 2015 to January 2020, and the patients were divided into type I group with 16 patients and type Ⅱ group with 25 patients. A retrospective analysis was performed for general information, laboratory markers, and clinical features. The independent samples t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data; a Spearman correlation analysis was also performed. ResultsThe type Ⅰ group had a significantly higher level of albumin (Alb) than the type Ⅱ group (t=0.976, P=0.048), and the type Ⅱ group had a significantly higher prothrombin time (PT) than the type I group (Z=3.115, P=0.001). Compared with the type I group, the type Ⅱ group had significantly higher incidence rates of esophageal and gastric varices, upper gastrointestinal bleeding and/or tarry stool, and portal hypertension (χ2=6.077, 5.468, and 2.403, P=0.002, 0.019, and 0.028). In the patients with type Ⅱ Caroli disease, the level of cholinesterase was negatively correlated with the incidence rates of esophageal and gastric varices and portal hypertension (r=-0.468 and -0.436, P=0.018 and 0.029); Alb level was negatively correlated with the incidence rate of esophageal and gastric varices (r=-0.561, P=0.004); red blood cell count was negatively correlated with the incidence rates of esophageal and gastric varices, upper gastrointestinal bleeding and/or tarry stool, and portal hypertension (r=-0.662, -0.566, and -0.436, P＜0.001, P=0.003, and P=0.029); hemoglobin count was negatively correlated with the incidence rates of esophageal and gastric varices, upper gastrointestinal bleeding and/or tarry stool, and portal hypertension (r=-0.605, -0.590, and -0.510, P=0.001, 0.002, and 0.009); PT was positively correlated with the incidence rates of esophageal varices and portal hypertension (r=0.488 and 0.520, P=0.013 and 0.008). ConclusionCompared with the patients with type I Caroli disease, the patients with type Ⅱ Caroli disease have a higher incidence rates of esophageal and gastric varices, upper gastrointestinal bleeding and/or tarry stool, and portal hypertension, with the changes in clinical indicators such as the decrease of Alb level and the increase of PT level, and they tend to have poor prognosis.

Objective:To evaluate the effectiveness of medical practical training with a multi-level comprehensive model.Methods:We randomly selected 100 medical undergraduates who received practical training in The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from 2017 to 2019, 20 medical education experts, and 30 teachers for a questionnaire survey using self-designed questionnaire with 3 first-level items, 8 second-level items, and 31 third-level items. Data processing and analysis was made by multi-level comprehensive model.Results:The comprehensive evaluation data (0.176 4, 0.512 3, 0.252 5, 0.058 8) obtained by the multi-level comprehensive model showed that the proportions of medical undergraduates achieving excellent, good, moderate, and poor effects of medical practical training were 17.64%, 51.23%, 25.25%, and 5.88% respectively. According to the principle of maximum membership, the final comprehensive evaluation result of the effectiveness of medical practical training was "good".Conclusion:This research has demonstrated the scientificity and feasibility of using the proposed multi-level comprehensive model to evaluate the effectiveness of medical practical teaching. In the comprehensive evaluation, the quantitative processing of qualitative indices can generate the matching score of each index in the multi-level index system. The evaluation results are intuitive and easy to analyze, thus providing the basis for the targeted improvement of medical practical teaching effect.

Objective:To explore the application effect of the teaching ward-round workshop on the teaching ability training for clinical teachers.Methods:From July to October 2019, 83 clinical teachers from The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University included in the study were divided into 8 groups for the training of teaching ward-round workshop. After the training, the evaluation results of clinical teaching ward-round, the satisfaction of clinical teaching ward-round, and the satisfaction of the workshop teaching model were compared. Chi-square test and t test were performed by SPSS 22.0. Results:The trainees were highly satisfied with the training mode of the teaching ward-round workshop. After the training, the clinical teaching ward-round assessment scores [(96.83±1.77) points] were higher than the average scores of the same period from April to June in 2019 [(91.25±2.86) points], with statistical significance ( P<0.05). In terms of satisfaction with clinical teaching ward rounds, the scores of 7 dimensions including preparation before ward rounds, highlighting the key and difficulties, and standard physical examination after the training were all higher than those before the training, with significant differences ( P<0.05). Conclusion:The training model of the teaching ward-round workshop helps to enhance the training effect, promote the teaching ability of clinical teachers, and improve the clinical teaching ward-round assessment results and satisfaction, which provides new ideas and references for the training of clinical medical professionals.

ObjectiveTo investigate the features and changing trend of drug-induced liver injury (DILI) in the elderly from 2009 to 2019, and to provide a reference for clinical prevention and treatment of DILI in the elderly. MethodsA retrospective analysis was performed for the clinical data of 2107 elderly patients, aged ≥60 years, who were diagnosed with DILI in The Fifth Medical Center of Chinese PLA General Hospital from January 2009 to December 2019, and they were divided into groups according to age. Related clinical data were analyzed, including age, sex, clinical features, prognosis, and regional distribution. The Chi-square test was used for comparison of categorical data between groups. ResultsAmong the 2107 patients with DILI, there were 802 male patients and 1305 female patients, with a male/female ratio of 1∶1.63. Cholestasis type was the most common clinical type and was observed in 1439 patients (68.3%). There was the highest number of patients in the 60-64 years group (942 patients, 44.7%), among whom 618(65.6%) were female, 589(62.5%) had cholestasis type, 471(50.0%) had chronic DILI, 421(44.7%) had drug-induced liver cirrhosis, and 25(2.7%) had drug-induced liver failure. There were 187 patients in the 75-79 years group, among whom 110 (58.8%) patients were male, 137(73.3%) had cholestasis type, 114(60.9%) had liver cirrhosis, 4(2.1%) had drug-induced liver failure. The results showed that chronic DILI was more common in the 60-64 years group, and liver cirrhosis was more common in the 75-79 years group. As for prognosis, in the 60-64 years group, 27 patients (2.9%) were cured, 885 (93.9%) were improved, 30(32%) had no response or died; in the 65-69 years group, 16 (2.8%) were cured, 528 (92.0%) were improved, and 30(5.2%) had no response or died; in the 70-74 years group, 9(2.8%) were cured, 305(94.1%) were improved, and 10 (3.6%) had no response or died. The results showed that there was no significant difference in mortality rate between the different age groups (P＞0.05). The proportion of elderly DILI patients among hospitalized DILI patients increased from 15.90% in 2009 to 22.05% in 2013 and 27.51% in 2019, with a 1.73-fold increase in 11 years. As for regional distribution, the patients in North China accounted for the highest proportion of 47.08% (the patients from Hebei, Shanxi, and Inner Mongolia accounted for 24.92%, 10.96%, and 10.25%, respectively), followed by those in Northeast China who accounted for 17.85%. The patients in Beijing accounted for 11.53%. ConclusionThe proportion of elderly DILI patients among hospitalized DILI patients tends to increase in these years. Cholestasis type is the most common clinical type, and most of the patients with this clinical type progress to chronic DILI and drug-induced liver cirrhosis. Early diagnosis, early intervention, and standardized treatment of elderly DILI should be taken seriously.

New sensor technologies play an important role in quality evaluation of Chinese materia medica (CMM) and include near-infrared spectroscopy, chemical imaging, electronic nose and electronic tongue. This review on quality evaluation of CMM and the application of the new sensors in this assessment is based on studies from 2010 to 2015, with prospects and opportunities for future research.