Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar status (HSS) are severe acute diabetic complications. This article mainly discusses the definition, mortality rate, pathophysiology, precipitating factors, main clinical manifestations, laboratory findings and principles of treatment in DKA and HHS.

OBJECTIVE:To determine the content of paeonol in Cynanchum paniculatum by three-dimensional fluorescence coupled with ATLD algorithm. METHODS:The trilinear model was established. The principle of least square was used for ATLD. The component value was fitted by core consistency diagnosis,and inner filter effect was corrected by mathematical correction method. Fluorescence scanning condition included excitation wavelength of 250-400 nm,emission wavelength of 410-600 nm, wavelength interval of 5 nm,slit width of 5.0/5.0 nm,scanning speed of 1200 nm/min. Determination and absorption spectrum condition included scanning wavelength of 250-600 nm,scanning speed of 600 nm/min;Al(Ⅲ)was used as the sensitizer to in-crease the fluorescence intensity of paeonol. The content of paeonol was determined by HPLC. RESULTS:The linear range of pae-onol was 0.132-1.188 μg/mL(r=0.9999). RSDs of precision,stability and reproducibility tests were less than 3.0%. The recover-ies were 100.1%-104.7%(RSD=2.39%,n=6). The analysis spectrum of paeonol was almost completely overlapped with the actu-al spectrum. The results of HPLC method are very similar to those of ATLD algorithm. CONCLUSIONS:The three-dimensional fluorescence coupled with ATLD algorithm is simple,rapid,efficient and accurate,and can be used for the qualitative and quantita-tive analysis of complex system.

ObjectiveTo investigate the developmental status and their relationship of self-supporting personality and career maturity of medical students.Methods450 medical students were surveyed by self-supporting personality scale and career maturity questionnaire.Descriptive statistical analysis,t-test,correlation analysis and regression analysis were used to do data analysis.Results ( 1 ) Most dimensions of self-supporting personality such as personal initiative,interpersonal initiative,interpersonal flexibility and personal responsibility were positively related to the career maturity ( r=0.53,P＜0.01 ; r=0.49,P＜0.01; r=0.46,P＜0.01 ; r=0.45,P＜ 0.01 ).(2)Career maturity of medical students can be positively predicted by several dimensions of self-supporting personality ( R2 =0.49,F=60.10,P＜ 0.01 ).ConclusionThe career maturity of medical students is closely associated with their self-supporting personality.

Objective To study the effect of adaptive group psychological training on mental quality and mental health of students in military university.Methods A total of 118 students were divided into two groups randomly:training group(n =60) and control group(n =58).Training group received group psychological training and read the textbook mental quality training for soldiers for 3 months.Armyman mental quality (AMQ) and Symptom checklist-90(SCL-90) were employed to evaluate the mental quality and mental health of students before and after training.All data were analyzed by paired-sample T test and test level was 0.05.Results ①AMQ scores of factors of aptitude,loyalty,bravery,self-confidence and willpower were increased significantly in training group post-training than pre-training (P ＜ 0.05) and there was no significant difference in those factors in control group after training (P ＞ 0.05).②SCL-90 scores of factors of obsessive-compulsive,interpersonal sensitivity,hostility and psychotism as well as the mean score were decreased significantly in training group post-training than pre-training (P ＜0.05) and only the score of psychotism factor was decreased in control group post-training (P ＜ 0.05).③Scores of trait anxiety inventory (TAI) were decreased significantly in training group post-training than pre-training (P ＜ 0.05) and there was no significant difference in those of control group post-training (P ＞ 0.05).Conclusion Group psychological training can improve mental quality and mental health of students in military university.

Endoscopic ultrasonography has been widely used in the diagnosis of digestive system disease,and has great important diagnostic significance in the differential diagnosis of the upper gastrointestinal mucosa or submucosal lesions,as well as to distinguish the gastrointestinal intracavitary and extracavitary lesions.At the same time,EUS can more accurately judge the depth of tumor invasion and the surrounding lymph node metastasis,which has great value in the preoperative TNM staging of esophageal cancer and gastriccancer,the judgment of resectability and the prognosis.We summarized the result of EUS in the upper gastrointestinal disease in our hospital.

Objective The aim of the study was to explore the difference between the expression of CDg7 in peripheral blood and bone marrow on acute myeloid leukemia (AML n=30). Methods A flow cytometric quantitative analysis of expression levels for CD87 was performed on fresh blast cells in peripheral blood and bone marrow from patients with acute myeloid leukaemia using CD87, monoclonal antibodies. Analysis the difference between the expression of CD87 using matched t -test. Results The values of CD87 expression in bone marrow of 14 M5 cases are from 9.47 %～80.32 %, and from 11.49 %～87.46 % in peripheral blood. The values of CD87, expression in bone marrow of 8 M4 cases are from 14.27 %～46.28 %,and from 14.79 %～47.19 % in peripheral blood. The values of CD87 expression in bone marrow of 6 M2 cases are from 4.67 %～34.26 %, and from 8.96 %～39.78 % in peripheral blood. The values of CDs, expression in bone marrow of 2 MI cases are from 3.56 %～7.69 %, and from 5.21 %～8.96 % in peripheral blood.The expression of CD87 in peripheral blood and bone marrow from patients with acute myeloid leukaemia had statistical difference (t =3.13, P<0.05). Conclusion The levels of CD87 expression had difference between peripheral blood and bone marrow. The level in peripheral blood was higher than bone marrow. So when we performed quantitative analysis of expression levels for CD87, peripheral blood instead of bone marrow was commended.

Objective To explore the relationship between serum leptin level and the hypothalamuspituitary-gonad ( HPG) axis in female adolescents with anorexia nervosa ( AN). Methods Sixteen newly diagnosed female adolescents with AN in Shanghai and Zhejiang province were investigated, and their serum leptin, FSH, LH and body composition were measured before and after 18 weeks treatment, and their menorrhea cycles were observed. The rhythm of 24 h serum leptin secretion was studied in 4 patients with AN. Twenty-six, healthy females with normal weight and without contraceptive medication were studied as controls. Results (1) All of 16 patients had amenorrhea, 3 primary amenorrhea and 13 secondary amenorrhea. At admission LH in 14 patients and FSH in 12 patients were below the low limit of the normal reference range (1.5 U/L and 4. 6 U/L respectively), and among them 5 patiend had both 15% weight gain and significantly increased serum leptin level (P

Objective To explore the serum levels of progestrone (Prog) and dehydroepiandrosterone sulfate(DHEAS),and the effect of sodium valproate(VPA) and lamotrigine(LTG) on the levels of Prog and DHEAS in infantile spasms.Methods A total of 36 cases of infantile spasms (spasms group) before treatment and 40 cases health infants(control group) were detected the serum Prog and DHEAS levels by electrochemiluminescence immunoassay,and were compared with 21 cases receiving monotherapy with VPA(VPA group),and 13 cases receiving therapy plus lamotrigine(LTG group) before and 4 months after treatment to observe the changes of sex hormone.Results There were no significant differences in Prog and log(DHEAS) (logarithmic transformation) levels between spasms group and control group (P ＞0.05).The serum Prog level of baby girls and baby boys were lower after treatment than those before treatment in VPA group respectively (t =2.603,3.146 ; P =0.003,0.008,respectively).The log (DHEAS) level of baby girls and baby boys were higher in LTG group after treatment than those before treatment respectively(t =3.185,2.663 ;P =0.007,0.041).Conclusion Infantile spasms would not influence the hormone metabolism,while VPA and LTG can influence the sex hormone.The hormone level should be monitored in the treatment.

Objective To explore the effects of group psychological training on mental health of military students and field soldiers.Methods A total of 60 students and 48 soldiers received group psychological quality training and studied a textbook Mental Quality Training for armymen for 3 months.Mental Quality Questionnaire for Amymen (MQQA),Symptom CheckList 90 (SCL-90),Self-rating Anxiety Scale (SAS),Self-rating Depression Scale (SDS) and State-Trait Anxiety Inventory(STAI) were employed to evaluate mental health and psychological quality of subject before and after the training.All the data were analyzed by independent-samples t test.Results (1) The difference in MQQA score of field soldiers before and after training was significantly larger than that of military students in loyalty and general score,and lower in willpower((-16.58 ± 7.75) vs.(-1.75 ± 8.68),(-27.74 ± 28.74) vs.(-12.57 ± 30.96),P ＜ 0.05).(2) The SCL-90 difference of field soldiers between before and after training was significantly larger than that of military students in hostility and phobic anxiety((0.26 ±0.47) vs.(0.07 ± 0.24),(0.13 ± 0.40) vs.(0.02 ± 0.13),P ＜ 0.05).(3) The difference in emotion score of field soldiers between before and after training was significantly larger than that of military students in SAS,SDS,SAI,TAI and STAI (P ＜ 0.01).Conclusion The effects of group psychological quality training on field soldier group are better than that of military students,which is helpful to improve mental quality and mental health,as well as to relax anxiety and depression of soldiers.

A patient with severe hypoglycemia due to insulin-like growth factor ( IGF)-IIsecreted by a giant solitary fibrous tumor of the pleura ( SFTP) was investigated through comprehensively reviewing his medical history and clinical records. The patient had severe hypoglycemia accompanied with significantly decreased serum insulin level. A solitary fibrous tumor of the pleura was found, and right pneumonectomy removed this giant tumor. Two years after the operation, the patient was fit and well with no further hypoglycemia episodes. Non-islet-cell tumor hypoglycemia should be considered in patients who have hypoglycemia episodes accompanied with significantly decreased serum insulin level.