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 investigate the acceptance of advance care planning and its influencing factors in heart failure patients.Methods:A total of 208 patients with heart failure were surveyed by general data questionnaires and advance care planning acceptance questionnaires.Results:The total score of advance care planning acceptance of heart failure patients was (44.26 ± 11.73), the score of feeling dimension was (13.67 ± 5.72), the score of attitude dimension was (30.59 ± 6.33). 53.4%(111/208) of patients were willing to accept the talking about advance care planning. Regression analysis results showed that education level, New York Heart Association (NYHA) classification, communication status with medical staff and whether they had received life-sustaining treatment were important factors influencing of the acceptance of advance care planning in patients with heart failure.Conclusion:Patients with heart failure had higher acceptance of advance care planning. In clinical work, it is necessary to strengthen the scientific popularization of advance care planning in patients with low education level, low NYHA grade and no exposure to life-sustaining treatment. And strengthen the daily communication with patients to prepare for the follow-up advance care planning related communication.

Objective To analyze psychological stress level and features of recruits in training camp.Methods Psychological stress self-evaluation test (PSET) was applied to 1 600 recruits in training camp.Results ①There were 64 recruits(64/1600,4％) who had high level of psychological stress(T score ≥70).②The psychological stress symptoms of recruits in training camp mainly manifested as increased alertness (87.7％),sleep deprivation (57.6％),mental and physical fatigue (48.7％) and nervous irritability (45.2％).③Psychological stress levels of recruits with different ages and different levels of self-feeling in camp had significant differences(P＜0.05).Conclusion Recruits in training camp have partly excessive psychological stress responses,targeted emergency decompression trainings should be carried out in recruits.

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.