Objective To analyze the risk factors for drug-induced hypoglycemia in elderly diabetic patients,and to provide the basis for clinical prevention and treatment.Methods 78 cases with drug-induced hypoglycemia in elderly diabetic patients (observation group) and 256 elderly diabetic patients without drug-induced hypoglycemia(control group) were included,and the relative factors for drug-induced hypoglycemia were analyzed between the two groups.Results The stable rate of patient's condition was lower in observation group than in control group [38.5％ (30/78) vs.52.7％(135/256),x2 =4.872,P＜0.05].There were 9 cases (11.5％)、with alimentary control,28 cases (35.9％) treated with insulin and 41 cases (52.6％) treated with sulfonamide in observation group,and 89 cases (35.9％) with alimentary control,89 cases (34.8％) treated with insulin and 78 cases (30.4％) treated with sulfonamide in control group.The alimentary control was lower in observation group than in control group(x2 =15.557,P＜0.001).There was no difference in successful rate of insulin treatment between the two groups(x2 =0.034,P＞0.05).The successful rate of sulfonamide treatment was higher in observation group than in control group(x2 =12.726,P＜ 0.001).The age was older in observation group than in control group(t=2.494,P＜0.01).The body mass indexes and glycosylated hemoglobin level were lower in observation group than in control group(t=4.334 and 7.251,both P＜0.001).There were no differences in fasting blood-glucose and serum creatinine levels between the two groups(t=1.010 and 0.297,both P＞0.05).The course of diabetes was longer in observation group than in control group(t=2.579,P＜0.01).Conclusions The relative factors for drug-induced hypoglycemia in elderly diabetic patients include older age,longer course of diabetes,lower body mass index,lower fasting blood-glucose level,poorer glycemic control and higher dose of sulfonamide treatment.

OBJECTIVE To know the incidence, etiology, risk factors of hospital-acquired pneumonia(HAP). METHODS From Jan 2003 to Dec 2004, 129 cases of HAP were retrospectively studied. Epidemiologic data, etiology , and evolution of pneumonia were recorded. RESULTS The 115 patients with HAP had one or more intrinsic risk factors, mainly malnutrition (albumin values

OBJECTIVE: To heighten the awareness of the facial nerve tumors. METHOD: The clinical data of twenty-three patients complaining of facial paralysis who were diagnosed postoperatively as facial nerve tumors were analyzed. The hearing assessment of all patients was based on pure tone audiometry at the frequency of 0. 5, 1, 2, 4 kHz. Temporal bone high resolution CT scan and temporal bone MRI with gadolinium enhancement were conducted on all patients. Facial nerve function was assessed with the House-Brackmann (HB) grading system. Facial electroneurography (ENoG) was conducted on 20 patients to quantify the degree of nerve degeneration preoperatively. The pathological types of tumor were determined by postoperative pathological reports. RESULT: Nineteen out of 23 cases presented hearing loss (82.6%), 10 cases suffered from tinnitus (43.5%), otalgia (17.4%) affected 4 cases, 3 cases manifested otorrhea (13.0%), and 2 cases presented vertigo (8.7%). Geniculate ganglion was the most commonly involved site (20 cases, 87.0%), followed by tympanic segments (18 cases, 78.3%), pyramid segment (16 cases, 69.6%), mastoid segment (10 cases, 43.5%), labyrinthine segment (9 cases, 39.1%), internal auditory canal segment and parotid gland segment (5 cases, 21.7%, respectively). Twenty-one cases (91.3%) of schwannomas, 1 case (4.3%) of neurofibroma and 1 case (4.3%) of hemangiomas were identified with histopathology postoperatively. The tumors were all completely excised, and the facial nerve function could recovered to HB III at the best after facial nerve repairment. CONCLUSION Facial nerve tumor is a rare and often misdiagnosed disease which was commonly manifested as facial nerve paralysis. Temporal bone CT and MRI can help to clarify the diagnosis preoperatively. Pure tone audiometry and electroneurography also plays a some certain roles in the diagnosis of facial nerve tumors. The tumors should be completely resected and the surgical approaches were determined based on tumor size, facial nerve function and preoperative auditory function.
Cranial Nerve Neoplasms ; complications ; Facial Nerve ; pathology ; Facial Nerve Diseases ; complications ; Facial Paralysis ; etiology ; Hearing Loss ; Hemangioma ; Humans ; Neurilemmoma ; Temporal Bone

Vascular endothelial cells and smooth muscle cells,structurally and functionally closely related,are two main cells of vascular wall.While the interaction between cycling factors and vascular wall cells can lead to the occurrence of atherosclerosis.The injury of endothelial cells results in secretory dysfunction and abnormal proliferation of smooth muscle cells which narrows the cavity of blood vessel and cause spasm.This is the common pathological basis of the occurrence and development of atherosclerosis and other vascular diseases.In the pathological state of atherosclerosis,the proliferation of smooth muscle cell will be affected by what the vascular endothelial cells secrete,like growth factors,cytokines,and vasoactive substances.This paper gives a comprehensive overview of the latest research advances in this field.

Objective To observe the expression and correlation of Twist,p53 and E-cadherin mRNA in breast cancer.Methods Thirty breast cancer tissue and adjacent noncancerous tissue in patients underwent modified radical surgery,and the normal breast tissue in 10 patients with benign breast lesions,respectively,were detected the expression of Twist,p53 and E-cadherin mRNA by RT-PCR and the relationship with clinicl pathological factors and their interrelationships.Results There was significant correlation between the expression of Twist mRNA and the degree of differentiation[high and middle differentiation 93.33％(14/15),1ow differentiation 53.33％(8/15)],lymphatic invasion[yes 93.75％(15/16),no 50.00％(7/14)]and TNM staging[Ⅰ-Ⅱ?stage 46.15％(6/13),III-Ⅳ?stage 94.12％(16/17)]in breast cancer tissue(P＜0.05),while there was no obvious correlation between the expression of Twist mRNA and the age,tumor diameter,adventitial infiltration,estrogen receptor,progesterone receptor(P＞0.05).The expression of Twist and p53 mRNA in breast cancer tissue were significantly higher than those in adjacent noncancerous tissue and normal breast tissue[(112.36±12.53)％ vs.(101.37±9.12)％ and(98.03±9.04)％,(101.73±13.32)％ vs.(91.43±7.43)％ and(90.83±6.58)％,P＜0.01],while the expression of E-cadherin mRNA in breast cancer tissue was significantly lower than that in adjacent noncancerous tissue and normal breast tissue[(55.43±12.49)％ vs.(69.39±5.63)％ and(72.73±7.93)％,P＜0.01],there was no significant difference between adjacent noncancerous tissue and normal breast tissue(P＞0.05).The expression of Twist mRNA in breast cancer tissue was positively correlated to the expression of p53 mRNA(r=0.526,P=0.004),and negatively correlated to the expression of E-cadherin mRNA(r=-0.500,P=0.000).Conclusions Twist and p53 in breast cancer tissue show higher expression,while E-cadherin shows lower expression.Twist can promote invasion,metastasis of breast cancer by up expression of p53 and down expression of E-cadherin,and it plays an important role.

Angiogenesis and invasion are two remarkable features of spongioblastoma,which lead to the failure of clinical treatment.With the development of the glioma（s） molecular biology mechanism in the realm of angiogenesis,some anti-angiogenesis drugs have got a positive therapeutic efficacy in the clinical trials,such as bevacizumab.However,it is reported that these drugs maybe also enhance the invasion and migration ability of glioma cells in the process of anti-angiogenesis therapy.Matrix metalloproteinases,hypoxia induced factor-1 and the inositol-requiring enzyme-1 maybe have some correlations with the change of the invasion and migration,but the molecular biological mechanism needs further research.

Objective To investigate the clinical effect of different local anesthetic epidural anesthesia for cesarean section. Methods 60 maternal intended to be carried out cesarean section by epidural anesthesia were randomly divided into two groups. A group(n =30 cases) was administrated with 0.5% ropivacaine to anesthesia,and B group(n = 30 cases) was administrated with 0. 5% bupivacaine to anesthesia. The changes of hemodynamic were monitored,and the analgesic effect and adverse reactions were observed in the two groups. Results The differences of blood pressure, heart rate had no statistical significance between the two groups (all P＞0.05);Compared to B group, the anesthesia onset time, anesthesia time between the start of fetus, analgesic effect, adverse reactions of A group were significantly different (t = 4. 347,4. 528, x2 = 3. 834, 6. 429, all P ＜ 0. 05 ) ; Neonatal Apgar score showed no significant differences between the two groups ( P ＞ 0. 05 ). Conclusion Anesthesia with 0.5% ropivacaine for cesarean section had satisfactory anesthesia effect,and less adverse reactions.

Objective To explore the relationships between life events,automatic thoughts,coping style and internet addiction disorder(IAD) of adolescent . Methods 54 cases of the IAD were assessed with the Adolescent Self-rating Life Events,Automatic Thought questionnaire and Coping Style questionnaire. Results Life events, automatic thoughts,and coping style were significantly correlated with IAD (r =0.312,r =0.325,r =0.295) ( P <0.01).There were significant correlations between life events and automatic thought, life events and coping style(r =0.554,r =0.392) ( P <0.01).The multiple linear stepwise regression revealed that only life events entered on the regression equation when the score of IAD server as dependent variable. Conclusion There may be three ways that life events influence in IAD:life events influence in IAD directly,life events influence in IAD by the mediators,automatic thought and coping style indirectly.Automatic thoughts and life events is not a necessary condition that led to internet addiction and life events may be influence in IAD by other ways.

Objective To compare the impacts of four different intravenous anesthetic agents on middle cerebral artery blood flow velocity(V‐MCA) during the anesthesia induction period .Methods Totally 80 cases were randomly divided into four groups (n=20) ,maintenance drugs of anesthesia were propofol 2 .00 mg/kg ,etomidate 0 .30 mg/kg ,midazolam 0 .15 mg/kg and dezocine 0 .20 mg/kg respectively ,the bispectral index (BIS) value was dropping to below 50 ,the endotracheal intubation and mechanical ventilation were performed .The transcranial Doppler (TCD) monitoring was adopted to monitor and record middle cerebral artery mean flow velocity (Vm‐MCA) ,mean arterial pressure (MAP) ,heart rate (HR) ,systolic blood pressure (SBP) ,diastolic blood pressure (DBP) in the four groups before induction after entering operation room (T0 ) ,at1 min before intubation (T1 ) ,immediate intubation (T2 ) ,at 1 min after intubation (T3 ) ,3 min after intubation (T4 ) ,5 min after intubation (T5 ) .Results Except for the midazolam group ,Vm‐MCA at T1 in the other three groups were significantly lower that that in the T0 group (P< 0 .05);Vm‐MCA ,SBP ,DBP after intubation in the midazolam group and the etomidate group were significantly increased compared with the basic values ,while the difference between the propofol group and the dezocine group had no statistical significance (P>0 .05) .Con‐clusion midazolam and etomidate are weaker than propofol and dezocine in the aspect of inhibiting the middle cerebral arterial blood flow fluctuations caused by intubation .

Objective To research the determination of hypersensitivity C-reactive protein(Hs-CRP) and cardiac troponin T(Hs-cTnT) in patients with coronary heart disease,and to analyze the correlation with cardiac function.Methods The function of left ventricle and the serum levels of Hs-CRP and Hs-cTnT in 100 patients with coronary heart disease and 50 healthy subjects were detected.Results The function of left ventricle and the serum levels of Hs-CRP and Hs-cTnT were significantly different in patients with coronary heart disease and healthy subjects(P ＜0.01).The function of left ventricle and the serum levels of Hs-CRP and Hs-cTnT were significantly different in coronary heart disease patients with different New York Heart Association class(P ＜ 0.01).The serum levels of Hs-CRP and Hs-cTnT were positively correlated with class of New York Heart Association,left ventricular end diastolic diameter,and negatively correlated with left ventricular ejection fraction and fraction shortening (Absolute value of r:0.536 ～ 0.849,P ＜ 0.05).Conclusion The serum levels of Hs-CRP and Hs-cTnT significantly increase in patients with coronary heart disease,which is correlated to function of left ventricle,and it can be used as the indicators of cardiac function in patients with coronary heart disease.