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 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.

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 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 investigate the application of numerical simulation technique in supraorbital and frontal osseous defect.Methods The data of the patients with complex supraorbital and frontal osseous defects were obtained by helix CT scan.Numerical model based on the data was built up by computer.And the true model was produced by Rapid Prototyping.Being stimulated before this operation.the model was directly used in the operation.Results All of these 12 patients(one of defect of brow,four fracture of brow and zygoma,seven of old fracture of brow and zygoma)in this study were satisfied and their brows were symmetry after operation.All of them were satisfied after 1 or 2 years,without implantation exposure and transfiguration except one with infection.Conclusion Based on numerical technique difficulties of repairing,complex supraorbital and frontal osseous defect could be resolved by such process as collecting the bone data,stimulating operation by true models,and producing implantation before the operation.The accuracy of these operations can be improved.

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 investigate the effect and changes of IL -18 and IL -35 in patients with recurrent Hp positive gastric ulcer by treating with leibeirazole quadruple therapy.Methods 180 patients with recurrent Hp positive gastric ulcer were divided into two groups.The control group(90 cases)was applied amoxicillin,clarithromy-cin and colloidal bismuth pectin.The observation group was added leibeirazole.The effect and changes of IL -18 and IL -35 were observed before and after treatment in the two groups.Results The effective rate (86.67% vs. 73.33%,χ2 =5.000,P =0.025),inflammatory reaction rate(26.67% vs.51.11%,χ2 =11.314,P =0.008)and Hp positive rate(16.67 % vs.31.11%,χ2 =5.163,P =0.023)were higher in the observation group than in the control group.Expression of IL -18 was decreased after treatment[(70.80 ±11.21)ng/L vs.(88.83 ±7.13)ng/L, t =8.27,P =0.0210]in the observation group,but no change in the control group[(85.62 ±10.84)ng/L vs. (87.64 ±9.28)ng/L,t =0.78,P =0.4512).Expression of IL -35 didn't change after treatment in the two group (P >0.05).Conclusion Leibeirazole quadruple can increase the clinical effect,decrease the expression of IL -18 in patients with recurrent Hp positive gastric ulcer,it is worthy to be applied in clinical treatment.