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

Aim To study the effect of paeonol on proliferation of vascular smooth muscle cell in atherosclerosis rabbits.Methods Atherosclerosis model on rabbits was established by high fat diet.The pathologic changes of aortic blood vessel were observed by lightmicroscope.The effect of paeonol on the proliferation of vascular smooth muscle cell in vitro was analyzed by MTT method.The lipid,SOD and MDA contents in aorta tissue were assayed by employing the automatic biochemistry analyzer and enzymic method respectively.IL-1?,TNF-? were quantified by radio immunoassay.The expresstion of PCNA protein was assayed by immunohistochemical method.Results Treated with Paeonol(75,150 mg?kg~(-1)) by interagastric administration for 6 weeks,the thickness of vascular tunica intima was observed and the number of foam cells was decreased in atherosclerosis rabbits.Paeonol(100～300 mg?L~(-1)) could inhibit the proliferation of cultured vascular smooth muscle cell and diminish the level of TC,MDA,pro-inflammatory cytokines,as well as enhanc the concentration of SOD in aortic tissue of atherosclerosis rabbits.The expressing intensity of PCNA protein was weakened.Conclusion Paeonol could inhibit the proliferation of vascular smooth muscle cell in vivo and in vitro,which may be related to decrease of contents of lipid,the extent of lipid peroxidation and the concentrations of proinflammatory cytokines.Paeonol might regulate the proliferation periods of vascular smooth muscle cell through inhibiting the expression of PCNA protein.

AIM: To observe the expression of hypoxia inducible factor-1? (HIF-1?) gene and heme oxygenase-1 (HO-1) gene in pulmonary arteries in hypoxic rats. METHODS: Forty male Wistar rats were exposed to hypoxia for 0, 3, 7, 14 or 21 days. Mean pulmonary pressure (mPAP), vessel morphometry, right ventricle hypertrophy index (RVHI) were measured. Lungs were either inflation fixed for immunohistochemistry and in situ hybridization or frozen for later measurement of HO-1 enzyme activity. RESULTS: During hypoxia, mPAP increased to significantly higher values than the control values after 7-day of hypoxia,reaching its peak after 14-day of hypoxia, then remained on the high level. Pulmonary artery remodeling developed significantly after 14-day of hypoxia. Expression of HIF-1? protein in control was poorly positive, but was up-regulated in pulmonary arterial tunica intimae of all hypoxic rats. In pulmonary arterial tunica media, the levels of HIF-1? protein were markedly up-regulated after 3-day and 7-day of hypoxia, then tended to decline after 14-day and 21-day of hypoxia. HIF-1? mRNA staining was poorly positive in control, hypoxia for 3 days and hypoxia for 7 days, but began to enhance significantly after 14-day of hypoxia, then remained stable. Expression of HO-1 protein began to increase after 7-day of hypoxia, reaching its peak after 14-day of hypoxia, then remained stable. Expression of HO-1 mRNA began to increase after 3-day of hypoxia, reaching its peak after 7-day of hypoxia, then declined. CONCLUSION: HIF-1? and HO-1 are both involved in the pathogenesis of hypoxia-induced pulmonary hypertension in rats. Furthermore, HIF-1? may inter-regulate with HO-1 gene in this process.

In the field of biomechanics, there have been many discoveries concerning the cervical spine injuries in recent years. With the help of biomechanical knowledge, we can not only judge the stability of the cervical spine and have a clear idea of the factors that may affect the stability but also conduct an appropriate classification of the injuries. In this article, we summarize the effects of the stiffness and preinjury biomechanical characteristics of the cervical spine (such as alignment, mass, inertial properties) on the injury, changes of the spinal canal during injury, and the rapidly developing research on finite element models of cervical spine injuries in the past few years.

Objective To design a new type of nasopharyngeal airway tube,which can resolve the upper respiratory tract obstruction due to general anesthesia.Methods All types of used flex endotracheal tube were collected.Take off the cuff outside of the tube wall and cut them into different lengths.Then,the connectors were reinstalled to the prepared tubes.Results With the designed nsopharyngeal airway tubes inserted,50 patients having complicated glossocoma in general anesthesia no longer snored and they could breathe freely.Conclusion The new type of nsopharyngeal airway tube is easy to produce and adapts well to clinical work.

OBJECTIVE To describe the sonographic features of carotid body tumor(CBT), and determine the utility of ultrasonography as a diagnostic study in the preoperative patients. METHODS Sonograms of 60 patients with 65 CBT were reviewed with gray scale and duplex Doppler sonography. The evaluated features included the location, size, margins, shape, internal echogenicity, the relationship between the tumor and the carotid artery,and blood flow velocity. RESULTS All carotid body tumors were located at the carotid artery bifurcation. Well-defined, solid, weakly hypoechoic masses were noted on gray scale sonography in the carotid bifurcation. Color Doppler sonography showed hypervascularity in 61 masses. Pulsed Doppler analysis of blood flow within the tumor mass was possible in 61 CBT, and low-resistance waveforms were obtained from multiple sites within the mass in all cases. CONCLUSION The ultrasound characteristics of the CBT possess specificity to some extent. Duplex Doppler ultrasound can provide the relationship between the tumor and the carotid artery,and provide important information of intratumor blood flow,which has important value in the diagnosis of CBT.

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.

Exosomes are nanosized membrane particles secreted by cells that transmit information from cell to cell.Exosomes in-volve in the regulation of important physiological activities of cells and play an important role in the formation and develop-ment of atherosclerosis (AS ).As one of extracellular vesicles, exosomes is getting increasingly attention.This article aims to review the role of exosomes derived from the AS related cells (immune cells,platelets,vascular endothelial cells,vascular smooth muscle cells)in the pathogenesis of AS.

Objective:To explore the imaging features of complicated lymphocele after the pelvic lymph node dissection. Methods: After pelvic lymph nodes dissection, lymphoceles in pelvic cavity of 47 patients with gynecological malignant tumor were found by magnetic resonance imaging (MRI) and all of these imaging data were retrospectively analyzed.Results:All of 47 cases had lymphoceles in pelvic cavity, and the number of lymph node lesion was 52 (30 were at left side of pelvis, 22 were at right side of pelvis); the distribution of most lymphocele were around of external vein and artery of iliac; the main MRI features were roundness, oval, reniform or dumb-bell shape with smooth and uniform lymphocele wall, and the intracystic manifestations were long T1signal and long T2signal; the manifestation of DWI was high signal of limited dispersion; after enhancement scan, the wall of lymphocele and intracyst appeared middle reinforcement signal, and there was no obvious reinforcement signal in cystic contents.Conclusion: There are characteristic MRI imaging manifestations in lymphocele, and the diagnosis of MRI is reliable and accurate.