Objective To detect and analyze the insulin resistance and islet beta cell function under different glucose metabolic state in the elderly.Methods 30 cases with impaired fasting glucose (IFG),impaired glucose tolerance (IGT),IFG plus IGT,diabetes mellitus (DM) and normal glucose tolerance (NGT) respectively were selected.The HOMA model was adopted for assessing insulin resistance and islet beta cell function.Results Insulin resistance index (HOMA-IR) was higher in IFG group (1.16±0.03) than in NGT group (0.87±0.03) (P＜0.05).The HOMA-IR was higher in IFG and IGF groups than in NGT group (both P＜0.05).The insulin secretion index (HOMA-IS) was lower in DM (3.95±0.06) than in NGT (5.15±0.05),IGT (5.13±0.03) and IFG (4.56 ± 0.07) groups (all P＜0.05).There was no significant difference in the HOMA-IS between IGT and NGT groups.Conclusions The IFG patients mainly present the defect in insulin secretion,and the IGT patients mainly present insulin resistance.With the deterioration of glucose metabolism,insulin resistance increases and islet beta cell function decays gradually.

Objective　To discuss the possibility of ultrasonic superficial spray anesthesia applied to bronchoscopy in children with intratracheal foreign bodies. Methods　50 cases with intratracheal foreign body were divided into two groups: surface anesthesia group (S group) and intravenous anesthesia group (Ⅰ group). 2% Lidocain by ultrasonic spraying inhalation for 8～10 min and r-OH 80 mg*kg-1+Ketamine 1 mg.kg-1 intravenous injection were adminstered respectively. Results　In S group perioperative the MAP and HR were stable， the complications were fewer and the SpO2 was >95%，the awaking time was shorter (70.1±15.3) min after operation；In I group the MAP and HR were descendent (P<0.05)， the complications were more and the SpO2 was <95% (P<0.05)， the awaking time was longer(P<0.01). Conclusion　The surface anesthesia is effective.The MAP and HR are stable，the complications are fewer and the awaking time is shorter.

Spatial statistics plays an important role in spatial epidemiology studies of echinococcosis .Spatial statistics can be used to describe the spatial distribution ,predict the prevalence ,identify disease clusters ,and analyze the influencing factors of echinococcosis .To describe spatial distribution and predict the prevalence ,we can use spatial interpolation ,empirical bayes smoothing and ellipsoidal gradient .Spatial autocorrelation always used to identify disease clusters .Moran's I value ,Getis'G val‐ue and spatial scan statistics are used to judge spatial autocorrelation .Molding plays an important role on analyzing risk factors of echinococcosis .Generalised linear mixed models and Bayesian model are always performed with both spatial factors ,such as geomorphologic features ,climatic characteristics ,vegetation index and factors which make great effect on disease transmission . To figure out the spatial distribution of echinococcosis is significant for echinococcosis control and prevention .

Currently,since a single treatment standard of benign tumors of liver is not established,many serious out-comes due to the excessive treatment of benign tumors of liver still happen sometimes.We should pay attention to composing the guideline on the treatment for the different types of benign tumors of liver on the basis of the multidisciplinary cooperation and the randomized controlled trials,and achieving the goals of an unified standard and the standardized therapy,meanwhile,avoiding the pain and burden of excessive treatment on the patients.

A large metaanalysis showed that immediate anticoagulation of patients with acute ischemic stroke was not associated with a significant reduction in death or dependency.The heparin data from the International Stroke Trial(IST) suggest that the use of early unmonitored subcutaneous heparin will reduce early stroke recurrence risks,but these benefits can be eliminated by increased hemorrhagic complications.The use of lower doses of heparin may provide more benefits rather than hemorrhagic side effects.We recommend early anticoagulation for various specific stroke subgroups including cardioembolic stroke,progressing stroke,stroke due to large-artery atherosclerotic stenosis,documented intra-luminal thrombus,and deep venous thrombosis prophylaxis.

A dynamic model of disease can be used to quantitatively describe the pattern and characteristics of disease transmission, predict the disease status and evaluate the efficacy of control strategy.This review summarizes the basic transmission dynamic models of echinococcosis granulosus and their application.

Objective To investigate the clinical and imaging characteristics of tumor like inflammatory demyelinating disease of CNS, We have analyzed the reason of misdiagnosis, and summed up the main point of differential diagnosis.Methods We have analyzed 14 cases which were confirmed as demyelinating disease in pathology after the operation, and all the clinical and image data were included.Results CNS inflammatory demyelinating disease could present edema and mass effect by CT or MRI, there was ring potentialization after enhancement, it was difficulty to distinguish from CNS demyelinating disease. All the 14 patients were misdiagnosis as CNS tumor before the operation.Conclusion CNS inflammatory demyelinating disease could have some atypical representation on CT or MRI image, they were made easily the misdiagnosis. We should get the differential diagnosis by many ways including clinical manifestation, course, laboratory examination and imaging characteristics.

Objective To evaluate the effects of selective mesenteric angiography with continuous papaverine perfusion for the diagnosis and treatment of non-occlusive mesenteric ischemia(NOMI).Methods Eighteen patients with NOMI underwent selective superior mesenteric arteriography and papaverine perfusion via the SMA simultaneously were analized retrospectively.Results Fifteen out of the 18 cases recovered;2 cases underwent laparotomy;1 case died within 10 days.Conclusion Selective superior mesenteric arteriography with continuous papaverine perfusion is an effective diagnostic and therapeutic method for non-occlusive mesenteric ischemia.(J Intervent Radiol,2006,15:209-212)