Nowadays,aging is the general trend of population development in the world.Type 2 diabetes is one of the most common chronic diseases in the elderly.Because of the atypical symptoms and signs,accompaniment of chronic cardiovascular disease and vulnerability to low blood glucose in the elder patients with diabetes,we should to make safe,effective,and individualized therapeutic programs for them.This paper will review the current prevalence,characteristics,and oral drug selection among elderly individuals with T2DM.

Objective:To investigate the clinical efficacy and safety of PCNL with the use of different percutaneous renal access in treatment of renal calculi.Methods:Percutaneous renal minimal access(F14～F16)or small access(F18～F20)was established randomly in 142 patients,and PCNL were performed in all patients.The clinical parameters including operative time,complication and stone-free rate were compared in the two groups.Results:The operative time of simple renal calculi were(78.3?15.6)min and(91.2? 18.2)min(P0.05)in small access group and minimal access group respectively.The operative time of complicated renal calculi were(115.3?20.1)min and(130.7?28.7)min(P

The main reason of recurrence and metastasis in breast cancer is the resistance for the radiotherapy and chemotherapy,and the mechanism of radio-resistance and chemo-resistance may be related to the DNA damage response (DDR).There is a complicated system of the DDR pathway,including cell cycle checkpoint,DNA repair,transcription and apoptosis to maintain the integrity of cell genes.In the cancer treatment,DDR occurs in various kinds of cytotoxic drugs and radiation to cause genetic damage,which limits the curative effect of chemotherapy and radiotherapy.This promotes the targeted therapy of DDR pathway,especially checkpoint kinase 1 (CHK1).Recently,the new viewpoint supports that CHK1 is a main marker of the DDR pathway activation,which shows that CHK1 not only activates the check point but also affects the DNA repair and apoptosis directly.Thus,the role of CHK1 in DDR will promote CHK1 inhibitor to be one of the new treatment strategies for the cancer patients who resist the radiation and chemotherapy.

Objective]To expound the essence and method of detoxification in the view of keeping internal balance ,based on Huangdi’s Internal Classic. [Method] From the present social understanding of toxin biased ,and on the basis of collecting and analyzing the materials concerning the record of concept and treatment of eliminating toxin in early medical classic ,eliminating toxin and keeping balance can be taken as a sort of health care idea. [Result] The toxin in body refers to the imbalance of Yin and Yang Qi and blood of human body ,it also may be the cause and new pathological products. This recognition corrects the understanding of contemporary society point ofDetoxification ,and guides people to follow the body's own adjustment mechanism,the function of organs and individual constitution to determine etiologic factors based on differentiation treatment. It will avoid and prevent producing the toxin in accordance withIn order to maintain body balance and adjust yin and yang of body through careful diagnosis said by Huangdi ’s Internal Classic. [Conclusion] That one specific treatment depending on one specific toxin reflects the principles of syndrome differentiation treatment and searching for the primary cause of disease in treatment by exploring Huangdi ’s Internal Classic. And it can make people understand more accurately and profoundly about detoxification and live healthier.

Objective To explore types and risk factors of recurrent ischemic stroke in ischemic stroke patients using antiplatelet drugs. Methods By retrospective study, 130 recurrent ischemic stroke patients using antiplatelet drugs (antiplatelet therapy group) and 101 recurrent ischemic stroke patients not taking antiplatelet drugs (non antiplatelet therapy group) were collected. Two groups of patients were divided according to the ischemic subtypes, and risk factors between different subtypes were analyzed. Results (1) Single factor analysis showed history of coronary heart disease and smoking are more frequent in antiplatelet therapy group with recurrent lacunar infarction (LI). History of coronary heart disease, diabetes, and high level of low density lipoprotein (LDL) are more frequent in antiplatelet therapy group suffer from recurrent atherosclerotic thrombosis (AT). (2)Logistic regression analysis showed the history of coronary heart disease , smoking are independent risk factors for recurrent LI in antiplatelet therapy group (P = 0.018, P = 0.027); history of coronary heart disease, diabetes, and high level of LDL are independent risk factors for recurrent AT in antiplatelet therapy group (P =0.003, P = 0.010, P = 0.002). Conclusions The history of coronary heart disease and smoking are independent risk factors for the recurrence of LI in patients with antiplatelet therapy. History of coronary heart disease , diabetes , and high level of LDL are independent risk factors for the recurrence of AT in patients with antiplatelet therapy. Combined coronary heart disease would increase both LI and AT recurrence.

Objective To explore the clinical efficacy of tirofiban in treatment of patients with high-risk non-ST-segment elevation of acute coronary syndrome (NSTE ACS),in order to improve the level of treatment effect. Methods 90 cases with high-risk NSTE ACS from January 2011 to April 2013 were randomly divided into control group and observation group. The control group were received treatments of conventional aspirin,clopidogrel, anticoagulation,coronary angiography (CAG)and percutaneous coronary intervention (PCI),while the observation group were added tirofiban therapy an the basis of control group. After the treatment,the differences of cardiovascular adverse events,thrombolysis in myocardial infarction (TIMI)flow grade and complications in both two group were observed and compared. Results There were significant differences in major adverse cardiovascular events in the distal vascular blockage,surgery without reflux,recurrent angina and myocardial infarction and post-PCI TIMI flow grade 2 and 3 (P<0.05),but not in bleeding complications,TIMI flow grade 0 and 1 before and after PCI treatment. Conclusion Tirofiban is safe and effective in treatment of high-risk NSTE ACS in interventional procedures. It can improve TIMI flow, increase tissue perfusion and reduce postoperative complications.

Angiocentric Glioma has been newly identified as an epilepsy associated tumory. Up to now, reported cases are still scarce. The tumor causes drug-resistant epilepsy. On histological findings, monomorphous bipolar tumor cells are arranged around vessels. Imaging studies show that the tumor is diffused or rimlike hyperintensity on T1-weighted SE sequences and a stalklike extension to the ventricle on T2-weighted sequences. The World Health Organization listed this new entity in its fourth edition of the WHO classification of tumors of the central nervous system published in 2007.

Objective To learn about the mastery level of midwives and obstetric nurses about fetal monitoring knowledge.Methods 77 midwives and obstetric nurses attending a fetal monitoring education programme in Huaxi Second Hospital of Sichuan University were investigated by using a self-made questionnaire.Results Some respondents lacked of systematic training in fetal monitoring knowledge,and they could not accurately answer the purpose or contents of fetal monitoring,as well as the basic elements and related knowledge about fetal electronic monitoring.Most of the respondents focused on fetal monitoring in clinical practice,but neglected the corresponding frontier progresses.Conclusions The training and education on fetal monitoring knowledge should be strengthened to improve obstetric quality because of the unsatisfactory survey results in midwives and obstetric nurses.

Background and purpose:Paclitaxel (Taxol,TXL) combined with cisplatin (DDP) has become the common chemotherapeutic regimen for cervical cancer. However, DDP has higher toxicities. Nedaplatin (NDP), a new platinum analogue,has been shown to have a higher antitumor efficiency against cervical cancer and lower toxicity. This study was done to investigate the antitumor effect of TXL+NDP on HeLa cells transplanted tumor compared with TXL+DDP. Methods:HeLa cells were transplanted subcutaneously in nude mice. These nude mice were randomly divided into 6 groups by sorting when tumor diameter reached 5-6 mm: Control, TXL, NDP,DDP, TXL+NDP,TXL+DDP. Tumor volume and body weight were measured during experiment. The volume ratio (T/ C) was the volume of single agent treatment group and control group and used to assess the antitumor effect, and the combination ratio (CR) was used for the combined therapy. More than 20% weight loss was defined as reaching toxicity level. Results:TXL+NDP regimen had a synergistic antitumor effect (CR=0.76) on HeLa cell transplanted tumor, with a maximum weight loss 8.3%. The tumor volume of TXL+NDP was 172?60 mm3, which was significantly smaller than that of TXL(304?55 mm3) group or NDP(356?67 mm3) group(P0.05), but had a higher toxicity with 4 mice death. Conclusion: TXL+NDP regimen has a synergistic inhibitory effect on HeLa cells and lower toxicity. The efficacy of TXL+NDP regimen needs to be confirmed in clinical trials.

Objective The aim of this study was to understand the pollen concentration and the daily variation during 2007 in Beijing by monitoring.Methods Burkard volumetric strap was used for the pollen sampling from August 1st to October 20th.Genus of pollen was identified by light microscope.Results Artemisia and Humulus.L pollen were the dominant airborne pollen in late summer and autumn in Beijing City.The average pollen concentration of Artemisia and Humulus.L were 71 grain/m3, 124 grain/m3.Both of them lasted from the August 8th until October 6th or 8th.Statistical analysis showed that the pollen concentration of Artemisia or Humulus.L at 2:00 pm to 4:00 pm was higher than that at 6:00 am to 8:00 am.Conclusion It is the first work to conduct the monitoring of the concentration of Artemisia and Humulus.L pollen with Burkard sampler in Beijing.Humulus.L is the dominant airborne pollen during August and September.