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.

Abnormalities, Multiple ; diagnosis ; pathology ; physiopathology ; Branchio-Oto-Renal Syndrome ; diagnosis ; pathology ; physiopathology ; therapy ; Child ; Deafness ; etiology ; physiopathology ; Diagnosis, Differential ; Ear ; abnormalities ; Female ; Humans ; Kidney ; abnormalities ; Renal Insufficiency ; etiology ; physiopathology ; therapy

The rapid cooling contracture in myocardial protection is getting more and more attention. Rapid cooling contracture is referred to as the undepolarized myocardial contracture induced by rapid cooling, which is related with the sudden increase of Ca2+. The Ca2+ released from sarcoplasmic reticulum subsequently causes myocardial contracture through the myofilaments sliding. Its deleterious effects include: more energy consumption, impaired cardiac function, Ca2+ overload, et al. And some investigators have put forward some principals to prevent the bad influences of rapid cooling contracture.

Objectives To study the reliability,validity and feasibility of the Chinese version of memory alteration test(M@T).Methods Cross-sectional survey with a convenience sample was employed to interview 220 elderly people over 60 years old,39 patients with mild cognitive impairment(MCI),20 with Alzheimer's disease(AD),and 161 normal cognitive elderly.The survey was,then evaluated with internal consistency,content validity,criterion validity,principal component/factor analysis and influencing factors.Results A Cronbach's α coefficient of 0.818 was obtained in M@T. The correlation coefficients which were the score of the subtest and the total were 0.5-0.9.The correlation coefficient of the scores of the Mini.mental State Examination(MMSE)and the M@T Was 0.933.The 5 factors were extracted with the factor analysis,which could explain the total variance of 69.449%,and the corresponding factors of the proieets have a satisfied amount of factor loading(≥0.4).There were significant diffeFences in the score of M@T among the different cognitive level groups with good discriminant validity(cognitive normal group:39.0±3.7,MCI group:29.0±3.7,AD group:16.9±3.7;F=498.419,P<0.05).There were no significant differences in the score of M@T among the different gender,age,occupation and education level groups.Conclusions The Chinese version of M@T has good reliability and validity and feasibility.The score of the M@T is not affected by gender,age,occupation,education level and other factors.

Optical coherence tomography (OCT) which was brought into existence in early 90s of 20 century is a noninvasive technique for creating cross-sectional images of transparent or semi-transparent internal biological tissue structure.In recent years applicability research in the field of stomatology has made great progress.The micro structure changes of surface layer of the lesions in oral hard and soft tissues could be detected by this technique,with its unique feature to detect insidious secondary caries beneath dental restorations that couldn't be found by current clinical techniques easily.In this review,secondary caries etiopathogenisis and diagnosis,principle were discussed firstly and then imaging observation of OCT to detect early second caries around dental restoration and monitoring on risk factors inducing secondary caries are reviewed.It indicated that OCT technique has great potential on diagnosis of secondary caries.

hydroxysteroid dehydrogenase (11? HSD) catalyzes the interconversion of cortisol with its inactive metabolite cortisone. The congenital deficiency of 11? HSD2 induce hypertension and hypokalemia. This disorder is called "Apparent Mineralocorticoid Excess(AME)". Glycyrrhizic acid and other endo and xenobiotics have been found to inhibit the activity of 11? HSD and cause excess mineralocorticoid effects that is similar to AME. The decrease in 11? HSD activity is related with the acquired and congenital hypertention.

Objective:To observe the effect of combining intraosseous infusion (IO) and hyperosmotic salt fluid in resuscitation of haemorrhagic shock. Methods:Twenty rabbit models of haemorrhagic shock were established. The blood pressure, heart rate, biochemical indexes, artery blood gas analysis, etc . were compared at 3 different time points after infusion between IO and peripheral intravenous infusion groups. Results:The resuscitative effect through IO with hyperosmotic salt fluid was the same as that of the peripheral vascular access. Conclusion:The combination of intraosseous infusion and hyperosmotic salt fluid is effective for resuscitation of haemorrhagic shock.

Objective To get new more sensitive signs reflecting cartilage degeneration,which were added to the present ARA differential criteria of knee osteoarthritis and to compare the sensitivity and specificity before and after new items.Methods Through review analysis of the clinical feature,radiography and operative presentation of 115 adult patients,the new signs reflecting cartilage degeneration as items were found,which were added to the present ARA differential criteria of knee osteoarthritis as new criteria.Then the 112 patients who have received either knee joint replacement or arthroscopy were re diagnosed with both the present ARA criteria and the new criteria.Sensitivity and specificity were calculated and compared.Results "Extensive knee joint tenderness" with cartilage degradation and "lockage on motion or a positive Apler test" were significantly related to the meniscus degradation.A 39 7% sensitivity of these patients was obtained using the present ARA clinical criteria,while it reached 70 6% using the new clinical criteria ( P 0 05).Conclusion The two new items added to the present ARA criteria help to increase the sensitivity for diagnosis of knee osteoarthritis without influence on the specificity.