The elderly patients with diabetes often have a high prevalence of hypertension.Meanwhile,hypertension is a major vascular risk factor in this population.The benefit of proper management of hypertension in elderly patients with diabetes has been well recognized.According to the IDF Global Guideline for Managing Old People with Type 2 Diabetes,lifestyle interventions are recommended to form the first step in managing hypertension in elderly patients with diabetes.Pharmacological therapy should be initiated in addition to lifestyle interventions after 6 weeks during which non-pharmacological therapy has failed to achieve blood pressure targets.ACE-inhibitors are the first choice for initial medication,especially in the presence of diabetic nephropathy.ARBs can be used in people who cannot tolerate ACE-inhibitors.Diuretics or calcium channel blockers can be used as the first add-on therapy to ACE-inhibitors or ARBs if they fail to achieve target blood pressure.β-blockers should be considered for combination therapy in people with tachycardia or coronary artery disease.The generally recommended blood pressure target for older people with diabetes should be less than 140/90 mmHg(1 mmHg=0.133 kPa).

[Objective]To evaluate the safety and efficacy of the surgery,which was done by a video-assisted thoracoscope to release the anteriorroute part of spine and done by posterior instrumented fusion with severe Adolescent Idiopathic Scoliosis(AIS).Clinic date:There were 10 cases of AIS(King Ⅱ 6,King Ⅲ 3,King Ⅳ 1),in which there were 6 males and 4 females.The average age was 17.2 years(range 14~21).The average preoperative primary curve in the coronal plane was 91.3?(ranged 67?~125?)and the average pliability of thoracic spine was 28.3%(ranged 19.3%~36.5%).[Method]With general anesthesia(onelung ventilation or two-lung ventilation),the disc complexes and part of the anterior longitudinal ligament of 5~6 disc near apex vertebra were excised under endoscopic visualization.In the same operation,the posterior instrumented fusion was done.[Result]The anterior releases under endoscopic visualization needed 120~150 min with average bleeding 157ml(ranged 100~200 ml).The thoracic draining was 100~150 ml After the posterior route surgery,the average coronal Cobbs angle was 47?(ranged 26?~75?)and the rate of rectification was 51.5%.The patients had good fusion and outlook without other complications.[Conclusion]This way,which is done by a videoassisted thoracoscope to release the anterior part of spine and done by posterior instrumented fusion has a good result about safety and efficacy.

Image segmentation is a key step of image processing,and it is a hard work too. The experts of this field have tried to find a suitable algorithm for image segmentation for a long term,however,there is not a algorithm is generally accepted till now. J. Holland created genetic algorithm(abbreviation :GA) in 1973. This algorithm has been used in many fields successfully ,and has been introduced to image segmentation field by exports. The principles of image segmentation and algorithm are stated in this article. The author mainly expounded the application of GA in medical image segmentation field in recently years.

Compared with proinflammatory processes in the development of type 2 diabetes,our knowledge on anti-inflammatory cytokines is rather limited.Anti-inflammatory cytokines such as adiponectin,interleukin 1 receptor antagonist(IL-1RA),transforming growth factor-β1 (TGF-β1),growth differentiation factor-15 (GDF-15),omentin,and secreted frizzled-related protein 5 (SFRP5) are strongly associated with increased risk of type 2 diabetes:Adiponectin and omentin levels decreased before type 2 diabetes,in contrast,concentrations of IL-1RA,TGF-β1,GDF-15 are increased.Change of SFRP5 levels in impaired glucose tolerance and type 2 diabetes remains controversial.This paper will summarize and recommend studies that investigated associations between circulating levels of anti-inflammatory cytokines and type 2 diabetes.

Objective To construct small interfering RNA(siRNA) expression vectors targeting EOLA1 (Endothelial-overexpressed lipopolysaccharide-associated factor 1) gene, and to assay their effects on the expression of EOLA1. Methods GFP-EOLA1 fusion protein expressive vector pEGFP-N2/EOLA1 was constructed and transfected into ECV304 cells. The transfected cells were cultured in M199 containing G418 (400?g/ml) for 5 weeks to screen the cell line stably expressing GFP-EOLA1 fusion protein. For interfering EOLA1 target gene, complementary oligonucleotides were desiqned and synthesized at different sites. The oligonucleotides were inserted into pSinencer3.1/H1 plasmid. Then, the vector was transfected into the ECV304 cells stably expressing GFP-EOLA1 fusion protein and the inhibiting affection to target gene EOLA1 was identitied by the observation of the green fluorescence in transfected cells with inverted fluorescent microscope and Western immunoblot assay. Results The ECV304 cell line stably expressing GFP-EOLA1 fusion protein was constructed, and the siRNA vector of EOLA1 can knockdown EOLA1 gene expression specifically. Conclusion The siRNA vectors specifically interfering EOLA1 expression were constructed successfully, which would be useful in the study of function of EOLA1 gene.

Objective To summarize perioperative nursing of babyport embedded.Methods The preoperative nursing included adequate preoperative evaluation,paying more attention to psychological nursing care for children and their families,introducing babyport characteristics and daily care,eliminating ideological concerns of children and their families; assisting relevant preoperative preparation.After surgery,children were under close observation of vital signs,the surface skin condition of the infusion port implanted,pain management,catering management,psychological care,standardization of nursing,treatment of common problems,enhanced education for discharge.Tracking files were established for each children with babyport implanted,regular follow-up tracing was given.Results Among 59 cases,58 cases were without complications,babyport of one case was removed due to infection.After followed-up for 3～18 months after discharge,58 cases of babyport embedded patients were without complications,patients and families expressed satisfaction.Conclusions Standardized perioperative nursing of babyport embedded surgery and standardized service of tracking and return service can ensure patients' safety and improve the patients'quality of life,increase service quality and patients' satisfaction.

60?) in the Huaxi Hospital of Sichuan University. Three cases aged less than 15 years, but the patients or their relatives were informed of and consented the operation scheme. Without rectification, fusion segments were propped open about 5 mm via the upper and lower fixed vertebra, and anterior one was transplanted with fresh-frozen fibular allograft (offered by the donor corpse and excised extremities due to surgical trauma from the Department of Orthopaedics in Huaxi Hospital. The immunogenicity was greatly reduced by routine defat, acellular procedure, soaking sterilization and deep freezing), while rear one was transplanted with costal bone for supporting graft and filling the graft bone intervals with autogenous bone strips. Gypsum (brace) was used to assist external fixation for 8-10 month postoperation. The complications, graft incorporation, neurological function (Frankel grading scale A-E: complete paralysis-normal or no paralysis), back pain (0-3: none-severe), and mobility score (1-4: lying in bed-needing no assistance) before operation and at final follow-up of each patient were collected for analysis. RESULTS: All the patients were available for follow-ups and the mean period was 3.4 years (1.5-5 years).①Apparent fusion was observed in all cases with no graft fracture, only one patient reported mild graft shift and the kyphosis was unchanged.②There was no worsening of the neurological status in any patient. Frankel grades of 3 adult patients were unchanged after operation. All adolescent patients (n =3) had definite neurological improvement and could walk without assistance, while another was adult patient. Complete relief of back pain was observed in all patients. CONCLUSION: Fresh-frozen allograft fibular is a liable graft material for the treatment of severe kyphosis induced by inactive upper thoracic tuberculosis. Anterior decompression and fusion can promote the recovery of motive function and the alleviation of pain, especially is effective for neurological recovery of adolescent.

AIM: To investigate the influence of Sijunzi Decoction(Radix et Rhizoma ginseng,Rhizoma atractylodis macrocephalae,poria,Radix et Rhizoma glycyrrhizae) on the pharmacokinetics of Levofloxacin(LVFX) in rats with deficiency of spleen. METHODS: Twenty-four rats were randomly divided into four groups: NS(normal rats given 0.9% saline solution),NS+SJZT(normal rats given 0.9% saline solution and Sijunzi Decoction),R(rats pretreated with Reserpine) and R+SJZT(rats pretreated with Reserpine and then cured with Sijunzi Decoction).After a single oral administration of LVFX 20 mg/kg,blood samples were collected at different intervals.The concentrations of LVFX plasma were determined by HPLC.Pharmacokinetic parameters were determined from the plasma concentration-time data. RESULTS: Reserpine led to the syndromes similar to the deficiency of spleen,a traditional Chinese medicine syndrome.The pharmacokinetic parameters of LVFX in NS,NS+SJZT,R and R+SJZT groups were as follows: AUC_((0-∞))=(8.55 ?0.99),(7.41?1.39),(4.68?0.95) and(7.89?1.41)mg/(L?h),respectively and C_(max)=(3.31?0.63),(2.38?1.15),(1.29?0.45) and(3.35?1.15) mg/L,respectively.Compared with the parameters of LVFX in NS group,Reserpine markedly decreased AUC_((0-∞)) and C_(max) of LVFX(P

[Objective]To explore the operative method through the trans-upper-sternal approach in the treatment of the cervicothoracic spinal lesions and evaluate its clinical effects.[Method]From August 1999 to February 2006,11 cervicothoracic patients,8 males and 3 females,age ranged from 17 to 77 years with a mean of 41.5 years underwent the trans-uppersternal approach surgical treatment.There were four traumatic lesions,six tumors and one tuberculosis.The lesions were located at T3,C7~T1 and T1、2 in 1 case respectively,C7 and C6~T1 in 2 cases respectively,T1 in 4 cases.The combined cervicothoracic incision and upper sternotomy were performed for the exposure of the vertebral bodies,then tumor or vertebral body was resected,the spinal cord was decompressed,the spinal column was reconstructed and fixed.Neurologic status was assessed using the Frankel classification.[Result]The duration of follow-up ranged from 10 to 56 months with an average of 31 months.One patient developed chyle leakage of 50 ml one day after surgery and the leakage stopped 2 days after continuous drainage.One patient had transient vocal cord paresis which recovered in 3 months.All patients had their neurological improvement at different level.Nonunion or instrument-related complications were not observed,and the vertebral column had good stability.[Conclusion]The trans-upper-sternal approach gives an excellent exposure of the cervicothoracic junction.It is a technically simple,safe and effective method for anterior decompression,maintenance of anatomic alignment,fusion with bone graft and internal fixation with less complications and trauma.Attention should be paid to avoid injury of the recurrent laryngeal nerve and the thoracic duct.

Objective:To observe therapeutic effect of Xiaoyou Granule on Helicobacter Pylorum(Hp)related chronic gastritis.Methods:120 cases were randomly divided into 3 groups,40 cases in each group.They were treated respectively with Xiaoyou Granule,Weisu Granule and western medicine.Their therapeutic effects were observed.Results:Xiaoyou Granule was superior to the control group of TCM in improving clinical symptoms,eliminating inflammation of mucosa and the long-term therapeutic effect of removing Hp was superior to the control group of western medicine.Conclusion:Xiaoyou Granule has a definite therapeutic effect on Hp related chronic gastritis.