Objective To investigate the clinical effect of psychological intervention combined with insulin and glimepiride on the the treatment of elderly patients with diabetes. Methods 150 cases of elderly patients with diabetes in our hospital from July 2012 to March 2017 were treated as the research object, the single and double number (hospital admission order) 150 cases of elderly patients with diabetes were randomly divided into study group (n=75) and control group (n=75). The control group of elderly diabetic patients receiving insulin combined with glimepiride treatment in the study group received the basic treatment combined with psychological intervention. Results After treatement, 2 hPG, FBG and HbAlc were better than those in the control group (P<0.05). HAMD score in the study group after treatment decreased significantly than that before treatment(P<0.05). The difference of HAMD score in the control group had no statistically significant. Conclusion Psychological intervention combined with insulin and glimepiride on the treatment of elderly patients with diabetes can improve the depression, has a positive significance to improve the effect of blood glucose.

Objective To evaluate the therapeutic effects of noninvasive bi-level positive airway pressure (BiPAP) ventilation after extubation in chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure.Methods Forty-one intubated COPD eases with severe respiratory failure due to pulmonary infection (pneumonia or purulent bronchitis) were involved in the study.At the time of pulmonary infection control (PIC) window,the extubation was conducted and followed by BiPAP ventilation in 21 cases (the experimental group),while the other 20 COPD cases with similar clinical characteristics,as the control group,who continuously received invasive mechanical ventilation after PIC window.Outcomes including the duration of invasive ventilation,the total duration of ventilation support,success rate,the incidence of ventilator associated pneumonia (VAP) and mortality rate were observed and compared between the two groups.Results The two groups had similar clinical characteristics and gas exchange at the time of PIC window (P ＞ 0.05 ).Compared with the control group,the experimental group had shorter duration of invasive mechanical ventilation (6.9±3.0) d vs.(13.1 ±4.3) d,t=5.38,P＜0.001),lower rate of VAP (1/20 vs.8/20,x2 =5.51,P=0.02) andhigher extubation rate (20/21 vs.13/20,x2 =4.19,P =0.04).Conclusion In COPD patients with intubation and mechanical ventilation for respiratory failure,BiPAP ventilation after extubation at the point of PIC window may improve patients' prognosis.

Objective To investigate the effects of exercise on learning and memory after cerebral ischemia. Methods Ninety Sprague-Dawley rats were randomly divided into a sham-operated group, a model group and a treadmill training group ( n=30 for each) , which were further subdivided into groups to receive 7 days, 14 days or 28 days of training with 10 rats in each. The training was treadmill running at 10 m/min for 30 min a day. Cerebral ische-mia was induced in the model and training groups using permanent, bilateral common carotid artery occlusion. The training began three days after the operation. Morris water maze tests were used to measure the rats′ learning and memory ability, and Nissl staining was employed to detect the survival rates of pyramidal neurons in the CA1 area of the hippocampus. Results The average escape latency in the treadmill trained group had shortened significantly by day 7, then further by days 14 and 28. It was significantly shorter than the model group′s average at each time point. The average platform crossing time increased significantly compared with the model group′s average. Few dead neu-rons were observed in the sham-operated group. On days 14 and 28 the average survival rate of pyramidal neurons in the model group was significantly lower than in the treadmill training group or the sham-operated group, though there was no significant difference on day 7. Conclusion Treadmill training can improve learning and memory after cere-bral ischemia, at least in rats. Better effects can be observed after longer training.

Objective To investigate the effects of methylthioadenosine phosphorylase (MTAP) on invasion and migration in breast cancer cells.Methods Human breast cancer cell line MCF-7 cells were treated with MTAPtargeted siRNA to diminish MTAP mRNA.MCF-7 cells proliferation was evaluated by cell counting kit-8,the analysis of cells invasion and migration was performed using Transwell chamber.The expressions of MTAP and matrix metalloproteinase 1 (MMP1) in cell extracts were detected by Western blotting.The experimental divided into blank contrd group,negative control group,MTAP-siRNA experimental group.Results The MCF-7 cells growth was promoted after knockdown the MTAP mRNA.MATP-siRNA experimental group 450 nm absorbance values at 24h,48 hand72 h of the control group were (112.3±11.9)％,(144.4±8.4)％,(169.3±9.4)％ respectively.Cell invasion analysis by Transwell chamber showed 570 nm absorbance values were 0.49 ± 0.06 (control),0.45 ± 0.07 (negative control) and 0.87 ± 0.07 (MTAP-siRNA) respectively.Cell migration analysis by Transwell chamber showed 570 nm absorbance values were 0.46 ± 0.06 (control),0.49 ± 0.08 (negative control)and 0.75 ± 0.07 (MTAP-siRNA) respectively.The expression of MMP1 in MCF-7 cells was upregulated after knockdown the MTAP mRNA.Conclusion The knockdown of MTAP in MCF-7 cell can increase the cells invasion and migration,and this may involve the the MMP1.

Objective To analyze the clinical manifestations,diagnosis,treatment and prognosis of patients with splenic abscess.Method The clinical data,including baseline clinical data,clinical features,past history,pathogen culture result,treatment and the prognosis were retrospectively analyzed in the patients with the discharge diagnosis splenic abscess from January 1991 to March 2012 in Peking Union Medical College Hospital.Results The media time from onset to Peking Union Medical College Hospital of the 19 patients were 29 days.Among them,9 patients were cured,8 were improved and 2 died.Risk factors,such as tumor burden,diabetes,and using immunosuppressive agents etc,can be found in most patients with splenic abscess.All the 19 patients had splenic image changes and non-specific clinical features.The most common three clinical symptoms were fever(18 cases),chills (12 cases) and shivering (11 cases).The most common three signs were abdominal tenderness (9 cases),left upper quadrant sensitive to percussion (7 cases) and splenomegaly (4 cases).The most common etiological culture results were gram negative bacilli (9 cases),gram positive coccus (8 cases),and fungi (4 cases).Conclusions Clinical features are non-specific in splenic abscess patients.Related exam such as ultrasound should be performed on patients with splenic abscess risk factors to avoid misdiagnosis.Empiric antibiotic administration should begin right after the diagnosis based on the image.Pathogen culture should be timely conducted after pus collection.Individual therapeutical protocol should be chosen according to patient's condition.

Objective To investigate the changes of serum nerve growth factor(NGF) and interleukin(IL)-15 levels in children with mycoplasma pneumoniae pneumonia(MPP) and its clinical significance.Methods Using the antibody sandwich ELISA method to measure the serum NGF and IL-15 levels in 65 cases of MPP (MPP group,which contains two groups:the severe group contains 25 patients and the mild group contains 40 patients) and 50 cases of healthy children (normal control group).Results The serum NGF,IL-15 levels in the acute phase of MPP group were (157.62 ± 33.45) pg/ml and (242.51 ± 60.04) pg/ml,and in the recovery period were (99.58 ±21.29) pg/ml and (145.90 ±50.25) pg/ml,they were all significantly higher than the normal control group [(29.86-± 11.74) pg/ml and (108.86 ± 21.14) pg/ml,P ＜ 0.05].The serum NGF,IL-15 of the acute phase were also higher than the recovery period (P ＜0.05).In the acute phase of MPP,serum NGF,IL-15 levels in the severe group were significantly higher than in the mild group [(204.38±27.52) pg/ml vs (128.39 ±22.07) pg/ml,(288.58 ±55.33) pg/ml vs (213.71 ±42.69) pg/ml],and the differences were statistically significant (P ＜ 0.05) ; in the recovery period of MPP group,the serum NGF,IL-15 levels of severe group were higher than the mild group,but the difference was not statistically significant (P ＞0.05).Conclusion The serum levels of NGF,IL-15 in the mycoplasma pneumoniae infection patients are significantly increased,and they are all decreased as the disease mitigation.It is prompted that NGF and IL-15 participate in the pathogenesis of infection by mycoplasma pneumoniae.

BACKGROUND: Tooth intrusion easily leads to root resorption. Previous studies regarding orthodontic treatment-caused tooth root resorption or retrospective clinical studies based on X-ray films have great errors in outcome evaluation because of intrusion force which cannot be precisely controlled. OBJECTIVE: This study established dog models of mini-implant anchorage for incisor intrusion to observe the histological changes of tooth root and periodontal tissue and to evaluate the feasibility and safety of mini-implant anchorage for incisor intrusion. METHODS: Nine dogs were assigned to one control group (n = 1) and four experimental groups per time to sacrifice (1, 2, 4 and 12 weeks; n = 2 dogs for each experimental group). No force was added to the control group. In the experimental groups, mini-implant as an anchorage was placed in the buccal alveoli between maxillary second and third incisors on each side. A traction force of 100 g was imposed to each side to intrude the maxillary first and second incisors on each side. At 1, 2, 3, and 4 weeks (traction force was imposed for 4 weeks and after withdrawal of extraction force, mini-implant was retained in place for 8 weeks), dogs were sacrificed. The first and second incisors together with gingival and alveolar bone were completely resected to prepare histological specimens. Following hematoxylin-eosin staining, histological changes of tooth root and periodontal tissue were observed. RESULTS AND CONCLUSION: Compared with the control group, in the 1-week group, histological changes were primarily at the root tip and alveolar ridge crest, alveolar bone and cementum were absorbed and peridental membrane presented glassy degeneration in local region; in the 2-week group, bone resorption degree and range were obviously enlarged, and bone resorption developed from root tip, root middle part to cervical part; in the 4-week group, bone resorption was still active and the glassy degeneration of peridental membrane disappeared; in the 12-week group, significant improvement in alveolar bone and cemental surface was observed, bone lacuna had deposition of newly formed bone, and peridental membrane was orderly arranged. These findings reveal that in the mini-implant anchorage for dog incisor intrusion, early histological changes primarily appear in the root tip and alveolar ridge crest, presenting as alveolar bone and cemental resorption and the glassy degeneration of the peridental membrane. Bone resorption extent and range expand with the persistence of traction force. After withdrawal of traction force, tooth root and periodontal tissue were gradually repaired

BACKGROUND:Currently,there are many studies concerning the pathogenesis,process,and damage of glaucoma,however,there is not an ideal glaucoma modelOBJECTIVE:To prepare rabbit intraocular hypertension models using three different material injections,and to verify the practical value of intraocular hypetension modelsMETHODS:Thidy New Zealand rabbits were divided randomly into 3 groups,with 10 animals in each group.One eye of each rabbit was served as the experimental eyes and the other eye as control eyes.Autoblood.methyl cellulose,C3F8 was injected into the anterior chamber of the experimental eyes.and the normal saline was injected into the control eyes.The intraocular pressure(IOP)was monitored prior to injection and at hours 0,24,36,48,72,96.120 and 168 after injection.RESULTS AND CONCLUSION:Intraocular hype Rension models could be induced by injecting 3 kinds of materials,and the IOP was obviously increased after injection(P＜0.05),and the ranges and periods of increasing were varied.The periods of increasing of 3 materials were 1,3 and 7 days,respectively,which could maintain for longer time for a second injection.The IOP ranged 1.86-6.65 kPa,and mild anterior segment inflammation could be found.The experiment demonstrated that intraocular hypeansion models using three different material injections are ideal models,which is characterized by simple,reliable and controllable.The suitable model can be selected for acute or chronic glaucoma research.

Combined with work experience, this paper described the project process of clinical research pro-jects and ethical review points, and pointed out that clinical research projects should be submitted to peer reviewers prior to ethical review. The ethics committee would review the projects in accordance with legality, scientificity, feasibility, ethics, and other points in detail. Accurately grasp of the balance between innovations and ethics ensure the standardized development of clinical research.

OBJECTIVE:To provide reference for performing quality control and protecting the subjects’rights and interests. METHODS:233 severe adverse events (SAE) cases reported by our hospital during Jan. 2012-Jun. 2015 were collected and ana-lyzed statistically in respects of subjects’gender and age,department,drug/equipment types,SAE types,relationship of SAE with drug/equipment,comorbidities,etc. RESULTS:The incidence of SAE in male was higher than female(71.2% vs. 28.8%);SAE mainly occurred in people over the age of 50(189 cases,81.1%);the incidence of SAE in cardiology department was the highest (137 cases,58.8%);main SAE type was hospitalization(183 cases,78.5%);most of SAE had nothing to do with studied drugs (164 cases,70.4%);more than half of the subjects suffered from other comorbidities(128 cases,54.9%). CONCLUSIONS:In order to ensure the quality of drug clinical trial data and safety of subjects,the investigator should strengthen the management of the elderly subjects and those suffering from comorbidities,to ensure that each SAE case is timely processed and accurately record-ed and reported.