Objective To analyze the risk factors for drug-induced hypoglycemia in elderly diabetic patients,and to provide the basis for clinical prevention and treatment.Methods 78 cases with drug-induced hypoglycemia in elderly diabetic patients (observation group) and 256 elderly diabetic patients without drug-induced hypoglycemia(control group) were included,and the relative factors for drug-induced hypoglycemia were analyzed between the two groups.Results The stable rate of patient's condition was lower in observation group than in control group [38.5％ (30/78) vs.52.7％(135/256),x2 =4.872,P＜0.05].There were 9 cases (11.5％)、with alimentary control,28 cases (35.9％) treated with insulin and 41 cases (52.6％) treated with sulfonamide in observation group,and 89 cases (35.9％) with alimentary control,89 cases (34.8％) treated with insulin and 78 cases (30.4％) treated with sulfonamide in control group.The alimentary control was lower in observation group than in control group(x2 =15.557,P＜0.001).There was no difference in successful rate of insulin treatment between the two groups(x2 =0.034,P＞0.05).The successful rate of sulfonamide treatment was higher in observation group than in control group(x2 =12.726,P＜ 0.001).The age was older in observation group than in control group(t=2.494,P＜0.01).The body mass indexes and glycosylated hemoglobin level were lower in observation group than in control group(t=4.334 and 7.251,both P＜0.001).There were no differences in fasting blood-glucose and serum creatinine levels between the two groups(t=1.010 and 0.297,both P＞0.05).The course of diabetes was longer in observation group than in control group(t=2.579,P＜0.01).Conclusions The relative factors for drug-induced hypoglycemia in elderly diabetic patients include older age,longer course of diabetes,lower body mass index,lower fasting blood-glucose level,poorer glycemic control and higher dose of sulfonamide treatment.

OBJECTIVE To know the incidence, etiology, risk factors of hospital-acquired pneumonia(HAP). METHODS From Jan 2003 to Dec 2004, 129 cases of HAP were retrospectively studied. Epidemiologic data, etiology , and evolution of pneumonia were recorded. RESULTS The 115 patients with HAP had one or more intrinsic risk factors, mainly malnutrition (albumin values

Objective To compare the impacts of four different intravenous anesthetic agents on middle cerebral artery blood flow velocity(V‐MCA) during the anesthesia induction period .Methods Totally 80 cases were randomly divided into four groups (n=20) ,maintenance drugs of anesthesia were propofol 2 .00 mg/kg ,etomidate 0 .30 mg/kg ,midazolam 0 .15 mg/kg and dezocine 0 .20 mg/kg respectively ,the bispectral index (BIS) value was dropping to below 50 ,the endotracheal intubation and mechanical ventilation were performed .The transcranial Doppler (TCD) monitoring was adopted to monitor and record middle cerebral artery mean flow velocity (Vm‐MCA) ,mean arterial pressure (MAP) ,heart rate (HR) ,systolic blood pressure (SBP) ,diastolic blood pressure (DBP) in the four groups before induction after entering operation room (T0 ) ,at1 min before intubation (T1 ) ,immediate intubation (T2 ) ,at 1 min after intubation (T3 ) ,3 min after intubation (T4 ) ,5 min after intubation (T5 ) .Results Except for the midazolam group ,Vm‐MCA at T1 in the other three groups were significantly lower that that in the T0 group (P< 0 .05);Vm‐MCA ,SBP ,DBP after intubation in the midazolam group and the etomidate group were significantly increased compared with the basic values ,while the difference between the propofol group and the dezocine group had no statistical significance (P>0 .05) .Con‐clusion midazolam and etomidate are weaker than propofol and dezocine in the aspect of inhibiting the middle cerebral arterial blood flow fluctuations caused by intubation .

Objective To investigate the potential role of asiaticoside in controlling the capsular formation around breast implant in rats. Methods Forty female Sprague-Dawley rats were implanted with 2 silicone elastomer in bilateral dorsal interscapular region subcutaneously each, and randomly assigned to 2 groups (n=20 in each group): control group and experimental group. The experimental group was of intragastric administration with asiaticoside (24 mg/kg) daily while control group with saline of identical volume. On day 7, 14, 28, 56 and 84, 4 rats from each group were sacrificed. Specimens were collected for HE staining. Image-pro Plus was applied to measure the thickness of capsule at different time intervals and the dynamic alteration in histology was observed. Results In experimental group, the formation of capsule ended up with a thickness of (194.33?23.27)?m, dramatically thinner than that of control group (306.08?31.31)?m (P

Aim To study the effect of paeonol on proliferation of vascular smooth muscle cell in atherosclerosis rabbits.Methods Atherosclerosis model on rabbits was established by high fat diet.The pathologic changes of aortic blood vessel were observed by lightmicroscope.The effect of paeonol on the proliferation of vascular smooth muscle cell in vitro was analyzed by MTT method.The lipid,SOD and MDA contents in aorta tissue were assayed by employing the automatic biochemistry analyzer and enzymic method respectively.IL-1?,TNF-? were quantified by radio immunoassay.The expresstion of PCNA protein was assayed by immunohistochemical method.Results Treated with Paeonol(75,150 mg?kg~(-1)) by interagastric administration for 6 weeks,the thickness of vascular tunica intima was observed and the number of foam cells was decreased in atherosclerosis rabbits.Paeonol(100～300 mg?L~(-1)) could inhibit the proliferation of cultured vascular smooth muscle cell and diminish the level of TC,MDA,pro-inflammatory cytokines,as well as enhanc the concentration of SOD in aortic tissue of atherosclerosis rabbits.The expressing intensity of PCNA protein was weakened.Conclusion Paeonol could inhibit the proliferation of vascular smooth muscle cell in vivo and in vitro,which may be related to decrease of contents of lipid,the extent of lipid peroxidation and the concentrations of proinflammatory cytokines.Paeonol might regulate the proliferation periods of vascular smooth muscle cell through inhibiting the expression of PCNA protein.

Objective To observe the expression and correlation of Twist,p53 and E-cadherin mRNA in breast cancer.Methods Thirty breast cancer tissue and adjacent noncancerous tissue in patients underwent modified radical surgery,and the normal breast tissue in 10 patients with benign breast lesions,respectively,were detected the expression of Twist,p53 and E-cadherin mRNA by RT-PCR and the relationship with clinicl pathological factors and their interrelationships.Results There was significant correlation between the expression of Twist mRNA and the degree of differentiation[high and middle differentiation 93.33％(14/15),1ow differentiation 53.33％(8/15)],lymphatic invasion[yes 93.75％(15/16),no 50.00％(7/14)]and TNM staging[Ⅰ-Ⅱ?stage 46.15％(6/13),III-Ⅳ?stage 94.12％(16/17)]in breast cancer tissue(P＜0.05),while there was no obvious correlation between the expression of Twist mRNA and the age,tumor diameter,adventitial infiltration,estrogen receptor,progesterone receptor(P＞0.05).The expression of Twist and p53 mRNA in breast cancer tissue were significantly higher than those in adjacent noncancerous tissue and normal breast tissue[(112.36±12.53)％ vs.(101.37±9.12)％ and(98.03±9.04)％,(101.73±13.32)％ vs.(91.43±7.43)％ and(90.83±6.58)％,P＜0.01],while the expression of E-cadherin mRNA in breast cancer tissue was significantly lower than that in adjacent noncancerous tissue and normal breast tissue[(55.43±12.49)％ vs.(69.39±5.63)％ and(72.73±7.93)％,P＜0.01],there was no significant difference between adjacent noncancerous tissue and normal breast tissue(P＞0.05).The expression of Twist mRNA in breast cancer tissue was positively correlated to the expression of p53 mRNA(r=0.526,P=0.004),and negatively correlated to the expression of E-cadherin mRNA(r=-0.500,P=0.000).Conclusions Twist and p53 in breast cancer tissue show higher expression,while E-cadherin shows lower expression.Twist can promote invasion,metastasis of breast cancer by up expression of p53 and down expression of E-cadherin,and it plays an important role.

Objective:This paper explores the development characteristics of posttraumatic growth,and the acceleration of resiliency in posttraumatic growth among adolescents after Wenchuan Earthquake.Methods:We constructed our sample which consisted of 46 adolescents who had traumatic experience in the Wenchuan Earthquake using stratified sampling method.We tracked and monitored the psychological well-being of our subjects for approximately two and half years and six months using questionnaires.9 individuals from the sample were selected based on purposeful sampling according to the longitudinal data and in-depth interviews were conducted for these selected adolescents.The data were collected by semi-structured interviews,organized by Nvivo8.0 and analyzed using thematic analysis.Results:Posttraumatic growth contained four dimensions,including new possibility of the emergence,positive changes of attitude in interpersonal relationship and in philosophy of life,personal strength except altruistic behavior and spiritual change.Protective factors of resiliency among the interviewed students showed individual and gender differences,adolescents with a higher level of resilience had a higher level of posttraumatic growth.Conclusion:The dimensions of posttraumatic growth have unique features.Resilience plays an important role in facilitating individual's posttraumatic growth after the Wenchuan Earthquake.Positive experience in the past and the positive reflection on the event can promote the level of posttraumatic growth.

OBJECTIVE To describe the sonographic features of carotid body tumor(CBT), and determine the utility of ultrasonography as a diagnostic study in the preoperative patients. METHODS Sonograms of 60 patients with 65 CBT were reviewed with gray scale and duplex Doppler sonography. The evaluated features included the location, size, margins, shape, internal echogenicity, the relationship between the tumor and the carotid artery,and blood flow velocity. RESULTS All carotid body tumors were located at the carotid artery bifurcation. Well-defined, solid, weakly hypoechoic masses were noted on gray scale sonography in the carotid bifurcation. Color Doppler sonography showed hypervascularity in 61 masses. Pulsed Doppler analysis of blood flow within the tumor mass was possible in 61 CBT, and low-resistance waveforms were obtained from multiple sites within the mass in all cases. CONCLUSION The ultrasound characteristics of the CBT possess specificity to some extent. Duplex Doppler ultrasound can provide the relationship between the tumor and the carotid artery,and provide important information of intratumor blood flow,which has important value in the diagnosis of CBT.

Exosomes are nanosized membrane particles secreted by cells that transmit information from cell to cell.Exosomes in-volve in the regulation of important physiological activities of cells and play an important role in the formation and develop-ment of atherosclerosis (AS ).As one of extracellular vesicles, exosomes is getting increasingly attention.This article aims to review the role of exosomes derived from the AS related cells (immune cells,platelets,vascular endothelial cells,vascular smooth muscle cells)in the pathogenesis of AS.

Objective:To explore the imaging features of complicated lymphocele after the pelvic lymph node dissection. Methods: After pelvic lymph nodes dissection, lymphoceles in pelvic cavity of 47 patients with gynecological malignant tumor were found by magnetic resonance imaging (MRI) and all of these imaging data were retrospectively analyzed.Results:All of 47 cases had lymphoceles in pelvic cavity, and the number of lymph node lesion was 52 (30 were at left side of pelvis, 22 were at right side of pelvis); the distribution of most lymphocele were around of external vein and artery of iliac; the main MRI features were roundness, oval, reniform or dumb-bell shape with smooth and uniform lymphocele wall, and the intracystic manifestations were long T1signal and long T2signal; the manifestation of DWI was high signal of limited dispersion; after enhancement scan, the wall of lymphocele and intracyst appeared middle reinforcement signal, and there was no obvious reinforcement signal in cystic contents.Conclusion: There are characteristic MRI imaging manifestations in lymphocele, and the diagnosis of MRI is reliable and accurate.