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

This article evaluates the necessity and possibility of endoscopic surgery training in medical undergraduates and designs a simple,suitable platform and exercise for the training.

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 investigate the application of numerical simulation technique in supraorbital and frontal osseous defect.Methods The data of the patients with complex supraorbital and frontal osseous defects were obtained by helix CT scan.Numerical model based on the data was built up by computer.And the true model was produced by Rapid Prototyping.Being stimulated before this operation.the model was directly used in the operation.Results All of these 12 patients(one of defect of brow,four fracture of brow and zygoma,seven of old fracture of brow and zygoma)in this study were satisfied and their brows were symmetry after operation.All of them were satisfied after 1 or 2 years,without implantation exposure and transfiguration except one with infection.Conclusion Based on numerical technique difficulties of repairing,complex supraorbital and frontal osseous defect could be resolved by such process as collecting the bone data,stimulating operation by true models,and producing implantation before the operation.The accuracy of these operations can be improved.

Objective To design a new type of nasopharyngeal airway tube,which can resolve the upper respiratory tract obstruction due to general anesthesia.Methods All types of used flex endotracheal tube were collected.Take off the cuff outside of the tube wall and cut them into different lengths.Then,the connectors were reinstalled to the prepared tubes.Results With the designed nsopharyngeal airway tubes inserted,50 patients having complicated glossocoma in general anesthesia no longer snored and they could breathe freely.Conclusion The new type of nsopharyngeal airway tube is easy to produce and adapts well to clinical work.

Objective: To understand and solve the problems in health education in intravenous infusion among elderly patients with cardiovascular disease.Methods: An investigation was conducted with a self-designed questionnaire among 127 elderly cardiovascular disease patients receiving intravenous infusion,with the purpose of finding out specific problems concerning the education so as to adopt effective countermeasures.Results: Among the patients investigated,88.9% considered the contents of the health education to be too simple,50% thought of the nurses as lacking in initiative,19.8% deemed the nurses short of expertise,and 41.3% thought that supervision had to be emphasized in the management of health education.Conclusion: Systematic,comprehensive and scientific health education in intravenous infusion plays an important role in ensuring the safety and improving the satisfaction rate of intravenous infusion among elderly patients with cardiovascular disease.

Objective To clarify the effect of esophageal valve forming esophageal and gastric sleeve joint surgery for preven‐ting postoperative anastomotic complications of esophageal cancer .Methods A randomized controlled trial was designed to incorpo‐rate a total of 394 patients with esophageal cancer from January 2010 to June 2013 .This study has been registered in the Chinese clinical trial center and received a registration number :ChiCTR‐TRC‐13003817 .Among them ,9 cases (2 .3% ) were excluded be‐cause of the non line esophageal cancer radical operation .The remaining patients were randomly divided into two groups ,191 cases in group A and 194 cases in group B ,according to the principle of random grouping .Group A was experimental group ,patients ac‐cepted esophageal valve forming esophageal and gastric sleeve joint surgery ,and group B was the control group ,patients received conventional anastomosis .Results The incidence of anastomotic leakage after operation in group A and group B were 4 .1% and 3 .6% ,thse results were not statistically significant (P=0 .768) .In the observation of anastomotic stenosis ,7 patients died after sur‐gery .In the remaining cases ,there were 13 cases (6 .9% ) and 25 cases (13 .2% ) in group A and group B ,respectively ,the differ‐ence was statistically significant (P=0 .044) .Furthermore ,reflux oesophagitis and Barrett′s epithelium were found in 105 patients (55 .3% ) in group B ,and 54 (28 .7% ) patients in group A ,the difference was statistically significant (P<0 .01) .Conclusion E‐sophageal valve forming esophageal and gastric sleeve joint surgery can effectively prevent postoperative gastroesophageal reflux , but also can reduce the postoperative incidence of anastomotic stenosis .

Objective To investigate the effect and changes of IL -18 and IL -35 in patients with recurrent Hp positive gastric ulcer by treating with leibeirazole quadruple therapy.Methods 180 patients with recurrent Hp positive gastric ulcer were divided into two groups.The control group(90 cases)was applied amoxicillin,clarithromy-cin and colloidal bismuth pectin.The observation group was added leibeirazole.The effect and changes of IL -18 and IL -35 were observed before and after treatment in the two groups.Results The effective rate (86.67% vs. 73.33%,χ2 =5.000,P =0.025),inflammatory reaction rate(26.67% vs.51.11%,χ2 =11.314,P =0.008)and Hp positive rate(16.67 % vs.31.11%,χ2 =5.163,P =0.023)were higher in the observation group than in the control group.Expression of IL -18 was decreased after treatment[(70.80 ±11.21)ng/L vs.(88.83 ±7.13)ng/L, t =8.27,P =0.0210]in the observation group,but no change in the control group[(85.62 ±10.84)ng/L vs. (87.64 ±9.28)ng/L,t =0.78,P =0.4512).Expression of IL -35 didn't change after treatment in the two group (P >0.05).Conclusion Leibeirazole quadruple can increase the clinical effect,decrease the expression of IL -18 in patients with recurrent Hp positive gastric ulcer,it is worthy to be applied in clinical treatment.

Objective To investigate the clinical effect of different local anesthetic epidural anesthesia for cesarean section. Methods 60 maternal intended to be carried out cesarean section by epidural anesthesia were randomly divided into two groups. A group(n =30 cases) was administrated with 0.5% ropivacaine to anesthesia,and B group(n = 30 cases) was administrated with 0. 5% bupivacaine to anesthesia. The changes of hemodynamic were monitored,and the analgesic effect and adverse reactions were observed in the two groups. Results The differences of blood pressure, heart rate had no statistical significance between the two groups (all P＞0.05);Compared to B group, the anesthesia onset time, anesthesia time between the start of fetus, analgesic effect, adverse reactions of A group were significantly different (t = 4. 347,4. 528, x2 = 3. 834, 6. 429, all P ＜ 0. 05 ) ; Neonatal Apgar score showed no significant differences between the two groups ( P ＞ 0. 05 ). Conclusion Anesthesia with 0.5% ropivacaine for cesarean section had satisfactory anesthesia effect,and less adverse reactions.