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 research the determination of hypersensitivity C-reactive protein(Hs-CRP) and cardiac troponin T(Hs-cTnT) in patients with coronary heart disease,and to analyze the correlation with cardiac function.Methods The function of left ventricle and the serum levels of Hs-CRP and Hs-cTnT in 100 patients with coronary heart disease and 50 healthy subjects were detected.Results The function of left ventricle and the serum levels of Hs-CRP and Hs-cTnT were significantly different in patients with coronary heart disease and healthy subjects(P ＜0.01).The function of left ventricle and the serum levels of Hs-CRP and Hs-cTnT were significantly different in coronary heart disease patients with different New York Heart Association class(P ＜ 0.01).The serum levels of Hs-CRP and Hs-cTnT were positively correlated with class of New York Heart Association,left ventricular end diastolic diameter,and negatively correlated with left ventricular ejection fraction and fraction shortening (Absolute value of r:0.536 ～ 0.849,P ＜ 0.05).Conclusion The serum levels of Hs-CRP and Hs-cTnT significantly increase in patients with coronary heart disease,which is correlated to function of left ventricle,and it can be used as the indicators of cardiac function in patients with coronary heart disease.

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 To explore the relationships between life events,automatic thoughts,coping style and internet addiction disorder(IAD) of adolescent . Methods 54 cases of the IAD were assessed with the Adolescent Self-rating Life Events,Automatic Thought questionnaire and Coping Style questionnaire. Results Life events, automatic thoughts,and coping style were significantly correlated with IAD (r =0.312,r =0.325,r =0.295) ( P <0.01).There were significant correlations between life events and automatic thought, life events and coping style(r =0.554,r =0.392) ( P <0.01).The multiple linear stepwise regression revealed that only life events entered on the regression equation when the score of IAD server as dependent variable. Conclusion There may be three ways that life events influence in IAD:life events influence in IAD directly,life events influence in IAD by the mediators,automatic thought and coping style indirectly.Automatic thoughts and life events is not a necessary condition that led to internet addiction and life events may be influence in IAD by other ways.

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.

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 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.