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 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.

This article reveals the present state of teaching staff in teaching hospitals and difficulties and obstacles the hospitals confront when conducting the clinical courses through the investigation and analysis of 6 teaching hospitals.It provides a very useful reference for teaching hospitals in term of expanding their teaching resources and carrying out staff training.

The university students must promote themselves to become persons with sound personality in order to adapt to the society request for talents.But the university students experience emotion burnout and the deviation of development in mental and behavior during the period full of variety and surging.So the education of sound personality should be placed in the higher education to raise the university student's comprehensive character.

To expatiate upon the characteristics of systematization and refinement in medical English curriculum planning,to visualize the developing strategies of curriculum construction,and trying to probe into the formula in medical English teaching and learning.

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 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 .

Angiogenesis and invasion are two remarkable features of spongioblastoma,which lead to the failure of clinical treatment.With the development of the glioma（s） molecular biology mechanism in the realm of angiogenesis,some anti-angiogenesis drugs have got a positive therapeutic efficacy in the clinical trials,such as bevacizumab.However,it is reported that these drugs maybe also enhance the invasion and migration ability of glioma cells in the process of anti-angiogenesis therapy.Matrix metalloproteinases,hypoxia induced factor-1 and the inositol-requiring enzyme-1 maybe have some correlations with the change of the invasion and migration,but the molecular biological mechanism needs further research.

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.