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 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.

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.

AIM: To observe the expression of hypoxia inducible factor-1? (HIF-1?) gene and heme oxygenase-1 (HO-1) gene in pulmonary arteries in hypoxic rats. METHODS: Forty male Wistar rats were exposed to hypoxia for 0, 3, 7, 14 or 21 days. Mean pulmonary pressure (mPAP), vessel morphometry, right ventricle hypertrophy index (RVHI) were measured. Lungs were either inflation fixed for immunohistochemistry and in situ hybridization or frozen for later measurement of HO-1 enzyme activity. RESULTS: During hypoxia, mPAP increased to significantly higher values than the control values after 7-day of hypoxia,reaching its peak after 14-day of hypoxia, then remained on the high level. Pulmonary artery remodeling developed significantly after 14-day of hypoxia. Expression of HIF-1? protein in control was poorly positive, but was up-regulated in pulmonary arterial tunica intimae of all hypoxic rats. In pulmonary arterial tunica media, the levels of HIF-1? protein were markedly up-regulated after 3-day and 7-day of hypoxia, then tended to decline after 14-day and 21-day of hypoxia. HIF-1? mRNA staining was poorly positive in control, hypoxia for 3 days and hypoxia for 7 days, but began to enhance significantly after 14-day of hypoxia, then remained stable. Expression of HO-1 protein began to increase after 7-day of hypoxia, reaching its peak after 14-day of hypoxia, then remained stable. Expression of HO-1 mRNA began to increase after 3-day of hypoxia, reaching its peak after 7-day of hypoxia, then declined. CONCLUSION: HIF-1? and HO-1 are both involved in the pathogenesis of hypoxia-induced pulmonary hypertension in rats. Furthermore, HIF-1? may inter-regulate with HO-1 gene in this process.

Vascular endothelial cells and smooth muscle cells,structurally and functionally closely related,are two main cells of vascular wall.While the interaction between cycling factors and vascular wall cells can lead to the occurrence of atherosclerosis.The injury of endothelial cells results in secretory dysfunction and abnormal proliferation of smooth muscle cells which narrows the cavity of blood vessel and cause spasm.This is the common pathological basis of the occurrence and development of atherosclerosis and other vascular diseases.In the pathological state of atherosclerosis,the proliferation of smooth muscle cell will be affected by what the vascular endothelial cells secrete,like growth factors,cytokines,and vasoactive substances.This paper gives a comprehensive overview of the latest research advances in this field.

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.

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.