Nowadays,aging is the general trend of population development in the world.Type 2 diabetes is one of the most common chronic diseases in the elderly.Because of the atypical symptoms and signs,accompaniment of chronic cardiovascular disease and vulnerability to low blood glucose in the elder patients with diabetes,we should to make safe,effective,and individualized therapeutic programs for them.This paper will review the current prevalence,characteristics,and oral drug selection among elderly individuals with T2DM.

The main reason of recurrence and metastasis in breast cancer is the resistance for the radiotherapy and chemotherapy,and the mechanism of radio-resistance and chemo-resistance may be related to the DNA damage response (DDR).There is a complicated system of the DDR pathway,including cell cycle checkpoint,DNA repair,transcription and apoptosis to maintain the integrity of cell genes.In the cancer treatment,DDR occurs in various kinds of cytotoxic drugs and radiation to cause genetic damage,which limits the curative effect of chemotherapy and radiotherapy.This promotes the targeted therapy of DDR pathway,especially checkpoint kinase 1 (CHK1).Recently,the new viewpoint supports that CHK1 is a main marker of the DDR pathway activation,which shows that CHK1 not only activates the check point but also affects the DNA repair and apoptosis directly.Thus,the role of CHK1 in DDR will promote CHK1 inhibitor to be one of the new treatment strategies for the cancer patients who resist the radiation and chemotherapy.

Objective:To investigate the clinical efficacy and safety of PCNL with the use of different percutaneous renal access in treatment of renal calculi.Methods:Percutaneous renal minimal access(F14～F16)or small access(F18～F20)was established randomly in 142 patients,and PCNL were performed in all patients.The clinical parameters including operative time,complication and stone-free rate were compared in the two groups.Results:The operative time of simple renal calculi were(78.3?15.6)min and(91.2? 18.2)min(P0.05)in small access group and minimal access group respectively.The operative time of complicated renal calculi were(115.3?20.1)min and(130.7?28.7)min(P

Objectives To study the reliability,validity and feasibility of the Chinese version of memory alteration test(M@T).Methods Cross-sectional survey with a convenience sample was employed to interview 220 elderly people over 60 years old,39 patients with mild cognitive impairment(MCI),20 with Alzheimer's disease(AD),and 161 normal cognitive elderly.The survey was,then evaluated with internal consistency,content validity,criterion validity,principal component/factor analysis and influencing factors.Results A Cronbach's α coefficient of 0.818 was obtained in M@T. The correlation coefficients which were the score of the subtest and the total were 0.5-0.9.The correlation coefficient of the scores of the Mini.mental State Examination(MMSE)and the M@T Was 0.933.The 5 factors were extracted with the factor analysis,which could explain the total variance of 69.449%,and the corresponding factors of the proieets have a satisfied amount of factor loading(≥0.4).There were significant diffeFences in the score of M@T among the different cognitive level groups with good discriminant validity(cognitive normal group:39.0±3.7,MCI group:29.0±3.7,AD group:16.9±3.7;F=498.419,P<0.05).There were no significant differences in the score of M@T among the different gender,age,occupation and education level groups.Conclusions The Chinese version of M@T has good reliability and validity and feasibility.The score of the M@T is not affected by gender,age,occupation,education level and other factors.

The rapid cooling contracture in myocardial protection is getting more and more attention. Rapid cooling contracture is referred to as the undepolarized myocardial contracture induced by rapid cooling, which is related with the sudden increase of Ca2+. The Ca2+ released from sarcoplasmic reticulum subsequently causes myocardial contracture through the myofilaments sliding. Its deleterious effects include: more energy consumption, impaired cardiac function, Ca2+ overload, et al. And some investigators have put forward some principals to prevent the bad influences of rapid cooling contracture.

Objective To take the initiative in Huaibei region of Pseudomonas aeruginosa OprM efflux phenotype and the presence of genetic analysis to explore the multi-drug resistant Pseudomonas aeruginosa and the active efflux mechanism.Methods assignment pump inhibitor carbonyl cyano-right-chlorophenyl hydrazone(CCCP)on Pseudomonas aeruginosa ciprofloxacin(CIP) reversal of the sensitivity tests to screen active efflux of Pseudomonas aeruginosa phenotype-positive bacteria;using PCR amplified active efflux phenotype-positive bacteria OprM genes.Results CCCP under the action of 36 Pseudomonas aeruginosa,24 strains of the CIP to improve the sensitivity of four times more active efflux phenotype positive rate was 66.7%(24/36);in OprM gene PCR extension by experiment,there are 16(44.4%,16/36)was amplified 848bp fragment of OprM.Conclusion active efflux phenotype in clinical Pseudomonas aeruginosa in widespread;OprM of Pseudomonas aeruginosa genes in active efflux of the most common bacteria.

As a new technique, photedynamic therapy was introduced in the end of 1970s and has been put into clinical application from experimental tests in recent years. Its mechanisms was established on the basis that a series of special typed cells and tissues could selectively absorb photosensitive drugs and generate photore-sponsive effects by light irradiation of definite wavelengths. Currently, the photodynamic theraputics is applied mainly in non surgical treatment of tumor betided in body superfacial and hollow viscus. Its application area has been expanded unceasingly in modern clinic due to the discovery of the selective aggregation of photoresponsive drugs to many pathological tissues and pathogenic microorganisms other than tumors, and the development of new photoresensitizer. In this paper, review is given on the effect mechanisms, the light sources and photosensitizer, as well as the application of photodynamic treatment of tumors in head and neck and its treatments of mucosal dis-ease and oral pathogenic microorganism infected diseases.

Magnesium and its alloys possess the features of low density,high strength and rigidity,good biocompatibility and biodegradability.Their elastic modulus is similar to human bone,which endows them with a broad application prospect in the field of orthopedic biomedical materials.This paper reviews the current research status of magnesium and its alloys as the orthopedic implant materials and as porous scaffold materials in bone tissue engineering.Methods to improve corrosion resistance of magnesium-based metals ale briefly described as well.

[Objective] To summarize the clinical experience of the national physician master professor GUO Chengjie application of malt, provide reference for clinical application. [Methods] By following GUO Lao clinical practice study and consulting GUO Lao of previous clinical cases, collection, analysis, summarize the experiences of application of malt of GUO Lao and features, case example is given. [Results] Guo Lao clinical application of this product, FaGu and innovation, to create, dosage, many decoction is exquisite, in prescription compatibility, such as liver and qi, clearly purging liver and gall, disinhibiting dampness and relieving jaundice shall use raw product, lactation most appropriate for raw and fry, back to milk needs fry and large dosage, the food is fried with appropriate medium doses, good clinical results will often begot. [Conclusion] GUO Lao unique method of clinical application of malt, clinical each fine effect, is worth learning to imitate.

Objective To investigate the value of early hematocrit (Hct) level in predicting early neurological deterioration (END) in patients with acute ischemic stroke. Methods The patients with acute ischemic stroke within 24 h of onset were enrolled prospectively. They were divided into low Hct, normal Hct, and high Hct according to the quantile of the measured Hct. END was defined as an increase of ≥2 of the National Institute of Health Stroke Scale (NIHSS) score or ≥1 of the motor item score within 5 d after admission compared with the baseline. The vascular risk factors, clinical features, baseline NIHSS score, infarct size, and laboratory test variables were compared between the END group and the non -END group. Multivariate logistic regression analysis was used to identify the independent risk factors for END. Results A total of 216 patients with acute ischemic stroke were enrolled, including 128 males (59.26%). Their mean age was 67.40 ±14.12 years. Sixty-two patients (28.70%) experienced END. The normal ranges of Hct in male and female were 40.12%-46.35% and 38.32%-44.17%, respectively. Univariate analysis indicated that there were significantly differences in baseline NIHSS score ( P =0.001), fasting glucose (P =0.030), C reactive protein (CRP) (P =0.041), and the proportions of different Hct levels between the END group and the non-END group (P =0.023). The END incidences in patients with high -level Hct (40.0%) and low –level Hct (35.2%) were significantly higher than that in the normal Hct patients (20 .4%), but there was no significant difference between the high-level and low -level Hct patients ( P = 0.690). Multivariate logistic regression analysis showed that theigh-level Hct (odds ratio 2.460, 95% confidence interval 1.146-5.283; P =0.021) and the baseline NIHSS score (odds ratio 1.070, 95% confidence interval 1.014-1.129; P = 0.013) were the independent risk factors for END. Conclusion The elevated Hct in patients with acute ischemic stroke are susceptible to END.