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

[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.

Objective To explore the relationship between transitional care model and diabetic patients. Methods 112 patients with type 2 diabetes mellitus were divided into observation group and control group according to random number table. Control group used the doctor as the center patient management mode. The observation group used thepatient-centeredpatient management, application of home nursing service. Results Glycosylated hemoglobin (HbA1c), triglyceride (TG), high-density lipoprotein (HGL), 2 h postprandial blood glucose (2hPBG), fasting blood glucose (FBG), body mass index (BMI) of observation group before treatment respectively were (11.2±2.4)%, (3.7±1.3) mmol/L, (0.5±0.2) mmol/L, (13.6±2.4) mmol/L, (11.8±2.9) mmol/L, (25.9±4.9) kg/m2. Patients discharged from hospital after care for 3 months respectively were (6.8±0.9)%, (1.0±0.3) mmol/L, (2.5±0.4) mmol/L, (8.9±1.5) mmol/L, (6.8 ± 2.0) mmol/L, (20.8 ± 5.8) kg/m2. There was statistically significant difference (t=3.5-6.6,P<0.05). Control group before treatment respectively were (11.9 ± 3.6) %, (3.8 ± 1.5) mmol/L, (0.6 ± 0.3) mmol/L, (13.9 ± 2.9) mmol/L, (11.6 ± 3.2) mmol/L, (25.9 ± 6.8) kg/m2,while patients discharged from hospital for 3 months respectively were (10.9±3.4)%, (3.3±0.7) mmol/L, (0.7±0.2) mmol/L, (12.8±4.2) mmol/L, (10.6± 2.6) mmol/L, (25.1 ± 6.6) kg/m2, there was no statistically significant difference (t=0.05-1.36,P>0.05). Patients discharged from hospital after 3 months, perception, diet, medication, exercise adherence score of observation group was (34.98 ± 5.67), (41.98 ± 5.00), (40.29 ± 5.60), (40.45 ± 7.21) points, which were obviously higher than (21.18±4.75) , (28.46±4.26), (21.88±4.58), (20.98±2.69) points of control group, the difference was statistically significant (t=13.96-19.03,P<0.01). Conclusions Using home nursing service mode in type 2 diabetes care is helping to improve blood sugar levels and improve patient compliance after discharge, fully improve the patients′prognosis.

hydroxysteroid dehydrogenase (11? HSD) catalyzes the interconversion of cortisol with its inactive metabolite cortisone. The congenital deficiency of 11? HSD2 induce hypertension and hypokalemia. This disorder is called "Apparent Mineralocorticoid Excess(AME)". Glycyrrhizic acid and other endo and xenobiotics have been found to inhibit the activity of 11? HSD and cause excess mineralocorticoid effects that is similar to AME. The decrease in 11? HSD activity is related with the acquired and congenital hypertention.

Objective:To observe the effect of combining intraosseous infusion (IO) and hyperosmotic salt fluid in resuscitation of haemorrhagic shock. Methods:Twenty rabbit models of haemorrhagic shock were established. The blood pressure, heart rate, biochemical indexes, artery blood gas analysis, etc . were compared at 3 different time points after infusion between IO and peripheral intravenous infusion groups. Results:The resuscitative effect through IO with hyperosmotic salt fluid was the same as that of the peripheral vascular access. Conclusion:The combination of intraosseous infusion and hyperosmotic salt fluid is effective for resuscitation of haemorrhagic shock.

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.

Atopic dermatitis (AD) is an inflammatory skin disease commonly complicated by atopic diseases such as asthma and allergic rhinitis,and occurs most frequently in children.Due to severe conditions and recurrent attacks,severe AD seriously affects the quality of life in patients and their families,and systemic treatments are needed.With further studies on immunosuppressants and expansion of their indications in recent years,immunosuppressants have become an important immunotherapy of AD.However,for special populations,especially children,the efficacy and safety of immunosuppressants are still needed to be evaluated for the treatment of AD through basic researches and randomized controlled clinical trials,so as to provide more information for clinical medication as well as better guidance for clinical treatment.