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.

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

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 analyze the clinical and X-ray manifestations of sclerosing adenosis of the breast,and to evaluate the val-ue of preoperative differential diagnosis between the sclerosing adenosis and the breast cancer combined with pathology.Methods X-ray manifestations and clinical features of 25 patients with the sclerosing adenosis of the breast confirm by surgical pathology were analyzed retrospectively.Then the X-ray manifestations and clinical features were compared with the pathological results.Results Total 25 patients suffered from the sclerosing adenosis of the breast.Among them,2 cases were bilateral sclerosing adenosis,23 ca-ses were unilateral sclerosing adenosis,6 cases with epithelial atypical hyperplasia,4 cases with intraductal papilloma,7 cases with fibroadenoma nodule formation,and the rest with the pure sclerosing adenosis.X-ray manifestations:7 cases presented the medium density nodular shadows with blurred and irregular edges,1 6 cases showed the star-shaped shadows of which 6 cases were the“black stars”,3 cases of“white stars”.One in 7 cases can only see a star shadow,another was unclear or the form was varied.1 3 patients showed the calcification among 4 cases presented the small clusters of distribution with needlepoint-like calcification,2 cases of bulky curved calcification,and the rest with scattered and regional distribution of dot,needlepoint-like calcification.Conclusion Combined with clinical manifestations,the breast X-ray plays an important role in the differential diagnosis of sclerosing adenosis and the breast cancer.

0.1), while in Yunnan Baiyao group, there were significant reductions in all scores (P

Objective To study the influence of defection of Fragile X mental retardation-1 gene (FMR1) on cyclic adenosine monophosphate (cAMP) and to discuss its mechanism. Methods FMR1 gene of peripheral blood mononuclear cell was silenced in vitro by sodium nitrointroprusside. The effect of gene-silencing was detected using reverse transcript polymerase chain reaction (RT-PCR). The specific activity of adenylate cyclase and phosphodiesterase was showed by the activity ratio of yield or consumption of cAMP during a unit time. Spectrophotometry was used to measure the two key enzymes (adenylate cyclase and phosphodiesterase), as to determining the level of intracellular cyclic adenosine monophosphate in the process of cAMP metabolism. Results FMR1 gene was fully silenced by sodium nitrointroprusside at 12th, 24th and 48th hour separately, re-expressed at 72th hour. If the cultivated fluild was replaced with new sodium nitrointroprusside at 48th hour, FMR1 gene would be silenced continuously. The intracellular cAMP level in the gene silenced group was lower, and significant depression of adenylate cyclase specific activity was found in the FMR1 gene silenced group (P=0.000). No significant difference was found on phosphodiesterase specific activity (P=0.983). Conclusions The results suggest that the yield of cAMP could be influenced by defection of FMR1. The depression of adenylate cyclase activity might be one of the causes of the decrease of intracellular cAMP production.

Abnormalities, Multiple ; diagnosis ; pathology ; physiopathology ; Branchio-Oto-Renal Syndrome ; diagnosis ; pathology ; physiopathology ; therapy ; Child ; Deafness ; etiology ; physiopathology ; Diagnosis, Differential ; Ear ; abnormalities ; Female ; Humans ; Kidney ; abnormalities ; Renal Insufficiency ; etiology ; physiopathology ; therapy

[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.