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 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.

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

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

Calculi ; chemically induced ; Ceftriaxone ; adverse effects ; Child ; Humans ; Lithiasis ; chemically induced

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.

Objective To explore types and risk factors of recurrent ischemic stroke in ischemic stroke patients using antiplatelet drugs. Methods By retrospective study, 130 recurrent ischemic stroke patients using antiplatelet drugs (antiplatelet therapy group) and 101 recurrent ischemic stroke patients not taking antiplatelet drugs (non antiplatelet therapy group) were collected. Two groups of patients were divided according to the ischemic subtypes, and risk factors between different subtypes were analyzed. Results (1) Single factor analysis showed history of coronary heart disease and smoking are more frequent in antiplatelet therapy group with recurrent lacunar infarction (LI). History of coronary heart disease, diabetes, and high level of low density lipoprotein (LDL) are more frequent in antiplatelet therapy group suffer from recurrent atherosclerotic thrombosis (AT). (2)Logistic regression analysis showed the history of coronary heart disease , smoking are independent risk factors for recurrent LI in antiplatelet therapy group (P = 0.018, P = 0.027); history of coronary heart disease, diabetes, and high level of LDL are independent risk factors for recurrent AT in antiplatelet therapy group (P =0.003, P = 0.010, P = 0.002). Conclusions The history of coronary heart disease and smoking are independent risk factors for the recurrence of LI in patients with antiplatelet therapy. History of coronary heart disease , diabetes , and high level of LDL are independent risk factors for the recurrence of AT in patients with antiplatelet therapy. Combined coronary heart disease would increase both LI and AT recurrence.