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.

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.

Objective To get new more sensitive signs reflecting cartilage degeneration,which were added to the present ARA differential criteria of knee osteoarthritis and to compare the sensitivity and specificity before and after new items.Methods Through review analysis of the clinical feature,radiography and operative presentation of 115 adult patients,the new signs reflecting cartilage degeneration as items were found,which were added to the present ARA differential criteria of knee osteoarthritis as new criteria.Then the 112 patients who have received either knee joint replacement or arthroscopy were re diagnosed with both the present ARA criteria and the new criteria.Sensitivity and specificity were calculated and compared.Results "Extensive knee joint tenderness" with cartilage degradation and "lockage on motion or a positive Apler test" were significantly related to the meniscus degradation.A 39 7% sensitivity of these patients was obtained using the present ARA clinical criteria,while it reached 70 6% using the new clinical criteria ( P 0 05).Conclusion The two new items added to the present ARA criteria help to increase the sensitivity for diagnosis of knee osteoarthritis without influence on the specificity.

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.

Objective]To expound the essence and method of detoxification in the view of keeping internal balance ,based on Huangdi’s Internal Classic. [Method] From the present social understanding of toxin biased ,and on the basis of collecting and analyzing the materials concerning the record of concept and treatment of eliminating toxin in early medical classic ,eliminating toxin and keeping balance can be taken as a sort of health care idea. [Result] The toxin in body refers to the imbalance of Yin and Yang Qi and blood of human body ,it also may be the cause and new pathological products. This recognition corrects the understanding of contemporary society point ofDetoxification ,and guides people to follow the body's own adjustment mechanism,the function of organs and individual constitution to determine etiologic factors based on differentiation treatment. It will avoid and prevent producing the toxin in accordance withIn order to maintain body balance and adjust yin and yang of body through careful diagnosis said by Huangdi ’s Internal Classic. [Conclusion] That one specific treatment depending on one specific toxin reflects the principles of syndrome differentiation treatment and searching for the primary cause of disease in treatment by exploring Huangdi ’s Internal Classic. And it can make people understand more accurately and profoundly about detoxification and live healthier.

As important adhesion molecule on cell surface,integrin is a kind of important receptor family. It′s im- portant role is to mediate intercellular adhesion and adhesion between cells and extracellular matrix,also regulate proliferation,differentiation,migration of cells and tissue remodeling,and plays an important role in maintaining cellular form and growth.The present article made a short review about research progress of integrin β1 effect in cardiovascular diseases in recent years.

Stem cell transplantation provides a new thinking for treating ischemic heart disease.However,the poor survival and differentiation rate of stem cells after transplantation limit its application in treatment of ischemic heart disease.Therefore,researchers study precondition stem cells through different methods to improve stem cell proper- ty in order to improve therapeutic effect of stem cell transplantation.The present article made a review on its re- search progress.