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 analysis the effects of laser and lucentis treatment of diabetic retinopathy. Methods:Fifty-three patients with DR were treated with laser and lucentis in our hospital from October 2012 to October 2013 as observer group. Forty-nine patients with DR were treated with laser in our hospital from September 2011 to September 2012 as control group. Results:The results indicated that visual acuity improved rate was 67.9%and decreased vision rate was 13.2% in observer group. Vision conditions in the observation group was better than that in the control group with significant difference (x2=4.60, x2=3.87; P<0.05). Simultaneously, improve time of hemorrhage, exudates, edema and macular thickness in the observation group was better than that in the control group with significant difference (t=4.17, t=3.92, t=4.06; P<0.05). Conclusion: The laser and lucentis treatment of diabetic retinopathy can significantly improving symptoms of retinal and promoting visual recovery.

Sepsis and septic shock are common critical diseases in the ICU, which have a high mortality and seriously affect the patients'' quality of life.The pathogenesis of sepsis is very complicated and involves the changes in the functions of multiple systems and organs.Recently, the investigation into the potential mechanisms underlying the development of sepsis is becoming a hotspot all over the world.The author presents an overview on the advances in the studies of the pathogenesis of sepsis, relating to the imbalance of inflammatory response, immune dysfunction, abnormal blood coagulation, nerve-endocrine-immunity network, mitochondrial function damage, endoplasmic reticulum stress, autophagy, and genetic polymorphism, in order to provide some theoretical evidence for the prevention and treatment of sepsis in clinical practice.

Objective To discuss the ways to train qualified clinical engineers,and thereby to enhance the teamwork of clinical engineers.Methods The problems in training the clinical engineer were pointed out in training mode,knowledge reserve,innovation and etc,and some countermeasures were put forward accordingly.Results The countermeasures were proposed from the aspects of basic theoretical system,continuing education system,self-adaptive working mode,enhanced communication and etc.Conclusion The clinical engineer needs to utilize their own advantages to elevate their personal qualities and raise their profiles so as to meet the requirements of social and technological development.

Mental disorders are caused by the synergy of genetic and environmental factors,and epigenetics provides a bridge for mental disorders between environmental exposure and genetic background.This review discussed the role of epigenetics on the development of mental disorders,especially in schizophrenia and depression.DNA methylation,histone acetylation,histone methylation,ncRNA,depressive disorder and schizophrenia were used as searching terms.('Schizophrenia OR depressive disorder') and all field of DNA methylation/histone acetylation/histone methylation/ncRNA were taken as index strategy.67 related articles in database of PubMed,ScienceDirect in March 2017 were acquired.41 articles were enrolled as reviewing materials according to literature screening.Existing researches suggest that epigenetic modifications,including DNA methylation,histone acetylation,histone methylation,and ncRNAs,may be associated with the occurrence of mental illnesses and play key roles in the pathogenesis of mental illnesses,especially in schizophrenia and depression.Further studies on them could provide us novel insights into the pathogenesis of these disorders and effective treatments based upon epigenetic mechanisms.

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.

Optical coherence tomography (OCT) which was brought into existence in early 90s of 20 century is a noninvasive technique for creating cross-sectional images of transparent or semi-transparent internal biological tissue structure.In recent years applicability research in the field of stomatology has made great progress.The micro structure changes of surface layer of the lesions in oral hard and soft tissues could be detected by this technique,with its unique feature to detect insidious secondary caries beneath dental restorations that couldn't be found by current clinical techniques easily.In this review,secondary caries etiopathogenisis and diagnosis,principle were discussed firstly and then imaging observation of OCT to detect early second caries around dental restoration and monitoring on risk factors inducing secondary caries are reviewed.It indicated that OCT technique has great potential on diagnosis of secondary caries.

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.