Objective To investigate the effect and safety of intensive insulin therapy on patients who had stress hy-perglycemia induced by critical trauma, when different blood glucose was aimed in surgery intensive care unit (SICU). Methods We retrospectively analyzed SICU patients who were admitted between 2010.1-2012.7 with admission blood glucose and 30 minutes blood glucose both over 11.1 mmol/L ,and without known history of diabetes. In total, 153 pa-tients were set into three groups according to their target blood glucose:intensive insulin therapy (IIT) group with target blood glucose of 4.0-6.1 mmol/L;NICE SUGAR (NST) group with target blood glucose of 6.2-8.3 mmol/L;conventional in-sulin therapy(CIT)group with target blood glucose of 9.9-11.1 mmol/L. Each group had 51 patients. To collect data from these three groups of patients,we compared daily insulin doses , hypoglycemia incidence, final blood glucose, APACHEⅡscores upon discharging from ICU, time of the ventilatory support, length of staying in ICU, morbidity and mortality rate. Results Comparing these three groups, daily insulin dosage and hypoglycemia incidence, were significantly lower in NST and CIT group than in IIT group. Daily insulin dosage was higher in NST group than in CIT group;no significant difference of hypoglycemia incidence was shown between NST group and CIT group. The final blood glucose was lowest in IIT group and highest in CIT group (P＜0.05). APACHE II score was 9.3±7.5 upon discharge from ICU in NST group. Ventilation time and duration of ICU admission both were shortest in NST group but show no significant difference between IIT and CIT group . No significant difference of complicate incidence and mortality rate was indicated among all three groups. Conclusion In patient with stress hyperglycemia induced by critical trauma,maintaining the patients’final blood glucose between 6.2-8.3 mmol/L can effectively control the stress hyperglycemia,improve prognosis and reduce the mortality of hypoglycemia.

To evaluate the internal quality of prepared pieces of Radix Sanguisorbae combinatively, the characteristics comparision, content determination of aqueous extract and tannins,and coagulation experiment of 10 prepared pieces of it on the market have been carried out. Based on these studies, it is the best to use the crude one in compound Chinese medicines. But its original property must be retained if it is baked into charcoal for use. The quality standards of Radix Sanguisorbae and its processed product into charcoal were also described.

Objective To observe changes of hemodynamics and regional cerebral blood flow(rCBF) in patients with Leukoaraiosis(LA) and to investigate the pathogenesis of LA.Methods 67 patients with LA were examined by Transcranial Doppler(TCD). Regional cerebral blood flow was detected by SPECT in 19 of 67 patients.Results The medium blood flow velocities(Vm) of internal carotid artery system in LA(included mild, moderate and severe group) were significantly decreased compared with the controls( P

BACKGROUND: Vascular endothelium growth factor (VEGF) is an endothelium mitogen and angiogenic factor with strong potential during recovery from cerebral infarction (CI). Can such therapeutic effect be detected with magnetic resonance diffusion imaging?OBJECTIVE: To study the therapeutic efficacy of VEGF plasmid in treating focal cerebral infarction in a dog experimental model with the aid of diffusion- and hemodynamic-weighted magnetic resonance imaging (MRI),with the morphological results compared with those of immunohistochemical examination.DESIGN: Completely randomized controlled, double blind evaluation,analysis of variance, Pearson correlation analysis, follow-up for 2 weeks.SETTING: Department of Medical Iconography, the Second Affiliated Hospital of Hebei Medical University.MATERIALS: This study was carried out at the Department of Medical Iconography, the Second Affiliated Hospital of Hebei Medical University,between April 2001 and March 2002. Totally 18 healthy adult dogs weighing 10-15 kg were randomly divided into control group and experiment group with half in each.METHODS: All dogs were subjected to femoral intubation and then made into CI model by the occlusion of middle cerebral artery with an embolus injected through the internal carotid artery. Dogs in control group were put to death at postoperative 24 hours, 1 week and 2 weeks with three at each time point, while four dogs in experiment group were put to death at postoperative 1 week and five at 2 weeks. Dogs in experiment group received microinjection of 0.5 mL fluid containing pcD2/hVEGF121 (500-600 μg)instantly after operation, which was replaced with physical saline of the same volume at the same time point in control group. Then they were subjected to MRI scanning once an hour for 4 times, with the sequence of T1WI, T2WI, 3D-TOFMRA, DWI and CET1WI, which was repeated at postoperative 24 hours, 3 days, 1 week and 2 weeks. Based on the MR images, pathological focuses were selected for morphological observation of cells with the aid of HE staining, and CD34 IHC staining was used for counting micrangium, as well as VEGF staining for VEGF positive cells.Then the apparent distribution coefficient (ADC) was calculated, and the differences between different time points and groups were analyzed by analysis of variance. The number of capillaries and VEGF positive cells of each high-power field was counted, with the results compared with those of MR scanning so as to explore the correlation between MR signal changes and IHC results.MAIN OUTCOME MEASURES: ① The number of capillaries and VEGF positive cells in each high-power field was counted at postoperative 24 hours, 1 week and 2 weeks; ② MR images of each group.RESULTS: Data of the 18 dogs entered the final analysis. ① Diffusionweighted imaging (DWI) showed higher signals at infarctional region at postoperative 1 hour, which became strengthened as time went by. ②ADC decreased to (5.61 ±1.39) mm2/s at postoperative 3-4 hours, about 43% lower than that of the opposite hemisphere [(9.85±2.04) mm2/s]. It resumed to (9.83±1.11) mm2/s, but was still lower than the normal level.③ The subsequent MR scanning proved that ADC ratio presented an increasing tendency in contrast with the decreasing tendency at super-acute stage. The increment was even more marked in control group and the difference was significant at postoperative 2 weeks (P=0.032, 0.006). ④ The number of capillary positive cells on the affected side in experiment group was significantly higher than that in control group at postoperative 2 weeks [(28.80±3.29)/field, (20.70±4.47)/field, (P ＜ 0.01)]. ⑤ The number of VEGF positive cells on the affected side in experiment group was significantly higher than that in control group at postoperative 1 and 2weeks [(64.20±9.40)/field, (51.90±5.74)/filed; (72.70±6.98)/filed,(58.40±6.35)/field, (P ＜ 0.01)].⑥ The results of MR scanning and IHC were subjected to correlation analysis and revealed that ADC ratio was closely correlated with the number of capillary positive cells, with Pearson correlation coefficient being 0.679 (P ＜ 0.01). Moreover, the number of capillaries and the number of VEGF positive cells were significantly correlated (r=0.668, P ＜ 0.01).CONCLUSION:Morphological observation and IHC revealed that both the local capillaries and VEGF protein content increased markedly in timedependant manner due to VEGF plasmid gene therapy.Meanwhile,the change of ADC ratio was found to be closely correlated with the number of VEGF positive cells and the number of capillaries.

0. 05). Conclusions Tinnitus is a common problem in the older population. With the aging of population, the problem will become more and more severe. More research is urgently needed on prevention and treatment of tinnitus in elderly people.

OBJECTIVE: To evaluate the prognostic value of acute physiology and chronic health evaluation Ⅱ(APACHEⅡ), sequential organ failure assessment(SOFA) score and the blood lactic acid in heat stroke patients combined with multiple organ dysfunction syndrome(MODS). METHODS: A judge sampling method was used to select 42 cases of heat stroke patients combined with MODS as study subjects. They were divided into survival group(23 cases) and death group(19 cases) according to prognosis. The APACHEⅡ, SOFA score and blood lactate level after admission to intensive care unit(ICU) were detected. The prognostic value of each index was analyzed according to receiver operating characteristic curve(ROC) curve. RESULTS: At the 48 th hour after admission to ICU, the APACHEⅡ and SOFA scores of the patients in the death group were higher than those in the survival group(P<0.05). At the 6 th hour after admission to ICU, the blood lactate level in the death group increased compare with that in the survival group(P<0.05). APACHEⅡ or SOFA scores at 48 hours, and the blood lactate levels at the 1 st, 2 nd, and 6 th hours after admission to ICU were all positively correlated with prognosis(P<0.05). ROC curve analysis showed that APACHEⅡ and SOFA scores at 48 hours, and the blood lactate levels at the 1 st, 2 nd, and 3 rd hours after admission to ICU could be used to evaluate the prognosis(P<0.01). CONCLUSION: The dynamic monitoring of APACHEⅡ, SOFA score and the blood lactic acid have important clinical significance on the prognosis of heat stroke patients with MODS.