The management of hyperglycemia in the intensive care unit(ICU)patients has been concerned in recent years.Epidemiological data show that the occurrence of severe hyperglycemia is associated with increased mortality and morbidity in ICU patients.Several large scale trials about intensive glycemic control in the critically ill patients were carried out,but reached disparate conclusions.Based on the latest clinical research evidences,the optimal target range of blood glucose Level in ICU patients seems to be 7.8-10 mmol/L.However,the target should be individualized in clinical practice.Both hyperglycemia and hypoglycemia should be carefully avoided.

Objective To evaluate 5 drug sensitivity tests in detecting carbapenem resistance of KPC-possessing Enterobacteriaceae.Methods Thirty-six Enterobacteriaceae isolates were collected from the First Affiliated Hospital,Cofiege of Medicine,Zhejiang Univeristy,including 32 of Klebsiella pneumoniae,1 of Escherichia coli,1 of Citrobacter freundii,1 of Klebsiella oxytoca,and 1 of Serratia marcescens,and the cacbapenemase producing was confirmed with PCR.Resistance to imipenem,meropenem and ertapenem was determined by agar dilution and disk diffusion tests,that to imipenem and meropehem was determined by ATB with G-5 panel,that to imipenem by BD Phoenix 100 with NMIC-109 panel,and that to imipenem and ertapenem by VITEK 2 Compact with AST-GN13 card.Results The resistance to imipenem determined by ATB,BD Phoenix100,VITEK 2 Compact,agar dilution and disk diffusion tests were 13.9%(5/36),11.1%(4/36),13.9%(5/36),22.2%(8/36)and 69.4%(25/36).ATB,agar dilution and disk diffusion tests reported 22.2%(8/36).55.6%(20/36)and 47.2%(17/36)as resistant to meropenem.VITEK 2 Compact,agar dilution and disk diflusion tests reported 69.4%(25/36),77.8%(28/36)and 88.9%(32/36)as resistant to ertapenem.The MICs of ertapenem determined by VITEK 2 Compact and agar dilution were≥2 μg/mL.Conclusion The sensitivity of agar dilution and agar disk diffusion is higher than other automatic methods in the identification of KPC-mediated carbapenem resistance,and ertapenem is a more sensitive indicator than mempenem and imipenem for screening KPC-possessing isolates.

Action for Health in Diabetes( Look AHEAD) trial showed that an intensive lifestyle intervention focusing on weight loss did not reduce the rate of cardiovascular events in overweight or obese adult patients with type 2 diabetes. However, the intensive lifestyle intervention improved the control levels of the risk factors for cardiovascular disease, attenuated the obesity-associated comorbidities, and improved the quality of life in these patients.

Standards of Medical Care in Diabetes released by American Diabetes Association (ADA) is one of the most important guidelines for clinicians. Based on the latest evidence of clinical studies,the Standards of Medical Care in Diabetes is annually updated by ADA. The statement of ADA on diagnosis,assessment and management in diabetes are recommended for clinicians,patients and researchers. The latest edition of Standards of Medical Care in Diabetes was published as supplement form on Diabetes Care in January 2017. This interpretation will focus on the updated contents and their best evidence and clinical importance in this guideline.

Objective To validate scientificalness,practicability and useful values in medical care of Zhang-Lu index(ZLI).Me-(thods) ZLI=weight(g)+250/height(cm)?head circumference(cm)?2 was computed and compared with the conventional body weight for gestational age based data of body height,body weight and head circumference measured from 858 neonates in Benxi.Results The ZLI of the first 3 days of fullterm appropriate for gestational age(AGA) was higher than reference from national neonatal physical growth science research association.The difference was significantly(P

Objective To describe the work of quality control for lipids measurement in CNHS 2002.Methods The quality control was applied over the whole project including staff training,making standard operating procedure(blood collection,separation,temporary storage,transportation,final storage),lab materials assignment,internal quality control in central lab and participating US Disease Control Center's Lipids Standard Program(LSP)as external quality control.Results Seven times of national training programs were held and 326 technicians from CDCs in 31 provinces,autonomous regions, municiplalities and 132 surveyed counties received related trainings.During the program,321 persons passed examination (98.5%)and among them 205 got the A score(62.9%);The field work was implemented strictly according to the procedure. Three automatic biochemical instruments were used in the measurement and there is no significant difference between means of serum TC,TG and HDL-C from several batches of quality control serum.Parallel measurements were conducted in five percent randomly selected samples,the ratio of bias less than 3% was 99.05%,96.40% and 98.30% for TC,TG and HLD-C, respectively.Compared with means of LSP control sera,the results showed that all bias was less than 5% except one bias of TG result(7.02%)in one batch of LSP controls.Conclusion The work of quality control in this survey guaranteed the accuracy of plasma lipids measurement,and provided the basic data for the epidemiological description of dyslipidemia status among Chinese and the further analysis.

Child ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Phytotherapy ; Pneumonia, Mycoplasma ; diagnosis ; drug therapy

Objective To explore the effects of dopamine and dobutamine on thyroid stimulating hormone(TSH),total thyroxine(T4) and growth hormone(GH) in preterm infants with hypotension.Methods Forty-seven preterm infants with hypotension were enrolled in the stu-dy,and 38 preterm infants remained hypotensive after two dose of isotonic saline solution,who were divided into two groups and assigned to receive dopamine or dobutamine.Drug infusion were all started at 4 ?g /(kg?min) and the dose increased by 2 ?g /(kg?min) in a stepwise fashion until either the mean blood pressure normalized or a maximal dose 20 ?g /(kg?min) was reached.Haemodynamic variables and se-rum levels of TSH,T4,and GH were assessed during the first 72 h of treatment and the first 3 d after stopping treatment.Microplate luminometer was used to test TSH,T4,GH levels.Results Necessary cumulative and mean drug doses and maximum infusion required to normalize blood pressure were significantly higher in the dobutamine group than those in the dopamine group(Pa0.05].Conclusions Dopamine and dobutamine both increase the syste-mic blood pressure,with higher drug doses in dobutamine group.Dopamine reduces levels of serum TSH,T4 and GH in preterm infants but such suppression is quickly reversed after treatment is stopped.

Objective To explore influence of different positive end expiratory pressure(PEEP)level on ventilative efficincy of premature infant with respiratory distress syndrome(RDS).Methods Forty preterm infants who were diagnosed RDS and needed ventilation were randomly assigned to lower PEEP(0.49~0.59 kPa)and high PEEP(0.59~0.78 kPa)group.They were treated by ventilation and pulmonary surfactant(PS).When they were medically stable,blood gas was done at 15 min,2,6,12,24 h after ventilation.Then the ratio of pa(O2)/FiO2,oxygen index(OI),ventilation index were calculated.Result The ratio of pa(O2)/FiO2,OI,ventilation index were better in lower PEEP group than those in high PEEP group(Pa

Adult ; Child ; Diet ; Female ; Fetus ; immunology ; Humans ; Hypersensitivity ; embryology ; immunology ; Maternal Behavior ; Pregnancy ; immunology ; Risk Factors