Objective To investigate clinical value of serum procalcition(PCT) in early diagnosis of nosocomial infection in severe cerebral injury.Methods 58 patients with severe cerebral injury needing ICU monitoring were enrolled.Levels of serum PCT and C-reactive protein(CRP) and white blood cell(WBC) and nosocomial infection when entering ICU or on days 3 were observed.Results There were not difference in level Serum PCT when entering ICU in infection group compared with non-infection group(P ＞ 0.05).Serum PCT increeassd remarkably when entering ICU on days 3 in infection group as compared with non-infection group,the difference was significant (t =5.44,P ＜ 0.01).There were not difference in CRP and WBC level when entering ICU or on days 3 (all P ＞ 0.05).Conclusion Detection of serum PCT helps diagnosis early nosocomial infection in patients with severe cerebral injury.It is suggested that antibiotics should be chosen early in patients with obviously increased PCT,control abuse of antibiotics contributes to reduce incidence of drug resistance and mortality.

Objective To study the clinical value of percutaneous dilational tracheostomy(PDT) in the critical patients. Methods 56 critical patients who needed mechanical ventilation hospitalized in ICU were enrolled and divided into two groups: PDT group ,25 cases and 0T groups ,31 cases. The length of incision wound, duration of operation, amount of haemorrhage, complications were observed. Results The operation time was significantly shortened [(9.9±3.4)minutes vs (27.2 ±5.1)minutes],blood loss was significantly decreased[(5.2±2.2)ml vs (18.2±3. 5)ml] ,size of operation incision was significantly shorter[(15.0 ± 1. 6)mm vs (41.2 ±3.9)mm],lacking oxygen time was significantly shorter [(10.2±2.1) seconds vs (31.1 ±6.2) seconds] in PDT group compared with OT group (all P＜0. 01). PDT had less subcutaneous emphysema and incision bleeding in PDT group than those in OT group (all P＜0.05). Conclusion PDT was easier in performance with less complication,and was deserved to apply in critical patients.

Objective To compare and investigate the efficacy of small bone window via lateral fissure and cranial awl hole puncture aspiration via temporal lobe in treatment of hypertensive intracerebral hemorrhage (HIH) in basal ganglia. Methods Eighty-two patients with HIH in basal ganglia were divided into group A (34 cases) and group B (48 cases) by random digits table method. The patients in group A underwent small bone window via lateral fissure, and the patients in group B underwent cranial awl hole puncture aspiration via temporal lobe. The hematoma clearance rate, short-term effects, Barthel index, Scandinavian stroke scale (SSS) score and complications were compared between 2 groups. Results The Hematoma clearance rate and excellent rate in group A were significantly higher than those in group B:(91.12 ± 6.55)%vs. (55.83 ± 4.32)%and 52.94%(18/34) vs. 33.33%(16/48), the incidence of complications was significantly lower than that in group B:5.88%(2/34) vs. 22.92%(11/48), and there were statistical differences (P<0.05). The SSS score 14 d after operation and Barthel index 60 d after operation in group A were better than those in group B:(29.72 ± 6.39) scores vs. (26.43 ± 6.11) scores and (83.91 ± 17.82) scores vs. (72.34 ± 15.62) scores, there were statistical differences (P<0.05 or<0.01). Conclusions The efficacy of small bone window via lateral fissure in treatment of HIH in basal ganglia is better than cranial awl hole puncture aspiration via temporal lobe, however, surgical trauma is relatively large, and operation should be a reasonable choice according to the specific circumstances of patients.

Objective To investigate the effect, preponderance and clinical significance of the examination of gastrointestinal transmitting function with small amount of barium meal. Methods Thirty cases of healthy subjects and 50 patients with constipation swallow 40 g barium meal once, then abdominal fluoroscopy or plain films were taken until barium meal being egested totally. Results The transit time of stomach, small intestine, colon, rectum and the whole digestive tract were (189?64)minutes, (330?108)minutes, (2239?659)minutes, (136?49)minutes, (2801?735)minutes in healthy subjects and (212?87)minutes, (366?94)minutes, (3665?1322)minutes, (650?219)minutes, (5973?2341)minutes in constipation patients respectively. The transit time of colon and rectum in constipation patients was obviously longer than that of healthy subjects (P0.05). Conclusion The pictures of the examination with small amount barium meal are clear, precise, reliable, and provide exact data for constipation classification.

The concentration of serum adiponectin [(2.51±1.42)mg/L] was lower in the group of patients with type 2 diabetes mellitus as compared with that in normal controlgroup [(5.26±0.78)mg/L ,P＜0.01]. The concentration of serum adiponectin was lower in the diabetics with macrovascular complications (MVC) [(1.38±0.77)mg/L] as compared with those without macrovascular complication [(3.66±0.91)mg/L]. The concentration of serum resistin was higher in the diabetic group as compared with that in control group[(7.07±1.11 vs 6.09±0.47)μg/L, P＜0.01]. It was also higher in patients with MVC [(7.96±0.65)μg/L] compared with those without MVC [(6.10±0.43)μgL, P＜0.01].

@@

@@

Objective To explore the relationship between visfatin and mild cognitive impairment(MCI)in patients with type 2 diabetes mellitus(T2DM).Methods A perspective study involving 75 hospitalized T2DM patients were divided into groups with(MCI,n=35)and without (NMCI,n =40)mild cognitive impairment.Another 30 non-diabetic patients were chosen as normal control(NC).Fasting plasma levels of glucose (FPG),insulin (FINS),lipid,glycosylated hemoglobin (HbAlc),HOMA-IR and visfatin were measured and calculated.Results The serum visfatin level was higher in MCI(28.81±3.32)μg/L than in NMCI(20.69±3.40)μg/L and NC(19.06±2.35)μg/L (F=96.491,P＜ 0.01).Visfatin was negatively correlated with Montreal Cognitive Assessment (MoCA) total score (MoCA-TS) (r =-0.646,P ＜ 0.01),but positively correlated with course of disease,waist hip ratio,FPG,HbAlc,FINS,HOMA-IR and triglyceride (r=0.282,0.276,0.318,0.496,0.339,0.433,0.309,P＜0.05 or P＜0.01).MoCA-TS was negatively correlated with course of disease,HbAlc,HOMA-IR,triglyceride,total cholesterol,low density lipoprotein cholesterol (r =-0.582,-0.365,-0.234,-0.330,0.277,-0.238,P＜0.05 or P＜0.01),but positively correlated with high density lipoprotein cholesterol(r=0.290,P＜0.05).Higher values of visfatin(OR =3.246,P＜0.01),HbAlc(OR=2.308,P＜0.01)and course of disease(OR=1.634,P＜0.05)were the risk factors for MCI.Conclusions The elevated visfatin level might be a risk factor for MCI in T2DM patients.

Objective:To establish the method for the determination of emodin and danshensu Pinggan oral liquid. Methods:The contents were determined by HPLC. The chromatographic conditions for emodin were as follows: an Agilent Eclipse XDB-C18 column (150 mm × 4. 6 mm, 5μm) was used and the mobile phase was methanol-water (80 ∶20). The detection wavelength was 287 nm and the flow rate was 1. 0 ml·min-1 . The column temperature was 25℃ and the injection volume was 20 μl. The chromatographic condi-tions for Danshensu were as follows:an Agilent Eclipse SB-C18 column (150 mm × 4. 6 mm, 5 μm) was used and the mobile phase was methanol-1% acetic acid solution (2 ∶98). The detection wavelength was 280 nm and the flow was 1. 0 ml·min-1. The column temperature was 30℃ and the injection volume was 20 μl. Results:Emodin had a good linear relationship within the range of 26. 75-428. 00 μg·ml-1(r=0. 999 9). The average recovery was 102. 7% and RSD was 0. 76% (n=6). Sodium Danshensu had a good linear relationship within the range of 10.17-162.77 μg·ml-1(r =0.999 9). The average recovery was 100.5% and RSD was 1. 47% (n=6). Conclusion:The method is simple, accurate and reproducible, which can be used for the quality control of the prep-aration.

[Summary] The characteristics ot clinical data and relevant inspection (quantitative sensory and electrophysiological studies) in 5 patients hospitalized with acute painful neuropathy following rapid glycaemic control with insulin from 2010 to 2012 in our hospital were analyzed.The results showed that 5 patients were all males,aged 31-49 years,with lower body mass index,and diagnosed as latent autoimmune diabetes of adults (LADA) or type 2 diabetes.Glycaemic control was poor before application of insulin.When insulin was used,the hyperglycemia was rapidly corrected in a short time,with recurrent episodes of hypoglycemia during insulin treatment.The painful neuropathic symptoms appeared within 2-4 weeks after application of insulin,and were relieved partially or completely after 2-6 months.Neuropathic symptoms manifested as tingling and tenderness,with worsening during night and after insulin injection.The neuropathic symptoms were not significantly alleviated after application of neurotrophic drugs such as methycobal,protogen,and prostaglandin.These patients often suffered from severe anxiety.Nerve electromyogram examination showed slowed or normal motor conduction velocity of tibial and fibular nerves,and normal feeling threshold.