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 compare the learning motivation of Tibetan college students with that of Han college students,and compare the learning motivation of Tibetan and Han students with different majors and genders.Methods Learning motivation questionnaire for university students were used,and 172 Tibetan students and 156 Han students participated in the study,while their general population information were collected at the same time.Results Learning motivation for both Tibetan and Han students was above the average level.Tibetan students scored ((3.97±0.52),(3.47±0.58),(3.49±0.50),(3.23±0.58),(3.37±0.50)) significantly higher than those of Han students ((3.83±0.56),(3.15±0.71),(3.37±0.50),(2.99±0.65),(3.20±0.53),P＜ 0.05) in hankering for capability,tendency of altruism,intrinsic motivation,extrinsic motivation and total motivation score.Tibetan boys ' score in altruistic orientation (3.48±0.54) was much higher than that of girls(3.45±0.61,P＜0.05).For Tibetan students,those who majored in liberal arts scored much more in all items than those who majored in science (P＜ 0.05).For Han students,there was no significant difference in the scores of boys' and girls'(P＞0.05).For those Han students who majored in liberal arts,their scores in hankering for capability,tendency of altruism and intrinsic motivation((3.17±0.49),(3.32±0.73),(3.47±0.46))were significantly higher than those who majored in science((2.91±0.56),(2.98±0.65),(3.28±0.52),P＜0.05).Conclusions (1)The Tibetan students showed stronger motivation than Han students.(2) Gender plays a different role in the learning motivation of Tibetan and Han students,that is,compared with the Tibetan girls,Tibetan boys have stronger motivation in altruistic orientation.For Han students,there is no significant difference between male and female students' learning motivation.(3) Tibetan and Han students from different majors show the same trend in learning motivation,that is,for both the Han students and Tibetan students,liberal arts students' learning motivation is higher than that of the science students.

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.

Based on analysis of the relationship between depression and seven emotions,etiopathogenisis and pathogenesis of depression,the relationship between depression and stagnation of liver qi,it showed that depression had highly correlation with sorrow,grief.The etiopathogenisis and pathogenesis of depression included body factor,exogenous pathogen,associated diseases,social psychic factor,etc.The essence of primary depression,endogenous depression and depressive emotion with dysthymia was deficient,and yang-deficinecy was the key pathologic basis.Exogenous evil was an indirect cause of depression.Because depressive emotion had connection with stagnation of liver qi at some extent,it should distinguish depression from stagnation of liver qi.

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.

20 mg/L again.Children without treatment regulared exam for phe concentration level in blood and test for physical and mental capability development.Results Forty-eight children with PKU were diagnosed in 355 615 newborns who were collected from June 1999 to April 2005.The incidence rate of PKU was 1/7408,carriers with PKU gene was 1/48.There was no significant difference in physical and mental condition compared with that of normal children.Conclusions The treatment results for children with PKU is significant.It has good social and economic value.It is one of the important measures for reducing infant defect and improving population quality.

Objective: To design and prepare HBc virus-like particle vaccine (VLP) harboring the specified epitope of gastric inhibitory peptide (GIP), and to study its immune effects, so as to cast new lights on immune therapy of obesity. Methods: GIP cDNA was cloned and was fused with HBc VLP (1-144aa) cDNA. Through prokaryotic expression and purification processes, a GIP vaccine linked to the HBc-derived VLP carrier was constructed. We also cloned the fusion gene into eukaryotic vector pVAX1 to prepare GIP nuclear acid vaccine. And the two kinds of vaccines were tested in rats for their immunological parameters. Results: GIP vaccine linked to HBc-derived VLP carrier was successfully prepared. We also prepared the genetic vaccine pVAX1-HBc-GIP. The combined vaccination with both vaccines could obtain high titer and peptide-specific IgG antibody, displaying a satisfactory immunogenicity. Conclusion: GIP protein vaccine using HBc as immune-enhancing vaccine carrier can effectively induce GIP-specific humoral immunity, disrupting the tolerance to self antigens in rats. The vaccine is worth studying as a new drug for control of obesity.

Objective To investigate the distribution of age and relationship of ESR with HCT.Methods The HCT,age and ESR datas of the patients which all ages were above 40 years were Collected,then count the mean and standard deviation x±s with different groups of HCT,t test was made to identify the significance of difference.Results HCT:The levels of hct in males was 0.47±0.26 in higher groups of HCT,0.39±0.27 in normal groups and 30.01 ±3.59 in lower groups.The levels of HCT in fe-males was 0.42±0.17 in higher groups,0.30±0.36 in normal groups,0.27±0.45 in lower groups;Age:The average age in males was 57.41±10.62 years in higher HCT groups of patients,67.23 ±12.75 in lower hct groups,there were significantly difference between them.The avarage age in females was 60.70 ± 11.60 in higher HCT groups of patients,61.60 ± 12.40 in lower HCT groups,there were no significantly difference between them.ESR:The levels of ESR in males was (3.95 ±3.26)mm/h in higher HCT groups,(61.61±40.04)mm/h in lower HCT groups;The ESR in females was (28.26±28.62)mm/h in higher HCT groups, (60.20±43.71)mm/h in lower HCT groups,there were significantly difference between different groups included both males and femals.Conclusion When the HCT were decreased,the age and ESR were increased in males,the ESR were also increased but had no relationship with ages in females.Conjuction the age and ESR,it could improve the prevention and monitoring in heart-brain blood disease through the HCT.

Objective To evaluate the application status of China Disease Prevention and Control Information System of Hy?datid Disease,in which questions existed are summarized in order to promote the system update. Methods A questionnaire was designed and distributed to Inner Mongolia,Sichuan,Tibet,Gansu,Qinghai,Ningxia,Xinjiang and Xinjiang Production and Construction Corps to evaluate the application status of China Disease Prevention and Control Information System of Hydatid Disease assistant with telephone. Results The recovery rate of questionnaires was 87.5%. The statistics of closed questions showed that national application rate of the China Disease Prevention and Control Information System of Hydatid Disease was 100%,of which 15.3%were low frequency users,57.1%believed the system was necessary,28.6%considered it was dispens?able,and 14.3%believed that it was totally unnecessary. The statistics of open?ended questions indicated that 6 endemic regions suggested to increase the guidance and training,while 4 endemic regions had opinions on sharing the information of the national infectious disease reporting systems and hydatid disease prevention and control information system,and the opinions on turning monthly report to quarterly report,and increasing statistics and analysis module,and 3 endemic regions deemed that the system had logic errors and defects. Conclusion The problems of the system are mainly focused on the existence of systemic deficien?cies and logic errors,lacking of statistical parameters and corresponding analysis function module,and lacking of the guidance and training,which limits the use of the system. Therefore,these problems should be resolved.

Objective To evaluate the effect of music and mood relaxation training for the anxiety in patients with breast tumor before operation. Methods With case-contrast method, 108 patients with breast tumor (52 patients with intervention, 56 with routine treatment) week assessed continuously. All cases were investigated on their common information, physiological indexes and psychological scales, including State-Trait Anxiety Inventory (STAI-Form Y), Social Support Rating Scale (SSRS) and Eysenck Personality Questionaire (EPQ). Results There were significant statistical difference in systolic pressure and pulse rate between two groups on one day (t =3.114, P ＜0.01) and 30-60 minutes (t =3.03, P=0.01) before the operation. There was remarkable difference for anxiety between two groups and among different interventions periods by Repeated Measures ANOVA analysis (Periods: F=18.61, P ＜0.01; Groups: F =7.001, P ＜0.05). Results of Stepwise regression analysis: The influencing factors on anxiety in patients with breast tumor before operation were trait anxiety, breast-feeding history, family history of breast tumor, age, economy and EPQ-N. Conclusion Relaxation music and mood relaxation training can reduce the level of anxiety and related physiological indexes on patients with breast tumor before operation. The influencing factors on anxiety in patients with breast tumor before operation are multi level factors, such as trait anxiety, breast-feeding history and so on.