Objective To investigate the influence of enteral nutrition (EN) emulsion containing slowrelease starch on blood sugar level in patients with craniocerebral injury. Methods Totally 120 patients with severe craniocerebral injury complicated with hyperglycemia joined this open study and were randomized into control group and study group. Study group was given EN emulsion containing slow-release starch ( Fresubin Diabetes)and control group was given routine EN emulsion ( Fresubin), both for 15 days. Fasting blood glucose (FBG),2-hour postprandial glucose (2hPG), and glycosylated hemoglobin (HbA1c) were examined before EN support and 7 days and 15 days after EN support. Results In the study group, the levels of 2hPG before EN support and on the seventh and fifteenth day after EN support were ( 12.26 ± 2. 36 )mmol/L, (9.76 ± 2.90 ) mmol/L, and (9.78 ± 1.86) mmol/L, respectively. The levels of 2hPG after EN support were both significantly lower than that before EN support (P ＜ 0. 05). However, the levels of FBG and HbA1c in the study group were not significantly different before and after EN support ( P ＞ 0. 05 ). In the control group, the levels of 2hPG on the seventh and fifteenth day after EN support were ( 11.70 ± 2. 80) mmol/L and ( 11.39 ± 2. 44 ) mmol/L, respectively, which were significantly higher than those in study group ( P = 0. 033, P = 0. 020). The levels of FBG and HbA1c werenot significantly different between the study group and the control group ( P ＞ 0. 05 ). Conclusion EN emulsion containing slow-release starch may promote the control of blood sugar in patients with craniocerebral injury complicated with hyperglycemia and improve the level of postprandial blood sugar in those patients.

AIM： To study the pathological relationship of vascular cell adhesion molecule-1 (VCAM-1) expression and monocyte/macrophage infiltration with focal brain ischemia. METHODS: Immunohistochemical technique and focal brain ischemia/reperfusion model were used in the study in order to explore profiles and time-course of VCAM-1 expression and monocyte macrophage (ED2 positive cell) infiltration in ischemic rat brain. RESULTS: VCAM-1 was up-regulated in microvascular endothelial cells in ischemic cortex at 1h postischemia, and continuously expressed during the time of reperfusion. ED2 positive cells infiltrated into ischemic cortex at 1h iscehmia/ 2h reperfusion and then ED2 positive cells increased gradually with the time of reperfusion, ED2 positive cell infiltration showed apparently relationship with VCAM-1 expression, and both of them exhibited the some changes of time-dependence. CONCLUSION: Cerebral ischemia induced VCAM-1 expression and ED2 positive cell infiltration and VCAM-1 may regulate the recruitment of ED2 positive cells in the ischemic brain region. The results suggested that VCAM-1 and ED2 positive cells may be participated in the pathogenesis of cerebral ischemic injury.

Objective To evaluate the values of CD64 expression in diagnosis of infected patients referred to intensive care unit.Method Sixty febrile children referred to the hospital intensive care unit from 2009.11 to 2010.03 were enrolled for a retrospective study.Fever was defined as a body temperature reaching 38℃ or higher with specifically bacterial infection or highly suspected with bacterial infection or viral infection.There were 28 patients with bacterial infection and 32 with viral infection.The non-infectious diseases such as juvenile rheumatoid arthritis and Kawasaki disease were excluded.The controls were 50 healthy children asking for physical examination.On admission,CD64 were measured by using flow cytometry,and blood routine examination,ESR,PCT,blood cultures and sputum cultures were simultaneously detected in all febrile patients.Data were statistically analyzed by using SAS 16.0 software.Data are given as means±SE.Categorical variables were analyzed using X2 test and continuous variables were compared by applying paired 1-tailed t test,Significance level was set at less than 0.05.Results of them,57.1%bacterial infection patients and 71.9%viral infection patients contracted pneumonia.CD64 in bacterial infection patients、viral infection patients and the subjects of control group were(12.6±9.7),(5.4±2.42)and (2.9±0.77),respectively.The CD64 in the bacterial infection patients were significantly higher than those in the virus infection patients(F=11.002,P=0.004).Conclusions CD64 in infected children referred to a hospital intensive care unit can be clearly distinguished between bacterial infections and viral infections, providing an important guidance and a flexible strategy for clinical treatment and determine the timing of withdrawal.

Aim To investigate the effect of magnesi-um isoglycyrrhizinate (MgIG)on radiation -induced pulmonary fibrosis in mice and the mechanism.Meth-ods Fifty female C57BL/6 mice were randomly divid-ed into control group,irradiation (RT)group,MgIG group,RT +MgIG group and RT +dexamethasone (DXM)group,with 1 0 mice in each group.Except for control group and MgIG group,the remaining mice were given a single 1 5Gy 60 Co γray on whole lung. The mice in each group were administered 2 h before irradiation and each day after irradiation:MgIG group and RT +MgIG group were administered with MgIG (1 00 mg·kg -1 )by intraperitoneal injection;control group and RT group were administered with normal sa-line (20 mL·kg -1 )by intraperitoneal injection;RT+DXMgroup was administered with DXM(0.5 mg· kg -1 )by intraperitoneal injection.After 1 2 weeks,the mice were sacrificed and lung tissues were taken out. The degree of alveolitis and pulmonary fibrosis were observed by HE staining and Masson staining.The ex-pressions of type Ⅰ collagen,type Ⅲ collagen and TGF-β1 protein were detected by immunohistochem-isty.Results The alveolitis,pulmonary fibrosis and expressions of type Ⅰ collagen,type Ⅲ collagen, TGF-β1 ,p-Smad2,p-Smad3 increased significantly in RT group compared with control group (P <0.05 ), and were significantly lower in RT +MgIG group and RT +DXMgroup than those in RT group(P <0.05). Conclusion MgIG can improve radiation-induced pulmonary fibrosis in mouse lung tissue,and its mech-anism may be related to the influence of MgIG on TGF-βsignaling pathway.

AIM: To study the pathological relationship of vascular cell adhesion molecule-1 (VCAM-1) expression and monocyte/macrophage infiltration with focal brain ischemia. METHODS: Immunohistochemical technique and focal brain ischemia/reperfusion model were used in the study in order to explore profiles and time-course of VCAM-1 expression and monocyte macrophage (ED2 positive cell) infiltration in ischemic rat brain. RESULTS: VCAM-1 was up-regulated in microvascular endothelial cells in ischemic cortex at 1h postischemia, and continuously expressed during the time of reperfusion. ED2 positive cells infiltrated into ischemic cortex at 1h iscehmia/ 2h reperfusion and then ED2 positive cells increased gradually with the time of reperfusion, ED2 positive cell infiltration showed apparently relationship with VCAM-1 expression, and both of them exhibited the some changes of time-dependence. CONCLUSION: Cerebral ischemia induced VCAM-1 expression and ED2 positive cell infiltration and VCAM-1 may regulate the recruitment of ED2 positive cells in the ischemic brain region. The results suggested that VCAM-1 and ED2 positive cells may be participated in the pathogenesis of cerebral ischemic injury.

Objective To retrospectively analyze the relationship between benign prostatic hyperplasia (BPH) and metabolic syndrome (MS) in senior patients. Methods The 859 male senior patients including 619 cases with BPH and 8 cases with MS were enrolled in this study, and there were 192 cases with both diseases and 40 controls. The levels of fasting blood glucose (FBG), total cholesterol (TC), triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were measured. The body mass index (BMI), prostate volume and annual prostate growth rate were determined or calculated. The correlations of BPH with other metabolic risk factors were analyzed. Results The levels of systolic blood pressure (SBP), diastolic blood pressure (DBP), body weight, BMI, TG and FPG were higher (t=6.15, 5.99, 13.12, 15.56, 10.63 and 9.94, all P＜0.01), while serum HDL-C level was lower (t=-7.57,P＜0.01) in BPH patients with MS than without MS. As the number of components of MS was increased, the prostate volume was increased (F=2.98, P=0.031). As the age, body weight, BMI, SBP and PG were increased, the prostate volume was increased (t=-6.39,-2.39,-2.36,-2.13,-25.85,all P＜0.05). Spearman analysis showed that prostate volume was positively correlated with age, SBP, body weight, BMI and hypertension (r=0.229, 0.079, 0.090, 0.089 and 0.088, all P＜0.05). And age, body weight and SBP were the independent risk factors for BPH (OR=1.07, 1.03 and 1.34, all P＜0.05). Conclusions The present study demonstrates a relationship between BPH and MS in senior patients. Future studies are needed to confirm our results and to explain underlying mechanisms.

Objective To explore the roles on psychosocial factors of suicide behavior in the suicide attempters.Methods132 suicide attempters and 132 matched controls treated in the emergency department were assessed using certain psychosocial questionnaires,such as Health Questionnaire of WHO,Questionnaire of Life Measure ( QLM),Beck Depression Inventory (BDI) and Beck Anxiety Inventory ( BAI),Barratt Impulsiveness Scale (BIS) and Buss Aggressiveness Scale ( BAS),Social Surpport Rate Scale and Questionnaire of Coping Style (QCS).Results( 1 ) The results of single-factor analysis showed that the scores of Health Questionnaire of WHO and QL were lower in the suicide attempter group than those in the control group( suicide attempter group:17.07±3.07 and 9.76 ±7.11; control group:13.42 ±3.31 and 17.08 ±3.81,all P＜0.05),otherwise the scores of BDI,BAI,BIS and BAS were higher( suicide attempter group:15.22 ± 11.22,27.87 ± 7.24,87.67 ±20.08 and 73.74 ± 19.61 ; control group:6.87 ± 6.36,26.22 ± 5.44,73.34 ± 14.54 and 63.78 ± 16.44,all P ＜ 0.05 ).Among QCS,the sub-score of self-blaming was higher( 3.42 ± 2.44 VS 2.35 ± 2.04,P ＜ 0.05 ),otherwise the sub-scores of question solvation,asking for help and rationalization were lower( all P ＜ 0.05 ).( 2 ) The result of multi-factors analysis showed that gender,mean education times,the scores of QL,HQ,BDI,and BIS,sub-score of rationalization,and so on,entried the Logistic aggressive equaltion.Conclusion The status of health,quality of life,depressive and anxious mood,impulsive and aggressive personality,and certain coping style play important role.

ObjectiveTo compare the clinical and social-psychological characteristics of patients with and without mental disorder.MethodsBase the diagnosis of mental disorder,232 suicide attempters were divided into two groups:suicide attempter with mental disorder ( 105 cases) and suicide attempter without mental disorder (127 cases).The Structured Clinical Interview for DSM-Ⅳ,the Strength of Suicide Ideation,Health Questionnaire of WHO,Questionnaire of Life Measure (QLM),Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI),Barratt Impulsiveness Scale (BIS) and Buss Aggressiveness Scale (BAS),Social Support Rate Scale and Questionnaire of Coping Style (QCS) were conducted.ResultsThe 105 suicide attempters with a mental disorder were older than the 127 suicide attempter without a mental disorder ( 37.9 ± 14.5 vs 32.9 ± 13.3,t =2.710,P =0.007 ),and the percentage of female was lower in the former than in the later(65.7％ vs 81.1％,x2 =7.099,P =0.008 ).In the total of 232 cases,female was more than male with the gender ratio of 2.87 ( female vs male).The strength level of suicide ideation was higher ( 7.1 ± 2.8 vs 4.8 ± 2.3,t =6.498,P =0.000).The scores of health questionnaire of WHO,BDI and BAI were higher in the suicide attempters with a mental disorder than those without a mental disorder,otherwise the scores of QLM,BIS and its three sub-scales were higher.Among QCS,the sub-score of Self-blaming was higher,and the sub-scores of Question solvation and Asking for help were lower.ConclusionThere are distinguished differences on the sociodemographic and psychological characteristics among the suicide attempters with and without a mental disorder.Mental diseases play an important role in the development of suicide attempter with a mental disorder.

ObjectiveTo understand the behavioral characteristics,strength on suicide ideation and mental disorder diagnosis among suicide attempers,so as to provide consultation for crisis intervention of suicide.Methods232 suicide attempters from emergency of 5 general hospital in south-west of Shandong province were enrolled.They were assessed using questionnaires on attempted suicide behaviors and scale on the strength of suicide ideation,and were diagnosed using the Structured Clinical Interview for DSM-Ⅳ Disorders axis Ⅰ for patient (SCID/I-P).Results( 1 ) In the total of 232 cases,female was more than male with the gender ratio of 2.87 (female vs male).The highest proportion rate (56.9％) existed between 16 years old to 35 years old.Oral application pesticide was the most commom suicide pattern (83.2％),91.4％ of the suicide attempt occurred in the their homes.The top three reasons leading to suicide were family contrary (61.2％),depressive mood (15.1％)and fail in love (9.5％).(2) In all cases,83.6％ did not think if they were found,84.1％ did not adopted any precaution measures,over 60.0％ did not tell anyone their attempted plans,and 90％ had no dying structions and /or dying testaments before their attempted behaviors.At the moment of attemp behaviors,62.9％ did not contact with someone.The 60.0％ of all the cases had wanted strongly to die,otherwise 7.3％ had wanted to manipulate others.(3) The diagnosis rate of mental disorder on DSM-Ⅳ was 45.3％,in which the mood disorder was most.ConclusionThere are no changes on the behavioral characteristics among the suicide attempters in the south-west rural area of Shandong province.Their strength of suicide ideation are moderate,and a certain proportion of suicide attempters may be impulsive suicide attempters.There is more relationship between mental disorder and suicide attempt.

ObjectiveTo investigate clinical characteristics and perioperative management of abdominal aortic aneurysm in elderly patients. MethodsThe clinical data of 24 patients aged 60 years and over with abdominal aortic aneurysm in our hospital were analyzed retrospectively. ResultsThe average age was 75.5 years and the proportion of male and female was 5 : 1. The course of disease was 2 days to 15 years and the median course was 2.8 months. 17 patients were complicated with hypertension, 5 patients with coronary heart disease, 4 patients with type 2 diabetes mellitus, 3 patients with chronic bronchitis, 2 patients with lacunar cerebral infarction, 3 patients with abdominal aortic aneurysm rupture, 13 patients with endovascular stent grafts, 10 patients with abdominal aortic aneurysm resection and artificial vascular replacement, 1 patient with endovascular stent grafts, endarterectomy of right femoral artery and right deep femoral artery,right deep femoral artery plasty and the application of artificial blood vessel in right femoro-popliteal arterial bypass. Postoperative complications happened in 15 cases (62.5%, 15/24) and the postoperative mortality rate was 20.8%.ConclusionsThe elderly patients with abdominal aortic aneurysm are always complicated with manyother chronic diseases such as hypertension, coronary heart disease , diabetes mellitus, chronicbronchitis. The operation for abdominal aortic aneurysm in elderly patients has high risk. Reasonablesurgical procedure and active perioperative management are the key for successful treatment.