OBJECTIVE:To investigate the effects of intensive insulin therapy on related indexes of stress diabetes patients with multiple trauma. METHODS:82 stress diabetes patients with multiple trauma were randomly divided into observation group and control group,with 41 cases in each group. Two groups were given specific processing. Observation group was additionally giv-en biosynthetic human insulin therapy with 1-2 IU/h drops of micro pump,adjusting dripping speed of micro pump according to re-al-time blood glucose value. Control group was given metformin hydrochloride tablets,with a meal,the initial dose of 0.5 g,twice a day,adjusting the dose of glucose-lowering drugs according to blood glucose value,increasing the dose to 1 g,twice a day. Both groups were treated for 10 d. CRP,TNF-α,IL-1,IL-6,average blood glucose were observed in 2 groups before and after treat-ment. The occurrence of complications as local infection,sepsis and SIRS were compared between 2 groups. RESULTS:After treat-ment,the serum levels of CRP,TNF-α,IL-1,IL-6,average blood glucose in 2 groups were significantly lower than before,and the serum level of CRP,IL-1,IL-6 in observation group after 5,10 d of treatment and the serum level of TNF-α,average blood glu-cose after 1,5,10 d of treatment was significantly lower than control group at same time,with statistical significance(P<0.05). The incidence of complications in observation group after multiple trauma was significantly lower than control group,with statisti-cal significance (P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:Based on routine treat-ment,intensive insulin therapy can more effectively reduce the levels of blood glucose and inflammatory factors and prevent the oc-currence of complications after multiple trauma,moreover,do not increase the occurrence of ADR.

The paper analyzed the experiences of clinical subjects development at hospitals of Capital Medical University.On this basis,the authors raised such development suggestions as further improvement of the management systems,progressive affiliation mechanism,information platform,and better performance appraisal mechanism,for the purposes of empowering the standard and strength of clinical subjects of the hospitals.

This paper reported that lidocaine given intravenously 5mg/kg 9 min before occlusion of left ventricular coronary artery (CO) may shorten the latent period for ventricular arrhythmias from 6.2?1.9 min to 3.7?0.9 min (P

Objective To analysis and conclude the problem of preventing post-operational acute pulmonary embolism. Methods Data from 29 cases of post-operational acute pulmonary embolism,including primary disease ,high risk factors ,process of operation, the coming on of post-operational acute pulmonary embolism,and the problem of prevention . Results There is inadequate attention on the prevention of post-operational acute pulmonary embolism.Conclusions Failing of bring the prevention measures into effect is the reason of the high incidence rate and mortality rate of post-operational acute pulmonary embolism.

Objective To analyze the clinical features of an autosomal dominant Charcot-Marie-Tooth disease(CMT) type 2F family in china.Methods Retrospective analysis were made to show the clinical manifestations and electrophysiological data of 3 patients who come from an autosomal dominant CMT2F family. Results The clinical manifestations of 3 patients were characterized by later onset (from 37 to 60 years)and mild sensory impairments. Right hearing of one patient was lost progressively after the onset. Nerve conduction studies showed there were slow sensory and motor conduction velocities or no nerve action potentials in lower limbs but normal or mildly slow in upper limbs. Somatosensory evoked potentials on tibial nerve indicated both central and peripheral somesthesia gateway were involved. Motor evoked potentials detection found the conduction velocities in the peripheral motor gateway were slowed in lower limbs. Brainstem auditory evoked potentials showed right peripheral acoustic pathway was severely impaired but left was normal. Bilateral visual evoked potentials were normal. Conclusion Patients with CMT2F had distinct characteristics in clinical manifestations and electrophysiological data which would help clinical typing and diagnosis of CMT.

Objective To compare the short-term curative effects of prucalopride and mosapride respectively combined with low dose polyethylene glycol in treating elderly refractory functional constipation.Methods Ninety patients with elderly refractory functional constipation in the outpatient department of our hospital from May 2014 to February 2016 were retrospectively analyzed and divided into two groups randomly,45 cases in each group.the prucalopride group:Prucalopride Succinate Tablets,2mg,4 times daily;the mosapride group:Mosapride Citrate Capsules,5mg,3 times daily.Polyethylene Glycol Electrolytes Powder(PEG) was also used in the two groups,13.125g,twice daily.The course of treatment was 4 weeks.The first defecating time and defecation difficulty relief time,average weekly spontaneous complete bowel movements (SCBM),defecating difficulty,stool character,adverse reactions and change of life quality were observed in the two groups.Results The treatment effective rate of slow transit constipation(STC) and defecatory disorder had the statistical difference between the two groups (P<0.05).The comparison of the effective rates in mixed type showed no statistical difference between the two groups(P>0.05).Compared with the mosapride group,the first defecating time and defecation difficulty relief time in the prucalopride group were shorter with statistical difference (P<0.05).After 4-week treatment,SCBM times per week in the two groups were more than 3 times;the times of the prucalopride group were even more.In the prucalopride group,the defecation difficulty improvement was more obvious,the difference between the two groups had statistical significance (P<0.05).As for the comparison of the stool character improvement,the difference had no statistical significance(P>0.05).The total effective rate had statistical difference between the two groups(P<0.05).The incidence rate of adverse reactions had no statistical difference between the two groups(17.78% vs.15.56%,P<0.05).The total average score of PAC-QOL after treatment in the two groups were both decreased,moreover the decrease in the prucalopride group was more obvious;the difference between the two groups had statistical significance(P<0.05).Conclusion Prucalopride +PEG take effect faster in the treatment of elderly refractory functional constipation and has the advantages in the aspects of overall curative effect and life quality improvement,which is specially suitable for STC and defecatory disorder type.

Objective:To observe the effect of etanercept on bleomycin-induced pulmonary fibrosis in mice and its possible mechanisms.Methods:Thirty male SPF Kun ming mice were randomly assigned to control group ( intratracheal saline injection ) or model group ( intratracheal injection of bleomycin 5 mg/kg ) or intervention group ( intratracheal bleomycin injection followed by etanercept 3 mg/kg intraperitoneal administration twice a week )(n=10 group).Lung tissue were taken after the sacrifice of the mice with 28 days of molding.The content of hydroxyproline of the right lung samples was measured by alkaline hydrolysis method ,while the left lungs were fixed in 4%paraformaldehyde and embedded in paraffin with the sections stained with hematoxylin -eosin or Masson′s trichrome for pathological examination .Total tissue protein was extracted from lung homogenates to detect the expression of NF -κB and phosphorylation of NF-κB( P-NF-κB) by Western blot.Results:The content of hydroxyproline in lung tissue of mice of intervention arm was decreased significantly compared with the model arm ( P<0.01 ).The alveolar structure of the intervention arm maintained integrity with alveolar septum slightly thickened.The inflammation and fibrosis scores were decreased significantly with noticeable greater improvement of pulmonary fibrosis than the model arm (P<0.01).In addition,the protein phosphorylation of NF-κB in the lung tissues was remarkably decreased in the intervention arm ( P<0.01 ).Conclusion: Etanercept can inhibit the phosphorylation of NF-κB and reduce lung inflammation and fibrosis caused by bleomycin in mice ,which may be useful in the treatment of pulmonary fibrosis.

Objective To observe the effects of different doses of Peng-Hui on expression levels of insulin receptor substance 1 (IRS-1) in type 2 diabetes (T2DM) rats. Methods T2DM rat model was established by feeding with high-fat-diet and intraperitoneal injecting streptozotocin (STZ). T2DM model rats were randomized into four groups: T2DM control group, high dose Peng-Hui (150 mg/kg) group, medium dose Peng-Hui (100 mg/kg) group and low dose Peng-Hui (50 mg/kg) group. The T2DM control group was fed with only high-fat-diet. The normal control group was fed with common diet. The expression levels of IRS-1 in pancreas and skeletal muscle tissues were detected by immunohistochemistry method after 8-week treatment, and fasting blood glucose (FBG) and insulin levels were also detected in five groups. Results FBG lev-els were significantly lower in medium dose Peng-Hui group than those of T2DM control group and low dose Peng-Hui group (P＜0.05). There were no significant differences in insulin levels between high, medium and low dose Peng-Hui groups and T2DM control group (P>0.05). The expression levels of IRS-1 of pancreas and skeletal muscle tissues were significant-ly lower in high dose Peng-Hui group than that of T2DM control group (P＜0.05). Conclusion The expression of IRS-1 was decreased in high dose Peng-Hui group, but no effects on FBG and plasma insulin.

Objective To explore the effects of intensive health education on psychological stress of outpatients with chronic HBV infection. Methods A convenient sample of 80 patients was selected as the subjects of the study. They were randomly allocated to the control and the intervention group with 40 patients in each group. The intervention group received intensive heath education, which was designed spe-cially by researcher, while the control group just received the routine clinic health education. Demographic Data Recording Form (DDRF) and the Perceived Stress Scale specific to Hepatitis B Patients (PSSH) were used to assess the intervention effect pre-treatment and 3 months after intervention. Results The scores of PSSH were high in two groups before intervention. Compared with the control group, the intensive health education decreased the score of PSSH more significantly in the intervention group. Conclusions The intensive heath education can reduce the psychological stress of the outpatients with chronic HBV infection.

Objective To summarize extracorporeal membrane oxygenation (ECMO) in percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) with cardiac arrest,and to evaluate the clinical efficacy comparing with literature review.Methods 5 patients of AMI with cardiac arrest who proved invalid to conventional cardio-pulmonaryresuscitation (CPR),were successfully resuscitated with ECMO support,and underwent emergency PCI with stable hemodynamic status.Results In support of ECMO,4 patients were successfully resuscitated with stable hemodynamic status,and underwent primary PCI.The duration of ECMO support ranged from 42 to 220 h (average 126.6 h).3 patients discharged with full recovery,one patient didn't wean from ECMO successfully,and one died of respiratory failure.Conclusion Although mortality of AMI with cardiac arrest is high,early ECMO-assisted cardiopulmonary resuscitation and secondary PCI treatment increase the possibility of cardiac recovery,and provide conditions for emergency revascularization treatment.This reduces mortality in critical patients with AMI,and is an effective short term life support method.