Objective To unravel the relationship between artefiM blood lactate (ABL) level and is1et β-cell secretion constituents in stress hyperglycemia(SHG)setting of critical illness,and analyze the effect of inadequate tissue perfusion on islet β-cell function.Method According to ABL level,68 critically ill patients with SHG were divided into three groups,namely,group A(ABL≤1.5 mmol/L),group B (ABL 1.6～4.4 mmol/L)and group C(ABL≥4.5 mmol/L).Another 25 healthy volunteers served as insulin (IRI) were measured.The homeostasis model assessment for secretion index of islet beta-cell (HOMA-β)was calculated.The relationship among the above B-c3eH secretion constituents were analyzed.Results The TI level of group C was significantly lower than that of group A(P<0.01).The PI levels of group B and C were significantly higher than those of group A and control group(P<0.05).The C-P level of group C was significantly higher that of group A and control group(P<0.05).The HOMA-β of group C was significant lower than that of group A and B and control group(P<0.05).The ABL had positive correlation with PI and C-P(r=O.322,P=O.015;r=0.513,P=0.000),and the ABL had negative correlation with TI and HOMA-β(r=-0.353,P=0.007;r=-0.294,P=0.002).Conclusions The worse tissue perfusion was in SHG of critical illness,the higher PI and C-P were,the lower TI was, Inadequate tissue perfusion setting could lead to islet beta-cell paracrisis and deceleration.

Objective To explore the method of comfort nursing in patients with nasogastric feeding and observe the influence on enhancement of patients satisfaction degree. Methods Case control study Was used in 162 conscious patients with nasogastric feeding.80 patients from January 2005 to January 2006 were selected as control group and given routine nursing.82 patients from February 2006 to May 2007 were named as the test group and received confort nursing.The satisfaction degree of patients, injury of nasal mucosa, shedding rate of the gastric tube and aspiration rate were investigated with self-designed discomfort questionnaires. Results The satisfaction degree in the test group Was 63.41％,which was higher than that of the control(40.00％,P＜0.01).The rate of nasal mucosa injury, shedding of the gastric tube and aspiration rate were lower in the test group(1.22％,2.44％,1.22％)than those in the control group(8.75％,10.00％,7.50％,P＜0.05).Conclusion The application of comfort nursing in patients with nasogastric feeding contributed to the enhancement of satisfaction degree of patients and nursing quality.

Objective To explore the clinical effect of application of mechanical insufflation-exsufflation (MI-E) for airway mucus clearance in patients with artificial airway.Methods 72 patients were divided into the observation group (36 cases) and the control group (36 cases)according to admission order by random number table.All subjects were given with individual treatment and nursing,while the control group was given with the application of rock sputum ejection machine twice per day,the observation group was given with application of both cough assist and rock sputum ejection machine for sputum excretion.The clinical effect of airway mucus clearance after 5 days' treatment was compared between two groups.Results Compared with the control group,oxygenation index after 5 days' treatment in the observation group increased [(48.16±9.57) kPa vs.(37.99±14.67) kPa,t=-3.48,P＜0.01],clinical pulmonary infection score [(3.39±0.77) scores vs.(5.33±1.47) scores] and procalcitonin level [0.10 (0.07,0.27) μg/L vs.0.43 (0.12,0.79) μg/L] were lower (t=-7.02,Z=-3.28,P＜0.01),the mean sputum amount was bigger [(3.64±0.43) ml vs.(2.31 ±0.44) ml] (t=-4.84,P＜0.01),and the mean interval of suction was longer [(97.81 ±7.28) min vs.(82.00±8.88) min](t=-3.08,P＜0.05).Conclusions MI-E can clear the airway secretion effectively so as to improve oxygenation and the inflammatory markers.And MI-E is a simple,noninvasive and safe technique.

Objective To observe the infiltration situation of Langerhans cells(LC)in laryngeal squamous cell carcinoma tissue and to investigate its clinical significance.Methods Seventy-two cases of laryngeal squamous cell carcinoma were selected and the tumor tissue in all cases was operatively resected.The immunohistochemical SP method was adopted to detect the infiltration situation of LC in laryngeal squamous cell carcinoma tissue.Then the relationship between the LC infiltration degree with tumor stage,relapse,metastasis and prognosis was analyzed.Results Among 72 cases of laryngeal squamous cell carcinoma,27 cases(37.5％)were LC infiltration degree of +,37 cases(37.5％)were ++ and 18 cases(25.0％)were +++.The LC infiltration degree in laryngeal carcinoma tissue was correlated with the cervical lymph node metastasis,recurrence,disease free survival,3-year survival and 5-year survival(P＜0.05),and had no correlation with the age,classification,TNM stage and postoperative radiotherapy(P>0.05).Conclusion LC infiltration can be seen in the tumor tissue of the patients with laryngeal squamous cell carcinoma.The LC infiltration degree is higher,indicating that the prognosis would be better.

Objective To investigate the protective effect of pitavastatin on the patients with earlystage diabetic nephropathy and its mechanism.Methods Seventy cases of early-stage type 2 diabetic nephropathy were divided into pitavastatin group and regular treatment group by random digits table method with 35 cases each.Meanwhile,35 healthy adults with physical examination were recruited as control group.Before and after treatment in pitavastatin group and regular treatment group and on the day of physical examination in control group,the blood glucose,blood lipid,renal function,urinary albumin excretion rate (UAER),high-sensitivity C-reactive protein (hs-CRP),tumor necrosis factor (TNF)-α,interleukin (IL)-18 were determined and compared.Results Before treatment,the levels of total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),triglycerides (TG),fasting blood sugar,2 h postprandial blood glucose,glycosylated hemoglobin,UAER,hs-CRP,TNF-α,IL-18,HDL-C were (5.74 ± 1.35) mmol/L,(3.73 ± 0.75) mmol/L,(3.46 ± 1.87) mmol/L,(10.25 ± 2.36) mmol/L,(15.59 ± 3.64) mmol/L,(8.67 ± 2.28)％,(124.2 ± 52.5) μg/min,(3.64 ± 1.48) mg/L,(43.74 ± 8.35) μ g/L,(113.43 ± 32.75) ng/L,(1.15 ± 0.36) mmol/L in regular treatment group and (5.93 ± 1.41) mmol/L,(3.68 ± 0.71) mmol/L,(3.29 ± 1.92) mmol/L,(10.48 ± 2.69) mmol/L,(16.04 ± 3.16) mmol/L,(9.48 ± 2.46)％,(116.2 ± 50.4) μ g/min,(3.48 ± 1.46) mg/L,(45.93 ± 9.41) μg/L,(120.68 ±35.20) ng/L,(1.18 ±0.35) mmol/L in pitavastatin group,and (4.57 ±0.83) mmol/L,(2.87 ± 0.64) mmol/L,(1.37 ± 0.58) mmol/L,(4.57 ± 1.37) mmol/L,(7.38 ± 1.30) mmol/L,(5.84 ± 1.57)％,(14.8 ± 9.4) μ g/min,(0.84 ± 0.52) mg/L,(10.42 ± 2.83) μ g/L,(20.84 ± 8.56) ng/L,(1.54 ± 0.39) mmol/L in control group.Before treatment,the levels of TC,LDL-C,TG,fasting blood sugar,2 h postprandial blood glucose,glycosylated hemoglobin,UAER,hs-CRP,TNF-α,IL-18 in regular treatment group and pitavastatin group were higher than those in control group,HDL-C was lower than that in control group,and there were significant differences(P ＜ 0.01).The levels of TC,LDL-C,TG were (4.42 ± 1.28),(3.20 ± 0.57),(2.02 ± 0.87) mmol/L after treatment in pitavastatin group,which were lower than those before treatment,and there were significant differences (P ＜ 0.01).The levels of UAER,hs-CRP,TNF-α,IL-18 were (88.3 ± 36.7) μ g/min,(2.54 ± 0.76) mg/L,(35.62 ± 5.28) μg/L,(83.23 ± 21.57) ng/L in regular treatment group and (64.8 ± 34.6)μ g/min,(2.19 ± 0.65) mg/L,(27.70 ± 7.58) μ g/L,(63.20 ± 18.67) ng/L in pitavastatin group after treatment,which were lower than those before treatment,but the decreased degree was obvious in pitavastatin group.Conclusions Pitavastatin can significantly reduce not only UAER,but also the levels of hs-CRP,TNF-α,IL-18,while effectively lower the blood lipid,in early diabetic nephropathy,which indicates that pitavastatin can reduce urine protein and protect renal function by inhibiting the inflammatory process.

[ABSTRACT]OBJECTIVETo evaluate the clinical value of ultrasound guided fine-needle aspiration (US-FNA) in the diagnosis of thyroid nodules with different size.METHODSThe clinical data of 122 thyroid nodules of 109 cases referred to FNAC for diagnosis were retrospectively reviewed. The final operating histological results of 122 nodules were considered gold standard. RESULTSNon-diagnostic FNAC results occurred in 17 nodules (13.9%). FNAC achieved a sensitivity of 78.6%, a specificity of 93.9%, a positive predictive value of 93.6%, a negative predictive value of 78.3%, and a total accuracy of 85.7%. There was no significant difference between the diameter of the nodule≤1 cm group and>1 cm group, except negative predictive value. The non-diagnostic results rate was no significant difference between groups of different nodule size, benign or malignant nodules, and different operators. CONCLUSIONFNAC is a sensitive, specific and accurate method for differential diagnosis of thyroid nodules.

Objective To compare the clinical effect of two different kinds of wound dressing on postoperative skin reactions and phlebitis for PICC in critical patients. Methods A total of 313 PICC critical patients were divided into control group (157 cases) and treatment group (156 cases) by random digits table method. After PICC, the control group was attached to transparent dressing, the experimental group was attached to Mepilex, all of the patients were received routine nursing. The incidences of adverse effect, and the degree of local skin pruritus by Visual Analogue Scale(VAS) were compared in two weeks. Results The incidence of skin allergy, infection, and mechanical phlebitis were 24.20%(38/157), 10.83%(17/157), 18.47%(29/157) in control group and 7.69%(12/156),4.49%(7/156), 3.21%(5/156) in treatment group, and there were significant differences between two groups (χ2=13.99, 4.44, 18.83, P<0.01 or<0.05). The score of VAS in control group and treatment group were (4.84±1.29) points and (3.15± 1.82) points respectively, and the difference was statistically significant (t=8.66, P<0.01). Conclusions Application of Mepilex for PICC in critical patients can decrease the incidences of adverse effect, and increase the degree of comfort. It is worth utilizing widely in the clinic.

OBJECTIVE:To explore the repairing effect and mechanism of Huazhuo jiedu yukui formula on the mucosal dam-age of rats with ulcerative colitis (UC). METHODS:72 rats were randomly divided into blank group,model group,mesalamine group(positive control,0.3 g/kg),Huazhuo jiedu yukui formula low-dose,medium-dose,high-dose groups(5,10,20 g/kg),12 in each group. Except for blank group,other groups were induced UC model. After 4 d of modeling,rats in administration groups received related medicines,ig,blank group and model group received normal saline,ig,once a day,for 2 weeks. After administra-tion,disease activity index(DAI)and mucosal damage index(CMDI)of rats were observed;IL-8,TNF-α contents in serum and cyclooxygenase 2 (COX-2) expression in colon tissue were detected. RESULTS:Compared with blank group,DAI and CMDI scores in model group were increased;IL-8,TNF-α contents in serum were increased;COX-2 expression in colon tissue was en-hanced,with statistical significances (P<0.05). Compared with model group,DAI and CMDI scores in model group were de-creased;IL-8,TNF-α contents in serum were reduced;COX-2 expression in colon tissue was weakened,with statistical signifi-cances (P<0.05). Compared with mesalamine group, the above-mentioned indicators in Huazhuo jiedu yukui formula medi-um-dose,high-dose groups changed more obviously (P<0.05),and effects of Huazhuo jiedu yukui formula showed significant dose-effect relationship. CONCLUSIONS:Huazhuo jiedu yukui formula can improve disease activity status of UC rats and reduce colon mucosal damage,and the effects of medium-dose and high-dose Huazhuo jiedu yukui formula were better than mesalamine, which may be related to reducing inflammatory reaction and inhibiting COX-2 expression in colon tissue.

Objective: To clone human T cell receptor (TCR) ? chain gene and express its encoding protein by baculoviral expression system in insect cells. Methods: TCR ? chain cDNA was cloned from normal human peripheral blood mononuclear cells (PBMC) by RT-PCR and inserted into baculoviral transfer vector. This vector was co-transfected with baculovirus into insect sf 9 cells. The recombinant protein expressed was identified by SDS-PAGE and flow cytometry with mouse anti-human ? chain monoclonal antibody. Results: Human TCR ? chain cDNA cloned and inserted into baculoviral vector specifically expressed protein in the insect sf 9 cells, accounting for about 11% of the total protein yield in the supernatant of cell lysate. The molecular weight of the recombinant protein determined by SDS-PAGE was identical to what we anticipated. The insect cells transfected with recombinant baculovirus were demonstrated by intracellular labeling flow cytometry to express ? chain protein. Conclusion: Human T cell receptor ? chain gene was successfully cloned from human PBMC, and its encoding protein was highly expressed in insect cells. The TCR ? chain protein obtained by bioengineering technique is useful for in depth biological function study.

OBJECTIVE To suvey the mastering of knowledge on prevention and treatment of AIDS among medical staff and evaluate the effect of health education on them.METHODS Suvey among medical staff was performed by self-designed questionnaires before and after education,then evaluated the effect of health education.RESULTS The mean score before education was 20.12?2.28;The mean score after education was 20.77?4.04.There were significant differences between them(t=6.417,P