OBJECTIVE:To investigate the effect of insulin use intervention and self management of blood glucose in the treat-ment of cystic fibrosis related diabetes. METHODS:In prospective cohort study,during Apr. 2007-Apr. 2013,1 295 CFRD inpa-tients selected from 14 hospitals of Shanghai were randomly divided into trial group (743 cases) and control group (552 cases). Control group maintained the dose of insulin,and trial group adjusted the dose of insulin every week and received patient education about self management of blood glucose. Blood glucose,blood lipid,quality of life,the ability of self management and other in-dex were detected,recorded and compared between 2 groups 1 year after intervention. RESULTS:1 year after intervention,fasting blood glucose,postprandial 2 h blood glucose and HbA1c of trial group were significantly lower than those of control gorup,with statistical significance(P<0.05). The time of blood glucose reaching the standard,the dose of insulin,the number of hyperglycemia and hypoglycemia in trial group were all significantly shorter or lower than control group,with statistical significance (P<0.05). There was statistically significant difference in the rate of standard blood glucose between trial group [93.5%(695/743)] and control group [59.6%(329/552)]. TG of trial group decreased while HDL increased,there was statistically significant difference between 2 groups (P<0.05). There was statistically significant difference in the quality of life score between trial group (196.24 ± 15.80) and control group(180.33±16.29)(P<0.05). The ability of self management in trial group was significantly higher than control group, with statistical significance(P<0.05). CONCLUSIONS:Insulin use intervention and self management of blood glucose can control the level of blood glucose in CFRD patients,and improve the quality of life,medication compliance and therapeutic effect.

Objective To evaluate the effect and safety of small dose ketamine combined with morphine for postoperative analgesia in elderly patients undergoing total knee replacement.Methods Sixty-two elderly (≥ 65 years old) patients undergoing total knee replacement under combined spinal-epidural anesthesia were randomly divided into two groups.In group MK,morphine (0.4 mg/ml) and ketamine (0.4 mg/ml) were used for postoperative analgesia.While in group MO,only morphine (0.4 mg/ml) was used for postoperative analgesia.Visual analogue scale (VAS) pain score,comfort level,Ramsay sedation level,cumulative morphine consumption,changes in vital signs (blood pressure,heart rate,respiration,blood oxygen saturation,etc) and occurrence of side-effects (pruritus,nausea and vomiting,psychiatric symptoms,etc) were recorded up to 48 h after surgery.Results The VAS pain scores were significantly lower in group MK than in group MO at time points of 4,8,12,24,36,48 h (Wald x2=16.713,P＜0.05),while the comfort levels were significantly higher in group MK than in group MO after surgery (Wald x2 11.238,P＜0.05).The total morphine consumption after 48 h was significantly lower in group MK than in group MO (t=3.807,P＜0.001).The incidence of postoperative nausea and vomiting was significantly lower in group MK than in group MO (x2 =4.356,P＝0.036).There were no significant differences in sedation level (Wald x2＝ 3.303,P＞0.05) and changes in vital signs (P＞0.05) between the two groups.No case with psychiatric symptoms was found in both groups.Conclusions When used for postoperative intravenous analgesia in elderly patients after total knee replacement,small-dose ketamine combined with morphine can provide better analgesic effects,decrease total consumption of morphine and the incidence of side-effects.

Objective To investigate the relationship between genetic polymorphism of methylenetetrahydrofolate reductase (MTHFR) and the risk of acute lymphocytic leukemia (ALL). Methods Eighty-three patients with ALL and a cohort of 83 matched healthy objects were included, and DNA was extracted from their peripheral blood. PCR-RFLP was used to determine the genotypes of MTHFR C677T and A1298C. The adjusted odds ratio (OR) and 95% confidence interval (CI) were calculated using unconditional logistic regression model. Results It was found that the frequency of the MTHFR C677T TT genotype among patients was significantly different from that among control objects (P=0.008). The MTHFR C677T TT genotype had an increased risk of ALL compared with that of 677CC genotype (OR=3.229, 95%CI: 1.328-7.847, P=0.01). No significant association between the MTHFR C677T CT genotype or A1298C polymorphism and the risk of leukemia. Conclusion The present findings suggest that 677C→T polymorphism in MTHFR may be a genetic susceptibility factor for acute lymphocytic leukemia.

Objective To investigate the effect of ulinastatin on acute lung injury in rats with severe heatstroke.Methods Fourty-eight rats were randomly (random number) assigned into control group (HS group,n =12),low dose Ulinastatin group (LUTI group,n =12),high dose Ulinastatin group (HUTI group,n =12) and non-thermal group (Sham group,n =12).Rats were prepared with pre-warm chamber to initiate heatstroke.The change of rectum temperature (Tc),heat-rate (HR) and mean arterial pressure (MAP) under heat-stress were recorded.The time-point of heatstroke onset and Tc ＞42 ℃ was observed.Arterial blood samples were draw at 0 min,20 min,40 min and 60 min for testing partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2).Bronchoalveolar lavage fluid (BALF) were collected at 60 min,and the concentrations of tumor necrosis factor-α (TNF-α),interleukin-1β (IL-l β) and interleukin-6 (IL-6) in BALF were measured with enzyme linked immunosorbent assay kit.Lung tissues were harvested for observing pathological change and measuring the expression of iNOS with Western blot test.Results Compared with HS group,the time-point of Tc ＞ 42℃ (P =0.00),severe heat-stroke (P =0.00) and the median of survival time (P =0.00) in LUTI and HUTI groups were significantly increased.At 60min after heat-stress,the level of PaO2 in HS group was much lower than those in other groups (P =0.00).But there were no differences between LUTI and HUTI groups (P =0.91).The value of PaCO2 in HS group was much higher than those in other groups (P =0.00).And the differences between LUTI and HUTI groups were no significant (P =0.79).The concentrations of TNF-α,IL-1β and IL-6 in HS group was the highest in four groups (P =0.00,P =0.04 and P =0.04),followed by LUTI,HUTI and Sham group.The concentrations of proinflammatory cytokine in LUTI were higher than those in HUTI group (P =0.02,P =0.00,P =0.00).Compared with HS group,the pathological injuries were alleviated in LUTI and HUTI group (P =0.00).The expression of iNOS in lung tissue of HS group was strengthened than LUTI and HUTI group (P =0.00),and there was a significant difference between LUTI and HUTI group (P =0.03).Conclusion Ulinastatin improves respiratory dysfunction and the prognosis of severe heatstroke rats through reducing the inflammatory and oxidative injury in lung tissue.

Daily dietary intakes of nitrate, nitrite and vitamin C were investigated in Chanle county, Fujian province, where gastric cancer was very common, with a marked geographic variation in mortality. The average daily intake of nitrate of residents in Zhanggang village (high risk area) was 132.75 mg, which was significantly higher than that (84.65 mg) in Shouzhan village (moderate risk area), but similar to that (113.12 mg) in Meihua village (low risk area). However, nitrite intake in Zhanggang village was greatly higher than that in Shouzhan and Meihua villages (3.36 mg vs 0.21 and 0.37 mg, respectively). The average daily intake of vitamin C in Shouzhan village was 56.37 mg, significantly lower than that in Zhanggang village (123.09 mg) and in Meihua village (105.90 mg). The molar ratio of vitamin C intake to nitrite in the three villages was 3.22, 3.30 and 4.33, respectively. It was invesely associated with the mortality of gastric cancer. The results suggested that nitrate and nitrite might be etiological factors of gastric cancer in the county.

ObjectiveTo observe the effect of Xuebijing injection pretreatment on systemic inflammatory response induced by severe heat-stroke, and to investigate the mechanism of alleviation of intestinal injury in rats. Methods Thirty-six healthy adult male Wistar rats with grade SPF were randomly assigned into three groups with randomized number method, namely sham group, severe heat-stroke model group, and Xuebijing pretreatment group (XBJ group), with 12 rats in each group. The animals were placed in a pre-warm chamber [temperature (40±2)℃, humidity (65±5)%] in order to induce typical heat-stroke. The duration of heat-stress was 60 minutes, while the animals in sham group were exposed to ambient temperature of 25℃. Arterial blood samples were collected at the beginning and the end of heat-stress, the concentrations of tumor necrosis factor-α(TNF-α), interleukins (IL-1β, IL-6), and lipopolysaccharide (LPS) in peripheral blood were determined by enzyme linked immunosorbent assay (ELISA). The intestinal tissues were harvested after heat-stress, and the pathological changes in intestine tissues were observed after hematoxylin-eosin (HE) staining and under optical microscope. The pathological injury scores were calculated. Immunohistochemistry was performed to determine inducible nitric oxide synthase (iNOS) expression in intestinal tissue. Apoptosis was determined by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining. Western Blot was used to measure the tight junction protein occludin expression.Results The concentrations of TNF-α, IL-1β, IL-6 and LPS in blood of the rats after heat-stress in model group were significantly higher than those of sham group [TNF-α (μg/L): 443.00±110.10 vs. 98.36±44.61, IL-1β (μg/L): 436.37±163.64 vs. 64.24±16.15, IL-6 (μg/L): 342.70±92.42 vs. 54.40±13.22, LPS (μg/L): 0.68±0.22 vs. 0.09±0.02, allP< 0.01], but the levels of these parameters in XBJ group were significantly lower than those of model group [TNF-α (μg/L):340.45±68.57 vs. 443.00±110.10, IL-1β (μg/L): 191.33±82.78 vs. 436.37±163.64, IL-6 (μg/L): 192.21±37.89 vs. 342.70±92.42, LPS (μg/L): 0.43±0.17 vs. 0.68±0.22, allP< 0.01]. Infiltration of inflammatory cells, necrosis and hemorrhage in intestinal mucosa were found in the intestine of heat-stroke animals in model group. The pathological lesions in XBJ group were milder than those of model group, with a decreased pathological injury score compared with model group (2.10±1.15 vs. 3.20±0.67,P< 0.01). The expression of iNOS and apoptosis of cells in intestinal tissue in model group were increased compared with that of sham group, but they were significantly less marked in XBJ group compared with model group [iNOS (adjustedA value): 0.32±0.15 vs. 0.74±0.17, apoptotic index: 0.23±0.08 vs. 0.56±0.07, bothP< 0.01]. The order of expression for occludin protein from high to low was sham group, XBJ group and model group (A value was 0.96±0.25, 0.62±0.20, 0.33±0.11, respectively). Furthermore, there was significant difference in the expression of occludin protein between model group and both XBJ group and sham group (bothP<0.01).Conclusions Xuebijing injection alleviates inflammation and endotoxemia produced by severe heat-stroke in rats. The mechanism may be related to amelioration of oxidative injury, apoptosis, and dysfunction of tight junction protein occludin expression.

Objective This study was aimed at investigating the ability of temporal gap detection (TGD) in listeners with auditory neuropathy spectrum disorder (ANSD ) .Methods The temporal gap detection thresholds were measured for subjects using a TGD program developed by University of California ,Irvine .Three groups of subjects were recruited in this study ,including 12 subjects with normal hearing ,12 subjects with sensorineural hearing loss (SNHL) ,and 15 subjects with ANSD .The differences of TGD thresholds among the three groups of subjects were analyzed using a one - sample ANOVA method .Results No significant difference of the TGD thresh‐old was observed between two ears for all the subjects .The mean and standard deviation of the gap - detection threshold for both ears was about 3 .9 ± 1 .1 ms ,3 .6 ± 1 .1 ms ,and 13 .7 ± 9 .9 ms for normal - hearing subjects , subjects with SNHL ,and subjects with ANSD ,respectively .The TGD threshold in subjects with ANSD was sig‐nificantly higher than those of in normal hearing group (P< 0 .01) and SNHL group (P< 0 .01) ,while no signifi‐cant difference was found in TGD thresholds between normal - hearing subjects and subjects with SNHL .Conclusion For listeners with auditory neuropathy spectrum disorder ,their ability to resolve temporal information was de‐graded with a large individual variability .

Objective To investigate the effect ofulinastatin on severe heat-stroke with acute lung injury induced by severe heat stroke.Methods Thirty severe heat stroke patients were divided into conventional group (n=15) and ulinastatin group (n=15) randomly,with another 80 healthy adults serving as controls.The baseline data such as age,gender,onset period and APACHE Ⅱ scores were recorded and compared between the two groups on admission.Peripheral leucocyte counts,oxygenation index and Murray scores were determined on the 1st,3rd and 5th day.The concentration of inflammatory mediators in bronchoalveolar lavage fluid (BALF) and alveolar macrophage supernatant were detected by enzyme-linked immunosorbent assay (ELISA).Western blotting and real-time PCR were used to measure expression of triggering receptor-1 on myeloid cells (TREM-1) on alveolar macrophages.Furthermore,comparison was made in terms of the ventilation period,ICU stay time and mortality in 28 days between the two groups.Results No differences were found in age,gender,onset period and APACHE Ⅱ scores between the two groups (P＞0.05).Compared with the conventional group,peripheral leucocyte counts and Murray scores in the ulinastatin group significantly decreased on the 3rd and 5th day (P＜0.05,P＜0.01).But oxygenation index was higher in the ulinastatin group than in the conventional group (P＜0.05).The concentration of TNF-α and IL-6 in BALF was lower in the ulinastatin group than in the conventional group (on the 3rd day:P＜0.05,P＜0.01;on the 5th day:P＜0.01,P＜0.01).The concentration of TNF-α and IL-6 in alveolar macrophage supernatant was lower in the ulinastatin group than in the conventional group (on the 3rd day:-P＜0.05,P＜0.01;on the 5th day:P＜0.01,P＜0.05).The expression of TREM-1 protein on alveolar macrophages were lower in the ulinastatin group than in the conventional group (on the 3rd day P＜0.01;on the 5rd day P＜0.05).TREM-1 mRNA was lower in the ulinastatin group than in the conventional group (on the 3rd day:P＜0.05;on the 5th day:P＜0.05).Eventually,the treatment of ulinastatin shorten ventilation period and ICU stay time (P＜0.01,P＜0.05).Nonetheless,it failed to show any improvement in terms of the mortality during 28 days (P＞0.05).Conclusion Our study exhibited that ulinastatin had good effect on the heat stroke patients with acute lung injury and it helped reduce the inflammatory reaction of pulmonary tissues.The underlying mechanism of these effects might lie in its ability to reduce heat stroke-induced inflammatory secretion and expression of TREM-1 on alveolar macrophage.

OBJECTIVE: This study was aimed at investigating the ability of lexical tone perception in listeners with sensorineural hearing impairment and auditory. neuropathy spectrum disorder. METHOD: Three groups of subjects were recruited in this study, including 11 subjects with normal hearing, 14 subjects with sensorineural hearing impairment, and 25 subjects with auditory neuropathy spectrum disorder. Ten monosyllabic syllables were selected, and combined with four lexical tones which were made up of 40 tone tokens as the original test materials. Then, these original words were recorded using one adult male and one adult female native Beijing Mandarin speaker. The speakers were asked to record these 40 monosyllabic words multiple times, and the 80 tokens in which the durations of four tones in each monosyllabic word were within 5ms precision were chosen as the test tone tokens. The subjects were asked to perform a four-alternative forced-choice study and select which tone they had heard. RESULT: The mean and standard deviation of the tone perception correct scores for normal-hearing subjects, subjects with sensorineural hearing impairment, and subjects with auditory neuropathy spectrum disorder were (97.3 ± 2.8)%, (88.0 ± 9.9)%, and (65.7 ± 17.1)%, respectively. Significant differences in tone perception scores were found to be between subjects with normal hearing and subjects with sensorineural hearing impairment (P < 0.01) and between subjects with auditory neuropathy spectrum disorder (P < 0.01). In addition, a significant difference was found to be between subjects with sensorineural hearing impairment and auditory neuropathy spectrum disorder (P < 0.05). A significantly negative correlation was observed between tone perception score and pure tone hearing thresholds for both subjects with sensorineural hearing loss (r = -0.756, P < 0.01) and subjects with auditory neuropathy spectrum disorder (r = -0.546, P < 0.01). CONCLUSION As the hearing loss became more severe, the ability to perceive lexical tone for both subjects with sensorineural hearing loss and auditory neuropathy spectrum disorder reduced. Subjects with auditory neuropathy spectrum disorder had more degraded ability to perceive lexical tone and a larger individual difference, in comparison with subjects with sensorineural hearing loss.
Adult ; Audiometry, Pure-Tone ; Case-Control Studies ; Female ; Hearing ; Hearing Loss, Central ; physiopathology ; Hearing Loss, Sensorineural ; physiopathology ; Humans ; Language ; Male ; Speech Perception

OBJECTIVE: The present study was aimed to assess the ability of tone recognition performance for postlingually deafed cochlear implanted adults using no-duration tone test materials. METHOD: Sixteen cochlear implanted users have used their devices at least six months. Ten monosyllabic syllables were selected, and combined with four lexical tones which were made up of 40 tone tokens. Then, these original words were recorded using one adult male and one adult female native Beijing Mandarin speaker. The speakers were asked to record these 40 monosyllabic words multiple times, and the 80 tokens in which the durations of four tones in each monosyllabic word were within 5 ms precision were chosen as the original tone tokens. The subjects were asked to perform a four alternative forced-choice study and select the tone they had heard. RESULT: The mean score of lexical tone perception tasks for 16 cochlear implanted users is (70.7 ± 22.0)%, and Tone 4 was the easiest to perceive, while Tone 2 was the hardest for cochlear implanted subjects to perceive. Tone 1 was more often misperceived as Tone 2 relative to other tones. Tone 2 was more often misperceived as Tone 1 and 3. Tone 3 was more often misperceived as Tone 2. The tone perception performance was positively correlated with duration of hearing aid use. CONCLUSION Duration cues may impact on the ability of tone recognition performance for cochlear implant subjects, especially for tone 3. Due to the limited ability for cochlear implant subjects on pitch perception, tone l and tone 2, and tone 2 and tone 3 are most often confused with each other without duration cues. The experience of hearing aid use may benefit for postlingual deafness cochlear implant recipients on tone perception performance.
Adult ; Asian Continental Ancestry Group ; Cochlear Implantation ; Cochlear Implants ; Female ; Hearing ; Hearing Aids ; Humans ; Language ; Male ; Pitch Perception ; Speech Perception ; Tongue