Objectives: This prospective,randomized and controlled clinical trial was designed to investigate the effect of short course intensive insulin therapy(SCIIT) on stress-induced hyperglycemia and outcomes in critically ill patient. Methods:The diabetes or other illness which directly influenced blood glucose were excluded and the critically ill patients was maintained with normoglycemia((4.4-6.1) mmol/L) in the first seven days by intensive insulin therapy.After the first seven days,these patients was treated like conventional insulin treatment group.Conventional insulin treatment group was maintained with blood glucose at a level between 3.9-10 mmol/L.Results: Of 41 patients enrolled in the study,30 patients were eligible for analysis.After intervention stopped,blood glucose level in intensive insulin treatment group(5.92?1.24 mmol/L) was lower than in conventional insulin treatment group((9.22?)2.51 mmol/L).And in the same time,insulin consumptions in SCIIT group was lower than in conventional insulin treatment group.There was no significant difference in ICU mortality between two groups,although decreasing trend favored to treatment group. Conclusion: In critical ill patient,(SCIIT) can achieve similar blood glucose range when compared with the plan of IIT.The benefit of improving morbidity and mortality could be expected in large sample RCTs.

OBJECTIVETo explore the neuro-protective effect and mechanism of qingkailing injection (QKL) against cerebral injury caused by E. coli-meningitis (CM).

METHODSThe CM model rabbits were treated by ampicillin with QKL as adjuvant. The leukocyte count and protein content in cerebral spinal fluid (CSF), the contents of water, sodium, potassium and calcium in cerebral tissues were measured before, 16 h and 26 h after Bacillus coli injection respectively. The expression of matrix metalloproteinase-9 (MMP-9) was determined at the same time.

RESULTSAdjunctive treatment with QKL can not only inhibit the increase of leukocyte cells, protein content in CSF, and water, sodium, calcium content in cerebral tissues, but also the decrease of potassium content revealed during simple antibiotic treatment. It also can decrease the expression of MMP-9 in cerebral tissues of rabbits with CM.

CONCLUSIONAs an adjunctive treatment, QKL can prevent transient inflammatory reaction and aggravation of brain injury in CM induced by simple antibiotic treatment, its mechanisms might relate with calcium antagonism and attenuation of MMP-9 expression in brain tissues.

Ampicillin ; therapeutic use ; Animals ; Anti-Bacterial Agents ; therapeutic use ; Brain ; metabolism ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Injections ; Male ; Matrix Metalloproteinase 9 ; biosynthesis ; Meningitis, Escherichia coli ; drug therapy ; Neuroprotective Agents ; therapeutic use ; Phytotherapy ; Rabbits