Objective To investigate and analyze the effect and insulin dosage of continuous subcutaneous insulin infusion(CSII) in type 2 diabetes.Methods 106 hospitalized patients with type 2 diabetes,who had poorly controlled blood glucose,were treated by insulin pump for 8 days,without oral hypoglycemic agents.The treatment days when blood glucose was well controlled and the insulin dosage at that time were observed.The related foctors for the therapeutic effects were analyzed.Results When blood glucose were well controlled,the mean time was 5.4±1.8 days,the(basal) insulin was 0.23±0.07(u/kg,day),the bolus before breakfest was 0.12±0.05(u/kg),the bolus before dinner was 0.14±0.06(u/kg),the bolus before supper was 0.14±0.06(u/kg).The dosage of insulin was decreased after blood glucose were well controlled.The frequency of hypoglycemia was 0.04±0.21(times/per patient),the frequency of biochemical hypoglycemia was 0.07±0.25(times/per patient) and reaction of hypoglycemia was 0.96±1.18(times/per patient).Conclusions The hyperglycemia of type 2 diabetes could be corrected by intensive insulin pump within 5-6 days.Multiple regression showed that fasting blood glucose and age were the factors that affect the time for blood glucose to be targeted.Duration of diabetes,fasting and postprandial blood glucose levels before treatment affect the required insulin dosage.

OBJECTIVE:To establish a method for quick content determination of clobetasol propionate in temeifu pigmentum.METHODS:UV spectrophotometry was used,and the determination was performed at the wavelength of 240nm.RES-ULTS:The detectable concentration of clobetasol propionate have a good linear relationship with its absorbability in the range of 12～18?g/ml.The inter-day and intra-day average recoveries were 99.87%(RSD=1.21%) and 99.79%(RSD=1.01%),respectively.CONCLUSIONS:The present method is rapid and accurate,which can be widely used in small hospitals not equipped with high performance liquid chromatography.

OBJECTIVETo compare the difference in the efficacy between acupuncture and oral administration of trazodone and the expressions of neurotransmitters in patients of insomnia differentiated as liver stagnation transforming into fire.

METHODSSeventy patients of insomnia differentiated as liver stagnation transforming into fire were randomized into an observation group and a control group, 35 cases in each one. In the observation group, acupuncture therapy was adopted at Shenmen (HT 7), Baihui (GV 20), Yintang (GV 29), Hegu (LI 4), Taichong (LR 3), etc. The needles were retained for 20 min each time. The treatment was given once a day, the treatment of 2 weeks made one session. In the control group, trazodone, 100 mg, oral administration, once a day, the treatment of 2 weeks made one session. Two sessions were required in the two groups. The scores in Pittsburgh sleep quality index (PSQI) and Asberg rating scale for side effects (SERS), the levels of neurotransmitters such as 5-hydroxy tryptamine (5-HT) and norepinephrine (NE) and the expressions of protein kinase C (PKC) and brain-derived neurotrophic factor (BDNF) in peripheral blood were observed before and after treatment in the two groups.

RESULTSPSQI score and SERS score after treatment were all decreased compared with those in both groups before treatment (both P<0. 05). After treatment, PSQI score and SERS score in the observation group were lower apparently than those in the control group (both P<0. 05). After treatment NE content and PKC level were decreased; 5-HT content and BDNF mRNA were increased compared with those in both groups before treatment (all P<0. 05). NE content and PKC level in the observation group were lower apparently than those in the control group (both P<0. 05). The serum 5-HT content and BDNF mRNA expression in the observation group were higher than those in the control group separately (both P<0. 05).

CONCLUSIONAcupuncture therapy improves the sleeping quality of patients of insomnia differentiated as liver stagnation transforming into fire, and reduces serum NE level and increases 5-HT content and BDNF expression, which achieves the better efficacy as compared with the oral administration of trazodone. It is one of the effective approaches to the treatment of insomnia differentiated as liver stagnation transforming into fire.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Brain-Derived Neurotrophic Factor ; genetics ; metabolism ; Female ; Humans ; Liver ; physiopathology ; Male ; Neurotransmitter Agents ; genetics ; metabolism ; Norepinephrine ; genetics ; metabolism ; Serotonin ; metabolism ; Sleep Initiation and Maintenance Disorders ; genetics ; metabolism ; physiopathology ; therapy ; Treatment Outcome

ObjectiveTo explore the value of acupuncture in treating insomnia due to stagnated liverqi transforming into fire and its theoretical foundation, by observing the treatment effect of acupuncture in treating insomnia due to stagnated liverqi transforming into fire and its influence on 5-hydroxy tryptamine (5-HT) content.MethodTotally 187patients with insomnia due to stagnated liver qi transforming into fire were selected and randomized into two groups. The 93 cases in the control group were intervened by orally taking Trazodone, 100 mg for each dose, twice a day, 10 d as a course, totallyfor 2 courses; the 94 cases in the observation group were intervened by acupuncture at Shenmen (HT7), Baihui (GV20), Yintang (GV29), Hegu (LI 4), and Taichong (LR 3), once a day, 10 d as a treatment course, totally for 2 courses. Peripheral blood was collected from the two groups before and after intervention to detect the change of 5-HT content. Meanwhile, the Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Scale (HAMD, 24-item version), Asberg Rating Scale for Side Effects (SERS), and clinicalefficacies were assessed.ResultThe difference in 5-HT content between the two groups was statistically insignificant before intervention (P>0.05); 5-HT contents were significantly increased in both groups after intervention (P<0.05), while the content in the observation group was markedly higher than that in the control group (P<0.05); after treatment, the PSQI and HAMD scores were decreasedin both groups (P<0.05), while the PSQI, HAMD, and SERS scores in the observation group were markedly lower than those in the control group (P<0.05);the total effective rate was 92.6% in the observation group, significantly higher than 81,7% in the control group (P<0.05). ConclusionAcupuncture can significantly down-regulate 5-HT content in insomnia patients, and its total effective rate is higher than that of medication.

Objective To investigate the effects of metabolic syndrome (MS) and the cardiocerebrovascular risk factors such as essential hypertension (EH), diabetes mellitus (DM), and lipid metabolise disturbance on the subtypes of acute cerebrovascular disease (ACVD). Methods A total of 502 ACVD patients were studied, including 121 cases of intracerebral hemorrhage (ICH) and 381 cases of cerebral infarct (CI). The effects of MS, EH, DM, and blood lipids on the subtypes of ACVD were analyzed. Results The ratio of all subtypes of ACVD combined with EH was significantly higher than that of the control group ( P 0.05). Additionally, the concentration of total cholesterol in the ischemic group was significantly lower than that in the control group ( P

Objective To evaluate body surface localization by virtue of lnnova CT reconstruction combined with DSA guidance in performing percutaneous fine needle biopsy of lung lesions. Methods Twenty-one patients with solid lung lesions were enrolled in this study. Before percutaneous lung needle biopsy, DSA rotation scanning was performed. Based on the reconstructed lnnova CT images, precise puncture scheme was formulated. Then, under DSA guidance, pereutaneous fine needle biopsy of lung lesions was carried out. Results A total of 41 percutaneous fine needle biopsies was made, of which definite pathologic diagnosis was obtained in 40, with a positive rate of 97.6%. Pneumothorax occurred in one patient (4.8%). Conclusion Percutaneous lung needle biopsy with the help of body surface localization, which is determined by Innova CT reconstruction images, and DSA guidance is a safe and technically-simple procedure with high accuracy in localization. It is of great value in the diagnosis of pulmonary space-occupying lesions.

Abdominal Neoplasms ; genetics ; metabolism ; pathology ; Chromosomes, Human, Pair 20 ; genetics ; Chromosomes, Human, Pair 8 ; genetics ; Fibromatosis, Aggressive ; etiology ; genetics ; metabolism ; pathology ; Genes, APC ; Humans ; Mutation ; Trisomy ; beta Catenin ; genetics ; metabolism

Objective To evaluate the technical method,clinical effect,safety and complication of the endovascular interventional therapy of intracranial A1 segment aneurysms of anterior cerebral artery(ACA).Methods The data of 14 cases with ruptured A1 segment aneurysms received interventional therapy were analyzed retrospectively.All patients were admitted with subarachnoid hem-orrhage (SAH)and classified by Hunt-Hess scale.There were 3 cases of Grade Ⅰ,5 cases of Grade Ⅱ,and 6 cases of Grade Ⅲ. One of fourteen patients was treated by stent implantation alone and 10 patients were treated by coiling alone.The other 3 patients were treated by stent-assisted coiling.Results All the cases were embolized successfully and cured.Angiography immediately after procedure showed Raymond Ⅰ in 1 1 patients,RaymondⅡ in 2 patients and Raymond Ⅲ in 1 patient.In one patient a coil loop was partly left in the parent artery.All of them showed excellent outcome without any serious complication except that one patient suf-fered transient left hemiparesis.Conclusion Endovascular interventional therapy is a safe,effective method in the treatment of the intracranial A1 segment ACA aneurysms.

OBJECTIVE To explore the resistance of Pseudomonas aeruginosa isolated in clinic against five antiseptics involving in povidone iodine(Iodophor),glutaraldehyde,chlorhexidine,symclosene(trichloroisocyanurate) and benzalkonium bromide.METHODS The susceptibility test of P.aeruginosa was determined by PhoenixTM-100 system.Minimun inhibitory concentration(MIC) of povidone iodine,glutaraldehyde,chlorhexidine,symclosene and benzalkonium bromide was detected by liquid dilution method.RESULTS The resistant rates of ampicillin/sulbactam,chloramphenicol,tetracycline and trimethoprim-sulfamethoxazole in 190 isolates of P.aeruginosa were all more than 98.0%.However,P.aeruginosa was to imipenem and meropenem were 15.3% and 6.8%.It was found that P.aeruginosa possessed the most resistant to glutaraldehyde and symclosene with its MIC50 being 32 ?g/ml and 64 ?g/ml.But the MIC50 of chlorhexidine and benzalkonium bromide were only 1 ?g/ml and 2.4 ?g/ml.Meanwhile,time-kill assays indicated that chlorhexidine could still produce rapid and powerful bactericidal effects at a concentration of 1MIC after 10 min treatment.CONCLUSIONS There are distinct differences in P.aeruginosa against povidone iodine,glutaraldehyde,chlorhexidine,symclosene and benzalkonium bromide.It is very important that antiseptics should be used rationally.Measurements should be taken to decrease dissemination of resistant bacteria and prevent nosocomial infection.

Objective To investigate the effect of dexmedetomidine on minimum alveolar concentration (MAC) of isoflurane required to inhibit the body movement during skin incision. Methods Forty-eight ASA Ⅰ or Ⅱ patients aged 40-60 yr with body mass index of 22-27 kg/m2 undergoing elective upper abdominal surgery under general anesthesia were randomly divided into 3 groups: control group (group C, n = 15);low dose dexmedetomidine group (group D1, n = 17) and high dose dexmedetomidine group (group D2, n = 16). The patients were unpremedicated. Dexmedetomidine 0.4 and 0.8 μg/kg in normal saline (NS) 15 ml was infused over 15 min before induction of anesthesia in D1 and D2 groups respectively. Anesthesia was induced with fentanyl-propofol-succinylcholine. The patients were mechanically ventilated after tracheal intubation. Anesthesia was maintained with isoflurane. MAC of isoflurane was determined by up-and-down technique. The initial end-tidal isofiurane concentration was set at 1.0%, 0.8% and 0.6% in C, D1 and D2 groups respectively. Each time the end-tidal isoflurane concentration was increased/decreased by 0.2%. Skin incision was made after 15 min of equilibration, when the twitch height returned to more than 90% of its control value. Movement of body and limbs including swallowing and coughing were carefully looked for when skin incision was made. MAC of isoflurane was the mean of end-tidal concentration of isoflurane of each crossover pair, and 95 % CI was calculated. Results MAC of isoflurane was significantly decreased in D1 and D2 groups as compared with group C and in group D2 as compared with group D1( P ＜ 0.05 or 0.01 ). Conclusion Dexmedetomidine can significantly decrease MAC of isoflurane required to inhibit the body movement during skin incision in a dose-dependent manner.