ObjectiveTo evaluate the impact of hyperglycemia in patients admitted to medical intensive care units(MICU)on their prognosis.MethodsMedical records of 1016 patients,including 126 cases of known diabetes,359 cases with newly diagnoses hyperglycemia,and 531 normoglycemic cases,admitted to MICU in Wuhan University People's Hospital during September 2006 to September 2007 were reviewed to compare their case-fatality,length of hospital stay,length of MICU stay,mechanical ventilation,blood transfusion and antibiotics use.ResultsIn.hospital case-fatality was 22.8%(82/359)in patients with newly-diagnosed hyperglycemia.significantly higher than that in patients with known diabetes of 12.7% (16/126)and in normoglyeemic cases of 5.1%(27/531)(P＜0.01),and that Was higher in those with diabetes than those with normal blood glucose level(P=0.002).Proportions of patients who needed mechanical ventilation,blood transfusion,antibiotics use was higher in newly diagnosed hyperglycemia group than those in the other two groups.ConclusionsHyperglycemia represents an important mal'ker of poor clinical outcomes and mortality in patients admitted tO MICU.Patients with newly diagnosed hyperglycemia had a significantly higher case-fatality and poorer outcomes than those with known diabetes or normoglyeemia.

Objective To evaluate the effect of comprehensive intervention measures on preventing and controlling surgical site infection (SSI)in patients undergoing total abdominal hysterectomy.Methods Patients undergoing total abdominal hysterectomy in a hospital between January 2011 and December 2014 were investigated retrospec-tively,patients in 2011 were as control group,from January 2012,a prospective monitoring on SSI was initiated, comprehensive intervention measures were taken,patients between January 2012 and December 2014 were as inter-vention group,SSI before and after the intervention was compared.Results A total of 1 052 patients undergoing to-tal abdominal hysterectomy were investigated,267 cases were monitored before intervention,25 patients (9.36%) developed healthcare-associated infection (HAI),12(4.49%)of whom were with SSI;785 cases were monitored af-ter intervention,13 (1 .66%)of whom were with SSI,incidence of SSI in 2012,2013,and 2014 were 2.31 %, 1 .89%,and 0.77% respectively,there was a decreasing tendency(χ2 =7.30,P <0.01 ).Conclusion Prospective monitoring on SSI and comprehensive intervention can reduce the incidence of SSI in patients undergoing total abdominal hysterectomy.

Aim To clarify the regulation role of ca-thepsin B ( Cat B ) in cell proliferation and apoptosis induced by SAHA in ER-positive breast cancer cell line MCF-7.Methods MTT was used to screen the optimal concentration and treatment time of SAHA . The expression levels of related proteins were deter-mined by ELISA , and the morphological changes were observed through time-lapse live cell imaging acquisi-tion.Cell viability and apoptosis assay in MCF-7 cells were assessed by Muse Cell Analyzer with SAHA and /or Cystatin C treatment .Results MTT assay showed that the anti-tumor efficacy of SAHA was significant . The optimal concentration and treatment time were 10μmol? L-1 and 24 h respectively . ELISA assay showed that SAHA could induce expression of Cat B in MCF-7 cells.Real-time live-cell imaging experiments demonstrated that the combination treatment of Cystatin C and SAHA significantly resumed the inhibitory effect caused by SAHA alone .Cytology test showed that SA-HA alone obviously depressed the cell viability and in-duced apoptosis . However , the effect was reversed with the combination of Cystatin C .Conclusion Cat B plays an important role in apoptosis induced by SAHA in ER +breast cancer cells MCF-7.

Objective To assess the effects of caffeine use in apnea of prematurity (AOP) in the early stage (caffeine was used within 3 days after birth) versus late stage (caffeine was used 4 to 10 days after birth ) . Methods Medline, Science Direct, Elsevier, Embase, CBMdisc and Wanfang databases were retrieved to incorporate studies that met the inclusion criteria. The retrieval time limit was from the establishment of the databases to November, 2015. References that were in line with the inclusion criteria were selected and relevant conference data were collected by manual retrieval. Two researchers conducted meta-analysis using software RevMan 5. 2 after independent data selection, information extraction and quality evaluation according to the inclusion and exclusion criteria. Results One randomized controlled trial and four retrospective cohort studies were included. A total of 59 288 patients were involved. Meta-analysis suggested that, compared with caffeine use in the late stage, the early stage group showed significant lower incidence ( P < 0. 05 ) of mortality, bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leukomalacia, retinopathy of prematurity and surgical intervention of patent ductus arteriosus. No significant difference (OR = 0. 98, 95% CI 0. 72 - 1. 33, P = 0. 881) was observed between the 2 groups in terms of the incidence of necrotic enterocolitis. Conclusions Patients with AOP should start caffeine treatment as early as possible, which significantly decreases mortality rate and the occurrence of other complications with little adverse reactions and good clinical tolerance.

0.05).There were significant differences between group B and C pre and postoperatively(P

Objective To investigate the relation of the expressions of matrix metalloproteinase-2(MMP-2)and-9(MMP-9)with polymyositis/dermatomyositis(PM/DM).Methods Blood samples were obtained from 8 patients with PM,12 patients with DM and 10 normal human controls.Real-time quantitative RT-PCR and Western-blot were applied to examine the mRNA and protein expressions of MMP-2 and MMP-9 respectively in the peripheral blood mononuclear cells(PBMC)of these patients.Results The mRNA expression levels of MMP-2 and MMP-9 in the PBMC of patients with PM or DM were 2.41 and 1.66 folds as high as those of the normal controls,respectively;these difierences were significant between the two groups.Increased expressions of MMP-2 and MMP-9 were also noted in the patients with PM or DM.Conclusion MMP-2 and MMP-9 may play a part in the development of polymyositis and dermatomyositis.

Objective To evaluate the association between stress hyperglycemia and clinical out-comes among patients with and without diabetes mellitns admitted to medical intensive care unit (MICU).Methods We reviewed the medical ICU records of 1016 consecutive patients admitted to Wu Han Univer-sity Ren Min Hospital. According to admission glucose level, 126 patients with debates and 890 patients without known debates were divided into group 1 ( <6 mmol/L), group 2(6 ～ 8mmol/L), group 3(8 ～10mmol/L), and group 4( > 10mmol/L). The primary end point of the study was in-hospital mortality. Secondary end points included length of hospital stay, length of ICU stay, the ratio of mechanical ventila-tion, blood transfusions, antibiotics and blood glucose treatment. Results The hospital mortality among patients without a history of diabetes mellitus was 4. 7%, 12. 1%, 20. 5%, 30. 3% in group 1, 2, 3, 4,respectively. The ratio of mechanical ventilation, blood transfusions, and antibiotics increased progressively as glucose values increased. Conclusions Hyperglycemia was a common disease, and it may be an impor-tant marker of poor clinical outcome and mortality in patients without history of diabetes.

Objective To compare the clinical efficacy between reformed laparoscopic-assisted vaginal hysterectomy with sutureless of cardinal and uterosacral ligament(LAVH)and trans abdominal hysterectomy(TAH)for large uterus.Methods A retrospective study was performed using 106 reformed LAVH patients(observation group)and 100 TAH patients(control group)whose uterus were big(≥ 12weeks of gestation),the information was observed in perioperative period.Results Anal exsufflation time,hospitalization time after operation and postoperative pain time in observation group[(25.4 ± 3.3)h,(6.5 ±1.5)d,(16.9 ± 2.4)h]were significantly shorter than those in control group[(42.4 ± 5.3)h,(8.5 ± 1.5)d,(30.6 ± 5.3)h](P ＜ 0.05),the rate of complication in observation group[5.7％(6/106)]waa lower than that in control group[10.0％(10/100)](P＜ 0.05).Conclusion As to large uterus,reformed LAVH has several advantages over TAH,the technique is easy to learn,operation time is short,and the rate of complication is low.

Objective To observe the regulatory effects of the preventive acupuncture and moxibustion at Guanyuan (RN4) points in ovariectomized rats, and discuss the mechanism of preventive acupuncture and moxibustion on hyoathalamus-pituitary-ovary (HPO) axis. Methods Totally 48 female SD rats were divided into 5 groups, including normal group, sham operation group, ovariectomized rats group, preventive acupuncture group and preventive moxibustion group. Except normal group and sham operation group, rats were ovariectomized after preventive acupuncture and preventive moxibustion for 30 d in corresponding groups. ELISA was used to determine the levels of E2, ER, GnRH, FSH and LH in the tissues including hypophysis, hypothalamus and uterus. Results Compared with the normal group, E2, ER and GnRH level in the tissue of the model group was significantly lower (P<0.01), the levels of FSH and LH increased obviously (P<0.01). Compared with the model group, E2, ER and GnRH level of preventive acupuncture group and preventive moxibustion group increased in different degree (P<0.05). FSH and LH level reduced in different degree (P <0.05). There was no obvious difference between preventive acupuncture and preventive moxibustion group (P>0.05). Conclusions The preventive acupuncture and preventive moxibustion at Guanyuan (RN4) has benign modulation to disordered HPO axis of ovariectomized rats. The ability of preventive acupuncture and preventive moxibustion are almost the same.

BACKGROUND: In subjects with different inflammatory and autoimmune diseases, soluble vascular cell adhesion molecule-1 (sVCAM-1) in sera increases, and its change may become an important monitoring index of immunological function, but its change rule has been unclear in acute cerebral infarction.OBJECTIVE: To observe the change of sVCAM-1 in sera of subjects with cerebral infarction and its clinical significance, and compare between the subjects with cerebral hemorrhage and normal population.DESIGN: A case controlled analysis.SETTING: Second Department of Brain, Research Institute of Surgery,Daping Hospital, Third Military Medical University of Chinese PLA.PARTICIPANTS: A total of 132 inpatients were selected from Second Department of Brain, Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA between May 2002 and April 2004. Among them, 89 subjects with cerebral infarction were classified into large infarction group (n=25,＞ 10 cm3), medium infarction group (n=31,4-10 cm3) and small infarction group (n=33, ＜ 4 cm3) respectively according to the size of infarct focus. There were 43 subjects in cerebral hemorrhage group, and 30 healthy persons were as normal control group.METHODS: Blood samples were isolated from subjects with cerebral infarction at hour 24, days 3, 7 and 14 after onset of the disease, while the blood samples were extracted from subjects with cerebral hemorrhage at hour24 and day 14 after the onset of the disease. 4 mL venous blood was obtained from the three groups. The serum concentration of sVCAM-1 was determined with double antibody sandwich method (DASM) in all the examinees.MAIN OUTCOME MEASURES: ①Dynamic change of the serum concentration of sVCAM-1 in the course of acute cerebral infarction, and compared with the other two groups. ②Comparison of the serum concentration of sVCAM-1 in different size of infarct focus. ③Change of the serum concentration of sVCAM-1 in acute cerebral infarction subjects complicated with infection.RESULTS: A total of 162 subjects were involved in the result analysis. ①The serum concentration of sVCAM-1 at the 24th hour after cerebral infarction was significantly higher in subjects with cerebral infarction than in subjects with cerebral hemorrhage group and normal control group [(1 184.5±68.3) ,(693.9±41.7), (576.1±39.8) μg/L,P＜0.01].Serum sVCAM-1 in the cerebral infarction subjects increased from the 24th hour to the 7th day after infarction gradually, while from the 7th day to the 14th day decreased gradually. However, the serum sVCAM-1 in the cerebral infarction subjects at day 14 was still markedly higher than that in the cerebral hemorrhage group and the normal control group (P ＜ 0.01 ). ②The serum concentration of sVCAM-1 was significantly higher in the large cerebral infarction group as compared with medium and small cerebral infarction groups [(1 217.4±59.3) ,(1 132.6±51.9) ,(983.7±54.2) μg/L,P ＜ 0.01]. ③The serum concentration of sVCAM-1 was significantly higher at days 3, 7and 14 in cerebral infarction subjects complicated with infection than in subjects without infection (P ＜ 0.01 ).CONCLUSION: The sVCAM-1 participates pathological change process of cerebral infarction, which can be regarded as monitoring index of cerebral infarction change. To block its production and expression can provide a new approach for improving the prognosis of cerebral infarction.