The management of hyperglycemia in the intensive care unit(ICU)patients has been concerned in recent years.Epidemiological data show that the occurrence of severe hyperglycemia is associated with increased mortality and morbidity in ICU patients.Several large scale trials about intensive glycemic control in the critically ill patients were carried out,but reached disparate conclusions.Based on the latest clinical research evidences,the optimal target range of blood glucose Level in ICU patients seems to be 7.8-10 mmol/L.However,the target should be individualized in clinical practice.Both hyperglycemia and hypoglycemia should be carefully avoided.

Action for Health in Diabetes( Look AHEAD) trial showed that an intensive lifestyle intervention focusing on weight loss did not reduce the rate of cardiovascular events in overweight or obese adult patients with type 2 diabetes. However, the intensive lifestyle intervention improved the control levels of the risk factors for cardiovascular disease, attenuated the obesity-associated comorbidities, and improved the quality of life in these patients.

Objective To compare the learning motivation of Tibetan college students with that of Han college students,and compare the learning motivation of Tibetan and Han students with different majors and genders.Methods Learning motivation questionnaire for university students were used,and 172 Tibetan students and 156 Han students participated in the study,while their general population information were collected at the same time.Results Learning motivation for both Tibetan and Han students was above the average level.Tibetan students scored ((3.97±0.52),(3.47±0.58),(3.49±0.50),(3.23±0.58),(3.37±0.50)) significantly higher than those of Han students ((3.83±0.56),(3.15±0.71),(3.37±0.50),(2.99±0.65),(3.20±0.53),P＜ 0.05) in hankering for capability,tendency of altruism,intrinsic motivation,extrinsic motivation and total motivation score.Tibetan boys ' score in altruistic orientation (3.48±0.54) was much higher than that of girls(3.45±0.61,P＜0.05).For Tibetan students,those who majored in liberal arts scored much more in all items than those who majored in science (P＜ 0.05).For Han students,there was no significant difference in the scores of boys' and girls'(P＞0.05).For those Han students who majored in liberal arts,their scores in hankering for capability,tendency of altruism and intrinsic motivation((3.17±0.49),(3.32±0.73),(3.47±0.46))were significantly higher than those who majored in science((2.91±0.56),(2.98±0.65),(3.28±0.52),P＜0.05).Conclusions (1)The Tibetan students showed stronger motivation than Han students.(2) Gender plays a different role in the learning motivation of Tibetan and Han students,that is,compared with the Tibetan girls,Tibetan boys have stronger motivation in altruistic orientation.For Han students,there is no significant difference between male and female students' learning motivation.(3) Tibetan and Han students from different majors show the same trend in learning motivation,that is,for both the Han students and Tibetan students,liberal arts students' learning motivation is higher than that of the science students.

Standards of Medical Care in Diabetes released by American Diabetes Association (ADA) is one of the most important guidelines for clinicians. Based on the latest evidence of clinical studies,the Standards of Medical Care in Diabetes is annually updated by ADA. The statement of ADA on diagnosis,assessment and management in diabetes are recommended for clinicians,patients and researchers. The latest edition of Standards of Medical Care in Diabetes was published as supplement form on Diabetes Care in January 2017. This interpretation will focus on the updated contents and their best evidence and clinical importance in this guideline.

Based on analysis of the relationship between depression and seven emotions,etiopathogenisis and pathogenesis of depression,the relationship between depression and stagnation of liver qi,it showed that depression had highly correlation with sorrow,grief.The etiopathogenisis and pathogenesis of depression included body factor,exogenous pathogen,associated diseases,social psychic factor,etc.The essence of primary depression,endogenous depression and depressive emotion with dysthymia was deficient,and yang-deficinecy was the key pathologic basis.Exogenous evil was an indirect cause of depression.Because depressive emotion had connection with stagnation of liver qi at some extent,it should distinguish depression from stagnation of liver qi.

20 mg/L again.Children without treatment regulared exam for phe concentration level in blood and test for physical and mental capability development.Results Forty-eight children with PKU were diagnosed in 355 615 newborns who were collected from June 1999 to April 2005.The incidence rate of PKU was 1/7408,carriers with PKU gene was 1/48.There was no significant difference in physical and mental condition compared with that of normal children.Conclusions The treatment results for children with PKU is significant.It has good social and economic value.It is one of the important measures for reducing infant defect and improving population quality.

Objective: To design and prepare HBc virus-like particle vaccine (VLP) harboring the specified epitope of gastric inhibitory peptide (GIP), and to study its immune effects, so as to cast new lights on immune therapy of obesity. Methods: GIP cDNA was cloned and was fused with HBc VLP (1-144aa) cDNA. Through prokaryotic expression and purification processes, a GIP vaccine linked to the HBc-derived VLP carrier was constructed. We also cloned the fusion gene into eukaryotic vector pVAX1 to prepare GIP nuclear acid vaccine. And the two kinds of vaccines were tested in rats for their immunological parameters. Results: GIP vaccine linked to HBc-derived VLP carrier was successfully prepared. We also prepared the genetic vaccine pVAX1-HBc-GIP. The combined vaccination with both vaccines could obtain high titer and peptide-specific IgG antibody, displaying a satisfactory immunogenicity. Conclusion: GIP protein vaccine using HBc as immune-enhancing vaccine carrier can effectively induce GIP-specific humoral immunity, disrupting the tolerance to self antigens in rats. The vaccine is worth studying as a new drug for control of obesity.

Two Kinds of monoclonal antibodies (McAbs), Ft9 and Ft9t44, have been produced using the vaccine strain of Franciisela.tularensis as an antigen.The McAbs. Ft9 and Ft4,4, were isotyped to be IgG2b and IgM respectively Ft9 was found to be directed against outer membrane protein of F. tularensis, while Ft44 directed against lipopolysaccharide. The McAbs have been identified in detecting F. tularensis cells in an enzyme-linked immunosorbent assay. Ft9 was able to react with the bacterium in agglutination test and fluorescent antibody stain with no cross-reaction with other bacteria was found.

Objective To investigate the effect of hyperuricemia(HUA) on inflammation and endothelin-1 (ET-1) production and treatment of Benzbnomanone in hypertensive patients.Methods 90 initial hypertensive patients were enrolled from the inpatient division and clinic of our hospital,60 patients of them were identified HUA,and 30 patients were normal in uric acid as control.All these hypertensive patients with HUA were treated with basic anti-hypertensive drugs,of them 30 patients were additionally treated with Benzbromarone table 50mg for 8 weeks.The levels of inflammation indices and ET-1 were compared between these hypertensive patients with HUA and hypertensive patients with normal serum uric acid,also hypertensive patients with HUA treated with or without Benzbromarone for 8 weeks.Results Compared with the hypertensive patients with normal serum uric acid,levels of ET-1,interleukin-1 (IL-1) and high-sensitive C reactive protein (hsCRP) were higher in the hypertensive patients with HUA.Also,the levels of these indices were positively correlated with the level of serum uric acid [(86.6 ± 4.8) pg/ml vs (82.4 ±6.9)pg/ml; (47.6 ±6.2)mg/L vs (19.1 ±4.1) mg/L; (3.4 ±0.8)mg/L vs (2.9 ± 1.1)mg/L,r =0.81,0.74,0.83,all P ＜ 0.05].Benzbromarone could effectively decrease the levels of ET-1,IL-1and hsCRP in the hypertensive patients with HUA [(49.8 ± 5.0) pg/ml vs (87.5 ± 5.9) pg/ml ; (17.6 ±8.8) mg/L vs (48.2 ± 7.0) mg/L; (1.7 ± 0.7) mg/L vs (3.5 ± 0.9) mg/L,all P ＜ 0.05].Conclusions HUA could increase the levels of inflammation and ET-1,while Benzbromarone effectivelv decreased these changes.Decreasing the level of serum uric acid would retard the process of atherosclerosis in the hypertensive patients with HUA.

Objective To investigate the distribution of age and relationship of ESR with HCT.Methods The HCT,age and ESR datas of the patients which all ages were above 40 years were Collected,then count the mean and standard deviation x±s with different groups of HCT,t test was made to identify the significance of difference.Results HCT:The levels of hct in males was 0.47±0.26 in higher groups of HCT,0.39±0.27 in normal groups and 30.01 ±3.59 in lower groups.The levels of HCT in fe-males was 0.42±0.17 in higher groups,0.30±0.36 in normal groups,0.27±0.45 in lower groups;Age:The average age in males was 57.41±10.62 years in higher HCT groups of patients,67.23 ±12.75 in lower hct groups,there were significantly difference between them.The avarage age in females was 60.70 ± 11.60 in higher HCT groups of patients,61.60 ± 12.40 in lower HCT groups,there were no significantly difference between them.ESR:The levels of ESR in males was (3.95 ±3.26)mm/h in higher HCT groups,(61.61±40.04)mm/h in lower HCT groups;The ESR in females was (28.26±28.62)mm/h in higher HCT groups, (60.20±43.71)mm/h in lower HCT groups,there were significantly difference between different groups included both males and femals.Conclusion When the HCT were decreased,the age and ESR were increased in males,the ESR were also increased but had no relationship with ages in females.Conjuction the age and ESR,it could improve the prevention and monitoring in heart-brain blood disease through the HCT.