Objective To compare the clinical efficacy and safety of continuous subcutaneous insulin infusion (CSII) and multiple subcutaneous insulin injection (MSII) in elderly patients with severe type 2 diabetes.Methods Thirty-seven elderly patients with severe type 2 diabetes in the hospital intensive care unit (ICU) were divided into observation group (19 cases) and control group (18 cases) by random number table method.The observation group was treated with continuous subcutaneous insulin recombinant human insulin lispro injection,and control group was treated with recombinant human insulin lispro injection before meals and at bedtime routine insulin glargine subcutaneous injection.Two groups of patients and their families were given diabetes education.Changes in blood glucose,insulin dosage,blood glucose control standard time,rate of hypoglycemia and hospitalization time between 2 groups before and after treatment were compared.Results After treatment,fasting blood glucose in observation group was (7.2 ± 1.2) mmol/L,2 hour postprandial blood glucose was (9.4 ± 1.2) mmol/L,bedtime blood glucose was (9.4 ± 1.3) mmol/L; which in control group was (8.5 ± 3.0),(10.0 ± 2.4),(10.2 ± 2.4)mmol/L respectively.Fasting blood glucose,2 hour postprandial blood glucose and bedtime blood glucose significantly decreased after treatment in two groups,but there was significant difference between 2 groups (P ＜ 0.05).Blood glucose control standard time in observation group was (5.4 ± 2.5) d,insulin dosage was (43 ± 9) U/d,in control group was (12.8 ± 3.8) d,(55 ± 10) U/d respectively,and there was significant difference (P ＜ 0.05).Observation group had no hypoglycemia.Conclusion CSII for elderly patients with severe type 2 diabetes has better curative effect and security than MSII,and is more conducive to the control of blood glucose and the improvement of the condition.

Objective To study the expression and clinical significance of anty-apoptosis protein BAG-1 in non-small cell lung cancer(NSCLC),and its relationship with cell apoptosis and expression of Bcl-2 protein. Methods Immunohisto chemistry streptavidin-peroxidase conjugated (SP)method was used to examine the expression of BAG-1protein and Bcl-2 protein,and terminal deoxynucleotidyl transferase mediated UTP nick end labeling(TUNEL) method was used to examine the apoptosis index in 54 cases of NSCLC.The expression of BAG-1 protein in 20 cases of normal bronchus mucosa tissue also be detected as control. Results Express positive rate of BAG-1 protein in NSCLC is 74.07%,obviously higher than that in normal bronchus mucosa tissue(positive rate is 5%).In cases of NSCLC,the expression of BAG-1 protein has not correlation with the age,gender,pathologic classification,but have closed correlation with lymph node metastasis,degree of differentiation,pTNM stage(P

Objective To assess lipid status of pregnant women with GDM based on the lipid reference intervals for pregnant women .Methods Maternal blood and venous cord blood samples were collected in 81 well-controlled GDM mothers and 86 control subjects .The total cholesterol (CHOL) ,trigalloyl glycerol (TRIG) ,high-density lipoprotein cholesterol (HDL) ,low-density lipo-protein cholesterol (LDL) ,apolipoprotein A1 (ApoA) ,apolipoprotein B (ApoB) and lipoprotein (a) levels were measured by auto-matic biochemical analyzer .We used a normal pregnancy specific lipid reference interval (PSR) and normal non-pregnant reference intervals (NPR) respectively to assess the lipid status of pregnant women with GDM .Results Compared with normal control group ,the Apo A ,HDL and LDL levels in GDM group were significantly lower (P<0 .05) .The HDL ,LDL and Lp(a) levels of GDM cord blood were significantly lower (P<0 .05) .The weight of offspring birth of GDM pregnant women with low level HDL was significantly higher (P<0 .05) ,and that of GDM pregnant women with high level LDL offspring birth weight was significantly lower (P<0 .05) .Maternal HDL was not correlated with birth weight (r= -0 .190 ,P=0 .103) .Parent LDH and birth weight was negatively correlated (r= -0 .252 ,P=0 .029) .Conclusion The reference range of normal pregnancy-specific lipid we had estab-lished is more scientific for assessment of blood lipids .

ObjectiveStudy the effects of mitral valve replacement using video-assisted thorascoscopy compared with median sternotomy mitral valve replacement.MethodsBetween October 2003 and October 2011,72 cases suffer from mitral valve disease underwent video-assisted thorascoscopic mitral valve replacement,74 cases underwent median sternotomy procedure.CPB time,cross clamp time,ventilation time,drainage,ICU stay time and hospital stay time of the two groups were compared.Results It was longer that CPB time and cross clamp time in video-assisted thoracospic group than those of median sternotomy group.There was statistically significant difference.However there was no statistically significant differentce in ventilation time and ICU stay time between two groups.Drainage of video-assisted thoracospic group was less than median sternotomy group.And there was statistically significant difference.ConclusionAs long as strictly a good indication,mitral valve surgery can routinely be performed with video-assisted thoracospic.

Objective:To establish a predictive model and investigate its value in evaluating short-term prognosis of patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF).Methods:Patients with HBV-ACLF admitted to Tianjin Second People's Hospital and Beijing Youan Hospital, Capital Medical University from May 2015 to October 2018 were enrolled. The data of gender, age, laboratory markers at admission, model for end-stage liver disease (MELD) score and clinical complications were collected for analysis. According to the prognosis on 12-week, patients were divided into survival group and death group. Univariate analysis and binary Logistic regression analysis were used to test the risk factors for short-term prognosis of the patients with HBV-ACLF, and a prediction model was established. The accuracy of each index and the established model were verified by the receiver operating characteristic (ROC) curve.Results:A total of 148 patients with HBV-ACLF were enrolled in the study, 91 cases survived while 57 cases died during the 12-week period. The age, total bilirubin (TBIL), neutrophil percentage (NEUT%), hepatitis B surface antigen (HBsAg), MELD score of death group were higher than those of survival group [age (years old): 50.00 (44.50, 55.00) vs. 43.00 (34.00, 53.00), TBIL (μmol/L): 310.30 (240.70, 405.70) vs. 266.40 (184.20, 360.20), NEUT%: (74.52±13.05)% vs. (66.64±12.35)%, lg HBsAg (kU/L): 3.72 (3.29, 3.92) vs. 2.97 (2.49, 3.78), MELD score: 24.27 (19.71, 27.40) vs. 21.88 (18.83, 24.38), all P < 0.05], while albumin (ALB), total cholesterol (CHO), prothrombin activity (PTA) and alpha-fetoprotein (AFP) were lower than those of survival group [ALB (g/L): 29.80 (27.05, 31.05) vs. 30.80 (28.00, 33.90), CHO (mmol/L): 1.98 (1.50, 2.38) vs. 2.49 (2.05, 3.01), PTA: (30.37±7.09)% vs. (32.94±6.03)%, AFP (μg/L): 21.54 (9.28, 51.54) vs. 66.16 (24.50, 152.80), all P < 0.05]. Logistic regression analysis showed that NEUT%, HBsAg and AFP were independent risk factors for short-term prognosis of patients with HBV-ACLF [odds ratio ( OR) was 77.843, 1.439, 0.995, respectively, all P < 0.05]. According to the results of regression analysis, the NHA-ACLF model (NEUT%+HBsAg+AFP) was established. The formula was logit (NHA-ACLF) = -5.441+5.688×NEUT%+0.430×lg HBsAg-0.005×AFP. The area under the ROC curve (AUC) of the NHA-ACLF model for pred HBV-ACLF patients was 0.790, which was better than NEUT% (AUC = 0.696), lg HBsAg (AUC = 0.670), AFP (AUC = 0.703) and MELD score (AUC = 0.640). When the cut-off value of NHA-ACLF model score was 0.459, the sensitivity was 73.7%, and the specificity was 79.1%. Conclusions:NEUT%, HBsAg and AFP are independent predictive indicator for short-term prognosis in patients with HBV-ACLF. Compared with MELD score, the risk assessment model NHA-ACLF has a greater value in predicting the short-term prognosis of patients with HBV-ACLF.