Objective To observe the effects of continuous injection sedation and target controlled infusion (TCI) sedation with midazolam and sulfentanyl for mechanical ventilation of ICU patients.Methods 62 mechanical ventilation patients were randomly divided into continuous group(n =31) and TCI group.Continuous group was given sedation with midazolam and sulfentanyl by continuous pumping.Sedation with fentanyl and midazolam pumping was adjusted to keep SAS scores of 3-4 points and bispectral index (BSI) of 70-75 in TCI group.The sedation span,sedative consumption and vital signs were measured andrecorded.Results Compared with continuous group,the consumption of midazolam [(1.29 ± 0.4) mg· kg-1 · 24h-1] and sulfentanyl [(16.9 ± 4.3) μg · kg-1 · 24h-1] in TCI group was significantly lower (t =2.875,2.593,all P ＜ 0.05).There was no significant difference in sedation span between TCI group (92.7 ± 15.1) h and continuous group (94.2 ± 16.3) h (t =0.293 P ＞ 0.05).Sedation satisfaction degree (62％) and human adaptation degree(87％) in TCI group were significantly higher than continuous group(x2 =3.883,2.204,all P ＜ 0.05).After sedative administration,HR,MAP and SpO2 did not significantly decrease compared with baseline.Conclusion TCI sedation can significantly decrease sedative administration of midazolam and sulfentanyl and increase human adaptation degree for mechanical ventilation ICU patients.TCI sedation could be a safe and effective sedation administration.

ObjectiveTo study the relationship between fasting plasma glucose (FPG) level and the first cerebral infarction event in the population with diabetes.Methods This was a prospective cohort stndy.8 306 diabetic subjects who determined FPG ≥ 7.0 mmol/L or treated with insulin or hypoglycemic drugs and FPG ＜7.0 mmool/L as the observation population and were followed-up for (48.01 ± 3.14) months.During the course,cerebral infarction events were determined every 6 months.Results( 1 ) By the end of following-up,with the increasing levels of the baseline FPG,the total cholesterol (TC),triglyceride (TG) levels were gradually increased in the diabetic population,the differences were significant [ TC:( 4.93 ± 1.15,5.10 ± 1.20,5.15 ± 1.28,5.33 ± 1.35 ) mmol/L,TG:( 1.70 ± 1.26,1.83 ± 1.29,2.18 ± 1.76,2.41 ± 2.08 ) mmol/L,P＜0.05 ] ; the plasma low density lipoprotein-cholesterol (LDL-C),systolic blood pressure ( SBP),diastolic blood pressure ( DBP),and body mass index (BMI) levels were also increased significantly ( P＜0.05 ).(2) The ineidence of cerebral infarction event in the group of patients with 7.0 mnol/L ≤ FPG ＜ 9.0 mmol/L was the lowest,the differences were significant ( 2.1％,P ＜0.01 ).Compared with the group of 7.0 mmol/L≤ FPG＜9.0 mmol/L,after adjusting for age,sex,BMI,SBP,DBP,TC,TG,low density lipoprotein-cholesterol,high density lipoprotein-cholesterol,smoking,diabetic duration and treatment,the relative risk for cerebral infarction events were 1.85 (95％ CI 1.09-3.15,P＜0.05) and 1.54 (95％CI 1.16-2.05,P ＜ 0.01 ) for those groups with 6.1 mmol/L ≤ FPG ＜ 7.0 mmol/L and FPG ≥ 9.0 mmol/L respectively.ConclusionThe risk of new in cidence of cerebral infarction events seems to be the lowest in the group of diabetic patients whose FPGs are wihin 7.0-9.0 mmol/L range.

Objective To investigate the relationship between waist circumference and new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus. Methods A total of 1 950 patients with diabetes mellitus, who determined fasting plasma glucose(FPG)≥7.0 mmol/L or who were using hypoglycemic drugs and FPG<7.0 mmol/L,and body mass index (BMI)< 25 kg/m2, was selected in this study using prospective cohort method. Patients were divided into five groups according to the baseline data of waist circumference, including waist circumference<78 cm (A group, n=387), 78 cm90 cm (E group, n=421). Multiple Logistic regression model was used to analyze influential factors of new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus. Re?sults The average duration of follow-up was(47.24±5.13) months. The incidence rate was 11.85%(231/1 950) in patients with non-alcoholic fatty liver disease. The incidence rates were 6.98%, 9.28%, 12.38%, 14.19%and 15.68%in A, B, C, D and E groups, and which were increased with the increased waist circumference (P<0.05). Results of multiple Logistic re?gression model analysis showed that compared with A group,OR values were 1.97 and 2.19 in D and E groups respectively (P<0.05). Conclusion Waist circumference≥85 cm was the risk factors of new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus.