Objectives: This prospective,randomized and controlled clinical trial was designed to investigate the effect of short course intensive insulin therapy(SCIIT) on stress-induced hyperglycemia and outcomes in critically ill patient. Methods:The diabetes or other illness which directly influenced blood glucose were excluded and the critically ill patients was maintained with normoglycemia((4.4-6.1) mmol/L) in the first seven days by intensive insulin therapy.After the first seven days,these patients was treated like conventional insulin treatment group.Conventional insulin treatment group was maintained with blood glucose at a level between 3.9-10 mmol/L.Results: Of 41 patients enrolled in the study,30 patients were eligible for analysis.After intervention stopped,blood glucose level in intensive insulin treatment group(5.92?1.24 mmol/L) was lower than in conventional insulin treatment group((9.22?)2.51 mmol/L).And in the same time,insulin consumptions in SCIIT group was lower than in conventional insulin treatment group.There was no significant difference in ICU mortality between two groups,although decreasing trend favored to treatment group. Conclusion: In critical ill patient,(SCIIT) can achieve similar blood glucose range when compared with the plan of IIT.The benefit of improving morbidity and mortality could be expected in large sample RCTs.

Accidents, Occupational ; statistics & numerical data ; Acute Disease ; China ; epidemiology ; Humans ; Occupational Diseases ; epidemiology ; Poisoning ; epidemiology

Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Heart ; Heart Diseases ; drug therapy ; Humans ; Medicine, Chinese Traditional

During the process of electroacupuncture (EA) therapy, whether there being a corrosive effect in ac- upuncture needles was observed. Acupuncture needles were inserted into a rabbit's acupoint to perform a 12-hour electrical stimulation with three types of common EA waveform; additionally two needles were put in 0.9% sodium chloride solution with 12-hour direct current. Afterwards, environmental scanning electron microscope was applied to detect the surface physical characteristics of acupuncture needles. As a result, after a 12-hour continued electri- cal stimulation with three types of common EA waveform in the rabbit, there was no corrosive effect in acupunc- ture needles; but the direct current could cause severe corrosion in acupuncture needles. It is believed that there is no corrosion effect on acupuncture needles in current EA treatment, and some accidents reported in literature may be related to quality of EA device or improper manipulation during the treatment.
Acupuncture Points ; Animals ; Corrosion ; Electroacupuncture ; instrumentation ; Male ; Needles ; adverse effects ; Rabbits

Objective To evaluate the clinical efficacy and safety of endoscopic submucosal dissection (ESD) guided with endoscopic ultrasonography (EUS) for rectal neuroendocrine neoplasms(NENs).Methods A retrospective analysis was performed on 58 patients with rectal ENEs who underwent ESD from January 2011 to December 2015 in JiangSu Province Hospital.Manifestations of EUS, clinicopathological characteristics, proliferation activity grade, complete resection rate, complications and follow-up results of lesion were studied.Results Those treated by ESD included 58 patients with 64 lesions of rectal NENs.EUS results showed that 3 lesions originated from mucosa, 3 from muscularis mucosa and 58 from submucosa.A total of 34 lesions located within 5 cm from anus, 26 in 6-10 cm from anus and 4 more than 10 cm from anus.All 64 lesions were successfully treated by ESD.The mean maximum diameter of the lesions was 0.8 cm(0.2-3.5 cm), and the mean procedure time was 31 min(10-60 min).The complete resection rate was 93.8% (60/64).There were 4 patients with positive basal surgical margin, and two of them underwent additional surgery and two others were treated with argon plasma coagulation after rejecting surgery and ESD.Histological examination determined that 59 lesions were pathologic grade 1(G1) and 5 were pathologic grade 2(G2).Delayed bleeding occurred in 4 cases after ESD,which was managed by medicine in 1 case and endoscopic treatment in 3 cases.No perforation occurred after ESD.During a mean follow-up period of 22.9 months(3-48 months), no lymph node metastasis or distant metastasis was observed.Conclusion EUS is able to distinguish the origin of rectal NENs and aid determining the range and depth of ESD.ESD appears to be a safe, feasible and effective procedure for providing accurate histopathologica1 evaluations as well as curative treatments for rectal NENs limited to submucosa.

Objective To understand the reliability and validity on SF-36 scale and the quality of life (QoL) among patients with advanced-schistosomiasis in Jiangsu province.Methods Cluster sampling method was used to choose 586 advanced-schistosomiasis patients who were registered in Jiangsu province.Questionnaire including SF-36 module,was used for face to face interview on the patients.Statistical analyses were made to assess the results,including correlation analysis,reliability analysis,factor analysis,t-test and one-way ANOVA.Results The split-half reliability coefficient was 0.92,P＜0.001 and the internal consistency reliability was 0.90,with the range of Cronbach' α coefficient on each dimension was from 0.69 to 0.98.Through principal component analysis,two factors were identified,with the accumulative contribution rate as 67.37％.SF-36 showed certain discriminant validity to distinguish groups in different economic levels.Compared with the domestic norm data,the scores of SF-36 on those patients were generally lows.Conclusion SF-36 had good reliability and good criterion validity,with a certain degree of discriminant validity,but with poor constructs validity.Level of QoL of patients with advanced schistosomiasis in Jiangsu was low because of being chronically ill,that called for more strategies to improve the QoL of patients.

Objective To explore the relationship between energy feature of the spontaneous neural activity and separate symptom clusters in first-episode depression.Methods 22 first-episode depression patients and 26 age-,gender-matched healthy controls were scanned with 3.0 T MRI Scanner.The t-test was employed to compare the difference of amplitude of low frequency fluctuation (ALFF) between the two groups,and the correlation analyses were conducted between ALFF of brain regions with significant difference and the severity of depressive symptoms clusters.Results Compared with healthy group,the depression group showed significantly increased ALFF in the right middle frontal gyrus (9,45,-6; K =18) and the bilateral fusiform gyrus (-34,-19,-12; K =37 and 30,-33,-18 ; K =31,respectively),and decreased ALFF in the left precuneus (0,-72,42; K =19) (P＜0.05,corrected by Alphasim).The ALFF of the the right middle frontal gyrus,the right fusiform gyrus,and the left precuneus were negative correlated with the scores of weight factor,retardation factor and sleep disturbance factor (r=-0.494,P=0.019; r=-0.486,P=0.022 and r=-0.484,P=0.023,respectively).Conclusion Abnormal energy feature of the spontaneous neural activity may be associated with severity of specific depressive symptoms clusters in first-episode depression patients during resting-state.

Objective To investigate the interconnection of the executive control network in major depressive disorder when they recognized the sad facial stimuli,and to discuss the aberrant mechanism of emotion processing.Methods Twenty major depressive patients and 20 well-matched healthy volunteers participated in the experiment.The brain actions of all subjects were recorded by the magnetoencephalography (MEG) when they were required to distinguish the emotion face.Based on prior knowledge,the interested brain area consisted of the primary visual cortex (V1),the orbitofrontal cortex(OFC),the dorsolateral prefrontal cortex (DLPFC),the anterior cingulated cortex (ACC).Then constructing three competing models to select an optimal model by the method of dynamic causal model(DCM),finally the differences of the effective connections of the optimal model between the depressed patients and healthy controls were analyzed.Results According to the results of Bayesian model selection (BMS),model 1 had the most exceedance probability of 0.80 with the features that there were bidirectional modulatory connections between the OFC,ACC and DLPFC.Given the best model,the parameters of effective connectivity of the optimal model were extracted,and then two-sample t-test over the model 1 was adopted.The modulatory effective connectivity from the OFC to the DLPFC in both hemisphere(t=-2.73,P=0.0096;t=-3.01,P=0.0046) and the OFC to the ACC (t=-2.93,P=0.0057) in the left hemisphere were significantly reduced in MDD.Conclusion There exists abnormal function of executive control network in depressed patients,the decreased effective connections between the OFC and the DLPFC,as well as the OFC and the ACC,may have correlation with the negative

Objective To explore the differences of the degree and distribution of hub regions of the brain structural networks between the schizophrenia and healthy and then analysis the importance of brain regions in the information transmission in across the whole brain.Methods The diffusion tensor imaging data were obtained from 22 schizophrenia patients and 24 healthy controls.The whole cerebral cortex was parcellated into 90 regions by the anatonical label map.Tractography was performed in the whole cerebral cortex of each subject to reconstruct white matter tracts of the brain using the fiber assignment by continuous tracking (FACT) algorithm.And then the brain structural binary networks were constructed using the complex network theory.The average degree of the network and the degree of the nodes in the network between the brain structural networks of both groups were examined by two sample t-tests.Results The average degree of the brain structural network in the patient group (7.82±0.56) decreased significantly when compared with the control group (8.17 ±0.56; P=0.04).The degree of the nodes in the brain structural network of the patient group (the left hippocampus:11.41 ± 1.84; the left parahippocampal gyrus:6.41± 1.33 ; the left calcarine fissure:11.50±2.97 ; the left fusiform gyrus:8.27± 1.83) decreased significantly when compared with the control group (14.43±2.26; 8.54±2.15; 14.79±2.80; 10.25± 1.36; all P＜0.01,survived critical FDR threshold for multiple comparisons).And the distribution of the hub regions in the temporal and occipital lobes of the patient group was difference from that of the control group.Conclusion The importance of the hippocampus and the brain regions in the occipital lobe is decrease for the information transmission across the whole brain.The damage of the topological properties of these brain regions maybe related to the disorder of the transmission and integration of information in the brain of the schizophrenia.

Objective To explore the differences of the global efficiency of the brain structural networks between the male paranoid schizophrenia and male healthy and its relationship with the psychotic symptoms of the schizophrenia.Methods The diffusion tensor imaging data were obtained from 27 male paranoid schizophrenia patients and 28 male healthy controls.The whole cerebral cortex was parcellated into 90 regions by the anatomical label map.Tractography was performed in the whole cerebral cortex of each subject to reconstruct white matter tracts of the brain using fiber assignment by continuous tracking(FACT) algorithm.And then the brain structural binary networks were constructed using the complex network theory.The average global efficiency of the brain network and the global efficiency of the nodes of both groups were examined by two sample t-test and its relationship with the psychotic symptoms in the male paranoid schizophrenia was explored by the correlation analysis.Results Compared with control group,the average global efficiency of the brain network of the patients decreased significantly (7.87±0.56,8.17±0.56,P=0.005),and the global efficiency of the nodes in the brain network of the patient decreased significantly in the left superior frontal gyrus (orbital part) (P=0.00025),the left superior parietal gyrus (P=0.00011),the left cuneus (P=0.00012) and the left putamen (P=0.00032),all survived FDR correction.Significant negative correlation was found between the global efficiency of the left putamen and the total scores (r=-0.43,P=0.03),the positive scores (r=-0.41,P=0.03) and the cognitive scores (r=-0.40,P=0.04) of PANSS.Conclusion The decreased global efficiency of the left frontal,parietal and occipital lobes and the subcortical structures lead to the occurrence of schizophrenia.And the reduced efficiency of the subcortical structures is associated with the positive symptoms and the abnormal cognitive function of the patients.