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 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 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.

We investigated the roles of the crude antigen(CA) of Clonorchis sinensis and excretory secretory products (ESPs) in the polarization of Th1 and Th2 cells.Bone marrow-derived cells were generated from BALB/c mice and isolated into immature DCs;immature DCs were then treated with either CA (CA stimulated group),ESPs (ESPs stimulated group),LPS (positive control group) or PBS (negative control group) for 24 hours.Then the CD4+T cells were isolated from mouse spleen by using anti mouse-CD4 Microbeads,and further cocultured with stimulated DCs for another 72 hours.The purities of DCs and CD4+ T cells were evaluated by flow cytometry and the expressing levels of T-bet mRNA and GATA-3 mRNA were detected by real-time PCR.ELISA was used to detect the levels of IFN-γ and IL-4 cytokines in the supernatant.mRNA levels of T-bet and GATA-3 in the ESPs group were higher than those in PBS-stimulated group (P＜0.05).The concentrations of IFN-γ and IL-4 cytokines in the culture were increased in the ESPs group,compared with PBS stimulated group(P＜0.05).IFN-γ but not IL-4 was increased in CA group (P＜0.05).The results implied that CA might play a role in Th1 type immune response,and ESPs likely play roles in both Th1 and Th2 immune responses.

Objective To investigate the prevalence,their autoantigen and the clinical significants of antiendothelial cell antibodies(AECAs) in systemic vasculitis.Methods Western blotting was performed to detect specific AECA in serum of systemic vasculitis,SLE,RA,SS and healthy donors.Then to analyze the relationships of AECA with the disease manifestation.Results(1)The prevalence of AECA was 77.7% in systemic vasculitis,87.5% in SLE,66.7% in SS,7.14% in RA and 10% in normal group respectively.(2)AECA reacted with a heterogeneous series of endothelial proteins which ranged in molecular size from 16 to 120 ku Furthermore,AECA against a 47 ku endothelial cell antigen were more frequently found in a variety of systemic vasculitis and SLE.(3)Compared with those in AECA-negative patients,the mean levels of ESR in AECA-positive patients with TA and the mean levels of BVAS in patients with WG,MPA and CSS were both significantly higher in AECA-positive patients.Patients with BD who have AECA against 47 ku endothelial cell proteins were more frequently found to have neuropathy than those 47 ku-AECA-negative patients,and the prevalence of inhanced CRP are also more frequent.Conclusion AECA showed to be correlated with the disease manifestation,and the same molecular sizeantigen could be found in a variety of systemic vasculitis and SLE.

Objective To explore the gray matter loss of Alzheimer's disease (AD) patients by processing the magnetic resonance imaging (MRI) with computer. Method A voxel-based morphometry (VBM) method was applied in this study. Result Bilateral loss of gray matter in AD patients was found in the entorhinal/ hippocampal/parahippocampal cortex areas, amygdala, the head of the caudate nucleus, middle temporal gyrus, cingulate gyrus, inferior parietal lobule, insula and dorsolateral prefrontal cortex. Furthermore, area of right pulvinar, cortex of superior temporal gyrus and superior parietal lobule reduced significantly. On the other hand, somatosensory/motor cortex, cerebellum and occipital lobe were relatively intact. Conclusion VBM overcomes the shortcomings of region of interesting(ROI), such as time-consuming, dependence on observer, and poorly reproducible, and can analyze the gray matter loss objectively and automatically and have a good perspective for clinical applications.

Objective To investigate the influence of hyperbaric oxygen treatment (HBOT) on blood pressure (BP) and the incidence of rebleeding in patients with hypertensive intracranial hemorrhage (HICH)Methods One hundred and twenty patients with HICH were treated for 60 min with 100% oxygen at 2.0 absolute atmospheres (ATA) daily when the condition was stable and BP was controlled ideally. Blood pressure was measured before the patients were sent into the HBO chamber and remeasured following completion of each HBOT session and 1 hour later. Rebleeding was monitored during and after each HBO session . Results HBOT caused a significant elevation of systolic BP in 25.83% (31/120) patients and a significant decrease in 16.67% (20/120) patients (P ＜0. 05 ),whereas the rest 57.5% (69/120) patients had no significant changes,when the BP was measured right after the HBOT session. The mean diastolic BP increased in 69 (57. 50% ) patients and decreased in 4. 17%(5/120) patients (P ＜ 0. 05 ), whereas we found no significant changes in the rest 46 (38. 33% ) patients. No differences were found in the comparison of BP before and 1 hour after the HBOT session and no one suffered from rebleeding during and after HBOT session. Conclusions HBOT may cause temporal blood pressure changes in most patients with HICH, however, it will not cause an increasing incidence of rebleeding if the patient's condition is stable and the blood pressure has been well controlled.