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.

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

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

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.

Objective To investigate the experience of endoscopic mini-invasive therapy for residual lesions of peripancreatic necrotizing infection with choledocoscopy-assisted debridement technique, and to explore its clinical application value. Methods 71 patients with postoperative surgical drainage and accompanied with residual focus were collected. Choledochoscope was inserted via the drainage sinus, and the focus was observed and necrotic tissue was removed under direct choledochoscopic vision. Results Of the 71 patients who underwent this procedure, 64 were cured (success rate, 90.1%); 3 patients withdraw from treatment due to economic reasons; 4 patients received open surgery after 1 ～ 3 times of choledocoscopy-assisted debridement. The 64 cured patients received 2 ～ 9 times of choledocoscopy-assisted debridement with a mean of 5.1 times. 87.5% patients needed 4 ～ 6 times of procedures. The healing time was 18 ～ 125 days (average 71.3 days). Hemorrhage occurred in 3 patients and digestive tract fistula occurred in 2 patients and were resolved with non-operative management. Conclusions With the help of postoperative established surgical drainage channel, choledochoscopy-assisted debridement could be considered as a safe and effective miniinvasive treatment for residual focus of peripancreatic necrotizing infection, and is worth of clinical application.

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.

Objective To investigate the feasibility of ultrasound-guided percutaneous drainage for the treatment of peripancreatic abscess. Methods The clinical data of 36 patients with peripancreatic abscess who were admitted to the General Hospital of the Chengdu Military Command were retrospectively analyzed. All the puncture sites were designed according to the region, range and shape of the abscess, and then the angle and the direction of the needle penetration were determined according to the spatial relationship between the puncture site and the abscess. Finally, the drainage tubes were placed under the guidance of the ultrasound. Results The technique was successfully performed on all the patients, and 33 patients were cured with the cure rate of 92%.The mean healing time was 37 days. Three patients were converted to laparotomy because of the unsatisfied therapeutic effects. Enterocutaneous fistula was detected in 3 patients after the surgery and they were cured after receiving nonoperative management. All patients were followed up for 3-48 months, and neither residual abscess nor recurrence was detected. Two patients were complicated with type one diabetes, one with dyspepsia, two with gallstone, and they were cured by symptomatic treatment. The body weights of 27 patients were increased compared to those before the operation. Conclusion Ultrasound-guided percutaneous drainage is effective for the treatment of peripancreatic abscess.

This study aims to explore the impact on patient's liver and kidney function by different dosage of Kudiezi injection. This study retrospectively analyzed 15 228 patients' records from 18 nationwide general hospital information system (HIS). All patients were treated with Kudiezi injection, 1 956 patients that were given doses of > 40 mL, which is above the recommended dose, acted as the observation group. Fifty-five patients receiving the recommended dose of < 40 mL were the control group. Data about alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine (Cr) and blood urea nitrogen (BUN) were collected before and after using Kudiezi injection, changes after treatment were outcomes. Also recorded were: age, costs, length of hospitalization and the patients' condition on admission. Propensity score method was used to balance 71 confounding variables such as gender, age, mortality, and costs. There were no significant difference on the four indexes between the two groups. It is hard to conclude that the use of Kudiezi injection over the recommended dose could influence the four indexes of liver and kidney from this data analysis. More conclusive evidence should be collected by further prospective study.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alanine Transaminase ; metabolism ; Aspartate Aminotransferases ; metabolism ; Blood Urea Nitrogen ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Hospital Information Systems ; Humans ; Injections ; Kidney ; drug effects ; metabolism ; Liver ; drug effects ; metabolism ; Male ; Middle Aged ; Prospective Studies ; Retrospective Studies ; Young Adult