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.

AIM: To investigate the role of the insulin secretion as well as insulin sensitivity in the onset and development of the type 2 diabetes mellitus (T2DM). METHODS: This study included 38 normal glucose tolerance(NGT) subjects without family history of diabetes, 32 NGT and 36 impaired glucose tolerance(IGT) subjects who were the first-degree relatives of type 2 diabetes, and 35 newly-diagnosed type 2 diabetic patients. ? cell function and insulin sensitivity were examined by using oral glucose-insulin release test (OG-IRT) with SIM reflecting insulin sensitivity and intravenous glucose tolerance test (IVGTT) with AIR3-5 reflecting the first-phase insulin secretion function. AIR3-5 was calculated as the average incremental plasma insulin concentration from the third to the fifth minute after the glucose bolus. AIR3-5 and SIM were compared among the four groups. RESULTS : From NGT, IGT to type 2 diabetes, there was a decreasing tendency of the level of AIR3-5 and SIM, with NGT the highest, IGT the medium and T2DM the lowest. The level of the AIR3-5 in the subjects of NGT who were first - degree relatives of type 2 diabetes were lower than those of NGT without family history of diabetes( P 0.05) . CONCLUSION: Insulin secretion dysfunction may be the primary factor in the onset of type 2 diabetes. Along with the developing of IGT and type 2 diabetes, the insulin secretion and sensitivity decrease.

Adenocarcinoma ; genetics ; pathology ; Adult ; Aged ; Base Sequence ; Cell Line, Tumor ; DNA Mutational Analysis ; Exons ; Female ; Genes, erbB-1 ; Humans ; Lung Neoplasms ; genetics ; pathology ; Male ; Middle Aged ; Mutation, Missense ; Oligonucleotide Probes ; Polymerase Chain Reaction ; methods ; Real-Time Polymerase Chain Reaction ; methods ; Receptor, Epidermal Growth Factor ; genetics ; Sensitivity and Specificity

OBJECTIVETo explain the essence of pungent-hot herb property express according to in vivo and in vitro studies on its effect on calmodulin on the base of the observation of the adjustment in hypothalamic-pituitary-gonad axis functions of Aconiti Lateralis Radix Praeparata, Curculiginis Rhizoma, Cinnamomi Cortex and bitter-cold herb Phellodendri Chinensis Cortex in rats under the state of yang deficiency.

METHODThe yang-deficient model was duplicated by intramuscularly injecting hydrocortisone sodium succinate powder injection. After the intervention with Aconiti Lateralis Radix Praeparata, Curculiginis Rhizoma, Cinnamomi Cortex and bitter-cold herb Phellodendri Chinensis Cortex for seven days, TSH, T3, T4, 17-OHCS, COR, T, E2 of hypothalamus-pituitary-target gland axis and other relevant indexes were detected. The calmodulin expression in livers and L02 cells cultured in vitro was detected by using Western blot.

RESULTPungent-hot herbs Aconiti Lateralis Radix Praeparata, Curculiginis Rhizoma, Cinnamomi Cortex can significantly correct indicators of hypothalamic-pituitary-gonad axis and calmodulin, whereas the bitter-cold herb Phellodendri Chinensis Cortex showed no obvious effect.

CONCLUSIONThe pungent-hot herb property expression may be closely related to calmodulin.

Animals ; Calmodulin ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; Gonads ; drug effects ; metabolism ; Hypothalamo-Hypophyseal System ; drug effects ; metabolism ; Liver ; drug effects ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Yang Deficiency ; drug therapy ; metabolism

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