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Objective@#To investigate the effect of intensive insulin therapy on the immune function and prognosis of severe thoracic injuries patients with stress hyperglycemia.@*Methods@#A retrospective case control study was performed to analyze the clinical data of 60 patients with severe chest trauma and stress-induced hyperglycemia admitted to Chongqing People's Hospital from October 2016 to October 2018. There were 31 males and 26 females, aged 25-61 years [(46.1±4.0)years]. The abbreviated injury scale (AIS) range was 3-5 points. Thirty patients received routine insulin therapy (routine treatment group) and thirty patients received intensive insulin therapy (intensive treatment group). Venous blood was collected from two groups of patients before treatment, 1 day, 3 days, 5 days and 7 days after treatment respectively. Level of inflammatory cytokines [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP)], and lymphocyte count (CD14＋, CD4＋ and CD4＋/CD8＋) were detected respectively. The incidence of nosocomial infection, length of hospital stay, mortality and incidence of hypoglycemia were compared between the two groups.@*Results@#There were no significant differences in plasma TNF-α, IL-6 and CRP levels between the two groups before treatment (P>0.05). After treatment (1-7 days), the levels of serum TNF-α, IL-6 and CRP in the intensive treatment group were lower than those of routine treatment group (P<0.05 or 0.01). Compared with these before treatment, the levels of TNF-α, IL-6 and CRP in both groups increased to varied degrees, reaching a peak on day 3, followed by a gradual decline (P<0.05 or 0.01). There were no statistically significant differences in CD14＋, CD4＋、CD4＋/CD8＋ lymphocyte counts between the two groups before treatment (P>0.05). On days 3, 5, and 7 after treatment, the counts of CD14＋ lymphocytes [3 d: (0.61±0.08)×109 vs. (0.55±0.09)×109, 5 d: (0.68±0.05)×109 vs. (0.63±0.05)×109, 7 d: (0.77±0.07)×109 vs. (0.71±0.06)×109], CD4＋ lymphocytes [3 d: (0.29±0.04)×109 vs. (0.25±0.03)×109, 5 d: (0.32±0.04)×109 vs. (0.30±0.05)×109, 7 d: (0.34±0.03)×109 vs. (0.32±0.06)×109], CD4＋/CD8＋ lymphocytes [3 d: (0.28±0.04)×109 vs. (0.26±0.06)×109, 5 d: (0.33±0.03)×109 vs. (0.31±0.06)×109, 7 d: (0.35±0.03)×109 vs. (0.32±0.06)×109] in the intensive treatment group were higher than those in the routine treatment group. Compared with before treatment, the counts of CD14+ , CD4+ , CD4+ /CD8+ lymphocytes in the two groups were raised to different degrees after treatment for 3 days, with significant differences (P<0.05 or 0.01). Compared with routine treatment group, patients in intensive treatment group had lower incidence of nosocomial infection [57%(17/30) vs. 30%(9/30)], shorter duration of mechanical ventilation [(12.8±2.4)vs. (7.4±1.2)days], and lower hospital mortality rate [27%(8/30) vs. 10%(3/30)]. There was no significant difference in the incidence of hypoglycemia between the two groups(P>0.05).@*Conclusion@#For severe chest trauma patients with stress hyperglycemia, intensive insulin therapy can effectively improve the immunity, inhibit the inflammatory reaction, reduce the complication incidence, restore ventilation function and improve survival rate.
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Objective To investigate the effect of intensive insulin therapy on the immune function and prognosis of severe thoracic injuries patients with stress hyperglycemia.Methods A retrospective case control study was performed to analyze the clinical data of 60 patients with severe chest trauma and stress-induced hyperglycemia admitted to Chongqing People's Hospital from October 2016 to October 2018.There were 31 males and 26 females,aged 25-61 years [(46.1 ± 4.0)years].The abbreviated injury scale (AIS) range was 3-5 points.Thirty patients received routine insulin therapy (routine treatment group) and thirty patients received intensive insulin therapy (intensive treatment group).Venous blood was collected from two groups of patients before treatment,1 day,3 days,5 days and 7 days after treatment respectively.Level of inflammatory cytokines [tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6) and C-reactive protein (CRP)],and lymphocyte count (CD14 +,CD4 +and CD4 +/CD8 +) were detected respectively.The incidence of nosocomial infection,length of hospital stay,mortality and incidence of hypoglycemia were compared between the two groups.Results There were no significant differences in plasma TNF-α,IL-6 and CRP levels between the two groups before treatment (P ＞ 0.05).After treatment (1-7 days),the levels of serum TNF-α,IL-6 and CRP in the intensive treatment group were lower than those of routine treatment group (P ＜ 0.05 or 0.01).Compared with these before treatment,the levels of TNF-α,IL-6 and CRP in both groups increased to varied degrees,reaching a peak on day 3,followed by a gradual decline (P ＜ 0.05 or 0.01).There were no statistically significant differences in CD14 +,CD4 + 、CD4 +/CD8 + lymphocyte counts between the two groups before treatment (P ＞ 0.05).On days 3,5,and 7 after treatment,the counts of CD14+ lymphocytes [3 d:(0.61 ±0.08) × 109 vs.(0.55 ±0.09) × 109,5 d:(0.68 ±0.05) × 109 vs.(0.63±0.05) ×109,7 d:(0.77±0.07) ×109 vs.(0.71±0.06) ×109],CD4 + lymphocytes [3 d:(0.29 ±0.04) × 109 vs.(0.25 ±0.03) × 109,5 d:(0.32 ±0.04) × 109 vs.(0.30 ±0.05) × 109,7 d:(0.34±0.03) ×109 vs.(0.32±0.06) ×109],CD4 +/CD8+ lymphocytes [3 d:(0.28 ±0.04) ×109 vs.(0.26 ±0.06) × 109,5 d:(0.33 ±0.03) × 109 vs.(0.31 ±0.06) × 109,7 d:(0.35 ±0.03) × 109 vs.(0.32 ± 0.06) × 109] in the intensive treatment group were higher than those in the routine treatment group.Compared with before treatment,the counts of CD14 +,CD4 +,CD4 +/CD8 + lymphocytes in the two groups were raised to different degrees after treatment for 3 days,with significant differences (P ＜0.05 or 0.01).Compared with routine treatment group,patients in intensive treatment group had lower incidence of nosocomial infection [57％ (17/30) vs.30％ (9/30)],shorter duration of mechanical ventilation [(12.8 ± 2.4) vs.(7.4 ± 1.2) days],and lower hospital mortality rate [27％ (8/30) vs.10％ (3/30)].There was no significant difference in the incidence of hypoglycemia between the two groups(P ＞ 0.05).Conclusion For severe chest trauma patients with stress hyperglycemia,intensive insulin therapy can effectively improve the immunity,inhibit the inflammatory reaction,reduce the complication incidence,restore ventilation function and improve survival rate.
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OBJECTIVE: To establish a method for detecting the contents of 12 toxic elements such as beryllium,vanadium and thallium in human whole blood,urine and hair by inductively coupled plasma-mass spectrometry( ICP-MS).METHODS: Whole blood( 0.25 mL) and urine( 10.00 mL) were diluted 20 times into suspension by 0.1% TritonX-100 + 0.5% nitric acid,and analyzed by ICP-MS.The hair( 0.20 g) was mixed with nitric acid and digested by microwave,then made up to 10.00 mL with purified water.The analysis was performed by ICP-MS.RESULTS: The linear correlation coefficients of all the 12 elements,such as beryllium,vanadium,chromium,manganese,cobalt,nickel,arsenic,cadmium,tin,antimony,tellurium and lead were≥0.999 5.The detection limit for whole blood and urine was 0.097-1.995 μg/L,and the detection limit for hair was 0.001-0.012 μg/g.The recovery rates for whole blood,urine and hair were 92.3%-105.0%,93.7%-115.5% and 92.5%-111.0%,respectively.The within-run relative standard deviation( RSD) were 0.7%-5.8%,0.8%-4.6% and 2.2%-8.4%,respectively; the between-run RSD were 1.6%-7.1%,3.5%-7.5% and 2.8%-8.8%,respectively.CONCLUSION: This method has good accuracy,high sensitivity and good precision,which is suitable for rapid screening for various elements in human biological samples.
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Objective To observe the effect and efficacy of DPP-4 inhibitor saxagliptin on nonalcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus.Methods Forty patients with newly diagnosed with type 2 diabetes complicated with NAFLD were divided into two groups:the saxagliptin group and the metformin group.On the basis of dietary and exercise therapies,the saxagliptin group received 0.005 g of saxagliptin daily and the metformin treatment group received 0.85-1.70 g of metformin daily.The levels of glycosylated hemoglobin(HbA1 c),triglyceride (TG),blood pressure (BP),alanine aminotransferase (ALT),liver CT and liver/spleen CT were observed before and 3 months after treatment.Results After treatment for 3 months,the TG,ALT,liver CT and liver / spleen CT of the metformin group and the saxagliptin group were significantly higher than those before treatment(P＜0.05).There was no significant difference in the TG,ALT and liver CT values between the two groups(P＞ 0.05).Conclusion In the state of diabetes mellitus complicate with nonalcoholic fatty liver,saxagliptin has a certain effect on relieving fatty liver.
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<p><b>OBJECTIVE</b>To establish a method for determination of disulfiram in the workplace atmosphere by liquid chromatography.</p><p><b>METHODS</b>Sampling with glass fiber filter, eluting with methanol, separating with C18 column, and determination with liquid chromatography.</p><p><b>RESULTS</b>The bearing capacity of glass fiber filter exceeded 3.45 mg per piece. The elution efficiency was 97.8%∼101.0% The relative standard deviation varied from 1.09% to 1.44%. The limit of detection was 0.1 µg/ml. The minimum detectable concentration was 0.011 mg/m³ (with sampled air volume of 45 L).</p><p><b>CONCLUSION</b>The method has high selectivity, accuracy, and precision and strong applicability.</p>