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Objective@#To explore the relationship of sleep with C reactive protein (CRP) abnormality and hyperinsulinemia in adolescents, and to provide reference for early prevention of metabolic disorders.@*Methods@#Based on the Chinese Metabolic Syndrome Cohort Study in Anhui Province, a total of 653 adolescents aged 12 to 19 were selected to examine the relationship between wakeup time, bedtime, sleep disordered breathing (SDB) and CRP abnormality as well as hyperinsulinemia.@*Results@#Later wakeup time (OR=1.68, 95%CI=1.03-2.75) was positively correlated with a higher risk of fasting hyperinsulinemia. Late bedtime (OR=1.96, 95%CI=1.29-2.99) was associated with 2 h postprandial hyperinsulinemia. Among those with high CRP concentration, late wakeup time and late bedtime were positely associated with hyperinsulinemia than those with normal CRP concentration; and the correlation between SDB and hyperinsulinemia was observed.@*Conclusion@#Later wakeup and late bedtime may be risk factors for hyperinsulinemia in adolescents. High concentrations of CRP may further increase the risk of hyperinsulinemia, a condition associated with sleep problems.Teenagers should get up and go to bed as early as possible.
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Objective:To investigate the diagnostic value of motility index (MI), time averaged mean velocity (TAMV) and blood lactic acid level for acute gastrointestinal injury(AGI) in critical patients.Methods:Patients were enrolled from January 2018 to June 2019 in Department of Emergency Intensive Care Unit, the People's Hospital of Guangxi Zhuang Autonomous Region. Patients were divided into the AGI group and control group according to whether there was acute gastrointestinal injury. Patients’ general information and AGI characteristics were assessed. Area under the receiver operating characteristic (ROC)curve was used to analyze the predictive value of MI, blood lactic acid level and TAMV, or combination on the occurrence of AGI.Results:A total of 73 critical patients were enrolled including 45 patients with AGI and 28 without. Logistic regression analysis found that MI ( OR=2.618, 95% CI: 1.214-5.646, P=0.014), TAMV( OR=1.483, 95% CI: 1.058-2.077, P=0.022), blood lactic acid level( OR=0.360, 95% CI: 0.002-0.865, P=0.040) at admission were independent risk factors for AGI. The sensitivity and specificity of MI, blood lactic acid level and TAMV in predicting AGl were 100% and 89.3%, respectively (AUC=0.982, Youden index=0.893). High blood lactic acid level and low MI and TAMV are independent risk factors for the development of AGI in critical patients. The predictive cut-off values are 4.44 for MI, 45.79 cm/s for TAMV and 5.03 mmol/L for blood lactic acid level. Conclusions:Combination of MI, TAMV and blood lactic acid level has apractical predictive value for AGI incriticalpatients
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Critical ultrasonography(CUS) is different from the traditional diagnostic ultrasound,the examiner and interpreter of the image are critical care medicine physicians.The core content of CUS is to evaluate the pathophysiological changes of organs and systems and etiology changes.With the idea of critical care medicine as the soul,it can integrate the above information and clinical information,bedside real-time diagnosis and titration treatment,and evaluate the therapeutic effect so as to improve the outcome.CUS is a traditional technique which is applied as a new application method.The consensus of experts on critical ultrasonography in China released in 2016 put forward consensus suggestions on the concept,implementation and application of CUS.It should be further emphasized that the accurate and objective assessment and implementation of CUS requires the standardization of ultrasound image acquisition and the need to establish a CUS procedure.At the same time,the standardized training for CUS accepted by critical care medicine physicians requires the application of technical specifications,and the establishment of technical specifications is the basis for the quality control and continuous improvement of CUS.Chinese Critical Ultrasound Study Group and Critical Hemodynamic Therapy Collabration Group,based on the rich experience of clinical practice in critical care and research,combined with the essence of CUS,to learn the traditional ultrasonic essence,established the clinical application technical specifications of CUS,including in five parts:basic view and relevant indicators to obtain in CUS;basic norms for viscera organ assessment and special assessment;standardized processes and systematic inspection programs;examples of CUS applications;CUS training and the application of qualification certification.The establishment of applied technology standard is helpful for standardized training and clinical correct implementation.It is helpful for clinical evaluation and correct guidance treatment,and is also helpful for quality control and continuous improvement of CUS application.
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Objective To investigate the effect of propofol on rat′s limb ischemia reperfusion injury .Methods Sixty healthy SD rats were randomly divided into sham operate group ,ischemia-reperfusion group and propofol group (n= 20) ,each group was divided into 4 subgroups according to the different reperfusion time .To copy the right lower limb ischemia reperfusion model ,5 min before reperfusion ,use propofol injection (50 mg/kg ,intraperitoneal inject) ,various subjects in the corresponding time points (3 ,6 , 9 ,12 h) were sacrificed .TNF-α ,NF-κB of blood and MDA ,SOD of Skeletal muscle were measured ,calculate muscle wet dry weight ratio .Results Compared with ischemia reperfusion group ,propofol could significantly reduce expression of TNF-alpha ,NF-κB lev-els in serum (P< 0 .05) ,inhibit the increase of the MDA level and decrease of the SOD level in muscle (P< 0 .05) ,also reduce the extent of skeletal muscle cell edema(P< 0 .05) .Conclusion Propofol can attenuate limb ischemia reperfusion injury by inhibiting inflammation response and reducing the oxygen free radicals′ damage .