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Objective To study the relationships between stress hyperglycemia and illness severity and medical expenditure in emergency patients. Methods Totally 6128 consecutive hospitalized patients were enrolled from the emergency department. The clinical data of age, gender, stress hyperglycemia, hospitalization expenditure and rescue condition were compared according to diabetic history [ assigned to diabetes mellitus group ( DM) and non-diabetic mellitus group ( NDM ) ] and categories of the diagnosis. The data was compared by subgroups [ stress hyperglycemia group (SH) and control group (CON)]. Results DM patients had longer hospital stays, higher hospitalization expenditure and rescue rates (all P>0. 01) than NDM patients. In DM and NDM group, SH subgroup had higher inspection and medicine expenses, total costs and rescue rates than CON subgroup (all P>0. 05), and NDM+SH subgroup had the highest total costs and rescue rates. Logistic regression analysis showed that SH was an independentriskfactorforrescueinbothNDM[OR=3.817,95％CI(3.151-4.624)]andDM[OR=2.435,95％CI (1. 634-3. 631)] groups. In cardiovascular, respiratory, digestive, neurological, traumatic, and other disease layers, SH was also an independent risk factor for rescue (all P>0. 05). Multivariate regression analysis showed that SH was an independent determinant for total costs, inspection and medicine expenses and days of hospital stay (βwere7077.608,998.472,3495.271,and0.766respectively,allP>0.01). Amongcardiovascular,digestive,and neurological disease layers, SH was an independent factor responsible for days of hospital stay and total costs ( both P>0. 05). Conclusion In emergency admission patients, patients in SH subgroup were severer and had higher medical expenditure than those in CON subgroup. In stratified diseases layers, SH was an independent risk factor for rescuing and increased hospitalization expenditure. Patients in NDM+SH subgroup had more serious illness and more medical expenditure, compared with those in CON subgroup of NDM and DM group.
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To analyze the relationship between obesity with related measurable indicators and insulin resistance among the residents over 50-year-old in Wuxi area.The questionnaire survey,physical examination,and relevant biochemical measurements as well as gender,age,height,body w eight,waist circumference,and hip circumference were obtained.The prevalence of obesity was 11.95％ of which 57.24％ were with central obesity,and the prevalence in male was higher than that in female(P＜0.05).With inereasing body mass index (BMI) and waist circumference(WC),the prevalence of insulin resistance increased gradually (P ＜ 0.05).Meanwhile,With the increasing HOMA-IR,the prevalence of obesity and central obesity also gradually increased (P＜0.05).BMI,WC,and waist-to-hip ratio can effectively predict insulin resistance.The cut-off point of waist circumference was 87.5 cm for male,and 84 cm for female.At the same level of body mass index,metabolic measurements in central obesity group were higher than those of non-central obesity group with the same body mass index,especially in normal weight group.The related metabolic measurements of metabolic obesity but normal weight group were mostly higher than metabolically healthy but obese group,and there were statistically significant differences in fasting blood glucose,fasting insulin,HOMA-IR and HOMA-β.Obesity,especially central obesity,is closely related to insulin resistance among residents over 50-year-old in Wuxi area.Meanwhile,waist circumference may effectively predict insulin resistance and may serve as a parameter in the occurrence of metabolic syndrome and cardiovascular diseases.
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Objective To explore the efficacy of prophylactic bilateral internal iliac arteries balloon occlusion in treatment of women with pernicious placenta previa complicated with placenta accreta.Methods A retrospective analysis was conducted on 41 cases of pernicious placenta previa with placenta accreta admitted to Guangzhou Women and Children's Medical Centre from January 2010 to December 2012.The study group (n=13) underwent prophylactic bilateral internal iliac arteries balloon placement before cesarean section and occlusion after delivery.The control group (n =28)received conventional haemostasis during cesarean section.The amount of blood loss and blood transfusion during the operation,the perioperative hemoglobin level,operation time and duration of hospitalization of the two groups were compared with t test or Chi square test.Results The volume of intraoperative hemorrhage of the study group was lower than of the control group [(1429±875) ml vs (4600± 2090) ml,t=6.840,P=0.000],the amount of intraoperative blood transfusion in the study group was also lower [(920±438) ml vs (3600± 1225) ml,t=10.251,P=0.000].Operation time and postoperative duration of hospitalization of the study group were shorter than those of the control group [(197±45) min vs (284±44) min,t 5.850,P=0.000; (6.7±1.3) d vs (8.2± 2.2) d,t=2.272,P=0.029].There was no statistical difference on hysterectomy rate between the two groups [11/13 vs 89％(25/28),x2=0.181,P 0.670)].In addition,two cases of reoperation,one case of pulmonary edema,two cases of coagulation disorder,one case of venous thrombosis in lower limbs,one case of renal dysfunction and pulmonary edema were reported in the control group,but none in the study group.Conclusions.Prophylactic bilateral internal iliac arteries balloon occlusion is effective in reducing intraoperative blood loss,transfusion,and relative complications in patients with pernicious placenta previa complicated with placenta accreta.
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Objective To study the effect of Bi-level positive airway pressure (BiPAP) on hemodynamics in patients with the chronic obstructive pulmonary disease (COPD) combined coronary heart disease.Methods One hundred patients with COPD combined coronary heart disease treated by BiPAP ventilation were enrolled.The blood gas analysis and the hemodynamics were monitored and analyzed in patients with the COPD combined coronary heart disease before treatment and after BiPAP ventilation treatment for 2 hours,24 hours,72 hours and 1 week.Results PaCO2 decreased significantly after 2-hour's treatment by BiPAP ventilation( P ＜ 0.05) and the heart rate and systolic blood pressure also decreased significantly after 24-hour's treatment by BiPAP ventilation.The left ventricurlar ejection fraction( [ 65.63 ± 6.86 ] ％ vs.[ 56.21 ±5.26]％,P ＜ 0.05 )was significantly improved after BiPAP reatilation treatment for one week.The mean pulmonary arterial pressure ( [ 3.74 ± 0.96 ] vs [ 5.12 ± 1.12 ] kPa,P ＜ 0.01 ),angina pectoris ( [ 0.20 ± 0.01 ]time/d vs [ 0.69 ± 0.03 ] time/d,P ＜ 0.05 ) were significantly decreased.Conclusion COPD combined coronary heart disease patients may achieve an optimal effect by BiPAP ventilation.BiPAP ventilation has no impact on the hemodynamics in patients with the COPD combined coronary heart disease.
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This retrospective analysis showed that the most frequent pathogen causing bacterial liver abscess was Klebsiella pneumoniae in 138 patients.Compared with the patients without diabetes mellitus,it was found that:( 1 ) the percentage of diabetic patients having typical abdominal pain was lower ( P ＜ 0.05 ) ; ( 2 ) neutrophilic granulocytosis was more marked,but albumin and hemoglobin levels were lower in diabetic patients( P＜0.05 ) ; ( 3 )more diabetic patients were complicated with urinary tract infection and suffered from septicemia( P＜0.05 ) ; (4) the clinical course of treatment in diabetic patients was much more prolonged( P＜0.05 ).
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AIM: To explore the cytokines level and the discrepancy of reaction to dexamethasone (Dex) in ALI rats induced by hydrochloric acid (HCl) and lipopolysaccharide (LPS). METHODS: Ninety-six SD rats were divided into six groups at random (n=16 in each group): NS group, HCl group, LPS group, NS+Dex group, HCl+Dex group and LPS+Dex group. Every group was divided into two subgroups: the bronchoalveolar lavage (BAL) subgroup and no bronchoalveolar lavage (NBAL) subgroup. The total leukocytes, PMN%, macrophage%, lymphocyte%, total protein in BALF and the wet/dry of the lung weight were measured. The concentrations of TNF-?, IL-1?, IL-4 and IL-10 in serum and BALF in every group were compared. RESULTS: (1) In the groups of LPS and HCl, the total leukocytes, PMN numbers, the protein concentration in the BALF and W/D were higher than those in control group (P