简介：InthisLetter,aminiaturewearableRamanspectroscopysystemisdeveloped.Awearablefiber-opticprobeiemployedtohelpthestableandconvenientcollectionofRamanspectra.Anonlinearpartialleastsquaresmodebasedonamultivariatedominantfactorisemployedtopredicttheglucoselevel.Themeancoefficientsofdeterminationare0.99,0.893,and0.844fortheglucosesolution,laboratoryrats,andhumanvolunteers.ThresultsdemonstratethataminiaturewearableRamanspectroscopysystemisfeasibletoachievethenoninvasivdetectionofhumanbloodglucoseandhasimportantclinicalapplicationvalueindiseasediagnosis.

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简介：ThisstudywasperformedtoassesswhetherthereisanassociationbetweenelevatedFastingBloodGlucose(FBG)andhearingimpairmentinBangladeshipopulation.Atotalof142subjects(72withelevatedFBG;70control)wereincludedinthestudy.Themeanauditorythresholdsofthecontrolsubjectsat1,4,8and12kHzfrequencieswere6.35±0.35,10.07±0.91,27.57±1.82,51.28±3.01dBSPL(decibelsoundpressurelevel),respectivelyandthatofthesubjectswithelevatedFBGwere8.33±0.66,14.37±1.14,38.96±2.23,and71.11±2.96dB,respectively.TheauditorythresholdsofthesubjectswithelevatedFBGweresignificantly(p<0.05)higherthanthecontrolsubjectsatalltheabovefrequencies,althoughhearingimpairmentwasmostevidentlyobservedatanextra-high(12kHz)frequency.Subjectswithalongdurationofdiabetes(>10years)showedsignificantly(p<0.05)higherlevelofauditorythresholdsat8and12kHz,butnotat1and4kHzfrequencies,comparedtosubjectswithshorterdurationofdiabetes(
10years).Inaddition,basedonthedataofoddsratio,moreacuteimpairmentofhearingattheextra-highfrequencywasobservedindiabeticsubjectsofbotholder(>40years)andyounger(
40years)agegroupscomparedtotherespectivecontrols.Thebinarylogisticregressionanalysisshoweda5.79-foldincreaseintheoddsofextra-highfrequencyhearingimpairmentindiabeticsubjectsafteradjustmentforage,genderandBMI.Thisstudyprovidesconclusiveevidencethatauditorythresholdatanextra-highfrequencycouldbeasensitivemarkerforhearingimpairmentindiabeticsubjects.

简介：AbstractBackground:Glucose control is an important aspect in managing critically ill patients. The goal of this study was to compare the effects of sequential feeding (SF) and continuous feeding (CF) on the blood glucose of critically ill patients.Methods:A non-inferiority randomized controlled trial was adopted in this study. A total of 62 patients who were fed enteral nutritional suspension through gastric tubes were enrolled. After achieving 80% of the nutrition target calories (25 kcal·kg-1·day-1) through CF, the patients were then randomly assigned into SF and CF groups. In the SF group, the feeding/fasting time was reasonably determined according to the circadian rhythm of the human body as laid out in traditional Chinese medicine theory. The total daily dosage of the enteral nutritional suspension was equally distributed among three time periods of 7 to 9 o’clock, 11 to 13 o’clock, and 17 to 19 o’clock. The enteral nutritional suspension in each time period was pumped at a uniform rate within 2 h by an enteral feeding pump. In the CF group, patients received CF at a constant velocity by an enteral feeding pump throughout the study. Blood glucose values at five points (6:00/11:00/15:00/21:00/1:00) were monitored and recorded for seven consecutive days after randomization. Enteral feeding intolerance was also recorded. Non-inferiority testing was adopted in this study, the chi-square test or Fisher test was used for qualitative data, and the Mann-Whitney U test was used for quantitative data to determine differences between groups. In particular, a repeated measure one-way analysis of variance was used to identify whether changes in glucose value variables across the time points were different between the two groups.Results:There were no significant demographic or physiological differences between the SF and CF groups (P > 0.050). The average glucose level in SF was not higher than that in CF (8.8 [7.3-10.3] vs. 10.7 [9.1-12.1] mmol/L, Z = -2.079, P for non-inferiority = 0.019). Hyperglycemia incidence of each patient was more common in the CF group than that in the SF group (38.4 [19.1-63.7]% vs. 11.8 [3.0-36.7]%, Z = -2.213, P = 0.027). Hypoglycemia was not found in either group. Moreover, there was no significant difference during the 7 days in the incidence of feeding intolerance (P > 0.050).Conclusions:In this non-inferiority study, the average blood glucose in SF was not inferior to that in CF. The feeding intolerance in SF was similar to that in CF. SF may be as safe as CF for critically ill patients.

简介：AbstractBackground:Previous studies have provided conflicting evidence about the increased overall survival (OS) in lung cancer patients with diabetes mellitus (DM) compared with those without DM. This study assessed progression-free survival (PFS)/OS in lung cancer patients with or without DM and tentatively analyzed the impact of blood glucose levels on PFS/OS in lung cancer patients.Methods:Data were collected from lung cancer patients based upon admission records from January 2010 to January 2012 and follow-up records from January 2010 to January 2015 in the Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai. The data included patient sex, age, body mass index (BMI), smoking status, history of DM, level of blood glucose, pathological type, clinical stage of cancer, chemotherapy regimen, and history of anti-DM drugs. The Cox regression model and Kaplan-Meier method were used for the analysis of hazard factors and PFS/OS. For comparison of PFS/OS in lung cancer with or without DM, patients were divided into three groups: lung cancer with DM, lung cancer without DM but with elevated level of blood glucose, lung cancer without DM or elevated level of blood glucose.Results:In total, the data from 200 lung cancer patients (138 males/62 females, aged 29.0 to 78.0 years, mean 60.0 ± 8.6 years) were collected. For the comparison of PFS/OS in lung cancer patients with or without DM, patients were divided into three groups: lung cancer with DM (n = 31); lung cancer without DM but with elevated levels of blood glucose (n = 40); and lung cancer without both DM and elevated levels of blood glucose (n = 128), whereas 1 patient dropped out of the study. All the patients underwent complete chemotherapy and were followed up for 36.0 to 60.0 months. Kaplan-Meier survival analysis showed that lung cancer patients with DM had increased PFS and OS compared with those without DM (log-rank, P < 0.05, P < 0.01); the median PFS in lung cancer with DM was 12.0 months (95% confidence interval [CI], 4.0-16.0) vs. 6.0 months in those without DM (95% CI, 5.8-6.3); and the median OS in lung cancer patients with DM was 37.0 months (95% CI, 29.0-46.6) vs. 12.0 months in those without DM (95% CI, 10.9-13.1). For the other two groups of patients without DM, there was a trend toward a shorter PFS and OS in patients with elevated blood glucose compared with those without elevated blood glucose. Cox regression showed that PFS in lung cancer patients was favorably associated with the usage of anti-DM drugs, BMI, clinical stage of cancer, and chemotherapy regimen (all P < 0.05) but was inversely associated with the level of blood glucose (P < 0.05).Conclusions:Lung cancer patients with DM have prolonged PFS and OS compared with those without DM, and the level of blood glucose was inversely associated with PFS. The current results indicate that PFS may be a meaningful intermediate endpoint for OS and that the levels of blood glucose hopefully represent a prognostic factor in lung cancer patients.

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简介：AbstractObjective:This article aimed to compare the peripheral blood flow intensity (BFI) in the maternal right and left kidney in uncomplicated third trimester pregnancies and to study possible associations between parenchymal BFI in the kidneys and maternal, labor and new-born characteristics.Methods:We conducted a prospective cohort study in third trimester pregnancies at Trondheim University Hospital, Norway, from January to April 2018. The BFI in the maternal kidneys was examined with color Doppler ultrasound and the peripheral BFI was calculated using the Pixel Flux-method which is a method based on pixel wise calculation of color in an image. Velocity was coded by the color bar in the ultrasound device. The peripheral BFI was calculated as the product of velocity and area encoded by all colored pixels divided by all pixels within the cortical layer by a software examining the color in each pixel of a standardized region of interest of the renal parenchyma in video-clips through a complete heart cycle. BFI (cm/s) was thus calculated as follows:The primary outcome measure was peripheral BFI in the renal cortex. We also examined associations between BFI in the entire cortex with maternal age, body mass index, blood pressure, pH in the umbilical artery, Apgar score after 5 minutes and birthweight.Results:In all, 51 pregnant women were included in the study, but 17 were excluded, mainly due to movement artifacts from the pulsating aorta, leaving 34 women in the final study population. We found significantly lower BFI in the cortex of the left kidney compared with the right kidney, 0.37 cm/s versus 0.69 cm/s, respectively (P = 0.04). Dividing into regions, the BFI was significantly lower in the proximal 25% of the left renal cortex compared to the corresponding right side (P= 0.01), and in the proximal 50% cortex (P= 0.02), but the differences were not significantly different in the distal 25% (P= 0.06) or in the distal 50% (P= 0.20) of the renal cortex.We observed a significant negative correlation between peripheral BFI in the left kidney and both systolic blood pressure (r = -0.38; P= 0.03) and diastolic blood pressure (r= -0.36; P= 0.04), and no significant correlations between BFI with maternal age, body mass index, blood pressure, pH in the umbilical artery, Apgar score after 5 minutes and birthweight in the left kidney (P > 0.05). We did not observe any significant correlations between BFI in the right kidney and maternal or new-born characteristics (P > 0.05).Conclusion:The BFI in the left renal cortex was lower compared with the right renal cortex, and BFI in the left renal cortex was negatively correlated with blood pressure, but not significantly correlated with maternal age, body mass index or newborn characteristics. We did not observe any significant correlations between BFI in the right kidney and maternal or new-born characteristics.

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简介：Ultrasonicbiophysicistsandphysicianshavecontinuouslyexhibitedgreatinterestinstudyingtheultrasonicpropertiesofblood.Itisshownthatcompressibilityofredcellappearstobeinverselypropor-tionalwithitshemoglobincontent.Amongultrasonicattenuationproducedbyredcellstructurelevelinblood,absorptionofredcellplayspredominantrole,viscousrelativemotionlossaccountsforlessthan15%,andcellscatteringcontributionisnegligible.Thecoagulationprocessofbloodisaccompaniedbysignificantchangeofsoundparameters.Themarkedadvantagehasbeenfoundintestofbloodcoagula-tionprocessbyusingultrasonictechniquethanthetraditionalviscousmethod.Bloodcoagulationcausessoundattenuation,soundbackscatteringandnonlinearityparameterB/Atoincrease,buttheattenuationfrequencydependencehardlychanges.Allofthesefindingsareofanimportantrealisticsignifi-cancefordevelopingultrasonicmedicine.

简介：AnovelphotoelectrochemicalbiosensorincorporatingnanosizedCdSsemiconductorcrystalswithenzymetoenhancephotochemicalreactionhasbeeninvestigated.CdSnanoparticlesweresynthe-sizedbyusingdendrimerPAMAMasinnertemplates.TheCdSnanoparticlesandglucoseoxidase(GOD)wereimmobilizedonPtelectrodevialayer-by-layer(LbL)techniquetofabricateabiological-inorganichybridsystem.Underultravioletlight,thephoto-effectoftheCdSnanoparticlesshowedenhancementofthebiosensortodetectglucose.PtnanoparticlesweremixedintotheNafionfilmtoimmobilizetheCdS/enzymecompositesandtoimprovethechargetransferofthehybrid.Experimentalresultsdemon-stratethedesirablecharacteristicsofthisbiosensingsystem,e.g.asensitivityof1.83A/(mMcm2),lowerdetectionlimit(1M),andacceptablereproducibilityandstability.

简介：Wehaveintroducedtheglousesupporter(GS)formicrosurgerysince1991andreporteditsexperimentalstudiesin1992,andnowwepresentitsresultsonclinicalapplicationsinthispaper.GSismadefromglucose,sodiumchlorideanddextranuminproperratio.Ithasbeenprovedtohavenomaterialtoxicityonanimalsandhuman

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简介：ＡＮＥＷＴＹＰＥＯＦＧＬＵＣＯＳＥＳＥＮＳＯＲＦＯＲＣＬＩＮＩＣＡＬＴＥＳＴＹｉｋａｉＺｈｏｕ，ＨｏｎｇＬｉ，ＳｈｕＲｅｎ（ＤｅｐａｒｔｍｅｎｔｏｆＥｎｖｉｒｏｎｍｅｎｔａｌＭｅｄｉｃｉｎｅＴｏｎｇｊｉＭｅｄｉｃａｌＵｎｉｖｅｒｓｉｔｙ，Ｗｕｈａｎ，...

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简介：CunanoclusterswereelectrochemicallydepositedonthefilmofaNafion-solubilizedmulti-wallcarbonnanotubes(CNTs)modifiedglassycarbonelectrode(CNTs-GCE),whichfabricatedaCu-CNTscompositesensor(Cu-CNTs-GCE)todetectglucosewithnon-enzyme.Thelinearrangeis7.0×10-7to3.5×10-3mol/Lwithahighsensitivityof17.76μA/(mmolL),withalowdetectionlimit2.1×10-7mol/L,fastresponsetime(within5s),goodreproducibilityandstability.

简介：Thepropertiesofimmobilizedglucoseoxidase(GOD)bythecomplexesofdiethylaminoethylcellulose(DEAEC)withdifferentpolymers,suchaspolymethylacrylicacid(PMAA),polyacrylicacid(PAA),polystyrenesulfonicacid(PSSA),polyvinylaleohol(PVA),polyethyleneoxide(PEO)andstyrene-maleicacidcopolymer(PSMA)wereinvestigated.TheactivityofimmobilizedGODwasobviouslyinfluencedbythecomponentoftheDEAECcomplexes.TherelativeactivityoftheimmobilizedGODreachedtomaximumandover90%ofthenativeGOD.whentheDEAEC-PMAADEAEC-PAAcomplexeswereusedasacarrierwiththemolarratioofDEAECandpolyacidofaboutone.Michaelisconstants(Km)oftheimmobilizedenzymesofDEAEC-GOD-PMAAandDEAEC-GOD-PAAweredeterminedtobe1.25and1.00,respectively.Moreover,theimmobilizedGODhasagoodstoragestabilityandcycliclife.

简介：Anewtypeoffiberopticglucosebiosensorbasedonfluorescencequenchinghasbeendesignedanditspropertieshavebeenstudied.Glucosecanbeoxidizedbyoxygenwhenglucoseoxidaseareusedasthecatalyst,therefore,theconcentrationofglucosecanbemeasuredbydetectingtheconsumptionofoxygen.Forthedetectionofoxygenconcentration,theruthenium(Ⅱ)complex,Ru(bpy)3Cl2,wereusedasthefluorescenceindicatoranditsfluorescencelifetimeweredetectedbylock-intechnology.Thedetectingrangeofthesensoris50-500mg/dlanditsresponsetimeis30seconds,showingthatthiskindofsensorsispossibletobeusedinclinicaldiagnosisanddetection.

简介：Itisveryimportanttomaintainthelevelofmeanarterialpressure(MAP).TheMAPcontrolisappliedinmanyclinicalsituations,includinglimitingbleedingduringcardiacsurgeryandpromotinghealingforpatient'spost-surgery.Thispaperpresentsafuzzycontroller-basedmultiple-modeladaptivecontrolsystemforpostoperativebloodpressuremanagement.Multiple-modeladaptivecontrol(MMAC)algorithmisusedtoidentifythepatientmodel,anditisafeasiblesystemidentificationmethodeveninthepresenceoflargenoise.Fuzzycontrol(FC)methodisusedtodesigncontrollerbank.Eachfuzzycontrollerinthecontrollerbankisinfactanonlinearproportional-integral(PI)controller,whoseproportionalgainandintegralgainareadjustedcontinuouslyaccordingtoerrorandrateofchangeoferroroftheplantoutput,resultinginbetterdynamicandstablecontrolperformancethantheregularPIcontroller,especiallywhenanonlinearprocessisinvolved.Fordemonstration,anonlinear,pulsatile-flowpatientmodelisusedforsimulation,andtheresultsshowthattheadaptivecontrolsystemcaneffectivelyhandlethechangesinpatient'sdynamicsandprovidesatisfactoryperformanceinregulationofbloodpressureofhypertensionpatients.