Plasma fibrinogen beta-148C/T gene polymorphism in cerebral infarction patients

BACKGROUND： Plasma fibrinogen （Fg） β-148C/T gene polymorphism is a risk factor for ischemic angiopathy. OBJECTIVE： To explore the frequency distribution of Fg β- 148C/T gene polymorphism and its relationship with plasma Fg levels in patients with cerebral infarction. DESIGN, TIME AND SETTING： Case control experiment of gene polymorphism was performed at the Central Laboratory of Qingdao University Medical College from January 2003 to June 2004. PARTICIPANTS： A total of 88 patients with cerebral infarction were recruited from the Affiliated Hospital of Qingdao University Medical College, including 52 males and 36 females, averaging （61±14） years of age In addition, 80 healthy cases served as the control group, comprising 48 males and 32 females, with an average age of （58 ± 12） years. METHODS： Blood DNA was extracted, and electrophoresis results were observed using an ultraviolet single photon image system. The frequency distribution of Fg β -148C/T was analyzed by polymerase chain reaction-restriction fragment length polymorphism method. Plasma Fg levels were measured by cerebral infarction time. MAIN OUTCOME MEASURES： Plasma Fg β -148C/T gene polymorphism and plasma Fg levels in patients with cerebral infarction. RESULTS： The frequency of the T allele, and plasma Fg levels in CC, CT, and CC＋CT genotype subgroup, were significantly greater in the cerebral infraction group, compared with the control group （P 〈 0.05）. However, there was no significant difference between the TT genotype subgroup and the control group （P 〉 0.05）. The plasma Fg levels in the CT, TT, and CT＋TT genotype groups were significantly greater than the CC genotype group （P 〈 0.05）. However, in the control group, plasma Fg levels in the TT genotype subgroup were significantly greater than the remaining genotype subgroups （P 〈 0.05）. CONCLUSION： Plasma Fg β -148C/T gene polymorphism is an important hereditary factor for differences in plasma Fg levels. The T allele plays a crucial role in influencing plasma Fg levels in cerebral infarction. Fg β - 148C/T may be a susceptibility factor for cerebral infarction.

Comparison of sequential feeding and continuous feeding on the blood glucose of critically ill patients:a non-inferiority randomized controlled trial

Background: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.