Objective To investigate the life quality (QoL) of end stage renal disease patients. Methods KDQOL-SFTM1.2 scale was used to assess the life quality of end-stage renal disease patients who received maintenance hemodialysis or Newly diagnosed but not yet received renal replacement therapy more than three months in the First Affiliated Hospital of Kunming Medical University or the Yunnan Kidney Disease Hospital from March 2011 to July 2012. Results (1) The QoL of maintenance hemodialysis group was significantly higher than not yet started renal replacement therapy group in the Physical functioning (PF),Role physical (RP),Body pain (BP) fields, the difference was statistically significant ( <0.05) . (2) The QoL of maintenance hemodialysis group was significantly higher than not yet started renal replacement therapy group in the Symptom/problem list (SPL), Sleep fields,but lower than not yet started renal replacement therapy group in the Effects of Kidney disease (EKD), Work status (WS) fields,the difference was statistically significant (<0.05) . Conclusion The life quality of maintenance hemodialysis patients is higher than newly diagnosed but not yet started renal replacement therapy patients in some aspects.

Objective To study on the application of biological variation total allowable error in quality management of serum lipid detection .Methods The σ score ,quality goal index (QGI) ,priority improvement measures and performance evaluation of lipid accuracy criteria were evaluated ,including cholesterol (CHOL) ,triglyceride (TG) ,high density lipoprotein (HDL‐C) ,low density lipoprotein (LDL‐C) ,which included in the standard of accuracy of the Ministry of Health in 2015 .The reason for unsatisfactory re‐sults of cholesterol (CHOL) test were analyzed .Results Based on the three levels of quality specifications derived in biological var‐iation ,when the total allowable error was located at an appropriate level ,the σ score of TG ,HDL‐C ,LDL‐C reached 6 ,it was not re‐quired for improvement .While the score of CHOL performance analysis was poor ,accuracy was required to give priority to impro‐ving .When the total allowable error reached the best level ,only the σ score of TG achieved “good” in the four items ,improvement of precision was needed .When the total allowable error was located at the lowest level ,the σ score of TG ,HDL‐C ,LDL‐C was grea‐ter than 6 ,the score of performance analysis reached the “excellent” .The σ score of CHOL (2 .9) had been closen to 3σ ,accuracy was required to be corrected .Conclusion The biological variation derived total allowable error is easy to meet the requirements of the quality management in serum lipid determination by current technologies and methods .The theory of 6σ quality can reflect the performance of detection indexes ,and improve the quality of analysis effectively .

Objective To evaluate the role of transesophageal echocardiography (TEE) in perioperative period of pediatric patients with congenital heart disease (CHD).Methods From July 2011 to December 2012,TEE was used in 393 pediatric patients(≤ 14 years) with congenital heart disease in perioperative period.We make a retrospective review with the clinical data of these cases.Results Operative schemes or therapeutic schedules of 60 patients(15.3％) were altered according to TEE.By preoperative TEE,the diagnosis of transthoracic echocardiography (TTE) of 4 cases(1.0％) were amended,4 cases (1.0％) were complemented,and 4 cases (1.0％) got the auxiliary diagnosis,among which operative schemes of 11 cases (2.8％)were altered.During the operate,29 cases(7.4％) found residual problems,11 cases(2.8％) got the auxiliary diagnosis.By postoperative TEE,7 cases(1.8％) found residual problems,1 case(0.3％) got the auxiliary diagnosis.Complications occurred in 9 cases(2.3％) of the 393 patients.Oral and pharyngeal mucous membrane bleeding occurred in 7 cases (1.8％),inadvertent tracheal extubation in 2 cases(0.5％).Conclusion TEE plays an important role in confirming preoperative diagnoses,formulating surgical plans,evaluating immediate operative results,identifying patients with residual defects and guiding the therapeutic schedule in perioperative period of pediatric patients with congenital heart disease.

Objective To summarize the clinical experience and risk factors for acute kidney injury (AKI) in neonates undergoing congenital cardiac surgery and demonstrate whether neonatal AKI after cardiac surgery was independently related to perioperative short-term outcomes. Methods Medical records of neonates undergoing congenital heart surgery from January 2014 to September 2021 were retrospectively reviewed. The patients were divided into an AKI group and a non-AKI group according to whether the AKI occured after the surgery. Multivariate logistic analysis was performed to analyze the risk factors for postoperative AKI and the relationship between postoperative AKI and postoperative short-term outcomes. Results A total of 609 patients were included. There were 395 males and 214 females with an age at surgery of 1.0-28.0 d and weight of 1.9-4.8 kg. After cardiac surgery, 139 neonates developed AKI. Multivariate logistic analysis showed that less intraoperative urine output [OR=0.96, 95%CI (0.94, 0.99), P=0.005], more intraoperative infusion of red blood cells [OR=1.49, 95%CI (1.16, 1.91), P=0.002], longer intraoperative deep hypothermic circulatory arrest time [OR=1.02, 95%CI (1.00, 1.04), P=0.020], higher vasoactive-inotropic score [OR=1.03, 95%CI (1.01, 1.04), P<0.001] and elevated lactate (increasing by 5 mmol/L) [OR=2.90, 95%CI (1.76, 4.76), P<0.001] when transferred to ICU were independent risk factors for AKI. AKI was an independent risk factor for increased in-hospital mortality [OR=12.61, 95%CI (3.00, 37.48), P<0.001]. Conclusion Less intraoperative urine output, more intraoperative infusion of red blood cells, longer intraoperative deep hypothermic circulatory arrest time, higher vasoactive-inotropic score and elevated lactate when transferred to ICU are independent risk factors for AKI. Furthermore, AKI is an independent risk factor for perioperative death after cardiac surgery.