Objective To investigate the value of clinical parameters in predicting the initiation of renal replacement therapy(RRT) in acute kidney injury (AKI) patients with cardiorenal syndrome (CRS).Methods A total of 75 AKI patients hospitalized with CRS were enrolled.All patients received pharmacologic therapy on the beginning 3 days.The patients whose heart function improved were divided into control group (n=39),and the patients whose heart function worsened were divided into RRT group (n=36).Clinical and laboratory data on the first day and the fourth day were collected and analyzed.The factors on the first day were labeled asⅠ ,and those on the fourth day were labeled asⅡ. The ratio of some parameters calculated were labeled asⅡ/Ⅰ .Area under curve (AUC) of receiver operating characteristic curve (ROC) of these factors was used to evaluate the sensitivity and specificity in predicting the initiation of RRT.Results The patients in RRT group had significantly higher levels of BNP-Ⅱ,BNP Ⅱ / Ⅰ and creatinine Ⅱ / Ⅰ (P ＜ 0.01),and lower levels of 24 hours urine volume-Ⅰ and 24 hours urine volume-Ⅱ (P ＜ 0.01).From ROC curve analysis,the AUC of 24 hours urine volume-Ⅰ,24 hours urine volume-Ⅱ,creatinine Ⅱ / Ⅰ,BNP-Ⅱ levels and BNP Ⅱ/Ⅰ to predict RRT were 0.736,0.875,0.747,0.779 and 0.894 respectively.When the cutoff values of 24 hours urine volume-Ⅰ,24 hours urine volume-Ⅱ,BNP-Ⅱ levels,BNP Ⅱ / Ⅰ and creatinine Ⅱ / Ⅰ were 905 ml (sensitivity 75％,specificity 94.9％),1450 ml (sensitivity 75％,specificity 100％),3360 ng/L (sensitivity 72.2％,specificity 100％),1.37 (sensitivity 75％,specificity 100％) and 1.25 (sensitivity 72.2％,specificity 94.4％) respectively,the value of the parameters to predict RRT was high.Conclusions The 24 hours urine volume,BNP levels after treatment and the dynamic changes of BNP levels and creatinine levels can be used as predictors of the initiation of RRT in the AKI patients with CRS.

Objective To explore the depression and its related factors of the patients with craniocerebral injury during rehabilitation.Methods 111 patients with craniocerebral injury were investigated with the questionnaire about general condition. They were assessed withHamilton Rating Scale for Depression (HAMD). The relationship between the general condition and the score of HAMD were analyzed. ResultsThere were 27 cases (24.32%) with score of HAMD≤7, 31 cases (27.93%) with the score from 8 to 17 and 53 cases (47.75%) with thescore≥18. The score of HAMD was significantly related to the patients' age, education, profession, economy status, economic compensationand the cause of injury (P<0.05). However, it was not related to the sexuality, marital status, registered residence, level of the injury, thecourse of disease and the coma time (P>0.05). Only economy state (x₁), education (x₂) and economic compensation (x₃) entered into the regressionequation by multiple regression analysis: y=22.782-6.879x₁+2.357x₂+3.54x₃ (F=75.609, P=0.000). Conclusion Patients with craniocerebralinjury generally depress during rehabilitation. The patients with a worse economy state, a higher education and no economic compensationappear more serious depression.