AKI is one of the frequent complications of critically ill patients,which is associated with high mortality.RRT is the main treatment,especially CRRT nowadays.But the optimal dosage of CRRT is unclear.In this article,we will review the evidence of CRRT in critically ill patients with AKI.Compared with traditional dosage of CRRT,high dose CRRT did not improve the clinical outcome.There was no difference in mortality rate,time for renal recovery,ICU hospitalization time,or organ failure in both groups,while there were more complications including hypokalemia and hypophosphatemia in the high dose CRRT group.Treatment with high dose CRRT could alter drug metabolism,cause malnutrition,unbalance the electrolyzes and cause hypothermia.So we conclude that traditional dosage of CRRT[20～35 mL/(kg?h)]is applicable for critically ill patients with AKI,but the determination of optimal dose depends on many clinical situations other than clearance of small solutes.

As one of the chronic diseases,asthma,plays a serious impact on human daily life.Asthma in children has showed an increasing trend in recent years,but the mechanisms of asthma are not yet clear.Studies have found that store-operated calcium entry(SOCE) plays an important role in the physiological activity of the body.The enhanced SOCE activity can promote cell growth,proliferation,and migration of a variety of cell types.SOCE important molecules STIM1 and ORAI1 may be involved in the asthmatic airway occurrence of hyperresponsiveness and airway remodeling,and closely to the asthmatic development.

Objective To realize current status of healthcare-associated infection (HAI)in a neonatal intensive care unit(NICU)of a hospital,and evaluate the effect of comprehensive intervention measures.Methods HAI in NICU was monitored,targeted intervention measures were implemented,incidence of HAI before and after inter-vention was compared.Results The implementation rates of intervention measures at intervention stage was higher than that of pre-intervention stage,the difference was significant(all P <0.001 ).Incidence of HAI at intervention stage was lower than that of pre-intervention stage(5.64%[46/816]vs 13.45% [46/342],χ2 =20.12,P <0.001). The main infection site was lower respiratory tract (38.04% [35/92]).Incidence of ventilator-associated pneumonia and catheter-related bloodstream infection after intervention were both lower than pre-intervention stage (0.38‰ vs 3.30‰,0.12‰ vs 1 .18‰,respectively).The main isolated pathogens before and after intervention were both gram-positive bacteria,accounting for 58.09% and 51 .16% respectively.Conclusion Routine HAI monitoring can reflect the weak links in infection control practice,HAI can be controlled effectively by carrying out intervention measures.

Vitamin D,an immune regulator,plays an important role in innate immune function of antibacterial peptide.Vitamin D takes part in the innate immune function via toll-like receptor in response to pathogen,then release antibacterial peptide.This study describes the antibacterial peptide constitution and the functions,effection of activeted Vitamin D in innate immune function of antibacterial peptide.

?AIM: To observe the application of phacoemulsification combined with laser peripheral iridoplasty ( LPIP ) for acute angle-closure glaucoma with cataract which could not be controlled well by drugs.?METHODS:From January 2011 to June 2015, 49 eyes in 47 patients with acute angle - closure glaucoma and cataract were recruited while their intraocular pressure remained higher than 40mmHg 12h after drug treatment. LPIP were performed and phacoemulsification and intraocular lens implantation were carried out 3d after. Their clinical data and follow-up results were reviewed.?RESULTS: The intraocular pressure before treatment, 1d after LPIP, 1d after phacoemulsification, 1mo after phacoemulsification and 3mo after phacoemulsification were 62. 35+10. 31mmHg, 17. 96 ± 4. 64 mmHg, 16. 58 ± 3. 19mmHg, 13. 50 ± 2. 74 mmHg and 13. 46 ± 2. 48 mmHg respectively (F=10. 02,P<0. 05); the intraocular pressure of 1d (t=4. 35), 1mo (t=6. 43) and 3mo (t=6. 97) after phacoemulsification were all lower than the initial pressure (P<0. 05). The visual acuity showed the same trendy, while the visual acuity before treatment, 1d after LPIP, 1d, 1 and 3mo after phacoemulsification were 0. 06± 0. 02, 0. 20 ± 0. 18, 0. 45 ± 0. 19, 0. 60 ± 0. 11 , 0. 65 ± 0. 09 respectively (F=8. 36,P<0. 05). The best corrected visual acuity at 1d, 1 and 3mo after phacoemulsification were better than that before laser treatment ( t= 3. 97, 5. 12, 5. 89,P<0. 05). At 1d and 3mo after phacoemulsification, the anterior chamber depth, angle opening distance, trabecular/iris angle were all better than the initial ones (P<0. 05). At 1 and 3mo after phacoemulsification, the goniosynechia got better as well (P<0. 05).?CONCLUSION:Phacoemulsification combined with LPIP can reduce intraocular pressure, improve the visual acuity and make the anterior chamber depth, angle opening distance, trabecular/ iris angle, goniosynechia better for patients with acute angle-closure glaucoma and cataract when drug cannot control intraocular pressure well.

Objective To investigate the clinical significance of detection of serum IL -6,IL -17, GM-CSF and TNF -αlevels in patients with rheumatoid arthritis.Methods A retrospective research was made in 79 cases with rheumatoid arthritis,and they were divided into stable period and active period,and another 40 healthy persons were chosen as control group.IL -6,IL -17,GM-CSF and TNF -αlevels were compared,and the relevance was investigated.Results CRP,ESR and DAS28 of active period [39.14 (35.81 )mg/L,41.92 (33.27)mg/L, 4.85(2.74)]were higher than those of the stable period[21.07(16.53)mg/L,29.57(25.14)mg/L,2.88(1.76)] and control group[5.92(2.80)mg/L,3.19(2.24)mg/L],the differences were statistically significant (F =7.013, 6.224,2.136,all P <0.05).Serum levels of GM-CSF,IL -6 and TNF -αof active period[33.81(26.97)pg/mL, 47.23(42.81 )pg/mL,75.35 (41.69 )pg/mL]were higher than those of control group [6.19 (5.11 )pg/mL, 4.68(5.21)pg/mL,33.18 (20.94)pg/mL]and stable period [12.81 (9.76 )pg/mL,8.46 (10.37 )pg/mL, 43.05(38.14)pg/mL],the differences were statistically significant (F =5.328,6.117,8.016,all P <0.05).And there was no significant difference in IL -17 level between the groups (F =0.776,P >0.05).No correlation was observed between IL17 and DAS28,GM-CSF and IL -6 (r =0.213,0.167,0.316,all P >0.05),TNF -αand DAS28,GM-CSF,IL -6 and IL -17 (r =0.761,0.729,0.549,0.421,all P <0.05 ),IL -6 and DAS28 and GM-CSF (r =0.648,0.626,all P <0.05),GM-CSF and DAS28 had good correlation (r =0.563,P <0.05). Conclusion IL -6,GM-CSF and TNF -αlevels were positively correlated with the progression of rheumatoid arthritis,joint detection is of great value in monitoring the disease.

Decorin( DCN) is one of the leucine-rich proteoglycan family of small molecules.It is recog-nized as a tumor suppressor gene.DCN can inhibit tumor cell proliferation and metastasis by binding and inactiva-tion of transforming growth factor beta( TGF-β) and inhibiting the expression of vascular endothelial growth fac-tor or by activating the signaling pathway that promotes cell proliferation by EGFR/MAPK/p21.it plays an impor-tant effect on tumor development,angiogenesis and metastasis.DCN is expressed in various malignant tumors,By up or down regulation,DCN can exert its anti tumor activity,as well as reducing or delaying the occurrence and development of many kinds of malignant tumor.DCN gene may be a potential target for the treatment of many kinds of malignant tumors.

OBJECTIVE:To investigate the characteristics and rules of leukocytopenia induced by essential antipsychotic medi-cines in psychotic in our hospital,and provide reference for the clinical treatment. METHODS:1 345 psychotics received essential antipsychotic medicines from Nov. 2012 to Nov. 2014 in our hospital were collected,and retrospective analysis was adopted to sta-tistically analyze the age,sex and the drug type,dose and treatment time that caused leukocytopenia,symptom duration,white blood cell(WBC)count,clinical manifestation and prognosis. RESULTS:In the 1 345 patients,there were 205 patients with WBC sustained reduction in the process of medication,accounting for 15.24%. The incidence rate of leukocytopenia in patients older than 60 years old reached up to 54.15%;57 patients with leukocytopenia was induced by combination medication,accounting for 20.14% in the total cases of combination medication,and it was significantly higher than the incidence rate of single medication (13.93%),the difference was statistically significant(P<0.05);incidence rate of leukocytopenia induced by the first generation of antipsychotic medicines was 63.36%,which was significantly higher than the second generation(36.64%),the difference was sta-tistically significant(P<0.05);there were 113 patients with the WBC count of 3.0×109-3.9×109 L-1,accounting for 54.63%,com-pared with other WBC count groups,there were significant differences(P<0.05);most of the patients had no discomfort and obvi-ous clinical symptoms,and all patients were improved or recovered after symptomatic treatment. CONCLUSIONS:The incidence rate of antipsychotic in elderly patients with essential antipsychotic medicines is relatively high,and the incidence of antipsychotic is more likely to be caused by combination medication and the first generation antipsychotic medicines. Although leukocytopenia can be cured,it may increase the risk of infection,so blood routine should be regularly checked and paid great attention during treatment.

Education of the adolescent includes sexual physiological education,sexual psychological education and sexual moral education.of both the sexual psychological education and sexual moral deucation,which are often ignored,are the very important two aspects.