Acute kidney injury is one of a number of conditions that affect kidney structure and function,which is a broad clinical syndrome encompassing various etiologies.There are general management principles that are common to all patients and these will be discussed here.Management of patients with acute kidney injury according to the stage and cause include hemodynamic monitoring,ensuring volume status,discontinuing all nephrotoxic agents,and nutritional support.

Hemodynamic monitoring is essential in titrating fluid therapy,in order to avoid the deleterious effects of over-and under-filling.Not all patients will respond to a fluid challenge.Therefore,it is useful to predict fluid responsiveness to identify those patients in whom fluid therapy will be of benefit.However,studies performed during the past decade have demonstrated the benefits of using dynamic parameters of filling to assess fluid responsiveness over static parameters during mechanical ventilation or after passive leg raising or volume challenge.

China ; Industry ; Occupational Health Services ; organization & administration

BACKGROUND: Drug therapy can improve the clinical symptoms and extend the gestational age through the maternal way to treat intrahepatic cholestasis of pregnancy (ICP), however, fetal hypoxia and meconium-stained amniotic fluid can not clearly improved. OBJECTIVE: To explore the effect of replacement of amniotic fluid that contains high concentrations of bile acids by artificial amniotic fluid through amniocentesis in the rat model of ICP. DESIGN, TIME AND SETTING: Random control animal experiments were completed in the Laboratory (first-degree laboratory) of Animal Experimental Center in Chongqing Medical University from March to September 2008. MATERIALS: Forty SD pregnant rats with 15 days of pregnancy were randomly divided into intracavitary injection of S-Adenosyl-L-methionine (SAMe) (IUS), intracavitary injection of sodium chloride (IUN), intravenous injection of SAMe (IVS) and blank control (IC) groups, with 10 rats in each group. METHODS: On day 15 of pregnancy, ICP rat models were induced by daily injection of estradiol benzoate. On day 17 of pregnancy, 1 mg SAMe and 0.3 mL sodium chloride were injected into amniotic cavity of in the IUS and IUN groups through amniocentasis. Meanwhile, 30 mg SAMe were injected though tail veins in IVS group. No treatment was performed in the IC group. MAIN OUTCOME MEASURES: The meconium-stained amniotic fluid rate and the still birth rate were calculated. Total bile acid (TBA) level in amniotic fluid was measured. In addition, the expression of hypoxia-inducible factor 1 ?(HIF-1?) mRNA in the placenta of rats were examined by immunohistochemistry and reverse transcription PCR at the days 20 of pregnancy. RESULTS: The meconium-stained amniotic fluid rate in the experimental group was lower than that of the IC group (P

TCM has a long history of treating diseases, which makes great contribution to people,s health in history. In the last decades, TCM has been considered as a method in fighting against AIDS, it get some experience and achievement. TCM has some advantages, such as enhancing immune function, improving quality of life, especially reducing or removing the symptoms. The Chinese medicine has many targets and whole curative effect in treating AIDS, so the curative effect evaluation that adopts immune function combined with virus load, clinical symptom and objective sign is to be in line with clinical fact.

The study intended to evaluate the efficacy and safety of patient-controlled intravenous analgesia with remifentanil for labor. Three hundred and two parturients at 37 -42 week of gestation received remifentanil (0. 1μg · kg-1 ·min-1 ) as patient-controlled intravenous analgesia for labor (analgesia group) and their clinical results were compared with those of 221 parturients in labor without intravenous analgesia (control group). Maternal monitoring, including pain scores(VAS), delivery mode, side effects, laboring time was performed for both groups. There was a significant decrease (P ＜0. 01) of pain scores in analgesia group compared with those in control group. Parturients in analgesia group experienced a significantly shorter first stage, than those in the control group ( P ＜ 0. 01). There were no differences between two groups in the rate of cesarean section and instrumental delivery. And there were no significant differences for newborns with Apgar scores less than 7 at the point of one minute. Patient-controlled intravenous analgesia with remifentanil for labor is an effective and safe procedure, which can significantly relieve pain, shorten first stage of labor and has no effect on the delivery mode and Apgar scores of neonates.

The accessibility of drugs is the fundamental condition for achieving the universal health care, and price is the important factor of accessibility.It is essential to have a national price negotiations mechanism for the patented drugs and for exclusive production of drugs.As for the regular works, the national price negotiations mechanism should be ruled by law, while rules and regulations should be formulated accordingly.This paper discusses the specific content and the clarification of the legislative principle of legal framework for the negotiations, main roles, and selection of objects, procedure, results and application of the negotiations.It also analyses the existing problems are analyzed, and put forward the future legislation and corresponding rules.

OBJECTIVE:To investigate the feasibility of mouse models establishment with kidney-positive deficiency with anti-sense oligonucleotide-loaded biodegradable polylactic acid microspheres. METHODS:Three-week old mice were randomized into groups A,B,C,D and E,with 6 mice in each group,where the mice in group A were given subcutaneous injection 0.2 ml nor-mal saline,and those in groups B-E were given subcutaneous injection 0.1,0.2,0.4 and 0.8 mg each mice of antisense oligonucle-otide-loaded biodegradable polylactic acid microspheres. After the administration,the weights and activities of mice in all groups were observed;and one month later,their livers,adrenal glands and brains were collected to detect the expression of glucocorti-coid receptor (GR) by real-time quantitative polymerase chain reaction (RT-PCR). RESULTS:All mice except those in group A were found to have kidney-positive deficiency symptoms such as developmental delay,light weight,less activities and gathering to-gether. Compared to group A,other groups showed lower GR expressions in liver,adrenal gland and brain. There was statistically difference (P<0.05). CONCLUSIONS:Antisense oligonucleotide-loaded biodegradable polylactic acid microspheres can inhibit GR expression,and the mice whose GR expression is inhibited show symptoms of kidney-positive deficiency,which provides a re-ference for the establishment of mouse models with kidney-positive deficiency.

Hemodynamic therapy in critically ill patients is based on the theory of hemodynamics, combined with characteristics and patterns of the circulatory system, to improve the outcome of patients.The basic direction of critical care ultrasound is to improve tissue perfusion, implement the target-goal hierarchical management, and distinguish appearance and essence.Through continuous monitoring, integrated clinical information and dynamic assessment, rapid screening of the etiology of shock and hemodynamic abnormalities are in order to optimize therapy for reducing or avoiding reinjury during treatment.Finally, organization of therapy and protection of organs are realized.The interpretation of ultrasound images, the analysis of etiology as well as the judgement of illness, the information of treatment decisions, and the fine adjustment of therapic direction and intensity are inseparable from the in-depth understanding of the medical laws and pathophysiological characteristics of severe diseases.

AIM:To analyze relevancy between the changes of the retinal thicknesses of children's anisometropic amblyopic macular at Area A1 before and at the end of amplyopia cure and amplyopia cure effect.
METHODS: Through randomly selecting 30 cases ( 60 eyes) of anisometropic amblyopic children as test group and 29 cases ( 58 eyes ) of children with normal vision after the vision correction as control group, the changes of the retinal thicknesses of macular of the test group and the control group at Area A1 by OCT-3 was observed dynamically and analyzed.
RESULTS: Compared with first diagnosis, the comparative difference of retinal thicknesses of macular at Area A1 in control group at 3, 6mo has statistical significance. The test group was divided into amblyopia group and non-amblyopia group. There has statistical significance for the comparative difference between the retinal thicknesses of macular centre at 3, 6mo and the first diagnosis in the non - amblyopia group, the amblyopia group was divided into the invalid cure group, progress group and the cured group according to amblyopic cure effect. Compared with first diagnosis, there is no statistical significance of macular at Area A1 in invalid cure group and progress group at 3, 6mo, and in the cured group at 3mo, but in the cured group at 6mo has statistical significance.
CONCLUSION: There is a certain relationship between the changes of retinal thicknesses of macular of children with anisometropic amblyopic at Area A1 before and at the end of amblyopia treatment and amblyopia cure effect. OCT is a kind of objective auxiliary test method and provides new clues for amblyopia research.