ObjectiveTo investigate the etiology, exacerbating factors and outcome of geriatric patients with acute renal failure (ARF) in emergency and critical internal medicine. MethodsClinical features of elderly inpatients with ARF who were diagnosed in internal medicine of our hospital during the past 10 years were retrospectively analyzed. Patients were divided into community-acquired ARF (CA-AFR) group and hospital-acquired ARF (HA-ARF) group. Comparisons between CA-ARF group and HA-ARF group, and between elderly patients and non-elderly patients with ARF in internal medicine were performed. ResultsAmong 381 elderly ARF patients in internal medicine, there were 218 (57.2%) CA-ARF patients and 163 (42.8%) HA-ARF patients. Most of the HA-ARF patients (153 cases) were distributed in medical intensive care. Compared with CA-ARF group, patients in HA-ARF group were older, with more underlying diseases, a higher ratio of infections and/or heart failure and more severe acute renal failure. Infection and heart failure/severe myocardial isehemia were the major exacerbating factors for HA-ARF. Of the 163 patients with HA-ARF, 146 patients died and 17 patients survived. Patients in the death group had more underlying diseases, a higher ratio of severe infections and heart failure/severe myocardial ischemia, a higher ratio of cases with multiple organ dysfunction syndrome(MODS) and a higher score of APACHE Ⅱ.When compared with non-elderly patients with ARF, the elderly patients had a higher proportion ofHA-ARF, a higher ratio of MODS, a higher score of APACHEⅡ and a higher mortality of ARF.ConclusionsThe elderly critical patients are susceptible to HA-ARF with more chronic underlying diseases. Infection and heart failure/severe myocardial ischemia are the major exacerbating factors.The prognosis depends on the treatment of predisposing diseases and removal of exacerbating factors.

In order to study on the properconcentrations for patch test(PT),and the availability of PT w ith the suspected cosm etic products used by the patients,PT ofvarious cosm etic products w as per- form ed on 35 healthy subjects and 38 patients w ith non-contactderm atitis and non-eczem a by using dif- ferent concentrations of cosm etic products and their vehicles in cosm etic products.In 62 patients w ith cosm etic derm atitis PT w as done using their ow n suspected causative cosm etic products.The results show ed thatm ost products could be tested “w ith originalproducts”,w ithout dilution,such as skin care products(cream ),lipsticks,hair care products(hair cream ,hair oil,m ousse),others had to be diluted, such as hair dyes,hotoiland soap,to 2% solution,sham poos to 5% solution,perm anent-w ave solutions and perfum es to 5% or 10% in distilled w ater,nailvarnish to 5% or 10% in acetone.The totalpositive rate of PT by using suspected cosm etics w as 95.16% .Our results indicate that PT concentrations and vehicles vary w ith different products in suspected cosm etics,PT of the suspected causative cosm etic products is an im portant m eans for the diagnosis of cosm etic derm atitis.Our study provides necessary data for the further study ofChinese standard cosm etic screening series allergens for PT.

ObjectiveTo investigate the effect of ulinastatin on perioperative renal function in patients undergoing orthotopic liver transplantation.MethodsSixty ASA Ⅱ or Ⅲ patients of both sexes aged 35-64 yr weighing 50-75 kg with normal blood urea nitrogen (BUN) and creatinine (Cr) before operation undergoing orthotopic liver transplantation were randomly divided into 2 groups ( n ＝ 30 each):control group (group C) and ulinastatin group ( group U).Anesthesia was induced with midazolam,fentanyl,etomidate and vecuronium and maintained with isoflurane inhalation,propofol TCI,continuous remifentanil infusion and intermittent iv boluses of fentanyl and vecuronium.The patients were tracheally intubated and mechanically ventilated.PET CO2 was maintained at 30-35 mm Hg.Ulinastatin 400 000 IU in normal saline 20 ml was infused iv after induction of anesthesia.Ulinastatin 200 000 IU was then infused every 4 h until 48 h after operation.Urine volume and the amount of furosemide administered were recorded before anhepatic phase,and during anhepatic and neohepatic phase.Venous blood samples and urine were collected before induction of anesthesia (T1),at 15 min of anhepatic phase ( T2 ),at 15min of neohepatic phase (T3),at the end of operation (T4) and 48 h after operation (T5) for determination of serum concentrations of BUN,Cr and creatinine clearance rate and urinary N-acetyl-beta-D-glucosaminidase (NAG)activity and microalbumin concentration.ResultsCompared with group C,ulinastatin significantly decreased the amount of furosemide administered and increased urine volume during anhepatic and neohepatic phase,decreased serum Cr concentration,increased creatinine clearance rate at T2.5,decreased urinary NAG activity and microalbumin concentration at T4.5 and serum BUN concentration at T3-s.ConclusionUlinastatin has protective effect on rehal function during perioperative period in patients undergoing orthotopic liver transplantation.

Objective To investigate the biological function of IFN-λ in 7 human esophageal carcinoma cells. MethodsThe gene expression of IL-28α, IL-10β and antiviral molecule was examined with PCR. The MHC molecules expression and the profiles of cell cycle were analyzed with flow cytometer. Cell proliferation was evaluated with MTT assay. ResultsAll of esophageal carcinoma cells express the gene of II-28α and IL-10β. IFN-λ induced or augmented the gene expression of antiviral molecules, 2′5′-OAS and MxA. IFN-λ enhanced the MHC class Ⅰ molecule expression. IFN-λ inhibited the growth of esophageal carcinoma cells through the regulation of cell cycle distribution. ConclusionEsophageal carcinoma cells express the IFN-λ receptor complex. IFN-λ has the antiviral, anti-proliferative and immunoregulation activity.

Objective To explore the relationships among organization climate,psychological empowerment and job embeddedness by using path analysis.Methods A total of 514 clinical nurses from 26 departments in 3 hospitals were recruited by convenience cluster sampling method and investigated with demography questionnaire,Nurses Organizational Climate Scale,Psychological Empowerment Scale and Job Embeddedness Scale.Results The mean scores of organization climate,psychological empowerment and job embeddedness was (3.01±0.46),(3.27±0.44),(3.08±0.39).The predictors of job embeddedness of nurses were resources support,work experience,human resources management,marital status,job title,management support,quality management,and self-egicacy,explained 48.9％ of its variance; organization climate,psychological empowerment had direct positive influence on nurses' job embeddedness,explained 33.3％ of its variance.Conclusions Improvement and maintenance of sound organizational climate,increase the sense of psychological empowerment of nurses,are effective ways and means to increase the degree of job embedding of nurses.

Objective To explore the effect of narrative therapy on family environment and values in adolescents with emotional disorder.Methods 35 adolescents with emotional disorder and their parents from Affiliated Brain Hospital,Nanjing Medical University were enrolled and treated by narrative therapy.Family environment was assessed using Family Environment Scale-Chinese Version (FES-CV)and was compared between pre-and posttherapy.Results 28 adolescents with emotional disorder and their parents completed therapy.The cohesion,independence,intellectual orientation,active-recreation orientation and organization in FES-CV showed higher scores at post-therapy than at pre-therapy ((6.89 ± 2.56) vs.(4.21 ± 3.21) ; (5.54 ± 1.35) vs.(4.68 ± 1.51) ;(4.75±2.07)vs.(3.50±2.12);(4.07±2.65)vs.(2.50±2.32);(3.68±1.77)vs.(2.50±1.62)respectively).The contradict in FES-CV showed lower scores at post-therapy than at pre-therapy ((2.75 ± 2.44) vs (5.25 ± 2.50)).The values of adolescents with emotional disorder and their parents had a positive change after narrative therapy.Conclusion Narrative therapy is effective on the positive change of FES-CV and values of adolescents with emotional disorder and their parents.

Objective: To explore the mechanism of congestive heart failure (CHF) by observing the effects of Tingli Shengmai Decoction on myocardial fibrosis and expression of TGF-?1 of rats with CHF. Methods: The CHF animal models were duplicated by the abdomen arteriarctia method, and 60 male wistar rats were randomly divided into the sham-operation group, the model group, the high-dose of Tingli Shengmai Decoction group, the low-dose of Tingli Shengmai Decoction group and the positive medicine (Xinbaowan) control group. After 4 weeks common fed, every group rats were given a certain dose of distilled water or medicine. After 8 weeks, hemodynamic parameters were detected, MASSON staining was used in the study of collagen type in left ventricular interstitial tissue, collagen volume fraction (CVF) were measured by image analysis, and expression of TGF-?1 in myocardium were evaluated by immunohistochemical staining. Results: Compared with the sham-operated group, CVF of model control group increased significantly (P

Objective To evaluate the effectiveness of the current measure of Oncomelania hupensis control in Jiangsu Province. Methods The snail control was carried out with molluscicides in the high transmission areas every year. Some snail habitat areas were modified. The snail areas within three years were re-treated with molluscicides in the maintenance phase. The snail survey was carried out every spring, and the data were analysed with SAS software. Results From 1995 to 2001, 14519.17 hm 2 of snail habitats were molluscicided, 2768.57 hm 2 were modified, and 8803.64 hm 2 were re-treated with molluscicides in the maintenance phase. The coverage rates of snail control areas dropped by 19.14% every year. The snail areas increased by 6.25% every year from 1995 to 2002. In which, the areas of infected snails increased by 18.52% every year. The correlation analysis showed that the areas of infected snails increased with the increasing of the total snail areas. At the same time, the areas of infected snails increased with the fall of the coverage rates of snail control areas. The analysis of the snail distribution showed that the main problem was poor snail control. Conclusion In recent years, the rise of area of snail habitats is serious in Jiangsu Province. The present measures of the snail control have not effectively stopped the spreading and increasing of snails. The research on the new molluscicides, the new methods of snail control and the better policies are very important.

Through analyzing the problems of time,selection mode,research plan,and tracking review in the ethical review of scientific research projects,this paper put forward the corresponding countermeasures:standardized application procedures,diverse selection mode,standardized research plan,and strict tracking review.It aimed to improve the quality of ethical review of scientific research projects and improve the ethical review system.

With the aid of scientific research management information system, we established an in-formation management for the scientific research funds. The structure,function and application of the system were introduced in this paper.