Acute kidney injury ( AKI) is a clinical syndrome associated with increased morbidity and mortality, and early recognition is critical .In an attempt to engage laypeople and non-experts,the term kidney attack has been introduced to refer to acute kidney injury (AKI),and AKI with functional loss and tubular damage can be diagnosed both with functional criteria ( CRIAKI, creatinine increase AKI ) and damage criteria ( NCRIAKI, non-creatinine increase AKI ) according to the most recent ADQI consensus .This comprehensive definition of Acute Kidney Syndromes may be a major advancement in terms of early referral , prevention of progression and therapeutic strategies for AKI .

Objective To compare the effect of thoracoscopic and laparoscopic surgery with conventional thoracic surgery on esophageal cancer and its influence on pulmonary function. Methods Ninety?four patients with esophageal cancer treated in the Second Affiliated Hospital of Chengdu Medical College from March 2010 to March 2016 were selected and were divided into the control group ( 54 cases) and the study group ( 40 cases) according to operation methods. The control group received traditional thoracotomy. The study group received thoracoscopic and laparoscopic surgery. The operation and pulmonary function indexes were compared. Results The operation time of the patients in the study group was significantly longer than that in the control group ( (218. 1±35. 8) min vs. (192. 3±40. 1) min,t=3. 23,P<0. 05). Intraoperative blood loss of the patients in the study group was significantly less than that in the control group ( (286. 4±83. 5) ml vs. (343. 7 ±96. 7) ml,t=3. 01,P<0. 05) . The number of lymph nodes cleared of the patients was significantly higher in the study group ( (18.0±5.4) node vs. (15.5±4.6) node,t=2.42,P<0.05).Thoracic drainage of the patients in the study group was significantly less than that in the control group ( (650. 3±61. 3) ml vs. (1153. 5 ±133. 7) ml,t=22. 12,P<0. 05). Chest tube pull out time in the study group was significantly earlier than that in the control group ( (5. 1±1. 3) d vs. (8. 0±1. 8) d,t=8. 65,P<0. 05). First exhaust time in the study group was significantly earlier than that in the control group ( (33. 2±6. 7) h vs. (40. 7±7. 3) h,t=5. 10,P<0. 05). Hospital stay in the study group was significantly shorter than that in the control group ( ( 13. 8 ± 2. 8 ) d vs. (18. 2± 3. 6) d, t=6. 42, P<0. 05) . Postoperative complications occurred in 4 cases in the study group, accounting for 10%, significantly lower than that in the control group, 15 cases, 27. 8%, the difference was statistically significant (χ2=4. 50,P<0. 05) . VC,FEV1 and MVV in the study group were significantly higher than those in the control group ( VC:( 81. 5 ± 15. 6 )% vs. ( 42. 3 ± 8. 1 )%;FEV1: ( 85. 7 ± 9. 1 )% vs. ( 43. 6 ±6. 8)%;MVV:(76. 0±8. 9)% vs. (48. 3±7. 6)%,t=15. 83,25. 68,16. 24,P<0. 05). 3?year survival rate of the study group and the control group were 45. 0% (18/40) and 44. 4% (24/54),respectively. There was no significant difference between the two groups (χ2 = 0. 01, P> 0. 05 ) . Conclusion Thoracoscopic and laparoscopic surgery for esophageal cancer has the advantages of small trauma,rapid recovery and low incidence of complications and obvious protective effect on pulmonary function. It is safe and feasible.

The smoke of anti-infrared smoke agent in a self-made miniature smoke chamber was determined by using Forier transform infrared spectrometer. The smoke changing and settling regulation with time were obtained by measuring the IR spectra of smoke at different time dynamically. Through testing the smoke of different quantity of the same smoke agent, it was found that the relationship between the concentration of the main smoke products and the absorbance obeyed Lambert-Beer′s Law. Finally, the relationship between the smoke screening ability and reactant agent amounts was obtained by calculating the screening ability of different amounts of reactant agent in three “atmosphere windows”.

Objective To assess the effectiveness of the Chinese herbal formula Tongxie Yaofang(TY) or its modified prescriptions in the management of irritable bowl syndrome(IBS).Methods A systematic review was carried out according to the Cochrane standards.A computerized literature search was carried out in main Chinese and English databases including CNKI,CBMdisc,Database of Chinese Doctorate Dissertation,Database of excellent Chinese Master Dissertation,MEDLINE and Cochrane Library.Studies were retrieved when they were randomized controlled trials(RCTs) whose interventions for IBS patients were TY or modified prescriptions of TY with placebos or conventional medicine as controls.Outcome measurement included the alleviation of main symptoms such as abdominal pain,diarrhea frequency,and(or) comprehensive effectiveness and quality of life(QOL).Meta-analysis was performed after evaluating the quality of included studies.Subgroup analysis was done between subgroups of diarrhea-predominant IBS and subtype-regardless IBS,and was also done between diarrhea-predominant IBS treated with TCM syndrome differentiation and that without TCM syndrome differentiation.Funnel plot analysis was used to analyze the publication bias.Results Forty-six studies met the inclusion criteria,and 4155 participants were included in the meta-analysis.The results showed that the effectiveness of TY or modified prescriptions of TY was better than that of conventional medicine or placebos[OR= 5.30,95%CI(4.38,6.41)].Subgroup analysis showed that the OR of TY or modified prescriptions of TY in the diarrhea-predominant groups[OR=5.61,95%CI(4.33,7.25)]was higher than that of subtype-regardless groups[OR=4.95,95%CI(3.74,6.55)],and OR of TY or modified prescriptions of TY in the studies of diarrhea-predominant IBS treated based on TCM syndrome differentiation [OR=6.50,95%CI(3.78,11.20)] was higher than that of the studies without TCM syndrome differentiation[OR=5.37,95%CI(4.01,7.19)],but the difference was insignificant.Funnel plot showed certain publication bias.Conclusion The effectiveness of TY or modified prescriptions of TY for IBS patients is better than that of western medicine and placebo.But their effectiveness for diarrhea-predominant IBS or with TCM syndrome differentiation was not proved to be better than those for other subtypes or without TCM syndrome differentiation.Biases may exist for overall quality of the studies is low;negative results in some high quality studies need further discussion.

Objective To establish a method for quality control of Arnebia euchroma inZizhu Ointment.Methods The TLC was used to make qualitative identification to Arnebia euchroma in Zizhu Ointment. The content of shikonin was targeted as the evaluation index and the method of orthogonal design was used to optimize the extraction of shikonin. UV-visible spectrophotometry was used for the determination of shikonin.Results Main spots of TLC were clear, and negative control had no interference. The optimum extraction of shikonin was extracted for three times, 30 min for each time, NaOH volume fraction of 1%, NaOH amount of 50 mL. The absorbance of shikonin showed a good linear relationship in the range of 0.010 2-0.035 7 mg (r2=0.999 7), and the average recovery was 103.27%, RSD=4.17%.Conclusion This method was simple and feasible, and can be used for the quality control and the evaluation ofZizhu Ointment.

Objective: This study aimed to analyze the high medical expenses of hospitalized medical insurance patients for the first ten systemic diseases.Methods: We investigated the medical expenses for the first ten systemic diseases among 10 900 hospitalized medical insurance patients of a hospital,calculated the average expenses and total payment for the treatment of each of the systemic diseases that involved 5% of the total patients,computed their percentage in the total expenses,and compared them with those of all the other hospitalized cases.Results: The medical cost of the 5% of the first 10 hospitalized systemic diseases accounted for 21%-29.9% of the total expenses of all the hospitalized patients,4.3-6.0 times that of the average expenses,and 30.8%-54.9% paid by the patients themselves.In addition,the hospital stay of these patients was 1.5-4.7 times that of the average.Conclusion: The high medical expenses involving 5% of the hospitalized patients with the first 10 systemic diseases amounted to a quarter of those paid by all the hospitalized patients.Effective measures have to be taken to keep high hospitalization expenses at a reasonable level.

Disciplinary construction plays a significant role in the building of a hospital.Based on the developmental trend of and existing problems in the disciplinary construction in modern hospitals and in view of the requirements of medical development,the authors proposed some specific measures for building up brand-name specialties,accelerating technological innovations and strengthening personnel training,so as to promote the competitiveness and sustainable development of the hospital.

Objective To study the effect of psychological intervention combined with the analysis of Budesonide and Formoterol Fumarate Powder for Inhalation in treatment of chronic obstructive pulmonary disease. Methods 100 patients with chronic obstructive pulmonary disease treated in our hospital from February 2015 to March 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. The control group was treated with the Budesonide and Formoterol Fumarate Powder for Inhalation treatment,the experimental group on the basis of psychological intervention on the mental status of patients and patients,strengthen communication and exchanges, increase confidence in the treatment and the treatment compliance of patients. Results After treatment, the SGRQ score of the experimental group was (57.33±16.81), and the score of the control group was (43.86±12.68) points, with statistical difference (P<0.05). The scores of depression and anxiety in the experimental group were significantly better than those in the control group,with statistical difference(P<0.05). Conclusion Budesonide and Formoterol Fumarate Powder for Inhalation combined with mental intervention in the treatment of chronic obstructive pulmonary disease can significantly improve the patients, improve the quality of life, help patients recover as soon as possible, has clinical significance.

BACKGROUND:Osteoporosis and its complications severely threaten the elder’s health. Simvastatin, widely accepted as a lipid-lowering drug, is reported to potentialy promote bone formation, but it is in debate when oraly administered, and there is no evidence to support whether this is due to the region difference.
OBJECTIVE:To investigate the effect of oraly administered simvastatin on bone mass and biomechanical properties of the femur and vertebrae in osteopenia rats induced by ovariectomy (OVX).
METHODS: Twenty-four 6-month-old female Sprague-Dawley rats were subjected to OVX+oraly administered saline vehicle (OVX group,n=8), OVX+oraly administered simvastatin (5 mg/kg/d; intervention group,n=8) or sham surgery (sham group,n=8). After 8 weeks of treatment, al rats were sacrificed and the level of procolagen type I N-terminal propeptide in blood serum was assessed by ELISA. Bone mineral density was determined in the L5 vertebra and left femur using dual-energy X-rays. Furthermore, the biomechanical properties of the L4 vertebra and right femur, including maximum load and elastic modulus, were detected by compression testing and three-point bending test, respectively.
RESULTS AND CONCLUSION: The serum level of procolagen type I N-terminal propeptide in the sham group was significantly lower than that in the other two groups. OVX rats showed significantly lower bone mineral density in both the L5 vertebra and left femur than sham rats (P < 0.05). Rats in the intervention group showed higher bone mineral density than those in the OVX group, with statisticaly significant difference in the L5 vertebra (P < 0.05), but insignificant difference in the femur. Maximum load and elastic modulus of the L4 vertebra in the OVX group were significantly lower than those in the sham and intervention group. Markedly lower elastic modulus of the femur was found in the OVX group than the sham and intervention groups. These findings demonstrate that simvastatin treatment can partialy prevent bone loss in OVX rats with more notable effect on the vertebrae than the femur, and for this model, the vertebra is superior to the femur used in biomechanical test.

Objective To establish an HPLC method to simultaneously determine the contents of shikonin andβ,β'-dimethylacrylshikonin inZizhu Ointment.Methods The contents of shikonin andβ,β'-dimethylacrylshikonin inZizhu Ointment were determined by HPLC. The chromatographic conditions were Welch Materials XB-C18 Column (4.6 mm × 250 mm, 18.5μm), with mobile phase of acetonitrile-water-formic acid (75:25:0.05), detection wavelength of 516 nm, temperature of 30℃, flow rate of 1.0 mL/min and the load of 20μL.Results Shikonin showed a good linearity in the range of 0.025 6-0.256μg (r2=0.999 5), and the average recovery rate was 98.12% (RSD=1.92%).β,β'-dimethylacrylshikonin showed a good linearity in the range of 0.174 4-2.616μg (r2=0.999 2), and the average recovery rate was 100.46% (RSD=1.17%).Conclusion This method is simple and accurate, which can be used for the quality control and evaluation of Zizhu Ointment.