BACKGROUND: Acute kidney injury (AKI) is associated with a high mortality. This study was undertaken to detect the factors associated with the prognosis of AKI. METHODS: We retrospectively reviewed 98 patients with AKI treated from March 2008 to August 2009 at this hospital. In these patients, 60 were male and 38 female. Their age ranged from 19 to 89 years (mean 52.4±16.1 years). The excluded patients were those who died within 24 hours after admission to ICU or those who had a history of chronic kidney disease or incomplete data. After 60 days of treatment, the patients were divided into a survival group and a death group. Clinical data including gender, age, history of chronic diseases, the worst laboratory values within 24 hours after diagnosis (values of routine blood tests, blood gas analysis, liver and renal function, levels of serum cystatin C, and blood electrolytes) were analyzed. Acute physiology, chronic health evaluation (APACHE) II scores and 60-day mortality were calculated. Univariate analysis was performed to find variables relevant to prognosis, odds ratio (OR) and 95％ confidence interval (CI). Multiple-factor analysis with logistic regression analysis was made to analyze the correlation between risk factors and mortality. RESULTS: The 60-day mortality was 34.7％ (34/98). The APACHE II score of the death group was higher than that of the survival group (17.4±4.3 vs. 14.2±4.8, P<0.05). The mortality of the patients with a high level of cystatin C>1.3 mg/L was higher than that of the patients with a low level of cystatin C (<1.3 mg/L) (50％ vs. 20％, P<0.05). The univariate analysis indicated that organ failures≥2, oliguria, APACHE II>15 scores, cystatin C>1.3 mg/L, cystatin C>1.3 mg/L+APACHE II>15 scores were the risk factors of AKI. Logistic regression analysis, however, showed that organ failures≥2, oliguria, cystatin C>1.3 mg/L +APACHE II>15 scores were the independent risk factors of AKI. CONCLUSION: Cystatin C>1.3 mg/L+APACHE II>15 scores is useful in predicting adverse clinical outcomes in patients with AKI.

Adult ; Aged ; Capsid Proteins ; metabolism ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Cervical Intraepithelial Neoplasia ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Oncogene Proteins, Viral ; metabolism ; Uterine Cervical Neoplasms ; metabolism ; pathology ; Uterine Cervicitis ; metabolism ; pathology ; Young Adult

BACKGROUND: Most studies suggest tooth whitening can create a coarse enamel surface which is likely to attract exogenous dyeing material and form the phenomenon of color relapse. After dental bleaching procedure, the use of resin surface treatment agent is expected to make the enamel surface smooth and alleviate tooth color relapse. OBJECTIVE: To unravel the efficacy of Adper Single Bond 2 Adhesive on color relapse phenomenon after dental bleaching treatment by cold light (xenon laser) whitening.METHODS: Twenty-four extracted teeth were collected and coated with 35% hydrogen peroxide followed by xenon laser whitening. The test group was made up of 12 samples coated with light-cured resin surface treatment agent and the left samples as control group were treated with no-coating agent after tooth whitening. Then the two groups were divided into two subgroups which were soaked in distilled water and tea for aging test respectively. The color differences (ΔE) which provided comparative values for statistical analysis was recorded at 1, 3, 5, 7, 14, 21, 28, 35 and 42 days after the aging test. The enamel surface microstructure of the samples was observed before and after bleaching, after resin agent coating, and 28 days after the aging test.RESULTS AND CONCLUSION: (1) Results from color differences observation: there was no significant difference between samples soaked in distilled water before and after whitening treatment (P > 0.05). Similarly, there was no statistical difference between test group and control group soaked in distilled water (P > 0.05). However, after soaking in tea, the color differences in the test group at 1-42 days showed statistically significant differences from those in the control group (P < 0.05). (2) Results from scanning electron microscope observation: after the tooth whitening producers, the enamel surface was damaged in the presence of cavities. After coated with resin surface treatment agent, the enamel surface became smooth and had few cavities. After soaking in tea, gradient smooth surface, some crack, inconspicuous flake dyeing color layer decomposition could be seen in the test group while rough surface with big holes and mottled dyeing layer were clearly visible in the control group. All samples soaked in distilled water had only a small amount of block dyeing layer, holes, weaker roughness than those soaked in tea. To conclude, Adper Single Bond 2 Adhesive light-cured resin surface treatment agent could weaken color relapse phenomenon after tooth whitening, achieving a smooth enamel surface and reducing dyeing material adhesion.

Objective To study the effect of Pingchuanguben Decoction on IL-17 level of bronchial alveolar lavage fluid (BALF) and airway remolding in mice with asthma.Methods Forty healthy female Kunming mice were randomly divided into 4 groups (10 rats in each group):normal control group,asthma group,Pingchuanguben Decoction group and Budesonide group.The asthmatic models were established by ovalbumin (OVA) ; the normal control group was treated with phosphate buffer solution (PBS liquid) by celiac injection,during this period Pingchuanguben Decoction was administered to the mice in Pingchuanguben Decoction group each day.In stimulation stage,the normal control group was atomization inhalated PBS liquid,and the rest of the 3 groups were given aerosolized OVA instead.Budesonide atomization was administered to mice in Budesonide group before stimulation.The levels of IL-17 in BALF were measured with enzyme-linked immunosorbent assay (ELISA),and the levels of matrix metalloproteinase-9 (MMP-9)and the tissue inhibitor of metalloproteinase-1 (TIMP-1) in lung tissues were tested with immunohistochemical analysis.Results 1.The levels of IL-17 in BALF in Pingchuanguben Decoction group and Budesonide group were significantly lower than those in asthma group (all P ＜0.05),and the IL-17 in BALF was increased compared with the normal control group (P ＜0.01).2.The levels MMP-9,T IMP-1 and MMP-9/TIMP-1 were decreased in the Pingchuanguben Decoction group and Budesonide group compared with those of asthmatic group (all P ＜ 0.01),and the MMP-9 and MMP-9/TIMP-1 were increased compared with the normal control group(all P ＜0.01).There was no significant difference between Pingchuanguben Decoction group and Budesonide group (all P ＞ 0.05).Conclusions Pingchuanguben Decoction may restrain airway inflammation and remolding,which can replace Budesonide to a certain extent.

OBJECTIVETo investigate the myocardial electrophysiological effect and its underlying mechanisms of atorvastatin (Ator) on isolated rat hearts injured by ischemia/reperfusion (I/R).

METHODSIsolated SD rat hearts were mounted on Langendorff system, and a local I/R was induced by ligation (30 min) and release (15 min) of the left anterior descending artery. During the reperfusion period, the effect of Ator on diastolic excitation threshold (DET), effective refractory period (ERP) and ventricular fibrillation threshold (VFT) on rat heart were measured.

RESULTCompared with the control group, medium concentration of Ator prolonged the ERP in normal rat hearts; low, medium and high concentration of Ator significantly inhibited the decrease of DET, ERP and VFT induced by I/R. However, pretreatment with L-NAME cancelled these cardiac electrophysiological effects of Ator.

CONCLUSIONAtor reduced electrophysiological alteration induced by I/R in isolated rat hearts, which may be mediated by activating nitric oxide pathway to enhance the myocardial electrophysiological stability.

Animals ; Atorvastatin Calcium ; Electrophysiological Phenomena ; Heart ; drug effects ; physiopathology ; Heptanoic Acids ; pharmacology ; In Vitro Techniques ; Myocardial Reperfusion Injury ; metabolism ; physiopathology ; Myocardium ; metabolism ; Nitric Oxide ; metabolism ; Pyrroles ; pharmacology ; Rats ; Rats, Sprague-Dawley

OBJECTIVENoncystic fibrosis (non-CF) bronchiectasis remains as a common health problem in Asia. Pathogens' distribution in airways of patients with non-CF bronchiectasis is important for doctors to make right decision.

DATA SOURCESWe performed this systematic review on the English language literatures from 1966 to July 2014, using various search terms included "pathogens" or "bacteria" or "microbiology" and "bronchiectasis" or "non-cystic fibrosis bronchiectasis" or "non-CF bronchiectasis" or "NCFB."

STUDY SELECTIONWe included studies of patients with the confirmed non-CF bronchiectasis for which culture methods were required to sputum or bronchoalveolar lavage fluid (BALF). Weighted mean isolation rates for Haemophilus influenzae, Pseudomonas aeruginosa, Streptococcus pneumoniae, Stapylococcus aureus, Moxarella catarrhails were compared according to different methodology.

RESULTSThe total mean bacterial culture positive rates were 63%. For studies using sputum samples, the mean positive culture rates were 74%. For studies using BALF alone or BALF and sputum, it was 48%. The distributions of main bacterial strains were 29% for H. influenzae, 28% for P. aeruginosa, 11% for S. pneumoniae, 12% for S. aureus, and 8% for M. catarrhails with methodology of sputum. Meanwhile, the bacterial distributions were 37% for H. influenzae, 8% for P. aeruginosa, 14% for S. pneumoniae, 5% for S. aureus, and 10% for M. catarrhails with methodology of BALF alone or BALF and sputum. Analysis of the effect of different methodology on the isolation rates revealed some statistically significant differences.

CONCLUSIONSH. influenzae accounted for the highest percentage in different methodology. Our results suggested that the total positive culture rates and the proportion of P. aeruginosa from sputum and BALF specimens had significant differences, which can be used in further appropriate recommendations for the treatment of non-CF bronchiectasis.

Bronchiectasis ; microbiology ; Bronchoalveolar Lavage Fluid ; microbiology ; Haemophilus influenzae ; pathogenicity ; Humans ; Pseudomonas aeruginosa ; pathogenicity ; Sputum ; microbiology

China implemented the public hospital reform in 2012.This study utilized bootstrapping data envelopment analysis (DEA) to evaluate the technical efficiency (TE) and productivity of county public hospitals in Eastern,Central,and Western China after the 2012 public hospital reform.Data from 127 county public hospitals (39,45,and 43 in Eastern,Central,and Western China,respectively) were collected during 2012-2015.Changes of TE and productivity over time were estimated by bootstrapping DEA and bootstrapping Malmquist.The disparities in TE and productivity among public hospitals in the three regions of China were compared by Kruskal-Wallis H test and Mann-Whitney U test.The average bias-corrected TE values for the four-year period were 0.6442,0.5785,0.6099,and 0.6094 in Eastern,Central,and Western China,and the entire country respectively,with average non-technical efficiency,low pure technical efficiency (PTE),and high scale efficiency found.Productivity increased by 8.12％,0.25％,12.11％,and 11.58％ in China and its three regions during 2012-2015,and such increase in productivity resulted from progressive technological changes by 16.42％,6.32％,21.08％,and 21.42％,respectively.The TE and PTE of the county hospitals significantly differed among the three regions of China.Eastern and Western China showed significantly higher TE and PTE than Central China.More than 60％ of county public hospitals in China and its three areas operated at decreasing return scales.There was a considerable space for TE improvement in county hospitals in China and its three regions.During 2012-2015,the hospitals experienced progressive productivity;however,the PTE changed adversely.Moreover,Central China continuously achieved a significantly lower efficiency score than Eastern and Westem China.Decision makers and administrators in China should identify the causes of the observed inefficiencies and take appropriate measures to increase the efficiency of county public hospitals in the three areas of China,especially in Central China.

BACKGROUNDVolatile anesthetics (VAs) may affect varied and complex physiology processes by manipulating Ca(2+)-calmodulin (CaM). However, the detailed mechanism about the action of VAs on CaM has not been elucidated. This study was undertaken to examine the effects of VAs on the conformational change, hydrophobic site, and downstream signaling pathway of CaM, to explore the possible mechanism of anesthetic action of VAs.

METHODSReal-time second-harmonic generation (SHG) was performed to monitor the conformational change of CaM in the presence of VAs, each plus 100 µmol/L Ca(2+). A hydrophobic fluorescence indicator, 8-anilinonaphthalene-1-sulfonate (ANS), was utilized to define whether the VAs would interact with CaM at the hydrophobic site or not. High-performance liquid chromatography (HPLC) was carried out to analyze the activity of CaM-dependent phosphodiesterase (PDE1) in the presence of VAs. The VAs studied were ether, enflurane, isoflurane, and sevoflurane, with their aqueous concentrations 7.6, 9.5, 11.4 mmol/L; 0.42, 0.52, 0.62 mmol/L; 0.25, 0.31, 0.37 mmol/L and 0.47, 0.59, 0.71 mmol/L respectively, each were equivalent to their 0.8, 1.0 and 1.2 concentration for 50% of maximal effect (EC50) for general anesthesia.

RESULTSThe second-harmonic radiation of CaM in the presence of Ca(2+) was largely inhibited by the VAs. The fluorescence intensity of ANS, generated by binding of Ca(2+) to CaM, was reversed by the VAs. HPLC results also showed that AMP, the product of the hydrolysis of cAMP by CaM-dependent PDE1, was reduced by the VAs.

CONCLUSIONSOur findings demonstrate that the above VAs interact with the hydrophobic core of Ca(2+)-CaM and the interaction results in the inhibition of the conformational change and activity of CaM. This in vitro study may provide us insight into the possible mechanism of anesthetic action of VAs in vivo.

Adenosine Monophosphate ; analysis ; Anesthetics, Inhalation ; pharmacology ; Anilino Naphthalenesulfonates ; Calmodulin ; antagonists & inhibitors ; chemistry ; physiology ; Cyclic Nucleotide Phosphodiesterases, Type 1 ; analysis ; Fluorescence ; Humans ; Hydrophobic and Hydrophilic Interactions

OBJECTIVETo study clinic character of liver failure complicated with bacterium and fungous infection.

METHODSThe patients with liver failure complicated with bacterial and fungous infection who were treated in our hospital from January 1986 to June 2006 were studied. All patients had clinical manifestation and positive of bacterium. The data were statistical analysis.

RESULTS507 patients diagnosed with fungous infection were found from January 1986 to June 2006 in which 132 patients were diagnosed with bacterial and fungous infection. There were 85 patients (64.39%) with chronic severe hepatitis and 40 patients (30.3%) with decompensation cirrhosis. Bacterial infection happened in 153 cases in which the rate of nosocomial infections was 54.90%. 204 bacterial strains were separated in which 143 strains (70.10%) were gram-negative bacterium and 61 (29.90%) strains were gram-positive bacterium. The main sites of bacterial infection were abdominal cavity (122 cases) and lung (30 cases). Fungous infection happened in 143 cases in which the rate of nosocomial infections was 86.71%. 155 fungous strains were separated in which 90 strains (58.06%) were Candida albicans, 17 strains (10.97%) were Aspergillus fumigatus and 25 (16.13%) strains were non-Candida albicans. The main sites of fouguns infection were lung (94 cases) and mouth (53 cases). 84 patients (63.64%) were ineffective and died after treatment.

CONCLUSIONThe patients with decompensation cirrhosis and chronic severe liver hepatitis were easy to be infected by bacterial and fungous. the rate of fungous nosocomial infections is higher than that of bacterium. The prognosis is bad in patients who had secondary fungous infection.

Adolescent ; Adult ; Aged ; Bacteria ; isolation & purification ; Bacterial Infections ; complications ; microbiology ; Cross Infection ; microbiology ; Female ; Fungi ; isolation & purification ; Humans ; Liver Failure ; complications ; pathology ; Male ; Middle Aged ; Mycoses ; complications ; microbiology ; Retrospective Studies ; Young Adult

OBJECTIVESTo study the clinical characteristics of hepatic failure with aspergillosis.

METHODSThe data of hepatic failure patients with fungal infection hospitalized in our hospital form January 1985 to June 2006 were collected. This research mainly focused on the clinical characteristics of the patients co-infected with aspergillosis.

RESULTSThe occurrence of aspergillosis was 20.5% (104 cases) among 507 hepatic failure patients with fungal infection. Compared with other fungal infection in hepatic failure patients, the effective rate of antifungal therapy and the improvement rate of underlying disease were worse in patients with aspergillus infection (36.5% vs 57.8%, P = 0.000; 26.0% vs 36.7%, P = 0.049). Aspergillus fumigatus was the most common species among 108 fungal species. The species next to Aspergillus fumigatus were Aspergillus niger and Aspergillus flavus. The mainly infected organ was lung and its clinical manifestation was atypical. Liver function could be improved with effective anti-fungus therapy.

CONCLUSIONSDiagnosis and treatment of aspergillosis is difficult in hepatic failure patients co-infected with aspergillosis. Early and effective antifungal therapy is helpful to the recovery of liver function in the hepatic failure patients suspected with aspergillosis co-infection.

Antifungal Agents ; therapeutic use ; Aspergillosis ; diagnosis ; drug therapy ; Aspergillus ; isolation & purification ; Humans ; Liver Failure ; diagnosis ; drug therapy ; microbiology