Objective To evaluate the value of the RIFLE criteria of acute kidney injury (AKI) for predicting the incidence and prognosis in critically ill patients and to identify the risk factors associated with the outcomes of those patients.Methods All ICU patients admitted over three years and 6-month period were retrospectively studied at Subei People's Hospital.Based on RIFLE criteria,AKI patients were diagnosed and classified into four groups:NAKI (non-AKI),R (risk),I (injury),F (failure)groups.Results (1) AKI occurred in 404 of the 2472 patients (16.3％) during their ICU stay.The mean age of the patients was (61.4 ± 17.4) years.Infectious disease,pulmonary disease,neurological disease and trauma were the major cause of AKI.(2) Mortality in the ICU was much higher in patients with AKI than in patients without AKI (47.3％ vs.23.0％,P ＜ 0.05).The mortality rate was 35.6％ in R group,48.9％ in I group and 60.6％ in F group.(3) The logistic regression suggested that MODS and septic shock were the independent risk factors of AKI,but continuous renal replacement therapy (CRRT) are the independent protective factor of AKI.Conclusions In these ICU patients,AKI is associated with increased hospital mortality.The RIFLE classification is a simple and useful diagnosis tool to detect and stratify the severity of AKI and aid in predicting outcome of patients.

objective To investigate the immunophenotype of Chinese patients with acute lymphoblastic leukemia(ALL)and its association to cytogenetics and clinical features.Methods In this study.a total of 113 Chinese patients with ALL were immunophenotyped by flow cytometry using a panel of monoclonal antibodies.50 000 cells were acquired and analyzed with Cell Quest and abnormal populations were recognized by CD_(45)/SSC gating.Among the 113 patients enrolled in this study,bone marrow cells of 74 patients were cultured for 72 hours to prepare for conventional chromosome detection.and karyotype was analyzed with R-banding technique.Results Of 113 ALL patients,14.2%(16/113)were identified as TALL,85.8%(97/113)as B-ALL Among the 106 out of 113 ALL cases,myeloid antigen(MyAg)expression was documented in 34.9%(37/106)and CD_(13) was the most commonly expressed MyAg in ALL patients(23.6%,25/106).MyAgs were more frequently associated with T-ALL(46.2%,6/13)than with B-ALL(33.3%,31/93)but there was no significant difieFence(X~2=0.825,P＞0.05)between the two groups.MyAg positivity in adult ALL patients(47.6%,20/42)was higher than that in children(26.6%,17/64).There was a significant difference between the two groups(X~2=4.948,P＜0.05).Abnormal karyotypes were detected in 39 out of 74(52.7%)patients.It showed that percentage of patients with high WBC count(＞50×10~9/L)in MyAg~+(48.6%,18/37)was higher than that in MyAg~-ALL types (20.3%,14/69).There was a significant difference between the two groups(X~2=9.191,P＜0.01).CD34 expression was found in 83.8%(31/37)of MyAg~+ and 53.6%(37/69)of MyAg~-cages.There was a significant difference between the two groups(X~2=9.527,P＜0.05).In addition,the percentage of adult ALL patients in MyAg~+ group(54.1%,20/37)was higher than that in MyAg~-group(31.9%,22/69).There was a significant difference between the two groups(X~2=4.948,P＜0.05).Conclusion lmmunophenotype analysis is useful for ALL diagnosis and classification and the immunophenotype has relevance to the abnormal cytogenetic changes and clinical features in ALL patients.

Objective To observe the clinical curative effect of fumigation and steaming with traditional SHE medicine and life intervention on women patients with metabolic syndrome( MS) .Methods 60 women with MS were randomly divided into treatment group and control group,30 cases in each group.The control group was orally given western medicine.The treatment group used fumigation and steaming with traditional SHE medicine and life interven-tion on the basis of oral western medicine therapy,3 days every 1 time,10 times for a period of treatment.The changes of triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),fasting plasma glucose(FPG),blood pressure, body mass,waist circumference,body mass index(BMI),abdominal fat thickness and body fat percentage(PBF) before and after treatment were observed.Results Before treatment,there were no statistically significant differences in TG,HDL-C,FPG,blood pressure,body mass,waist circumference,BMI,abdominal fat thickness,PBF between the two groups.After treatment, TG, HDL -C, FPG, SBP, DBP, body quality, waist circumference, BMI, abdominal fat thickness and body fat in the treatment group were (1.52 ±0.32) mmol/L,(1.36 ±0.31) mmol/L,(6.12 ± 0.31)mmol/L ,(140.67 ±9.32)mmHg,(82.23 ±7.03)mmHg,(65.50 ±11.35)kg,(79.09 ±19.67)cm, (21.30 ±6.12) kg/m2,(26.63 ±3.77) mm,(23.6 ±3.18)% respectively,which in the control group were (1.76 ±0.31) mmol/L,(1.18 ±0.32) mmol/L,(6.40 ±0.32) mmol/L,(150.83 ±12.10) mmHg,(86.50 ± 6.97)mmHg,(71.57 ±12.07)kg,(89.65 ±20.92)cm,(25.15 ±7.41)kg/m2,(30.40 ±3.22)mm,(26.5 ± 3.32)%respectively.The differences between the two groups were statistically significant( t=2.950,2.211,3.414, 3.644,2.362,2.007,2.014,2.194,4.165,3.455,all P<0.05).Conclusion It has obviously improved clinical curative effect for patients with MS,and has certain advantages in the reshape by fumigation and steaming with tradi-tional SHE medicine and life intervention.

Objective To evaluate the toxicological safety of antithrombotic small peptide RWR with independent intellectual property right. Methods Toxicity test in mice, mice bone marrow micronucleus assay, mice sperm abnormality test, and 30-day feeding test in rats were carried out in this study.ResuIts The MTD of acute toxicity test for rats was larger than 120 mg/kg.The results of bone marrow micronucleus assay, mice sperm abnormality test were all negative.Thirty-day feeding test had no adverse effects on body weight, food utility rate, organ coefficient, blood routine index of rats.There was also no histological changes related to RWR in lung, liver, spleen, kidney and heart of rats.ConcIusion RWR had no obvious toxicity on animal growth, hematopoietic function, kidney function and organ tissue and so on.

Objectiye To reveal epidemiology of malignant tumor in Quanzhou area of Fujian province. Methods Medical record of adults who received health check-up between 2006 and 2010 was collected to estimate the incidence of malignant tumor. Chi-square test was used for data analyses.Results Nearly 12 323 individuals received an annual health check-up during 2006 and 2010,177 of whom were found to have malignant tumors. The identification rate of malignant tumors was 2. 87‰ per year, and the most commonly seen cancer included liver cancer ( 42. 93% ), lung cancer ( 20. 90% ), oesophageal cancer (9. 03% ), cervical cancer ( 8.47% ) and gastric cancer (6. 78% ). Those of 60 to 70 years old showed the highest incidence of cancer. Conclusion Annual health check-up may be helpful to identify early-stage malignant tumors.

Clinical medicine and its teaching patterns put forward the new demand to the teaching of laboratory diagnostics. According to the teaching objectives and development tendency of laboratory diagnostics, a novel teaching pattern based on organ-system diseases was established through systematical reform measures. The course content system was reconstructed and focused on the diseases. And the professional teacher group carefully orchestrated, applied new teaching methods,such as case-based learning and problem-based learning. The independent learning on a resource sharing network platform was encouraged, and the evaluation system was innovated. The novel teaching pattern has obtained gratifying achievement, and showed a bright prospect of development.

Clinical practice is an important stage in clinical education and the future career of the graduates. Taking the students of Clinical Inspection Major as an example,this article analyzes the questions need to be paid attention to in the clinical practice and the importance of pre-post training in increasing the quality of clinical practice.

Objective To investigate the changes of T cells and dendritic cells (DCs) and their related factors in children with immune thrombocytopenia (ITP) before and after therapy,and to analyze their clinical significance.Methods T-cells and DCs subsets were determined by flow cytometry both in 64 children with ITP (ITP group) before and after therapy and the control group.The serum levels of interleukin (IL)-4,interferon-γ (IFN-γ),transforming growth factor beta 1 (TGF-β1),and IL-27 were detected by enzyme linked immunosorbent assay (ELISA).Results Treatments of glucocorticoid or IVIg were effective in 41 cases of 64 ITP children.Compared to the control group,helper T cells (Th),Th/suppressor T cells (Ts),T regulatory cells (Treg),plasmacytoid DC (pDC),pDC/myeloid DC (mDC),and TGF-β1 in ITP patient group before treatment were significantly lower,while IFN-γ and IFN-γ/IL-4 were significantly higher (P ＜0.05).In ITP group,Th,Th/Ts,Treg,pDC,pDC/mDC,TGF-β1,and IL-27 were significantly increased,while IFN-γ and IFN-γ/IL-4 were decreased in children with ITP after therapy and achieved response (P ＜ 0.05).However,there was no significant difference between before and after therapy in ITP children without treatment response (P ＞ 0.05).Conclusions T cells and DCs subsets disorder and abnormal cytokine levels are observed in children with ITP,which can be corrected by immunosuppressive therapy,indicating that Th1 overactivity and the decrease of Treg and pDC both in quantity and function may be related to the pathogenesis of ITP in children.

Objective To design a support system based on HIS for enhancing hospital managers' ability in making decision. Methods Through modeling and programming for the system,we integrate,classify and analyze the date from outside and inside. Results Managers can analyze the outcome using multi-dimensions online tools. This system brings the convenience to managers,and enhances scientific and timely decision. Conclusion We put forward the basic method for hospital support system,which is the foundation for future research.

Objective To evaluate the role ofpleth variability index (PVI) by passive leg raising (PLR) test in volume responsiveness and volume status prediction in patients with septic shock.Methods A prospective randomized controlled trial (RCT) was conducted.Eighty-seven patients suffering from septic shock undergoing mechanical ventilation in Department of Critical Care Medicine of Subei People's Hospital from June 2012 to September 2014 were enrolled.The hemodynamic changes before and after PLR were monitored by pulse indicated continuous cardiac output (PiCCO) and PVI monitoring.Responsive group:positive fluid response was defined as an increase in cardiac index (CI) ≥ 10％ after PLR.Unresponsive group:negative fluid response was defined as an increase in CI ＜ 10％ after PLR.The hemodynamic parameters,including heart rate (HR),mean arterial pressure (MAP),central venous pressure (CVP),stroke volume variation (SVV),CI and PVI,and the changes in cardiac parameters (△ HR,△ MAP,△ CVP,△ SVV,△ CI,and △ PVI) before and after PLR were determined.The relations between hemodynamic parameters and their changes with △ CI were analyzed by the Pearson analysis.The role of the parameters for volume responsiveness prediction was evaluated by receiver operating characteristic (ROC) curves.Results 145 PLRs in 87 patients with septic shock were conducted,with 67 in responsive group and 78 in unresponsive group.There were no statistically significant differences in HR,MAP,CVP and CI before PLR between the responsive and unresponsive groups.SVV and PVI in responsive group were significantly higher than those in the unresponsive group [SVV:(16.9± 3.1)％ vs.(8.4±2.2) ％,t =9.078,P =0.031; PVI:(20.6±4.3)％ vs.(11.1 ±3.2)％,t =19.189,P =0.022].There were no statistically significant differences in HR,MAP,CVP,SVV,and PVI after PLR between the responsive group and unresponsive group.CI in the responsive group was significantly higher than that in the unresponsive group (mL·s-1·m-2:78.3±6.7 vs.60.0±8.3,t =2.902,P =0.025).There were no statistically significant differences in △HR,△MAP,△ CVP between responsive group and unresponsive group.△ SVV,△ CI and △ PVI in responsive group were significantly higher than those in the unresponsive group [△ SVV:(4.6 ± 1.5)％ vs.(1.8 ± 0.9)％,t =11.187,P =0.022;△ CI (mL·s-1·m-2):18.3 ± 1.7 vs.1.7 ± 0.5,t =3.696,P =0.014; △ PVI:(6.4 ± 1.1)％ vs.(1.3 ± 0.2)％,t =19.563,P =0.013].No significant correlation between HR,MAP or CVP before PLR and △ CI was found.SVV (r =0.850,P =0.015) and PVI (r =0.867,P =0.001) before PLR were correlated with △ CI.It was shown by ROC curve that the area under ROC curve (AUC) for SVV fluid responsiveness prediction was 0.948,and cut-off of SVV was 12.4％,the sensitivity was 85.4％,and specificity was 86.6％.The AUC for PVI fluid responsiveness prediction was 0.957,and cut-off was 14.8％,the sensitivity was 87.5％,and specificity was 84.8％.It was higher than other hemodynamic parameters (HR,MAP,CVP).Conclusions PVI and SVV can better predict fluid responsiveness in mechanically ventilating patients with septic shock after PLR.PVI as a new continuous,noninvasive and functional hemodynamic parameter has the same accuracy as SVV.