Liver failure is a clinical syndrome characterized by serious liver damages.It can results from a variety of causes,and the prognosis is usually poor.How to objectively assess the severity of liver failure and accurately predict the prognosis are the hot spots and challenges in studies on liver failure.The assessment criteria and models widely used clinically include:Child-Turotte-Pugh (CTP) score,acute physiology,age and chronic health evaluation(APACHE) Ⅱ/Ⅲ score,King's College Hospital (KCH) criteria,sequential organ failure assessment (SOFA) score and model for end-stage liver disease (MELD) score.Besides,more factors are identified as potential markers in prognosis assessment.This paper reviews the importance of prognosis assessment in liver failure,and introduces current and new systems or markers in prognosis assessment.

OBJECTIVE:To study the protective effect of tanshinoneⅡA(TSⅡA)sulfonate injection against vancomycin(VAN)-induced renal injury model rats and its mechanism. METHODS:72 rats were randomly divided into blank group,model group, positive control group(amifostine,1 mg/kg)and TSⅡA sulfonate injection low-dose,medium-dose and high-dose groups(15,30, 60 μg/kg),with 12 rats in each group. Except for blank group,those groups were given VAN(200 mg/kg)intravenously via tail vein to induce renal injury rat model;after modeling,each drug group was given relevant medicine intraperitoneally once a day, and blank group and model group were given normal saline intragastrically for consecutive 10 days. The levels of 24 h protein, NAG and KIM-1 in urine were determined,and those of Cys C,Scr and BUN in serum and those of SOD,MDA,GSH-Px and NO in renal homogenate were also determined;the pathological change of renal tissue was observed. RESULTS:Compared with blank group,the levels of Cys C,Scr and BUN in serum,those of 24 h protein,NAG and KIM-1 in urine and those of MDA and NO in renal tissue increased significantly in model group,while the levels of SOD and GSH-Px decreased significantly(P<0.01);the pathological slice indicated that model group suffered from renal injury such as kidney tubules albuminoid degeneration,brush border abscission,renal tubular epithelial cell disintegration and abscission. Compared with model group,the levels of Cys C,Scr and BUN in serum,those of 24 h protein,NAG and KIM-1 in urine and those of MDA and NO in renal tissue decreased signifi-cantly in treatment groups,while the levels of SOD and GSH-Px in renal tissue increased significantly(P<0.05 or P<0.01);path-ological changes of renal tissue were relieved significantly. CONCLUSIONS:TSⅡ A sulfonate injection can effectively relieve VAN-induced renal injury in rats,and its mechanism may be associated with inhibiting the oxidative reaction of rats in vivo.

ObjectiveTo verify whether the three different framing effects distinguished by Levin still exist in imitatively medical situation.MethodsEstablished medical decision making problems concerning doctor evaluation,medical compliance and treatment options selection.All these problem were described in the gain and loss frames.300 volunteers were randomly assigned to six groups.Every volunteer completed 2 decision making problems and evaluated their degrees of certainty.ResultsIf doctors were described in valid number,people tended to make more positive evaluations than described in invalid number( x2 =32.09,P ＜ 0.01 ).If treatment options were described in survival rates,people tended to choose adventure option of long-term benefit,otherwise people tended to choose conservative option of short-term benefit( x2 =25.92 P ＜ 0.01 ).If doctors' advices were respectively described in damaging or beneficial frames,the former one has better compliance (x2 =11.07,P ＜0.01 ).Parts of the deferences between the decision making confidence of choosing the adventure or conservative options were significant ( t attribute,positive =3.84,P ＜ 0.01 ; t goal,negative =6.44,P ＜ 0.01 ; t risky,positive =6.57,P ＜0.01 ).People were likely to be more confident with these options conforming to the framing effect.Conclusion-Framing effect exists in imitatively medical situation.

Objective To analysis the relationship among coping styles,personality and mental health of female reserve duty soldiers in parade training,and built a path model on them.Methods Coping style questionnaire ,self check list(SCL-90) and Eysenck personality questionnaires were administered to 264 female reserve duself-blame( r=0.194) effected mental health directly.Self-blame(r=0.230) ,retreat( r=0.197) and illusion( r = 0.322) predicated mental health indirectly by the mediation of neuroticism.Conclusion Coping styles can influence mental health directly,and neuroticism is a mediation variance between coping styles and mental health.

Objective To evaluate the model for end-stage liver disease (MELD) and MELD combined with serum natrium level (MELD-Na) in predicting short-term prognosis of liver failure.Methods Clinical data of 322 patients with liver failure admitted in the First Affiliated Hospital of Xinjiang Medical University from April 2003 to April 2012 were retrospectively analyzed.MELD and MELD-Na scores were calculated at diagnosis and one week after the diagnosis,and then △MELD and △MELD-Na were determined.Receiver operating characteristics (ROC) curve and Kaplan-Meier survival curve were used to evaluate the value of the above scores in predicting 3-month prognosis.Results The 3-month mortality rates of acute/sub-acute,acute-on-chronic and chronic liver failure were 77.4％ (24/31),41.7％ (50/120) and 56.1％ (96/171),respectively,and the difference was of statistical significance (x2 =14.273,P ＜0.01).For acute/sub-acute liver failure,the areas under ROC curve (AUCs) were 0.699-0.836 for each scoring system in predicting short-term prognosis,and no significant difference was observed (Z =0.507,0.622,0.712,0.727,0.779 and 0.599,P ＞0.05).For acute-on-chronic liver failure,AUCs were 0.889 and 0.897 for △MELD and △MELD-Na in predicting short-term prognosis,which were higher than those of MELD and MELD-Na scores at the baseline (Z =3.110 and 3.500,P ＜ 0.05),but no significant difference was observed between △MELD and △MELD-Na (Z =0.310,P ＞ 0.05) ; Kaplan-Meier survival curve showed that the 3-month mortality rate for patients with △MELD ＞ 3.5 was 87.8％,and the average survival time was 34.05 d.For chronic liver failure,AUC of △MELD was 0.871 in predicting short-term prognosis,which was higher than that of △MELD-Na (Z =4.229,P ＜0.05) ; Kaplan-Meier survival curve showed that the 3-month mortality rate for patients with △MELD ＞ 4.5 was 89.9％,and the average survival time was 29.08 d.Conclusion For acute/sub-acute liver failure,MELD,MELD-Na,△MELD and △MELD-Na are all satisfactory in predicting short-term prognosis; for acute-on-chronic liver failure,△MELD and △MELD-Na are better than MELD,MELD-Na scores at the baseline; and for chronic liver failure,△MELD is the best indicator.

Objective To explore the relevant factors for job burnout of female reserve duty soldiers in parade training.Methods Maslach burnout inventory-general survey(MBI-GS),Eysenck personality questionnaire (EPQ),coping pressure style questionnaire,self rating social adaptation and will power test were conducted in 380 female reserve duty soldiers in parade training.Results ①The results showed that the score of the job burnout in female reserve duty soldiers in parade training was in middle level.The scores was 12.83±5.28:5.86±3.90;23.28±6.18,respectively.②There were some relevant factors of job burnout and the significant correlation existed between job burnout of female reserve duty soldiers and coping pressure styles,personality,social adaptation and will power(P<0.01).③These factors could significantly predict job burnout(Standardized βwas 0.264,0.186;0.331,-0.161,-0.206,-0.144;0.391,0.179,0.199,-0.164).Conclusion To prevent the job burnout of female soldiers,it should be taken seriously about building up of their character,improving social adaptation and enhancing their will power.

Purpose To assess the feasibility of measuring maximal density of a region of interest (ROI) with contrast-enhanced CT in quantifying degrees of intestinal ischemia in patients with intestinal obstruction.Materials and Methods Abdominal CT images and reports of 160 patients with intestinal obstruction were retrospectively studied.All the data were reviewed by CT visual evaluation method and measuring maximal density of ROI respectively.The CT visual evaluation took the way of accumulated points,and divided the degrees of intestinal ischemia into five categories.The measuring maximal density of ROI quantified the degrees of bowel enhancement with a bar histogram on CT workstation.The results were compared with the pathological examination.The sensitivity,specificity,positive and negative predictive values and accuracy of the two methods were calculated respectively,and compared.Results The sensitivity,specificity,positive and negative predictive values and accuracy of CT visual evaluation method were 96.7％,72.9％,82.1％,94.4％ and 86.2％,respectively.The sensitivity,specificity,positive and negative predictive values and accuracy of the measuring maximal density of ROI were 68.8％,100.0％,100.0％,71.4％,82.5％,respectively.By measuring the area under the ROC curve,the ROI method (0.995) was more accurate than CT visual evaluation method (0.908) in the diagnosis of bowel ischemia.Conclusion Measuring the maximal density of ROI can quantize bowel wall enhancement.It is a reliable and useful method in the diagnosis of intestinal ischemia,and in accordance with pathological results.

Objective:To study the effects of panax notoginsenosides on the proliferation and oxidation indices of cisplatin-induced nephroxicity in HK-2 cells. Methods:HK-2 cells were cultured in vitro till the number was up to 1 × 106/ml. The cells were inoculated in 96-well culture plate and randomly divided into six groups:normal saline ( NS) group,the model group, the positive control group and the high dose group , medium dose group and low dose group of panax notoginsenosides ( PNS) . The nephroxicity model was dupli-cated with the addition of cisplatin (the final concentration was 6. 25μg·L-1). The model group, positive control group and the three panax notoginsenosides groups was treated with saline solutions, amifostine, panax notoginsenosides at the dose of 100,50 and 25 mg· L-1 , respectively. The cell viability was detected with an MTT method, the content of MDA and the activity of SOD, GSH-PX and LDH were measured and the cell structure was observed. DCFH-DA was used as the fluorescence probe to detect the level of ROS by a fluorescence microplate reader. Results:Compared with those in the model group, the cell viability and the activity of SOD and GSH-PX in the three PNS groups and the positive control group significantly increased (P<0. 05);the content of MDA, the level of ROS and the activity of LDH significantly decreased (P<0. 05); the cell structure was significantly improved. Conclusion: PNS can pro-mote the proliferation of HK-2 cells in vitro, and improve the biochemical parameters and enzyme levels. The results suggest that PNS has a protective effect on HK-2 cell,and the protective mechanisms may be related with its antioxidant effect.

Objective To explore the hypertensive vulnerability of residents living in Xuzhou City to provide evidence for effective intervention. Methods Based on multi-stage stratified randomized sampling methed,a total of 4980 residents aged 15 to 69 years from 9 counties of Xuzhou City were selected and completed a standard questionnaire. Hypertensive vulnerability was compared by using Chi-square test. Results The prevalence of hypertension was 13.62% among 15 to 69 years old participants. The residents who had no idea of normal level of blood pressure accounted for 45. 26%. The residents who thought it was unnecessary to measure blood pressure every year since 35 year-old accounted for 29. 68%. Those who did not know individual's salt intake per day accounted for 57. 23%. The participants who had no information on hypertension prevention or control accounted for 21.53% and 12. 05%, respectively. The higher hypertensive vulnerability was associated with lower educational level or monthly income per capita; higher hypertensive vulnerability of patients is less than normal crowed. The rates of current smoking, alcohol consumption,salt over-intake and non-blood pressure measurement were 16. 45%, 11.10% ,30. 00%, and 32. 05% respectively. The higher educational level, higher monthly income per capita or older age crowd ,the lower rate of non-blood pressure measurement, the higher rate of alcohol consumption ; salt over-intake was different in different education levels ( χ2 = 23.37, P＜0. 05 ) ; the older age group were in a higher proportion of current smokers;the behavior vulnerabilities were no difference between the patients and normal crowds. Conclusion Hypertensive vulnerability of residents living in Xuzhou City is high. Hypertension education and healthy living style should be improved to effectively prevent the development of hypertension.

Objective To study risk factors for high-normal blood pressure (HNBP) in residents of urban Xuzhou, Jiangsu province, China. Methods A cross-sectional survey was conducted among 17 500 residents in urban area of Xuzhou from June to December 2008 by cluster sampling with self-designed questionnaire to collect their demographic information and measurements of body height, weight and blood pressure. Data were approached to univariate and multivariate non-conditional logistic regression analysis. Results In total, 17 306 residents finished the survey, with an overall response rate of 98.9percent. Results of univariate analysis revealed that 13 variables such as living region, sex, age,occupation, annual average family income, history of dyslipidemia, smoking, alcohol drinking, intake of pork, and vegetables, daily length of sleeping, body mass index (BMI), abdominal obesity, all were related to HNBP ( P ＜ 0. 05 ). Results of multivariate logistic regression analysis showed that living region, sex,age, annual average family income, alcohol drinking, intake of vegetable, BMI, abdominal obesity all associated with HNBP (P＜0. 05). Conclusions Older age, history of alcohol drinking, increased BMI,abdominal obesity all are risk factors to prompt occurrence of HNBP, and intake of large amount of vegetables is its protective factor.