Acute kidney injury(AKI)has become the public health problem that harms the human's health, is a common critically illness,characterized by complicated etiology,high prevalence,high risk of combine other organs'injury and high mortality,these become the huge challenge in clinic.Thus,it is valuable in clinic how to improve cog-nition about AKI,to early detection,to early treatment so that postpone pathogenetic condition,increae survival rate and improve prognosis.In recent years,the researchers have processed vast of reseaches about etiology,new biomark-er,risk fator,prognosis,etc.However,these parts are still controversial.This paper summarizes the research progress of AKI.

The pre-examination process is the first key step in the total testing process of clinical laboratories.Specimen acceptability is an important indicator to measure the quality of pre-examination.In order to identify the risks and the root causes in the process , establishment and monitoring of quality indicators about specimen will effectively control the risks , enhance the acceptability of specimens , promote the improvement of pre-examination quality and finally get the aim of assuring patients′safety.

OBJECTIVE:To evaluate the pain-relieving and sedative efficacy and safety of sufentanil in patient-controlled intravenous analgesia after spinal column surgery.METHODS:60 patients undergoing selective spinal column surgery were randomized to either fentanyl group or sufentanil group.General anesthesia was performed for all the 60 cases,with tracheal catheter withdrawn and patient-controlled intravenous analgesia(PCIA) performed after completion of surgery when patients had regained consciousness.The analgesic efficacy within 24 hours was evaluated using visual analogue score(VAS),VRS score,Ramsay score and the adverse effects were recorded.RESULTS:In sufentanil group,effective analgesic efficacy was obtained,and the VAS score was significantly lower but the VRS score was significantly higher than in fentanyl group(P0.05).CONCLUSION:Sufentanil is proved to be safe and effective with reliable analgesic and sedative efficacy but fewer side effects for PCIA patients.

Objective To discuss the nursing for the different postoperative residual urine of patient with pelvic floor dysfunction.Method To evaluate the nursing for the postoperative residual urine of patient with pelvic floor dysfunction and the time of urinary catheters inserted,We completed a retrospective review of 138 adult patients.Results ①Toally 138 participants were categorized into 3 groups:74 (53.6％) patients carried a residual volume ＜ 100ml,53 (38.4％) patient did 100～300ml,11 (8.0％)did ＞300ml.②About11 patients who were able to void but carried a residual volume ＞300ml required indwelling catheterization.In these cases,100％ carried a residual volume ＜ 100ml after indwelling urinary catheter extraction (IUCE) after 4～5 days.③About 53 patients who were able to void but carried a residual volume between 100ml to 300ml received urine nursing,phychological nursing and bladder function exercise.Two days after IUCE 41 (77.4％) patients' residual volume was ＜100ml;three days after IUCE 11 (20.7％) patients' residul volume was ＜100ml;five days 1 patiens' residul volum was ＜100ml.Conclusion When a postvoid residual＞300ml,the patient should be performed catheterization,When a postvoid residual between 100ml to 300ml,the nurse should give the patient mental easing and teach them to perform pelvic floor muscle exercise.This can reduce the suffering of patients.

Objective To study the clinicopathological features of C3 glomerulonephritis and the associations between plasma complement fragments level and clinical manifestations.Methods The clinical and pathological data of the 12 patients with C3 glomerulonephritis in our division from January 1999 to June 2010 were analyzed retrospectively.Concentrations of plasma factor B,Ba,C3,C3a,C4a and C5a were detected by commercial available sandwich ELISA kits on the day of renal biopsy.Results Ten of the 12 patients were C3 glomerulonephritis without MPGN,and the rest 2 were C3 glomerulonephritis with MPGN.All the patients presented proteinuria.Two of the 10 C3 glomerulonephritis patients without MPGN presented nephrotic range proteinuria,6 with microhematuria,1 with gross hematuria,and 2 with renal insufficiency.One of the 2 C3 glomerulonephritis patients with MPGN presented nephrotic range proteinuria,accompanied by microhematuria,hypertension and renal insufficiency.The other patient showed moderate proteinuria with normal renal function.Most of C3 glomerulonephritis patients without MPGN showed mild mesangial proliferative glomerulonephritis,and 4/10 patients had various degree cresentic formation.One C3 glomerulonephritis patient with MPGN had 47.1％ cresentic formation.The concentration of plasma C3 in C3 glomerulonephritis patients was normal,while the plasma factor B was significantly decreased,and the concentrations of plasma Ba,C3a,C4a and C5a were significantly elevated.The concentration of plasma Ba was positively correlated with the proteinuria level,while the concentrations of plasma C3a,C4a and C5a were not correlated with the levels of proteinuria or plasma creatinine.Conclusions Majority of these 12 patients were C3 glomerulonephritis without MPGN,manifests as nephritic syndrome clinically and mild mesangial proliferative glomerulonephritis histopathologically.Complement activation via alternative pathway may play an important role in the pathogenesis of C3 glomerulonephritis.

Understanding inter-species transmission of influenza viruses is an important research topic. Scientists try to identify and evaluate the functional factors determining the host range of influenza viruses by generating the recombinant viruses through reverse genetics in laboratories, which reveals the viruses' molecular mechanisms of infection and transmission in different species. Therefore, the reverse genetic method is a very important tool for further understanding the biology of influenza viruses and will provide the insight for the prevention and treatment of infections and transmission. However, these recombinant influenza viruses generated in laboratories will become the potential threat to the public health and the environment. In this paper, we discussed the biological safety issues of recombinant influenza viruses and suggested we should set up protocols for risk management on research activities related to recombinant highly pathogenic influenza viruses.
Influenza A Virus, H5N1 Subtype ; genetics ; Laboratories ; Microbiology ; Orthomyxoviridae ; genetics ; Public Health ; Reassortant Viruses ; genetics ; Recombination, Genetic ; Safety

The pre-analytical process is the first key step in the total testing process of clinical laboratories,which will directly influence the accuracy and timeliness of testing results.Efficient preanalytical quality assurance system consists of scientific personnel structure,regular training and monitoring,bright and comfortable phlebotomy environment,advanced comprehensive phlebotomy facilities,strict biosafety practice in each procedure and harmonious relationship between clinicians/patients and laboratory.Besides,the application and monitoring of sound quality indicators in pre-analytical process will promote the improvement of quality and finally get the aim of assuring patients' safety.

Objective To explore psychological experience of nurses as the relatives of patients with malignant tumors in order to carry out mental care to malignant tumor patients as well as their family members. Method Nine nurses whose family members were malignant cancer patients were interviewed. Results As the relatives of malignant cancer patients, all the nine nurses presented with anxiety and fear. They were lack of ways to relieve negative emotions, desperate for more information and worried uncertainties about future and medical fees. Conclusion In order to offer better nursing experience, it is necessary for nurses to change ideas and improve recognition in order to establish a psychological supportive system for patients′ relatives in different phases and a social supportive system and fulfill their requirements for knowledge, which can thus help patients and their relatives out of the predicament.

Objective To know the effects of using hierarchical management for psychiatric nursing in psychiatric ward,and then to offer some rationales and theoretical support for hospital management.Methods The fine hierarchical management was implemented from Janurary 2012 in Xi'an Mental Health Center and the metal hygiene clinics of Xi'an Jiaotong University.Before and after the hierarchical management carried out,the nursing care quality was assessed among the family members of hospitalized patients by using satisfaction survey questionnaires,flight rate of patients was evaluated,and at the same time,nursing care quality and the nurse comprehensive ability was inspected.And then,the EPIDATE 3.0 and SPSS16.0 software was used to analyze and compare the satisfaction scores.The nurse comprehensive ability,and nursing care quality scores before and after implementation.Results The nurse comprehensive ability were improved.The satisfaction scores of family members of hospitalized patients was higher than that before implementation after the fine management implementation,which had statistical difference,P＜ 0.05.The satisfaction rate of patients' family member was 96.77％(2 543/2 628) after the fine management implementation,which was significant higher than that of before implementation,91.19％(2 382/2 612),x2=107.66,P＜0.05.Flight rate of patients was reduced after the hierarchical management,which was significantly lower than that of in before,P＜0.05.Nursing care quality scores were higher than those of in before,which has a statistical difference respectively,P＜0.05.Conclusions The hierarchical management could improve the satisfaction of family numbers,reduce the flight rate of patients,enhance nursing care quality and improve the nurse comprehensive ability.It would reduce the incidence of medical malpractice.The fine hierarchical management is worth to be applied and generalized in nursing care of psychiatric nursing in psychiatric ward.

Robot-assisted surgery is becoming a widely popular technology and now entering total knee replacement. The development of total knee replacement is introduced in this paper with the emphasis on femur positioning technologies. The experiments and error analysis of robot-assisted surgical system for total knee replacement demonstrate that femur positioning technologies have a high precision and thus deserve to be popularized theoretically and practically.