Objective To compare the clinical characteristics of community-acquired acute kidney injury (CA-AKI) and hospital-acquired acute kidney injury (HA-AKI) patients.Methods Hospital network system was employed to screen the clinical data of adult patients in the First Affiliated Hospital in Xinjiang Medical University in January to July 2013.A total of 19 528 patients were screened,and 544 AKI patients were identified based on KIDGO (Kidney Disease:Improving Global Outcomes) AKI guidelines.Three hundred and thirty patients were included in HA-AKI group and 214 patients in CA-AKI group.Clinical variables including mortality were analyzed retrospectively.Results The incidence of AKI in hospitalized patients was 2.8％ (544/19 528):1.7％ in CA-AKI group and 1.1％ in HA-AKI group.The mean age in CA-AKI group was significantly older than that in HA-AKI group [(62.9 ± 16.8) years vs (56.6± 15.9) years].Medical patients in CA-AKI group accounted for 62.4％,and surgical patients in HA-AKI group accounted for 64.1％.The co-morbid diseases were cardiac disease,hypertension,diabetes and chronic liver disease.Majority of AKI was caused by pre-renal etiologies.The length of hospitalization was significantly shorter in CA-AKI group compared to that in HA-AKI group [12(8,20) days vs 19 (12,27) days,P ＜ 0.01].Compared to that in HA-AKI group,all-cause mortality was significantly lower in CA-AKI group (11.5％ vs 20.1％,P=0.005).Results by multivariate logistic regression analysis demonstrated that the common independent risk factors of AKI in both groups were ICU hospitalization and shock.The independent risk factor of AKI in CA-AKI group was diabetes (OR=3.019).In contrary,the independent risk factors of AKI in HA-AKI group were elderly (≥65 years) (OR=3.303),oliguria (24 h urine volume ＜ 400 ml) (OR=6.906),use of antiinflammatory drugs (OR=13.079) and multiple organ dysfunction syndrome (OR=17.778).Conclusions The incidence of AKI in hospitalized patients is not rare,among which both communityacquired and hospital-acquired AKI are mainly caused by pre-renal etiologies.All-cause mortality is lower in community-acquired AKI compared to that in hospital-acquired AKI and the independent risk factors are different between CA-AKI and HA-AKI.

Objective:To discuss the training method of teachers for clinical pharmacists. Methods:The application of problem-based learning ( PBL) in the training of teachers for clinical pharmacists was introduced. Results and Conclusion: PBL centers on trainees, and can notably improve the learning enthusiasm, expression and communication skills and logical thinking preciseness of the trainees. Meanwhile, the method shows great significance in improving the teaching ability.

Objective To investigate the effect of telerehabilitation on memory disorders. Methods From August, 2010 to April, 2015, 81 patients with memory disorders were randomized into control group (n=26), computer-assisted training group (n=33) and telerehabilita-tion training group (n=22). All the patients accepted medicine to facilitate the recovery of memory. Besides, the computer-assisted training group and the telerehabilitation training group accepted memory-based training programs with cognitive rehabilitation system locally or on network respectively, for six weeks. They were evaluated with Wechsler Memory Scale, Rivermead Behavioural Memory Test-2nd Edition and Rey Auditory Verbal Learning Test before and after training. Results Both computer-assisted and telerehabilitation training groups im-proved in all the assessment after training (t>4.059, P<0.001). There was no significant difference between them (P>0.05). There was no sig-nificant improvement in the control group after training (t<0.771, P>0.05). Conclusion Memory rehabilitation training can significantly im-prove memory abilities, similar with locally or telerehabilitation system.

Objective:To increase the understanding of neuroleptic malignant syndrome, rhabdomyolysis and acute renal injury in advanced-aged patients with Parkinson's disease after abdominal surgery.Methods:We report a case of malignant syndrome, rhabdomyolysis and acute renal injury in an 85-year-old patient with Parkinson's disease after abdominal surgery in our department.The diagnosis and successful treatment experience were summarized, and a literature review was conducted.Results:The body temperature was as high as 40.5℃ in this patient, accompanied by stiffness, sustained involuntary shaking, increased muscle tone, serum creatine kinase at 104 615 U/L, tachycardia, low blood pressure, accelerated breathing rate, disturbance of consciousness, excessive sweating and other clinical manifestations, which met the diagnostic criteria for neuroleptic malignant syndrome.The patient had complications including concurrent rhabdomyolysis, acute renal injury and shock.The emergency was resolved after an early diagnosis and proactive treatment.Conclusions:If patients with Parkinson's disease have a high fever with rigidity or sudden aggravation within a short period of time after medication, the possibility of neuroleptic malignant syndrome should be considered and the causes should be screened.

The primary function of cardiac mitochondria is the production of ATP to support heart contraction. Examination of the mitochondrial redox state is therefore crucially important to sensitively detect early signs of mitochondrial function in pathophysiological conditions, such as ischemia, diabetes and heart failure. We study fingerprinting of mitochondrial metabolic oxidative state in living cardiomyocytes with spectrally-resolved fluorescence lifetime spectroscopy of NAD(P)H, the principal electron donor in mitochondrial respiration responsible for vital ATP supply. Here NAD(P)H is studied as a marker for non-invasive fluorescent probing of the mitochondrial function. NAD(P) H fluorescence is recorded in cardiac cells following excitation with 375nm UV-light and detection by spectrally-resolved time-correlated single photon counting (TCSPC), based on the simultaneous measurement of the fluorescence spectra and fluorescence lifetimes. Modulation of NADH production and/or mitochondrial respiration is tested to study dynamic characteristics of NAD(P) H fluorescence decay. Our results show that at least a 3-exponential decay model, with 0.4-0.7ns, 1.2-1.9ns and 8.0-13. Ons lifetime pools is necessary to describe cardiomyocyte autofluorescence (AF) within 420-560nm spectral range. Increased mitochondrial NADH production by ketone bodies enhanced the fluorescence intensity, without significant change in fluorescent lifetimes. Rotenone, the inhibitor of Complex I of the mitochondrial respiratory chain, increased AF intensity and shortened the average fluorescence lifetime. Dinitrophenol (DNP), an uncoupling agent of the mitochondrial oxidative phosphorylation, lowered AF intensity, broadened the spectral shoulder at 520 nm and increased the average fluorescence lifetime. These effects are comparable to the study of NADH fluorescence decay in vitro. In the present contribution we demonstrated that spectrally-resolved fluorescence lifetime technique provides promising new tool for analysis of mitochondrial NAD(P) H fluorescence with good reproducibility in living cardiomyocytes. This approach will enhance our knowledge about cardiomyocyte oxidative metabolism and/or its dysfunction at a cellular level. In the future, this approach can prove helpful in the clinical diagnosis and treatment of mitochondrial disorder.
Animals ; In Vitro Techniques ; Mitochondria, Heart ; metabolism ; Myocytes, Cardiac ; cytology ; metabolism ; NADP ; analysis ; metabolism ; Oxidation-Reduction ; Rats ; Rats, Sprague-Dawley ; Spectrometry, Fluorescence ; methods

OBJECTIVE: To analyze the action of miRNA-326 on its target gene BCL-XL and the molecular mechanism of platelet apoptosis regulated by miRNAs. METHODS: Dual-luciferase vectors containing respectively the wild-type and mutant 3'-untranslated region (3'UTR) fragments of the BCL-XL gene were constructed with firefly and renilla luciferases and transfected into 293T cells. Relative fluorescence intensities of the transfected cells were measured. RESULTS: Dual-luciferase reporter gene vectors for PsiCHECK- BCL-XL -3'UTR-WT (wild-type) and PsiCHECK- BCL-XL -3' UTR-MT (variant) were respectively constructed. Relative fluorescence intensities of the 293T cells co-transfected by miRNA-326 and PsiCHECK- BCL-XL -3'UTR-WT plasmid were significantly lower compared with the control group (co-transfected by a miRNA-326 negative sequence and PsiCHECK- BCL-XL -3' UTR-WT plasmid) ( P = 0.034). The relative fluorescence intensity was also significantly reduced in cells co-transfected by miRNA-326 and PsiCHECK- BCL-XL -3' UTR-WT plasmid compared with the mutant control group co-transfected by miRNA-326 and PsiCHECK- BCL-XL -3'UTR-MT plasmid (P = 0.022). CONCLUSION miRNA-326 may participate in the regulation of platelet apoptosis by acting on the 3'-UTR of the BCL-XL gene.

Objective:To investigate the cognition of orthopedic nurses on perioperative nursing risk of orthopedic elderly patients in Beijing, and to understand its influencing factors.Methods:From August to October 2019, 171 orthopedic nurses from two Class Ⅲ Grade A hospitals and one Class Ⅱ Grade A hospital in Beijing were selected as research subjects. The self-designed questionnaire was used to conduct a questionnaire survey, and the survey content included the general information, nursing risk cognition and nursing risk management of the survey subject. The t-test and one-way ANOVA analysis were used for group comparisons, and multiple linear regression analysis was used for multivariate analysis. Results:Among 171 orthopedic nurses, the total score of nursing risk was (39.56±7.85) . In individual scores, two aspects of awareness of the cause and preventive measures of falls had the highest scores, respectively (3.62±0.76) and (4.04±0.72) , and the lowest postoperative delirium score was (3.00±0.99) and (3.06±1.02) respectively. Univariate analysis showed that there were statistical differences in the scores of nurses' cognition on perioperative nursing risk of orthopedic elderly patients among nurses with different education levels, positions, whether they were specialist orthopedic nurses, the proportion of elderly patients in the ward, the importance of nursing managers and the number of department training in the past two years ( P<0.01) . Multivariate analysis showed that the influencing factors of orthopedic nurses' cognition on perioperative nursing risk of orthopedic elderly patients included whether they were specialist orthopedic nurses, the proportion of elderly patients in the ward, the importance of nursing managers and the number of department training in the past two years with statistical differences ( P<0.05) . Conclusions:Orthopedic nurses have a moderate level of cognition on the nursing risk of orthopedic elderly patients, and their overall cognition needs to be improved. Nursing managers should focus on cultivating the risk awareness and risk assessment capabilities of orthopedic nurses, pay attention to the training and use of orthopedic specialist nurses, and improve the management system of orthopedic specialist nurses.

Objective To investigate the effect of rehabilitation on memory deficits after acquired brain injury, to compare different training models of memory rehabilitation and to analyze the possible factors affecting memory rehabilitation. Methods 144 patients with acquired brain injury following memory deficits were randomly assigned to computer-assisted training group, face-to-face training group and control group. Both training groups were given memory-based cognitive training program once a day which sustained 30 minutes for 6 or 12 weeks. The instantaneous memory, short-term memory and long-term memory were evaluated and compared before and after training. The effect of gender, age, education, course, site of injury and coma time on training efficacy were analyszed as well. Results 6 weeks and 12 weeks at training, both computer-assisted and face-to-face training groups showed a significant improvement in memory abilities when compared to controls (P<0.01), with the former making more progress (P<0.01). Negative correlation was found between age and memory performance. Conclusion Effectiveness of memory rehabilitation is proven. 12 weeks training can significantly improve memory. Cognitive training using professional equipment is significantly more effective than the face-to-face training and should be recommended.

Objective To explore the factors that affect the coordinated development of blood banks and apheresis plas-ma collection banks(hereinafter referred to as plasma banks),and explore feasible measures for the coordinated develop-ment of blood banks and plasma banks.Methods The blood information management system and blood source information management system were used to retrieve related data of blood and plasma donation from 9 cities in Shandong province from 2017 to 2021.The number of blood donors and plasma donors and the intersection of them were analyzed.The data analysis was performed using chi-square test,and a questionnaire survey was conducted to investigate the policies and information status,as well as expectations for coordinated development for blood and plasma donation.Results From 2017 to 2021,the total number of blood donors in 9 cities was higher than that of plasma donors,both have been increasing year by year,and the increase in plasma donors was significantly higher than that of blood donors(131.78%vs 23.90%,P<0.05).The inter-section proportion of blood and plasma donors had increased from 0.45%in 2017 to 1.04%in 2021,with an increase of 131.11%.Among the administrative regions where the participating blood and plasma banks located,94.2%have not re-leased relevant policy to promote the coordinated development of blood and plasma donation.The majority(63%)expected blood banks and plasma banks to be set at a distance more than 50 km apart.The top four functional requirements for the in-terconnection between blood banks and plasma banks management information system were blood test results(94.61%),ID number(87.54%),blood and plasma donation records(85.51%)and health consultation/examination results(82.15%).The top four elements of coordinated development between blood and plasma banks were policy support(96.25%),informa-tion networking(92.36%),top-level design(87.44%)and cultural construction(86.58%).Conclusion The number of donors who donate both blood(mainly whole blood)and plasma has been increasing year by year,which deserves our close attention.To achieve the coordinated development of blood donation and plasma donation,policy support is the most crucial and fundamental means.Establishment of a standard system and the share of blood and plasma donation information is neces-sary for blood informatization construction.It was critical to promote the coordinated development of blood and plasma dona-tion and ensure blood safety with improving legislation,formulating policies for coordinated development,strengthening top-level design,standardizing the publicity of blood and plasma donation and establishing the idea that blood and plasma dona-tion are equally honorable.

OBJECTIVE： To re-evaluate t he methodology quality of published systematic review/Meta-analysis of antidepressants in the treatment of post-stroke depression. METHODS ：Retrieved from Cochrane Library ，PubMed，Embase， SinoMed，CNKI，Wanfang database ，VIP，CBM and other databases ，systematic review/Meta-analysis of antidepressants in the treatment of post-stroke depression were collected during the inception to Dec. 2019. After literature screening and data extraction ， methodology quality of included literatures were evaluated by using the AMSTAR scale. RESULTS ：A total of 33 systematic reviews/Meta-analysis were included ，involving 523 RCTs and 41 020 patients. Average score of AMSTAR methodological quality evaluation was 6.76. Citalopram ，duloxetine and paroxetine were effective for the therapy of post-stroke depression ，but the conclusions about the effectiveness among antide-pressants were not consistents. The ADR incidence of Paroxetine was low. It was not clear that sertraline and citalopram may improve the neurological function of patients. CONCLUSIONS ：The methodological quality of systematic review/Meta-analysis of antidepressants in the treatment of post-stroke depression is medium ，and the conclusions about the effectiveness of antidepressants ，improvement of daily life ability and the recovery of neurological function are still controversial.