Objective: To investigate the impact of acute myocardial infarction (AMI) concurrent acute kidney injury (AKI) on major adverse cardiac events (MACE) occurrence during hospitalization.
Methods: A total of 625 AMI patients treated in our hospital from 2011-01 to 2014-03 were retrospectively studied. According to AKI incidence, the patients were divided into 2 groups: AKI group,n=86 and Non-AKI group,n=539. Based on AKI network (AKIN) criteria, AKI group was further divided into 3 subgroups as AKI-I subgroup,n=45, AKI-II subgroup,n=27, AKI-III subgroup,n=14; based on renal function at admission, AKI group was divided into another set of 2 subgroups as Normal renal function subgroup [(eGFR≥90 ml/(min·1.73m2)],n=61 and Renal dysfunction subgroup [(eGFR<90/(min·1.73m2)],n=25. The incidence of MACE was compared among different groups and the risk factors for MACE occurrence in AMI patients during hospitalization were studied by multivariate Logistic regression analysis.
Results: The incidences of MACE in AKI group and Non-AKI group was (59.3% vs 16.9%),P<0.05; in Normal renal function subgroup and Renal dysfunction subgroup was (59% vs 60%),P>0.05. Multivariate Logistic regression analysis showed that AKI was the independent risk factor for MACE occurrence in AMI patients; elevated AKI stages were accompanied with the higher incidence of MACE accordingly, compared with AKI-I subgroup, the incidences of MACE in AKI-III subgroup and AKI-II subgroup were as (OR=1.68, 95% CI 1.14-1.69),P<0.05 and (OR=2.01, 95% CI 1.35-1.84), P<0.05 respectively.
Conclusion: AKI was closely related to MACE occurrence in AMI patients, effectively preventing AKI may improve the prognosis in relevant patients.

Objective To explore the epidemiologic al features of emergency calls around the spring festival holiday in past 5 years,so as to guide emergency medical services during holldays.Methods An investigation was made into emergency calls around the spring festival holiday in 2001～2005(1～7 of the first month of the lunar year) as well as one week before and after the holiday.Results The person-times to emergency during the spring festival holiday was correspondly stabilize in the recent 5 years,compared to the datas of the previous and subsequent 1 week,the person-times of emergency and the patients needed to rescue at first significantly increased,and the patients to pediatric emergency increased most significantly.The most part of the person-times to emergency were internal medicine.Conclusion It is essential to do a good job of health education and disease prevention,especially among high risk groups of people,and to reinforce the establishment of the emergency medical services system so as to effectively guarantee the the development of holiday economy.

Objective To explore the effect of bronchofibroscope joint mechanical ventilation on the treatment of the geratie surgery postoperative patients with acute respiratory failure.Methods 62 geratic surgery postoperagedative patients with acute respiratory failure were randomly divided into two groups(control group and treatment group).The treatment group(n=32) applyed bronchofibroscope aspiration and/or bronchial lavage joint mechanical ventilation.The control group(n=30) were treated only with mechanical ventilation.Compare with two groups parameters of arterial blood gas,the time of mechanical ventilation,average in ICU,success rate one time pull out windpipe conduit and case fatality rate.Results Compare with the control group,the treatment group patients parameters of arterial blood gas had been improved significantly;the time of mechanical ventilation and average in ICU had been cut short significantly;all showed a statistical difference(P<0.05).Success rate one time pull out windpipe conduit and case fatality rate were better than the control group,but there were no significant difference(P>0.05).Conclusion The effect of bronchofibroscope joint mechanical ventilation to treat the geratic surgery postoperative patients with acute respiratory failure was better than only mechanical ventilation,which can decrease the time of mechanical ventilation and average in ICU.The method was worth to spread.

Objective To investigate the risk factors for acute kidney injury (AKI) in patients with non-ST-segment elevation myocardial infarction (NSTEMI),and to establish a prediction score system for AKI.Methods Totally 296 patients with NSTEMI,who were admitted to the emergency room and further transferred to the Cardiovascular Department in Shantou Central Hospital,were enrolled during January 2011 to April 2014.All patients were divided into AKI group and non-AKI group.Demographics,clinical data and laboratory examinations were collected before and after AKI.AKI risk factors and its OR values were determined after statistically analyzed data by One-Way ANOVA,multivariate logistic regression analysis.Prediction score system for AKI was further established by area under the ROC curve and Hosmer-Lemeshow goodness of fit tests.Results For total 296 patients,the incidence of AKI was 18.4％,including 35 (64.8％) patients in stage Ⅰ,12 (22.2％) patients in stage Ⅱ and 7 (13.0％) patients in stage Ⅲ.Logistic analysis showed that age,heart function (Killip),anemia,the time to emergency department after AMI attack,and absence β-blocker were independent factors associated with AKI.Prediction score system was established which the highest score was 13.A risk score of 3.5 points was determined by Youden' s index,as the optimal cut-off for predict AKI.Patients with ≤3.0 points were considered at low risk,and ≥4.0 points were considered at high risk for AKI.The prediction score system of AKI showed adequate discrimination (area under ROC curve was 0.806) and calibration (Hosmer-Lemeshow statistic test,P =O.503).Conclusions Age,heart function (Killip),anemia,the time to emergency department after AMI attack,and absence β-blocker were independent factors associated with AKI.The clinical prediction score system may help clinicians to make pre-intervention for NSTEMI patients with high AKI risk.

Objective To find out about the epidemiological features of emergency calls around the National Day holiday so as to guide emergency medical services during holidays. Methods An investigation was made into e-mergency cases during the National Day holiday in 2002 (October 1-October 7) as well as one week before and after the holiday and comparison was made between the numbers of emergency cases in the past three years. Results In the past three years, the number of emergency cases around the National Day holiday has been going down year by year whereas at the same time the number of hospitalized patients and patients admitted to the observation ward has been going up. During the National Day holiday in 2002, the number of emergency cases, hospitalized patients and patients admitted to the observation ward increased markedly compared with those before and after the holiday, with the most remarkable increase in the number of pediatric emergency cases and the biggest number of emergency cases in internal medicine. Conclusion It is essential to do a good job of health education and disease prevention, especially among high risk groups of people, and to reinforce the establishment of the emergency medical service system so as to effectively guarantee the development of holiday economy.