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.

Objective To observe the response of activated microglia/macrophages within and around the lesion site after rats' spinal cord injury treated with chitosan.Methods 35 adult female Wistar rats were randomly divided into the sham group (n=5), completely transection group (n=15) and chitosan treated group (n=15). The responses of activated microglia/macrophages on the 1st day, 3rd day, 7th day, and in the 2nd week and 4th week after surgery were examined by immunohistochemistry.Results Microglia/macrophages were fully activated and the number of these cells increased and got the highest level on the 3rd day post injury, then quickly decreased. In the chitosan treated animals, the microglia/macrophages were fully activated and the number increased to peak on the 7th day, then quickly decreased, there were still a few microglia/macrophages around the wound in the 2nd to 4th week after the treatment.Conclusion Microglia/macrophages could be recruited within and around the lesion area longer when treated by chitosan.

Objective To evaluate the curative effect of Jiejiu-Hugan decoction combined with polyene phosphatidylcholine capsules on the patients with alcoholic liver disease of liver-qi stagnation and spleen deficiency syndrome. Methods A total of 60 ALD patients were divided by random number table into two groups:combined treatment group (35 cases) and conventional treatment group (25 cases). Both groups received treatment according to the changes of symptomatic treatment. Besides, the conventional treatment group was treated with polyene phosphatidylcholine capsules, and combined treatment group was with both polyene phosphatidylcholine capsules and Jiejiu-Hugan decoction. Treatment last for 3 months. The improvement of liver function, blood lipid and the clinical symptoms and signs were observed. Results The total effective rate of the combined treatment group was 94.28%, whilethe conventional treatment group was 68%. The difference between two groups was statistically significant (χ2=7.255, P=0.007). After the treatment, the levels of AST (52.60 ± 9.48 U/L vs. 63.28 ± 19.92 U/L, t=2.964), TBil (18.91 ± 7.23 U/L vs. 27.41 ± 8.53 U/L, t=4.678) in the combined treatment group were significantly lower than that in the conventional treatment group (P<0.01). And TG (2.70 ± 0.52 mmol/L vs. 3.65 ± 0.74 mmol/L, t=4.809), LDL-C (3.56 ± 0.41 mmol/L vs. 4.20 ± 0.40 mmol/L, t=3.810) in the combined treatment group were significantly lower than that in the conventional treatment group (P<0.01). Conclusions Jiejiu-Hugan decoction combined with polyene phosphatidylcholine capsule can effectively improve ALD patients' liver function;reduce the level of blood lipid. The combined treatment curative effect is better than the only western medicine conventional therapy.

Objective To establish a mouse model of orthotopic Lewis lung carcinoma using Matrigel, to evaluate the tumor growth and metastasis, and to provide a more stable mouse model of orthotopic lung cancer, which is more similar to human lung cancer.Methods Logarithmic phase of cultured Lewis lung cancer cells were suspended in Matrigel, vac-cinated into the left lung of inbred C57BL/6 mice.Five mice were killed on the 4th, 7th, 10th, 13th, and 16th days, re-spectively, and to observe the median survival, tumor formation rate, tumor growth, and metastasis.Pathological changes of the mouse lung, liver, kidney and spleen were examined.Results In 5 mice killed on the 7th postoperative day, small tumor nodules were observed on the lung in three mice and no tumor was visible by gross inspection in the other two mice, but small tumor nodules were observed under the microscope.For all the mice killed on the 10th postoperative day, tumors were visible to the naked eye on the lung of all the five mice.On the 13th day, orthotopic tumor was observed on the lung with bloody pleural effusion and pleural metastasis in all the five mice.On the 25th day, in addition to the pleural metasta-sis, one mouse had pericardial metastasis and renal metastasis.The survival periods of the 5 mice were 17 d, 20 d, 22 d, 22 d, and 25 d, respectively, with a median survival period of 21.2 d (17-25 d), and the tumor formation rate was 100%.Conclusions Mouse models of orthotopic Lewis lung carcinoma is successfully established using injection of tumor cells suspended in Matrigel.This model is more similar to the growth of human lung cancer, with good stability, high tumor formation rate and characteristics of distant metastasis, therefore, is worthy of further application.

This review analyzed domestic and foreign literatures on intestinal absorption,introduced the current methods and models commonly used in phenolic glycosides researches and their impacts focused on intestinal absorption,summarized the research status,aims to provide a reference for improving their oral bioavailability,improve formulations,new medicine and clinical rational use of phenolic glycosides.

Abstract: Objective　To establish a risk prediction model for nosocomial infection in preterm very low birth weight infants, and conduct internal validation. Methods　A total of 206 cases of very low birth weight premature infants hospitalized in the Department of Neonatology of Union Hospital Affiliated to Tongji Medical College from January 2018 to June 2020 were included in this study, factors that may affect the nosocomial infection of children were collected, and the infants were divided into two groups according to whether there is nosocomial infection. The influencing factors were compared between the two groups, and multivariate Logistic regression analysis was performed after screening variables with LASSO regression. According to the results of multi factor analysis, the nomogram model was constructed and verified internally. Results　A total of 29 of 206 children had nosocomial infection (14.08%), and 33 pathogenic bacteria were detected, including 23 Gram-negative bacteria, 9 Gram-positive bacteria and 1 fungus. The results of multivariate logistic regression analysis based on LASSO regression showed that the risk factors for nosocomial infection of VLBW premature infants were 28-31+6 weeks of gestation, amniotic fluid pollution, mechanical ventilation, indwelling gastric tube, unreasonable use of antibiotics, and hospitalization time ≥ 7 days. The protective factors were Apgar score ≥ 7 points at 1 min and breast feeding accounting for 50% or more (P<0.05). The Area Under Curve (AUC) of ROC curve of nomogram model was 0.946 [95%CI(0.923, 1.000)]. The calibration curve showed that the probability of hospital infection predicted by the model was basically consistent with the actual probability. The decision curve showed that when the probability threshold of nomogram model to predict the risk of nosocomial infection of very low birth weight premature infants was 0-0.85, the net rate of return was greater than 0. Conclusion　Preterm infants with extremely low birth weight are at high risk of nosocomial infection, mainly affected by factors such as gestational weeks, hospitalization time, amniotic fluid pollution, etc. The nomogram model constructed by the above factors has high accuracy and discrimination for predicting nosocomial infection in such children.

Objective To investigate the risk of falling and nutritional status in elderly surgical patients,and to assess the correlation between them.Methods Patients aged ≥65 in Department of General Surgery of Beijing Hospital between January and June 2015 were enrolled in this study.The Morse Fall Scale was used to evaluate the risk of falling.Anthropometrics,body composition,and Nutritional Risk Screening 2002 (NRS 2002) scores were collected to evaluate the nutritional status of the patients.The correlation between risk of falling and nutritional status was analyzed.Results A total of 383 patients were included,including 314 cases under 80 (65-79 years) and 69 cases ≥ 80.Patients ≥ 80 years showed significantly lower grip [(24.53 ± 8.09)kgvs.(30.57 ±8.48)kg,P＜0.05] and4-meter gait speed [(0.66 ±0.19)m/s vs.(0.84 ± 0.20) m/s,P ＜ 0.05],but significantly increased undemutrition [15.9％ (11/69) vs.7.0％ (22/314),P ＜ 0.05] and nutritional risk [56.5％ (39/69) vs.38.2％ (120/314),P ＜0.05].Altogether 33.9％ of the patients (130/383) were at high risk of falling,and the prevalence was significantly higher in patients ≥80 than in patients ＜ 80 [44.9％ (31/69) vs.31.5％ (99/314),P =0.036].Compared with patients not at high risk of falling,high-risk patients had lower body mass index [(22.33 ± 1.82) kg/m2 vs.(23.76 ± 3.26) kg/m2] and grip [(24.95 ± 8.56) kg vs.(30.72 ± 8.39) kg],but higher prevalence of nutritional risk [46.9％ (61/130) vs.38.7％ (98/253)] (all P＜0.05).Conclusions Eldedy surgical patients have a high risk of falling,which may be related with their nutritional status.Nursing and nutrition intervention should be emphasized in there patients to prevent falling and improve clinical outcome.

[ ABSTRACT] AIM:To establish an animal model of rheumatoid arthritis ( RA) in DBA/1 mice induced by im-munodominant mixed peptides derived from glucose-6-phosphate isomerase (GPI).METHODS: The DBA/1 mice were immunized with emulsified mixed peptide fragments of hGPI 325-339+hGPI469-483 or single peptide hGPI325-339 in com-plete Freund′s adjuvant by subcutaneous injection to induce the model of RA .Body weight , ankle joint symptom scores , the pathological change of the ankle joint , the levels of CD4 +T cells in the spleen and peripheral blood , the proportion of iNKT cells in the peripheral blood , and the levels of TNF-αand IL-6 in serum were detected to evaluate and analyze the model.RESULTS:The hind paw of the model mice appeared red swelling on the 8th day, and then aggravated gradually to the limbs.The red swelling reached peak on the 14th day, and then relieved gradually .Inflammation response dominated by lymphocytes and monocytes was observed in the ankle joint .The inflammatory effect of mixed peptides was more obvious than that of the single one (P<0.05).Compared with control group and the mice treated with single peptide , the weight gain was slow, the amount of CD4 +T cells in the peripheral blood and spleen were increased , the proportion of peripheral iNKT cells in the inflammatory peak was decreased (P<0.05), and the serum level of TNF-αwas increased significantly ( P<0.05) in the mice treated with mixed peptide fragments .CONCLUSION: The immunological characteristics of RA model induced by mixed GPI peptides in DBA/1 mice is closer to that in RA patients , especially in the immunopathology of iNKT cells.Therefore, this model can be used as a new tool for studying the mechanism and immunological intervention of RA.

Objective:To explore the effect of the synthetic immunomodulator CH 2b with a thiazolidin-4-one ring on the pathogenesis of rheumatoid arthritis (RA) mice induced by glucose-6-phosphate isomerase(GPI) mixed peptides.Methods:hGPI325-339 ,hGPI469-483 peptide fragments were mixed with complete freund′s adjuvant fully ,DBA/1 mice were givien subcutaneous injection of the emulsifiers,pertussis toxin to strengthen immunity.And then RA mice were intervened with α-GalCer and CH2b,the changes of body weight ,ankle joint symptoms scores were observed .The joint tissues stained with hematoxylin and eosin ( HE) was used to evaluate the inflammatory cells.Fluorescence-activated cell sorting ( FACS) was used to detect the frequency changes of iNKT cells .Cytometric bead array(CBA) was used to analyze the levels of serum cytokines TNF-α,IL-6,IL-4,IFN-γ.Results: Compared with the model group,α-GalCer,CH2b could reduce the inflammation of the model mice ,significantly improve the body weight growth and the joint swelling(P<0.05).The inflammatory cells infiltration were decreased.More importantly,CH2b improved the frequency of iNKT cells in peak,the difference was statistically significant (P<0.05).The levels of TNF-α,IL-6,IFN-γin serum were significantly decreased(P<0.05) by CH2b.α-GalCer,CH2b could decrease the levels of TNF-α,IL-6,IFN-γ,and the two groups had no statistically significant difference(P>0.05).Conclusion:Immunomodulator CH2b by activating iNKT cells affect the secretion of inflammatory cytokines ,and it relieved the GPI induced arthritis .

Objective To investigate the nutritional status of elderly inpatients with benign orthopedic diseases and to assess its relationship with clinical outcomes.Methods Nutritional Risk Screening 2002 ( NRS 2002) was used to prospectively investigate undernutrition and nutritional risk in elderly patients hospitalized between April 1 and May 31, 2012 in Beijing Hospital for benign orthopedic diseases.Associations between nu-tritional status and clinical outcomes were analyzed.Results A total of 520 patients were included, with a mean age of (75 ±7.09) years.The mean body mass index (BMI) was (23.20 ±3.83) kg/m2, mean dominant-hand grip strength was (16.87 ±19.19) kg, mean mid-upper arm circumference was (25.62 ±3.81) cm, mean calf circumference was (31.92 ±4.02) cm.Compared with patients aged 65-79 years, patients≥80 years showed significantly lower hand grip strength [ (13.58 ±15.92) kg vs.(18.48 ±20.42) kg, P=0.004].All the pa-tients completed NRS 2002, which showed that 9.31%of the patients had undernutrition (BMI≤18.5 kg/m2), and 45.19%had nutritional risk (NRS 2002 score≥3).Compared with patients aged 65-79 years, patients≥80 years had significantly higher incidence of undernutrition (13.97% vs.7.21%, P=0.024) and nutritional risk (52.38%vs.41.76%, P=0.024), higher incidence of infectious complications in patients with nutritional risk (10.21%vs.5.26%, P=0.044), longer hospital stay [ (11.66 ±5.76) days vs.(10.42 ±4.37) days, P=0.016], and higher hospital expense [(20.28 ±1.811) thousand yuan vs.(16.39 ±1.362) thousand yuan, P=0.016].Conclusion Elderly patients hospitalized for benign orthopedic diseases have a high incidence of undernutrition and nutritional risk, which is associated with worse clinical outcomes.