Objective To investigate the incidence and the prognosis of acute kidney injury (AKI) and to find out the risk factors associated with the outcome for better understanding and preventing AKI among inpatients. Methods All the hospitalized patients were screened by Lab Administration Network of Renji Hospital,Shanghai Jiaotong University School of Medicine from Jan.to Dec.2009.Study cohort was comprised of all the patients with AKI defined by Acute Kidney Injury Network (AKIN) and with complete clinical data recorded.The incidence,etiology and distribution characteristics, prognosis of AKI in hospitalized patients were retrospectively analyzed.Logistic regression analysis was used to investigate the risk factors of patients and renal outcome. Results A total of 934 patients with AKI were enrolled.The incidence of AKI in hospitalized patients was 2.41％ (934/38 734).The ratio of male to female was 1.88∶1.Age was (60.82±16.94) years old.Increasing incidence could be seen with age rising.There was 63.4％ AKI found in surgical department,35.4％ in internal medicine department and 1.2％ in obstetric and gynecologic department.Pre-AKI,acute tubular necrosis (ATN),acute glomerular and renal vascular injury (AGV),acute interstitial nephritis (AIN) and post-AKI were accounted for 51.7％,37.7％,3.8％,3.5％ and 3.3％ of the causes of AKI,respectively.On day 28,the survival rate was 71.8％,complete renal recovery rate was 65.7％,partial renal recovery rate was 16.9％ and renal loss rate was 17.4％ among all the patients with AKI.The mortality of AKI with stage Ⅰ,Ⅱ and Ⅲ among inpatients was 24.8％,31.2％ and 43.7％ respectively.Multivariate Logistic regression analysis showed that renal injury drugs [odds ratio (OR)=2.313],hypotension (OR=4.482),oliguria (OR =5.267),the number of failure organs except kidney (OR =1.376) and requiring renal replacement therapy (RRT)(OR=4.221) were independent risk factors for death among AKI patients.The number of failure organs except kidney (OR=1.529) and RRT (OR=2.117) were independent risk factors for kidney loss. Conclusions AKI is one of the most common complications in hospitalized patients.The mortality is high and renal outcome is poor after AKI.The prognosis is closely associated with the severity of AKI.Renal injury drugs,hypotension,oliguria,the number of failure organs except kidney and requiring RRT are independent risk factors for death among AKI patients,while the number of failure organs except kidney and requiring RRT are independent risk.factors for renal loss.

Objective To validate the effect of Renji acute kidney injury score (RAKIS) on predicting patients with acute kidney injury (AKI) after cardiac surgeries,and make comparison with Cleveland score,simplified renal index (SRI) and acute kidney injury following cardiac surgery (AKICS).Methods Patients undergoing open heart surgery from 2008/01/01 to 2010/10/31 in Renji hospital were enrolled,and their scores of those four scoring models were calculated.AKI patients were diagnosed by KDIGO,and those scores of AKI patients and non-AKI patients were compared.Receiver operating characteristic (ROC) curve and area under curve (AUC) were used to decide the predictive values of those models.Results A total of 1126 patients were chosen in this cohort,with the average age of (58.43±14.88) years (rang from 18 to 88).The male to female ratio was 1.47:1.And 355(31.5％) patients were developed AKI.AKI stage Ⅰ,Ⅱ and Ⅲ were 65.4％,23.7％ and 11.0％ respectively.RAKIS was significantly higher in AKI patients than in non-AKI patients (17.5 vs 9.0,P ＜ 0.001).The AUCs of RAKIS to predict AKI,AKI Ⅱ-Ⅲ stages,renal replacement therapy (RRT)and in-hospital death were 0.818,0.819,0.800 and 0.784 respectively.The AUCs of Cleveland score and SRI were 0.659 to 0.710,lower than those of RAKIS and AKICS.AKICS had lower value for predicting AKI and AKI Ⅱ-Ⅲ stages (AUC 0.766 and 0.793),but good value in predicting RRT and inhospital death after surgery (AUC 0.804 and 0.835) as compared with RAKIS.Conclusions RAKIS is valid and accurate in the discrimination of KDIGO defined AKI patients,while for predicting the composite end point,AKICS may be more useful.

Objective:To explore the effect of the principle of tissue gradient difference in repairing the over wide eyelid fold after double eyelid operation by incision.Methods:From July 2019 to July 2020, we applied the principle of tissue gradient difference to 30 cases (a total of 60 eyes; age ranging 20-35 years with mean 30) of female patients with excessively wide eyelids after incision double eyelid surgery needing a repair. All cases were from the Plastic Surgery Department of Sichuan Provincial People＇s Hospital. The difference in tissue gradient was manifested as the difference in thickness, texture and tension of soft tissues such as the skin above and below the double eyelid line and the orbicularis oculi muscle.Results:Satisfactory evaluation results showed in a total of 30 patients with 60 eyes, 95.0% ( n=57) were satisfied, and 5.0% ( n=3) were dissatisfied. Two of the patients received the second repair due to the inconsistency of the double eyelid width after correction. One patient obtained satisfactory double eyelid morphology after the second repair, and the other patient obtained satisfactory double eyelid morphology after the third repair. Evaluation results of double eyelid morphology showed that it obeyed a normal distribution by analyzing the difference between preoperative and postoperative double eyelid morphology scores. The results of paired t test showed that the double eyelid morphology was significantly improved 6 months after operation compared with preoperative, and the difference was statistically significant ( t=15.86, P<0.01). Conclusions:The principle of tissue gradient difference guides the repair of double eyelid width that is simple and easy, the effect is good, and it is worth applying.

Objective To evaluate the efficacy of the sublingual immunotherapy with Dermatophagoides farianae drops on different age groups. Methods The efficacy of 117 patients with AR received SLIT treatment for more than one year were retrospectively analyzed. These patients were divided into three groups according to the age,children group(6-14 year old,35 patients),youth age group(15-35 year old,45 cases)and middle-aged group(36-66 year old,37 pa-tients). Before and SLIT treatment for half one year, one year,symptom score, medication score and signs score were evaluated. Results After SLIT treatment for half a year and one year, the symptom score, medication score and signs score in these patients significantly reduced compared with before(P<0.05). Compared with after half a year treatment,the symptom score of children group significantly reduced(q=3.05,P<0.05),and other indicators were not statistically significant (P>0.05). The symptom score, medication score and signs score among three age groups were not statisti-cally significant (P>0.05) at all the time points. Conclusion Dermatophagoides farinae drops on allergic rhinitis can play a significant and similar effect in the different age groups.

Cystatin, a cysteine protease inhibitor found in many parasites, plays important roles in immune evasion. This study analyzed the molecular characteristics of a cystatin from Fasciola hepatica (FhCystatin) and expressed recombinant FhCystatin (rFhcystatin) to investigate the immune modulatory effects on lipopolysaccharide-induced proliferation, migration, cytokine secretion, nitric oxide (NO) production, and apoptosis in mouse macrophages. The FhCystatin gene encoded 116 amino acids and contained a conserved cystatin-like domain. rFhCystatin significantly inhibited the activity of cathepsin B. rFhCystatin bound to the surface of mouse RAW264.7 cells, significantly inhibited cell proliferation and promoted apoptosis. Moreover, rFhCystatin inhibited the expression of cellular nitric oxide, interleukin-6, and tumor necrosis factor-α, and promoted the expression of transforming growth factor-β and interleukin-10. These results showed that FhCystatin played an important role in regulating the activity of mouse macrophages. Our findings provide new insights into mechanisms underlying the immune evasion and contribute to the exploration of potential targets for the development of new drug to control F. hepatica infection.

Objective:To understand the epidemic characteristics of epidemic Japanese encephalitis and the antibody level of healthy people in Longnan City, Gansu Province, analyze and evaluate its epidemic risk, and provide scientific basis for future prevention and control of Japanese encephalitis.Methods:By retrospective analysis, the data of Japanese encephalitis cases in Longnan City from 2015 to 2020 were collected from the "Japanese Encephalitis Monitoring Information Report Management System" of the "China Disease Prevention and Control Information System", and the distributions of the cases(time, region and population distribution) were statistically described and analyzed. In 2018, the cluster stratified sampling method was adopted to select Li County and Xihe County with higher incidence rate of Japanese encephalitis in Longnan City, and Wudu District and Hui County with lower incidence rate as monitoring sites, and 3 administrative villages (communities) were selected from each monitoring site to collect blood samples from healthy people to detect the level of Japanese encephalitis IgG antibodies.Results:From 2015 to 2020, a total of 261 cases of Japanese encephalitis were reported in Longnan City, with an average annual incidence of 1.66 per 100 000; among them, the number of reported cases in 2017 and 2018 accounted for 82.38% (215/261) of the total number of cases. The incidence of Japanese encephalitis was mainly concentrated in August, accounting for 72.03% (188/261); 9 counties (districts) in Longnan City had reported cases of Japanese encephalitis, and the top 5 counties (districts) with the number of cases were Li County (68 cases), Xihe County (64 cases), Wudu District (40 cases), Kang County (33 cases) and Cheng County (18 cases), accounting for 85.44% (223/261) of the total number of cases. The age of onset of Japanese encephalitis cases was mainly concentrated in the 40 - < 60 years old, accounting for 40.23% (105/261); male to female ratio was 1.00 ∶ 1.14 (122 ∶ 139); the occupation was mainly farmers, accounting for 75.86% (198/261). A total of 887 sera samples from healthy people were tested, and the antibody positive rate was 91.09% (808/887); the difference in antibody positive rate of different age groups was statistically significant (χ 2 = 5.77, P < 0.05); the differences of positive rate of antibodies between different genders and regions were not statistically significant (χ 2 = 0.45, 2.06, P > 0.05). Conclusions:The incidence of Japanese encephalitis in Longnan City is mainly middle-aged farmers, with a high incidence in August each year. After the outbreak of Japanese encephalitis in Longnan City in 2017 and 2018, it has showed a low epidemic trend, and the positive rate of Japanese encephalitis antibody in healthy people is high. It is recommended to carry out regular monitoring of Japanese encephalitis immunization level of healthy people and strengthen the immunization of key populations in time.

Objective: To clinically validate the feasibility and accuracy of cine images acquired through the multitasking method, with no electrocardiogram gating and free-breathing, in measuring left ventricular (LV) function indices by comparing them with those acquired through the balanced steady-state free precession (bSSFP) method, with multiple breath-holds and electrocardiogram gating. Materials and Methods: Forty-three healthy volunteers (female:male, 30:13; mean age, 23.1 ± 2.3 years) and 36 patients requiring an assessment of LV function for various clinical indications (female:male, 22:14; 57.8 ± 11.3 years) were enrolled in this prospective study. Each participant underwent cardiac magnetic resonance imaging (MRI) using the multiple breath-hold bSSFP method and free-breathing multitasking method. LV function parameters were measured for both MRI methods. Image quality was assessed through subjective image quality scores (1 to 5) and calculation of the contrast-to-noise ratio (CNR) between the myocardium and blood pool. Differences between the two MRI methods were analyzed using the Bland–Altman plot, paired t-test, or Wilcoxon signed-rank test, as appropriate. Results: LV ejection fraction (LVEF) was not significantly different between the two MRI methods (P = 0.222 in healthy volunteers and P = 0.343 in patients). LV end-diastolic mass was slightly overestimated with multitasking in both healthy volunteers (multitasking vs. bSSFP, 60.5 ± 10.7 g vs. 58.0 ± 10.4 g, respectively; P < 0.001) and patients (69.4 ± 18.1 g vs. 66.8 ± 18.0 g, respectively; P = 0.003). Acceptable and comparable image quality was achieved for both MRI methods (multitasking vs. bSSFP, 4.5 ± 0.7 vs. 4.6 ± 0.6, respectively; P = 0.203). The CNR between the myocardium and blood pool showed no significant differences between the two MRI methods (18.89 ± 6.65 vs. 18.19 ± 5.83, respectively; P = 0.480). Conclusion Multitasking-derived cine images obtained without electrocardiogram gating and breath-holding achieved similar image quality and accurate quantification of LVEF in healthy volunteers and patients.

Objective To investigate the effect of lower thoracic epidural block on intestinal epithelial cell apoptosis during hemorrhagic shock and resuscitation in rats.Methods Sixty-four male SD rats placed with lower thoracic epidural catheter were randomly divided into four groups (n=1 6 each):group Sham (sham operation),group HSR (hemorrhagic shock and resuscitation),group NS (hemorrhagic shock and resuscitation+epidural saline 100 μl/kg),and group TEA (hemorrhagic shock and resuscitation+epidural 0.075% ropivacaine 100 μl/kg).The hemorrhagic shock was made described by Chaudry.Rats were resuscitated by transfusing shed blood and normal saline 60 min after hemorrhagic shock.Malondialdehyde (MDA)content,superoxide dismutase (SOD)activity, and protein expression of Bax and Bcl-2 in intestinal epithelium were detected,and epithelial apoptosis index was calculated at 2 h after resuscitation.Results Compared with group Sham,intestinal epithe-lial MDA,Bax expression and epithelial apoptosis were significantly increased,while SOD activity were markedly decreased in groups HSR,NS and TEA (P<0.05).Compared with groups HSR and NS,intestinal epithelial MDA,Bax expression and epithelial apoptosis were significantly decreased, while SOD activity and Bcl-2 expression were markedly increased in group TEA (P <0.05 ). Conclusion Lower thoracic epidural block can enhance the antioxidant and anti-apoptotic ability,and inhibit the oxidative stress and cell apoptosis of intestinal epithelium.Therefore,it can promote the survival rate after hemorrhagic shock and resuscitation through protecting intestinal barrier.

Objective:To understand the influencing factors of death of epidemic Japanese encephalitis (EJE) cases in Longnan City of Gansu Province.Methods:In the EJE Monitoring Information Report Management System of the Chinese Disease Prevention and Control Information System, data on EJE cases with onset from 2014 to 2018 and current address in Longnan City were derived. An "Individual Questionnaire of Epidemic Japanese Encephalitis in Longnan City" was designed, retrospective study was conducted on enrolled cases, their information on demographic data, consultation, onset, clinical classification, and chronic underlying diseases were collected, characteristics of EJE cases and death-related factors were analyzed.Results:From 2014 to 2018, a total of 260 EJE cases were reported in Longnan City, and 259 cases completed the questionnaire. Among them, 70 cases (27.0%) were aged ≥60 years old, 67 cases (25.9%) were severe and extremely severe, and 55 cases (21.2%) had chronic underlying diseases. Among 259 EJE cases, 46 cases died, with a fatality rate of 17.8%. After multivariate unconditional logistic regression analysis, age ≥60 years old [odds ratio ( OR)=2.667, 95% confidence interval ( CI): 1.140-6.237], severe and extremely severe ( OR = 2.762, 61.820, 95% CI: 1.053-7.091, 5.149-742.239), and chronic underlying diseases ( OR = 2.489, 95% CI: 1.038-5.964) were risk factors for death in EJE cases. Conclusions:The influencing factors of death of EJE cases in Longnan City are age, clinical classification and chronic underlying diseases. Therefore, we should focus on patients over 60 years old, clinically classified as severe or extremely severe, and suffering from chronic underlying diseases, and strengthen the immunization of EJE vaccine for key populations.