Objective:To explore the predictive value of complement and coagulation indicators in sepsis related acute kidney injury (AKI).Methods:Clinical data of 217 patients with sepsis admitted to the Department of Internal Medicine and Intensive Care Unit of Affiliated Hospital of Jiangnan University from January 2018 to June 2019 were retrospectively analyzed. All patients were divided into sepsis with AKI group and without AKI group. Laboratory indicators of all patients were collected, including complement C 3, complement C 4, activated partial thrombin time (APTT), prothrombin time (PT), international normalized ratio (INR), D-dimer, procalcitonin(PCT), etc. logistic regression analysis was used to explore the risk factors of sepsis related AKI. Receiver operating characteristic curve (ROC) was used to evaluate the predictive value of independent risk factors. Results:Among 217 patients, 120 patients developed sepsis related AKI and 97 patients didn′t. PCT, lactic acid, PT, APTT, INR and D-dimer in AKI patients were significantly higher than those without AKI ( P<0.01). Complement C 3 and complement C 4 were significantly lower in AKI group ( P<0.01). Multivariate logistic regression analysis suggested that blood pressure<90/60 mmHg (1 mmHg=0.133 kPa)( OR=3.705, 95% CI 1.536-8.934, P=0.004), increased lactic acid ( OR=1.479, 95% CI 1.089-2.008, P=0.012), decreased complement C 3 ( OR=0.027, 95% CI 0.005-0.152, P<0.001) and prolonged APTT ( OR=1.090, 95% CI 1.047-1.137, P<0.001)were independent risk factors predicting AKI. The area under the ROC curve (AUC) of these multivariates were 0.741 (95% CI 0.675-0.807), 0.798 (95% CI 0.732-0.864), 0.712 (95% CI 0.643-0.781) and 0.716 (95% CI 0.648-0.783) respectively. The relevant sensitivity was 57.5%, 80.8%, 87.5%, 59.2%, and the specificity was 90.7%, 75.3%, 51.5%, 77.3%, respectively. The AUC of the combined four indicators was 0.880 (95 %CI 0.835-0.926) with the sensitivity 75.0% and the specificity 90.7%. Conclusion:The low level of complement C 3 and prolonged APTT predict sepsis related AKI, and the predictive value can be enhanced if hypotension and hyperlactacidemia are added.

Objective: To study the therapeutic effect of triptorelin acetate combined with psychological intervention on the chil-dren with idiopathic central precocious puberty. Methods: Totally 40 cases of central precocious puberty were randomly divided into the observation group and the control group with 20 ones in each. The control group was injected with triptorelin acetate, once every 28 d; the observation group was given psychological intervention on the basis of the control group, once every 28 d. The emotional stabili-ty, depressive psychology, treatment compliance, height, body weight, growth rate, bone age ( BA) and adult height ( PAH) of the two groups before and after one-year treatment were observed and compared. Results: After the one-year treatment, the scores of emo-tional stability and depressive psychological HAMD in the observation group were significantly lower than those in the control group (P<0. 05), and the medication compliance was significantly higher in the observation group than that in the control group (P<0. 05). The growth rate and adult height of the children in the observation group were significantly higher than those in the control group (P<0. 05). Conclusion: Triptorelin acetate combined with psychological intervention in the treatment of children with idiopathic central precocious puberty can relieve depression, stabilize mood and improve medication compliance, and also effectively improve the growth rate and adult prediction height of the children.