Objective:To construct and validate a model of acute kidney injury ( AKI ) in sepsis patients based on albumin-corrected anion gap ( ACAG ).Methods:The clinical data of patients with sepsis admitted to our hospital from September 2020 to January 2025 were retrospectively analyzed. They were divided into training set and validation set according to the ratio of 7 : 3. The patients in the training set were divided into AKI group and non-AKI group according to whether AKI occurred during hospitalization. The basic information, disease treatment data and laboratory data of the patients were collected, and ACAG was calculated. Multivariate Logistic regression analysis was used to analyze the risk factors of AKI, and R language was used to construct a nomogram model to predict the risk of AKI. The receiver operating characteristic ( ROC ) curve was drawn to measure the distinguishing ability of the model, and the calibration curve was drawn to test the consistency between the predicted results of the model and the actual situation. Decision curve analysis ( DCA ) was used to judge the practicability of the model in clinical practice.Results:382 patients with sepsis were included and divided into training set ( n = 267 ) and validation set ( n = 115 ) according to the ratio of 7 : 3. Among the 382 patients, 124 cases of AKI occurred during hospitalization, accounting for 32.46%( 124 / 382 ). Among them, 85 cases of AKI occurred in the training set, accounting for 31.84%( 85 / 267 ), and 39 cases of AKI occurred in the validation set, accounting for 33.91%( 39 / 115 ). Multivariate Logistic regression analysis showed that age ( OR=2.815, 95% CI:1.316~6.022), white blood cell count ( WBC ) ( OR = 1.926, 95% CI : 1.330-2.790 ), lactic acid ( Lac ) ( OR = 2.189,95%CI : 1.300 ~ 3.687 ), serum creatinine ( Scr ) ( OR = 3.156,95% CI : 1.702 -5.852 ), blood urea nitrogen ( BUN ) ( OR = 2.951,95% CI : 1.652-5.271 ), uric acid ( OR = 3.122,95% CI: 1.588-6.139 ), C-reactive protein ( CRP ) ( OR = 2.847,95% CI: 1.384-5.856 ), ACAG ( OR = 2.953,95% CI: 1.669-5.224 ) were risk factors for AKI in sepsis patients with intensive training ( P < 0.05 ). According to the results of multivariate logistic regression analysis, a nomogram model was established. ROC analysis showed that the area under the curve ( AUC ) of the nomogram model for predicting postoperative AKI in patients with sepsis in the training set and the validation set were 0.95 ( 95% CI: 0.90-0.98 ) and 0.92 ( 95% CI: 0.89-0.97 ), respectively. The statistical values after Hosmer-Lemeshow goodness-of-fit test were 0.295 and 0.264 ( P = 0.563 and 0.488 ), respectively. The calibration curve and DCA results showed. The calibration and clinical practicability of the nomogram prediction model are good. Conclusions:Age, WBC, Lac, Scr, BUN, uric acid, CRP and ACAG are all associated with AKI in patients with sepsis. Based on these risk factors, a nomogram model was constructed to predict the risk of AKI in patients with sepsis. The model has good discrimination ability, calibration ability and clinical practical value.

Objective To study the occurrence,diagnosis and treatment of uveal metastasis in patients with breast cancer.Methods In 2400 cases of breast cancer patients,2 cases of uveal metastasis admitted from Jan.2007 to Aug.2011 in our hospital were retrospectively analyzed to study the occurrence,diagnosis and treatment.Results Both the 2 cases had the symptoms of blurred vision and hypopsia.Fundus examination and funds fluorescein angiography showed that the 2 cases had unilateral choroidal metastasis with the discovery rate of 0.08％.Case 1 was found to have uveal metastasis before breast cancer was confirmed and case 2 was found to have uveal metastasis during the 4th chemotherapy cycle.No other distant metastasis was found in these 2 patients.The eye symptoms improved obviously after chemotherapy.Conclusions In order to get a good therapeutic effect for breast cancer patients with uveal metastasis,we should pay attention to patients' symptoms and signs.Eyes examination should be taken when patients have eye symptoms and signs.

Objective:To observe the influence of damaging celiac ganglion(CG)by high intensity focused ultrasound(HIFU)on expression of substance P(SP) in spinal cord following gastric distension in rabbits,and study whether SP participate in transferring pain information as neurotransmitter. Mothods:20 rabbits were randomly divided into four groups in a 2 ?2 factorial design:not distended not damaged(nDnB),distended not damaged(DnB),not distendedly damaged(nDB),distendedly damaged(DB),with 5 in each group. At first,group nDB and DB were damaged by HIFU,group nDnB and DnB not damaged. 7 days later,they all were installed with the device of gastric distension. In group nDB and nDnB,tissue were directly fixed through infusing 4% parafomaldehyde under deep anaesthesia,then spinal cord of thoracic 6￣8(T6￣T8) was extracted. In group DB and DnB stomach was distended for 1 h,and the spinal cord were extracted in the way similar to that in the above two groups. Immunohistochemistry technique of strept avidin biotin complex(SABC)was used to display the content of SP in spinal cord. Results:In lamina and Ⅱ of dorsal horn,damaged CG could induce the OD in afferent projections and medial zone to increas significantl(yP

Objective To investigate the ablative effect of high intensity focused ultrasound (HIFU) on the celiac ganglion (CG) and the subsequent change in gastro-intestinal (GI) function. Methods Thirty-three New Zealand white rabbits of both sexes aged 5-10 months weighing 1.6-2.7 kg were randomly divided into 3 groups (n=11 each) according to the dose of HIFU (intensity?time) : group A 50 W?cm-2?10 sec; group B 10 W?cm-2 ?10 sec and group C no HIFU. Upper abdomen was opened through median incision under general anesthesia. CG was exposed to HIFU. One animal was killed in each group at 4h after operation and CG was obtained for microscopic examination. The GI function was observed for 3 days in the rest 10 animals in each group. The motor function of the hind limbs and the appearance of skin were observed for 30 days after operation. One animal in each group was killed 30 days after HIFU and CG was obtained for microscopic examination. Results Stroma edema was observed in group A and B 4 hours after HIFU. The neurons became smaller and the nuclei condensed, and fiber hyperplasia and satellite cells were observed in CG 30 days after HIFU in group A and B. The incidence of diarrhea was significantly increased in group A as compared with group B and C (P

Objective: To observe the influence of high intensity focused ultrasound(HIFU) and alcohol blocking celiac ganglion(CG) on the discharge frequency of left greater splanchnic nerve(LGSN) and postganglion fibre.Methods: 10 New Zealand rabbits were randomly divided into two groups: HIFU and alcohol groups with five rabbits in each group.CG was blocked by HIFU and 95% alcohol separately.The discharge of postganglion and preganglion fibre to gastric distension(GD) was recorded.Results: After blocked by HIFU,the discharge frequency of LGSN showed no obvious changes,however the alcohol group kept increasing in discharged frequency to GD(P

0.05). Conclusion:HIFU damaging the celiac plexus(CG) has no influence on expression of c-fos in spinal cord of gastric distension rabbits. This is different from the expression of c-fos in spinal cord caused by other visceral nerves being damage of nociceptive stimulus, which might relate to the special central mechanism of modulating nociceptive signal for stomach.