Objective:To investigate the occurrence of drug-induced acute kidney injury (AKI) in adult hospitalized patients in Xuanwu Hospital, Capital Medical University.Methods:All medical records of adult inpatients who were discharged from January 1, 2014 to December 31, 2014 and whose diagnosis were in accordance with AKI during their hospitalization in Xuanwu Hospital, Capital Medical University were collected. The patients were divided into drug-induced AKI group and non-drug-induced AKI group according to whether AKI was caused by drugs. Basic information, comorbidity, change in serum creatinine (Scr), disease outcome, nephrotoxic medication exposure, and evaluation of the relationship between drugs and AKI of the patients were collected and retrospectively analyzed.Results:A total of 592 patients enrolled in the study, including 138 (23.31%) in the drug-induced AKI group and 454 (76.69%) in the non-drug-induced AKI group. The differences in gender, age, days in hospital, comorbidity, Scr level on admission, time for Scr level to peak after admission, and outcome between the patients in the 2 groups were not statistically significant, respectively ( P>0.05 for all). Peak value of Scr during hospitalization and at discharge in patients in the drug-induced AKI group (178 μmol/L, 116 μmol/L) were obviously higher than those in the non-drug-induced AKI group (129 μmol/L, 103 μmol/L), and the differences were statistically significant ( P<0.001, P=0.001). A total of 231 times of suspected drugs were involved in the 138 patients in the drug-induced AKI group. The top 6 types of drugs in turn were anti-infectious agents (35.06%, 81/231), diuretics (17.32%, 40/231), contrast agents (13.42%, 31/231), plasma substitutes (9.96%, 23/231), angiotensin converting enzyme inhibitors/angiotensinⅡreceptor blocker (8.23%, 19/231), and non-steroidal anti-inflammatory drugs (NSAIDs) (6.93%, 16/231). Contrast agents and plasma substitutes had the shortest (range: 1-3 days) but anti-infectious agents had the longest time (range: 1-12 days) from medication to AKI occurrence. Peak values of Scr in AKI inpatients caused by NSAIDs and contrast agents were lower [median value: 118 (103, 300) μmol/L, 133 (90, 243) μmol/L], but in those caused by anti-infectious agents was the highest [median value: 223 (138, 396) μmol/L]. Multivariate logistic regression analysis showed that hypoproteinemia ( OR=8.369, 95 %CI: 3.379-20.724, P<0.001) and advanced age ( OR=1.689, 95 %CI: 1.206-2.365, P=0.002 for every 10 years of aging) were independent risk factors related to the death of patients with drug-induced AKI. Conclusions:The patients with AKI induced by drugs accounts for 23.31% of all AKI adult inpatients in Xuanwu Hospital, Capital Medical University. Anti-infectious agents, diuretics, and contrast agents are the most common suspected pathogenic drugs. Hypoproteinemia and advanced age are independent risk factors for hospital deaths in drug-induced AKI patients.

Objective:To investigate the occurrence of drug-induced acute kidney injury (AKI) in adult hospitalized patients in Xuanwu Hospital, Capital Medical University.Methods:All medical records of adult inpatients who were discharged from January 1, 2014 to December 31, 2014 and whose diagnosis were in accordance with AKI during their hospitalization in Xuanwu Hospital, Capital Medical University were collected. The patients were divided into drug-induced AKI group and non-drug-induced AKI group according to whether AKI was caused by drugs. Basic information, comorbidity, change in serum creatinine (Scr), disease outcome, nephrotoxic medication exposure, and evaluation of the relationship between drugs and AKI of the patients were collected and retrospectively analyzed.Results:A total of 592 patients enrolled in the study, including 138 (23.31%) in the drug-induced AKI group and 454 (76.69%) in the non-drug-induced AKI group. The differences in gender, age, days in hospital, comorbidity, Scr level on admission, time for Scr level to peak after admission, and outcome between the patients in the 2 groups were not statistically significant, respectively ( P>0.05 for all). Peak value of Scr during hospitalization and at discharge in patients in the drug-induced AKI group (178 μmol/L, 116 μmol/L) were obviously higher than those in the non-drug-induced AKI group (129 μmol/L, 103 μmol/L), and the differences were statistically significant ( P<0.001, P=0.001). A total of 231 times of suspected drugs were involved in the 138 patients in the drug-induced AKI group. The top 6 types of drugs in turn were anti-infectious agents (35.06%, 81/231), diuretics (17.32%, 40/231), contrast agents (13.42%, 31/231), plasma substitutes (9.96%, 23/231), angiotensin converting enzyme inhibitors/angiotensinⅡreceptor blocker (8.23%, 19/231), and non-steroidal anti-inflammatory drugs (NSAIDs) (6.93%, 16/231). Contrast agents and plasma substitutes had the shortest (range: 1-3 days) but anti-infectious agents had the longest time (range: 1-12 days) from medication to AKI occurrence. Peak values of Scr in AKI inpatients caused by NSAIDs and contrast agents were lower [median value: 118 (103, 300) μmol/L, 133 (90, 243) μmol/L], but in those caused by anti-infectious agents was the highest [median value: 223 (138, 396) μmol/L]. Multivariate logistic regression analysis showed that hypoproteinemia ( OR=8.369, 95 %CI: 3.379-20.724, P<0.001) and advanced age ( OR=1.689, 95 %CI: 1.206-2.365, P=0.002 for every 10 years of aging) were independent risk factors related to the death of patients with drug-induced AKI. Conclusions:The patients with AKI induced by drugs accounts for 23.31% of all AKI adult inpatients in Xuanwu Hospital, Capital Medical University. Anti-infectious agents, diuretics, and contrast agents are the most common suspected pathogenic drugs. Hypoproteinemia and advanced age are independent risk factors for hospital deaths in drug-induced AKI patients.

Objective: To detect the expression of NRAGE protein in esophageal squamous cell carcinoma and investigate the relationship between NRAGE and therapeutic effect of radiotherapy. Methods: The expression level of NRAGE in 44 patients with esophageal squamous cell carcinoma was evaluated by immunohistochemistry and statistically analyzed along with clinical data by using multivariate analysis using Cox regression model. Results: The overall expression level of NRAGE protein in esophageal squamous cell carcinoma (P=0.025) and the expression level of NRAGE nuclear protein (P=0.008) were negatively correlated with short-term efficacy. In terms of the overall expression level of NRAGE protein, the 3-year survival rates in the strongly positive group and the positive weakly positive group were 16% and 36%(P=0.198). As for the expression of NRAGE nuclear protein, the 3-year survival rates in the strongly positive group and the positive+ weakly positive group were 0% and 41%(P<0.001). Multivariate analysis using Cox regression model demonstrated that as for the expression of NRAGE nuclear protein, the risk of death in the strongly positive group was significantly higher than those in the positive+ weakly positive group (P=0.002). Conclusion The overall expression level of NRAGE protein in the esophageal cancer is negatively correlated with the short-term efficacy of radiotherapy, whereas it is not correlated with long-term survival rate. The strongly positive expression level of NRAGE nuclear protein is negatively correlated with the short-term efficacy of radiotherapy and the long-term survival rate, prompting that NRAGE may be a molecular indicator for predicting radiation resistance and even the efficacy of radiotherapy for esophageal squamous cell carcinoma

Objective This paper studies on feasibility of low dose CT scanning in lung cancer patients simulated localisation.Methods 62 patients cases of lung cancer are selected.Scan parameter:scan twice by 20/100 mA,the other parameter remain unchanged as voltage of 120 kV,thickness of 5 mm,pitch of 1:1 and scan time of 1 s.After scan,picture quality was evaluated according to excellent,good,bad under different condition.Volume of target was determined by treatment planning system.Data such as dose index value of single helical scan,z-axis scan range,dose length product value and etc.are recorded in order to evaluate radiation dose of patients.Picture quality and the difference of radiation dose were statistically analyzed using Fisher's and pair t-test.Results Picture quality of low dose scanning was a little bit lower than that of normal dose,however,picture quality difference of difference dose scanning was statistically meaningless (number of patients according to excellent,good,bad were 46,13,3 and 50,11,1,P =0.541).There is no obvious difference of target volume under different dose scanning in the same (36.78 cm3,40.35 cm3,t =2.57,P =0.189).Radiation dose of low dose scanning group is far less than that of high dose scanning group and the difference is obvious (133.05 mGy,941.25 mGy,t =-41.24,P =0.000).Conclusions Low dose scanning of 20 mA current during CT simulated localisation tremendously reduces harm that may happen to patients during CT scan,while tumor target delineation and scanned picture quality is guaranteed.