Acute kidney injury (AKI) is one of the most common complications in critically ill patients, and sepsis is the main cause of AKI in the intensive care unit (ICU), which can lead to a poor prognosis in severe cases. For patients with sepsis-associated acute kidney injury (SA-AKI) for whom urgent dialysis is indicated, it is now clear that renal replacement therapy (RRT) can be initiated immediately to control disease progression. However, the optimal timing to initiate RRT in patients whose disease is not severe enough to warrant urgent dialysis remains controversial. Some previous studies were small and heterogeneous, and there was a lack of effective reference indicators for guiding RRT in SA-AKI patients. Therefore, this article reviews the relevant experimental studies on the treatment of critically ill patients with AKI in recent years, and reviews the latest research progress on the optimal timing of RRT initiation, in order to provide an effective reference for clinical practice.
Humans ; Acute Kidney Injury/etiology* ; Renal Replacement Therapy/methods* ; Sepsis/therapy* ; Time Factors ; Intensive Care Units

To analyze the disease group structure and its trends in key departments of large public hospitals using diagnosis related group (DRG) data, explore the key points of intervention and optimization of disease groups in departments, and further promote the rational allocation of department resources.

Objective This study aims to analyze the application value of the Kirkpatrick Evaluation Model in the evalu-ation of hospital service training.Methods A total of 100 hospital front desk service personnel participating in service training from July 2021 to July 2023 at Qingyuan People's Hospital were selected as the research subjects.They were randomly divided into a study group and a control group,with 50 participants in each group.The study group implemented training based on the Kirkpatrick Evaluation Model,while the control group received conventional training.The learning level,behavior level,reaction level,and result level(including service satisfaction,complaint rate,and occurrence of service incidents)of the two groups were compared,as well as the evaluation effects.Results The study group showed significantly higher scores in theoretical knowl-edge,skill operations,thinking patterns,and humanistic care compared to the control group.The training satisfaction was signifi-cantly higher in the study group.The scores for interpersonal communication,question answering,and front desk material man-agement were significantly higher in the study group.The service satisfaction and training effectiveness were significantly higher,while the complaint rate and occurrence of service incidents were significantly lower in the study group compared to the control group(P<0.05).Conclusion Implementing training for hospital front desk service personnel based on the Kirkpatrick Evalua-tion Model can improve their theoretical knowledge and service level,enhance patient satisfaction,and reduce the complaint rate and occurrence of service incidents.

Objective:To summarize the clinical characteristics of ulcerative colitis (UC) with primary sclerosing cholangitis (PSC) .Methods:The clinical characteristics, diagnosis and treatment of 6 UC patients with PSC admitted to Sir Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine from May 2017 to May 2022 were analyzed retrospectively. Meanwhile "ulcerative colitis", "primary sclerosing colangitis" were used as retrieval words to search associated literatures from CNKI, Wanfang Data, and PubMed databases as of August 2022. Relevant literatures were reviewed and summarized.Results:There were 6 UC patients complicated with PSC, included 4 males and 2 females. Four UC cases were diagnosed before PSC and other 2 cases were diagnosed simultaneously. Six cases were all extensive colonic type (E3), 2 patients were rectal sparing, and 4 patients had backwash ileitis. Five patients had elevated alkaline phosphatase (AKP) levels. All the patients received oral treatment with ursodeoxycholic acid (UDCA). Two patients with concurrent cholangiocarcinoma died within one year of follow-up. A total of 75 relevant literatures were retrieved.Conclusions:Patients with UC complicated with PSC are often diagnosed with UC before PSC, and PSC is often discovered due to abnormal liver function. The main clinical manifestations include jaundice, abdominal pain and diarrhea, and some may be accompanied by symptoms such as fever, vomiting, and fatigue. There are clinical characteristics such as elevated AKP, pancolitis, rectal sparing, and backwash ileitis. UC complicated with PSC is more likely to develop cholangiocarcinoma.

This article reports a rare Crohn′s disease (CD) case complicated with deep vein thrombosis and Guillain-Barre syndrome (GBS). Through the diagnosis and treatment of the multidisciplinary team, the condition of patient is relieved with no recurrence. Prevention of venous thromboembolism, rare extraintestinal manifestations and rare side adverse of anti-tumor necrosis factor-α monoclonal antibodies and their mechanisms in CD patients were discussed for reference.

Objective:To summarize the clinical characteristics of ulcerative colitis (UC) with primary sclerosing cholangitis (PSC) .Methods:The clinical characteristics, diagnosis and treatment of 6 UC patients with PSC admitted to Sir Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine from May 2017 to May 2022 were analyzed retrospectively. Meanwhile "ulcerative colitis", "primary sclerosing colangitis" were used as retrieval words to search associated literatures from CNKI, Wanfang Data, and PubMed databases as of August 2022. Relevant literatures were reviewed and summarized.Results:There were 6 UC patients complicated with PSC, included 4 males and 2 females. Four UC cases were diagnosed before PSC and other 2 cases were diagnosed simultaneously. Six cases were all extensive colonic type (E3), 2 patients were rectal sparing, and 4 patients had backwash ileitis. Five patients had elevated alkaline phosphatase (AKP) levels. All the patients received oral treatment with ursodeoxycholic acid (UDCA). Two patients with concurrent cholangiocarcinoma died within one year of follow-up. A total of 75 relevant literatures were retrieved.Conclusions:Patients with UC complicated with PSC are often diagnosed with UC before PSC, and PSC is often discovered due to abnormal liver function. The main clinical manifestations include jaundice, abdominal pain and diarrhea, and some may be accompanied by symptoms such as fever, vomiting, and fatigue. There are clinical characteristics such as elevated AKP, pancolitis, rectal sparing, and backwash ileitis. UC complicated with PSC is more likely to develop cholangiocarcinoma.

This article reports a rare Crohn′s disease (CD) case complicated with deep vein thrombosis and Guillain-Barre syndrome (GBS). Through the diagnosis and treatment of the multidisciplinary team, the condition of patient is relieved with no recurrence. Prevention of venous thromboembolism, rare extraintestinal manifestations and rare side adverse of anti-tumor necrosis factor-α monoclonal antibodies and their mechanisms in CD patients were discussed for reference.

In order to more accurately and effectively understand the intermuscular coupling of different temporal and spatial levels from the perspective of complex networks, a new multi-scale intermuscular coupling network analysis method was proposed in this paper. The multivariate variational modal decomposition (MVMD) and Copula mutual information (Copula MI) were combined to construct an intermuscular coupling network model based on MVMD-Copula MI, and the characteristics of intermuscular coupling of multiple muscles of upper limbs in different time-frequency scales during reaching exercise in healthy subjects were analyzed by using the network parameters such as node strength and clustering coefficient. The experimental results showed that there are obvious differences in the characteristics of intermuscular coupling in the six time-frequency scales. Specifically, the triceps brachii (TB) had relatively high coupling strength with the middle deltoid (MD) and posterior deltoid (PD), and the intermuscular function was closely connected. However, the biceps brachii (BB) was independent of other muscles. The intermuscular coupling network had scale differences. MVMD-Copula MI can quantitatively describe the relationship of multi-scale intermuscular coupling strength, which has good application prospects.
Arm ; Electromyography ; Exercise ; Humans ; Muscle, Skeletal ; Upper Extremity

Objective To observe the oral part of the facial artery and facial vein and to provide anatomical data for clinical applica-tion. Methods The origin, branches, course, diameter, position of oral part of facial artery and facial vein were observed on 32 fixed cada-ves (64 sides). Results The position relation between the facial artery and facial vein is non-constant. Measure the distance from inferior border of mandible to corner of the mouth, angulus mandibulae, mental protuberance midpoint. It is (5. 49 ± 0. 63) cm, (2. 50 ± 0. 89) cm and (6. 20 ± 1. 68) cm in the left side respectively, and (5. 69 ± 0. 72) cm, (2. 56 ± 1. 08) cm and (6. 85 ± 1. 86) cm in the right side re-spectively. The diameter of facial artery in inferior border of mandible is (0. 33 ± 0. 08) cm in the left side and (0. 38 ± 0. 07) cm in the right side;while the diameter of facial vein is (0. 40 ± 0. 12) cm in the left side and (0. 42 ± 0. 18) cm in the right side. The facial artery and facial vein are not concomitant and they are not asymmetry also. The position of superior labial artery arteries is constant, but the position of inferior labial artery arteries have more variations. Conclusion The branches, course, diameter and position of oral part of facial artery and facial vein have a number of variations. The superior labial artery arteries could be positioned more easily than inferior labial artery arter-ies. Being familiar with their distribution is of great importance for clinical application.

Objective To explore the related factors influencing the prognosis of children with Tourette syndrome ( TS) . Methods We collected 420 outpatient cases of TS children in the department of pediatrics of Guangdong Provincial Hospital of Traditional Chinese Medicine from January of 2007 to October of 2010 as the research objects. Using the unified survey questionnaire, we observed the influencing factors of TS prognosis such as sex, onset age, mother’s pregnancy situation, the perinatal period, partiality for food intake, family relationship, the first symptom, the severity of disease, underlying diseases, comorbidities ( such as attention deficit hyperactivity disorder, anxiety disorder, and obsessive-compulsive disorder) , family history of psychiatric or neurological diseases, trace elements levels, electroencephalogram (EEG), antistreptolycin O (ASO), course of disease, and maintenance treatment. The related factors of prognosis was analyzed with single factor and multiple factors Logistic regression analysis. Results Among the 420 cases of TS children, 396 cases were included into the final analysis, 24 were lost and the follow-up lost rate was 5.7%. The remission rate of TS was 78.3%, and the uncured rate was 21.7%. The results of preliminary screening of the influencing factors by single factor Logistic analysis showed that the related influencing factors for TS prognosis were 12, and they were course of diseases, abnormal birth history, father’s education level, mother’s education level, upbringing methods, family history of psychiatric or neurological diseases, underlying disease history, comorbidities history, abnormal ASO, the severity of disease, the frequency of disease relapse, and the medication history of western medicine (P<0.05) . And then the obtained 12 factors were analyzed by the multiple fac tors Lo gistic regression analysis, the results showed that upbringing methods, comorbidities history, the severity of disease, and the frequency of disease relapse were correlated with TS prognosis ( P < 0.05) . Conclusion TS children will have poor prognosis when their parents spoil, indiscipline, beat and scold, and dictate them, or when the children have severe illness state, frequent recurrence of the disease, and the history of comorbidities ( atten tion deficit hyperactivity disorder, anxiety disorder, obsessive-compulsive disorder, etc.) .