Objective:To investigate the effect of intensive care unit (ICU) admission model on acute kidney injury (AKI) development and the prognosis in patients with sepsis.Methods:Patients with sepsis admitted to the ICU of Xinjiang Uygur Autonomous Region People's Hospital from January 2019 to July 2020 were retrospectively analyzed. According to the ICU admission model, the patients were divided into emergency group (first admission or emergency transfer from relevant surgical departments) and delayed group (transferred from the general ward due to disease evolution). Patients were divided into AKI group and non-AKI group according to whether AKI was accompanied. The gender, age, underlying diseases, surgical history, heart rate, laboratory test indicators, acute physiology and chronic health evaluationⅡ(APACHEⅡ), sequential organ failure assessment (SOFA), organ failure and acute complications were collected. The incidence of AKI, 28-day mortality and length of ICU stay were recorded. Univariate and multivariate Logistic regression was used to analyze the risk factors of AKI in patients with sepsis.Results:A total of 185 patients with sepsis were enrolled, including 96 cases in the emergency group and 89 cases in the delayed group. 119 cases of AKI occurred while 66 cases without AKI development. The incidence of AKI within 7 days and the 28-day mortality of patients in the delayed group were significantly higher than those in the emergency group [AKI incidence rate: 77.53% (69/89) vs. 52.08% (50/96), 28-day mortality: 24.72% (22/89) vs. 10.42% (10/96), both P < 0.05], and the length of ICU stay was significantly longer than that of the emergency group (days: 18.70±7.29 vs. 14.56±4.75, P < 0.05). Univariate Logistic analysis showed that there were significant differences in age, diabetes, hypertension, organ failure, heart failure, APACHEⅡscore, SOFA score, white blood cell count (WBC), absolute neutrophil value, platelet count (PLT), blood lactate, total bilirubin, and ICU transferred from general wards between AKI group and non-AKI group. Multivariate Logistic regression analysis showed that transfer from general ward to ICU due to disease evolution was an independent risk factor for AKI in ICU sepsis patients [odds ratio ( OR) = 5.165, 95% confidence interval (95% CI) was 3.911-6.823, P < 0.001]. Conclusion:Septic patients transferred from general ward to ICU due to disease evolution are more likely to develop AKI, and also had a higher mortality and longer ICU stay. It may be an independent risk factor for AKI complicated by patients with sepsis in ICU.

Objective:To investigate the effect of enhancing the strength of the hamstring on the stability of the knee joint.Methods:Thirty patients with anterior cruciate ligament (ACL) tears were randomly divided into a training group ( n=15) and a control group ( n=15). After the injury′s edema stage, all of the subjects received the standard 6-stage rehabilitation training for ACL injury, including isokinetic exercise, isometric tension and contraction exercise, single or bipedal jumping, proprioception exercises and cardiovascular exercise. On the basis of that standard training, additional hamstring strengthening training was given to the training group. It involved three sessions of weight-bearing flexion of the knee joint six to eight times, at least five times a week for three months. All of the subjects underwent the passive relaxation test (PRT), knee function scoring (Lysholm scores) and weight-bearing MRI before and within 1 month after the training. Anterior shift of the tibia (TAS) was measured using weight-bearing magnetic resonance imaging (MRI). Results:Before the training there were no significant differences between the groups in terms of average PRT or Lysholm scores. After the training, the average PRT score in neither group had improved significantly. The average Lysholm scores of the training and control groups were not significantly different either, though both groups′ averages had improved significantly compared with before the training. The average tibial shifts were also significantly smaller than before the training, with the training group′s average significantly smaller than that of the control group.Conclusion:Increasing hamstring muscle strength can reduce tibial anteversion in the weight-bearing upright position and improve the stability of the knee joint after ACL injury.

Objective To observe the evolution of astrocytes,GDNF,BDNF and Jak-STAT signal pathway after spinal cord ischemia-reperfusion injury in rabbits.Methods Spinal cord ischemia was induced by means of balloon occlusion of the infrarenal aorta for 22 minutes in 54 male New Zealand white rabbits.We assigned rabbits to 9 groups (n =6),one sham group,eight operation groups.The operation process in the sham group was the same as the operation group except the ischemia reperfusion of the spinal cord.At 0 h,1 h,2 h,3 h,8 h,24 h,48 h and 72 h after reperfusion,animals were sarcrificed and the spinal cord was removed for histologic,immunohistochemical study and western blotting.Results Normal neurons were decreased with the extension of reperfusion time.Levels of GFAP increased at 3 h and reached a peak at 48 h after reperfusion.GDNF was increased reaching two peaks after injury,the first peak was at 3 h,the second was at 72 h.BDNF level was increased and peaked at 24 h after reperfusion.The expression of p-STAT3 showed a biphasic pattern which peaked at 1h and 48 h.GFAP,GDNF,BDNF were rare and the level of p-STAT3 could be neglected in sham group.Conclusion Spinal cord ischemia-reperfusion injury could induce the activation of astrocytes,the expression of GDNF,BDNF and the activation of JakSTAT signal pathway.They showed different expression rules in this study.

Objective: To observe the activation of microglia and the changing rule of inflammatory cytokine as IL-6, IL-10 and nuclear factor-κB (NF-κB) in experimental rabbits after spinal cord ischemia reperfusion (SCIR) injury in order to provide theoretical basis for post-conditioning time. Methods: Rabbit SCIR injury model was established by thoracic aorta balloon occlusion. 54 New Zealand male adult white rabbits were divided into 9 groups: Sham group (the animals received balloon implantation without occlusion), SCIR-0h group (reperfusion was conducted at 0 hour of spinal cord ischemia), SCIR-1h, -2h, -3h, -8h, -24h,-48h and -72h groups. n=6 in each group. The number of normal and apoptosis neurons, the levels of Iba-1, IL-6, IL-10 and NF-κB in spinal tissue were examined and compared among different groups respectively. Results: The number of normal neuron was decreasing with the extended reperfusion time, TUNEL-positive neuron began to increasing in SCIR-8h group and the peak was reached in SCIR-24h group. The expression of Iba-1 began to elevating in SCIR-2h group and the peak was obtained in SCIR-8h group; NF-κB began to rising in SCIR-3h group and the peak was observed in SCIR-8h group; both IL-6 and IL-10 arrived the peak in SCIR-24h group. The expressions of NF-κB, IL-6 and IL-10 were positively related to Iba-1 level. Conclusion: Microglia activation had dynamic changes in experimental SCIR rabbits and the expression levels of NF-κB, IL-6 and IL-10 were positively to microglia activation; post-conditioning time at front and back to microglia activation may reduce neuron injury.

ObjectiveTo investigate the efficiency of autologous transplantation of peripheral blood stem cells for treatment of patients with diabetic lower limb ischemia.MethodsEighteen patients of type 2 diabetes with diabetic lower limb ischemia (30 legs) were treated by autologous transplantation of peripheral blood stem cells.ResultsThe limb pain, cool feeling and numbness feeling improved significantly after PBSC transplantation,the improvement rate were 96.7％, 100.0％ and 95.8％ respectively.Intermittent claudication was also relieved significantly, total remission rate was 76.9％.The ABI and TcPO2 of patients increased significantly at 3 months after transplantation.After the transplantation ABI raised from 0.60 ± 0.11 to 0.71 ±0.12(t =-6.882, P ＜ 0.01) .93.3％ of patients' TcPO2 raised in different degrees.The foot infections were well controlled.Ulcer or toes gangrene got better or healed.No obvious complications or adverse reaction were observed after the transplantation.ConclusionAutologous transplantation of peripheral blood stem cells shows to be a simple, safe and effective method in treating patients with diabetic lower limb ischemia.

ObjectiveTo explore the effect of metabolic syndrome (MS) on the occurrence and development of benign prostate hyperplasia (BPH).Methods 101 elderly BPH patients were divided into two groups:BPH (n = 45) and BPH with MS (n= 56)group.The effects of metabolic indexes,including body mass index (BMI),waist,high density lipoprotein cholesterol (HDL-C),fasting blood glucose (FBS) and insuline resistance index (H()MA-IR),on prostate volume(PV),prostate-specific antigen (PSA),international prostate symptom score (IPSS) and lower urinary tract symptoms (LUTS) were surveyed in BPH patients.Results BPH with MS group showed significantly higher values of PV (t = 3.22,P= 0.003)and longer course of LUTS (t= 2.02,P =0.046) than BPH group.The BPH patients with overweight and obesity had significantly higher levels of PV(49.44±26.83 ml and 51.7±22.2 ml,P=0.021 and 0.043) than BPH patients with normal weight (38.10 ± 10.64 ml).Additionally,BPH patients with abdominal obesity had significantly higher levels of PV than BPH patients without abdominal obesity(50.26±26.51 ml vs.38.99± 11.25ml,P=0.005).BPH patients with low HDL-C had significantly higher PV than BPH patients with normal HDL-C[(54.23±28.92)ml vs.(40.40± 14.87) ml,P=0.009].The values of PV,PSA in the BPH patients with elevated FBS were significantly higher than in BPH patients with normal FBS (t=3.17 and 2.4I,P= 0.035 and 0.013).BPH patients with insuline resistance (IR) had higher values of PV and longer courses of LUTS than BPH patients without IR (t= 3.43 and 3.58,P-0.001).The PV was positively correlated with BMI(r= 0.459.P= O.OOO),FINS (r= 0.42,P=O.OOI),HOMA-IR (r= 0.49,P= 0.003) and gatively correlated with HDL-C (r= 0.38,P-0.000)- Multiple linear stepwise regression analysis showed that PV was closely correlated with HOMA-IR.ConclusionsMS has evident effects on the occurrence and development of BPH.

Objective The purpose of this article was to investigate the internal tunnel position during anterior cruciate ligament (ACL) reconstruction with single-bundle ACL. Methods MRI were performed in 10 knees form 10 volunteers at full extension and at 30°, 60°, 90°, and 120° flexion position. All the images obtained were exported into Mimics 10.01. Three-dimensional models were established with Mimics in a computer. All the mark points were confirmed on femur and tibia. The distance between the femoral mark point and tibial mark point was measured. The isometric point was determined as the change in the distance was shorter than 3mm during knee flexion-extension. Results Ten three-dimensional models were established successfully and the isometric points of A0-X, A15-X, A30-X, A45-X, B0-Y, B15-Y, B30-Y, B45-Y, C0-Z, C15-Z, C30-Z, C45-Z, and C60-Z were identified. Conclusion There was no absolute anatomical isometric point, whereas the physiological isometric point did exist. Therefore, determination of tibial point should be considered synthetically. B45-Y was recommended for tunnel position.

Objective To understand the elementary information and pharmacotherapy for benign prostatic hyperplasia (BPH) in outpatients in geriatrics department of three hospitals. Methods The outpatients diagnosed as BPH were investigated by daily BPH diagnosis report form, BPH medical-care requirement questionnaire, international prostate symptom score (IPSS) questionnaire and BPH quality of life scale (BPHQLS) in odd months. Results There were 657 outpatients in the three hospitals, including 456 males and 201 females. 289 patients were diagnosed as BPH, accounting for 44% of all outpatients and 63.4% of male patients. The average age of BPH patients was (77.2±5.7)years, the mean volume of prostate was (41.44 ± 21.00)ml, the median value of prostate specific antigen (PSA) was 2.24 μg/L, the mean maximum flow rate was (12. 65± 5.74)ml/s, and the average of IPSS and BPHQLS were 14.8±8. 11, 2. 56±1.36, respectively. The percentage of pharmacotherapy was 66.21% (96/145), and the rates of a-receptor blocker monotherapy and 5α-reduetase inhibitor monotherapy were 6.90% and 8. 97%, respectively. The percentage of drug combination was 26.90%. Conclusions BPH outpatients in geriatrics department of the three hospitals are at high risk, and most of them receive drug therapy. The drug choice is reasonable.

Objective To access the ability of MRI for detecting the radial meniscal tears.Methods Arthroscopy of the knee was performed by a single orthopedic surgeon on 1085 patients. On the basis of the results of arthroscopy, 107(9.9%) knees had radial tears of menisci. Through interval sampling of the patients with meniscal tears but not radial tears, 100 patients were selected as a controlled group. All MR images were analyzed by two radiologists independently. Four radiological signs were used to detect radial tears: cleft and marching cleft sign, detached sign, ghost sign, and small meniscal sign. All the features of MRI were compared with the results of the arthroscopy. Results (1) The most frequent location of radial tears was the midbody of lateral meniscus (71/107, 66. 4%)followed by the boundary of anterior horn and midbody of the lateral meniscus (25/107, 23.4%). (2) One hundred and two of 107 patients were identified as radial tears on MRI. However, 11 of 100 patients with non-radial tears were misdiagnosed as radial tears by MRI. The sensitivity, specificity, positive predictive value, and negative predictive value of MRI were 95.3% (102/107),89.0% (89/100),90.3% (102/113), and 94.7% (89/94),respectively. (3) The cleft sign (59/102, 57.8%) and detached sign (43/102, 42.2%) were the most frequent and important MRI signs. Conclusion The accuracy of MRI to identify the radial meniseal tears'is very high and MRI is the best imaging modality for patients suspected of radial meniscal tears.

Objective To determine whether rizatriptan has an effect on cortical spreading depression (CSD) and c-Fos expression within periaqueductal grey (PAG) induced by CSD in rats. Methods The experimental SD rats were randomly divided into group A injected with KCl, group B KCl plus rizatriptan and group C NaCL The number and amplitude of CSD were recorded after KCl or NaCl injection. C-Fos positive neurons of different layer were identified by the immunohistochemical technique 2 hours after the first injection of KCl or NaCl. Results There was no CSD in group C. The number of CSD in group A ( 10.70±3.23 ) was significantly more than that in group B (6.10±2.56, t = - 3.528, P < 0.01 ). The amplitude of CSD in group A ( 17.33 (95% CI 11.45--23.11 ) mV) was significantly greater than that in group B (11.82 (95%CI 9.24--14.70) mV, Z= -4.360, P< 0.01). There were more cFos-like immnoreactive neurons in every layer in group A than in group C (P < 0.01 ) and in group B (P < 0.05 ). Conclusion Rizatriptan has an inhibitory effect on CSD, which might induce the headache through exciting the neurons in PAG.