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Objective:To investigate the incidence and risk factors of renal injury in human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome (AIDS) patients with poor immune reconstitution.Methods:The HIV infection/AIDS patients with poor immune reconstitution who were visited Second Department of Infection of Hangzhou Xixi Hospital from January to December 2021 were enrolled. The clinical data and laboratory examinations of the patients were collected, and the relevant risk factors were analyzed by logistic regression.Results:Among 303 HIV infection/AIDS patients with poor immune reconstitution, 59(19.5%) patients had renal injury. Logistic regression analysis showed that hypertension (odds ratio ( OR)=0.200, 95% confidence interval (95% CI) 0.065 to 0.618, P=0.005), taking tenofovir ( OR=0.275, 95% CI 0.130 to 0.580, P=0.001), hypoproteinemia ( OR=1.045, 95% CI 1.006 to 1.086, P=0.022), and low CD4 + T lymphocytes level ( OR=1.009, 95% CI 1.003 to 1.014, P=0.001) were risk factors for renal injury. Conclusions:The incidence of renal injury in HIV infection/AIDS patients with poor immune reconstitution is high. Hypertension, taking tenofovir, hypoproteinemia, and low CD4 + T lymphocytes level are risk factors for renal injury in patients.
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Post-payment for patients can minimize their errands and improve their medical experience. Since February 2019, Hangzhou Municipal Health Commission began to try the " post-payment" service. This mode is integrated into the municipal credit system, and the patients can obtain the corresponding credit line according to their credit rating. Within such line, the patient can pay only once for all their medical services received per visit. The mode covers all Hangzhou residents with credit rating and has served nearly 20 million outpatient and emergency patients with expedient services. Thanks to the reform, the number of payment for patients to see a doctor reduced from an average of 2 to 3 times to only 1 time. It is proved that the credit system can realize payment after medical service and it is controllable.
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China's pre - hospital emergency resources are shortage, city traffic is congestion, and the arrival of ambulance takes some time. For this reason, the emergency center designed and manufactured a pre - hospital e-mergency volunteer mobile application software. This paper analyzed some ethical problems encountering in the practical application of the software in the 120 emergency alarm of Hangzhou area, such as volunteer identification, patient information confidentiality, volunteer rescue whether to cause a dispute and other issues, and gave the rele-vant solution countermeasures, including setting access threshold for the emergency volunteer, adopting various technical measures to protect the information of patient and formulating and perfecting the relevant legal regulations.
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Pre-hospital care is an important part of the health care system. Nowadays , there are many defects in the pre-hospital emergency charging method in China. It analyzes the effectiveness and impact of adjustment the charging method. There will be a preliminary study of hospital first aid fees adjustment of changing the current method from front-line staff receiving cash to entrusting the local hospital, charge with real-time settlement of health insurance for the convenience of the patient and reduce the workload of health insurance agencies, make financial emergency center management more standardized and efficient.
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Objective To study the effects of bioartificial kidney(BAK)treatment on cytokines interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α),biochemistry indexes,and survival time in acute uremic pigs with multiple organ dysfunction syndrome(MODS).Method Pigs with MODS and acute renal failure(ARF)were treated with BAK(group A,n = 6)or sham BAK containing no cells(group B,n = 6)or received no treatment(group C,n = 5).Data on blood pressure,hepatic and renal functions,serum IL-10 and TNF-α levels,arterial blood gas and survival time of all the pigs were recorded.Comparisons of values were done using Student's t-test or repeated-measures analysis of variance(ANOVA).ResultsMean arterial pressure(MAP,mmHg)responsed more rapidly and reached higher values in group A (91.82±5.73)compared with group B and C at 24 hours(P＜0.01).The peak level of serum EL-10(pg/mL)ingroupA(249.57±43.51)was significantly higher than that in group B and C(132.06± 17.53,104.25 ±13.42,P＜0.01).Serum TNF-a level(pg/mL)in group A dropped gradually to(402.91 ± 32.47)at 24 hours,and had significant discrepancy compared with that before the treatment(537.16 ± 38.45)and that in groupB(P＜0.05).The average survival time(hours)in group A(113.01 ± 14.32)was significantly longer than that in the group B and C(P＜0.01),which was prolonged by 35.93%and 63.90%,respectively.ConclusionsTreatment with BAK can prolong the survival time of uremic pigs with MODS,possibly through ameliorating the MAP,increasing the level of IL-10 and reducing the concentration of TNF-α.
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Objective To investigate the method of constructing bioartificial renal tubule assist device(RAD) and its transport function to creatinine,glucose,sodium and asparagine,theonine,serine,glutamic acid in vitro.Methods The cultured LLC PK1 cells were seeded into the inner space of the hemofilter(FH66)and the hemofilter was incubated for two weeks.Then the filtration in vitro was simulated to detect the function of the RAD.The transport rates of sodium,creatinine,glucose and four kinds of amino acids were measured.Meanwhile,the effects of oubaine and phlorizin on the transport rates of sodium,glucose and amino acids were determined and compared with no LLC PK1 device.Results The creatinine transport rate of RAD was significantly decreased as compared with control group(P