ABSTRACT
Acute kidney injury (AKI) is a clinical syndrome characterized by a rapid decline of renal function in a short period of time. In recent years, the incidence of AKI has been increasing gradually. Once the AKI occurs in a patient whose mortality in hospital may be increased significantly, the length of stay in hospital will be prolonged and the hospitalization costs increased in a short term, the long-term consequences include AKI recurrence, development into chronic kidney disease (CKD) or end-stage kidney disease (ESRD), cardiovascular events and death, etc. Ischemia/reperfusion (I/R) injury and contrast agents are common causes of AKI. The nephropathy induced by I/R and contrast agent is associated with intracellular calcium overload caused by Na+-Ca2+ exchanger (NCX). In this article, a systematic review of the relationship between NCX and AKI was conducted, aiming to provide a reference for further recognizing the prevention, treatment and prognosis of AKI.
ABSTRACT
Purpose To study the MRI manifestations of hippocampus with acute injury in children with epilepsy, and to explore its causes and outcomes for a better understanding of the changes of hippocampal structure with acute injury.Materials and Methods The clinical and imaging data of 8 children with epilepsy whose hippocampus showed hyperintensity in DWI were retrospectively analyzed. The bilateral hippocampal volume and ADC values were measured; changes of hippocampal volume and T2WI signal and ADC value were also analyzed.Results Eight patients were clinically diagnosed as epilepsy, 7 cases had recurrent history of seizures. MRI was performed from 1 to 5 days after the onset of epilepsy. All the 8 patients had increased unilateral hippocampal volume, 6 of whom were on the left side and the other 2 were on the right side. The affected ipsilateral hippocampal volume was significantly higher than that on the contralateral side [(2.096±0.570) cm3 and (1.768±0.447) cm3, respectively,t=-4.763,P<0.01]. The signals increased on T2WI and FLAIR; DWI showed hyperintensity with increase by approximately 25.52%. The affected ipsilateral ADC value was significantly lower than the contralateral one [(0.763±0.049)×10-3 mm2/s and (0.859±0.054)×10-3 mm2/s, respectively, t=9.598,P<0.01]. No abnormalities were found in bilateral hippocampus when 3 patients underwent MRI due to febrile convulsions and seizures before the onset of epilepsy. The affected ipsilateral hippocampal volume reduced in 3 patients after 3 to 5 months;signal was still high on T2WI and FLAIR; ADC values increased by 15.6%, the imaging results indicated hippocampal sclerosis.Conclusion Epilepsy can cause acute injury in hippocampus which demonstrates hippocampus swelling, signal increase on T2WI, and reduced ADC value and may lead to hippocampal sclerosis.
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Purpose To investigate the correlation between the brain white matter changes of MR diffusion tensor imaging (DTI) and cognitive function in the patients with mild cognitive impairment. Materials and Methods The patients (40 cases) were classified into two groups:group A (20 patients with ischemic foci in the deep white matter ) and group B (20 patients without ischemic foci in the deep white matter), and 20 normal controls was enrolled. Conventional MRI, DTI, mini-mental state examination (MMSE) and montreal cognitive assessment (MoCA) were applied, then fractional anisotropy (FA) value and apparent diffusion coefficient (ADC) value were compared among three groups. The scores of MoCA was analyzed between the patient groups. Results The decreased FA value, increased ADC value and decreased MoCA scores was demonstrate in group A, and showed significant difference compared with group B (t=-4.229,-3.251,-7.533,-2.702,-2.660;P<0.05). The increased ADC value and decreased FA value in the frontal and hippocampus region were detected in group B compared with normal controls (t=-7.790,-2.785,-4.415,-5.164;P<0.05). Conclusion The early and special structural changes can be detected using DTI compared with conventional MRI. The severe white matter lesions can be demonstrated in the patients with ischemic foci in the deep white matter, who is prone to dementia.
ABSTRACT
OBJECTIVE To understand situation in management of nosocomial infections in primary health centers in order to provide evidence for improving the management quality.METHODS An observatory study was(conducted) in 14 primary health centers using the evaluation criteria based on the requirements of The Guidelines for Management of Nosocomial Infections and the Guidelines for Disinfection in Hospitals.RESULTS Problems were found to a different extent in all of the 14 health centers.Most alarming problems were high incidence(15.7%),high(missing report)(67.7%),frequent use of antibiotics(71.2%),low proportion of nosocomial infection(specimens) submitted for testing(12.9%),lack of surveillance system for nosocomial infections and the data(feedback),and non-qualified hand-washing equipment in wards and clinics.CONCLUSIONS Special attention to management of nosocomial infections,improvement of surveillance system,and capacity-building of professionals in management of nosomial infections is the key issues for sustained and perfect development of management of nosocomial(infections) in primary health centers.