Predictive value of neutrophil to lymphocyte ratio on acute kidney injury after on-pump coronary artery bypass: a retrospective, single-center study.

OBJECTIVE: To investigate the predictive value of preoperative neutrophil to lymphocyte ratio (NLR) on acute kidney injury (AKI) after on-pump coronary artery bypass (ONCAB). METHODS: Patients who underwent elective ONCAB for coronary heart disease were included. NLR was calculated according to the results of preoperative routine blood test, patients were divided into non-AKI and AKI groups, and the differences in clinical baseline data between the two groups were compared. RESULTS: A total of 154 patients were included in this study, including 57 (37%) with postoperative AKI and 97 (63%) without AKI. Compared with the patients in non-AKI group, those in AKI group had higher NLR (2.63 (1.83, 3.505) vs. 2.06 (1.7, 2.56), p = 0.002), higher serum creatinine (78 (67, 98.5) vs. 70.9 ± 16.8 umol/L, p < 0.001), longer cardiopulmonary bypass time, and longer aortic cross clamp time. After dividing patient into tertiles based on NLR, those with higher NLR had higher risk of postoperative AKI than those with lower NLR (30% vs. 25% vs. 55.8%, p for trend = 0.003). Patients in Tertile2 and Tertile3 had higher NLR compared to those in Tertile1 (p < 0.05); multivariate logistic regression analysis showed patients with elevated preoperative NLR and blood creatinine had higher risk of postoperative AKI. ROC curve showed that patients' preoperative NLR combined with blood creatinine had better predictive value for postoperative AKI. CONCLUSION: Elevated preoperative NLR is associated with AKI after ONCAB, and had prognostic utility independent of other recognized risk factors.

Application of "medical Salon" teaching in standardized training of residents in gynecology and obstetrics department / 中华医学教育探索杂志

Objective To investigate the application of "medical Salon" teaching in standardized training of residents in gynecology and obstetrics department. Methods A total of 30 residents of obstetrics and gynaecology receiving standardized training in the People's Hospital of Wuhan University from August 2015 to March 2018 were enrolled. They were randomly divided into experimental group and control group, with 15 persons in each group. In addition to daily training, the experimental group held a "theoretical salon" once a week and a "surgical salon" every quarter. Both groups of physicians took examinations of basic theories and clinical practice level and received evaluation of training satisfaction;SPSS 17.0 was used to perform t-test or paired t-test on intra-and inter-group data. Results Before the standardization training began, there was no significant difference in the scores of the basic theory and clinical practice between the two groups (P>0.05). After the training, the basic theory and clinical practice scores of the two groups were improved compared with those before training, and the difference was statistically significant (P<0.05). After the training, the scores of the basic theoretical examination of the experimental group were higher than those of the control group [(95.20±3.67) vs. (82.10±5.62)], and the scores of clinical practice of the experimental group was higher than the control group [(96.80±3.26) vs. (79.50±5.28)]; the teaching satisfaction scores of the experimental group were higher as well [(95.50±3.54) vs. (86.70±4.95)]. The differences were statistically significant (P<0.05). Conclusion The"Medical Salon"teaching helps to improve the quality of standardized training for obstetrics and gynecology residents and is worth promoting.

Rapid detection of human MTHFR gene polymorphism by the TaqMan-ARMS method / 临床检验杂志

Objective To establish a rapid detection method for human methylene tetrahydrofolate reductase ( MTHFR) gene polymor-phism by using the primer mismatching amplification and fluorescence quantitative PCR. Methods A total of 214 samples with differ-ent MTHFR C677T genotypes ( CC, CT, TT) or different A1298C genotypes ( AA, AC, CC) , which were verified by gene sequen-cing, were collected, and the plasmids with the corresponding wild-type and homozygous mutants were constructed, respectively. The amplification refractory mutation system ( ARMS) primers and TaqMan probes were designed based on the wild-type standard sequence of MTHFR gene, and the optimal mutation detection system was established. The results from the system were compared with the known sequencing results to verify the feasibility of the system. Results The performance of the established TaqMan-ARMS method was ex-cellent, which had 10 copies/μL of lowest detectable limit and high specificity. There was no nucleic acid amplification in the cross de-tection between samples and the negative control. In addition, the established method had good repeatability. The standard deviations of the reproducibility detection of MTHFR-667 and 1298 loci ranged from 0.11 to 0.44, and the coefficients of variation ( CV) of homozy-gous and heterozygous samples were all less than 4.52％. The consistency of the established method with the sequencing method in 214 clinical samples was 100％. Conclusion The established TaqMan-ARMS method for the detection of MTHFR gene polymorphism is simple, rapid and accurate, which may be used for the rapid diagnosis of clinical patients.