Objective:To investigate the risk factors of acute kidney injury (AKI) in patients with acute respiratory distress syndrome (ARDS) caused by bacterial pneumonia.Methods:This is a case-control, non-randomized study.A total of 118 patients with ARDS caused by bacterial pneumonia admitted to Beijing Chao-Yang Hospital, Capital Medical University, from January 2015 to May 2021 were enrolled.The patients were divided into AKI and non-AKI groups according to with or without AKI.The laboratory index, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score and 28-day mortality between two groups were included as comparators.Multivariate logistic regression was used to analyze the risk factors for AKI.Receiver operating characteristic (ROC) curves were applied to evaluate the predictive value of relevant risk factors for AKI.The Kaplan Meier method was applied to plot survival curves.Results:There were 56 AKI patients among 118 ARDS patients, with a incidence of 47.5% for AKI.Compared with patients without AKI, severe hypoxemia, white blood cell counts, procalcitonin (PCT), N-Terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin I, fasting plasma glucose, lactic acid, prothrombin time (PT), APACHE II score, SOFA scores, and 28-day mortality were all up-regulated of the patients with AKI, whereas oxygenation index and serum albumin were down-regulated (all P<0.05). Multivariate logistic regression analysis showed that PCT>1.5 μg/L ( OR=10.821, 95% CI: 3.304-35.439, P<0.001), NT-proBNP>1 600 ng/L ( OR=3.518, 95% CI: 1.166-10.617, P=0.026), fasting plasma glucose>7.5 mmol/L ( OR=6.765, 95% CI: 2.049-22.330, P=0.002), PT>13.9 s ( OR=6.204, 95% CI: 1.903-20.228, P=0.002) and oxygenation index <135 mmHg (1 mmHg=0.133 kPa, OR=2.900, 95% CI: 1.002-8.432, P=0.049) were independent risk factors for AKI.The sensitivity and specificity were 82.1% and 93.5% of the five combined indicators in predicting AKI, respectively, with an area under the ROC curve of 0.937, 95% CI: 0.877-0.974, P<0.001.The 28-day cumulative survival rate was significantly lower for patients with AKI than patients without AKI ( P<0.001). Conclusions:PCT, NT-proBNP, fasting plasma glucose, PT and oxygenation index are independent risks factors for AKI in patients with ARDS caused by bacterial pneumonia.The combination of these 5 indicators can effectively predict the occurrence of AKI.The 28-day cumulative survival rate was significantly lower in patients with AKI than those without AKI ( P<0.001).

Objective:To explore the influencing factors of pleural fluid adenosine deaminase (ADA) in patients with tuberculous pleurisy (TBP), aiming to reduce the missed diagnosis of TBP.Methods:This is a case-control study.From June 2013 to May 2021, totally 119 confirmed TBP cases admitted to the West District of Beijing Chao-Yang Hospital, Capital Medical University were enrolled by non-random sampling method, and divided into the elevated ADA group (ADA greater than 40 U/L) and the normal ADA group (ADA less than 40 U/L). Multivariate logistic regression was used to analyze the influencing factors of pleural fluid ADA in TBP patients.The cut-off value of pleural fluid ADA relevant influencing factors was evaluated by receiver operating characteristic (ROC) curve, so as to assist the cinical diagmosis on TBP.Results:Of the 119 included TBP patients, 74(62.2%) were in the elevated ADA group and 45(37.8%) in the normal ADA group.Multivariate logistic regression analysis showed that pleural lactate dehydrogenase (LDH), protein in pleural effusion, and blood C-reactive protein (CRP) were the risk factors for elevated ADA, with cut-off values were 338.3 U/L, 40.05 g/L and 31 mg/L respectively.The combined these three indicators had a sensitivity of 86.7% and a specificity of 68.9% for forecasting normality of pleural ADA, with an area under curve (AUC) of 0.843 (95% CI: 0.772~0.915, P<0.001). Conclusions:The pleural fluid ADA level of TBP patients is affected by pleural fluid LDH, protein in pleural effusion, and CRP.The above indexs of normal ADA patients with suspected TBP should be emphasized to carefully exclude TBP.

Objective The aim of our study was to estimate the cost of the elderly′s health care model so as to bring data support for later economic analysis and evaluation and provide evidence for government to measure the budgetary subsidies and medical service prices. Methods The cost data were selected by the ways of literature study,questionnaire survey and inter-view in October 2010 and March 2011. The efficient working hours of medical personnel were determined via non - participant ob-servation. Results It cost about 183. 67 yuan for each elderly receiving health care service per year under the present model. The expected reference value of standard item cost after popularization would be 133. 58 yuan. Conclusion Accurate cost estimation can give a solid basis for policymakers to make an acceptable compensation standard and promote community health service institu-tions to provide better public health services.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的了解北京市餐饮业量化分级管理实施效果,确定不同类型餐饮单位食品安全的关键环节,为监管重点提供依据。方法选取2009、2010年北京市所有餐饮单位,分别有15 391和19 138家为研究对象,采用秩和检验和参照单位分析比较组间量化等级分布差异,有序多分类logistic回归分析差异的影响因素。结果 2010年北京市餐饮单位食品安全规范（42.9%）和基本合格（51.2%）的单位比例较高,与2009年评定结果差异无统计学意义（P&gt;0.05）;餐馆规模越大,量化评定等级越高（P&lt;0.001）;学校食堂量化等级明显高于其他类型食堂（P&lt;0.001）;多因素分析结果表明,冷藏存储、盥洗及通风设施、留样要求等7个指标影响餐馆等级分布（OR=1.471².284）;交叉污染、内外环境、面积等7个指标影响食堂等级分布（OR=1.461².812）,其中食品安全制度、洗手设施、食物保存要求和摆台要求4项指标相同。结论北京市餐饮业食品安全情况较好,不同类型单位监管重点有所不同。</span>

Objective To evaluate the current state of county CDC's health emergency response teams,and to give some evidence on strengthening the construction of health emergency system at basic level.Methods County-level CDCs of eight cities were selected for investigation by stratified-cluster random sampling method,and the collected data of the health emergency teams was analyzed.Results All of the county CDCs had established health emergency teams,the median of each team was 20(10,24),the maximum was 49,the minimum was 4;the percent of the team's main construction principle,that choosing the backbone was 47.1%;74.7% of the units established emergency management system,54.0% established team construction plan,the percent of the team's construction principle,including the event's classification,the function and choosing the backbone,which were 26.4%,23.0% and 47.1%;74.7% of the units set up health emergency office,and there is 76.9% in affiliated form;56.1% of the units set up the training evaluation system.Conclusions There are many differences in health emergency system at basic level,such as the way of team building,the management system,the quantity,training and exercise.We should formulate the general principle of construction and management in emergency team.Each district should follow general principle,combining with local characteristics,to carry out local health emergency team construction.

Objective To investigate disease prevention and control emergency response team status of county-level institution from 8 cities.Methods Stratified cluster sampling was adopted combined with individual questionnaire survey and in-depth interview.Results The male to female ratio was 1.2 ∶ 1.The average age of team members was(37.47±8.54)years old.6.7% of them were over the age of 50 years old.As for their educational background,55.9% of them were undergraduates.Their main major was public health(46.5%).The title structure was given priority to with primary title(39.7%) 30.3% of them considered their physical condition was well.58.6% of them thought about themselves competent health emergency work.Conclusions The structure about disease prevention and control emergency response team members of county-level institution from 8 cities is reasonable,which is basically in line with the requirement of the health emergency.However,there are still many problems.We should base on the task requirements,optimize primary health emergency response team from the quantity,quality and structure,also pay more attention to the health emergency response team physical and mental health and team building.

肺动脉高压(Pulmonary aerial hypertesion, PAH)是一种以肺血管阻力进行性增加为特征的慢性肺循环疾病,进展快,预后差,严重威胁着患者的健康.通过可靠的检查措施对PAH患者的预后进行评估十分必要.目前用于其预后评估的方法较多,各种方法及其指标在评估中的价值不同.

由卫生部甲型H1N1流感临床专家组领衔,首都医科大学附属北京朝阳医院、北京地坛医院等多家单位组成的研究组对我国早期的426例新型甲型H1N1流感患者的症状、体征、实验室检查和影像学变化等临床特征进行了系统性描述及分析研究.