INTRODUCTION Sclerotherapy is a widely used non-surgical treatment for hemorrhoids but can lead to rare severe complications. We present a case of severe anal stenosis developing one year after sclerotherapy, a debilitating iatrogenic complication. PRESENTATION OF CASE A female patient presented with progressive difficulty in defecation for one year, acutely worsened over five days. One year prior, she underwent sclerotherapy for mixed hemorrhoids. Physical examination revealed severe anal stenosis admitting only the fingertip. Endoscopy and pelvic MRI confirmed a tight cicatricial stricture. She underwent V-Y advancement flap anoplasty combined with stricture incision. DISCUSSION Post-sclerotherapy stenosis results from excessive submucosal fibrosis and scar contracture. Diagnosis is primarily clinical, supported by endoscopy to exclude malignancy. Severe strictures require surgical correction. V-Y advancement flap anoplasty effectively relieves stenosis by introducing healthy tissue into the anal canal. CONCLUSION The patient achieved an excellent postoperative outcome with restored bowel function. Severe anal stenosis is a rare but devastating complication of hemorrhoid sclerotherapy. This case underscores the efficacy of V-Y advancement flap anoplasty. Clinicians should maintain high suspicion for this complication in patients with obstructive defecation symptoms post-injection.

BACKGROUND The opinions on the efficacy and safety of no anticoagulation versus regional citrate anticoagulation for continuous KRT (CKRT) were controversial in patients with severe liver failure with a higher bleeding risk. We performed a randomized controlled trial to assess no anticoagulation versus regional citrate anticoagulation for CKRT in these patients. METHODS Adult patients with liver failure with a higher bleeding risk who required CKRT were considered candidates. The included participants were randomized to receive regional citrate anticoagulation or no-anticoagulation CKRT. The primary end point was filter failure. RESULTS Of the included participants, 44 and 45 were randomized to receive regional citrate anticoagulation and no-anticoagulation CKRT, respectively. The no-anticoagulation group had a significantly higher filter failure rate (25 [56%] versus 12 [27%], P = 0.003), which was confirmed by cumulative incidence function analysis and sensitive analysis including only the first CKRT sessions. In the cumulative incidence function analysis, the cumulative filter failure rates at 24, 48, and 72 hours of the no-anticoagulation and regional citrate anticoagulation groups were 31%, 58%, and 76% and 11%, 23%, and 35%, respectively. Participants in the regional citrate anticoagulation group had significantly higher incidences of Ca2+tot/Ca2+ion >2.5 (7% versus 57%, P < 0.001), hypocalcemia (51% versus 82%, P = 0.002), and severe hypocalcemia (13% versus 77%, P < 0.001). However, most (73%) of the increased Ca2+tot/Ca2+ion ratios were normalized after the upregulation of the calcium substitution rate. In the regional citrate anticoagulation group, there was no significant additional increase in the systemic citrate concentration after 6 hours. CONCLUSIONS For patients with liver failure with a higher bleeding risk who required CKRT, regional citrate anticoagulation resulted in significantly longer filter lifespan than no anticoagulation. However, regional citrate anticoagulation in patients with liver failure was associated with a significantly higher risk of hypocalcemia, severe hypocalcemia, and Ca2+tot/Ca2+ion >2.5. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER RCA for CRRT in Liver Failure and High Risk Bleeding Patients, NCT03791190.

Background: Stroke has become one of the diseases with the highest mortality and disability rates in the world, especially in low-income and developing countries. Our objective was to discuss the relationship between the longitudinal dynamic changes of TG and stroke onset in healthy population by constructing different parametric joint models. Methods: 298 participants aged 23 to 69 in Xijing hospital of Xi’an City in Shanxi Province from 2008 to 2015 were included. The Cox proportional hazards model was performed to analyze the correlation between TG and stroke incidence at baseline. Different parameterized joint models were used to analyze the impact of dynamic changes of TG on the incidence of stroke under longitudinal data. Results: Of the 298 participants, a total of 70 (23.49%) subjects developed stroke during the study period. Cox proportional hazards model showed that the risk of disease increased by 1.056 times (95% CI =0.920-0.975) for each 1 unit of baseline age decrease. Each 1 mmol/L increase in sqrt(TG) increased the risk by 1.816 times (95% CI =1.017-3.245). Joint model showed that the risk of sqrt (TG) increased by 4.869 times (95% CI =3.987-8.857) for each 1 mmol/L increase in longitudinal direction.The lagged effects ( HR =5.284, 95% CI =4.397-9.680) and cumulative effects ( HR =1.786, 95% CI =1.613-3.399) of sqrt (TG) dynamic trajectory were also statistically related to the incidence of stroke. Conclusions: Over time, the longitudinal growth of TG levels in individuals will increase the risk of stroke even more. People should pay more attention to the dynamic changes of individual TG value, as well as the lagged effect and cumulative effect, to reduce the incidence of stroke.

Background. Patients with severe coronavirus disease 2019 (COVID-19) who develop acute kidney injury (AKI) in the intensive care unit (ICU) have extremely high rates of mortality. This study evaluated the prognostic impact of AKI duration on in-hospital mortality in elder patients. Methods. We performed a retrospective study of 126 patients with confirmed COVID-19 with severe or critical disease who treated in the ICU from February 4, 2020, to April 16, 2020. AKI was defined according to the Kidney Disease Improving Global Outcomes serum creatinine (Scr) criteria. AKI patients were divided into transient AKI and persistent AKI groups based on whether Scr level returned to baseline within 48 h post-AKI. Results. In total, 107 patients were included in the final analysis. The mean age was 70 (64–78) years, and 69 (64.5%) patients were men. AKI occurred in 48 (44.9%) during their ICU stay. Of these, 11 (22.9%) had transient AKI, and 37 (77.9%) had persistent AKI. In-hospital mortality was 18.6% (n=11) for patients without AKI, 72.7% (n=8) for patients with transient AKI, and 86.5% (n=32) for patients with persistent AKI (P<0.001). Kaplan–Meier curve analysis revealed that patients with both transient AKI and persistent AKI had significantly higher death rates than those without AKI (log-rank P<0.001). Multivariate Cox regression analysis revealed that transient and persistent AKI were an important risk factor for in-hospital mortality in older patients with severe COVID-19 even after adjustment for variables (hazard ratio HR=2.582; 95% CI: 1.025–6.505; P=0.044; and HR=6.974; 95% CI: 3.334–14.588; P<0.001). Conclusions. AKI duration can be an important predictive parameter in elder patients suffering from COVID-19 and are admitted to ICU. Among these patients, those exhibiting persistent AKI have a lower in-hospital survival rate than those with transient AKI, emphasizing the importance of identifying an appropriate treatment window for early intervention.

Background: Anticoagulation-free continuous renal replacement therapy (CRRT) was recommended by the current clinical guideline for patients with increased bleeding risk and contraindications of citrate. Nevertheless, anticoagulation-free CRRT yielded heterogeneous filter lifespan. Furthermore, the specific cutoff values for traditional coagulation parameters to predict sufficient filter lifespan of anticoagulation-free CRRT have not yet been determined. The purpose of our present study was to develop and validate a model for predicting sufficient filter lifespan in anticoagulation-free CRRT patients. Methods: Patients who underwent anticoagulation-free CRRT in our center between June 2013 and June 2019 were retrospectively included. The primary outcome was sufficient filter lifespan (≥24 h). Thirty-seven predictors were included for modeling based on their clinical significance and previous reports. The final model was developed by using multivariable logistic regression analysis and was validated in a separate external cohort. Results: The development cohort included 170 patients. Sufficient filter lifespan was observed in 80 patients. Thirteen variables were independent predictors for sufficient filter lifespan by logistic regression: body temperature, mean arterial pressure, activated partial thromboplastin time, direct bilirubin, alkaline phosphatase, blood urea nitrogen, vasopressor use, body mass index, white blood cell, platelet count, D-dimer, uric acid, and pH. The area under the curve (AUC) of the stepwise model and internal validation model was 0.82 (95% confidence interval [CI] [0.76–0.88]) and 0.8 (95% CI [0.74–0.87]), respectively. The positive predictive value and the negative predictive value of the stepwise model were 0.77 and 0.79, respectively. The validation cohort included 44 eligible patients and the AUC of the external validation model was 0.82 (95% CI [0.69–0.96]). Conclusions: The use of a prediction model instead of an assessment based only on coagulation parameters could facilitate the identification of the patients with filter lifespan of ≥24 h when they accepted anticoagulation-free CRRT.

There are controversial opinions on the use of regional citrate anticoagulation (RCA) continuous renal replacement therapy (CRRT) in hyperlactatemia patients with increased bleeding risk. Patients with hyperlactatemia and increased bleeding risk who accepted RCA or no‐anticoagulation CRRT in our center were retrospectively included. Eighty patients who underwent RCA‐CRRT and 47 patients received no‐anticoagulation CRRT were included. Filter lifespan was significantly longer in the RCA group than the no‐anticoagulation group (44.5 hours [2‐89] vs 24.5 hours [1.5‐70], P < .001). The adjusted results demonstrated that patients in the no‐anticoagulant group had significantly higher risk of filter failure (HR = 4.765, 95% CI 2.703‐8.4, P ＜ .001). Bleeding episodes occurred in 19 (24.1%) and 22 (46.8%) patients in the RCA and no‐anticoagulation group, respectively ( P = .012). The overall citrate accumulation (CA) rate was 5% in the RCA group. Patient mortality was associated with the comorbidity of hypertension, increased serum lactate level, and increased SOFA score. After matching, the filter lifespan was significantly longer in the RCA group than the no‐anticoagulation group. With careful monitoring and timely adjustment, RCA most likely was safe and effective for CRRT in hyperlactatemia patients with increased bleeding risk.

PURPOSE:We conducted a retrospective study to evaluate the efficacy and safety of regional citrate anticoagulation (RCA) versus those of low molecular weight heparin (LMWH) anticoagulation for CVVH in severe hypercalcemia patients. METHODS:Between January 2014 and May 2019, 33 severe hypercalcemia patients underwent CVVH. Patients were divided into the RCA and LMWH groups. Calcium-free replacement solution was used. Serum total calcium reduction rate (RRSeCa), filter lifespan, bleeding, totCa/ionCa ratio, citrate accumulation, and catheter occlusion were evaluated as outcomes. RESULTS:RCA and LMWH were employed for CVVH in 14 and 43 filters, respectively. RRSeCa was not significantly different between the LMWH and RCA groups (p = .320), but RCA-CVVH was more effective in reducing ionized calcium at half of the time points (p < .05). RCA significantly prolonged the median filter lifespan (>72 h vs. 24.0 h [IQR, 15.0-26.0], p = .012). The incidence of filter failure was 55.8% (24/43) in the LMWH group and 21.4% (3/14) in the RCA group (p = .033). The adjusted results demonstrated that RCA could significantly reduce the risk of filter failure (p = .043, 95% CI 0.059-0.957, HR = 0.238). No citrate accumulation or bleeding episodes were observed in the RCA-CVVH group. Seven bleeding episodes (7/43, 16.3%) occurred in the LMWH-CVVH group. CONCLUSIONS:In patients with severe hypercalcemia who underwent CVVH, RCA more effectively decreased calcium levels and had a superior filter lifespan and no obvious adverse events compared with LMWH. Further prospective, randomized, controlled studies are warranted to obtain robust evidence.

Background: Anticoagulation-free continuous renal replacement therapy (CRRT) was recommended by the current clinical guideline for patients with increased bleeding risk and contraindications of citrate and resulted in heterogeneous filter lifespan. There was no prediction model to identify the patients would have sufficient filter lifespan when they have to accept CRRT without the use of any anticoagulation. The purpose of our present study is to develop a clinical prediction model of sufficient filter lifespan in anticoagulation-free CRRT patients. Method: Patients who underwent anticoagulation-free CRRT in our center between June 2013 and June 2019 were retrospectively included. The primary outcome was sufficient filter lifespan (≥ 24 hours). The final model was established by using multivariable logistic regression analysis. And, the prediction model was validated in an external cohort. Results: A total of 170 patients were included in the development cohort. Sufficient filter lifespan were observed in 80 patients. The probability of sufficient filter lifespan could be calculated using the following regression formula: P (%) = exp (Z)/1 + exp (Z), where Z = 0.49896-(0.08552*BMI)+(0.44107*T)+(0.03373*MAP)-(0.03389*WBC)+(1.51579*[vasopressor=1])-(0.01132*PLT)+(0.00422*ALP)-(2.66910*pH)-(0.00214*UA)+(0.05992*BUN)+(0.00400*Db)–(0.00014*D-dimer)+(0.02818*APTT). The area under the curve (AUC) of the stepwise model and internal validation model was 0.82 (95%CI [0.76-0.88]) and 0.8 (95%CI [0.74-0.87]), respectively. At the optimal cut-off value of -0.1052, the positive predictive value and the negative predictive value of the stepwise model was 0.77 and 0.79, respectively. The AUC of the external model was 0.82 (95%CI [0.69-0.96]). Conclusion: The use of a prediction model instead of an assessment based only on coagulation parameters could facilitate the identification of the patients with filter lifespan of ≥ 24 hours when they accepted anticoagulation-free CRRT.

Background : Hyperbilirubinemia is one of the common complications after cardiac surgery and is associated with increased mortality. However, to the best of our knowledge, the reports on clinical significance of postoperative severe hyperbilirubinemia in Stanford type A aortic dissection (AAD) patients were limited. Methods : Patients who underwent surgical treatment for AAD in our center between January 2015 and December 2018 were retrospectively screened. In-hospital mortality, long-term mortality, acute kidney injury (AKI), and the requirement of continuous renal replacement therapy (CRRT) were assessed as endpoints. Univariate and multivariate regression models were employed to identify the risk factors of these endpoints. Results : After screening, 271 patients were included in our present study. Of the included patients, 222 (81.9%) experienced postoperative AKI, and 50 (18.5%) received CRRT. The in-hospital mortality was 30.3%. The 1-year, 2-year, and 3-year cumulative mortality were 32.9%, 33.9%, and 35.3%, respectively. Multivariate Logistic regression analysis indicated that age ( P < 0.033), AKI stage 3 ( P < 0.001), the amount of blood transfusion after surgery ( P = 0.019), mean arterial pressure (MAP) in the first postoperative day ( P = 0.012), the use of extracorporeal membrane oxygenation (ECMO) ( P = 0.02), and the peak total bilirubin (TB) concentration ( P = 0.023) were independent risk factors of in-hospital mortality. The optimal cut-off value of peak TB on predicting in-hospital mortality was 121.2 μmol/L. Patients with post-operation TB ≥ 121 μmol/L was associated with worse long-term survival as well. Conclusions : Severe post-operation hyperbilirubinemia is a common clinical situation in patients had AAD repair. In AAD patients with severe post-operation hyperbilirubinemia, older age, lower MAP, increased blood transfusion, stage 3 AKI, the use of ECMO, and the increased peak TB lead to increase in-hospital mortality.

目的 分析Stanford A型主动脉夹层术后出现急性肾损伤(acute kidney injury,AKI)并接受连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)的患者预后因素.方法 筛选2015年4月～2018年3月西京医院收治A型主动脉夹层心脏手术后出现AKI并接受CRRT治疗的患者,记录患者术前、术中、术后临床资料,按患者是否存活分为2组:存活组(n=32)和死亡组(n=34).结果 最终纳入66例患者,年龄(49±9)岁,男性占91％,术前血肌酐(144±77) μmol/L.其中,34例患者死亡(52％).多因素Logistic回归分析表明术中红细胞输注的量(HR =3.169,95％CI 1.180-8.513;P＜0.05)和术后多脏器功能衰竭(HR =3.575,95％CI 1.196-10.687;P ＜0.05)是A型主动脉夹层术后出现AKI并接受CRRT的患者死亡独立危险因素.结论 对于A型主动脉夹层术后需要CRRT治疗的AKI患者,术中输注红细胞量越多以及术后出现多脏器功能衰竭患者的死亡风险越大.

急性肾损伤(AKI)是危重症患者的常见并发症之一.近年来需要肾脏替代治疗(RRT)的AKI患者发病率显著升高.对于血液动力学不稳定的患者,连续肾脏替代治疗(CRRT)是最常用的RRT模式.目前,虽有一些临床研究对CRRT治疗的适应证、开始和停止治疗的时机进行了深入探讨,但在一些结果上仍存在较大争议.本文就危重症患者使用CRRT治疗的适应证、开始和停止治疗的时机等方面的研究进展作一综述,以期为CRRT相关的临床工作和临床研究提供重要信息.

目的 分析连续性肾脏替代治疗(CRRT)介入时机与主动脉夹层术后急性肾损伤(AKI)患者预后的关系.方法 选择主动脉夹层术后出现AKI并接受CRRT治疗的患者,回顾性分析患者的临床资料,随访患者预后,以术后2 d为时间节点,2 d内(≤2 d)开始行CRRT治疗为早期透析组,2 d后为晚期透析组,比较早期透析与晚期透析对患者预后的影响.结果 纳入83例患者进行分析,其中早期透析治疗组46例,晚期透析治疗组37例.早期透析治疗组较晚期透析治疗组术前血肌酐值较高(182.20μmol/L vs.126.86μmol/L),利尿剂使用较少(45.65％vs.70.27％).与晚期透析治疗组相比,早期透析治疗组90 d死亡率低(43％vs.68％),ICU治疗时间短(9.76 d vs.15.32 d),但28 d、60 d死亡率、肾功能恢复情况、CRRT治疗时间、住院时间、机械通气时间无统计学差异.结论 早期行CRRT治疗可降低主动脉夹层术后AKI患者90 d死亡率.

OBJECTIVE:There are controversial opinions on anticoagulation for continuous venovenous hemofiltration (CVVH) in patients with liver failure (LF) and increased bleeding risk. Therefore, we conducted a retrospective study to evaluate the efficacy and safety of regional citrate anticoagulation (RCA) versus no-anticoagulation for CVVH in these patients.METHODS:The included patients were divided into RCA and no-anticoagulation group according to the CVVH anticoagulation strategy they accepted for CVVH. Filter lifespan, bleeding, citrate accumulation, catheter occlusion, and totCa/ionCa ratio were evaluated as outcomes.RESULTS:In the original cohort, the filter lifespan of the RCA group (41 patients, 79 filters) was significantly longer than the no-anticoagulation group (62 patients, 162 filters) (> 72 hours vs 39.5 hours (IQR 31.2-47.8), P = 0.002). The adjusted results demonstrated that RCA could significantly reduce the risk of filter failure (HR = 0.459, 95%CI 0.26-0.82, P = 0.008). Four episodes of totCa/ionCa > 2.5 were observed in the RCA group and continuously accepted RCA-CVVH after the reduction of citrate dose and blood flow. No obvious citrate accumulation was observed in these patients. In the matched cohort, the filter lifespan of the RCA group was significantly longer than the no-anticoagulation group (P = 0.013) as well. No significant difference in the episodes of totCa/ionCa > 2.5 was observed between the two matched groups (P = 0.074). Both in the original cohort and the matched cohort, the bleeding, acidosis, alkalosis, and catheter occlusion incidences were not significantly different between the two groups.CONCLUSIONS:In LF patients with increased bleeding risk who underwent CVVH, RCA could prolong the filter lifespan and be safely used with careful blood gas monitoring and citrate dose adjusting. Further prospective, randomized, control studies are warranted to obtain robust evidences.

目的 探讨胆红素吸附治疗心脏术后高胆红素血症患者的有效性和安全性.方法 回顾性的分析我院2017年1月～2018年12月应用胆红素吸附治疗的11例心脏术后急性肝功能不全患者的临床数据.记录患者基础疾病、心脏手术名称、术后胆红素升高时间及治疗前后肝功能、胆红素、凝血功能等指标变化.结果 患者11(男7,女4)例,年龄(45±13)岁,体外循环时间(226土104)min.治疗前血清总胆红素(409±137) μmol/L,直接胆红素(321±100) μmol/L,治疗后血清总胆红素(298±107) μmol/L,直接胆红素(166±111) μmol/L,治疗前后差异具有统计学意义(分别P ＜0.05,P＜0.01).转氨酶、血清总蛋白、白蛋白、国际标准化比值(INR)、血小板计数、白细胞计数、血红蛋白、尿素氮、肌酐在治疗前后差异无统计学意义.1 1例患者胆红素吸附共治疗22次,8例患者治疗1次,其余3例患者分别治疗2次、5次、7次.血清总胆红素下降率2.8％～47.6％.4例存活,7例死亡,生存率36％.治疗过程中未发现治疗相关副作用.结论 胆红素吸附治疗心脏术后高胆红素血症的是一种安全较为有效的降低胆红素及肝脏支持系统技术.

Purpose: This study was aimed at evaluating the efficacy and safety of regional citrate anticoagulation (RCA) versus no-anticoagulation continuous venovenous hemofiltration (CVVH) in acute severe hypernatremia patients with increased bleeding risk. Materials and Methods: Acute severe hypernatremia patients with high bleeding risk who underwent CVVH in our center between January 2011 and October 2017 were considered as candidates. Patients who were <18 years old, with hypovolemic hypernatremia, and had systemic anticoagulation were excluded. The included patients were divided into RCA and no-anticoagulation groups according to their anticoagulation strategy during CVVH and matched by age, sequential organ failure assessment scores, and vasopressor dependency. Results: Of the 64 included patients, no-anticoagulation and RCA were employed for CVVH in 23 and 41 patients, respectively. The serum sodium reduction rate (RRSeNa) was not significantly different between the no-anticoagulation and RCA groups (p = 0.729). Compared to no-anticoagulation, RCA significantly prolonged the circuit survival time (15 h [4.1–23.9] vs. 51 h [21.3–80.7], p = 0.001). The incidence of filter failure was 65.2% (15/23) in the no-anticoagulation group and 2.4% (1/41) in the RCA group (p < 0.001), respectively. In the matched cohort, the RRSeNas were not different between the 2 groups (p = 0.569), and the filter lifespan was significantly longer in the RCA group as well (p < 0.001). Conclusion: RCA might be safe and effective for acute severe hypernatremia patients who underwent CVVH treatment. Further prospective, randomized, control trials are warranted to obtain robust evidences.

Specialty education is one of the most important stages of thetraining of high-quality physicians.The prevalence of chronic kidney disease in China is 10.8％.There is short of nephrology specialties for the supply of high quality medical services.The American specialty education system is one of the advanced system for graduate medical education.This article analyzes the strategies of American nephrology specialty education,including the organization model,training time,training targets,training arrangement,and training evaluation strategies.Furthermore,it presentes several suggestions for the nephrology specialty education of our country and believes that the American strategies of the training time and training evaluation have important reference value for the construction of our training strategies.Of course,the nephrology specialty training model of our country should adapt the current situation of our hospitals and have Chinese characteristics.

目的 分析心脏术后出现急性肾损伤(acute kidney injury,AKI)并接受肾脏替代治疗(renal replaeement therapy,RRT)患者肾脏预后的影响因素.方法 接受心脏手术后出现AKI并接受RRT治疗的患者,记录患者临床资料,观察患者RRT后3个月是否脱离透析.脱离透析定义为肾功能恢复存活并脱离RRT连续2周.结果 最终纳入185例患者,平均年龄(50.2±13.1)岁,男性占67.6％,术前肾小球滤过率估算值(eGFR) 78.5(44.7-82.0)ml/(min· 1.73 m2).其中,95例患者脱离透析(51.4％).多因素Logistic回归分析表明术前eGFR(HR=0.52,95％CI 0.46-0.77;P ＜0.05)、术中输注红细胞的量(HR=1.05,95％ CI 1.01-1.26;P＜0.05)、血管活性药物(HR=1.26,95％ CI 1.09-1.56;P＜0.05)是未脱离透析的独立危险因素.结论 对于心脏术后需要RRT治疗的AKI患者,术前肾功能状态越差、术中红细胞输注量越高,RRT时需要使用血管活性药物的患者无法达到长期肾功能恢复的危险性越大.

Objective To investigate the expression pattern of long non coding RNA(lncRNA)linc00152 expression in renal tissues of rats with acute renal failure(ARF)and its influence on ARF.Methods A total of 72 male SD rats were randomly divided into the control group(n=6)and the model group(n=66).A rat model of ARF induced by gentamicin was established,the rats in the control group were injected with the same volume of saline.The serum urea nitrogen,creatinine,urinary n-acetyl-β-D-glycosidase enzymes lev-els and the expression and distribution of linc00152 in renal tissues of 6 rats in the control group were detected on Day 1,3,7,14 and 21 using real-time quantitative polymerase chain reaction(PCR)method.The remaining 36 rats were divided into the saline group(n=12),1 mg/kg siRNA group(n=12)and 2 mg/kg siRNA group(n=12).The rats in the 1 mg/kg siRNA group and 2 mg/kg siRNA were given tail vein injection of 1 mg/kg and 2 mg/kg linc00152-siRNA,respectively,to achieve the purpose of living level block of linc00152 expression;rats in the saline group were injected the same volume of saline.Linc00152 expression level,serum biochemical index and urine composition were detected in 24 hours and 72 hours after blocking.Results In the model group,the serum urea nitro-gen,creatinine and urinary n-acetyl-β-D-glycosidase enzymes levels rose significantly on Day 1,constantly rose on Day 3 and reached the peak value on Day 7,and returned to normal level on Day 21.Linc00152 was mainly expressed in the cortex of normal kidney tis-sues.In the model group,linc00152 expression in the cortex and medulla were significantly increased on Day 1,constantly increased on Day 3,reached the peak value on Day 7 and returned to normal level on Day 21.The level of linc00152 in cortex was more obvi-ous.After 24 hours intervention of 1 mg/kg and 2 mg/kg linc00152-sirna,the expression level of linc00152 in the renal cortex of acute renal failure rats reduced about 40% and 70%;after 72 hours intervention with 1 mg/kg and 2 mg/kg linc00152-siRNA,the expres-sion level of linc00152 in the renal cortex of acute renal failure rats reduced about 50% and 80%.After 24 hours and 72 hours inter-vention with 1 mg/kg and 2 mg/kg linc00152-siRNA,the serum total protein,albumin,urea nitrogen,creatinine,K+,urine protein and urine ketone body level in acute renal failure rats significantly reduced compared with those in the saline group,Na+level significantly increased compared with that in the saline group,and the difference was statistically significant(P <0.05);after 24 hours and 72 hours intervention with 2 mg/kg linc00152-siRNA,the serum total protein,albumin,urea nitrogen,creatinine,K+,urine protein and urine ketone body level in acute renal failure rats significantly reduced compared with those in the 1 mg/kg siRNA group,Na+level significantly increased compared with that in the 1 mg/kg siRNA group,and the difference was statistically significant(P<0.05). Conclusion The expression of linc00152 is significantly increased in renal tissue of rats with gentamicin-induced ARF,and blockade of linc00152 can prevent and treat acute renal injury in vivo.