简介：AbstractAcute kidney injury (AKI), characterized by acute renal dysfunction, is an increasingly common clinical problem and an important risk factor in the subsequent development of chronic kidney disease (CKD). Regardless of the initial insults, the progression of CKD after AKI involves multiple types of cells, including renal resident cells and immune cells such as macrophages. Recently, the involvements of macrophages in AKI-to-CKD transition have garnered significant attention. Furthermore, substantial progress has also been made in elucidating the pathophysiological functions of macrophages from the acute kidney to repair or fibrosis. In this review, we highlight current knowledge regarding the roles and mechanisms of macrophage activation and phenotypic polarization, and transdifferentiation in the development of AKI-to-CKD transition. In addition, the potential of macrophage-based therapy for preventing AKI-to-CKD transition is also discussed.

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简介：SYPHILISISAchronicsexuallytransmitteddiseasecausedbyTreponumPallidumspreadingtothewholebody.LateSyphiliscanencroachonmostoftheorgans,butearlysyphilishaslessdamagetotheinternalorgans.Hereisacaseofsecondarysyphiliswithliverandkidneyinvolvementreportedasfollows:

简介：Hypemecrospenniaisthecommondiseasefrequentlyseeninandriatry.It'soneofthemainreasonsthatcausethemasculinesterility.DuringMarch1997December2003.Theauthorapplieddecoctionfortonifyingthekidneyandgeneratingthespermintreatmentofthisdiseaseandreceivedrathergoodefficacy.Thecompletesummaryof136caseswasreportedasfollowed.

简介：AbstractBackground:Acute kidney injury (AKI) is a common and serious complication following lung transplantation (LTx), and it is associated with high mortality and morbidity. This study assessed the incidence of AKI after LTx and analyzed the associated perioperative factors and clinical outcomes.Methods:This retrospective study included all adult LTx recipients at the China-Japan Friendship Hospital in Beijing between March 2017 and December 2019. The outcomes were AKI incidence, risk factors, mortality, and kidney recovery. Multivariate analysis was performed to identify independent risk factors. Survival analysis was presented using the Kaplan-Meier curves.Results:AKI occurred in 137 of the 191 patients (71.7%), with transient AKI in 43 (22.5%) and persistent AKI in 94 (49.2%). AKI stage 1 occurred in 27/191 (14.1%), stage 2 in 46/191 (24.1%), and stage 3 in 64/191 (33.5%) of the AKI patients. Renal replacement therapy (RRT) was administered to 35/191 (18.3%) of the patients. Male sex, older age, mechanical ventilation (MV), severe hypotension, septic shock, multiple organ dysfunction (MODS), prolonged extracorporeal membrane oxygenation (ECMO), reintubation, and nephrotoxic agents were associated with AKI (P < 0.050). Persistent AKI was independently associated with preoperative pulmonary hypertension, severe hypotension, post-operative MODS, and nephrotoxic agents. Severe hypotension, septic shock, MODS, reintubation, prolonged MV, and ECMO during or after LTx were related to severe AKI (stage 3) (P < 0.050). Patients with persistent and severe AKI had a significantly longer duration of MV, longer duration in the intensive care unit (ICU), worse downstream kidney function, and reduced survival (P < 0.050).Conclusions:AKI is common after LTx, but the pathogenic mechanism of AKI is complicated, and prerenal causes are important. Persistent and severe AKI were associated with poor short- and long-term kidney function and reduced survival in LTx patients.

简介：Chronicheartfailureisincreasinglyprevalentworldwideandisassociatedwithsignificantmorbidityandmortality.TheCochranereviewdemonstratedthatcardiacrehabilitation(CR)resultedinimprovementsinQOLandareductioninlong-termmortality.Chronickidneydisease(CKD)isanotherworldwidepublichealthproblem.ThisreviewfocusesontheimportanceandefficacyofrehabilitationforCKDpatientsasanewtargetofCR.PatientswithCKDonhemodialysis(HD)haveahighmortalityrate,withcardiovasculardiseases,suchaschronicheartfailure.Anewsystematicreviewandmeta-analysisofrandomizedcontrolledtrialsreportedthatexercise-basedrenalrehabilitationimprovedaerobiccapacity,muscularfunctioning,cardiovascularfunction,walkingcapacity,andQOLinCKDpatientswithHD.Moreover,exercisetrainingmayhaverenalprotectiveeffects,notonlyinsomeanimalmodelsofpre-HDCKD,butalsoinpre-HDCKDpatients.Exercisetherapycouldbeaneffectiveclinicalstrategyinimprovingrenalfunction,loweringtheneedforrenalreplacementtherapy,suchasHD,andreducingrenaltransplantriskinpre-HDCKDpatients.ThisledtheMinistryofHealth,LaborandWelfareofJapantoextendrenalrehabilitationpartialcoveragetostage4pre-HDCKDpatientsforthefirsttimeintheworldin2016.

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简介：DiabetespertainstoXiaokeinTCM.Itisdividedintothreekinds,namely,upperlung,middlestomachandlowerkidney,itstreatmentisalsodividedintomoisteninglung,clearingawaystomach-heatandnourishingthekidneyaccordingly.Buttogettherootofthematter,thetreatmentoflong-durationDMshouldbedominatedbynourishingkidneyandfosteringtheYin.Accordingtothistheory,theXiaoTangYinwasformulated.Ifconsiderationcanbegiventoothersymptomsandflexiblemodificationcanbemade,goodeffectsweregotalways.

简介：AbstractThe incidence of septic acute kidney injury (AKI) is increasing, it has become a major threat to human health because of its acute onset, poor prognosis, and high hospital costs. The most common cause of AKI in critical-care units is sepsis. Septic AKI is a complex and multi-factorial process; its pathogenesis is not fully understood. In sepsis, the destruction of mucosal barriers, intestinal flora disorders, intestinal ischemia/reperfusion injury, use of antibiotics, and lack of intestinal nutrients lead to an inflammatory reactions that in turn affects the metabolism and immunity of the host. Such changes further influence the occurrence and development of AKI. New technology is enabling various detection methods for intestinal flora. Clinical application of these methods in septic renal injury is expected to clarify the relationship among pathogenesis, disease progression mechanism, and intestinal flora.

简介：AbstractObjective:This study aims to describe presenting characteristics of patients diagnosed with non-invasive chronic rhinosinusitis (CRS) following liver or kidney transplant and determine factors associated with disease-related complications, selection of endoscopic sinus surgery (ESS), and disease resolution in this population.Study design:Retrospective chart review.Setting:An academic tertiary care center (Mayo Clinic, Rochester, Minnesota).Subjects and methods:Liver and kidney transplant recipients evaluated by Mayo Clinic otolaryngologists for CRS between 1998 and 2018 were identified. Univariate and multivariate logistic regression analyses were used to determine patient factors and treatment modalities associated with developing complications, selection of ESS, and disease resolution.Results:Fifty-seven patients met inclusion criteria. No patients developed intraorbital or intracranial complications of their CRS. Multivariate modeling demonstrated that the presence of polyps (P = 0.036) was associated with undergoing ESS within one year of presentation. A higher Lund-Mackay (LM) computed tomography score (P = 0.023) and older age (P = 0.018) were significantly associated with decreased disease resolution. No other factors were significantly associated with the use of endoscopic sinus surgery within one year of otolaryngology presentation or resolution of CRS in this cohort.Conclusion:The risk of developing CRS-related intraorbital or intracranial complications in this immunecompromised patient cohort may be lower than originally thought. For liver- and kidney-recipients stable on immunosuppressive medication for many years, prognostic factors for CRS may mirror those for immunocompetent patients.

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简介：电影冷却是一项重要措施启用一台煤气的汽轮机并且从而的入口温度的增加，到改进它的全面效率。冷却剂在片或endwalls通过洞的spanwise排被逐出建立防护材料的一部电影。洞经常在下游的方向被使倾向并且产生一个肾旋涡。这是相反旋转的旋涡对，与在二个旋涡之间的一个向上的流动方向，它趋于上升离开表面并且局部地在对外面向片喂热空气。颠倒旋涡的旋转感觉颠倒这二个缺点进优点。在考虑盒子中，一个反肾旋涡用两个都使倾向的洞的二随后的排被产生有内错角的下游、偏航的spanwise。在以前的研究，我们执行了大旋涡的模拟(它集中了于充分狂暴的边界层)凉下来电影、比较的这个反肾旋涡他们到一个相应物理实验。现在的工作详细分析模仿的流动领域，在全体会议开始(在片或endwall内)通过直到有热边界层的混合的洞。识别在吝啬的流动并且在即时流动发现的旋涡的结构，我们主要使用2标准和显示的线积分卷绕旋转(LIC)技术部分优化。流动区域(冷却剂全体会议，洞，和边界层)随后被学习并且连接了到对方。在整个边界层追踪反肾旋涡，我们建议基于涡度的二个标准并且在LIC结果上。这使我们能在墙把喷气旋涡与冷却有效性联系，它是电影冷却的特色。

简介：AbstractObjective:Pseudoxanthoma elasticum (PXE) is a rare genetic disorder caused by loss-of-function mutations in the ABCC6 gene. While PXE is characterized by ectopic mineralization of connective tissues clinically affecting the skin, eyes, and cardiovascular system, kidney stones were reported in some individuals with PXE. The aim of this study is to determine whether kidney stones are an incidental finding or a frequent manifestation of PXE.Methods:We first investigated the genetic basis of two siblings diagnosed with PXE. The younger patient presented with recurrent kidney stones since 8 years old. Secondly, to address whether kidney stones are associated with PXE, the prevalence of kidney stones in a survey cohort of 563 respondents with PXE was compared to that of a general U.S. population survey, National Health and Nutrition Examination Survey, with 28,629 participants.Results:Genetic analysis in both patients identified compound heterozygous mutations in ABCC6, c.2787+1G>T, and c.3774_3775insC. The analysis of participants 20 years old and older revealed that 23.4% of PXE patients had previously had a kidney stone, a significant increase compared to 9.2% in the general population (P < 0.01). In addition, 17.8% of PXE patients reported their first kidney stone episode before age of 18 years old.Conclusions:PXE correlates with an increased risk of developing kidney stones with considerable morbidity and health-care cost.

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简介：Extrapulmonarysmallcellcarcinoma(EPSCC)isarareneoplasmcomprising2.5%to5%ofsmallcellcarcinomas(SCCs).BladderSCCisthemostcommonsiteofgenitourinarytract.PrimaryrenalSCCisextremelyrare.WereportacaseofprimarySCCofthekidneywhichisrarelyreportedintheurinarytractandpresentsanaggressiveclinicalpicture.A59-year-oldfemalevisitedaurologicclinicwithcomplaintofpersistentleftflanksoreness10yearsafterundergoingrenaltransplantation.Abdominalcomputedtomographyshowedaleftrenalpelvistumor.Afterthepatientreceivedleftnephroureterectomywithbladdercuffresection,herpathologyresultsshowedSCC.Aftersurgery,shereceivedadjuvantsystemicchemotherapy,andherrecoveryhasbeenuneventfulasof8months.PrimaryrenalSCCpresentswithanadvancedtumorstageandashortmediansurvivalperiod,thereforeearlyinterventionandclosefollow-uparerecommended.