简介：AbstractBackground:This study aims to observe the dynamic changes of renal artery (RA) disease and cortical blood perfusion (CBP) evaluated by contrast-enhanced ultrasound (CEUS) after percutaneous transluminal renal artery stenting (PTRAS) in patients with severe atherosclerotic renal artery stenosis (ARAS) and to analyze the relationship between CBP and prognosis.Methods:This was a single-center retrospective cohort study. A total of 98 patients with unilateral severe ARAS after successful PTRAS in Beijing Hospital from September 2017 to September 2020 were included. According to renal glomerular filtration rate (GFR) detected by radionuclide imaging at 12 months after PTRAS, all patients were divided into the poor prognosis group (n = 21, GFR decreased by ≥20% compared with baseline) and the control group (n = 77, GFR decreased by < 20% or improved compared with baseline). Renal artery stenosis was diagnosed by digital subtraction angiography, and renal CBP was evaluated by CEUS using TomTec Imaging Systems (Germany) before PTRAS, at 6 months and 12 months after discharge. The receiver operating characteristic (ROC) curve with area under the curve (AUC) was used to analyze the predictive value of CBP parameters, including area under ascending curve (AUC1), area under the descending curve (AUC2), rising time (RT), time to peak intensity (TTP), maximum intensity (IMAX), and mean transit time (MTT) for poor prognosis.Results:Among the 98 patients, there were 52 males (53.1%), aged 55-74 years old, with an average age of 62.1 ± 8.7 years, and an average artery stenosis of 82.3 ± 12.9%. The poor prognosis group was associated with significantly increased incidence of diabetes (76.2% vs. 41.6%), and lower levels of GFR of the stenotic kidney (21.8 mL/min vs. 25.0 mL/min) and total GFR (57.6 mL/min vs. 63.7 mL/min) (all P < 0.05), compared with the control group (P < 0.05). In addition, the rate of RA restenosis was significantly higher in the poor prognosis group than in the control group (9.5% vs. 0, χ2 = 9.462, P = 0.002). Compared with the control group, the poor prognosis group was associated with significantly decreased baseline AUC1 and AUC2, and extended duration of TTP and MTT (P < 0.05). At 6 months and 12 months of follow-up, patients in the control group were associated with markedly increased AUC1, AUC2, and IMAX, and shorter duration of RT and MTT (P < 0.05). The ROC curve showed that the predictive values of AUC1, AUC2, RT, TTP, IMAX, and MTT for poor prognosis were 0.812 (95% CI: 0.698-0.945), 0.752 (95% CI: 0.591-0.957), 0.724 (95% CI: 0.569-0.961), 0.720 (95% CI: 0.522-0.993), 0.693 (95% CI: 0.507-0.947), and 0.786 (95% CI: 0.631-0.979), respectively.Conclusions:Preoperative renal CBP in severe ARAS patients with poor prognosis is significantly reduced, and does not show significant improvement after stent treatment over the first year of follow-up. The parameter AUC1 may be a good predictor for renal dysfunction after PTRAS in severe ARAS patients.Trial Registration:ChiCTR.org.cn, ChiCTR1800016252.

简介：

简介：无

简介：Overthepastdecade,percutaneousrenaldenervationhasbeenvigorouslyinvestigatedasatreatmentforresistanthypertension.TheSYMPLICITYradiofrequencycathetersystem(MedtronicCardioVascularInc.,SantaRosa,CA,USA)isthemosttesteddeviceinclinicaltrials.AfterthepositiveresultsofsmallphaseIandIIclinicaltrials,SYMPLICITYHTN-3(aphaseIII,multi-center,blinded,sham-controlledrandomizedclinicaltrial)wascompletedin2014,butdidnotshowsignificantbloodpressureloweringeffectwithrenaldenervationcomparedtomedicaltherapyandcausedtheinvestigatorsandindustrytorevisitboththebasicscienceelementsofrenaldenervationaswellasthedesignofrelatedclinicaltrials.ThisreviewsummarizestheSYMPLICITYtrials,analyzestheSYMPLICITYHTN-3data,andprovidesinsightsgainedfromthistrialinthedesignofthemostrecentclinicaltrial,theSPYRALHTNGlobalclinicaltrial.Otherthanhypertension,theroleofrenaldenervationinthemanagementofotherdiseaseprocessessuchassystolicanddiastolicheartfailure,metabolicsyndrome,arrhythmia,andobstructivesleepapneawiththecommonpathophysiologicpathwayofsympatheticoveractivityisalsodiscussed.

简介：

简介：Treated50casesofrenalcolicwithelectroacupunctureandcomparedtheresultswiththoseintwocontrolgroups.Totaleffectiverateinthetreatmentgroup,controlgroupⅠandcontrolgroupⅡwas98.0%,90.0%and92.0%respectively.

简介：

简介：Arecentreportintroducedthephosphodiesterase-5inhibitionbyvardenafilasanoveltreatmentofportalhypertensioninpatientswithcirrhosis.Inthehereinpresented'lettertotheeditor',theadministrationoftadalafildidnotinfluenceportalhaemodynamicsbutimpairedsystemichaemodynamicsinpatientswithcirrhosis.OurobservationsconcurwiththeresultsofareportinapreviousissueofWorldJournalofGastroenterology(October2008).Moreover,tadalafiladverselyaffectedrenalfunctioninpatientswithdecompensatedliverdisease.

简介：Objective:Toinvestigatenephroprotectiveeffectsofamixtureof8L-aminoacidsonrenalischemia-reperfusioninjuryanditseffectsonrenalendothelin-1(ET-1).Methods:Themixtureof8L-aminoacidsincludesglycine,alanine,threonine,serine,valine,leucine,isoleucineandproline.Acuteischemicrenalinjurywasinducedbyclampingrenalpediclefor45minutesinrats.SixtymaleSprague-Dawieyratswererandomlydividedinto3groups:asham-operatedgroup(GroupA,n=8),acontrolgroup(GroupB,n=26)andanaminoacid-treatedgroup(GroupC,n=26).Aminoacidswereinfusedatarateof1mi·100g-1·h-1Ihourbeforeischemiaandduring3hoursofthewholereperfusion.Theserumcreatininevalues,BUNlevels,creatiulneclearance,urinesodium&potassiumexcretion,urinelactatedehydrogenase(LDH),therateofurineflowandhistologicalexaminationweremeasured.RenalET-1levelswereassayedwithradioimmunologicalassay(RIA)Results:Thecreatinineclearancewas471.0μl/min±121.5pi/maininGroupCand227.0μl/min±27.0μl/mininGroupB3hoursafterreperfnsion,P＜0.01).Theurineflowratewas63.6pi/min±15.2μl/mininGroupCand24.3μl/min±7.7μl/mininGroupB,P＜0.01)1.5hoursafterreperfusion.Theserumcreatininewas85.0μl/min±7.7μmol/LandBUNoncentration11.4mmol/L±3.9mmol/LinGroupCand112.7μmol/L±19.5μmol/Land20.7mmol/L±6.6mmol/LrespectivelyinGroupBafter24hoursofreperfusion(P＜0.05).ThemeanhistologicalscorebystandardsofPallerinkidneyswas108.7±15.7inGroupC,and168.8±14.8inGroupB(P＜0.01).TherenalET-1levels15minuteand3hoursafterreperfusionwere7.2pg/mg±0.8pg/mgand9.6pg/ml±1.0pg/mlinGroupC,and10.1pg/ml±2.8pg/mland13.0pg/ml±2.7pg/miinGroupB(P＜0.01).Conclusions:Themixtureof8L-aminoacidscanprovideremarkableprotectionagainstrenalisehemia-reperfusioninjuryinrats.Thismayassociat

简介：无

简介：无

简介：无

简介：

简介：Aprimaryhumanrenalcellcarcinomawasdevelopedasaxenograft(NT-25)andmaintainedbyserialtransplantationinnudemice.TheeffectofUFTonthisneogrowthwastestedandevaluatedaswellitsdistributionintheanimaltissues.TheconcentrationofUFTwashigherintumortissuesthanthatinothertissuesandintheanimalexperimentationUFTwasfoundtobeeffectiveonhumanrenalcellcarcinoma.

简介：AbstractBackground:The impacts of previous cardio-cerebrovascular disease (pre-CCVD) on the outcomes of hematopoietic cell transplantation (HCT) are not well described. Patients with pre-CCVD may often be poor candidates for HCT. This study aimed to investigate the impact of pre-CCVD on transplant outcomes.Methods:A retrospective study was conducted between patients with and without pre-CCVD who consecutively received allogeneic or autologous HCT between November 2013 and January 2020 with a matching of age and disease status. The cardiovascular complications and HCT outcomes of the two groups were evaluated and compared. The primary endpoints were post-transplant cardio-cerebrovascular disease (post-CCVD) and non-relapse mortality (NRM). We used a multivariable Cox proportional hazard model and the Fine-Gray competing risk regressions for analyses to estimate the hazard ratios (HRs).Results:The outcomes of 23 HCT recipients with pre-CCVD were compared with those of 107 patients in the control group. No significant differences were noted in terms of engraftment, overall survival (OS) (67.00% vs. 67.90%, P = 0.983), or relapse (29.78% vs. 28.26%, P = 0.561) between the pre-CCVD group and the control group. The cumulative incidences of 2-year NRM were similar between patients with pre-CCVD and the controls (14.68% vs. 17.08%, P = 0.670). However, pre-CCVD was associated with an increased incidence of post-CCVD (HR: 12.50, 95% confidence interval [CI]: 3.88-40.30, P < 0.001), which was an independent risk factor for increased NRM (HR: 10.29, 95% CI: 3.84-27.62, P < 0.001) and inferior OS (HR: 10.29, 95% CI: 3.84-27.62, P < 0.001).Conclusions:These findings suggest that the existence of pre-CCVD before transplantation might not result in increased mortality directly but superpose the toxicity of the transplantation procedure, leading to a risk of post-CCVD. Post-CCVD was a powerful predictor for high NRM and inferior OS. Further risk stratification of pre-CCVD is needed to reduce NRM in various transplantation settings.

简介：AbstractBackground:Regulated upon activation, normal T-cell expressed, and secreted (RANTES) is a chemokine actively involved in the initiation and progression of atherosclerosis (AS), which is the major cause of ischemic cerebrovascular disease (ICVD). This study aimed to determine the associations between circulating RANTES level and overall AS conditions of cardiac and cerebral vessel beds in patients with ICVD.Methods:Patients with ICVD admitted to the department of neurology of Xuanwu Hospital from April 1, 2019 to June 30, 2019 were prospectively enrolled in the study. Plasma RANTES level was measured by enzyme-linked immunosorbent assay to represent the circulating RANTES level. The integrated AS burden of the cervicocephalic and coronary arteries was examined using computed tomography angiography and reflected by "cardio-cerebral AS burden (CCAB)" as a continuous variable. Then, the relationship of plasma RANTES level and CCAB in patients with ICVD was analyzed by correlation analyses and general linear models.Results:A total of 40 patients with ICVD were included in the study. There was a significant positive correlation between CCAB and plasma RANTES level in ICVD (r = 0.786, P < 0.001), independent of age, sex, acute or chronic phase of ICVD, and mono or dual antiplatelet therapy (adjusted B for ln RANTES, 12.063; 95% confidence interval, 7.572-16.533). The association of plasma RANTES level with AS conditions (burden, severity, and extent) in single cardiac or cerebral vessel bed was similar to that with CCAB, but the correlation coefficient for CCAB was higher (increment ranged from 0.126 to 0.397).Conclusions:Plasma RANTES level was an independent indicator for the integrated AS burden of the cervicocephalic and coronary arteries in ICVD. Comprehensive evaluation of AS conditions using the novel continuous index CCAB might be important in revealing the systematic relationship between circulating RANTES and AS in patients with ICVD.

简介：背景：为疼痛地势的Opioid药方正在增加。Codeine是在几个欧洲国家的统治opioid，与在最高的codeine用户之中的挪威。瞄准：决定codeine是否首先为剧烈疼痛被使用或是否有一个药方模式，显示有问题的opioid使用。方法：在挪威的所有药店被强迫在所有分配药方上在公共健康的挪威的研究所电子地提交数据到挪威的药方数据库。因为所有药方与一个独特的人标识符被识别，识别所有药方到一个题目是可能的。codeine的有的药方在2004，2005或2006分配了到他们的所有题目在学习被包括。结果：385190个挪威的人有在2005由于非癌症疼痛分配到他们的codeine的至少一张药方，相应于8.3%的1年的周期的流行。223(58%)778在2005收到了仅仅一张药方，121(31%)025收到了超过一张药方，但是<120定义每日的剂量(DDD)，30(8%)939在120和365DDD之间收到了，7661(2%)在365和730DDD之间，当(0.5%)仅仅1787超过了730DDD的最大的推荐剂量时。在后者组，有benzodiazepines(65%)和carisoprodol(45%)的合作药是流行的。结论：大约一在在挪威的10个成年的人是在2005的分配codeine。一个多数(58%)收到了codeine仅仅一次，为剧烈疼痛最可能，而一个小少数(0.5%)有一个药方模式显示有问题的opioid，使用。

简介：Increasedabdominalimaginghasledtoanincreaseinthedetectionoftheincidentalsmallrenalmass(SRM).WithincreasingrecognitionthatthemalignantpotentialofSRMsisheterogeneous,rangingfrombenign(15%-20%)toaggressive(20%),enthusiasmformoreconservativemanagementstrategiesintheelderlyandinfirmed,suchasactivesurveillance(AS),havegrownconsiderably.AsthemanagementoftheSRMevolvestoincorporateablativetechniquesandASforlowriskdisease,theroleofrenalmassbiopsy(RMB)tohelpguideindividualizedtherapyisevolving.Historically,theroleofRMBwaslimitedtotheevaluationofsuspectedmetastaticdisease,renalabscess,orlymphoma.However,inthecontemporaryera,theroleofbiopsyhasgrown,mostnotablytoidentifypatientswhoharborbenignlesionsandforwhomtreatment,particularlytheelderlyorfrail,maybeavoided.WhenperformingaRMBtoguideinitialclinicaldecisionmakingforsmall,localizedtumors,themostrelevantquestionsareoftenrelegatedtoproofofmalignancyanddocumentation(ifpossible)ofgrade.However,significantintratumoralheterogeneityhasbeenidentifiedinclearcellrenalcellcarcinoma(ccRCC)thatmayleadtoanunderestimationofthegeneticcomplexityofatumorwhensingle-biopsyproceduresareused.HeterogeneousgenomiclandscapesandbranchedparallelevolutionofccRCCswithspatiallyseparatedsubclonescreatesanillusionofclonaldominancewhenassessedbysinglebiopsiesandraisesimportantquestionsregardinghowtumorscanbeoptimallysampledandwhetherfutureevolutionarytumorbranchesmightbepredictableandultimatelytargetable.Thisworkraisesprofoundquestionsconcerningthegeneticlandscapeofcancerandhowtumorheterogeneitymayaffect,andpossiblyconfound,targeteddiagnosticandtherapeuticinterventions.Inthisreview,wediscussthecurrentroleofRMB,theimplicationsoftumorheterogeneityondiagnosticaccuracy,andhighlightpromisingfuturedirections.

简介：无

简介：无