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：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.

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

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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

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

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.

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简介：ObjectivesToexploretheeffectoflosartanoncardiacandrenalfunctioninpatientswithchronicheartfailure(CHF).MethodsSixty-fivepatientswithCHFweredividedintotwogroupsusingarandomized,controlandsingleblindmethod:losartangroup(n=30)andconventiongroup(n=35),withatreatmentcourseof8weeksforbothgroups.TheconcentrationsofcystatinC(cysC)inserum,microamountalbumin(MA)inurineweremeasuredbyimmunoturbidimetry.Theconcentrationofaquaporin-2(AQP-2)wasdeterminedbyenzyme-linked-immunosorbentassay(ELISA)andtheheartcontractilefunctionwasmeasuredbyechocardiographybeforeandaftertreatmentrespectively.ResultsComparingwithroutinetreatmentgroup,leftventricularend-diastolicdimension(LVEDd)decreasedsignificantly,whileleftventricularejectionfraction(LVEF)andleftventricularfractionalshortening(LVFS)increasedsignificantlyinlosartangroup.ThelevelsofcysCinserumandMA,AQP-2inurineweresignificantlylowerinlosartangroupthaninroutinetreatmentgroup.ConclusionLosartancanimprovecardiacandrenalfunctioninpatientswithCHF.

简介：Objective:Tostudytheexpressionofdendriticcellsinhumanrenalcellcarcinomaandexplorethecause,sotorevealthemechanismofescapingimmunesurveillanceinRCC.Methods:TheexpressionsofCD83+DCS,CD1a+DCS,VEGFandTGF-β1intumoral,peritumoralandnormalkidneytissuesofRCCin30casesweredetectedbyimmunohistochemistryusingstreptavidin/peroxidese(SP)Results:CD83+DCSweremainlylocatedintheperitumoralareas;whereasCD1a+DCS、weremainlyretainedwithinthecancernests.ThenumberofCD83+DCSwasinverselycorrelatedwiththeclinicalstage(P<0.05);buttherewerenosignificantcorrelationsbetweenthenumberofCD1a+DCS、andtheclinicalstage(P>0.05).TheexpressionsofCD83+DCSandCD1a+DCShavesignificantdifferencebetweenthetumoral,peritumoralandnormalkidneytissues(P<0.001).TheexpressionofVEGFandTGF-β1weresignificantlylowerinsampleswithhighlyinfiltratingCD83+DCS(P<0.05);WhereasCD1a+DCSwerenot(P>0.05).Conclusion:DChasthetendencytogatheringintumor,butbecauseoftheimmunosuppressivecytokins,forexampleVEGFandTGF-β1,inhibitsthematurationofDC,therearelessmatureTIDCS(CD83+TIDCS)inthetumoraltissues,theyaremainlylocatedintheperitumoralareas.ThismaycontributetothemechanismofescapingimmunesurveillanceinRCC.

简介：钝肾的损伤的管理一直在演变。过去的管理主要基于分级系统的损伤(AAST)的外科的美国协会，即要求了计算断层摄影术(CT)扫描。尽管CT扫描使用正在增加并且变得调查的标准化模式，分级的AAST不再在外科的干预的决定起唯一的作用。保守方法成功地管理的钝肾的损伤的二份案例报告被介绍。当与一顶头盔和完整的保护的设备在20km/h骑一辆机器脚踏车时，大小写一是有下降的1820岁的男孩。他被他的左胁腹打到岩石上。对比揭示的腹的CT4厘米，等级III脾的眼泪和等级IV与大perirenalhaematoma离开了肾损害。他的国际严厉分数(ISS)是34。他与床休息和监视的经常的浆液血色素保存地被管理。有推迟的对比的随后的CT与与等级IV肾的损害一致的尿溢出揭示了稳定的perirenalhaematoma。当他意指时，大小写二是在一条跑道上有一个马达自行车事故的4020岁的男性80～100km/h，穿一顶头盔。他失去了控制并且撞击了到跑道的sidewall上。对比揭示的腹的CT有大尿溢出的等级IV左肾的损害。他的肾的损害与间隔保存地被管理腹部的推迟的阶段CT。腹部上的重复CT被执行在没揭示剩余urinoma的起始的损害以后的五个月。在这学习，而且，到钝肾的损伤的管理的文学的评论被进行表明增加如此的损伤的保守管理的趋势。额外的放射学的参数可以指导未来决策。然而，数据的适用性可以被限制直到使随机化的试用是可得到的。

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