简介：BackgroundDataarelimitedregardingtheriskofcontrast-inducednephropathy(CIN)forpatientsafterthesecondcontrastexposure.ObjectiveToexaminetheriskofCINafterthesecondcontrastexposureinpatientsofacutecoronarysyndrome(ACS)withchronickidneydisease(CKD).MethodsPatientsofACSscheduledforasecondelectivePCI.Patientswererequiredtohaveanestimatedcreatinineclearance(CrCl)between15and60ml/min.Thevalueofserumcreatinin(sCr)priortothesecondcontrastexposuremustnotbe≥25%or≥88.4μmol/Lcomparedtobaseline.CINwasdefinedasanincreaseofsCr≥25%frombaselinewithin48-72hafterthesecondcontrastexposure.Theprimaryend-pointwasriskofdevelopingCIN.ResultsThirty-ninepatientscompletedthestudy.Theaverageofintervalbetweencontrastexposureswas116±64h,contrastvolumewas266±100mLandlengthofhospitalizationwas8.3±4.7days.TheincidenceofCINintheoverallstudypopulationwas10.3%.TherewasnotchangesignificantlyinaveragesCrandCrClafterthesecondcontrastexposure(sCr1.52±0.62vs.1.54±0.60mg/dLbaseline,P=0.75;CrCl(40.68±14.46vs.39.16±12.10mL/minbaseline,P=0.26).Noneofthepatientwasdeathin30days.One(2.6%)ofthepatientswhodevelopedCINrequireddialysisin-hospital.ConclusionOurfindingssuggestthatpatientswithpriorrenaldysfunctionarenotincreasedriskofdevelopingCINafterthesecondcontrastexposure.Thiscohortmaybebenefitfromsufficientprophylaxis.

简介：AbstractBackground:The diagnosis of contrast-induced nephropathy (CIN) is usually based on changes in serum creatinine (sCr). However, sCr has poor sensitivity as a biomarker of kidney injury. The aim of this study was to investigate the usefulness of serum cystatin C (sCysC) to predict CIN after intra-arterial interventions.Methods:A total of 360 consecutive patients underwent intra-arterial procedures using digital subtraction angiography. SCr, sCysC, and estimated glomerular filtration rate were measured at 1 to 2 days before and at 48, 72 h, and 7 days after the procedure.Results:Thirty-one patients (8.61%) developed CIN. Receiver operating characteristic (ROC) curve analysis showed that preoperative sCysC levels had good discriminatory power (area under the curve [AUC] = 0.634; 95% confidence interval [CI] = 0.526-0.743) for evaluating the risk of CIN after an endovascular procedure, with a sensitivity of 53.33% and specificity of 73.70%. ROC analysis showed that sCysC at 48 h after contrast medium administration was predictive of CIN after an endovascular procedure (AUC = 0.735; 95% CI = 0.647-0.822) with satisfactory sensitivity of 74.20% and specificity of 63.90%. Diabetes mellitus was an independent risk factor for CIN (odds ratio = 2.778; 95% CI = 1.045-7.382; P = 0.040).Conclusions:SCysC is an appropriate biomarker to predict the occurrence of CIN. Baseline sCysC before an intervention is useful to obtain a preliminary estimate of the risk of CIN. A 48-h cut-off value of sCysC of 0.99 mg/L after an endovascular procedure may help to rule out patients at lower risk of CIN.

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简介：BackgroundTherewerefewstudiestoexploretherelationshipbetweenpostoperativemeansystolicbloodpressure(PMSBP)within6haftercardiaccatheterizationandcontrast-inducednephropathy(CIN).MethodsFromJune2010toFebruary2013,299consecutivepatientsundergoingcardiaccatheterizationwererecruited.PatientswereclassifiedintoquartilesbasedonPMSBP(<112,112-120,121-131,and>132mmHg).Baselinedata,CINincidenceandin-hospitaloutcomeswerecomparedbetweenthegroups.LogisticregressionwasusedtoassesstherelationshipbetweenPMSBPandCIN.ResultsCINoccurredin26(8.7%)patients.TheincidenceofCINinPMSBPquartileswere15.3%(11/72),15.1%(11/73),2.4%(2/82)and2.8%(2/72)(P=0.001)respectively.Therewerenosignificantdifferenceinin-hospitaldeath,renalreplacementtherapyandintra-aorticballoonpump(IABP)supportbetweenthegroups(P>0.05).UnivariatelogisticregressionanalysisshowedthatPMSBPwassignificantlyassociatedwithCIN(OR=0.956,95%CI:0.928-0.986,P=0.004).Multivariatelogisticregressionanalysisfoundthatafteradjustingbaselineestimateglomerularfiltrationrate,age>75yearsandacutemyocardialinfarction,PMSBP<120mmHgwasstillanindependentriskfactorforCIN(OR=5.049,95%CI:1.820-14.009,P=0.002).ConclusionsLowerPMSBPwassignificantlyassociatedwithanincreasedriskofCIN.PMSBP<120mmHgwasanindependentriskfactorforCIN.Intensiveblood-pressurecontrolaftercardiaccatheterizationmightincreasetheriskofCIN.

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简介：Objectives:Apoptosisisrecognizedasanimportantmechanismincontrast-inducednephropathy(CIN).Cordycepssinensis(CS),atime-honoredtonicfoodandherbalmedicineinChina,canimprovethemicrocirculation,increasethetolerancetoischemiainpatientswithmicrocirculatorydisorders.AsCShasbeenfoundtoberenoprotectiveandanti-apoptoticinmultiplekidneyinjuries,wehypothesizedthatCSwouldpreventCIN.TheobjectiveofthisresearchistostudythemechanismofCSontubularepithelialcellapoptosisindiabeticCINrats.

简介：BackgroundIntravascularvolumeexpansionrepresentsabeneficialmeasureagainstcontrast-inducedacutekidneyinjury(CI-AKI)inpatientsundergoingelectiveangiographicprocedures.However,theefficacyofthispreventivestrategyhasnotyetbeenestablishedforpatientswithST-elevation-myocardialinfarction(STEMI),whoareathigherriskofthiscomplicationafterprimarypercutaneouscoronaryintervention(PCI).Inthisrandomizedstudyweinvestigatedthepossiblebeneficialroleofperiproceduralintravenousvolumeexpansionandwecomparedtheefficacyof2differenthydrationstrategiesinpatientswithSTEMIundergoingprimaryPCI.MethodsandResultsWerandomlyassigned450STEMIpatientstoreceive(1)preprocedureandpostprocedurehydrationofsodiumbicarbonate(earlyhydrationgroup),(2)postprocedurehydrationofisotonicsaline(latehydrationgroup),or(3)nohydration(controlgroup).TheprimaryendpointwasthedevelopmentofCI-AKI,definedasanincreaseinserumcreatinineof≥25%or0.5mg/dLoverthebaselinevaluewithin3daysafteradministrationofthecontrastmedium.Moreover,weevaluatedapossiblerelationshipbetweentheoccurrenceofCI-AKIandtotalhydrationvolumeadministered.Therewerenosignificantdifferencesinbaselineclinical,biochemical,andproceduralcharacteristicsinthe3groups.Overall,CI-AKIoccurredin93patients(20.6%):theincidencewassignificantlylowerintheearlyhydrationgroup(12%)withrespecttoboththelatehydrationgroup(22.7%)andthecontrolgroup(27.3%)(Pfortrend=0.001).Inhydratedpatients(earlyandlatehydrationgroups),lowerinfusedvolumeswereassociatedwithasignificantincreaseinCI-AKIincidence,andtheoptimalcutoffpointofhydrationvolumethatbestdiscriminatespatientsathigherriskwas≤960mL.ConclusionsAdequateintravenousvolumeexpansionmaypreventCI-AKIinpatientsundergoingprimaryPCI.Aregimenofpreprocedureandpostprocedurehydrationtherapywithsodiumbicarbonatea

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简介：AbstractBackground:High levels of plasma homocysteine occur almost uniformly in patients with end-stage renal disease (ESRD). IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis and a common cause of ESRD in young adults. Here, we aimed to detect whether homocysteine was elevated and associated with clinical-pathologic manifestations of IgAN patients and tested its causal effects using a two-sample Mendelian randomization (MR) approach.Methods:For observational analysis, 108 IgAN patients, 30 lupus nephritis (LN) patients, 50 minimal change disease (MCD) patients, and 206 healthy controls were recruited from April 2014 to April 2015. Their plasma homocysteine was measured and clinical-pathologic manifestations were collected from medical records. For MR analysis, we further included 1686 IgAN patients. The missense variant methylenetetrahydrofolate reductase C677T (rs1801133) was selected as an instrument, which was genotyped by TaqMan allele discrimination assays.Results:Majority of IgAN patients (93.52%, 101/108) showed elevated levels of plasma homocysteine (>10 μmol/L). Plasma homocysteine in IgAN patients was significantly higher than that in MCD patients (median: 18.32 vs. 11.15 μmol/L, Z = －5.29, P < 0.01) and in healthy controls (median: 18.32 vs. 10.00 μmol/L, Z = －8.76, P < 0.01), but comparable with those in LN patients (median: 18.32 L vs. 14.50 μmol/L, Z = －1.32, P = 0.19). Significant differences were observed in sub-groups of IgAN patients according to quartiles of plasma homocysteine for male ratio (22.22% vs. 51.85% vs. 70.37% vs. 70.37%, χ2 = 14.29, P < 0.01), serum creatinine (median: 77.00 vs. 100.00 vs. 129.00 vs. 150.00 μmol/L, χ2 = 34.06, P < 0.01), estimated glomerular filtration rate (median: 100.52 vs. 74.23 vs. 52.68 vs. 42.67 mL·min－1·1.73 m－2, χ2 = 21.75, P < 0.01), systolic blood pressure (median: 120.00 vs. 120.00 vs. 125.00 vs. 130.00 mmHg, χ2 = 2.97, P = 0.05), diastolic blood pressure (median 80.00 vs. 75.00 vs. 80.00 vs. 81.00 mmHg, χ2 = 11.47, P < 0.01), and pathologic tubular atrophy and interstitial fibrosis (T) (T0/T1/T2: 62.96%/33.33%/3.70% vs. 29.63%/40.74%/29.63% vs. 24.00%/48.00%/28.00% vs. 14.81%/37.04%/48.15%, χ2 = 17.66, P < 0.01). The coefficient of each rs1801133-T allele on homocysteine levels after controlling age and sex was 7.12 (P < 0.01). MR estimates showed causal positive effects of homocysteine on serum creatine (β = 0.76, P = 0.02), systolic blood pressure (β = 0.26, P = 0.02), diastolic blood pressure (β = 0.20, P = 0.01), and pathologic T lesion (β = 0.01, P = 0.01) in IgAN.Conclusions:By observational and MR analyses, consistent results were observed for associations of plasma homocysteine with serum creatinine, blood pressures, and pathologic T lesion in IgAN patients.

简介：不管是在应试英语还是在实用英语中，比较性文章的写作都是很常见的，有时要强调两种事物的共同点、有时要强调不同点、有时对两者都需要强调。中国人的比较往往只是零散地罗列。使文章显得无组织无层次，那么怎样才能写出英语地道、结构紧凑的比较性文章呢？

简介：Anewmethodofcontrastenhancementisproposedinthepaperusingmultiscaleedgerepresentationofimages,andisappliedtothefieldofCTmedicalimageprocessing.ComparingtothetraditionalWindowtechnique,ourmethodisadaptiveandmeetsthedemandofradiologyclinicsmorebetter.TheclinicalexperimentresultsshowthepracticalityandthepotentialappliedvalueofourmethodinthefieldofCTmedicalimagescontrastenhancement.

简介：the meals often have a great cementing effect on family life. In the eyes of the British people,half of the flavoring could not be found here. Maybe that is one of the reasons why the British food is not very delicious.The British people like desserts very much,and some have no breakfast at all or only a hot drink. The midday lunch time is from about 12

简介：only a glass of wine will be a whole night. The wine culture in Britain is like the characteristics of the British people. So we seldom see some people drunkard in the street. Additionally if the food is different,British wine culture possesses the less sense of the sensitive considerations which is connected with the social superiorities and inferiorities. I think this is a distance between China and Britain. III. The significance of knowing the differences of customWe have had a glimpse of the different customs of Britain and China. Of course what we have discussed just now are only one small aspect of the different culture. To learn the different culture is very important for our English major students and it really means a lot. Then what is the significance of understanding these differences,the fish head would be left for the guest of honor - and it is the most nutritious part (the eyes and lips are the valued delicacies offered to the senior lady present). The platter holding the fish will always be laid on the table in such a way that the fish head points towards the guest of honor (at family meals

简介：语言习得是指一个人习得语言的过程。儿童与成人之间的区别导致第一语言和第二语言习得的差异。本文从语言认知和情感因素两方面做深入分析，对第一语言和第二语言习得的差异进行比较和对照。

简介：weshouldunderstandthatthesuccessesoftheexchangesareonthebasisofmutualunderstandingofeachcountry’scustomandvalues.Thenwewillhavethepossibilitytomakeacademicexchangesandgainsomeachievements.Inauniversity,北京、上海,Inwhichwayisitwonderful

简介：目的：探讨脑电地形图与CT在常见神经系统疾病中的对比应用。方法：509例患者进行了脑电地形图和CT检查。结果：在509例患者中脑电地形图和脑CT显示了不同的改变。结论：脑电地形图和脑CT在常见神经系统疾病的诊断中，各具有其优点和不足。脑电地形图在常见神经系统疾病的临床应用中有重要价值。

简介：Nanotechnologyprovidesvariousnanomaterialswithtremendousfunctionalitiesforcancerdiagnosticsandtherapeutics.Recently,theranosticshasbeendevelopedasanalternativestrategyforefficientcancertreatmentthroughcombinationofimagingdiagnosisandtherapeuticinterventionsundertheguidanceofdiagnosticresults.Ultrasound(US)imagingshowsuniqueadvantageswithexcellentfeaturesofreal-timeimaging,lowcost,highsafetyandportability,makingUScontrastagents(UCAs)anidealplatformforconstructionofcancertheranosticagents.ThisreviewfocusesonthedevelopmentofnanomaterialsincorporatedmultifunctionalUCAsservingastheranosticagentsforcancerdiagnosticsandtherapeutics,viaconjugationofsuperparamagneticironoxidenanoparticles(SPIOs),CuSnanoparticles,DNA,siRNA,goldnanoparticles(GNPs),goldnanorods(GNRs),goldnanoshell(GNS),grapheneoxides(GOs),polypyrrole(PPy)nanocapsules,Prussianblue(PB)nanoparticlesandsoontodifferenttypesofUCAs.Thecancertreatmentcouldbemoreeffectivelyandaccuratelycarriedoutundertheguidanceandmonitoringwiththehelpoftheachievedtheranosticagents.Furthermore,nanomaterialsincorporatedtheranosticagentsbasedonUCAscanbedesignedandconstructedbydemandforpersonalizedandaccuratetreatmentofcancer,demonstratingtheirgreatpotentialtoaddressthechallengesofcancerheterogeneityandadaptation,whichcanprovidealternativestrategiesforcancerdiagnosisandtherapeutics.

简介：WereportonthetemporalcontrastperformanceofthePHELIXfacilityinviewoftherequirementsimposedbysolidtargetinteractionexperiments.Therequirementanalysisforthenanosecondandpicosecondtemporalcontrastisderivedfromempiricaldataandsimpletheoreticalmodeling,whiletherealizationshowsthatusinganultrafastopticalparametricamplifierandplasmamirrorsenablesmeetingthisspecification.