简介：　　MenandwomengoouttogetheragreatdealinAmerica,especiallyinthecities.Theyskitogether,worktogether,dinetogether,eitheratrestaurantsorineachother'sapartments.Thisdoesnotmeanthattheyarenecessarilyinterestedinhavingsextogether,thoughitmayappearso,and,ofcourse,withsomemenandwomenitisso.……

简介：Hereditaryfructoseintolerance(HFI)isanunderrecognized,preventablelife-threateningcondition.ItisanautosomalrecessivedisorderwithsubnormalactivityofaldolaseBintheliver,kidneyandsmallbowel.Symptomsarepresentonlyaftertheingestionoffructose,whichleadstobriskhypoglycemia,andanindividualwithcontinuedingestionwillexhibitvomiting,abdominalpain,failuretothrive,andrenalandliverfailure.AdiagnosisofHFIwasmadeina50-year-oldwomanonthebasisofmedicalhistory,responsetofructoseintolerancetest,demonstrationofaldolaseBactivityreductioninduodenalbiopsy,andmolecularanalysisofleukocyteDNAbyPCRshowedhomozygosityfortwodosesofmutantgene.HFImayremainundiagnoseduntiladultlifeandmayleadtodisastrouscomplicationsfollowinginadvertentfructoseorsorbitolinfusion.SeverallethalepisodesofHFIfollowingsorbitolandfructoseinfusionhavebeenreported.Thediagnosiscanonlybesuspectedbytakingacarefuldietaryhistory,andthiscanpresentseriouscomplications.

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简介：AbstractImportance:Childhood and adolescence are critical periods for lifelong bone mineral accrual, but few studies have determined the impact of childhood adiposity on adult bone density.Objective:To determine the long-term impact of childhood adiposity on adult areal bone mineral density (aBMD) and the effect of adult adiposity on this relationship.Methods:We conducted a longitudinal study of 1156 adults (56.3% men), for whom skinfold thickness (SFT) had been measured during childhood (6-18 years) and fat mass percentage (FMP) and aBMD were measured during adulthood (29-43 years). Adult aBMD in the lumbar spine (LS), femoral neck (FN), arms, and legs was measured using dual-energy X-ray absorptiometry. The direct effect of childhood SFT and its indirect effect through adult FMP on adult aBMD were estimated using general linear regression and a causal steps approach.Results:Significant positive associations between childhood SFT and adult aBMD were found in the LS in men (β = 0.089, P = 0.044) and in all the skeletal sites in women. With respect to the adult fat-bone relationship, high adult FMP was associated with low aBMD in most of the sites in men, but with high FN aBMD in women (β = 0.144, P = 0.002). Moreover, suppressive effects of adult FMP on the associations between childhood SFT and adult aBMD in the LS (-34.8%) and legs (-67.1%) of men, and a positive effect on the FN aBMD in women (17.0%) were identified.Interpretation:Childhood adiposity appears to have a positive long-term effect on adult aBMD, which may be reduced by adiposity in adult men but reinforced by adiposity in adult women.

简介：ＡＤＵＬＴＭＥＳＥＮＣＨＹＭＡＬＨＡＭＡＲＴＯＭＡＯＦＴＨＥＬＩＶＥＲ：ＡＣＡＳＥＲＥＰＯＲＴＷａｎｇＸｉａｎｇｈｕｉ王湘辉ＣｈａｉＦｕｌｕ柴福录ＤｏｎｇＬｉａｎｇ董亮ＬａｎｚｈｏｕＧｅｎｅｒａｌＨｏｓｐｉｔａｌｏｆＰＬＡ，Ｌａｎｚｈｏｕ７３００５０...

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简介：ThispaperisaboutthedesigninganddescriptionofanadultspokenEnglishcourse.TeachingChineseadultlearnersspokenEnglishoftenposesagreatdifficultybecauseoftheirheterogeneousEnglishlevel.Yetwithcarefulplanningandresearchitcanbeasuccessfulstory,too.First,theobjectiveofthecoursemustbeset.Second,aninterviewmustbecarriedouttofindouthowwidetherangeofEnglishabilityis.Third,atextbookthatcanfulfiltheobjectiveandmeettheEnglishlevelofthelearnersmustbeselected.Fourth,ateachingmethodthatwillhelpthelearnersworkfromcontrolledexpressiontoguidedexpressionandeventuallytofreeexpressionmustbedeveloped.Last,butnottheleast,teacherfeedbackisofvitalimportanceinteachingadultlearners.andinprovidingsuchfeedbackreformulationhasprovedtobeeffective.

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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.

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简介：ThestudypresentstheattitudetowardsmoneyamongadultMongolians.Theresearchfocusedondifferencesoftheattitudetowardsmoneyrelatedtoage,gender,andemploymentinMongolianpeople.TheaimofthisstudywastoexaminethedifferentiationoftheattitudetowardsmoneyofadultMongoliansrelatedtosatisfactionwithlife,thesenseofsecurity,andtheroleofsocio-demographicalparameters,suchasage,gender,andemployment.People’sattitudestowardsmoneyseemtobeacquiredthrougheducation,professionalexperience,andmonetaryhabits.Peopleperceivedmoneyasasymbolofasenseofsecurity,amarkerofachievementorstatus,andthesourceofworryoranxiety.Researchersnotedthatmoneyhasamulti-dimensionalpsychologicalmeaning.TheresearchsampleconsistedofMongolianpeople:Agroupof300Mongolians.Theageofparticipantsvariedfrom21to60yearsold.StatisticalVersion10.0wasusedtoanalyzethedata.Theresultsshowedthattheattitudetowardsmoneydependsonthesatisfactionwithlife,thesenseofsecurity,andweredifferentbygenderandemployment.Mongolianshavestrongtendenciestousemoneyasasymbolofpowerandstatus.However,thistendencyisstrongerinthegroupofmenincomparisontowomen,inthisculture.Retention-Timewasbiggerdifferentiatedbyvariableemployment.Accordingtotheresults,therewasnosignificantdifferenceinage.Furthermore,therewerenegativeassociationbetweensatisfactionwithlifeanddistrustinthegroup.Theywhohavefinancialworryseemtobelesssatisfiedwiththeirlife.ThemostnumberofpeopleinMongoliansampleevaluatedownincomeasaverage.Thepercentagesofpersonalprofessionalactivitywerethehighestthananothercategoryinthegroup.Theresultsofstatisticalanalysisshowedthatdifferencesoffrequenciesofsomecomponentsofeconomicsecurityweresignificantinthesample.Insum,ourstudywillcontributetoknowledgeabouttheimportanceofgenerallifesatisfactionandfeelingsecurityontheattitudetowardmoney.The

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简介：同类相食，或intraspecificpredation，能在改变单个健康和人口过程起一个主要作用。在昆虫，同类相食经常越过生活阶段发生，与消费一个更小或更脆弱的阶段的吃人的人。对方上的成年昆虫的Predation被认为不平常。我们在科罗拉多土豆甲壳虫调查了成年同类相食，Leptinotarsadecemlineata(说)，它是在家庭Solanaceae，和一个重要农业害虫在植物上专业化的一个寡食性的草食动物。在实验室条件，饥饿和在对方，它在饥饿的时期期间减少了他们的重量损失之上喂的拥挤的鼓励的teneral成年人下面。然而，蛹以前被攻击并且消费成年人。受伤甲壳虫有比未经触动的甲壳虫被吃的更高的可能性。男性们更经常比女性被攻击，但是那看起来是他们的更小的尺寸而非另外的性特定的特点的功能。在一个幼虫的阶段吃鸡蛋没影响甲壳虫倾向在一个成年阶段吃成年人。当给在同种的成年人和生于谷类之间的一种选择时，甲壳虫喜欢吃conspecifics。包括成年同类相食，吃人肉的行为能为在这种的人口坚持是重要的。

简介：第二与雄激素受体(AR)的敏感为出生前的睾丸激素和covaries作为通常认为的biomarker被建议了到第四位比率(2D:4D)。出生前的睾丸激素和AR在阴茎生长起一个中央作用。在这研究，我们调查了在位比率和阴茎长度之间的关系。在一个单个第三级的学术中心为urological外科被就医的朝鲜的人在这被检查给了知情同意的20岁以上的学习，和144个人有希望地被注册。右边的秒位和第四位的长度被一个单个调查者在阴茎长度的测量以前测量。在麻醉下面，松驰、拉长的阴茎长度被另一个调查者测量没测量也不有任何东西关于位长度的信息。用线性回归模型的Univariate和multivariate分析证明那唯一的高度是为松驰的阴茎长度的一个重要预兆的因素(univariate分析：r=0.185，P=0.026；multivariate分析：r=0.172，P=0.038)并且那唯一的位比率是为拉长的阴茎长度的一个重要预兆的因素(univariateanalysis:r=−；0.216，P=0.009；multivariate分析：r=−；0.201，P=0.024；拉长的阴茎length=−；9.201×；位比率+；20.577)。把证据基于这，我们建议位比率能预言成年阴茎尺寸并且出生前的睾丸激素的效果可以部分地在成年阴茎长度解释差别。

简介：Theventricularseptumseparatestherightandleftventriclesandthusispartofbothventricles.Itisdirectedobliquelybackwardtotheright,andcurvedwiththeconvexitytowardtherightventricle;itmustbeemphasizedthatthetotalcardiacseptumhasacomplex,longitudinaltwistanddoesnotlieinanysingleplane.Itsupperandposteriorpart,isthinandfibrous,andistermedthemembranousventricularseptum.Thegreaterportionoftheseptumisthickandmuscularandconstitutesthemuscularventricularseptum.Theventricularseptumconsistsoftwolayers,athinlayerontheRVsideandathickerlayerontheLVside[1].Themajorseptalarteriestendtorunbetweenthesetwolayers.

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