简介：有象锰(Mn)和镍(Ni)那样的金属的环境污染经常在植物纸巾导致这些金属的提高的集中。在高集中，这些金属被知道在某些昆虫草食动物上有有害效果。用实验室生物鉴定和人工的饮食，我们调查了大都会的昆虫detritivore的发展和幸存，Megaselia数量(双翅目：Phoridae)，暴露了到到达2600mgMn/kg和5200mgNi/kg的Mn和Ni的集中在人工的饮食的干燥质量(dm)。令人惊讶地，在测试的集中的Ni和Mn没伤害这个苍蝇。从显著地更短的幼虫的开发时间，成年出现的全面时间，和pupariation和蛹的羽化与一个控制组相比预定的有2602600mgMn/kgdm和Ni/kgdm有的13005200mg的食谱的处理组。女性的翅膀长度，成年健康的相互关联，在金属处理组也是更大的。包括的另外的措施鸡蛋开口，雌的新兴的苍蝇的百分比，和雄的苍蝇的翅膀长度评价，不在金属处理组是显著地不同的。我们断定那Megaselia数量是是容忍的Mn和Ni特别高级。

简介：ObjectiveChronictinnitusisahighlyprevalentconditionandhasbeenhypothesizedtoresultfromaninnatedisturbanceincentralnervousserotonergictransmission.Giventhefrequentcomorbiditywithmajordepressionandanxiety,wearguethatcandidategenesforthesedisordersarelikelytooverlap.Thepresentstudyaddressesthegeneencodingforthe5-HT1Areceptorasaputativeriskfactorfortinnitus.MethodsIn88subjectswithadiagnosisofchronicsubjectivetinnituswhounderwentadetailedneurootologicalexamination,theentire5-HT1AgenewasamplifiedusingoverlappingPCRproducts.Ampliconswerecustomsequencedbidirectionallyandwerescreenedforvariantsinmultiplealignmentsagainstthehumangenomereference.ResultsWeidentifiedasynonymousC>Texchangeatresidue184(Pro)in7/88subjects,butdetectednomissensevariantsinthepopulationunderstudy.Specifically,thefollowingresidueswerefullyconserved:16(Pro),22(Gly),28(Ile),98(Val),220(Arg),267(Val),273(Gly),and418(Asn).DiscussionThepresentdatacountagainstthecausationofchronictinnitusbyachangeinthe5-HT1Areceptor'saminoacidsequence.However,theallelefrequencyforthe184Prominorallele(0.04)reachedtwicethefrequencyreportedincontrolcohortsfromthesameethnicity.Additionalinvestigationsareinvitedtoclarifytheroleofthe5-HT1Apolymorphisminlargersamples,andtocontrolforcomorbidaffectivedisorders.

简介：Sincethe1960's,hundredsofarticleshavebeenpublishedontheeffectsofexerciseoncognitionandmorerecentlyonexecutivefunctions.Alargevarietyofeffectshavebeenobserved:acuteorlong-lasting,facilitatingordebilitating.Severaltheoreticalframeworkshavebeenproposedtoexplaintheseeffectswithplausiblemechanisms.However,asyetnoneofthesemodelshassucceededinunifyingalltheobservationsinasingleframeworkthatsubsumesalleffects.Theaimofthepresentreviewistorevisitthestrengthmodelofself-controlinitiatedbyBaumeisterandhiscolleaguesinthe1990'sinordertoextenditsassumptionstoexercisepsychology.Thismodelprovidesaheuristicframeworkthatcanexplainandpredicttheeffectsofacuteandchronicexerciseoneffortfultaskstappingself-regulationorexecutivefunctions.Areconsiderationofexerciseasaself-controltaskresultsfromthisperspective.Anewavenueforfutureresearchisdelineatedbesidesmoretraditionalapproaches.

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.

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简介：AIM:Toevaluatetheimpactofsociodemographic/clinicalfactorsonearlyvirologicalresponse(EVR)topegin-terferon/ribavirinforchronichepatitisC(CHC)inclinicalpractice.METHODS:Weconductedamulticenter,cross-sectional,observationalstudyinHepatologyUnitsof91Spanishhospitals.CHCpatientstreatedwithpeginterferonα-2aplusribavirinwereincluded.EVRwasdefinedasundetectablehepatitisCvirus(HCV)-ribonucleicacid(RNA)or≥2logHCV-RNAdecreaseafter12wkoftreatment.AbivariateanalysisofsociodemographicandclinicalvariablesassociatedwithEVRwascarriedout.IndependentfactorsassociatedwithanEVRwereanalyzedusingamultipleregressionanalysisthatincludedthefollowingbaselinedemographicandclinicalvariables:age(≤40yearsvs>40years),gender,race,educationallevel,maritalstatusandfamilystatus,weight,alcoholandtobaccoconsumption,sourceofHCVinfection,alanineaminotransferase(ALT)andaspartateaminotransferase(AST)levels,andgammaglutamyltranspeptidase(GGT)(≤85IU/mLvs>85IU/mL),serumferritin,serumHCV-RNAconcentration(<400000vs≥400000),genotype(1/4vs3/4),cirrhoticstatusandribavirindose(800/1000/1200mg/d).RESULTS:Atotalof1014patientswereincludedinthestudy.Meanageofthepatientswas44.3±9.8years,70%weremale,and97%wereCaucasian.ThemainsourcesofHCVinfectionwereintravenousdrugabuse(25%)andbloodtransfusion(23%).SeventyeightpercentwereinfectedwithHCVgenotype1/4(68%hadgenotype1)and22%withgenotypes2/3.TheHCV-RNAlevelwas>400000IU/mLin74%ofpatients.ThemeanALTandASTlevelswere88.4±69.7IU/mLand73.9±64.4IU/mL,respectively,andmeanGGTlevelwas82±91.6IU/mL.Themeanferritinlevelwas266±284.8μg/L.Only6.2%ofpatientspresentedwithcirrhosis.Allpatientsreceived180mgofpeginterferonα-2a.Themostfrequentlyusedribavirindoseswere1000mg/d(41%)and1200mg/d(41%).Theplannedtreatm

简介：Toinvestigatethehistologicalchangeandtheexpressionsofepidermalgrowthfactor(EGF)andepidermalgrowthfactorreceptor(EGFR)inatrophicgastricmucosainratssoastoappraisetheeffectoftheseregulatorsontheformationofatrophicgastritis,tostudytheexpressionsofEGFandEGFRinratswithchronicatrophicgastritis(CAG)aftertheirradiationofHe-Nelaser,andtoinvestigatetherelationsofHe-Nelaserandprecancerouslesionorapoptosis.Theratsweredividedintonormalgroup,modelgroupandlasergroup.ThemodelsofCAGratswereestablishedwithenemawhichwasthemixedliquorconsistedofsodiumsalicylateandalcohol,combinedwithirregularfastingandcompulsivesportingaspathogenicfactors.He-Nelaser(3.36J/cm2)wasusedtoirradiateCAGrats,onceadayfor7min,20daysasacourseoftreatment;theexpressionsofEGFandEGFRweredetectedwithimmunohistochemicalmethod.Duringtheprocessofantralatrophy,theexpressionsofEGFandEGFRincreased,theywerehigherinmodelgroupthanthoseinnormalgroup(P<0.05).AftertheirradiationofHe-Nelaser,theexpressionsofEGFandEGFRwereobviouslylowerthanthoseinmodelgroup(P<0.05).Wedrawtheconclusionasfollows:gastricmucosaofmodelratisinahyper-proliferationstatus,withhighproteinexpressionsofapoptosissuppressorEGFandEGFR.CAGhassomecorrelationwiththeimbalancebetweencellproliferationandapoptosis.He-Nelaser(3.36J/cm2)canreducetheexpressionsofEGFandEGFR,whichisaneffectivephysiostimulatortostimulatethegastricmucosaofrat.TheappropriatesecretionsofEGFandEGFRarepropitioustotherepairandregenerationforthegastricmucosatissues,thuspreventingCAGtocanceration.

简介：AbstractObjectives:Multiple treatments are described in the literature for the treatment of chronic Eustachian tube dysfunction but high-level quality evidence seems missing to support these treatments. This systematic review aimed to determine and compare the safety and efficacy of Laser Eustachian tuboplasty and Microdebrider Eustachian tuboplasty as a treatment for long-term Eustachian tube dysfunction.Data sources:A total of 12 electronic databases were searched up to April 2018 for published and unpublished literature in the English language. References of included studies were checked.Methods:A systematic review was undertaken. Outcomes assessed were: primary outcomes-subjective improvement in symptoms (ETDQ-7), audiometric improvement of hearing, improvement of negative middle ear pressure noticed in tympanometry, objective improvement of tympanic membrane retraction. Secondary outcomes were-the ability to auto-insufflate Eustachian tube i.e. Valsalva manoeuvre, improved quality of life, passive tubal opening, tubomanometry, swallowing test, reduction in mucosal inflammation of Eustachian tube orifice in the nose, complications from the procedure, the need for further procedures. Results are reported in a narrative synthesis as a meta-analysis was not possible due to heterogeneous data.Results:Three studies were included. All included studies were small-scale case series (13-38 par-ticipants). Studies were conducted outside the UK. Subjective and objective improvement of Eustachian tube function was reported in all studies. But all included studies were at high risk of bias and subject to multiple limitations. No major complications were reported in either study.Conclusions:Based on current evidence, it is not possible to recommend the clinical use of either of these two interventions i.e. Laser or Microdebrider Eustachian tuboplasty. Lack of controlled studies was identified as a gap in the evidence. Future research should be directed toward designing randomised controlled trials. These trials should use strict standard methodology and reporting criteria. Future trials should make use of consensus statement document about Eustachian tube dysfunction definition, diagnostic methods, and outcome assessment criteria to design clinical trials.

简介：摘要INTRODUCTIONThis case study explores the gains in hand function in an individual with a chronic spinal cord injury (SCI). The intervention was long-term paired associative simulation (PAS). We aimed to provide PAS until full recovery of hand muscle strength occurred, or until improvements ceased.CASE PRESENTATIONA 46-year-old man with traumatic C7 AIS B tetraplegia was administered PAS three times per week. After 24 weeks, PAS was combined with concomitant motor training of the remaining weak hand muscles. Outcome measures included the manual muscle test (MMT), motor-evoked potentials (MEPs), F-responses, hand functional tests, and the spinal cord independence measure (SCIM)．DISCUSSIONAfter 47 weeks of PAS the subject had improved self-care and indoor mobility and was able to perform complex motor tasks (SCIM score improved from 40 to 56). His left hand regained maximum MMT score (total 75; increase of score from baseline condition 19); the effect remained stable in the 32-week follow up. In the right-hand muscles, MMT scores of 4-5 were observed in follow up (total 71; increase from baseline 48). Improved values were also observed in other outcomes. This is the first demonstration of long-term PAS restoring muscle strength corresponding to MMT scores of 4-5 in an individual with chronic SCI. The effect persisted for several months, indicating that PAS induces stable plastic changes in the corticospinal pathway.

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简介：AbstractBackground:Early body composition changes, associated with physical inactivity and disease advancement are devastating for patient-related outcomes in predialysis chronic kidney disease (CKD), thus warranting a detailed analysis of body composition beyond conventional measures.Methods:The study included 40 subjects diagnosed with CKD; recruited between January to May 2021. Body composition was measured using the multifrequency analyzer, InBody 770. International Physical Activity Questionnaire-Short Form was used to assess physical activity. Suitable statistical analyses were performed using SPSS 21.0.Results:The mean age of the subjects was 58.68 ± 12.24 years. Sarcopenic obesity was prevalent in 62.5% of the subjects. Body mass index under identified obesity by 15% compared to percent body fat, especially in subjects with low muscle mass. The decline in a unit of estimated glomerular filtration rate (eGFR) significantly correlated with a decrease in weight (p = 0.02), body fat mass (p = 0.05), visceral fat area (p = 0.05), and phase angle (p = 0.01) with marginal changes in waist–hip ratio and extracellular water/total body water. The effect of physical activity on skeletal muscle mass was homogeneous between low and moderate levels, but significantly different from high activity level.Conclusion:Changes in fat and fluid compartment were associated with eGFR decline, whereas higher physical activity positively affected body composition.

简介：ObjectivesToinvestigatetherelationshipofserumleptinconcentrationwiththelipidsandbodymassindex(BMI)inpatientswithchroniccongestiveheartfailure(CHF).MethodsTheserumconcentrationofleptinin39patientswithCHF(14incardiacfunctionclassⅡ,21inclassⅢ,4inclassⅣ,NYHA)andin46patientswithcardiacfunctionclassⅠ(NYHA)wereassessedbyradioimmunoassay.ResultsTheserumconcentrationofleptinwere9.018±4.519μg/linCHFgroup(cardiacfunctionclassⅡ11.492±5.649μg/l,classⅢ7.763±3.321μg/l,classⅣ6.100±2.657μg/l);11.674±6.911μg/linclassⅠgroup.TheserumconcentrationsofleptinweresignificantlylowerinCHFgroup,ascomparedwithclassⅠgroup(P<0.05).Moreover,thedecreaseofserumleptinconcentrationwassignificantlycorrelatedwiththedecreasedserumconcentrationsoftotalcholesterol,triglyceride,bodymassindexandleftventricularejectionfractioninCHFgroup,respectively(P<0.05).ConclusionsThesignificanceofthedecreaseinserumleptininCHFpatientsneedsfurtherstudy.

简介：长期的subduralhematoma(CSDH)和蛛网状的包囊(交流)的协会是不平常的。我们报导了2个少年运动员，CSDH与在他们的每日的运动活动发生了并且考察了文学的交流联系了。他们俩通过手术被对待，与令人满意的结果。交流是在有CSDH的年轻病人的一个普通预先安排因素。intracranial流血的复杂并发症是为外科的管理的一个指示。尽管仍然在无征状的交流的治疗有争吵，有交流的病人应该避免强烈运动以便减少intracranial的发生，这是一致出血源于头损害。

简介：瞄准：为了在病人调查胰岛素抵抗和糖尿病的临床的参数的流行，由长期的丙肝(CHC)或长期的肝炎B(CHB)影响了。方法：我们回顾地评估了经历了肝活体检视的852个连续病人(726CHC和126CHB)。我们记录了年龄，性别，中高音，类型2糖尿病或新陈代谢的症候群(MS)，身体团索引(BMI)，和明显的疾病持续时间(增加)。结果：年龄，增加，BMI，在有温和/中等的肝纤维变性的病人的MS和糖尿病的流行在CHC是显著地更高的。然而，脂肪变性的度和在肝活体检视评估的肝纤维变性没在CHC和CHB病人之间不同。在多变量分析，年龄，性别，BMI，中高音和糖尿病是为在CHC的肝纤维变性的独立风险因素，而仅仅年龄与在CHB的肝纤维变性有关。我们也评估了在重要脂肪变性之间的协会(>30%)并且年龄，性别，BMI，糖尿病，MS和肝纤维变性。糖尿病，BMI和肝纤维变性与脂肪变性>被联系30%在CHC，而仅仅年龄和BMI与在CHB的脂肪变性有关。结论：这些数据可以显示丙肝病毒感染是为胰岛素抵抗的一个风险因素。

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简介：ObjectivesTocomparethedifferentpatternsofcoronaryarterycalcification(CAC)inacuteandchroniccoronarysyndromesutilizingelectronbeamcomputedtomography.BackgroundPathologic,angiographic,andintracoronaryultrasoundstudiesrevealedsharpdifferencesintheplaquemorphologybetweenpatientswithacuteversuschroniccoronarysyndromes.Whethertherearedifferentpatternsofcoronaryarterycalcificationinpatientswithstableanginapectoris(SAP)andinthosewithunstableanginapectoris(UAP)oracutemyocardialinfarction(AMI),however,remainsunclear.MethodsTwohundredandsixty-fourpatients,including67withSAP,94withUAPand103withAMIwerestudiedwithelectronbeamcomputedtomographyforanalysisofcoronaryarterycalcificationandwithselectivecoronaryangiographyfordeterminationofatheroscleroticlesions.CACprevalenceandcalciumscorewerecomparedamongthreegroups,andrelationofCACtotheseverityofatheroscleroticdiseaseintheSAPandUAP