Shear Wave Elastography in the Evaluation of Renal Parenchymal Stiffness in Patients With Chronic Kidney Disease: A Meta-Analysis.

Background: Chronic kidney disease (CKD) is a progressive loss of renal function, mainly due to hypertension, diabetes, and primary kidney disease. The histopathological findings are that of glomerulosclerosis, tubulointerstitial fibrosis and loss of renal parenchyma characterized. Therefrom, CKD can lead to higher morbidity and mortality. Patients with CKD have multiple risk factors, and the prevention work is complicated and arduous. Therefore, it is important to quantify the severity of CKD. The aim of this study is to investigate the value of shear wave elastography (SWE) in the evaluating renal parenchymal stiffness in patients with CKD. Methods: We carried out the systematic search of databases for publications in PubMed, Embase and Cochrane Library on SWE evaluating renal fibrosis in patients with CKD. The Endnote X9, STATA 16, Review Manager 5.3 and other software were used to sort out documents, extract, integrate and analyze data. Results: The outcomes were utilized to appraise the diagnostic accuracy of SWE and diagnose the CKD with renal fibrosis. A total of 405 patients were enrolled and their data analysis results were as follows: summary of sensitivity (S-SEN) 84% (95% confidence interval (CI): 80-87%); specificity (S-SPE) 80% (95% CI: 76-84%); summary of DLR (digital light radiography) positive (DLR-P) 4.29 (95% CI: 3.43 - 5.37); and DLR negative (DLR-N) 0.20 (95% CI: 0.16 - 0.25). The corresponding areas under the curves of diagnostic odds ratio (DOR) and summary receiver operating characteristic curve (SROC) were 21.50 (95% CI: 14.69 - 31.46) and 89% (95% CI: 86-92%), respectively. Conclusions: SWE is highly accurate and has clinical significance for evaluating renal fibrosis, especially when the shear modulus value is used as the threshold.

[Response of Maize to Lead Stress and Relevant Chemical Forms of Lead].

A sand-culture experiment was carried out to research the differences in lead (Pb) chemical-form among different maize varieties for roots and shoots under Pb stress, and further investigate into the mechanism of maize endurance to resist Pb. The results showed that the wheat varieties of Zhengdan 958 and Longping 206 have the maximum Pb tolerance, whereas Lianchuang 5's tolerance of Pb was the minimum. Pb form in roots and shoots were mainly harmfulness HAc-extractable and HCl-extractable, accounting for a high proportion of 60% - 87%. Moreover, these values in roots were slightly higher than those in shoots. And concentrations of alcohol-extractable and water-extractable Pb accounted for the proportion of 6% - 20%. Under 100 mg x L(-1) Pb stress, the alcohol-extractable together with water-extractable Pb content in shoots of Longping 206 was the lowest (0.52 mg x kg(-1)), and that of in Zhengdan 958 shoots was 0.93 mg x kg(-1) which was also very low. However, for Lianchuang 5, the content could reach 2.78 mg x kg(-1). Under the stress of 800 mg x L(-1) Pb, content of alcohol-extractable together with water-extractable Pb in Zhengdan 958 shoots was 2.41 mg x kg(-1), which was still the lowest. These were probable reasons why Zhengdan 958 was more resistant to Pb stress than other varieties. Tolerance of Zhengdan 958 to Pb stress was related to it's strong ability to convert toxic Pb into non-toxic Pb.

[A multi-center, randomized control trial on clinical research education to diabetes patients].

OBJECTIVE: To assess the effect of implementing education about clinical research in changing the awareness and attitudes of diabetic patients. METHODS: A randomized control trial was implemented in 258 patients with diabetes from 6 hospitals. The participants were assigned to the intervention group (129 cases, who received education about the clinical research) and the control group (129 cases, who received no intervention). The outcome indicators were the variables on knowledge, attitude for the clinical research between before and after intervention in the same group and between the two groups. RESULTS: There was no withdrawal or lost in the two groups. Comparing the contents between inter-groups and intra-group for 19 assignment questions, it showed statistical significance (P<0.05). After the patients received education, their knowledge about and attitude towards clinical research, informed consent, placebo, follow-up, random allocation, and ethics, etc. were markedly improved. Their attitudes for the participants to join in scientific research, opinion, confidence were obviously changed, and it also showed that the method was feasible. The patients' education level was positively correlated with the clinical research educated outputs. CONCLUSION: This study proved the necessity for patients participating in future clinical trials to receive education, as well as its feasibility and effectiveness.