Swelling pressure evolution characterization of strong expansive soil considering the influence of reserved expansion deformation

Numerous engineering cases have demonstrated that the expansive soil channel slope remains susceptible to damage with the implementation of a rigid or closed protective structure. It is common for the protective structure to experience bulging failure due to excessive swelling pressure. To investigate the swelling pressure properties of expansive soil, the constant volume test was employed to study the influence of water content and reserved expansion deformation on the characteristics of swelling pressure in strong expansive soils, and also to explore the evolution mechanism of the swelling pressure. The findings demonstrate that the swelling pressure-time curve can be classified into swelling pressure-time softening and swelling pressure-time stability type. The swelling pressuretime curve of the specimen with low water content is the swelling pressure-time softening type, and the softening level will be weakened with increasing reserved expansion deformation. Besides, the maximum swelling pressure Psmax decreases with increasing water content and reserved expansion deformation, especially for expansion ratio η from 24% to 37%. The reserved deformation has little effect on reducing Psmax when it is beyond 7% of the expansion rate. The specimen with low water content has a more homogeneous structure due to the significant expansion-filling effect, and the fracture and reorganization of the aggregates in the specimens with low water content cause the swelling pressure-time softening behavior. In addition, the proposed swelling pressure-time curve prediction model has a good prediction on the test results. If necessary, a deformation space of about 7% expansion rate is recommended to be reserved in the engineering to reduce the swelling pressure except for keeping a stable water content.

Clinical application of reserved gastric tube in neuroendoscopic endonasal surgery for pituitary tumor

BACKGROUND The neuroendoscopic approach has the advantages of a clear operative field,convenient tumor removal,and less damage,and is the development direction of modern neurosurgery.At present,transnasal surgery for sphenoidal pituitary tumor is widely used.But it has been found in clinical practice that some patients with this type of surgery may experience post-operative nausea and vomiting and other discomforts.AIM To explore the effect of reserved gastric tube application in the neuroendoscopic endonasal resection of pituitary tumors.METHODS A total of 60 patients who underwent pituitary adenoma resection via the endoscopic endonasal approach were selected and randomly divided into the experimental and control groups,with 30 in each group.Experimental group:After anesthesia,a gastric tube was placed through the mouth under direct vision using a visual laryngoscope,and the fluid accumulated in the oropharynx was suctioned intermittently with low negative pressure throughout the whole process after nasal disinfection,during the operation,and when the patient recovered from anesthesia.Control group:Given the routine intraoperative care,no gastric tube was left.The number of cases of nausea/vomiting/aspiration within 24 h post-operation was counted and compared between the two groups;the scores of pharyngalgia after waking up,6 h post-operation,and 24 h postoperation.The frequency of postoperative cerebrospinal fluid leakage and intracranial infection were compared.The hospitalization days of the two groups were statistically compared.RESULTS The times of postoperative nausea and vomiting in the experimental group were lower than that in the control group,and the difference in the incidence of nausea was statistically significant(P<0.05).After the patient woke up,the scores of sore throat 6 h after the operation and 24 h after operation were lower than those in the control group,and the difference was statistically significant(P<0.05).The number of cases of postoperative cerebrospinal fluid leakage and intracranial infection was higher than that of the control group,but there was no statistically significant difference from the control group(P>0.05).The hospitalization days of the experimental group was lower than that of the control group,and the difference was statistically significant(P<0.05).CONCLUSION Reserving a gastric tube in the endoscopic endonasal resection of pituitary tumors,combined with intraoperative and postoperative gastrointestinal decompression,can effectively reduce the incidence of nausea,reduce the number of vomiting and aspiration in patients,and reduce the complications of sore throat The incidence rate shortened the hospitalization days of the patients.

Many Kinds of Reserved Judgement in No-Data Problem

The reserved judgment can be broadly categorized into three types: Re-Do, Re-Set, and Natural Flowing Case (i.e. step by step in Re-Try). Hori et al. constructed the Bayes-Fuzzy Estimation and demonstrated that system theory can be applied to the possibility of Markov processes, and that decision-making approaches can be applied to sequential Bayes estimation. In this paper, we focus on the Natural Flowing Case within reserved judgment. Here, the possibility of oblique (or principal) factor rotation is considered as a part of the tandem fuzzy system that follows step by step for sequential Bayes estimation. Ultimately, we achieve a significant result whereby the expected utility can be calculated automatically without the need to construct a utility function for reserved judgment. There, this utility in Re-Do can be calculated by the prior utility, and that utility in Re-set does not exist by our research in this paper. Finally, we elucidate the relationship between fuzzy system theory and fuzzy decision theory through an applied example of Bayes-Fuzzy theory. Fuzzy estimation can be applied to only normal making decision, but it is impossible to apply abnormal decision problem. Our Vague, specially Type 2 Vague can be applied to abnormal case, too.

Fuzzy-Bayes Decision Making with Reserved Judgement

This paper discusses a method for identifying states in a multistage Decision Making Problem in which an Indifferent Event is either predetermined or can be automatically derived after the fact. First, when they are pre-set, the amount of possible information about Indifferent Event tends to be large. Therefore, since the decision is risk tolerant, the Max-Product method of Tanaka et al. is used to calculate the expected utility possibility. Next, in the case of automatic derivation after the fact, the amount of information on the possibility of Indifferent Event is relatively small, so the expected utility possibility is derived using Zadeh’s Fuzzy Event Possibility Measure. Here, it is assumed that the setting of the utility function is independent of the information on the occurrence of the Indifferent Event and is identified by the decision maker by lot drawing using the certainty equivalence method. As a concrete example, we focus on the pass/fail decision of a recommendation test, which is a two choice question in the No-Data Problem, and illustrate the multistage state identification method. .

Evaluation of land-use pattern change in West Bhanugach Reserved Forest,Bangladesh,using remote sensing and GIS techniques

A study was conducted to investigate the land-use pattern change over a period of 18 years （1988-2006） by using remote sens- ing and Geographical Information System （GIS） technologies, in the West Bhanugach Reserved Forest, a hill forest, in Sylhet Forest Divi- sion of Bangladesh, The images were processed using ERDAS Imagine software. Both supervised and unsupervised approaches were ap- plied and ground control points were collected using a GPS. Maps were prepared using GIS software. Results showed that vegetation cover drastically decreased from the year 1988 to 1996 （l 826 ha to l 714.85 ha）, but increased gradually from the year 1996 to 2006 （l 714.85 ha to l 847.83 ha） due to the initiation of co-management practice involving local communities. Change in bare land was inversely proportionate to the amount of vegetation cover changes unless any other land-uses were converted into bare land. The area of water bodies increased from the year 1988 to 1996 （307.67 ha to 379.53 ha）, but decreased from the year 1996 to 1997, then remained invariabile from the year 1997 to 2006. Some recommendations were also made for applying the RS and GIS techniques to study the land-use pattern change in the Bhanugach Reserved Forest and to create a GIS data base for the study area.

Be Reserved in Front of Love—A Brief Analysis on the Characteristic of Jane Bennet in the Novel Pride and Prejudice

This essay mainly discusses the attitude that modern ladies should preserve towards love since people treat love and divorce as less seriously as before.It reveals the idea that to be reserved in front of love should be considered by nowadays people according to analyzing the characteristic of the female image,Jane Bennet,in Jane Austen's novel Pride and Prejudice.

Exploring willingness-to-pay for the restoration and maintenance of reserved forests in the Greater Accra Region of Ghana

In recent years, debates on the alarming rate of forest depletion emanating from growth in urban settlement and changed urban land-use patterns have gained prominence across the globe. The present study adopts a demandside management approach to investigate household’s willingness-to-pay for the restoration and maintenance of protected forest reserves in three municipalities in Ghana. Using survey data of 733 households from the Greater Accra Region of Ghana, we model the demand for forest restoration and maintenance, respectively, by means of the contingent valuation technique. As part of the findings, the study shows evidence that a household is willing to pay Gh￠50.99($8.67) and Gh￠31.12($5.29) per annum to restore and maintain the protected forests,respectively. These amounts constitute less than one percent of the average household income per month.Consequently, critical validity tests are conducted to validate the robustness of the results. This study provides willingness-to-pay estimates for forest and forest resources, and its associated determinants. These estimates seek to bridge the information gap and inform policy decisions toward the overarching aim of ensuring sustainable forest management in Ghana.

Influence of the Number of Reserved Fruit on Fruit-bearing Branch of Early-maturing Citrus unshiu Marc. on Fruit Growth and Development

In order to provide theoretical references for early-maturing Citrus unshiu Marc. in terms of fruit thinning, timely fertilization and harvesting, as wel as for for-mulation of of Early-maturing Citrus unshiu Marc. Cultivation Technique Standards in Guizhou Province, the dynamic changes of fruit longitudinal diameter and trans-verse diameter of 11-year-old and 12-year-old early maturing Citrus unshiu Marc. were tested in two consecutive years and the effects of single-fruit bearing branch on fruit growth and development were compared. The results showed annual varia-tion of longitudinal and transverse diameter of the fruit in Guizhou grew faster at the beginning and then slowed down gradual y, maintaining a slow-growth period after October; the growth curve final y was flat in mature stage. General y, the growth and development stage of fruit showed four growth peaks, showing an in-creasing S-shape curve and fruit net increase also had four growth peaks with a double S-shape curve. Specifical y, longitudinal diameters growth alternated with transverse diameter growth and the former proved much stronger. In terms of ef-fects of single-fruit bearing branch on longitudinal and transverse diameter growth, the number of reserved fruits had direct effects on the growth, net increase of weight, time of growth peak, fluctuation and the number of growth peak. The growth and development, and quality of fruits in the treatments with two or three fruits re-served on single fruit-bearing branch proved better compared with the control with four left fruits. It suggested that early June and early July are the best time for fer-tilization of early-maturing Citrus unshiu Marc. in Guizhou Pprovince and would have better effect if combined with foliage spraying. The suitable harvest time is in the end of October. The preferred number of reserved fruit on single fruit-bearing branch is 2-3. In actual production, the implementation of flower and fruit thinning should also takes tree age, balance of tree vigor, strength of fruit bearing branch, alternate bearing phenomenon and other factors into consideration.

Rationality of Reincorporating the Reserved Seat Provision in the Constitution of The People’s Republic of Bangladesh

The Constitution (17th Amendment) Act 2018, passed on this 8th July 2018, provides for the tenure of the reserved seats for women in Parliament to be extended for a period of 25 years from the first day of the 11th parliament. In Bangladesh, there is a consensus in general that women’s political participation is necessary for both the democratic development of the country and women’s empowerment. Studies and research on the constitutionality of the Reserved Seat Provision for women in Parliament show that this Reserved Seat Provision does not actually help women impact in the political process in Parliament and/or in achieving the goals of women empowerment. Hence, this paper shall discuss how this Reserved Seat Provision is affecting the election system, leaving a scope for it to be less democratic, effective, and meaningful. This paper shall highlight that merely a sizable presence of women in Parliament for such a long period won’t aid in achieving the aims and objectives of women empowerment. This paper shall conclude with the recommendation that the Reserved Seat Provision may be integrated in the Constitution in a manner that provides for direct election of reserved seat nominations for women in Parliament and that too should not be in the Constitution for an indefinite period.

Assessment of Tree Diversity and Abundance in Rashad Natural Reserved Forest, South Kordofan, Sudan

This study aims to estimate the tree diversity status of Rashad Forest Reserves in the Rashad locality of the South Kordofan State of Sudan. For data collection, eight sample plots (20 × 20 m) were taken randomly, and parameters were determined: trees species diversity, composition, relative density, dominance, important value index, and species richness in the Rashad forest reserve. The results show that a total of 237 and 56 tree species, including 22 families, have been identified in the study area. Fabaceae family and species numbers have the highest number of 13 species in 8 genera, followed by Combretaceae with 8 species belonging to 3 different genera, Malvaceae with 5 species belonging to 4 different genera, Apocynaceae with 3 species belonging to 3 different genera. The Arecaceae, Burseraceae, Capparaceae, Euphorbiaceae, Meliaceae, and Rubiaceae families each had two species, and all the other 11 families had one species each. Among the 56 different tree species found within the reserve. The results also indicated that Tamarindus indica L. and Ziziphus spina-christi (L.) Desf. had the highest relative density and dominance of 4.64% and 11% respectively. Adansonia digitata L., Grewia villosa Willd, Vepris nobilis (Delile) Mziray had density and dominance of 4.80% and 9%. Followed by Anogeissus leiocarpa (DC.) Guill. & Perr, Adansonia digitata L., Catunaregam nilotica (Stapf) Tirveng. (Syn: Xeromphis nilotica (Stapf) Keay, Vangueria madagascariensis J. F. Gmel. with 3.38% and 8%, respectively. Eleven species recorded the least relative dominance of 0.42%. Shannon-Weiner diversity index (H’) value stood at 3.82. And as diversity indices varied with location depending on the species available within an ecological zone, Rashad forest reserve is blessed with a moderate diversity index.

Structural Evolution of Ultra-High Molecular Weight Polyethylene Low-Entangled Films with Reserved Shish Crystals During Hot Stretching

Shish crystals are crucial to achieving high performance low-dimensional ultra-high molecular weight polyethylene(UHMWPE)products.Typically,high stretch and shear flow fields are necessary for the formation of shish crystals.In this study,UHMWPE gel films with reserved shish crystals were prepared by gel molding,the structural evolution and properties of UHMWPE films stretched at temperatu res of 100,110,120and 130℃were investigated by in situ small-angle X-ray scattering(SAXS)/ultra-small-angle X-ray scattering(USAXS)/wide-angle X-ray diffraction(WAXD)measu rements as well as scanning electron microscopy(SEM)and differential scanning calorimetry(DSC)measurements.Our findings showed that the reserved shish crystals can facilitate the formation and structural evolution of shish-kebab crystals during the hot stretching.Additionally,the reserved shish crystals promote the structu ral evolution of UHMWPE films to a greater extent when stretched at 120 and 130℃,compared to 100 and 110℃,resulting in higher crystallinity,orientation,thermal properties,breaking strength and Young's modulus.Com pared to UHMWPE high-entangled films with reserved shish crystals prepared by compression molding,UHMWPE low-entangled films with reserved shish crystals prepared by gel molding are more effective in inducing the formation and evolution of shish-kebab crystals during the hot stretching,resulting in increased breaking strength and Young's modulus.

Viscoelastic solution of optimal reserved deformation for deep soft rock tunnels with large deformation

In the construction process of soft rock tunnels,determining a reasonable amount of reserved deformation is important to ensure the tunnel stability.This article presents the viscoelastic solution of reserved deformation for deep soft rock tunnels considering the support effects.Based on the analytical solution of the Burgers model,the expression of surrounding rock displacement was derived by considering reserved deformation and optimal reserved deformation.Subsequently,based on numerical simulation experiments,the variation laws and errors of the numerical and analytical solutions of the expressions of reserved deformation and surrounding rock displacement were analyzed.To gain a better understanding of the factors that affect reserved deformation,the factors influencing the expression of optimal reserved deformation were analyzed.The errors in the numerical simulation and analytical solution results were within 10%.This study could provide a theoretical basis for determining the amount of reserved deformation and analyzing the variation law of surrounding rock affected by the amount of reserved deformation.

Photo-activated microtubule targeting drugs: Advancing therapies for colorectal cancer

Over the years immunotherapy has demonstrably improved the field of cancer treatment.However,achieving long-term survival for colorectal cancer(CRC)patients remains a significant unmet need.Combination immunotherapies incor-porating targeted drugs like MEK or multi-kinase inhibitors have offered some palliative benefit.Nevertheless,substantial gaps remain in the current therapeutic armamentarium for CRC.In recent years,there has been a surge of interest in exploring novel treatment strategies,including the application of light-activated drugs in conjunction with optical devices.This approach holds promise for achie-ving localized and targeted delivery of cytotoxic agents,such as microtubule-targeting drugs,directly to cancerous cells within the colon.

Report for Type 2 Bayes-Fuzzy Estimation in No-Data Problem

It is well known that the system (1 + 1) can be unequal to 2, because this system has both observation error and system error. Furthermore, we must provide our mustered service within our cool head and warm heart, where two states of nature are existing upon us. Any system is regarded as the two-dimensional variable error model. On the other hand, we consider that the fuzziness is existing in this system. Though we can usually obtain the fuzzy number from the possibility theory, it is not fuzzy but possibility, because the possibility function is as same as the likelihood function, and we can obtain the possibility measure by the maximal likelihood method (i.e. max product method proposed by Dr. Hideo Tanaka). Therefore, Fuzzy is regarded as the only one case according to Vague, which has both some state of nature in this world and another state of nature in the other world. Here, we can consider that Type 1 Vague Event in other world can be obtained by mapping and translating from Type 1 fuzzy Event in this world. We named this estimation as Type 1 Bayes-Fuzzy Estimation. When the Vague Events were abnormal (ex. under War), we need to consider that another world could exist around other world. In this case, we call it Type 2 Bayes-Fuzzy Estimation. Where Hori et al. constructed the stochastic different equation upon Type 1 Vague Events, along with the general following probabilistic introduction method from the single regression model, multi-regression model, AR model, Markov (decision) process, to the stochastic different equation. Furthermore, we showed that the system theory approach is Possibility Markov Process, and that the making decision approach is Sequential Bayes Estimation, too. After all, Type 1 Bays-Fuzzy estimation is the special case in Bayes estimation, because the pareto solutions can exist in two stochastic different equations upon Type 2 Vague Events, after we ignore one equation each other (note that this is Type 1 case), we can obtain both its system solution and its decision solution. Here, it is noted that Type 2 Vague estimation can be applied to the shallow abnormal decision problem with possibility reserved judgement. However, it is very important problem that we can have no idea for possibility reserved judgement under the deepest abnormal envelopment (ex. under War). Expect for this deepest abnormal decision problem, Bayes estimation can completely cover fuzzy estimation. In this paper, we explain our flowing study and further research object forward to this deepest abnormal decision problem.

High quality repair of osteochondral defects in rats using the extracellular matrix of antler stem cells

BACKGROUND Cartilage defects are some of the most common causes of arthritis.Cartilage lesions caused by inflammation,trauma or degenerative disease normally result in osteochondral defects.Previous studies have shown that decellularized extracellular matrix(ECM)derived from autologous,allogenic,or xenogeneic mesenchymal stromal cells(MSCs)can effectively restore osteochondral integrity.AIM To determine whether the decellularized ECM of antler reserve mesenchymal cells(RMCs),a xenogeneic material from antler stem cells,is superior to the currently available treatments for osteochondral defects.METHODS We isolated the RMCs from a 60-d-old sika deer antler and cultured them in vitro to 70%confluence;50 mg/mL L-ascorbic acid was then added to the medium to stimulate ECM deposition.Decellularized sheets of adipocyte-derived MSCs(aMSCs)and antlerogenic periosteal cells(another type of antler stem cells)were used as the controls.Three weeks after ascorbic acid stimulation,the ECM sheets were harvested and applied to the osteochondral defects in rat knee joints.RESULTS The defects were successfully repaired by applying the ECM-sheets.The highest quality of repair was achieved in the RMC-ECM group both in vitro(including cell attachment and proliferation),and in vivo(including the simultaneous regeneration of well-vascularized subchondral bone and avascular articular hyaline cartilage integrated with surrounding native tissues).Notably,the antler-stem-cell-derived ECM(xenogeneic)performed better than the aMSC-ECM(allogenic),while the ECM of the active antler stem cells was superior to that of the quiescent antler stem cells.CONCLUSION Decellularized xenogeneic ECM derived from the antler stem cell,particularly the active form(RMC-ECM),can achieve high quality repair/reconstruction of osteochondral defects,suggesting that selection of decellularized ECM for such repair should be focused more on bioactivity rather than kinship.

Peat properties of a tropical forest reserve adjacent to a fire-break canal

Tropical peat comprises decomposed dead plant material and acts like a sponge to absorb water,making it fully saturated.However,drought periods dry it readily and increases its vulnerability to fire.Peat fires emit greenhouse gases and particles contributing to haze,and prevention by constructing fire-break canals to reduce fire spread into forest reserves is crucial.This paper aims to determine peat physical and chemical properties near a fire-break canal at different fire frequency areas.Peat sampling was conducted at two forest reserves in Malaysia which represent low fire frequency and high fire frequency areas.The results show that peat properties were not affected by the construction of a fire-break canal,however lignin and cellulose content increased significantly from the distance of the canal in both areas.The study concluded that fire frequency did not significantly influence peat properties except for porosity.The higher fibre content in the high frequency area did not influence moisture content nor the ability to regain moisture.Thus,fire frequency might contribute differently to changes in physical and chemical properties,hence management efforts to construct fire-break canals and restoration efforts should protect peatlands from further degradation.These findings will benefit future management and planning for forest reserves.

Effects of excessive body fat on colostrum lipid patterns: overweight/obese vs. normal weight mothers

Prenatal overweight/obesity(OW/OB)can alter colostrum lipid patterns,thereby affecting the lipid metabolism and even the cognitive and healthy development of infants.However,studies on changes in colostrum lipids in the context of OW/OB are limited,particularly for glycerides and polar lipids.Therefore,this study investigated the infl uence of maternal prenatal weight on colostrum in lipid subclasses and molecular species.The concentration of triacylglycerols(TAGs)in the colostrum of the OW/OB group(35894.43 mg/L)was higher than that of the normal weight(NW)group(26639.20 mg/L),suggesting that colostrum from OW/OB mothers could provide more energy to their infants.Further analysis of the fatty acid composition of TAGs revealed that elevated maternal body weight enhanced the concentration of TAGs containing saturated or n-6 fatty acids and shortened the carbon number of TAGs.Docosahexaenoic acid(DHA)/arachidonic acid(AA)/choline-containing lipids,such as DHA-containing TAGs,AA/DHA-containing phosphatidylethanolamine,and choline-containing phospholipids,were present in higher levels in the colostrum of OW/OB mothers than NW mothers.However,the concentrations of palmitic acid-containing TAGs,linoleic acid-containing TAGs,dihomo-γ-linolenic acid-containing TAGs,and polar lipids and the ratio of TAGs containing n-6 fatty acid/n-3 fatty acid were signifi cantly higher in the colostrum of OW/OB mothers than in that of NW mothers.The fatty acid composition and sphingoid bases of sphingolipids were also altered due to elevated body weight.In conclusion,OW/OB affects colostrum lipids with respect to composition,concentration,and percentage.Although the colostrum of healthy OW/OB mothers can provide suffi cient DHA/AA/choline-containing lipids to their infants,normalization of body weight and fat reserves should be considered as a strategy for highquality human milk lipids.

Coal-rock gas:Concept,connotation and classification criteria

In recent years,great breakthroughs have been made in the exploration and development of natural gas in deep coal-rock reservoirs in Junggar,Ordos and other basins in China.In view of the inconsistency between the industrial and academic circles on this new type of unconventional natural gas,this paper defines the concept of"coal-rock gas"on the basis of previous studies,and systematically analyzes its characteristics of occurrence state,transport and storage form,differential accumulation,and development law.Coal-rock gas,geologically unlike coalbed methane in the traditional sense,occurs in both free and adsorbed states,with free state in abundance.It is generated and stored in the same set of rocks through short distance migration,occasionally with the accumulation from other sources.Moreover,coal rock develops cleat fractures,and the free gas accumulates differentially.The coal-rock gas reservoirs deeper than 2000 m are high in pressure,temperature,gas content,gas saturation,and free-gas content.In terms of development,similar to shale gas and tight gas,coal-rock gas can be exploited by natural formation energy after the reservoirs connectivity is improved artificially,that is,the adsorbed gas is desorbed due to pressure drop after the high-potential free gas is recovered,so that the free gas and adsorbed gas are produced in succession for a long term without water drainage for pressure drop.According to buried depth,coal rank,pressure coefficient,reserves scale,reserves abundance and gas well production,the classification criteria and reserves/resources estimation method of coal-rock gas are presented.It is preliminarily estimated that the coal-rock gas in place deeper than 2000 m in China exceeds 30×10^(12)m^(3),indicating an important strategic resource for the country.The Ordos,Sichuan,Junggar and Bohai Bay basins are favorable areas for large-scale enrichment of coal-rock gas.The paper summarizes the technical and management challenges and points out the research directions,laying a foundation for the management,exploration,and development of coal-rock gas in China.

Changes in renal function and morphological variations of kidney diseases in rheumatoid arthritis patients

Objective:Rheumatoid nephropathy is one of the most severe extra-articular manifestations of rheumatoid arthritis(RA)associated with a very unfavorable prognosis.This study aimed to identify changes in renal function and morphological variations of kidney diseases in RA patients.Methods:The study enrolled patients(126 patients)between 18 and 55 years of age with a confirmed active RA of more than 12 months.Each patient underwent the following range of laboratory and instrumental research methods:general clinical analysis of blood and urine,performing urinalysis according to Nechiporenko method;determining daily proteinuria;determining the blood content of glucose,urea,creatinine,uric acid,total bilirubin,liver transaminase level,ionogram,lipidogram,and coagulogram;determining the blood content of rheumatoid factor,anti-streptolysin O,and C-reactive protein;and X-ray of the joints of hands and feet.Renal function was examined by estimating glomerular filtration rate,tubular reabsorption index,and renal functional reserve.For studying the morphological changes in the kidneys under ultrasound examination,renal biopsy was performed in 31 patients with RA with urinary syndrome(proteinuria more than 0.3 g per day and hematuria).Results:Nephropathy in RA is characterized by impaired renal function and manifested by an increased blood creatinine and a decrease in glomerular filtration rate and renal functional reserve.Among morphological variations of nephropathy at RA,mesangial proliferative glomerulonephritis prevails,accounting for 48.4%of patients.Other disorders include the secondary amyloidosis(29.0%of patients),tubulointerstitial nephritis(16.1%),membranous glomerulonephritis(3.2%),and focal-segmental glomerulosclerosis(3.2%).Conclusion:Kidney damage is a common systemic manifestation of RA with a long and active course,a major nephropathy trigger.

Deferred revascularization in diabetic patient according to combined invasive functional and intravascular imaging data:A case report

BACKGROUND Invasive functional evaluation by fractional flow reserve(FFR)is considered as a gold standard for the evaluation of intermediate coronary stenosis.However,in patients with diabetes due to accelerated progression of atherosclerosis the outcome may be worse even in the presence of negative functional testing.CASE SUMMARY We present a case of 55-year-old male diabetic patient who was admitted for chest pain.Diagnostic coronary angiography disclosed 2 intermediate stenoses of the obtuse marginal branch with no evidence of restenosis on previously implanted stent.Patient undergone invasive functional testing of intermediate lesion with preserved FFR(0.88),low coronary flow reserve(1.2)and very high index of microvascular resistance(84).Due to discrepancy in invasive functional parameters,intravascular imaging with optical coherence tomography showed fibrotic stenoses without signs of thin-sup fibroatheroma.Because of the preserved FFR and no signs of vulnerable plaque,the interventional procedure was deferred and the patient continued with optimal medications.CONCLUSION Combined functional and anatomic imaging of intermediate coronary stenosis in diabetic patients represent comprehensive contemporary decision pathway in the management of the patients.