Comparative study of clinical efficacy of laparoscopic proximal gastrectomy with double-channel anastomosis and tubular gastroesophageal anastomosis

BACKGROUND According to statistics,the incidence of proximal gastric cancer has gradually increased in recent years,posing a serious threat to human health.Tubular gastroesophageal anastomosis and double-channel anastomosis are two relatively mature anti-reflux procedures.A comparison of these two surgical procedures,tubular gastroesophageal anastomosis and double-channel anastomosis,has rarely been reported.Therefore,this study aimed to investigate the effects of these two reconstruction methods on the quality of life of patients with proximal gastric cancer after proximal gastrectomy.AIM To compare short-term clinical results of laparoscopic proximal gastrectomy with double-channel anastomosis vs tubular gastric anastomosis.METHODS Patients who underwent proximal gastrectomy at our hospital between January 2020 and January 2023 were enrolled in this retrospective cohort study.The patients were divided into an experimental group(double-channel anastomosis,33 cases)and a control group(tubular gastric anastomosis,30 cases).Baseline characteristics,surgical data,postoperative morbidities,and postoperative nutrition were recorded.RESULTS The differences in baseline data,surgical data,and postoperative complications(20.0%vs 21.2%)were not statistically significant between the two groups.There were no statistically significant differences in the levels of postoperative nutrition indicators between the two groups of patients during the preoperative period and at 3 months postoperatively.In addition,the levels of postoperative nutrition indicators in patients in the experimental group declined significantly less at 6 months and 12 months postoperatively compared with those of the control group(P<0.05).At 12 months postoperatively,the difference in anastomotic reflux esophagitis between the two groups was statistically significant(P<0.05)with the experimental group showing less reflux esophagitis.CONCLUSION Both double-channel anastomosis and tubular gastric anastomosis after proximal gastrectomy are safe and feasible.Double-channel anastomosis has a better anti-reflux effect and is more beneficial in improving the postoperative nutritional status.

A review of down-hole tubular string buckling in well engineering

Down-hole tubular string buckling is the most classic and complex part of tubular string mechanics in well engineering. Studies of down-hole tubular string buckling not only have theoretical significance in revealing the buckling mechanism but also have prominent practical value in design and control of tubular strings. In this review, the basic principles and applicable scope of three classic research methods （the beam-column model, buck- ling differential equation, and energy method） are intro- duced. The critical buckling loads and the post-buckling behavior under different buckling modes in vertical, inclined, horizontal, and curved wellbores from different researchers are presented and compared. The current understanding of the effects of torque, boundary condi- tions, friction force, and connectors on down-hole tubular string buckling is illustrated. Meanwhile, some unsolved problems and controversial conclusions are discussed. Future research should be focused on sophisticated description of buckling behavior and the coupling effect of multiple factors. In addition, active control of down-hole tubular string buckling behavior needs some attention urgently.

Recent progresses in the development of tubular segmented-in-series solid oxide fuel cells:Experimental and numerical study

Solid oxide fuel cells(SOFCs)have attracted a great deal of interest because they have the highest efficiency without using any noble metal as catalysts among all the fuel cell technologies.However,traditional SOFCs suffer from having a higher volume,current leakage,complex connections,and difficulty in gas sealing.To solve these problems,Rolls-Royce has fabricated a simple design by stacking cells in series on an insulating porous support,resulting in the tubular segmented-in-series solid oxide fuel cells(SIS-SOFCs),which achieved higher output voltage.This work systematically reviews recent advances in the structures,preparation methods,perform-ances,and stability of tubular SIS-SOFCs in experimental and numerical studies.Finally,the challenges and future development of tubular SIS-SOFCs are also discussed.The findings of this work can help guide the direction and inspire innovation of future development in this field.

From concept to commercialization:A review of tubular solid oxide fuel cell technology

The reduced sealing difficulty of tubular solid oxide fuel cells(SOFCs)makes the stacking of tubular cell groups relatively easy,and the thermal stress constraints during stack operation are smaller,which helps the stack to operate stably for a long time.The special design of tubular SOFC structures can completely solve the problem of high-temperature sealing,especially in the design of multiple single-cell series integrated into one tube,where each cell tube is equivalent to a small electric stack,with unique characteristics of high voltage and low current output,which can significantly reduce the ohmic polarization loss of tubular cells.This paper provides an overview of typical tubular SOFC structural designs both domestically and internationally.Based on the geometric structure of tubular SOFCs,they can be divided into bamboo tubes,bamboo flat tubes,single-section tubes,and single-section flat tube structures.Meanwhile,this article provides an overview of commonly used materials and preparation methods for tubular SOFCs,including commonly used materials and preparation methods for support and functional layers,as well as a comparison of commonly used preparation methods for microtubule SOFCs,It introduced the three most important parts of building a fuel cell stack:manifold,current collector,and ceramic adhesive,and also provided a detailed introduction to the power generation systems of different tubular SOFCs,Finally,the development prospects of tubular SOFCs were discussed.

Polar-coordinate line-projection light-curing continuous 3D printing for tubular structures

3D printing techniques offer an effective method in fabricating complex radially multi-material structures.However,it is challenging for complex and delicate radially multi-material model geometries without supporting structures,such as tissue vessels and tubular graft,among others.In this work,we tackle these challenges by developing a polar digital light processing technique which uses a rod as the printing platform.The 3D model fabrication is accomplished through line projection.The rotation and translation of the rod are synchronized to project and illuminate the photosensitive material volume.By controlling the distance between the rod and the printing window,we achieved the printing of tubular structures with a minimum wall thickness as thin as 50 micrometers.By controlling the width of fine slits at the printing window,we achieved the printing of structures with a minimum feature size of 10 micrometers.Our process accomplished the fabrication of thin-walled tubular graft structure with a thickness of only 100 micrometers and lengths of several centimeters within a timeframe of just 100 s.Additionally,it enables the printing of axial multi-material structures,thereby achieving adjustable mechanical strength.This method is conducive to rapid customization of tubular grafts and the manufacturing of tubular components in fields such as dentistry,aerospace,and more.

Renal tubular epithelial cell quality control mechanisms as therapeutic targets in renal fibrosis

Renal fibrosis is a devastating consequence of progressive chronic kidney disease,representing a major public health challenge worldwide.The underlying mechanisms in the pathogenesis of renal fibrosis remain unclear,and effective treatments are still lacking.Renal tubular epithelial cells(RTECs)maintain kidney function,and their dysfunction has emerged as a critical contributor to renal fibrosis.Cellular quality control comprises several components,including telomere homeostasis,ubiquitin-proteasome system(UPS),autophagy,mitochondrial homeostasis(mitophagy and mitochondrial metabolism),endoplasmic reticulum(ER,unfolded protein response),and lysosomes.Failures in the cellular quality control of RTECs,including DNA,protein,and organelle damage,exert profibrotic functions by leading to senescence,defective autophagy,ER stress,mitochondrial and lysosomal dysfunction,apoptosis,fibroblast activation,and immune cell recruitment.In this review,we summarize recent advances in understanding the role of quality control components and intercellular crosstalk networks in RTECs,within the context of renal fibrosis.

Hydrogenation of CO_(2) to p-xylene over ZnZrO_(x)/hollow tubular HZSM-5 tandem catalyst

The conversion of CO_(2) into specific aromatics by modulating the morphology of zeolites is a promising strategy.HZSM-5 zeolite with hollow tubular morphology is reported.The morphology of zeolite was precisely controlled,and the acid sites on its outer surface were passivated by steam-assisted crystallization method,so that the zeolite exhibits higher aromatic selectivity than sheet HZSM-5 zeolite and greater p-xylene selectivity than chain HZSM-5 zeolite.The tandem catalyst was formed by combining hollow tubular HZSM-5 zeolites with ZnZrO_(x)metal oxides.The para-selectivity of p-xylene reached 76.2%at reaction temperature of 320℃,pressure of 3.0 MPa,and a flow rate of 2400 mL g^(-1)h^(-1)with an H_(2)/CO_(2) molar ratio of 3/1.Further research indicates that the high selectivity of p-xylene is due to the pore structure of hollow tubular HZSM-5 zeolite,which is conducive to the formation of p-xylene.Moreover,the passivation of the acid site located on the outer surface of zeolite effectively prevents the isomerization of p-xylene.The reaction mechanism of CO_(2) hydrogenation over the tandem catalyst was investigated using in-situ diffuse reflectance Fourier transform infrared spectroscopy and density functional theory.The results showed that the CO_(2) to p-xylene followed a methanol-mediated route over ZnZrO_(x)/hollow tubular HZSM-5 tandem catalysts.In addition,the catalyst showed no significant deactivation in the 100 h stability test.This present study provides an effective strategy for the design of catalysts aimed at selectively preparing aromatics through CO_(2)hydrogenation.

Effect of Types and Orders of Electromagnetic Field Finite Element Meshes on Power Communication Harmonic Parameters Calculation Results of Tubular Hydrogenerators

In generator design field,waveform total harmonic distortion(THD)and telephone harmonic factor(THF)are parameters commonly used to measure the impact of generator no-load voltage harmonics on the power communication quality.Tubular hydrogenerators are considered the optimal generator for exploiting low-head,high-flow hydro resources,and they have seen increasingly widespread application in China's power systems recent years.However,owing to the compact and constrained internal space of such generators,their internal magnetic-field harmonics are pronounced.Therefore,accurate calculation of their THD and THF is crucial during the analysis and design stages to ensure the quality of power communication.Especially in the electromagnetic field finite element modeling analysis of such generators,the type and order of the finite element meshes may have a significant impact on the THD and THF calculation results,which warrants in-depth research.To address this,this study takes a real 34 MW large tubular hydrogenerator as an example,and establishes its electromagnetic field finite element model under no-load conditions.Two types of meshes,five mesh densities,and two mesh orders are analyzed to reveal the effect of electromagnetic field finite element mesh types and orders on the calculation results of THD and THF for such generators.

Integrated design and control technology of liner completion and drilling for horizontal wells

Aiming at the problems of large load of rotation drive system,low efficiency of torque transmission and high cost for operation and maintenance of liner steering drilling system for the horizontal well,a new method of liner differential rotary drilling with double tubular strings in the horizontal well is proposed.The technical principle of this method is revealed,supporting tools such as the differential rotation transducer,composite rotary steering system and the hanger are designed,and technological process is optimized.A tool face control technique of steering drilling assembly is proposed and the calculation model of extension limit of liner differential rotary drilling with double tubular strings in horizontal well is established.These results show that the liner differential rotary drilling with double tubular strings is equipped with measurement while drilling(MWD)and positive displacement motor(PDM),and directional drilling of horizontal well is realized by adjusting rotary speed of drill pipe to control the tool face of PDM.Based on the engineering case of deep coalbed methane horizontal well in the eastern margin of Ordos Basin,the extension limit of horizontal drilling with double tubular strings is calculated.Compared with the conventional liner drilling method,the liner differential rotary drilling with double tubular strings increases the extension limit value of horizontal well significantly.The research findings provide useful reference for the integrated design and control of liner completion and drilling of horizontal wells.

Tubular Heat Enhancement Using Twisted Tape Inserts with Large Holes

Heat augmentation techniques play a vital role in the heating and cooling processes in industries,including solar collectors and many applications that utilize heat exchangers.Several studies are based on inserting fillers inside the tubes to enhance heat transfer.This investigation considered the effects of twisted tapes with large holes on a tubular heat exchanger’s(HX)heat transmission,pressure drop,and thermal boosting factor.In the experimental section,counter-swirl flow generators used twisted tapes with pairs of 1.0 cm-diameter holes and changes in porosity(Rp)at 1.30%and 2.70%.In the experiments,air was utilized as a working fluid in a tube with a circular cross-section.The turbulent flow was considered,with Reynolds numbers(Re)domain from 4800 to 9500,and a boundary condition with a uniform wall heat flux was constructed.The findings expound that when the number of holes rose,the Nusselt number(Nu),the factor of friction(f),and the thermal enhancement factor(η)all increased as well.Additionally,as the friction factor increased,the Nusselt number of the tape-equipped tube was noticeably higher.Additionally,it was discovered that the friction factor was between 70%and 94%lower than the values of the tube without tape,while the(Nu)was between 87%and 97%higher than the conventional tube values.The maximum value ofηis 89%.According to the experimental results,empirical correlations for Nu,f,andηwere also generated.

Reliability of neutrophil gelatinase-associated lipocalin in detecting acute tubular necrosis in decompensated cirrhosis:Systematic review and meta-analysis

BACKGROUND Acute kidney injury(AKI)in cirrhosis is common.The diagnosis of AKI in cirrhosis patients depends on clinical presentation and laboratory tests like serum creatinine.However,urine biomarkers could also be used to assess the type of AKI and the severity of the disease.We performed a systematic review with metaanalysis to evaluate the association with urine neutrophil gelatinase-associated lipocalin(NGAL)marker in identifying acute tubular necrosis(ATN)in patients with cirrhosis.AIM To assess the reliability of urine NGAL in the detection of ATN in patients with cirrhosis.METHODS We systematically searched MEDLINE and PubMed using keywords including“urine biomarkers”,“NGAL”,“kidney dysfunction”,and“cirrhosis”to identify relevant studies.Data was screened and extracted.Included studies assessed hospitalized cirrhosis patients with AKI using the urine NGAL biomarker.We synthesized the data using diagnostic odds ratio(DOR),comparative and descriptive analyses,and Cochran Mantel-Haenszel(CMH)statistics to evaluate heterogeneity.RESULTS Three thousand seven hundred and one patients with cirrhosis were analyzed from a total of 21 cohort studies.The DOR of 14 of those studies[pooled DOR:22.150,(95%CI:17.58-27.89),P<0.0001]demonstrated a significant association between urine NGAL levels and its identification of ATN.Following stratification by cirrhosis status,heterogeneity was analyzed and showed a significant non-zero correlation between NGAL and AKI(CMH statistic=702.19,P<0.0001).CONCLUSION In patients with cirrhosis,the use of urine NGAL is a reliable biomarker for detecting ATN and identifying the etiology of AKI.

Clinical efficacy and safety of double-channel anastomosis and tubular gastroesophageal anastomosis in gastrectomy

BACKGROUND With the continuous progress of surgical technology and improvements in medical standards,the treatment of gastric cancer surgery is also evolving.Proximal gastrectomy is a common treatment,but double-channel anastomosis and tubular gastroesophageal anastomosis have attracted much attention in terms of surgical options.Each of these two surgical methods has advantages and disadvantages,so it is particularly important to compare and analyze their clinical efficacy and safety.AIM To compare the surgical safety,clinical efficacy,and safety of double-channel anastomosis and tubular gastroesophageal anastomosis in proximal gastrectomy.METHODS The clinical and follow-up data of 99 patients with proximal gastric cancer who underwent proximal gastrectomy and were admitted to our hospital between January 2018 and September 2023 were included in this retrospective cohort study.According to the different anastomosis methods used,the patients were divided into a double-channel anastomosis group(50 patients)and a tubular gastroesophageal anastomosis group(49 patients).In the double-channel anastomosis,Roux-en-Y anastomosis of the esophagus and jejunum was performed after proximal gastric dissection,and then side-to-side anastomosis was performed between the residual stomach and jejunum to establish an antireflux barrier and reduce postoperative gastroesophageal reflux.In the tubular gastroesophageal anastomosis group,after the proximal end of the stomach was cut,tubular gastroplasty was performed on the distal stump of the stomach and a linear stapler was used to anastomose the posterior wall of the esophagus and the anterior wall of the stomach tube.The main outcome measure was quality of life 1 year after surgery in both groups,and the evaluation criteria were based on the postgastrectomy syndrome assessment scale.The greater the changes in body mass,food intake per meal,meal quality subscale score,and total measures of physical and mental health score,the better the condition;the greater the other indicators,the worse the condition.The secondary outcome measures were intraoperative and postoperative conditions,the incidence of postoperative long-term complications,and changes in nutritional status at 1,3,6,and 12 months after surgery.RESULTS In the double-channel anastomosis cohort,there were 35 males(70%)and 15 females(30%),33(66.0%)were under 65 years of age,and 37(74.0%)had a body mass index ranging from 18 to 25 kg/m2.In the group undergoing tubular gastroesophageal anastomosis,there were eight females(16.3%),21(42.9%)individuals were under the age of 65 years,and 34(69.4%)had a body mass index ranging from 18 to 25 kg/m2.The baseline data did not significantly differ between the two groups(P>0.05 for all),with the exception of age(P=0.021).The duration of hospitalization,number of lymph nodes dissected,intraoperative blood loss,and perioperative complication rate did not differ significantly between the two groups(P>0.05 for all).Patients in the dual-channel anastomosis group scored better on quality of life measures than did those in the tubular gastroesophageal anastomosis group.Specifically,they had lower scores for esophageal reflux[2.8(2.3,4.0)vs 4.8(3.8,5.0),Z=3.489,P<0.001],eating discomfort[2.7(1.7,3.0)vs 3.3(2.7,4.0),Z=3.393,P=0.001],total symptoms[2.3(1.7,2.7)vs 2.5(2.2,2.9),Z=2.243,P=0.025],and other aspects of quality of life.The postoperative symptoms[2.0(1.0,3.0)vs 2.0(2.0,3.0),Z=2.127,P=0.033],meals[2.0(1.0,2.0)vs 2.0(2.0,3.0),Z=3.976,P<0.001],work[1.0(1.0,2.0)vs 2.0(1.0,2.0),Z=2.279,P=0.023],and daily life[1.7(1.3,2.0)vs 2.0(2.0,2.3),Z=3.950,P<0.001]were all better than those of the tubular gastroesophageal anastomosis group.The group that underwent tubular gastroesophageal anastomosis had a superior anal exhaust score[3.0(2.0,4.0)vs 3.5(2.0,5.0),Z=2.345,P=0.019]compared to the dual-channel anastomosis group.Hemoglobin,serum albumin,total serum protein,and the rate at which body mass decreased one year following surgery did not differ significantly between the two groups(P>0.05 for all).CONCLUSION The safety of double-channel anastomosis in proximal gastric cancer surgery is equivalent to that of tubular gastric surgery.Compared with tubular gastric surgery,double-channel anastomosis is a preferred surgical technique for proximal gastric cancer.It offers advantages such as less esophageal reflux and improved quality of life.

Mechanical Behavior of Moderately Inflated Tubular Organs: A Three-Dimensional Analytical Approach

Hollow tubular tissues and organs of our body have various functions: gastrointestinal (esophagus), respiratory (trachea), and vascular (veins, arteries). A panel of pathologies is associated with each of these tissues and therapeutic interventions, surgery or replacement may be necessary. A precise knowledge of the mechanical properties of these tissues is thus required in order to understand their functioning in native conditions, to be able to elaborate some prostheses, or to design appropriate surgical training tools. These tissues may undergo expansions or contractions (peristalsis) and are exposed to internal pressures. The wall of tubular organs is organized in different layers, and each layer consists of various cell types and extra-cellular matrix, depending on the physiological functions that the organ has to fulfil. This yields anisotropic and compliant structures. In inflation experiments, the linear elasticity approach is acceptable as long as the organ’s inflation remains moderate. In this paper, elasticity laws are revisited and supplemented in order to show that, coupled with modern experimental characterization tools, they provide useful information (compliances, directional Young moduli, Poisson ratios) for the design of artificial tubular organs. The importance of a precise determination of the wall thickness and its evolution during inflation is pointed out.

EXPERIMENTAL RESEARCH AND NONLINEAR FINITE ELEMENT ANALYSIS ON NEW TYPE JOINT BETWEEN COLUMN AND STEEL BEAM OF CONCRETE-FILLED RECTANGULAR STEEL TUBULAR

Experimental results of new type joints between the column and the. steel beam of concrete-filled rectangular steel tubular （CFRT） under reversed cyclic loads are presented. The earthquake resistant capacity of the joint is influenced by infilled concrete, stiffener length and relative dimensions of column and beam. It is found that the hysteresis curves obtained in the experiment are full and the joints have a good energy dissipation capacity. The nonlinear finite element models are also used to analyze the hysteresis behavior of the joints under reversed cyclic loads using ANSYS 8.0. The influences of the stiffener length and the infilled concrete are analyzed. Analytical results show that the stiffener length and the infilled concrete are critical for the joints. Furthermore, the skeleton curves of the finite element models are in good agreement with those of experiments.

Capillary Electrochromatography Using C_8 Open Tubular Column Prepared by Sol-Gel Technique

Open tubthar C8 columns were prepared by sol-gel technology and used in the electrochromatographic separations.

法式tubular代数与仿射Kac-Moody代数

彭联刚-肖杰等利用有限维遗传代数A的根范畴的Ringel-Hall李代数实现所有可对称化Kac-Moody代数,其中Ringel-Hall李代数的李乘不完全由Hall积提供.本文通过新方法实现仿射Kac-Moody代数,李代数L(A)1C/I的李乘完全由Hall积给出.对任意D4(1),E6(1),E7(1)或E8(1)型扩张Dynkin图Δ,在型为Δ的法式tubular代数A的退化合成李代数L(A)1C上构造它关于一个具体李理想I的商代数L(A)1C/I,证明商代数L(A)1C/I同构于对应的Δ型仿射Kac-Moody代数.这将有助于利用法式tubular代数的模范畴研究仿射Kac-Moody代数.

由Tubular代数的Hall代数实现相应的单李代数

与李代数的交叉与渗透是近年来有限维代数表示理论发展的重要特点之一.用Hall代数的方法实现李代数是一个有趣的问题.按照Asashiba的思路,本文利用Tubular代数的根范畴的Ringel-Hall李代数与2-Toroidal李代数的同构对应,在T(2,2,2,2),T(3,3,3),T(4,4,2),T(6,3,2)型Tubular代数的退化合成李代数上构造商代数,并证明它们同构于相应的D4,E6,E7,E8型单李代数,而且李运算完全由Hall积给出.作为例子文中还通过计算系数给出D4型单李代数的具体实现.

Samaria-doped Ceria Modified Ni/YSZ Anode for Direct Methane Fuel in Tubular Solid Oxide Fuel Cells by Impregnation Method

A porous NiO/yttria-stabilized zirconia was prepared by gel casting technique. anode substrate for tubular solid oxide fuel cells Nano-scale samaria-doped ceria （SDC） particles were formed onto the anode substrate to modify the anode microstructure by the impregnation of solution of Sm（NO3）3 and Ce（NO3）3. Electrochemical impedance spectroscopy, current-voltage and current-powder curves of the cells were measured using an electrochemical workstation. Scanning electron microcopy was used to observe the microstructure. The results indicate that the stability of the performance of the cell operated on humidified methane can be significantly improved by incorporating the nano-structured SDC particles, compared with the unmodified cell. This verifies that the coated SDC electrodes are very effective in suppressing catalytic carbon formation by blocking methane from approaching the Ni, which is catalytically active towards methane pyrolysis. In addition, it was found that a small amount of deposited carbon is beneficial to the performance of the anode. The cell showed a peak power density of 225 mW/cm^2 when it was fed with H2 fuel at 700 ℃, but the power density increased to 400 mW/cm^2 when the fuel was switched from hydrogen to methane at the same flow rate. Methane conversion achieved about 90%, measured by gas chromatogram with a 10.0 mL/min flow rate of fuel at 700 ℃. Although the carbon deposition was not suppressed absolutely, some deposited carbon was beneficial for performance improvement.

Predictors of kidney tubular dysfunction induced by adefovir treatment for chronic hepatitis B

AIM:To investigate the predictors of proximal kidney tubular dysfunction(PKTD)induced by adefovir dipivoxil(ADV)treatment for chronic hepatitis B.METHODS:Seventy-nine patients(age at the evaluation of PKTD:56.9±10.7 years)with chronic hepatitis B undergoing long-term oral antiviral nucleos(t)ide analogue treatment were consecutively recruited.PKTD was defined by the presence of at least two of the following five abnormalities:phosphate diabetes,nondiabetic glucosuria,metabolic acidosis,β2-microglobulinuria,or renal hypouricemia.The single-nucleotide polymorphisms(SNPs)in the SLC22A6 gene encoding human organic anion transporter 1(h OAT1)and ABCC2 encoding multidrug resistance protein 2(MRP2)were analyzed using the Taq Man Allelic Discrimination Demonstration Kit.RESULTS:Nine(30.0%)of the 30 ADV-treated patients were diagnosed with PKTD,while no patients without ADV developed PKTD(P<0.001).Three patients with ADV were diagnosed with symptomatic osteomalacia.Among the patients who took ADV,those with PKTD were of higher age at initiation,had significantly longer treatment duration,and had a significantly lower body mass index than those without PKTD.The incidence of PKTD dramatically increased after 96 mo from the start of ADV administration.In contrast,the SNPs were not correlated with PKTD.Logistic regression analysis extracted older age at initiation(OR=5.0,95%CI:1.1-23.4;P=0.040)and longer treatment duration(OR=3.2,95%CI:1.2-8.6;P=0.020)as significant factors associated with PKTD.CONCLUSION:Our results suggest that the tubular function of the kidney of older patients undergoing longterm ADV treatment should be carefully evaluated.