Background and objectives AKI is a clinical syndrome with various causes involving glomerular, interstitial, tubular, and vascular compartments of the kidney. Acute kidney disease (AKD) is a new concept that includes both AKI and the conditions associated with subacute decreases in GFR (AKD/non-AKI). This study aimed to investigate the correlation between AKI/AKD defined by clinical presentation and diffuse histologic criteria for acute abnormalities based on renal biopsy.Design, setting, participants, & measurements All 303 patients who were histologically diagnosed as having acute tubular necrosis (ATN), acute tubulointerstitial nephritis, cellular crescentic GN, acute thrombotic microangiopathy, or complex lesions on renal biopsy from January 2009 to December 2011 were enrolled in the study. The 2012 Kidney Disease Improving Global Outcomes AKD/AKI definitions were applied to classify patients as follows: AKI, AKD/non-AKI, non-AKD, or unclassified.Results A total of 273 patients (90.1%) met the AKD criteria; 198 patients (65.3%) were classified as having AKI according to serum creatinine (SCr) and urine output criteria. The urine output criteria added 4.3% to the SCr criteria and reclassified 6.7% of the AKI cases into higher stages. Of patients with ATN on pathology, 79.2% met AKI criteria; this was a higher percentage than for those who had other individual pathologic lesions (50%-64%). The major cause of not being defined as having AKI was a slower SCr increase than that required by the definition of AKI (98, 93.3%). Patients with AKI had more severe clinical conditions and worse short-term renal outcome than those in the non-AKI group.Conclusions Diffuse, acute abnormality defined by renal biopsy and AKI defined by clinical presentation are two different entities. Most patients who have diffuse acute histologic findings met the criteria for AKD, whereas only two thirds met the definition of AKI.
Biopsy has been used to diagnose thoracic diseases for more than a century. Percutaneous needle biopsy plays a crucial role in the diagnosis, staging, and treatment planning for tumors in the lungs, thoracic wall, hilum, and mediastinum. With the continuous improvement in imaging techniques, the range of clinical applications for percutaneous needle biopsy is also expanding. It has become important to improve Chinese professionals’ and technicians’ understanding of percutaneous transthoracic needle biopsy (PTNB) in order to standardize operating procedures and to strengthen perioperative management. However, there is currently no Chinese expert consensus that provides systematic standardization and guidance for PTNB in clinical practice. The Committee of Chinese Society of Interventional Oncology (CSIO) of the Chinese Anti‐Cancer Association (CACA) initiated a Chinese multidisciplinary expert consensus on PTNB. The consensus includes image‐guided methods, indications, contraindications, multidisciplinary team recommendations, biopsy procedures, daytime/outpatient biopsy, complications, pathological examination, and management of negative results.
Microearthquakes accompanying shale gas recovery highlight the importance of exploring the frictional and stability properties of shale gouges. Aiming to reveal the influencing factors on fault stability, this paper explores the impact of mineral compositions, effective stress and temperature on the frictional stability of Longmaxi shale gouges in deep reservoirs located in the Luzhou area, southeastern Sichuan Basin. Eleven shear experiments were conducted to define the frictional strength and stability of five shale gouges. The specific experimental conditions were as follows: temperatures: 90-270°C; a confining stress: 95 MPa; and pore fluid pressures: 25-55 MPa. The results show that all five shale gouges generally display high frictional strength with friction coefficients ranging from 0.60 to 0.70 at the aforementioned experiment condition of pressures, and temperatures. Frictional stability is significantly affected by temperature and mineral compositions, but is insensitive to variation in pore fluid pressures. Fault instability is enhanced at higher temperatures (especially at >200°C) and with higher tectosilicate/carbonate contents. The results demonstrate that the combined effect of mineral composition and temperature is particularly important for induced seismicity during hydraulic fracturing in deep shale reservoirs.
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