心肾的

Now, researches on CHF pathogenesis and treatment have evolved deeply. CHF medication can achieve anticipated curative effect at the early stage, however, which is difficult to have the intended effect for decompensate CHF. Patients with DCHF often emerge oliguria, internal environment disorders and renal failure and died at the end stages.

目前，人类对于心衰的发病机制及治疗的研究已相当深入，在心衰失代偿早期通过药物治疗尚能达到较为满意的疗效，但是对于难治性心衰的患者药物治疗难以奏效，患者往往因顽固性心衰而出现少尿、内环境紊乱、肾功能衰竭而死亡。

International Circulation: What about direct renin inhibition and its effect on cardio-renal protection?

国际循环》：直接的肾素抑制剂是如何发挥心肾保护作用的？

Could you please discuss the mechanism of direct renin inhibition in antihypertension and cardio- renal protection?

请您谈谈直接肾素抑制剂在降压和心肾保护方面的作用机理。

4SX9va:I*U0 Cardiorenal syndrome is a clinical syndrome when chronic heart failure ca using renal dysfunction.

心肾综合征（cardiorenal syndrome，CRS）是指由于心力衰竭引起肾功能不全时的一种临床综合征。

Cardiorenal syndrome is a clinical syndrome when chronic heart failure causing renaldysfunetion.In a narrower sense.

心肾综合征(cardiorenal syndrome，CRS)是指由于心力衰竭引起肾功能不全时的一种临床综合征。

E.ug{hV:x.V0 Cardiorenal syndrome is a clinical syndrome when chronic heart failure ca using renal dysfunction.

心肾综合征（cardiorenal syndrome，CRS）是指由于心力衰竭引起肾功能不全时的一种临床综合征。

National Heart, Lung, and Blood Institute's Heart Failure Network, the Effectiveness of Ultrafiltration in Treating People with Acute Decompensated Heart Failure and Cardiorenal Syndrome trial, involves a second comparison of ultrafiltration and diuretic treatment, specifically in patients who have worsening renal function during their decompensation episode.

&目前，美国国家心肺和血液研究所心衰网络正在开展一项名为'超滤治疗对急性失代偿性心衰患者和心肾综合征患者的疗效'的试验，该试验将再一次比较超滤治疗与利尿剂治疗的疗效，尤其对于那些在失代偿期内肾功能不断恶化的患者。&

Fie years after initiation of treatment, 79% patients were still on renin-angiotensin inhibitors, 65% on -blockers, 56% on spironolactone, and 83% on statins. Notably, multiple drug treatment and increased seerity of heart failure was associated with persistence of treatment. Nonpersistence with renin-angiotensin inhibitors,-blockers, and statins was associated with increased mortality with hazard ratios for death of 1.37 (95% CI, 1.31 to 1.42), 1.25 (95% CI, 1.19 to 1.32), 1.88 (95% CI, 1.67 to 2.12), respectiely.

开始治疗5年后，有79％病人继续使用肾素血管紧张素抑制剂，65％用阻滞剂，56％用安体舒通，83％使用他汀类，值得注意的是，联合用药和心衰的加重同坚持治疗相关，无法坚持使用肾素血管紧张素抑制剂，阻滞剂，安体舒通，他汀类药物的病人同增加的死亡率相关，其死亡危险比分别为1.37 (95%可信区间， 1.31 － 1.42)， 1.25 (95%可信区间， 1.19 － 1.32)， 1.88 (95%可信区间， 1.67 － 2.12)，。

After administration of L-N〓-nitro-Arginine, a specific antagonist of NOS, it was found that the basal and stimulated NO release of blood vessels (aorta, internal carotid, renal and mensenteric artery) was decreased further. The increase of coronary blood flow stimulated by Ach was also reduced further, while the platelet aggregation degree and erythrocyte aggregation index increased significantly. Pathological examination indicated that aortic endothelium was destroyed, the blood vessels in cerebral, cardiac and renal tissues were hypertrophied further and some were almost occluded. The above fin dings resulted in SHR feeded with L-NNA having high incidence of stroke rate and high degree of renal cirrhosis when compared to control SHR. The infarct and hemorrhagic focuci in cerebral tissues, infarct focuci in cardiac tissues, atrophy and hyalinedegeneration of renal glomeruli and degeneration even necrosis of renal tubuli in renal tissues were al so found. The increase ratio of brain and heart to body weight and decrease ratio of kidney to body wei ght further demonstrated that the cerebral, cardiac and renal injuries were aggravated.

在上述结果的基础上进一步给予SHR NOS特异性拮抗剂左旋亚硝基精氨酸后，血管(胸主、颈内、肾及肠系膜动脉)NO基础释放及激动剂刺激释放进一步减少，Ach刺激冠脉流量的增加和胸主动脉内膜NOS活性也进一步减少，血小板聚集程度及红细胞聚集指数显著上升，病理切片显示胸主动脉内皮细胞破坏明显，脑心肾组织内的血管进一步增厚甚至几乎阻塞，导致饲L-NNA的SHR缺血性及出血性脑卒中发生率显著高于对照SHR，脑体重比显著升高；心肌内出现明显的缺血梗塞疤痕灶，心体重比显著升高；肾小球明显萎缩、玻璃样变性，肾小管也变性甚至坏死，使肾硬化程度显著增加呈颗粒性固缩肾，肾体重比也显著减少。

Leaf blade reniform-cordate or cordate, usually shorter than wide; perianth yellow-white.

叶片肾形心形的或心形，通常短于宽；花被黄白色。 3 R 。 webbianum 须弥大黄

The labia have now been sutured together almost completely.The drains and the Foley catheter come out at the top.

此刻阴唇已经几乎完全的缝在一起了，排除多余淤血体液的管子和Foley导管从顶端冒出来。

To get the business done, I suggest we split the difference in price.

为了做成这笔生意，我建议我们在价格上大家各让一半。