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Background: The present study aimed to prove the progression of immunoglobulin A nephropathy (IgAN) patients with isolated hematuria based on repeat renal biopsy data for the first time.Methods: 29 IgAN patients with isolated hematuria who received repeat renal biopsies were analyzed retrospectively, while 29 non-isolated hematuria IgAN patients with similar age and background were randomly selected as the control group. Clinical parameters were collected at the time of biopsy. The treatment strategies (conservative treatment with RASS blocker or immunosuppressive treatment) were choosen according to the pathological results at the first renal biopsy. The activity and chronicity indexes of renal lesions were evaluated. Markers of cell inflammation and proliferation were tseted by immunochemistry. The ultrastructure of podocytes was observed by transmission electron microscopy (TEM). Podocyte and oxidative stress marker (NPHS2 and 4-HNE) were detected by immunofluorescence.Results: The IgAN patients with isolated hematuria had better clinical indicators than those with no-isolated hematuria, such as better renal function, higher albumin and lower uric acid. The interval between two biopsies in IgAN patients with isolated hematuria was 630 (interquartile range, 409.5–1,171) days. The hematuria of the patients decreased significantly from 30 (IQR, 4.00–35.00) RBC/ul in the first biopsy to 11 (IQR, 2.50–30.00) RBC/ul in the repeated biopsy (p < 0.05). The level of triglyceride decreased significantly (p < 0.05). The other clinical indicators were not statistically significant (p > 0.05). Deposits of IgA and C3 in the glomerulus were persistent. The activity index decreased, especially cellular crescent formation, while the chronicity index increased. The ultrastructure of podocytes was improved after treatment. The oxidative stress products of podocytes reduced after treatment.Conclusion: Although the clinical indicators of the IgAN patients with isolated hematuria were in the normal range, various acute and chronic pathological changes have occurred, and irreversible chronic changes have been progressing. Cell inflammation and proliferation persisted. Oxidative stress of podocytes was likely to be the therapeutic target. This study provided a strong basis for the progress of IgAN with isolated hematuria through pathological changes before and after treatment. This study will help clinicians recognize the harm of hematuria, change the traditional treatment concept, and help such patients get early treatment.

The autogenous healing potential of cement-based materials is affected by multiple factors, such as mix composition, crack width, pre-cracking age and external environmental conditions. In this study, the effects of curing conditions and supplementary cementitious materials (SCMs) on autogenous self-healing of early age cracks in cement mortar were investigated. Three curing conditions, i.e., standard curing, wet–dry cycles and incubated in water, and two SCMs, i.e., fly ash (FA) and blast furnace slag (BFS) with various contents (cement replacement ratio at 0%, 20%, and 40%) were examined. A single early age crack (pre-cracking age of 3 days) with a width of 200~300 μm was generated in cylindrical mortar specimens. Autogenous crack self-healing efficiency of mortar specimens was evaluated by performing a visual observation and a water permeability test. Moreover, microstructure analysis (XRD, SEM and TG/DTG) was utilized to characterize the healing products. The results indicated that the presence of water was essential for the autogenous self-healing of early age cracks in cement mortar. The efficiency of self-healing cracks was highest in specimens incubated in water. However, no significant self-healing occurred in specimens exposed to standard curing. For wet–dry cycles, a longer healing time was needed to obtain good self-healing compared to samples incubated in water. SCMs type and content significantly affected the autogenous self-healing ability of early age cracks. The self-healing efficiency of early age cracks decreased with increases in FA and BFS content. BFS mortars exhibited greater recovery in relation to water penetration resistance compared to the reference and FA mortars. Almost the same regain of water tightness and a lower crack-healing ratio after healing of 28 days in FA mortars were observed compared to the reference. The major healing product in the surface cracks of specimens with and without SCMs was micron-sized calcite crystals with a typical rhombohedral morphology.

Cracking seriously affects the functionality and durability of the concrete structure. Therefore, the development of robust self-healing concrete is important to extend the service life of the structure. In this study, artificial functional aggregates with fly ash, silica fume, metakaolin, limestone powder and sodium carbonate powder were designed and prepared by the powder granulation technology to promote the self-healing efficiency of concrete. Mortar specimens with artificial functional aggregates which partially replaced the sand were prepared to verify the feasibility of the approach. Crack self-healing efficiency was evaluated by visual observation and the water ingress test. In addition, healing products formed in the crack were analyzed with XRD, TG and SEM, respectively. Experimental results indicated that the artificial functional aggregates were well combined with the mortar matrix and could be intersected by cracking. The addition of artificial functional aggregates improved the self-healing capacity of mortar specimens. Mortar specimens with artificial functional aggregates exhibited higher closure ratio of surface crack and better regain of water tightness compared with the control specimens. The maximum crack width that can be healed was about 0.47 mm in the mortar specimen with artificial functional aggregates. Microstructure investigation showed that the major healing products in the crack mouth were calcite precipitations which firstly deposited on both walls of the crack and then gradually overlapped together to become denser and denser with the extension of healing time. More calcium carbonate precipitations were observed in internal crack of mortars with artificial functional aggregates compared to the control mortar due to the effective supply of carbonate ions from the artificial functional aggregates. Typical hydration product C-S-H gel was also detected by SEM observation in the internal crack wall.