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Background: To investigate the clinical features, kidney pathology, treatment regimens, and clinical outcomes of IgA vasculitis nephritis (IgAVN) with nephrotic-range proteinuria in children. Methods: A retrospective review of children diagnosed with IgAVN between January 2019 and December 2022 was conducted. Participants were divided into two groups based on their urine protein/creatinine (UPCR) levels. Biodata, clinical characteristics, laboratory findings, pathologic features, treatment regimens, and outcomes were abstracted from case records and analyzed. Results: A total of 255 children were identified, 94 with nephrotic-range proteinuria (UPCR ≥ 200 mg/mmol) and 161 with non-nephrotic proteinuria (UPCR < 200 mg/mmol). Patients in the nephrotic-range proteinuria group were significantly younger and had worse grades of glomerular and acute tubulointerstitial injury compared to those in the non-nephrotic proteinuria group. Higher levels of blood urea nitrogen (BUN), D-dimer (DD), and fibrin degradation products (FDP), and lower levels of total protein (TP), albumin (ALB), urine creatinine (Cr), prothrombin time (PT), activated partial thromboplastin time (APTT), IgG, CD3 + cells, and CD4 + cells were found in patients in the nephrotic-range proteinuria group. Clinical outcome of patients with nephrotic-range proteinuria was significantly associated with ISKDC grading, proportion of glomerular crescents and severity of acute tubulointerstitial injury. Conclusions: Children with nephrotic-range proteinuria exhibit more severe disordered immunologic function, hypercoagulability, glomerular and tubulointerstitial pathological damage, and have worse outcomes than those with lower proteinuria levels. Clinicians should pay great attention to the kidney injury and more extensive studies are required to identify optimal treatment regimens to improve outcomes in patients. [ABSTRACT FROM AUTHOR]

Aim: Spontaneous abortion (SA) is a multiple‐original syndrome with immune imbalance as one of its major risk factors. As Wharton's jelly‐mesenchymal stem cells (WJ‐MSCs) are considered to be able to prevent abortion, this study aims to explore the currently poorly understood underlining molecular signaling pathways and regulatory mechanisms of WJ‐MSCs in pregnancy maintenance. Methods: Abortion mode is established by subcutaneous injection of bromocriptine in rat on day 9 and abortion prevention is achieved by WJ‐MSCs injection via tail vein. WJ‐MSCs were cultured with/without the inhibitors of JAK/STAT or NF‐κB. The uterus was collected on the 14th day of gestation and the rate of embryo absorption was calculated. The expression of Th1/Th2/Th3 cytokines in decidual, placental tissue, and peripheral blood was analyzed. Results: WJ‐MSCs treatment significantly reduced the abortion rate in bromocriptine‐treated pregnancy such that it was not significantly different from a normal pregnancy. JAK/STAT inhibition abolished pregnancy preserving effects of WJ‐MSCs but NF‐κB inhibition did not. The levels of Th1‐related cytokines and mRNA levels in the bromocriptine abortion model were significantly higher than the normal pregnancy group and ethanol control group, while levels of the Th2‐related cytokines and mRNA levels significantly decreased. WJ‐MSCs transfusion into the abortion model restored cytokine profiles such that they were not significantly different from the normal pregnancy group and ethanol control group. JAK/STAT inhibition of WJ‐MSCs prevented their effect on cytokine and mRNA levels, but NF‐κB inhibition did not. Conclusions: WJ‐MSCs significantly lower the rate of embryo resorption of spontaneous abortion by reducing Th1‐related cytokines while increasing Th2 and Th3‐related cytokines in JAK/STAT‐dependent manner. [ABSTRACT FROM AUTHOR]

Background: Portal vein thrombosis is a common complication of liver cirrhosis and hepatocellular carcinoma; however, few studies have reported its long-term clinical prognosis. This study aimed to establish and validate easy-to-use nomograms for predicting gastrointestinal bleeding, portal vein thrombosis resolution, and mortality of patients with portal vein thrombosis. Methods: This multicenter retrospective cohort study included 425 patients with portal vein thrombosis who were divided into training (n = 334) and validation (n = 91) sets. Prediction models were developed using multivariate Cox regression analysis and evaluated using the consistency index and calibration plots. Results: Predictors of gastrointestinal bleeding included a history of gastrointestinal bleeding, superior mesenteric vein thrombosis, red color sign observed during endoscopy, and hepatic encephalopathy. Meanwhile, predictors of resolution of portal vein thrombosis included a history of abdominal infection, C-reactive protein and hemoglobin levels, and intake of thrombolytics. Predictors of death included abdominal infection, abdominal surgery, aspartate aminotransferase level, hepatic encephalopathy, and ascites. All models had good discriminatory power and consistency. Anticoagulation therapy significantly increased the probability of thrombotic resolution without increasing the risk of bleeding or death. Conclusions: We successfully developed and validated three prediction models that can aid in the early evaluation and treatment of portal vein thrombosis. [ABSTRACT FROM AUTHOR]

Aim: Maternal complications caused by the cesarean delivery inhibit the capability of preserving the uterus and subsequent fertility. However, successful restoration of the incisional scar continuously still remains a challenge. This work was to evaluate the repairing effect of Human Wharton's Jelly Mesenchymal Stem Cells (hWJ‐MSC) on incisional scar of the uterine. Methods: Eighteen rats were randomly assigned into two groups and nine for each: one group injected with hWJ‐MSC in phosphate buffer saline (PBS) and the other injected with PBS for comparison. Results: With hWJ‐MSC in PBS injected, the uterine endometrium and myometrium with full‐thickness injury were restored and the functionality was greatly improved in comparison with the group only with PBS injected. Conclusion: The hWJ‐MSC can repair the injured uterine effectively by promoting the uterine endometrium and myometrium cells proliferation and according to the chi‐square analysis the pregnancy is improved. [ABSTRACT FROM AUTHOR]

Stroke is one of the most common diseases that caused high mortality and has become burden to the health care systems. Stem cell transplantation has shown therapeutic effect in ameliorating ischemic damage after cerebral artery occlusion mainly due to their neurogenesis, immune regulation, or effects on the plasticity, proliferation, and survival of host cells. Recent studies demonstrated that skin-derived precursor cells (SKPs) could promote central nervous system regeneration in spinal cord injury model or the neonatal peripheral neuron. Here, we investigated the therapeutic potential of SKPs in a rat model of cerebral ischemia. SKPs were isolated, expanded, and transplanted into rat cortex and striatum after transient middle cerebral artery occlusion. Our results revealed that SKPs transplantation could improve the behavioral measures of neurological deficit. Moreover, immunohistology confirmed that SKPs could secrete basic FGF and VEGF in the ischemic region and further markedly increase the proliferation of endogenous nestin+ and βIII-tubulin+ neural stem cells. Furthermore, increased angiogenesis induced by SKPs was observed by vWF and α-SMA staining. These data suggest that SKPs induced endogenous neurogenesis and angiogenesis and protected neuron from hypoxic-ischemic environment. In conclusion, SKPs transplantation may be a promising approach in treatment of stroke. [ABSTRACT FROM AUTHOR]

Purpose To describe the health care utilization of injured workers who made a workers' compensation claim for neck pain. Methods. We conducted a cohort study of injured workers who made an incident claim involving neck pain to the Ontario Workplace Safety and Insurance Board between 1997 and 1998. We linked their workers' compensation and Ontario Health Insurance Plan files to collect all health care services accrued during the year prior to and 2 years after the claim was initiated. We report the 7 day simple moving average of health care services per 1,000 claimants per day. We stratified our analysis by age, sex, the pre-claim level of health care utilization, diagnostic category and health care specialty. Results 58.1 % of claimants were males and 35.1 % were between the ages of 35 and 44 years. The cumulative rate of health care utilization was stable (mean = 60.80 services/1,000 claimants/day; 95 % CI: 59.7-62.0) throughout the year prior to the claim. However, it peaked during the first 4 days following the onset of the claim (mean = 473.3 services/1,000 claimants/day) and remained on average 311 % higher than baseline during the first month post-claim. On average in our sample, the health care utilization remained 11 % higher in the second year after the claim compared to the pre-claim level. This sustained increase was attributable to 6 % of claimants. Conclusions We report a long-term increase in the average number of health care services utilized by injured workers who make a workers' compensation claim involving neck pain. This increase was attributable to a minority of claimants. The health reasons for this increase deserve further investigation. [ABSTRACT FROM AUTHOR]