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Objective: The aim of the present study was to investigate the specific mechanism by which MSCs protect against SA-AKI.Methods: Male C57BL/6 mice underwent cecal ligation and puncture operation to induce sepsis and then received either normal IgG or MSCs (1* 106 cells intravenously) plus Gal-9 or soluble-Tim-3 3h after surgery. Results: After cecal ligation and puncture operation, injection with Gal-9 or MSCs plus Gal-9 had a higher survival rate than the IgG treatment group. Treatment with MSCs plus Gal-9 decreased serum creatinine and blood urea nitrogen levels and improved recovery of tubular function. Reduce the levels of IL-17, RORγt and induce the expression of IL-10 and FOXP3. Additionly, remodel the balance of TH17/Treg. However, when used soluble Tim-3 to block the Gal-9/Tim-3 pathway, the septic mice developed badly kidney injury and exhibited a higher mortality. Treatment with MSCs plus soluble Tim-3 blunted the therapeutic effect of MSCs, and inhibited the induction of Tregs and suppressed the inhibition of the differentiation to Th17 cells.Conclusion: Treatment with MSCs significantly reversed the TH1/TH2 balance. And the important mechanism for MSCs protection against SA-AKI maybe through the Gal-9/Tim-3 pathway.

Background: For patients without arteriovenous fistula and with dysfunctional central veins caused by long indwelling tunnel-cuffed catheter (TCC), no consensus on how to achieve functional hemodialysis access has been reached. This study investigated the value of percutaneous transluminal angioplasty (PTA) of a dysfunctional central vein caused by a TCC under digital subtraction angiography (DSA) guidance. Methods: In total, thirteen patients with indwellingTCC-related complications were admitted to our institution. The TCC indwelling duration was 35.2 months (range, 6 to 70 months). The failed TCCs were removed under the support of a stiff guide wire,and an angiogram showed central vein stenosis (CVS) or occlusion. PTA was performed to recanalize the central vein, and new TCCs were placed in situ or in another central vein under DSA guidance. Results: TCCs were successfully removed in twelve patients. TCC removal failed in one patient due to severe adhesion of the TCC and the left innominate vein 4 years after implantation. PTA of central veins, including the right internal jugular vein, innominate vein, superior vena cava, and right iliac vein, was performed, and new TCCs were successfully placed in all patients. No stents were implanted in any patients. The mean follow-up was 12.9 months (range, 3 to 36 months). The new TCCs functioned well in all patients. Conclusions: Under DSA guidance, recanalization of TCC-related CVS or occlusion by PTA and implantation of anew TCC catheter in situor another central vein can establish dialysis access for patients with poorly functioning TCCs successfully.

Objective Studies have shown that serum response factor (SRF) is increased in chronic kidney injury, such as diabetic nephropathy, hyperuricemic nephropathy and renal cell carcinoma. The objective is to explore the early diagnostic value of SRF in acute kidney injury (AKI). Methods AKI-related microarray data were analyzed, and the expression and location of SRF were investigated in the early phase of AKI. Results Bioinformatics results demonstrated that SRF was dramatically elevated 2-4 h after ischemia/reperfusion (I/R) in mouse renal tissue. In I/R rats, SRF was mostly expressed and located in renal tubular epithelial cells (TECs). SRF started to increase at 1 h, peaked at 3-9 h and started to decrease at 12 h after I/R. The areas under the ROC curve of renal SRF mRNA, renal SRF protein, urinary SRF, serum SRF and serum creatinine (Scr) were 87.9%, 83.0%, 81.3%, 78.8%, 68.8%, respectively. Conclusion SRF is remarkably upregulated in early (before 24 h) AKI and can replace Scr as a potential new early diagnostic biomarker of AKI.

Objective: The aim of the present study was to investigate the specific mechanism by which MSCs protect against SA-AKI. Methods: Male C57BL/6 mice underwent cecal ligation and puncture operation to induce sepsis and then received either normal IgG or MSCs (1* 10 6 cells intravenously) plus Gal-9 or soluble-Tim-3 3h after surgery. Results: After cecal ligation and puncture operation, injection with Gal-9 or MSCs plus Gal-9 had a higher survival rate than the IgG treatment group. Treatment with MSCs plus Gal-9 decreased serum creatinine and blood urea nitrogen levels and improved recovery of tubular function. Reduce the levels of IL-17, RORγt and induce the expression of IL-10 and FOXP3. Additionly, remodel the balance of TH17/Treg. However, when used soluble Tim-3 to block the Gal-9/Tim-3 pathway, the septic mice developed badly kidney injury and exhibited a higher mortality. Treatment with MSCs plus soluble Tim-3 blunted the therapeutic effect of MSCs, and inhibited the induction of Tregs and suppressed the inhibition of the differentiation to Th17 cells. Conclusion: Treatment with MSCs significantly reversed the TH1/TH2 balance. And the important mechanism for MSCs protection against SA-AKI maybe through the Gal-9/Tim-3 pathway.

Runze Li,1,2,* Chuanxiao Wang,3,* Quandong Bu,4 Wenshen Pu,5 Bin Zhou,4 Lin Che,4 Hui Zhang,4 Yan Xu,4 Hong Luan4 1Department of Medicine, Qingdao University, Qingdao, People’s Republic of China; 2Department of Endocrine, Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China; 3Department of Thoracic Surgery, Qingdao Municipal Hospital, Qingdao, People’s Republic of China; 4Department of Nephrology, Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China; 5Department of Nephrology, Baoshan People’s Hospital, Baoshan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hong Luan, Department of Nephrology, Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, People’s Republic of China, Tel +86 18661803208, Fax +86 532-82911601, Email luanhong985@qdu.edu.cnPurpose: Madelung’s disease (MD) is a rare disease characterized by the deposition of unencapsulated fat masses on the face, neck, chest, back and other areas of patients. The aim of the study was to analyze the clinical characteristics, comorbidities and treatment of MD in Chinese populations.Patients and Methods: We retrospectively reviewed the medical records of 54 patients who were diagnosed with MD at the Affiliated Hospital of Qingdao University and Qingdao Municipal Hospital from January 2005 to February 2021 and collected the subjects’ demographic information, clinical indicators, location of fat deposits, treatment, complications and prognostic data.Results: Among 54 MD patients in the study, only 1 (1.85%) was female, and the subjects had an average age of 56.65 ± 7.93 years. More than 70% of patients had a history of long-term smoking or/and alcohol abuse. In our study, type I accounted for approximately 61.11% of cases according to Donhauser’s classification, and almost all patients had neck fat deposition. MD patients often have multiple comorbidities across several systems, such as the endocrine, digestive, circulatory, urinary, and neurological systems. Among these, endocrine system diseases were the most common comorbidities in our study, accounting for 81.48%. Notably, up to 20.37% of cases were complicated with cancer, especially digestive system tumors. More than 70% of the patients received surgical treatment, and nearly 40% experienced postoperative recurrence.Conclusion: Considering that MD patients often have comorbidities of multiple systems and that a small number of cases are even complicated by cancer, we recommend that clinicians comprehensively assess a patient’s condition and complications, advocate that patients quit consuming alcohol and smoking as soon as possible, establish healthy dietary and living habits, and formulate individualized and comprehensive diagnosis and treatment plans.Keywords: Madelung’s disease, multiple symmetric lipomatosis, Launois-Bensaude syndrome, benign symmetric lipomatosis, alcohol abuse

The effects of early thiamine use on clinical outcomes in critically ill patients with acute kidney injury (AKI) are unclear. The purpose of this study was to investigate the associations between early thiamine administration and clinical outcomes in critically ill patients with AKI. The data of critically ill patients with AKI within 48 h after ICU admission were extracted from the Medical Information Mart for Intensive Care III (MIMIC III) database. PSM was used to match patients early receiving thiamine treatment to those not early receiving thiamine treatment. The association between early thiamine use and in-hospital mortality due to AKI was determined using a logistic regression model. A total of 15 066 AKI patients were eligible for study inclusion. After propensity score matching (PSM), 734 pairs of patients who did and did not receive thiamine treatment in the early stage were established. Early thiamine use was associated with lower in-hospital mortality (OR 0·65; 95 % CI 0·49, 0·87; P < 0·001) and 90-d mortality (OR 0·58; 95 % CI 0·45, 0·74; P < 0·001), and it was also associated with the recovery of renal function (OR 1·26; 95 % CI 1·17, 1·36; P < 0·001). In the subgroup analysis, early thiamine administration was associated with lower in-hospital mortality in patients with stages 1 to 2 AKI. Early thiamine use was associated with improved short-term survival in critically ill patients with AKI. It was possible beneficial role in patients with stages 1 to 2 AKI according to the Kidney Disease: Improving Global Outcomes criteria.

Background HBV-GN is one of the most common secondary kidney diseases in China. Entecavir is one of the first-line antiviral nucleoside drugs at present, which can also effectively apply to antiviral therapy for HBV-GN.Objective The retrospective study to explore whether the entecavir is efficacy and safety for the treatment of Hepatitis B virus-associated glomerulonephritis(HBV-GN) with renal function insufficient.Methods We screened patients diagnosed with HBV-GN in The Affiliated Hospital of Qingdao University, elevated serum creatinine at 130umol/l ~ 250umol/l. Group 1 (30 patients) was given entecavir as antiviral treatment. Group 2 (28 patients) was treated with angiotensin II receptor blocker (ARB). The changes of renal function and the possible influencing factors were observed, with a mean follow-up time of 36 months.Results Baseline demographic and clinical parameters were not different between the 2 groups. For both cohorts, serum creatinine levels were increased gradually and the levels of eGFR declined progressively during the follow-up. At the end of the follow-up, serum creatinine levels in group 1 (t = 1.64, P = 0.1) and in group 2 ( t = 4.35, P = 0.001) were considered statistically significant compared to baseline creatinine. The levels of eGFR in group 1 (t = 2.37, P = 0.0018) and in group 2 ( t = 4.35, P = 0.001) were considered statistically significant compared to baseline eGFR. Comparison between the two groups showed that the elevated serum creatinine level and reduction in the level of eGFR were significantly lower in group 1 (t = 2.67, P = 0.008) than in group 2 (t = 2.76, P = 0.006), which were considered statistically significant. At the same time, cumulative renal survival, using end-stage renal disease (ESRD, eGFR P = 0.005). Meanwhile, urine protein excretion was significantly decreased in both groups compared with baseline values, group 1 (t = 5.74, P = 0.001) and group 2 (t = 4.27, P = 0.001), while no significant difference was found(P = 0.370)in both groups. We performed a multivariate Cox regression analysis required eGFR Conclusion Entecavir treatment slows the progression of renal function impairment in HBV-GN, meanwhile, entecavir shows a significantly renal protective effect.

Background: Clinically, IgA nephropathy has a variety of symptoms including paroxysmal gross hematuria, nephritic and nephrotic syndrome. This study aimed at investigating hub geneand genes modular related to IgA nephropathy clinical characteristics by using weighted gene co-expression network analysis combining clinical, microarray and network database parameters. Methods: We collected 32 human samples from the European Renal cDNA Bank and used RMA method to preprocess the data and utilize the limma package to obtain differentially expressed gene in renal interstitium and glomeruli. We used the WGCNA package to construct the gene co-expression of differential expression genes and identify hub genes associated with clinical characteristics in renal interstitium and glomeruli, respectively. Gene ontology enrichment analysis and KEGG analysis for hub genes which associated with clinical characteristics were performed by DAVID. PPI information was acquired from STRING. Results: For glomeruli, 1470 genes differentially expressed between IgA nephropathy patients and healthy control, containing 10 hub genes associated with age, 8 hub genes associated with sex, 48 hub genes associated with Bp enrichd in ERK1 and ERK2 cascade and Rap1 signaling pathway, 223 hub genes associated with BMI enrich in organic acid catabolic process and fatty acid degradation pathway, 136 hub genes associated GFR enriched in immune response and PI3K-Akt signaling pathway, 82 hub genes associated with proteinuria enriched in extracellular matrix organization and PI3K-Akt signaling pathway. In tubulointerstitium, there were 480 genes differentially expressed between IgA nephropathy patients and healthy control. Among 480 DEGs, 6 hub genes associated with age, 15 hub genes associated with sex, 35 hub genes associated with Bp enrichd in positive regulation of apoptotic process, 87 hub genes associated with GFR enriched in negative regulation of macromolecule metabolic process and RNA transport, 33 hub genes associated with proteinuria enriched in regulation of apoptotic process and FoxO signaling pathway. PPI enrichment analysis shown that all hub genes sets are biologically connected cluster. Conclusions: We made a preliminary investigation on molecular mechanisms of relationship between IgA nephropathy and clinical characteristics and identified hub genes and pathways closely related with BMI, GFR and Proteinuria in IgA nephropathy by a series of bioinformatics analysis.

Aim: To evaluate the protective effects of resveratrol on acute kidney injury (AKI) in septic rats. Methods: A septic rat model was established by cecal ligation and puncture (CLP). A total of 108 male Sprague Dawley rats were randomly divided into an observation group, a 6 h resveratrol intervention group and a 12 h resveratrol intervention group. Then each group was subdivided into Sham, Sham + Res, CLP and CLP + Res groups. After surgery, the survival and morphological changes in kidney tissues were observed. Serum creatinine and urea nitrogen levels, expression of GRP78, BiP, IRE1 and p65 in kidney tissues, and serum levels of TNF-α, IL-1β, IL-6 and IL-10 were investigated. Results: The survival rate of CLP + Res group (75.00%) significantly exceeded that of the CLP group (41.67%) (P