Acute kidney injury (AKI), as a complex and severe kidney disease, has always been the hotspot of research. The epidemiological research of AKI in China has made significant progress, including initially reports on the domestic incidence of AKI, geographical distribution and risk factors; however, accompanying challenges like AKI prevention and treatment emerge. For improvement of the diagnosis and treatment of the AKI, this article summarizes and analyses the two challenges: early warning biomarkers and AKI treatment strategies, based on new ideas and research progress. The aim is to make Chinese nephrology scholars and specialists realize the focus of AKI prevention and protection of renal function, to standardize the treatment strategy of AKI, and to put forward the direction of future research.
Objective To obtain highly purified and large amount of Schwann cells (SCs) by improved primary culture method, to investigate the biocompatibility of small intestinal submucosa (SIS) and SCs, and to make SIS load nerve growth factor (NGF) through co-culture with SCs. Methods Sciatic nerves were isolated from 2-3 days old Sprague Dawley rats and digested with collagenase II and trypsin. SCs were purified by differential adhesion method for 20 minutes and treated with G418 for 48 hours. Then the fibroblasts were further removed by reducing fetal bovine serum to 2.5% in H-DMEM. MTT assay was used to test the proliferation of SCs and the growth curve of SCs was drawn. The purity of SCs was calculated by immunofluorescence staining for S-100. SIS and SCs at passage 3 were co-cultured in vitro. And then the adhesion, proliferation, and differentiation of SCs were investigated by optical microscope and scanning electron microscope (SEM). The NGF content by SCs was also evaluated at 1, 2, 3, 4, 5, and 7 days by ELISA. SCs were removed from SIS by repeated freeze thawing after 3, 5, 7, 10, 13, and 15 days of co-culture. The NGF content in modified SIS was tested by ELISA. Results The purity of SCs was more than 98%. MTT assay showed that the SCs entered the logarithmic growth phase on the 3rd day, and reached the plateau phase on the 7th day. SCs well adhered to the surface of SIS by HE staining and SEM; SCs were fusiform in shape with obvious prominence and the protein granules secreted on cellular surface were also observed. Furthermore, ELISA measurement revealed that, co-culture with SIS, SCs secreted NGF prosperously without significant difference when compared with the control group (P gt; 0.05). The NGF content increased with increasing time. The concentration of NGF released from SIS which were cultured with SCs for 10 days was (414.29 ± 20.87) pg/cm2, while in simple SIS was (4.92 ± 2.06) pg/cm2, showing significant difference (P lt; 0.05). Conclusion A large number of highly purified SCs can be obtained by digestion with collagenase II and trypsin in combination with 20-minute differential adhesion and selection by G418. SIS possesses good biocompatibility with SCs, providing the basis for further study in vivo to fabricate the artificial nerve conduit.
Objective To discuss the relationship between recovery of anatomical integrity and functional outcome in elderly patients with distal radius fractures by comparing the effects of open reduction and closed reduction. Methods The cl inical data were retrospectively analyzed from 78 elderly patients with distal radius fractures treating with nonoperation andoperation from February 2005 to March 2009. Thirty-seven patients underwent closed reduction and spl intlet fixation or cast appl ication (non-operation group), and forty-one patients underwent open reduction and internal fixation (operation group). In non-operation group, there were 15 males and 22 females with an average age of 73 years (60-83 years). According to the AO classification system for fracture, there were 8 cases of type A2, 7 cases of type A3, 7 cases of type B1, 4 cases of type B2, 2 cases of type B3, 4 cases of type C1, 2 cases of type C2, and 3 cases of type C3. The time from injury to admission was between 30 minutes and 3 days with a mean time of 1 day. In operation group, there were 18 males and 23 females with an average age of 71 years (62-80 years). According to the AO classification system for fracture, there were 5 cases of type A2, 7 cases of type A3, 7 cases of type B1, 6 cases of type B2, 3 cases of type B3, 4 cases of type C1, 5 cases of type C2, and 4 cases of type C3. The time from injury to admission was between 30 minutes and 7 days with a mean time of 1 day. There were no significant differences (P gt; 0.05) in sex, age, disease course and fracture classification between two groups. Results All incisions obtained heal ing by first intention after operation in operation group. All patients were followed up for 9-36 months (20 months on average). Fracture heal ing was achieved within 8 to 15 weeks, with an average of 11 weeks. There were no significant differences (P gt; 0.05) in fracture heal ing time between non-operation group [(10.8 ± 2.0) weeks] and operation group [(11.7 ± 2.5) weeks]. At last follow-up, thepalmar tilt angle was (5.6 ± 2.0)° and (8.6 ± 3.0)°, the radial incl ination angle was (19.1 ± 4.9)° and (21.8 ± 2.0)°, and the radial length was (8.3 ± 1.3) mm and (10.4 ± 1.4) mm in non-operation group and operation group, respectively; showing significant differences (P lt; 0.05) between two groups. According to the Gartland-Werley score, the results were excellent in 9 cases, good in 21 cases, fair in 5 cases, and poor in 2 cases in non-operation group, the excellent and good rate was 81.1%; in operation group, the results were excellent in 13 cases, good in 25 cases, fair in 2 cases, and poor in 1 case, the excellent and good rate was 92.7%, showing no significant difference (P gt; 0.05) between two groups. There were no significant differences (P gt; 0.05) in flexion and extension activity of wrist, radioulnar partial activity, pronation-supination activity, grip and pinch strength between two groups. Conclusion Open reduction and closed reduction can achieve satisfactory functional outcomes, but closed reduction was inferior to open reduction in anatomic reduction for treating distal radius fractures in elderly patients.
Objective To evaluate the effect of copper-ion on the prol iferation and differentiation of human umbil ical vein endothel ial cell (HUVEC). Methods HUVEC were cultured and passaged in vitro. HUVEC were inoculated into 96-well plate with density of 5 × 103/well. All the cells were divided into 3 groups randomly according to different culture mediums: group A (5 μmol/L CuSO4), group B (25 μmol/L CuSO4), group C (control group). Every group had 4 wells, and the basic culture medium was MCDB131. The cell growth curves of 3 groups were drawn by using MTT. HUVEC were inoculated into 6-well plate with density of 2 × 105/well. Grouping of the cells was the same as the above. The gene expressions of endothel ial nitric oxide synthase (eNOS) and tyrosine kinase with immunoglobul in-l ike and EGF-l ike domain 1 (Tie-1) were detected by real-time RT-PCR. Results The growth curves revealed that the exponential growth time was the first 3 days, plateau growth time begun on the 4th day. The prol iferation of group A was ber than that of groups B and C from the 3rd day, within 2 days, the prol iferation of group B was ber than that of group C; however, it decreased and was weaker than group C from the 4th day, all showing statistically significant difference (P lt; 0.05). The results of real-time RT-PCR revealed that the expressions of eNOS in groups A, B and C were 7.294 ± 1.488, 0.149 ± 0.044 and 1.000 ± 0.253; and the expressions of Tie-1 in groups A, B and C were 1.481 ± 0.137, 1.131 ± 0.191 and 1.000 ± 0.177. Group A compared with groups B and C, both of 2 genes were up-regulated (P lt; 0.05). Group B compared with group C, eNOS was down-regulated (P lt; 0.05) and the difference of Tie-1 expression was not statistically significant (P gt; 0.05). Conclusion 5 μmol/L copper-ion can promote the prol iferation and differentiation of HUVEC effectively.