Gender and socioeconomic disparities in global burden of chronic kidney disease due to glomerulonephritis: A global analysis.

AIM: To investigate the gender and socioeconomic disparities in the global burden of chronic kidney disease (CKD) due to glomerulonephritis from 1990 to 2019. METHODS: Data were extracted from the global burden of diseases (GBD) 2019 study, including incidence, prevalence and disability-adjusted life-years (DALYs). Estimated annual percentage changes (EAPCs) were calculated to quantify the temporal trends in age-standardized rate (ASR) of CKD due to glomerulonephritis. Paired t-test, paired Wilcoxon signed-rank test and Spearman correlation were performed to analyse the association and gender disparity in CKD due to glomerulonephritis. RESULTS: Globally, incident cases of CKD due to glomerulonephritis increased 81% from 9 557 397 in 1990 to 17 308 071 in 2019. The age-standardized incidence rate increased by 1.47 compared with 1990 and DALYs increased by 1.35 compared with 1990 (per 100 000). The number of patients with CKD due to glomerulonephritis in low-middle SDI (3829917) and middle SDI (6268817) regions accounts for more than 55% of the total cases. CKD due to glomerulonephritis caused a higher burden including the incidence rate (p < .0001) and DALY rate (p < .0001) in men compared to women. The age-standardized DALY rate was negatively correlated with SDI (ρ = -0.64, p < .001). In the analysis of risk factors for DALYs, male individuals had a larger burden of hypertension, high BMI and high sodium diet in the DALY rates than female subjects. CONCLUSION: The burden of CKD due to glomerulonephritis was more skewed towards developing and less developed economies and differed by gender, so certain nations should implement far more focused and targeted policies.

[Assessment of Serum IgG and Its Subclasses in Cystic Echinococcosis Patients and Its Application for Diagnosis].

OBJECTIVE: To assess the diagnostic performance of hydatid cyst fluid (HCF) in detecting the anti-HCF IgG and its subclasses IgG1, IgG2 and IgG4 in serum of cystic echinococcosis patients. METHODS: ELISA was used to measure IgG and its subclasses IgG1, IgG2, and IgG4 specific for Echinococcus granulosus HCF, in the sera of 37 cystic echinococcosis (CE) patients and 29 healthy subjects in Huan County, Gansu Province. The receiver operating characteristic (ROC) curves of the four antibodies were analyzed by MedCalc software, referenced with the gold-standard B ultrasonic imaging. The diagnostic performances between the four antibodies were compared using paired z statistics based on the areas under the curve (AUC), and the best diagnostic threshold was determined for each. The sensitivity and specificity for detecting the four types of antibodies were compared using Chi-square test. RESULTS: The AUCs for IgG and its subclasses IgG1, IgG2, and IgG4 were 0.722, 0.919, 0.712, and 0.835, respectively; the AUC of IgG1 was significantly higher than those of IgG (z = 3.629, P < 0.05) and IgG2 (z = 3.292, P<0.05). The sensitivity for detecting IgG, IgGl, IgG2, and IgG4 was 54.1%, 91.9%, 67.6%, and 75.7%, respectively; the sensitivity for IgGl was significantly higher than that for IgG (χ2 = 3.84, P < 0.05), IgG2 (χ2 = 6.80, P < 0.05), and IgG4 (χ2 = 10.16, P < 0.05). The specificity for the four antibodies was 89.7%, 82.8%, 72.4%, and 89.7%, respectively, and no significant difference was found between them. In addition, the sensitivity for detecting IgG4 antibody was significantly higher in CE I-III than in CE IV-V patients. CONCLUSION: The IgG1 antibody shows the highest detection sensitivity by HCF, thus having potential value in diagnosis of cystic echinococcosis.

Prefabrication of axial vascularized tissue engineering coral bone by an arteriovenous loop: a better model.

The most important problem for the survival of thick 3-dimensional tissues is the lack of vascularization in the context of bone tissue engineering. In this study, a modified arteriovenous loop (AVL) was developed to prefabricate an axial vascularized tissue engineering coral bone in rabbit, with comparison of the arteriovenous bundle (AVB) model. An arteriovenous fistula between rabbit femoral artery and vein was anastomosed to form an AVL. It was placed in a circular side groove of the coral block. The complex was wrapped with an expanded-polytetrafluoroethylene membrane and implanted beneath inguinal skin. After 2, 4, 6 and 8 weeks, the degree of vascularization was evaluated by India ink perfusion, histological examination, vascular casts, and scanning electron microscopy images of vascular endangium. Newly formed fibrous tissues and vasculature extended over the surfaces and invaded the interspaces of entire coral block. The new blood vessels robustly sprouted from the AVL. Those invaginated cavities in the vascular endangium from scanning electron microscopy indicated vessel's sprouted pores. Above indexes in AVL model are all superior to that in AVB model, indicating that the modified AVL model could more effectively develop vascularization in larger tissue engineering bone.

Enhanced treatment of articular cartilage defect of the knee by intra-articular injection of Bcl-xL-engineered mesenchymal stem cells in rabbit model.

Direct intra-articular injection of mesenchymal stem cells (MSCs) has been proposed as a potential cell therapy for cartilage defects. This cell therapy relies on the survival of the implanted MSCs. However, the arduous local environment may limit cell viability after implantation, which would restrict the cells' regenerative capacity. Thus, it is necessary to reinforce the implanted cells against the unfavourable microenvironment in order to improve the efficacy of cell therapy. We examined whether the transduction of an anti-apoptotic protein, Bcl-xL, into MSCs could prevent cell death and improve the implantation efficiency of MSCs in a rabbit model. Our current findings demonstrate that the group treated with Bcl-xL-engineered MSCs could improve cartilage healing both morphologically and histologically when compared with the controls. These results suggest that intra-articular injection of Bcl-xL-engineered MSCs is a potential non-invasive therapeutic method for effectively treating cartilage defects of the knee.

Modified approach to construct a vascularized coral bone in rabbit using an arteriovenous loop.

The most important factor for the survival of thick three-dimensional tissues is the degree of vascularization. In this study, a modified arteriovenous loop (AVL) model was developed to prefabricate an axial vascularized tissue-engineered coral bone. In group A (n = 28), an arteriovenous fistula between rabbit femoral artery and vein was anastomosed to form an AVL. The AVL was placed in a coral block (6 x 8 x 10 mm (3)) as a vascular carrier. The complex was wrapped with polytetrafluoroethylene membrane and implanted subcutaneously. In group B (n = 20), there was no vascular carrier, and the same dimensional coral was directly implanted beneath inguinal skin. After 2, 4, 6, and 8 weeks, the rabbits were perfused with heparinized saline (for scanning electron microscopy), India ink (for histological examination), and ethylene perchloride (for vascular casts) via the abdominal aorta. In group A, histology showed that newly formed vasculature extended over the surfaces and invaded the entire coral blocks. The vascular density was significantly superior to that in group B. Vascular casts showed that new blood vessels robustly sprouted from the AVL. Scanning electron microscopy demonstrated that there were minute sprouting cavities in the vascular endangium. In this model, an axial vascularized coral bone could be effectively constructed.

[Constructing tissue engineered trachea-like cartilage graft in vitro by using bone marrow stromal cells sheet and PLGA internal support: experimental study in bioreactor].

OBJECTIVE: To explore the feasibility of constructing tissue engineered trachea-like cartilage graft in vitro by using bone marrow stromal cells (BMSCs) sheet and PLGA internal support. METHODS: Rabbit BMSCs were expanded and induced by transforming growth factor-1 to improve chondrocyte phenotype of BMSCs. BMSCs sheets were obtained by continuous culture and wrapped the PGLA scaffold in the shape of cylinder. The constructs were incubated in spinner flask for 8 weeks and cartilage formation was investigated by gross inspection, histology, glycosaminoglycan and mechanical strength content. RESULTS: After in vitro culture, cartilage like tissue in cylindrical shape had been regenerated successfully. Stiff, shiny, pearly opalescence tissues were observed. Histological analysis showed engineered trachea cartilage consisted of evenly spaced lacunae embedded in matrix, cells stationed in the lacunae could be noticed clearly. Safranin-O staining on the sections showed homogenous and positive red staining, which demonstrated that the engineered tissue was rich in proteoglycans. CONCLUSIONS: Based on the cell sheet and internal support strategy, trachea-like cartilage in cylindrical shape could be successfully fabricated which provided a highly effective cartilage graft substitute and could be useful in many situations of trachea-cartilage loss encountered in clinical practice.

[Correction of progressive hemifacial atrophy using dermis-fat graft and Medpor implant shaped by reverse engineering technique].

OBJECTIVE: To evaluate the therapeutic effect of dermis-fat graft combined with Medpor implant shaped by reverse engineering technique in the correction of the progressive hemifacial atrophy. METHODS: A skull model was made by rapid prototyping and the bony deficiency model was acquired with reverse engineering technique. The Medpor implant was shaped precisely based on the deficiency model and implanted with dermis-fat graft at the same stage. RESULTS: 11 cases were treated successfully without infection, necrosis and rejection. The patients were followed up for six months to one year with satisfactory cosmetic improvement. The dermis-fat graft survived without obvious absorption. CONCLUSION: The technique can correct both the bony and soft tissue deficiency for progressive hemifacial atrophy. It is very practical and easily performed with reliant results and less morbidity.

Dental implants with the periodontium: a new approach for the restoration of missing teeth.

Tooth loss is a common occurrence in mankind and damages human health. Osseointegrated dental implants have been successfully used as a popular prosthetic restoration for the missing teeth for many years. However, osseointegration, representing a direct connection between the implant and bone tissue without the periodontium, causes some inevitable problems, such as masticatory force concentration and immobility of the dental implant. Thus, an ideal dental implant should have its own peri-implant periodontium, as do the natural teeth. A number of attempts have been made to reconstruct the periodontium around the implants. Unfortunately, it has been established that a predictable periodontal reconstruction, especially the acellular cementum reconstruction on the surface of the implant, is a very difficult task. In this paper, we propose the hypothesis that the cementum may be a special phenotype of the bone tissue, on the basis of its strong similarity in development, structure, and function. In a certain condition, the bone tissue may change to cementum for special functional needs. In accordance with this hypothesis, we consider a novel approach to reconstruct the peri-implant tissues. Unlike previous studies, this approach imitates the tooth re-plantation process. The key point is to convert the implant-surrounding bone tissues to cementum as a result of adaptive changes to the implant-support demands. This hypothesis, if proven to be valid, will not only represent a breakthrough in cementum research, but also will open a new door to the restoration of missing teeth.