The inauguration of Medicine Advances Yu, Xueqing
Medicine advances (Online),
March 2023, 2023-03-00, 2023-03-01, Letnik:
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Journal Article
Lithium-ion batteries (LIBs) have become one of the most prevalent techniques for feasible and fascinating energy storage devices used in portable electronics and electric vehicles; however, they ...still face a significant challenge due to the complicated electrode–electrolyte interface (EEI), which is closely related to the chemical/electrochemical instability of high-capacity high-voltage electrodes and electrolytes. In particular, the decomposition of an electrolyte on the electrode surface is unambiguously regarded as a crucial controlling factor for the obtainable capacity, rate capacity, and interfacial chemistries of batteries. Previously, significant efforts have been devoted toward modifying the EEI with remarkable progress. The incorporation of a small dose of foreign molecules, called film-forming additives, is regarded as one of the most economical and effective approaches to circumvent these predicaments. In this regard, this review provides an overview of various film-forming additives used for classified anodes and cathodes, aiming at emphasizing the state-of-the-art developments in the electrolyte research. Moreover, the authors intend to help the readers arouse new ideas and easily identify the additives suitable for their target materials, paving the way for greater progress in the lithium-ion battery community.
Summary Background The prevalence of chronic kidney disease is high in developing countries. However, no national survey of chronic kidney disease has been done incorporating both estimated ...glomerular filtration rate (eGFR) and albuminuria in a developing country with the economic diversity of China. We aimed to measure the prevalence of chronic kidney disease in China with such a survey. Methods We did a cross-sectional survey of a nationally representative sample of Chinese adults. Chronic kidney disease was defined as eGFR less than 60 mL/min per 1·73 m2 or the presence of albuminuria. Participants completed a lifestyle and medical history questionnaire and had their blood pressure measured, and blood and urine samples taken. Serum creatinine was measured and used to estimate glomerular filtration rate. Urinary albumin and creatinine were tested to assess albuminuria. The crude and adjusted prevalence of indicators of kidney damage were calculated and factors associated with the presence of chronic kidney disease analysed by logistic regression. Findings 50 550 people were invited to participate, of whom 47 204 agreed. The adjusted prevalence of eGFR less than 60 mL/min per 1·73 m2 was 1·7% (95% CI 1·5–1·9) and of albuminuria was 9·4% (8·9–10·0). The overall prevalence of chronic kidney disease was 10·8% (10·2–11·3); therefore the number of patients with chronic kidney disease in China is estimated to be about 119·5 million (112·9–125·0 million). In rural areas, economic development was independently associated with the presence of albuminuria. The prevalence of chronic kidney disease was high in north (16·9% 15·1–18·7) and southwest (18·3% 16·4–20·4) regions compared with other regions. Other factors independently associated with kidney damage were age, sex, hypertension, diabetes, history of cardiovascular disease, hyperuricaemia, area of residence, and economic status. Interpretation Chronic kidney disease has become an important public health problem in China. Special attention should be paid to residents in economically improving rural areas and specific geographical regions in China. Funding The Ministry of Science and Technology (China); the Science and Technology Commission of Shanghai; the National Natural Science Foundation of China; the Department of Health, Jiangsu Province; the Sichuan Science and Technology Department; the Ministry of Education (China); the International Society of Nephrology Research Committee; and the China Health and Medical Development Foundation.
This phase 3 multicenter, randomized, double-blind, placebo-controlled 2-year trial compared the efficacy and safety of intravenous belimumab with those of placebo, plus standard therapy, in patients ...with active lupus nephritis. More patients who received belimumab had a primary efficacy renal response than those who received placebo.
Due to limited medical and economic resources, particularly in the countryside and remote areas, the proportion of individuals with end-stage kidney disease who are treated with dialysis in China is ...only about 20%. For the rest, renal replacement therapy currently is not available. Peritoneal dialysis (PD) has been developed and used for more than 30 years in China to treat patients with end-stage kidney disease. Several national PD centers of first-rate scale and quality have sprung up, but the development of PD varies widely among geographic regions across China. The Chinese government has dedicated itself to continually increasing the coverage and level of medical service for patients with end-stage kidney disease. Under the guidance of the government and because of promotion by kidney care professionals, presently there are more than 40,000 prevalent PD patients in China, representing approximately 20% of the total dialysis population. Recently, a National Dialysis Unit Training Program for countywide hospitals has been initiated. Through the efforts of programs like this, we believe that awareness of PD and advances in the underlying technology will benefit more patients with end-stage kidney disease in China.
Although epithelial-mesenchymal transition (EMT) and the subsequent development of peritoneal fibrosis are key processes leading to the peritoneal failure related to peritoneal dialysis (PD), ...mechanisms underlying these processes remain largely unclear. In the present study, we found that miR-30a was significantly down-regulated in peritoneal tissues, with progressive fibrosis in patients with continuous ambulatory peritoneal dialysis and in a rat model of PD. In vitro , transforming growth factor (TGF)-β1–induced EMT, identified by de novo expression of α-smooth muscle actin and a loss of E-cadherin in both human and rat peritoneal mesothelial cells, was associated with down-regulation of miR-30a but up-regulation of Snai1, suggesting a close link between miR-30a and Snai1 in TGF-β1–induced peritoneal fibrosis. It was further demonstrated in vitro that miR-30a was able to bind the 3′ untranslated region of Snai1 and overexpression of miR-30a blocked TGF-β1–induced up-regulation of Snai1 and, therefore, inhibited EMT and collagen expression. To determine the functional role of miR-30a, we overexpressed miR-30a in the peritoneal tissue in a rat model of PD and found that overexpression of miR-30a blocked both Snai1 and EMT and inhibited peritoneal fibrosis, with improvement of peritoneal dysfunction. In conclusion, miR-30a negatively regulates Snai1-mediated EMT during peritoneal fibrosis in vitro and in vivo . Blockade of peritoneal fibrosis by overexpressing miR-30a in a rat model of PD reveals a therapeutic potential of miR-30a for peritoneal fibrosis associated with PD.
Peritoneal dialysis (PD)-associated peritonitis is a serious complication of PD and prevention and treatment of such is important in reducing patient morbidity and mortality. The ISPD 2022 updated ...recommendations have revised and clarified definitions for refractory peritonitis, relapsing peritonitis, peritonitis-associated catheter removal, PD-associated haemodialysis transfer, peritonitis-associated death and peritonitis-associated hospitalisation. New peritonitis categories and outcomes including pre-PD peritonitis, enteric peritonitis, catheter-related peritonitis and medical cure are defined. The new targets recommended for overall peritonitis rate should be no more than 0.40 episodes per year at risk and the percentage of patients free of peritonitis per unit time should be targeted at >80% per year. Revised recommendations regarding management of contamination of PD systems, antibiotic prophylaxis for invasive procedures and PD training and reassessment are included. New recommendations regarding management of modifiable peritonitis risk factors like domestic pets, hypokalaemia and histamine-2 receptor antagonists are highlighted. Updated recommendations regarding empirical antibiotic selection and dosage of antibiotics and also treatment of peritonitis due to specific microorganisms are made with new recommendation regarding adjunctive oral N-acetylcysteine therapy for mitigating aminoglycoside ototoxicity. Areas for future research in prevention and treatment of PD-related peritonitis are suggested.
Graphical Abstract
This is a visual representation of the abstract.
•Water ages, SGD, and associated nutrients on different scales of Xiangshan Bay were evaluated using radium-based model.•SGD fluxes in XSB Channel and three inner embayments are at least 1–2 orders ...of magnitude higher than river discharge.•SGD is primarily regulated and modulated by ocean dynamics and anthropogenic activities.•SGD rates and associated nutrient rates in the XSB were comparable to those in other global mariculture regions.
Submarine groundwater discharge (SGD) is a predominant component of chemical fluxes in the solute budgets in coastal ecosystems because of its large flux and the corresponding concentrated constituents. A quantitative study regarding the mass balance model of 226Ra and 228Ra was performed to assess SGD and associated nutrient inputs in Xiangshan Bay (XSB), a typical Chinese aquaculture bay. Based on these mass balance models, the SGD rates in the XSB Channel were 8.9–13.2 cm d−1. The SGD rates in the three corresponding embayments were 3.5–3.7 cm d−1 in Embayment I, 5.6–5.8 cm d−1 in Embayment II, and 4.5–5.8 cm d−1 in Embayment III. Significant spatial variabilities in SGD rates were observed in the different XSB districts, reflecting that ocean dynamics and anthropogenic activities play significant roles at different scales. SGD-derived nutrient fluxes in XSB were the dominant sources of nutrient loading, and their magnitudes were approximately 1–2 orders larger than those of riverine input. SGD rates in the XSB Channel were approximately three times higher than those in the three embayments, but the SGD-derived nutrient rates in the XSB Channel were comparable with those in the three embayments, even significantly lower than that for NO3-N in the inner regions of the embayment. These results imply that aquaculture activities and urbanization jointly influence SGD. When combined with the results of other studies, our observations demonstrate the significant comprehensive effects of multiple factors on SGD, a critical but overlooked nutrient source.
FG-4592 (roxadustat) is an oral hypoxia-inducible factor (HIF) prolyl hydroxylase inhibitor (HIF-PHI) promoting coordinated erythropoiesis through the transcription factor HIF. Two Phase 2 studies ...were conducted in China to explore the safety and efficacy of FG-4592 (USAN name: roxadustat, CDAN name: ), a HIF-PHI, in patients with anemia of chronic kidney disease (CKD), both patients who were dialysis-dependent (DD) and patients who were not dialysis-dependent (NDD).
In the NDD study, 91 participants were randomized to low (1.1-1.75 mg/kg) or high (1.50-2.25 mg/kg) FG-4592 starting doses or to placebo. In the DD study, 87 were enrolled to low (1.1-1.8 mg/kg), medium (1.5-2.3 mg/kg) and high (1.7-2.3 mg/kg) starting FG-4592 doses or to continuation of epoetin alfa. In both studies, only oral iron supplementation was allowed.
In the NDD study, hemoglobin (Hb) increase ≥1 g/dL from baseline was achieved in 80.0% of subjects in the low-dose cohort and 87.1% in the high-dose cohort, versus 23.3% in the placebo arm (P < 0.0001, both). In the DD study, 59.1%, 88.9% (P = 0.008) and 100% (P = 0.0003) of the low-, medium- and high-dose subjects maintained their Hb levels after 5- and 6-weeks versus 50% of the epoetin alfa-treated subjects. In both studies, significant reductions in cholesterol were noted in FG-4592-treated subjects, with stability or increases in serum iron, total iron-binding capacity (TIBC) and transferrin (without intravenous iron administration). In the NDD study, hepcidin levels were significantly reduced across all FG-4592-treated arms as compared with no change in the placebo arm. In the DD study, hepcidin levels were also reduced in a statistically significant dose-dependent manner in the highest dose group as compared with the epoetin alfa-treated group. Adverse events were similar for FG-4592-treated and control subjects.
FG-4592 may prove an effective alternative for managing anemia of CKD. It is currently being investigated in a pivotal global Phase 3 program.
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