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The prevalence of chronic kidney disease (CKD) varies by race because of genetic and environmental factors. The Glu504Lys polymorphism in aldehyde dehydrogenase 2 (ALDH2), commonly observed among East Asian people, alters the enzyme's function in detoxifying alcohol-derived aldehydes, affecting kidney function. This study investigated the association between variations in ALDH2 levels within the kidney and the progression of kidney fibrosis. Our clinical data indicate that diminished ALDH2 levels are linked to worse CKD outcomes, with correlations between ALDH2 expression, estimated glomerular filtration rate, urinary levels of acrolein - an aldehyde metabolized by ALDH2 - and fibrosis severity. In mouse models of unilateral ureteral obstruction and folic acid nephropathy, reduced ALDH2 levels and elevated acrolein were observed in kidneys, especially in ALDH2 Glu504Lys-knockin mice. Mechanistically, acrolein modifies pyruvate kinase M2, leading to its nuclear translocation and coactivation of HIF-1α, shifting cellular metabolism to glycolysis, disrupting mitochondrial function, and contributing to tubular damage and the progression of kidney fibrosis. Enhancing ALDH2 expression through adeno-associated virus vectors reduced acrolein and mitigated fibrosis in both WT and Glu504Lys-knockin mice. These findings underscore the potential therapeutic significance of targeting the dynamic interaction between ALDH2 and acrolein in CKD.

Many different patient-centered care models have been promoted around the world in recent years. The goal of current nursing innovation includes simplifying nursing workflows, constructing creative care methods, developing innovative assistive devices, activating the workplace, and improving care quality. In addition to enhancing the ability of nurses to care for the sick, employ critical thinking, improve their information literacy, and deepen their research knowledge, innovative attitudes and R&D momentum represent new trends in nursing education and talent cultivation. In nursing education worldwide, including both in-school education and clinical in-service training, innovative courses, projects, and competitions as well as corresponding academic seminars have been launched with the intention to promote practical creativity and innovative solutions. The definition of design thinking is first introduced and the Stanford University`s design thinking model is next explained. The five stages of the design thinking model - empathize, define, ideate, prototype, and test - are then introduced. Finally, using the innovative nursing product as an example, the teacher-student team is proposed as the design thinking mentorship model. The authors hope that this article serves as a reference for novice educators, developers, and researchers in the field of nursing innovation.