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Background Minimal change disease (MCD) is not a simple immune disease, and its pathogenesis has not been elucidated because of its complexity in terms of the glomerular microenvironment and genetic susceptibility. Hence the therapeutic approach is equally imprecise. Methods We downloaded GSE108109 from the Gene Expression Omnibus (GEO) database for bioinformatic analyses. Genome-wide expression analysis (GSEA) and functional enrichment analysis of differentially expressed genes (DEGs) were performed. Single sample gene set enrichment analysis (ssGSEA) was applied to assess the level of immune infiltration patterns of diseases. Protein-Protein Interaction (PPI) network was constructed to identify hub genes. Hub genes were intersected with immune-related genes downloaded from the Immunology Database and Analysis Portal (ImmPort) to obtain key genes. In addition, the expression levels of key genes were validated in the Kidney Interactive Transcriptomics webpage and Nephroseq database. Receiver operating characteristic (ROC) analysis and principal component analysis (PCA) was performed to explore the value of key genes for MCD diagnosis. Results 1029 DEGs were screened, of which 493 were up-regulated, and 536 were down-regulated. GSEA analysis revealed that DEGs were significantly enriched in three pathways, including T-cell receptor signaling pathway, natural killer cell-mediated cytotoxicity, and B-cell receptor signaling pathway. In addition, 17 of the 21 immune cell types were significantly different in MCD compared to the normal group. A total of five key genes (ISG15, IRF1, OAS1, RSAD2, BST2) were shown to play essential roles in the immune response. Among them, IRF1, OAS1, RSAD2, and BST2 were highly expressed in podocytes. Conclusions In this study, bioinformatics analysis revealed new insights into MCD: (1) Immune cell infiltration analysis provided new evidence and clues to the molecular mechanisms of MCD. (2) Key genes such as ISG15, IRF1, OAS1, RSAD2 and BST2 may contribute to the immunopathological process of MCD development.

Background Madelung's disease (MD) is a rare disorder of lipid metabolism, characterized by the growth of unencapsulated masses of adipose tissue symmetrically deposited around the neck, shoulders, or other sites around the body. Its pathological mechanism is not yet known. One of the most common comorbidities in MD patients is liver disease, especially chronic alcoholic liver disease (CALD); however, no reports exist of acute kidney injury (AKI) with MD. Case summary We report a 60-year-old man who presented with complaint of edema in the lower limbs that had persisted for 3 d. Physical examination showed subcutaneous masses around the neck, and history-taking revealed the masses to have been present for 2 years and long-term heavy drinking. Considering the clinical symptoms, along with various laboratory test results and imaging characteristics, a diagnosis was made of MD with acute exacerbation of CALD and AKI. The patient was treated with liver function protection and traditional Chinese medicine, without surgical intervention. He was advised to quit drinking. After 10 d, the edema had subsided, renal function indicators returned to normal, liver function significantly improved, and size of subcutaneous masses remained stable. Conclusion In MD, concomitant liver or kidney complications are possible and monitoring of liver and kidney functions can be beneficial.

Lack of relevancy, administrative support, collegial support, and time are just a few of the many barriers that prevent practicing music teachers from accessing relevant professional development (PD) and taking steps to improve their practice. Quality music education PD should help teachers transform practice to improve student learning. Some characteristics of impactful PD include long-term engagement, teacher-to-teacher collaboration, and context-specific classroom implementation and documentation. In this intrinsic case study, we examined the role of a collaborative PD group designed to guide music teachers in using the reflection-on-action cycle to make improvements in their middle-level general music practice. Results from this project suggest that the reflection-on-action cycle is useful for PD projects that focus on improving classroom practice and empowering teachers with autonomy and choice. Teacher-to-teacher collaboration may also support teacher resilience during project difficulties.

Adversity response is fundamental to dealing with adversity. This paper reports the re-development and subsequent psychometric evaluation of the Adversity Response Profile for Chinese University Students (ARP-CUS). The data were collected from a Chinese university student sample (n = 474). Factor analysis and Rasch analysis were used to examine the psychometric properties of the ARP-CUS. Exploratory factor analysis revealed a six-factor model; then confirmatory factor analysis supported a five-factor solution. Rasch analysis provided further evidence of the psychometric quality of the instrument in terms of dimensionality, rating scale effectiveness, and item fit statistics for those six dimensions. The final version of the ARP-CUS contains 24 items across five subscales for assessing students’ responses to adversity, including control, attribution, reach, endurance, and transcendence. Overall, ARP-CUS demonstrates satisfactory psychometric properties for quantifying the adversity quotient of Chinese university students.

Cognitive impairment is a common symptom after ischemic stroke. Such symptom can cause effect on rehabilitation of patients and their quality of life and. As stroke rapidly growth on nowadays, a reliable scoring tool to detect the risk of cognitive impairment after stroke is now being put on the first place.We enrolled patients with acute ischemic stroke (AIS) as samples and hospitalized all at the First Affiliated Hospital of Soochow University between October 2018 and June 2020. All patients were assessed by the Montreal Cognitive Assessment (MoCA) scales and MoCA score26 was defined as standard to have having cognitive impairment. All patients were randomly (7:3) divided into two cohorts: the primary ones and the validated ones. Based on multivariate logistic model, the independent predictors of cognitive impairment in the acute phase were identified. The predictive nomogram was generated and evaluated by Harrell's concordance index (C-index) and calibration plot both in two cohorts, respectively.A total of 191 patients were enrolled, of whom 135 comprised the primary cohort and 56 comprised the validated cohort. Gender, age, baseline NIHSS score, hyperhomocysteinemia (HHcy) and multiple lesions were independently associated with acute cognitive impairment after stroke and included to construct the nomogram. The nomogram derived from the primary cohort had an Area Under Curve (AUC) of 0.773 and the validated ones had an AUC of 0.859. Calibration plot revealed adequate fit of the nomogram in predictive value.The new nomogram based on gender, age, baseline NIHSS score, HHcy and multiple lesions gave rise to an accurate and comprehensive prediction for cognitive impairment in AIS patients. After further validation, it could potentially be a reliable forecasting tool.

The incorporation of nanofillers in interfacial polymerization is a promising approach to elevate the permeability of thin-film nanocomposite (TFN) membranes. However, commonly-used inorganic nanomaterials (e.g., silica, zeolites, and carbon nanotubes) often bring defects, and thus low selectivity to the membranes due to their poor interfacial compatibility with polymeric matrix. In this work, organic polydopamine/poly(ethylene glycol) (PDA/PEG) nanocapsules were designed as fillers of the TFN membranes prepared by interfacial polymerization of piperazine with trimesoyl chloride. No aggregation phenomenon was observed for the nanocapsules in the membranes, which is attributed to their good dispersity brought by the grafted PEG brushes on the shells. Defect-free separation layer was obtained for the TFN membranes due to good miscibility of polymeric nanocapsules with polyamide matrix. The inner cavities of the embedded nanocapsules played a role of shortcuts for water permeation through the thin-films. The resultant PDA/PEG-TFN membranes showed a high water permeance of 11.7 L·m−2·h−1·bar−1, approximately 2.2 times that of the control TFC membrane, while maintained high solute rejections (RNa2SO4 = 95% and RVitamin B12 = 98%). Moreover, the PDA/PEG-TFN membranes exhibited high selectivity towards di-/mono-valent salts. This work presents a novel strategy of constructing water transport channels in selective layer to develop high performance nanofiltration membranes.

Background: Renal cell carcinoma (RCC) is a common malignant tumor of the urinary system.The incidence rate was increasing year by year, which has become a worldwide health problem. Achyranthis bidentate radix（ABR) is a traditional Chinese medicine that has been commonly reported on the prevention and treatment of RCC. However, the detailed mechanism of ABR is unclear. Therefore, this study aims to explore the possible molecular mechanism of ABR in the treatment of RCC based on network pharmacology and molecular docking.Methods: The main active compounds of ABR were obtained from pharmacology analysis platform of the Chinese Medicine System (TCMSP). The targets of ABR active compounds were obtained from TCMSP and Swiss Target Prediction. The targets of RCC were then screened in the Gene Cards and Online Mendelian Inheritance in Man (OMIM). The network of “medicine-ingredients-disease-targets” was established employing network pharmacology, and the key targets and core pathways were determined by R analysis. The molecular docking method was used to evaluate the binding activity between the target and the active compounds of ABR.Results: Twenty active compounds were found from ABR and are involving in 164 targets. The results of network analysis indicated that the targets mainly involve biological processes such as active oxygen metabolism, oxidative stress, cell proliferation, and apoptosis. ABR was able to treat RCC through regulating AGE-RAGE, PI3K-Akt, MAPK, JAK-STAT, NF-KB, and other major signaling pathways. Quercetin, baicalein, kaempferol had a strong binding to the target proteins of and MAPK1, AKT1, HSP90AA1.Conclusion: Flavonoids in ABR may be the material basis for its treatment of RCC. The mechanisms of action were through regulating active oxygen metabolism, inhibiting oxidative stress, cell proliferation, activating tumor cell apoptosis pathway, regulating protein kinase activity and nuclear receptor Activity, etc.

Background. Diabetic nephropathy (DN) is one of the most common complications of diabetes mellitus and is a major cause of end-stage kidney disease. Cordyceps sinensis (Cordyceps, Dong Chong Xia Cao) is a widely applied ingredient for treating patients with DN in China, while the molecular mechanisms remain unclear. This study is aimed at revealing the therapeutic mechanisms of Cordyceps in DN by undertaking a network pharmacology analysis. Materials and Methods. In this study, active ingredients and associated target proteins of Cordyceps sinensis were obtained via Traditional Chinese Medicine Systems Pharmacology Database (TCMSP) and Swiss Target Prediction platform, then reconfirmed by using PubChem databases. The collection of DN-related target genes was based on DisGeNET and GeneCards databases. A DN-Cordyceps common target interaction network was carried out via the STRING database, and the results were integrated and visualized by utilizing Cytoscape software. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed to determine the molecular mechanisms and therapeutic effects of Cordyceps on the treatment of DN. Results. Seven active ingredients were screened from Cordyceps, 293 putative target genes were identified, and 85 overlapping targets matched with DN were considered potential therapeutic targets, such as TNF, MAPK1, EGFR, ACE, and CASP3. The results of GO and KEGG analyses revealed that hub targets mainly participated in the AGE-RAGE signaling pathway in diabetic complications, TNF signaling pathway, PI3K-Akt signaling pathway, and IL-17 signaling pathway. These targets were correlated with inflammatory response, apoptosis, oxidative stress, insulin resistance, and other biological processes. Conclusions. Our study showed that Cordyceps is characterized as multicomponent, multitarget, and multichannel. Cordyceps may play a crucial role in the treatment of DN by targeting TNF, MAPK1, EGFR, ACE, and CASP3 signaling and involved in the inflammatory response, apoptosis, oxidative stress, and insulin resistance.

Objectives. Diabetic nephropathy (DN) is a major cause of end-stage renal disease (ESRD) throughout the world, and the identification of novel biomarkers via bioinformatics analysis could provide research foundation for future experimental verification and large-group cohort in DN models and patients. Methods. GSE30528, GSE47183, and GSE104948 were downloaded from Gene Expression Omnibus (GEO) database to find differentially expressed genes (DEGs). The difference of gene expression between normal renal tissues and DN renal tissues was firstly screened by GEO2R. Then, the protein-protein interactions (PPIs) of DEGs were performed by STRING database, the result was integrated and visualized via applying Cytoscape software, and the hub genes in this PPI network were selected by MCODE and topological analysis. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were carried out to determine the molecular mechanisms of DEGs involved in the progression of DN. Finally, the Nephroseq v5 online platform was used to explore the correlation between hub genes and clinical features of DN. Results. There were 64 DEGs, and 32 hub genes were identified, enriched pathways of hub genes involved in several functions and expression pathways, such as complement binding, extracellular matrix structural constituent, complement cascade related pathways, and ECM proteoglycans. The correlation analysis and subgroup analysis of 7 complement cascade-related hub genes and the clinical characteristics of DN showed that C1QA, C1QB, C3, CFB, ITGB2, VSIG4, and CLU may participate in the development of DN. Conclusions. We confirmed that the complement cascade-related hub genes may be the novel biomarkers for DN early diagnosis and targeted treatment.

Background: Chronic renal failure (CRF) is a common kidney disease characterized by a slow and progressive decline in kidney function. Clinical practice suggests that traditional Chinese medicinal enemas have a therapeutic effect on CRF. To assess the therapeutic efficacy and safety of traditional Chinese medicinal enemas in treating CRF, we created a protocol for a systematic review to inform future clinical applications. Methods: We completed a literature search of all clinical randomized controlled trials evaluating traditional Chinese medicinal enemas on CRF in the following five English and four Chinese databases completed before August 2020: Medline, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Library database, Chinese National Knowledge Infrastructure (CNKI), WANFANE Database, Chinese Scientific and Technological Periodical Database (VIP) and Chinese Biomedical Database (CBM). The primary outcomes evaluated blood urea nitrogen levels, uric acid levels, endogenous creatinine clearance rate, and serum creatinine, and the secondary outcomes included clinical efficacy and adverse effects of treatment. Two independent researchers performed data extraction and quality assessment. RevMan5.3 software was used to assess data quality and bias. This protocol was conducted according to the Preferred Reporting Item for Systematic Review and Meta-analysis Protocol (PRISMA-P) statement. Results: This study will provide a rational synthesis of current evidence for traditional Chinese medicinal enemas for the treatment of CRF. Conclusion: This study presents evidence on whether traditional Chinese medicinal enemas are an effective and safe intervention for CRF patients. Registration number: INPLASY202080052

Acute kidney injury (AKI) is a common clinical critical illness, and ischemic kidney injury is the main type. The mortality rate of ischemic kidney injury is high, because the efficacy of treatment is limited due to symptomatic and supportive treatment. Establishing a reliable animal model of ischemic AKI is an important prerequisite for conducting research on physiological, pathological and pharmacological researches, so as to explore effective prevention methods and strategies. In recent years, the establishment methods of animal models of ischemic AKI have been continuously improved. The article summarizes the common methods and model characteristics of animal models of ischemic AKI in order to provide a reference for researchers to choose a reasonable modeling method.

Developing a low-cost and well-recyclable adsorbent with high adsorption capacity is greatly desirable in dye wastewater treatment. Here, we demonstrate a kind of novel tough and reusable hydrogel beads with quite high capacity of dye adsorption via incorporating mussel-bioinspired poly(L-DOPA) (PDOPA) into alginate/poly(acrylamide) double network (DN) hydrogels. The synthesized PDOPA nanoaggregates were introduced into the DN hydrogels by simple one-pot mixing with the monomers prior to polymerization. The fabricated hydrogel beads exhibited high mechanical strength and good elastic recovery due to the interpenetrating Ca2+-alginate and poly(acrylamide) networks. It was shown that the beads exhibited relatively high dye adsorption capacity compared to other adsorbents reported in literature, and the introduction of PDOPA with an appropriate amount raised the adsorption capacity. It is believed that the addition of PDOPA and the matrix of double network architecture contributed synergistically to the high adsorption capacity of hydrogel beads. Moreover, the desorption of dyes could be easily realized via rinsing in acidic water and ethanol solution. The hydrogel beads remained the high adsorption capacity even after 5 times of adsorption and desorption cycles. This tough and stable hydrogel with high adsorption capacity may have potential in treatment of dye wastewater released by textile dyeing industry.

Developing thin-film composite (TFC) nanofiltration (NF) membranes with high water permeability and salt rejection is highly desirable in water desalination. In this study, a new TFC membrane with high NF performances was developed to achieve such a goal by constructing active separation layer with a special crater-like surface morphology using a rigidly-contorted spirocyclic monomer, 5,5,6′,6′-tetrahydroxy-3,3,3′,3′-tetramethyl spirobisindane (TTSBI), as the co-monomer with piperazine (PIP) in aqueous phase during interfacial polymerization (IP) process. This design endowed the separation layer with the characteristics of low thickness, high microporosity, and high permeation surface area. The pure water permeability was therefore increased to 9.9 L m−2 h −1 bar−1, approximately two times higher than that of the typical TFC NF membrane prepared with PIP and trimesoyl chloride, without compromise in the rejection (the rejection of Na2SO4 up to 98%). The introduction of TTSBI tuned the diffusion and reaction behaviors of monomers at the aqueous-organic interface and controlled the special microporous structure and surface morphology, which are advantageous to the improvement of water permeability. This study provides new insights for synthesizing highly permeable TFC NF membranes with remarkable rejection characteristics to address the crisis of the current potable water scarcity.

Mussel-inspired polydopamine (PDA) deposition provides a prominent approach for constructing functional coatings, which has received much research interest over the past decade. However, large PDA aggregates often formed and precipitated from the solution during the deposition process, significantly lowering the utilization efficiency of dopamine for surface modification. It is of both fundamental and practical importance to "reactivate" and reuse the precipitated aggregates to achieve higher usage efficiency of PDA in surface modifications. In this work, we report a facile, substrate-independent, and cost-effective coating strategy, by disassembling the precipitated PDA aggregates, to achieve the coating deposition through the complexation of disassembled polydopamine (d-PDA) species with Fe(III) ions on various substrates. Adsorption tests determined by a quartz crystal microbalance with dissipation (QCM-D) monitoring technique indicated that the pH of the solution and the ratio of d-PDA to Fe(III) significantly influence the deposition behavior of d-PDA/Fe(III). Force measurements using a surface force apparatus demonstrated that the coordination interaction between d-PDA and Fe(III) was the major force leading to the formation of coatings. The deposited d-PDA/Fe(III) coatings featured controllable nanoscale thickness, uniform surface morphologies, and light color. Furthermore, the d-PDA/Fe(III) coating could act as an intermediate layer in the preparation of hydrophobic polyurethane sponge for highly efficient oil/water separation. This work provides a useful strategy to realize the reusability of PDA aggregates for versatile surface functionalization, with implications for the fundamental understanding of the formation mechanism in the metal-phenolic complexation systems and development of new coating approaches in various engineering applications.

En este trabajo se comparan los sistemas vocálicos del español y del chino pronunciados por hablantes nativos con el objetivo de presentar a continuación las peculiaridades del sistema vocálico español de un grupo de estudiantes de China con un nivel intermedio de español. El estudio de las similitudes y las diferencias entre los sistemas nativos nos ha permitido prever en qué áreas pueden diferir las vocales pronunciadas por aprendices chinos de las vocales españolas. Los resultados indican que el sistema vocálico español de los estudiantes chinos es estructuralmente similar al sistema nativo, pero con algunas diferencias fonéticas: en primer lugar, tiene una extensión mayor por lo que respecta a F1, como resultado del traslado directo de las distancias entre las vocales del chino; en segundo lugar, algunas vocales, particularmente /a/, /e/ y /o/, muestran más dispersión que en el sistema nativo, y, finalmente, las vocales de los aprendices chinos son más largas, aunque más cortas que las vocales del chino. Así pues, se ha comprobado que, si bien los aprendices chinos no encuentran grandes dificultades para adquirir las vocales del español, los rasgos del sistema vocálico chino afectan a su realización, especialmente a su grado de abertura y a su duración. In this paper we compare the Spanish and Chinese vowel systems as pronounced by native speakers in order to analyze afterwards the peculiarities of the Spanish vowels produced by a group of Chinese students with an intermediate level of Spanish. The study of the similarities and differences between the two native systems allows us to predict the points in which the Spanish vowels from Chinese learners may differ from the native system. The results indicate that the vowel system displayed by these students is structurally similar to the native system, but with some phonetic differences. Firstly, it shows a greater F1-amplitude, as a result of the direct translation of the distances between the Chinese vowels. Secondly, some vowels, particularly /a/, /e/ and /o/, show more dispersion than in the Spanish native system. Finally, the vowels produced by Chinese learners are clearly longer than in Spanish, although shorter than in Chinese. All in all, we have found that, even though Chinese learners do not experience great difficulties in acquiring the Spanish vowels, the features of the Chinese vowel system influence their realization, especially their openness and their duration.

The study objective was to examine hospital mortality outcomes and structure using 2008 patient-level discharges from general community hospitals. Discharges from Florida administrative files were merged to the state mortality registry. A cross-sectional analysis of inpatient mortality was conducted using Inpatient Quality Indicators (IQIs) for acute myocardial infarction (AMI), congestive heart failure (CHF), stroke, pneumonia, and all-payer 30-day postdischarge mortality. Structural characteristics included bed size, volume, ownership, teaching status, and system affiliation. Outcomes were risk adjusted using 3M APR-DRG. Volume was inversely correlated with AMI, CHF, stroke, and 30-day mortality. Similarities and differences in the direction and magnitude of the relationship of structural characteristics to 30-day postdischarge and IQI mortality measures were observed. Hospital volume was inversely correlated with inpatient mortality outcomes. Other hospital characteristics were associated with some mortality outcomes. Further study is needed to understand the relationship between 30-day postdischarge mortality and hospital quality.

It has been demonstrated that dopamine can undergo oxidation and complicated self-reaction in aqueous solution to form so-called polydopamine (PDA). In this paper, for the first time, the hierarchical self-assembly of dopamine into surface patterned structures is described. PDA nanoaggregates are first prepared assisted by ethylenediamine, based on the covalent self-polymerization and noncovalent self-assembly. The surface fractal patterns are further created and modulated by the dynamic self-assembly of PDA nanoaggregates to develop more macroscopic ordered structure of PDA. Various surface patterns of PDA aggregates are successfully obtained by evaporative dewetting method. The effects of solution pH, type of inorganic salts, and temperature on the morphology of surface pattern are investigated. Mineralization or metal deposition is used to keep the pattern fixed. The surface patterning strategy reported here is applicable to a broad range of materials, which allows the developments of materials with controllable patterned structure.

We studied characteristics of all, occasional, and frequent emergency department (ED) visits due to ambulatory care-sensitive conditions (ACSCs). We used a cross-sectional, split-sample design with multivariate logistic regressions using encounter-level, all-payer ED data from all Florida hospitals for the year of 2005. We evaluated associations of key patient characteristics, characteristics of ED utilization, and availability of primary care physicians in the area, with ED visits for ACSCs. We concluded that factors associated with ED use for ACSCs were similar for occasional and frequent ED users. Therefore, universal strategies for reduction of ED overutilization by increasing access to, timeliness, and quality of primary care for all patients likely to experience ACSCs should be used.

This study explores associations between patient outcomes (7- and 30-day hospitalization and mortality) and healthcare provider (physician and facility) volumes of outpatient colonoscopy, cataract removal, and upper gastrointestinal endoscopy performed in outpatient surgical settings in Florida. Findings indicate that patients treated by high-volume physicians or facilities had lower adjusted odds ratios for hospitalizations and mortality. When physician and facility volume were assessed simultaneously, physician volume accounted for larger effects than facility volume in hospitalization models. When assessing both physician and facility volume together for mortality, facility volume was a stronger predictor of mortality outcomes at 30 days. Further examinations of associations of outpatient physician and facility volumes and patient outcomes are suggested.

We compared financial performance of freestanding ambulatory surgery centres (ASCs) and hospital-based outpatient departments (HOPDs). Patient-level ambulatory surgery data (1997-2004) for the state of Florida were assembled and analysed. We used a pooled, cross-sectional design. We applied multiple regression models to study pricing differences for freestanding ASCs and HOPDs. Substantial charge differences exist for patients undergoing the most common outpatient procedures, and that these differentials are in favour of freestanding ASCs over HOPDs in the majority of studied procedures. These differences in charges are large enough to presume that they may translate into similar difference in actual costs. Although previous research does not show a clear 'winner' (neither ASCs nor HOPDs) in terms of quality outcomes, healthcare policymakers, payers, and patients may be led to look more carefully at charge and cost data in their contracting processes, or choosing a certain provider of outpatient services.