A Tempol compound with an amine group (4-amino-2,2,6,6-tetramethylpiperidine-1-oxyl, NH-Tempol) was cross-linked to hemoglobin in a one-step polymerization reaction to produce a novel hemoglobin-based oxygen carrier (HBOC) designated PolyHb-Tempol. The reaction parameters, including the reaction time, pH, temperature, and ratio of reactants, were optimized, and the physiochemical properties of the resulting product were characterized. PolyHb-Tempol didn't show any toxicity towards endothelial cells. Furthermore, from observations of cell morphology and viability, PolyHb-Tempol showed a significant ability to inhibit or eliminate oxidative stress induced by superoxide free radicals. These results suggest that PolyHb-Tempol may potentially be suitable as an HBOC.

Background Minimal change disease (MCD) is one of the major causes of nephrotic syndrome (NS). A confirmed MCD diagnosis mainly depends on renal biopsy at present, which is an invasive procedure with many potential risks. The overall incidence of complications caused by renal biopsy procedures has been reported as approximately 11 and 6.6% outside and within China, respectively. Unfortunately, there is currently no noninvasive procedure or practical classification method for distinguishing MCD from other primary glomerular diseases available. Method A total of 1009 adult patients who underwent renal biopsy between January 2017 and November 2019 were enrolled in this study. Twenty-five parameters extracted from patient demographics, clinical manifestations, and laboratory test results were statistically analysed. LASSO regression analysis was further performed on these parameters. The parameters with the highest area under the curve (AUC) were selected and used to establish a logistic diagnostic prediction model. Results Of the 25 parameters, 14 parameters were significantly different (P < 0.05). MCD patients were mostly younger (36 (22, 55) vs. 41 (28.75, 53)) and male (59% vs. 52%) and had lower levels of diastolic blood pressure (DBP) (79 (71, 85.5) vs. 80 (74, 89)) and IgG (5.42 (3.17, 6.36) vs. 9.38 (6.79, 12.02)) and higher levels of IgM (1.44 (0.96, 1.88) vs. 1.03 (0.71, 1.45)) and IgE (160 (46.7, 982) vs. 47.3 (19, 126)) than those in the non-MCD group. Using the LASSO model, we established a classifier for adults based on four parameters: DBP and the serum levels of IgG, IgM, IgE. We were able to clinically classify adult patients with NS into MCD and non-MCD using this model. The validation accuracy of the logistic regression model was 0.88. A nomogram based on these four classifiers was developed for clinical use that could predict the probability of MCD in adult patients with NS. Conclusions A LASSO model can be used to distinguish MCD from other primary glomerular diseases in adult patients with NS. Combining the model and the nomogram potentially provides a novel and valuable approach for nephrologists to diagnose MCD, avoiding the complications caused by renal biopsy.

Background: Idiopathic membranous nephropathy (IMN), one of the most common causes resulting into nephrotic syndrome in adults, is usually clinically treated with steroids and/or other immunosuppressive agents. However, the treatment on the patients with IMN coexisting with type 2 diabetes mellitus (DM) is still challenging. There are few convincing literatures available on the efficacy and safety of therapeutic regimens in this subgroup of patients to guide clinical practice. Methods: We retrospectively collected and analyzed the data of twenty-three patients who underwent renal biopsies between January 2013 and March 2018 in our institute and were diagnosed with IMN coexisting with type 2 DM. Nine patients received prednisone combining with tacrolimus and mycophenolate mofetil (group 1), while 14 patients received prednisone and intravenous cyclophosphamide (group 2). The primary endpoint was measured by percentage of patients achieved complete remission (CR) or partial remission (PR), the secondary endpoints included changes of urinary protein excretion from baseline and treatment-related adverse events. Results: The remission rates were compared between the group 1 and the group 2 at both 6 months (44.4% versus 50%, P>0.05 ) and 12 months (77.8% versus 64.3%, P>0.05 ). Significant decrease in urinary protein excretion was observed in both groups during treatment, which was significantly greater in group 1 than that in group 2. No significant renal impairment was observed during the follow-up period. Infections and worsening glycemic control were the most common adverse effects of two therapy. Patients treated with prednisone plus cyclophosphamide were more likely to develop worsening diabetes, while infections tended to be more common in patients treated with prednisone combining with tacrolimus and mycophenolate mofetil. Conclusions: The combination therapy of prednisone, tacrolimus and mycophenolate mofetil is one of the effective and safe options for patients with IMN and type 2 DM.