After comparative interpretation of the essentials and highlights of the expert recommendations based on European experience published in 2019 and the expert recommendations based on Asia Pacific experience published in 2021, this article summarizes the core principles of adsorptive hemofiltration for sepsis in following aspects, including patient selection, laboratory index, and key factors in the implementation of treatment (covering initiation timing and duration, choice of anticoagulant mode, discontinuation, etc) combined with the experience in West China Hospital of Sichuan University as well, to provide references for sepsis management with adsorptive hemofiltration in clinical practice.
With the development of medical information technology, smart teaching has been widely applied in various fields of medical education. The application of smart teaching technologies such as virtual simulation, intelligent evaluation, and smart teaching platform in blood purification specialized nursing teaching have gradually increased. This article provides an overview of the application of smart teaching mode in blood purification specialized nursing teaching both domestically and internationally, and introduces the integration of online and offline smart teaching mode, in order to provide a theoretical basis for improving the quality of blood purification specialized nursing teaching.
To set up an economic and effective method for islet isolation from rat, and thereby prove a laboratory protocol of animal model for cl inical islet transplantation. Methods Twenty-five adult male SD rats weighing 230-380 g were used as organ donor. In each of 5 repeated experiments, pancreatic islets of 5 animals were isolated by intraductal infusion of compound sodium chloride injection (CSCI), and subsequently, digested with low concentration (0.5 mg/mL)of collagenase V solution. Islet purification was performed by using a discontinuous density gradient centrifugation thatwas prepared with 27.0%, 23.0%, 20.5% and 11.0% of Ficoll 400. Islet yield and purity were determined by dithizon (DTZ)stain, and propidium iodide (PI)/fluorescein diacetate (FDA) double stain was used to check viabil ity of islets. The endocrine secretory function was assessed by insul in secretion in either low (2.8 mmol/L) or high (25.0 mmol/L) glucose incubation after 3 days of culture in RPMI1640 media. Results Average islet digestion time of 5 experiments was (13.8 ± 1.6) min. Before purification, average isolated number was (5 626 ± 422) islets, and the number was significantly reduced to (2 914 ± 485) islets after purification (P lt; 0.01). The average recovery rate was 51.6% ± 6.0%, and the average yield was (583 ± 97) islets/pancreas. The average purity and viabil ity of islets were 90.2% ± 3.4% and 81.6% ± 7.0%, respectively. After 3 days of culture, insul in secretion of the islets was (116.1 ± 17.4) EU/L in high glucose incubation, which was significantly higher than that of low glucose environment [(39.7 ± 7.5) EU/L, P lt; 0.01)]. The average insul in stimulation index was 3.0 ± 0.4. Conclusion The islet isolation with the CSCI solution and digestion with low concentration of collagenase V decrease experimental cost and also have a beneficial effect on islet recovery and their function.
End-stage renal disease is a late complication of chronic kidney disease (CKD) and one of the leading causes of high mortality worldwide. Over the years, the impacts of gut microbiota and their associated uremic toxins on kidney diseases through the intricate “gut-kidney axis” have been extensively studied. However, translation of microbiome-related omics results into specific mechanisms is still a significant challenge. In this paper, we review the interaction between gut microbiome and blood purification, as well as the current microbiota-based therapies in CKD. Additionally, the current sequencing technologies and progresses in the gut microbiome research are also discussed.
Blood purification, as a critical medical intervention for renal function replacement, metabolic waste clearance, and homeostasis maintenance, relies heavily on the optimization of therapeutic solutions to ensure clinical efficacy. In recent years, significant advancements have been made in the formulation design, biocompatibility, and clinical outcomes of blood purification solutions, driven by progress in clinical medicine and biomedical engineering. This article systematically elaborates on the latest research developments in key therapeutic solutions, including continuous renal replacement therapy replacement fluids, hemodialysis dialysate, hemodialysis catheter lock solutions, and peritoneal dialysate. By synthesizing current evidence, the aim is to offer scientific guidance for clinicians in selecting optimal treatment regimens while exploring future directions and emerging trends in the development of blood purification solutions.
Sepsis is a common clinical critical illness, which often leads to multiple organ damage including the kidney damage, which is difficult to treat and has a high mortality rate. In recent years, extracorporeal blood purification therapy has made some progress in the field of sepsis. There are a variety of blood purification modes to choose, but there is still no unified standard for the initiation timing of blood purification therapy. Clinicians mainly evaluate the indicators and the initiation timing of blood purification therapy according to the patient’s needs for renal function replacement and/or inflammatory mediator clearance. This article mainly summarizes and discusses the initiation timing of blood purification therapy in sepsis.
Objective Neuron purification is essential to procedure of various nerve cell experimental research, however, at present there is few reports on the effect of various factors on neural axons during purification. To find out a simple method of neuron purification, and to investigate the influence factors of corresponding purification culture in dorsal root gangl ion (DRG) tissue culture on β3-tubul in positive axon. Methods The DRGs were obtained from the 3 days neonatal SD rat microscopically and were made into cell suspension. Then, the amount of attached DRG neurons and non neuronal cells in poly-D-lysine (PDL) group, PDL/Laminin (PDL/LN) group and collagen-I (Col I) group was observed from 10 to 100 minutes. Then, the extension and arborization of β3-tubul in positive axons were observed after 72 hours completely randomised DRG tissue culture for the research of the influences among culture substrates (PDL, PDL/LN, and Col I), FBS (0, 5%, and 10%), 5 fluorouracil (5-Fu, 0, 20, and 40 μmol/L), and cytrarabine (Ara-C, 0, 10, and 20 μmol/L). Results Adherent cells were observed instantly after inoculation by inverted phase contrast microscope and inverted fluoresence microscope; after cell suspension was removed, adherent growth of DRGn cells and non-DRGn cells were still seen. In PDL group, the amount of NSE negative cells was significantly higher than that of NSE positive cells at 10 and 30 minutes (P lt; 0.05); the amount of NSE positive cells was significantly higher than that of NSE negative cells at 80, 90 and 100 minutes (P lt; 0.05). In PDL/LN gruop, there was no significant difference (P gt; 0.05) in the amount of NSE negative cells and NSE positive cells at 10, 20, 30, 40, and 50 minutes; the amount of NSE positive cells was significantly higher (P lt; 0.05) than that of NSE negative cells at 60, 70, 80, 90, 100 minutes. In Col I group, the amount of NSE negative cells was higher than that of NSE positive cells at 10-40 minutes, but showing no significant difference (P gt; 0.05); the amount of NSE positive cells was significantly higher (P lt; 0.05) than that of NSE negative cells at 70-100 minutes. At 72 hours after DRG tissue culture, the best result of β3-tubul in positive axon extension and arborization was obtained when the substrate level was PDL/LN, and the average length of PDL/LN level was significantly larger than that of other two substrates (P lt; 0.05). The highest number of β3-tubul in positive axon distal end was obtained at 5% concentration level of FBS (P lt; 0.05), but showing no significant differences in β3-tubul in positive axon length among three levels (P gt; 0.05). Both the most of β3-tubul in positive axon distal ends and the longest β3-tubul in positive axon average length were obtained at 0 μmol/L concentration level of 5-Fu, showing significant differences between 0 μmol/L level and 20, 40 μmol/L levels (P lt; 0.05). A similar result of β3-tubul in positive axon distal end was got at the 0 μmol/L level and 10 μmol/L level of Ara-C, which was significantly higher than that of 20 μmol/L level (Plt; 0.05). Conclusion? A purified DRG neuron suspension for neuron culture could be obtained via PDL differential attachment for 30 minutes. When DRG neuron culture, neuron special medium, PDL/LN substrate and 10 μmol/L Ara-C are recommended in β3-tubul in positive axon research.
Blood purification is not only an effective treatment for patients with acute and chronic renal failure, but also plays an important role in the rescue of various critically ill patients. The current blood purification devices is relatively bulky and not suitable for use in daily life and disaster rescue sites. Portable blood purification devices can be divided into portable artificial kidney, wearable artificial kidney, implantable artificial kidneys and mobile continuous renal replacement therapy machine, which have not yet been widely applied in clinical practice. In recent years, with the advancement of materials science and computer science, efficient regeneration of dialysate and intelligent operation of equipment have become possible, and portable blood purification devices is also expected to experience rapid development. This article briefly reviews the development history and future research directions of portable blood purification devices.
Objective The purity and activity of islets will greatly affect the outcome of xenotransplantation therapy of type 1 diabetes mell itus. To set up an improved method of the isolation and purification of rat islets, which can obtain highpurity,high-yield, and high-viabil ity islets. Methods Ten healthy and adult male SD rats, weighing 250-300 g were used asorgan donors. Collagenase V was perfused into pancreas via pancreatic duct. Pancreas was digested with collagenase in water bath at 38℃ about 15 minutes, islet purification was performed using two techniques: with Ficoll 400 density gradient (group A), and Ficoll-Paque™ PLUS (group B). Dithizone (DTZ) was util ized for identifying islets, counting islets equivalent quantity (IEQ) and islets’ purity. Trypan blue staining was used to detect the viabil ity of islets. Islets of group B was encapsulated with alginate/poly-L-lysine/alginate (APA). Islets function of microencapsulated and nonmicroencapsulated was evaluated by the insul in release test. Results DTZ staining showed that islets shape were round, ell ipse and irregular with a clear edge and a diameter range of 50-300 μm. The IEQ values were 338.04 ± 76.61 and 834.80 ± 54.00 in groups A and B, respectively, showing significant difference (P lt; 0.05). The purities were 88.31% ± 2.67% and 95.63% ± 1.96% in groups A and B, respectively, showing no significant difference (P gt; 0.05). The activities of islets were 67.40% ± 5.15% and 86.05% ± 2.52% in groups A and B, showing significant difference (P lt; 0.05). Islet APA microcapsules had round shape, unified size, and its diameter was between 1.5 and 2.0 mm. Each microcapsule was encapsulated of 1 to 3 islets. The result of insul in release assay was that the concentrations of insul in secretion with islets of microencapsulated and nonmicroencapsulated were (5.53 ± 1.64) ng/ mL and (4.76 ± 0.26) ng/mL in low glucose, and its concentrations of insul in secretion in high glucose were (11.95 ± 2.07) ng/ mL and (14.34 ± 3.18) ng/mL. Stimulated insul in secretion in high glucose was 2 times more than that in low glucose (P lt; 0.05), but there was no significant difference (P gt; 0.05) in the stimulation index between group A (2.16 ± 0.30) and group B (3.01 ± 0.59). Conclusion The method of islets isolation and purification using Ficoll-Paque™ PLUS own the virtues of more convenient, high islet yield, and high islet purity. Both microencapsulated and nonmicroencapsulated islets show high-viabil ity while culture in vitro.
In recent years, Regional citrate anticoagulation (RCA) technology has been widely used not only in adult blood purification, but also in children’s blood purification, and its advantages in patients with high bleeding risk, active bleeding and heparin-induced thrombocytopenia have been repeatedly confirmed. Therefore, this article reviews and analyzes the application of RCA in different blood purification modes at home and abroad in recent years. It is found that its anticoagulation is not only safe and effective, but also can prolong the life of filter and reduce bleeding complications, which is suitable for the practice of blood purification.