The incidence of chronic kidney disease is increasing worldwide, which greatly increases the risk of end-stage renal disease. It is particularly important to find out the risk factors for the development and progression of chronic kidney disease. Whether gender is a risk factor for the progression of kidney disease remains controversial with inconsistent results in human cohort studies with diabetic or non-diabetic kidney disease. In most of the studies, women seem to exhibit certain gender advantages. Sex hormones, renal hemodynamics and lifestyle differences may play an important role. The underlying mechanism of gender affecting the progression of kidney disease deserves further exploration. This article reviews the gender differences and possible mechanisms in diabetic and non-diabetic chronic kidney disease, in order to provide reference for future research.
Objective To investigate the feasibility and effectiveness of selective treatment of senile osteoporotic thoracolumbar burst fractures of Denis type B with kyphoplasty and Jack vertebral dilator. Methods Between August 2007 and May 2011, 30 patients (32 vertebra) with osteoporotic thoracolumbar burst fractures of Denis type B were treated with kyphoplasty and Jack vertebral dilator. There were 7 males and 23 females, aged 57-85 years (mean, 76.9 years). The injured vertebrae included T11 in 2 vertebrae, T12 in 11 vertebrae, L1 in 7 vertebrae, L2 in 5 vertebrae, L3 in 3 vertebrae, and L4 in 4 vertebrae. The visual analogue scale (VAS) score, Oswestry disability index (ODI), the anterior and middle height of the vertebral body, and the Cobb angle were assessed before and after operation. Results The operation was completed smoothly in all cases; no cement leakage or intraoperative complication was found. Obvious back pain relief was achieved in all patients after operation. Thirty patients were followed up at 1 week and 6 months after operation. The VAS score was decreased from 8.2 ± 1.3 before operation to 1.5 ± 0.9 at 1 week after operation and 1.9 ± 0.5 at 6 months after operation; the ODI was decreased from 82.4% ± 15.0% to 17.8% ± 9.5% and 23.0% ± 8.6%; the anterior height of the vertebral body was increased from (19.5 ± 3.2) mm to (24.8 ± 3.0) mm and (24.0 ± 2.6) mm; the middle height of the vertebral body was increased from (18.5 ± 3.4) mm to (23.7 ± 3.7) mm and (22.8 ± 3.5) mm; the Cobb angle was decreased from (14.9± 7.5)° to (7.6 ± 6.0)° and (8.3 ± 6.0)°; and there were significant differences in the VAS score, ODI, the anterior and middle height of the vertebral body, and the Cobb angle between at pre- and at post-operation (P lt; 0.05), but no significant difference between at 1 week and at 6 months after operation (P gt; 0.05). Conclusion Kyphoplasty with Jack vertebral dilator for selective treatment of senile osteoporotic thoracolumbar burst fractures of Denis type B can restore the anterior and middle height of the vertebral body, correct the Cobb angle, and relieve pain, and it has good short-term effectiveness and safety.
Objective To study the effect of rat osteoblast conditioned culture medium on the BMSCs differentiation of allogeneic rat and to find a new approach to provide seed cells for bone tissue engineering. Methods BMSCs and osteoblasts were harvested from 10 healthy one-week-old SD rats (male and female, weighing 20-30 g) by adherent method and enzyme digestion method respectively. Cell identification was conducted. Osteoblast conditioned culture medium was prepared by mixing supernatant of osteoblasts at passage 1-5 with complete medium (1:1). Then, BMSCs at passage 2 were co-cultured with osteoblast conditioned culture medium (inducement group) and complete medium (control group), respectively. The morphological changes of co-cultured BMSCs were observed by inverted phase contrast microscope, the growth condition of BMSCs was detected by MTT method, the expressions of ALP, Col I and osteocalcin (OCN) in the cocultured BMSCs were tested by immunohistochemistry staining, and the expressions of Col I and OCN mRNA were detected by RT-PCR. Results In the inducement group, BMSCs grew bigger, changing from long fusiform to flat and polygon with protuberance 7 days after co-culture; the presence of cell colony-l ike growth was observed 9 days after co-culture. Cell growth curve demonstrated that the counts of BMSCs was increased with time, there were more cells in the control group than that of the inducement group, and there was a significant difference in cell counts between the control and the inducement group 4-7 days after co-culture (P lt; 0.05). For the inducement group, ALP staining was positive 12 days after co-culture, the calcium nodules were appeared 18 days after co-culture, Col I and OCN were positive 21 days after co-culture, and the expressions of Col I and OCN mRNA were detected by RT-PCR 21 days after co-culture. Conclusion Rat osteoblast conditioned culture medium can significantly induce the differentiation of allogeneic rats’ BMSCs towards osteoblasts.