Diabetic nephropathy (DN) is a prevalent complication of diabetes, with current treatment options offering limited effectiveness, particularly in advanced stages. Human pluripotent stem cells (hPSCs), particularly induced PSCs (iPSCs), show promising potential in the treatment of DN due to their pluripotency, capacity for differentiation into kidney-specific cells, and suitability for personalized therapies. iPSC-based personalized approaches can effectively mitigate immune rejection, a common challenge with allogeneic transplants, thus enhancing therapeutic outcomes. Clustered regularly interspaced short palindromic repeats (CRISPR) gene editing further enhances the potential of hPSCs by enabling the precise correction of disease-associated genetic defects, increasing both the safety and efficacy of therapeutic cells. In addition to direct treatment, hPSCs have proven valuable in disease modeling and drug screening, particularly for identifying and validating disease-specific targets. Kidney organoids derived from hPSCs replicate key features of DN pathology, making them useful platforms for validating therapeutic targets and assessing drug efficacy. Comparatively, both hPSCs and mesenchymal SCs (MSCs) have shown promise in improving renal function in preclinical models, with hPSCs offering broader differentiation capacity. Integration with tissue engineering technologies, such as three-dimensional bioprinting and bioengineered scaffolds, expands the regenerative potential of hPSCs by supporting the formation of functional renal structures and enhancing in vivo integration and regenerative capacity. Despite current challenges, such as tumorigenicity, genomic instability, and limited direct research, advances in gene editing, differentiation protocols, and tissue engineering promise to address these barriers. Continued optimization of these approaches will likely lead to successful clinical applications of hPSCs, potentially revolutionizing treatment options for DN.

The Malnutrition-Inflammation Score (MIS) is a composite indicator widely used in dialysis populations to evaluate nutritional deficiency and chronic inflammation. However, its association with structural peritoneal alterations remains unclear. This study aimed to investigate the relationship between MIS and the Peritoneal Sclerosis Index (PSI) in long-term peritoneal dialysis (PD) patients. This single-center cross-sectional study included 191 PD patients with dialysis duration >=3 years. MIS was assessed using a standardized scoring system, and PSI was quantified based on structural abnormalities identified on abdominal computed tomography (CT). In response to the reviewer comment, beta2-microglobulin was additionally incorporated into the comparative analysis together with dialysis vintage, age, PET score, and Kt/V. The association between MIS and CT-defined peritoneal sclerosis was evaluated using Spearman correlation, multivariate linear regression, and logistic regression analyses, and an exploratory screening of other candidate clinical indicators associated with PSI was also performed. When PSI was used as the CT-based marker of peritoneal sclerosis, dialysis vintage showed the strongest correlation with PSI (r = 0.333, P < 0.001). MIS showed only a weak correlation with PSI (r = 0.114, P = 0.116), whereas beta2-microglobulin was also weakly correlated (r = 0.154, P = 0.034). In univariate logistic analysis, MIS was associated with clinically significant peritoneal sclerosis (PSI >=5; OR 1.13, P = 0.017), but this association was attenuated after adjustment for dialysis vintage, age, PET score, Kt/V, and beta2-microglobulin. Exploratory analysis further showed that lower urine output and higher PD volume were associated with higher PSI values. MIS may be clinically useful as a composite risk-stratification marker reflecting malnutrition-inflammatory burden and systemic vulnerability, rather than as an independent specific predictor of CT-defined peritoneal sclerosis. In this cohort, dialysis vintage remained the most stable correlate of CT-defined sclerosis burden, while beta2-microglobulin provided only limited additional discriminatory value.

Maintenance hemodialysis patients are at increased risk of cardiovascular complications and mortality following COVID-19 infection due to compromised immune function. This study aims to evaluate the effect of COVID-19 vaccination (CoronaVac) on cardiac function and survival in this population. Background/Objectives: This study aimed to evaluate the effects of CoronaVac on echocardiographic parameters, BNP levels, and survival rates in maintenance hemodialysis patients. By comparing vaccinated and unvaccinated patients, we sought to assess whether vaccination provides a protective effect on cardiac function and contributes to improved clinical outcomes in this population. Methods: We conducted a retrospective analysis of 531 maintenance hemodialysis patients, comprising 452 unvaccinated and 79 vaccinated with CoronaVac. We compared changes in echocardiographic parameters and BNP levels before and after COVID-19 infection between the vaccinated and unvaccinated groups and assessed their association with survival rates. Results: Vaccinated patients were younger (60.54 ± 13.51 vs. 65.21 ± 13.76 years, p=0.006), had shorter dialysis durations (56.04 ± 51.88 vs. 73.73 ± 64.79 months, p=0.022). The mortality rate was also significantly lower in the vaccinated group (6.33% vs. 14.38%, p=0.049). In the unvaccinated group, BNP levels and multiple echocardiographic parameters (IVSD, LVPWD, AO, LA, EF, FS) significantly deteriorated post-infection, whereas no significant changes were observed in the vaccinated group. Multivariate analysis identified age, CAD, Hs-CRP, and LVIDs abnormalities as independent predictors of mortality, indicating that the independent protective effect of vaccination requires further validation. Conclusions: CoronaVac is associated with lower mortality and stable cardiac function in maintenance hemodialysis patients. The vaccine may reduce infection severity, lower cardiac load, and improve prognosis.

Maintenance hemodialysis patients are at increased risk of cardiovascular complications and mortality following COVID-19 infection due to compromised immune function. This study aims to evaluate the impact of the COVID-19 vaccine (CoronaVac) on cardiac function and survival in this population. Background/Objectives: We aimed to examine whether CoronaVac vaccination affects heart function and survival rates in maintenance hemodialysis patients. Specifically, we assessed changes in heart ultrasound (echocardiographic) measurements, B-type natriuretic peptide (BNP) levels, and survival outcomes by comparing vaccinated and unvaccinated patients. Methods: A retrospective analysis was conducted on 531 maintenance hemodialysis patients, including 79 who received CoronaVac and 452 who did not. We compared the pre- and post-infection changes in heart function (echocardiographic parameters) and BNP levels between the two groups and assessed their association with the survival rates. Results: The vaccinated patients were younger (60.54 ± 13.51 vs. 65.21 ± 13.76 years, p = 0.006) and had shorter dialysis durations (56.04 ± 51.88 vs. 73.73 ± 64.79 months, p = 0.022). The mortality rate was also significantly lower in the vaccinated group (6.33% vs. 14.38%, p = 0.049). After infection, the unvaccinated patients showed significant declines in heart function and increased B-type natriuretic peptide levels, while the vaccinated patients demonstrated no significant deterioration. Older age, coronary artery disease, inflammation levels, and heart abnormalities were identified as the key risk factors for mortality. Conclusions: CoronaVac was linked to lower mortality and better heart function in maintenance hemodialysis patients. The vaccine may help to reduce infection severity, lower strain on the heart, and improve the overall prognosis.

Retained surgical items, such as cotton balls (gossypibomas), are rare yet preventable complications that may cause chronic infection and diagnostic difficulty. We report the case of a 65-year-old man with a non-healing right calf wound and sinus tract persisting for 1 year following orthopedic surgery. Magnetic resonance imaging (MRI) revealed an abscess characterized by T1-weighted hypointensity and T2-weighted spiral-like low-signal fringes, prompting surgical exploration. A retained cotton ball was identified and excised, followed by debridement and local rotational flap closure. The patient achieved complete recovery without recurrence. A review of 26 published lower-limb cases indicates that most gossypibomas occur after fracture fixation, often presenting with long latency, nonspecific symptoms, and variable MRI appearances. Preventive strategies include rigorous counting, enhanced team communication, and emerging tracking technologies such as radio-frequency identification (RFID) and barcode systems. This case emphasizes early recognition of atypical chronic wounds and supports incorporating automated tracking into surgical workflows to prevent retained foreign bodies and improve patient safety.

Retained surgical items, such as cotton balls (gossypibomas), are rare yet preventable complications that may cause chronic infection and diagnostic difficulty. We report the case of a 65-year-old man with a non-healing right calf wound and sinus tract persisting for 1 year following orthopedic surgery. Magnetic resonance imaging (MRI) revealed an abscess characterized by T1-weighted hypointensity and T2-weighted spiral-like low-signal fringes, prompting surgical exploration. A retained cotton ball was identified and excised, followed by debridement and local rotational flap closure. The patient achieved complete recovery without recurrence. A review of 26 published lower-limb cases indicates that most gossypibomas occur after fracture fixation, often presenting with long latency, nonspecific symptoms, and variable MRI appearances. Preventive strategies include rigorous counting, enhanced team communication, and emerging tracking technologies such as radio-frequency identification (RFID) and barcode systems. This case emphasizes early recognition of atypical chronic wounds and supports incorporating automated tracking into surgical workflows to prevent retained foreign bodies and improve patient safety.