MicroRNA-214 provokes cardiac hypertrophy via repression of EZH2.

Micro RNAs are small, non-coding RNA molecules that regulate gene expression via either translational inhibition or mRNA degredation. Enhancer of zeste homolog 2 (EZH2)-mediated hypertrophic signaling is a major regulatory response to hypertrophic stimuli. In this study, we constructed AAC rat models and PE-induced hypertrophic cardiomyocytes. We demonstrated that miR-214 relative levels were upregulated, whereas EZH2 was downregulated in both vivo and vitro models. Further, one conserved base-pairing site in the EZH2 3'-untranslated region (UTR) was verified. Mutation of the site in the EZH2 3'-UTR completely blocked the negative effect of miR-214 on EZH2, suggesting that EZH2 is a direct target for miR-214 regulation. Using a gain-of-function approach, incorporating the lentivirus constructed miR-214 and its sponge, we demonstrated that miR-214 significantly regulated endogenous levels of EZH2 gene expression; whereas, changes in the expression of the Sine oculis homeobox homolog gene were induced by an adrenergic receptor agonist in the AAC rat model. Having made this study it is possible to conclude that the negative regulation of EZH2 expression contributed to miR-214-mediated cardiac hypertrophy.

Birth growth curves of neonates in high-altitude areas: A cross-sectional study.

Background: Since the current commonly used birth growth curves are unsuitable for neonates in high-altitude areas; this study aimed to establish birth growth curves for full-term neonates residing at 2,000-3,000 m. Methods: This cross-sectional study retrospectively analyzed the physical measurement data of 1,546 full-term neonates delivered at the Red Cross Hospital of Qinghai province, China, from July 2021 to April 2022. The percentile curves of birth weight, length, and head circumference of neonates of different gestational ages and genders were developed using curve fitting. The newly developed birth-weight percentile reference was compared with the INTERGROWTH-21st Neonatal Growth Curve (International Standard) and the Chinese Neonate Growth Curve (Chinese Standard). Results: The median birth weight, length, and head circumference of the study population were 3,200 g, 52.0 cm, and 32.8 cm, respectively, except for the group with a gestational age of 37 weeks. The growth indicators of male infants in all groups were higher than those of the female infants (P < 0.05). We found differences between the newly developed birth-weight percentile curves in the high-altitude areas and the International and Chinese Standards. Conclusion: Establishing birth growth curves corresponding to altitude may be more suitable than the existing standards for local medical staff to conduct health assessments of neonates.

Elevated intraoperative expression of ventricular myosin light chain predicts heart failure after valve replacement surgery.

BACKGROUND: It can be difficult to predict which patients will survive and recover cardiac function after valve replacement surgery. We hypothesized that the expression levels of ventricular myosin light chain (MLCv) might reflect the severity of disease or the extent of irreversible myocardial damage and might be useful for predicting the postoperative course. Thus, the aim of this study was to explore the relationship between MLCv expression in specimens obtained during valve replacement surgery and the postoperative New York Heart Association (NYHA) class. METHODS: The levels of expression of the regulatory MLCv (MLC-2v) and MLC-1v in papillary muscle specimens from 80 patients who underwent valve replacement surgery for rheumatic valvular disease were evaluated by Western blot analysis. RESULTS: The patients were similar with regard to the intraoperative expression of MLC-1v, regardless of postoperative NYHA class. The preoperative NYHA class, the end-systolic left ventricular internal dimension, and the intraoperative expression of MLC-2v emerged as independent risks factors for a NYHA class status of III/IV at 6 months after surgery, with an area under the receiver operating characteristic curve of 0.862. CONCLUSION: The intraoperative level of MLC-2v expression was predictive of the patients' NYHA class after valve replacement surgery. This result suggests that future studies evaluating the use of preoperative specimens (such as biopsy or peripheral blood samples) for measurement of MLC-2v levels could lead to a valuable preoperative tool for the assessment of candidates for valve replacement.

Role of miR-22 in intestinal mucosa tissues and peripheral blood CD4+ T cells of inflammatory bowel disease.

OBJECTIVE: miR-22 is known to be involved in the pathogenesis of several autoimmune diseases, but it remains unclear whether miR-22 is associated with inflammatory intestinal disease (IBD). METHODS: The patients with ulcerative colitis (UC) and Crohn's disease (CD) were enrolled in this study. After the CD4+ T cells from healthy controls and active IBD patients were isolated and then transfected with miR-22 mimics/inhibitors, Quantitative real-time polymerase chain reaction (qRT-PCR) was conducted to measure expressions of miR-22, HDAC4, specific transcription factors in intestinal mucosa tissue and CD4+ T cells, while enzyme-linked immuno sorbent assay (ELISA) to detect expressions of inflammatory cytokines in PB. Antisense miR-22 was administered into mice during trinitrobenzene sulphoni cacid (TNBS)-induced colitis to determine its role in IBD. RESULTS: A significant elevation of miR-22 but an evident decrease of HDAC4 was found in CD4+ T cells in PB and intestinal mucosa tissues from IBD patients. In addition, there was a great reduction in HDAC4 and a dramatic enhancement in Th17 cell specific transcription factor (RORC) and inflammatory cytokines (IL-17A, IL-6 and TNF-α) after overexpression miR-22, which was opposite to the effect of inhibition of miR-22. Furthermore, administration of antisense miR-22 in TNBS-induced mouse colitis model significantly decreased numbers of interleukin (IL)-17A+ CD4+ T cells and the expressions of IL-17A, RORC, IL-6 and TNF-α. CONCLUSION: MiR-22 was up-regulated in CD4+ T cells in PB and intestinal mucosa tissues of IBD patients, which could promote Th17 cell differentiation via targeting HDAC4 to be involved in IBD progression.

[Diagnosis and treatment of pulmonary histoplasmoma: report of 3 cases].

OBJECTIVE: To investigate the diagnosis and treatment of pulmonary histoplasmoma. METHODS: The clinical data of 3 patients with pulmonary histoplasmoma. 2 males, both 49-years-old, and 1 female, 27-years-old, were analyzed. RESULTS: Nodules in the lung, regardless solitary or multiple, with clear border and calcification, were the first radiological finding. All 3 patients were misdiagnosed as with tuberculosis or primary or metastatic lung neoplasm and underwent operation. The diagnosis was confirmed after surgery. Pathological examination showed caseous necrosis and a great amount of histoplasma in the multinuclear cells. Follow-up lasting 1, 2, and 3 years respectively showed no recurrence. CONCLUSION: Pulmonary nodule, regardless solitary or multiple, with clear border and calcification, is the first radiological finding of pulmonary histoplasmoma Autopsy is necessary for diagnosis of pulmonary histoplasmoma, difficult to diagnose, however, with a good prognosis.

Successful surgical strategy in a late case of Boerhaave's syndrome.

Boerhaave's syndrome refers to the spontaneous transmural rupture of the esophagus. Primary repair may be performed in patients who present within 24 h of perforation, and such cases have the best outcomes as most complications have not yet developed. However, the treatment of late perforations remains controversial. Various approaches and strategies to repair late perforations have been described in the literature, but there is no uniform approach. We present a case of Boerhaave's syndrome in which the patient underwent surgical repair 48 h after the acute event and was subsequently treated successfully. The initial approach included direct esophageal repair, a drainage series, and nutritional support via a feeding jejunostomy. Although the repair site was subsequently disrupted, the patient showed complete healing of the perforation after three weeks. We consider that our surgical treatment strategy is safe and technically feasible, and appears to be a promising alternative approach for the treatment of patients with late Boerhaave's perforation.

Successful esophagectomy in a patient with combined esophageal cancer and hemophilia B.

Patients with esophageal cancer often require esophagectomy with esophagogastrostomy. However, the incidence of complications, such as hemorrhage, during operations for esophageal cancer is high, even with minimally invasive surgery. Without the appropriate interventions, the risk of major intraoperative and postoperative hemorrhage is very high in patients with esophageal cancer and hemophilia. We report the case of a 45-year-old man with esophageal cancer and hemophilia B who underwent a successful hybrid, minimally invasive Ivor-Lewis esophagectomy with appropriate perioperative management.