[The role of miRNA in kidney development].

MicroRNAs (miRNAs) are endogenous small non-coding RNAs (19-25 nucleotides) that negatively regulate gene expression at the post transcriptional level by binding to complementary target sequences in the target mRNA. miRNAs play an important role in a wide range of biological processes, including organ development. Recent studies have shown that some miRNAs are highly expressed in the kidney and are closely related to kidney development and diseases, suggesting that miRNAs are important regulators in kidney physiology and pathology. This review will focus on the research progress of miRNA in kidney development, and discuss the role of miRNAs in the occurrence and development of renal dysplasia, which will provide a reference for the diagnosis and research of diseases related to kidney development.

[Effects of mild hypothermia on low cardiac output after cardiac surgery].

OBJECTIVE: To evaluate the effectiveness of mild hypothermia on low cardiac output in patients after cardiac surgery. METHODS: Twelve patients manifesting low cardiac output after cardiac surgery despite of the use of massive doses of catecholamine and intra-aortic balloon pump (IABP) underwent mild hypothermia during May 2009 to February 2011. Changes in hemodynamic parameters of the patients were measured, including cardiac index (CI),mixed venous oxygen saturation [SvO(2)] and urine volume. RESULTS: In the process of mild hypothermia treatment, bladder temperature of patients was lowered to 33-35 centigrade in order to reduce the body oxygen demand. The CI [ml·s(-1)·m(-2)]of patients after mild hypothermia treatment was increased obviously (38.34 ± 5.00 vs. 30.01 ± 5.00), the same as SvO(2) (0.64 ± 0.07 vs. 0.54 ± 0.08) and urine output [ml·kg(-1)·h(-1): 3.0 ± 2.1 vs. 1.5 ± 1.1, all P < 0.05]. However, there was no significant change in heart rate, mean arterial pressure and blood oxygen pressure. CONCLUSION: Mild hypothermia is an effective and simple procedure to improve the cardiac function in patients after cardiac surgery complicated with low cardiac output.

Preterm neonate with a large congenital hemangioma on maxillofacial site causing thrombocytopenia and heart failure: A case report.

BACKGROUND: We report a rare case of a large congenital hemangioma (CH) in the maxillofacial region in a female neonate that caused thrombocytopenia and heart failure. With close multidisciplinary collaboration, the congenital hemangioma was successfully resected with good results. CASE SUMMARY: The patient was delivered at gestational age of 36 wk by cesarean section due to cephalopelvic disproportion and lack of onset of labor (birth weight: 2630 g). A right-sided facial tumor was detected in the fetus during routine antenatal ultrasound examination of the mother at 32 wk of gestation. Physical examination revealed a 7 cm × 7 cm × 3 cm hard, dull purple-colored mass on the right maxillofacial region. The mass was tense and had prominent surface telangiectasias. Laboratory investigations revealed reduced hemoglobin and platelet count, and increased activated partial thromboplastin time, prothrombin time, and thrombin time. International normalized ratio, fibrin degradation products, and D-Dimer levels were significantly increased. Thromboelastography showed increased alpha angle, mean amplitude, and the clot formation speed. Thyroid-stimulating hormone level was significantly elevated. The patient was administered prednisone, propranolol, euthyrox, vitamin K1, milrinone, and digoxin. After operation, cefepime was administered for anti-infection and propranolol was prescribed at discharge. CONCLUSION: We report a rare case of CH in the right maxillofacial region causing thrombocytopenia and heart failure.

[Application of ultrasound in treating postpartum pubis symphysis diastasis by bone setting manipulation].

OBJECTIVE: To explore application value of ultrasound in treating postpartum pubis symphysis diastasis by bone setting manipulation. METHODS: Retrospective analysis was performed on 30 patients (case group) with postpartum pubis symphysis diastasis diagnosed in Wangjing Hospital, China Academy of Chinese Medical Sciences from June 2017 to January 2021, aged from 21 to 43 years old, with an average of (33.0±3.5) years old. The main clinical manifestations were mobility disorders such as turning over and walking, and all patients were treated by bone setting manipulation. Before and after treatment, pain and degree of pubic symphysis separation were evaluated by visual analogue scale(VAS) and ultrasonography. In normal group, 30 menopausal women aged from 49 to 59 years old with an average of(54.0±2.9) years old who wanted to remove intra uterine device(IUD) and were underwent conventional pelvic plain radiographswere selected, and the width of pubic symphysis space was measured by ultrasound and plain radiographs. RESULTS: In normal group, the width of pubic symphysis was about (5.2±1.7) mm by ultrasonography, X-ray measurement was (5.0±2.1) mm, and showed no difference(P>0.05).In case group, the width of pubic symphysis measured by ultrasound before manipulation was about (9.5±1.8) mm, VAS was 6.05(5.27, 6.80) scores;while the width of pubic symphysis measured by ultrasound before manipulation was about (5.8±1.3) mm, VAS was 0(0, 0) scores, and there were statistical difference before and after manipulation (P<0.05). CONCLUSION: Ultrasound is examation method with safe, non radioactive, easy to repeat for many times, could clearly show cartilage, ligament and bone structure around pubic symphysis, and is more suitable for the imaging diagnosis of postpartum pubis symphysis diastasis, which provide quantitative imaging basis for clinical evaluation of the curative effect of bone setting manipulation in treating postpartum pubis symphysis diastasis.

Alternatively Polarized Macrophages Regulate the Growth and Differentiation of Ependymal Stem Cells through the SIRT2 Pathway.

Ependymal stem cells (EpSCs) are dormant stem cells in the adult spinal cord that proliferate rapidly and migrate to the site of injury after spinal cord injury (SCI). Although they can differentiate into neurons under appropriate conditions in vitro, EpSCs mainly differentiate into astrocytes in vivo. Our previous study confirmed that alternatively polarized macrophages (M2) facilitate the differentiation of EpSCs towards neurons, but the detailed mechanism remains elusive. In the present study, we found that M2 conditioned medium could upregulate the expression of Sirtuin 2 (SIRT2) in EpSCs in vitro through the BDNF/TrkB-MEK/ERK signaling pathway. As an important deacetylase, SIRT2 deacetylated stable Ac-α-tubulin (Acetyl alpha Tubulin) in microtubules and thus promoted EpSC differentiation into neurons. The present study provides a theoretical basis and a new way to improve neural recovery, such as regulating the growth and differentiation of EpSCs by increasing the proportion of M2 cells in the local microenvironment or upregulating the expression of SIRT2 in EpSCs.

[Clinical value of DC and DRs in warning sudden cardiac death of patients with coronary artery disease].

OBJECTIVE: To make risk stratification of aged patients with coronary artery disease by deceleration capacity of rate (DC) and heart rate deceleration runs (DRs) and to investigate the value of the two detection technologies in warning sudden cardiac death. METHODS: Two hundrend and eighteen patients diagnosed with coronary artery disease (CAD) by coronary angiography (CAG) were selected as observa-tion group:including 55 patients with latent coronary artery disease (LCHD), 56 patients with acute myocardial infarction (AMI), 53 patients with angina pectoris (AP), 54 patients with ischemic heart failure. Fifty-five healthy controls in our hospital were selected at the same time (control group). All patients were detected by 24-hour dynamic electrocardiogram while values of DC and DRs were automatically analyzed and calculated by software. RESULTS: The values of DC and DRs descended significantly in all CHD groups (AMI group, AP group, Ischemic Heart Failure group, LCHD group) and the difference was statistically significant (P < 0.01) compared with normal group; DC and DRs indicated the risk classification of each CAD subgroup was obviously higher than those in normal group and the difference was statistically significant(P < 0.01); CAG showed that the more coronary lesions, the larger the rage, prompt the heavier the illness, which was consistent with the risk classification of each CHD subgroup indicated by DC and DRs. CONCLUSIONS: DC and DRs can be used to analyze the function of vagus nerve, it also can be used to make risk classification of patients with CHD, and it has a higher value of pre-warning for high-risk groups. DC and DRs can be used as sensitive indexes in warning sudden cardiac death of patients with CHD.

[Effects of different anesthesia methods on perioperative hemodynamics and ECG in old CHD patients].

OBJECTIVE: To explore an optimal anesthesia method with less impact on hemodynamics and electrocardiogram (ECG) of old patients with coronary artery disease (CHD) during abdominal operation. METHODS: The 133 CHD patients waiting for abdominal operation were randomly divided into continuous epidural anesthesia (EA) group, general anesthesia group (GA) and combined spinal-epidural anesthesia (CSEA) group. Continuous monitoring was carried out during operation and mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SaO2), abnormal ECG were measured respectively at different time for comparison and the differences of the above hemodynamic parameters and abnormal ECG features were compared among the 3 groups. RESULTS: At the 15 min and 30 min point after anesthesia, SaO2 in GA group was significantly increased compared to that in the EA group (P < 0.05). At 15 min, 30 min and 60 min point after anesthesia, MAP in CSEA group was significantly increased compared to that in the EA group (P < 0.05). At 30 min point after anesthesia, HR in CSEA group was increased significantly compared to the EA group (P < 0.05). At 15 min and 30 min point after anesthesia, SaO2 in the CSEA group was increased significantly compare to the EA group (P < 0.05). Compared with preanesthesia (T0) in EA group, MAP, HR and SaO2 decreased significantly at 15, 30 and 60 min after anesthesia (P < 0.05). The fluctuation of the three parameters in GA and CSEA groups were relatively small (P > 0.05). As well as the comparison of abnormal ECG among the 3 groups was concerned, the incidence of ST-T changes in GA and CSEA groups were significantly lower than that in EA group at the time of 15 min, 30 min and 60 min after anesthesia and at the time of surgery termination (P < 0.05, P < 0.01). The incidence of arrhythmia in GA and CSEA groups were significantly lower than that in EA group at the time of 15 min, 30 min and 60 min after anesthesia (P < 0.05, P < 0.01). Compared with T0 in the same group, the incidences of ST-T changes and arrhythmia in GA or CSEA group at the time of 15, 30 and 60 min after anesthesia and at the time of surgery termination were significantly lower than that before anesthesia (P < 0.05, P < 0.01). CONCLUSION: GA and CSEA have less impact on hemodynamics and have smaller incidence of abnormal ECG of old CHD patients with abdominal operation.

[Perioperative cardiovascular abnormality in elder patients with silent coronary heart disease].

OBJECTIVE: To explore the perioperative cardiovascular dysfunction and its relevance to age in patients with silent coronary heart disease (or silent myocardial ischemia), and explore the clinical treatment and recovery of perioperative arrhythmias. METHODS: One hundred and eighty cases were selected from selective surgery patients with silent myocardial ischemia (SMI). Among the cases, 130 patients older than 51 years old were divided into 51 - 60 year-old group, 61- 70 year-old group and 71 - 80 year-old group. Control group was set up by other 50 patients younger than 51 years old. Electrocardiogram data of 24 h before the operation, 24 h after the operation and 48 h after the operation were continuously monitored by dynamic electrocardiogram (DCG). The electrocardiogram data of ST shifting, arrhythmia incidences of different type and at different time were analyzed by professional doctors. At the same time, the treatment and recovery of perioperative arrhythmia were recorded. RESULTS: As the age increase, the magnitude and duration of ST shifting appeared upward trend compared to the control group (P < 0.05, P < 0.01). The incidence of ST elevation in 71 - 80 year-old group was higher than the control group (P < 0.05). The ST depression duration in 61 - 70 and 71 - 80 year-old group and ST elevation magnitude in 71 - 80 year-old group were higher than 51 - 60 year-old group (P < 0.05). Compared to the control group, the incidence of accelerated idioventricular rhythm (AIR) in 61 - 70 year-old group and the incidence of sinus bradycardia (SB), ventricular premature beat (VPB), ventricular tachycardia (VT) in 71 - 80 year-old group were higher (P < 0.05, P < 0.01). Compared to the 51 - 60 year-old group, the incidence of atrial fibrillation (AF) in 61 - 70 year-old group and the incidence of VP, VT, AF in 71 - 80 year-old group were higher (P < 0.05, P < 0.01). The arrhythmia incidences in 24 h after operation were higher than 48 h after operation and 24 h before operation (P < 0.01). As the age increase, the recovery incidence by removing inducement was decreased, but the recovery incidences by drug and electric-shock treatment were increased (P < 0.05). CONCLUSION: Old SMI patients have high levels of perioperative myocardial ischemia and arrhythmia, and 24 h after operation is the period of high incidence.

[The role of nitric oxide on the dysfunction of intestinal motility in rats subjected to hemorrhagic shock].

OBJECTIVE: To determine the role of nitric oxide (NO) in intestinal motility dysfunction in rats subjected to hemorrhagic shock (HS). METHODS: Sixteen male Wistar rats were randomly and equally divided into two groups. The HS model of rat was induced by bleeding from femoral artery. After animal models were made, different inducers were added, and duodenum samples were harvested for the determination of contractile response to acetylcholine (ACh) in vitro, activities of inducible nitric oxide synthase (iNOS), contents of NO in tissue, and morphological changes. RESULTS: The spontaneous contraction of intestinal smooth muscle and contractile response induced by ACh were significantly decreased at 180 minutes in HS group, compared with control group, the contractile response induced by ACh of intestinal smooth muscle was decreased by almost 60% (0.40±0.11 g×mm(-2)×s(-1) vs. 1.00±0.20 g×mm(-2)×s(-1), P<0.01). The inhibitor of iNOS N(G)-nitro-L-arginine methyl ester hydrochloride (L-NAME) could significantly restore the suppressed contractile response of smooth muscle strips obtained from HS rats (0.97±0.25 vs. 0.40±0.11, P<0.01). Moreover, the inhibitor of soluble guanylyl cyclase 1H-[1,2,4] Oxadiazolo [4,3-a] quinoxalin-1-one (ODQ) also improved the contractility of HS muscle strips significantly (0.79±0.17 vs. 0.40±0.11, P<0.01). But the blocker of ATP-sensitive potassium channel glibenclamide had no effect on the contractility of HS muscle strips (0.47±0.14 vs. 0.40±0.11, P>0.05). Compared with those of control group, iNOS activities (2.295±0.310 U/g vs. 1.319±0.322 U/g) and NO contents (2.880±0.353 µmol/g vs. 1.505±0.387 µmol/g) in duodenum of HS rats were both significantly increased (both P<0.01). Under light microscopy, the most significant morphological change in duodenum following HS was the infiltration of obvious inflammatory cells. CONCLUSIONS: The NO produced by the overexpression of iNOS induced by HS involves in the motility dysfunction of intestine through the mechanism of cyclic guanosine monophosphate (cGMP) system. Moreover, NO-mediated infiltration of inflammatory cells in tissue may also contribute to the development of motility dysfunction of intestine following HS.