ABSTRACT
Hematopoietic toxicity due to ionizing radiation (IR) is a leading cause of death in nuclear incidents, occupational hazards, and cancer therapy. Oxymatrine (OM), an extract originating from the root of Sophora flavescens (Kushen), possesses extensive pharmacological properties. In this study, we demonstrate that OM treatment accelerates hematological recovery and increases the survival rate of mice subjected to irradiation. This outcome is accompanied by an increase in functional hematopoietic stem cells (HSCs), resulting in enhanced hematopoietic reconstitution abilities. Mechanistically, we observed significant activation of the MAPK signaling pathway, accelerated cellular proliferation, and decreased cell apoptosis. Notably, we identified marked increases in the cell cycle transcriptional regulator Cyclin D1 (Ccnd1) and the anti-apoptotic protein BCL2 in HSCs after OM treatment. Further investigation revealed that the expression of Ccnd1 transcript and BCL2 levels were reversed upon specific inhibition of ERK1/2 phosphorylation, effectively negating the rescuing effect of OM. Moreover, we determined that targeted inhibition of ERK1/2 activation significantly counteracted the regenerative effect of OM on human HSCs. Taken together, our results suggest a crucial role for OM in hematopoietic reconstitution following IR via MAPK signaling pathway-mediated mechanisms, providing theoretical support for innovative therapeutic applications of OM in addressing IR-induced injuries in humans.
Subject(s)
Alkaloids , Mice , Humans , Animals , Phosphorylation , Alkaloids/pharmacology , Signal Transduction , Apoptosis , Proto-Oncogene Proteins c-bcl-2/geneticsABSTRACT
Broflanilide is a newly-developed meta-diamide insecticide, proposed for the control of a wide variety of chewing pests on many crops. In view of the proposed use of broflanilide and its environmental fate, it may be exposed to consumers and non-target organisms, which adversely affect human and the environment. In this paper, a rapid, sensitive and valid UPLC-MS/MS method was established for simultaneous analysis of broflanilide and its two major metabolites, DM-8007 and S (PFP-OH)-8007, in cauliflower. Then, the dissipation behaviors and final residues of broflanilide and its two major metabolites in cauliflower from eight sites with different climatic conditions in China were studied via the described analytical method. In addition, the acute toxicity test of 9.5 % suspension concentrate of broflanilide, broflanilide standard, DM-8007 and S (PFP-OH)-8007 were conducted to non-target terrestrial organisms. Risk assessment for human and non-target terrestrial organisms in cauliflower production was evaluated based on the maximum annual application rates and intervals. The results showed that the highest residue of broflanilide detected in cauliflower samples was all lower than the corresponding MRLs (2 mg/kg) in Japan. Chronic food dietary risk estimates for broflanilide do not exceed 50 % for all the Chinese population groups. Moreover, broflanilide is of low acute toxicity to birds and earthworm, while broflanilide and its metabolites is classified as highly toxic to adult honeybees. Acute risks of broflanilide to birds and earthworms were deemed to be acceptable in a realistic worst-case scenario, while its risk to adult honeybees and ladybug was unacceptable. A protection statement for honeybees and ladybug is required to recognize the high toxicity of broflanilide on related product labels. The study will be conducive to provide guidance for the rational application of broflanilide in cauliflower production.
Subject(s)
Benzamides , Brassica , Fluorocarbons , Insecticides , Pesticide Residues , Humans , Animals , Bees , Pesticide Residues/analysis , Tandem Mass Spectrometry/methods , Chromatography, Liquid/methods , Insecticides/toxicity , Risk AssessmentABSTRACT
Bioinspired smart superwetting surfaces with special wettability have aroused great attention from fundamental research to technological applications including self-cleaning, oil-water separation, anti-icing/corrosion/fogging, drag reduction, cell engineering, liquid manipulation, and so on. However, most of the reported smart superwetting surfaces switch their wettability by reversibly changing surface chemistry rather than surface microstructure. Compared with surface chemistry, the regulation of surface microstructure is more difficult and can bring novel functions to the surfaces. As a kind of stimulus-responsive material, shape-memory polymer (SMP) has become an excellent candidate for preparing smart superwetting surfaces owing to its unique shape transformation property. This review systematically summarizes the recent progress of smart superwetting SMP surfaces including fabrication methods, smart superwetting phenomena, and related application fields. The smart superwettabilities, such as superhydrophobicity/superomniphobicity with tunable adhesion, reversible switching between superhydrophobicity and superhydrophilicity, switchable isotropic/anisotropic wetting, slippery surface with tunable wettability, and underwater superaerophobicity/superoleophobicity with tunable adhesion, can be obtained on SMP micro/nanostructures by regulating the surface morphology. Finally, the challenges and future prospects of smart superwetting SMP surfaces are discussed.
ABSTRACT
Traditional noninvasive blood pressure measurement methods in experimental animals are time consuming and difficult to operate, particularly for large numbers of animals. In this study, the possibility of sensing fecal odor to estimate the blood pressure status of spontaneous hypertension rats (SHRs) was explored with the aim of establishing a new method for non-invasive monitoring of blood pressure. The body weight and blood pressure of SHRs kept increasing with growth, and the odor information monitored using an E-nose varied with the blood pressure status, particularly for sensors S6 and S7. The fecal information was analyzed using principal component analysis, canonical discriminant analysis and multilayer perception neural networks (MLP) to discriminate SHRs from normal ones, with a 100% correct classification rate. For better prediction of blood pressure, the model built using multiple linear regression analysis, partial least squares regression analysis and multilayer perceptron neural network analysis were used, with coefficients of determination (R2) ranging from 0.8036 to 0.9926. Moreover, the best prediction model for blood pressure was established using MLP analysis with an R2¬ higher than 0.91. Thus, changes in blood pressure levels can be tracked non-invasively, and normotension can be distinguished from hypertension or even at different hypertension levels based on the odor information of rat feces, providing a foundation for non-invasive health monitoring. This work might provide potential instructions for functional food research aimed at lowering blood pressure.
Subject(s)
Hypertension , Hypotension , Rats , Animals , Blood Pressure , Electronic Nose , Hypertension/diagnosis , Blood Pressure DeterminationABSTRACT
Vortex beam generators carrying orbital angular momentum (OAM) with both transmission and reflection modes has broad application prospects in full-space high data capacity communication and orbital angular momentum multiplexing systems. In this work, we proposed a vanadium dioxide (VO2) assisted metasurface to independently produce and manipulate focused vortex transmission-reflection modes with different number of beams and focal lengths under right-handed circular polarized (RCP) wave incidence. The proposed metasurface generates the diagonal vortex beams, four vortex beams, and focused vortex beam for transmission mode at 1.26THz and reflection mode at 1.06THz by changing phase state of the VO2. Our work may find many potential applications in future high data capacity information multiplexing communication systems.
ABSTRACT
Metformin is still being investigated due to its potential use as a therapeutic agent for managing overweight or obesity. However, the underlying mechanisms are not fully understood. Inhibiting the adipogenesis of adipocyte precursors may be a new therapeutic opportunity for obesity treatments. It is still not fully elucidated whether adipogenesis is also involved in the weight loss mechanisms by metformin. We therefore used adipose-derived stem cells (ADSCs) from inguinal and epididymal fat pads to investigate the effects and mechanisms of metformin on adipogenesis in vitro. Our results demonstrate the similar effect of metformin inhibition on lipid accumulation, lipid droplets fusion, and growth in adipose-derived stem cells from epididymal fat pads (Epi-ADSCs) and adipose-derived stem cells from inguinal fat pads (Ing-ADSCs) cultures. We identified that cell death-inducing DFFA-like effector c (Cidec), Perilipin1, and ras-related protein 8a (Rab8a) expression increased ADSCs differentiation. In addition, we found that metformin inhibits lipid droplets fusion and growth by decreasing the expression of Cidec, Perilipin1, and Rab8a. Activation of AMPK pathway signaling in part involves metformin inhibition on Cidec, Perilipin1, and Rab8a expression. Collectively, our study reveals that metformin inhibits lipid storage, fusion, and growth of lipid droplets via reduction in Cidec and its regulatory factors in ADSCs cultures. Our study supports the development of clinical trials on metformin-based therapy for patients with overweight and obesity.
Subject(s)
Lipid Droplets , Metformin , Adipocytes/metabolism , Adipogenesis , Adipose Tissue/metabolism , Animals , Humans , Lipid Droplets/metabolism , Lipids , Metformin/metabolism , Metformin/pharmacology , Obesity/metabolism , Overweight/metabolism , Proteins/metabolism , Rats , Stem Cells/metabolismABSTRACT
Most reported metasurfaces operate in single propagation direction mode (either transmissive mode or reflective mode), which hamper practical application. Here, we proposed a bi-directional operation coding metasurface based on a phase change material of a vanadium dioxide (VO2) assisted metasurface. It can realize a dynamically invertible switch between the transmissive mode or reflective mode in the terahertz regime by changing the external ambient temperature. The proposed structure consists of a silicon column, polyimide dielectric substrate layer, and VO2 film bottom layer. When VO2 is in dielectric state, the designed metasurface possesses the functions of transmission beam splitting and deflection and generates a transmission vortex beam. When VO2 is in metallic state, the proposed metasurface exhibits many functions such as reflection beam splitting, deflection, radar scattering surface (RCS) reduction and reflection vortex beam generation. The proposed metasurface can solve transmissive and reflective bi-direction terahertz encoding regulation. This scheme provides a new method to realize multi-function terahertz devices.
ABSTRACT
BACKGROUND: Evidence for peritoneal dialysis catheter (PDC) usage in pediatric patients undergoing surgery for deteriorating cardiac dysfunction is lacking. This investigation explored factors associated with PDC usage and its effectiveness in children with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). METHODS: Eighty-four children undergoing left coronary artery transfer were retrospectively recruited. The primary endpoint was the postoperative ratio of the general ward/[intensive care unit (ICU)] length of stay. Univariable and multivariable analyses were fitted to assess factors related most strongly to PDC and the ratio of general ward/ICU length of stay. RESULTS: Of the 84 patients, 17 (20.2%) underwent postoperative PDC placement. Patients with extreme cardiac dysfunction [left ventricular ejection fraction (LVEF) ≤25%] were much more likely to require a PDC (OR, 9.88; 95% CI, 2.13-45.76; P = 0.003). Moreover, univariate analysis indicated that concomitant mitral repair significantly decreased the likelihood of PDC placement (OR, 0.25; 95% CI, 0.07-0.85; P = 0.026). In those with cardiac dysfunction (LVEF ≤50%), PDC use was associated with a reduced ratio of ward/ICU length of stay (B, - 1.62; 95% CI, - 2.77- -0.46; P = 0.008), as was age ≤ 12 months (B, - 1.57; 95% CI, - 2.88- -0.26; P = 0.02). At the 1-year follow-up, cardiac improvement was significantly greater in patients with PDC usage than in those without it (P < 0.001), and the number of mitral recoveries was comparable between the groups (64.2% vs. 53.3%, P = 0.434). CONCLUSION: In cohorts with ALCAPA, PDC placement following surgery may be necessary for patients with extreme cardiac compromise, while concomitant mitral repair can probably reduce their usage rate. PDC is beneficial in conferring an improvement in cardiac and mitral performance. Importantly, after patients are transferred from the ICU, recovery efficiency in the general ward can be enhanced by PDC placement, and hospital discharge can therefore be achieved early, especially for patients younger than 12 months or with LVEF ≤50%.
Subject(s)
Bland White Garland Syndrome , Peritoneal Dialysis , Catheters , Child , Cohort Studies , Humans , Infant , Retrospective Studies , Stroke Volume , Treatment Outcome , Ventricular Function, LeftABSTRACT
OBJECTIVES: The study compared machine-learning models with traditional logistic regression to predicting liver outcomes after aortic arch surgery. DESIGN: Retrospective review from January 2013 to May 2017. SETTING: Fuwai Hospital. PARTICIPANTS: The study comprised 672 consecutive patients who had undergone aortic arch surgery. MEASUREMENTS AND MAIN RESULTS: Three machine-learning methods were compared with logistic regression with regard to the prediction of postoperative liver dysfunction (PLD) after aortic arch surgery. The perioperative characteristics, including the patients' baseline medical condition and intraoperative data, were analyzed. The performance of the models was assessed using the area under the receiver operating characteristic curve. Naïve Bayes had the best discriminative ability for the prediction of PLD (area under the receiver operating characteristic curveâ¯=â¯0.77) compared with random forest (0.76), support vector machine (0.73), and logistic regression (0.72). The primary endpoint of PLD was observed in 185 patients (27.5%). The cardiopulmonary bypass time, long surgery time, long aortic clamp time, high preoperative bilirubin value, and low rectal temperature were strongly associated with the development of PLD after aortic arch surgery. CONCLUSION: The machine-learning method of naïve Bayes predicts PLD after aortic arch surgery significantly better than traditional logistic regression.
Subject(s)
Aorta, Thoracic , Liver Diseases , Aorta, Thoracic/surgery , Bayes Theorem , Humans , Machine Learning , Retrospective StudiesABSTRACT
Hematopoietic stem cells (HSCs) regularly produce various blood cells throughout life via their self-renewal, proliferation, and differentiation abilities. Most HSCs remain quiescent in the bone marrow (BM) and respond in a timely manner to either physiological or pathological cues, but the underlying mechanisms remain to be further elucidated. In the past few years, accumulating evidence has highlighted an intermediate role of inflammasome activation in hematopoietic maintenance, post-hematopoietic transplantation complications, and senescence. As a cytosolic protein complex, the inflammasome participates in immune responses by generating a caspase cascade and inducing cytokine secretion. This process is generally triggered by signals from purinergic receptors that integrate extracellular stimuli such as the metabolic factor ATP via P2 receptors. Furthermore, targeted modulation/inhibition of specific inflammasomes may help to maintain/restore adequate hematopoietic homeostasis. In this review, we will first summarize the possible relationships between inflammasome activation and homeostasis based on certain interesting phenomena. The cellular and molecular mechanism by which purinergic receptors integrate extracellular cues to activate inflammasomes inside HSCs will then be described. We will also discuss the therapeutic potential of targeting inflammasomes and their components in some diseases through pharmacological or genetic strategies.
Subject(s)
Hematopoietic Stem Cells/metabolism , Homeostasis , Inflammasomes/metabolism , Adenosine Triphosphate/metabolism , Animals , HumansABSTRACT
BACKGROUND: In the previous randomized controlled trial by our research group, we evaluated the effect of remote ischemic preconditioning (RIPC) in 130 patients (65 per arm) on acute kidney injury (AKI) within 7 days of open total aortic arch replacement. Significantly fewer RIPC-treated patients than sham-treated patients developed postoperative AKI, and, epically, RIPC significantly reduced serious AKI (stage II-III). However, the long-term effect of RIPC in patients undergoing open total aortic arch replacement is unclear. METHODS: This study was a post-hoc analysis. We aimed to assess the roles of RIPC in major adverse kidney events (MAKE), defined as consisting persistent renal dysfunction, renal replacement therapy and mortality, within 90 days after surgery in patients receiving open total aortic arch replacement. RESULTS: In this 90-day follow-up study, data were available for all study participants. We found that RIPC failed to improve the presence of MAKE within 90 days after surgery (RIPC: 7 of 65[10.8%]) vs sham: 15 of 65[23.1%]; P = 0.061). In those patients who developed AKI after surgery, we found that the rate of MAKE within 90 days after surgery differed between the RIPC group and the sham group (RIPC: 4 of 36[11.2%]; sham: 14 of 48[29.2%]; P = 0.046). CONCLUSIONS: At 90 days after open total aortic arch replacement, we failed to find a difference between the renoprotective effects of RIPC and sham treatment. The effectiveness or ineffectiveness of RIPC should be further investigated in a large randomized sham-controlled trial. TRIAL REGISTRATION: This study was approved by the Ethics Committee of Fuwai Hospital (No. 2016-835) and our previous study was registered at clinicaltrials.gov before patient enrollment ( NCT03141385 ; principal investigator: G.W.; date of registration: March 5, 2017).
Subject(s)
Acute Kidney Injury/prevention & control , Aorta, Thoracic/surgery , Ischemic Preconditioning/methods , Postoperative Complications/prevention & control , Adult , Humans , Middle AgedABSTRACT
OBJECTIVE: To investigate the prevalence, risk factors, and clinical outcomes associated with early fluid overload (FO) in a special group of pediatric patients undergoing repair of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). DESIGN: It was a retrospective study performed with multiple variable regression analysis. SETTING: A single cardiac surgical institution. PARTICIPANTS: Eighty-eight patients younger than 18 years of age undergoing ALCAPA surgical repair with cardiopulmonary bypass were recruited at the authors' institution from June 2010 to September 2017. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: Of 88 pediatric patients with ALCAPA after surgical repair, 37.5% developed early FO, defined as fluid accumulation ≥5% within the period from surgery until midnight of postoperative day 1. Patients with early FO were younger, weighed less, and had worse preoperative cardiac dysfunction. With logistic regression analysis, being underweight was confirmed to be a risk factor for FO development (odds ratio, 8.66; 95% confidence interval, 2.83-26.52; p < 0.001). Early FO also predicted severe acute kidney injury, respiratory morbidity, and low cardiac output syndrome after reimplantation procedure. Patients with early FO also had significantly longer mechanical ventilation hours (p â¯<⯠0.001), intensive care unit length of stay (pâ¯=â¯0.003), and hospital length of stay (pâ¯=â¯0.009). CONCLUSION: Early FO ≥5% has been linked to adverse postoperative outcomes in pediatric patients undergoing repair for ALCAPA. The use of restrictive fluid management is crucial for patients who have lower weight and poor myocardial function before and after complex surgical procedures such as in ALCAPA settings.
Subject(s)
Bland White Garland Syndrome , Coronary Vessel Anomalies , Child , Coronary Vessel Anomalies/diagnostic imaging , Coronary Vessel Anomalies/epidemiology , Humans , Infant , Pulmonary Artery/diagnostic imaging , Pulmonary Artery/surgery , Retrospective Studies , Treatment OutcomeABSTRACT
Endometrial receptivity has become the main cause of in vitro fertilization and pregnancy outcomes in infertile patients,bringing large psychological damage and economic loss to the patients and their family. In recent years,the role of non-coding RNA has increasingly been recognized. The relationship between non-coding RNA and endometrial receptivity is reviewed in this article.
Subject(s)
Endometrium/physiology , RNA, Untranslated/genetics , Embryo Implantation , Female , Fertilization in Vitro , Humans , Pregnancy , Pregnancy OutcomeABSTRACT
BACKGROUND: Acute kidney injury is a common complication after open total aortic arch replacement but lacks effective preventive strategies. Remote ischemic preconditioning has controversial results of its benefit to the kidney and may perform better in high-risk patients of acute kidney injury. We investigated whether remote ischemic preconditioning would prevent postoperative acute kidney injury after open total aortic arch replacement. METHODS: We enrolled 130 patients scheduled for open total aortic arch replacement and randomized them to receive either remote ischemic preconditioning (4 cycles of 5-minute right upper limb ischemia and 5-minute reperfusion) or sham preconditioning (4 cycles of 5-minute right upper limb pseudo ischemia and 5-minute reperfusion), both via blood pressure cuff inflation and deflation. The primary end point was the incidence of acute kidney injury within 7 days after the surgery defined by the Kidney Disease: Improving Global Outcomes criteria. Secondary end point included short-term clinical outcomes. RESULTS: Significantly fewer patients developed postoperative acute kidney injury with remote ischemic preconditioning compared with sham (55.4% vs 73.8%; absolute risk reduction, 18.5%; 95% CI, 2.3%-34.6%; P = .028). Remote ischemic preconditioning significantly reduced acute kidney injury stage II-III (10.8% vs 35.4%; P = .001). Remote ischemic preconditioning shortened the mechanical ventilation duration (18 hours [interquartile range, 14-33] versus 25 hours [interquartile range, 17-48]; P = .01), whereas no significant differences were observed between groups in other secondary outcomes. CONCLUSIONS: Remote ischemic preconditioning prevented acute kidney injury after open total aortic arch replacement, especially severe acute kidney injury and shortened mechanical ventilation duration. The observed renoprotective effects of remote ischemic preconditioning require further investigation in both clinical research and the underlying mechanism.
Subject(s)
Acute Kidney Injury/prevention & control , Aorta, Thoracic/surgery , Blood Vessel Prosthesis Implantation/adverse effects , Ischemic Preconditioning/methods , Upper Extremity/blood supply , Acute Kidney Injury/diagnosis , Acute Kidney Injury/etiology , Adult , Beijing , Double-Blind Method , Female , Humans , Ischemic Preconditioning/adverse effects , Male , Middle Aged , Regional Blood Flow , Respiration, Artificial , Time Factors , Treatment OutcomeABSTRACT
BACKGROUND: The cardioprotective effect of remote ischemic preconditioning (RIPC) in cardiovascular surgery is controversial. This study investigated whether RIPC combined with remote ischemic postconditioning (RIPostC) reduces myocardial injury to donor hearts in patients undergoing heart transplantation. METHODS: One hundred and twenty patients scheduled for orthotopic heart transplantation were enrolled and randomly assigned to an RIPC+RIPostC group (n = 60) or a control (n = 60) group. In the RIPC+RIPostC group, after anesthesia induction, four cycles of 5-min of ischemia and 5-min of reperfusion were applied to the right upper limb by a cuff inflated to 200 mmHg (RIPC) and 20 min after aortic declamping (RIPostC). Serum cardiac troponin I (cTnI) levels were determined preoperatively and at 3, 6, 12, and 24 h after aortic declamping. Postoperative clinical outcomes were recorded. The primary endpoint was a comparison of serum cTnI levels at 6 h after aortic declamping. RESULTS: Compared with the preoperative baseline, in both groups, serum cTnI levels peaked at 6 h after aortic declamping. Compared with the control group, RIPC+RIPostC significantly reduced serum cTnI levels at 6 h after aortic declamping (38.87 ± 31.81 vs 69.30 ± 34.13 ng/ml, P = 0.02). There were no significant differences in in-hospital morbidity and mortality between the two groups. CONCLUSION: In patients undergoing orthotopic heart transplantation, RIPC combined with RIPostC reduced myocardial injury at 6 h after aortic declamping, while we found no evidence of this function provided by RIPC+RIPostC could improve clinical outcomes. TRIAL REGISTRATION: Trial Registration Number: chictr.org.cn . no. ChiCTR-INR-16010234 (prospectively registered). The initial registration date was 9/1/2017.
Subject(s)
Heart Diseases/surgery , Heart Transplantation/methods , Ischemic Preconditioning, Myocardial/methods , Remote Sensing Technology/methods , Adult , Double-Blind Method , Female , Heart Diseases/blood , Heart Diseases/diagnosis , Heart Transplantation/trends , Humans , Ischemic Preconditioning, Myocardial/trends , Male , Middle Aged , Prospective Studies , Remote Sensing Technology/trends , Tissue DonorsABSTRACT
OBJECTIVES: The authors compared the renal outcomes of single-stage hybrid aortic arch repair without deep hypothermic circulatory arrest versus conventional total arch replacement in management of thoracic aortic diseases. DESIGN, SETTING, AND PARTICIPANTS: A retrospective review from January 2013 to December 2016 in Fuwai Hospital of 757 consecutive patients who underwent aortic arch repair: conventional total arch replacement (CTAR, 651), and hybrid arch repair (HAR, 106), with propensity matching (95 pairs). MEASUREMENTS AND MAIN RESULTS: The primary end-point was postoperative acute kidney injury (AKI) defined using the Kidney Disease Improving Global Outcome criteria. The secondary end-point was short-term outcomes such as in-hospital mortality and paraplegia determined by the Society of Thoracic Surgeons. The patients in the HAR group were older (60.20 ± 9.95 v 46.43 ± 10.79, p < 0.0001) and exhibited a greater rate of diabetes (11.3% v 2.0%, pâ¯=â¯0.0004), hyperlipidemia (47.2% v 25.4%, p < 0.0001), and coronary artery disease (13.2% v 4.3%, p < 0.0001) than those in the CTAR group. Following propensity score matching of 95 matched pairs, the difference in preoperative risk diminished. The HAR group led to a shorter cardiopulmonary bypass time (133.33 ± 41.47 v 179.62 ± 40.79, p < 0.0001) and avoided circulatory arrest. The incidence of postoperative AKI between HAR and CTAR groups was significantly different (before match: 75.5% v 59.45%, pâ¯=â¯0.0046; after match: 78.9% v 57.9%, pâ¯=â¯0.0008). CONCLUSION: In the management of thoracic aortic diseases, HAR is associated with a significantly lower incidence of postoperative AKI, and showed equivalent short-term outcomes despite the older age compared with the CTAR group.
Subject(s)
Acute Kidney Injury/epidemiology , Aorta, Thoracic/surgery , Aortic Aneurysm, Thoracic/surgery , Aortic Dissection/surgery , Blood Vessel Prosthesis Implantation/adverse effects , Postoperative Complications/epidemiology , Risk Assessment/methods , Acute Kidney Injury/etiology , China/epidemiology , Circulatory Arrest, Deep Hypothermia Induced/adverse effects , Female , Hospital Mortality/trends , Humans , Incidence , Male , Middle Aged , Postoperative Complications/etiology , Propensity Score , Retrospective Studies , Risk Factors , Survival Rate/trends , Treatment OutcomeABSTRACT
OBJECTIVES: Acute kidney injury (AKI) is common after thoracic aortic surgery and is a significant predictor of morbidity and mortality. Total arch replacement (TAR) combined with frozen elephant trunk (FET) implantation has been reported to produce satisfactory clinical outcomes, whereas several features of the surgical procedure may induce postoperative AKI. The authors aimed to clarify the incidence of and risk factors for postoperative AKI and the association of AKI with short-term outcomes. DESIGN: This study was a retrospective analysis of a prospectively collected cohort. A multivariate logistic regression model was used to identify predictors of postoperative AKI. SETTING: Single center. PARTICIPANTS: Clinical data were analyzed for 553 consecutive patients who underwent TAR combined with FET implantation between 2013 and 2016. INTERVENTIONS: None MEASUREMENTS AND MAIN RESULTS: Postoperative AKI was defined using the Kidney Disease Improving Global Outcomes criteria. Postoperative AKI occurred in 77.6% of the whole cohort. Patients in stage 3 AKI were associated with a higher incidence of major adverse events and in-hospital and 90-day mortality (p < 0.001, p < 0.05, p < 0.01, respectively). In the multivariate analysis, male sex (odds ratio [OR] 1.94; 95% confidence interval [95% CI] 1.22-3.18; p = 0.005); older age (per 10 years) (OR 1.37; 95% CI 1.14-1.67; p = 0.001); elevated body mass index (per 5 kg/m2) (OR 1.41; 95% CI 1.08-1.87; p = 0.01); and prolonged cardiopulmonary bypass duration (per 30 minutes) (OR 1.17; 95% CI 1.01-1.37; p = 0.03) were identified as independent predictors of postoperative AKI. CONCLUSION: TAR combined with FET implantation carries a high-risk for postoperative AKI compared with other types of thoracic aortic surgeries. Cardiopulmonary bypass duration was identified as the only modifiable predictor of AKI, and patients may benefit from moderate hypothermic circulatory arrest instead of deep hypothermic circulatory arrest.
Subject(s)
Acute Kidney Injury/epidemiology , Aorta, Thoracic/surgery , Aortic Aneurysm, Thoracic/surgery , Aortic Dissection/surgery , Blood Vessel Prosthesis Implantation/adverse effects , Postoperative Complications/epidemiology , Risk Assessment , Acute Kidney Injury/etiology , Adolescent , Adult , Aged , Aged, 80 and over , China/epidemiology , Humans , Incidence , Middle Aged , Retrospective Studies , Risk Factors , Survival Rate/trends , Treatment Outcome , Young AdultABSTRACT
Lung cancer remains a leading cause of cancer-associated mortality worldwide and non-small lung cancer (NSCLC) is responsible for over 80% of lung cancer-related deaths. Identifying novel molecular biomarker that can inhibit the progression of lung cancer will facilitate the development of new treatment strategies. Phospholipase C epsilon 1 (PLCE1) is a susceptibility gene in NSCLC. Nevertheless, the role of PLCE1 in NSCLC tumorigenesis has not been elucidated. Herein, we demonstrated that miR-1976 is a tumor-suppressor miRNA in NSCLC progression. We found that expression of miR-1976 was decreased obviously in NSCLC tissues. Down-regulation of miR-1976 was associated with TNM stage and postoperative survival. Overexpression of miR-1976 inhibited the growth and metastasis of NSCLC cells. The PLCE1 was a direct target of miR-1976 and promoted the growth and metastasis of NSCLC cells. Further study showed that PLCE1 could reverse the inhibitory effect of miR-1976 on growth and metastasis of NSCLC cells. Taken together, our data highlight the pivotal role of miR-1976 in the progression of NSCLC. Thus, miR-1976 may be a potential prognostic marker and of treatment relevance for NSCLC progression intervention.
Subject(s)
Biomarkers, Tumor/genetics , Carcinoma, Non-Small-Cell Lung/genetics , Carcinoma, Non-Small-Cell Lung/mortality , Lung Neoplasms/genetics , Lung Neoplasms/mortality , MicroRNAs/genetics , Phosphoinositide Phospholipase C/genetics , Aged , Aged, 80 and over , China/epidemiology , Genes, Tumor Suppressor , Genetic Markers/genetics , Genetic Predisposition to Disease/epidemiology , Genetic Predisposition to Disease/genetics , Humans , Middle Aged , Prevalence , Prognosis , Risk Assessment , Survival RateABSTRACT
Cancer remains as the leading cause of death all over the world due to the lack of efficient diagnostic techniques and therapeutic methods. Many studies have reported the potential diagnostic value of microRNA-17 (miRNA-17, miR-17) family members as biomarkers for cancer detection. However, inconsistent results were revealed from a wide range of studies. As a result of this, a meta-analysis based on 19 studies was conducted to assess the diagnostic performance of miR-17 family for cancer detection. A total of 1772 patients with certain types of cancer and 1320 healthy controls were involved in these studies. The overall diagnostic accuracy was measured by the following: sensitivity, 0.67 (95 % confidence interval (CI) 0.60-0.74); specificity, 0.83 (95 % CI 0.74-0.85); positive likelihood ratio (PLR), 3.9 (95 % CI 2.6-5.9); negative likelihood ratio (NLR), 0.40 (95 % CI 0.34-0.48); and diagnostic odds ratio (DOR), 10 (95 % CI 6-16), respectively. Additionally, the pooled area under the summary receiver operator characteristic (SROC) curve (area under the curve (AUC)) was 0.79 (95 % CI 0.75-0.82), indicating a relatively low accuracy of miR-17 family as biomarkers for cancer detection. Subgroup analysis further showed that miR-17 family had more reliable performance in cancer diagnosis for Asian than that for Caucasian. Moreover, multiple miRNAs containing miR-17, -20a/b, and -93 reflected higher diagnostic accuracy than both miR-106a/b (single miRNA) and the overall miR-17 family assay. Therefore, appropriate combinations of miR-17 family may be used as non-invasive screening biomarkers for cancer, and it is necessary to carry out a large-scale population-based study to further assess the potential diagnostic value of miR-17 family.