Isolated metastasis of hepatocellular carcinoma in the right ventricle.

BACKGROUND: Hepatocellular carcinoma (HCC) with right ventricle metastasis without inferior vena cava and right atrium involvement is very rare and the prognosis of HCC with RV metastasis is generally poor. The mass in the cardiac chamber may lead to lethal instability of hemodynamics, however, the initial symptom is probably non-specific, which means that diagnosis timely becomes even harder. CASE PRESENTATION: We present a 63-year-old male with isolated metastasis of HCC in the right ventricle which caused inflow obstruction. Moreover, we reviewed a series of studies of isolated metastasis of hepatocellular carcinoma between 1980 and 2018, and summarized the relative outcomes. CONCLUSIONS: Isolated metastasis of hepatocellular carcinoma in the right ventricle is extraordinarily rare. It may damage cardiac structure and broke hemodynamic balance. Multimodality imaging plays an important in accurate pre-operation assessment. Nowadays, palliative treatments could relieve fatal symptoms to some degree, however, standard treatment has not been well established.

Elevated expression of periostin in diabetic cardiomyopathy and the effect of valsartan.

BACKGROUND: Periostin, an extracellular matrix protein, plays a significant role in adverse cardiac remodeling. However, no report has documented the function of periostin in left ventricular remodeling of streptozototin (STZ)-induced diabetic rats. The aim of the present study was to observe the expression of periostin in Wistar rat's myocardium of diabetic cardiomyopathy (DCM) and the effect of valsartan on it. METHODS: Immunohistochemistry, real-time polymerase chain reaction, and Western blot analysis were used to determine the degree of expression and location of periostin, transforming growth factor (TGF)-ß1, TGF-ß1 type II receptor (TGF-ß1 R II), and Type I and III collagens in the myocardium of STZ-induced diabetic rats. RESULTS: Periostin, TGF-ß1, TGF-ß1 R II, and Type I and III collagens were significantly increased in the myocardium of diabetic rats compared with control group on both messenger ribonucleic acid and protein levels. In addition, diabetic rats treated with valsartan could have reduced expression of periostin and improved cardiac remodeling of DCM. CONCLUSIONS: Periostin may play a crucial role in cardiac remodeling and myocardial interstitial fibrosis process of DCM and it could be one of the important mechanisms for valsartan to improve the ventricular remodeling of DCM.

Risk factors for nosocomial infections and/or sepsis in adult burns patients: An integrative review.

BACKGROUND: In comparison to general trauma patients, loss of skin barrier amongst the burns cohort predisposes them to a higher risk of nosocomial infections and sepsis, and this often leads to unfavourable morbidity and mortality outcomes. PURPOSE: This integrative review aimed to explore existing literature to identify risk factors related to nosocomial infections and/or sepsis in adult burns patients following hospital admission. METHODS: Electronic searches for journals published between 2007 and 2021 were performed in CINAHL, Scopus and Medline, and key journals were hand-searched. Inclusion criteria was: (1) peer-reviewed, primary studies; (2) qualitative, quantitative or mixed-methods studies; (3) study participants had sustained burns-related injury and developed nosocomial infections and/or sepsis during the course of hospitalisation. Studies were appraised using the Critical Appraisal Skill Program checklists. RESULTS: 15 studies ranging from 'poor' to 'fair' to 'moderate' quality were included in the final review. Patient factors that contributed to the development of nosocomial infections and/ or sepsis included: (1) Full thickness burns; (2) age; (3) % Total Burns Surface Area; and (4) Herpes Simplex Virus activation. Several provider-system risk factors were identified by 'poor' quality studies and further research is required to substantiate those findings. DISCUSSION: Findings remained inconclusive due to the lack of 'good' quality studies however, there was an overemphasis on patient-related risk factors instead of healthcare workers or the system. Future research may focus on activation of the latest infection prevention strategies and early enforcement of care bundles. Through identification of related risk factors, it may reduce the incidence of nosocomial infection and/or sepsis post-burns.

Correction to "A Stepwise Targeting Curcumin Derivative, Ser@TPP@CUR, for Acute Kidney Injury".

[This corrects the article DOI: 10.1021/acsmedchemlett.1c00585.].

A Stepwise Targeting Curcumin Derivative, Ser@TPP@CUR, for Acute Kidney Injury.

Based on the pathological mechanisms of acute kidney injury (AKI), a stepwise targeting curcumin derivative, Ser@TPP@CUR, was developed in this study. Ser@TPP@CUR can be specifically internalized by renal tubular epithelial cells via KIM-1 receptor-mediated endocytosis and then actively distributed in mitochondria under the effect of TPP, a mitochondrial targeting molecule. Both in vitro and in vivo results showed that Ser@TPP@CUR effectively ameliorated injured renal tubular epithelial cells and improved renal functions of AKI mice.

Engineering of stepwise-targeting chitosan oligosaccharide conjugate for the treatment of acute kidney injury.

Acute kidney injury (AKI) is a common and serious clinical syndrome of acute renal dysfunction in a short period. One of therapeutic interventions for AKI is to reduce ROS massively generated in the mitochondria and then ameliorate cell damage and apoptosis induced by oxidative stress. In this study, stepwise-targeting chitosan oligosaccharide, triphenyl phosphine-low molecular weight chitosan-curcumin (TPP-LMWC-CUR, TLC), was constructed for sepsis-induced AKI via removing excessive ROS in renal tubular epithelial cells. Benefiting from good water solubility and low molecular weight, TLC was rapidly and preferentially distributed in the renal tissues and then specifically internalized by tubular epithelium cells via interaction between Megalin receptor and LMWC. The intracellular TLC could further delivery CUR to mitochondria due to high buffering capacity of LMWC and delocalized positive charges of TPP. Both in vitro and in vivo pharmacodynamic results demonstrated the enhanced therapeutic effect of TLC in the treatment of AKI.

Doxazosin attenuates renal matrix remodeling mediated by anti-α1-adrenergic receptor antibody in a rat model of diabetes mellitus.

Diabetic nephropathy is a major complication of diabetes mellitus (DM). Recent studies suggest that immunological mechanisms have a key role in the pathogenesis of DM, therefore these mechanisms may be important targets for diabetes therapy. The present study evaluated the effects of anti-α1-adrenergic receptor antibody (α1-R Ab) mediation and doxazosin treatment in a rat model of DM. It was observed that levels of 24-h urinary protein, serum creatinine and transforming growth factor-ß1 in DM were significantly increased after α1-R Ab mediation (all P<0.05). In addition, electron microscopy identified severe damage in the renal tissue microstructures of DM rats following α1-R Ab mediation, while only mild abnormalities were observed in that of healthy rats mediated with α1-R Ab and of untreated DM rats. No marked abnormalities were observed in the renal tissue of healthy blank controls. Furthermore, in DM rats treated with α1-R Ab mediation + doxazosin intervention, the expression of TGF-ß1 significantly decreased, and renal functions and renal matrix remodeling were significantly improved, relative to untreated DM controls (P<0.01). These results suggest that α1-R Ab may be involved in renal matrix remodeling during DM, and that kidney protection during DM may be achieved through treatment with corresponding receptor antagonists.