The lncRNA CASC9 alleviates lipopolysaccharide-induced acute kidney injury by regulating the miR-424-5p/TXNIP pathway.

OBJECTIVE: This study aimed to clarify the mechanism by which the long non-coding RNA cancer susceptibility candidate 9 (CASC9) alleviates sepsis-related acute kidney injury (S-AKI). METHODS: A lipopolysaccharide (LPS)-induced AKI model was established to simulate S-AKI. HK-2 human renal tubular epithelial cells were treated with LPS to establish an in vitro model, and mice were intraperitoneally injected with LPS to generate an in vivo model. Subsequently, the mRNA expression of inflammatory and antioxidant factors was validated by quantitative reverse transcription polymerase chain reaction (RT-qPCR). Reactive oxygen species (ROS) production was assessed using an assay kit. Apoptosis was detected by western blotting and fluorescence-activated cell sorting. RESULTS: CASC9 was significantly downregulated in the LPS-induced AKI model. CASC9 attenuated cell inflammation and apoptosis and enhanced the antioxidant capacity of cells. Regarding the mechanism, miR-424-5p was identified as the downstream target of CASC9, and the interaction between CASC9 and miR-424-5p promoted thioredoxin-interacting protein (TXNIP) expression. CONCLUSIONS: CASC9 alleviates LPS-induced AKI in vivo and in vitro, and CASC9 directly targets miR-424-5p and further promotes the expression of TXNIP. We have provided a possible reference strategy for the treatment of S-AKI.

Effects of emergency treatment mode of damage-control orthopedics in pelvic fracture complicated with multiple fractures.

OBJECTIVE: This study aimed to observe the application effect of emergency treatment mode of damage-control orthopedics (DCO) in pelvic fracture complicated with multiple fractures. METHODS: Ninety-four patients with pelvic fracture complicated with multiple fractures in our hospital were recruited and divided into two groups according to the random number table method, with 47 cases in each group. Patients in the control group received traditional methods for emergency treatment (early complete treatment), and patients in the research group received DCO for emergency treatment (treatment performed in stages according to patient's physiological tolerance, with simplified initial surgery, followed by ICU resuscitation, and finally definitive surgery). The two groups were compared in terms of mortality, the incidence of acidosis and hypothermia three days after the first surgery, surgery-related indexes (time of the first surgery, blood transfusion volume, intraoperative blood loss, recovery time of temperature, and length of hospital stay), coagulation function indexes (activated partial thromboplastin time (APTT), thrombin time (TT), prothrombin time (PT) and fibrinogen (FIB)), postoperative reduction of fracture, complication rate, and quality of life. RESULTS: The incidences of acidosis, hypothermia, and mortality three days after the first surgery in the research group were lower than those in the control group (P<0.05). Compared with the control group, the research group experienced shorter time of the first surgery, less intraoperative blood transfusion volume, less intraoperative blood loss, shorter recovery time of body temperature, and shorter length of hospital stay (P<0.05). Seven days after surgery, PT, TT and APTT decreased and FIB increased in both groups (P<0.05), PT, TT and APTT in the research group were lower than those in the control group (P<0.05), while FIB was higher (P<0.05). The good rate of reduction in the research group was higher than that in the control group (P=0.025). The incidence of complications in the research group was lower than that in the control group (P=0.049). Six months after surgery, the scores of physiological function (PF), body pain (BP), role physical (RP), emotional function (EF), social function (SF), vitality, and general health (GH) of the research group were higher than those of the control group (P<0.05), but there was no significant difference in mental health (MH) between the two groups (P>0.05). CONCLUSION: The emergency treatment mode of DCO is effective in pelvic fracture complicated with multiple fractures, which can effectively improve postoperative reduction of patients, improve the coagulation function, reduce complications, and improve the quality of life.

Phase-field simulation of microstructure evolution in electron beam additive manufacturing.

Electron beam additive manufacturing (EBAM) is an emerging additive manufacturing technology with extremely high energy beam. The rapid solidification in the molten pool is of interest but not fully understood. In EBAM, with both large thermal gradient and cooling rate, the microstructure evolution during solidification is difficult to be described. The quantitative multi-phase-field model provides an effective way to reveal the dynamic evolution of dendrites in the molten pool of EBAM. In this study, the thermal profile is interpolated from the macroscale simulation at each time-step, to couple the realistic thermal evolution in the molten pool. The microstructure evolution and competitive growth have been investigated in details. Simulations of dendrite arrays with the same orientation showed how the growth velocity and the primary spacing of columnar dendrites depend on thermal gradient and cooling rate. The results are in agreement with theoretical models qualitatively. Moreover, the Gaussian nucleation model was introduced so as to give a better prediction of the microstructure in EBAM.

[Comparison of the effect of low molecular weight heparin sodium and that of heparin sodium on pre-disseminated intravascular coagulation stage in patients suffering from exertional heat stroke].

OBJECTIVE: To study the effect of low molecular weight heparin sodium ( LMWHS ) therapy for exertional heat stroke ( EHS ) patients with pre-disseminated intravascular coagulation ( pre-DIC ). METHODS: A prospective randomized controlled trial ( RCT ) was conducted. Thirty-six patients with EHS with pre-DIC admitted to Department of Critical Care Medicine of 180th Hospital of Chinese PLA from April 2012 to November 2014 were divided into heparin sodium group ( n = 20 ) and LMWHS group ( n = 16 ) in accordance with the random number table. All patients received bundle treatment after being admitted to the hospital, including rapid cooling, fluid resuscitation, organ support ( mechanical ventilation, hemopurification if necessary ), supplement of pro-coagulation factors, etc. The patients in heparin sodium group were treated with continuous heparin sodium 12 500 U throughout 24 hours with intravenous pump for 5 days, and the patients in LMWHS group were given LMWHS 2 500 U subcutaneously, twice a day for 5 days.The incidence of DIC, incidence of bleeding and mortality of two groups were compared.The platelet count ( PLT ), prothrombin time ( PT ), activated partial thromboplastin time ( APTT ), fibrinogen ( Fib ) and D-dimer of each patient between pre and post treatment times were compared. RESULTS: No significant difference was found in the incidence of DIC and mortality between LMWHS group and heparin sodium group ( 31.2% vs. 30.0%, χ (2) = 0.007, P = 0.936; 6.2% vs. 5.0%, χ (2) = 0.026, P = 0.871 ). Incidence of bleeding during treatment in LMWHS group was significantly lower than that in heparin sodium group ( 12.5% vs. 45.0%,χ (2) = 4.425, P = 0.035 ). After treatment, PLT in both LMWHS group and heparin sodium group was significantly increased compared with that before treatment ( ×10(9)/L: 140.5±17.5 vs. 110.5±16.5, 152.6±21.5 vs. 120.0±20.0, both P < 0.05 ) and D-dimer was significantly decreased ( mg/L: 0.5±0.1 vs. 3.2±1.2, 0.6±0.2 vs. 4.4±1.8, both P < 0.05 ). APTT after treatment in heparin sodium group was significantly prolonged compared with that before treatment ( s: 75.3±10.6 vs. 44.1±8.2, P < 0.05 ) while no change in APTT was found in LMWHS group ( s: 38.6±5.5 vs. 42.1±8.4, P > 0.05 ). No significant difference was found in PT and Fib between pre and post treatment in all the patients. CONCLUSIONS: When LMWHS was applied in EHS patients in pre-DIC stage, it could not only prevent DIC as efficiently as heparin sodium, but also results in lower incidence of bleeding. So LMWHS is safer.