The Efficacy of Sacubitril Valsartan Sodium in Combination with Levosimendan in the Treatment of Cardiorenal Syndrome and the Effect on Cardiac and Renal Function.

Objective: To investigate the effects of sacubitril valsartan sodium combined with levosimendan on improving cardiac and renal functions in patients with CRS. Methods: 90 patients with the cardiorenal syndrome who were hospitalized in our hospital from February 2020 to February 2022 were selected and divided into two groups, the control group, and the joint group, according to both single and double number methods, with 45 cases in each group. Patients who met the diagnostic criteria for CRS, were older than 18 years of age, had NYHA class II to IV, and had stage 1 or 2 chronic kidney disease were included in the study. Patients with severe hypersensitivity to the drugs used in this test, haemodynamic instability, combined hyperthyroidism, malignancy, severe pulmonary hypertension, cardiogenic shock, malignant arrhythmias and pregnant women were excluded. Among them, the control group was treated with sacubitril valsartan sodium alone, and the joint group was treated with levosimendan supplemented with the treatment method of the control group. The treatment effect, the improvement of cardiac and renal function, and the incidence of adverse reactions were compared between the two groups of CRS patients, and the prognostic effect was followed up 6 months after treatment. Results: The total effective rate of treatment in the joint group was 95.56%, which was significantly higher than that in the control group of 80.00%, and the difference was statistically significant by using χ2 test (P < .05). After treatment, LVEF, LVEDD, and NT-proBNP levels in both groups were significantly improved compared with those before treatment (P < .05), and the improvement effect of each index in the joint group was more significant than that in the control group (P < .05). After treatment, the levels of SCr, BUN, and UA in both groups were significantly lower than those before treatment (P < .05), and the levels of each index in the joint group were significantly lower than those in the control group, statistical analyses showed significant differences (P < .05) using t test. The incidence of adverse effects such as tachycardia, premature ventricular contractions, heart failure, and myocardial ischaemia was 22.22% in the combined group, which was significantly lower than 42.22% in the control group, and the difference in the total incidence between the two groups was statistically significant by χ2 test (P < .05). One case of malignant arrhythmia and five cases of recurrence of heart failure occurred 6 months after surgery in the combined group, which were significantly lower than the eight and twelve cases in the control group. Conclusion: Sacubitril valsartan sodium combined with levosimendan can significantly improve the therapeutic effect of CRS, with significant improvement in cardiac and renal function of CRS patients, and its incidence of adverse effects and long-term prognostic effects are lower than those of sacubitril valsartan sodium alone. This combination therapy offers a promising new direction for CRS management, warranting further investigation in larger, multicenter trials.

The effect of MiR-497 on the expression of target genes BCL-2 and LC3B on cardiomyocytes injured by hypoxia/reoxygenation.

Myocardial ischemia is easy to cause hypoxia or necrosis of myocardial cells. At present, the performance of various patients is different. Basically, it is mainly caused by chest pain or chest discomfort. Severe patients may die suddenly. Therefore, looking for effective drugs or methods to prevent and treat Cardiomyocyte injury is of great significance for clinical practice, in which the expression of regulatory gene BCL-2 and microtubule-associated protein light chain 3B (LC3B) has a certain effect on hypoxia/reoxygenation injured cardiomyocytes. To this end, the team designed a study on the effect of miR-497 on the expression of target genes BCL-2 and LC3B on cardiomyocytes injured by hypoxia/reoxygenation. In this study, a control group experiment was set up for the study. During the experiment, the cells were treated with hypoxia-reoxygenation and transfected with the corresponding miR-497 treated cells. By detecting apoptosis, the kit was used to detect cell activity and RT-PCR detection. Gene expression levels and other methods are comparatively judged. The results of this study showed that compared with the normal group 14.50±0.78, the viability of cardiomyocytes in the model group was significantly reduced (P<0.01), the amount of NO released by cardiomyocytes was reduced (P<0.01), and the protein expression in cardiomyocytes was significantly reduced (P<0.01). The experimental results of this study prove that miR-497 can alleviate the damage caused by hypoxia-reoxygenation of cardiomyocytes by regulating target genes BCL-2 and LC3B.

Quantitative analysis of fibrosis formation on the microcapsule surface with the use of picro-sirius red staining, polarized light microscopy, and digital image analysis.

Transplantation of microencapsulated cells shows potential to treat a variety of diseases. To improve the quality of microcapsules, efficient methods need to be established and standardized for the evaluation of biocompatibility of microcapsules. To this end, a microscopical method was developed to analyze quantitatively the degree of fibrotic overgrowth (FO), which serves as the index of biocompatibility. In this method, sections were stained with picro-sirius red and illuminated with a polarized light microscope. The images were digitized with the use of a computer-video system in which collagenous content was depicted by gray levels 1 to 255. Both the area of collagen and the thickness of FO were examined. The ratio of Type I/Type III collagen and the thickness were used as indexes of the degree of FO. The data showed that the ratio of Type I/Type III collagen and the thickness increased with time, and FO was not significant 4 weeks after transplantation. In comparison, this new method is more efficient to evaluate FO.

[The effect of glutamine on the growth, metabolism and endostatin production of microencapsulated rCHO cells].

Cell transplantation is a promising technology in cancer therapy, however, immunological rejection is the major problem of cell transplantation. Based on the permselective property of microcapsule membrane, encapsulated cells can be immuno-protected. The normal physiological state and function expression of cells can be maintained so as to realize allo- or xenotransplantation. The microencapsulated cells grow in three dimensions, giving a more biologically representative in vivo model, which hints difference in characters of growth and metabolism compared to the monolayer cells. Therefore, characterization of growth and metabolism of microencapsulated recombinant CHO cells is essential for further large-scale culture. In present study, the effect of concentration of glutamine on the growth, metabolism and endostatin production of microencapsulated cells was investigated. In the experimental range of initial glutamine concentrations from 2.69mmol/L to 9.05mmol/L in the culture of microencapsulated recombinant CHO cells, the maximum density of active cells and multiplication ratios almost kept constant. The specific consumption rate of glucose increased with lower initial glutamine concentration (2.69mmol/L). When initial glutamine concentration was much higher (7.91mmol/L to approximately 9.05mmol/L), the specific consumption rates of both glucose and glutamine increased while the efficiencies of glucose and glutamine decreased. The highest efficiencies of glucose and glutamine utilization were observed with initial glutamine concentration of 4.97mmol/L. It was also demonstrated that glutamine had significant effect on the accumulation of endostatin. The accumulative concentration of endostain reached its peak of 546.36 ng/mL with the initial glutamine concentration of 4.97mmol/L.