Thyroid hormone, cortisol, interleukin-2, and procalcitonin regulate postoperative delirium in acute type A aortic dissection patients.

BACKGROUND: We assessed the relationships between levels of preoperative thyroid hormone (TH), cortisol, interleukin-2 (IL-2), and procalcitonin (PCT) and postoperative delirium (POD) in acute type A aortic dissection (ATAAD) patients receiving modified triple-branched stent-graft (MTBSG) implant surgeries. METHODS: ATAAD patients received MTBSG implant surgeries in our hospital between February 2019 and December 2020 were recruited. We separated them into a POD and non-POD cohort and employed univariable and multivariable regression analysis to establish independent correlations between preoperative THs, cortisol, IL-2, and PCT and POD. In addition, we conducted stratification analyses to examine the link between pre-surgical THs and POD in normal TSH and lower TSH subgroups. RESULTS: POD occurred in 78 of 224 patients (34.8%). POD patients exhibited markedly reduced preoperative free triiodothyronine (FT3) (P = 0.008) and free thyroxine (FT4) (P = 0.023) levels, while remarkably enhanced preoperative cortisol (P < 0.001), IL-2 (P < 0.001), and PCT (P < 0.001) levels. Based on multivariate regression analysis, reduced preoperative FT3 (P = 0.032), as well as augmented preoperative IL-2 (P = 0.001), cortisol (P < 0.001), and PCT (P = 0.016) were strong stand-alone risk factors for POD. Moreover, subgroup analysis found the association between FT3 (P = 0.029), FT4 (P = 0.042) and POD was both significant in patients with normal TSH levels. CONCLUSIONS: Reduced preoperative FT3 and elevated preoperative cortisol, IL-2, and PCT were strong indicators of POD in ATAAD patients. Hence, we recommend that the thyroid function, cortisol, PCT, and IL-2 should be evaluated prior to surgery in ATAAD patients.

Blockade of TMEM16A protects against renal fibrosis by reducing intracellular Cl- concentration.

BACKGROUND AND PURPOSE: Renal fibrosis is the final common outcome in most forms of chronic kidney disease (CKD). However, the underlying causal mechanisms remain obscure. The present study examined whether transmembrane member 16A (TMEM16A), a Ca2+ -activated chloride channel, contributes to the progression of renal fibrosis. EXPERIMENTAL APPROACH: Masson staining, western blot and immunohistochemistry were used to measure renal fibrosis and related proteins expression. MQAE was used to evaluate the intracellular Cl- concentration. KEY RESULTS: TMEM16A expression was significantly up-regulated in fibrotic kidneys of unilateral ureteral obstruction (UUO) and high-fat diet murine models and in renal samples of IgA nephropathy patients. In vivo knockdown of TMEM16A with adenovirus harbouring TMEM16A-shRNA or inhibition of TMEM16A channel activity with inhibitors CaCCinh-A01 or T16Ainh-A01 effectively prevented UUO-induced renal fibrosis and decreased protein expression of fibronectin, α-SMA and collagen in the obstructed kidneys. In cultured HK2 cells, knockdown or inhibition of TMEM16A suppressed TGF-ß1-induced epithelial-mesenchymal transition, reduced snail1 expression and phosphorylation of Smad2/3 and ERK1/2, whereas overexpression of TMEM16A showed the opposite effects. TGF-ß1 increased [Cl- ]i in HK2 cells, which was inhibited by knockdown or inhibition of TMEM16A. Reducing [Cl- ]i significantly blunted TGF-ß1-induced Smad2/3 phosphorylation and profibrotic factors expression. The profibrotic effects of TGF-ß1 were also reduced by inhibition of serum- and glucocorticoid-inducible protein kinase 1 (SGK1). SGK1 was also suppressed by reducing [Cl- ]i. CONCLUSION AND IMPLICATIONS: Blockade of TMEM16A prevented the progression of kidney fibrosis, likely by suppressing [Cl- ]i/SGK1/TGF-ß1 signalling pathway. TMEM16A may be a potential new therapeutic target against renal fibrosis.

A Modified Approach with Caval Transection for Supracardiac Total Anomalous Pulmonary Venous Connection: Comparison Between Conventional and Sutureless Surgery in 173 Patients.

The efficacy of primary sutureless repair for supracardiac total anomalous pulmonary venous connection (TAPVC) needs to be confirmed. This study aimed to compare the long-term outcomes between the conventional surgery and the sutureless technique with a modified approach in superior TAPVC. Between January 2008 and December 2018, 173 patients with supracardiac TAPVC underwent surgery either with the conventional procedure (n = 130) or the sutureless repair (n = 43). Multivariate analysis and competing-risk analysis were used to identify risk factors for early death and postoperative pulmonary venous obstruction (PVO), respectively. Among 173 patients who underwent repair of supracardiac TAPVC, 46 (28%) had preoperative PVO, and 22 (12.7%) had postoperative PVO. The sutureless group had a lower postoperative PVO rate compared with the conventional group (p = 0.027). The risk factors for death were age ≤ 28 days [odds ratio (OR), 11.56; 95% confidence interval (CI) 1.33-100.47, p = 0.015], weight ≤ 3 kg (OR 9.57; 95% CI 1.58-58.09, p = 0.009), emergency operation (OR 19.24; 95% CI 3.18-116.35, p = 0.002), cardiopulmonary bypass time (OR 2.16; 95% CI 1.36-3.43, p = 0.003), cross-clamp time (OR 1.73; 95% CI 1.20-2.50, p = 0.022), and duration of ventilation (OR 1.11; 95% CI 1.02-1.21, p = 0.027). Age ≤ 28 days [Hazard Ratio (HR) 1.92; 95% CI 1.92-11.02, p < 0.001] and preoperative PVO (HR 41.70; 95% CI 8.15-213.5, p < 0.001) were associated with postoperative PVO. The sutureless repair is a reliable technique for supracardiac TAPVC. Age ≤ 28 days is associated with 30-day mortality and postoperative PVO.

ClC-3 Deficiency Impairs the Neovascularization Capacity of Early Endothelial Progenitor Cells by Decreasing CXCR4/JAK-2 Signalling.

BACKGROUND: Endothelial progenitor cell (EPC) therapy has been suggested as a major breakthrough in the treatment of ischemic diseases. However, the molecular mechanism that underlies EPC functional regulation is still unclear. METHODS: We examined the angiogenic capacity of EPCs in a hindlimb ischemia model of wild-type and ClC-3 knockout mice. RESULTS: Mice lacking of ClC-3 exhibited reduced blood flow recovery and neovascularization in ischemic muscles 7 and 14 days after hind limb ischemia. Moreover, compared with wild-type EPCs, the hindlimb blood reperfusion in mice receiving ClC-3 knockout EPCs was significantly impaired, accompanied by reduced EPC homing and retention. In vitro, EPCs derived from ClC-3 knockout mice displayed impaired migratory, adhesive, and angiogenic activity. CXC chemokine receptor 4 (CXCR4) expression was significantly reduced in EPC from ClC-3 knockout mice compared with wild-type. Moreover, the expression and phosphorylation of Janus kinase 2 (JAK-2), a downstream signalling of CXCR4, was also reduced in ClC-3 knockout EPC, indicating that CXCR4/JAK-2 signalling is dysregulated by ClC-3 deficiency. Consistent with this assumption, the migratory capacity of wild-type EPCs was attenuated by either CXCR4 antagonist AMD3100 or JAK-2 inhibitor AG490. More importantly, the impaired migratory capacity of ClC-3 knockout EPCs was rescued by overexpression of CXCR4. CONCLUSIONS: ClC-3 plays a critical role in the angiogenic capacity of EPCs and EPC-mediated neovascularization of ischemic tissues. Disturbance of CXCR4/JAK-2 signalling may contribute to the functional impairment of ClC-3 deficient EPCs. Thus, ClC-3 may be a potential therapeutic target for modulating neovascularization in ischemic diseases.

ClC-3 promotes angiotensin II-induced reactive oxygen species production in endothelial cells by facilitating Nox2 NADPH oxidase complex formation.

Recent evidence suggests that ClC-3, a member of the ClC family of Cl- channels or Cl-/H+ antiporters, plays a critical role in NADPH oxidase-derived reactive oxygen species (ROS) generation. However, the underling mechanisms remain unclear. In this study we investigated the effects and mechanisms of ClC-3 on NADPH oxidase activation and ROS generation in endothelial cells. Treatment with angiotensin II (Ang II, 1 µmol/L) significantly elevated ClC-3 expression in cultured human umbilical vein endothelial cells (HUVECs). Furthermore, Ang II treatment increased ROS production and NADPH oxidase activity, an effect that could be significantly inhibited by knockdown of ClC-3, and further enhanced by overexpression of ClC-3. SA-ß-galactosidase staining showed that ClC-3 silencing abolished Ang II-induced HUVEC senescence, whereas ClC-3 overexpression caused the opposite effects. We further showed that Ang II treatment increased the translocation of p47phox and p67phox from the cytosol to membrane, accompanied by elevated Nox2 and p22phox expression, which was significantly attenuated by knockdown of ClC-3 and potentiated by overexpression of ClC-3. Moreover, overexpression of ClC-3 increased Ang II-induced phosphorylation of p47phox and p38 MAPK in HUVECs. Pretreatment with a p38 inhibitor SB203580 abolished ClC-3 overexpression-induced increase in p47phox phosphorylation, as well as NADPH oxidase activity and ROS generation. Our results demonstrate that ClC-3 acts as a positive regulator of Ang II-induced NADPH oxidase activation and ROS production in endothelial cells, possibly via promoting both Nox2/p22phox expression and p38 MAPK-dependent p47phox/p67phox membrane translocation, then increasing Nox2 NADPH oxidase complex formation.

[Radiation Environment Study of Near Space in China Area].

Aerospace activity in near space (20-50 km) has become a research hotspot for aviation big countries worldwide. Solar radiation study, as the prerequisite to carry out aerospace activity, is facing the barrier of lacking of observation in near space layer. Ozone is the most important factor that affects radiation value in this layer. Based on ECMWF reanalysis data, this input key parameter and its horizontal, vertical and temporal characteristics are analyzedwith results showing obvious regional features in temporal-spatial distribution and varieties. With meteorological data and surface parameters, near space over China is divided into 5 parts. Key factors' value is confirmed over each division. With SBDART radiation transfer model, solar radiation and ultraviolet radiation simulation in near space are conducted separately. Results show that it is influenced by latitude, total ozone and its vertical distribution, radiation varies under complex rules. The average year and monthly solar radiation strengthens changes with latitude reduction, while annual range changes reversely. Air absorbing is related to latitude and land-sea contrast and shows different values and seasonal variations. The ultraviolet radiation over South China Sea reaches its maximum value and minimum annual range, as well as minimum monthly range with value strengthening in summer and weakening in winter. In other areas radiation increases in summer while weakens in winter, monthly range shows double peaks with higher value in spring and autumn, lower in summer and winter. Air absorption in ultraviolet radiation is influenced by multiple factors, vertical varieties over areas besides South China Sea enhance in summer time. The vertical changes of monthly ranges affected by air absorption show consistence in higher and lower layer in June and July, while in other months ranges are bigger in higher layer.

[Research on calibration methods of ground-based thermal-infrared radiometer CE312].

The accuracy of the calibration coefficients of the ground-based thermal-infrared radiometer CE312 is one of the most important factors affecting the calibration of the thermal-infrared remote sensors. The theory of two calibration methods which calculate the bandpass radiance and spectral radiance respectively is introduced. The calibration of the CE312-1b is conducted with the blackbody in the laboratory, the accuracy and influence factors of the results are conducted by the MODIS data combined with in situ measurements data at Qinghai Lake in Aug 2010. The results show that calibration coefficients of thermal-infrared field radiometer CE312 calculated by the bandpass radiance method has better performance in the accuracy and applicability than the spectral radiance method.

[Stereoscopic remote sensing used in monitoring Enteromorpha Prolifra disaster in Chinese Yellow Sea].

In the summer 2008, Enteromorpha Prolifra broke out in Yellow Sea and East Sea on a large scale for the first time, and became a marine disaster. The authors constructed a stereoscopic monitoring system which monitored the disaster continuously, dynamically and in real time. The present paper introduced the construction of the stereoscopic monitoring system; through analyzing the spectral characteristics of Enteromorpha Prolifra and ocean water which were acquired in a field experiment, confirmed Enteromorpha Prolifra retrieval models based on multi-platform multi-sensor and multi-spectral remote sensing data, contrasted the different scale monitoring results, and analyzed the evolvement rules with time-series analysis. This system was applied to the Enteromorpha Prolifra emergency monitoring in the 29th Olympic sailing area. It was proved feasible and valuable for the Olympic safeguard.

[Simulation and analysis of polarization characteristics for real sea surface sunglint].

The sea surface sunglint is caused by specular reflectance. Water is a kind of dark target with a very low reflectance, so sunglint becomes a big noise in the aerial or aerospace remote sensing images; sunglint is strongly polarized, and can be a natural standard light source for polarized sensor in-flight calibration; sunglint also can be utilized to retrieve gaseous constituents and aerosol properties. For both de-noising and being standard light source, the radiative physic parameters should be calculated accurately. First, A 3-D sea surface model was constituted according to the Cox & Munk model; Second, the polarized radiative model of sunglint was deduced based on the 3-D sea surface model and polarized Fresnel reflectance law; Third, the sensitivities of solar-viewing relative azimuth, zenith, wind speed and wind direction were analyzed utilizing the polarized radiative model. The polarization characteristics analysis of sunglint provides a theoretical basis for the quantitative remote sensing retrievals which uses sunglint.

[Simulation of polarization SAR imaging of ocean surface].

The polarization synthetic aperture radar (SAR) imaging simulation is of great significance to ocean surface scattering. According to the theory of wind-wave spectrum, rough ocean surface was modeled in the present paper using the two-scale-model. This treatment takes both the large scale and small scale surface into account. By using the velocity bunching (VB) theory, Bragg scattering model and the small perturbation model (SPM), the polarization SAR system can simulate the ocean surface with various parameters and ocean states. The effects of the parameters of ocean waves and the parameters of SAR system were analyzed. Finally, some useful conclusions were drawn, which are helpful for extracting the information of ocean surface. The method is an effective way in the ocean SAR design and the ocean surface research.

[Atmospheric correction method for HJ-1 CCD imagery over waters based on radiative transfer model].

Atmospheric correction is a bottleneck in quantitative application of Chinese satellites HJ-1 data to remote sensing of water color. According to the characteristics of CCD sensors, the present paper made use of air-water coupled radiative transfer model to work out the look-up table (LUT) of atmospheric corrected parameters, and thereafter developed pixel-by-pixel atmospheric correction method over waters accomplishing the water-leaving remote sensing reflectance with accessorial meteorological input. The paper validates the HJ-1 CCD retrievals with MODIS and in-situ results. It was found that the accuracy in blue and green bands is good. However, the accuracy in red or NIR bands is much worse than blue or green ones. It was also demonstrated that the aerosol model is a sensitive factor to the atmospheric correction accuracy.