CircRNA circFADS2 is under-expressed in sepsis and protects lung cells from LPS-induced apoptosis by downregulating miR-133a.

BACKGROUND: It has been reported that hsa_circRNA_100833 (identified as circFADS2) and miR-133a play opposite roles in LPS-induced cell apoptosis, which contributes to the development of sepsis. This study was carried out to explore the interaction between circFADS2 and miR-133a in sepsis. METHODS: Expression of circFADS2 and miR-133a in plasma from both sepsis patients (n=62) and healthy controls (n=62) was studied by RT-qPCR. Pearson's correlation coefficient analysis was utilized to analyze the correlation between circFADS2 and miR-133a levels across plasma samples from sepsis patients. Cell viability and apoptosis, levels of proteins associated with apoptosis (cleaved caspase-3 and cleaved caspase-9), and expression of pro-inflammatory cytokines in LPS-treated HBEpCs were detected by MTT assay, cell apoptosis assay, western blot, and ELISA, respectively. In addition, a dual-luciferase reporter assay was performed to verify the interaction between circFADS2 and miR-133a. RESULTS: CircFADS2 was under-expressed (0.56-fold vs. control) in sepsis, and miR-133a was highly expressed (2.05-fold vs. control) in sepsis. An inverse correlation between circFADS2 and miR-133a was observed across sepsis samples. LPS decreased cell viability, increased cell apoptosis, and elevated productions of tumor necrosis factor (TNF)-α, interleukins (IL)-1ß, IL-6, and IL-8 in HBEpCs in a dose-dependent manner. In addition, circFADS2 was identified as a target gene of miR-133a. The further experiment revealed that circFADS2 overexpression and miR-133a inhibition prominently promoted cell viability (1.71-fold vs. pcDNA3.1; 1.65-fold vs. NC miRNA) and decreased apoptosis of LPS-treated HBEpCs (0.44-fold vs. pcDNA3.1; 0.47-fold vs. NC miRNA). Moreover, circFADS2 knockdown and miR-133a overexpression inhibited viability (0.36-fold vs. pcDNA3.1; 0.37-fold vs. NC miRNA) and increased apoptosis (1.54-fold vs. pcDNA3.1; 1.51-fold vs. NC miRNA) of LPS-treated HBEpCs. Notably, circFADS2 overexpression reduced the effects of miR-133a on LPS-treated HBEpCs. CONCLUSIONS: CircFADS2 is under-expressed in sepsis and may protect lung cells from LPS-induced apoptosis by downregulating miR-133a.

Effects of comprehensive nursing on negative emotion and prognosis of patients with sepsis.

OBJECTIVE: To explore the effect of comprehensive nursing on negative emotion and prognosis of patients with sepsis. METHODS: As a prospective study, 104 patients with sepsis were randomized into the observation group (n=52) and the control group (n=52). The patients in the control group underwent routine nursing, whereas the patients in the observation group underwent comprehensive nursing care in addition to routine nursing. The level of negative emotions, patients' prognosis, quality of life (QOL), Acute Physiology and Chronic Health Evaluation (APACHE) ll score, clinical indicators, and patient satisfaction with nursing were compared between the two groups. RESULTS: Compared with the control group, the observation group had lower Self-Rating Anxiety Scale score, Self-Rating Depression Scale score, and APACHE ll score (all P<0.001). The scores of physical functioning, general health perceptions, social role functioning, emotional role functioning, and mental health of the observation group were all higher than those of the control group (all P<0.01). The duration of mechanical ventilation, hospitalization expenses, and the length of stay in the Intensive Care Unit (ICU) in the observation group were lower than those in the control group (all P<0.01). Moreover, the observation group had a lower total incidence of shock, multiple organ dysfunction syndrome, and death and higher patient satisfaction with the nursing care than the control group (all P<0.05). CONCLUSION: Comprehensive nursing care can alleviate anxiety and depression in patients with sepsis and can improve the prognosis and QOL of patients. Also, it can shorten the length of stay in the ICU, lower treatment costs, and improve patient satisfaction; all of which can be recommended for clinical application.

Hydrogen sulfide reduces pyroptosis and alleviates ischemia-reperfusion-induced acute kidney injury by inhibiting NLRP3 inflammasome.

AIMS: Ischemia-reperfusion (I/R)-induced acute kidney injury (AKI) shows high mortality. Hydrogen sulfide (H2S) is essential for regulating kidney function. This study explored the role and mechanism of H2S in I/R-induced AKI. MATERIALS AND METHODS: I/R-induced mouse model and hypoxia/reoxygenation (H/R)-induced HK2 cell model of AKI were established and treated with NaHS (H2S donor), MCC950 (NLRP3 inhibitor) or DL-Propargylglycine (PAG, CSE inhibitor). Serum creatinine (Cr) and blood urea nitrogen (BUN) were measured to evaluate kidney function. The pathological changes of kidney tissues were detected. H2S level and H2S synthetase activity in kidney tissues were detected. Pyroptosis was assessed by pyroptotic cell numbers and pyroptosis-related protein levels determination. HK-2 cell viability and apoptosis were measured. NLRP3 protein level was detected. The role of NLRP3/Caspase-1 was verified in vivo and in vitro after MCC950 or PAG intervention. KEY FINDINGS: I/R-induced mice showed elevated levels of serum Cr and BUN, and obvious pathological changes, including severe tubular dilatation, tubular cell swelling, tubular epithelial cell abscission, tubular cell necrosis and inflammatory cell infiltration. H2S level and H2S synthetase activity were decreased. Increasing the level of H2S by NaHS improved the pathological changes of kidney tissues and limited the number of pyroptotic cells. In vitro, NaHS could reverse H/R-induced cell injury. H2S suppressed cell pyroptosis and kidney injury via inhibiting the NLRP3/Caspase-1 axis. SIGNIFICANCE: We highlighted that H2S prevented cell pyroptosis via suppressing the NLRP3/Caspase-1 axis, thereby inhibiting I/R-induced AKI. These findings may confer novel insights for the clinical management of I/R-induced AKI.

Upregulation of endothelial cell-derived exosomal microRNA-125b-5p protects from sepsis-induced acute lung injury by inhibiting topoisomerase II alpha.

OBJECTIVE: Emerging evidence has revealed that exosomal microRNAs (miRNAs) are implicated in human diseases. However, role of exosomal miR-125b-5p in sepsis-induced acute lung injury (ALI) remains further explored. We focused on the effect of exosomal miR-125b-5p on ALI progression via targeting topoisomerase II alpha (TOP2A). METHODS: The ALI mouse models were established by cecal ligation and perforation, which were then treated with miR-125b-5p agomir or overexpressed TOP2A. Next, the pathological structure of ALI mouse lung tissues were observed, miR-125b-5p, TOP2A and vascular endothelial growth factor (VEGF) expression was determined, and the lung water content, inflammatory response, protein content in bronchoalveolar lavage fluid (BALF) and cell apoptosis in ALI mouse lung tissues were assessed. Exosomes were extracted from endothelial cells (ECs) and identified, which were then injected into the modeled mice to observe their roles in ALI. The targeting relationship between miR-125b-5p and TOP2A was confirmed. RESULTS: MiR-125b-5p was downregulated while TOP2A was upregulated in ALI mice. MiR-125b-5p elevation or ECs-derived exosomes promoted VEGF expression, improved pathological changes and restrained lung water content, inflammatory response, protein content in BALF and cell apoptosis in lung tissues ALI mice. TOP2A overexpression reversed the repressive role of miR-125b-5p upregulation in ALI, while downregulated miR-125b-5p abrogated the effect of ECs-derived exosomes on ALI. TOP2A was confirmed as a direct target gene of miR-125b-5p. CONCLUSION: Our study indicates that ECs-derived exosomes overexpressed miR-125b-5p to protect from sepsis-induced ALI by inhibiting TOP2A, which may contribute to ALI therapeutic strategies.

lncRNA HAND2­AS1 mediates the downregulation of ROCK2 in hepatocellular carcinoma and inhibits cancer cell proliferation, migration and invasion.

Long noncoding (lnc)RNA HAND2­AS1 inhibits the development of several human malignancies. The role of HAND2­AS1 was investigated in hepatocellular carcinoma (HCC). It was found that levels of HAND2­AS1 in serum were significantly lower, while serum levels of Rho­associated protein kinase 2 (ROCK2) in HCC patients were significantly increased compared with hepatitis B (HB) patients and healthy controls. Decreased HAND2­AS1 levels distinguished HCC patients but not HB patients from healthy controls. A significant negative correlation between HAND2­AS1 and ROCK2 was found in HCC patients but not in HB patients or healthy controls. HAND2­AS1 overexpression inhibited, while ROCK2 overexpression promoted HCC cell migration, proliferation and invasion. HAND2­AS1 overexpression led to downregulated ROCK2 expression. ROCK2 overexpression did not significantly affect ROCK2 expression but attenuated the inhibitory effects of HAND2­AS1 overexpression. It was therefore concluded that HAND2­AS1 might mediate the downregulation of ROCK2 in HCC to inhibit cancer cell migration, proliferation and invasion.

Inhibition of mTORC1 renders cardiac protection against lipopolysaccharide.

Sepsis-induced cardiac dysfunction is a severe clinical problem. It is evident that rapamycin can protect heart from pathological injuries. However, there are no data demonstrating rapamycin reverse cardiac dysfunction induced by sepsis. In this study, Lipopolysaccharide (LPS) was administrated to mice and H9c2 cells. After treatment, we further determined cardiac function by echocardiography, ANP, BNP and inflammatory markers by qPCR and apoptosis by TUNEL staining. Moreover, mTORC1 signaling pathway and Akt activity were measured by Western blots. We found that rapamycin attenuated cardiac dysfunction, increase in ANP and BNP as well as apoptosis induced by LPS both in mice and in H9c2 cells. Unexpectedly, LPS did not significantly affect the mRNA levels of TNF-α and IL-6. Furthermore, rapamycin further reduced the decrease in mTORC1 signaling and Akt activity induced by LPS. In conclusion, rapamycin can protect heart from LPS induced damages by inhibition mTORC1 signaling and elevation of Akt activity.

The anatomic basis of total mesorectal excision.

BACKGROUND: Total mesorectal excision is considered the gold standard for rectal cancer surgery, but the anatomic descriptions and nomenclatures that are used are hardly clear and sometimes are contradictory. The aim of this study was to clarify the delimitation of the mesorectum and anatomic landmarks of the correct surgical plane for total mesorectal excision. METHODS: Cadaveric dissections were performed on 32 pelvises. RESULTS: The pelvic fasciae around the rectum can be divided into visceral fascia, vesicohypogastric fascia, and parietal fascia. The lateral ligament is the dense connective tissue between the rectum and visceral fascia instead of the pelvic sidewall. There are 2 different fascial envelopes around the rectum. The diffusion type of pelvic plexus is difficult to separate from the visceral fascia. CONCLUSIONS: The autonomic nerves and lateral rectal ligament can be distinguished as the landmark to judge the different planes. The correct surgical plane of posterior dissection is conducted between the visceral fascia and parietal fascia, and anterolateral dissection is conducted between the vesicohypogastric fascia and parietal fascia.

The anatomy of lateral ligament of the rectum and its role in total mesorectal excision.

BACKGROUND: Lateral ligament of the rectum has suffered many diverse descriptions in its existence and composition. This study was undertaken to define the anatomy, nature, content of the lateral ligament of the rectum, and its role in total mesorectal excision. METHODS: Cadaver dissections were performed on 32 formalin-preserved cadavers. RESULTS: Bilateral lateral ligament appeared in all 32 cadavers as a bundle of dense connective tissue traversing between rectum and visceral fascia instead of pelvic sidewall. No substantial tissue strand except pelvic splanchnic nerves was found between visceral fascia and parietal fascia at the same level. The middle rectal artery was observed in only 18 of 64 pelvic-halves (28.1%). The constant component of the lateral ligament of the rectum was the rectal branches from the pelvic plexus, whereas the middle rectal artery was almost invisible in lateral ligament of the rectum. CONCLUSIONS: During total mesorectal excision, it is impossible to reveal the lateral ligament of the rectum in the correct plane between visceral and parietal fascia. The entire rectum may be mobilized without the need for ligating the middle rectal artery. The clinical significance of lateral ligament is that, during lateral dissection, if the dense lateral ligament was identified, then the surgical plane was medial to the visceral fascia and incorrect surgical plane thus entered.