Accidental placement of venous return catheter in the superior vena cava during venovenous extracorporeal membrane oxygenation for severe pneumonia: A case report.

BACKGROUND: Venovenous extracorporeal membrane oxygenation (V-V ECMO) has become an important treatment for severe pneumonia, but there are various complications during the treatment. This article describes a case with severe pneumonia successfully treated by V-V ECMO, but during treatment, the retrovenous catheter, which was supposed to be in the right internal vein, entered the superior vena cava directly in the mediastinum. The ECMO was safely withdrawn after multidisciplinary consultation. Our experience with this case is expected to provide a reference for colleagues who will encounter similar situations. CASE SUMMARY: A 64-year-old man had severe pulmonary infection and respiratory failure. He was admitted to our hospital and was given ventilation support (fraction of inspired oxygen 100%). The respiratory failure was not improved and he was treated by V-V ECMO, during which the venous return catheter, which was supposed to be in the right internal vein, entered the superior vena cava directly in the mediastinum. There was a risk of massive mediastinal bleeding if the catheter was removed directly when the ECMO was withdrawn. Finally, the patient underwent vena cava angiography + balloon attachment + ECMO withdrawal in the operating room (prepared for conversion to thoracotomy for vascular exploration and repair at any time during surgery) after multidisciplinary consultation. ECMO was safely withdrawn, and the patient recovered and was discharged. CONCLUSION: Patients may have different vascular conditions. Multidisciplinary cooperation can ensure patient safety. Our experience will provide a reference for similar cases.

Macrophage scavenger receptor A1 antagonizes abdominal aortic aneurysm via upregulating IRG1.

AIMS: Abdominal aortic aneurysm (AAA) is a common, usually asymptomatic disease with high mortality and limited therapeutic options. Extensive extracellular matrix (ECM) fragmentation and transmural inflammation act as major pathological processes of AAA. However, the underlying regulatory mechanisms remain incompletely understood. Herein, we aimed to investigate the role of scavenger receptor A1 (SR-A1), a key pattern recognition receptor modulating macrophage activity, in pathogenesis of AAA. METHODS AND RESULTS: The AAA model was generated by administration of angiotensin II (Ang II) into apolipoprotein E knockout mice or peri-arterial application of calcium phosphate in C57BJ/6L mice. We found that SR-A1 was markedly down-regulated in the macrophages isolated from murine AAA aortas. Global or myeloid-specific ablation of SR-A1 aggravated vascular inflammation, loss of vascular smooth muscle cells and degradation of the extracellular matrix. These effects of SR-A1 deficiency on AAA development were mediated by suppressed immunoresponsive gene 1 (IRG1) and increased inflammatory response in macrophages. Mechanically, binding of SR-A1 with Lyn led to STAT3 phosphorylation and translocation into the nucleus, in which STAT3 promoted IRG1 transcription through directly binding to its promoter. Restoration of macrophage SR-A1 in SR-A1-deficient mice by bone marrow transplantation or administration of 4-octyl itaconate, the derivate of IRG1 product itaconate, could relieve murine AAA. CONCLUSION: Our study reveals a protective effect of macrophage SR-A1-STAT3-IRG1 axis against aortic aneurysm formation via inhibiting inflammation.

Neuroprotective effects of fermented yak milk-derived peptide LYLKPR on H2O2-injured HT-22 cells.

This study explored the neuroprotective effect of the peptide LYLKPR derived from fermented yak milk by Lactiplantibacillus plantarum JLAU103 on H2O2-injured HT-22 cells. Peptide LYLKPR showed good stability in the simulated gastrointestinal tract and strong penetrating ability of the blood-brain barrier (BBB) in vitro. LYLKPR could activate the Nrf2/Keap-1/HO-1 pathway, increase the activities of SOD and CAT, and reduce the levels of ROS and MDA in HT-22 cells. In addition, LYLKPR controlled the activation of the NLRP3 inflammasome by inhibiting the oxidative stress, ultimately preventing the cleavage of pro-IL-18 and pro-IL-1ß by caspase-1, and reducing the level of intracellular mature IL-18 by 29.08%. Based on the molecular docking verification, LYLKPR could effectively bind to the Keap-1 protein, and directly inhibit the inflammasome to significantly increase intracellular BDNF, synaptophysin, and PSD95, and protect synaptic function. Collectively, LYLKPR ameliorated oxidative stress-mediated neuronal injury by inhibiting the NLRP3 inflammasome via modulation of the Nrf2/Keap-1/HO-1 pathway.

Scavenger receptor A1 attenuates aortic dissection via promoting efferocytosis in macrophages.

Macrophage class A1 scavenger receptor (SR-A1) is a pattern recognition receptor with an anti-inflammatory feature in cardiovascular diseases. However, its role in acute aortic dissection (AD) is not known yet. Using an aortic dissection model in SR-A1-deficient mice and their wild type littermates, we found that SR-A1 deficiency aggravated beta-aminopropionitrile monofumarate induced thoracic aortic dilation, false lumen formation, extracellular matrix degradation, vascular inflammation and accumulation of apoptotic cells. These pathological changes were associated with an impaired macrophage efferocytosis mediated by tyrosine-protein kinase receptor Tyro3 in vitro and in vivo. SR-A1 could directly interact with Tyro3 and was required for Tyro3 phosphorylation to activate its downstream PI3K/Akt signaling pathway. Importantly, co-culture of SR-A1-/- macrophages with apoptotic Jurkat cells resulted in less devoured apoptotic cells accompanied by swelling mitochondria and damaged ATP generation, following poor IL-10 and robust TNF-α production. Deficiency of SR-A1 did not influence phagolysosome formation during the efferocytosis. Lentiviral overexpression of Tyro3 in SR-A1-/- macrophages induced restorative phagocytosis in vitro. Administration of Tyro3 agonist protein S could restore SR-A1-/- macrophages phagocytosis in vitro and in vivo. These findings suggest that SR-A1-Tyro3 axis in macrophages mitigate AD damage by promoting efferocytosis and inhibiting inflammation.

Role of the Ca2+-Calcineurin-Nuclear Factor of Activated T cell Pathway in Mitofusin-2-Mediated Immune Function of Jurkat Cells.

BACKGROUND: Mitofusin-2 (MFN2), a well-known mitochondrial fusion protein, has been shown to participate in innate immunity, but its role in mediating adaptive immunity remains poorly characterized. In this study, we explored the potential role of MFN2 in mediating the immune function of T lymphocytes. METHODS: We manipulated MFN2 gene expression in Jurkat cells via lentiviral transduction of MFN2 small interfering RNA (siRNA) or full-length MFN2. After transduction, the immune response and its underlying mechanism were determined in Jurkat cells. One-way analysis of variance and Student's t-test were performed to determine the statistical significance between the groups. RESULTS: Overexpression of MFN2 enhanced the immune response of T lymphocytes by upregulating Ca2+ (359.280 ± 10.130 vs. 266.940 ± 10.170, P = 0.000), calcineurin (0.513 ± 0.014 vs. 0.403 ± 0.020 nmol/L, P = 0.024), and nuclear factor of activated T cells (NFATs) activation (1.040 ± 0.086 vs. 0.700 ± 0.115, P = 0.005), whereas depletion of MFN2 impaired the immune function of T lymphocytes by downregulating Ca2+ (141.140 ± 14.670 vs. 267.060 ± 9.230, P = 0.000), calcineurin (0.054 ± 0.030 nmol/L vs. 0.404 ± 0.063 nmol/L, P = 0.000), and NFAT activation (0.500 ± 0.025 vs. 0.720 ± 0.061, P = 0.012). Furthermore, upregulated calcineurin partially reversed the negative effects of MFN2 siRNA on T cell-mediated immunity evidenced by elevations in T cell proliferation (1.120 ± 0.048 vs. 0.580 ± 0.078, P = 0.040), interleukin-2 (IL-2) production (473.300 ± 24.100 vs. 175.330 ± 12.900 pg/ml, P = 0.000), and the interferon-γ/IL-4 ratio (3.080 ± 0.156 vs. 0.953 ± 0.093, P = 0.000). Meanwhile, calcineurin activity inhibitor depleted the positive effects of overexpressed MFN2 on T cells function. CONCLUSIONS: Our findings suggest that MFN2 may regulate T cell immune functions primarily through the Ca2+-calcineurin-NFAT pathway. MFN2 may represent a potential therapeutic target for T cell immune dysfunction-related diseases.

Rare Earth Complex as Electron Trapper and Energy Transfer Ladder for Efficient Red Iridium Complex Based Electroluminescent Devices.

In this work, we experimentally demonstrated the new functions of trivalent rare earth complex in improving the electroluminescent (EL) performances of iridium complex by codoping trace Eu(TTA)3phen (TTA = thenoyltrifluoroacetone, phen = 1,10-phenanthroline) into a light-emitting layer based on PQ2Ir(dpm) (iridium(III)bis(2-phenylquinoly-N,C(2'))dipivaloylmethane). Compared with a reference device, the codoped devices displayed higher efficiencies, slower efficiency roll-off, higher brightness, and even better color purity. Experimental results demonstrated that Eu(TTA)3phen molecules function as electron trappers due to its low-lying energy levels, which are helpful in balancing holes and electrons and in broadening recombination zone. In addition, the matched triplet energy of Eu(TTA)3phen is instrumental in facilitating energy transfer from host to emitter. Finally, highly efficient red EL devices with the highest current efficiency, power efficiency and brightness up to 58.98 cd A(-1) (external quantum efficiency (EQE) of 21%), 61.73 lm W(-1) and 100870 cd m(-2), respectively, were obtained by appropriately decreasing the doping concentration of iridium complex. At certain brightness of 1000 cd m(-2), EL current efficiency up to 51.94 cd A(-1) (EQE = 18.5%) was retained. Our investigation extends the application of rare earth complexes in EL devices and provides a chance to improve the device performances.

Enhanced physicochemical-biological sewage treatment process in cold regions.

Biological treatment processes give relatively poor pollutant removal efficiencies in cold regions because microbial activity is inhibited at low temperatures. We developed an enhanced physicochemical-biological wastewater treatment process that involves micro-membrane filtration, anaerobic biofilter, and aerobic biofilter to improve the pollutant removal efficiencies that can be achieved under cold conditions. Full-scale experiments using the process were carried out in the northeast of China, at outdoor temperatures of around -30 °C. The average removal efficiencies achieved for chemical oxygen demand, total phosphorus, ammonia nitrogen, and suspended solids were 89.8, 92.9, 94.3, and 95.8%, respectively, using a polyaluminium chloride dosage of 50 mg L⁻¹. We concluded that the process is effective to treat sewage in cold regions.