Long non-coding RNA AK006774 inhibits cardiac ischemia-reperfusion injury via sponging miR-448.

In recent years, the incidence and mortality of myocardial infarction (MI) have been increasing throughout the world, threatening public health. Non-coding RNAs (ncRNAs), including microRNAs (miRNAs) and long non-coding RNAs (lncRNAs), play critical roles in the progression of MI. The present study aimed to investigate the role of lncRNA AK006774 in the progression of myocardial infarction and find out novel therapeutic or diagnostic target of myocardial infarction. A mouse ischemia/reperfusion (I/R) model and 2,3,5-Triphenyte-trazoliumchloride (TTC) staining were performed to evaluate the effects of AK006774 on I/R injury in vivo. Hypoxia/reoxygenation (H/R) models using primary cardiomyocytes have been established. Flow cytometry and Terminal Deoxynucleotide Transferase dUTP Nick End Labeling (TUNEL) assays were performed to evaluate the effects of AK006774 on cardiomyocyte apoptosis. Luciferase and RNA pull-down assays were performed to verify the interaction between miR-448 and its targets. Western blotting and quantitative PCR were performed to determine protein and gene expression, respectively. We first found that AK006774 overexpression reduced I/R-induced infarct area and cardiomyocyte apoptosis in vivo. Accordingly, AK006774 inhibited apoptosis and oxidative stress in cardiomyocytes subjected to H/R treatment in vitro. Mechanistically, AK006774 modulated the expression of bcl-2 by sponging miR-448. Overexpression of miR-448 antagonized the effects of AK006774 on cardiomyocyte apoptosis. The AK006774/miR-448/bcl-2 signaling axis acts as a key regulator of I/R injury and may be a potential therapeutic or diagnostic target for the treatment of MI.

Semiquantitative Power Doppler Ultrasound Score to Predict Acute Kidney Injury in Patients With Sepsis or Cardiac Failure: A Prospective Observational Study.

BACKGROUND: Diagnosing acute kidney injury (AKI) stage 3 in critically ill patients may help physicians in making treatment decisions. This diagnosis relies chiefly on urinary output and serum creatinine, which may be of limited value. This study aimed to explore the diagnostic performance of renal resistive index (RRI) and semiquantitative power Doppler ultrasound (PDU) scores in predicting AKI stage 3 in patients with sepsis or cardiac failure. METHODS: This study is a prospective observational study that included 83 patients (40 with sepsis and 43 with cardiac failure). Renal resistive index and semiquantitative PDU scores were measured within 6 hours following admission to the intensive care unit. Acute kidney injury was defined according to the criteria set by Kidney Disease Improving Global Outcomes. RESULTS: The predictive values of RRI (area under the curve [AUC] = 0.772, 95% confidence interval [CI] = 0.658-0.886) and PDU score (AUC = 0.780, 95% CI = 0.667-0.892) were similar in all patients. Power Doppler ultrasound score (AUC = 0.910, 95% CI = 0.815-1.000) could effectively predict AKI stage 3 in the cardiac failure subgroup, and the optimal cutoff for this parameter was ≤ 1 (sensitivity = 87.5%, specificity = 92.6%, Youden index = 0.801, accuracy in our population = 90.7%). However, PDU scores (AUC = 0.620, 95% CI = 0.425-0.814) could not predict AKI stage 3 in the sepsis subgroup. The predictive values of RRI for AKI stage 3 in the cardiac failure (AUC = 0.820, 95% CI = 0.666-0.974) and sepsis (AUC = 0.724, 95% CI = 0.538-0.910) subgroups were similar. CONCLUSIONS: Power Doppler ultrasound scores could effectively predict AKI stage 3 in patients with cardiac failure but not in patients with sepsis. Renal resistive index is a poor predictor of AKI stage 3 in patients with sepsis or cardiac failure.

[Diagnostic accuracy of bedside ultrasound measurement of limb skeletal muscle thickness for intensive care unit-acquired weakness].

OBJECTIVE: To explore the diagnostic accuracy of bedside ultrasound measurement of limb skeletal muscle thickness for intensive care unit-acquired weakness (ICU-AW) in patients receiving mechanical ventilation. METHODS: A prospective observational study was conducted. Patients receiving mechanical ventilation admitted to the emergency ICU of Cangzhou Central Hospital from June 2018 to March 2020 were enrolled. The demographic data were collected. Medical Research Council (MRC) score was used to assess muscle strength and to determine the presence of ICU-AW once the patients were awake. The thicknesses of biceps brachii (BB), flexor carpi radialis (FCR), rectus femoris (RF) and tibialis anterior (TA) were measured by bedside ultrasound. The difference of each index was compared between the patients in ICU-AW group and in non-ICU-AW group. Receiver operator characteristic (ROC) curves were plotted to examine the values of the thicknesses of these four muscles in diagnosing ICU-AW. RESULTS: Forty-one patients receiving mechanical ventilation (15 patients with ICU-AW, 26 patients without ICU-AW) were recruited. Compared with the non-ICU-AW group, the MRC score, the thicknesses of FCR, RF and TA were lower in the ICU-AW group [MRC score: 36 (30, 40) vs. 60 (56, 60), FCR (cm): 1.09±0.19 vs. 1.30±0.28, RF (cm): 1.57±0.58 vs. 2.23±0.58, TA (cm): 1.76±0.33 vs. 2.21±0.43, all P < 0.05], and the length of ICU stay was longer [days: 15 (9, 26) vs. 10 (4, 12), P < 0.05]. Although the thickness of BB was also lower in the ICU-AW group, there was no statistical difference between the two groups (cm: 2.45±0.57 vs. 2.70±0.61, P = 0.205). ROC curve showed that the thicknesses of FCR, RF and TA had diagnostic values for ICU-AW [area under ROC curve (AUC) and 95% confidence interval (95%CI) was 0.742 (0.582-0.866), 0.787 (0.631-0.899), 0.817 (0.665-0.920), respectively, all P < 0.01]. The thicknesses of BB couldn't diagnose ICU-AW (AUC = 0.597, 95%CI was 0.433-0.747, P = 0.296). CONCLUSIONS: The thicknesses of FCR, RF and TA measured by bedside ultrasound in patients with mechanical ventilation had diagnostic values for ICU-AW, while the thickness of BB could not diagnose ICU-AW.

Comparison of severity index and plasma paraquat concentration for predicting survival after paraquat poisoning: A meta-analysis.

BACKGROUND: Severity index and plasma paraquat (PQ) concentration can predict the prognosis of patients with PQ poisoning. However, the better parameter is yet to be systematically investigated and determined. Thus, we conduct this systematic review and meta-analysis to investigate the prognostic value of severity index and plasma PQ concentration in patients with PQ poisoning. METHODS: We searched PubMed, Embase, Web of Science, ScienceDirect, and Cochrane Library to identify all relevant papers that were published up to March 2019. All diagnostic studies that compared severity index and plasma PQ concentration to predict mortality in patients with PQ poisoning were enrolled in this meta-analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) for individual trials were pooled using a random-effect model. We also aggregated heterogeneity testing, sensitivity analysis, and publication bias analysis. RESULTS: Ultimately, seven studies involving 821 patients were included. The pooled OR with a 95% CI of severity index was 24.12 (95% CI: 9.34-62.34, P < .001), with an area under the curve of 0.88 (95% CI: 0.85-0.90), sensitivity of 0.84 (95% CI: 0.74-0.91), and specificity of 0.81 (95% CI: 0.75-0.87). Meanwhile, the pooled OR with 95% CI of plasma PQ concentration was 34.39 (95% CI: 14.69-80.56, P < .001), with an area under the curve of 0.94 (95% CI: 0.91-0.96), sensitivity of 0.86 (95% CI: 0.75-0.93), and specificity of 0.89 (95% CI: 0.76-0.95). Sensitivity analysis demonstrated the stability of the results of our meta-analysis. No significant publication bias was observed in this meta-analysis. CONCLUSION: Overall, this study indicated that severity index and plasma PQ concentration have relatively high-prognostic value in patients with PQ poisoning, and that the sensitivity and specificity of plasma PQ concentration are superior to those of severity index.

Prediction of acute kidney injury: the ratio of renal resistive index to semiquantitative power Doppler ultrasound score-a better predictor?: A prospective observational study.

This study aimed to explore the diagnostic performance of the ratio of renal resistive index (RRI) to semiquantitative power Doppler ultrasound (PDU) score in predicting acute kidney injury (AKI) 3 in critically ill patients.This study was a prospective, observational study that included 101 critically ill patients. RRI and semiquantitative PDU score were measured within 6 hours following admission to the intensive care unit (ICU). The ratio of RRI to PDU (RRI/PDU) was calculated as follows: RRI / PDU. If PDU score was 0, the RRI/PDU was 1. Meanwhile, AKI was defined according to the Kidney Disease Improving Global Outcomes criteria.Median RRI/PDU was 0.234 (0.190, 0.335) in patients with AKI 0-2 and 0.636 (0.411, 0.738) in patients with AKI 3 (P < .001). As assessed by the area under the receiver operator characteristic curves (AUC), RRI/PDU performed best in diagnosing AKI 3 [AUC = 0.935 (95% CI: 0.868-0.974)]. Optimal cuto for RRI/PDU was > 0.37, and the sensitivity and specificity were 90.5% and 90.0%, respectively. In 93 patients, except for 8 patients with a PDU score of 0, the AUC of RRI/PDU [0.938 (95% CI: 0.868-0.977)] was superior to the PDU score (0.905 [95% CI: 0.826-0.956], P = .133), RRI [0.782 (95% CI: 0.684-0.861), P = .016], serum creatinine [0.801 (95% CI: 0.705-0.877), P = .017], or 6 hours AKI stage (0.876 [95% CI: 0.791-0.935], P = .110) in predicting AKI 3 on D5.In our study, RRI, PDU score, RRI/PDU, and 6 hours AKI stage were useful in predicting AKI 3. Furthermore, RRI/PDU may be a better predictor of AKI 3.

Risk factors for extrahepatic cholangiocarcinoma: a case-control study in China.

To investigate risk factors for extrahepatic cholangiocarcinoma (ECC) in China. A total of 200 ECC cases and 200 matched control were included in the study. The presence of cigarette smoking, alcohol drinking, choledocholithiasis, primary sclerosing cholangitis, liver fluke infection (Clonorchis sinensis), diabetes mellitus, was investigated through clinical records. Blood from all cases was tested for hepatitis B surface antigen. Odds ratios (OR) and 95% confidence intervals (CIs) were estimated using conditional logistic regression. Compared with controls, ECC patients had a higher prevalence of cigarette smoking (61.0 vs. 47.0%, P=0.007), alcohol drinking (17.5 vs. 3.5%, P<0.000), and choledocholithiasis (6.0 vs. 1.0%, P=0.011). By multivariate analysis, the significant risk factors for the development of ECC were current smoking (OR=1.90, 95% CI=1.08-3.34), heavy alcohol drinking (OR=2.08, 95% CI=1.39-3.13), and choledocholithiasis (OR=6.68, 95% CI=1.48-30.27). The prevalence of hepatitis B virus infection, diabetes mellitus were not significantly different between cases and controls. These findings suggest that smoking, alcohol drinking, and choledocholithiasis are positive risk factors for the development of ECC in China.

Inhibiting role of rosiglitazone in the regulation of inflammatory response and protective effects for severe acute pancreatitis in mice.

OBJECTIVES: Our study aimed to probe the effects of rosiglitazone treatment on a severe acute pancreatitis (SAP) model induced by caerulein and investigate the underlying mechanism. METHODS: Differentially expressed messenger RNAs (mRNAs) in the mice of a SAP group were screened out by microarray analysis. The inflammatory response pathway was obtained from the online website DAVID Bioinformatics Resources 6.8. The interactions of caerulein and its target proteins were shown by search tool for interactions of chemicals (STITCH). Functional interactions of the genes associated with pancreatitis and the target proteins of caerulein were obtained with search tool for interactions of chemicals (STRING). SAP mice were established by hourly intraperitoneal injection of caerulein. Rosiglitazone was used as treatment drug, and pancreatic inflammation was assessed. The expression of Socs3 was studied by reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blot analysis. The expression of interleukin (IL)-6, IL-1b, and Egr1 were studied by RT-PCR and Western blot analysis. RESULTS: The GSE77983 data were analyzed, and the results showed that Socs3 was overexpressed in SAP tissues. The inflammation response pathway in pancreas was selected by DAVID, STITCH, and STRING. After injection of rosiglitazone in mice, the serum levels of amylase and lipase were decreased. Furthermore, the mRNA and protein levels of Socs3 and inflammatory cytokines in pancreatic tissues were downregulated. CONCLUSIONS: Rosiglitazone could protect mice with SAP from injury by downregulating Socs3 and inhibiting the inflammatory response pathway.

[Effect of a stabilization device for maintaining the balance of a CPR performer during ambulance transportation on quality of CPR in out-of-hospital cardiac arrest: a prospective randomized controlled trial].

OBJECTIVE: To investigate the effect of a stabilization device for maintaining the balance of a cardiopulmonary resuscitation (CPR) performer during ambulance transportation on quality of CPR in out-of-hospital cardiac arrest (OHCA). METHODS: A prospective randomized controlled trial was performed. 167 OHCA patients with cardiac arrest (CA) time < 10 minutes admitted to Cangzhou Central Hospital from October 2014 to January 2017 were enrolled, and divided into armed stabilization device group (n = 86) and unarmed stabilization device group (n = 81) by random number table. Restoration of spontaneous circulation (ROSC) rate, 24-hour survival rate and survival rate of discharge were evaluated. RESULTS: Compared with unarmed stabilization device group, ROSC rate (29.1% vs. 9.9%, χ2 = 9.691, P = 0.002), 24-hour survival rate (20.9% vs. 6.2%, χ2 = 7.649, P = 0.006) and survival rate of discharge (12.8% vs. 3.7%, χ2 = 4.485, P = 0.035) were significant increased in armed stabilization device group. CONCLUSIONS: CPR with stabilization device during ambulance transport could effectively ensure quality of CPR and improve prognosis in OHCA. CLINICAL TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR-IPR-14005337.

Down-regulation of c-Myc expression inhibits the invasion of bile duct carcinoma cells.

Cholangiocarcinoma is the second most common primary hepatic tumour originating from biliary tract epithelial cells with poor prognosis. Enhanced c-Myc protein expression contributes to many aspects of tumour cell biology. Although the ability of c-Myc to drive unrestricted cell proliferation and to inhibit cell differentiation had been well recognized, whether down-regulated c-Myc expression can inhibit tumour cell invasion still remains to be explored. The c-Myc ASODN (antisense oligodeoxyribonucleotide) and NSODN (nonsense oligodeoxyribonucleotide) were designed, synthesized and transfected into human QBC939 bile duct carcinoma cells using the Lipofectamine 2000 reagent. The protein expression of c-Myc was detected by Western blot. A transwell experiment was applied to evaluate the invasive capacity of the QBC939 cells. c-Myc ASODN could significantly suppress the c-Myc protein expression (P<0.05) and the invasion (P<0.01) of QBC939 cells transfected with c-Myc ASODN compared with that in the control and c-Myc NSODN-transfected group. Thus in the present study we show that down-regulation of c-Myc expression can inhibit the invasion of QBC939 cells in vitro.