Circular RNA_HIPK3-Targeting miR-93-5p Regulates KLF9 Expression Level to Control Acute Kidney Injury.

Acute kidney injury (AKI) is a clinical syndrome caused by various reasons that results in the rapid decline of renal function in a short period of time. Severe AKI can lead to multiple organ dysfunction syndrome. Circular RNA HIPK3 (circHIPK3) derived from the HIPK3 gene is involved in multiple inflammatory processes. The present research was performed to explore the function of circHIPK3 on AKI. The AKI model was established by ischemia/reperfusion (I/R) in C57BL/6 mice or hypoxia/reoxygenation (H/R) in HK-2 cells. The function and mechanism of circHIPK3 on AKI were explored via biochemical index measurement; hematoxylin and eosin (HE) staining; 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT); flow cytometry; enzyme-linked immunosorbent assay (ELISA); western blot; quantitative real-time polymerase chain reaction (RT-qPCR); detection of reactive oxygen species (ROS) and adenosine triphosphate (ATP); and luciferase reporter assays. circHIPK3 was upregulated in kidney tissues of I/R-induced mice and in H/R-treated HK-2 cells, while the microRNA- (miR-) 93-5p level was decreased in H/R-stimulated HK-2 cells. Furthermore, circHIPK3 silencing or miR-93-5p overexpression could reduce the level of proinflammatory factors and oxidative stress and recover the cell viability in H/R-stimulated HK-2 cells. Meanwhile, the luciferase assay showed that Krüppel-like transcription factor 9 (KLF9) was the downstream target of miR-93-5p. Forced expression of KLF9 blocked the function of miR-93-5p on H/R-treated HK-2 cells. Knockdown of circHIPK3 improved the renal function and reduced the apoptosis level in vivo. In conclusion, circHIPK3 knockdown alleviated oxidative stress and apoptosis and inhibited inflammation in AKI via miR-93-5p-mediated downregulation of the KLF9 signal pathway.

Risk factors analysis for patients aged over 65 years undergoing combined heart valve surgery and coronary artery bypass grafting / 中华胸心血管外科杂志

Objective To analyze the risk factors for in-hospital mortality in patients aged over 65 years undergoing heart valve surgery combined with coronary artery bypass grafting(CABG).Methods Between February 2002 and September 2014,540 patients aged over 65 years undergoing heart valve surgery combined with CABG in our institute were retrospectively studied.Univariate analyses and multivariate logistic regression analyses were performed to explore risk factors associated with in-hospital mortality.Results Overall in-hospital mortality was 4.26％.Univariate analysis depicted that chronic obstructive pulmonary disease (COPD) (P =0.001),last serum creatinine (P =0.043),unstable angina(P =0.046),Canadian Cardiovascular Society 111-ⅣV (P =0.005),number of diseased coronary vessels (P =0.043),cardiopulmonary bypass time-delayed (P =0.003),post-operative morbidity (P =0.000) had a significant impact on in-hospital mortality.Multivariate logistic regression analysis revealed that COPD (P =0.005,OR =5.598),CPB time-delayed (P ＜ 0.001,OR =1.011),re-exploration (P ＜0.001,OR =15.813),malignant arrhythmia (P =0.014,OR =4.900) were independent risk factors of in-hospital mortality.Conclusion The present research demonstrates that COPD,CPB time-delayed,re-exploration and malignant arrhythmia dramatically impacted the in-hospital mortality of patients aged over 65 years undergoing combined heart valve surgery and CABG.

Risk Factor Analysis for the Prognosis in Elder Patients With Combined Aortic Valve Replacement and Coronary Artery Bypass Grafting / 中国循环杂志

Objectives: To analyze clinical characteristics with the early and late prognosis in elder patients with combined aortic valve replacement (AVR) and coronary artery bypass grafting (CABG). Methods: A total of 232 patients≥65 years of age who received AVR-CABG in our hospital from 2004-02 to 2014-09 were retrospectively analyzed. The risk factors affecting the early and late prognosis in those patients were studied by multivariate Logistic regression analysis and Cox proportional hazards model. Results: The in-hospital death happened in 7/232 (3.0%) patients, early post-operative complication with prolonged mechanical ventilation time was 28 (12.1%) and bleeding was 14 (6.0%). The follow-up study was conducted in 225/232 (97.0%) survived patients from 3 months to 10 years at the mean of (41.2 ± 29.0) months; 6 (2.7%) patients had cardiac death, the major late post-operative adverse events were cardiac dysfunction (III to IV) or recurrence of angina (8.9%). Multivariate Logistic regression analysis revealed that female (P=0.019, OR=2.576), pre-operative atrial ifbrillation (AF) (P=0.012, OR=3.541) and CPB time (P=0.000, OR=3.781) were the independent risk factors affecting early post-operative outcome. Cox proportional hazards model presented that hyperlipidemia (P=0.025, HR=2.535), smoking (P=0.009, HR=3.414) and the history of PCI (P=0.013, HR=3.562) were the independent risk factors inlfuencing late prognosis of AVR-CABG. Conclusion: The overall effect of AVR-CABG in elder patients was satisfactory. Female, pre-operative AF, CPB time may affect the early post-operative outcome, while hyperlipidemia, smoking and PCI history could inlfuence the long-term prognosis in relevant patients.

Diagnostic and therapeutic strategy of traumatic pulmonary pseudocyst / 中国医师进修杂志

Objective To evaluate the diagnostic and therapeutic strategy of traumatic pulmonary pseudocyst (TPP).Methods Fifteen patients who were diagnosed and treated as TPP between January 2000 and November 2011 were studied retrospectively.Results Nonpenetrating chest trauma was the underlying cause in all cases.A typical sign shown on chest radiograph was a thin-walled cavitary lesion in 9 patients,6 patients accompanied by traumatic wet lung,with or without an air-fluid level.Serial radiological images of CT showed high resolution of the above lesions.Single TPP lesion occurred in 9 patients,and multiple TPP lesions in 6 patients.The size of the lesions was 5 -75 (32 ± 17) mm.The pseudocyst was located in the left lung in 5 patients(33％),located in the right lung in 7 patients (47％),located in bilateral lung in 3 patients (20％).All TPP patients were treated conservatively with no occurrence of complications.Conclusions TPP is an uncommon benign lesion secondary to thoracic trauma.CT scan is an optimal option for diagnosis and evaluation of TPP.Uncomplicated cases can take conservative treatment.For complicated patients,theraneutic strategy should be made individually.