BACKGROUND: Chronic kidney disease (CKD) is associated with common pathophysiological processes, such as inflammation and fibrosis, in both the heart and the kidney. However, the underlying molecular mechanisms that drive these processes are not yet fully understood. Therefore, this study focused on the molecular mechanism of heart and kidney injury in CKD. METHODS: We generated an microRNA (miR)-26a knockout (KO) mouse model to investigate the role of miR-26a in angiotensin (Ang)-II-induced cardiac and renal injury. We performed Ang-II modeling in wild type (WT) mice and miR-26a KO mice, with six mice in each group. In addition, Ang-II-treated AC16 cells and HK2 cells were used as in vitro models of cardiac and renal injury in the context of CKD. Histological staining, immunohistochemistry, quantitative real-time polymerase chain reaction (PCR), and Western blotting were applied to study the regulation of miR-26a on Ang-II-induced cardiac and renal injury. Immunofluorescence reporter assays were used to detect downstream genes of miR-26a, and immunoprecipitation was employed to identify the interacting protein of LIM and senescent cell antigen-like domain 1 (LIMS1). We also used an adeno-associated virus (AAV) to supplement LIMS1 and explored the specific regulatory mechanism of miR-26a on Ang-II-induced cardiac and renal injury. Dunnett's multiple comparison and t -test were used to analyze the data. RESULTS: Compared with the control mice, miR-26a expression was significantly downregulated in both the kidney and the heart after Ang-II infusion. Our study identified LIMS1 as a novel target gene of miR-26a in both heart and kidney tissues. Downregulation of miR-26a activated the LIMS1/integrin-linked kinase (ILK) signaling pathway in the heart and kidney, which represents a common molecular mechanism underlying inflammation and fibrosis in heart and kidney tissues during CKD. Furthermore, knockout of miR-26a worsened inflammation and fibrosis in the heart and kidney by inhibiting the LIMS1/ILK signaling pathway; on the contrary, supplementation with exogenous miR-26a reversed all these changes. CONCLUSIONS Our findings suggest that miR-26a could be a promising therapeutic target for the treatment of cardiorenal injury in CKD. This is attributed to its ability to regulate the LIMS1/ILK signaling pathway, which represents a common molecular mechanism in both heart and kidney tissues.
Animals ; MicroRNAs/metabolism* ; Angiotensin II/toxicity* ; Mice ; Renal Insufficiency, Chronic/chemically induced* ; Mice, Knockout ; Disease Models, Animal ; Male ; Signal Transduction/genetics* ; LIM Domain Proteins/genetics* ; Mice, Inbred C57BL ; Cell Line ; Humans

Serotonin syndrome (SS), also known as serotonin toxicity, is a rare but life-threatening drug reaction syndrome. This case involves a 17-year-old female patient who developed tremors, fatigue, and tachycardia after taking fluoxetine combined with bupropion and tandospirone for five days. SS was highly suspected, and her symptoms improved following treatment targeted at serotonin syndrome. This case is reported to raise awareness among clinicians about the potential adverse reactions of drug combinations, the importance of early identification of SS symptoms, and precautions when prescribing combined medications to avoid serious consequences.

Objective:To investigate the selection of treatment methods for renal tumors in pilots as well as the clinical significance of robot-assisted surgery by summarizing the process of robot-assisted surgery in the treatment of renal cell carcinoma in a pilot.Methods:The diagnosis, robot-assisted surgery and aeromedical assessment of a pilot with renal cell carcinoma were reported, and the related literature was reviewed.Results:The patient was a 44-year-old male transporter pilot, who was diagnosed with a left renal mass in the middle-lower pole of the kidney during a routine abdominal CT scan. After detailed preoperative evaluation that ruled out the possibility of distant metastasis and other surgical contraindications, the patient underwent robot-assisted laparoscopic partial nephrectomy in August 2022. The postoperative recovery went well, and renal function remained within normal limits at follow-ups. In March 2023, the pilot was concluded as qualified for flight after aeromedical assessment.Conclusions:Robot-assisted partial nephrectomy can significantly reduce surgical trauma, lower the risk of complications, and maximally preserve renal function. It is a good approach to renal tumors in pilots who can recover quickly.

With the ongoing reform of medical insurance policies and the growing prevalence of private hospitals,domes-tic public hospitals must explore a suitable development path tailored to their operational and management requirements.Aligning with the principles of high-quality development,this study identifies shortcomings in public hospital operation and management across five key areas:management systems,budget and cost management,business process management,performance manage-ment,and information system construction.Targeted solutions are proposed to facilitate the high-quality development of public hospitals.

Breast cancer is the most common malignant tumor among women worldwide.Currently,its treatment mainly depends on sur-gery.Societal development has driven an increase in demand for improved quality of life post-breast cancer surgery.Thus,minimally invas-ive surgery utilizing laparoscopic technologies has matured into a widely used procedure in the field of breast surgery.Compared with tradi-tional open surgery,minimally invasive surgery has unique aesthetic advantages,especially applicable to simultaneous radical breast cancer and prosthetic breast reconstruction surgery.Combining axillary lymph node dissection,breast gland excision,and prosthetic breast recon-struction leaves no obvious scarring on breast surface skin after reconstruction.Compared to autologous surgery,luminal prosthetic breast reconstruction reduces operation time,facilitates rapid postoperative recovery,and reduces scarring.This article summarizes the develop-ment of luminal prosthetic breast reconstruction and discusses its directions.

With the ongoing reform of medical insurance policies and the growing prevalence of private hospitals,domes-tic public hospitals must explore a suitable development path tailored to their operational and management requirements.Aligning with the principles of high-quality development,this study identifies shortcomings in public hospital operation and management across five key areas:management systems,budget and cost management,business process management,performance manage-ment,and information system construction.Targeted solutions are proposed to facilitate the high-quality development of public hospitals.

Breast cancer is the most common malignant tumor among women worldwide.Currently,its treatment mainly depends on sur-gery.Societal development has driven an increase in demand for improved quality of life post-breast cancer surgery.Thus,minimally invas-ive surgery utilizing laparoscopic technologies has matured into a widely used procedure in the field of breast surgery.Compared with tradi-tional open surgery,minimally invasive surgery has unique aesthetic advantages,especially applicable to simultaneous radical breast cancer and prosthetic breast reconstruction surgery.Combining axillary lymph node dissection,breast gland excision,and prosthetic breast recon-struction leaves no obvious scarring on breast surface skin after reconstruction.Compared to autologous surgery,luminal prosthetic breast reconstruction reduces operation time,facilitates rapid postoperative recovery,and reduces scarring.This article summarizes the develop-ment of luminal prosthetic breast reconstruction and discusses its directions.

Serotonin syndrome (SS), also known as serotonin toxicity, is a rare but life-threatening drug reaction syndrome. This case involves a 17-year-old female patient who developed tremors, fatigue, and tachycardia after taking fluoxetine combined with bupropion and tandospirone for five days. SS was highly suspected, and her symptoms improved following treatment targeted at serotonin syndrome. This case is reported to raise awareness among clinicians about the potential adverse reactions of drug combinations, the importance of early identification of SS symptoms, and precautions when prescribing combined medications to avoid serious consequences.

Objective:To investigate the selection of treatment methods for renal tumors in pilots as well as the clinical significance of robot-assisted surgery by summarizing the process of robot-assisted surgery in the treatment of renal cell carcinoma in a pilot.Methods:The diagnosis, robot-assisted surgery and aeromedical assessment of a pilot with renal cell carcinoma were reported, and the related literature was reviewed.Results:The patient was a 44-year-old male transporter pilot, who was diagnosed with a left renal mass in the middle-lower pole of the kidney during a routine abdominal CT scan. After detailed preoperative evaluation that ruled out the possibility of distant metastasis and other surgical contraindications, the patient underwent robot-assisted laparoscopic partial nephrectomy in August 2022. The postoperative recovery went well, and renal function remained within normal limits at follow-ups. In March 2023, the pilot was concluded as qualified for flight after aeromedical assessment.Conclusions:Robot-assisted partial nephrectomy can significantly reduce surgical trauma, lower the risk of complications, and maximally preserve renal function. It is a good approach to renal tumors in pilots who can recover quickly.

Objective:To explore the effect of high-frequency repetitive transcranial magnetic stimulation(rTMS)on brain functional remodeling and function of core muscle group in patients with stroke.Methods:A total of 104 patients with stroke who admitted to Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2022 to June 2023 were prospectively selected,and they were randomly divided into a control group(52 cases,received conventional rehabilitation treatment)and a study group(52 cases,received conventional rehabilitation+high-frequency rTMS treatment).The differences in clinical efficacy,brain functional remodeling(LI value),and postural assessment scale for stroke(PASS)of the function of core muscle group and manual muscle test(MMT)scores of core muscle group between two groups were analyzed.Results:The total effective rate of clinical treatment in study group was 92.31％,which was significantly higher than that in the control group(73.08％),and the difference was significant(x2=6.718,P＜0.05).There were no significant difference in the scores of PASS and MMT between the two groups before treatment(P＞0.05).The scores of PASS and MMT of two groups after treatment were significantly higher than those before treatment(t=21.017,13.359,P＜0.05),respectively.After treatment,the PASS and MMT scores of study group were respectively(31.15±1.78)points and(11.88±2.03)points,which were significantly higher than those[(28.33±1.82)points and(9.41±2.27)points]of control group(t=7.988,5.849,P＜0.05),respectively.After treatment,the brain activation areas of study group mainly distributed in the precentral gyrus,precuneus,somatosensory area,cerebellum and ipsilateral supplementary motor area,which appeared a trend of centralization.The distribution of brain activation areas of control group after treatment still showed the characteristics of bilateral extensive activation,which did not appear significant changes than those before treatment.There was no significant difference in LI value between the two groups before treatment(P＞0.05).After treatment,the LI values of two groups were significantly improved,and the LI value of study group was significantly higher than that of control group(t=17.199,P＜0.05).Pearson correlation analysis was performed on the LI values and the scores of PASS and MMT when the hemiplegic side of the patients of two groups conducted chunking motion.The results showed that the LI values appeared significantly positive correlation with PASS score and MMT score(r=0.863,0.847,P＜0.05),respectively.Both two groups did not occur serious abnormal reactions during the treatment.Two patients of study group reported they occurred mild dizziness and headache,which were relieved by themselves after rest.Conclusion:High-frequency rTMS can effectively improve the treatment effect for patients with stroke,and promote the recovery of the motor function area of brain and the function of core muscle group of patients.