OBJECTIVES: To investigate the mechanism mediating the regulatory effect of miR-155-5p on proliferation of human submandibular gland epithelial cells (HSGECs) in primary Sjogren's syndrome (pSS). METHODS: Dual luciferase reporter assay was used to verify the targeting relationship between miR-155-5p and the PI3K/AKT pathway. In a HSGEC model of pSS induced by simulation with TRAIL and INF-γ, the effects of miR-155-inhibitor-NC or miR-155 inhibitor on cell viability, cell cycle, apoptosis and proliferation were evaluated using CKK8 assay, flow cytometry and colony formation assay. ELISA and RT-PCR were used to detect the expressions of inflammatory cytokines and miR-155-5p mRNA in the cells; Western blotting was performed to detect the expressions of proteins in the PI3K/AKT signaling pathway. RESULTS: Dual luciferase assay showed that miR-155-5p targets the PI3K/AKT pathway via PIK3R1 mRNA. The HSGEC model of pSS showed significantly decreased cell viability, cell clone formation ability and expressions IL-10 and IL-4 and increased cell apoptosis, cell percentage in G2 phase, expressions of TNF‑α, IL-6, miR-155-5p and PIK3R1 mRNA, p-PI3K/PI3K ratio, p-Akt/AKT ratio, and PIK3R1 protein expression. Treatment of the cell models with miR-155 inhibitor significantly increased the cell viability, G1 phase cell percentage, colony formation ability, and expressions of IL-10 and IL-4 levels, and obviously reduced cell apoptosis rate, G2 phase cell percentage, expressions of TNF-α, IL-6, miR-155-5p and PIK3R1 mRNA, p-PI3K/PI3K ratio, p-AKT/AKT ratio, and PIK3R1 protein expression. CONCLUSIONS In HSGEC model of pSS, inhibition of miR-155-5p can promote cell proliferation and reduced cell apoptosis by targeting PI3K1 mRNA to negatively regulate the overexpression of PI3K/AKT signaling pathway.
Humans ; MicroRNAs/genetics* ; Cell Proliferation ; Signal Transduction ; Proto-Oncogene Proteins c-akt/metabolism* ; Sjogren's Syndrome/pathology* ; Epithelial Cells/cytology* ; Submandibular Gland/cytology* ; Phosphatidylinositol 3-Kinases/metabolism* ; Apoptosis ; Class Ia Phosphatidylinositol 3-Kinase ; Cells, Cultured

OBJECTIVES: To compare the efficacy of transcatheter tricuspid valve replacement (TTVR) using Lux-Valve and Lux-Valve Plus in patients with severe tricuspid regurgitation. METHODS: A total of 28 consecutive patients with severe tricuspid regurgitation who underwent TTVR with Lux-Valve (n=14) or Lux-Valve Plus (n=14) in the First Affiliated Hospital of the Air Force Medical University from August 2019 to November 2023 were enrolled. Transthoracic echocardiography was performed in all patients before and 6 months after the TTVR. The ultrasound indexes were compared before and 6 months after the TTVR in all patients and between Lux-Valve and Lux-Valve Plus groups. RESULTS: Compared with the Lux-Valve group, the Lux-Valve Plus group showed significantly reduced intraoperative bleeding and shorter postoperative hospital stays (both P<0.05). Six months after the TTVR, none of the patients exhibited more than a mild tricuspid valve regurgitation, and none of the patients had moderate or above perivalvular leakage except for one patient in the Lux-Valve Plus group who had a separation of the clamping member from the anterior tricuspid leaflet. The incidence of perivalvular leakage was significantly lower in the Lux-Valve Plus group (14.29%, 2/14) than in the Lux-Valve group (64.29%, 9/14, P<0.05). At 6 months after operation, the right chamber volume and right ventricle middle transverse diameter were reduced (both P<0.05); the peak blood flow velocity across the tricuspid valve, peak pressure gradient across the tricuspid valve, mean blood flow velocity of tricuspid valve, mean pressure gradient across the tricuspid valve and velocity time integral were increased in both groups (all P<0.05).Compared with the Lux-Valve group, the Lux-Valve Plus group showed higher left ventricular ejection fraction at 6 months postoperatively (P<0.05), while the rest of the indicators were not statistically different (all P>0.05). CONCLUSIONS The efficacy of using Lux-Valve and Lux-Valve Plus for TTVR in patients with severe tricuspid regurgitation is comparable. Six months after the TTVR, the right side of the heart has undergone reverse remodeling.While Lux-Valve Plus offers greater minimally invasive benefits, valve selection should consider device-specific characteristics and differences in individual patients.
Humans ; Tricuspid Valve Insufficiency/surgery* ; Male ; Female ; Heart Valve Prosthesis Implantation/methods* ; Middle Aged ; Aged ; Tricuspid Valve/surgery* ; Heart Valve Prosthesis ; Treatment Outcome ; Echocardiography ; Adult ; Cardiac Catheterization/methods*

OBJECTIVES: To investigate the application of transesophageal echocar-diography assessment for mitral valve in patients with atrial septal defects undergoing repair surgery. METHODS: The study group comprised of thirty-two adult patients with atrial septal defect who underwent thoracoscopic repair surgery at the First Affiliated Hospital of the Air Force Medical University from March to September 2022. Two-dimensional and real-time three-dimensional transesophageal ultrasonography of the mitral valve were performed after anesthesia. The parameters of the mitral valve structure at the late diastolic and late systolic stages were recorded, including anteroposterior and left-right annular diameters, anterior and posterior valves lengths, the vertical distance from the coaptation point of leaflet zone 2 during systole to the annular plane (mitral valve coaptation depth) and mitral valve coaptation length. Data from 32 patients with normal intracardiac structure and no mitral valve regurgitation (control group) were also collected and compared with those of the study group. Concurrent mitral valvoplasty was performed during the atrial septal defect repair surgery for 7 patients with significant mitral valve structural abnormalities and 2 patients with significantly increased mitral regurgitation after cardiac resuscitation. The study group was followed up with transthoracic echocardiography for 2 years postoperatively. RESULTS: In the study group, 26 (81.3%) patients had varying degrees of mitral valve morphological abnormalities. Among them, 10 (31.3%) patients had short mitral valve coaptation length or depth, 12 (37.5%) patients had closure point malposition, and 4 (12.5%) patients had different bulge of anterior and posterior leaflets. Compared with the control group, the study group had significantly smaller systolic and diastolic mitral left-right annular diameter, mitral posterior valves lengths, mitral coaptation length or depth (all P<0.05), a higher pulmonary systemic flow ratio (P<0.01), and a lower maximum blood flow velocity across the mitral valve (P<0.05). After 2 years of follow-up, among the 9 patients who underwent concurrent mitral valvoplasty, the mitral valve maintained no or little regurgitation, and the average mitral valve pressure difference was less than 5 mmHg (1 mmHg=0.133 kPa). Among the 23 patients without concurrent mitral valvoplasty, 2 patients had moderate regurgitation 1 year after surgery, with a pulmonary/systemic flow ratio larger than 2.8. CONCLUSIONS Patients with large atrial septal defects often have abnormal mitral valve structure. Therefore transesophageal echocardiography is recommended for mitral valve assessment during the surgery. If significant mitral valve structural abnormalities are detected, concurrent mitral valvoplasty is recommended.
Humans ; Heart Septal Defects, Atrial/diagnostic imaging* ; Echocardiography, Transesophageal/methods* ; Mitral Valve/surgery* ; Adult ; Female ; Male ; Middle Aged ; Mitral Valve Insufficiency/diagnostic imaging*

Objective To investigate the differences in cortical activation and functional connectivity during speech under different cognitive loads in young individuals.Methods Twenty-one participants(mean age 21.9±1.33 years)were instructed to read short sentences embedded with color words under both congruent(where the color words matched the font color)and incongruent(where the color words did not match the font color)condi-tions.The color words required reading the font color instead of the word itself.Functional near-infrared spectros-copy(fNIRS)was utilized to analyze differences in cortical activation(changes in HbO concentration)and functional connectivity(Pearson correlation of HbO between brain regions)in the dorsolateral prefrontal cortex(DLPFC)and supplementary motor area(SMA)bilaterally.Results The fNIRS results revealed significant increase in HbO con-centration changes in the RDLPFC(t=3.4,P=0.003),LDLPFC(t=2.58,P=0.019),RSMA(t=3.59,P=0.002),and LSMA(t=4.06,P=0.001)under the incongruent condition compared to the congruent condition.Additionally,there was a significant enhancement in the correlation between RDLPFC and LDLPFC(t=2.44,P=0.025).However,the differences in correlation between left and right SMA,as well as between SMA and DLPFC,were not statistically significant(P＞0.05).Conclusion These findings suggest that during speech under incongru-ent conditions,increased cognitive load leads to elevated cortical activation in the DLPFC and SMA,along with in-creased functional connectivity between the left and right DLPFC.

Objective To investigate the effect of Schisandra chinensis polysaccharide(SCP)on mitochondrial autophagy in skeletal muscle in exercise-fatigue mice based on the nuclear factor erythroid 2-related factor 2(Nrf2)/antioxidant response element ARE pathway.Methods A fatigue mouse model was established by swimming training.Mice were assigned randomly to fatigue,SCP(20 mg/kg),Rhodiola rosea(8 mL/kg),inhibitor(30 mg/kg ML385),and SCP+inhibitor groups,with normal mice as the control group.Serum was separated and levels of lactic acid(LA),lactate dehydrogenase(LDH),blood urea nitrogen(BUN),and creatine kinase(CK)were detected.Liver tissue was also isolated and levels of malondialdehyde(MDA),hepatic glycogen(HG),and superoxide dismutase(SOD)were detected.Skeletal muscle tissues were isolated and muscle glycogen(MG),changes in skeletal muscle tissue in exercise fatigue,and mitochondrial morphology were detected.Gene expression levels of mitochondrial transcription factor A(TFAM)and nuclear respiratory factor-1(NRF-1),and Nrf2,quinone oxidoreductase 1(NQO1),heme oxygenase-1(HO-1),and LC3 protein expression levels were analyzed.Results HG,MG,SOD,TFAM mRNA,NRF-1 mRNA,Nrf2,NQO1,HO-1,and LC3 Ⅱ/LC3 Ⅰ were lower in the fatigue group than in the control group,while levels of LA,BUN,LDH,CK,and MDA were higher than in the control group(P＜0.05).HG,MG,SOD,TFAM mRNA,NRF-1 mRNA,Nrf2,NQO1,HO-1,and LC3 Ⅱ/LC3 Ⅰ levels were higher in the SCP and Rhodiola rosea groups than in the fatigue group,while LA,BUN,LDH,CK,and MDA levels were lower than in the fatigue group(P＜0.05).The above indexes were opposite in the inhibitor group(P＜0.05).Conclusions SCP promotes mitochondrial autophagy in skeletal muscle in exercise-fatigue mice by activating the Nrf2/ARE pathway,effectively exerting anti-fatigue effects.

Objective To investigate the differences in cortical activation and functional connectivity during speech under different cognitive loads in young individuals.Methods Twenty-one participants(mean age 21.9±1.33 years)were instructed to read short sentences embedded with color words under both congruent(where the color words matched the font color)and incongruent(where the color words did not match the font color)condi-tions.The color words required reading the font color instead of the word itself.Functional near-infrared spectros-copy(fNIRS)was utilized to analyze differences in cortical activation(changes in HbO concentration)and functional connectivity(Pearson correlation of HbO between brain regions)in the dorsolateral prefrontal cortex(DLPFC)and supplementary motor area(SMA)bilaterally.Results The fNIRS results revealed significant increase in HbO con-centration changes in the RDLPFC(t=3.4,P=0.003),LDLPFC(t=2.58,P=0.019),RSMA(t=3.59,P=0.002),and LSMA(t=4.06,P=0.001)under the incongruent condition compared to the congruent condition.Additionally,there was a significant enhancement in the correlation between RDLPFC and LDLPFC(t=2.44,P=0.025).However,the differences in correlation between left and right SMA,as well as between SMA and DLPFC,were not statistically significant(P＞0.05).Conclusion These findings suggest that during speech under incongru-ent conditions,increased cognitive load leads to elevated cortical activation in the DLPFC and SMA,along with in-creased functional connectivity between the left and right DLPFC.

Objective To investigate the effect of Schisandra chinensis polysaccharide(SCP)on mitochondrial autophagy in skeletal muscle in exercise-fatigue mice based on the nuclear factor erythroid 2-related factor 2(Nrf2)/antioxidant response element ARE pathway.Methods A fatigue mouse model was established by swimming training.Mice were assigned randomly to fatigue,SCP(20 mg/kg),Rhodiola rosea(8 mL/kg),inhibitor(30 mg/kg ML385),and SCP+inhibitor groups,with normal mice as the control group.Serum was separated and levels of lactic acid(LA),lactate dehydrogenase(LDH),blood urea nitrogen(BUN),and creatine kinase(CK)were detected.Liver tissue was also isolated and levels of malondialdehyde(MDA),hepatic glycogen(HG),and superoxide dismutase(SOD)were detected.Skeletal muscle tissues were isolated and muscle glycogen(MG),changes in skeletal muscle tissue in exercise fatigue,and mitochondrial morphology were detected.Gene expression levels of mitochondrial transcription factor A(TFAM)and nuclear respiratory factor-1(NRF-1),and Nrf2,quinone oxidoreductase 1(NQO1),heme oxygenase-1(HO-1),and LC3 protein expression levels were analyzed.Results HG,MG,SOD,TFAM mRNA,NRF-1 mRNA,Nrf2,NQO1,HO-1,and LC3 Ⅱ/LC3 Ⅰ were lower in the fatigue group than in the control group,while levels of LA,BUN,LDH,CK,and MDA were higher than in the control group(P＜0.05).HG,MG,SOD,TFAM mRNA,NRF-1 mRNA,Nrf2,NQO1,HO-1,and LC3 Ⅱ/LC3 Ⅰ levels were higher in the SCP and Rhodiola rosea groups than in the fatigue group,while LA,BUN,LDH,CK,and MDA levels were lower than in the fatigue group(P＜0.05).The above indexes were opposite in the inhibitor group(P＜0.05).Conclusions SCP promotes mitochondrial autophagy in skeletal muscle in exercise-fatigue mice by activating the Nrf2/ARE pathway,effectively exerting anti-fatigue effects.

Objective:To investigate the acute gastrointestinal injury (AGI) in patients with extracorporeal membrane oxygenation (ECMO) at the early stage of operation and its influencing factors.Methods:A total of 70 patients with ECMO who were hospitalized in the Emergency Care Unit of Guangxi Zhuang Autonomous Region People's Hospital from September 2020 to December 2021 were retrospectively analyzed, and a total of 70 patients with ECMO who were hospitalized in the emergency care unit of Guangxi Zhuang Autonomous Region People's Hospital from September 2020 to December 2021 were retrospectively analyzed. According to the 2012 guidelines of the European Society of Intensive Care Medicine on the classification of acute gastrointestinal injury in critically ill patients, the patients were divided into AGI group and non-AGI group. The incidence of acute gastrointestinal injury in the early stage was statistically analyzed, and the results of blood gas analysis during ECMO loading and ECMO parameters, hemodynamic indexes and biochemical indexes after ECMO transfer were statistically analyzed. To explore the influencing factors and independent risk factors of AGI in the early stage. In addition, 70 patients were divided into successful group and non-successful group according to whether they were successfully withdrawn. The occurrence of acute gastrointestinal injury between the two groups was compared, and the effect of acute gastrointestinal injury on ECMO patients was analyzed.Results:Among the 70 ECMO patients, the incidence of early AGI was 71.43% (50 cases), and the components of AGI Ⅰ, Ⅱ, Ⅲ and Ⅳ were 18.57% (13 cases), 41.43% (29 cases), 11.43% (8 cases) and 0% (0 cases), respectively. ① Univariate analysis showed that systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP), vasoactive drug index (VIS), pH, lactic acid and BMI were significantly different between AGI group and non-AGI group when ECMO was used ( P < 0.05). Logistic binary regression analysis showed that BMI was an independent risk factor for early AGI in ECMO patients (ROC area 0.657, 95% confidence interval 0.522-0.791 ( P < 0.05), and Yoden index 0.15). (3) The AGI composition ratio of the unsuccessful group was higher than that of the unsuccessful group ( P < 0.05). Conclusions:Patients with ECMO have a high incidence of AGI in the early stage, mainly occurring in grade I and Ⅱ. Systolic blood pressure, diastolic blood pressure, MAP, VIS, pH, lactic acid and BMI when ECMO is put on are influential factors for the early development of AGI in ECMO patients, among which BMI is an independent risk factor for the early development of AGI in ECMO patients. The occurrence of AGI reduces the probability of successful withdrawal in ECMO patients.

Objective:To investigate the recovery of renal function and its influencing factors in patients receiving extracorporeal membrane oxygenation (ECMO) support and complicated with acute kidney injury(AKI).Methods:This was a retrospective observational study. The clinical data of patients with ECMO support and AKI admitted to the Emergency intensive care unit of the People's Hospital of Guangxi Zhuang Autonomous Region from October 2019 to December 2021 were collected. The patients were divided into renal function recovery group and renal function non-recovery group according to the recovery of renal function after 28 days of ECMO. With renal function non-recovery at 28 days as the end point of the study, and the variables with significant differences in baseline were selected for stepwise backward regression to determine the independent risk factors. The receiver operator characteristic (ROC) curve was drawn, and the area under the curve (AUC) was used to evaluate the diagnostic value of independent risk factors.Results:A total of 40 patients were enrolled, of which 28 patients (70%) had recovery of renal function, and 12 patients (30%) did not have recovery of renal function. Stepwise backward multivariate logistic regression analysis showed that lactate level at ECMO initiation was an independent risk factor for non-recovery of renal function ( OR = 1.380, 95% CI: 1.096-1.738, P = 0.006). The ROC curve showed that the AUC and 95% CI were 0.863 (0.751-0.975), the sensitivity was 100%, and the specificity was 75%. Conclusion:Lactate level at ECMO initiation was an independent risk factor for non-recovery of renal function on 28 days after ECMO initiation among patients undergoing ECMO support complicated with AKI. Lactate has a high predictive value for the non-recovery of renal function.

Objective To explore the application of the integrated graded diagnosis,treatment and ambulance model based on circulation respiration abdomen motor speech (CRAMS) score in patients with multiple traumas. Methods From March 2023 to March 2024,160 patients with multiple traumas admitted to the department of emergency of Shanghai Sixth People's Hospital were selected as the research subjects. Based on a random number table,the patients were divided into an observation group and a control group,with 80 patients in each group. And the control group received routine emergency treatment,while the observation group was assessed by the intervention team using the CRAMS scoring scale to evaluate the condition,and then implemented an integrated graded diagnosis and treatment model based on the assessment results. The specific measures were as follows:establish an intervention team composed of 1 attending doctor from the emergency resuscitation room,1 head nurse specializing in trauma care,and 3 trauma specialty nurses. The attending doctor was responsible for diagnosing and treating the patient's condition;the head nurse specializes in assessing the patient using the CRAMS scoring scale;the trauma specialty nurses were tasked with implementing interventions for the patient. The CRAMS score,injuy seveity scoe (ISS),triage time,waiting time for treatment,treatment time,complication rate,and patient satisfaction rate were compared between the two groups before and after the intervention. Results There were no significant differences in CRAMS scores and ISS scores between the two groups before intervention. After intervention,the CRAMS score of the observation group was significantly higher than that of the control group (8.85±0.89 vs. 7.52±1.02,P<0.05),while the ISS score was significantly lower than that of the control group (15.98±2.98 vs. 20.77±3.02,P<0.05). The triage time,waiting time for treatment,and treatment time of the observation group were significantly shorter than those of the control group[triage time (minutes):3.25±0.62 vs. 5.89±1.02,waiting time for treatment (minutes):3.02±0.45 vs. 5.78±0.98,treatment time (minutes):45.85±5.23 vs. 65.22±6.41,all P<0.05]. Complication incidence of the observation group was significantly lower than that of the control group[3.75％ (3/80) vs. 12.50％ (10/80),P<0.05],while the satisfaction rate of the observation group was significantly higher than that of the control[93.75％ (75/80) vs. 77.50％ (62/80),P<005]. Conclusion The integrated graded diagnosis and rescue model based on CRAMS scores can improve the treatment efficiency of multiple trauma patients,improve their condition and prognosis,and enhance their satisfaction with treatment.