| 3 | Exosomal transfer of microRNA-590-3p between renal tubular epithelial cells after renal ischemia-reperfusion injury regulates autophagy by targeting TRAF6显示文摘Background:Acute kidney injury(AKI)is a common complication in patients,especially elderly patients,who undergo cardiac surgery with cardiopulmonary bypass.Studies have indicated a protective role of autophagy in AKI.However,the mechanisms underlying the regulatory effect of autophagy in AKI among patients undergoing cardiac surgeries are poorly understood.In this study,we aimed to test the hypothesis that exosomal microRNAs(miRNAs)regulate autophagy in tubular epithelial cells after AKI.Methods:Plasma exosomal RNA was extracted from young and elderly AKI patients undergoing cardiac surgery,and the miRNAs expression during the perioperative period were analyzed using next-generation sequencing.The screened miRNAs and their target genes were subjected to gene oncology function and Kyoto Encyclopedia of Genes and Genome enrichment analyses.Renal tubular epithelial cell line(HK-2 cells)was cultured and hypoxia/reoxygenation(H/R)model was established,which is an in vitro renal ischemia/reperfusion(I/R)model.We used Western blot analysis,cell viability assay,transfection,luciferase assay to investigate the mechanisms underlying the observed increases in the levels of renal I/R injury-mediated exosomal miRNAs and their roles in regulating HK-2 cells autophagy.Results:miR-590-3p was highly enriched in the plasma exosomes of young AKI patients after cardiac surgery.Increased levels of miR-590-3p led to the increases in the expression of autophagy marker proteins,including Beclin-1 and microtubule associated protein 1 light chain 3 beta(LC3II),and prolonged the autophagic response in HK-2 cells after H/R treatment.These effects were achieved mainly via increases in the exosomal miR-590-3p levels,and the tumor necrosis factor receptor-associated factor 6 protein was shown to play a key role in I/R injury-mediated autophagy induction.Conclusion:Exosomes released from HK-2 cells after renal I/R injury regulate autophagy by transferring miR-590-3p in a paracrine manner,which suggests that increasing the miR-590-3p levels in HK-2 cell-derived exosomes may increase autophagy and protect against kidney injury after renal I/R injury. | Yimeng Chen Congya Zhang Yingjie Du Xiying Yang Min Liu Wenjing Yang Guiyu Lei Guyan Wang | 2022 | Chinese Medical Journal2022，135，20： | 1 |
| 5 | 关于心脏手术中自体血回收有效性随机试验的荟萃分析显示文摘背景在心脏手术中可以通过自体血回收来避免输注同种异体血。另外已有人提出,血液中的碎片可能会增加卒中或神经意识功能障碍的风险,因此,清除回收血中的碎片可改善患者的预后。在此研究中,我们试图通过系统性回顾已发表的随机控制性试验进行荟萃分析,明确在心脏手术中自体血回收的整体安全性和有效性。方法全面检索找出关于所有有关心脏手术中应用自体血回收技术的所有随机试验。截止到2008年11月的MEDLINE、Cochrane图书馆、EMBASE和摘要资料库均被检索完全。将所有心脏手术中应用自体血回收技术与未应用自体血回收技术进行比较,并且报道至少一个明确的临床结果的随机试验均被列为研究对象。随机效应模型被用来依次计算比值比(OR,95%可信区间)、二分法加权平均差(WMD,95%可信区间)和连续变量。结果包括2282例患者在内的31个随机试验最终被作为研究对象进行荟萃分析。在心脏手术中,进行手术中自体血回收减少了接触同种异体异基因血制品(比值比0.63,95%可信区间:0.43—0.94,P=0.02)及红细胞(比值比0.60,95%可信区间:0.39—0.92,P=0.02)的概率,也降低了平均每例患者输注同种异体异基因血制品的总量(加权平均差-256ml,95%可信区间:-416--95ml,P=0.002)。但在以下几个方面进行自体血回收组与未进行自体血回收组之间并无差异,包括:院内死亡率(比值比0.65,95%可信区间:0.25—1.68,P=0.37)、手术后卒中或短暂缺血性发作(比值比0.59,95%可信区间:0.20~1.76,P=0.34)、房颤(比值比0.92,95%可信区间:0.69—1.23,P=0.56)、肾功能衰竭(比值比0.86,95%可信区间:0.41—1.80,P=0.70)、感染(比值比1.25,95%可信区间:0.75—2.10,P=0.39)、接受新鲜冰冻血浆治疗(比值比1.16,95%可信区间:0.82—1.66,P=0.40)以及接受血小板输注治疗(比值比0.90,95%可信区间:0.63—1.28,P=0.55)。结论现有的证据表明应用自体血回收技术可减少心脏手术中患者异体血制品或红细胞的输注。进一步的分析认为,只有在收集失血和(或)剩余机血,或在整个手术过程中应用自体血回收技术才是有利的。如果只在体外循环期间用自体血回收技术作为心内吸引,则对于血液保护没有明显效应且增加新鲜冰冻血浆的输注。 | Guyan Wang,MD, PhD Daniel Bainbridge, MD, FRCPC Janet Martin, PharmD, mSc(HTA&M) Davy Cheng, MD, MSc, FRCPC, FCAHS 蒋琦亮(译) | 2011 | 麻醉与镇痛2011，7，3： | 0 |
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