液体负平衡对感染性休克合并急性肺损伤患者早期复苏及预后的影响

目的:探讨液体负平衡对感染性休克合并急性肺损伤(ALI)患者早期复苏及预后的影响。方法:将2010年1月~2014年9月我院急诊外科收治的84例感染性休克合并ALI的患者随机分为治疗组和对照组,每组各42例患者。治疗组采用出入量负平衡方式进行液体管理,对照组采用出入量平衡方式进行液体管理。观察和比较两组治疗前后氧合指数(PaO_2/FiO_2)、中心静脉压(CVP)、平均动脉压(MAP)、心指数(CI)、血管外肺水指数(ELWI)及APACHEⅡ评分的变化,记录和比较两组的机械通气时间、ICU住院时间、多器官功能障碍综合征(MODS)的发生率及28 d的病死率。结果:入院后3d、7d,治疗组的MAP较对照组明显降低,ELWI、PaO_2/FiO_2则明显升高(P0.05);治疗前、治疗后6h,两组的APACHEⅡ评分比较均无显著性差异(P0.05),而治疗组治疗后24h、48h的APACHEⅡ评分较对照组则明显降低(P0.05);与对照组比较,治疗组的机械通气时间、ICU住院时间显著缩短,MODS发生率明显降低(P0.05)。结论:在维持循环稳定和保证器官灌注的前提下,液体负平衡有助于减轻感染性休克合并ALI患者的心肺损伤,促进患者早期复苏,改善患者的预后。     

大鼠室旁核注射orexin-A对体重的影响

目的:探讨大鼠室旁核(PVN)注射orexin-A对体重的影响。方法:大鼠室旁核(PVN)微量注射orexin-A,用大脑置管埋管、组织化学染色等方法探讨PVN注射orexin-A对其体重的影响。结果:与安慰剂组大鼠相比,PVN注射orexin-A组大鼠体重明显减轻(P0.05),而orexin-A组和安慰剂组摄食量无明显差异(P0.05)。注射结束后6天,orexin-A处理大鼠的体重仍显著低于注射前(P0.05),而安慰剂组大鼠则比注射前显著增重(P0.05)。药物注射可显著降低机体脂肪,但并不特异存在于注射orexin-A或安慰剂的大鼠身上。Orexin-A组和安慰剂组大鼠的肌肉量和脂肪量均显著降低(P0.05),但注射orexin-A的大鼠降低更明显。与安慰剂组相比,orexin-A处理后的摄食转化率显著降低(P0.05)。结论:大鼠室旁核(PVN)注射orexin-A可通过增加活动量产生负能量平衡,引起体重减轻。     

Long non‐coding RNA cardiac hypertrophy‐associated regulator governs cardiac hypertrophy via regulating miR‐20b and the downstream PTEN/AKT pathway

Pathological cardiac hypertrophy (CH) is a key factor leading to heart failure and ultimately sudden death. Long non‐coding RNAs (lncRNAs) are emerging as a new player in gene regulation relevant to a wide spectrum of human disease including cardiac disorders. Here, we characterize the role of a specific lncRNA named cardiac hypertrophy‐associated regulator (CHAR) in CH and delineate the underlying signalling pathway. CHAR was found markedly down‐regulated in both in vivo mouse model of cardiac hypertrophy induced by pressure overload and in vitro cellular model of cardiomyocyte hypertrophy induced by angiotensin II (AngII) insult. CHAR down‐regulation alone was sufficient to induce hypertrophic phenotypes in healthy mice and neonatal rat ventricular cells (NRVCs). Overexpression of CHAR reduced the hypertrophic responses. CHAR was found to act as a competitive endogenous RNA (ceRNA) to down‐regulate miR‐20b that we established as a pro‐hypertrophic miRNA. We experimentally established phosphatase and tensin homolog (PTEN), an anti‐hypertrophic signalling molecule, as a target gene for miR‐20b. We found that miR‐20b induced CH by directly repressing PTEN expression and indirectly increasing AKT activity. Moreover, CHAR overexpression mitigated the repression of PTEN and activation of AKT by miR‐20b, and as such, it abrogated the deleterious effects of miR‐20b on CH. Collectively, this study characterized a new lncRNA CHAR and unravelled a new pro‐hypertrophic signalling pathway: lncRNA‐CHAR/miR‐20b/PTEN/AKT. The findings therefore should improve our understanding of the cellular functionality and pathophysiological role of lncRNAs in the heart.     

Interleukin-13 interferes with CFTR and AQP5 expression and localization during human airway epithelial cell differentiation

Interleukin-13 (IL-13) is a central regulator of Th2-dominated respiratory disorders such as asthma. Lesions of the airway epithelial barrier frequently observed in chronic respiratory inflammatory diseases are repaired through proliferation, migration and differentiation of epithelial cells. Our work is focused on the effects of IL-13 in human cellular models of airway epithelial cell regeneration. We have previously shown that IL-13 altered epithelial cell polarity during mucociliary differentiation of human nasal epithelial cells. In particular, the cytokine inhibited ezrin expression and interfered with its apical localization during epithelial cell differentiation in vitro. Here we show that CFTR expression is enhanced in the presence of the cytokine, that two additional CFTR protein isoforms are expressed in IL-13-treated cells and that part of the protein is retained within the endoplasmic reticulum. We further show that aquaporin 5 expression, a water channel localized within the apical membrane of epithelial cells, is completely abolished in the presence of the cytokine. These results show that IL-13 interferes with ion and water channel expression and localization during epithelial regeneration and may thereby influence mucus composition and hydration.     

The WD repeat protein FAN regulates lysosome size independent from abnormal downregulation/membrane recruitment of protein kinase C

FAN (factor associated with neutral sphingomyelinase [N-SMase] activation) exhibits striking structural homologies to Lyst (lysosomal trafficking regulator), a BEACH protein whose inactivation causes formation of giant lysosomes/Chediak-Higashi syndrome. Here, we show that cells lacking FAN show a statistically significant increase in lysosome size (although less pronounced as Lyst), pointing to previously unrecognized functions of FAN in regulation of the lysosomal compartment. Since FAN regulates activation of N-SMase in complex with receptor for activated C-kinase (RACK)1, a scaffolding protein that recruits and stabilizes activated protein kinase C (PKC) isotypes at cellular membranes, and since an abnormal (calpain-mediated) downregulation/membrane recruitment of PKC has been linked to the defects observed in Lyst-deficient cells, we assessed whether PKC is also of relevance in FAN signaling. Our results demonstrate that activation of PKC is not required for regulation of N-SMase by FAN/RACK1. Conversely, activation of PKC and recruitment/stabilization by RACK1 occurs uniformly in the presence or absence of FAN (and equally, Lyst). Furthermore, regulation of lysosome size by FAN is not coupled to an abnormal downregulation/membrane recruitment of PKC by calpain. Identical results were obtained for Lyst, questioning the previously reported relevance of PKC for formation of giant lysosomes and in Chediak-Higashi syndrome. In summary, FAN mediates activation of N-SMase as well as regulation of lysosome size by signaling pathways that operate independent from activation/membrane recruitment of PKC.