Review and update on the management of triangular fibrocartilage complex injuries in professional athletes

Triangular fibrocartilage complex injuries are common in amateur and professional sports.These injuries are mainly caused by acute or chronic repetitive axial loads on the wrist,particularly on the ulnar side and in association with rotations or radial/ulnar deviations.In order to treat professional athletes,a detailed specific knowledge of the pathology is needed.Moreover,the clinician should fully understand the specific and unique environment and needs of the athletes,their priorities and goals,the type of sport,the time of the season,and the position played.An early diagnosis and appropriate management with the quickest possible recovery time are the uppermost goals for both the athlete and the surgeon.A compromise between conservative vs surgical indications,athletes’needs and expectations,and financial implications should be achieved.Arthroscopic procedures should be timely planned when indicated as they could allow early diagnosis and treatment at the same time.Conservative measures are often used as first line treatment when possible.Peripheral lesions are treated by arthroscopic repair,whilst central lesions are treated by arthroscopic debridement.Further procedures(such as the Wafer procedure,ulnar osteotomies,etc.)have specific indications and great implications with regard to rehabilitation.

Clinical study on the surgical treatment of atypical Lisfranc joint complex injury

BACKGROUND Lisfranc injuries have not received much attention by orthopedic doctors in the past,and there is little related research on the diagnosis and treatment of these injuries.In recent years with the rise in foot and ankle surgery,doctors are now paying more attention to this type of injury.However,there is still a high rate of missed diagnosis due to insufficient attention causing treatment delays or inadequate treatments,which eventually result in greater sequelae;including long-term pain,arthritis,foot deformity etc.In particular,for cases with a mild Lisfranc joint complex injury,the incidence of sequelae is higher.AIM To select an active surgical treatment for an atypical Lisfranc joint complex injury and to evaluate the clinical efficacy of the surgical treatment.METHODS The clinical data of 18 patients,including 10 males and 8 females aged 20-64 years with Lisfranc injuries treated in our department from January 2017 to September 2019 were retrospectively analyzed.All patients were treated with an open reduction and internal fixation method using locking titanium mini-plates and hollow screws or Kirschner wires.X-ray images were taken and follow-up was performed monthly after the operation;the internal fixation was then removed 4-5 mo after the operation;and the American Orthopedic Foot and Ankle Society(AOFAS)score was used for evaluation on the last follow-up.RESULTS All patients were followed up for 6-12 mo.A good/excellent AOFAS score was observed in 88.9%of patients.CONCLUSION For atypical Lisfranc joint complex injuries,active open reduction and internal fixation can be performed to enable patients to obtain a good prognosis and satisfactory functional recovery.

Early débridement of the maxillofacial missile wound:an experimental study

Rapid debridement and 1% chlorhexidine iodine complex (CIC)wereused for treating badly cdntaminated and/or infected missile wounds 72 h after in-jury.The result showed that the combined use of the two methods proved to behighly effective in clearing out the necrotic tissues,bony debris and pathogenicbacteria,and in achieving primary healing.The problems about the extent andthe method of debridement in the early débridement of the fire-arm injury are dis-cussed in this paper.

Etiology, Prevalence, and Management of Oral and Maxillofacial Soft Tissue Injuries in Children at the Komfo Anokye Teaching Hospital, Kumasi-Ghana

Background: Maxillofacial injury may vary from simple soft tissue lacerations to complex fractures of the orofacial region. Soft tissue injuries, whether isolated or in combination with other injuries, form part of the frequent traumatic craniofacial injuries seen at the emergency department. The force of impact and the injury type is directly related to the severity of the injury sustained. This study aimed to analyze the etiological factors, prevalence, and management of oral and maxillofacial soft tissue injuries at the Komfo Anokye Teaching Hospital. Methods: This was a prospective study that involved children presenting with oral and maxillofacial injuries at the Accident and Emergency Department and the Oral and Maxillofacial Surgery unit of the Komfo Anokye Teaching Hospital in Kumasi between the period of April to October 2020 (6 months). Patient selection was by convenience sampling targeting all children with injuries who met the inclusion criteria. Inclusion criteria were children below the age of 18 years whose parents or caregivers consent to participation. Children with maxillofacial injuries as a result of burns were excluded from the study. Results: During the study period a total of 134 children were reviewed with oral and maxillofacial injuries at KATH. Of these, 107 (78.9%) were recorded cases of orofacial soft tissue injuries. There were 63 (58.9%) males and 44 (41.1%) females and the male-to-female ratio was 1.5:1. The age range of patients studied was 8 months – 17 years, with mean age ± SD being 9.5 ± 5.3 years. Road Traffic Crash (50.5%) was the most common etiology of which Motor cycle crash constituted 24.3% and Pedestrian knockdown was 19.6%. Falls (42.1%) were the next most common etiology. The lips (19.8%) and the forehead (18.5%) were the most frequently injured sites on the face whiles the tongue (3.3%) had the most injuries intraorally. Laceration (45.7%) was the most frequent injury reviewed, followed by abrasions (35.8%). Most of the soft tissue injuries underwent primary closure (56.3%). A complication rate of 21.2% was recorded in this study and hypertrophic scarring (11.3%) was the most observed.

The Prevalence of Brain and Neck Injuries in Patients with Maxillofacial Fractures in Teaching Hospitals of Rasht in 2016

This study aimed to determine the prevalence of brain and neck injuries in patients with maxillofacial fractures in teaching hospitals of the city of Rasht in 2016. This is an analytical retrospective study. Some 361 patients of the training centers of Rasht who had been diagnosed with maxillofacial fractures entered the study, 286 of which were male and 75 were female. Information was collected through questionnaires and patients’ records who admitted to Emergency Department of Poursina and Velayat Hospitals with maxillofacial fractures. The patients were examined to see whether they have brain and cervical spine injuries. The diagnosis of the fracture and brain and neck injuries had been separately written by the related doctors on the records of the patients based on clinical examination and Plain radiography and CT scans. After data collection, the results were analyzed. The results showed that 61 percent of the fractures were due to accidents. Among the most common spine damages, 77 percent were related to bone fractures. The highest frequency of brain damages was related to Extradural Hematoma by 23.65 percent. Results of the treatments also showed that 76% of the patients were partially recovered.

Maxillofacial Injuries at the Komfo Anokye Teaching Hospital, Kumasi, Ghana: A Preliminary Study

Background: The aetiology and pattern of maxillofacail injuries vary in different parts of the world and even the same country. The purpose of the study was to determine the epidemiology of maxillofacial injuries at a tertiary Hospital in Ghana. Methodology: This is a six-month (January to June 2015) prospective study. Information on age, sex, aetiology, injury type etc. was collected using a specialized design data collection form. Data was analyzed using the SPSS 17th version. Ethical approval was obtained. Result: The total study sample was 111 with a male to female ratio of 2.5:1. Majority (34.2%) were within the ages of 21 to 30 years. Majority of the victims were urban dwellers. Most of the injuries occurred on the highway (42.3%) and in the evening (35.2%). Only a small percentage (5.4%) of the road traffic crashes (RTC) victims were in some form of protection. Twenty-one (18.9%) of the injuries were intentional, of which 18 (85.7%) were assault. The commonest maxillofacial injury was a combination of soft and hard tissues 72 (64.7%). The commonest cause of maxillofacial soft tissue injuries was RTC, 72.8%. Laceration (55.6%) was the most common soft tissue injury recorded. Mandibular fractures constituted the commonest hard tissue injuries. Conclusion: This study has shown that road traffic crashes are the most common cause of injuries to the maxillofacial region. The mandible is the most frequent site of fracture, while the commonest soft tissue injury is laceration. Majority of the victims were young energetic males and adherence to road traffic regulations was very low.

Advance in Functional Restoration of Injured Nerve with Low Level Laser and its Utilization in the Dental and Maxillofacial Region

The inferior alveolar nerve and facial nerve are the two most important nerves in the dental and maxillofacial region.The injury to them is one of the major postoperative complications after alveolar surgery and orthognathic surgery.However,recovering the nerve function after injury takes a long time and the recovery effect tends to be unsatisfactory.In recent years,an intensively investigated technique,low level laser which has been applying in assisting the recovery of nerve function,has been gradually proved to be effective in clinically treating postoperative nerve injury.In this article we review in terms of the mechanisms involved in low level laser-assisted functional restoration of nerve injury and its clinical application in the recovery of nerve function in the dental and maxillofacial area as well.

Analysis of the effect of repeated-pulse transcranial magnetic stimulation at the Guangming point on electroencephalograms

Here, we administered repeated-pulse transcranial magnetic stimulation to healthy people at the left Guangming （GB37） and a mock point, and calculated the sample entropy of electroencephalo- gram signals using nonlinear dynamics. Additionally, we compared electroencephalogram sample entropy of signals in response to visual stimulation before, during, and after repeated-pulse tran- scranial magnetic stimulation at the Guangming. Results showed that electroencephalogram sample entropy at left （F3） and right （FP2） frontal electrodes were significantly different depending on where the magnetic stimulation was administered. Additionally, compared with the mock point, electroencephalogram sample entropy was higher after stimulating the Guangming point. When visual stimulation at Guangming was given before repeated-pulse transcranial magnetic stimula- tion, significant differences in sample entropy were found at five electrodes （C3, Cz, C4, P3, T8） in parietal cortex, the central gyrus, and the right temporal region compared with when it was given after repeated-pulse transcranial magnetic stimulation, indicating that repeated-pulse transcranial magnetic stimulation at Guangming can affect visual function. Analysis of electroencephalogram revealed that when visual stimulation preceded repeated pulse transcranial magnetic stimulation, sample entropy values were higher at the C3, C4, and P3 electrodes and lower at the Cz and T8 electrodes than visual stimulation followed preceded repeated pulse transcranial magnetic stimula- tion. The findings indicate that repeated-pulse transcranial magnetic stimulation at the Guangming evokes different patterns of electroencephalogram signals than repeated-pulse transcranial mag- netic stimulation at other nearby points on the body surface, and that repeated-pulse transcranial magnetic stimulation at the Guangrning is associated with changes in the complexity of visually evoked electroencephalogram signals in parietal regions, central gyrus, and temporal regions.

Diagnostic value of tissue plasminogen activator-inhibitor complex in sepsis-induced liver injury:A single-center retrospective casecontrol study

BACKGROUND Sepsis often causes severe liver injury and leads to poor patient outcomes.Early detection of sepsis-induced liver injury(SILI)and early treatment are key to improving outcomes.AIM To investigate the clinical characteristics of SILI patients and analyze the associated risk factors,to identify potential sensitive biomarkers.METHODS Retrospective analysis of clinical data from 546 patients with sepsis treated in the intensive care unit of the 908th Hospital of Chinese People’s Liberation Army Joint Logistic Support Force between May 2018 and December 2022.The patients were divided into the sepsis group(n=373)and SILI group(n=173)based on the presence of acute liver injury within 2 hours of admission.We used the random forest algorithm to analyze risk factors and assessed potential diagnostic markers of SILI using the area under the receiver operating characteristic curve,Kaplan-Meier survival curves,subgroup analysis and correlation analysis.RESULTS Compared with the sepsis group,tissue plasminogen activator-inhibitor complex(t-PAIC)levels in serum were significantly higher in the SILI group(P<0.05).Random forest results showed that t-PAIC was an independent risk factor for SILI,with an area under the receiver operating characteristic curve of 0.862(95%confidence interval:0.832-0.892).Based on the optimal cut-off value of 11.9 ng/mL,patients at or above this threshold had significantly higher levels of lactate and Acute Physiology and Chronic Health Evaluation II score.The survival rate of these patients was also significantly worse(hazard ratio=2.2,95%confidence interval:1.584-3.119,P<0.001).Spearman’s correlation coefficients were 0.42 between t-PAIC and lactate,and 0.41 between t-PAIC and aspartate transaminase.Subgroup analysis showed significant differences in t-PAIC levels between patients with different severity of liver dysfunction.CONCLUSION T-PAIC can serve as a diagnostic indicator for SILI,with its elevation correlated with the severity of SILI.

MicroRNA-451 from Human Umbilical Cord-Derived Mesenchymal Stem Cell Exosomes Inhibits Alveolar Macrophage Autophagy via Tuberous Sclerosis Complex 1/Mammalian Target of Rapamycin Pathway to Attenuate Burn-Induced Acute Lung Injury in Rats

Objective Our previous studies established that microRNA(miR)-451 from human umbilical cord mesenchymal stem cell-derived exosomes(hUC-MSC-Exos)alleviates acute lung injury(ALI).This study aims to elucidate the mechanisms by which miR-451 in hUC-MSC-Exos reduces ALI by modulating macrophage autophagy.Methods Exosomes were isolated from hUC-MSCs.Severe burn-induced ALI rat models were treated with hUC-MSC-Exos carrying the miR-451 inhibitor.Hematoxylin-eosin staining evaluated inflammatory injury.Enzyme-linked immunosorbnent assay measured lipopolysaccharide(LPS),tumor necrosis factor-α,and interleukin-1βlevels.qRT-PCR detected miR-451 and tuberous sclerosis complex 1(TSC1)expressions.The regulatory role of miR-451 on TSC1 was determined using a dual-luciferase reporter system.Western blotting determined TSC1 and proteins related to the mammalian target of rapamycin(mTOR)pathway and autophagy.Immunofluorescence analysis was conducted to examine exosomes phagocytosis in alveolar macrophages and autophagy level.Results hUC-MSC-Exos with miR-451 inhibitor reduced burn-induced ALI and promoted macrophage autophagy.MiR-451 could be transferred from hUC-MSCs to alveolar macrophages via exosomes and directly targeted TSC1.Inhibiting miR-451 in hUC-MSC-Exos elevated TSC1 expression and inactivated the mTOR pathway in alveolar macrophages.Silencing TSC1 activated mTOR signaling and inhibited autophagy,while TSC1 knockdown reversed the autophagy from the miR-451 inhibitor-induced.Conclusion miR-451 from hUC-MSC exosomes improves ALI by suppressing alveolar macrophage autophagy through modulation of the TSC1/mTOR pathway,providing a potential therapeutic strategy for ALI.

Effects of angelica sinensis polysaccharide-iron complex on hemolytic anemia and bone marrow injury in mice

To investigate the therapeutic effects of angelica sinensis polysaccharide-iron complex （APIC） on hemolytic anemia and bone marrow injury in mice models. The hemolytic anemia mouse model was established by i.p. of phenylhydrazine （PHZ）. Changes of the indices including red blood cell count （RBC）, hemoglobin （Hb） and hematocrit （HCT） were determined by blood analyzer, and reticulocytes were observed by brilliant cresol blue staining during administration. Bone marrow injured mouse model was established by i.p. of cytoxan （CY） and chloramphenicol （CH）, and the therapeutic effect was observed by H-E staining. The indices of APIC treated groups with the medium and high doses were higher than those of the model group significantly. Moreover, the Hb and HCT were restored to the normal level after drug treatments. In addition, APIC can promote the proliferation and differentiation of reticulocytes obviously in the early stage of anemia mice, decrease adipose cell proliferation in bone marrow of injured mice and hasten the recuperation. In conclusion, APIC has therapeutic efficacy on hemolytic anemia and bone marrow injury caused by chemicals, which is reported for the first time.

Neuronal changes resulting in up-regulation of alpha-1 adrenoceptors after peripheral nerve injury

Under normal conditions, the sympathetic neurotransmitter noradrenaline inhibits the production and release of pro-inflammatory cytokines. However, after peripheral nerve and tissue injury, pro-inflammatory cytokines appear to induce the expression of the alphalA-adreno- ceptor subtype on immune cells and perhaps also on other cells in the injured tissue. In turn, noradrenaline may act on up-regulated alphal-adrenoceptors to increase the production of the pro-inflammatory cytokine interleukin-6. In addition, the release of inflammatory mediators and nerve growth factor from keratinocytes and other cells may augment the expression of alphal-adrenoceptors on peripheral nerve fibers. Consequently, nociceptive afferents acquire an abnormal excitability to adrenergic agents, and inflammatory processes build. These mechanisms could contribute to the development of sympathetically maintained pain in conditions such as post-herpetic neuralgia, cutaneous neuromas, amputation stump pain and complex regional pain syndrome.

Development and application of rapid rehabilitation system for reconstruction of maxillofacial soft-tissue defects related to war and traumatic injuries

Background: Maxillofacial war injuries usually cause severe facial organ defects and deformities, handicapping the patient's daily activities, even result in a tendency to commit suicide. The application of maxillofacial prosthesis is an alternative to surgery in functional–aesthetic facial reconstruction. Computer aided design and computer aided manufacturing has opened up a new approach to the fabrication of maxillofacial prosthesis. An intelligentized rapid simulative design and manufacture system for prosthesis was developed to facilitate the prosthesis fabrication procedure.Methods: Maxillofacial prosthesis rapid simulation design and rapid fabrication system consists of three components: digital impression, intelligentized prosthesis designing, and rapid manufacturing. The patients' maxillofacial digital impressions were taken with Structured-light 3D scanner; and then the 3D model of prostheses and their negative molds could be designed in specific software; finally, with the resin molds fabricated by rapid prototyping machine, the prostheses could be produced directly and quickly.Results: Fifteen patients of maxillofacial defect caused by traumatic injuries received prosthesis rehabilitation provided by the established system. The contour of the prostheses coordinated properly with the appearance of the patients, and the uniform-thickness border sealed well to adjacent tissues. All the patients were satisfied with their prostheses.Conclusions: The rapid simulative rehabilitation system of maxillofacial defects has been approaching completion. It could provide advanced technological reservation for the Army in the issue of maxillofacial defect rehabilitation.

Comparison of Efficacy between 3D Navigation-Assisted Percutaneous Iliosacral Screw and Minimally Invasive Reconstruction Plate in Treating Sacroiliac Complex Injury

The clinical efficacy was compared between 3D navigation-assisted percutaneous iliosacral screw(3DPS)and minimally invasive reconstruction plate(MIRP)in treating sacroiliac complex injury and the surgical procedures of 3DPS were introduced.A retrospective analysis was performed on 49 patients with sacroiliac complex injury from March 2013 to May 2017.Twenty-one cases were treated by 3DPS,and 28 cases by MIRP.Intraoperative indexes as operative time,blood loss,incision length,length of hospital stay and postoperative complications were respectively documented.Quality of reduction was postoperatively evaluated by Matta radiological criteria,and clinical effect was assessed by Majeed scoring criteria at the last followup.Operative time and hospital stay were significantly shortened,and blood loss,and incision length were significantly reduced in 3DPS group as compared with those in MIRP group(P<0.05).No statistically significant difference was found between 3DPS group and MIRP group in the assessment of reduction and function(P>0.05).It was concluded that both 3DPS and MIRP can effectively treat the sacroiliac complex injury,and 3DPS can provide an accurate,safe and minimally invasive fixation with shorter operative time and hospital stay.

Motorcycle Related Oral and Maxillofacial Injuries Seen at Komfo Anokye Teaching Hospital, Kumasi-Ghana

Background: Motorcycle related injuries have become a major public health problem because the increased use of motorcycles has been accompanied with a corresponding increase of road traffic accidents. Objective: The purpose of this study was to evaluate the occurrence of oral and maxillofacial injuries associated with motorcycles as seen at the second largest Teaching Hospital in Ghana, the Komfo Anokye Teaching Hospital (KATH). Method and Materials: The compiled data that were reviewed for this retrospective study were obtained from the Accident and Emergency unit of KATH. These comprised 135 successive maxillofacial trauma patient records entered from August 2017 to August 2018. Results: Total number of road traffic related injuries seen at OMFS was 135 during the study period. Out of this number, 66 were related to motorcycle injuries. This represented 48.7% of the Road Traffic Accidents seen at oral and maxillofacial surgery department (OMFS). The age range was from 3 to 64 years. The average age was 26.7 years. 62 (93.9%) were males and 4 (6.1%) were females. 16 (24.2%) of the motorcycle injuries were caused by the “Okada”, 2 (3.0%) by “Pragia” and 48 (72.8%) by the “Aboboyaa”. 46 (69.7%) of the motorcycles victims were themselves the riders, 12 (18.2%) were pedestrians and 8 (12.1%) were passengers. There were 8 deaths. 6 (75.0%) of the deaths were caused by the “Aboboyaa”. “Okada” accounted for only 2 (15.0%) deaths. Concerning the riders and the passengers, only 8 (14.8%) of the victims were helmeted. The majority were unhelmeted (85.2%). Conclusion: Motorcycle transportation is the cause of many oral and maxillofacial injuries. Majority of the victims suffered multiple facial bone fractures. Males were more often affected than females and the majority were unhelmeted.

Kicked in the Face by a Fish

Facial trauma caused by animals is a well known aetiology for maxillofacial injuries. Our case is an injury to the midface and upper face, caused by an unusual animal in the world of maxillofacial trauma, in circumstances not very commonly seen, and certainly only exists in few parts of the world. This assault results in a fracture in one of the stronger corners of the orbital cavity rather than the commonly seen floor fractures which is partly likely to break first with blunt external trauma.

Correlation of QRS complex after percutaneous coronary intervention with myocardial ischemia reperfusion injury and apoptosis molecule contents

Objective: To study the correlation of QRS complex after percutaneous coronary intervention (PCI) with myocardial ischemia reperfusion injury and apoptosis molecule contents. Methods:Patients with non-ST-segment elevation myocardial infarction who were treated in Nanchong Central Hospital between June 2014 and August 2016 were selected and divided into the PCI group who received emergency PCI surgery and the control group who accepted selective PCI or refused emergency PCI after the medical data were retrospectively analyzed. The fQRS as well as the contents of ischemia reperfusion injury indexes and apoptosis molecules was determined after 1 week of treatment. Results: The incidence of fQRS in PCI group was significantly lower than that in control group;serum MDA, cTnI, H-FABP, sTWEAK, sFas, sTRAIL and Caspase-3 contents as well as peripheral blood Nrf-2 and HO-1 expression of PCI group were greatly lower than those of control group;serum MDA, cTnI, H-FABP, sTWEAK, sFas, sTRAIL and Caspase-3 contents as well as peripheral blood Nrf-2 and HO-1 expression of PCI group of patients with fQRS complex (+) were greatly higher than those of patients with fQRS complex (-). Conclusion: The occurrence of fQRS after PCI is closely related to myocardial ischemia reperfusion injury and apoptosis.

Gunshot （Pellets） injury to the maxillofacial complex： a case report

Gunshot injuries are rather serious but uncommon type of trauma in India. A 45-year-old male was presented with gunshot （pellets） embedded in the maxillofacial area for 22 years. There is no consensus in the literature whether to attempt their removal or leave them in situ. Our patient had no long-term sequela like infection, fistula formation, carcinogenesis or metal poisoning to date except for chill feeling on cold days. Management of this patient presented a dilemma in treatment in view of the effects of foreign bodies in the maxillofacial area.

下肢重复蹬伸至力竭过程中肌肉功能网络拓扑特性

背景:表面肌电已经被广泛用于监测肌肉疲劳,但传统肌电指标通常针对于单块肌肉,无法评价一组肌肉在疲劳过程中的变化。目的:建立肌肉功能网络,提取复杂网络参数,研究不同疲劳程度下的肌肉功能网络拓扑特性变化,为疲劳的监测、预防提供理论和方法依据。方法:11名受试者进行直到力竭的50%1RM单腿下肢蹬伸运动,同步采集股直肌、股外侧肌、股内侧肌、股二头肌长头、胫骨前肌、腓肠肌外侧肌、腓肠肌内侧肌7块肌肉的肌电信号,以及心电信号和Borg CR-10量表评分;根据Borg CR-10量表评分划分为轻度、中度和重度三个疲劳阶段,采用心率和心率变异性验证疲劳阶段划分的有效性;以7块肌肉为节点,使用肌肉信号的相干性构建肌肉功能网络,提取聚类系数、平均加权度、全局效率、特征向量中心性4个复杂网络参数;提取肌电信号的均方值振幅、中位频率、瞬时平均频率和共激活比4种指标,并在3种疲劳程度下进行比较。结果与结论:①3种疲劳阶段在心率及心率变异性上产生显著性差异,证明了疲劳阶段划分的有效性;②对于不同肌肉在3种疲劳程度下的肌电指标:均方值振幅和共激活比未表现出差异,中位频率在股外侧肌、股内侧肌和股二头肌长头表现出稳健的疲劳趋势,瞬时平均频率则在股直肌、股外侧肌、股内侧肌和股二头肌长头表现出稳健的疲劳趋势;瞬时平均频率的性能优于中位频率和均方值振幅,但三者仅在主要工作肌群能够获得较好的稳健趋势,共激活比不受疲劳因素的影响;③股外侧肌-股内侧肌、股外侧肌-股二头肌长头、股外侧肌-腓肠肌内侧肌和股内侧肌-股二头肌长头连接强度逐渐增加,平均加权度、聚类系数和全局效率在疲劳后表现出显著差异,并且与疲劳程度之间显著相关。结果表明:肌肉功能网络内的连通强度变化能够反映疲劳过程中肌肉间的协同性和互补性;聚类系数、平均加权度、全局效率可作为一组肌肉疲劳的监测指标。

MicroRNA-30a inhibits cell proliferation in a sepsis-induced acute kidney injury model by targeting the YAP-TEAD complex

Background Acute kidney injury(AKI)is a primary feature of renal complications in patients with sepsis.MicroRNA(miRNA/miR)-30a is an essential regulator of cardiovascular diseases,tumors,phagocytosis,and other physical processes,but whether it participates in sepsis-induced AKI(sepsis-AKI)is unknown.We aimed to elucidate the functions and molecular mechanism underlying miR-30a activity in sepsis-AKI.Methods The classical cecal ligation and puncture(CLP)method and lipopolysaccharide(LPS)-induced Human Kidney 2(HK-2)cells were used to establish in vivo and in vitro sepsis-AKI models.Specific pathogen-free and mature male Sprague-Dawley(SD)rats,aged 6–8 weeks(weight 200–250 g),were randomly divided into five-time phase subgroups.Fluid resuscitation with 30 mL/kg 37°C saline was administered after the operation,without antibiotics.Formalin-fixed,paraffin-embedded kidney sections were stained with hematoxylin and eosin.SD rat kidney tissue samples were collected for analysis by real-time quantitative polymerase chain reaction and enzyme-linked immunosorbent assay.HK-2 cells were transfected with hsa-miR-30a-3p mimics or inhibitors,and compared with untreated normal controls.RNA,protein,and cell viability were evaluated by quantitative reverse transcription-polymerase chain reaction(qRT-PCR),western blot,and cell counting kit-8 methods.A Dual-Luciferase Assay Kit(Promega)was used to measure luciferase activity 48 h after transfection with miR-30a-3p mimics.Results Expression levels of miR-30a-3p and miR-30a-5p in renal tissues of the sepsis group were significantly reduced at 12 h and 24 h(P<0.05).Tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)were significantly increased in renal tissue 3 h after the operation in rats(P<0.05),and gradually decreased 6 h,12 h,and 24 h after CLP.Levels of miR-30a-5p and miR-30a-3p were significantly down-regulated at 3 h after LPS treatment(P<0.05),and gradually decreased in HK-2 cells.One hour after LPS(10µg/mL)treatment,TNF-αand IL-1βlevels in HK-2 cells were significantly up-regulated(P<0.05),and they were markedly down-regulated after 3 h(P<0.05).IL-6 expression levels began to rise after LPS treatment of cells,peaked at 6 h(P<0.05),and then decreased to the initial level within a few hours.Stimulation with 10µg/mL LPS promoted HK-2 cells proliferation,which was inhibited after miR-30a-3p-mimic transfection.Bioinformatics prediction identified 37 potential miR-30a-3p target genes,including transcriptional enhanced associate domain 1(TEAD1).After transfection of HK-2 cells with miR-30a-3p mimics and miR-30a-3p inhibitor,TEAD1 transcript was significantly up-and down-regulated,respectively(both P<0.05).After LPS treatment(24 h),expression of TEAD1 in the inhibitors group was significantly increased(P<0.01),while that in the mimics group was significantly suppressed(P<0.01).In the dual luciferase reporter experiment,miR-30a-3p overexpression decreased fluorescence intensity(P<0.01)from TEAD1-wt-containing plasmids,but did not influence fluorescence intensity from TEAD1-muta-containing plasmids.LPS may promote HK-2 cells proliferation through the miR-30a-3p/TEAD1 pathway.Conclusion In a background of expression of inflammatory factors,including TNF-α,IL-1β,and IL-6,which were transiently increased in the sepsis-AKI model,miR-30a was down-regulated.Down-regulated miR-30a-3p may promote cell proliferation by targeting TEAD1 in LPS-induced HK-2 cells,demonstrating its potential as a biomarker for early sepsis-AKI diagnosis.