Long non-coding RNA HOXC cluster antisense RNA 1 (HOXC-AS1) exhibits elevated expression in gastric and prostate cancers, yet its involvement in esophageal cancer (EC) remains unexplored. This investigation assessed the expression patterns and functional implications of HOXC-AS1 in EC. Quantitative real-time PCR was employed to evaluate HOXC-AS1 expression in EC cell lines, while its impact on cell proliferation, migration, invasion, tumor growth, and metastasis was examined through MTT, EdU, transwell, wound healing assays, and animal models. Mechanistic insights into HOXC-AS1 were pursued using dual-luciferase reporter assays and RNA immunoprecipitation. Analysis of TCGA data demonstrated significant upregulation of HOXC-AS1 in EC tissues, consistent with its enriched expression in EC cell lines. Knockdown experiments revealed that suppressing HOXC-AS1 reduced proliferation, migration, and invasion of EC cells in vitro and inhibited tumor growth and metastasis in vivo. Mechanistically, HOXC-AS1 acted as a molecular sponge for miR-195-5p, with anillin actin-binding protein (ANLN) identified as a direct downstream target of miR-195-5p. Functional rescue experiments showed that inhibiting miR-195-5p or overexpressing ANLN counteracted the suppressive effects induced by HOXC-AS1 silencing on the aggressive phenotypes of EC cells. These findings establish HOXC-AS1 as a promoter of EC progression via regulation of the miR-195-5p/ANLN axis, suggesting its utility as a prospective therapeutic target for EC management.

BACKGROUND:Myocarditis is a cardiomyopathy associated with the inflammatory response. Rosuvastatin (RS) demonstrates cardioprotective effect in the clinical setting, although its cellular and molecular mechanisms in ameliorating myocarditis are largely unknown. MG53 (muscle-specific E3 ligase Mitsugumin 53), a newly identified striated muscle-specific protein, is involved in skeletal muscle membrane repair. We aimed to explore whether RS mediated the repair of cardiomyocytes in an MG53-dependent manner.METHODS:The RS-induced upregulation of MG53 was determined using RT-qPCR and western blotting. A lipopolysaccharide (LPS)-induced cell inflammatory model was constructed using rat cardiac muscle cell H9C2. Inflammatory injury was evaluated according to the alterations of cell viability, mitochondrial membrane potential, cell apoptosis, and expression of pro-inflammatory cytokines (interleukin-1β, interleukin-6, tumor necrosis factor-α, and monocyte chemoattractant protein-1). Small interfering RNAs (siRNAs) were used to silence MG53. The cardioprotective effect of RS and the inhibition of this protection by MG53 silence were evaluated in the forementioned in vitro model. The underlying mechanism was finally investigated using western blotting to detected the expressions of apoptotic markers (Bcl-2, Bax, Cleaved caspase-9, Cleaved caspase-3), cell cycle regulatory factors (Cyclin A, Cyclin E1, Cyclin D1, CDK2), and components involved in NF-κB signaling pathway (p-IκBa, Iκba, p-p65, p65).RESULTS:RS ameliorated LPS-induced inflammatory injury. RS upregulated the expression of MG53. MG53 was crucial for the RS-mediated repair response in vitro. Ablation of MG53 inhibited the RS-mediated protective effect. Furthermore, RS and MG53 interact in multiple signaling pathways to modulate recovery.CONCLUSION:RS exerts cardioprotective effect in an MG53-dependent manner. MG53 may serve as a novel drug target for myocarditis treatment.

目的 探讨晚期妊娠合并严重心脏瓣膜病患者围产期综合治疗方法及其临床效果.方法 回顾性分析2007年12月-2017年12月间在厦门大学附属第一医院心脏外科与妇产科联合治疗的32例晚期妊娠合并心脏瓣膜重度狭窄和(或)关闭不全患者的临床资料,对其产前治疗、围产期抗凝策略、麻醉和分娩方式选择、围产期并发症等进行总结分析.结果 32例患者均在有体外循环的条件下,于全身麻醉下行剖宫产结束妊娠.其中,按术前计划行剖宫产同期心脏手术患者11例;2例患者分别于麻醉过程中和娩出胎儿挤压子宫时出现心室颤动,遂紧急开胸于体外循环下继续完成剖宫产术,同期行心脏手术;1例重度二尖瓣狭窄患者剖宫产术后早期出现急性左侧心力衰竭、肺水肿,积极药物治疗效果不理想,紧急返回手术室行心脏瓣膜置换+三尖瓣成形术;18例患者单纯行剖宫产术,顺利度过围产期,另择期行心脏手术.无一例产妇死亡,母婴均,顺利恢复后出院.结论 晚期妊娠合并严重心脏瓣膜病的患者应在全身麻醉、体外循环准备下选择剖宫产做为结束妊娠的方式.并由产科、心脏外科、麻醉科等经验丰富的专家共同协作,根据孕妇心脏基础疾病、心功能状态、胎儿状况等决定分娩时机,以及是否同期行心脏手术.

OBJECTIVES:It is difficult to predict the evolution of uncomplicated type B intramural hematoma (IMHB) with a focal intimal disruption (FID) in the acute phase. The aims of this study were to investigate the predictors of FIDs and summarize the risk factors for the evolution of uncomplicated IMHB in the acute phase.METHODS:Eighty-six patients with uncomplicated IMHB were included and were divided according to the development of an FID during the acute phase: the FID group (n = 32) and the no-FID group (n = 54). Geometric measurements and computed fluid dynamic calculations were based on a computed tomography scan performed on admission. Multivariate logistic regression analysis was used to estimate the predictors of FID development.RESULTS:Thirty-two (37%) patients developed an FID. Patients with an FID had higher C-reactive protein levels (18.6 ± 2.3 vs 8.1 ± 0.2 mg/dL, P < 0.001) and white blood cell counts (10.3 ± 2.1 vs 7.5 ± 1.7 109 /L, P < 0.001). The no-FID group had lower occurrences of disease progression (15% vs 64%, P < 0.001) and aorta-related mortality (6% vs 25%, P = 0.016). Multivariate logistic regression analysis indicated a significant risk for the occurrence of an FID with a larger maximum aortic diameter (OR, 1.35; 95% CI, 1.05-1.73, P = 0.020), thicker hematoma (OR, 2.20; 95% CI, 1.40-3.48, P = 0.001), and higher oscillatory shear index (per 0.01 unit, OR, 1.74; 95% CI, 1.21-2.49, P = 0.003). The aorta-related mortality during the acute phase was 25% (n = 8).CONCLUSIONS:Certain aortic conditions, including ta larger aortic diameter, thicker hematoma and higher oscillatory shear stress, are associated with the FID development and result in worse clinical outcomes.

Objective: To explore the diagnosis, therapy and prevention method of chronic sternal osteomyelitis with sinus tract after cardiovascular surgery. Methods: A total of 53 patients with chronic sternal sinus tract after cardiovascular surgery between January 2000 and January 2016. After definite diagnosis by contrast fistulography and CT scanning, all the patients received combined modality therapy including debridement, musculocutaneous flap transplantation and intermediate thickness free skin graft transplantation if necessary. Results: One patient died of false aneurysm due to the sternal sinus tract infection, there were no peri-operative death for all the left 52 patients. Forty-five patients had primary healing and 7 patients had secondary healing. All the patients became total recovery within 3-12 weeks after operation and maintained well during the 5-18 months' follow-up. Conclusions: For the patients with chronic sternal osteomyelitis, operative therapy should be performed as soon as possible once the diagnosis is confirmed. Combined modality therapy including debridement, musculocutaneous flap transplantation and intermediate thickness free skin graft transplantation is confirmed to be effective and secure.

目的 探讨三尖瓣置换术的手术效果,总结三尖瓣置换术的外科治疗经验.方法 回顾性分析2012年7月至2017年6月我院共施行三尖瓣置换术35例,其中风湿性心脏病23例,先天性心脏病6例,退行性病变4例,感染性心内膜炎2例.置换双叶机械瓣13例,生物瓣22例,全组在全麻体外循环下手术.结果 全组无住院死亡,术后早期并发症主要有术后胸腔活动性出血3例,完全性房室传导阻滞2例,右心功能不全2例,消化道出血1例.术后随访3个月～5年,心功能Ⅰ～Ⅱ级28例,Ⅲ级7例.结论 三尖瓣置换术是治疗严重器质性三尖瓣病变的有效手段,需要严格掌握手术适应证与手术时机,加强围术期管理,手术效果满意.

目的:通过兔异体颈动脉旁路移植模型,对玻璃化深低温及去细胞光氧化交联处理的兔颈动脉进行体内性能比较,评价两种血管作为临床异体小血管替代物的可行性.方法:将36只SPF级纯种兔随机分成两组,分别予以玻璃化深低温处理的兔颈动脉及去细胞光氧化处理的兔颈动脉行异体颈动脉移植.实验动物分别饲养观察1周、2周和4周后,观察移植血管的通畅情况及内膜增生情况.结果:超声检查发现术后4周去细胞光氧化组的累计通畅率显著高于玻璃化深低温组(P<0.05).HE染色显示玻璃化深低温组术后免疫反应表现比较严重.去细胞光氧化组术后内皮细胞则生长良好,炎性细胞浸润少.Ⅷ因子染色显示,术后4周玻璃化深低温处理组内皮细胞有不同程度的破坏;而去细胞结合光氧化组内皮生长良好.通过图像分析发现,移植后1周两组血管内/中膜比差异无统计秀而意义(P>0.05),术后2周及4周内膜两组血管内/中膜比差异有统计学意义(P<0.05).结论:体内性能方面,去细胞光氧化技术制备同种异体小动脉生物稳定性、抗血栓性及内膜增生情况均要优于玻璃化深低温处理的异体兔颈动脉,但同样也存在瘤样扩张,内膜增生等不足.

Objective To analyze the early efficacy of bipolar radiofrequency ablation procedure for atrial fibrillation during the heart valve replacement. Methods Clinical data of 122 patients with heart valve disease and atrial fibrillation (AF) in our hospital were randomly selected as research subjects. Valve replacement and concomitant bipolar radiofrequency ablation was performed for a observation group (n=70) while only the valve replacement was performed for a control group (n=52). Both groups were observed for the duration of mechanical ventilation, ICU stay time, the rate of malignant arrhythmia, LVEF and LVDd index. The clinical efficacy was evaluated according to the electrocardiogram and echocardiogram after the opration. Results On the mechanical ventilation time, ICU stay time, the rate of malignant arrhythmia, as well as LVEF, the observation group was significantly better than the control group,and the difference was statistically significant (P<0.05). LVDd index difference between the two groups was not statistically significant. Conclusion The valve replacement and concomitant bipolar radiofrequency ablation procedure for atrial fibrillation with early efficacy significantly, can be widely applied.

BACKGROUND STAT1/4 has been suggested to be involved in cardiac allograft rejection. However, no direct evidence regarding STAT3 has been established in cardiac allograft rejection. Here, we hypothesized that inhibition of STAT3 attenuates cardiac allograft rejection. MATERIAL AND METHODS To test our hypothesis, homotopic mouse heart transplantation was carried out in syngeneic C57BL/6 to C57BL/6 strain mice with or without oral gavage with NSC 74859, an inhibitor of STAT3. The immune response was investigated using real-time PCR for CD4 and CD8 surface makers of T cells and CD14 of monocytes and cytokines, including IL-2, IL-15, and IL-6 of allografts at 3, 6, and 9 days after transplantation. Prognosis was also evaluated. RESULTS We found that allografts with oral gavage of NSC 74859 whose CD4, CD8 T, and CD14 monocytes were significantly lower than that of allograft without oral gavage of NSC 74859, and the same was true for the expression of IL-2, IL-15, and IL-6. Immunohistochemical analysis of grafts showed reduced infiltration of monocytes/macrophages into the graft myocardium. Survival was also markedly extended in the NSC 74859 group. CONCLUSIONS Inhibition of IL-6/STAT3 using NSC 74859 was shown to remarkably alleviate cardiac allograft rejection in mice, indicating that the target against IL-6/STAT3 pathway might be clinically used as an alternative therapy for cardiac allograft rejection.

目的 探讨右美托咪定在心脏术后患者中的应用效果.方法 200例心脏术后患者,依据镇静方法差异分为对照组和右美托咪定组,各100例.对照组采用丙泊酚镇静,右美托咪定组采用右美托咪定镇静.比较两组镇静效果、机械通气时间、镇静达标时间,不良反应(谵妄、躁动)发生率,血压、呼吸和心率变化情况.结果 右美托咪定组镇静优良率为95.00%,高于对照组的80.00%,差异有统计学意义(P<0.05).用药后,两组患者血压、呼吸和心率比较差异无统计学意义(P>0.05).右美托咪定组机械通气时间、镇静达标时间与对照组比较,差异无统计学意义(P>0.05).右美托咪定组不良反应发生率为3.00%,低于对照组的16.00%,差异有统计学意义(P<0.05).结论 右美托咪定在心脏术后患者中的应用效果确切,可提高镇静效果,维持生命体征稳定,降低谵妄、躁动发生率,安全有效,值得推广应用.

目的 回顾总结24例冠脉搭桥术(CABG)后合并肝素诱导性血小板减少症(HIT)的治疗情况,以提高对该类并发症的治疗效果.方法 回顾性分析24例冠脉搭桥术后合并肝素诱导性血小板减少患者治疗情况.结合临床表现、4T评分及抗体检测情况,在冠脉搭桥术后一经确诊HIT,立即停止肝素暴露,强化抗血小板治疗同时采用非肝素类抗凝药物治疗,血小板恢复后继续采用华法林抗凝治疗.结果 16例患者经检查发现栓塞证据.术后早期因栓塞死亡5例,其余患者血小板恢复正常时间(5.8±2.2)d.出院后随访1个月～3年,1例患者术后2年再次发现乳内动脉及大隐静脉桥血管栓塞,经内科支架植入后好转,其余患者出院后未再出现血栓形成或出血并发症.结论 CABG患者须重视术后血小板计数的变化情况,HIT一旦发生,可能会导致桥血管急性栓塞、急性肺栓塞等致命性后果,早期诊断和治疗至关重要.

OBJECTIVE:To analyze two common factors for perioperative ischemic stroke in patients with concomitant carotid and coronary artery severe stenosis and to improve the therapeutic effect.
 Methods: A total of 44 patients with multi-vessel coronary artery disease combined with carotid stenosis, who admitted to the Department of Cardiac Surgery, the First Affiliated Hospital of Xiamen University from 2008 to 2014, were enrolled in this study. Among them, 32 cases were male, 12 cases was female. All patients received coronary artery bypass grafting after treatment of neck diseases. The surgical outcomes and follow-up results were analyzed retrospectively.
 Results: One patient received carotid endarterectomy suffered hemiplegia, whose symptoms were improved after positive clinical treatment. One patient suffered transient ischemic attack, and 5 patients displayed the cerebrovascular syndromes a week later after surgery. Twelve patients suffered nerve function damage 48 hours later after surgery. Nine patients received intra-aortic ballon pump, 1 patient received thoracotomy hemostasis, 3 patients suffered sternal dehiscence; 27 patients showed atrial fibrillation. Two patients died after surgery. The follow-up duration ranged from 1-7 years and the follow-up rate was 90%. The ischemic symptoms were improved in 44 patients. Six patients complained the recurrence of angina, but no abnormalities were found in coronary angiography or computed tomography angiography. One patient died of malignant tumor during the follow-up duration.
 Conclusion: For patients with concomitant carotid and coronary artery severe stenosis, it is more likely to suffer ischemic cerebral stroke. However, carotid stenosis is not the only factor, other key factors relevant to ischemic cerebral stroke shouldn't be ignored either.

目的 分析冠脉搭桥术后24小时内采取甲状腺素替代治疗对早期心功能的影响.方法 选取厦门大学附属第一医院心脏外科2014 ～ 2016年间收治的71例多支冠脉病变患者,其中男性40例,女性31例,年龄40 ～ 77岁,平均(56.7±13.6)岁.随机分组后观察组患者予以甲状腺替代治疗.观测并比较各组的早期心功能指标.结果 观察组与对照组患者的心率,平均动脉压,中心静脉压、血乳酸水平等变量在观测时间点内没有显著差异,两组间的血管活性药平均总剂量无明显区别.但观察组患者的平均心脏指数较高,全身血管阻力较低.结论 搭桥术后早期采取甲状腺素的替代治疗可改善患者的平均心脏指数和全身血管阻力,但总体而言,对于非原发性甲状腺功能低下的特定人群,搭桥术后的甲状腺替代治疗仍应持保守态度.

Prion disorders are progressive neurodegenerative diseases characterized by extensive neuronal loss, which is linked to the extracellular accumulation of the scrapie isoform (PrPSC) of the normal cellular prion protein (PrPC). As microglial activation is a central event in pathogenesis of prion disease, the strategies that reduce microglial activation may have therapeutic benefits. In this study, the neuroprotective effects of hydroxylated C60(C60-OH) and amino modified-C60(C60-NH2) were evaluated by using PrP(106-126)-stimulated BV-2 cells as a model of activated microglia. Herein, we showed that microglial activation in response to PrP(106-126) was effectively attenuated by pretreatment with C60-OH as compared with C60-NH2. C60-OH significantly inhibited the excessive production of inflammatory mediators, such as prostaglandin E2 (PGE2), nitric oxide (NO), tumor necrosis factors (TNF)-α, interleukin (IL)-1β, and IL-6, and blocked the expression of cyclooxygenase-2 (COX-2) and inducible nitric-oxide synthase (iNOS) in PrP(106-126)-stimulated BV-2 cells. C60-OH exerted anti-inflammatory potential by up-regulating the expression of antioxidant enzymes via activation of nuclear factor erythroid 2-related factor 2 (Nrf2). The inhibitory effect of C60-OH against PrP(106-126)-induced inflammatory response was abolished by siRNA of Nrf2. In addition, conditioned culture media taken from PrP(106-126)-stimulated microglia cause apoptotic neuronal cell death, which was suppressed by pretreatment with C60-OH. Take together, these results suggest that C60-OH protects neuronal cells against PrP(106-126)-mediated neurotoxicity through activation of Nrf2 pathway, and provides evidence that fullerene derivatives may have therapeutic potential in prion diseases.

Objective To investigate the effect of insulin-like growth factor-1(IGF-1)inducing proliferation of human umbilical vein smooth muscle cell(HUVSMC)and human umbilical artery smooth muscle cell(HUASMC)and its mechanism.Methods HUVSMC and HUASMC were cultured.Cell proliferation was measured using MTT and phosphatidylinositol3-kinase(PI3K)-Akt(protein kinase B)signal path was measured by Western blot analysis.Results Different concentrations of IGF-1 can stimulate proliferation of HUVSMC and HUASMC but this proliferation was higher in HUVSMC than HUASMC.An upregulation of PI3K-Akt was observed in the HUVSMC in response to IGF-1 stimulation with lower effect in HUASMC.This effect was inhibited by wortmannin.Conclusions IGF-1 can promote the proliferation of SMC and this effect is greater in HUVSMC than HUASMC;the activation of IGF-1 on the proliferation of SMC is mainly through PI3K-Akt.This may explain the greater propensity of the vein conduits than the atery to undergo intimal hyperplasia following CABG(coronary artery bypass grafting).

目的 比较胰岛素生长因子-1(IGF-1)对人脐静脉平滑肌细胞(HUVSMC)和脐动脉平滑肌细胞(HUASMC)增殖的影响并探讨其机制.方法 采用人源HUVSMC和HUASMC进行研究,噻唑蓝(MTT)法检测IGF-1对两种细胞增殖的影响,并通过Western blotting技术检测IGF-1对两种细胞中PI3K-Akt信号通路的影响.结果 不同浓度的IGF-1对HUVSMC和HUASMC的增殖都有明显的促进作用,但对HUVSMC的促增殖作用明显高于对HUASMC.进一步检测PI3K-Akt信号通路,IGF-1可激活PI3K-Akt信号通路,并且IGF-1对HUVSMC的激活明显强于HUASMC.IGF-1R抗体或wortmannin(渥曼青霉素)明显抑制IGF-1对细胞增殖的促进作用.结论 IGF-1可明显促进SMC增殖,并且在HUVSMC更为明显;IGF-1主要通过激活PI3K-Akt信号通路来促进平滑肌细胞的增殖.冠状动脉搭桥术(CABG)后静脉移植物比动脉移植物更容易发生内膜增生的原因可能就在于此.

Objective To investigate the effect of treatment of jugular vein graft with glutaraldehyde on intimal hyperplasia in rabbits. Methods Sixty New Zealand white rabbits were randomly divided into experimental group and the control group. Before the anastomosis, the vein in the experimental group was soaked in 1% glutaraldehyde solution for 10 min, and that in control group in normal saline for 10 min. The vein graft was harvested after 4 and 12 weeks. HE staining, smooth muscle cell α-actin and proliferating cell nuclear antigen ( PCNA ) immunohistochemical staining were performed. Apoptosis was detected by TUNEL. Results Four and 12 weeks after grafting, the number of smooth muscle cells in the experimental group was significantly less than that in the control group, and intima thickness [(0. 016 ±0. 004), (0. 031 ±0. 008) mm]in the experimental group was thinner than in the control group [(0. 025± 0. 005), (0. 093 ± 0. 024 ) mm, ( P < 0. 05 )]. However, there was no statistically significant difference in the rate of cell proliferation between two groups ( P > 0. 05 ). The apoptosis rate in the experimental group was higher than in the control group [(3. 3 ± 0. 7 ) %, (6. 7 ± 1. 5) % vs ( 1.2 ± 0. 4) %, ( 1.8 ±0. 5 ) %]in 4 and 12 weeks after grafting ( P < 0. 05 ). Conclusion Treatment of vein graft with glutaraldehyde can significantly reduce the number of graft smooth muscle cells and inhibit intimal hyperplasia.

目的 总结216例风湿性心脏病的外科治疗经验.方法 手术在全麻体外循环中度低温下进行,其中行二尖瓣置换术(MVR)130例,主动脉瓣置换术(AVR)28例,二尖瓣、主动脉瓣双瓣置换术(BVR)58例,三尖瓣成形术71例,左心耳结扎术24例,左房折叠术10例,左房血栓清除术25例.结果 209例(96.8%)恢复出院,早期死亡7例(3.2%),死因分别为低心排综合征2例、左室后壁及主动脉后壁破裂出血各1例、多脏器功能衰竭1例、恶性心律失常1例、脑栓塞1例.结论 瓣膜置换术是治疗风湿性心脏瓣膜病的有效手段.充分的术前准备、加强心肌保护、提高和改进手术技术、术后有效的监护治疗,可显著提高手术疗效,减少术后并发症,降低死亡率,取得满意的临床效果.

双腔右心室(DCRV)又称右室异常肌束.是一种少见的右室流出道梗阻性疾病,通常合并室间隔缺损(VSD).笔者科室于1999年3月-2007年6月收治DCRV患者11例,手术治疗取得良好效果,报告如下.