Renal ischemia-reperfusion (I/R) injury is a leading cause of acute kidney injury (AKI), with high mortality. Recent studies have reported that human umbilical cord mesenchymal stem cells (HucMSCs) play an important role in repairing organ and tissue injuries because of their unique characteristics. However, the potential of HucMSC extracellular vesicles (HucMSC-EVs) to promote the repair of renal tubular cells remains to be explored. This study found that HucMSC-EVs derived from HucMSCs played a protective role and were associated with kidney I/R injury. We found that miR-148b-3p in HucMSC-EVs had a protective effect against kidney I/R injury. HK-2 cells overexpressing miR-148b-3p were protected against I/R injury by inhibiting apoptosis. Next, the target mRNA of miR-148b-3p was predicted online, and the target mRNA, pyruvate dehydrogenase kinase 4 (PDK4), was identified and verified using dual luciferase. We discovered that I/R injury significantly increased endoplasmic reticulum (ER) stress, whereas siR-PDK4 inhibited these effects and protected against I/R injury. Interestingly, after administrating HucMSC-EVs to HK-2 cells, PDK4 expression and ER stress induced by I/R injury were significantly inhibited. HK-2 ingested miR-148b-3p from HucMSC-EVs, and its ER induced by I/R injury was significantly deregulated. This study suggests that HucMSC-EVs protect kidneys from I/R injury during the early I/R stage. These results suggest a new mechanism for HucMSC-EVs in treating AKI and provide a new treatment strategy for I/R injury.

Bicalutamide (BIC) resistance impedes the treatment of prostate cancer (PCa) and seems to involve ferroptosis; however, the underlying mechanism remains unclear. Our study aimed to explore how miR-15b-3p modulates ferroptosis in response to BIC resistance and determine whether the miRNA is suitable for early screening of PCa. Here, we found that PCa tissues had significantly higher miR-15b-3p expression than adjacent normal tissues. Analysis of blood samples in patients who underwent prostate-specific antigen (PSA) screening revealed that miR-15b-3p was a more accurate diagnostic than PSA (miR-15b-3p area under the curve [AUC] = 0.941, PSA AUC = 0.815). In vitro experiments then demonstrated that miR-15b-3p expression was markedly higher in LNCaP, PC-3, and DU145 cells than in RWPE-1 cells. Treatment with BIC decreased miR-15b-3p expression and progressive ferroptosis. Mechanistically, we identified KLF2 as the downstream target of miR-15b-3p. Overexpressing KLF2 facilitated ferroptosis via augmenting MDA and iron concentrations, in turn inhibiting the SLC7A11/GPX4 axis and decreasing GSH concentration. Through modulating ferroptosis, miR-15b-3p mimic and inhibitor weakened and enhanced BIC sensitivity, respectively. Furthermore, BIC treatment limited xenograft tumor volume in vivo, whereas agomir-15b-3p promoted tumor growth, indicating that miR-15b-3p attenuated the tumor-suppressive effects of BIC. Taken together, our results suggested that miR-15b-3p is crucial to BIC resistance, specifically via targeting KLF2 and thereby suppressing ferroptosis. High miR-15b-3p expression in early PCa screening should reflect a higher probability of cancer. In conclusion, miR-15b-3p has strong potential as a screening and diagnostic biomarker with reliable prospects for clinical application. Furthermore, because patients with high miR-15b-3p and low KLF2 expression have a greater risk of BIC resistance and malignant progression, targeting the miRNA and its downstream protein may be a new treatment strategy.

Thoracoabdominal aortic aneurysm (TAAA) involves both the thoracic and abdominal aorta and surgical treatment requires reconstructing several important visceral branch arteries. Open surgery is considered the standard treatment for TAAA, but it carries high risks and many complications. With the advancement of endovascular techniques, endovascular repair of TAAA has gradually become a new trend in treatment. This article presents a case of a 61-year-old female with TAAA. The patient underwent a follow-up thoracoabdominal CTA after teratoma surgery, which revealed a thoracoabdominal aortic aneurysm (Crawford Type III) extending from the sixth intercostal space to 5 cm below the renal arteries. The challenge in treating this case lay in reconstructing the visceral arteries. The octopus technique, a type of parallel stenting, offers advantages but has inherent technical limitations, such as multiple access routes for simultaneous stent placement, the potential risk of gutter endoleaks, and mutual compression among parallel stents. To avoid these drawbacks, modifications to the octopus technique are necessary. We connected multiple small stent grafts side-by-side and end-to-end to a single branch of the main aortic stent graft. This improved design effectively circumvented the gutter endoleaks and stent compression issues, allowing for sequential visceral artery reconstruction through single upper limb access. This modified octopus technique closely aligns with the design concept of branched stents. This article aims to describe a case of complete endovascular reconstruction of TAAA using the modified octopus technique combined with the external branch technique, providing an in-depth analysis of the specific procedural steps and their clinical application value.

Thoracoabdominal aortic aneurysm (TAAA) involves both the thoracic and abdominal aorta and surgical treatment requires reconstructing several important visceral branch arteries. Open surgery is considered the standard treatment for TAAA, but it carries high risks and many complications. With the advancement of endovascular techniques, endovascular repair of TAAA has gradually become a new trend in treatment. This article presents a case of a 61-year-old female with TAAA. The patient underwent a follow-up thoracoabdominal CTA after teratoma surgery, which revealed a thoracoabdominal aortic aneurysm (Crawford Type III) extending from the sixth intercostal space to 5 cm below the renal arteries. The challenge in treating this case lay in reconstructing the visceral arteries. The octopus technique, a type of parallel stenting, offers advantages but has inherent technical limitations, such as multiple access routes for simultaneous stent placement, the potential risk of gutter endoleaks, and mutual compression among parallel stents. To avoid these drawbacks, modifications to the octopus technique are necessary. We connected multiple small stent grafts side-by-side and end-to-end to a single branch of the main aortic stent graft. This improved design effectively circumvented the gutter endoleaks and stent compression issues, allowing for sequential visceral artery reconstruction through single upper limb access. This modified octopus technique closely aligns with the design concept of branched stents. This article aims to describe a case of complete endovascular reconstruction of TAAA using the modified octopus technique combined with the external branch technique, providing an in-depth analysis of the specific procedural steps and their clinical application value.