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Additional file 1: Drp1 promoter sequence.

Background: Inflammatory response exerts an important role in ischemia/reperfusion (I/R) injury. TLR4 and myeloid differentiation factor 88 (MyD88) are key components in inflammation and are involved in the cerebral I/R injury. Irisin is a skeletal muscle-derived myokine produced after exercise, which was found to suppress inflammation. In this study, we investigated whether irisin could protect the brain from I/R injury through the TLR4/MyD88 pathway. Methods: Male Sprague Dawley rats (20 months, 190 ∼ 240 g) were pretreated with irisin at 10, 50, or 100 mg/kg for consecutive 3 days and then subjected to surgery of middle cerebral artery occlusion or sham operation. Infarct size and neuron loss were measured to evaluate brain damage. The mRNA and protein levels of TLR4 and MyD88 were measured by in situ hybridization and immunohistochemistry, respectively. NF-κB activation was assessed by electrophoretic mobility shift assay. Neurological function was evaluated by neurobehavior score test and passive avoidance test. Results: Irisin could reduce neuronal damage and neurofunctional impairment after I/R injury. This effect was mediated by downregulating the TLR4/MyD88 and inhibiting NF-κB activation. Conclusion: Irisin plays a beneficial effect in I/R injury through regulating the TLR4/MyD88 pathway.

A number of trials have shown that remote ischemic preconditioning (RIPC) could reduce lung injury of patients suffering cardiovascular surgery, pulmonary transplantation surgery and thoracic surgery with one-lung ventilation. However, there is still a controversy over the lung protection of RIPC in patients who suffers different types of surgery. We undertook meta-analysis of the randomized controlled trials to evaluate the effect of remote ischemic preconditioning on clinical outcomes of patients with lung injury.Systematic review and meta-analysis.Perioperative care areas.Adults and infants suffering cardiovascular surgery with lung injury.Remote ischemic preconditioning.The literatures were selected complying with the inclusive and exclusive criteria from the following databases as PubMed, Embase, Medline, Chinese Biomedical Literature and Journal Databases, Chinese Academic and VIP journal full-text Databases. Inclusion criteria includes: (1) Human clinical randomized and controlled trial; (2) the article we included is a clinical randomized controlled study; (3) the article discusses the effect of RIPC on lung injury of patients; (4) the primary evaluation indicators of the inclusive studies included postoperative intensive care unit stay time and mechanical ventilation time; (5) published in the form of full text, any language; (6) the type of operation is cardiovascular surgery; (7) there is no serious COPD, ARDS, respiratory failure and other lung diseases. Articles were excluded if they reported none of the outcomes as follows: postoperative intensive care unit stay time and mechanical ventilation time, human clinical controlled trails, pulmonary protection of RIPC, prospective clinical controlled trials. Two independent reviewers screened abstracts and titles, and selected records following full-text review. Software RevMan5.3 and STATA 12.0 were adopted to perform Meta-analysis.The search finally includes10 studies of 708 patients, 352 patients in RIPC group and 356 patients in control group. The baseline characteristics of patients are no differences in two groups (P 0.05). Compared with control group, RIPC significantly reduced the duration of ICU (P 0.05) and mechanical ventilation time (P 0.05) in RIPC group. In addition, the serum TNF-α and MDA concentration 24 h after operation in RIPC group are significantly lower than control group (P 0.05). However, there are no significant differences between RIPC group and control group in terms of serum IL-6, IL-8 concentrations, A-aDORIPC can decrease pulmonary inflammatory responses, reduce the duration of ICU and mechanical ventilation time, and improve the clinical outcomes of patients with lung injury.