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Objective To study the role of D‐lactate gradient across the lung in the rapid diagnosis of pneumonia and evalua‐tion of therapeutic efficacy .Methods Patients were divided into pneumonia group (n=46) and non‐pneumonia group (n=28) in ICU .D‐lactate gradient across the lung were calculated by the difference between arterial and mixed‐venous D‐lactate concentrations before the treatment ,after 3 and 7 days of treatment .Serum procalcitonin (PCT) ,Oxygenation index ,the lung injury score (LIS) and clinical pulmonary infection score(CPIS) were recorded at the same time .Results The mean D‐lactate gradient across the lung in pneumonia group was significantly higher than that in non‐pneumonia group[(163 .84 ± 10 .72) ng/mL vs .(30 .33 ± 7 .25) ng/mL ,P<0 .01) ]before treatment .Using a cut‐off value of 106 .11 ng/mL ,D‐lactate gradient across the lung′s sensitivity for di‐agnosis pneumonia was 90 .7% and its′specificity was 75 .5% .D‐lactate gradient across the lung correlated with LIS (r= 0 .554 , P<0 .01) and CPIS(r=0 .543 ,P<0 .01) .Conclusion D‐lactate gradient across the lung correlates with lung injury and pulmonary infection positively and may be a potential biomarker for rapid diagnosis of pneumonia .
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Objective To investigate the impact of Ang-1 on the septic mice′pulmonary vascular endothelial barrier function and VE-cadherin and its mechanism. Methods 80 BALB/c mice were randomly divided into NS, LPS, LPS+Ang-1, LPS+Ang-1+ Ly and Ang-1 groups (n = 16). Measure VE-cadherin, Ang-2 levels in plasma and lung permeability index (LPI).Test the total VE-cadherin of lung and the phosphorylation of VE-cadherin expression. Results Plasma Ang-2 was higher compared with NS group(P<0.01) except Ang-1 group. In LPS+Ang-1 group and LPS+Ang-1+Ly group, plasma Ang-2 was lower compared with LPS group (P <0.05). In LPS+Ang-1+Ly group, plasma Ang-2 was higher compared with LPS+Ang-1 group (P<0.01). LPI, plasma VE-cadherin and lung phosphorylation of VE-cadherin were the same with the trends of the plasma Ang-2 , but the lung total VE-cadherin showed the opposite tendency. Conclusion Through the PI3K/Akt signal transduction pathway , Ang-1 may regulate septic mice′VE-cadherin , hence the pulmonary vascular endothelial barrier function improved.
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Objective To investigate the expression of livin of kidney tissues in rats with acute kidney injury (AKI) induced by endotoxin ,and the role of livin in the cell apoptosis of AKI .Methods The rat models with AKI were induced by endotoxin .The de-gree of kidney injury was observed by hematoxylin and eosin stain ,measuring the levels of the serum creatinine and urea nitrogen . The expression of livin and caspase-3 in kidney tissue at different time points was analyzed by immunohistochemistry assay ,and the relationship between the expression of livin and caspase-3 and kidney injury was analyzed .Results Compared to the control group , the rats injected endotoxin had the performance of AKI ,with obviously pathomorphological damage in the kidney tissues ,signifi-cantly increasing in the serum creatinine and urea nitrogen (P<0 .01) .The livin and caspase-3 of kidney tissues in rats with AKI caused by endotoxin were positive expression (P<0 .01) .With the lapse of time ,the trend of increasing of caspase-3 showed gradu-ally slow after the highest expression of livin .Conclusion The livin involved in the pathogenesis of endotoxin-induced AKI ,it might relieve the kidney injury and protect renal function by inhibiting casepase-3 important apoptotic effector protein .
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Objective: To investigate the influence of Xuebijing injection (血必净注射液) on hemodynamics of dogs with endotoxic shock and its mechanism. Methods: Endotoxic shock was induced by intravenous infusion of lipopolysaccharide of E.coli. O55:B5 to dogs, and the 24 dogs were randomly divided into control group and Xuebijing injection group. Xuebijing injection was administered in the Xuebijing injection group. The hemodynamic parameters and plasma lactate levels were monitored. Results: After the administration of endotoxin, the mean arterial pressure (MAP) decreased significantly, while the mean pulmonary artery pressure (MPAP) and cardiac index (CI) increased markedly in both groups (all P0.05). Moreover, plasma lactate level was lower in Xuebijing injection group than that in control group (P