Tanshinone IIA prevents acute lung injury by regulating macrophage polarization / 中西医结合学报

OBJECTIVE@#Acute lung injury (ALI) is a serious respiratory dysfunction caused by pathogen or physical invasion. The strong induced inflammation often causes death. Tanshinone IIA (Tan-IIA) is the major constituent of Salvia miltiorrhiza Bunge and has been shown to display anti-inflammatory effects. The aim of the current study was to investigate the effects of Tan-IIA on ALI.@*METHODS@#A murine model of lipopolysaccharide (LPS)-induced ALI was used. The lungs and serum samples of mice were extracted at 3 days after treatment. ALI-induced inflammatory damages were confirmed from cytokine detections and histomorphology observations. Effects of Tan-IIA were investigated using in vivo and in vitro ALI models. Tan-IIA mechanisms were investigated by performing Western blot and flow cytometry experiments. A wound-healing assay was performed to confirm the Tan-IIA function.@*RESULTS@#The cytokine storm induced by LPS treatment was detected at 3 days after LPS treatment, and alveolar epithelial damage and lymphocyte aggregation were observed. Tan-IIA treatment attenuated the LPS-induced inflammation and reduced the levels of inflammatory cytokines released not only by inhibiting neutrophils, but also by macrophage. Moreover, we found that macrophage activation and polarization after LPS treatment were abrogated after applying the Tan-IIA treatment. An in vitro assay also confirmed that including the Tan-IIA supplement increased the relative amount of the M2 subtype and decreased that of M1. Rebalanced macrophages and Tan-IIA inhibited activations of the nuclear factor-κB and hypoxia-inducible factor pathways. Including Tan-IIA and macrophages also improved alveolar epithelial repair by regulating macrophage polarization.@*CONCLUSION@#This study found that while an LPS-induced cytokine storm exacerbated ALI, including Tan-IIA could prevent ALI-induced inflammation and improve the alveolar epithelial repair, and do so by regulating macrophage polarization.

CT signs and diagnostic significance in patients with benign or malignant pulmonary ground-glass nodules / 第二军医大学学报

Objective To explore the factors related to the identification of benign or malignant pulmonary ground-glass nodule (GGN) through studying the clinical features of patients with lung GGN diagnosed by pathology. Methods The clinical data and imaging data from 181 patients, who were pathologically confirmed to have lung GGN in Changhai Hospital of Second Military Medical University from Oct. 2013 to Oct. 2016, were retrospectively analyzed. Statistical software SPSS 19.0 was used to conduct univariate analysis and multivariate logistic regression analysis of influencing factors of benign or malignant lung GGN. The coincidence of chest CT diagnosing benign or malignant lung GGN and the pathology diagnosis was analyzed with Kappa consistency test. Results Of the 181 patients, 106 had malignant lung GGN and 75 had benign lung GGN. Univariate analysis showed that age, smoking index, maximum diameter of GGN, spiculation, lobulation, pleural indentation, vacuole sign, air bronchogram sign and CT value were the influencing factors for the differential diagnosis of benign and malignant lung GGN (all P0.05). Multivariate regression analysis showed that aged, spiculation, lobulation, pleural indentation, air bronchogram sign, vacuole sign and increased CT value were independent risk factors of malignant lung GGN (all P0.05). Compared with benign lung GGN, chest CT had a higher accuracy in diagnosing the malignant lung GGN (80.3% vs 65.3%, χ2＝5.698, Kappa＝－0.122, P＝0.017). For the benign GGN, inflammatory lesions were more likely to be misdiagnosed versus tuberculosis (χ2 ＝22.626, Kappa＝0.593, P0.001). Conclusion For older patients with chest CT signs including lobulation, spiculation, pleural indentation, air bronchogram sign, vacuole sign and increased CT value, malignant lung GGN should be highly suspected. When diagnosing benign lung GGN, the doctors should comprehensively analyze patient general situation, clinical features and imaging findings of the patients.

Reverse fasciocutaneous flap pedicled with perforator branch of anterior medial malleolus artery for soft tissue defect on the dorsal side of foot / 中华整形外科杂志

<p><b>OBJECTIVE</b>To report the therapeutic effect of reverse fasciocutaneous flap pedicled with perforator branch of anterior medial malleolus artery for soft tissue defect on the dorsal side of foot.</p><p><b>METHODS</b>The perforator branch was located under the guidance of Doppler flowmeter. The flap was designed along the saphenous neurovascular axis. Then the flap was transferred reversely with the perforator branch as rotation point.</p><p><b>RESULTS</b>From Feb. 2002 to Mar. 2008, 12 cases were treated and followed up for 6 - 18 months. All the flaps survived completely. The flap size ranged from 13.5 cm x 3.0 cm to 8 cm x 3 cm. The perforator branch located at 0.5 - 1.5 cm anterior-inferior to the medial malleolus. Both the cosmetic and functional results were satisfactory.</p><p><b>CONCLUSIONS</b>The flap has a reliable blood supply and a flexible design. It is easily performed for soft tissue defect on the dorsal side of foot. It is a new type flap which combined neurocutaneous vascular flap with the perforator flap.</p>