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Objective:To evaluate the role of aryl hydrocarbon receptor (AhR) in the down-regulation of Clara cell secretory protein (CCSP) expression during endotoxin-induced lung injury in rats.Methods:Twenty-four clean-grade healthy male Sprague-Dawley rats, aged 8 weeks, weighing 200-250 g, were divided into 4 groups ( n=6 each) using a random number table method: normal control group (group C), acute lung injury (ALI) group, ALI+ AhR antagonist group, and ALI+ vehicle group. Lipopolysaccharide(LPS) 1 mg/kg was intratracheally instilled to develop the model of lung injury, while the equal volume of normal saline was given instead in group C. At 2 h before LPS injection, AhR antagonist 6, 2′, 4′-trimethoxyflavone solution 5 mg/kg (diluted to 1 ml in dimethyl sulfoxide solution) was intraperitoneally injected in ALI+ AhR antagonist group, while dimethyl sulfoxide solution 1 ml was given in ALI+ vehicle group. The rats were sacrificed under anesthesia at 48 h after LPS administration. The left lung was lavaged and the broncho-alveolar lavage fluid (BALF) was collected for determination of the concentrations of CCSP by enzyme-linked immunosorbent assay, and the expression of CCSP in the bronchial epithelium in right lung tissues was determined by immunohistochemistry. Results:Compared with group C, the expression of CCSP in the bronchial epithelium was significantly down-regulated, and the concentrations of CCSP in BALF were decreased in the other three groups ( P<0.05 or 0.01). Compared with ALI group and ALI+ vehicle group, the histopathological injury was significantly reduced, the expression of CCSP in the bronchial epithelium was up-regulated, and the concentrations of CCSP in BALF were increased in ALI+ AhR antagonist group ( P<0.01). Conclusions:AhR partially mediates the down-regulation of CCSP expression during endotoxin-induced lung injury in rats.
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COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.
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Objective To evaluate the effect of high-frequency chest well oscillation expectoration system on ventilator-associated pneumonia (VAP) and time for withdrawing mechanical ventilation (MV) system in ICU patients with invasive mechanical ventilation (IMV). Methods 100 ICU patients with IMV were divided into observationgroup (n = 50) and control group (n = 50). The high-frequency chest well oscillation expectoration was used in the former group and the mechanical vibration expectoration was used in the latter. The two groups were compared in terms of amount of sputum, vital signs (heart rate, breathing, systolic blood pressure and blood oxygen saturation), time for withdrawing MV system and VAP rate. Results On days 1, 2, 3, 4 and 5, the amount of sputum in the observationgroup was (33.5 ± 4.2)mL/d, (41.1 ± 3.0)mL/d, (38.2± 3 .5) mL/d, (34.8 ± 2.5) mL/d and (31.1 ± 2.1) mL/d, and those of the control group respectively was (27.4 ± 3.1) mL/d, (30.3 ± 3.6) mL/d, (28.1 ± 2.2) mL/d, (25.7±1.8)mL/d and (20.8 ± 1.7)mL/d. The differences between the two groups were statistically significant (P 0.05). The time for withdrawing MV system in the observationgroup and the control group respectively was (5.8 ± 2.2)d and (9.5 ± 1.8)d, (P < 0.05). The rates of VAP in the observationgroup and the control group respectively was 30.0% (15/50) and 52.0% (26/50), with significant difference between them (P < 0.05). Conclusion The high-frequency chest well oscillation expectoration for ICU patients with invasive mechanical ventilation can promote sputum expectoration , improve blood oxygen saturation , shorten the time for withdrawing the ventilator, and prevent the incidence of VAP.
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An investigation on pathogens was performed on 219 consecutive adult inpatients with community-acquired pneumonia (CAP) from November 2008 to August 2009 in Hebei Province.Sputum samples from all patients in acute phase were collected for multiplex polymerase chain reaction (PCR) detection. Pathogens were identified in 125 patients. Streptococcus pneumoniae was the most common pathogen isolated in 75 cases (60％) ; influenza A virus was the most common virus isolated in 32 cases (26％) ; and mixed infection were found in 31 patients (25％). Streptococcus pneumoniae species were more frequent among patients aged ≤30 and 51 -70; Haemophilus influenzae species were more frequent among patients with coexisting disease; the percent of Mycoplasma pneumoniae species infections in the lowrisk groups( Ⅰ - Ⅱ ) was higher than patients in the high-risk groups ( Ⅲ - V ).The percent of virus pneumoniae species infections in patients with coexisting disease trended to higher than patients without coexisting disease,but the difference was not statistically significant ( P ＞ 0.05 ).The results indicate that Streptococcus pneumoniae remains the major bacteria,Viruses are frequently detected in CAP with influenza A virus being the most common one; and mixed infection should not be ignored.The age and underlying diseases are important factors influencing the distribution of pathogens.
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Objective To study the relationship between viral infection and chronic obstructive pulmonary disease (COPD),and the effect of viral infections on the changes of Th1/Th2 in COPD patients. Methods The se-ra from 81 patients with acute exacerbations of COPD,25 patients with stable COPD and 22 healthy subjects were tested for specific IgM of respiratary syncytial virus(RSV) ,herpes simplex virus type 1 (HSV-1), parainfluenza vi-rus (PIV), adenovirus (ADV) and cytomegalovirus (CMV) by indirect enzyme-linked immunosorbent assay (ELISA). Supernatant INF-γ and IL-4 cultured with PHA were determined. Results The positive rates of IgM in patients with acute exacerbations of COPD compared with those in patients with stable COPD and healthy subjects were significantly different(P <0.001 ). The level of INF-γ, and IL-4 in patients with acute exacerbations of COPD and stable COPD compared with normal control group;the level of INF-γ (242±43) and the of IL-4(42±9) in pa-tients with acute exacerbations of COPD was not significantly different as compared with the level of INF-γ( 198±32) and the level of IL-4(56±11 ) in patients with stable COPD (P<0.05), but the level of INF-γ was increased (90±18)and IL-4 was decreased (141±24) in control group (P<0.05). Compared with those in IgM negative group, the levels of INF-γ were significantly higher and the levels of IL-4 were significantly lowerIL-4 in lgM positive group( P<0.01 ). Conclusion Virus infection is a rather important factor in acute exacerbations of COPD, and COPD is characterized by a predominance of Th1-type response,and there is more significant Th1 response predomi-nance in COPD with virus infection.
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0.05).The concentration of IL-6 in sputum of multi-virus infection group(122.51?39.86)ng/L was higher than in single virus infection group(65.30?34.92)ng/L.The concentration of IL-6 in sputum of bacteria-virus mixed infection group(120.31?46.62)ng/L was higher than in bacteria or virus single infection group(83.61?47.83)ng/L.Conclusion Streptococcus pneumonia and influenza virus A infection are important factors in AECOPD at early stage.Virus infection would prolong recovery time,increase inflammation of the airway and even induce bacteria infection.Therefore,we should pay more attention to the virus infection in COPD patients,especially A-type influenza virus.
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AIM:To look for a better method to deal with interstitial lung disease,interferon-gamma(IFN-?)combined with methylprednisolone(M-pred)to influence human embryonic lung fibroblast on proliferation,collagen synthesis and the expression of transforming growth factor-?1(TGF-?1)protein and mRNA were investigated.METHODS:Exponentially growing cells were preincubated for 48 h before harvested.The microculture tetrazolium(MTT)assay was used to measure the inhibition ratios of M-pred combined with different concentrations of IFN-?.The expression of proliferation cell nuclear antigen(PCNA)was detected by immunocytochemical analysis.Hydroxyproline kit was adopted to detect collagen synthesis.The expressions of TGF-?1 mRNA and protein were detected respectively by RT-PCR and Western blotting.RESULTS:Methylprednisolone,IFN-? as well as the combination of methylprednisolone and IFN-? inhibited the proliferation of HELF and the expression of PCNA in comparison with control group(P
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AIM: To explore the cytokines level and the discrepancy of reaction to dexamethasone (Dex) in ALI rats induced by hydrochloric acid (HCl) and lipopolysaccharide (LPS). METHODS: Ninety-six SD rats were divided into six groups at random (n=16 in each group): NS group, HCl group, LPS group, NS+Dex group, HCl+Dex group and LPS+Dex group. Every group was divided into two subgroups: the bronchoalveolar lavage (BAL) subgroup and no bronchoalveolar lavage (NBAL) subgroup. The total leukocytes, PMN%, macrophage%, lymphocyte%, total protein in BALF and the wet/dry of the lung weight were measured. The concentrations of TNF-?, IL-1?, IL-4 and IL-10 in serum and BALF in every group were compared. RESULTS: (1) In the groups of LPS and HCl, the total leukocytes, PMN numbers, the protein concentration in the BALF and W/D were higher than those in control group (P