ABSTRACT
Objective To investigate the effect of lipopolysaccharide (LPS) on the activation of mouse lung fibroblasts. Methods Primary cultured mouse lung fibroblasts were incubated in 96 well plates and randomly divided into 2 groups: control group ( group C, n = 6) and LPS group ( n = 24). The fibroblasts were cultured for 72 h in group C. LPS 1 μg/ml was added and then the fibroblasts were incubated for 72 h in group LPS. The expression of type Ⅰ procollagen mRNA, α-smooth muscle actin (α-SMA) mRNA, Toll-like receptor 4 (TLR4)mRNA and integrin β1 mRNA was determined using real-time PCR at 3, 6, 24 and 72 h of incubation (6 wells at each time point). Results Compared with group C, there was no significant change in the expression of type Ⅰ procollagen mRNA, α-SMA mRNA, TLR4 mRNA and integrin β1 mRNA at 3, 6 and 24 h of incubation ( P ＞0.05), but the parameters mentioned above were significantly up-regulated at 72 h of incubation in group LPS ( P ＜ 0.05). Conclusion In the early acute lung injury, LPS leads to pulmonary fibrosis through activating lung fibroblasts directly, and also accelerates the activation of lung fibroblasts and promotes the process of pulmonary fibrosis through up-regulating the expression of TLR4 and integrin β1 in mice.
ABSTRACT
Objective To evaluate the changes in three-dimensional computer tomography (3DCT) images of upper airway in patients with difficult tracheal intubation and provide theoretical evidence for predicting the difficult tracheal intubation. Methods Seventeen ASA Ⅰ or Ⅱ male patients, 25-60 yr old, height 165-185 era, weight 55-110 kg, body mass index 19-33 kg/m2, scheduled for elective surgery under general anesthesia, were studied. The airway condition was evaluated with Mallampati classification and Willsan score system in all patients before the operation. The patients underwent 3DCT scanning under 2 different statuses: with or without tongue protruding while opening his mouth maximally. The volume of the oropharyngeal cavity (Va1, Va2) andtongue body (Vt1, Vt2), and area of the oropharyngeal cavity (Aa1, Aa2) and tongue body (At1, At2) in the coronal position were measured before and during tongue protruding. The midline sagittal images of the upper airway were made on computer to measure the direct laryngoscope angle and vertical distance between the mandible and hyoid (MHD). Awake blind tracheal intubation was performed in all patients. The exposure of the glottis was performed after anesthesia induction and evaluated with Cormack-Lehane classification. The patients were divided into non-difficult intubation group (group NDI, Cormack-Lehane grade Ⅰ or Ⅱ) and difficult intubation group (group DI, Cormack-Lehane grade Ⅲ or Ⅳ) according to Cormack-Lehane classification. Results There were 8 patients in group NDI, and 9 patients in group DI. There was no significant difference in the indices before tongue protruding between group DI and NDI (P>0.05). Va2, Va1 - Va1, Aa2, Aa1 - Aa2, and At1- At2 weresignificanfly smaller, MHD was significantly longer and Va1,/Vt1- Va2/Vt2was significantly larger in group DI than in group NDI (P < 0.05 or 0.01). Va2 and Aa2 were significantly smaller than Va1 and Aa1 in group DI respectively (P < 0.05). Conclusion The changes in 3DCT images of the upper airway in patients with difficult tracheal intubation are mainly presented as smaller volume and area of the oropharyngeal cavity, larger difference value of the ratio of cavity volume to tongue volume and prolonged MHD.