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El dengue es la infección trasmitida por vectores con mayor impacto en carga de enfermedad, económica y social a nivel mundial, con más de 3,6 billones de personas en riesgo de infección. Sus manifestaciones son variables, caracterizadas en su mayoría por síndrome febril con riesgo de sangrado, choque y muerte. El compromiso pulmonar es infrecuente, siendo el síndrome de dificultad respiratoria aguda una complicación inesperada, aunque informada, asociada a un mal pronóstico. Se presenta un paciente sin antecedentes relevantes de importancia, con focalización pulmonar severa asociado a infección por el virus dengue. En el caso presentado se descartaron procesos infecciosos bacterianos u otros agentes causales de síndrome de dificultad respiratoria aguda, lo que sumado a las características clínicas de ingreso, zona de ocurrencia del caso considerada como endémica, curso clínico, paraclínico y la franca positividad de las pruebas para dengue así como la seroconversión de estas, a pesar de no haber sido realizadas pruebas moleculares, se consideró como el agente causal más probable el virus dengue. Todo esto lleva a recomendar siempre considerarlo como potencial agente causal, lo que permite así un diagnóstico y manejo óptimos(AU)
Dengue is the vector-borne infection with the greatest impact on disease, economic and social burden worldwide, with more than 3.6 billion people under risk of contagion. Its manifestations are varied, most of them characterized by febrile syndrome with a risk of bleeding, shock and death. Pulmonary involvement is infrequent, and acute respiratory distress syndrome is an unexpected complication, though it has been reported in association to a bad prognosis. A case is presented of a male patient without relevant antecedents of interest, with severe pulmonary focalization associated to dengue virus infection. Bacterial infectious processes and other causative agents of acute respiratory distress syndrome were ruled out. In view of the patient's clinical status at admission, the endemicity of the patient's area of residence, the clinical and paraclinical course, and the obvious positivity of the dengue tests performed and their seroconversion, despite not having conducted molecular tests, it was concluded that the most probable causative agent was dengue virus. Therefore, it is recommended that dengue infection always be considered as a potential causative agent of acute respiratory distress syndrome, thus contributing to optimal diagnosis and management(AU)
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Humans , Male , Adult , Respiratory Distress Syndrome, Newborn , Endemic Diseases , Molecular Diagnostic Techniques , Dengue Virus , Prognosis , Cost of Illness , SeroconversionABSTRACT
Objective:To explore clinical manifestations, imaging features and prognosis of juvenile idiopathic arthritis (JIA) combined with lung injury, aiming to improve the understanding of the disease.Methods:Clinical data from 464 children with JIA who were hospitalized in Beijing Children′s Hospital from January 2016 to September 2019 were retrospectively analyzed.Their clinical manifestations, high resolution CT (HRCT) features, lung function and follow-up of children with lung injury were analyzed.Results:Among 464 children with JIA, 40 cases (8.62%) combined with lung injury.There were no significant differences in the age and sex between JIA children either combined with lung injury or not (all P>0.05). Among them, there were 125 cases of systemic-onset juvenile idiopathic arthritis (SoJIA) and 28 cases (22.4%) of JIA combined with lung injury, accounting for the highest proportion (70%, 28/40 cases) in JIA children combined with lung injury.Among 40 JIA children combined with lung injury, 22 cases (55.0%) had respiratory symptoms and 7 cases (17.5%) had obvious hypoxia.HRCT examination was performed in them, and the imaging findings included high-density strip or strip flocculation (75.0%, 30/40 cases), pleural thickening (45.0%, 18/40 cases), ground glass shadow (22.5%, 9/40 cases), nodular lesion (20.0%, 8/40 cases), vesicles or cystic emphysema (15.0%, 6/40 cases). Lung function was detected in 12/20 children with varying degrees of pulmonary function abnormalities, most of which were mixed ventilation dysfunction, and 2 cases still had pulmonary function abnormalities after treatment.During the follow-up for 3 months to 3.5 years, 4 cases (10%) JIA combined with lung injury died.A total of 29 children were re-examined by pulmonary CT in the follow-up visit, including 14 (48.28%) improved, 8 cases (27.58%) with no significant improvement, and 7 cases (24.14%) with repeated disease. Conclusions:JIA is a common rheumatic immune disease in children and all subtypes can be combined with lung injury, manifesting as interstitial lung disease mainly.The age and sex of JIA children combined with lung injury are not specific factors.The proportion of lung injury in SoJIA is significantly higher than that in other subtypes.SoJIA combined with macrophage activation syndrome can lead to respiratory failure, respiratory distress syndrome, and even death, which is one of the main factors leading to poor prognosis of JIA.HRCT is more sensitive to the diagnosis of lung injury.Lung function detection is a simple and easy method to evaluate and monitor lung injury.The prognosis of JIA children combined with lung injury is poor, which should be well concerned.
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Objective@#To investigate the principles of differential diagnosis of pulmonary infiltrates in cancer patients during the outbreak of novel coronavirus (2019-nCoV) by analyzing one case of lymphoma who presented pulmonary ground-glass opacities (GGO) after courses of chemotherapy.@*Methods@#Baseline demographics and clinicopathological data of eligible patients were retrieved from medical records. Information of clinical manifestations, history of epidemiology, lab tests and chest CT scan images of visiting patients from February 13 to February 28 were collected. Literatures about pulmonary infiltrates in cancer patients were searched from databases including PUBMED, EMBASE and CNKI.@*Results@#Among the 139 cancer patients underwent chest CT scans before chemotherapy, pulmonary infiltrates were identified in eight patients (5.8%), five of whom were characterized as GGOs in lungs. 2019-nCoV nuclear acid testing was performed in three patients and the results were negative. One case was a 66-year-old man diagnosed as non-Hodgkin lymphoma and underwent CHOP chemotherapy regimen. His chest CT scan image displayed multiple GGOs in lungs and the complete blood count showed decreased lymphocytes. This patient denied any contact with confirmed/suspected cases of 2019-nCoV infection and without fever and other respiratory symptoms. Considering the negative result of nuclear acid testing, this patient was presumptively diagnosed as viral pneumonia and an experiential anti-infection treatment had been prescribed for him.@*Conclusions@#The 2019 novel coronavirus disease (COVID-19) complicates the clinical scenario of pulmonary infiltrates in cancer patients. The epidemic history, clinical manifestation, CT scan image and lab test should be combined consideration. The 2019-nCoV nuclear acid testing might be applicated in more selected patients. Active anti-infection treatment and surveillance of patient condition should be initiated if infectious disease is considered.
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Objective::To observe the effect of compound Kushen injection on the expressions of transforming growth factor-β1 (TGF-β1), drosophila mothers against decapentaplegic protein 3 (Smad3), glycogen synthase kinase-3β (GSK-3β) and β-catenin mice models with radiation-induced pulmonary injury (RIPI), in order to explore its possible mechanism of action. Method::On XStrahl precision radiation research platform for small animals (SARRP), a single 20 Gy bilateral lung field irradiation was performed to establish a mice model of RIPI. Thirty-two mice were randomly divided into normal control group, model group, compound Kushen injection group and dexamethasone injection group. The normal control group and the model group were given an equal volume of 0.9%sodium chloride solution and injected intraperitoneally for 4 weeks. The pathology of lung tissue tissues was observed by using hematoxylin-eosin (HE) staining. Immunohistochemical(IHC) was used to detect the expressions of E-cadheren and Vimentin proteins in mice lung tissues.Real-time polymerase chain reaction (Real-time PCR) was used to detect the mRNA expressions of TGF-β1, Smad3, GSK-3β and β-cateninin.Western blot was used to detect the protein expressions of TGF-β1, Smad3, GSK-3β and β-cateninin. Result::Compared with the normal group, the pulmonary coefficient of the model group was significantly decreased (P<0.01). Inflammatory cell infiltration, pulmonary interstitial edema, congestion, destruction of alveolar structure and partial alveolar atrophy were observed in the lung tissues of the model group. Compared with the model group, in the compound Kushen injection group, the levels of infiltration of lung inflammatory cells and pulmonary interstitial lesions in mice, the expression of Vimentin in lung tissues (P<0.01), and the expressions of TGF-β1, Smad3, GSK-3β and β-cateninin were significantly decreased (P<0.01), whereas the expression of E-cadheren was significantly increased (P<0.01). However, compared with the dexamethasone injection group, in the compound Kushen injection group, the pathological changes of lung tissues were similar, and the expression levels of E-cadheren, Vimentin, TGF-β1, Smad3, GSK-3β and β-cateninin were not significantly different. Conclusion::Compound Kushen injection can alleviate pulmonary fibrosis of lung in the treatment of RIPI, and the mechanism may be associated with inhibiting the mRNA and protein expressions of TGF-β1, Smad3, GSK-3β and β-catenin related to epithelial-mesenchymal transition(EMT), promoting the expression of E-cadheren, and inhibiting the expression of Vimentin, so as to inhibit the occurrence of EMT.
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Acute pulmonary damage caused by transfusion is characterized by the sudden onset of respiratory distress in newly transfused patients within 6 hours after the transfusion, bilateral infiltrative changes in chest X-ray, PaO2/FIO2 <300 mmHg, absence of other risk factors for acute lung injury and absence of signs suggesting cardiogenic origin of pulmonary edema. Being one of the most serious complications of blood transfusion, plasma is the most involved factor, although all blood components can cause it, and is caused by antigen reactions/leukocyte antibody and lipid activity with ability to modify the biological response on primitive leukocytes. The diagnosis is based on the integration of clinical, radiological and gasometric elements, ruling out the rest of the possible causes of acute lung injury. Its differential diagnosis should include hemodynamic overload, anaphylactic reaction, bacterial contamination of transfused blood products and transfusion hemolytic reaction. The treatment is supportive measures based on the needs and does not differ from the treatment of acute lung injury secondary to other etiologies, severe cases require endotracheal intubation and mechanical ventilation while the non-severe can be managed with oxygen therapy.
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Objective: To observe the protective effect of Jinshuibao Tablets on lung injury of rats induced by particulate matter (PM2.5), and investigate its mechanism. Methods: A total of 60 healthy adult male SD rats were randomly divided into five groups, the control group, the model group and Jinshuibao Tablets (low, moderate and high-dose) groups that were administered with drug through gavage at the doses of 0.225, 0.450, and 0.900 g/kg body weight (BW), with twelve rats in each group. The blank group was treated with normal saline by intratracheal instillation, the other groups were exposed by intratracheal instillation of PM2.5 saline suspension with the dose of 10 mg/kg BW, repeated three times per week for four weeks. At the end of the exposure, the rats in each group except control and model groups were given Jinshuibao Tablets suspension with the doses of 0.225, 0.450, and 0.900 g/kg BW, repeated once a day for 14 d. The peak expiratory flow (PEF), forced vital capacity (FVC) and volume expired in first 30 ms of fast expiration (FEV0.3) were measured, and the ratio of FEV0.3/FVC was calculated. The collected bronchoalveolar lavage fluid (BALF) was analyzed for the levels of interleukin-6 (IL-6), necrosis factor alpha (TNF-α), and eosinophils (EOS). The level of transforming growth factor-β1 (TGF-β1) was analyzed in lung homogenate. The histological changes of lung were observed. The protein kinase B (Akt), phosphorylation-protein kinase B (p-Akt), α smooth muscle actin (α-SMA) and matrix metallopeptidase 9 (MMP-9) of lung were assayed by western blotting. Results: Compared to the model group, the PEF, FVC, FEV0.3 and FEV0.3/FVC of the moderate and high-dose groups were significantly increased (P < 0.01), the levels of IL-6, TNF-α, EOS, TGF-β1 in moderate and high-dose groups were significantly decreased (P < 0.05, P < 0.01). The pathological changes of the lungs in moderate and high-dose groups treated with Jinshuibao Tablets were obviously relieved. The expression of p-Akt, α-SMA, and MMP-9 in the moderate and high-dose groups were obviously reduced (P < 0.05, P < 0.01). Conclusion: Jinshuibao Tablets has obvious antagonistic effect on PM2.5-induced damage of rat respiratory system, and its regulation mechanism may be related to the reduction of inflammatory reactions and the delay of fibrosis progression through the PI3K/Akt signaling pathway.
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OBJECTIVE: To discuss the effect of Qingfei-yangyin-huoxue recipe on radiation-induced pulmonary injury by regulating the lncRNA NANCI-NKX2.1 pathway. METHODS: The C57BL/6 mice were randomly divided into normal control group (A group, n=16), drug only group (B group, n=16), model group (C group, n=16) and drug model group (D group, n=16). After exposure to Qingfei-yangyin-huoxue recipe for 10 w, the pathological change of lung tissue was examined by H&E and Masson staining. The expressions of lncRNA NANCI and NKX2.1 mRNA in lung tissues were detected by qRT-PCR. And the NKX2.1 protein expressions were detected by Western blot. RESULTS: The mean animal weight in D groups was less than A and B group, but more than C group after treatment of 7 d(P<0.05). There were marked interstitial edema and inflammatory cells, fibrocytes accumulation in C group but not in A and B groups by H&E and Masson stain. The alveolitis and fibrosis changes in D group were better than C group. And the mean radiation-induced pulmonary injury score in D group was (3.875±1.746), which was less than C group, but more than A and B groups (P<0.05). The expression of lncRNA NANCI and NKX2.1in D group was higher than C group, but lower than A and B groups (P<0.05). Besides, the radiation-induced pulmonary injury score was negative related with lncRNA NANCI and NKX2.1 (r=-0.510, -0.786, P<0.05). CONCLUSION: There are significant evidences that Qingfei-yangyin-huoxue recipe could protect radiation-induced pulmonary injury by up-regulation lncRNA NANCI-NKX2.1 pathway.
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The atmospheric particulate matter(PM) is widely regarded as one of major environmentally and unfriendly ambient air pollution,and therein PM2.5 (diameter≤2.5 μm) is most closely related to human health.Because of its smaller diameter with longer suspension duration,PM can absorb many pathogenic microorganisms,and easily enter into the deep of airway and then deposit on the bronchus and alveoli,and it brings damage to the lung tissues and the surfactant proteins.PM can give rise to oxidative stress,inflammation response,cells and DNA damage.Now,this review focuses on the characterization and composition of PM,as well as the impact of PM2.5 on the lung,surfactant proteins and human health,which helps to call for more people to pay attention to this environmental issue in order to better mitigate and prevent the damage caused by PM.
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The atmospheric particulate matter(PM) is widely regarded as one of major environmentally and unfriendly ambient air pollution, and therein PM2.5 (diameter≤2.5 μm) is most closely related to human health.Because of its smaller diameter with longer suspension duration, PM can absorb many pathogenic microorganisms, and easily enter into the deep of airway and then deposit on the bronchus and alveoli, and it brings damage to the lung tissues and the surfactant proteins.PM can give rise to oxidative stress, inflammation response, cells and DNA damage.Now, this review focuses on the characterization and composition of PM, as well as the impact of PM2.5 on the lung, surfactant proteins and human health, which helps to call for more people to pay attention to this environmental issue in order to better mitigate and prevent the damage caused by PM.
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Objective To establish an animal model of SM by equal toxicity dose(1LD50)-induced acute pulmonary injury in rats and compare the differences of inflammatory factor and protein expression. Methods Rats were randomly divided into five groups. ELISA and immunohistochemical methods were measured. Results Serum INF-γ and IL-23 levels in the intraperitoneal SM group were increased compared with the tracheal SM group;there were also significant differences in serum IL-4 levels between the two groups. In the alveolar septum , the positive expression ratios of NF-Kβ1,NF-Kβp65,ERK,JNK,and p38MAPK in the intraperitoneal SM group were increased compared with the tracheal SM group. Conclusion Using SM (1LD50),There are significantly higher serum inflammatory factor levels and protein-related expression in the alveolar septum of rats intraperitoneally injected with SM compared with those administered SM by intratracheal instillation. The results suggest that pulmonary inflammatory reactions associated with SM are dependent on the route of exposure.
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Objective To investigate the protective effect of modified Qianjin Weijing Decoction(MQJWJD)on TNF-α and NF-κB in rats with lung injury induced by particulate matter; To discuss relevant mechanism of action. Methods A tracheal drip 15 mg/kg fine particles of saline solution was used to establish modeling, every other day, three times. Thirty-two Wistar rats were randomly divided into normal group, model group and MQJWJD high-dose and low-dose groups, with eight rats in each group. Medication groups were given relevant medicine for gavage. The level of TNF-α in bronchoalveolar lavage fluid (BALF) was measured by ELISA. The expression of NF-κB protein in lung tissues was measured by immunohistochemistry. The histopathology of the lung injury was observed by light microscope. Results Compared with normal group, the level of TNF-α and the expression of NF-κB protein in the model group were higher than those in the normal group (P<0.01). Compared with model group, the level of TNF-α and the expression of NF-κB protein in MQJWJD low-dose and high-dose groups were lower than those in the model group (P<0.05, P<0.01). Pathological observation showed that, compared with normal group, model group showed intratracheal, alveolar and interstitial bacteria within a large number of fine particles calm, alveolar and pulmonary interstitial visible large amounts of phagocytic fine particles of macrophages and accompanied by more neutrophils and lymphocyte infiltration; Lung tissue pathological changes were significantly lighter in MQJWJD high-dose and low-dose groups than the model group. MQJWJD high-dose group showed mild inflammation, alveolar and pulmonary interstitial visible phagocytic fine particles of macrophages, a small amount of neutrophils and lymphocyte infiltration. Conclusion MQJWJD can reduce the pulmonary injury in rats induced by particulate matter and has protective effects on the rat model through decreasing the levels of TNF-α and the expressions of NF-κB protein in injured lung tissues.
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Objectives To analyze the clinical manifestation of pulmonary injury in children with systemic lupus erythematosus (SLE).Methods The clinical data of 8 SLE children with onset of respiratory symptoms as the first sign were retrospectively analyzed from January 2011 to December 2015.Results In these 8 children (4 females and 4 males) aged 6-15 years old.All of them presented cough,and 7 cases had fever,5 cases had anhelation,3 cases had hemoptysis,3 cases had stethalgia,3 cases had dyspnea and 3 cases had cyanosis.The types of pulmonary injury were pleural efthsion in 5 cases (62.5％),acute lupus pneurnonitis in 4 cases (50.0％),chronic interstitial pneumonia in 2 cases (25.0％),and pneumorrhagia in 2 cases (25.0％).In 7 children who performed chest high resolution CT examination,it showed that 5 cases had ground-glass shadow,5 cases had pleural effusion,5 cases had enlargement of mediastinum or lymph nodes,and 4 cases had segmental pulmonary consolidation.After treatment of the primary disease,the respiratory symptoms and pulmonary images were improved rapidly in 7 cases,and one case died of pneumorrhagia.Conclusion The clinical ministrations in SLE children with onset of respiratory symptoms as the first sign were not specific,and it was usually confused with respiratory infection.However,it usually had other organs involved and the chest imaging was more commonly showed groundglass shadow,segmental pulmonary consolidation,and pleural effusion.
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Objective To investigate the expression of heme oxygenase-1 in lungs of transgenic mice and normal mice and its effects.Methods 32 newborn mice were divided into four groups:wild-type group (WT group),specific transgenic mice expressed hemoglobin oxygenase-1 high level group[HO-1-FL(H) group,cytoplasm],low level WT group[HO-1-FL(L) group,cytoplasm] and the C-terminal heme oxygenase-1 group(Nuc-HO-1-TR group,nucleus).Then four groups of mice were exposed to high oxygen for 3 days,after that placed in normal air environment.Immunohistochemistry and immunofluorescence were used to observe the alveolar development and hemoglobin addition at 3 days,7 days and 14 days oxygenase-1 expression in the lungs of mice.Results The levels of heme oxygenase-1 were significantly higher in the lungs of HO-1-FL (H) group,and the alveolar development in the lungs of the four groups after 3 days of hyperoxia exposure was impaired.In the normal air environment,the recovery of alveolar development in HO-1-FL (H) group on the 7th and 14th day was the best.Conclusion The moderately high levels of heme oxygenase-1 expression in the lungs contribute to the recovery of lung injury in mice caused by hyperoxic environments.
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Radiation-induced pulmonary injury(RPI)refers to intrathoracic neoplasm after radiotherapy, radiation wild area normal lung tissue injury complicated by damage to the reaction. Traditional Chinese medicine was used for nourishing yin and clearing lung, heat-clearing and detoxifying, promoting blood circulation to remove blood stasis in reducing the adverse reaction of radiotherapy. TCM showed the advantage for radioactive lung injury. Based on the different mechanism of action and from the perspective of TCM treatment, the article reviewed the latest experiment research of TCM on radiation-induced pulmonary injury were summarized, and we discussed and pointed out the existing problems and prospect solution
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Objective To evaluate the radioprotective effects of metformin on radiation-induced pulmonary injury in rats. Method A total of 30 Sprague-Dawley ( SD) rats were randomly divided into three groups:control, radiation (20 Gy) and radiation (20 Gy) with metformin, with 10 rats in each group. The right lungs of rats were irradiated to 20 Gy with 6 MV X-rays. Computed tomography (CT) was performed and Hounsfield Units ( HU) were determined during the observation period. The tissue samples of lung were extracted to perform the histological analysis, measurement of hydroxyproline content, fibrosis score and evaluation of fibrosis/inflammatory markers by Western blot at 12 weeks post-irradiation. CCK-8 method was used to explore the effects of metformin on non-small cell lung cancer( NSCLC) cells A549 and H460. Results Metformin reduced radiologic and histologic signs of fibrosis, lung density(6. 52 ± 0. 43 vs. 3. 31 ± 0. 57, t=6. 37, P<0. 01) and hydroxyproline content(32. 58 ± 1. 59 vs. 23. 47 ± 2. 46,t=12. 72, P<0. 01) which had been increased due to irradiation. Meanwhile, it significantly decreased the expressions of Col1, p-AMPKα and TGF-β, while inhibited the expressions of p-Smad2 and p-Smad3 compared to the irradiation alone group. Moreover, metformin reduced A549 and H460 cells growth. Conclusions Metformin exerted a protective effect on normal tissues in radiation-induced pulmonary fibrosis. Thus, it might act as a promising radioprotective agent in the treatment of lung cancer.
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Objective To investigate the expression of heme oxygenase-1 in lungs of transgenic mice and normal mice and its effects.Methods 32 newborn mice were divided into four groups:wild-type group (WT group),specific transgenic mice expressed hemoglobin oxygenase-1 high level group[HO-1-FL(H) group,cytoplasm],low level WT group[HO-1-FL(L) group,cytoplasm] and the C-terminal heme oxygenase-1 group(Nuc-HO-1-TR group,nucleus).Then four groups of mice were exposed to high oxygen for 3 days,after that placed in normal air environment.Immunohistochemistry and immunofluorescence were used to observe the alveolar development and hemoglobin addition at 3 days,7 days and 14 days oxygenase-1 expression in the lungs of mice.Results The levels of heme oxygenase-1 were significantly higher in the lungs of HO-1-FL (H) group,and the alveolar development in the lungs of the four groups after 3 days of hyperoxia exposure was impaired.In the normal air environment,the recovery of alveolar development in HO-1-FL (H) group on the 7th and 14th day was the best.Conclusion The moderately high levels of heme oxygenase-1 expression in the lungs contribute to the recovery of lung injury in mice caused by hyperoxic environments.
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Radiation-induced pulmonary injury(RPI)refers to intrathoracic neoplasm after radiotherapy, radiation wild area normal lung tissue injury complicated by damage to the reaction. Traditional Chinese medicine was used for nourishing yin and clearing lung, heat-clearing and detoxifying, promoting blood circulation to remove blood stasis in reducing the adverse reaction of radiotherapy. TCM showed the advantage for radioactive lung injury. Based on the different mechanism of action and from the perspective of TCM treatment, the article reviewed the latest experiment research of TCM on radiation-induced pulmonary injury were summarized, and we discussed and pointed out the existing problems and prospect solution
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Objective To evaluate the radioprotective effects of metformin on radiation-induced pulmonary injury in rats. Method A total of 30 Sprague-Dawley ( SD) rats were randomly divided into three groups:control, radiation (20 Gy) and radiation (20 Gy) with metformin, with 10 rats in each group. The right lungs of rats were irradiated to 20 Gy with 6 MV X-rays. Computed tomography (CT) was performed and Hounsfield Units ( HU) were determined during the observation period. The tissue samples of lung were extracted to perform the histological analysis, measurement of hydroxyproline content, fibrosis score and evaluation of fibrosis/inflammatory markers by Western blot at 12 weeks post-irradiation. CCK-8 method was used to explore the effects of metformin on non-small cell lung cancer( NSCLC) cells A549 and H460. Results Metformin reduced radiologic and histologic signs of fibrosis, lung density(6. 52 ± 0. 43 vs. 3. 31 ± 0. 57, t=6. 37, P<0. 01) and hydroxyproline content(32. 58 ± 1. 59 vs. 23. 47 ± 2. 46,t=12. 72, P<0. 01) which had been increased due to irradiation. Meanwhile, it significantly decreased the expressions of Col1, p-AMPKα and TGF-β, while inhibited the expressions of p-Smad2 and p-Smad3 compared to the irradiation alone group. Moreover, metformin reduced A549 and H460 cells growth. Conclusions Metformin exerted a protective effect on normal tissues in radiation-induced pulmonary fibrosis. Thus, it might act as a promising radioprotective agent in the treatment of lung cancer.
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Objective To explore the role of pulmonary function analysis in drug efficacy evaluation of radiation-induced lung injury.Methods Totally 30 C57BL/6 mice were randomly divided into 3 groups:control group, radiation group and dexamethasone group.Mice in radiation group and dexamethasone group were irradiated with 20 Gy X-ray on the whole chest.Then mice in dexamethasone group was intraperitoneally injected with dexamethasone at the dose of 4.5 mg/( kg· d) for 2 weeks and then the dose was halved up to 1 month after radiation while control group and radiation group were intraperitoneally injected with 0.9%saline.One month after irradiation, pulmonary function of all the mice was tested with EMKA system.Then mice were sacrificed and pathological changes of pulmonary tissue were observed by HE staining. Furthermore, the area of alveolar cavity was measured with the Image-pro plus software.Results One month after irradiation, the pulmonary function parameters of mice in radiation and dexamethasone groups, such as mid-expiratory flow, minute volume,tidal volume,peak inspiratory flow,and peak expiratory flow,decreased obviously compared with the control group, but those parameters of the dexamethasone group decreased much less significantly than in the radiation group.The pathological changes of pulmonary tissues showed that the area of alveolar cavity of radiation group and dexamethasone group was smaller than that of the control group, but the extent of the loss of alveolar cavity area of the dexamethasone group was less than in the radiation group.Neutrophils infiltration could be found in the radiation group and dexamethasone group, but was less serious in the dexamethasone group.The result of pulmonary function analysis was coincident with pathological changes of the lung.Conclusion Dexamethasone can alleviate radiation induced pulmonary injury.Pulmonary function analysis combined with pathological observation of pulmonary tissues can effectively evaluate the efficacy of drugs in radiation induced lung injury.
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Objective To observe the incidence,clinical types,and prognosis of pulmonary involvement in children with systemic lupus erythematosus(SLE),and to probe the relationship between the relative factors.Methods The clinical data of 61 children with SLE,who treated in Children's Hospital of Shanghai from Jan.2006 to Dec.2011 were analyzed retrospectively.The lung manifestations of the patients were classified according to their clinical symptoms and signs,and lung imaging examination (chest X-ray and CT).Other data of the SLE patients with lung injury or without lung injury were collected,including the course of the disease,activity index [SLE disease activity index (SLEDAI) scoring 0-4 was divided into no activity,5-9 was divided into low activity,10-14 was divided into moderate activity,and more than 15 as severe activity],blood sedimentation,the values of serum complement and the positive rate of dsDNA in autoantibody,and a comparison was made and statistical analysis was performed.Results Pulmonary injury occurred in 17 cases with an incidence rate of 27.9％ (17/61 cases),and the average course of the disease was (8.76 ± 6.96) months.The clinical manifestations of 17 cases included fever,cough,dyspnea,hypoxemia,chest pain,lower breath sound,and lung rale,which were not non-specificity.According to imageological examination,in 17 cases there were 2 cases with pulmonary hypertension (the incidence rate was 11.8％),4 cases with acute lupus pneumonitis (the incidence rate was 23.5％),6 cases with interstitial pneumonia (the incidence rate was 35.3％),7 cases with lesion of pleura (the incidence rate was 41.2％),10 cases with pulmonary infection (the incidence rate was 58.8％).There were no statistical differences between patients with and without lung injury(infectious and non-infectious)in the course,the values of serumn complement,the positive rate of dsDNA and activity index.Lung lesions of the 17 patients recovered quickly after early diagnosis and active treatment.Conclusions Pulmonary manifestation in children with SLE is not uncommon,and it can happen at any stage of the disease,not just on the stage of lupus activity,but it usually indicates disease was not controlled.Pulmonary manifestation of SLE in children involve many parts of lung,including pulmonary parenchyma,interstitial,blood vessels,pleura,etc.Early diagnosis and active treatment can improve the short-term prognosis of lung injury with lupus,and long-term outcome remains to be observed.