Clinical abservations of pulmonary surfactant' s autologous transfusion in massive lung lavage / 中华劳动卫生职业病杂志

Objective@#Investigate the pulmonary surfactant autotransfusion effect on the recovery of respiratory function in patients with whole lung lavage, to provide theoretical basis for the clinical application.@*Methods@#We taken 30 patients of pneumoconiosis treated by whole lung lavage as the subjects. We extracted the pulmonary surfactant from lavage fluid, after single postoperative lung lavage for the first time; after one weeks when the second times of lung lavage were performed to the other side of the lung of patients, we put PS into the right side. We taken the patients the second times of lung lavage who were put PS into the right side as returning group, the first times of lung lavage who were not put PS into as on returning group. We observed indi-cators, such as expiratory resistance, respiratory work, lung compliance, airway pressure, PO2, the pulmonary function recovery time and other indicators, comparing with the changes of pulmonary function before lung la-vage for the first time and at 0、60、90、120 min after the pulmonary surfactant autotransfusion.@*Results@#Com-pared with the no returning group, the expiratory resistance of the returning group decreased significantly at 90 min、120 min after the pulmonary surfactant autotransfusion; the respiratory work and airway pressure of the re-turning group decreased significantly at 60、90、120 min after the pulmonary surfactant autotransfusion, there was statistically significant in the difference between different groups (P<0.05, P<0.01). Compared with the no returning group, the lung compliance and the PO2 of the returning group increased significantly at 60 min、90 min、120 min after the pulmonary surfactant autotransfusion, there was statistically significant in the difference between different groups (P<0.05, P<0.01). The lung function recovery time of returning group was (155.7 ± 35.2) min, the lung function recovery time of no returning group was (183.71±41.81) min, there was statistical-ly significant in the difference between different groups (P<0.05). Compared with the no returning, there were not statistically significant in the difference of the Heart rate、the systolic blood pressure and the diastolic blood pressure about the returning at 60、90、120 min after the pulmonary surfactant autotransfusion.There was no ad-verse reactions such as pulmonary infection, pulmonary infection and so on.@*Conclusion@#The pulmonary surfac-tant autotransfusion may reduce expiratory resistance, work of breathing, airway pressure; improve lung compliance, alveolar ventilation function; increase oxygen partial pressure and decrease the surgery recovery time in patients with pneumoconiosis.

The study of autophagy in alveolar macrophages of patients with coal workers' pneumoconiosis / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To evaluate the differences in the autophagy activity of alveolar macrophages between patients with different stages of coal workers' pneumoconiosis (CWP).</p><p><b>METHODS</b>A total of 116 coal workers were investigated in the field. Their lung lavage fluid was collected and purified to obtain alveolar macrophages. The morphological characteristics of autophagy were observed by transmission electron microscopy. The expression of autophagy marker (LC3) and autophagy regulators (Beclin1, mTOR, and p-mTOR) was measured by Western blot. The autophagy activity of alveolar macrophages was compared between dust-exposed subjects and patients with stage I, II, and III CWP.</p><p><b>RESULTS</b>The autophagy activity of alveolar macrophages differed between patients with different stages of CWP, according to transmission electron microscopy. Patients with stage II CWP had significantly higher protein expression of LC3 II/I and Beclin1 in pulmonary macrophages than those with stage ICWP (P < 0.05); patients with stage III CWP had significantly lower protein expression of LC3 II/I and Beclin1 in pulmonary macrophages than those with stage II CWP (P < 0.05), but had significantly higher protein expression of LC3 II/I and Beclin1 than those with stage I CWP (P < 0.05); patients with stage II CWP had a significantly higher protein expression of Beclin1 than the dust-exposed subjects (P < 0.05). Patients with stage II CWP had significantly lower expression of mTOR and p-mTOR in pulmonary macrophages than the dust-exposed subjects and those with stage I CWP (P < 0.05), while patients with stage III CWP had significantly higher expression of mTOR and p-mTOR than those with stage II CWP (P < 0.05).</p><p><b>CONCLUSION</b>The autophagy activity of alveolar macrophages varies between patients with different stages of CWP.</p>

Relationship between recovery levels of pulmonary surfactants and lung compliance after whole-lung lavage / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the relationship between the recovery levels of pulmonary surfactants (PS) and lung compliance after whole-lung lavage.</p><p><b>METHODS</b>Patients with pneumoconiosis in different stages (healthy subjects, stage I, and stage II, n = 10 for each group) were selected. The recovery levels of PS and lung compliance at different time points after whole-lung lavage were determined, and their relationship was analyzed.</p><p><b>RESULTS</b>Before whole-lung lavage and at 0, 10, 30, 60, 90, and 120 min after the operation, the lung compliance levels were 39.5±6.7, 28.3±5.6, 31.5±5.2, 37.6±4.4, 38.0±5.3, 38.7±5.5, and 39.2±5.3 ml/cm H2O for healthy subjects, 38.8±5.1, 25.1±6.1, 28.4±6.8, 30.5±5.9, 36.3±5.5, 37.3±5.4, 38.2±4.5, and 38.8±5.1 ml/cm H2O for patients with stage I pneumoconiosis, and 32.9±6.1, 20.3±6.0, 24.3±5.4, 25.1±5.4, 26.8±5.8, 27.8±4.8, and 32.8±4.5 ml/cm H2O were for patients with stage II pneumoconiosis. It was observed that in patients with pneumoconiosis, the lung compliance levels showed a declining trend along with the increasing stage, reaching the lowest level in stage II patients; comparison between groups indicated a significant difference (P < 0.05). For healthy subjects, 30 min was needed for restoring lung compliance to its preoperative level, while 60 and 120 min were needed for stage I and stage II patients, respectively. Compared with that at 0 min after operation, PS levels were elevated significantly at 10 min after operation in all patients (P < 0.05), whereas for stage I and stage II patients, the PS levels at 30 min after operation were significantly higher than that at 10 min (F = 4.27, P < 0.05; F = 20.40, P < 0.05). For all patients, the PS levels at 60 min after operation were significantly higher than those at 10 and 30 min (P < 0.05). After whole-lung lavage, the PS levels in all patients were restored to a large extent within 10∼30 min, but the recovery of lung compliance needed 30∼ 90 min.</p><p><b>CONCLUSION</b>After whole-lung lavage, the lung compliance declines obviously, but recovers gradually afterwards; the higher stage suggests a longer recovery. The recovery of lung compliance needs a longer time than that of PS.</p>