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Objective To explore the impact of glucocorticoid on coagulation through administrating on rats with smoke inhalation.Methods Totally 150 male S-D rats were randomly (random number) divided into 5 groups:control group (ambient air inhalation),smoke group (smoke inhalation for 30 min),smoke+high dosage methyl prednisolone group(MP 40 mg/kg,intraperitoneal injection,s+HMP group),smoke+medium dosage MP (4 mg/kg) group (s+MMP group),smoke+low dosage MP (0.4 mg/kg) group (s+LMP group) (all n=30).Survival rates were calculated 24 h after smoke inhalation.Lung tissues were collected for histopathology and wet to dry (W/D) ratio.Arterial blood was collected for blood gas test.Coagulation factors in lung and plasma were tested.Results Survival rates of three MP groups were markedly improved compared with the smoke group (all P＜0.05),and was significantly higher in the medium dosage group(85.17％) than those in the low and high dosage groups (65.73％ and 60.07％,all P＜0.05).The W/D ratio and blood gas test were markedly improved in the high and medium groups (all P＜0.05).Tissue factor (TF) and thrombin-antithrombin complex (TAT-c) in bronchoalveolar lavage fluid (BALF) increased dramatically after SI (P＜0.01,P=0.005) with a remarkable drop of factor Ⅱ (F Ⅱ) (P=0.007),all of which were attenuated by MP with dosage dependence.The mRNA expression of TF increased dramatically after SI and recovered significantly with MP administration,while the expression of thrombomodulin (TM) recovered in the opposite direction with MP,all of which were in a dosage dependent manner.TF,fibrinogen (FIB),TAT-c increased significantly in plasma after smoke inhalation (P＜0.01,P=0.027,P=0.005).F Ⅷ ％ increased with MP administration and TF was raised by high dosage MP compared with the smoke group.FIB and TAT-c were decreased in all MP groups,which were significant higher in the high and middle dosage groups.The change of TM and endothelial cell protein C receptor (EPCR) in circulation were similar with FIB or TAT-c with or without MP.Protein C (PC％) and antithrombin (AT Ⅲ ％) dropped dramatically after SI,high and middle dosages of MP could restore the activity significantly,while low dosage would restore AT Ⅲ ％ but not PC％.Conclusions Glucocorticoid can significantly improve local and systemical coagulation disorder caused by smoke inhalation,and high-and medium-dosage hormones are effective.The regulation of hormones on the coagulation system is an important mechanism in the treatment of smoke inhalation induced lung injury.
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Objective To investigate the therapeutic effect of different doses of methylprednisolone (MP) in smoke inhalation-induced acute lung injury (SI-ALI).Methods Adult male Sprague-Dawley (SD) rats were divided into control group (group A,n = 6), smoke inhalation group (group B, smoke inhalation 30 minutes,n = 30) and smoke+MP 40, 4, 0.4 mg/kg intervention group (groups C, D, E; intraperitoneal injection of MP at 1 hour before smoke inhalation, n = 30) according to random number table method. The survival status of rats in each group was observed at 24 hours, and murine smoke inhalation induced trauma score (MSITS) according to the symptoms and signs of rats at 3 hours after smoke inhalation were scored. The blood of abdominal aorta of rats was collected. Then the rats were sacrificed to harvest bronchoalveolar lavage fluid (BALF) and lung tissue. The levels of interleukin (IL-6, IL-17a) in plasma and BALF were detected by enzyme linked immunosorbent assay (ELISA); the total number of white blood cells and the proportion of leukocytes or macrophages in BALF were calculated; the histopathological changes of lung were observed and the lung injury score was given; the expression of myeloperoxidase (MPO) and high mobility group protein B1 (HMGB1) in lung tissue were detected by Western Blot.Results The 24-hour survival rate of group B rats was 33.67％. The survivalrate of groups C, D and E (65.73％, 85.17％, 60.07％) were significantly higher than that of group B (allP < 0.05), and the survival rate of group D was significantly higher than that of groups C and E. Diffuse inflammatory cell infiltration, intra-alveolar hemorrhage and a large amount of edema fluid were seen in the lung tissue of group B; and the lung injury score was significantly higher than that of group A. Compared with group B, the lung injury in different doses of MP group were decreased to different degrees, while the lung injury scores in groups C and D were significantly decreased (3.31±1.37, 2.62±0.98 vs. 5.52±0.97, bothP < 0.01); correlation analysis showed that MSITS score was significantly and positively correlated with lung injury score (r = 0.862,P < 0.001). The levels of plasma inflammatory factors and BALF protein, inflammatory cells and inflammatory factors, and the expression of MPO, HMGB1 in group B were significantly higher than those in group A. Compared with group B, the levels of inflammatory factors in plasma, and protein content, inflammatory cells and inflammatory factors in BALF in different doses of MP group were decreased to different degrees, with significant differences in groups C and D [plasma: IL-17a (pg/L): 49.28±27.12, 36.57±16.52 vs. 191.79±88.21; IL-6 (ng/L): 206.47±109.96, 197.52±113.86 vs. 669.00±299.60; BALF: protein content (mg/L):892.0±164.5, 566.1±120.9 vs. 1838.0±145.8; white blood cell count (×109/L): 5.40±1.67, 2.81±1.20 vs. 9.02± 2.06; neutrophil ratio: 0.315±0.081, 0.273±0.080 vs. 0.590±0.096; IL-17a (ng/L): 22.63±8.62, 18.92±8.43 vs. 43.31±19.17; IL-6 (ng/L): 156.49±46.94, 123.66±64.91 vs. 253.43±80.03; allP< 0.01]; in addition, the expression of MPO and HMGB1 protein in lung tissues of MP groups with different doses were significantly decreased, the expression of MPO in group D was significantly lower than that in group E [MPO/β-actin (fold increase from group A):2.14±0.97 vs. 4.35±0.87,P < 0.01], the expression of HMGB1 in groups C and D were significantly lower than that in group E [HMGB1/β-actin (fold increase from group A): 1.77±0.73, 1.23±0.67 vs. 3.65±1.08, bothP < 0.05]. Conclusions MP can significantly improve the survival rate of SI-ALI rats and reduce the acute pulmonary and systemic inflammatory response. The MP effect of 4 mg/kg was better than 40 mg/kg and 0.4 mg/kg.
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Objective To explore the effects of hydrogen sulfide (H2 S) on the inflammatory reaction and the expression of single immunoglobin IL-1 receptor related protein (SIGIRR) in rats with acute lung injury (ALI) induced by lipopolysaccharide (LPS). Methods Forty male SD rats were randomly divided into 4 groups (normal group, H2 S group, ALI group and ALI + H2 S group). The ALI rat model was established by LPS peritoneal injection. After LPS stimulation for 1 h, rats inhaled H2 S 80mg /m3 for 6h. Then, rats were sacrificed with a supraphysiological dose of pentobarbital sodium. The histological changes in the lung, the levels of TNF-α and IL-1β in serum and lung tissue homogenates, and the protein expression of SIGIRR in lung tissues were examined. Results Compared with the normal and H2 S groups, typical histological features of ALI were observed in ALI group, and the lung injury scores of ALI group were higher than those of the normal and H2 S groups (P ＜ 0. 05). Moreover, there were marked increases in the levels of TNF-α and IL-1β in serum and lung tissue homogenates after LPS injection. In contrast, inhalation of H2 S could attenuate lung pathological changes and inhibit the productions of TNF-α and IL-1β in serum and lung tissue homogenates (P ＜ 0. 05). Additionally, inhalation of H2 S could induce the protein expression of SIGIRR in rat lung tissues. Conclusion Inhalation of H2 S protected rats from LPS-induced ALI and its mechanisms were partially associated with inhibition of the productions of TNF-α and IL-1β and modulation of SIGIRR expression.
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Objective To investigate the status of invasive fungal infection(IFI)associated with hematopathy,and evaluate drug resistance and risk factors of fungal infection.Methods 1 246 cases of infection occurred in patients in a hospital from 2006 to 2010 were analyzed retrospectively,pathogenic features and risk factors of IFI were ana-lyzed.Results There were 281 cases of fungal infection,and 162 fungal isolates were isolated,the main infection site was respiratory tract(134 isolates,82.72%).Four major Candida were Candida albicans ,Candida tropicalis , Candida glabrata ,and Candida krusei ;in 2006-2009,the main fungi were Candida albicans ,while in 2010,the majority were non-Candida albicans .The resistant rates of four isolated Candida to fluconazole and itraconazole were 5.15% and 4.41 % respectively,6 isolated Candida krusei strains were all resistant to both fluconazole and itraconazole,voriconazole-resistant strain was not found.The independent risk factors for fungal infection were dia-betes and duration time of agranulocytosis>14 days.Conclusion The proportion of infection caused by non-Candi-da albicans increased obviously,fluconazole-and itraconazole-resistant non-Candida albicans strains have emerged, comprehensive measures should be adopted to prevent IFI actively and treat patients early.
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Objectives To explore the effect of the standardized residents training method on intern teaching in department of respiratory. Methods Sixty interns of Grade 2010 from the Second Military Medical School were randomly divided into 2 groups with 30 interns each. The traditional teaching method was adopted in control group, while the standardized residents training method was used in experiment group. When the rotating internship was finished in department of respiratory, the survey of satisfaction about teaching and the assessment of teaching effect were performed in two groups. The contents of examination included academic knowledge exam, clinical skills test, basic skills test and comprehensive quality assessment. Results There was no difference between two groups in academic knowledge exam (P>0.05). The total scores, clinical skills scores and basic skills scores of experiment group were higher than those of control group (P<0.05). And, higher satisfaction was ac-quired in experiment group(P<0.05). Conclusions Using the standardized residents training method can improve the effect of the intern teaching and teaching satisfaction and it can be widely applied in intern teaching.
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<p><b>OBJECTIVE</b>To explore the value of ¹⁸F-FDG PET-CT in evaluating bronchial mucosa involvement in patients with saroidosis.</p><p><b>METHODS</b>A retrospective analysis was conducted among 6 sarcoidosis patients with and 14 patients without bronchial mucosa involvement to collect the data including the standard uptake value (SUVMax/Mean) of ¹⁸F-FDG, serum angiotensin converting enzyme (sACE), and proportion of lymphocytes and CD4⁺/CD8 ⁺ T lymphocyte ratio in bronchoalveolar lavage fluid (BALF).</p><p><b>RESULTS</b>The lung focal SUV(Max/Mean) was higher in patients with bronchial mucosa involvement than those without (7.04 ± 5.83/5.00 ± 4.69 vs 5.68 ± 3.66/3.82 ± 2.39), but such differences were not statistically significant (P=0.565/0.495). The SUV(Max/Mean) of the hilum of the lung and the mediastina lymph nodes were significantly higher in patients with bronchial mucosa involvement (13.28 ± 5.57/10.48 ± 4.43 vs 6.20 ± 1.77/4.52 ± 1.43, P=0.0003/0.0002; 13.84 ± 4.35/9.69 ± 2.74 vs 7.16 ± 2.52/5.28 ± 1.77, P=0.0004/0.0004). The level of sACE and CD4⁺/CD8 ⁺ T lymphocyte ratio in BALF were also significantly higher in patients with bronchial mucosa involvement (60.58 ± 16.3 vs 49.16 ± 13.3 IU/L, P=0.045; 7.30 ± 5.0 vs 2.90 ± 3.1, P=0.026). The proportion of lymphocytes in BALF was comparable between the patients with and without bronchial mucosa involvement (44.10 ± 10.3% vs 35.30 ± 12.5%, P=0.148).</p><p><b>CONCLUSIONS</b>For patients with saroidosis, ¹⁸F-FDG PET-CT is useful in evaluating bronchial mucosa involvement, which is one of the key features of active sarcoidosis.</p>
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Humanos , Brônquios , Patologia , Líquido da Lavagem Broncoalveolar , Relação CD4-CD8 , Fluordesoxiglucose F18 , Linfonodos , Patologia , Peptidil Dipeptidase A , Sangue , Tomografia por Emissão de Pósitrons , Mucosa Respiratória , Patologia , Estudos Retrospectivos , Sarcoidose , DiagnósticoRESUMO
Objective To investigate the effects of dexamethasone on absorption of lung edema in rabbits with seawater drowning-induced acute lung injury.Methods Seawater(4 ml/kg body weight)was instilled into the lower trachea of ventilated and anesthetized rabbits.These rabbits were assigned randomly to receive intravenous injection of 1 mg/ kg body weight of dexamethasone(dexamethasone group,DG)or 2 ml of normal saline(control group,CG).Lung edema was measured by extravascular lung water index(EVLWI)using a gravimetric method.Three hours after treatment, epithelial Na~+ channel subunit-?(?-ENaC)mRNA and Na~+/K~+-adenosine triphosphatase subunit-?l(NKA-?l) protein abundances in lung tissues were respectively measured by reverse transcriptase-polymerase chain reaction and Western blotting,and NKA activity was measured by monitoring the release of inorganic phosphate(Pi)from adenosine triphosphate(ATP).Results The DG's EVLWI was significantly lower than the CG's[(0.508?0.089)vs.(0.648?0.102),P＜0.05)],but the DG's NKA activity,?-ENaC mRNA and NKA-?l protein abundances were significantly higher than the CG's,correspondingly(P＜0.05).Conclusions With up-regulation of the NKA activity and expressions of?-ENaC and NKA-?l,dexamethasone treatment could promote the absorption of lung edema in rabbits with seawater drowing-induced acute lung injury.
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0. 05) . Conclusion Despite immersing in seawater and in freshwater worsen the ALI after open chest trauma,the ALI induced by seawater-immersion is severer than that caused by freshwater-immersion. It is attributed to higher plasma osmotic pressure and abundance of salts after seawater immersion,which increasing the pulmonary penetration index and aggravating the inflammatory response.
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Objective:To observe the therapeutic effects of lung protective ventilation on acute lung injury caused by chest trauma and seawater.Methods: Acute lung injury was induced in 18 healthy dogs by open pneumothorax and seawater and the dogs were then randomly divided into 3 groups: non-treatment group(received no treatment),common treatment group(nasal ventilation,thoracic drianage and intravenous 5% glucose solution) and lung protective ventilation group(mechanical ventilation,thoracic drianage and intravenous 5% glucose solution).Blood samples were taken at different time points to observe the changes of blood gas(PaO_(2),PaCO_(2)and PaO_(2)/FiO_(2)),hemodynamic parameters(heart rate,mean blood pressure,cardiac output) and cytokines(TNF-?,IL-4 and IL-8).Results: After injury,PaO_(2) declined significantly in the dogs,PaO_(2)/FiO_(2) was lower than 300 and the levels of TNF-?,IL-6 and IL-8 were increased obviously.PaO_(2),PaO_(2)/FiO_(2) and TNF-? level were significantly higher in lung protective ventilation group than those in common treatment group(P
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Objective To evaluate the application of mobile ultrasonoscope in earthquake rescue. Methods According to the characteristic of environment and traumatic conditions in earthquake area, the mobile ultrasonoscope was used to diagnose for clinicians, and the advantages and disadvantages were evaluated. Results The mobile ultrasonoscope played an important role in routine diagnosis, such as organic injury and calculus, superficial organellae injury, soft tissue injury, injury of limbs and blood vessels, gynaecology and obstetrics and so on. As far as certain conditions were conferred in which the mobile ultrasonoscope was seldom used to diagnose in common practice, it played a dramatic role too in bone fracture, joint damage, craniocerebral injury and foreign objects. Conclusion In routine diagnosis or certain conditions, the mobile ultrasonoscope is very practical, especially in earthquake rescue.