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Objective: To observe the effect of captopril on the tumor necrosis factor-α (TNF-α) level and arterial blood gases in acute lung injury (ALI) induced by HCL in rats, and to analyze its protective mechanism. Methods: Fifty Wistar rats were selected and randomly divided into three groups, with 20 rats in Group I and II, respectively and 10 animals in Group III. ALI model was constructed by intratracheal injection of diluted hydrochloric acid (pH=1.25, 1.2 mL/kg). Group I rats received not any treatment after construction of ALI model. Group II rats were treated with captopril (5 mg/kg, i.p.) 5 min after induction of ALI. Group III served as normal control without any treatment. Ninety minutes after construction of ALI model, all the rats were sacrificed. Blood was withdrawn for detection of TNF-α level and arterial blood gases index. And lung tissue slices of the three groups were prepared for observation of pathologic histology changes. Results: TNF-α level in serum of Group I and II rats was significantly higher than that in Group III (P<0.05), while TNF-α level in serum of Group II was significantly lower in Group I (P<0.05). PaCO
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OBJECTIVE@#To observe the effect of captopril on the tumor necrosis factor-α (TNF-α) level and arterial blood gases in acute lung injury (ALI) induced by HCL in rats, and to analyze its protective mechanism.@*METHODS@#Fifty Wistar rats were selected and randomly divided into three groups, with 20 rats in Group I and II, respectively and 10 animals in Group III. ALI model was constructed by intratracheal injection of diluted hydrochloric acid (pH=1.25, 1.2 mL/kg). Group I rats received not any treatment after construction of ALI model. Group II rats were treated with captopril (5 mg/kg, i.p.) 5 min after induction of ALI. Group III served as normal control without any treatment. Ninety minutes after construction of ALI model, all the rats were sacrificed. Blood was withdrawn for detection of TNF-α level and arterial blood gases index. And lung tissue slices of the three groups were prepared for observation of pathologic histology changes.@*RESULTS@#TNF-α level in serum of Group I and II rats was significantly higher than that in Group III (P<0.05), while TNF-α level in serum of Group II was significantly lower in Group I (P<0.05). PaCO2 level was significantly higher (P<0.05), while PaO2 was significantly lower (P<0.05) in Group I and II rats than those in Group III. PaCO2 was significantly lower (P<0.05) and PaO2 was significantly higher (P<0.05) in Group II than those in Group I. Histological observation showed diffuse congestion and severe edema of lung tissue, obvious thickening and structure damage of alveolar walls and a large amount of neutrophil infiltration in Group I rats. Group II rats showed mild edema of lung tissue; only a small portion of alveolar walls showed thickening and only a few of neutrophil infiltration could be observed. The degree of injury was remarkably slighter than that of Group I rats. Group III rats showed clear lung tissue structure and normal morphology; alveolar walls were uniform and the margin was smooth and few neutrophil could be observed.@*CONCLUSIONS@#Captopril can significantly reduce serum TNF-α level, elevate PaO2 and reduce PaCO2 in rats with ALI. It has a protective effect on ALI rats.
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<p><b>BACKGROUND</b>Cervicogenic headache (CEH) is caused by a structural abnormality in the cervical spine. Available treatments for CEH include medical therapy, local botulinum toxin injection, cervical epidural corticosteroid injection, and surgery. The objective of this study was to investigate the safety and efficacy of a continuous epidural block of the cervical vertebra.</p><p><b>METHODS</b>Medical records were retrospectively analyzed for 37 patients diagnosed with CEH treated by a continuous epidural block of the cervical vertebra with lidocaine, dexamethasone, and saline (5 ml/min) for 3 - 4 weeks and triamcinolone acetonide 5 mg once weekly for 3 - 4 weeks. Pain was measured via the visual analogue scale (VAS) in combination with quality of life assessment. Outcome measures were patient-reported days with mild or moderate pain, occurrence of severe pain, and the daily oral dosages of non-steroidal anti-inflammatory drug use (NSAID).</p><p><b>RESULTS</b>In the 3 months immediately preceding placement of the epidural catheter, the mean number of days with mild or moderate pain was 22.0 +/- 4.3. The mean occurrence of severe pain was (3.20 +/- 0.75) times and the mean oral dosage of NSAID was (1267 +/- 325) mg. During the first 6 months after epidural administration of lidocaine and corticosteroids, the mean number of days with mild or moderate pain, the mean occurrence of severe pain, and the mean daily oral dosages of NSAIDs were significantly decreased compared to 3-month period immediately preceding treatment (P < 0.01). By 12 months post-treatment, no significant difference in these three outcome measures was noted.</p><p><b>CONCLUSIONS</b>Continuous epidural block of the cervical vertebra for patients with CEH is effective for at least six months. Further research is needed to elucidate mechanisms of action and to prolong this effect.</p>