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ObjectiveTo explore the optimal formula of Maxing Shigantang in regulating epidermal growth factor receptor（EGFR）expression and alleviating airway injury in asthmatic rats and to reveal the underlying mechanism. MethodSD male rats were randomly divided into normal group, model group, dexamethasone group (5×10-4 g·kg-1) and Maxing Shigantang 1∶0.5, 1∶1, 1∶2 groups (group A, B, C, 10 g·kg-1), with 8 rats in each group. The other groups except the normal group received nebulization of 2% acetylcholine chloride and 0.4% histamine phosphate for the modeling of asthma. One hour before modeling， the normal group and the model group were given the same amount of normal saline， and the other groups were given the same amount of corresponding drugs， once a day for 7 days. On the 7th day， the model was established and the incubation period of asthma was recorded. The rats were then immediately anesthetized， and arterial blood and tracheal tissue were collected. Enzyme-linked immunosorbent assay （ELISA） was employed to detect the levels of interleukin-2 （IL-2）， interleukin-4 （IL-4）， and tumor necrosis factor-α （TNF-α） in serum. Pathological sections were prepared for the observation of the pathological changes of tracheal tissues and the ultrastructure of epithelial cells in each group. Terminal-deoxynucleotidyl transferase-mediated nick-end labeling （TUNEL） was adopted to detect epithelial cell apoptosis， and in situ hybridization and Western blot were employed to determine the mRNA and protein levels of epidermal growth factor receptor （EGFR）， respectively. ResultCompared with the model group， groups A， B and C prolonged the incubation period of asthma （P<0.05，P<0.01）. Compared with the control group， the model group showed declined IL-2 level （P<0.01）， risen IL-4 and TNF-α levels （P<0.05，P<0.01）， increased airway pathology score， collagen volume fraction， and airway epithelial cell apoptosis index （P<0.01）， and up-regulated mRNA and protein levels of EGFR in trachea tissue （P<0.01）. Compared with the model group， group A showed increased IL-2 level （P<0.05） and declined IL-4 （P<0.05，P<0.01） level， and group B showed declined IL-4 level （P<0.05）. The level of TNF-α in groups A， B， and C declined compared with that in the model group （P<0.01）. Maxing Shigantang repaired the tracheal tissue to different degrees （P<0.05）. Among the three groups， group A inhibited tracheal fibrosis （P<0.05） and had the most significant effect of repairing the ultrastructural changes of airway epithelial cells. Groups A， B and C all inhibited the apoptosis of airway epithelial cells （P<0.05）. All the three groups inhibited the up-regulation of EGFR mRNA level （P<0.05，P<0.01）， and groups B and C inhibited the up-regulation of EGFR protein level （P<0.05，P<0.01）. ConclusionMaxing Shigantang can inhibit the abnormal changes of airway epithelial structure， alleviate airway injury， and can down-regulate the expression of EGFR in the tracheal tissue of asthma model rats. In this study， the optimal compatibility of Maxing Shigantang to repair airway epithelial injury in asthmatic rats was group A， with the Ephedrae Herba-Armeniacae Semen Amarum-Glycyrrhizae Radix et Rhizoma-Gypsum Fibrosum ratio of 1∶0.5∶4∶1.
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Objectves To investigate the effectiveness and safety of bronchoalveolar lavage for the treatment of neonatal pulmonary atelectasis under ultrasound monitoring.Methods Thirty-two neonates diagnosed with pulmonary atelectasis by lung ultrasound,and hospitalized in the Neonatal Intensive Care Unit of Bayi Children's Hospital,the General Hospital of the Chinese People's Liberation Army between July 2014 and June 2016,were included in this study.Bronchoalveolar lavage was performed in all the patients by injection of lavage fluid (0.9％ NaC1 or 0.9％ NaCl plus ambroxol hydrochloride and/or exogenous pulmonary surfactant) 1.5 to 3.0 ml via tracheal intubation.Lung ultrasonography was performed immediately after each lavage to reveal the status of lung recruitment.Repeated lavage one to three times made up of one course of treatment.The bronchoalveolar lavage could be performed for one to two courses daily according to the status of atelectasis recovery.Medical records were reviewed to analyze descriptively the effectiveness,side effects and complications of the bronchoalveolar lavage.Results Bronchoalveolar lavage was significantly effective in 25 patients (78.1％) with disappearance of pulmonary atelectasis after one course of treatment;effective in five cases (15.6％) with disappearance or reduction of atelectasis after two or three courses;with a total effectiveness rate of 93.8％(30/32).Bronchoalveolar lavage was ineffective in two cases (6.2％) with no remarkable change in atelectasis after three courses of treatment.Vital signs were stable in all the infants during the bronchoalveolar lavage,and no adverse effects and complications occurred.Conclusions Bronchoalveolar lavage is effective for the treatment of neonatal pulmonary atelectasis under ultrasound monitoring,and it is easy to operate and with no adverse effects and complications,and thus worth of clinical application.
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<p><b>OBJECTIVE</b>To observe therapeutic effect of electroacupuncture (EA) at Jiaji (EX-B 2) combined with laser needle-knife on lumbar disc herniation.</p><p><b>METHODS</b>One hundred and twenty cases of lumbar disc herniation were divided into an Jiaji EA group, a laser needle-knife group and a combination group (Jiaji EA plus laser needle-knife) according to random number table. Changes of symptoms at different stages before and after treatment were investigated with SF-MPQ cumulative scores.</p><p><b>RESULTS</b>All the 115 cases completed all of the study, SF-MPQ score in the combination group was significantly lower than those in the Jiaji EA group and the laser needle-knife group (P<0. 01, P<0.05), with a significant difference at the end of treatment of 2 weeks (P<0.01) between the laser needle-knife group and the Jiaji EA group, and with no significant difference at treatment of 1 week and 3 weeks (P>0.05). The recurrence rate at a half year later in the combination group was significantly lower than those in laser needle-knife group and the Jiaji EA group (P<0.05).</p><p><b>CONCLUSION</b>EA at Jiaji (EX-B 2) combined with laser needle-knife can significantly increase clinical therapeutic effect, alleviate pain of the patient and reduce recurrence.</p>