Objective To study the effects of edaravone on the lung injury of severe acute pancreatitis （SAP） in rats. Methods Thirty-six SD rats were randomly divided into three groups: normal control group, model group and edaravone group, and SAP was induced by intraductal administration of 5% sodium taurocholate. Edaravone was given in edaravone group, while normal saline was given in normal control group and model group. After operation 6 h rats were executed, and dry/wet weight (D/W) ratio of lung was counted, and malondialdehyde (MDA) content, superoxide dismutase (SOD) activity in serum and lung were detected, respectively. In addition, the levels of tumor necrosis factor-α (TNF-α), interleukin-1, -6 (IL-1, -6) of serum were detected.Results The MDA contentof serum and lung and the levels of TNF-α, IL-1, IL-6 in model group were markedly higher than those in normal control group and edaravone group, but D/W ratio of lung, SOD activity of serum and lung were significantly lower (Plt;0.05). Conclusion Edaravone can alleviate lung injury of rats caused by SAP.
Because lung tissues have no the capacity of regeneration, it is difficult to cure for lung diseases. At present, it is known that bone marrow derived stem cells are able to differentiate into lung tissue cells directionally, bone marrow derived stem cells are engrafted into the injured lung tissues,and induced to differentiate into alveolar epithelial cells, and further develop alveolar tissue. This is a promised therapeutic tool, but it still is the basal research stage.Now we will review engraftment of bone marrow derived stem cell in various kinds of lung disease model.
Objective To investigate the protective effects of endotoxin pretreatment on lung injury of rats with endotoxemia. Methods The rat model of acute endotoxemia was established by injecting lipopolysaccharide (LPS) intraperitoneally. Seventy-two male Wistar rats were randomly divided into three groups, ie. a saline control group (N, n=24) , a LPS-treated group (L, n=24) , and a LPS pretreated group ( P, n=24) . Each group was divided into 2 h, 4 h, 6 h, and 12 h subgroups. The rats in group P were firstly administered with introperitoneal injection of 0.25 mg/kg LPS. After 24 hours, they were subjected to the injection of 0.5 mg/kg LPS. The rats in group N and L received injection of equivalent amount of saline. After 72 hours, the rats in group L and P were challenged with intravenous injection of 10 mg/kg LPS, otherwise saline in group N. Six rats were killed at 2, 4, 6 and 12 hours respectively after injection of LPS in group L and P. The lungs were removed for detecting intercellular adhesion molecule-1 ( ICAM-1) , superoxide dismutase ( SOD) , and malondialdehyde (MDA) . Meanwhile the level of tumor necrosis factoralpha ( TNF-α) in serum was measured, and the pathological changes of lung were also examined. Results The contents of ICAM-1, MDA and TNF-α in the LPS-treated 4 h group were 75.07 ±0. 53, ( 3.93 ± 0.42) μmol/g, and (478.62 ±45.58) pg/mL respectively, significantly higher than those in the saline control group. The endotoxin pretreatment reduced the above indexes to 42.40 ±0.44, ( 2.89 ±0.49) μmol / g and ( 376.76 ±43.67) pg/mL respectively (Plt;0.05) . The content of SOD in the LPS-treated 4 h group was ( 6.26 ±0.31) U/mg, significantly lower than that in the saline control group. The endotoxin pretreatment increased SOD to ( 8.79 ±0.35) U/mg. Conclusion Endotoxin pretreatment can suppress the progress of lung injury in rats with endotoxemia and protect the lung tissue by down-regulating the inflammatory response and oxygen free radical production.
ObjectiveTo discuss the risk factors of acute respiratory distress syndrome (ARDS) in patients with severe pneumonia.MethodsData of 80 patients with severe pneumonia admitted in our ICU were analyzed retrospectively, and they were divided into two groups according to development of ARDS, which was defined according to the Berlin new definition. The age, gender, weight, Acute Physiology and Chronic Health EvaluationⅡscore, lactate, PSI score and LIPS score, etc. were collected. Statistical significance results were evaluated by multivariate logistic regression analysis after univariate analysis. Receiver operating characteristic (ROC) curve was plotted to analyze the predictive value of the parameter for ARDS after severe pneumonia.ResultsForty patients with severe pneumonia progressed to ARDS, there were 4 moderate cases and 36 severe cases according to diagnostic criteria. Univariate analysis showed that procalcitonin (t=4.08, P<0.001), PSI score (t=10.67, P<0.001), LIPS score (t=5.14, P<0.001), shock (χ2=11.11, P<0.001), albumin level (t=3.34, P=0.001) were related to ARDS. Multivariate logistic regression analysis showed that LIPS ［odds ratio (OR) 0.226, 95%CI=4.62-5.53, P=0.013］ and PSI (OR=0.854, 95%CI=132.2-145.5, P=0.014) were independent risk factors for ARDS. The predictive value of LIPS and PSI in ARDS occurrence was significant. The area under ROC curve (AUC) of LIPS was 0.901, the cut-off value was 7.2, when LIPS ≥7.2, the sensitivity and specificity were both 85.0%. AUC of PSI was 0.947, the cut-off value was 150.5, when PSI score ≥150.5, the sensitivity and specificity were 87.5% and 90.0% respectively.ConclusionsPSI and LIPS are independent risk factors of ARDS in patients with severe pneumonia, which may be references for guiding clinicians to make an early diagnosis and treatment plan.
ObjectiveTo investigate the expression of C/EBP homologous protein (CHOP) in lung tissue of chronic intermittent hypoxia rats, and explore the intervention effect of edaravone and its possible mechanism.MethodsA total of 120 adult male Wistar rats were randomly divided into three groups: a normal control group (UC group), a chronic intermittent hypoxia group (CIH group), an edaravone intervention group (NE group), and a normal saline group (NS group). The above four groups were also randomly divided into five time subgroups of 3 days, 7 days, 14 days, 21 days and 28 days, respectively, with 6 rats in each time subgroup. The histopathological changes of lung tissue were observed by hematoxylin-eosin (HE) staining and the expression of CHOP in lung tissue was detected by immunohistochemical method.ResultsHE staining results showed that there was no obvious pathological change in UC group. The epithelial cells of lung tissue in CIH group showed edema, hyperemia, widening of alveolar septum and inflammatory cell infiltration. The pathological injury was more serious with the prolongation of intermittent hypoxia time. There were also pathological changes in NE group, but the degree of lung tissue injury was significantly lower than that in CIH group. The results of immunohistochemistry showed that the expression of CHOP in CIH group was significantly higher than that in UC group. The expression of CHOP in NE group was higher than that in UC group, but it was still significantly lower than that in CIH group.ConclusionsThe expression of CHOP protein in lung tissue of chronic intermittent hypoxic rats is enhanced and the high expression of CHOP protein plays a certain role in the lung injury of chronic intermittent hypoxia rats complicated with lung injury. Edaravone may protect lung tissue from chronic intermittent hypoxia by inhibiting the expression of CHOP.
Objective To explore the effects of exogenous ubiquitin on lung injury and serum nitric oxide ( NO) level of mice in the early stage of sepsis induced by cecal ligation and perforation ( CLP) . Methods Seventy-seven mice were devided randomly into three groups, ie. CLP Group ( n =28) , SHAM Group ( n =28) and UB Group( n = 21) . Six hours after operation, seven mice of both Group CLP and SHAM were sacrificed for lung and blood sampling. Meanwhile all mice of Group UB were injected intravenously with exogenous ubiquitin of 10 mg/kg body weight. Seven mice of each group were sacrificed at seven, eight and nine hours after operation. Lung water content and serum level of nitrate /nitrite ( NO2 /NO3 , the stable end-products of NO) , were determined. Pathological changes of lung were compared among the groups. Results Lung water content of Group UB was lower than that of Group CLP at each observational time point. Futhermore, there was a significant differentce in lung water content between Group UB and CLP at 9 hours. Pathological examination revealed that inflammatory hyperemia and infiltration of pulmonary parenchyma reduced in Group UB, compared with Group CLP. Serum NO levels of Group CLP and UB were similar at each time point. Conclusions In the early stage of murine sepsis induced by CLP, a single introvenous bolus of exogenous ubiquitin significantly decreases lung capillary vascular permeability, and probably makes a temporal reduction of acute lung injury while it has no obvious effects on serumNO level.
Objective To investigate the effects of mechanical ventilation on lung pathology and concentration of proinflammatory cytokines in rats.Methods Forty-five healthy Sprague-Dawley rats were randomly divided into three groups with 15 rats each group，ie.a control group(No mechanical ventilation)，a high tidal volume group(VT 34 mL/kg，RR 30 bpm) and low tidal volume group(VT 8 mL/kg，RR 60 bpm).Results There were enlarged alveolar spaces，interalveolar septum collapse，swollen and spotty hemorrhages，inflammatory cell infiltration in the ventilation groups，which was more serious in the high tidal volume group.Lung wet-to-dry weight ratio of high tidal volume group was significantly higher than that of other groups（both Plt;0.05）.The concentrations in both macrophage-inflammatory protein-2（MIP-2）and tumor necrosis factor-α(TNF-α) of bronchoalveolar lavage fluid(BALF) and blood samples was significantly higher in two ventilation groups than the control group（Plt;0.05），which were higer in the high tidal volume group than in the low tidal volume group（Plt;0.05）.Conclusions These results indicate that mechanical ventilation can cause lung injury，which is more serious in high tidal volume ventilation.And mechanical ventilation-induced lung injury can cause proinflammatory cytokines release，with different levels in bronchoalveolar lavage fluid and blood samples.
Objective To evaluate the effect of exogenous pulmonary surfactant(PS) replacement therapy for infants who suffered pulmonary injury after cardiopulmonary bypass. Methods Seven infants (age 0.49±0 82 year, weight 4.87±2.18kg) who depended on respiratory mechanical support with clinical and radiological evidence of pulmonary surfactant sufficiency were enrolled in the study. Oxygen index(OI), artery oxygen saturation(SaO 2) and artery bicarbonate pressure(PaCO 2) were measured at 4, 6, 12, 24, 48, and 72 h after the first application of PS(100mg/kg). At the meantime, maximum spontaneous respiratory tidal volume, chest X ray changes and ventilator time were recorded. Results Compared to the baseline values, OI and SaO 2 increased significantly 4 h after PS therapy, with a maximal increase slope (34.7%, 6.6%) after 24 h. While PaCO 2 decreased significantly 4 h after PS therapy, with a lowest decrease slope (22.8%) after 6 h ( P lt;0.05, 0.01). Spontaneous tidal volume and chest X ray si...更多gn were improved in all infants. The success rate of extubation was 85 7%. Conclusion Exogenous PS replacement therapy could improve pulmonary function for postoperative infants, and highly decrease the ventilator time.
ObjectiveTo explore the clinical value of three early predictive scale of lung injury (ALI) in patients with high risk of acute lung injury (ALI) after lung cancer surgery.MethodsA convenient sampling method was used in this study. A retrospective analysis was performed on patients with lung cancer underwent lung surgery. The patients were divided into an ALI group and a non-ALI group according to ALI diagnostic criteria. Three kinds of lung injury predictive scoring methods were used, including lung injury prediction score (LIPS), surgical lung injury prediction (SLIP) and SLIP-2. The differences in the scores of the two groups were compared. The correlation between the three scoring methods was also analyzed. The diagnostic value was analyzed by drawing receiver operating characteristic (ROC) curves.ResultsA total of 400 patients underwent lung cancer surgery, and 38 patients (9.5%) developed ALI after operation. Among them, 2 cases progressed to acute respiratory distress syndrome and were treated in intensive care unit. There were no deaths. The predictive scores of the patients in the ALI group were higher than those in the non-ALI group, and the difference was statistically significant (all P<0.001). There was a good correlation between the three scoring methods (allP<0.001). The three scoring methods had better diagnostic value for early prediction of high risk ALI patients after lung cancer surgery and their area under ROC curve (AUC) were larger than 0.8. LIPS score performed better than others, with an AUC of 0.833, 95%CI (0.79, 0.87).ConclusionThree predictive scoring methods may be applied to early prediction of high risk ALI patients after lung cancer surgery, in which LIPS performs better than others.
