Objective To observe the eotaxin expression of rat airway smooth muscle cells ( ASMCs) induced by serum from asthmatic rats, and explore the possible mechanism. Methods ASMCs isolated fromrat tracheas were cultured in vivo. Then they were treated with serum from asthmatic rats, or treated with serum and dexamethasone simultaneously. The level of eotaxin protein in supernatant and eotaxin mRNA in ASMCs were measured by ELISA and reverse transcription-polymerase chain reaction. The expression of cAMP in ASMCs was examined by radioimmunoassay. Results After the treatment with sensitized serum, the eotaxin level in supernatant and mRNA expression in ASMCs were significantly higher [ ( 107. 09 ±7. 12) ng/L vs. ( 0. 63 ±0. 56) ng/L, P lt; 0. 05; 1. 39 ±0. 04 vs. 0. 05 ±0. 01, P lt;0. 05] , and the level of cAMP in ASMCs was significantly lower compared with the control group [ ( 17. 58 ±3. 62) ng/L vs. ( 32. 39 ±3. 36) ng/L, P lt; 0. 05] . After intervened by the sensitized serum and dexamethasone simultaneously, the protein and mRNA expressions of eotaxin were lower compared with those intervened by sensitized serumalone [ ( 64. 18 ±4. 04) ng/L and 0. 77 ±0. 19] . The level of eotaxin in supernatant was negatively correlated with cAMP level in ASMCs ( r = - 0. 788, P lt; 0. 01) . Conclusions There is anautocrine function in ASMCs as inflammatory cells after stimulation with sensitized serum. Eotaxin may play an important roll in the pathogenesis of asthma via a cAMP-dependent pathway.
ObjectiveTo investigate the clinical effect of combined air pressure wave and oral glucosamine in the treatment of knee osteoarthritis. MethodsWe chose 200 patients with knee osteoarthritis treated in the Department of Rehabilitation between April 2013 and March 2015 as our research subjects. The patients were randomly divided into observation group and control group with 100 in each. The control group accepted conventional physical therapy, while the observation group underwent normal physical therapy in combination with air pressure wave and oral glucosamine treatment. We compared the two groups in terms of curative effects. ResultsThe total effective rate was not significantly different between the two groups (P＞0.05) , but in terms of efficiency rate, the observation group (85.0%) was significantly superior to the control group (73.0%) (P ＜ 0.05) . ConclusionCombined air pressure wave and oral glucosamine treatment for knee osteoarthritis is high efficient, which is worthy of being popularized.
Pneumothorax and pulmonary air leakage are common emergency and complication in department of thoracic surgery. The treatment measures of air leakage include conservative observation, needle aspiration, chest tube drainage, surgical operation, and pleurodesis. In selection of treatment methods, there is no unified and feasible standard to choose a reasonable, effective and economic therapeutic regimen. Inapposite treatment will prolong hospitalization days, increase cost, even may lead to death. Therefore, sorting out and summarizing the therapies is vitally important for clinical conduction. We retrieved about 80 reports in PubMed, Sciencedirect, and CNKI while we searched "pneumothorax" or "lung air leakage" and "treatment" as key words or title in recent ten years. We review and summarize the selection and development of them.
At present, tamponade agent which being used in retinal surgery is mainly sterile air, gas and silicone oil. Sterile air is mostly used in the treatment of simple retinal detachment. Gas or silicone oil as tamponade is greatly applied for complicated retinal detachment. In recent years, with the application of micro-invasive vitrectomy under a wide-angle viewing system and perioperative anti-vascular endothelial growth factor drugs, application of intraocular filling materials also has changed. The application of silicone oil is significantly reduced. Percentage rate of gas as tamponade for retinal detachment is reduced. The application of sterile air as tamponade is rising. With selecting indication carefully and picking up the suitable air or gas, doctor will reduce the workload. It will also reduce the social burden and benefit patients.
ObjectiveTo observe the effect of metformin on airway remodeling in asthma and its possible mechanism.MethodsTwenty-eight B/N rats were randomly divided into control group, asthma group, metformin intervention group and rapamycin intervention group. After that, the asthma model was established and intervened with metformin and rapamycin. The airway resistance and airway reactivity were measured 48 hours after the last challenge, and then the lung tissue samples were collected. Histopathological examination was used to observe airway inflammatory cell infiltration, goblet cell proliferation, airway wall fibrosis and remodeling, as well as airway smooth muscle proliferation. The expression of AMPK/mTOR pathway related proteins was detected by Western blot.ResultsCompared with the asthma group, metformin and rapamycin significantly reduced the airway responsiveness induced by high concentration of acetylcholine (P<0.05), reduced the infiltration of inflammatory cells in lung tissue and the changes of airway wall structure (P<0.05), reduced goblet cell proliferation in airway epithelium, collagen fiber deposition in lung tissue and bronchial smooth muscle hyperplasia (P<0.05). Further studies showed that the effects of metformin and rapamycin were related to AMPK/mTOR pathway. Compared with the asthma group, metformin and rapamycin could significantly reduce the expression of p-mTOR, p-p70s6k1 and SKP2, while p21 protein expression was significantly increased (P<0.05). In addition, metformin and rapamycin had similar effects (P>0.05).ConclusionMetformin can alleviate airway hyperresponsiveness and airway remodeling by activating AMPK and then inhibiting mTOR pathway, which may be a potential drug for treating asthma and preventing airway remodeling.
Objective To investigate the application of air leak test combined with methylene blue solution leak test in the detection of anastomotic leakage after total mesorectal excision （TME） in rectal cancer. Methods In total of132 patients with rectal cancer underwent Dixon according to TME in our hospital from Mar. 2010 to Mar. 2013 were enrolled. All patients were randomly divided into air leak test group （n=65） and air leak＋methylene blue solution leak test group （n=67）. The intestinal anastomosis of patients in air leak test group were clamped at 2 cm from the upper endof bowel， then injecting 500 mL distilled water to pelvic， and placing 24# Foley catheter through the anus. The catheter balloon was injected with water to close anus， and then injected with 50 mL gas to find the anastomotic leakage where bubbles happened， and then repaired it. Patients of air leak＋methylene blue solution leak test group were treated with methylene blue solution test in addition. After sucking out of the distilled water in pelvic and gas in the rectum， 1 bottle of methylene blue solution （20 mg） and 50 mL saline were injected， observing the location where the methylene blue solutionleaking out and repaired it. Results Three cases （4.62%） of anastomotic leakage were found during operation in air leak test group， and 9 cases （13.85%） were found after operation. Of the 9 cases， 5 cases were cured with placement of adeq-uate drainage and symptomatic treatment， 3 cases were cured with anal patch， and 1 case was cured with transverse colon fistula and drainage. In total of 15 cases （22.39%） were found anastomotic leakage， 2 cases of them were found by air leak test and another 13 cases were found by methylene blue solution leak test during operation in air leak＋methylene bluesolution leak test group， but no one suffered anastomotic leakage after operation. Compared with air test group， detectionrate of anastomotic leakage during operation was higher （P＜0.05）， and incidence rate of anastomotic leakage after opera-tion was lower in air leak＋methylene blue solution leak test group （P＜0.05）. Conclusions Large anastomotic leakage can be found by using air leak test， and small and hidden leakage can be found by using methylene blue solution leak test， combination method of the two experiments is better. Repair can be performed effectively under direct vision.
ObjectiveTo compare the effects of different airway management strategies on outcomes of patients with out-of-hospital cardiac arrest (OHCA).MethodsWe searched PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and WanFang Data for relevant studies comparing the influence of different airway management strategies on outcomes of OHCA patients. The deadline was up to 31st May, 2019. Grading of Recommendations Assessment, Development and Evaluation system 3.6 was used for quality assessment, and RevMan 5.3 software was used for meta-analysis. Odds ratio (OR) and 95% confidence interval (CI) were used to conduct the comparison. Results A total of 20 studies were finally enrolled, including 880 567 OHCA patients. Compared with supraglottic airway (SGA), bag-valve mask (BVM) improved the rate of survival to discharge of OHCA patients [OR=1.45, 95%CI (1.01, 2.08), P=0.04], while the rate of return of spontaneous circulation (ROSC) was not improved (P>0.05); in the subgroup analysis, BVM and SGA had similar effect on the rate of ROSC and the rate of survival to discharge in Asian countries (P>0.05), while BVM performed better than SGA in the two rates in European and American countries. BVM and endotracheal intubation (ETI) had similar effect on the two rates (P>0.05). In Asian countries, ETI performed better than BVM in the rate of ROSC [OR=0.63, 95%CI (0.49, 0.81), P=0.000 3], and there was no statistically significant difference in the rate of survival to discharge between ETI and BVM (P>0.05); while in European andAmerican countries, BVM performed better than ETI in the rate of survival to discharge [OR=3.10, 95%CI (2.69, 3.56), P<0.000 01], and there was no statistically significant difference in the rate of ROSC between ETI and BVM (P>0.05). Compared with SGA, ETI improved the rate of ROSC [OR=0.68, 95%CI (0.62, 0.76), P<0.000 01] and the rate of survival to discharge [OR=0.89, 95%CI (0.81, 0.98), P=0.02]. In Asian countries, ETI performed better than SGA in the two rates (P<0.05); while in European and American countries and New Zealand, ETI performed better than SGA in the rate of ROSC (P<0.05), but there was no statistically significant difference in the rate of survival to discharge (P>0.05). Conclusions Different airway management strategies have differente effects on OHCA patients. The optimal airway management strategy when rescuing OHCA patients might be selected based on local emergency medical service system conditions.
Objective To identify the short ( lt;30 days) and intermediate ( 30 days to 6 months) benefits and risks of tracheobronchial stents in patients with malignant airway stenosis. Methods 55 cases with malignant airway disease who underwent tracheobronchial stents placement from January 2006 to May 2008 were followed up for 6 months. The efficacy rate, complication rate, reintervention rate, and survival were analyzed. Results There were 61 self-expanding metal stents placed in 55 patients with malignant disease, with no intraoperative mortality. The immediate efficacy rate was 100% , the short-term( lt;30 days) efficacy rate was 94. 5% , and the survival rate in 6 months was 32. 7% . The complications included tumor ingrowth, excessive granulation tissue, stent migration, and restenosis. A total of 14 cases of complicationswere observed, in which two occurred during the short-term period ( lt; 30 days ) and the remaining complications occurred after 30 days. Conclusions Tracheobronchial stents can improve symptoms immediately for the patients with unresectable malignant central airway obstruction with fairly safety. The benefit of airway stents is particularly seen in the short-termperiod and the complications occur mainly after 30 days.
ObjectiveTo study immunodepression effect of bone marrow-derived mesenchymal stem cell (BMSC) on acute asthmatic airway inflammation by galectin-1 (gal-1) in vivo.MethodsEighty-five female BALB/c mice were equally randomized into normal control group, asthmatic group, BMSC treatment group, gal-1 treatment group and BMSC and gal-1 inhibitor group. Ovalbumin (OVA) was used to establish acute asthmatic model. Total cell number and differential cell analysis in each group in bronchoalveolar lavage fluid (BALF) were determined. Furthermore, hematoxylin-eosin and periodic-acid Schiff staining was used to compare airway inflammation among five groups. Measurement of cytokines, including interleukin (IL) -4, IL-5 and gal-1 in BALF and OVA specific IgE (OVA-IgE) in serum were evaluated by enzyme linked immunosorbent assay. Moreover, dendritic cell (DC) in lung tissue was sorted by immunomagnetic beads and its MAPK signal pathway was analyzed by western blotting among five groups.ResultsAccumulation of inflammation cells, particularly eosinophils around airway and in BALF was evident in asthmatic mouse model, meanwhile hyperplasia of Goblet cell was also obvious in asthmatic group. BMSC engraftment or gal-1 infusion significantly reduced airway inflammation and hyperplasia of Goblet cell and the number of inflammation cells in BALF, especially eosinophils attenuated dramatically. However, there was no effect on airway inflammation and hyperplasia of Goblet Cell by simultaneous infusion BMSC engraftment and gal-1 inhibitor. Compared to normal control group, the level of IL-4, IL-5 in BALF and OVA-IgE in serum was increased remarkably in asthmatic group, but the level of gal-1 reduced obviously. Moreover, infusion of BMSC or gal-1 could mitigate the level of IL-4, IL-5 in BALF and OVA-IgE in serum and increase the level of gal-1 in asthmatic mouse. However, infusion with both BMSC and gal-1 inhibitor exerted no effect on cytokine and OVA-IgE in asthmatic mouse. DC was sorted by immunomagnetic beads and western blotting was used to detect the expression of MAPK signal pathway among five groups. The expression of ERK phosphorylation in asthmatic group was much lower than that in normal control group. On the contrary, the expression of p38 phosphorylation was much higher than that in normal control group. BMSC engraftment or gal-1 infusion significantly activated the ERK pathway and inhibited the p38 MARP pathway on asthmatic mouse DC. Nevertheless, the expression of ERK phosphorylation and p38 phosphorylation for group with BMSC and gal-1 inhibitor infusion was between the level of asthmatic group and normal control group.ConclusionsBMSC infusion alleviates airway inflammation in asthmatic mouse, especially weakens eosinophils infiltration, and the underlying mechanism might be protective effect of gal-1 secreted by BMSC which plays a role in lung tissue DC and regulates the DC expression of MAPK signal pathway.
ObjectivesTo investigate the prevalence of respiratory diseases and lung function of school-age children in Chongqing and to compare them with that of children in 25 years ago and to explore the possible causes of this change.MethodsAccording to the air quality data of Chongqing from 1998 to 2016, the annual variation of air quality days and pollutant concentrations were plotted. 2 126 school-age children in two districts of Chongqing were selected by random cluster sampling for questionnaires. 771 children were randomly selected from the children who completed the questionnaire for pulmonary function tests. The results were compared with that of 25 years ago.ResultsFrom 1998 to 2016, the number of days with good air quality in Chongqing increased annually, and the concentration of SO2 decreased significantly. The main air pollution composition changed from SO2 to PM10 and PM2.5. The prevalence of bronchitis (P<0.05) was higher than that of 25 years ago. After adjusting for confounding factors by multivariate logistic regression, the OR value of bronchitis in children was 1.667 (P<0.05) compared with 25 years ago. After adjusting for age, sex, height and weight by multiple linear regression, the results showed that the subjects' lung function indexes (FVC, FEV1, PEF and FEV3) were lower than that of 25 years ago. In this survey, there were differences in lung function indexes between children with different frequency of eating fruits and dairy products (P<0.05), and those with high frequency consumption were higher than low frequency. In terms of exercise time, subjects exercising ≥1 hour/day had greater FVC and FEV3 values than those exercising <1 hour/day (P<0.05).ConclusionsThe overall air quality in Chongqing has improved from 1998 to 2016; The respiratory health of children has decreased when compared with that of 25 years ago. Changes in the composition of air pollutants may endanger children's respiratory health, and fruit and dairy foods and exercise may be protective factors for children's respiratory health.