Clinical scientists have paid more and more attention to the acute respiratory distress syndrome(ARDS), a severe complication after thoracotomy, for its high mortality rate. Compared with other surgical patients, patients who received thoracotomy often have a worse cardiopulmonary function and are prone to suffering from ARDS. Surgical treatment or injury, massive blood transfusion, respiratory tract infection, improper fluid replacement and ventilation are probable reasons to cause ARDS. Mechanical ventilation is an important treatment for ARDS，but ventilation with lungprotective strategies was proved to be the only therapy which can improve the prognosis of patients with ARDS. At present, thinking highly of and promoting the perioperative management, lessening surgical injury and active prevention are still very important measures to reduce the mortality after thoracotomy. This article is aimed to review the high risk factors of ARDS after thoracotomy as well as its treatment.
Objective To identify the effects of single immunoglobin IL-1 receptor related protein （SIGIRR） on inflammation induced by high mobility group box 1 （HMGB1） in A549 derived from human alveolar epithelial cells. Methods Eukaryotic expression vectors pCDNA3.1（+） constructed with SIGIRR cDNA were transiently transfected into A549 cells，in which SIGIRR was forced to be over-expressed. Western blot and RT-PCR were applied to detect the expression level of SIGIRR after transfection. After the stimulation by HMGB1，the transcriptional activity of NF-κB in A549 cells was detected by dual-luciferase reporter assay system，and the protein levels of inflammatory cytokine TNF-α and IL-1β were measured by ELISA. Results The expression level of SIGIRR increased significantly in A549 cells transfected with SIGIRR vectors. The transcriptional activity of NF-κB was enhanced obviously after HMGB1 treatment in A549 cells by dual-luciferase reporter assay system，while the transfection of SIGIRR vectors decreased the activity. The protein levels of TNF-α and IL-1β were down-regulated in A549 cells over-expressing SIGIRR after HMGB1 stimulation compared with the non-transfected cells. Conclusions Up-regulated SIGIRR expression can inhibit HMGB1-induced proinlammatory cytokine release in A549 cells such as TNF-α and IL-1β. The transcriptional activity of NF-κB is dampened by SIGIRR transfection，implying that the anti-inflammatory effects of SIGIRR may be involved in the regulation of NF-κB.
【摘要】 目的 研究双侧迷走神经切断对肺缺血再灌注引起的氧化应激反应的影响。 方法 将24只健康雄性新西兰大白兔随机分为:假手术组（S组）、缺血再灌注组（IR组）、双侧迷走神经切断合并缺血再灌注组（NIR组）。缺血前和再灌注末抽取动脉血进行血气分析，观察动脉血氧分压PaO2及肺泡动脉氧分压差（A-aDO2）的变化。再灌注末取肺组织检测肺的湿干重比值（W/D）和氧化应激指标，包括丙二醛（MDA）、超氧化物歧化酶（SOD）及过氧化氢酶（CAT）。 结果 与S组比较，缺血再灌注明显降低了PaO2，增加了A-aDO2和W/D值，增加了肺组织MDA含量并降低了SOD、CAT活性；双侧迷走神经切断进一步降低了SOD活性。 结论 切断实验兔的双侧迷走神经，降低了肺组织抗氧化酶-超氧化物歧化酶的活性，提示迷走神经在降低肺缺血再灌注引起的氧化应激反应中发挥了重要的调节作用。【Abstract】 Objective To evaluate the effect of bilateral vagal nerves transection on lung ischemia-reperfusion induced oxidative stress. Methods A total of 24 New Zealand male rabbits were randomly divided into 3 groups: sham group (S group), ischemia-reperfusion group (IR group), and bilateral vagal nerves transection with ischemia-reperfusion group (NIR group). Before ischemia and at the end of reperfusion, arterial blood samples were collected for blood gas analysis. Arterial partial pressure of oxygen (PaO2) and alveolo-arterial oxygen tension difference (A-aDO2) were detected. At the end of reperfusion, lung tissues were obtained to measure wet/dry weight ratio (W/D). Evaluation of oxidative stress indicators, including content of lung malondialdehyde (MDA), superoxide dismutase enzyme (SOD) and catalase (CAT) activities was also performed. Results Compared with the S group, lung ischemia-reperfusion significantly decreased the PaO2, elevated A-aDO2 and lung W/D weight ratio. At the same time, MDA level in the lung tissue was elevated and SOD and CAT activities were decreased. After bilateral vagal nerves transection, SOD activity was further decreased. Conclusion Transection of bilateral vagal nerves reduced the activity of antioxidant enzyme, especially superoxide dismutase in lung tissue, suggesting that the integrity of the vagal nerves plays an important regulatory role in ischemia-reperfusion mediated oxidative stress in the lung.
Objective To evaluate the safety and efficacy of procedure for prolapse and hemorrhoids （PPH） combined with Shaobei injection in treatment for obstructed defecation syndrome （ODS） caused by rectocele. Methods Seventy-two female patients with rectocele from December 2009 to January 2011 in this hospital were divided into PPH combined with Shaobei injection group （36 cases） and only PPH group （36 cases）. The Longo ODS score was performed on week one，month one，month three，and month six after operation，respectively；pain was evaluated， complications such as urine retention，postoperative bleeding，and anal function were observed；hospital stay and recovery work time were recorded in two groups. Results All patients were followed up for 6 months，there were no significant differences in complications，hospital stay，and the Longo ODS score on week one and month one after operation between two groups （P＞0.05）. But the Longo ODS score of the PPH combined with Shaobei injection group on month three and month six after operation were significantly lower than those of the only PPH group （P＜0.05）. Conclusion PPH combined with Shaobei injection has a better efficacy as compared with only PPH，and at least as safe as only PPH.
The main shortcomings of using electrocortical stimulation (ECS) in identifying the motor functional area around the focus in neurosurgery are certainly time-consuming, possibly cerebral cortex injuring and perhaps triggering epilepsy. To solve these problems, we in our research presented an intraoperative motor cortex functional mapping based on electrocorticography (ECoG). At first, using power spectrum estimation, we analyzed the characteristic of ECoG which was related to move task, and selected Mu rhythm as the move-related feature. Then we extracted the feature from original ECoG by multi-resolution wavelet analysis. By calculating the sum value of feature in every channel and observing the distribution of these sum values, we obtained the correlation between the cortex area under the electrode and motor cortex functional area. The results showed that the distribution of the relationship between the cortex under the electrode and motor cortex functional area was almost consistent with those identified by ECS which was called as ‘the gold-standard’. It indicated that this method was basically feasible, and it just needed five minutes totally. In conclusion, ECoG-based and passive identification of motor cortical function may serve as a useful adjunct to ECS in the intraoperative mapping.
In order to accurately localize the image coordinates and serial numbers of intraoperative subdural matrix electrodes, a matrix electrode localization algorithm for image processing is proposed in this paper. Firstly, by using point-by-point extended electrode location algorithm, the electrode is expanded point-by-point vertically and horizontally, and the initial coordinates and serial numbers of each electrode are determined. Secondly, the single electrode coordinate region extraction algorithm is used to determine the best coordinates of each electrode, so that the image coordinates and serial numbers of all electrodes are determined point-by-point. The results show that the positioning accuracy of electrode serial number is 100%, and the electrode coordinate positioning error is less than 2 mm. The algorithms in this paper can accurately localize the image coordinates and the serial numbers of a matrix electrode arranged in an arc, which could aid drawing of cortical function mapping, and achieve precise positioning of brain functional areas, so that it can be widely used in neuroscience research and clinical application based on electrocorticogram analysis.
ObjectiveTo explore the therapeutic effect and safety of irreversible electroporation (IRE) ablation technique on esophageal cancer.MethodsAn ECM830 electroporator was used for IRE treatment on esophageal cancer cells EC109 and KYSE30. According to the different electric field intensity, five groups were assigned: a control group, a 500 V/cm group, a 1000 V/cm group, a 1500 V/cm group, and a 2 000 V/cm group. After 24 h, methyl thiazolyltetrazolium (MTT) was used to detect the cell proliferation of each group. Western blotting was performed to evaluate the expression of apoptosis proteins in cells before or after IRE treatment. Eight healthy BALB/c nude mice were equally divided into two groups: a control group (n=4) and an IRE group (n=4). EC109 was used to establish subcutaneous transplantation tumors and subsequently the mice in the IRE group were treated with flat electrode. The weight and volume of tumors were measured after 14 days. Ten healthy New Zealand white rabbits were equally divided into two groups: a control group (n=5) and an IRE group (n=5). After exposing the abdominal cavity, the abdominal esophagus of the IRE group was treated with flat electrode. Seven days later, the esophagus was extracted for HE and Masson staining.ResultsWhen the electric field intensity was low (500 V/cm), there was no change in esophageal cancer cells proliferation after IRE treatment compared to the control group (EC109: P=0.385, KYSE30: P=0.600). With the increase of electric field intensity, the influence of IRE on the proliferation of esophageal cancer cell gradually increased. When it reached 2 000 V/cm, there was basically no cell viability after IRE treatment (P<0.001). The results of Western blotting showed that the expression of cleaved caspase-3 increased after IRE treatment (P<0.01). Animal experiments indicated that the weight and volume of tumors in nude mice reduced (P<0.05) and the growth of tumors was slowed down after IRE treatment. In addition, the parenchymal cells of rabbit esophagus were largely damaged, while interstitial tissues such as fibers were well preserved.ConclusionIRE ablation has the potential to inhibit the proliferation of esophageal cancer cell and slow down the tumor growth.What’s more, it is safe for the esophagus.
Objective To detect the expression of single immunoglobin IL-1 receptor related protein ( SIGIRR) in normal human lung tissues, and study its changes in alveolar epithelial cell acutely injured by lipopolysaccharide ( LPS) . Methods Twenty samples of human normal lung tissue were collected during the lobectomies. The expression of SIGIRR was detected by immunohistochemistry, western blot and RT-PCR. The human type II alveolar epithelial cell acute injury model was established by stimulating A549 cells with LPS of a final concentration of 10 μg/mL. The cells were collected at 0, 3, 6, 12, and 24 hours after the stimulation. The changes of SIGIRR expression at the same time points were observed by western blot. The expression vector containing full-length SIGIRR cDNA was transfected transiently into A549 cells to induce SIGIRR overexpression. MTT assay was performed to measure the injury of A549 cells caused by LPS. Results The immunohistochemistry, western blot and RT-PCR showed that there was a high expression of SIGIRR in normal human lung tissues. The expression of SIGIRR was located in alveolar epithelial cells by immunohistochemistry. The expression of SIGIRR at 3, 6, and 12 hours was down-regulated after LPSstimulation and raised again at 24 hours to the baseline. MTT assay showed that SIGIRR overexpression substantially reduced the growth inhibition ratio of A549 cells after LPS stimulation. Conclusions Expression of SIGIRR in normal human lung tissues was confirmed by different detection methods. SIGIRR alleviates the injury of alveolar epithelial cells caused by LPS, implying SIGIRR might be involved in the regulationof acute lung injury mediated by LPS.
【摘要】 目的 研究大剂量辣椒素对兔肺P物质和降钙素基因相关肽(CGRP)的影响。方法 将16只成年健康雄性新西兰大白兔随机分为两组:载体组(A)、大剂量辣椒素组(B)。两组动物取样前7 d和前6 d分别于颈部皮下注射等量的载体或者辣椒素(20 mg/mL)。大剂量戊巴比妥钠静脉麻醉处死动物后立即切取左肺下叶,称重,匀浆,离心后取上清液置于-80℃冰箱保存待测P物质和CGRP。结果 A组肺组织中P物质的浓度高于B组(Plt;0.05),而CGRP的浓度两组差异无统计学意义(P＞0.05)。结论 大剂量辣椒素(100 mg/kg)不能完全耗竭兔肺初级感觉神经纤维的神经肽类物质。