Objective To investigate the protective effects of ulinastatin on acute lung injury ( ALI)induced by seawater drowning in rats. Methods Thirty male SD rats were randomly divided into three groups, ie. a control group, a model group, and an ulinastatin treatment group. The rats in the model group and the ulinastatin treatment group received intratracheal artificial seawater ( 4 mL/kg) instillation. Then the ulinastatin treatment group received ulinastatin ( 100 000 U/kg) injection after infusion of seawater while the model group received an injection of same amount of saline. The rats were sacrificed at 4 hours after instillation. The pathological changes of lung were evaluated by hematoxylin-eosin stain under light microscope. Lung wet/dry weight ratios were measured to assess the level of pulmonary edema.Concentrations of tumor necrosis factor ( TNF) -α, interleukin ( IL) -1β, IL-6, and IL-10 in bronchoalveolar lavage fluid ( BALF) were detected by enzyme-linked immunosorbent assay ( ELISA) . The myeloperoxidase activity in lung tissue homogenates were measured by colorimetric method. Results Ulinastatin treatmentsignificantly relieved the decline of PaO2 and lung pathological changes, inhibited myeloperoxidase activity,and reduced lung wet/dry weight ratios. Ulinastatin also inhibited the release of TNF-α, IL-1β, and IL-6,whereas increased the expression of IL-10 simultaneously. Conclusion Ulinastatin attenuates seawater induced ALI, which may be related to its inhibitory effects on inflammation reaction through regulating cytokine secretion.
Abstract： Objective To explore the diagnosis and treatment of descending necrotizing mediastinitis (DNM). Methods We retrospectively analyzed the records of eight DNM patients treated at Tangdu Hospital between 2006 and 2009 year. There were 7 males and 1 female aged from 21-98 years with a median age of 49.5 years. The diagnostic criteria included clinical manifestations, neck and chest CT scans, and bacteriological culture. Six of the patients had odontogenic infections and six had diabetes. Antibiotic treatment, incision drainage, and other symptomatic treatments were applied. Two patients received cervical incision drainage, five received thoracotomy, and one received video-assisted thoracoscopic surgery (VATS). Results After treatment, six patients recovered and two died of heart failure and neck vessel rupture. According to the bacterial culture, six patients presented mixed infections, and four of these presented mixed aerobic and anaerobic infections. The mean operation time was 75.6 minutes, the average volume of pus removed during the operation was 318.7 ml, and the average inpatient stay was 18 days. At six months follow-up, all six surviving patients showed improvements in quality of life. Conclusion The valid diagnosed criteria of DNM include history, sign, symptom, neck and chest CT scanning, and secretion culture.DNM mortality can be reduced by employing broad spectrum antibiotics early in treatment, individual surgical managements, and effective treatments for complicating illnesses.