Objective To explore the effect of salbutamol combined with Rho associated coiled-coil forming protein kinase (ROCK) inhibitor Y-27632 on airway smooth muscle and to find a new way for drug treatment of asthma. Methods Pig tracheal smooth muscle tissue strips were prepared, and after treatment they were divided into an electrical stimulation group (Fmax, 50%Fmax) and a blank group. The smooth muscle tissue strips were quickly frozen to determine the expression level of Rock-Ⅱ and the phosphorylation level of MLC20. The Fmax and 50%Fmax electrical stimulation groups were divided into a blank group, a salbutamol group, a Y-27632 group, and a salbutamol combined with Y-27632 group according to different intervention drugs. The relaxation of smooth muscle strips was observed. Results In the blank group, 50%Fmax group and Fmax group, the expression level of Rock-Ⅱ and the phosphorylation of MLC20 in smooth muscle tissue showed an increasing trend, with statistically significant differences (P<0.05). In the 4 subgroups of the 50%Fmax group intervention with different drugs (blank group, salbutamol group, Y-27632 group, salbutamol plus Y-27632 group), the diastolic ratio smooth muscle tissue strips showed an increasing trend. When the time reaches 10 min, the diastolic ratios were 0.7%, 2.5%, 6.0%, and 15.0%. the diastolic ratios were 1.8%, 4.5%, 7.5%, and 21.0% at the time of 20 min. the diastolic ratios were 1.9%, 7.5%, 7.9% and 22.0% at the time of 40 min. the diastolic ratios were 2.0%, 8.0%, 8.8%, and 22.5% at the time of 60 min. In the four subgroups of the Fmax electrical stimulation group, the relaxation ratio of smooth muscle tissue strips also showed an increasing trend. When the time reaches 10 min, the diastolic ratios were 1.0%, 3.0%, 7.0%, and 17.0%. the diastolic ratios were 2.6%, 5.5%, 9.0%, and 24.0% at the time of 20 min. the diastolic ratios were 2.8%, 9.0%, 9.5%, and 27.5% at the time of 40 min. diastolic ratios were 2.9%, 10.5%, 10.5%, and 28.0% at the time of 60 min. The analysis of difference between groups showed that at the same time, the diastolic ratio of smooth muscle in salbutamol combined with Y-27632 group was significantly higher than that in salbutamol alone group and Y-27632 group (P<0.05). In addition, the smooth muscle diastolic ratio of combined intervention was also better than the the mathematical sum effect of both single drug intervention (P<0.05). Conclusions The contractility and intensity of smooth muscle are positively correlated with the expression level of ROCK and the phosphorylation level of MLC20. Salbutamol combined with Y-27632 can enhance the relaxation of porcine airway smooth muscle, which may have a synergistic effect.
Objective To evaluate the perioperative safety of lung surgery for patients with COVID-19. Method We retrospectively analyzed the clinical data of the patients recovered from COVID-19 infection and received lung surgery from December 2022 to February 2023 in the Department of Thoracic Surgery at Beijing Hospital. Patients who performed lung surgery and without COVID-19 at the same time were selected as a control group. Perioperative data between the two groups were compared. Results A total of 103 patients were included with 44 males and 49 females at average age of 62.2±2.1 years. All surgeries were performed by single-utility video-assisted thoracoscopic surgery (VATS). Among patients who recovered from COVID-19, 53 (51.5%) performed lobectomy, 30 (29.1%) performed segmentectomy, and 20 (19.4%) performed wedge resection. The interval between diagnosis of infection and lung surgery was less than 1 month in 32 (31.1%) patients, and more than 1 month in 71 (68.9%) patients. The results of nucleic acid test for all patients before surgery were negative. 13 (12.6%) patients had positive COVID-19 antibody of IgM, and 100 (97.1%) patients had positive IgG. A total of 20 patients experienced perioperative complications (13 patients with pulmonary air leakage, 3 with chylothorax, 2 with atrial fibrillation, and 2 patients with severe pulmonary complications). There was one perioperative death. Compared the patients who recovered from COVID-19 with those without COVID-19, there was no statistical difference in perioperative data including surgical duration, postoperative drainage, duration of thoracic tube, and duration of postoperative stay (P>0.05). There was no significant difference in perioperative complications between the two groups (P>0.05). Multivariable logistical regression analysis demonstrated that positive IgM before surgery (OR=7.319, 95%CI 1.669 to 32.103, P=0.008), and longer duration of surgery (OR=1.016, 95%CI 1.003 to 1.028, P=0.013) were independent risk factors of perioperative complications for patients who recovered from COVID-19. Conclusion It is safe for patients recover from COVID-19 to receive lung surgery when symptoms disappeared and the nucleic acid test turned negative. However, positive COVID-19 IgM was an independent risk factor for perioperative complications. We suggest that lung surgery could be performed when the nucleic acid test and COVID-19 IgM were both negative for patients recover from COVID-19 infection.