Objective To investigate the effect of dexmedetomidine on the outcome of rats with acute lung injury following blunt chest trauma.Method Forty male SD rats weighing 250～300 g were randomly (random number)divided into 5 groups(n=8 each),namely,group C(normal),group D(normal plus dexmedetomidine),group T(trauma),group TD(trauma plus dexmedetomidine),group TDY(trauma plus dexmedetomidine plus yohimbine).Au rats were sacrificed by using exsanguination from arteria femoralis 6 hours later.The TNF-α and IL-1β levels in plasma were examined by using ELISA.Lung wet/dry(W/D)weight and the percentage of neutrophil in leucocytes in bronehoalveolar lavage fluid(BALF)of rats were detected.HE staining was performed to observe the injury of lung tissue under microscope.Results There was significant lung injury after blunt chest trauma.The serum concentrations of TNF-α and IL-1β,PMN%and lung wet/dry(W/D)weight were significantly higher in traumatic group(P<0.05,P<0.01).chest trauma,but this protective effect of dexmedetomidine could be blocked by yohimbine,at least in part,via the inhibition of α2-adrenergie receptor.Conclusions Dexmedetomidine has a certain protective effect on acute traumatic acute lung injury in rats.

0.05).The value of J of negative group was(6.180?0.214) ?g?cm-2?h-1,while there was significant difference between trial group and negative group(P

Objective:To understand the levels of selenium and T-2 toxin in the historical critical disease area of Kashin-Beck disease in Aba State of Sichuan Province.Methods:From July 2018 to February 2019, in five cities (counties) of historical critical Kashin-Beck disease areas, namely, Ma'erkang, Rangtang, Aba, Ruo'ergai and Hongyuan, one township was selected, respectively, and then one village in the historical critical disease area and one village in non-disease area were selected from the selected townships. Hair samples from 30 children aged 6 to 12 years old were collected to test selenium content in each village. Staple food samples of 10 households were collected to test the selenium and T-2 toxin contents in each village. Ten soil samples were collected from each village to test the selenium content.Results:The medians selenium of children's hair in the diseased and non-diseased villages ( n= 180, 120) were 0.260 0 and 0.330 0 mg/kg, respectively, and the diseased village was lower than non-diseased village ( Z = - 6.319, P < 0.01). In Ma'erkang and Hongyuan, the medians selenium in the diseased villages were lower than those in non-diseased villages ( Z = - 3.327, - 4.939, P < 0.01), and there were no statistically significant differences between the diseased villages and non-diseased villages in Rangtang and Ruo'ergai ( P > 0.05). The medians selenium of staple food in the diseased and non-diseased villages ( n = 110, 70) were 0.005 8 and 0.018 0 mg/kg, respectively, and the diseased village was lower than non-diseased village ( Z = - 2.263, P < 0.05). In Ruo'ergai, the median selenium in the diseased village was lower than that in non-diseased village ( Z = - 2.306, P < 0.05), and there were no statistically significant differences between the diseased villages and non-diseased villages in Ma'erkang, Rangtang and Hongyuan ( P > 0.05). The T-2 toxin contents in staple food were all less than detection limit (1 μg/kg) in the diseased and non-diseased villages ( n = 103, 65). The soil selenium contents in the diseased and non-diseased villages ( n = 60, 40) were (0.045 3 ± 0.021 5) and (0.065 8 ± 0.045 4) mg/kg, respectively, and the diseased village was lower than non-diseased village ( t = 2.672, P < 0.05). The soil selenium content in the diseased village was lower than that in non-diseased village in Hongyuan ( t = 14.838, P < 0.01). There were no statistically significant differences in the soil selenium content between the diseased villages and non-diseased villages in Ma'erkang, Rangtang and Ruo'ergai ( P > 0.05). Conclusions:The overall selenium level of children's hair is at a medium level (0.25 - < 0.50 mg/kg) in the historical critical disease area of Aba State of Sichuan Province, the selenium levels of staple food and soil are at a deficiency level (< 0.025, < 0.125 mg/kg), and the diseased villages are lower than non-diseased villages. No T-2 toxin is detected in staple food.

Objective:To investigate the monitoring value of echocardiography for atrial septostomy during the treatment of extracorporeal membrane oxygenation(ECMO).Methods:Sixteen patients underwent atrial septostomy during the treatment of ECMO in Wuhan Asia Heart Hospital from Jan.2017 to Dec.2019 were included. The diameter of the ostomy, the direction of interatrial shunt, the tricuspid regurgitation degree and the pulmonary artery pressure were measured by echocardiography daily after atrial septostomy.Results:There were no significant differences in the diameter of the ostomy in 16 patients(the range of coefficient of variation 0.86%-4.77%). The direction of interatrial shunt changed gradually from right - left atrial shunt to left - right atrial shunt. Pulmonary arterial pressure decreased gradually(the range of coefficient of variation 14.70%-32.13%) as estimated by tricuspid regurgitation pressure gradient.Conclusions:Atrial septostomy is an effective measure to relieve right heart pressure and improve right heart function in patients with ECMO. The echocardiography can be helpful for the monitoring of atrial septostomy.

Objective To investigate the value of echocardiography in monitoring the treatment of extracorporeal membrane oxygenation (ECMO) in patients with cardiogenic shock (CS).Methods A total of 21 patientss were included into the present study,who were treated by ECMO due to CS in Wuhan Asia Heart Hospital from January 2013 to December 2015.The left ventricular ejection fraction (LVEF) and Tei index were measured by echocardiography before,in the middle of (flow reduced to one half)and immediately after the process of ECMO.The systolic blood pressure (SBP) and the arterial oxygen saturation (SaO2) were also recorded,and the parameters were compared.The differences of LVEF,Tei index,SBP and SaO2 among different phases of ECMO were compared by using one-way ANOVA and LSD-t test.The differences of heart beat rate,the diameters of left ventricle,diameters of inferior vena cava,subsidence rate of inferior vena cava,pulmonary capillary wedge pressure and central venous pressure among different phases of ECMO were also compared by paired-samples t test.Results Compared with the pre-ECMO level,the LVEF increased during and immediately after the ECMO (t=31.952,59.404,both P ＜ 0.01),while the Tei index decreased significantly (t=34.406,58.969,both P ＜ 0.01).Compared with the pre-ECMO level,the SBP,SaO2 and subsidence rate of inferior vena cava all increased during and immediately after the ECMO,while the diameter of left ventricle,pulmonary capillary wedge pressure and central venous pressure all decreased significantly (t=7.382,37.785,-11.286,3.294,13.923,16.971,all P ＜ 0.01 or 0.05).In contrast,there was no significant change for the parameters of heart beat rate and diameter of inferior vena cava.Conclusion When treating CS patients with ECMO,the echocardiography can monitor the cardiac function effectively,and provide important parameters for the clinical doctors to estimate the ECMO efficacy and decide the weaning time.

Objective To evaluate the diagnostic value and misdiagnosis cause of echocardiography (UCG) and CT in aorto-left ventricular tunnel (ALVT). Methods UCG and CT of 5 patients who were diagnosed as ALVT by surgical operation during August 2010 to October 2014 in Wuhan Asia Heart Hospital were reviewed and analyzed. Results By UCG, 4 cases were diagnosed as ALVT. The abnormal tunnel between aortic root and left ventricle could be clearly displayed with two dimensional echocardiography. On color Doppler flow image (CDFI), it could be clearly demonstrated that the blood flow went into aorta from left ventricle in systolic period via aortic valves and ALVT, and back to left ventricle in diastolic period via ALVT. Bicuspid aortic valve (BAV) was found in 2 patients, and aortic valve reflux in 1 patient. According to Hovaquimian classification, 2/4 patients were diagnosed as ALVT of typeⅠ, and other 2 patients as ALVT of typeⅡ. One case was misdiagnosed as left coronary artery-left ventricle fistula. By CT, 2 cases were diagnosed as ALVT and 1 case was misdiagnosed as left coronary artery-left ventricle fistula. Conclusion The combination of UCG and CT is a reliable technique in the diagnosis of ALVT, which has significance in therapeutic strategy making and prognosis prediction.

Objective To compare the roles of Toll-like receptor 4 (TLR4)/NF-κB signal pathway in acute lung injury (ALl) induced by blunt chest trauma and by blunt chest trauma-hemorrhagic shock and resuscitation (double hits) in rats.Methods Forty male Sprague-Dawley rats,aged 8 weeks,weighing 240-280 g,were randomly assigned into 3 equal groups (n =10 each) using a random number table:sham operation group (S group),blunt chest trauma group (T group),and blunt chest trauma and hemorrhagic shock and resuscitation group (group THSR).Lung contusion was induced in anesthetized rats by dropping a 300 g weight onto a precordial protective shield to direct the impact force away from the heart and toward the lungs.Blood was withdrawn via the femoral artery 5 min later until MAP was decreased to 35-45 mmHg within 15 min and maintained at this level for 60 min,followed by resuscitation.At 6 h after the model was established,the arterial blood samples were collected for blood gas analysis and detection of tumor necrosis factor-alpha (TNF-α) concentrations in serum.Oxygenation index (PaO2/FiO2) was calculated.The rats were then sacrificed and pulmonary specimens were obtained for determination of TLR4 expression and NF-κB ac tivity (by immunohistochemistry and Western blot) in lung tissues and for microscopic examination.Results Compared with group S,PaO2 and PaO2/FiO2 were significantly decreased,PaCO2 and TNF-α concentrations in serum were increased,TLR4 expression was up-regulated,and NF-κB activity was enhanced in T and THSR groups (P ＜ 0.05).Compared with group T,PaO2 and PaO2/FiO2 were significantly decreased,PaCO2 and TNF-α concentrations in serum were increased,TLR4 expression was up-regulated,and NF-κcB activity was enhanced in THSR group (P ＜ 0.05).The histopathological damage to lung tissues was aggravated in THSR group as compared with T group.Conclusion The role of TLR-4/NF-κB signal pathway in ALI induced by blunt chest traumahemorrhagic shock and resuscitation (double hits) is significantly stronger than that in ALI induced by blunt chest trauma alone in rats.

Objective To investigate the effect of penehyclidine hydrochloride on the cell apoptosis in lung tissues in a rat model of traumatic acute lung injury (ALI) .Methods Fifty-four SD rats weighing 225-275 kg were randomly divided into 3 groups ( n = 18 each) : control group (group C) , ALI group, penehyclidine hydrochloride group ( group P) . Traumatic ALI was induced by dropping a self-made impact device on the chest of anesthetized rats according to the technique described by Raghavendran et al. Intraperitoneal penehyclidine hydrochloride 2 mg/kg was injected immediately after blunt chest trauma and at 12 h after blunt chest trauma in group P. Six rats in each group were sacrificed at 3, 12 and 24 h after blunt chest trauma and the lung tissues collected for microscopic examination and determination of cell apoptosis (by TUNEL) and expression of Bax and Bcl-2 (by immuno-histochemical staining) . The apoptosis index was calculated. Results The apoptosis index and expression of Bax and Bcl-2 were significantly higher, while the ratio of Bcl-2/Bax was significantly lower at each time point in groups ALI and P than in group C ( P ＜ 0.05) . The apoptosis index and Bax expression were significantly lower,while the Bcl-2 expression and ratio of Bcl-2/ Bax higher at each time point in group P than in group ALI.The microscopic examination showed that penehyclidine hydrochloride injection significantly attenuated the pathologic changes. Conclusion Penehyclidine hydrochloride can reduce the traumatic ALI through inhibiting the cell apoptosis in rat lung tissues.

Objective To investigate the role of gamma-aminobutyric acid (GABA) A receptor (GABAAR) in lung tissues in lipopolysaccharide (LPS)-induced acute lung injury in rats.Methods Thirty-two male Wistar rats,aged 8 weeks,weighing 200-230 g,were randomly divided into 4 groups (n =8 each) ∶ control group (group C),group LPS,GABA pretreatment + LPS group (group GABA) and GABAAR antagonist bicuculline pretreatment + LPS group (group BIC).Acute lung injury was induced by intravenous LPS 5 mg/kg in groups LPS,GABA and BIC,while the equal volume of normal saline was given in group C.GABA 50 mg/kg and bicuculline 10 μmol/kg were injected intraperitoneally 30 min before LPS injection in GABA and BIC groups,respectively.Arterial blood samples were collected at 6 h after LPS injection for measurement of arterial partial pressure of oxygen (PaO2).The animals were then sacrificed and lungs removed for determination of W/D lung weight ratio,GABAAR expression,contents of interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α) and malondialdehyde (MDA) and superoxide dismutase (SOD) activity in lung tissues and for microscopic examination.Results Compared with group C,PaO2 was significantly decreased in the other three groups,and W/D lung weight ratio,TNF-α,IL-6 and MDA contents were significantly increased,GABAAR expression was up-regulated,and SOD activity was decreased in groups LPS and GABA (P ＜ 0.05).Compared with group LPS,W/D lung weight ratio,TNF-α,IL-6 and MDA contents were significantly increased,GABAAR expression was up-regulated,and SOD activity was decreased in group GABA (P ＜ 0.05),and no significant change was found in the parameters mentioned above in group BIC and in PaO2 in groups GABA and BIC (P ＞ 0.05).Conclusion GABAA R in lung tissues is involved in the development of acute lung injury induced by LPS.

Objective To explore the condition of cortistatin (CST)expression in human renal tissue and the changes in the level of CST in IgA nephropathy (IgAN)of different degrees.Methods Ten tumor adjacent normal renal tissue samples were collected.The mRNA and protein expressions of CST in human renal tissue were detected by reverse transcription-polymerase chain reaction (RT-PCR)and Western blotting,respectively.Immunohistochemisty (IHC)was performed to locate the expression of CST in renal tissue.According to the grading system of Lee et al,IgAN was divided into three groups:grade Ⅰ -Ⅱ (group A),grade Ⅲ -Ⅳ (group B),and grade Ⅴ (group C),and ten renal biopsy tissue samples were collected for each group.IHC was performed to detect the change in the level of CST in normal and IgAN renal tissue of different degrees.The effect of clinical indices on the level of CST in IgAN renal tissue was assessed by multiple linear regression analysis.Results RT-PCR and Western blotting showed that CST was expressed in renal tissue and IHC showed that CST was expressed on renal tubular epithelial cells.In IgAN,the higher the pathological grade was, the higher the expression of CST in renal tubules was.Multiple linear regression analysis showed that the pathological grade was associated with the expression of CST in renal tissue (r =0.875,P <0.01).Conclusion CST may participate in the inflammatory reaction of IgAN pathological injury and exert anti-inflammation effects.