Objective To discuss the therapeutic effect of ulinastatin combined with dexamethasone on blast-induced acute lung injury (ALI) in rabbits.Methods Thirty-eight New Zealand white rabbits with blast-induced ALI were divided into four groups according to the random number table:injury group (n =8),treatment group Ⅰ (dexamethasone alone,n =10),treatment group Ⅱ (ulinastatin alone,n =10),combination therapy group (dexamethasone + ulinastatin,n =10).In addition,8 uninjured rabbits were randomly selected as control group.Treatment groups were given relevant medication by intramuscular injection at 0.5,12,24,36 and 48 hours after successful modeling.Injury group and control group were given equal volume of isotonic saline at the same time.Parameters of respiratory rate,oxygenation index (PaO2/FiO2),TNF-α,IL-6,IL-8 and neutrophil elastase (NE)were detected before and afterfirst treatment at 6,24,48 and 72 hours.All rabbits were sacrificed after 72 hoars to detect TNF-α,IL-6,IL-8 and NE contents in bronchoalveolar lavage fluid (BALF) and to measure wet to dry lung weight ratio.HE staining was performed to observe pathological changes of lung tissues Results In contrast,respiratory rate was high in injury group at each time point,which increased to the peak (75.0 ± 7.4) times/min at 6 hours far higher than (33.0 ± 4.5) times/min in control group (P ＜0.01).Wet to dry lung weight ratio and TNF-α,IL-6 as well as IL-8 contents of the peripheral blood and BAI.F in injury group were significantly higher than those in control group (P ＜0.01).PaO2/ FiO2 in injury group was decreased to the lowest level of (180.5 ± 12.6)mmHg at 72 hours far lower than (403.7-8.0)mmHg in control group (P ＜0.01).While improvements were observed in treatment groups with respect to these indicators,and significantly much better results were detected in combination therapy group rather than in treatment groups Ⅰ and Ⅱ (P ＜ 0.01).Conclusion Ulinastatin combined with dexamethasone is an effective therapy on blast-induced ALI in rabbits,and the effect is significantly better than that with single use of uliinastatin or dexamethasone.

Objective To study the effect of ulinastatin (UTI) on blood gas analysis in rabbits with acute lung injury (ALI) after an explosion.Methods A total of 24 healthy New Zealand white rabbits were made to be ALI models by an explosion at a distance of 11 cm.The rabbits met the criteria of ALI,and were randomly (random number) divided into A and B groups.In group B,rabbits received UTI injected at 0.5 h,6 h,12 h,24 h after modeling.In group A,an equal volume of saline was given to rabbits instead at the same intervals after modeling.Arterial blood pH,carbon dioxide partial pressure (PaCO2) and partial pressure of blood oxygen (PaO2) were determined by a portable blood gas analyzer before modeling and at given intervals after modeling.All rabbits were sacrificed after 48 h later.The pathological changes of lung tissue were observed with naked eye and extent of lung injury with HE staining.Results Compared with group A,pulmonary edema and infiltration of inflammatory cells in the lungs of rabbits in group B were less significant.The blood gas analysis showed there were significant difference in pH at 24 h after injury between group A (7.24 ± 0.07) and group B (7.35 ± 0.06),P ＜ 0.05.There was significant difference in PaO2 at 24 h after injury between group A (50.5 ± 9.9) mmHg and group B (78.1 ± 8.4) mmHg,P ＜ 0.05.And there was significant difference in PaCO2 at 24 h after injury between group A (52.4 ± 5.5) mmHg and group B (42.8 ± 4.5) mmHg,P ＜ 0.05.Conclusion UTI can significantly reduce acidosis,PaCO2 and increase PaO2 in rabbits with ALI following a blast,improving oxygenation and mitigating lung histopathological changes.