OBJECTIVE: To study the changes in the expression of rat beta-defensin-2 (RBD-2) gene in the lung tissue with P. aeruginosa (PA) pneumonia following tracheal mechanical ventilation (MV), and to evaluate the pathogenesis of ventilator-associated pneumonia (VAP). METHODS: A total of 58 normal healthy Sprague-Dawley rats, weighing between 280 and 320 g, were randomly divided into the control group and the conventional MV group (CMV). A tracheal catheter was inserted via mouth in every rat under urethane anesthesia. PA (1 MIC, 0.2 ml) was instilled into the tracheal in the control group. Rats of CMV group received MV (V(T)=12 ml/kg) through tracheal tube for 24 hours, and then were challenged intra-tracheally with PA (1 MIC, 0.2 ml). Fluid loss was replenished through intravenous infusion. The arterial catheter was used for hemodynamics, parameters were monitored, and arterial blood gases were determined. Samples of lung were harvested at 0 hours, 15 hours, 3 hours, 6 hours, 12 hours, 1 day, 3 days and 5 days, respectively, after bacterial challenge. The mRNA of RBD-2 was detected by reverse transcription-polymerase chain reaction (RT-PCR), and the protein levels were analyzed by Western blotting. RESULTS: Expression of RBD-2 mRNA and protein was lower in CMV group compared with the control 3 hours before instillation of bacteria. RBD-2 mRNA increased 3 hours after bacteria instillation, reaching the peak at 12-24 hours. No significant difference in RBD-2 expression between the control group and the CMV group within 3 hours, but it was significantly higher at 3 hours, 6 hours, 12 hours, 1 day, 3 days and 5 days in the control group than in the CMV group. The number of inflammatory cells infiltrating the bronchial submucous layer was significantly higher in the control group than in the CMV group (P<0.05). There was milder interstitial pulmonary edema and less red blood cells in the alveoli in the control group than in the CMV group. The mortality rate of the CMV group was 60%, which was significantly higher than that of the control group (20%, P<0.05). The positive rates of blood culture and bronchoalveolar lavage fluid (BALF) bacterial culture were also higher in the CMV group (P<0.05). The survival rate in CMV group (40%) was lower than that of the control group (P<0.05). CONCLUSION: The lowering of BD-2 gene and protein expression in the CMV group 3 hours after bacteria challenge might be one of the contributory factors in causing VAP.
Disease Models, Animal ; Lung/metabolism ; Lung/pathology ; Pneumonia, Ventilator-Associated/*metabolism ; Pneumonia, Ventilator-Associated/pathology ; RNA, Messenger/metabolism ; Random Allocation ; Rats, Sprague-Dawley ; beta-Defensins/genetics ; beta-Defensins/*metabolism

Objective　To investigate the relationship between tinnitus and glucose metabolism in auditory cortex and whether positron emission tomography (PET) can be an objective tool in measuring tinnitus. Methods　Eleven right-handed patients with severe tinnitus and ten right-handed control subjects participated in the 18　 F-FDG/PET study. Analysis with regions of interests was used to calculate asymmetry indices according to the formula: ［(L-R)×100/［(L+R)÷2］］. Results　Glucose metabolism in the auditory cortex of tinnitus patients was asymmetric between the left and right auditory cortices, with that of the left being much higher than that of the right. The asymmetry indices of tinnitus patients was significantly higher than that of the control group (unpaired t test, P<0.001). This revealed that the increased metabolic activity was present in the predominant left hemisphere with a significant focus on the superior and transverse temporal gyri (Brodmann areas 41 and 42, respectively corresponding to primary and secondary auditory cortex), and the results were independent of the subjective localization of the tinnitus sensation. Conclusion　It is suggested that the increased metabolism in the left auditory cortex is related to the tinnitus sensation. PET is capable of providing objective evidence for tinnitus and may be used as a potential tool in measuring tinnitus.