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 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 evaluate the systolic function of left ventricle in myocardial infarction(MI)patients with ventricular aneurysm and the changing law of blood flow in ventricle with regional abnormality of wall movement by vector flow mapping (VFM).Methods Tirty-one MI patients with ventricular aneurysm and 35 healthy participants were enrolled in this study.The characteristic of vector and streamline,and the changing of the velocity gradient in left ventricular outflow tract (LVOT), and the average flow quantity through aneurysm neck were detected in the isovolumic contraction period, the rapid ejection period and the slow ejection period by VFM.Results The distinction between aneurysm and control group was mainly the persistance of vortex in aneurysm.The size of vortex in aneurysm was highly correlated with that measured by 2-D ultrasound(P ＜0.01).The percentage of vortex duration to cardiac cycle in patients group was significantly greater than that in control group(P ＜0.01).In the early systolic contraction the velocity gradient in LVOT in patients with ventricular aneurysm was smaller than that of control group(P ＜0.05).The average flow through aneurysm neck was notablely decreased compared with control group(P ＜0.01).Conclusions VFM can reveal the hemodynamics of left ventricle with aneurysm directly as well as quantitively measure the regional velocity and flow quantity.VFM can evaluate the systolic function of left ventricle exactly.

[ ABSTRACT] AIM:To investigate the potential role of exogenous hydrogen sulfide ( H2 S) and ATP-sensitive po-tassium ( KATP ) channels in chronic stress-induced colonic hypermotility.METHODS:Male Wistar rats were divided into water avoidance stress ( WAS) group and sham WAS ( SWAS) group.Organ bath recordings were used to test the contrac-tile activity of colonic strips.The effects of H2 S donor NaHS and pretreatment with glibenclamide on the contractions of co-lonic smooth muscle were studied and the IC50 of NaHS was calculated.The localization and expression of the subunits of KATP channels were determined by the methods of immunohistochemistry and Western blotting.RESULTS:WAS increased contractile activity of colonic strips.NaHS concentration-dependently inhibited the spontaneous contractions of strips from the SWAS and WAS rats.The IC50 of NaHS for longitudinal muscle ( LM) and circular muscle ( CM) of the WAS rats was 0.2033 mmol/L and 0.1438 mmol/L, significantly lower than those of the SWAS rats.Glibenclamide significantly in-creased the IC50 of NaHS for LM and CM from the SWAS and WAS rats.In both SWAS and WAS rat colon, Kir6.1, Kir6.2 and SUR2B were expressed on the plasma membrane of the smooth muscle cells.WAS treatment resulted in up-reg-ulation of the expression of Kir6.1 and SUR2B in the colon devoid of mucosa and submucosa.CONCLUSION: The in-creased expression of Kir 6.1 and SUR2B in colonic smooth muscle cells may be a defensive response to chronic WAS.H2 S donors may have potential clinical effect on treating chronic stress-induced colonic hypermotility.

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 explore the application value of transesophageal echocardiography (TEE)in secondum atri-al septal defect (ASD)intervention and minimally invasive occlusion surgery in adult patients.Methods:A total of 134 cases adult patients (>15 years)with pure secondum ASD (including 91 cases undergoing interventional occlu-sion and 43 cases undergoing minimally invasive occlusion surgery),who were screened via transthoracic echocardio-graphy (TTE)and TEE from Jan 2012 to Dec 2012,were selected.Intervention group and minimally invasive sur-gery group received TTE and TEE monitoring respectively during operation.Preoperative TTE and TEE parameters and operation results were compared and analyzed.Results:The parameters of ASD diameter measured by TEE were significantly higher than those measured by TTE in two groups (P <0.01 all).Maximum defect diameter of ASD measured by TEE was significantly higher than that of measured by TTE [(19.8±5.2)mm vs.(18.7±4.9)mm], P <0.01. The correlation between maximum defect diameter measured by TTE and occluder size (intervention group r =0.926,minimally invasive surgery group r =0.215)was all lower than that of TEE (intervention group r=0.965,minimally invasive surgery group r =0.627),P <0.01 both.Conclusion:TEE is better than TTE in as-sessment of ASD size.It should be regarded as a routine preoperative screening method for adult ASD patients.It has important value in real-time monitoring,guidance and immediate evaluation of therapeutic effects during mini-mally invasive ASD occlusion surgery.

Objective To investigate the mechanism of myocardial ischemia and reperfusion-induced acute lung injury (ALl) and protective effect of ischemic postconditioning.Methods Forty SD rats were allocated to sham group,myocardial ischemia/reperfusion group (reperfusion group),ischemic postconditioning group (postconditioning group),and ischemic postconditioning + phosphatase and tensin homolog deleted on chromosome ten (PTEN) inhibiting group (inhibitor group) according to the random number table,with 10 rats per group.Myocardial ischemia/reperfusion was induced by left anterior descending coronary artery occlusion.Postconditioning was performed within 1 minute before reperfusion consisting of 3 10 s cycles of reperfusion followed by 10 s occlusion.Lung was immediately removed 120 minutes after reperfusion for HE stain,immunohistochemical detection of inflammatory factors and apoptosis factors,TUNEL assay of cell apoptosis,and Western blot of protein kinase B (Akt),phospho-Akt (p-Akt),glycogen synthase kinase-3β (GSK-3β),and phospho-GSK-3β (p-GSK-3β).Results Down-regulated B-cell lymphoma-2 (Bcl-2) and IL-10 and up-regulated Bcl-2 associated X protein (Bax),cysteinyl aspartate specific proteinase-3 (Caspase-3),IL-6 as well as IL-8 were observed in other 3 groups compared with sham group (P ＜0.01).Moreover,down-regulated Bax,Caspase-3,IL-6,IL-8 as well as TUNEL and up-regulated Bcl-2 as well as IL-10 were observed in reperfusion group compared to postconditioning group and tensor group (P ＜ 0.01).No statistical differences were found among the four groups in levels of Akt,p-Akt,and GSK-3β,but level of p-GSK-3β was significantly down-regulated in reperfusion group compared to other 3 groups(P ＜ 0.01).Conclusion Development of ALI may relate to down-regulation of p-GSK-3β evoked directly by the release of inflammation factors in early period of myocardial ischemia/reperfusion and ischemic postconditioning may attenuate the condition.