Objective: To investigate the relationship of intercellular adhesion molecule-1(ICAM-1) and E-selectin with the pathogenesis of chronic obstructive pulmonary disease(COPD). Methods: The serum soluble ICAM-1(sICAM-1) and E-selectin(sE-selectin) and tumor necrosis factor-?(TNF-?) from 45 exacerbated COPD patients,35 stable patients and 30 healthy as controls were measured by double antibody sandwich quantitative enzyme linked immunosoebent assay(ELISA). Results: The levels of both sICAM-1 and sE-selectin in the exacerbated group were significantly higher than those in the control(P

Objective To study the protective effects of colquhounia root tablet against oleic acid-induced acute lung injury (ALI) .Methods Forty-eight healthy Wistar rats weighing 200-250 g were randomly divided into 3 groups: ALI group ( n = 18) ; colquhounia root tablet group ( n = 18) and control group ( n = 12) . The animals were anesthetized with intraperitoneal 2% pentobarbital. ALI was induced by intravenous injection of oleic acid 0.04 ml?kg-1. In colquhounia root group colquhounia root tablet 300 mg?kg-1 was instilled into the stomach twice a day for 10 days before Ⅳ oleic acid injection. In control group normal saline 0.04 ml?kg-1 was given Ⅳ instead of oleic acid. The animals were killed 4h after intravenous oleic acid. Blood was collected from left ventricle immediately before the animals were killed for determination of expression of CD11a, CD11b and CD18 in neutrophils, monocytes and lymphocytes by flow cytometry using monoclonal antibodies. The lungs were immediately removed and left lung was lavaged via left main bronchus. Broncho-alveolar lavage fluid (HALF) was collected, WBC count in BALF and the percentage of active neutrophils were determined. Lung permeability index (BALF protein concentration/plasma protein concentration) was calculated. Results The expression of CD11la, CD11b and CD18 in neutrophils and monocytes, the lung permeability index, the WBC count and percentage of active neutrophils in BALF were significantly higher in ALI group than in control group. Colquhounia root tablet pretreatment significantly attenuated the changes induced by Ⅳ oleic acid. Conclusion Colquhounia root tablet pretreatment can effectively protect the animals from oleic acid induced ALI by downregulation of the expression of CD11a / CD18 and CD11b / CD18 in WBC.

Objective To evaluate the effect of colquhounia root tablet on the expression of tight junction proteins claudin-5 and ZO-1 in the renal tissues of rats with acute lung injury (ALI).Methods Twenty-four healthy male Sprague-Dawley rats,weighing 250-300 g,were randomly divided into 3 groups (n =8 each) using a random number table:control group (group C),ALI group;and colquhounia root tablet group (group H).Oleic acid 0.04 ml/kg was injected into the trail vein to establish the model of ALI.In group H,colquhounia root tablet 600 mg · kg-1 · d-1 was instilled into the stomach of each rat for 10 consecutive days,and oleic acid was injected at 1 h after instillation on 10th day.Blood samples were collected from the abdominal aorta at 6 h after injection of oleic acid for determination of plasma creatine (Cr) and blood urine nitrogen (BUN) concentrations.The animals were then sacrificed.The lungs were removed for determination of wet/dry lung weight ratio (W/D ratio),and for examination of the pathological changes.The kidneys were removed for determination of the expression of claudin-5 and ZO-1 (by immunohischemistry assay and Western blot) and for examination of the pathological changes.The damage to the renal tubules was scored.Results Compared with group C,W/D ratio,plasma Cr and BUN concentrations,and renal tubular damage score were significantly increased,and the expression of claudin-5 and ZO-1 was down-regulated in group ALI (P＜0.01).Compared with group ALI,W/D ratio,plasma Cr and BUN concentrations,and renal tubular damage score were significantly decreased,and the expression of claudin-5 and ZO-1 was up-regulated in group H (P＜0.01).The pathological changes of lungs and kidneys were significantly attenuated in group H as compared with group ALI.Conclusion Colquhounia root tablet can attenuate kidney injury through up-regulating the expression of tight junction proteins claudin-5 and ZO-1 in the renal tissues of rats with ALI.

Objective To study the leukocyte adhesion molecules in the pathogrnesis of ALI and ARDS.Methods The positive expression rates of CD11a、CD11b and CD18 in peripheral blood were quantitatively analyzed by flow cytometry using monoclonal antibodies in 26 cases of ALI,18cases of ARDS and 15 healthy controls.Results The expression rates of CD11a、CD11b and CD18 in polymorphonuclear neutrophils and monocytes from the ALI group and ARDS group were much higher than those in the control group(P

Objective To compare the measured resting energy expenditure (MREE) in patients with sepsis calculated using respiratory indirect calorimetry and Harris-Benedict (HB) coefficient method,and to investigate the influence of different energy target on the prognosis of patients with sepsis.Methods This was a prospective comparative study.60 patients with sepsis who were suitable for nutrition support and respiratory indirect calorimetry in the Intensive Care Unit (ICU) of the General Hospital of Ningxia Medical University from January to October 2015 were selected.(1) MREE was measured simultaneously with respiratory indirect calorimetry and HB coefficient (Harris-Benedict equation × stress coefficient) in the 60 patients on the 0,3rd,7th,and 14th days of nutrition support.The MREE calculated with the two methods were compared to detect difference.(2) The septic patients were randomly divided into two groups according to the random number table:respiratory indirect calorimetry group (n =30),in which the nutrition support was given according to the MREE measured using respiratory indirect calorimetry as the energy target;HB coefficient method group (n =30),in which the nutrition support energy target was the MREE measured using HB coefficient method.The clinical data of the patients in both groups were recorded and compared,which included the baseline characteristics,nutrition-related complications,and prognostic indicators.Results (1) Within 2 weeks during nutrition support,the dynamic MREE in the respiratory indirect calorimetry group was significantly higher than that in the HB coefficient method group (P ＜0.05).There was no significant difference in MREE on the 0,3rd,7th,and 14th days of nutrition support measured by respiratory indirect calorimetry (P ＞ 0.05).(2) There were no significant differences between the two groups in incidence of liver function damage and abnormal blood glucose within 2 weeks of nutrition support (both P ＞ 0.05).Compared with the HB coefficient method group,the length of ICU stay and 28-day mortality were significantly lower in the respiratory indirect calorimetry group [193.5 (172.2,289.7) h vs.247.5 (194.7,393.2),Z=-2.061,P=0.039;3.3％ vs.23.3％,x2 =5.129,P=0.023],but there was no significant difference between the two groups in mechanical ventilation time (P ＞ 0.05).Conclusions The MREE of septic patients may be considerably high and with little fluctuation in a short period.Respiratory indirect calorimetry may be more suitable to guide the energy intake target in septic patients.

Objective To observe the clinical findings about the endothelial cell injury related to the genesis of inflammatory cytokines and coagulation.Methods A total of 70 critically ill patients with SIRS (systemic inflammatory response syndrome) admitted to intensive care unit (ICU) between September 2009 and February 2010 were enrolled for a prospective and control study.According to diagnostic criteria of Sepsis/SIRS,the patients were divided into two groups:sepsis group (n =38) and SIRS group (n =32),and another 20 healthy volunteers served as control group.Patients in the sepsis group and SIRS group were matched by clinical signs of high blood pressure,diabetes and its complications.The demographics of patients including age,sex,body mass index (BMI),smoking and alcohol addict were comparable among the different groups.The 6 ml peripheral blood samples were collected within 24 h after admission to ICU for enzyme-linked immunosorbent assay (ELISA) to detect the plasma levels of s-CD62P,TNF-α,and hsCRP.And variables of coagulation function such as platelet (PLT),prothrombin time (PT),activated partial thromboplastin time (APTT),D-dimer and antithrombin-Ⅲ (AT-Ⅲ) were analyzed during 24 h after admission to ICU.Meanwhile sequential organ failure assessment (SOFA) score of critically ill patients was evaluated.Data were expressed in mean ± standard deviation and were statistically analyzed by using SPSS 17.0 statistical software.The differences in plasma levels of s-CD62P of patients in each group were analyzed by ANOVA and Kruskal Wallis test.The relationship between s-CD62P and inflammatory cytokines as well as with coagulation were determined by Pearson correlation analysis.Changes were considered as statistically significant if P value was less than 0.05.Results ① Compared with control group and SIRS group,the levels of s-CD62P,TNF-α and high sensitive C-reactive protein (hs-CRP) were significantly higher in sepsis group (P ＜ 0.05).② The plasma levels of D-dimer,PT,APTT in sepsis group and SIRS group were significantly higher than those in control group,while the platelet count (PLT) and the activity of AT-Ⅲ were obviously lower (P ＜ 0.05).③ In sepsis group,the plasma levels of hs-CRP and TNF-α positively correlated with PT,APTT,D-dimer,and negatively correlated with AT-Ⅲ,PLT (P ＜ 0.05).④ Plasma levels of s-CD62P were significantly correlated with plasma levels of TNF-α,hs-CRP,D-dimer,PT,APTT,whereas correlated negatively well with PLT,AT-Ⅲ (P ＜ 0.05).Conclusions The plasma s-CD62P concentration is elevated as a early biomarker in patients with sepsis,and it acted as one of pathogenic factors responsible for endothelial cell damage.Coagulation and mediators of inflammation promotes each other,aggravating the severity of the sepsis.The plasma s-CD62P may be the important factor associated with initiation of coagulation development and inflammatory reaction.

Objective To investigate the influencing factors of successfully switching to sequential ventilation in patients with prolonged weaning due to acute respiratory failure (ARF) after thoracolaparotomy based on the initial rapid shallow breathing index (RSBI) at 60 min after spontaneous breathing trial (SBT), namely, the f/VT optimal value range of 80-120 times/ (min · L), thus providing the basis for determining the ideal timing of weaning in clinical practice.Methods A prospective observational study of sequential ventilation [RSBI during the initial SBT (60 min), 80-120 breaths/ (min · L)] was carried out in 42 patients on mechanical ventilation (≥ 48 h) due to post-thoracolaparotomy ARF in the ICUs.According to the duration of the mechanical ventilation, the patients were divided into 2 groups : successfully prolonged weaning group (≥ 7 days, n =24) and refractory weaning group (＜ 7 days, n =18).The patients with cardiac failure, aged less 18 or over 80, with hepatic dysfunction, or those needing gastrointestinal decompression after esophageal surgery or upper abdomen surgery were excluded.The demographics, APACHE Ⅱ scores and duration of mechanical ventilation of both groups were recorded, and the respiratory work and oxygen metabolism variables before the switch to sequential ventilation (within 24 hours after admission to ICU) and at the time of switching (24 hours in the ICU after admission) were recorded, respectively: clinical puhnonary infection score (CPIS), assessment of cough severity, pH, PaO2, PaCO2 and PaO2/FiO2;hemodynamic and microcirculation-related variables: HR, MAP, fluid balance, BNP and Lac;endocrine and metabolism variables : Hb, ALB and random serum cortisol (COR).The clinical features and the changes of the above-mentioned variables before and at the time of switching were compared between both groups.The independent sample t test was used for the single factor comparison and Mann-Whitney U test was applied to the non-normal distributions.The Fisher exact probability test was used for the single factor comparison of ranked data such as categorical variables.Results There were no significant differences in age, gender and severity of disease between two groups (P ＞ 0.05);the successfully prolonged weaning group had longer duration of invasive mechanical ventilation and ICU stay compared with the refractory weaning group (P ＜ 0.05).There were significant differences in cough severity, PaCO2, pH, HR and fluid balance between two groups before switching (P ＜ 0.05).Compared with those before switching, in the refractory weaning group there were marked decrease in Lac (P ＜ 0.05), obvious increase in cough severity, pH, Hb and ALB (P ＜ 0.05), but there was no significant difference in COR (P ＞ 0.05);while in the successfully delayed weaning group, there were significant decrease in CPIS, PaCO2, HR, MAP, BNP, fluid balance and Lac (P ＜ 0.05), and cough severity, pH, ALB and COR showed an upward trend (P ＜ 0.05).Conclusions The key of successful sequential ventilation is within the values of RSBI ranging from 80 to 120 times/ (min · L) during the initial SBT (60 min) selected as the switching point in patients with prolonged weaning after thoracolaparotomy.The major influencing factors for determining the ideal timing of switching include the matching status between respiratory endurance and respiratory work, the balance between myocardial strength and both cardiac preload and afterload, the severe disease associated with adrenal insufficiency, and malnutrition.

Objective To explore the effects of surface functionalized multi-walled carbon nanotubes (FMWCNTs) on the cytotoxicity of human peripheral blood mononuclear cell (PBMC).Methods Five different types of MWCNTs (hydroxylated,carboxylated,aminated,nickel-plated and pristine MWCNTs (P-MWCNTs)) with the same diameter and length were evaluated the dispersion and characterizations in physiological salt solution by transmission electron microscopy.PBMC were isolated by density gradient centrifugation from human peripheral blood,and 5 types of MWCNTs were ultrasonically dispersed in serum-containing medium respectively.After incubation with PBMC for 12,24,48 or 72 h,cytotoxicity was detected by CCK-8 kits.Results All the MWCNTs had well dispersion,especially the F-MWCNTs.Cytotoxicity results showed that all types of MWCNTs could induced PBMC death,and presented dose-dependence manner and a certain degree of time-dependence manner.Compared with the P-MWCNTs,F-MWCNTs changed cytotoxicity statistically,with the hydroxylated,carboxylated,aminated MWCNTs weakened,aminated MWCNTs significant (P＜0.05),nevertheless the nickel-plated MWCNTs increased.Compared with the P-MWCNTs (25 μg/ml),cell viability of PBMC after 24 and 48 h incubation with the same dose of nickelplated MWCNTs both decreased,and the differences was statistically significant (P＜0.01,P＜0.05).Conclusions The functional group modification affects not only the MWCNTs dispersion in medium,but also the cytotoxicity of the MWCNTs on PBMC.

AIM:To study the effects of colquhounia root tablet on the expression of adhesion molecule in acute lung injury of rats. METHODS: The rats were divided into 3 groups: ALI group, colquhounia root tablet+ALI group and control group . ALI animal model was performed by treatment with oleic acid. The positive expression rates of CD11a, CD11b and CD18 in polymorphonuclear neutrophils and monocytes were analyzed by flow cytometry. ICAM-1 expression in lung tissue was determined by immunohistochemistry, histopathological examination and biological markers were measured from lung specimens.RESULTS: Colquhounia root tablet decreased the expression of CD11a, CD11b and CD18 in polymorphonuclear neutrophils and monocytes, and ICAM-1 in lung tissue (P