Objectlve To investigate the effects of different ventilation modes on the efficacy of exogenous pulmonary surfactant(PS)for the treatment of rats with ventilator-induced lung injury(VILI).Methods Forty-two male Wistar rats weighing 310-356 g were randomly divided into 6 groups(n=7 each):group CVT6,group SVT6,group CVT10,group SVT10,group CVT14 and group SVT14.The tidal volume(VT)was set at 6,10 and 14 ml/kg respectively and the respiratory rate(RR) was 75,45 and 32 bpm respectively.The animals were anesthetized with intraperitoneal 3% Pentobarbital 50 mg/kg,then tracheostomized and intubated.VILI model was induced by high-pressure ventilation (HPV) with peak inspimtory pressure (PIP) 40 cm H2O and without positive end-expiratory pressure (PEEP).The air was injected into the trachea via the airway at the end ofexpiration before HPV (T0,baseline value) and 15-25 min of HPV,the airway pressure monitored and the lung compliance(C) calculated.When C was decreased to half of the baseline value,PEEP was increased to 7.5 cm H20.After the tracheal edema fluid was removed,the PS 100 mg/kg was immediately injected into the trachea in group SVT6,SVT10 and SVT14.The equal volume of air was injected into the trachea in group CVT6,CVT10 and CVr14 instead of PS.Then the rats in different groups were ventilated with the corresponding ventilation modes.MAP was monitored and blood samples were token from femoral artery for blood gas analysis at T0, 5 min after HPV (T1 ), and 15, 30, 60, 90, 120 min (T2-6) after administration of PS. The tracheal edema fluid was collected at T1 and T6.The rats were killed at T6 and the lung tissues taken for microscopic examination. Results With the same ventilation mode, the VILI was significantly alleviated after administration of PS. With different ventilation modes,the lung injury was significantly reduced in group SVT 10 compared with the other groups. Conclusion The efficacy of PS for the treatment of rats with VILI is good using the ventilation strategy with VT of 10 ml/kg and RR of 45 bpm.

Objective To investigate whether physical training can activate the PI3K/Akt (phosphatidyli-nositol 3-kinase/Protein Kinase B) signal transduction pathway after focal brain isehemia, leading to the reduction ofendothelial cell apoptosis. Methods Twenty-four male adult Sprague-Dawley rats (2 ～ 3 month old, n = 24) weresubjected to 60-min right middle cerebral artery occlusion (MCAO). All rats were randomly assigned to one of thethree groups: physical training group, control group and sham operation group. 24 hours after MCAO ,physical train-ing group underwent 30 min treadmill training per day for 2 weeks. Results After two weeks, the phosphorylationlevel of PI3K/Akt in the physical training group was significantly higher when compared with that in the control group(P <0.05), while the expression level of Bax in physical training group was lower when compared with that in thecontrol group( P < 0.05 ). Conclusion Physical training can activate PI3K/Akt signal transduction pathway,which may be associated with the neurological recovery.

Objective:To screen the time points of high survival rate and efferocytosis dysfunction of rat alveolar macrophages stimulated by cigarette smoke extract (CSE), establish an in vitro model of alveolar macrophage efferocytosis function, and study chronic respiratory diseases with chronic inflammatory reaction as the main pathological changes. Methods:① Time point screening experiment: rat alveolar macrophages (NR8383 cells) were cultured in vitro, and the cells in logarithmic growth phase were divided into blank control group (100 μL complete medium) and 5% CSE group (90 μL complete medium + 10 μL 100% CSE). Alma blue method was used to detect the effect of 5% CSE on the activity of NR8383 cells at 6, 12, 24 and 48 hours. ② Apoptosis induction experiment: rat type Ⅱ alveolar epithelial cells (RLE-6TN cells) were cultured in vitro as phagocytic target cells of NR8383 cells, and the cells in logarithmic growth phase were divided into blank control group and 10, 30 and 60 minutes groups after ultraviolet exposure (apoptosis was induced by 30 000 μJ/cm 2 ultraviolet irradiation for 15 minutes). Flow cytometry was used to detect the apoptosis rate of RLE-6TN cells cultured for 10, 30 and 60 minutes after ultraviolet exposure. ③ Cell efferocytosis experiment: NR8383 cells in logarithmic phase were divided into blank control group and 5% CSE group. Two hours before NR8383 cells were stimulated by CSE for 6, 12 and 24 hours, RLE-6TN cells were exposed to ultraviolet to induce apoptosis, and the RLE-6TN cell suspension was added to NR8383 cells (the ratio of RLE-6TN cells to NR8383 cells was 5∶1). Flow cytometry was used to detect the efferocytosis rate of NR8383 cells to RLE-6TN cells at different time points treated with 5% CSE. Results:① Compared with the blank control group, the activity of NR8383 cells significantly decreased after treatment with 5% CSE for 48 hours [cell reduction rate: (68.5±4.1)% vs. (73.6±2.3)%, P < 0.05]. However, there were no significant differences when the activities of NR8383 cells treated with 5% CSE for 6, 12 and 24 hours were compared with the blank control group, so these three time points were selected for the subsequent establishment of alveolar macrophage cell efferocytosis dysfunction in vitro model experiment. ② Compared with the blank control group, the apoptosis rate of RLE-6TN cells significantly increased at 10, 30 and 60 minutes after ultraviolet exposure [(66.87±8.63)%, (85.51±2.39)%, (96.13±2.74)% vs. (9.13±3.17)%, all P < 0.01] in a time-dependent manner. Considering that it taked about 50 minutes for RLE-6TN cells to be labeled with PKH26 membrane labeling probe, 10 minutes after ultraviolet exposure was selected to label RLE-6TN cells. ③ Compared with the blank control group, the efferocytosis function of NR8383 cells was significantly decreased after treatment with 5% CSE for 12 hours [cell efferocytosis rate: (33.64±1.30)% vs. (44.02±2.71)%, P < 0.01], but there was no significant effect on the efferocytosis function of NR8383 cells at 6 hours and 24 hours. Conclusions:CSE can induce alveolar macrophage cell efferocytosis dysfunction. Based on the test results of the effect of 5% CSE on NR8383 cell activity and cell efferocytosis function, 12 hours with high survival rate and weak efferocytosis effect of NR8383 cells can be selected as the in vitro model condition of alveolar macrophage cell efferocytosis dysfunction.

Objective To evaluate the therapeutic efficacy of stereotactic body radiotherapy (SBRT) with gamma knife on stage Ⅰ-Ⅱ non-small-cell lung cancer(NSCLC)and the quality of life of the patients undergoing this therapy.Methods Twenty NSCLC patients with the median age of 76,10 at stage Ⅰ and 10 at stage Ⅱ who were unable or unwilling to undergo surgery were given SBRT with gamma knife at the doses of 3-6 Gy in 8-15 fractions,finished within 2 to 3 weeks.The prescription isodose line was 50％,the marginal dose was 39-56 Gy,the central dose was 78-112 Gy,and the total biologically effective dose was 51-83 Gy.The patients were observed after admission and followed up by chest CT 1,3,6,and 12 months after treatment until progressive disease or death.EORTC QLQ-LC43 questionnaire was used to investigate the changes in quality of life.Results The 20 patients were followed up for 24 (12-46) months.At six months after the treatment,the overall response rate was 80％,and the complete response rate was 35％.The 1,2 and 3-year local control rates were 100％,95％ and 95％,respectively.The 1,2 and 3-year overall survival rates were 95％,80％ and 50％ respectively; The 1,2,and 3-year progression free survival rates were 85％,64％ and 33％,respectively.The failure rate was 20％ and the rate of progress within the planning target volume was 5％.No acute toxicity at grade 3 and over occurred in any patient during the treatment.15％ of the patients developed grade 1-2 radiation pneumonia.Age,gender,pathologic index or not were weakly correlated with the overall survival.The emotional function was improved significantly after treatment (P ＜ 0.05),dyspnea and cough were improved at different degrees,however,not significantly.There were no significant changes in the physical function and symptoms,such as fatigue,lack of appetite,insomnia,etc.Conclusions Significantly improving the motional function and maintaining the quality of life,SBRT with gamma knife is effective for elderly NSCLC patients with high local control rate fair overall survival rate and few side effects.

Objective To investigate the late effects induced by ionizing radiation and the rehabilitation treatment of local radiation injury by medical follow-up of the patient exposed to192 Ir at 5.7 accident in Nanjing,and to provide more experience for the treatments in the medical emergency of nuclear or radiological accident.Methods According to the history inquiry and physical examination of the patient in detail and the record of clinical symptoms and signs,the changes of the blood system,immune system,reproductive system,eyes,nervous system were systematically evaluated.The effects of rehabilitation treatment for the patient with lower limb dysfunction were also assessed.Results After the medical treatments of the patient,the hematopoietic immune system was restored,but the bone marrow aspiration still showed low bone marrow hyperplasia in right ilium.Meanwhile,the level of sex hormones was within the normal range,but semen examination showed sperm motility was 0.The radiation damage also occurred in the eye lens,retina and fundus.Howevcr,the psychological evaluation showed that the patient was stable and the right lower limb skin wound healing was well except for dysfunction and pain in some extent,which was relieved after the rehabilitation treatment.Conclusions The physiological function of the exposed victim with mild bone marrow type acute radiation sickness could be completely or partially restored after the clinical treatment in the early stage.

As one of the top three causes of death in the world, chronic obstructive pulmonary disease (COPD) is a serious hazard to human health. Macrophages play an important role in COPD, and their efferocytosis function is essential for ending chronic inflammation of COPD. Efferocytosis damage of alveolar macrophages (AM) in patients with COPD causes the rising of bacterial infection and airway bacterial colonization risk in lungs, which is the main reason for the acute exacerbation and the rising of incidence rate and mortality rate in COPD. In recent years, the regulation of macrophage efferocytosis function in COPD has becoming a research hotspot. Progress on the role of macrophage efferocytosis function on COPD, and the breakthrough points of improving AM efferocytosis dysfunction by traditional Chinese medicine is reviewed, so as to provide new ideas for the prevention and treatment of COPD.

Objective In order to explore the effects of rehabilitation training and acupuncture on the neural function deficit and motor function in patients with ischemic streke.Methods Eighty patients with ischemic stroke were randomly divided into rehabilitation and acupuncture groups.According to different recovery stages,the rehabilitation group received purposeful rehabilitation training for 28 days while the acupuncture group received scalp needling combined with body acuptmcture.The neural deficit scores(NDS)and motor fimction comprehensive assessment(FCA) were evaluated at the recruitment(M_0),the 28~(th)(M_1)and 56~(th)(M_2)days after treatment.Results No significant difierences were found in the NDS and motor FCA between the rehabilitation and the acurluncture groups at the recruitment.The significant differences appeared at the 28~(th) and the 56~(th) days comparing with baseline assessments in each group.There was no significant difference in the changes of NDS and motor FCA between the two groups at 28~(th) day,however,the NDS and motor FCA in rehabilitation group revealed better outcome than the acupuncture group at the 56~(th) day.Conclusion The study indicated that both rehabilitation training and acupuncture could improve the neural function and enhance the motor function in patients with ischemic stroke.

Objective To analyze the efficacy and prognosis of stereotactic radiotherapy (SRT) and whole-brain radiotherapy (WBRT) in treatment of brain metastases,and to observe the influence of temozolomide (TMZ) on survival rate during the period of radiotherapy.Methods A total of 52 patients with brain metastases were divided into two groups according to treatment methods,including 35 patients treated with WBRT plus SRT and 17 patients treated with SRT alone.WBRT dose was 1.8 - 3.0 Gy per fraction,one fraction a day,five fractions per week,with total dose of 30 - 40 Gy.After WBRT,gamma knife was performed with prescription isodose line of 45％ -70％ surrounding the planned target volume in WBRT + SRT group.The marginal dose was 12 - 15 Gy and the center dose was 20-30 Gy.In SRT group,the prescription isodosc line was 45％ - 70％ and the marginal dose was 36 - 40 Gy while the center up to 70 - 80 Gy.The follow up time was 1 - 2 years.Besides 20 patients in this study took temozolomide capsule during and after radiotherapy.The schedule of concomitant chemotherapy was temozolomide of 75 mg/m2 by oral administration every day until radiotherapy was over,and then temozolomide of 150 mg/m2 was taken for 3 -6 months after radiotherapy.Results The efficiency during 1 -3 months after treatment was 84.62％ in this study.In the WBRT + SRT group,the efficiency was 88.57％ and declined to 76.47％ in the SRT group.The six month-and one year-local control rate were 92.10％ and 85.20％,respectively.The average survival time of WBRT + SRT was 13.2 months and median survival time was 11 months.Six month-,one year-and eighteen months-survival rate were 71.40％,54.30％ and 14.30％,respectively.In the SRT group,the average survival time was 10.2 months and median survival time was 9 months.Six month-,one year- and eighteen month-survival rate were 41.20％,23.50％ and 5.88％,respectively,while those for RT + TMZ group were 80.00％,60.00％ and 10.00％.In comparison,those in RT group were 56.30％,37.50％ and 12.50％,respectively.Conclusions Effect of gamma knife stereotactic radiotherapy combined with WBRT is better than GK stereotactic radiotherapy alone in treatment of brain metastases.Compared with radiotherapy alone,concomitant temozolomide chemotherapy could improve the survival rate of the patients with brain metastases without increasirg adverse reactions significantly.

Based on the biomechanical response of human knee joint to a front impact in occupants accidents, a finite element (FE) model of human knee joint was developed by using computer simulation technique for impacting. The model consists of human anatomical structure, including femoral condyle, tibia condyle, fibular small head, patellar, cartilage, meniscus and primary ligament. By comparing the results of the FE model with experiments of the knee joint in axial load conditions, the validation of the model was verified. Furthermore, this study provides data for the mechanical of human knee joint injury, and is helpful for the design and optimization of the vehicle protective devices.
Biomechanical Phenomena ; Finite Element Analysis ; Humans ; Knee Injuries ; physiopathology ; Knee Joint ; anatomy & histology ; physiology ; Models, Anatomic ; Models, Biological

OBJECTIVE: To explore the role of phosphorylation of cAMP response element binding protein (CREB) in the incision-induced pain hypersensitivity. METHODS: A longitudinal incision was made in one plantar hind paw of isoflurane-anesthetized rats. Spinal cords were removed at various postoperative time after behavior test. Phosphorylation of CREB was determined by immunohistochemistry and double-labeling immunofluorescence. Morphine and gabapentin were intraperitoneally injected before the behavior test and were used to determine the interaction between phosphorylation of CREB and morphine and gabapentin. RESULTS: After the hind-paw incision, phosphorylation of CREB was enhanced in the ipsilateral lumbar spinal cord (P<0.05). The enhancement of p-CREB was mainly in the neurons in the dorsal horn of the spinal cord. All these were shown by double-labeling technique and p-CREB was mainly in the neurons. Intraperitoneal injection of morphine prevented the increased phosphorylation of CREB in the spinal cord and inhibited the mechanical allodynia induced by the incision (P>0.05). Gabapentin didn't inhibit the phosphorylation of CREB (P<0.05) but partly inhibited the mechanical allodynia. CONCLUSION Incision induces the phosphorylation of CREB in the spinal cord, and the increase of p-CREB is mainly in the neurons. Phosphorylation of CREB in the spinal cord contributes to the pain hypersensitivity induced by surgical incision.
Animals ; Cyclic AMP Response Element-Binding Protein ; metabolism ; Female ; Foot ; surgery ; Neurons ; metabolism ; Pain Threshold ; Pain, Postoperative ; metabolism ; Phosphorylation ; Rats ; Rats, Sprague-Dawley ; Spinal Cord ; metabolism