Alveolar Epithelial Cells ; cytology ; metabolism ; Animals ; Apoptosis ; Lung ; drug effects ; metabolism ; Nitric Oxide ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Tyrosine ; analogs & derivatives ; metabolism

Female ; Forced Expiratory Volume ; Humans ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Male ; Positive-Pressure Respiration ; methods ; Pulmonary Ventilation ; Respiratory Insufficiency ; physiopathology ; therapy ; Treatment Outcome

OBJECTIVESTo explore whether the angiotensin I -converting enzyme (ACE) I/D (insertion/ deletion) polymorphism is associated with the susceptibility to high altitude pulmonary edema (HAPE) in the Han Chinese.

METHODSOne hundred and forty-seven HAPE-p (HAPE patients) and 193 HAPE-r (HAPE resistants) were enrolled from the Yushu earthquake reconstruction workers in Qinghai province where the altitude is over 3 500 m above sea level. Blood samples were collected from each of the HAPE-p and HAPE-r groups. Information about physiological phenotypes was obtained via fieldwork investigation. The ACE-I/D polymorphism in HAPE-p and HAPE-r was detected by polymerase chain reaction (PCR).

RESULTSThe SaO2 was significantly lower while HR was significantly higher in HAPE-p group than those in HAPE-r group. The genotype frequencies of ACE-I/D for II, ID, DD in HAPE-r and HAPE-p groups were 0.430, 0.446, 0.124 and 0.435, 0.469, 0.095, respectively, the allelic frequencies of I and D were 0.650, 0.350 and 0.670, 0.330, respectively. The OR of ID, DD and D alleles relative to II for HAPE was 0.961 (0.610-1.514), 1.322 (0.634-2.758) and 1.080 (0.783-1.489). There was no significant difference of the genotypic and the allelic frequencies in ACE-I/D polymorphism between HAPE-p and HAPE-r groups.

CONCLUSIONSThere is no relation between ACE-I/D polymorphism and HAPE in the Han Chinese.

Alleles ; Altitude ; Asian Continental Ancestry Group ; genetics ; Case-Control Studies ; Gene Frequency ; Genotype ; Humans ; Peptidyl-Dipeptidase A ; genetics ; Polymorphism, Genetic ; Pulmonary Edema ; genetics

Objective To research the effects of short-term intensive insulin treatment on regaining the sensitivity of sulfonylureas in diabetes patients. Methods Thirty patients from outpatient and emergency department,including 12 male and 18 female,who took regular-dose sulfonylureas but was high blood glucose level,were selected to suspend the sulfonylureas treatment and were given the BIAsp30 to control the blood glucose level for three months,then they were stopped the BIAsp30 and took the same sulfonylureas used before.Results The average fasting blood glucose(FBG) was(9.4?7.5)mmol/L and the average postprandial 2 h blood glucose(PG2h)(or random blood glucose) was(14.2?7.2)mmol/L in 3 months before stopping the sulfonylureas.The average FBG was(5.7?0.7)mmol/L and PG2h was(7.2?1.4)mmol/L at the beginning of the insulin getting the blood glucose under control.The average FBG was(6.0?0.8)mmol/L and PG2h was (7.8?1.2)mmol/L during the insulin treatment.The average FBG was(6.1?0.6)mmol/L and PG2 h was(7.7?1.3)mmol/L at the end of the insulin treatment.The average FBG was(6.5?0.5)mmol/L and PG2h was(8.1?(0.8))mmol/L when continuing the sulfonylureas treatment in one months.It increased significantly to compare the blood glucose before the treatment of insulin to that after the treatment of insulin(P

OBJECTIVETo investigate the anti-inflammation and anti-oxidation effects of recombinant human CuZn superoxide dismutase(rhSOD) on acute lung injury (ALI) induced by meconium aspiration in rats.

METHODS1 ml/kg of 20% human newborn meconium suspension was intratracheally (IT) administrated to induce the model of ALI in 32 male Sprage-Dawley rats, and the animals were then randomized to 4 groups: 3 treatment groups with IT administration of 5, 10 and 20 mg/kg rhSOD dissolved in 1 ml/kg saline and the control group with IT administration of 1 ml/kg saline. The animals were killed after 24 h of treatments. The measurements included lung tissue wet/dry ratio, broncho-alveolar lavage fluid (BALF) protein, BALF protein/plasma protein (pulmonary permeability index, PPI),lung myeloperoxidase (MPO) and superoxide dismutase (SOD) activity, nitric oxide (NO) and 8-isoprostane levels. Lung injury score was also evaluated.

RESULTSCompared with the control group, pulmonary MPO activity, NO and 8-isoprostane levels were significantly decreased and SOD activity was markedly increased in all rhSOD treatment groups (P<0.05 or 0.01). Compared with the rhSOD 5 mg/kg group, pulmonary 8-isoprostane level was further low in the rhSOD 20 mg/kg group(P=0.01). Lung injury score was decreased in rhSOD 20 mg/kg group (P<0.05). But there were no statistically differences in lung wet/dry, BALF protein and PPI among all groups.

CONCLUSIONThe results suggest that a single IT dose of 5,10 or 20 mg/kg rhSOD can prevent lung damages in rats with ALI following meconium aspiration.

Animals ; Anti-Inflammatory Agents, Non-Steroidal ; pharmacology ; Antioxidants ; pharmacology ; Humans ; Lung ; drug effects ; pathology ; Male ; Meconium ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Recombinant Proteins ; pharmacology ; Superoxide Dismutase ; pharmacology

OBJECTIVERespiratory distress syndrome (RDS) is a frequently seen acute respiratory disorder in the newborn infants. Since the original description of deficiency of the pulmonary surfactant in premature neonates by Avery in 1959, RDS has most commonly been attributed to developmental immaturity of surfactant production. But in clinical practice it has been found that there was RDS in term and late-term neonates. Many of them were recognized as transient tachypnea at the beginning, they were diagnosed as RDS until respiratory distress and the typical radiological signs were demonstrated. The purpose of this study was to investigate the clinical characteristics of RDS of term and late-term neonates.

METHODSAll neonates admitted to the neonatal intensive care unit of the Children's Hospital, Zhejiang University School of Medicine between May, 2005 and May, 2007 on the basis of RDS were analyzed. RDS was diagnosed when respiratory distress and the typical radiological signs were documented. Patients were grouped into preterm group (Group 1, gestational age < 35 w, n = 103) and term and late-term group (Group 2, gestational age > or = 35 w, n = 74).

RESULTSIn Group 1, 76 preterm infants were male, the mean gestational age was 31.1 w, the mean Apgar score at 1 min was 7.6, the mean birth weight was 1702 g, 56 cases were vaginally delivered and 47 were delivered through Cesarean section. Only one was delivered via elective Cesarean section before onset of labor. A total of 88 patients needed mechanical ventilation (MV), the time for beginning MV was 8.7 h (1 - 72 h), and lasted for 4.3 d (0.5 - 29 d). The oxygenation index (OI) was 11.9 (10.00 - 52.63) and PaO2/PAO2 was 0.29 (0.03 - 0.98). Four patients had an OI > 40. A total of 28 patients were treated with pulmonary surfactant (PS), and 11 of the 28 underwent MV, the OI before and 2 h, 8 - 12 h and 20 - 24 h after using PS were 10.5, 5.4, 3.4, and 4.3, respectively (P < 0.01). A total of 33 patients in Group 1 had intracranial hemorrhage, 4 patients had pneumothorax, 4 patients had persistent pulmonary hypertension of the newborn (PPHN) and 15 patients had ventilator associated pneumonia (VAP). In Group 2, 54 infants were male, the mean gestational age was 37 w, the mean Apgar score at 1 min was 8.5, the mean birth weight was 2789 g, 8 cases were vaginally delivered, 66 were delivered through Cesarean section and 59 were delivered via elective Cesarean section before onset of labor. A total of 63 patients needed MV, the time for beginning MV was 27.8 h (1 - 72 h, compared to Group 1, P < 0.01), and lasted for 3.7 d (0.5 - 13.5 d). The OI was 19.70 (10.00 - 56.67, compared to Group 1, P < 0.01) and PaO2/PAO2 was 0.16 (0.017 - 0.470, compared to Group 1, P < 0.01). Seven patients had an OI > 40. A total of 8 patients were treated with PS and 7 of them had MV, the OI before and 2 h, 8 - 12 h and 20 - 24 h after using PS were 11.2, 7.6, 7.5, and 7.6 (the last two compared to group 1, P < 0.01, respectively). A total of 16 patients had pneumothorax, 10 patients had intracranial hemorrhage, 16 patients had PPHN and 7 patients had VAP.

CONCLUSIONMost of the term and late-term neonates who developed RDS were delivered through cesarean section before onset of labor. They underwent MV later. The oxygenation was worse than RDS in preterm infants. PS did not have the same effect as seen in preterm infants. They had more pneumothorax and PPHN.

Female ; Humans ; Infant, Newborn ; Infant, Premature ; Male ; Pulmonary Surfactants ; therapeutic use ; Respiration, Artificial ; Respiratory Distress Syndrome, Newborn ; therapy ; Treatment Outcome

OBJECTIVETo evaluate the risks and benefits of two transfusion strategies (liberal-transfusion and restrictive-transfusion), as judged by the clinical progress and outcome, in very low birth weight infants.

METHODSThe clinical data of 93 hospitalized very low birth weight infants who required blood transfusions were retrospectively studied. The infants were assigned to either the liberal transfusion group (n=58), with higher hematocrit levels, or the restrictive-transfusion group (n=35), with lower hematocrit levels.

RESULTSThe infants in the restrictive-transfusion group received more numbers of RBC transfusions compared with the liberal-transfusion group (2.6+/-1.8 vs 1.8+/-1.0; p<0.05). Liberal-transfusion was associated with faster weight gain and the duration to return to the birth weight averaged 10 days in the liberal-transfusion group compared with 13 days in the restrictive-transfusion group (p<0.01). The infants in the liberal-transfusion group had shorter duration of mechanical ventilation than in the restrictive-transfusion group (5.5+/-4.2 days vs 8.0+/- 5.9 days; p<0.05). There were no significant differences in the incidence of apnea and nosocomial infections between two groups.

CONCLUSIONSThe study suggests the possible benefits from liberal-transfusion for clinical recovery in very low birth weight infants. The restrictive transfusion does not decrease the number of transfusions. It in fact increases the number of clinical indicated transfusions. Neonatologists should weigh the advantages and disadvantages on transfusions to make the optimal decision.

Anemia ; etiology ; therapy ; Blood Transfusion ; methods ; Erythrocyte Transfusion ; Female ; Humans ; Infant, Newborn ; Infant, Very Low Birth Weight ; Male ; Retrospective Studies

Objective To observe the sequence of fat deposit and its relationship with insulin resistance in SD rats fed by high fat diet.Methods Normal 8-week-old male SD rats were randomly divided into normal chow (NC,n=40)and high fat diet(HF,n=40)groups.Triglyceride(TG)in serum,liver and muscle were measured;glucose infusion rate(GIR)and the mRNA level of genes related to lipid metabolism in liver and muscle were determined in different stages.GIR was detected by eugiyeemic-hyperinsulinemic clamp for evaluating the insulin sensitivity.Gene expression was determined by real-time PCR.Results(1)As compared with NC group,serum TG was not increased after high fat feeding for4 and 8 weeks,it began to increase after 12 weeks [0.52(0.15-1.00) mmol/L vs O.31(0.09-0.53)retool/L, P0.05)in skeletal muscle.After 8 weeks,the expression of ACC1 in liver in HF group was increased by 20.6%,CPT-1 was decreased by 27.1%(P

Objective To study the effects of fluorine and aluminum on index of hematologic tests of rats. Methods According to body mass,56 Wistar rats of 130-200 g were randomly divided into control,low-fluorine (F),middle-F,high-F,low-F + aluminum(Al),middle-F + Al,high-F + Al group,8 rats in each group were given a series of doses of fluoride and aluminum,which were (0 + 0),(100 + 0),(200 + 0),(300 + 0),(100 + 10),(200 + 10),(300 + 10)mg/L After 90-day intragastrie administration,blood samples were collected on eyes of rats to undergo blood routine test,including red blood cell (RBC),lymphocyte (LYM),platelet (PLT),hemoglobin (HGB),white blood cell (WBC),hematocrit (HCT),mean corpuscular hemoglobin (MCH),mean corpuscular-hemoglobin concentration(MCHC),mean corpuscular volume(MCV),and at the same time some blood biochemistry indicators related to functio ns of liver and kidney were determined such as aspartic acid aminotransferase(AST),alanine aminotransferase(ALT),alkaline phosphatase(ALP),Crea(Cr) and Urea. Organ coefficient of liver and kidney were calculated. Results The difference of RBC,HCT,MCV among all groups of rats was statistically significant(F = 3.202,3.316,2.915,P < 0.05). The RBC,HCT of the low-F group[(7.59± 2.40)×10~(12)/L,0.51±0.11],the middle-F group[(8.60±1.16)×10~(12)/L,0.55±0.05],the high-F group[(9.23± 0.60)×10~(12)/L,0.54±0.03],the low-F + Al group[(9.25±0.79)×10~(12)/L,0.53±0.04],the middle-F + Al group[(7.98±2.14)×10~(12)/L,0.49±0.08]and the high-F + Al group[(7.61±3.17)×10~(12)/L,0.49±0.16]were significantly higher than that in the control group[(4.46±3.10)×10~(12)/L,0.31±0.16,P< 0.05 or < 0.01)]. The MCV of the middle-F group[(64.06±6.51)fl],high-F group[(58.67±1.13)fl],low-F + Al group[(57.78± 1.57)fl]and the middle-F + Al group[(63.04±10.64)fl]were significantly higher than the control group[(78.54± 15.57)fl,P < 0.05 or < 0.01]. The difference of AST and Urea among all the groups of mrs serum was statistically significant(F= 2.847,5.549,P < 0.05 or < 0.01). The serum AST of low-F group[(399.00±54.99)U/L],the middle-Fgroup[(465.60±76.99)U/L],the high-F group[(465.80±75.41)U/L],the low-F + Al group[(346.00±69.26) U/L],the middle-F + Al group[(437.40±68.31)U/L]and the high-F + Al group[(403.00±30.61)U/L]were all significantly higher than that in the control group[(336.67±94.34)U/L,P < 0.05],and the high-F group significantly higher than the high-F + Al group(P < 0.05). The serum Urea of the middle-F group[(7.70±0.52)mmol/L],the high-F group[(8.44±1.30)mmol/L],the low-F + Al group[(7.83±0.62)mmol/L],the middle-F + Al group [(7.73±0.47)mmol/L],and the high fluoride + aluminum group[(7.70±0.21)mmol/L]were all significantly higher than that in the control group[(6.55±0.50)mmol/L,P< 0.05 or < 0.01],and the low-F group was significantly lower than the low-F + Al group(P < 0.01),however the high-F group was significantly higher than that in the high-F + Al group(P< 0.05). The liver organ coefficient of the low-F group(2.94±0.36) was higher than the low-F + Al group (2.60±0.15,P < 0.05). Conclusions Fluorine and combination of aluminum and fluorine have toxicity on rats to a certain extent,including the proliferation of crythrocytes of rat,while the cell size gets smaller and the cell quality is deteriorated,meanwhile functions of liver and kidney are impaired. Aluminum shows different joint action in different concentrations of fluorine.

OBJECTIVEThe authors compared the protective ventilation strategies with the assistance of pulmonary mechanic measurements (PM) to the conventional ventilation practice in order to investigate the incidence of VALI, explore the best ventilator settings in RDS and the clinical effects of hypercapnia in neonates.

METHODSOne hundred and ten newborn infants, diagnosed as respiratory distress syndrome of neonatal and needed ventilator support, were recruited from the intensive care unit from 1994 to 2001. Infants with RDS were divided into non-pulmonary mechanics measurement (NPM) group and pulmonary mechanics measurement (PM) group. The ventilator settings, artery blood gas analysis, ventilator-associated lung injury and other clinical data were analyzed and compared.

RESULTSIn the PM group, expiratory tidal volume of (7.70 +/- 1.05) ml/kg, C(20)/C of (1.98 +/- 0.92) and time constant of (0.09 +/- 0.03) sec were measured. Ventilator setting in PM group [PIP of (26.7 +/- 1.7) cmH(2)O, MAP of (11.9 +/- 2.0) cmH(2)O, Ti of (0.45 +/- 0.10) sec] were significantly less than those in NPM group [PIP of (30.5 +/- 3.4) cmH(2)O, MAP of (14.9 +/- 3.4) cmH(2)O, Ti of (0.75 +/- 0.10) sec P < 0.001, respectively]. No differences were noted in demographic data between the two groups regarding to the pH (7.30 +/- 0.04 vs 7.31 +/- 0.10), PaO(2) [(59 +/- 16) vs (57 +/- 17) mmHg], heart rate [(145 +/- 6) vs (144 +/- 8) bpm] and blood pressure [(39.0 +/- 3.6) vs (40.0 +/- 4.6) mmHg], except for PaCO(2) in PM group which was significantly higher than that in NPM group [(48 +/- 6) vs (40 +/- 10) mmHg, P < 0.001]. OI in PM group was significantly less than that in NPM group (14 +/- 8 vs 19 +/- 13, P < 0.05). Incidence of ventilator-associated lung injury in PM group was significantly lower than that in NPM group (13% vs 32%, P < 0.05). No differences were noted in demographic data between the two groups regarding to the length of ventilator support [(4.2 +/- 1.7) vs (3.9 +/- 1.8) day], length of supplemental oxygen requirements [(13 +/- 7) vs (11 +/- 7) day], length of hospitalization [(22 +/- 11) vs (19 +/- 14) day], mortality (8% vs 14%), incidence of PDA (33 vs 36%) and IVH (40% vs 42%).

CONCLUSIONSThe assistance use of pulmonary mechanics measurement can guide the ventilator adjustment and decrease the ventilator-associated lung injury in neonatal RDS. The low PIP, low tidal volume, shorter inspiratory time and adequate PEEP strategies in the treatment of RDS showed no significant effects on the oxygenation in neonates. The mild permissive hypercarbia in newborn did not increase the incidence of IVH.

Blood Gas Analysis ; Female ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Male ; Respiration, Artificial ; methods ; Respiratory Distress Syndrome, Newborn ; physiopathology ; therapy ; Respiratory System ; physiopathology