Objective To observe the eotaxin expression of rat airway smooth muscle cells ( ASMCs) induced by serum from asthmatic rats, and explore the possible mechanism. Methods ASMCs isolated fromrat tracheas were cultured in vivo. Then they were treated with serum from asthmatic rats, or treated with serum and dexamethasone simultaneously. The level of eotaxin protein in supernatant and eotaxin mRNA in ASMCs were measured by ELISA and reverse transcription-polymerase chain reaction. The expression of cAMP in ASMCs was examined by radioimmunoassay. Results After the treatment with sensitized serum, the eotaxin level in supernatant and mRNA expression in ASMCs were significantly higher [ ( 107. 09 ±7. 12) ng/L vs. ( 0. 63 ±0. 56) ng/L, P lt; 0. 05; 1. 39 ±0. 04 vs. 0. 05 ±0. 01, P lt;0. 05] , and the level of cAMP in ASMCs was significantly lower compared with the control group [ ( 17. 58 ±3. 62) ng/L vs. ( 32. 39 ±3. 36) ng/L, P lt; 0. 05] . After intervened by the sensitized serum and dexamethasone simultaneously, the protein and mRNA expressions of eotaxin were lower compared with those intervened by sensitized serumalone [ ( 64. 18 ±4. 04) ng/L and 0. 77 ±0. 19] . The level of eotaxin in supernatant was negatively correlated with cAMP level in ASMCs ( r = - 0. 788, P lt; 0. 01) . Conclusions There is anautocrine function in ASMCs as inflammatory cells after stimulation with sensitized serum. Eotaxin may play an important roll in the pathogenesis of asthma via a cAMP-dependent pathway.
Objective To explore the feasibility and safety of extracorporeal membrane oxygenation (ECMO) to support the airway reconstruction for the patients with airway obstruction or stenosis who cannot be ventilated routinely. Methods There were 3 patients received trachea reconstruction procedures assisted by ECMO. Among the patients, 2 cases with tracheal neoplasms underwent fibrobrochoscopy treatments, another one with endotracheal stenosis and fistula received tracheoplasty and semi-tracheostomy. Results ECMO can provide enough oxygenation for the patients with airway obstruction or stenosis and more time for advanced therapies. All three patients recovered after interventional surgeries, in whom one case died due to multiple organ failure caused by esophageal carcinoma metastasis after 3 months, and the others survived with dyspnea classification of 2-3 grade. Conclusion ECMO can be a safe and effective approch for the patients who cannot be ventilated conventionally in airway reconstruction.
Objective To identify the short ( lt;30 days) and intermediate ( 30 days to 6 months) benefits and risks of tracheobronchial stents in patients with malignant airway stenosis. Methods 55 cases with malignant airway disease who underwent tracheobronchial stents placement from January 2006 to May 2008 were followed up for 6 months. The efficacy rate, complication rate, reintervention rate, and survival were analyzed. Results There were 61 self-expanding metal stents placed in 55 patients with malignant disease, with no intraoperative mortality. The immediate efficacy rate was 100% , the short-term( lt;30 days) efficacy rate was 94. 5% , and the survival rate in 6 months was 32. 7% . The complications included tumor ingrowth, excessive granulation tissue, stent migration, and restenosis. A total of 14 cases of complicationswere observed, in which two occurred during the short-term period ( lt; 30 days ) and the remaining complications occurred after 30 days. Conclusions Tracheobronchial stents can improve symptoms immediately for the patients with unresectable malignant central airway obstruction with fairly safety. The benefit of airway stents is particularly seen in the short-termperiod and the complications occur mainly after 30 days.
ObjectiveTo investigate the changes of lung function after exposure to fine particulate matter (PM2.5) for 60 days and the expression of miR-146 in mice.MethodsThirty SPF BALB/c mice were treated with noninvasive tracheal instillation of fine particulate matter suspension at different doses (2.5 mg/kg, 5.0 mg/kg, 10.0 mg/kg) for 2 months (two times one week), the blank group and normal saline group were set as control groups. The mice were examined and killed on the next day after the last instillation. Histopathological changes of the lungs, pro-infammatory factors levels in the lung tissues, pulmonary functions and the relative expression of miR-146a and miR-146b in the lung tissues were detected.ResultsPeak inspiratory flow (PIF) and peak expiratory flow (PEF) were decreased significantly after PM2.5 exposure, however, lung resistance increased and maximal voluntary ventilation reduced from the general tendency without significant difference. Hematoxylin-eosin stain showed lymphocyte infiltration and macrophage infiltration by phagocytic particles, alveolar spacer widening, inflammatory response increased with the increase of PM2.5 exposure dosage. Pro-infammatory factors as interleukin-6 in the bronchoalveolar lavage fluid, interferon-γ and tumor necrosis factor-α in the lung homogenate were increased significantly by enzyme linked immunosorbent assay. The relative expressions of miR-146a and miR-146b were up-regulated remarkablely in treatment groups compared to the control group by real-time fluorescence quantitative polymerase chain reaction, which had negative relationships with PIF and PEF.ConclusionsThe lung function of mice decreases significantly after exposure to fine particulate matter, and the expression of miR-146 is up-regulated.
ObjectiveTo evaluate the efficacy and impacts of air tamponadein treating rhegmatogenous retinal detachments (RRD) including inferior breaks after 25G pars plana vitrectomy (PPV).MethodsA prospective non-randomized study. From November 2016 to December 2018, 110 RRD patients receiving PPV in the Ophthalmology Department of Affiliated Hospital of Nantong University were included in the study. All the patients choose the operation mode voluntarily after fully understand the condition and operation mode. There were 90 eyes in the air filling group and 20 eyes in the silicone oil filling group. There was no difference of age (t=－0.082), sex ratio (χ2=1.538), left or right eye (χ2=0.839), average course of disease (Z=－0.276), intraocular pressure (t=3.669), axial length (t=0.765), grade of proliferative vitreous retinopathy (Z=－2.101), high myopia (χ2=0.013), lens state (χ2=1.275), logMAR BCVA (t=－0.681), the scope of retinal detachment (t=0.970), the site (χ2=0.108) and numbers (t=0.158) of the retinal holes, whether involving macula (χ2=1.791) between the two groups (P＞0.05). At 1, 3, and 6 months after surgery, the first retinal reduction rate, BCVA increase rate, visual recovery rate, intraocular pressure, fovea retinal thickness (CFT), ellipsoid and cross sectional area, and the occurrence of postoperative complications in the two groups were observed and compared. Independent sample t test and Chi-squared test, Mann-Whitney U test, and ANOVA were used for data comparision.ResultsAfter the first operation, retinal reattachmnents were achieved in 87 eyes (96.6%) in the air group and 19 eyes (95.0%) in the silicone oil group (χ2=0.130, P＞0.05). In the air group and the silicone oil group, there were 7 and 2 eyes with subretinal holes, whose retinal reattachmnents were achieved. At 6 months after surgery, logMAR BCVA of the eyes in the air group and the silicone oil group were 0.23±0.23 and 0.37±0.23, respectively. All of them were higher than that before operation (t=－2.410, P＜0.001). BCVA in the air group was superior to that in the silicone oil group (P＜0.05). The increase rate of BCVA of the eyes in the air group and the silicone oil group were 0.69±0.28 and 0.48±0.30 logMAR units, respectively (t=－3.225, P＜0.05). The CFT of the eyes in the air group and the silicone oil group were 226.87±42.30 μm and 234.83±36.10 μm, respectively (t=－0.448, P=0.657). In the air group and silicone oil group, posterior cataract was observed in 15 and 4 eyes, subretinal residual fluid in 1 and 2 eyes, and visual object deformation in 3 eyes respectively. In the air group and silicone oil group, posterior cataract was observed in 15 and 4 eyes, subretinal residual fluid in 1 and 2 eyes, and visual object deformation in 3 eyes respectively.ConclusionsAir filling combined with PPV can effectively treat RRD, which is suitable for both superior and inferior holes. The visual acuity recovered well and the complication is less. The time of retinal detachment (especially the time of macular detachment) is an important factor affecting the prognosis.
Objective To investigate the effects of TiotropiumBromide on airway inflammation in a rat model of chronic obstructive pulmonary disease( COPD) . Methods Thirty Wistar rats were randomly divided into three groups. Group A received normal breeding as normal control. Group B and group C received LPS( 200 μg, intratracheally injected at the 1st and the 14th day) and tobacco exposure( from the 2nd day to the 30th day except the 14th day) to establish COPD model. And group C received a nebulized dose of Tiotropium Bromide( 0. 12 mmol / L, 10 minutes) 30 minutes before the tobacco exposure each time. Airway resistance and compliance were measured before sacrificed. Histological examination was performed with Hematoxylin-Eosin staining. The concentrations of IL-8 and LTB4 , total and differential cells counts in bronchoalveolar lavage fluid( BALF) were examined, and the concentrations of IL-8 and LTB4 in blood serum were also examined by ELISA. Results Severe lung inflammation and decreased lung function were demonstrated in the rats in the group B compared with those in the group A. The inflammatory cell counts in BALF, and the levels of IL-8 and LTB4 in BALF and serum were significantly increased in the group B compared with those in the group A. Tiotropium Bromide administration improved the parameters above. Conclusions The results suggest that Tiotropium Bromide can alleviate the lung inflammation and improve the lung function in a rat COPD model. These effects may be exerted through reducing the mediators of inflammation.
Objective To explore the role of nuclear factor kappa B(NF-KB)in the pathogenesis of chronic obstructive pulmonary disease(COPD)and the therapeutic efects of glucocorticoid．Methods Twenty-four Wistar rats were randomly divided into three groups，ie．normal control，COPD model and prednisone preventive treatment group．Rat COPD model Was established by exposing the rats to cigarette smoke daily．Prednisone Was given through stomachal injection on altemate days．After COPD model Was set up，bronchoalveolar lavage(BAL)Was performed．Total cell counts and neutrophil counts in BALF were examined．Pathological changes of lung tissue Was observe0 by hematoxylin-eosin staining．The morphological indices of pulmonary emphysema(MLI，MAN and PAA)Was measured by a computerizedimage analyzer and compared in three groups．NF-KB expression in lung tissues were detected by immunohistochemistry assay．Rults Emphysema Was confirmed by three morphological indices in COPD model group compared to those of normal control group[MLI：(97.97±11.10)×10-6m vs (47．23±2．80)×10-6 m，MAN：(95.98±l4.89)×106 ／m vs (164.21±9．30)×106 ／m ，PAA：(64 ±5.7)％vs (44±2.7)％，Plt;0.01]．Total cell counts and neutrophil counts in BALF of COPD model group were significantly higher than those of control group[（5.76±0.29）×108/L vs （1.64±0.12）×108/L，（1.26±0.25）×108/L vs （0.099±0.065）×108/L，Plt;0.01]．After the preventive treatment with prednisone，MLI，MAN and PAA were significantly changed[（57.66±4.62）×10－6mvs （97.97±11.10）×10－6m，（111.40±16.92）×106個/m2 vs （95.98±14.89）×106個/m2，Plt;0.01；（58±6.1）% vs （64±5.7）%，Plt;0.05]，which indicated that airway inflammation and emphysematous injury in preventive treatm ent group were milder than those of COPD mode1．Total ceil counts and neutrophil countsin BALF were found in preventive treatment group as compared to those of COPD model[[（3.18±0.29）×108/L vs （5.76±0.29）×108/L，（0.57±0.12）×108/L vs （1.26±0.25）×108/L，Plt;0.01].The percentage of positive cells of NF-KB nuclear staining in bronchiolar epithelial ceils was significantly increased in the COPD group than that in the control group[（29.02±1.25）% vs （12.17±1.13）%，Plt;0.01]，but was significantly decreased in the preventive treatment group[(19.23±1.18)％vs (29.02±1.25)％，Plt;0．01]．Conclusions NF-KB may be responsible for the persistence and amplification of inflammation in COPD through neutrophil recruitment and activation．Prednisone may suppress airwayinflammation in COPD by inhibiting NF-KB．
ObjectiveTo observe repairing process of trachea epithelium cells in chlorine-induced airway epithelial injury.MethodsTwelve mice were exposed to chlorine gas and prepared the mice model of airway damage. Three mice were executed respectively on 2nd, 4th, 7th, 10th day after exposure to chlorine gas, and tracheal tissues were collected. In addition 3 normal mice served as control. Airway repair and cell proliferation were detected by EdU labeling method. The basal cell markers keratin 5 (K5), keratin 14 (K14) were adopted as the tracheal epithelial markers for locating the position of the proliferation of repairing cells. Morphological analysis was adopted to measure the proliferation rate as well as the recovery of the false stratified epithelium.ResultsIn the control group, cell proliferation rate was very low, all basal cells expressed K5, and most basal cells did not express K14. Most of epithelial cells shed from the trachea epithelium after exposure to chlorine gas. 2-4 days after chlorine exposure, K5 and K14 expression basal cells increased, K14 expression cells increased greatly. In the peak period of cell proliferation, only a small number of ciliated cells appeared in the repairing trachea area. Epithelial cells repaired fast and widely at the bottom of the trachea.ConclusionThe trachea residual basal cells play roles of progenitor cells and repair the airway epithelium after chlorine damage in mice.
Objective To investigate the modulating roles of Clara cell secretory 16 kD protein ( CC-16) , transcription factor T-bet, and GATA-3 in airway inflammation of patients with asthma. Methods 25 patients with acute exacerbation of asthma were enrolled as an asthma group and 33 healthy volunteers were enrolled as control. The plasma levels of CC16, IFN-γ, and IL-4 were measured by enzyme-linked immunosorbent assay ( ELISA) . The mRNA expressions of T-bet and GATA-3 in the peripheral bloodmononuclear cells ( PBMCs) were measured by reverse transcription-polymerase chain reaction ( RT-PCR) .Results The levels of CC16 and IFN-γin the asthma group were lower than those in the control group [ ( 21. 96 ±7. 31 ) ng/mL vs. ( 64. 88 ±25. 27) ng/mL, ( 118. 73 ±22. 59) pg/mL vs. ( 145. 53 ±29. 50) pg/mL, both P lt;0. 01] . The IL-4 level in the asthma group was significantly higher than that in the control group [ ( 425. 22 ±4. 37) pg/mL vs. ( 69. 72 ±10. 15 ) pg/mL, P lt; 0. 01] . The T-bet mRNA expression and T-bet /GATA-3 ratio of PBMCs in the asthma group were significantly lower than those in the control group( both P lt; 0. 01) . The expression GATA-3 mRNA was significantly higher than that in the control group( P lt;0. 01) . The level of CC16 was positively correlated with T-bet mRNA expression and the ratio of T-bet /GATA-3 ( r =0. 792, 0. 761, respectively, P lt; 0. 01) . There was no correlation between CC16 and the GATA-3 mRNA expression ( P gt;0. 05) . Conclusions These results suggest that CC16 and T-bet play important protection roles in the pathogenesis of asthma. GATA-3, IFN-γ, and IL-4 also participate in the airway inflammation of asthma.
ObjectiveTo compare the effects of different airway management strategies on outcomes of patients with out-of-hospital cardiac arrest (OHCA).MethodsWe searched PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and WanFang Data for relevant studies comparing the influence of different airway management strategies on outcomes of OHCA patients. The deadline was up to 31st May, 2019. Grading of Recommendations Assessment, Development and Evaluation system 3.6 was used for quality assessment, and RevMan 5.3 software was used for meta-analysis. Odds ratio (OR) and 95% confidence interval (CI) were used to conduct the comparison. Results A total of 20 studies were finally enrolled, including 880 567 OHCA patients. Compared with supraglottic airway (SGA), bag-valve mask (BVM) improved the rate of survival to discharge of OHCA patients [OR=1.45, 95%CI (1.01, 2.08), P=0.04], while the rate of return of spontaneous circulation (ROSC) was not improved (P>0.05); in the subgroup analysis, BVM and SGA had similar effect on the rate of ROSC and the rate of survival to discharge in Asian countries (P>0.05), while BVM performed better than SGA in the two rates in European and American countries. BVM and endotracheal intubation (ETI) had similar effect on the two rates (P>0.05). In Asian countries, ETI performed better than BVM in the rate of ROSC [OR=0.63, 95%CI (0.49, 0.81), P=0.000 3], and there was no statistically significant difference in the rate of survival to discharge between ETI and BVM (P>0.05); while in European andAmerican countries, BVM performed better than ETI in the rate of survival to discharge [OR=3.10, 95%CI (2.69, 3.56), P<0.000 01], and there was no statistically significant difference in the rate of ROSC between ETI and BVM (P>0.05). Compared with SGA, ETI improved the rate of ROSC [OR=0.68, 95%CI (0.62, 0.76), P<0.000 01] and the rate of survival to discharge [OR=0.89, 95%CI (0.81, 0.98), P=0.02]. In Asian countries, ETI performed better than SGA in the two rates (P<0.05); while in European and American countries and New Zealand, ETI performed better than SGA in the rate of ROSC (P<0.05), but there was no statistically significant difference in the rate of survival to discharge (P>0.05). Conclusions Different airway management strategies have differente effects on OHCA patients. The optimal airway management strategy when rescuing OHCA patients might be selected based on local emergency medical service system conditions.