Background It has found that ischemic postconditioning （IPO） might decrease pulmonary ischemia/reperfusion （I/ R） injury,which is one of the main reasons of lung injury caused by cardiopulmonary bypass （CPB）.It ...Background It has found that ischemic postconditioning （IPO） might decrease pulmonary ischemia/reperfusion （I/ R） injury,which is one of the main reasons of lung injury caused by cardiopulmonary bypass （CPB）.It was found that aquaporins （AQPs） play a role in the maintenance of fluid homeostasis.But it is still unclear whether IPO influences the expression of aquaporin-1 （AQP1）.This study was designed to investigate whether IPO can reduce CPB-related lung injury and affect the expression of AQP1 of lungs.Methods Twelve healthy dogs were divided into control group （C group） and ischemia postconditioning group （IPO group）.CPB procedures were implemented.Ten minutes later,the left pulmonary artery was separated and blocked.Postconditioning consisted of two cycles of 5-minute pulmonary artery reperfusion/5-minute reocclusion starting at the beginning of reperfusion.The 2×4 cm tissues of both sides of pulmonary apex,superior,middle and inferior lobe were taken before CPB （T1）,before occlusion and reopening of left pulmonary artery （T2,T3）,and 2 hours after CPB （T4）.Samples were used to evaluate lung injury degrees and to detect the expression of AQP1.At T1 and T4,blood was collected from femoral artery to calculate pulmonary function.Results At T4,each pulmonary function showed significant deterioration compared with T1.Lung injury could be found at the onset of CPB.However,the expression of AQP1 decreased and wet to dry weight ratio （W/D） increased after T2.In the left lung of C group,the worst pulmonary function and structures were detected.The slightest changes were discovered in the right lung of C group.A close relationship between W/D and lung injury score was found.The lung injury score was negatively related with the expression of AQP1.It was found that the expression of AQP1 was negatively connected with W/D.Conclusions In dog CPB models,lung injury induced by CPB was related with down regulated expression of AQP1.AQP1 is believed to be involved in the mechanisms of展开更多
Objective： To evaluate the efficacy of Xuebijing Injection（血必净注射液, XBJ） on the lung injury induced by cardiopulmonary bypass（CPB）. Methods： Fifty patients undergoing CPB were randomized to either the salin...Objective： To evaluate the efficacy of Xuebijing Injection（血必净注射液, XBJ） on the lung injury induced by cardiopulmonary bypass（CPB）. Methods： Fifty patients undergoing CPB were randomized to either the saline group or XBJ group according to a random number table（25 cases in each group）. The patients in the saline group received saline and patients in XBJ group received XBJ at 12 h prior to the operation, at the beginning of the operation, and at 12 h after the second injection. The PaO_2/Fi O2 at extubation 3 days post-operation, duration of ventilation in the intensive care unit（ICU）, and lengths of stay in the ICU and hospital were recorded. The levels of inflammatory mediators including interleukin（IL）-1β, IL-8, IL-10, and C-reactive protein（CRP） in bronchoalveolar lavage fluid（BALF） and plasma were measured. The neutrophil count and elastase neutrophil elastase in BALF were also measured. In addition, adverse events were monitored. Results： The PaO-2/FiO_2 in the XBJ group was higher than that in the saline group from 12 to 72 h post-operation（all P〈0.05）. The blood levels of IL-1β, IL-8, and CRP in the XBJ group from 12 to 72 h were all significantly lower than those in the saline group（all P〈0.05）. In contrast, the level of the anti-inflammatory cytokine IL-10 was significantly higher in the XBJ group than in the saline group（P〈0.05）. In addition, 4 patients presented with atelectasis in the saline group and none in the XBJ group. Ten patients experienced mild acute respiratory distress syndrome（ARDS） during hospitalization, and 5 patients with mild ARDS were in the XBJ group（P〈0.05）. Conclusion： XBJ shows protective potential against lung injury in patients who undergo CPB surgery, possibly through the downregulation of inflammatory mediators, reduction in neutrophil infiltration, and upregulation of IL-10（Trial registry： Chi CTR-TRC-14004628）.展开更多
目的通过猪心脏骤停窒息模型探讨参附注射液对此类肺损伤保护作用的可能机制。方法34只健康近交系五指山小型猪使用气管插管夹闭方法制作窒息型心脏骤停动物模型及行标准的心肺复苏术,其中18只成功恢复自主循环(return of spontaneous c...目的通过猪心脏骤停窒息模型探讨参附注射液对此类肺损伤保护作用的可能机制。方法34只健康近交系五指山小型猪使用气管插管夹闭方法制作窒息型心脏骤停动物模型及行标准的心肺复苏术,其中18只成功恢复自主循环(return of spontaneous circulation,ROSC),使用随机数字表法分为两组:参附组(n=9):于ROSC后即刻以参附注射液0.24mg/min的剂量持续静脉泵入直至复苏后6h;盐水组(n=9):于ROSC后即刻持续静脉泵入相同剂量及速度的生理盐水直至复苏后6h。通过血气分析仪测量基础状态、ROSC即刻、ROSC后15min、30min、1h、2h、4h及6h的氧代谢及呼吸力学指标[包括:氧合指数(OI)、呼吸指数(RI)、氧输送(DO2)、氧消耗(VO2)、氧摄取(O2ER)、二氧化碳分压(PaCO2)及血乳酸(LAC),并监测同一时刻动物的肺顺应性(Cdyn)、气道阻力(Raw)、血管外肺水指数(EVLWI)和肺血管通透性指数(PVPI)];酶联免疫吸附法测定Na+-K+-ATP酶活性、Ca2+-ATP酶活性、SOD及MDA含量、TNF-α、IFN-γ和IL-4浓度,计算IFN-γ/IL-4值;利用TUNEL法检测细胞凋亡并计算凋亡指数(AI);免疫组织化学法检测Bcl-2、Bax蛋白浓度,计算BAX/BCL-2值;Western blot法检测Caspase-3蛋白定量。结果至ROSC后6h,参附组存活率为88.9%(8/9),盐水组存活率为66.7%(6/9);参附组平均生存时间(5.77±0.71)h长于盐水组(4.77±0.59)h,两组比较差异无统计学意义(P>0.05)。与基础状态比较,两组的OI和Cdyn在ROSC即刻明显降低(P<0.05),而RI、DO_2、VO_2、O_2ER、Raw、EVLWI、PVPI、PaCO_2和LAC在ROSC即刻则显著升高(P<0.05),各指标不论升高或降低均随时间延长而恢复;与盐水组比较,参附组在ROSC后的各个时间点,OI、Cdyn、DO_2、VO_2和O2ER显著高于盐水组(P<0.05,P<0.01),而RI、Raw、EVLWI、PVPI、PaCO_2和LAC则低于盐水组(P<0.05,P<0.01)。与盐水组比较,参附组Na^+-K^+-ATP酶、Ca^(2+)-ATP酶、SOD水平、IFN-γ水平、IFN-γ/IL-4值及Bcl-2浓度升高,而M展开更多
文摘Background It has found that ischemic postconditioning （IPO） might decrease pulmonary ischemia/reperfusion （I/ R） injury,which is one of the main reasons of lung injury caused by cardiopulmonary bypass （CPB）.It was found that aquaporins （AQPs） play a role in the maintenance of fluid homeostasis.But it is still unclear whether IPO influences the expression of aquaporin-1 （AQP1）.This study was designed to investigate whether IPO can reduce CPB-related lung injury and affect the expression of AQP1 of lungs.Methods Twelve healthy dogs were divided into control group （C group） and ischemia postconditioning group （IPO group）.CPB procedures were implemented.Ten minutes later,the left pulmonary artery was separated and blocked.Postconditioning consisted of two cycles of 5-minute pulmonary artery reperfusion/5-minute reocclusion starting at the beginning of reperfusion.The 2×4 cm tissues of both sides of pulmonary apex,superior,middle and inferior lobe were taken before CPB （T1）,before occlusion and reopening of left pulmonary artery （T2,T3）,and 2 hours after CPB （T4）.Samples were used to evaluate lung injury degrees and to detect the expression of AQP1.At T1 and T4,blood was collected from femoral artery to calculate pulmonary function.Results At T4,each pulmonary function showed significant deterioration compared with T1.Lung injury could be found at the onset of CPB.However,the expression of AQP1 decreased and wet to dry weight ratio （W/D） increased after T2.In the left lung of C group,the worst pulmonary function and structures were detected.The slightest changes were discovered in the right lung of C group.A close relationship between W/D and lung injury score was found.The lung injury score was negatively related with the expression of AQP1.It was found that the expression of AQP1 was negatively connected with W/D.Conclusions In dog CPB models,lung injury induced by CPB was related with down regulated expression of AQP1.AQP1 is believed to be involved in the mechanisms of
文摘Objective： To evaluate the efficacy of Xuebijing Injection（血必净注射液, XBJ） on the lung injury induced by cardiopulmonary bypass（CPB）. Methods： Fifty patients undergoing CPB were randomized to either the saline group or XBJ group according to a random number table（25 cases in each group）. The patients in the saline group received saline and patients in XBJ group received XBJ at 12 h prior to the operation, at the beginning of the operation, and at 12 h after the second injection. The PaO_2/Fi O2 at extubation 3 days post-operation, duration of ventilation in the intensive care unit（ICU）, and lengths of stay in the ICU and hospital were recorded. The levels of inflammatory mediators including interleukin（IL）-1β, IL-8, IL-10, and C-reactive protein（CRP） in bronchoalveolar lavage fluid（BALF） and plasma were measured. The neutrophil count and elastase neutrophil elastase in BALF were also measured. In addition, adverse events were monitored. Results： The PaO-2/FiO_2 in the XBJ group was higher than that in the saline group from 12 to 72 h post-operation（all P〈0.05）. The blood levels of IL-1β, IL-8, and CRP in the XBJ group from 12 to 72 h were all significantly lower than those in the saline group（all P〈0.05）. In contrast, the level of the anti-inflammatory cytokine IL-10 was significantly higher in the XBJ group than in the saline group（P〈0.05）. In addition, 4 patients presented with atelectasis in the saline group and none in the XBJ group. Ten patients experienced mild acute respiratory distress syndrome（ARDS） during hospitalization, and 5 patients with mild ARDS were in the XBJ group（P〈0.05）. Conclusion： XBJ shows protective potential against lung injury in patients who undergo CPB surgery, possibly through the downregulation of inflammatory mediators, reduction in neutrophil infiltration, and upregulation of IL-10（Trial registry： Chi CTR-TRC-14004628）.
文摘目的通过猪心脏骤停窒息模型探讨参附注射液对此类肺损伤保护作用的可能机制。方法34只健康近交系五指山小型猪使用气管插管夹闭方法制作窒息型心脏骤停动物模型及行标准的心肺复苏术,其中18只成功恢复自主循环(return of spontaneous circulation,ROSC),使用随机数字表法分为两组:参附组(n=9):于ROSC后即刻以参附注射液0.24mg/min的剂量持续静脉泵入直至复苏后6h;盐水组(n=9):于ROSC后即刻持续静脉泵入相同剂量及速度的生理盐水直至复苏后6h。通过血气分析仪测量基础状态、ROSC即刻、ROSC后15min、30min、1h、2h、4h及6h的氧代谢及呼吸力学指标[包括:氧合指数(OI)、呼吸指数(RI)、氧输送(DO2)、氧消耗(VO2)、氧摄取(O2ER)、二氧化碳分压(PaCO2)及血乳酸(LAC),并监测同一时刻动物的肺顺应性(Cdyn)、气道阻力(Raw)、血管外肺水指数(EVLWI)和肺血管通透性指数(PVPI)];酶联免疫吸附法测定Na+-K+-ATP酶活性、Ca2+-ATP酶活性、SOD及MDA含量、TNF-α、IFN-γ和IL-4浓度,计算IFN-γ/IL-4值;利用TUNEL法检测细胞凋亡并计算凋亡指数(AI);免疫组织化学法检测Bcl-2、Bax蛋白浓度,计算BAX/BCL-2值;Western blot法检测Caspase-3蛋白定量。结果至ROSC后6h,参附组存活率为88.9%(8/9),盐水组存活率为66.7%(6/9);参附组平均生存时间(5.77±0.71)h长于盐水组(4.77±0.59)h,两组比较差异无统计学意义(P>0.05)。与基础状态比较,两组的OI和Cdyn在ROSC即刻明显降低(P<0.05),而RI、DO_2、VO_2、O_2ER、Raw、EVLWI、PVPI、PaCO_2和LAC在ROSC即刻则显著升高(P<0.05),各指标不论升高或降低均随时间延长而恢复;与盐水组比较,参附组在ROSC后的各个时间点,OI、Cdyn、DO_2、VO_2和O2ER显著高于盐水组(P<0.05,P<0.01),而RI、Raw、EVLWI、PVPI、PaCO_2和LAC则低于盐水组(P<0.05,P<0.01)。与盐水组比较,参附组Na^+-K^+-ATP酶、Ca^(2+)-ATP酶、SOD水平、IFN-γ水平、IFN-γ/IL-4值及Bcl-2浓度升高,而M
