BACKGROUND：Animal experiments showed that recruitment maneuver （RM） and protective ventilation strategy of the lung could improve oxygenation and reduce extravascular lung water. This study was to investigate the e...BACKGROUND：Animal experiments showed that recruitment maneuver （RM） and protective ventilation strategy of the lung could improve oxygenation and reduce extravascular lung water. This study was to investigate the effects of RM on respiratory mechanics and extravascular lung water index （EVLWI） in patients with acute respiratory distress syndrome （ARDS）. METHODS：Thirty patients with ARDS were randomized into a RM group and a non-RM group. In the RM group, after basic mechanical ventilation stabilized for 30 minutes, RM was performed and repeated once every 12 hours for 3 days. In the non-RM group, lung protective strategy was conducted without RM. Oxygenation index （PaO2/FiO2）, peak inspiratory pressure （PIP）, Plateau pressure （Pplat）, static pulmonary compliance （Cst） and EVLWI of patients before treatment and at 12, 24, 48, 72 hours after the treatment were measured and compared between the groups. Hemodynamic changes were observed before and after RM. One-way ANOVA, Student＇s t test and Fisher＇s exact test were used to process the data. RESULTS：The levels of PaO2/FiO2 and Cst increased after treatment in the two groups, but they were higher in the RM group than in the non-RM group （P〈0.05）. The PIP and Pplat decreased after treatment in the two groups, but they were lower in the RM group than in the non-RM group （P〈0.05）. The EVLWI in the two groups showed downward trend after treatment （P〈0.05）, and the differences were signifcant at all time points （P〈0.01）; the EVLWI in the RM group was lower than that in the non-RM group at 12, 24, 48 and 72 hours （P〈0.05 or P〈0.01）. Compared with pre-RM, hemodynamics changes during RM were significantly different （P〈0.01）; compared with pre-RM, the changes were not significantly different at 120 seconds after the end of RM （P〉0.05）. CONCLUSIONS： RM could reduce EVLWI, increase oxygenation and lung compliance. The effect of RM on hemodynamics was transient.展开更多
Our preliminary study found that the long noncoding RNA(LncRNA)-5657 can reduce the expression of inflammatory factors during inflammatory reactions in rat glial cells.However, the role played by LncRNA-5657 during se...Our preliminary study found that the long noncoding RNA(LncRNA)-5657 can reduce the expression of inflammatory factors during inflammatory reactions in rat glial cells.However, the role played by LncRNA-5657 during septic brain injury remains unclear.In the present study, rat models of septic encephalopathy were established by cecal ligation and puncture, and then the rats were treated with a hippocampal injection small hairpin RNA(sh RNA) against LncRNA-5657(sh-LnCRNA-5657).The sh-LncRNA-5657 treatment reduced the level of neuronal degeneration and necrosis in the rat hippocampus, reduced the immunoreactivities of aquaporin 4, heparanase, and metallopeptidase-9, and lowered the level of tumor necrosis factor-alpha.Glial cells were pre-treated with sh-LncRNA-5657 and then treated with 1 μg/mL lipopolysaccharide.Sh-LncRNA-5657 transfection decreased the expression of LncRNA-5657 in lipopolysaccharide-treated glial cells and decreased the mRNA and protein levels of tumor necrosis factor-alpha, interleukin-1β, and interleukin-6.These findings suggested that LncRNA-5657 expression can significantly reduce the inflammatory reaction during septic encephalopathy and induce protective effects against this disease.This study was approved by the Institutional Ethics Committee at the First Affiliated Hospital of Nanchang University of China(approval No.2017-004) in 2017.展开更多
BACKGROUND There is no research on quantitative pleural line movement.In this study,we assume that tissue Doppler and its quantitative technology can quantify the pleural line movement and can be used to diagnose pneu...BACKGROUND There is no research on quantitative pleural line movement.In this study,we assume that tissue Doppler and its quantitative technology can quantify the pleural line movement and can be used to diagnose pneumothorax.AIM To evaluate the quantitative assessment of pleural line movement measured by tissue Doppler imaging(TDI)for pneumothorax diagnosis.METHODS Adult patients(n=45)diagnosed with unilateral pneumothorax were included in this study.Each patient underwent TDI of both lungs.The pneumothorax side and contralateral normal lung side were compared using several indices obtained from TDI:peak pleural line velocity(PV_(max)),peak chest wall tissue velocity(CV_(max)),peak pleural line strain value(PS_(max)),peak chest wall tissue strain value(CSmax),PV_(max)/CV_(max)and PS_(max)/CSmax.The receiver operating characteristic analysis was used to evaluate the performance of these quantitative assessments for pneumothorax diagnosis.RESULTS Various quantitative variables of the pneumothorax side were all lower than that of the non-pneumothorax side and included the PV_(max)(0.36 cm/s vs 0.59 cm/s,P<0.001),PS_(max)(1.14%vs 1.90%,P=0.001),PV_(max)/CV_(max)(1.06 vs 4.93,P<0.001),and PS_(max)/CSmax(0.76 vs 1.74,P<0.001).For the discrimination of pneumothorax,the cut-off values of the PV_(max),PS_(max),PV_(max)/CV_(max),and PS_(max)/CSmax were calculated as 0.50 cm/s,0.94%,1.96,and 1.12,respectively.Similarly,the sensitivities and specificities of PV_(max),PS_(max),PV_(max)/CV_(max),and PS_(max)/CSmax were 96%and 62%,47%and 91%,93%and 96%,and 82%and 93%,respectively.The area under the receiver operating characteristic curve were 0.84,0.72,0.99,and 0.91,respectively,for PV_(max),PS_(max),PV_(max)/CV_(max),and PS_(max)/CSmax.CONCLUSION Quantification analysis of pleural line movement using TDI is a useful tool for the diagnosis of pneumothorax.展开更多
文摘BACKGROUND：Animal experiments showed that recruitment maneuver （RM） and protective ventilation strategy of the lung could improve oxygenation and reduce extravascular lung water. This study was to investigate the effects of RM on respiratory mechanics and extravascular lung water index （EVLWI） in patients with acute respiratory distress syndrome （ARDS）. METHODS：Thirty patients with ARDS were randomized into a RM group and a non-RM group. In the RM group, after basic mechanical ventilation stabilized for 30 minutes, RM was performed and repeated once every 12 hours for 3 days. In the non-RM group, lung protective strategy was conducted without RM. Oxygenation index （PaO2/FiO2）, peak inspiratory pressure （PIP）, Plateau pressure （Pplat）, static pulmonary compliance （Cst） and EVLWI of patients before treatment and at 12, 24, 48, 72 hours after the treatment were measured and compared between the groups. Hemodynamic changes were observed before and after RM. One-way ANOVA, Student＇s t test and Fisher＇s exact test were used to process the data. RESULTS：The levels of PaO2/FiO2 and Cst increased after treatment in the two groups, but they were higher in the RM group than in the non-RM group （P〈0.05）. The PIP and Pplat decreased after treatment in the two groups, but they were lower in the RM group than in the non-RM group （P〈0.05）. The EVLWI in the two groups showed downward trend after treatment （P〈0.05）, and the differences were signifcant at all time points （P〈0.01）; the EVLWI in the RM group was lower than that in the non-RM group at 12, 24, 48 and 72 hours （P〈0.05 or P〈0.01）. Compared with pre-RM, hemodynamics changes during RM were significantly different （P〈0.01）; compared with pre-RM, the changes were not significantly different at 120 seconds after the end of RM （P〉0.05）. CONCLUSIONS： RM could reduce EVLWI, increase oxygenation and lung compliance. The effect of RM on hemodynamics was transient.
基金supported by the National Natural Science Foundation of China, Nos.81660314, 82060345Jiangxi Provincial Natural Science Foundation of China, No.20192 BAB205057(both to YAZ)。
文摘Our preliminary study found that the long noncoding RNA(LncRNA)-5657 can reduce the expression of inflammatory factors during inflammatory reactions in rat glial cells.However, the role played by LncRNA-5657 during septic brain injury remains unclear.In the present study, rat models of septic encephalopathy were established by cecal ligation and puncture, and then the rats were treated with a hippocampal injection small hairpin RNA(sh RNA) against LncRNA-5657(sh-LnCRNA-5657).The sh-LncRNA-5657 treatment reduced the level of neuronal degeneration and necrosis in the rat hippocampus, reduced the immunoreactivities of aquaporin 4, heparanase, and metallopeptidase-9, and lowered the level of tumor necrosis factor-alpha.Glial cells were pre-treated with sh-LncRNA-5657 and then treated with 1 μg/mL lipopolysaccharide.Sh-LncRNA-5657 transfection decreased the expression of LncRNA-5657 in lipopolysaccharide-treated glial cells and decreased the mRNA and protein levels of tumor necrosis factor-alpha, interleukin-1β, and interleukin-6.These findings suggested that LncRNA-5657 expression can significantly reduce the inflammatory reaction during septic encephalopathy and induce protective effects against this disease.This study was approved by the Institutional Ethics Committee at the First Affiliated Hospital of Nanchang University of China(approval No.2017-004) in 2017.
文摘BACKGROUND There is no research on quantitative pleural line movement.In this study,we assume that tissue Doppler and its quantitative technology can quantify the pleural line movement and can be used to diagnose pneumothorax.AIM To evaluate the quantitative assessment of pleural line movement measured by tissue Doppler imaging(TDI)for pneumothorax diagnosis.METHODS Adult patients(n=45)diagnosed with unilateral pneumothorax were included in this study.Each patient underwent TDI of both lungs.The pneumothorax side and contralateral normal lung side were compared using several indices obtained from TDI:peak pleural line velocity(PV_(max)),peak chest wall tissue velocity(CV_(max)),peak pleural line strain value(PS_(max)),peak chest wall tissue strain value(CSmax),PV_(max)/CV_(max)and PS_(max)/CSmax.The receiver operating characteristic analysis was used to evaluate the performance of these quantitative assessments for pneumothorax diagnosis.RESULTS Various quantitative variables of the pneumothorax side were all lower than that of the non-pneumothorax side and included the PV_(max)(0.36 cm/s vs 0.59 cm/s,P<0.001),PS_(max)(1.14%vs 1.90%,P=0.001),PV_(max)/CV_(max)(1.06 vs 4.93,P<0.001),and PS_(max)/CSmax(0.76 vs 1.74,P<0.001).For the discrimination of pneumothorax,the cut-off values of the PV_(max),PS_(max),PV_(max)/CV_(max),and PS_(max)/CSmax were calculated as 0.50 cm/s,0.94%,1.96,and 1.12,respectively.Similarly,the sensitivities and specificities of PV_(max),PS_(max),PV_(max)/CV_(max),and PS_(max)/CSmax were 96%and 62%,47%and 91%,93%and 96%,and 82%and 93%,respectively.The area under the receiver operating characteristic curve were 0.84,0.72,0.99,and 0.91,respectively,for PV_(max),PS_(max),PV_(max)/CV_(max),and PS_(max)/CSmax.CONCLUSION Quantification analysis of pleural line movement using TDI is a useful tool for the diagnosis of pneumothorax.
