Total liquid ventilation reduces oleic acid-induced lung injury in piglets

Background Pediatric patients are susceptible to lung injury that does not respond to traditional therapies. Total liquid ventilation has been developed as an alternative ventilatory strategy for severe lung injury. The aim of this study is to investigate the effect of total liquid ventilation on oleic acid （OA）-induced lung injury in piglets. Methods Twelve Chinese immature piglets were induced acute lung injury by OA. Twelve piglets were randomly treated with conventional gas ventilation （control group） or total liquid ventilation （study group） for 240 minutes. Samples for blood gas analysis were collected before, and at 60-minute intervals after OA-induced lung injury. The degree of lung injury was quantified by histologic examination. The inflammatory cells and the levels of IL-1β, IL-6, IL-10 and TNF-α in plasma, tissue and bronchoalveolar lavage were analyzed. Results Neutrophil and macrophage counts in bronchoalveolar lavage were significantly decreased in the study group （P〈0.05）. The total lung injury score was also reduced in the study group （P〈0.05）. The concentrations of IL-1β, IL-6, IL-10 and TNF-α in plasma, tissue and bronchoalveolar lavage were significantly reduced in the study group （P〈0.05）. Conclusions Total liquid ventilation reduces biochemical and histoloaic OA-induced luna iniurv in nialets.     

Pulmonary artery perfusion with HTK solution prevents lung injury in infants after cardiopulmonary bypass

Background Pulmonary artery perfusion during cardiopulmonary bypass （CPB） is a novel adjunctive method, which can minimize the lung ischemic-reperfusion injury and inflammatory response. This study evaluated the protective effect of pulmonary perfusion with hypothermic HTK solution in corrections of congenital heart defects with pulmonary hypertension. Methods Between June 2009 and December 2009, 24 consecutive infants with congenital heart defects and pulmonary hypertension were randomly divided into perfused group （n=12） and control group （n=-12）. Oxygen index, alveolar-arterial 02 gradient, serum levels of malondialchehyche （MDA）, interleukin （IL）-6, -8, -10, soluble intercellular adhesion molecule-1 （slCAM-1）, and P-seiectin were measured before commencement and serially for 48 hours after termination of bypass. Results Oxygenation values were better preserved in the perfused group than in the control group. The serum levels of IL-6 increased immediately after CPB in both groups and returned to baseline at 48 hours after CPB, but it was restored faster and earlier in the perfused group. The serum levels of IL-8, slCAMol, and MDA remained at baseline at each point after CPB in the perfused group and elevated significantly immediately after CPB in the control group, except for slCAM-1 The serum level of IL-10 increased immediately after CPB and decreased to baseline at 48 hours after CPB in both groups, but the IL-10 level in the perfused group was significantly higher than in the control group at 12 hours after CPB. The serum P-selectin levels in the control group immediately after CPB were significantly higher than prebypass levels. Moreover, there were no significant differences in postoperative clinical characters, except for the intubated time. Conclusion In infants with congenital heart defects, pulmonary perfusion with hypothermic HTK solution during cardiopulmonary bypass could ameliorate lung function and reduce the inflammatory response.     

Effects of Erigeron Injection on Vascular Endothelium in Patients

Objective： To observe the levels of serum C-reactive protein （CRP）, endothelin-1 （ET-1）, nitric oxide （NO）, and superoxide dismutase （SOD） in patients after intracoronary stenting （ICS）, and the effects of Erigeron Injection （E1） on them. Methods： Seventy-two patients, who received ICS and had symptoms of chest stuffiness, palpitation and chest pain, were randomly divided into two groups, with 36 patients in the control group treated with Plavix alone for anti-platelet aggregation, and the other 36 patients in the treated group treated with Plavix and El in combination. CRP, ET-1, NO and SOD were determined and compared before and 1, 2 and 3 weeks after treatment. Results： As compared with those in the control group, improvement of symptoms in the treated group was significantly better, with the levels of CRP and ET-1 lower and levels of SOD and NO higher or approaching to normal ranges and significant difference was shown between the two groups （P〈0.01）. Conclusion： El could alleviate uncomfortable feelings such as chest stuffiness in patients after lOS, and improve the function of vascular endothelium.     

Effects of Shehuang Paste(麝黄膏) on hemodynamics, endotoxin, nitric oxide and endothelin-1 in patients with refractory cirrhotic ascites

Objective： To explore the influence of Shehuang Paste （麝黄膏, SHP） to the hemodynamics, endotoxin, nitric oxide （NO）, and endothelin-1 （ET-1） in patients with refractory cirrhotic ascites. Methods： Fifty-nine cases of refractory cirrhotic ascites were randomly assigned to two groups, 32 cases in the treatment group and 27 cases in the control group. The basic treatment was the same for both groups, including liver protecting medicines, diuretics and supportive drugs, but SHP navel sticking was applied for the treatment group additionally once a day. A course of one month of treatment was applied and the general efficacy on ascites was observed by the end of the therapeutic course. Before and after the treatment, examinations by limulus lysate chromogenic test was conducted to measure plasma endotoxin content; colorimetry to measure plasma content of NO indirectly, radioimmunoassay to measure plasma ET-1 content; and color Doppler ultrasonography to measure the blood flow of portal vein and splenic vein. The relationship between the blood flow of portal vein and splenic vein and endotoxin, NO and ET-1 in the treatment group was analyzed as well. Results： The total effective rate on ascites was 84.4% in the treatment group, and 48. 1% in the control group, with significant difference shown between them （P〈0.01）. In the treatment group the blood flow of portal vein and splenic vein, contents of endotoxin, NO and ET-1 all got significantly reduced after treatment （ P〈0.05 or P〈0.01）; while these indexes in the control group were not significantly changed （P〉0.05）. Moreover, it was found that in the treatment group, the blood flow of portal vein and splenic vein had a positive correlation to the levels of NO, ET-1, and endotoxin, either before or after treatment. Conclusion： Application of SHP navel sticking could clearly reduce the blood flow of portal vein and splenic vein, and lower the content of endotoxin, NO and ET-1. The blood flow of portal vein and splenic vein in the treatment group showed a positive correlation with the contents of endotoxin, NO and ET-1.     

Effects of serum of the rats ventilated with high tidal volume on endothelial cell permeability and therapeutic effects of ulinastatin

Background With the widespread use of ventilators in treating critically ill patients, the morbidity of ventilator-induced lung injury (VILI) is increasing accordingly. VILI is characterized by a considerable increase in microvascular leakiness and activation of inflammatory processes. In this study we investigated the effects of inflammatory mediators in VILI rat serum on endothelial cytoskeleton and monolayer cellular permeability, as well as the therapeutic effect of ulinastatin, to explore the pathogenesis and the relationship between biotrauma and lung oedema induced by VILI. Methods Thirty healthy male Sprague-Dawley rats were randomly divided into three groups: group A (normal tidal volume ventilation), group B (high tidal volume ventilation) and group C (high tidal volume ventilation plus ulinastatin). The serum of each rat after ventilation was added to endothelial cell line ECV-304 medium for two hours to observe the effects of serum and/or ulinastatin on endothelial fibrous actin and permeability. Results Compared to rats ventilated with normal tidal volume, serum of rats ventilated with high tidal volume caused a striking reorganization of actin cytoskeleton with a weakening of fluorescent intensity at the peripheral filament bands and formation of the long and thick stress fibres in the centre resulting in endothelial contraction and higher permeability. Prior treatment with ulinastatin lessened the above changes significantly. The changes of permeability coefficient of endothelial permeability after group A, B or C rats serum stimulation were (6.95±1.66)%, (27.50±7.77)% and (17.71±4.66)% respectively with statistically significant differences (P<0.05) among the three groups. Conclusions The proinflammatory mediators in the serum of the rats given high tidal volume ventilation increases endothelial permeability by reorganizing actin cytoskeleton, and pretreatment with ulinastatin lessens the permeability by inhibiting of proinflammatory mediators.     

Effects of kadsurenone on the systemic inflammatory response in rat model of acute pancreatitis

Objective： To study the effects of kadsurenone on inflammatory mediators Platelet-activating factor （PAF）, tumor necrosis factor-α（TNF-α） and interleukin-6（IL-6） in rat model of acute pancreatitis（AP）. Methods： SD male rats （104） were randomly divided into sham group （n = 24）, AP group （n = 40） and kadsurenone group （n = 40）. The rats were killed 3, 6, 12 and 24 hours after operation. The serum level of PAF, TNF-α and IL-6 was measured. Results： The serum level of PAF, TNF-α and IL-6 of AP group was significantly increased（P 〈 0.01 ）compared with control group. The serum level of TNF-α got to a peak 6 hours after operation, and the serum IL-6 getting to a peak 12 hours after operation in AP group. After kadsurenone was administered to AP rats, pancreas and lung myeloperoxidase （MPO）, serum amylase activity was reduced. Histology showed a trend toward improvement. The serum level of PAF, TNF-α and IL-6 was significantly decreased （P 〈 0.05）. Conclusion. Kadsurenone can reduce the severity of systemic inflammation in rats with AP and relieve the damage of the pancreas and lung in AP rats. These results suggested that kadsurenone may be useful in the treatment of acute pancreatitis.     

Effect of ligustrazine injection on levels of interleukin-4 and interferon-gamma in patients with bronchial asthma

Objective： To explore the effect of ligustrazine injection （LI） on serum levels of interleukin-4 （IL-4） and interferon- -γ （IFN- -γ ） in patients with bronchial asthma and determine the mechanism of action of LI in preventing and treating asthma. Methods： Sixty-eight patients with mild or moderate bronchial asthma were assigned to two groups equally according to their sequence number, odd or even. The conventional treatment was administered to both groups, and LI was given to the treatment group by ultrasonic spray inhalation twice a day but not to the control group. The therapeutic course for all was 2 weeks. Further, 30 healthy subjects who had no history of smoking were enrolled as the normal control group. The clinical condition scores, frequency of attacks and dosage of Terbutaline inhaled were scored and recorded on the first day of hospitalization （before treatment） and after treatment. At the same time, the indexes of lung function, including forced expiratory volume in one second （FEV1）, forced expiratory volume in one second to forced vital capacity ratio （FEV1%） and the peak expiratory flow （PEF） were determined before treatment. The levels of IL-4 and IFN--γ in peripheral blood were detected by ELISA before and after treatment, and compared with that of the healthy control group. Results： After treatment, the clinical condition scores were found to be lower, indexes of lung function were elevated, but serum level of IL-4 and ratio of IL-4/IFN-γwere reduced in both groups, showing significant differences as compared to those before treatment （P〈0.05）. However, the changes in all the indexes were more significant in the treatment group than in the control group, also showing statistical significance （P〈0.05）. No significant difference was revealed when IFN--γ levels were compared before and after treatment in both groups, though a lowering trend could be seen, significant difference could not be found in the comparison of IFN--γ levels between groups a     

Effect of Liangxue Huoxue Xiaoyin Tang on Serum Levels of TNF-α, IFN-γ and IL-6 in Psoriasis of Blood-Heat Type

To explore the effect of Liangxue Huoxue Xiaoyin Tang （LHXT 凉血活血消银汤 Decoction of Removing Heat from the Blood and Promoting Blood Flow to Eliminate Psoriasis） on serum levels of tumor necrosis factor-or （TNF-α）, interferon （IFN-γ） and interleukin-6 （IL-6） in psoriasis of blood-heat type. Blood samples from both the treatment group （N=33） and control group （N=30） were taken before and after treatment, and the serum levels of TNF-ct, IFN-T and IL-6 were determined by radio-immunoassay and ELISA. The total effective rate achieved in the treatment group was 90.91%. The remarkably high serum levels of TNF-α IFN-γ and IL-6 in patients before treatment （P〈0.01） were obviously decreased after one course of treatment （P〈0.05） and were close to those of healthy subjects after two course of treatment （P〉0.05）. The data demonstrate that LHXT has the actions of reducing serum levels of TNF-α, IFN-γ and IL-6 in psoriasis of blood-heat type, and may exert a pharmacological effect targeting at the cytokines.     

Characteristics of neutrophils infiltration in ventilation-induced lung injury

Neutrophils play a critical role in ventilation-induced lung injury. This study was aimed to investigate the characteristics of neutrophils influx in lungs induced by high tidal volume ventilation. Anaesthetized rats were randomly divided into low tidal volume ventilation group (Vt: 7 mL/kg, LV group) or high tidal volume ventilation group (Vt:42mL/kg, HV group ) (n=40 in each). Rats in each group were ventilated for 0, 60, 90, 120 and 240 min. The wet/dry lung weight ratio (W/D) was measured. The levels of macrophage inflammatory protein-2 (MIP-2) and tumor necrosis factor-α (TNF-α), and the activity of myeloperoxidase (MPO) were detected by enzyme-linked immunosorbent assay (ELISA). The number of neutrophils in bronchoalveolar lavage fluid (BALF) was counted after Wright’s staining, and the percentage of netrophils in lung tissues calculated. Histopatholgical examination was used to observe the changes of lung tissues after different ventilations. The results showed that the W/D weight ratio was increased, and the levels of MIP-2 and TNF-α significantly enhanced in HV group at 90, 120 and 240 min. Neutrophils in BALF and the neutrophil percentage in lung tissues were also elevated at 120 and 240 min, which coincided with the enhanced activity of MPO in HV group. The lung injury was significantly related with the ventilation time and the infiltration of neutrophils in lungs in HV group. In conclusion, in ventilation-induced lung injury, neutrophil infiltration is present in a time-dependent manner and associated with the aggravated lung injury. Pulmonary structural damage may be the main reason for ventilation-induced lung injury.     

机械通气对急性肺损伤兔肺水肿影响的实验研究

目的研究不同潮气量联合不同水平呼气末正压(PEEP)机械通气对急性肺损伤(ALI)兔肺水肿的影响。方法用数字表法将36只新西兰兔随机分为正常对照(NC)组、ALI组、常规潮气量(15mL/kg)低PEEP(5cmH2O)(CVLP)组、常规潮气量高PEEP(10cmH2O)(CVHP)组、小潮气量(8mL/kg)低PEEP(LVLP)组和小潮气量高PEEP组(LVHP组)。以内毒素静脉注射建立ALI动物模型,经机械通气的4组动物分别给予不同潮气量联合不同水平PEEP机械通气4h。实验结束后取肺组织测定湿质量/干质量比值评价肺水肿严重程度。结果NC组、ALI组、CVLP组、CVHP组、LVLP组和LVHP组的肺湿质量/干质量比值分别为4.81±0.19、5.84±0.20、5.47±0.28、5.25±0.12、5.24±0.12和5.12±0.10,NC组低于其他各组,差异有统计学意义(P<0.05);ALI组高于各机械通气组,差异有统计学意义(P<0.05);LVHP组低于CVLP组,差异亦有统计学意义(P<0.05)。结论机械通气能够减轻ALI肺水肿,小潮气量联合高PEEP机械通气减轻ALI肺水肿的作用更加显著。     

Alveolar stability under different combinations of positive end-expiratory pressure and tidal volume: alveolar microscopy in isolated injured rat lungs

Background High positive end-expiratory pressure （PEEP） and low tidal volume （VT） ventilation is thought to be a protective ventilation strategy. It is hypothesized that the stabilization of collapsible alveoli during expiration contributes to lung protection. However, this hypothesis came from analysis of indirect indices like the analysis of the pressure-volume curve of the lung. The purpose of this study was to investigate isolated healthy and injured rat lungs by means of alveolar microscopy, in which combination of PEEP and VT is beneficial with respect to alveolar stability （I-E%）. Methods Alveolar stability was investigated in isolated, non-perfused mechanically ventilated rat lungs. Injured lungs were compared with normal lungs. For both groups three PEEP settings （5, 10, 20 cmH20） were combined with three VT settings （6, 10, 15 ml/kg） resulting in nine PEEP-VT combinations per group. Analysis was performed by alveolar microscopy. Results In normal lungs alveolar stability persisted in all PEEP-VT combinations （I-E% （3.2±11.0）%）. There was no significant difference using different settings （P 〉0.01）. In contrast, alveoli in injured lungs were extremely instable at PEEP levels of 5 cmH20 （mean I-E% 100%） and 10 cmH2O （mean I-E% （30.7±16.8）%）; only at a PEEP of 20 cmH20 were alveoli stabilized （mean I-E% of （0.2±9.3）%）. Conclusions In isolated healthy lungs alveolar stability is almost unaffected by different settings of PEEP and VT. In isolated injured lungs only a high PEEP level of 20 cmH2O resulted in stabilized alveoli whereas lower PEEP levels are associated with alveolar instability.     

开胸手术单肺通气时行PEEP和CPAP对氧合作用的影响及麻醉管理

目的:评价开胸单肺通气麻醉时行呼气未正压通气(PEEP)和连续气道正压通气(CPAP)对患者血氧合作用的影响。方法:选择40例开胸行肺叶切除的单纯肺癌患者,随机分为A、B两组。A组于手术开始后15min(A1),单肺通气后15min(A2),患侧肺0cmH2OPEEP健侧肺5cmH2OPEEP后15min(A3)、患侧肺5cmH2OCPAP健侧肺0cmH2OPEEP后15min(A4)、患侧肺5cmH2OCPAP健侧肺5cmH2OPEEP后15min(A5)。分别监测平均动脉压(MAP)、心率(HR)、动脉血氧分压(PaO2、混合静脉血氧分压(PvO2)、动脉血氧饱和度(SaO2)、混和静脉血氧饱和度(SvO2),计算分流值(Qs/Qt)。B组用10cmH2OPEEP和10cmH2OCPAP重复上述过程。结果:与A2相比,A3、A4和A5PaO2显著增加,Qs/Qt值显著降低(P<0.05),但A3、A4、A5间相比较差异则无显著性(P>0.05)。B组各时点的各项指标变化与A组类同。结论:在开胸行单肺通气麻醉时,健肺使用PEEP、患肺使用CPAP或联合使用PEEP和CPAP,能提高患者手术中的氧合作用,降低Qs/Qt值,与5cmH2OPEEP和CAMP比较,10cmH2OPEEP和CPAP不能进一步改善PaO2和Qs/Qt。麻醉管理应采取措施,预防低氧血症。     

不同机械通气模式对急性肺损伤患者呼吸及血流动力学的影响

目的研究采用不同机械气模式对急性肺损伤（ALI）患者呼吸及血流动力学的影响。方法选择我院2010年1月~2011年12月收治的30例急性肺损伤患者,按照ALI评分分为两组,其中ALI评分值≥2.5的16例患者采用低潮气量＋呼气末正压（PEEP）通气,对14例ALI评分值〈2.5者最初采用辅助/控制通气（A/C）,逐渐改为同步间歇指令通气（SIMV）和压力支持通气（PSV）。观察机械通气过程中患者的呼吸及血流动力学的变化。结果 PEEP在5~15 cmH2O（1 cm H2O=0.098 kPa）范围内,动脉血氧分压（PaO2）、氧合指数（PaO2/FiO2）、肺静态顺应性（Cst）随着PEEP的增高而逐渐增加（P〈0.05）。在PEEP增加到20 cm H2O时心输出量（CO）和Cst下降,外周循环阻力（SVR）、肺循环阻力（PVR）和气道峰值压（PIP）增加（P〈0.05）。SIMV,PSV与A/C相比可明显降低气道峰值压（PIP）并使Cst增加（P〈0.05）。SIMV和PSV方式均可降低SVR。结论对急性肺损伤患者,应根据不同时期选择不同的机械通气模式,才能更好的增加氧供,减少对患者的呼吸和血流动力学的影响。     

呼气末正压对急性肺损伤伴腹内高压猪心肺功能的影响

目的评估在急性肺损伤（Au）伴腹内高压（IAH）时不同的呼吸末正压（PEEP）对家猪呼吸系统及血流动力学的影响。方法将6只家猪进行麻醉、气管切开后接呼吸机辅助通气,采用容量控制通气,潮气量（VT）8mL／kg,呼吸频率16次／min,吸入氧浓度（FiO2）0．40,PEEP5cmH20。基础状态维持30rain后,先用稀盐酸法制造ALI模型,再通过自动控制气腹机腹腔内注入氮气复制20mmHg的IAH模型。6只家猪均在同一呼吸机参数下选择不同的PEEP水平（5、10、15、20cmH2O）维持机械通气1h,观察以上4种不同PEEP水平下的肺氧合、呼吸力学及血流动力学指标的变化。结果PEEP15和PEEP20的Pa02／FiO2分别为（172±23）mmHg和（200±34）mmHg,明显高于PEEP5的（90±11）mmHg和PEEPIO的（102．4-10）mmHg（P〈0．05）,而PEEP15与PEEP20之间差异无统计学意义（P〉0．05）。PEEP15和PEEP20的胸壁顺应性（Ccw）分别为（76±15）mL／cmH20和（85±14）mI．,／cmH20,均明显高于PEEP5的（26±3）mL／emH20（P〈0．05）。4组不同PEEP水平的肺顺应性（C L）比较差异均无统计学意义（P〉0．05）。PEEP15和PEEP20的平台压（P山）分别为（36-I-2）cmH20和（38±4）emH20,明显高于PEEP5的（30±3）cmH20和PEEPIO的（31．4-2）emH2O（P〈0．05）,而PEEP15与PEEP20比较差异无统计学意义（P〉0．05）。PEEP15和PEEP20的心率分别为（147．4-30）次／min和（160．4-30）次／min,均明显高于PEEP5（113±17）次／min（P〈0．05）,而PEEP15和PEEP20比较差异无统计学意义（P〉0．05）。PEEP20的心排指数（CI）为（3．5±0．6）L·min-1·m-2,较PEEP5的（4．5±0．6）L·min-1·m-2明显下降（P〈0．05）,而PEEP5、PEEPIO和PEEP15组间比较差异无统计学意义（P〉0．05）。PEEP15和PEEP20的中心静脉压（CVP）分别为（17±2）mmHg和（18±3）mmHg,明显高于PEEP5的（12±2）mmHg（P〈0．05）,而PEEP15和PEEP20?     

不同潮气量联合呼气末正压机械通气对急性肺损伤犬血气与血流动力学的影响

目的 观察不同潮气量（Vt）联合呼气末正压（PEEP）机械通气（MV）对油酸型急性肺损伤（ALI）犬血气与血流动力学的影响。方法 用油酸静脉注射法制备犬ALI模型,造模成功后随机分为不同Vt组行机械通气4 h：小Vt组（A组,n=6）, Vt 为6 mL/kg;大Vt组(B组,n=6)：Vt 为20 mL/kg,PEEP均为10 cmH2O（1cmH2O=0.098 kPa）。观察动脉血气、血流动力学的变化。结果 各组犬pH持续降低,但A组pH显著低于B组水平（Ｐ<0.01）;PaO2、SO2造模后下降、MV后升高;B组PaCO2波动不大,而A组PaCO2在MV后上升,组间异显著（Ｐ<0.01）。各组犬PAP水平在ALI后较前升高（Ｐ<0.05）,而MV后继续升高（Ｐ<0.05）;而各组CO水平在ALI时、MV1h后较前显著降低（Ｐ<0.05）;但A组犬在机械通气4 h 时较机械通气2 h时上升（Ｐ<0.05）,且机械通气4 h 时较B组升高（Ｐ<0.05）。结论 PEEP=10cmH2O 机械通气可改善油酸型ALI犬的氧合状况但影响血流动力学;小Vt机械通气可导致高碳酸血症的同时升高CO。     

硫辛酸对急性肺损伤大鼠IL-10的影响

目的探讨硫辛酸(LA)对内毒素(脂多糖,LPS)诱导的急性肺损伤(ALI)大鼠白细胞介素(IL)-10含量的影响。方法72只大鼠随机分为4组,对照组、LPS组LPS+LA30mg干预组。LPS+LA100mg干预组。各实验组舌下静脉注射LPS诱导大鼠ALI模型,30min后2个干预组分别给予LA30mg/kg和100mg/kg舌下静脉注射,对照组给予等体积生理盐水。LPS注射1、3、6h后测定血清及肺组织中IL-10浓度。结果各实验组血清及肺组织中IL-10分别在不同时间点显著高于对照组(P<0.01)。2个干预组血清及肺组织中IL-10水平在3h、6h明显升高,均显著高于LPS组(P<0.01),且LPS+LA100mg组显著高于LPS+LA30mg组(P<0.05)。结论LPS可导致ALI的发生,LA可提高IL-10水平,改善肺损伤。     

氯胺酮对哮喘大鼠机械通气肺损伤的保护作用

目的：探讨氯胺酮对哮喘大鼠机械通气肺损伤的影响。方法：40只SD大鼠制备慢性哮喘模型后随机分成4组（n=10）：对照组（N组），哮喘大鼠旷置8h，不行机械通气；机械通气组（A组），采用容量控制机械通气模式（Vt=10ml／kg，f=30次／min）通气8h：不同剂量氯胺酮干预组（K1、K2组），机械通气前K1组静脉注射氯胺酮5mg／kg，K2组静脉注射氯胺酮10mg／kg，余同A组。实验结束后处死大鼠，测量肺湿干重比（W／D）及支气管肺泡灌洗液（BALF）中蛋白含量、白细胞（WBC）计数、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）及一氧化氮（NO）含量，观察肺组织病理形态学变化。结果：与N组比较，A组、K1组、K2组W／D增加，BALF中蛋白含量、白细胞计数、TNF-α、IL-6、NO含量增高（均P〈0．05），病理损伤程度加重；与A组比较，K1组、K2组W／D降低，BALF中蛋白含量、白细胞计数、TNF-α、IL-6、NO含量下降（均P〈0．05），病理损伤程度减轻；K2组蛋白含量、白细胞计数低于K1组（均P〈0．05），其余指标K1、K2两组间差异无显著性（P〉0．05）。结论：氯胺酮可抑制TNF-α、IL-6及NO的释放，从而对哮喘大鼠机械通气所致肺损伤起到保护作用。     

参麦注射液对机械通气相关肺损伤大鼠肺炎性反应的影响

目的：探讨参麦注射液对机械通气相关肺损伤（VILI）大鼠肺炎性反应的影响。方法：健康成年雄性SD大鼠30只,体质量300~350 g,随机分为3组（n=10）：常规潮气量通气组（TV组,潮气量8 m L/kg）、大潮气量通气组（HV组,潮气量40 m L/kg）、大潮气量通气＋参麦注射液组（HS组）。HS组于机械通气前30min通过尾静脉注射10 m L/kg参麦注射液。机械通气4 h后抽取股动脉血行血气分析,留取肺组织和支气管肺泡灌洗液（BALF）,计算大鼠肺湿干重比（W/D值）和肺泡通透性指数（PPI）,测定BALF中肿瘤坏死因子（TNF-α）、白细胞介素1β（IL-1β）、白细胞介素10（IL-10）浓度,测定肺组织匀浆Na＋-K＋-ATP酶活性,观察肺组织病理学变化。结果：与TV组相比,机械通气4 h后HV组Pa O2下降,W/D值和PPI升高,BALF中TNF-α、IL-1β及IL-10浓度增加,TNF-α/IL-10比值升高,Na＋-K＋-ATP酶活性降低（P〈0.05）,肺组织出现明显损伤;与HV组相比,HS组Pa O2升高,W/D值、PPI及TNF-α/IL-10比值降低,TNF-α及IL-1β浓度降低,IL-10浓度、Na＋-K＋-ATP酶活性增高（P〈0.05）,肺组织损伤程度减轻。结论：参麦注射液可减轻炎性反应,改善肺水代谢,从而减轻VILI。     

血红素氧合酶1干预对呼吸机所致肺损伤的影响

目的探讨血红素氧合酶1（HO-1）的干预对家兔呼吸机所致肺损伤（VILI）的影响。方法 24只家兔随机分为常规潮气量＋PEEP组（C组）、呼吸机所致肺损伤组（VILI组）、呼吸机所致肺损伤＋HO-1诱导剂干预组（Hm组）;实验终点行动脉血气分析,Western blot和免疫组化方法检测肺组织HO-1的表达水平和细胞定位,观察肺组织形态变化并进行肺损伤评分,测定肺组织湿干重比值。结果 VILI组较C组HO-1蛋白表达水平升高,HO-1蛋白主要定位于肺泡上皮细胞和血管内皮细胞,在肺泡巨噬细胞和中性粒细胞也有表达。Hm组与VILI组比较,HO-1蛋白表达水平升高,PaO2/FiO2升高,肺湿干重比值和肺损伤评分降低,差异有统计学意义（P〈0.05）。结论 HO-1蛋白表达升高能减轻VILI,对VILI有一定的保护作用。