盲肠结扎穿刺致豚鼠急性肺损伤动物模型建立

目的 研究败血性急性肺损伤的动物模型，并探讨其在急性肺损伤研究中的意义。方法 用盲肠结扎穿刺(CLP)法的豚鼠急性肺损伤模型，结合动脉血气分析、外周血白细胞计数、肺湿重／干重比值(W／D)及肺组织病理观察。结果 CLP模型中动物的症状和表现缓慢出现，逐渐恶化．最后导致败血性休克，于2d左右出现大量死亡。结论 用盲肠结扎穿刺的方法制作豚鼠急性肺损伤动物模型较大鼠内毒素性休克，表现更类似于人类的肠源性肺损伤，且症状缓慢发生，逐渐恶化，有利于观察和进行各种干预。     

Extracorporeal membrane oxygenation in burn and smoke inhalation injury

A systematic review and meta-analysis was conducted to assess the level of evidence for the use of extracorporeal membrane oxygenation (ECMO) in hypoxemic respiratory failure resulting from burn and smoke inhalation injury. We searched any article published before March 01, 2012. Available studies published in any language were included. Five authors rated each article and assessed the methodological quality of studies using the recommendation of the Oxford Centre for Evidence Based Medicine (OCEBM). Our search yielded 66 total citations but only 29 met the inclusion criteria of burn and/or smoke inhalation injury. There are no available systematic reviews/meta-analyses published that met our inclusion criteria. Only a small number of clinical trials, all with a limited number of patients, were available. The overall data suggests that there is no improvement in survival for burn patients suffering acute hypoxemic respiratory failure, with the use of ECMO. ECMO run times of less than 200 h correlate with higher survival compared to 200 h or more. Scald burns show a tendency of higher survival than flame burns.     

Paracrine factors from mesenchymal stem cells: a proposed therapeutic tool for acute lung injury and acute respiratory distress syndrome

Despite extensive researches in acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), current pharmacological therapies and respiratory support are still the main methods to treat patients with ALI and ARDS and the effects remain limited. Hence, innovative therapies are needed to decrease the morbidity and mortality. Because of the proven therapeutic effects in other fields, mesenchymal stem cells (MSCs) might be considered as a promising alternative to treat ALI and ARDS. Numerous documents demonstrate that MSCs can exert multiple functions, such as engraftment, differentiation and immunoregulation, but now the key researches are concentrated on paracrine factors secreted by MSCs that can mediate endothelial and epithelial permeability, increase alveolar fluid clearance and other potential mechanisms. This review aimed to review the current researches in terms of the effects of MSCs on ALI and ARDS and to analyse these paracrine factors, as well as to predict the potential directions and challenges of the application in this field.     

Development and characterization of DNAzyme candidates demonstrating significant efficiency against human rhinoviruses

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急性肺损伤患者液体管理的临床研究

目的 探讨急性肺损伤(ALI)患者不同液体管理策略与预后及肺力学特征的关系.方法 选择我科2007-07～2009-06收治的42例ALI病例,随机分为限制性液体管理组和非限制性液体管理组,依中心静脉压(CVP)水平实施液体管理,试验观察持续7 d.比较两组患者治疗前和治疗第2天的氧合指数、肺损伤评分、呼吸力学及28 d使用呼吸机时间、28 d住ICU时间、60 d病死率.结果 治疗第2天,限制性液体管理组较非限制性液体管理组氧合指数上升,肺损伤评分降低,呼吸力学指标中气道峰压、气道阻力降低,肺顺应性升高(P<0.05);限制性液体管理组28 d使用呼吸机时间、28 d住ICU时间均显著低于非限制性液体管理组(P<0.05),60 d病死率亦较非限制性液体管理组显著下降(P<0.05).两组肾衰竭发生率比较差异无统计学意义.结论 限制性液体管理策略有助于改善ALI患者预后.     

血管生成素-1对脓毒症小鼠肺血管通透性的影响

目的 探讨外源性血管生成素-1(Ang-1)对脓毒症小鼠肺血管通透性的影响.方法 腹腔注射脂多糖(LPS)制作脓毒症小鼠模型.64只BALB/c小鼠随机分为NS组、Ang-1组、LPS组和LPS+ Ang-1组(n=16).各组经处理12 h后,分别收集血浆、肺泡灌洗液及肺组织标本.ELISA法测定血浆Ang-1、Ang-2浓度并计算Ang-2/Ang-1比值,测定血浆、肺泡灌洗液的总蛋白浓度并计算肺通透指数(LPI),测定肺组织湿干比及观察肺组织病理变化.结果 Ang-1组血浆Ang-1浓度较NS组明显升高(P＜0.05).LPS组和LPS+ Ang-1组血浆Ang-1浓度较NS组均明显降低(P＜0.01),而血浆Ang-2浓度及Ang-2/Ang-1比值较NS组均明显升高(P＜0.01).LPS+ Ang-1组血浆Ang-1浓度较LPS组明显升高(P＜0.01),且血浆Ang-2浓度及Ang-2/Ang-1比值较LPS组明显降低(P＜0.01).Ang-2/Ang-1比值与小鼠肺湿干比呈明显正相关(r=0.76,P＜0.01).LPS组肺湿干比、肺通透指数较NS组明显升高(P＜0.01),LPS+ Ang-1组肺湿干比、肺通透指数较LPS组明显降低(P＜0.01),且肺组织病理渗出水肿较LPS组明显好转.结论 外源性Ang-1通过调节脓毒症小鼠Ang-2/Ang-1失平衡而发挥降低肺血管通透性及改善肺水肿作用.     

Pulmonary delivery of siRNA against acute lung injury/acute respiratory distress syndrome

The use of small interfering RNAs (siRNAs) has been under investigation for the treatment of several unmet medical needs, including acute lung injury/acute respiratory distress syndrome (ALI/ARDS) wherein siRNA may be implemented to modify the expression of pro-inflammatory cytokines and chemokines at the mRNA level. The properties such as clear anatomy, accessibility, and relatively low enzyme activity make the lung a good target for local siRNA therapy. However, the translation of siRNA is restricted by the inefficient delivery of siRNA therapeutics to the target cells due to the properties of naked siRNA. Thus, this review will focus on the various delivery systems that can be used and the different barriers that need to be surmounted for the development of stable inhalable siRNA formulations for human use before siRNA therapeutics for ALI/ARDS become available in the clinic.