Zhao W.-B.,Songjiang District Center Hospital of Shanghai |
Wan S.-X.,Lanzhou University |
Gu D.-F.,Songjiang District Center Hospital of Shanghai |
Shi B.,Songjiang District Center Hospital of Shanghai
Medical Journal of Chinese People's Liberation Army | Year: 2014
Objective: To observe the effect of glucocorticoid inhalation on the clinical symptoms and pulmonary fibrosis index in ARDS patients.Methods: Fifty-three ARDS patients admitted to ICU of Songjiang District Center Hospital of Shanghai from Dec. 2011 to Jun. 2013 were randomly divided into two groups. Group A (n=29) received conventional therapy, and group B (n=24) was given glucocorticoid inhalation treatment (budesonide, 2 mg, 1/12 h, for 12 days) on the basis of the conventional therapy. The oxygenation index, time of extubation, changes in pulmonary fibrosis index, including collagen Ⅰ(Co Ⅰ), Ⅲ procollagen peptide (PⅢP) and transforming growth factor (TGF-β1) were compared between the two groups, and the incidence of common adverse reactions were analyzed.Results: The oxygenation index of patients in group B was significantly improved on the 15th day compared with group A (P<0.05). There was a significant difference in the level of Co I, PⅢP and TGF-β1 between two groups as measured with enzyme-linked immunosorbent assay (P<0.05). The hormone therapy did not increase adverse effects (P>0.05).Conclusion: A small dose of glucocorticoids introduced by inhalation can improve the oxygenation index and pulmonary fibrosis level without increasing common adverse reactions, suggesting that the inhalation of corticosteroid may be a clinically safe and effective way in patients with ARDS. © 2014, People's Military Medical Press. All rights reserved.
Liu J.-Q.,Peoples Care |
Ma G.-G.,Songjiang District Center Hospital of Shanghai |
Shi B.,Songjiang District Center Hospital of Shanghai |
Lou X.-L.,Songjiang District Center Hospital of Shanghai |
And 4 more authors.
Medical Journal of Chinese People's Liberation Army | Year: 2013
Objective To investigate the effect of sepsis on the changes in PepT1 expression in the small intestinal epithelium of rats, and its correlation with ghrelin. Methods Forty-eight male SD rats were randomly divided into control group (n=8) and sepsis group (n=40). The sepsis model was reproduced with cecal ligation and puncture (CLP). The small intestinal mucosa and blood samples were obtained 4, 8, 12, 16 and 20h after CLP. The pathologic changes in the jejunal mucosa were investigated under light microscope. The level of ghrelin in the serum and intestinal mucosa was detected by ELISA. The expressions of PepT1 mRNA and protein were determined by Western blotting and real-time PCR. Results In the sepsis animals, intestinal mucosa showed marked injury with shortening and shedding of the epithelium, detachment of the lamina propria, hemorrhage and ulceration. Compared with control group, the expression of PepT1 mRNA in sepsis group significantly decreased 8, 12, 16 and 20h after CLP (P<0.05). But there were no differences among the subgroups (P>0.05). The expressions of PepT1 protein 12, 16 and 20h after CLP were significantly lowered compared with that of control group and 4, 8h after CLP (P<0.05). In the sepsis group, the Ghrelin level in the serum and intestinal mucosa reached its peak 4h after CLP, then it significantly decreased as compared with control group (P<0.05). Ghrelin level in both serum and intestinal mucosa was positively related to PepT1 protein (r=0.792, r=0.756, P<0.001). Conclusion In sepsis rats, the expression of ghrelin decreased significantly after a brief increase, which was positively correlated with PepT1 protein level in the intestinal epithelium, and may be the cause of the decrease of PepT1 expression in the intestinal epithelium.