The Role of Autophagy and the Chemokine (C-X-C Motif) Ligand 16 During Acute Lung Injury in Mice.

BACKGROUND Acute lung injury (ALI) is responsible for mortality in hospitalized patients. Autophagy can negatively regulate inflammatory response, and CXCL16 (chemokine (C-X-C motif) ligand 16) is a kind of chemokine, which is closely related to the inflammatory response. However, the relationship between autophagy and CXCL16 in ALI is still unclear. This study aimed to investigate the role of autophagy and chemokine CXCL16 in ALI in mice. MATERIAL AND METHODS Thirty-two male C57BL/6 mice were divided into four groups. The control group (C group) was given normal saline through intraperitoneal injection. The L group was given LPS (lipopolysaccharide) at 30 mg/kg to construct an ALI model. The 3-MA group received an intraperitoneal injection of inhibitor of autophagy 3-methyladenine at 15 mg/kg, 30 minutes before LPS injection. The anti-CXCL16 group was given 20 mg/kg of CXCL16 monoclonal antibody 30 minutes before the LPS injection. RESULTS In the 3-MA Group, the level of histological analysis, lung wet/dry ratio, total protein of BAL (bronchoalveolar lavage fluid) and TNF-a level were higher than the L group (p<0.05), the level of autophagy was lower than the L group (p<0.05), and the level of CXCL16 was higher than the L group (p<0.05). In the anti-CXCL16 group, the level of histological analysis, lung wet/dry ratio, BAL protein, and TNF-α level were declined compared to the L group (p<0.05), but there was no statistically significant difference in expression of CXCL16 detected by ELISA between the anti-CXCL16 group and the L group (p>0.05). CONCLUSIONS Autophagy played a protective role in ALI induced by LPS in mice. Autophagy could regulate the level of CXCL16. The chemokine CXCL16 could exacerbate ALI.

Efficacy of intestinal decompression with long nasointestinal tube and selective contrast radiography in the treatment of small bowel obstruction in elderly patients.

BACKGROUND: This study's aim was to assess the efficacy of intestinal decompression with long tube and selective intestinal radiography in the diagnosis and treatment of small bowel obstruction (SBO) in elderly patients. METHODS: Thirty-two elderly patients with SBO received intestinal decompression with a 300-cm long nasointestinal tube inserted into upper jejunum under radiographic control. The long tube was passed into the proximal part of obstruction or the proximal end of ileum driven by intestinal peristalsis. Selective contrast radiography was done using direct injection of double-contrast medium consisting of 20-100 mL of 76% gastrografin and 50-200 mL of air. The dynamic and multi-position radiographic observation was conducted. RESULTS: Intubation was successful in all 32 patients. SBO resolution was successful in 29/32 (90.6%) patients. The 3 remaining patients proceeded to undergo surgery. Radiographic findings showed no obvious abnormalities in 25/32 (78.1%) patients, adhesive SBO in 6/32 (18.6%), and metastatic intestinal tumor in 1/32 (3.1%) patient. CONCLUSIONS: Decompression using long tube can quickly and effectively relieve obstructive symptoms in elderly patients, and help to avoid emergency surgery and to resolve obstruction. Concurrent contrast radiography is helpful to verify the location and degree of obstruction, and to reveal the cause of the obstruction.