Caracterización de la enfermedad pulmonar intersticial en los pacientes con esclerosis sistémica

Introducción: La esclerosis sistémica es una enfermedad autoinmune crónica, caracterizada por vasculopatía, activación del sistema inmune y aumento de depósitos de matriz extracelular. En los últimos años, el compromiso pulmonar ha cobrado gran importancia, ha pasado a ser la primera causa de muerte en estos pacientes. La afección pulmonar puede ocurrir como hipertensión o enfermedad pulmonar intersticial. La meta del tratamiento es detener el deterioro de la función pulmonar. Objetivo: Caracterizar las manifestaciones clínicas, imagenológicas y la función respiratoria en pacientes con esclerosis sistémica y enfermedad pulmonar intersticial. Métodos: Se realizó un estudio observacional, descriptivo de corte transversal en el período comprendido entre diciembre de 2018 y diciembre de 2019. En el Servicio de Reumatología para caracterizar la enfermedad pulmonar intersticial en pacientes con esclerosis sistémica. El universo estuvo constituido por 168 pacientes, diagnosticados con esa enfermedad y la muestra se conformó por 55 pacientes que cumplieron los criterios de inclusión establecidos. Resultados: La enfermedad pulmonar intersticial fue más frecuente en pacientes mayores de 40 años, del sexo femenino, piel mestiza, predominó la forma clínica difusa, el síntoma más frecuente fue la disnea de esfuerzo, la mayoría tuvo ANA positivo y el patrón tomográfico en panal de abejas. La capacidad vital forzada estaba disminuida con mayor frecuencia, se asoció a un comportamiento autoinmune positivo para anti-ScL-70. Conclusiones: Se caracterizó las manifestaciones clínicas y radiográficas de la enfermedad pulmonar intersticial fueron comprobadas por la utilidad de la tomografía computarizada y la espirometría para identificar la presencia de fibrosis pulmonar.

Introduction: Systemic sclerosis is a chronic autoimmune disease, characterized by vasculopathy, activation of the immune system and increased extracellular matrix deposits. In recent years, lung involvement has gained great importance, it has become the first cause of death in these patients. Lung involvement can occur as hypertension or interstitial lung disease. The goal of treatment is to stop the decline in lung function. Objective: To characterize the clinical and imaging manifestations and respiratory function in patients with systemic sclerosis and interstitial lung disease. Methods: An observational, descriptive, cross-sectional study was carried out from December 2018 to December 2019 in the rheumatology service to characterize interstitial lung disease in patients with systemic sclerosis. The universe consisted of 168 patients diagnosed with this disease and the sample was made up of 55 patients who met the established inclusion criteria. Results: Interstitial lung disease was more frequent in patients older than 40 years, female, mixed-race skin color, the diffuse clinical form predominated, the most frequent symptom was exertional dyspnea, the majority had positive ANA and the pattern honeycomb tomography. Forced vital capacity was more frequently decreased, associated with positive autoimmune behavior for Anti-ScL-70. Conclusions: The radiographic and clinical manifestations of PID were verified by the usefulness of computed tomography and spirometry to identify the presence of pulmonary fibrosis.

Uso prolongado de cánula nasal de alto flujo en niños con problemas respiratorios / Prolonged use of high flow nasal cannula in children with respiratory problems

La cánula nasal de alto flujo (CNAF) es una modalidad ventilatoria no invasiva segura y efectiva, usada ampliamente en patología respiratoria aguda en adultos y niños. Objetivo: presentar casos clínicos pediátricos que utilizaron CNAF por tiempo prolongado por problemas respiratorios crónicos. Descripción de casos clínicos, revisión de fichas clínicas de 5 pacientes que utilizaron CNAF por más de 1 mes, entre los años 2017-2020 en el Complejo Asistencial Dr. Sótero del Río. Aprobado por Comité de Ética. Resultados: 5 pacientes varones de mediana 61 (44 a 212) días de edad al inicio del uso de CNAF. Diagnóstico de base: displasia broncopulmonar (2/5), síndrome de Treacher Collins (1/5), síndrome de cimitarra con hipoplasia pulmonar derecha (1/5) y traqueobroncomalacia severa (1/5). Todos requirieron previamente uso de ventilación invasiva o no invasiva con mediana de 59 (4 a 78) días. A todos se les realizó broncoscopia, saturometría contínua o poligrafía para diagnóstico y titulación de CNAF y oxígeno. Todos mejoraron clínicamente, la SpO2 y el número de apneas. Dos pacientes se enviaron a domicilio con uso de Airvo2 nocturno. La mediana de uso de CNAF fue 165 (34 a 445) días. Conclusiones: el uso prolongado de CNAF es útil en pacientes pediátricos seleccionados, bien tolerado y factible de utilizar en domicilio.

The high-flow nasal cannula (HFNC) is a safe and effective non-invasive ventilation support widely used in acute respiratory pathology in adults and children. Objective: To present pediatric clinical cases that used HFNC for an extended period due to chronic respiratory disease. Description of clinical cases, review of medical records of 5 patients who used HFNC for more than 1 month, between the years 2017-2020 at Complejo Asistencial Dr. Sótero del Río. Approved by the Ethics Committee. Results: 5 male patients with a median age of 61 (44 to 212) days at the start of HFNC use. Underlying diagnoses: bronchopulmonary dysplasia (2/5), Treacher Collins syndrome (1/5), Scimitar syndrome with right pulmonary hypoplasia (1/5), and severe tracheobronchomalacia (1/5). All of them previously required invasive or non-invasive ventilation for a median of 59 (4 to 78) days. All patients underwent bronchoscopy, continuous pulse oximetry or polygraphy for diagnosis and titration of HFNC and oxygen. All showed clinical improvement, including SpO2 levels and the number of apneas. Two patients were discharged with nocturnal use of Airvo 2 at home. The median duration of HFNC use was 165 (34 to 445) days. Conclusions: Prolonged use of HFNC is useful in selected pediatric patients, well tolerated, and feasible for home use.

Impact of supplemental vitamins and natural honey for treatment of COVID-19: A review

Abstract The main aim of the paper is to assess whether vitamin C, vitamin D, and natural honey can be administered in the course of the COVID-19 pandemic for promising in line methods with recent evidence. Both systematic literature and clinical trial identification were conducted by searching various databases. A total 58 articles and 29 clinical trials were selected wherein 11 for vitamin C, 16 for vitamin D, and 2 for natural honey were identified for analysis. The high doses of vitamin C (i.e. '200 mg/kg body weight/day, divided into 4 doses') has been found to reduce COVID-19 lung damage, various flu infections. Additionally, the high doses of vitamin C can shorten around 7.8% stay in the intensive care unit. At the same time, vitamin D can effectively protect from lung injury and acute respiratory infections whereas vitamin D deficiency severely affects 75% of the institutionalized people (serum 25(OH) D < 25 nmol/L). Meanwhile, natural honey which contains proteins (0.1-0.4%); ash (0.2%); water (15-17%) has potential antiviral effects and the ability to improve immunity. Therefore, the administration of vitamins and honey is the promising evidence-based approach for reducing fatalities, saving lives, and bringing the COVID-19 pandemic to a rapid end. It is believed that the utilization of vitamin C, vitamin D, and natural honey with the current treatment may be effective in treating COVID-19-caused fatal complications such as pneumonia. Therefore, high-level clinical studies are required on COVID-19 to administrate the effects of vitamins and natural honey

Professor JIANG Liang-duo's Experience and Thought on Treatment of Coronavirus Disease-2019 / 中国实验方剂学杂志

In this paper, the author systematically summarized and explained the idea of Prof. JIANG Liang-duo for preventing and treating the coronavirus disease-2019(COVID-19). According to Prof. JIANG, in the early stage of the disease, dampness and heat injury to the lung is the main cause and pathogenesis, and the high-risk group can be protected by supplementing Qi and nourishing Yin, clearing away heat and penetration. The patients with mild disease can be treated with Chinese medicine. But the accurately treatment can be given only knowing the ratio of the dampness, heat, deficiency and excess. For the patients with severe disease, both strengthening and removing pathogenic factors are important. But the drug for Qi should be prescribed instead of drugs for blood. The prognosis of critical illed patients is very poor, and the method of Invigorating Qi and taking Jin is useful to strengthen the foundation, promot lung, remove dampness, clear heat and cool Ying. Clinical medication should be adjusted according to people, time and place in the different situations.

The anti-inflammatory effect of hesperetin on lung damage induced by paraquat in rats / 中华劳动卫生职业病杂志

Objective@#To investigate the anti-inflammatory effect of hesperetin (HSP) on lung damage induced by paraquat (PQ) in rats by detecting the levels of inflammatory makers in rat lung tissues.@*Methods@#140 Wistar male rats were randomly divided into negative control group, HSP control group, HSP control group, paraquat model group, pirfenidone (PDF) positive control group, and 100, 200, 400 mg/kg HSP treatment groups. All groups were exposed to 50mg/kg paraquat by oral gavage except for the negative control group and HSP control group. After 24 hours, the rats in each group were given drug intervention once daily. 10 rats were randomly sacrificed at 7th day and 28th day after exposure to paraquat respectively. 3 rats were randomly selected from them and HE, Masson staining were used to observe the pathological changes in the lungs of each group. Each group randomly selected 6 rats at two time points to detect the levels of TGF-β1, TNF-α, IL-4, IL-10, IL-1β and IFN-γ in rat lung tissues.@*Results@#Histopathological examination found that the lung injury were reduced in the rats of PDF positive control group and all HSP treatment groups. Compared with the negative control group, the levels of TGF-β1, IL-1β, TNF-α, IL-4, and IL-10 in rat lung tissues were significantly increased (P<0.05, P<0.01) after PQ exposure at two points in time, and there was no significant difference in the level of IFN-γ in lung tissues compared with the negative control group (P>0.05) . The levels of TGF-β1, IL-1β, IL-4, IL-10 and TNF-α in the lung tissues of rats on the 7th day in different dose treatment groups of HSP were reduced compared with those in the PQ model group with varying degrees (P<0.05, P<0.01) . The level of IFN-γ in lung tissues of rats were not significantly different from that of model group (P>0.05) . The levels of TGF-β1 and TNF-α in lung tissue of rats on the 28th day in PDF positive control group and different dose treatment groups of HSP were reduced compared with those in the PQ model group with varying degrees (P<0.05, P<0.01). The levels of IFN-γ in the rat lung tissues were increased compared with those in the PQ model group (P<0.05). Besides, there were no significant in the levels of IL-1β, IL-4 and IL-10 in lung tissues compared with PQ model group (P>0.05).@*Conclusion@#HSP can reduce lung damage induced by PQ in rats by inhibiting the release of inflammatory factors and promoting the secretion of anti-inflammatory factors.

Effect of aging on repair capability of lung stem cells / 中国比较医学杂志

Objective To study the impact of aging on the capability of lung stem cell steady-state maintaining and bronchial epithelial cells regeneration and differentiation during the repair of lung epithelial cells after naphthalene induced bronchial epithelialium injury.Methods The proportion of lung stem cells in mice after naphthalene treatment was analyzed by immunohistochemistry and FACS.The repair efficiency of lung epithelial cell in young and old mice was examined by immunohistochemistry staining and FACS.Results The data suggested that aging didn ’ t change the proportion of lung stem cells ( including the distal lung epithelial stem cells/progenitor cells and lung mesenchymal stem cells/progenitor cells) under normal physiological conditions.After naphthalene injury, more serious injury and decreased repairing capacity was observed in old group.Lung progenitor cells /total lung cells decreased during the repair process of lung bronchial epithelialium ( clara cell) injury.The ratio of regenerated cell to lung progenitor and stem cells were also significantly decreased in old group.Conclusion The regenerated capability of lung stem cells after lung bronchial epithelialium injury decreased with aging.This might be the reason of more incidence of lung injury and worse therapeutic results in the elder in clinic.

Inhalación masiva de amoniaco: reporte de dos casos / Massive ammonia inhalation: report of two cases

Ammonia (NH3) is an irritant and corrosive gas whose inhalation at high concentrations mainly occurs during agricultural and industrial activities, as occupational accidents. The extent and severity of the damage depends on the concentration and time of exposure to the toxic, which can cause skin, eye, respiratory and life-threatening injuries. We present two cases of patients acutely exposed to high concentrations of NH3. Both patients survived to the acute phase of the respiratory injury, but developed chronic lung derangements.

El amoniaco (NH3) es un gas irritante y corrosivo cuya inhalación aguda en altas concentraciones se produce principalmente durante accidentes laborales en el sector agrícola e industrial. La extensión y severidad del daño depende de la concentración y tiempo de exposición al tóxico, el cual puede causar lesiones a nivel cutáneo, ocular, respiratorio y riesgo vital. Presentamos dos casos de pacientes expuestos en forma aguda a NH3 en altas concentraciones. Ambos pacientes sobrevivieron a la fase aguda y evolucionaron con lesiones respiratorias crónicas.

Correlative study on interleukin-6,interleukin -8 and interleukin-10 with radiation-induced lung damage / 实用肿瘤学杂志

Objective To study radiation -induced lung damage after lung ionizing radiation and the temporal and spatial release of pro -inflammatory cytokines of interleukin -6(IL-6),interleukin-8(IL-8) and interleukin-10(IL-10)in the irradiated lung tissue.Methods BALB/C male mice weighted around 25 g were randomly divided into two groups:radiation group ( R) and control group ( C) ,with 30 mice in R group and10 mice in C group.The thorax of mice was irradiated by 6 MV X-ray with 25 Gy in 5 fractions.The mice were sac-rificed at 12 weeks post irradiation.Lung tissues were collected and embedded in paraffin .After HE staining,lung histopathological changes were detected by immunohistochemistry to detect IL -6,IL-8 and IL-10 expression in lung tissue.Results Immunohistochemistry results showed that the expressions of IL -6,IL-8 and IL-10 were mainly expressed in macrophages and inflammatory cells .The results showed that the expressions of IL -6 and IL-8 in R group were significantly higher than that in C group .IL-10 expression level was lower than C group.Conclusion After 12 weeks exposing to radiation ,cytokines of IL-6,IL-8 and IL-10 in lung tissue are associated with radiation -induced lung injury .

Study on the impact of different levels intensive glycemic control on the morphology of liver and lung in rats with sepsis / 重庆医学

Objective To investigate the changes and significance of different target blood glucose on septic liver and lung dam‐age and its morphology .The purpose of this study was to evaluate the pathological injury of liver and lung induced by higher blood glucose .Methods Forty SD rats randomly divided into sham operation group ,sepsis group ,group A (glucose was controlled at 4 .4 to 6 .1 mmol/L) ,group B (glucose was controlled at 6 .1 to 8 .3 mmol/L) and group C (glucose was controlled at 8 .3 to 10 .0 mmol/L) ,with 8 rats in each group .The liver and lung tissue were obtained 12 hours after cecal ligation and puncture .Then evalu‐ate and analyze the morphology change in liver and lung injury from different pathological scores ,including eight observation marker for liver and seven marker for lung .Results The pathological injury of liver and lung was significantly higher than sham treatment group for CLP and group A to C(P0 .05) ,but in the three blood glucose groups ,liver and lung injury progressive dis‐ease with the level of blood glucose elevating and the difference was significant(P0 .05) .For liver injury the main pathological features were hydropic and fatty degeneration ,and CLP group had significant differences with group A ,B and C(P<0 .05) .While CLP group showed a significant piecemeal necrosis for liver injury .Conclusion The injury of liver and lung injury in septic rats were gradually increased with elevated blood glucose levels ;blood glucose controlled within the normal range of liver rat model of sepsis could reduce the liver and lung injury .

El ejercicio físico aumenta el daño pulmonar inducido por la exposición aguda e intermitente a 0, 5 ppm de ozono en ratas juveniles / Physical exercise increases pulmonary damage induced by acute and intermittent exposure to 0.5 ppm of ozone in juvenile rats

El ozono (O3) troposférico es el principal oxidante del esmog fotoquímico. Como es un contaminante aéreo, sus efectos están relacionados con la dosis efectiva = [Concentración] x [tiempo de exposición] x [ventilación minuto]. Objetivo: Determinar si el ejercicio físico -que aumenta la ventilación minuto- puede aumentar el daño pulmonar inducido por la exposición a O3 en ratas en reposo. Material y Métodos: Se usó 4 series de ratas Sprague-Dawley juveniles. Dos series fueron expuestas a 0,5 ppm de O3 (4 h diarias por 2 días) en reposo (n = 13) o durante ejercicio (n = 12). Dos series control respiraron aire filtrado (AF) en reposo (n = 13) o durante sesiones de ejercicio (n = 13), en una rueda vertical giratoria (15 min de ejercicio alternados con 15 min de descanso hasta completar 4 h diarias durante 2 días). Las ratas fueron eutanasiadas y se determinó la razón peso húmedo/peso seco (PH/PS) en el pulmón izquierdo. En el lavado broncoalveolar (LBA) del pulmón derecho, se determinó recuento total de células, proteínas totales y actividad de gamma-glutamiltraspeptidasa (GGT). Resultados: la razón PH/PS y el recuento de células y las proteínas del LBA aumentaron en las ratas en reposo expuestas a O3 comparadas con las ratas en reposo que respiraron AF (p < 0,05 ANOVA & Newman-Keuls). La actividad de GGT en el LBA fue mayor en las ratas que en ejercicio respiraron AF en comparación con las ratas que respiraron AF en reposo (p < 0,05). Hubo aumento de GGT, proteínas y recuento de células en el LBA de la serie [ejercicio + O3] comparada con la serie [reposo + O3] (p < 0,05). Conclusión: El ejercicio físico aumenta el daño pulmonar inducido por la exposición aguda e intermitente a 0,5 ppm de O3 en ratas juveniles.

Tropospheric ozone (O3) is the major oxidant of photochemical smog. Being an air pollutant, its effects are related to effective dose = [Concentration] x [exposure time] x [pulmonary ventilation]. Objective: Determine whether physical exercise -that increases pulmonary ventilation- is able to augment the pulmonary damage induced by O3 exposure in resting rats. Material and Methods: Four series of juvenile Sprague-Dawley rats were used. Two series were exposed to 0.5 ppm O3 (4 hours a day for 2 days) at rest (n=13) or during exercise (n=12). Two control series breathed filtered air (FA) at rest (n=13) or during exercise sessions (n=13), in a vertical rotary wheel (15 min exercise alternated with 15 min resting until to completing 4 hours a day for 2 days). Rats were euthanized and wet weight / dry weight ratio (W/D ratio) was determined in left lung. Total cell counting, total protein content and γ-glutamyltraspeptidase (GGT) activity were determined in the right lung bronchoalveolar lavage fluid (BALF). Results: W/D weight ratio as well as total cell counting and protein content increased in BALF from resting rats exposed to O3 as compared with resting rats breathing FA (p < 0.05 ANOVA & Newman-Keuls test). GGT activity in BALF increased in rats under exercise breathing FA as compared with resting rats breathing FA (p<0.05). GGT, proteins and cells counting increased in BALFfrom series [exercise + O3] as compared to series [resting + O3] (p< 0.05). Conclusion: Physical exercise increases lung damage induced by intermittent and acute 0.5 ppm O3 exposure in juvenile rats.

Clinical characteristics and imaging features of rheumatism-related lung damage in children / 中华实用儿科临床杂志

Objective To explore the clinical manifestations and imaging features of rheumatism-related lung damages in children in order to improve the understanding of the disease.Methods The clinical data from 16 children hospitalized in provincial Hospital Affiliated to Shangdong University from Sep.2007 to Mar.2012 with rheumatism-related lung damage were analyzed retrospectively and the literature data were reviewed.Results In 16 children with rheumatism-related lung damages,the primary problems included systemic lupus erythematosus in 6 children,juvenile idiopathic arthritis and juvenile dermatomyos in 5 children respectively.Four children (25％) exhibited the respiratory symptoms and 12 children (75.0％) exhibited the subclinical symptoms.Through chest CT,the positive results were showed in all 16 children.Among them,12 children (75.0％) were found to have interstitial lung disease,6 children (37.5％)were found to have lesion of pleura and 5 children (31.3％)to have lung parenchyma lesions.Sixteen children were all treated with glucocorticoid,moreover,14 of them (87.5％)were also given the combination therapy with immunosuppressive agents.Thirteen children(81.3％)exhibited a symptom improvement,3 children died,in which,2 children died of respiratory failure caused by lung damage.Conclusions The clinical manifestations of rheumatismrelated lung damage in children are various and latent with the different severity of condition.It has a higher mortality.The changes through the chest CT are mainly pulmonary interstitial damage and pleurisy,also they are earlier than those in clinic and chest film,thus helping to find earlier lung damage.The early glucocorticoid combined with immunosuppressive therapy is expected to improve the prognosis.

Intoxicação aguda por nitrogênio através de inalação em paciente com insuficiência respiratória e coma: relato de caso / Acute nitrogen intoxication by patient inhalation with breathing insufficiency and coma: case report

JUSTIFICATIVA E OBJETIVOS: Apresentação de um caso único não encontrado na literatura nacional. O objetivo deste relato foi apresentar um caso de grave intoxicação por nitrogênio líquido (NO), com edema agudo de pulmão e encefalopatia isquêmica, em que se obteve bom desfecho, provavelmente, pela rapidez no atendimento e na administração adequada da terapêutica. RELATO DO CASO: Paciente do sexo masculino, 26 anos, encontrado desacordado havia aproximadamente uma hora, em sala fechada onde havia uma máquina utilizada para manutenção do gelo de pista de patinação. Constatou-se aspiração de conteúdo gástrico e edema das vias respiratórias altas. A intubação na emergência foi difícil pelo intenso edema de laringe. O paciente desenvolveu edema agudo de pulmão e sinais de edema encefálico por encefalopatia anóxica. Evoluiu com melhora pulmonar lenta com ventilação protetora para síndrome da angústia respiratória aguda (volume corrente de 5 mL/kg, PEEP de 15 cmH2O) e corticoterapia com hidrocortisona (200 mg) a cada seis horas para tratamento de broncoespasmo. CONCLUSÕES: Trata-se do primeiro caso publicado em nosso meio de intoxicação por nitrogênio. Na literatura internacional encontram-se várias citações de situações semelhantes ao deste caso pelo fato de existir varias pistas de gelo para prática de esportes como por exemplo o hockey. Há relatos de exacerbações de quadros de broncoespasmo nas pessoas que assistem ao jogo, apresentando-se de forma tardia, por vezes até sete a dez horas após a exposição aos vapores que exalam destas pistas que são ricas em nitrogênio.

BACKGROUND AND OBJECTIVES: To present the first case reported in the Brazilian literature of liquid nitrogen intoxication. The objective of this report was to present a case of severe intoxication by liquid nitrogen, with acute lung edema and ischemic encephalopathy, which a good outcome, due to a fast diligence and a proper therapy administration. CASE REPORT: Male patient, 26 years, unconscious for one hour, in a close room with a machine to keep frozen the ice-roller ring. There was evidence of gastric aspiration and laryngeal edema. The intubation was difficult. The patient developed acute lung edema and brain edema due to hypoxia. There was a slow lung resolution with a protective ventilatory strategy for ARDS (VT 5 mL/kg, PEEP de 15 cmH2O) and corticotherapy with hydrocortisone (200 mg) every 6 h to treat bronchospasm. CONCLUSIONS: This the first case published in Brazil of nitrogen intoxication. In the international literature there are several reports of similar cases occurred in gymnasiums for hockey game. There are reports of bronchospasm exacerbations in people after the matches, even up to 10h after exposal to the gases riches in nitrogen.

Perspectivas del uso de antioxidantes como coadyuvantes en el tratamiento del asma / Perspectives in the use of antioxidants for the treatment of asthma

Al tratarse de un proceso inflamatorio, en el asma hay participación e incremento en la generación de especies reactivas del oxígeno, dando lugar a un desequilibrio oxidante/antioxidante, fenómeno que se ha descrito como estrés oxidante, que causa daño a diferentes biomoléculas. La utilización de agentes antioxidantes exógenos o activadores de antioxidantes endógenos como coadyuvantes de la terapéutica del paciente asmático, es una posibilidad a discutir.

Oxidative stress seen in bronchial asthma can damage different kinds of biomolecules; this oxidant/antioxidant imbalance results from an increment in the production of oxygen reactive species. The utilization of exogenous antioxidant agents or promoters of endogenous antioxidants can be seen as an alternative therapy for asthma that is worth discussing.

Estrés oxidante en asma / Oxidative stress in asthma

El asma es una enfermedad inflamatoria crónica del tracto respiratorio de etiología aún desconocida; sin embargo, nuevas evidencias han involucrado al estrés oxidante, en el que la participación e incremento en la generación de especies reactivas del oxígeno por diferentes sistemas bioquímicos, superan a los mecanismos antioxidantes en el ambiente de las vías respiratorias del asmático, lo cual es acompañado de alteraciones inducidas por radicales libres que involucran daño estructural y modificaciones metabólicas presentes, a nivel sistémico y en el tracto respiratorio.

Asthma is a chronic inflammatory disease of the airways: its precise etiology is still unknown. New evidence points to oxydative stress, in which the participation and increment of reactive species of oxygen by several biochemical systems overwhelms the anti oxidant mechanisms of the airways; this, in conjunction with changes induced by free radicals involving systemic and local respiratory structural damage and metabolic changes.

THE CHANGES AND ITS CLINICAL SIGNIFICANCE OF ULTRASTRUCTURE IN LUNGS OF TYPE 2 DIABETIC PATIENTS / 解剖学报

Objective To investigate the pathological characteristics and clinical significance of ultrasructure in lung tissues of type 2 diabetic adult patients.Methods Normal lung tissues far from lung neoplasm in 10 cases of type 2 diabetic patients associated with lung cancer were observed under a transmission electron microscope. Results Type Ⅱ alveolar cells became small,and cell superficial microvilli disappeared,Osmiophilic lamellar body became atrophy,lacked lamellar structure and formed a solid globule with high electrom dense;Rough endoplasmic reticulum and mitochodria in cytoplasm were enlarged cystiformly,and there were translucent materials deposited in vesicle,euchromatin decreased,heterochromatin condensed;The basement membrane of bronchial capillary were diffusely thickened and mostly showed onion-skin like change,protein deposited around and mixed with basement membrane.Conclusion Lung is confirmed to be the target organ of chronic damage in diabetes.Pathological changes of pulmonary tissues induced by diabetes have its specific characteristics,which are different from other pulmonary diseases.These changes are pathological basis of pulmonary function abnormalities.

The Role of Lipid Peroxidation in Lung Damage after Smoke Inhalation / 第三军医大学学报

The role of lipid peroxidation in the precipitation of umg damage after smoke inhalation was investigated in 16 dogs. Superoxide dismutase(SOD) activity and plasma MDA in arterial blood, and ethane in the exhaled air were determined to demonstrate oxygen free radicals and lipid peroxidation. PaO2 and extravascular lung water (EVLW) were determined to evaluate lung damage.It was found that in the early postinjury period, the experimental animals suffered from pulmonary edema and acute pulmonary dysfunction. MDA in arterial plasma and exhaled ethane markedly increased (P

Protective effect of polysaccharide from spirulina platensis on injured lung induced by ozone / 中国药理学通报

AIM To observe the effect of polysaccharide from spirulina platensis(PSP) on lung injured by exposing ozone. METHODS The injury model of lung were induced by exposing ozone. The xanthine oxidase method and TBA were used to determine SOD and MDA in serum and lung respectively. The transmission electron microscope was used to observe the structural change of lung cell. RESULTS Compared with model mice, SOD in the groups of PSP administrated mice were increased and MDA were decreased significantly(P

Hemodynamic Changes after Oleic Acid Induced Lung Damage in Dogs / 第三军医大学学报

In order to study the characteristics of the early cardiovascular responses after oleic acid induced lung damage, oleic acid (OA) 0.1ml/kg body weight was infused intravenously into 11 anesthetized and artificially ventilated dogs, and the effects were observed for 3 hours. After OA infusion, PaO2 decreased progressively to a fairly low level with a coincident increase of the alveolar-arterial PO2 gradient and decrease of the oxygen delivery. Cardiac index gradually decreased and reached only 49% of the baseline value at 180 minutes after OA injection. Mean systemic arterial pressure decreased transiently at 60 minutes after OA injection without concomitant increase of the pulmonary arterial pressure. The left ventricular stroke work, +dp/dtmax and - dp/dtmax, and the impedance contractility index were inhibited throughout the experiment. The postmortem lung-body ratio was significantly increased.These results suggest that the dogs following OA injection exhibit severe hypoxemia, reduced cardiae output, suboptimal cardiac performance and reduced oxygen delivery; the reduced cardiac outpur is associated with early and sustained inhibition of the myocardial contractility; and the pulmonary arterial pressure does not change significantly in the whole course of the experiment, so the edema formation does not result from the increase of the capillary hydrostatic pressure.