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Carbon dioxide insufflation in esophageal endoscopic submucosal dissection reduces mediastinal emphysema: A randomized, double-blind, controlled trial

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World Journal of Gastroenterology 2016年第32期22卷 7373-7382页

作者： Yuki Maeda Dai Hirasawa Naotaka Fujita Tetsuya Ohira Yoshihiro Harada Taku Yamagata Yoshiki Koike Kenjirou Suzuki Department of Gastroenterology Sendai City Medical Center Sendal 983-0824 Japan Miyagi Medical Check-up Plaza Sendai 984-0015 Japan

AIM To assess the efficacy of CO2 insufflation for reduction of mediastinal emphysema(ME) immediately after endoscopic submucosal dissection(ESD).METHODS A total of 46 patients who were to undergo esophageal ESD were randomly assigned to receive either CO2 insufflation(CO2 group, n = 24) or air insufflation(Air group, n = 22). Computed tomography(CT) was carried out immediately after ESD and the next morning. Pain and abdominal distention were chronologically recorded using a 100-mm visual analogue scale(VAS). The volume of residual gas in the digestive tract was measured using CT imaging. RESULTS The incidence of ME immediately after ESD in the CO2 group was significantly lower than that in the Air group(17% vs 55%, P = 0.012). The incidence of ME the next morning was 8.3% vs 32% respectively(P= 0.066). There were no differences in pain scores or distention scores at any post-procedure time points. The volume of residual gas in the digestive tract immediately after ESD was significantly smaller in the CO2 group than that in the Air group(808 m L vs 1173 m L, P = 0.013).CONCLUSION CO2 insufflation during esophageal ESD significantly reduced postprocedural ME. CO2 insufflation also reduced the volume of residual gas in the digestive tract immediately after ESD, but not the VAS scores of pain and distention.

关键词： Endoscopic submucosal dissection Carbon dioxide insufflation Mediastinal emphysema Superficial esophageal cancer Complication

Effects of Bilirubin on Alveolar Macrophages in Rats with emphysema and Expression of iNOS and NO in Them

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2004年第4期24卷 322-325,341页

作者：李建强赵卉宋满景徐永健张珍祥 Department of Respiratory Medicine Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Department of Respiratory Medicine the Second Hospital of Shanxi Medical University

To explore the effects of bilirubin on alveolar macrophages (AM) and expression of iNOS and NO in them in emphysema model, the rats were pretreated with bilirubin before exposed to smoke. AM were isolated from bronchoalveolar lavage fluid (BALF) and cultured. Pathological microscopic examination of AM and immunohistochemical analysis of iNOS were performed. Nitric oxide (NO) content in the samples was determined by nitrate reductase technique. The results showed both alveoli and alveolar septum appeared normal in size and shape in normal group. AM showed kidney-shaped nucleus and were rich in Golgi complexes and primary lysosomes in the cytoplasm. The inner membrane of mitochondrion was continuous. Most cristae of the mitochondria were intact. In model group, the alveoli were expanded, ruptured and bullaes were formed. Both the population and sizes of AM increased significantly. Secondary lysosomes were rich in the cytoplasm. Deformation and pyknosis of the nucleus, swelling of the mitochondrions and rupture of the inner mitochondrial membrane could also be seen. At high magnification, most of the mitochondrial cristae were broken, or completely lost at certain points. In bilirubin group, alveoli partly expanded and the population of AM also increased, with morphological changes being slighter than that in model group. Both NO contents and expression of iNOS in model group were higher than those in normal group (Pemphysema associated with smoking in rats. Bilirubin may exert protective effects on AM and retards the development of emphysema in rats.

关键词： bilirubin emphysema alveolar macrophage

Effects of Shenmai and Aminophylline on Apoptosis of Small Airway Smooth Muscle Cells and the Expression of Relevant Genes in Rats with emphysema

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2002年第4期22卷 310-312页

作者：牛汝楫刘辉国傅娟 DepartmentofRespiratoryMedicine

The effects of Shenmai injection (SMI) and am inophylline on apoptosis of sm all airway smooth muscle cells (SASMC) and the Fas/ Fas L expression in rats with papain- induced em physe- ma were *** emphysema model was established by a single intratracheal instillation of *** and Fas/Fas L expression of SASMC were detected by im munohistochemistry SABC and TU NEL assay at day1,3,5 ,7,15 ,30 after modeling,and the effect of SMI and am inophylline on them were *** results indicated that the Fas/Fas L expression positive rate in SASMC was2 .31± 0 .5 5 /1.2 8± 0 .4 *** a single intratracheal instillation of papain,the expression of Fas/Fas L positive rate in the placebo group was increased in a tim e- dependent *** could inhibit the expression of Fas/ Fas L ,but aminophylline couldn't. The positive rate of apoptosis in the control group was 0 .87± 0 .32 .After a single intratracheal in- stillation of papain,the SASMC apoptosis positive rate in the placebo group was increased in a tim e- dependent *** SASMC apoptosis rate in all groups was declined after treatment with SMI,but the effect of am inophylline was *** dem onstrated thatin the patho- genesis of emphysem a Fas/Fas L played an important role in the regulation of SASMC apoptosis. SMI influenced the expression of Fas/ Fas L and declined SASMC apoptosis by inhibiting the releas- ing of inflamm atory m edia and played an im portant role in the therapy of em physema.

关键词： emphysema small airway smooth muscle cells Fas Fas L apoptosis

mRNA Expression of Basic Fibroblast Growth Factor from A Single Intratracheal Instillation of Papain induced emphysema in Rats

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2001年第4期21卷 297-300页

作者：傅娟徐永健张珍祥 Department of Respiratory Medicine Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430030

The relations between mRNA expression of basic fibroblast growth factor (bFGF) and the changes in collagen Ⅰand collagen Ⅲ in pulmonary tissues from a single intratracheal instillation of papain induced emphysema in rats were investigated. Wistar rats ( n =42) were randomly divided into normal group and emphysema model 1, 3, 5, 7, 15, 30 day groups ( n =6 in each group). The rat model of emphysema was induced by a single intratracheal instillation of papain. The results of immunohistochemistry SABC and in situ hybridization with bFGF probe were quantitatively analyzed to examine the changes of collagen Ⅰand collagen Ⅲ and bFGF mRNA expression in lung tissues and the percent of positive expression of bFGFmRNA in alveolar macrophages. The results were as follows: (1) In the emphysema model groups the optical densities of collagen Ⅰand collagen Ⅲ began to increase after 3 days, reached the highest at the 7 th day, and began to reduce at the 15 th day; (2) No expression of bFGFmRNA in pulmonary tissues was detectable in the normal group. The positive expression of bFGFmRNA was detectable in lung tissues one day after the intratracheal instillation of papain. The average optical densities reached the peak (41.895±7.017) at the 7th day, significantly higher than in the normal group (0.581±0.139, P <0.01). The positive expression of bFGFmRNA in lung tissues began to reduce at the 15th day; (3) Positive expression of bFGFmRNA in alveolar macrophages of instillation papain rats was detectable 3 days after the intratracheal instillation of papain, and reached the highest at the 7th day with the percent of positive expression of bFGF mRNA in alveolar macrophages being 70.13±11.21, higher than in the normal group (5.12±0.18, P <0.01); (4) The expression of bFGF mRNA in the lung tissues and macrophages was postively related with the changes in collagen Ⅰ and collagen Ⅲ ( P <0.01 or P <0.05) respectively. It was suggested that the up regulation of bFG

关键词： emphysema basic fibroblast growth factor pulmonary interstitial fibrosis

Pneumomediastinum, pneumorachis, subcutaneous emphysema: An unusual complication of leukemia in a child

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World Journal of Clinical Cases 2013年第7期1卷 224-226页

作者： Hakim Irfan Showkat Aleem Jan Arif Hussain Sarmast Gull Mohammad Bhat Basharat Mujtaba Jan Yasir Bashir Department of Internal Medicine Sheri-Kashmir Institute of Medical Sciences

Pneumorrhachis(PR), or epidural emphysema, denotes the presence of air in the spinal epidural space. It can be associated with a variety of etiologies, including trauma; recent iatrogenic manipulations during surgical, anesthesiological and diagnostic interventions;malignancy and its associated therapy. It usually represents an asymptomatic epiphenomenon but also can be symptomatic by itself, as well as by its underlying pathology, and rarely can be fatal. The pathogenesis and etiology of PR are varied and can sometimes be a diagnostic challenge. As such, there are no standard guidelines for the management of symptomatic PR and its treatment is often individualized. Here, we present a case of a 14-year-old boy treated for leukemia who developed this complication and whether chemotherapy related or not, it proved to be fatal for him. To our knowledge, this is the first case in the literature of this complication with acute lymphoblastic leukemia.

关键词： Pneumomediastinum Leukemia Pneumorachis Subcutaneous emphysema Chemotherapy

Interaction of Wnt/β-catenin and Nrf2 pathways in cigarette smoke-induced inflammation and emphysema

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中国药理学与毒理学杂志 2016年第10期30卷 1035-1036页

作者： CUI Wen-hui MO Xiao-ting ZHOU Wen-cheng ZHANG Zhi-hui GAO Jian School of Pharmacy Anhui Medical University The First Affiliated Hospital of Anhui Medical University The Second Affiliated Hospital of Dalian Medical University

OBJECTIVE The present study aimed to investigate the relationship between Wnt/β-catenin and Nrf2 signaling pathways,and understanding the mechanisms underlying the process of inflammatory in chronic obstructive pulmonary disease(COPD),which was a serious disease of respiratory *** We duplicate the emphysema model with porcine pancreatic elastase(PPE)in Nrf2-/-and WT mouse for 21d,and intraperitoneal injection of Li Cl,the activator of Wnt/β-catenin signaling pathway from 14 d to the *** and eosin(H&E)staining was performed to assess the histopathologic level,and immunohistochemistry(IHC)for Mac-3(the marker of macrophagocyte)and Ly6G(the marker of neutrophil)was used to observe the inflammatory infiltrate,while the levels of Wnt/β-catenin and Nrf2 signaling pathways related proteins heme oxygenase-1(HO-1),NAD(P)H:quinone oxidoreductase 1(NQO1),and the expression of inflammatory cytokine interleukin-6(IL-6)were detected by Western blotting of lung *** vitro,cigarette smoke extract(CSE)-treated normal human bronchial epithelial(NHBE)cells,cell viability was examined by MTT assay,and then we treated recombinant human Wnt3a,si Nrf2 and si Wnt3a to measure the expression of Wnt3a,β-catenin,Nrf2,HO-1,NQO-1,and *** immunofluorescence staining was employed to identify the nuclear translocation of *** We found that the Li Cl-treated group has markedly decreased the damage of alveolar structure and inflammatory signs than the model group of WT mice rather than Nrf2-/-*** also seen that Li Cl not only increasedβ-catenin,but it also led to a comparable increase in Nrf2,HO-1,NQO1,and decrease of IL-6 compared with WT model groups but except to Nrf2-/-group in *** it showed that Wnt3atreatment has significantly increased the nuclear translocation of Nrf2 and the expression of HO-1 and NQO1,reduced the IL-6 release,while there has no significance when Nrf2 was blocked in CSE-induced NHBE *** Our results demons

关键词： chronic obstructive pulmonary disease emphysema interleukin-6 inflammation nuclear factor erythroid-2-related factor-2 Wnt/β-catenin

Electrocardiographic changes in emphysema

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World Journal of Cardiology 2021年第10期13卷 533-545页

作者： Puneet Gupta Hitangee Jain Misbah Gill Gurpreet Bharaj Nauman Khalid Waseem Chaudhry Lovely Chhabra Department of Interventional Cardiology Northeast Ohio Medical UniversityCantonOH 44272United States BA-MD Brooklyn CollegeBrooklynNY 11210United States Department of Family Medicine Memorial Hospital of CarbondaleCarbondaleIL 62901United States Psychiatry Loretto HospitalChicagoIL 60644United States Department of Interventional Cardiology St.Francis Medical CenterMonroeLA 71201United States Department of Cardiology Westchester Medical Center Network Advanced Physician ServicesPoughkeepsieNY 12601United States

Chronic obstructive lung disease(COPD),predominantly emphysema,causes several thoracic anatomical and hemodynamic changes which may cause changes in various electrocardiographic parameters.A 12-lead electrocardiogram(ECG),which is often a part of routine evaluation in most clinical settings,may serve as a useful screening modality for diagnosis of COPD or *** current article aims to provide a comprehensive review of the electrocardiographic changes encountered in COPD/emphysema utilizing published PubMed and Medline literature *** important ECG changes are present in COPD/emphysema and may serve as a good diagnostic *** of Pvector,changes in QRS duration,pattern recognition of precordial R-wave progression and axial shifts can be considered some of the most valuable markers among other *** conclusion,12-lead surface electrocardiogram can serve as a valuable tool for the diagnosis of COPD and/or *** appropriate knowledge of these ECG changes can not only help in the diagnosis but can also immensely help in an appropriate clinical management of these patients.

关键词： emphysema Chronic obstructive pulmonary disease Electrocardiogram Pwave axis Sensitivity Specific

Animal models of emphysema

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Chinese Medical Journal 2019年第20期132卷 2465-2475页

作者： Gui-Bin Liang Zhi-Hui He Department of Intensive Care Unit The Second Xiangya HospitalCentral South UniversityChangshaHunan 410011China

Objective:Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease of human beings characterized by not fully reversible airflow limitation. emphysema is the main pathological feature of COPD which causes high mortality worldwide every year and consumes a large amount of medical expenses. This paper was to review the establishment and evaluation methods of animal models of emphysema or COPD, and put forward some new ideas on animal selection, method of modeling, and model *** sources:The author retrieved information from the PubMed database up to July 2019, using various combinations of search terms, including emphysema, model, and *** selection:Original articles, reviews, and other articles were searched and reviewed for animal models of ***:This review summarized animal models of emphysema from the perspectives of animal selection, emphysema mechanism, modeling method and model evaluation, and found that passive smoking is the classic method for developing animal model of emphysema, mice are more suitable for experimental study on emphysema. Compared with pulmonary function indicators, airway inflammation indicators and oxidative stress indicators, pathomorphological indicators of lung tissue are the most important parameters for evaluating the establishment of the animal model of ***:Mice model induced by passive smoking is the classic animal model of emphysema. Pathomorphological indicators are the most important parameters for evaluating the establishment of the animal model of emphysema.

关键词： Animal Chronic obstructive pulmonary disease emphysema Model

Small airway immunoglobulin A profile in emphysema-predominant chronic obstructive pulmonary disease

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Chinese Medical Journal 2020年第16期133卷 1915-1921页

作者： Hu Liu Huo-Yan Tang Jian-Ying Xu Zhi-Gang Pang Department of Respiratory Medicine Shanxi Bethune Hospital Affiliated to Shanxi Medical UniversityTaiyuanShanxi 030032China Shanxi Medical University TaiyuanShanxi 030001China

Background:Due to airway remodeling and emphysematous destruction in the lung,the two classical clinical phenotypes of chronic obstructive pulmonary disease(COPD)are emphysema and *** present study was designed to investigate the levels of small airway immunoglobulin A(IgA)in COPD with“emphysema phenotype.”The study also evaluated the associations between the small airway IgA levels and the severity of disease by the extent of emphysema versus airflow ***:Thirty patients(20 with COPD and ten healthy smokers)undergoing lung resection surgery for a solitary peripheral nodule were *** study was conducted from January 2015 to December 2018 in the Shanxi Dayi *** presence of small airway IgA expression was determined in the lung by *** vivo,Wistar rats were exposed to silica by intratracheal *** were sacrificed at 15 and 30 days after exposure of silica(n=10 for each group).We also evaluated airway IgA from ***:Small airway secretory IgA(sIgA),dimeric IgA(dIgA),and dIgA/sIgA of Global Initiative for Chronic Obstructive Lung Disease grade 1–2 COPD patients showed no difference compared with smoking control subjects(5.15±1.53 vs.6.03±0.85;1.94±0.66 vs.1.67±0.04;41.69±21.02 vs.28.44±9.45,all P>0.05).dIgA/sIgA level in the lung of COPD patients with emphysema showed higher levels than that of COPD patients without emphysema(51.89±24.81 vs.31.49±9.28,P=0.03).The percentage of low-attenuation area below 950 Hounsfield units was positively correlated with dIgA/sIgA levels(r=0.45,P=0.047),but not associated with the severity of disease by spirometric measurements(forced expiratory volume in the first second%pred,P>0.05).Likewise,in the rat study,significant differences in sIgA,dIgA,dIgA/sIgA,mean linear intercept,mean alveoli number,and mean airwaythickness of bronchioles(VVairway,allP<0.01)were only observed between control rats and those exposed for 30 ***,in the group exposed fo

关键词： Immunoglobulin A B cell emphysema Chronic obstructive pulmonary disease