综合护理干预慢性支气管炎(寒饮停肺)40例临床观察

[目的]观察综合护理干预慢性支气管炎(寒饮停肺)疗效。[方法]对40例住院患者综合护理,包括临症护理、用氧护理、中医专科护理(拔罐联合穴位贴敷、情志护理、饮食调护、用药指导、健康指导)。连续护理30d为1疗程。观测临床症状、护理满意度、治疗依从性、不良反应。护理1疗程(30d),判定疗效。[结果]满意32例,基本满意7例,不满意1例,满意度97.5%。依从性好34例,依从性一般6例,依从性差0例,依从性100.00%。[结论]益中医综合护理干预慢性支气管炎(寒饮停肺),可提高护理满意度和治疗依从性,值得推广。

Protection of ghrelin postconditioning on hypoxia/ reoxygenation in gastric epithelial cells

AIM: To investigate the protective effect and mechanisms of ghrelin postconditioning against hypoxia/reoxygenation (H/R)-induced injury in human gastric epithelial cells. METHODS: The model of H/R injury was established in gastric epithelial cell line (GES-1) human gastric epithelial cells. Cells were divided into seven groups: normal control group (N); H/R postconditioning group; DMSO postconditioning group (DM); ghrelin postconditioning group (GH); D-Lys3-GHRP-6 + ghrelin postconditioning group (D + GH); capsazepine + ghrelin postconditioning group (C + GH); and LY294002 + ghrelin postconditioning group (L + GH). 3-(4,5-dimethylthazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay was used to detect GES-1 cell viability. Hoechst 33258 fluorochrome staining and flow cytometry were conducted to determine apoptosis of GES-1cells. Spectrophotometry was performed to determine release of lactate dehydrogenate (LDH). Protein expression of Bcl-2, Bax, Akt, and glycogen synthase kinase (GSK)-3β was determined by western blotting. Expression of vanilloid receptor subtype 1 (VR1), Akt and GSK-3β was observed by immunocytochemistry. RESULTS: Compared with the H/R group, cell viability of the GH group was significantly increased in a dosedependent manner (55.9% ± 10.0% vs 69.6% ± 9.6%, 71.9% ± 17.4%, and 76.3% ± 13.3%). Compared with the H/R group, the percentage of apoptotic cells in the GH group significantly decreased (12.38% ± 1.51% vs 6.88% ± 0.87%). Compared with the GH group, the percentage of apoptotic cells in the D + GH group, C + GH group and L + GH groups significantly increased (11.70% ± 0.88%, 11.93% ± 0.96%, 10.20% ± 1.05% vs 6.88% ± 0.87%). There were no significant differences in the percentage of apoptotic cells between the H/R and DM groups (12.38% ± 1.51% vs 13.00% ± 1.13%). There was a significant decrease in LDH release following ghrelin postconditioning compared with the H/R group (561.58 ± 64.01 U/L vs 1062.45 ± 105.29 U/L). There was a significant increase in LDH release in the D + GH, C + GH and L + GH groups compared with the GH group (816.89 ± 94.87 U/L, 870.95 ± 64.06 U/L, 838.62 ± 118.45 U/L vs 561.58 ± 64.01 U/L). There were no significant differences in LDH release between the H/R and DM groups (1062.45 ± 105.29 U/L vs 1017.65 ± 68.90 U/L). Compared with the H/R group, expression of Bcl-2 and Akt increased in the GH group, whereas expression of Bax and GSK3β decreased. Compared with the GH group, expression of Bcl-2 decreased and Bax increased in the D + GH, C + GH and L + GH groups, and Akt decreased and GSK-3β increased in the L + GH group. The H/R group also upregulated expression of VR1 and GSK-3β and downregulated Akt. The number of VR1-positive and Akt-positive cells in the GH group significantly increased, whereas the number of GSK-3β-positive cells significantly decreased. These effects of ghrelin were reversed by capsazepine and LY294002.CONCLUSION: Ghrelin postconditioning protected against H/R-induced injury in human gastric epithelial cells, which indicated that this protection might be associated with GHS-R, VR1 and the PI3K/Akt signaling pathway.

Protective effect of ischemic postconditioning on lung ischemia-reperfusion injury in rats and the role of heme oxygenase-1

Objective： To investigate the effect of ischemic postconditioning （1PO） on acute lung ischemia-reperfusion （I/R） injury and the protein expression of haeme oxygenase-1 （HO-1）, a cytoprotective defense against oxidative injury. Methods： After being anesthetized with chloralhydrate, forty-eight healthy SD rats were randomly divided into 6 groups （8 in each）： sham operation group （S group）; I/R group： left lung hilum was clamped for 40 minutes followed by 105 minutes of reperfusion; IPO group： left lung hilum was clamped for40 minutes and postconditioned by 3 cycles of 30 seconds of reperfusion and 30 seconds of reocclusion; Heroin （HM）＋ I/R group： heroin, an inducer of HO-1 was injected intraperitoneally at 40 μmol·kg^-1·day^-1 for two consecutive days prior to 40 minutes clamping of left lung hilum; ZnPPIX＋IPO group： zinc protoporphyrin IX, an inhibitor of HO-1 was injected intraperitoneally at 20 mg·kg^-1 24 hours prior to 40 minutes clamping of left lung hilum; and HM＋S group： HM was administered as in the HM＋I/R group without inducing lung I/R. Arterial partial pressure of oxygen （PaO2） and malondialdehyde （MDA） content in serum were assessed. The left lung was removed for determination of wet/dry lung weight ratio and expression of HO-1 protein by immuno-histochemical technique and for light microscopic examination. Results： The PaO2 was significantly lower in all the experimental groups compared with sham group （90 roan Hg ±11 mmHg）. However, the values of PaO2in IPO （81 mm Hg±7 mm Hg） and HM＋I/R （80 mm Hg±9 mm Hg） were higher than that in I/R （63 mm Hg±9 mm Hg） and ZnPPIX＋IPO （65 mm Hg±8 mm Hg） groups （P〈0.01）. The protein expression of HO- 1 in lung tissue was significantly increased in I/R group compared with S group （P〈0.01）. While the HO-1 protein expression was higher in IPO and HM＋I/R groups as compared with I/R group （P〈0.05, P〈0.01 ）. The lung wet/ dry （W/D） weight ratio and MDA content in serum were significantly increased in I/R group as compared with S or HM＋S groups （P〈0.01）, accompanied by severe lung tissue histological damage, which was attenuated either by IPO or by HM pretreatment （P〈0.01, IPO or HM＋I/R vs. I/R）. The protective effect of IPO was abolished by ZnPPIX. Conclusion： Ischemic postconditioning can attenuate the lung ischemia-reperfusion injury through upregulating the protein expression of HO-I that leads to reduced postischemic oxidative damage.