Respiratory mechanics in brain injury: A review

Several clinical and experimental studies have shown that lung injury occurs shortly after brain damage. The responsible mechanisms involve neurogenic pulmonary edema, inflammation, the harmful action of neurotransmitters, or autonomic system dysfunction. Mechanical ventilation, an essential component of life support in brain-damaged patients(BD), may be an additional traumatic factor to the already injured or susceptible to injury lungs of these patients thus worsening lung injury, in case that non lung protective ventilator settings are applied. Measurement of respiratory mechanics in BD patients, as well as assessment of their evolution during mechanical ventilation, may lead to preclinical lung injury detection early enough, allowing thus the selection of the appropriate ventilator settings to avoid ventilatorinduced lung injury. The aim of this review is to explore the mechanical properties of the respiratory system in BD patients along with the underlying mechanisms, and to translate the evidence of animal and clinical studies into therapeutic implications regarding the mechanical ventilation of these critically ill patients.

Special AT-rich sequence-binding protein 1 promotes cell growth and metastasis in colorectal cancer

AIM: To evaluate the expression of special AT-rich sequence-binding protein 1 (SATB1 ) gene in colorectal cancer and its role in colorectal cancer cell proliferation and invasion.METHODS: Immunohistochemistry was used to detect the protein expression of SATB1 in 30 colorectal cancer (CRC) tissue samples and pair-matched adjacent nontumor samples. Cell growth was investigated after enhancing expression of SATB1. Wound-healing assay and Transwell assay were used to investigate the impact of SATB1 on migratory and invasive abilities of SW480 cells in vitro . Nude mice that received subcutaneous implantation or lateral tail vein were used to study the effects of SATB1 on tumor growth or metastasis in vivo . RESULTS: SATB1 was over-expressed in CRC tissues and CRC cell lines. SATB1 promotes cell proliferation and cell cycle progression in CRC SW480 cells. SATB1 over-expression could promote cell growth in vivo . In addition, SATB1 could significantly raise the ability of cell migration and invasion in vitro and promote the ability of tumor metastasis in vivo . SATB1 could up-regulate matrix metalloproteases 2, 9, cyclin D1 and vimentin, meanwhile SATB1 could down-regulate E-cadherin in CRC. CONCLUSION: SATB1 acts as a potential growth and metastasis promoter in CRC. SATB1 may be useful as a therapeutic target for CRC.

Extracorporeal membrane oxygenation as a platform for the management of massive hemoptysis caused by bronchial artery aneurysm

To the editor： Extracorporeal membrane oxygenation （ECMO） can be considered in patients with life-threatening acute respiratory failure despite adequate management with a mechanical ventilator. However, due to the perceived risk of increased bleeding secondary to the use of systemic anticoagulation, ECMO is often not used to treat patients with severe hemoptysis. Here we report a case of successful application of ECMO as a bridge to bronchial angiographic embolism （BAE） and surgery therapy in a patient with fatal hemoptysis and refractory hypoxia caused by bronchial artery aneurysm.

Peripheral Pulmonary Emboli Detected by Radial Probe Endobronchial Ultrasound

To the Editor： Endobronchial ultrasound （EBUS） has been utilized as a useful noninvasive diagnostic tool for mediastinal lymph nodes or masses. Recently, convex probe EBUS （CP-EBUS） has recently come to be used to diagnose central pulmonary embolism.I However, CP-EBUS cannot detect peripheral pulnaonary embolism. It is here believed that the potential use of EBUS is still underestimated.