Basic Research On Hyperbaric Oxygen Combined With Hydrogen Water For Severe Lung Injury In War Trauma

ObjectiveLung injury is one of the most serious injury of chest trauma,lacking of effective treatment.Hyperbaric oxygen therapy can increase the content of oxygen in arterial blood,rapidly improve PaO2 and the organ tissue hypoxia,reduce the acidic metabolites,restore the function of various organs.Hydrogen is a good antioxidant.in recent years,study on the reaction of antioxidant,anti-inflammatory on hydrogen has become a hot spot.At present,there are no reports on the two combined treatment for lung injury,this study explores the feasibility of the combination of the two in the treatment of invasive acute lung injury and discusses the corresponding intervention measures.According to the related literature and many experiments,it was found that there were many variables in the chest trauma model,which resulted in a large deviation from the experimental results.Therefore,we used the mature lipopolysaccharide(LPS)technique to produce a severe lung injury model.After the model was successfully established,the rats were treated with saturated hydrogen water alone,or the hyperbaric oxygen therapy alone,and the combined treatment were used.The pathological changes of lung tissue and infiltration of inflammatory cells were observed.The levels of inflammatory factors in blood and lung tissues were measured.Apoptosis Rate and Antioxidant Enzymes in Lung Tissue were examilated.Through the observation of the above indexes,to determine the mechanism of action and Therapeutic implications of the saturated hydrogen water combined with hyperbaric oxygen in lung injury and to provide a theoretical basis for the new treatment methods of clinical lung injury.Methods40 male Sprague-Dawlay rats,weighing about(240±10)g,were randomly divided into 5 groups(n=8/group),which were the control group(sham group),LPS group,LPS+O2group,LPS +H2 group,LPS+O2+H2 group.Sham group was injected with saline,then feed freely;LPS group was given LPS at dosage as 3mg/kg to create lung injury model,then no treatment after;LPS+ O2 group,1 hour after model setup was given 2.5ATA hyperbaric oxygen treatment for 2 hours,then after 12 hours was given hyperbaric oxygen treatment once;LPS+H2 group,1 hour after model setup was given intraperitoneal injection of saturated hydrogen water at 5ml/kg,12 hours after repeated intraperitoneal administration;LPS+ O2+H2 group,1 hour after model setup was given intraperitoneal injection of saturated hydrogen water at 5ml/kg,and then immediately served with 2.5ATA hyperbaric oxygen treatment for 2hours,then after 12 hours,was given both intraperitoneal injection of saturated hydrogen water and hyperbaric oxygen treatment.3-day treatments were repeated on all the groups.Then lung wet-to-dry weight ratio were compared,content of TNF-??IL-1??IL-6 in serum,lung tissue and bronchoalveolar lavage fluid were detected,MDA content and SOD activity in serum and lung tissue were tested,cell apoptosis in lung tissue was monitored by method TUNEL,and.pathological changes of lung tissue were observed under microscope.Results1.Rats' lung wet-to-dry weight ratio:The ratio of wet-to-dry weight of LPS group is higher than that of LPS + O2 group,LPS +O2 group and LPS+O2+H2 group.There was no statistically significant difference between LPS+O2+H2 groups,LPS+H2 group and LPS+O2.2.Pathological observation:sham group alveolar cavity structure is complete,the walls of alveolar cavity is smooth,no blood cell infiltration in cavity.LPS group showed alveolar structure being damage,pulmonary interstitial thickening,interstitial filled with a large number of white blood cells,alveolar cavity can find red blood cells and leukocyte infiltration.LPS+O2 group and LPS+H2 group alveolar wall thickening,alveolar and interstitial also find leukocyte infiltration,but pathological scores of them lower than the LPS group.There was no significant difference in pathological score between LPS +O2 +H2 group and LPS+O2 group and LPS+H2 group.3.The content of MD A in LPS+O2 group,LPS+H2 group and LPS +O2 +H2 group was lower than that in LPS group(P<0.05),but there was no difference between the two groups.The activity of SOD in LPS + O2 group,LPS + H2 group and LPS+O2+H2 group was higher than that in LPS group(P<0.05),which was lower than that in sham group(P<0.05).4.The levels of TNF-?,IL-1? and IL-6 in lung tissue and serum:About IL-1?LPS group is significantly higher than those in LPS +O2 group,LPS + H2 group and LPS+O2+H2 group in lung tissue and serum(P<0.05).TNF-? and IL-6 were not significantly different between lung tissue and serum,which may be related to the time of extraction.5.The levels of TNF-a and IL-1? in alveolar lavage fluid were lower in LPS+O2 group,LPS+H2 group and LPS+O2+H2 group than in LPS group(P<0.05),hyperbaric oxygen and hydrogen water There was no significant difference between groups and hydroxyl groups.6.Cell apoptosis:There is significant difference between LPS and sham group.And the apoptosis index of LPS group higher than LPS+H2and LPS+O2 group(P<0.0001).There was significant difference between LPS+H2 group and LPS+H2+O2 also had a difference(P = 0.0012<0.05),showing that there is synergistic effect between hydrogen and hyperbaric oxygen therapy.Conclusion1.hydrogen-rich saline can reduce lung inflammation,cut down the production of inflammatory products,decrease the expression of inflammatory factors.It has a significant protective effect for acute lung injury.2.hyperbaric oxygen can reduce the release of inflammatory substances in lung tissue,lessen the accumulation of oxidation products,relieve lung injury.It has obviously curative effect for acute lung injury.3.Hyperbaric oxygen combined with hydrogen water in the treatment of acute lung injury has a synergistic effect in reducing apoptosis.In the expression of inflammatory factors and inflammatory products,the combination of hydrogen and hyperbaric oxygen compare with each one,the former has a relatively downward trend.