Li-Ye Yang’s research while affiliated with First Affiliated Hospital of China Medical University and other places

Background Ventilator-induced lung injury (VILI) is caused by overdistension of the alveoli by the repetitive recruitment and derecruitment of alveolar units. This study aims to investigate the potential role and mechanism of fibroblast growth factor 21 (FGF21), a metabolic regulator secreted by the liver, in VILI development. Methods Serum FGF21 concentrations were determined in patients undergoing mechanical ventilation during general anesthesia and in a mouse VILI model. Lung injury was compared between FGF21-knockout (KO) mice and wild-type (WT) mice. Recombinant FGF21 was administrated in vivo and in vitro to determine its therapeutic effect. Results Serum FGF21 levels in patients and mice with VILI were significantly higher than in those without VILI. Additionally, the increment of serum FGF21 in anesthesia patients was positively correlated with the duration of ventilation. VILI was aggravated in FGF21-KO mice compared with WT mice. Conversely, the administration of FGF21 alleviated VILI in both mouse and cell models. FGF21 reduced Caspase-1 activity, suppressed the mRNA levels of Nlrp3 , Asc, Il-1β, Il-18, Hmgb1 and Nf-κb , and decreased the protein levels of NLRP3, ASC, IL-1β, IL-18, HMGB1 and the cleaved form of GSDMD. Conclusions Our findings reveal that endogenous FGF21 signaling is triggered in response to VILI, which protects against VILI by inhibiting the NLRP3/Caspase-1/GSDMD pyroptosis pathway. These results suggest that boosting endogenous FGF21 or the administration of recombinant FGF21 could be promising therapeutic strategies for the treatment of VILI during anesthesia or critical care.

Objective: To introduce a new modified technique for radial artery catheterization. Materials and methods: A prolongated needle was made by using routine Vasocan Braunule needle and 1 ml syringe. A table of random digits was used for randomization of 32 interns. 14 interns were involved in group T and 18 interns were in group M. Each intern accomplished 20 cases. Then 640 patients were divided into 2 groups: group T included 280 patients with traditional direct technique, group M included 360 patients with 1 ml hollow tube-assisted technique. Results: Satisfactory results were obtained for 107 patients in group T and 292 patients in group M (P < 0.05). The success rates for catheter insertion after one attempt were 38.2% in group T and 81.1% in group M (P < 0.001). The blood flow times for observation were 1.7 ± 0.2 s in group T and 19.6 ± 1.8 s in group M (P < 0.001). Conclusion: The authors suggested the use of 1 ml hollow tube-assisted radial artery cannulation technique rather than a direct technique. This modified technique provided easy, safe, quick and less cost cannulation.