No abstract

Acute respiratory distress syndrome (ARDS) is a fatal clinical condition that can be caused by pulmonary and non-pulmonary diseases. Oxidative stress and inflammation play key roles in the development of ARDS. In this study, we investigated whether ferulic acid (FA), an anti-oxidant, was beneficial for prophylaxis of ARDS. We established an ARDS rat model using lipopolysaccharide (LPS) administration. Lung injury was assessed by lung wet/dry ratio and broncho-alveolar lavage fluid (BALF) analysis. Hematoxylin and eosin staining was performed to evaluate the histological changes of the lungs. Enzyme-linked immunosorbent assay (ELISA) and immunoblotting were performed to detect proteins in BALF and lung tissue, respectively. Pulmonary function was determined by testing the oxygen level in BALF. FA pretreatment significantly alleviated LPS-induced pulmonary histological changes. FA reversed LPS-induced changes of lung wet/dry ratio, total protein in BALF, P(A-a)O2, and PaO2/FiO2. In addition, LPS dramatically up-regulated the secretion of interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, and IL-10 in BALF (P < 0.01). However, pretreatment of FA significantly improved LPS-induced inflammation. We found that FA indeed reduced oxidative stress in the lungs by testing malondialdehyde level, myeloperoxidase level, and total anti-oxidant capacity. We also proved that FA inactivated multiple mitogen-activated protein kinase signaling pathways in the lungs. In conclusion, FA alleviated LPS-induced ARDS through its anti-inflammatory and anti-oxidant activities.

Background: Postoperative gastrointestinal dysfunction (PGD) leading to nausea, vomiting, and abdominal distension are common complications after laparoscopic surgery for abdominal diseases. However, drugs cannot completely stop PGD. Over the years, transcutaneous electrical acupoint stimulation (TEAS) therapy has shown potential in preventing PGD, but there is no medical evidence that TEAS represents the best choice for the treatment of PGD. This network meta-analysis sought to evaluate the effectiveness of TEAS therapy in preventing PGD in patients after abdominal laparoscopic surgery.Methods: Articles (published from the establishment of the databases to July 2021) were retrieved from the following databases: PubMed/Medline, Cochrane Library, Web of Science, Embase, China Biomedical Literature Database (CBM), China Technical Journal VIP Database (CQVIP), China Knowledge Infrastructure (CNKI), and the Wanfang Database. The Cochrane risk of bias tool was used to evaluate the quality of the included studies, and a network meta-analysis was performed using RevMan 5.20.Results: A total of 7 randomized controlled trials, comprising 440 TEAS-treated patients and 468 control patients, were included in the meta-analysis. The meta-analysis showed that there was no significant difference between the TEAS treatment group and the control group in relation to postoperative nausea and vomiting [relative risk (RR) =0.66; 95% confidence interval (CI): 0.37-1.21; P=0.18], postoperative abdominal distension (RR =0.53; 95% CI: 0.40-0.72; P<0.0001), the time of first postoperative fart (imply gastrointestinal motility) [mean difference (MD) =-7.31; 95% CI: -11.33 to -3.30; P=0.0004], and the time of first postoperative bowel movement (MD =-5.28; 95% CI: -7.23 to -3.33; P<0.0001); there were significant differences among these 3 indicators.Discussion: We found that TEAS can promote postoperative fart and bowel movement, and has good clinical value in promoting postoperative gastrointestinal function recovery.