Quantitative analysis of high pressure ventilation stress on lung cell with one lung ventilation

我们报道了在高呼气末正压通气条件下，c-fos基因在肺组织中的表达。这种基因表达意味着一个肺细胞受到共同的压力。我们证实了30min的高PEEP通气量对c-fos基因表达的影响是足够的，定量分析c-fos基因表达可以检测到不同程度的肺表面应激。结果提示，高PEEP组大鼠肺组织c-fos基因表达高于低PEEP组，且两组大鼠肺细胞基因表达趋势不同。因此，我们尝试使用双侧肺叶，通风和非通风，来分析基因表达的差异。血液流动应受到重力的影响，通风可能会在上半部引起共同应激。腹侧肺细胞表达高于背侧肺细胞。结果提示，PEEP越高，应激基因表达越多，但大鼠之间存在一定程度的差异，其原因是手术方式和全肺操作方式不同，不采用全肺操作。部分大鼠通气侧肺细胞c-fos基因表达高于非通气侧，腹侧肺细胞c-fos基因表达也较高。这些结果支持我们的假设，即更高的压力通风承受更多的应激，并诱导更多的应激基因表达。但是一些大鼠表现出与我们的假设相反的表达，即使在通风侧肺细胞中也没有表达。现在，我们安排了诺瑟图分析，以帮助减少人工噪声，如手术操作，并反馈到c-fos基因表达的RT-PCR结果。

We reported that we could confirm c-fos gene expression in a lung tissue under high positive end-expiratory pressure ventilation. This gene expression means that a lung cell is suffered with share stress. We confirm that 30 minutes high PEEP ventilation is enough for c-fos gene expression and quantitative analysis of c-fos gene expression detects difference of degree of lung surface share stress.We applied one lung ventilated rat to detect c-fos mRNA expression induced by high PEEP ventilation. Our result suggest ventilation with high PEEP may induce c-fos mRNA expression more than low PEEP ventilation and there is different tendency between ventilated and non-ventilated rat lung cell gene expressions. So we tried to use both side lung lobes, ventilated and non-ventilated, for analysis of difference of gene expression. Blood flow should be affected by gravity and ventilation may induce share stress in upper area. Abdominal side lung cell expressed more than backside lung cell. Out result suggest the tendency of higher PEEP induces more stress gene expression but some extent difference between rats and the reasons are surgical procedure and total lung maneuver so we applied no total lung maneuver.Some rats revealed ventilated lung cell expressed c-fos mRNA more than non-ventilated side lung cell and abdominal side also showed more gene expression. These results support our hypothesis that higher pressure ventilation suffered more stress and induce more stress gene expression. But some rats show inverse expression against our hypothesis and no expression even though in ventilated side lung cell.Now we scheduled Nothern-Plot analysis for help to reduce artificial noise, such as surgical procedure, and feedback to RT-PCR result of c-fos gene expression.