stimulate the release of NO and ET-1 from HUVECs, also induce iNOS-mRNA expression. The
change of NO may be the result of iNOS mRNA expression upregulation induced by hypoxia.
259.
HYPOXIA INDUCES THE GENE EXPRESSION OF ENDOTHELIN-1 AND INOS IN
HUMAN VASCULAR ENDOTHELIAL CELLS. Hu Xiaolan
1
, Lin Shuxin
1
, Yu Daihua
1
, Zhang
Shifan
2
. Department of Pathophysiology, Fourth Military Medical University
1
, Department of
Thoracic Cardiovas Surgery, Lanzhou General Hospital of PLA
2
.
To examine the changes of endothelin-1(ET-1) and inducible nitric oxide synthase
(iNOS)gene expression levels under normoxic and hypoxic conditions in human umbilical vein
endothelial cells(HUVECs), and to investigate the possible mechanisms of hypoxic pulmonary
hypertension. Methods _On the basis of the hypoxic cell culture model, HUVECs were
incubated for 6,12 and 24 hours(h) under normoxic(21%O2)and hypoxic(3%O2) condition. The
methods of nitrate reductase and radioimmunoassay were used to determine the changes of
nitrite/nitrate (NO2-/NO3-) and ET-1 in the medium secreted by HUVECs, and reverse
transcription-polymerase chain reaction (RT-PCR) was respectively used to analyze the
expression levels of iNOS and ET-1 mRNA, and the expression of iNOS protein level was
detected by western blot.after exposure to hypoxia at different time points. Results _Comparing
with normoxic group, The contents of ET-1 in the medium increased significantly in hypoxic
group in time-dependent manner, and further study revealed that the expression of the mRNA of
ET-1 also increased markedly in hypoxic group in time-dependent manner. As compared with
normoxic group, upon exposure to hypoxia for 6h, the expression of the mRNA and protein of
iNOS increased significantly in hypoxic group, and the content of NO2-/ NO3- secreted by
HUVECs increased markedly in hypoxic group upon exposure for 12 and 24h. Conlusion:
Hypoxia can stimulate the synthesis and release of nitric oxide (NO) and ET-1 by HUVECs and
upregulate the levels of iNOS and ET-1 gene expression.
260.
CLINICAL NURSING EXPERIENCE OF 61 CHILDREN WITH HIGH ALTITUDE
PULMONARY EDEMA IN TIBET . Lei Xiao-Ming
1
, Zhao Shi-Mei
1
, Xu Li
1
, Xiao Dong-Mei
1
,
Ma Xiao-Reng
1
, Ou Zhuo-Ga
1
, Zhang Xin-Ran
1
. Dept. of Pediatric, Lhasa People's Hospital,
Lhasa, 8
5
0000, China
1
.
The purpose of this study was to summarize the experience of clinical nursing with children
suffering from high altitude pulmonary edema (HAPE) in order to decrease mortality and
improve quality of clinical nursing. We retrospectively analyzed the data of 61 patients with
HAPE who were hospitalized in Lhasa People's Hospital (3664m) over the past 10 years. The
diagnosis of HAPE was confirmed according to the diagnostic criteria of HAPE established at the
1991 International Hypoxia Symposium. All patients were Han Chinese. Of the patients_37
were male and 24 female. During the period of observation 55 patients had their primary attack
and 6 patients suffered recurrences. The age ranged from 5 months to 14 years with a mean of 6.5
years. All attacks occurred between 6 hours to 3 days after arrival in Tibet. 56 patients had
traveled to Tibet by air, 5 by bus. The clinical signs and symptoms included headache (55 cases,
89.6%), chest discomfort and shortness breath (46, 75.4%), cough (52, 85.2%), heart palpitations
(42, 68.9%), insomnia (31, 50.8%), poor appetite (39, 63.9%), nausea and vomiting (28, 45.9%),
bloody sputum (29, 47.5%), cyanosis (28, 45.9%) and bilateral rales (49, 80.3%). The chest ray
revealed pulmonary infiltrates with normal heart size in 46 cases (75.4%). All patients recovered
within 3 to 9 days with an average of 4 days. In conclusion, close observation of signs including
respiratory distress, cyanosis, and level of consciousness as well as arterial blood gas monitoring
are important for successful treatment. The maintenance of sedation, clear airway and adequate
oxygen or hyperbaric oxygen are essential for a favorable outcome.
