The Experimental Study Of Effect And Significance Of Lesion Of Lung Induced By Inflammation In Elderly Hip Fracture

Objective: To define the biological and histological changes of lung and other organs induced by hip fracture in elderly rat, and investigate whether the inflammation reaction induced by hip fracture in elderly rat can lead to lung lesion, and explore the relationship between lung lesion and other organs lesions; To compare the timing of operation for hip fracture, and study the effect of the damage control orthopedics (DCO) in elderly hip fracture or elderly COPD hip fracture.Methods: Partâ… : Seventy two elderly WISTAR male rats were divided randomly into four groups. Thirty rats of elderly hip fracture group, six rats of elderly control group , thirty rats of elderly hip fracture combined COPD, six rats of elderly COPD control group. Then, a model of hip fracture or COPD was made. The content of TNF-a,IL-6,IL-10,HMGB-1,myeloperoxidase activity in lung,liver were determined in elderly control group,elderly COPD control group , also were determined at 2 hour, 24 hour, 48 hour, 72 hour, 96 hour after hip fracture in groups of elderly hip fracture and elderly hip fracture combined COPD, and Bronchoalveolar lavage (BAL) protein concentration were quantified with BCA and were normalized to serum protein levels(BAL-serum-protein ratio). We also compare the histological appearance of main organs(lung,liver,cardia,kidney) between these groups. Through the inflammatory reaction and histological appearance, we try to find the peak inflammatory reaction in lung. Partâ…¡: Twenty four elderly WISTAR rats were randomly divided into four groups. A group: six rats for early operation group of hip fracture, B group: six rats for early operation group of hip fracture combined COPD, C group: six rats for DCO group of hip fracture, D group: six rats for DCO group of hip fracture combined COPD. These groups of early operation were operated at 24 hour after hip fracture, then 72 hour after hip fracture were DCO. These four group were killed at 24 hour after operation. The content of TNF-a,IL-6,IL-10,HMGB-1,myeloperoxidase activity in lung,liver, and were determined by ELISA in these four groups, and the BAL-serum-protein ratio also were determined. We also evaluate histological appearance of major organs.Results:Partâ… Compared with control group, an increased TNF-a,IL-6,IL-10,HMGB-1 of lung were found in hip fracture group, the peak of IL-6,IL-10,HMGB-1 were 24 h after hip fracture, and will drop soon after. We also found that it was increased for the lesion index of lung (myeloperoxidase activity,BAL-serum-protein ratio),inflammatory factor(TNF-a,IL-6,IL-10,HMGB-1) and MPO of liver, but these changes did not cause the histological appearance of lung,liver,cardia,kidney changed; Compared with COPD control group, an significant increase TNF-a,IL-6,IL-10,HMGB-1 of lung were found in COPD hip fracture group. the peak of IL-6,IL-10,HMGB-1 were 24 h after hip fracture, and would last until for 48 hours. We also found that it was significant increased for the damage index of lung (myeloperoxidase activity,BAL-serum-protein ratio),inflammatory factor (TNF-a,IL-6,IL-10,HMGB-1) and MPO of liver. these changes caused the histological appearance of lung,liver,cardia,kidney changed significantly.Partâ…¡Compared with the other groups, an more increased TNF-a,IL-6,IL-10,HMGB-1 of lung were found in B group, and the damage index of lung (myeloperoxidase activity,BAL-serum-protein ratio),inflammatory factor(TNF-a,IL-6,IL-10,HMGB-1) and MPO of liver were also significantly more severe than other 3 groups. The histological appearance of lung,liver,cardia,kidney in B group changed more significantly than other 3 groups, but we did not find any difference between A group and C group.Conclusion: (1) The inflammatory factor induced by hip fracture played an important role in lesion of lung after hip fracture(operation) in elderly rat, when hip fracture happened in elderly COPD rat, the lung lesion would be more serious, and the excess lung lesion would evoke other organs (liver, carnia, kidney) lesion. (2) It can decrease the lesion of lung and other organs which use DCO for elderly hip fracture in COPD rat, but it is not decrease the lesion of lung and other organs in hip fracture rat.