Volume 112 · Issue 11 · 1999

Purpose To summarize the experiences in using all-trans retinoic acid (ATRA) for the differentiation therapy for acute promyelocytic leukemia (APL) since our introduction of its use in clinic in 1986. Data resources Data resources came from Chinese Journal of Hematology, English-language literature using MEDLINE (1988 - 1998), book entitled "Treatment of Malignancies by Inducing Differentiation and Apoptosis" published by Shanghai Publishing House on Sciences and Technology, and our recent data to be published. Study selection Thirty-five articles related to the purpose of this review were reviewed. Data extraction Data were checked for their quality, reliance and originality. Results ATRA combined with chemotherapy can decrease the incidence of retinoic acid syndrome and produce a very high remission rate (90% - 95%) . Post-remission treatment should include chemotherapy and ATRA, the 5-year survival probability was able to attain 0.71 ± 0.06. The main problem in the treatment is early tolerance to ATRA and relapse of the disease. The most effective treatments for relapsed APL is to use arsenic trioxide. Conclusion The combination of ATRA, chemotherapy and arsenic oxide in the treatment of APL for elevating the remission rate and prolonging survival time deserves further study. Chin Med J 1999; 112(11):963-967

Objective To analyze clinical factors affecting the outcome of coronary artery bypass grafting (CABG). Methods 1539 patients were divided into the following two groups based on admission sequence: group I (n = 570), 1974-1994; group II (n = 969), 1995-1998. Comparison of clinical data and procedure between the two groups was made. Results After CABG, 1482 patients were alleviated from angina, 57 patients died within 30 days of operation, with an overall mortality rate of 3.7%. The mortality rates in group I and group II were 7.9%and 1.2%, respectively. Since 1995, the mortality rate has significantly decreased. Conclusion CABG is a safe and effective therapy for coronary heart disease. Surgical technique is a key factor affecting the outcome of CABG in selected patients. Chin Med J 1999; 112(11): 978-981

Objective To report our initial experience of the first 5 cases of partial left ventriculectomy (PLV or Batista operation), a new surgical therapy for treatment of end-stage dilated cardiomyopathy in China. Methods From April to August 1998, 5 patients with idiopathic dilated cardiomyopathy received PLV at Anzhen Hospital. The mean age of the patients was 48.4 years (range: 42 to 53 years) . Three patients were in New York Heart Association (NYHA) class Ⅲand 2 in class Ⅳ. All patients had mitral valve insufficiency (3 moderate and 2 severe) and 1 had severe tricuspid valve insufficiency in addition preoperatively. Cardiopulmonary bypass and cardiac arrest with cold blood cardioplegia were used in all patients. The average weight of the resected left ventricle muscle was 46.3 g. All patients underwent mitral annuloplasty and 1 plus tricuspid annuloplasty (De Vega). Results Echocardiography demonstrated a significant decrease in left ventricular diastolic diameter (8.4 ±1.1 cm to 5.4 ± 0.4 cm, P < 0.01) and an increase in ejection fraction (17.78% ± 6.26% to 34.82% ±3.18%, P<0.025). One patient died of heart failure on the 6th postoperative day. The mean follow-up period of the 4 discharged patients were 4 months (from 3 to 6 months). One were in NYHA class I and 3 in class II; all had a normal life. Conclusion Batista operation is a new and valuable alternative of the surgical treatment for end-stage dilated cardiomyopathy and the long-term results need further studies. Chin Med J 1999; 112(11): 1001-1004

Objective To study the experience in the treatment of subclavian steal syndrome (SSS) and the relation between SSS and the damage of brain. Methods In 28 patients with SSS, 23 were operated on. They complained of vertigo, TIA, and claudication of arms. One patient suffered from severe stem ischemia spasm. All the patients were subjected to subtraction angiography. Fifteen of them showed retrograde flow in the vertebral arteries. Transcranial Doppler revealed retrograde blood flow in 8 patients. Single photon emission tomography showed inadequate blood supply to the brain with affected subclavian arteries in 4 patients. Carotid-subclavian arterial bypass was performed in 16 patients, axilloaxillary bypass in 3, PTA in 1, and aorta-carotid graft bypass in 3. Results 13 patients (13/23) had their cerebrovascular symptoms relieved. Transcranial Doppler and emission tomography after operation showed nothing abnormal. Conclusion SSS is harmful and the patients should be closely mornitored by means of transcranial Doppler and emission tomography. Chin Med J 1999; 112(11): 1005-1007

Objective To investigate the expression of Fas/APO-1 in the course of cell cycles. Methods Fas/APO-1 expression of renal cell carcinoma (RCC) cell line GRC-1 cells synchronized by twice overdose thymidine blocks and nitrous oxide (N2O) gas was detected by means of flow cytometry employing FITC-labeled DX2 Fas monoclone antibody and reverse transcription-polymerase chain reaction (RT-PCR) in cell suspension in the M, G1 and S phases of cell cycle. Results The expression level of Fas/APO-1 receptor was highest in G1 phase (29.90%), moderate in S phase (17.72%) and lowest in M phase (6.61%). The expression level of Fas/APO-1 mRNA showed the same tendency in G1, S and M phases. Conclusions The degree of Fas/APO-1 receptor clustering changes significantly with different cell cycles and it may be very important in the induction of malignant cells' apoptosis via Fas/APO-1 pathway. Several factors may contribute to the production of this clustering. The possible therapeutic implications of Fas/APO-1 system in the treatment of malignant diseases are discussed. Chin Med J 1999; 112(11):1008-1012

Objective To secure anti-endotheliocyte hyperplasia functional fragment of human angiostatin K (1-3) gene. Methods As the template of leukocytotic cDNA, functional fragment of human angiostatin K (1-3) cDNA was amplified by PCR, cloned into the vector pGEM-3Zf, and sequenced according to Dye primer sequencing kit. Results The functional fragment of angiostatin K (1-3) cDNA (859 bp) was obtained by PCR and determined by sequencing. Conclusion The angiostatin K (1-3) gene has been cloned. The gene is of great significance in tumor-antiangiogenesis therapy. Chin Med J 1999; 112(11): 1013-1015

Objective To study the role of nitric oxide synthase/nitric oxide pathway in the pathophysiological process of intussusception (IN). Methods The IN model of rat was induced by lipopolysaccharide (LPS) . The content of NOx in plasma and the NOS activity in colic smooth muscle tissues were measured. The content of cGMP was determined by radioimmunoassay. Results LPS (10 mg/kg, ip) induced IN in up to 40% of the rats 6 hours after treatment with LPS. The incidence of IN was significantly increased by 58.3%(P < 0.05) and by 66.8% (P < 0.01) in L-arginine (L-Arg)-treated rats (2% in drinking water) and in sodium nitroprusside (NSP)-treated rats (1 mg/kg, ip), respectively, but it is significantly decreased by 66.8% (P <0.01) after administration of M-ω-nitro-L-arginine methyl ester ( L-NAME, 15 mg/kg, ip), an inhibitor of nitric oxide synthase (NOS) activity. Furthermore, LPS increased total NOS activity, NOx production and cGMP levels in plasma or in colic smooth muscle tissues. These parameters in LPS-IN rats were significantly elevated by 38.8%, 50.7%, and 48.7% respectively (P < 0.01) compared with LPS-non-IN rats. Conclusion NOS/NO pathway plays an important role in the process of IN, and inhibition of NO production may serve as a possible approach to prevent IN. Chin Med J 1999; 112(11): 1016-1019

Objective To examine the quantitative and qualitative alterations in mast cells and eosinophils distributed in the cutaneous and subcutaneous tissues of hookworm-infected, uninfected and vaccinated mice. Methods Outbred male Kunming strain mice, weighing 18-22 g, were vaccinated thrice by subcutaneous inoculation with 500 living third-stage infective larvae (L3) of Ancylostoma caninum (A. caninum) every 2 weeks, and then challenged subcutaneously with 500 L3 one week after the final immunization. Uninfected mice and non-immunized mice but infected with L3 served as controls. The abdominal skin at the site of percutaneous entry was excised from challenged mice at intervals between 6 hours and 7 days after challenge, fixed, and then examined by light microscopy after staining with either toluidine blue or hematoxylin and eosin. Results The total number of mast cells appearing in cutaneous, and subcutaneous tissues, and underlying abdominal musculature of immunized mice increased significantly compared with non-immunized mice. Mast cells from hookworm-infected mice showed evidence of membrane rupture and degranulation in contrast to the intact appearance of mast cells from uninfected mice. The degree of mast cell degranulation was greater in vaccinated and challenged mice when compared with non-immunized and infected mice. Similarly, eosinophilic infiltration was greatly enhanced after L3 infection. Tissues from vaccinated mice had a greater number of eosinophils than non-immunized mice after infection. Conclusions Mast cell alterations appearing earlier than tissue eosinophilic infiltration is major inflammatory response to Ancylostoma caninum (A. caninum) L3 infection in mice. These processes are more obvious in L3-vaccinated mice. Chin Med J 1999; 112(11): 1020-1023

Objective To investigate the effect of integrin on fibroblasts from scleroderma in the production of procollagen. Methods Phosphorothioate modified antisense oligonucleotides were used to interfere with the expression of integrin α5 or β1 subunit on fibroblasts from 10 cases of scleroderma, and then the changes of procollagen mRNA due to the decline in level of integrin were observed by using RT-PCR. Results Expression of integrin α5 or β1 subunit was specifically inhibited by their corresponding antisense oligonucleotides. Fibroblasts with decreased expression of α5 or β1 subunit produced lower level of procollagenα1 (I), α1 (III) mRNA in comparison to the control. Conclusion Overproduction of procollagen may be inhibited at the level of transcription by lowering the expression of integrin α5 or β1 subunit on fibroblasts in scleroderma. Chin Med J 1999; 112(11): 1024-1027

Objective To study the effect of diabetes on the creatine kinase (CK) activity in different tissues of streptozotocin-induced diabetic rats. Methods Serum samples, heart, extensor digitorum longus, brain and bladder were collected from both streptozotocin-induced diabetic rat and control group. Ck was measured by enzymologic method. Results The body weight, heart weight and brain weight were reduced significantly compared with control group (P < 0.001), but bladder weight was increased significantly (P < 0.001) . CK activity in serum and extensor digitorum longus in diabetic rat was significantly lower (P < 0.001); CK activity in diabetic heart was lower (P < 0.01); and in brain also lower (P< 0.05). A higher CK activity in diabetic bladder was found (P<0.001). Conclusions Diabetes can result in a lower CK activity in serum, heart, brain and extensor digitorum longus that may affect the energy metabolism in the tissues. A higher CK activity in diabetic bladder may reflect a functional compensatory mechanism. Chin Med J 1999; 112(11): 1028-1031

Objective To investigate the molecular mechanism of recessive congenital methemoglobinemia (RCM) in Chinese and to establish a gene diagnostic method of polymerase chain reaction-restricted fragment length polymorphism (PCR-RFLP). Methods Total RNA was isolated from the peripheral leukocytes of the propositus and b5R cDNA synthesized by reverse transcription-polymerase chain reaction (RT-PCR). The coding region of b5R cDNA was analyzed by sequencing of the RT-PCR products. Results Both propositi A and B were found to be homozygotes for a G to A transition at codon 57 in exon 3, changing a guanine to an adenine. This point mutation was not an artificial occurrence during polymerase chain reaction (PCR), as confirmed by Msp I restriction enzyme analysis of the genomic DNA. Propositus A's mother and propositus B's sister and her nephew were found to be heterozygotes for the mutation. Conclusion A guanine-to-adenine transition at codon 57, replacing arginine with glutamine, was the molecular basis for RCM in two Chinese families. Chin Med J 1999; 112(11): 1032-1035

Objective To explore the possibility and the efficacy of immune responses in mice inoculated with recombinant plasmid pCD-HCV1 and to lay a foundation for HCV nucleic acid vaccine development in the future. Methods The gene fragment coding C and E regions of HCV-Ⅱ (type Ⅰb) was inserted into pCD-SRα1 expression vector and formed pCD-HCV1 and then was injected into quadriceps muscles of Balb/c mouse. Serum anti-HCV level of mice was tested by ELISA (A value). Spleen cells proliferation responses to HCV antigens were detected by 3H-TdR incorporation (cpm). Results Balb/c mice immunized with recombinant plasmid pCD-HCV1 three or four times can generate specific antibody responses to HCV antigens and the antibody levels gradually ascend to the plateaus and did not have the trend of descending in 18 weeks detected. The serum antibodies in mice immunized by recombinant plasmid pCD-HCV1 were 100 percent positive when the serum were diluted 40 times and the positive rate of antibody still were 16.6 percent positive when the serum were diluted 320 times. Balb/c mice immunized with recombinant plasmid pCD-HCV1 (100 μg, 50 μg, 10 μg/mouse three times respectively) can elicit antibody responses to HCV antigens and the antibody levels of three groups were 0.70 ± 0.07, 0.33 ± 0.04 and 0.11 ± 0.09 respectively. Spleen cells of Blab/c mice injected with pCD-HCV1 three times were induced to produce proliferation responses to HCVc + e specific antigens. Conclusions These results demonstrated that constructs expressioning HCV core and envelope proteins can generate anti-HCVc + e specific antibody responses and lymphoproliferation responses in mice, which suggested it to be possible to elicit immune responses to viral epitopes from HCV via DNA immunization with HCV-DNA recombinant and to warrant further investigation as a potential vaccine against HCV infections. Chin Med J 1999; 112(11): 1036-1039

Objective To review the relationship between personal behavior and cultural factors and reproductive tract infections (RTIs). Methods An English-language literature search using MEDLINE (1994-1998), Social Science Index (1994-1998), and informal discovery. Any original researches and reviews related to RTIs' epidemiology, behavior and culture were selected. Results RTIs have become a silent epidemic that is devastating women's lives each year. Conclusion The influencing factors include sexual behavior, health related behavior (preventive health behavior, health-seeking behavior, reproductive behavior etc.) and culture, belief, etc. A holistic point of view should be taken. Chin Med J 1999; 112(11): 1044-1048

Objective To evaluate the possible effect of percutaneous transluminal coronary (PTCA) on myocardium. Methods Serum cTnI and CK-MB were measured in 60 patients with coronary artery disease (CAD) who underwent PTCA before and at the 6th, 12th, 24th, 48th and 72nd hour after the interventional procedure respectively. Results The serum cTnl levels began to increase at 6 hours (9.65 ± 6.27 μg/L) in 18 patients, reached the peak levels during 12-24 hours (20.43 ± 11.28 μg/L, 18.52±9.52 μg/L), and returned to normal range till 48 - 72 hours (7.35 ± 7.62 μg/L, 5.51 ± 3.13 μg/L) after PTCA. The serum cTnI and CK-MB levels were kept normal range pre- and post-PTCA in 30 cases. The levels of cTnl in 12 cases were over baseline either before or after the procedure, while for CK-MB, only in 3 cases were over normal range after PTCA. Compared with normal cTnl group, elevated cTnl levels were related to total inflation times and dilated times (P< 0.05). Conclusions PTCA may cause some minor damage in myocardium, serum cTnl level was more sensitive and specific for monitoring myocardial injury. Chin Med J 1999; 112(11): 1049-1051

Objective To classify the effect of thrombin, the key enzyme which enables fibrinogen to form fibrin (fibrinogen clotting) on the formation of metastasis by comparing the inhibition of some antineoplastic drugs on fibrinogen clotting in vitro. Methods Time intervals of different drugs to reach a maximum OD (340 nm) data in fibrinogen solution added with thrombin were used in this work. Results It was found that L-4-oxalysine (8-40 μg/ml) and arabinosyl cytosine (10-50 μg/ml) could inhibit the effect of thrombin by extending the fibrinogen clotting time to 100% - 150% (P < 0.001) and 61 % - 100%(P < 0.001) while the other antimetastatic drugs razoxane, probimane, adriamycin, harringtonine homoharringtonine and α-anordrin at the treatment concentrations showed no such activity. The positive rate of drugs to thrombin activity was approximately 25%. Conclusion It suggests that L-4-oxalysine and arabinosyl cytosine may even exhibit antimetastatic effect through thrombin-fibrinogen pathway, and thrombin might operate in tumor metastasis for only limited step but crutial to fibrin formation in tumor nodules. Chin Med J 1999; 112(11):1052-1053

Objective To investigate the effects of H1R antagonists on the inflammative adhesion mechanism of airway inflammation in asthmatic guinea pigs. Methods The guinea pigs were divided into 3 groups. Group 1 was treated with loratadine (2mg/kg·d-1); Group 2 with normal saline (1 ml/d); and Group 3 with ketotifen (0.1 mg/kg·d-1). In 3 groups, the following tests were performed: (a) the sICAM-1, sP-selectin, IL-8 and eosinophilic cationic protein (ECP) values both in plasm (or serum) and bronchoalveolar lavage fluid (BALF) were mesured by ELISA; (b) the expressions of intercellular adhesion molecule-1 (ICAM-1) and IL-8 on the bronchial epithelial cells were measured by immuno-histochemistry staining; (c) the lung functions (Vt, Cdyn, RL) were tested. Results (a) Except for IL-8 in plasm, the values of sICAM-1, sP-selectin and ECP were inhibited by H1R antagonists (loratadine and ketotifen) both in the plasm (or serum) and BALF of asthmatic animals (P < 0.05) . (b) The expressions of ICAM-1 and IL-8 on the bronchial epithelial cells and pulmonary vascular endothelial cells in asthmatic animals were down-regulated both in ketotifen and loratadine groups especially in loratrdine group (P < 0.05). (c) The lung functions (Vt, Cdyn, RL) of the asthmatic animals were improved by 2 kinds of H1R antagonists (P <0.05). Conclusion ICAM-1 is the natural ligand of leukocyte functional associated antigen-1 (LFA-1), a widely expression integrin, and present also on eosinophils surface, the present study clearly demonstrated that H1R antagonists especially for loratadine decreased different components of the allergic airway inflammation especially significant reduction of ICAM-1 expression on target cells. Since it has been widely demonstrated that the ICAM-1 is deeply involved in cell-to-cell interaction during allergic inflammation of asthma, administration of loratadine may be necessary to suppress the late allergic reaction (LAR) of asthma.

Objective To study the effects of arachidonic acid, linoleic acid, and kupffer cell-conditioned medium (KCCM) derived from arachidonic acid and linoleic acid treatment on proliferation of rat hepatic stellate cells (HSC). Methods HSC and kupffer cells were isolated and cultured from liver of Wistar rats by in situ perfusion with proteinase and collagenase, and density gradient centrifugation with Nycodenz; HSC and kupffer cells were identified by immunohistochemistry, endocytosis, and ultrastructure, ect.; kupffer cells were incubated with arachidonic acid (5μg/ml) or linoleic acid (5 μg/ml) for 24 hours. KCCM were prepared, and MTT colorimetric assay was detected for HSC proliferation. Results HSC proliferation in the presence of arachidonic acid was 0.0793 ± 0.003 (6.25 μg/ml), 0.08 ± 0.0063 (12.5 μg/ml), 0.1175 ± 0.0198 (25 μg/ml), 0.0578 ±0.0034 (50 μg/ml) and 0.0572 ± 0.0038 (100 μg/ml), respectively; HSC proliferation in the presence of linoleic acid was 0.0607 ± 0.0135 (6.25 μg/ml), 0.0672 ±0.0053 (12.5 μg/ml), 0.0703 ± 0.0046 (25 μg/ml), 0.1022 ± 0.027 (50 μg/ml) and 0.1273 ± 0.0263 (100 μg/ml), respectively. Compared with the control (0.0765± 0.0136), 25 μg/ml of arachidonic acid, 50 and 100 μg/ml of linoleic acid had an promoting effect on proliferation of HSC (P < 0.05 or 0.01); 6.25 and 12.5μg/ml of arachidonic acid, 6.25, 12.5 and 25 μg/ml of linoleic acid had no effects (P > 0.05), but 50 and 100μg/ml of arachidonic acid had an inhibiting effect (P <0.01) and showed cytotoxity on HSC under inverted microscope; HSC proliferation was measured after 48 hours of incubation with KCCM. The results were 0.223 ± 0.0164 in the presence of KCCM + arachidonic acid, 0.1986 ±0.0155 in the presence of KCCM + linoleic acid, 0.1569 ±0.0144 in the presence of KCCM and 0.1430 ± 0.0121 in the control. Compared with the control and KCCM, KCCM+ arachidonic acid and KCCM + linoleic acid might promote HSC proliferation (P < 0.01); KCCM + arachidonic acid promoted HSC proliferation more obviously than KCCM +linoleic acid (P < 0.05) ; KCCM was more obvious in HSC proliferation than the control, but there was no significance (P > 0.05). Conclusion The technique for isolation of HSC and Kupffer Cell described here was simple, reliable and pure; arachidonic acid, linoleic acid and KCCM stimulated by arachidonic acid and linoleic acid might promote HSC proliferation and be associated with fatty liver and hepatic fibrogenesis by lipid perioxidation.

Objective To observe the changes in ultrastructure of the colon myenteric plexus in patients with slow transit constipation (STC). Methods Fourteen patients (1 man and 13 women, aged 26 ~ 68 years, mean age; 44 years) with severe, long¬standing idiopathic STC demonstrated by radiopaque marked gastroenterological transit studies underwent a partial or total colectomy. Sigmoid colon specimens from 14 patients with STC and 11 patients with non-obstructed rectal carcinoma as controls were studied by electron microscopy. Results In the colon myenteric plexus of controls, neurons and neuroglia that form the neuropile were in a ratio of 2:1 - 3:1. Ganglions were enveloped not by thick connective tissue but by a thin basal lamina. Occasionally, Slender projections of fibroblasts could be seen. Abundant rough endoplasmic reticulum, ribosome and smooth endoplasmic reticulum could be seen in the neuroplasm. Golgi bodies were well developed. The nucleus mainly contained euchromatin. It was lightly stained and a nucleolus could be seen distinctly. Cross-sections, both horizontal and vertical, of axons and dendrites could be seen in the neuropile. There were abundant neurotubules and neurofilaments in the axon. The end bulb contained various forms of synaptic vesicles. The myenteric plexus of STC patients all showed distinct pathologic changes, which could be categorized as: (1) distinct degenerative changes in the neurons and their projections, axons and dendrites were vacuolated with lattice formation, the neuroglia had various sized vacuoles and lipofuscin deposits; (2) reduction in the number of small vesicles in both the axon end bulb and presynaptic zone, vacuolization in most synaptic vesicles. Conclusions STC patients have distinct ultrastructural changes in their colon myenteric plexus. These morphological changes might be related to the disturbed colon motility and laxative abuse.

Objective To explore the immunogenetic basis, we studied the association of tuberculosis with major histocompatibility complex (MHC) class Ⅱ genes. Methods MHC-DRB1, DQA1, DQB1 were examined by polymerase chain reaction/sequence specific oligonuleotide probes (PCR/SSOP) in 97 patients with tuberculosis and 91 controls. Results The gene frequency of DRB1 * 1501 was markedly increased. The relative risk (RR) was 6.18 in patient group (Pc < 0.05). DRB1 * 1502, 1602, 0901 were decreased in the patients with tuberculosis (Pc > 0.005). Conclusion Tuberculosis of children in North China was markedly associated with HLA-DRB1 * 1501. DRB1 * 1502, 1602, 0901 were decreased in the patient group, which might mean some protective function. However there were no statistic differences. According to our results and the conformation of MHC class-II molecules, the steric hindrance hypothesis was proposed. The susceptibility to tuberculosis was probably determined by valine at amino acid position 86 of β chain in HLA-DR molecule.

Objective To approach the actions of nitric oxide (NO) and inducible nitric oxide synthase (iNOS) on endotoxin (LPS) induced rat acute lung injury (ALI), and the affection of Rhubarb on them. Methods LPS was injected into the sublingual vein of male Wistar rats to prepare ALI animal models. 160 rats were divided into 4 groups: LPS group, control group, Rhubarb treatment group and dexamethasone group. Histopathological examinations were performed and biological indexes were measured for the lung specimens. The indexes included wet/dry weight, the rate of neutrophils and protein content in the pulmonary alveolar lavage fluid, pulmonary vascular permeability and pulmonary alveolar permeability index. The activities of serum NO and lung tissue iNOS were measured. Results In the LPS group, the lung wet/dry weight (4.47± 0.14 vs 4.18 ± 0.28), the rate of neutrophils (49.21%± 8.52% vs 23.29% ± 9.84%), protein content (240.33± 109.67 μg/mg vs 62.17 ± 19.13 μg/mg) were significantly higher than those in the control group (P <0.01). In the Rhubarb and dexamethasone groups, the lung wet/dry weight (4.24 ± 0.14, 4.22 ± 0.16 vs 4.47 ±0.14), the rate of neutrophils (37.28 ± 8.72, 30.17 ±15.66 vs 49.21 ± 8.52), protein content (83.20 ± 45.6, 116.0 ± 38.47 vs 240.33 ± 109.67 μg/mg) were significantly lower than those in the LPS group (P < 0.05, P < 0.01) . The pulmonary alveolar permeability index and vascular permeability during ALI in LPS group (4.78 ±1.9, 6.08 ± 0.73 vs 1.90 ± 0.28, 2.7 ± 0.78 μg/ml, respectively) were significantly higher than those in the control group (P < 0.01) . After Rhubarb and dexamethasone treatment, the two indexes (R: 1.59 ±0.52, 3.42 ± 1.25; D: 2.88 ± 0.19, 3.9±0.78 μg/ml) were significantly lower than those in the LPS group (P <0.05, P < 0.01). The concentrations of serum NO and lung tissue iNOS in the LPS group were significantly higher than those in the control group (NO: 3.12 ± 0.88 vs 2.10 ±0.34 μg/ml; iNOS: 109.87 ± 50.28 vs 37.25 ± 12.1, respectively. P < 0.05, P < 0.01). After Rhubarb and dexamethasone treatments, the serum NO level (R: 1.65 ±0.97 μg/ml; D: 1.26 ± 0.69 μg/ml) and the concentration of iNOS (R: 49.50 ± 13.46; D: 40.77 ± 6.91) in the lung tissue in the ALI were significantly lower than those in the LPS group (P <0.05, P <0.01). Under light microscope, in the LPS group, there were diffuse hemorrhage in the lung stroma and a large amount accumulate of erythrocytes and neutrophils in the alveolar cavities, the lung presented widespread congestion, edema, alveolar septum thickness, fluid accumulation in alveolar cavity. But in the Rhubarb and dexamethasone group, these changes in ALI were drastically ameliorative. Conclusion From the LPS induced ALI rat models, it is demonstrated that NO and iNOS play important roles in the onset of ALI. Dexamethasone and Rhubarb treatment can ameliorate the lung injury and decrease the concentrations of NO and iNOS, showing that these two agents have protective effect on LPS induced ALI and their therapeutic mechanism is possibly through inhibiting the activities of NO and iNOS.