Objective:To analyze the intervention effect of respiratory care on asthma patients.Methods:49 asthma patients admitted to the hospital between December 1,2018 and November 30,2022 were selected for this study.The pat...Objective:To analyze the intervention effect of respiratory care on asthma patients.Methods:49 asthma patients admitted to the hospital between December 1,2018 and November 30,2022 were selected for this study.The patients were divided into Group A(25 cases)and Group B(24 cases).The patients in Group A received respiratory care,while the patients in Group B received routine care,and the nursing effects of both groups were compared.Results:Group A demonstrated a better nursing effect compared to Group B;the patients in Group A were generally more satisfied with the care given compared to those of Group B.Furthermore,Group A showed better improvements in respiratory function compared to Group B(P<0.05).Before care,there was no difference in quality-of-life scores between the two groups(P>0.05).After care,Group A’s quality of life score was lower than Group B’s(P<0.05).Conclusion:Respiratory care for asthma patients can improve the quality of care and patient satisfaction.Besides,it also leads to a better improvement in respiratory function and the quality of life of the patients.展开更多
Acute respiratory distress syndrome(ARDS)is a common and clinically devastating disease that causes respiratory failure.Morbidity and mortality of patients in intensive care units are stubbornly high,and various compl...Acute respiratory distress syndrome(ARDS)is a common and clinically devastating disease that causes respiratory failure.Morbidity and mortality of patients in intensive care units are stubbornly high,and various complications severely affect the quality of life of survivors.The pathophysiology of ARDS includes increased alveolar–capillary membrane permeability,an influx of protein-rich pulmonary edema fluid,and surfactant dysfunction leading to severe hypoxemia.At present,the main treatment for ARDS is mechanical treatment combined with diuretics to reduce pulmonary edema,which primarily improves symptoms,but the prognosis of patients with ARDS is still very poor.Mesenchymal stem cells(MSCs)are stromal cells that possess the capacity to self-renew and also exhibit multilineage differentiation.MSCs can be isolated from a variety of tissues,such as the umbilical cord,endometrial polyps,menstrual blood,bone marrow,and adipose tissues.Studies have confirmed the critical healing and immunomodulatory properties of MSCs in the treatment of a variety of diseases.Recently,the potential of stem cells in treating ARDS has been explored via basic research and clinical trials.The efficacy of MSCs has been shown in a variety of in vivo models of ARDS,reducing bacterial pneumonia and ischemia-reperfusion injury while promoting the repair of ventilator-induced lung injury.This article reviews the current basic research findings and clinical applications of MSCs in the treatment of ARDS in order to emphasize the clinical prospects of MSCs.展开更多
With the influence of many factors such as the aging of the population,the younger smokers,and the serious air pollution,the incidence of chronic respiratory diseases is increasing year by year.In the treatment of res...With the influence of many factors such as the aging of the population,the younger smokers,and the serious air pollution,the incidence of chronic respiratory diseases is increasing year by year.In the treatment of respiratory diseases,clinical intervention is still mainly based on drug control of pulmonary symptoms.However,systemic drugs have disadvantages such as many adverse reactions and severe systemic side effects.In recent years,the research and development of local drug delivery systems for the respiratory tract has brought new changes to the treatment of respiratory diseases.Locally delivered drugs can directly act on the airways and have the characteristics of fast onset,good curative effect and small side effects.It is a simple,efficient and safe treatment method,which has a very significant effect,and has become a hot topic of current research and promotion.This paper briefly reviews the development track and latest research progress of respiratory local drug delivery systems at home and abroad,in order to provide reference for clinical workers in drug selection and application.展开更多
BACKGROUND Sepsis,as a non-limiting host infection disease,can be accompanied by serious complications such as organ failure,which seriously threatens patient quality of life.AIM To investigate the effect of early ste...BACKGROUND Sepsis,as a non-limiting host infection disease,can be accompanied by serious complications such as organ failure,which seriously threatens patient quality of life.AIM To investigate the effect of early stepwise cardiopulmonary rehabilitation on cardiopulmonary function and quality of life in patients evacuated from mechanical ventilation with sepsis.METHODS A total of 80 patients with sepsis who were hospitalized in our hospital from January 2021 to January 2022 were selected and divided into the observation group(n=40)and the control group(n=40)according to the random number table method.The observation group was treated with early stepwise cardiopulmonary rehabilitation,and the control group was treated with a conventional treatment regimen.Cardiac function indexes(central venous pressure,cardiac troponin I,B-type brain natriuretic peptide),lung function indicators(diaphragmatic mobility,changes in central venous oxygen saturation,oxygenation index),and quality of life(Quality of Life Evaluation Scale)were compared between the two groups after treatment.RESULTS After treatment,the central venous pressure,diaphragm mobility,central venous oxygen saturation,oxygenation index,and Quality of Life Evaluation Scale scores in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The observation group was less than that of the control group for other parameters,and the differences were statistically significant(P<0.05).CONCLUSION Early stepwise cardiopulmonary rehabilitation can effectively enhance cardiac and pulmonary function and improve the quality of life in patients evacuated from mechanical ventilation with sepsis.展开更多
BACKGROUND Uridine diphosphate glucuronosyltransferase 1A1(UGT1A1)plays a crucial role in metabolizing and detoxifying endogenous and exogenous substances.However,its contribution to the progression of liver damage re...BACKGROUND Uridine diphosphate glucuronosyltransferase 1A1(UGT1A1)plays a crucial role in metabolizing and detoxifying endogenous and exogenous substances.However,its contribution to the progression of liver damage remains unclear.AIM To determine the role and mechanism of UGT1A1 in liver damage progression.METHODS We investigated the relationship between UGT1A1 expression and liver injury through clinical research.Additionally,the impact and mechanism of UGT1A1 on the progression of liver injury was analyzed through a mouse model study.RESULTS Patients with UGT1A1 gene mutations showed varying degrees of liver damage,while patients with acute-onchronic liver failure(ACLF)exhibited relatively reduced levels of UGT1A1 protein in the liver as compared to patients with chronic hepatitis.This suggests that low UGT1A1 levels may be associated with the progression of liver damage.In mouse models of liver injury induced by carbon tetrachloride(CCl_(4))and concanavalin A(ConA),the hepatic levels of UGT1A1 protein were found to be increased.In mice with lipopolysaccharide or liver steatosis-mediated liver-injury progression,the hepatic protein levels of UGT1A1 were decreased,which is consistent with the observations in patients with ACLF.UGT1A1 knockout exacerbated CCl_(4)-and ConA-induced liver injury,hepatocyte apoptosis and necroptosis in mice,intensified hepatocyte endoplasmic reticulum(ER)stress and oxidative stress,and disrupted lipid metabolism.CONCLUSION UGT1A1 is upregulated as a compensatory response during liver injury,and interference with this upregulation process may worsen liver injury.UGT1A1 reduces ER stress,oxidative stress,and lipid metabolism disorder,thereby mitigating hepatocyte apoptosis and necroptosis.展开更多
Objective Lower respiratory tract infections continue to pose a significant threat to human health. It is important to accurately and rapidly detect respiratory bacteria. To compensate for the limits of current respir...Objective Lower respiratory tract infections continue to pose a significant threat to human health. It is important to accurately and rapidly detect respiratory bacteria. To compensate for the limits of current respiratory bacteria detection methods, we developed a combination of multiplex polymerase chain reaction(PCR) and capillary electrophoresis(MPCE) assay to detect thirteen bacterial pathogens responsible for lower respiratory tract infections, including Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus, Mycoplasma pneumoniae, Legionella spp., Bordetella pertussis, Mycobacterium tuberculosis complex, Corynebacterium diphtheriae, and Streptococcus pyogenes. Methods Three multiplex PCR reactions were built, and the products were analyzed by capillary electrophoresis using the high-throughput DNA analyzer. The specificity of the MPCE assay was examined and the detection limit was evaluated using DNA samples from each bacterial strain and the simulative samples of each strain. This assay was further evaluated using 152 clinical specimens and compared with real-time PCR reactions. For this assay, three nested-multiplex-PCRs were used to detect these clinical specimens. Results The detection limits of the MPCE assay for the 13 pathogens were very low and ranged from 10^(-7) to 10^(-2) ng/μL. Furthermore, analysis of the 152 clinical specimens yielded a specificity ranging from 96.5%-100.0%, and a sensitivity of 100.0% for the 13 pathogens. Conclusion This study revealed that the MPCE assay is a rapid, reliable, and high-throughput method with high specificity and sensitivity. This assay has great potential in the molecular epidemiological survey of respiratory pathogens.展开更多
AIM:To implement high-throughput 16S rDNA sequencing to study microbial diversity in the fecal matter of rats with acute lung injury/acute respiratory distress syndrome(ALI/ARDS).METHODS:Intratracheal instillation of ...AIM:To implement high-throughput 16S rDNA sequencing to study microbial diversity in the fecal matter of rats with acute lung injury/acute respiratory distress syndrome(ALI/ARDS).METHODS:Intratracheal instillation of lipopolysaccharide was used to induce ALI,and the pathological changes in the lungs and intestines were observed.D-lactate levels and diamine oxidase(DAO)activities were determined by enzymatic spectrophotometry.The fragments encompassing V4 16S rDNA hypervariable regions were PCR amplified from fecal samples,and the PCR products of V4 were sequenced by Illumina MiSeq.RESULTS:Increased D-lactate levels and DAO activities were observed in the model group(P<0.01).Sequencing results revealed the presence of 3780 and4142 species in the control and model groups,respectively.The percentage of shared species was 18.8419%.Compared with the control group,the model group had a higher diversity index and a lower number of species of Fusobacteria(at the phylum level),Helicobacter and Roseburia(at the genus level)(P<0.01).Differences in species diversity,structure,distribution and composition were found between the control group and early ARDS group.CONCLUSION:The detection of specific bacteria allows early detection and diagnosis of ALI/ARDS.展开更多
Respiratory syncytial virus(RSV)infection is known as a risk factor for chronic obstructive pulmonary disease(COPD).RSV infection induces the upregulation of Toll-like receptor 3(TLR3).This study aimed to investigate ...Respiratory syncytial virus(RSV)infection is known as a risk factor for chronic obstructive pulmonary disease(COPD).RSV infection induces the upregulation of Toll-like receptor 3(TLR3).This study aimed to investigate the association of TLR3 with RSV induced acute exacerbations of chronic obstructive pulmonary disease(AECOPD).Serum/sputum samples from AECOPD patients,stable chronic obstructive pulmonary disease(SCOPD)patients,and healthy controls were collected.Nested PCR was used to detect RSV.The lung function parameters were assessed by blood gas and lung function analysis.The expression levels of inflammatory factors in sputum and serum samples were determined by enzyme-linked immunosorbent assay.BEAS-2B cell lines were infected with RSV,and the expression of TLR3 mRNA was determined by PCR and the levels of inflammatory factors were also investigated.The presence of RSV was detected in 3 SCOPD and 8 AECOPD patients,but not in healthy patients.The expression levels of TNF-αand IRF-3 in both sputum and serum samples of RSV-positive group were significantly higher than in RSV-negative group.TLR3 mRNA levels in RSV-positive group were significantly higher than those in RSVnegative group.Interestingly,the level of TLR3 mRNA expression was negatively correlated with oxygenation index and lung function parameters.Furthermore,BEAS-2B cells infected with RSV led to significant increase of the expression of TLR3 mRNA and inflammatory factors IFN-β,IL-13,IL-32,and TNF-α.Our observations indicate that AECOPD is associated with RSV infection and the upregulation of TLR3.展开更多
BACKGROUND Acute respiratory distress syndrome(ARDS)is an acute,diffuse,inflammatory lung injury.Previous studies have shown prone position ventilation(PPV)to be associated with improvement in oxygenation.However,its ...BACKGROUND Acute respiratory distress syndrome(ARDS)is an acute,diffuse,inflammatory lung injury.Previous studies have shown prone position ventilation(PPV)to be associated with improvement in oxygenation.However,its role in patients with ARDS caused by sepsis remains unknown.AIM To analyze the clinical effects of PPV in patients with ARDS caused by sepsis.METHODS One hundred and two patients with ARDS were identified and divided into a control group(n=55)and a PPV treatment group(n=47).Outcomes included oxygenation index,lung compliance(Cst)and platform pressure(Pplat),which were compared between the two groups after ventilation.Other outcomes included heart rate(HR),mean arterial pressure(MAP),central venous pressure(CVP),left ventricular ejection fraction(LVEF),the length of mechanical ventilation time and intensive care unit(ICU)stay,and levels of C-reactive protein(CRP),procalcitonin(PCT),and interleukin-6(IL-6)after ventilation.Finally,mortality rate was also compared between the two groups.RESULTS On the first day after ventilation,the oxygenation index and Cst were higher and Pplat level was lower in the PPV group than in the conventional treatment group(P<0.05).There were no significant differences in oxygenation index,Cst,and Pplat levels between the two groups on the 2^(nd),4^(th),and 7^(th) day after ventilation(P>0.05).There were no significant differences in HR,MAP,CVP,LVEF,duration of mechanical ventilation and ICU stay,and the levels of CRP,PCT,and IL-6 between the two groups on the first day after ventilation(all P>0.05).The mortality rates on days 28 and 90 in the PPV and control groups were 12.77% and 29.09%,and 25.53% and 45.45%,respectively(P<0.05).CONCLUSION PPV may improve respiratory mechanics indices and may also have mortality benefit in patients with ARDS caused by sepsis.Finally,PPV was not shown to cause any adverse effects on hemodynamics and inflammation indices.展开更多
Objective:To investigate the application of peripheral blood triggering receptor expressed on myeloid cells-1(TREM-1)for sequential treatment switching points in patients with chronic obstructive pulmonary disease(COP...Objective:To investigate the application of peripheral blood triggering receptor expressed on myeloid cells-1(TREM-1)for sequential treatment switching points in patients with chronic obstructive pulmonary disease(COPD)complicated with respiratory failure.Methods:A total of 120 cases of COPD patients with respiratory failure from June 2017 to December 2018 were randomly divided into two groups:60 cases in the control group and 60 cases in the observation group.The control group received spontaneous breathing trials for 2 h to select the time for non-invasive positive pressure ventilation,while the observation group received peripheral blood TREM-1(≤90.0 pg/mL)to select the time for non-invasive positive pressure ventilation.The stress hormones,clinical pulmonary infection score and vital signs of two groups after 24 h of mechanical ventilation were detected.The treatment time and the adverse reactions of the two groups were recorded.Results:There was no significant difference in rennin,adrenaline,noradrenaline and angiotensin II between two groups(P>0.05).Compared with the control group,the clinical pulmonary infection score was decreased in the observation group(P<0.05).There was no significant difference in heart rate,respiratory rate,pH,partial pressure of carbon dioxide and partial pressure of oxygen between two groups(P>0.05).There was no significant difference in intensive care monitoring time between two groups(P>0.05).Compared with the control group,the observation group had no significant difference in invasive ventilation time and total mechanical ventilation.The time of hospitalization and hospitalization had significantly decreased(P<0.05).There was no significant difference in mortality,ventilator-associated pneumonia and re-intubation between two groups(P>0.05).Conclusion:TREM-1 can be used as a switching point during invasive-noninvasive sequential ventilation for COPD patients with respiratory failure,which can shorten the time of invasive ventilation,total mechanical ventilation and hospitalization.展开更多
Next-generation sequencing(NGS) technology is capable of sequencing millions or billions of DNA molecules simultaneously.Therefore, it represents a promising tool for the analysis of molecular targets for the initial ...Next-generation sequencing(NGS) technology is capable of sequencing millions or billions of DNA molecules simultaneously.Therefore, it represents a promising tool for the analysis of molecular targets for the initial diagnosis of disease, monitoring of disease progression, and identifying the mechanism of drug resistance. On behalf of the Tumor Biomarker Committee of the Chinese Society of Clinical Oncology(CSCO) and the China Actionable Genome Consortium(CAGC), the present expert group hereby proposes advisory guidelines on clinical applications of NGS technology for the analysis of cancer driver genes for precision cancer therapy. This group comprises an assembly of laboratory cancer geneticists, clinical oncologists, bioinformaticians,pathologists, and other professionals. After multiple rounds of discussions and revisions, the expert group has reached a preliminary consensus on the need of NGS in clinical diagnosis, its regulation, and compliance standards in clinical sample collection. Moreover, it has prepared NGS criteria, the sequencing standard operation procedure(SOP), data analysis, report, and NGS platform certification and validation.展开更多
The effects of different solvents on the extraction of effective components from the cell wall tissues of Chinese traditional medicines were studied by the histochemical methods, such as the bare-handed section, swell...The effects of different solvents on the extraction of effective components from the cell wall tissues of Chinese traditional medicines were studied by the histochemical methods, such as the bare-handed section, swelling ratio, paraffin section, IR spectrum and cell wall component analysis. The results show that the ethanol-alkali solvent could increase the swelling ratio as well as the swelling speed. The effective components of cell wall tissues extracted by ethanol-alkali solvent become loose shown by the paraffin section. According to the IR spectrum analysis and the results of cell wall tissue component analysis, it was found that the ethanol-alkali solvent could decrease the contents of pectin and hemicellulose in the cell wall to make the wall broken, and therefore the effective components can be extracted easily by the solvent and the extraction rate is increased.展开更多
Chronic obstructive pulmonary disease is a common,highly disabling,and burdensome disease.Anti-inflammatory glucocorticoid medication plays a key role in its treatment;however,glucocorticoid resistance in patients wit...Chronic obstructive pulmonary disease is a common,highly disabling,and burdensome disease.Anti-inflammatory glucocorticoid medication plays a key role in its treatment;however,glucocorticoid resistance in patients with chronic obstructive pulmonary disease considerably weakens the effects of the treatment.Despite recent advances in determining the mechanism of glucocorticoid resistance in patients with chronic obstructive pulmonary disease,the role of traditional Chinese medicine in treating such patients remains unclear.In this review,we reviewed the mechanism of chronic obstructive pulmonary disease-related glucocorticoid resistance with reference to the glucocorticoid receptor,the important signaling pathways(phosphatidylinositol-3-kinase/protein kinase B signaling pathway,p38 mitogen-activated protein kinase signaling pathway,and interferon-γ/Janus kinase/stransducer and activator of transcription signaling pathway),histone deacetylase,nuclear transcription factor-κB,exosomes,and microRNA.Moreover,the methods of establishing the glucocorticoid resistance model associated with chronic obstructive pulmonary disease and advances in therapeutic approaches including traditional Chinese medicine to restore chronic obstructive pulmonary disease glucocorticoid sensitivity have also been reviewed.This review shows that traditional Chinese medicine reverses glucocorticoid resistance mainly by regulating the expression of glucocorticoid receptor,p38 mitogen-activated protein kinase signaling,histone deacetylase 2,and nuclear transcription factor-κB in chronic obstructive pulmonary disease models.Future research is suggested to evaluate traditional Chinese medicine understanding of chronic obstructive pulmonary disease-related glucocorticoid resistance in relation to exosomes,microRNA,and other signaling pathways.展开更多
Objective:To evaluate the applicable value of respiratory impedance for the stage 0 of chronic obstructive pulmonary disease （COPD）. Methods:Respiratory impedance was measured by impulse oscillometry （IOS） in 41 c...Objective:To evaluate the applicable value of respiratory impedance for the stage 0 of chronic obstructive pulmonary disease （COPD）. Methods:Respiratory impedance was measured by impulse oscillometry （IOS） in 41 cases at stage 0 of COPD （NHLBI/WHO, 2001 Standard） and their conventional pulmonary function values were compared with 42 healthy subjects. Both groups had no significant deviation in age, stature and avoirdupois, etc. Master-Screen pulmonary function test system （Jaeger Co, Germany） were used to determine IOS parameters including viscous resistance of 5Hz, 20 Hz and 35Hz （R5, R 20, R 35）, reactance of 5Hz, 35 Hz （X5, X 35 ）, resonant frequency （Fres） ,total respiratory impedance （Zrs） and routine pulmonary function values including forced expiratory volume in one second to predicted value （FEV1%）, forced expiratory volume in one second to forced vital capacity ratio（ FEV1/FVC%）, maximal mid-expiratory flow （MMEF%）,V 25% and V 50%. Results:Both groups had no significant deviation in FEV1%, FEV1/FVC% and X 35 （P>0.05）. It was increased significantly in viscous resistance of 5Hz, 20 Hz and 35Hz （R5, R 20, R 35） in COPD group than that in healthy group （P<0.01）. So were Fres and Zrs （P<0.01）. MMEF%,V 25%,V 50% and reactance of 5Hz （X5） in COPD group were marked lower than that in healthy group （P<0.01）. The sensitivity of MMEF%, V 25%,V 50% was higher than others, but its specificity was lower. In parameters of IOS, Fres was the most sensitive index for diagnosis of the small airway function and its specificity was higher than that of MMEF%, V 25%,V 50%. Conclusion:In the risk case at the stage 0 of COPD, MMEF%, V 25% and V 50% could be decreased, but Fres, R5,R 5-20 could be increased in spite of FEV1% and FEV1/FVC% in normal range.展开更多
Objective:To explore the effect of adjuvant tiotropium bromide therapy on the oxygenation function and inflammatory response in patients with COPD and type Ⅱ respiratory failure. Methods:a total of 58 patients with C...Objective:To explore the effect of adjuvant tiotropium bromide therapy on the oxygenation function and inflammatory response in patients with COPD and type Ⅱ respiratory failure. Methods:a total of 58 patients with COPD and type II respiratory failure treated in our hospital between August 2012 and January 2016 were collected and divided into observation group (n=29) and control group (n=29) according to the single blind randomized control method. Control group of patients received clinical routine treatment, and observation group of patients received adjuvant tiotropium bromide treatment on the basis of routine treatment. Before treatment and 30d after treatment, spirometer was used to determine pulmonary ventilation function;blood gas analyzer was used to test oxygenation function indexes;enzyme-linked immunosorbent assay (ELISA) was used to detect serum inflammatory factor levels.Results: Before treatment, differences in pulmonary ventilation function, oxygenation function and serum inflammatory factor levels were not statistically significant between two groups of patients. 30 d after treatment, FEV1, FEF75%, PEF, PaO2/FiO2, DO2 and O2ER levels of observation group were significantly higher than those of control group while VO2 level was significantly lower than that of control group;serum IL-1β, IL-18, IL-27 and CRP levels were significantly lower than those of control group.Conclusion:Adjuvant tiotropium bromide treatment can optimize the pulmonary ventilation and oxygenation function and reduce systemic inflammatory response in patients with COPD and type II respiratory failure.展开更多
Objective:To explore the value of arterial blood lactate and early lactate clearance in evaluating the prognosis in patients with COPD merged with respiratory failure.Methods:A total of 78 patients with COPD merged wi...Objective:To explore the value of arterial blood lactate and early lactate clearance in evaluating the prognosis in patients with COPD merged with respiratory failure.Methods:A total of 78 patients with COPD merged with respiratory failure were included in the study. The arterial blood lactate level 1 d before treatment and 6 h after treatment was detected. The early lactate clearance was evaluated. The patients were divided into the severe elevation group, mild elevation group, and normal control group according to the blood lactate level. APACHEⅡ score, 28 d death rate, and other clinical related indicators in the three groups were compared. According to the early lactate clearance, the patients were divided into the high lactate clearance group and low lactate clearance group. The arterial blood lactate level, APACHEⅡ score, death rate, and arterial blood gas indicators in the two groups were compared. The multiple-factor analysis of prognosis was performed.Results:With the increasing of blood lactate concentration before treatment, APACHEⅡ score, mechanical ventilation time, ventilation rate, hospitalization time, and death rate were gradually elevated, and the comparison among the three groups was not statistically significant. When compared with before treatment, the arterial blood lactate level, APACHEⅡ score, and PaCO2 in the high lactate clearance group were significantly reduced, but PaO2 and pH were significantly elevated, while PaO2 in the low lactate clearance group was significantly elevated. The death rate in the high lactate clearance group was significantly lower than that in the low lactate clearance group. The early lactate clearance was a factor in protecting the prognosis in patients with COPD merged with respiratory failure.Conclusions:The arterial blood lactate level and early lactate clearance can affect the prognosis in patients with COPD merged with respiratory failure. Dynamic monitoring of early blood lactate level can better evaluate the disease severity degree and prognosis.展开更多
Background:Ulcerative colitis(UC)is a chronic disease that often presents with abdominal pain,diarrhea,hematochezia,and significant morbidity.Gancao Xiexin decoction(GXD),a traditional Chinese medicine,has been applie...Background:Ulcerative colitis(UC)is a chronic disease that often presents with abdominal pain,diarrhea,hematochezia,and significant morbidity.Gancao Xiexin decoction(GXD),a traditional Chinese medicine,has been applied for the clinical treatment of UC,while its action mechanisms are unclear.Methods:The active ingredients and their targets of GXD,and UC-related targets,were derived from public databases.Protein-protein interaction,Gene Ontology(GO),and the Kyoto Encyclopedia of Genes and Genomes(KEGG)were used to analyze the important active compounds,key targets,and signaling pathways.Then,molecular docking and animal experiments were performed to verify the findings.A total of 213 active compounds and 89 common targets of GXD for UC were obtained.Results:The hub gene network showed ALB,AKT1,IL6,TNF,VEGFA,TP53,CXCL8,MAPK1,PTGS2,and IL1βmay be potential targets of GXD against UC.GO and KEGG pathway enrichment analyses suggested that the action of GXD against UC was mainly related to response to oxygen levels,lipopolysaccharide,and molecule of bacterial origin,etc.,and achieved by advanced glycation endproducts/receptors for advanced glycation endproducts signaling pathway in diabetic complications,hypoxia-inducible factor(HIF)-1 signaling pathway,interleukin-17/HIF-1 signaling pathway,TNF signaling pathway,etc.Molecular docking results showed that the GXD had good potency of action with the hub target.In vivo experiments showed that GXD significantly alleviated the symptoms of UC and down-regulated the expression of inflammatory factors,nuclear factor-κB and signal transducer and activator of transcription 3.Conclusions:The anti-UC action of GXD is mainly attributed to its anti-oxidative stress,antiinflammatory,and immunomodulatory functions.展开更多
Objective:To evaluate the clinical safety and efficacy of Lianhuaqingwen(LHQW)capsules in patients with high-risk common type COVID-19 pneumonia.Methods:A retrospective multicenter study on 383 high-risk common type C...Objective:To evaluate the clinical safety and efficacy of Lianhuaqingwen(LHQW)capsules in patients with high-risk common type COVID-19 pneumonia.Methods:A retrospective multicenter study on 383 high-risk common type COVID-19 pneumonia cases was conducted.Patients were categorized as the standard treatment(SDT)group(n=168)and the LHQW+SDT group(n=215).The primary endpoint was the rate of symptom(fever,fatigue,coughing)recovery and the secondary endpoints included the time to symptom recovery,the proportion of patients with improvement in chest CT images,the proportion of patients with clinical cure,the timing and rate of negative conversion of SARS-CoV-2 RNA assay.Results:The recovery rate was significantly higher in the LHQW+SDT group as compared with the SDT group(89.7%vs.72.0%,P<0.01).The combined use of LHQW+SDT also showed shorter time for symptom recovery,as well as shorter time for individual symptom of fever,fatigue and coughing recovery than use of SDT alone.A higher proportion of patients in the LHQW+SDT group with improvements in chest CT images and clinical cure(77.7%vs.57.1%,P<0.01)but the proportion of patients deteriorating to severe cases(1%vs.25%,P<0.01)in this group was significant lower than those in the SDT group.No significant difference in negative conversion rate of viral assay results was observed(76.8%vs.75.0%,P>0.05).No serious adverse events were reported.Conclusions:LHQW capsules could be recommended to ameliorate clinical symptoms and reduce the rate of deteriorating to severe cases for high-risk common type COVID-19 pneumonia.展开更多
Host-directed therapy(HDT)is an emerging novel approach for treating multidrug-resistant Staphylococcus aureus(S.aureus)infection.Functioning as the indispensable specific cellular receptor for a-toxin(Hla),a-disinteg...Host-directed therapy(HDT)is an emerging novel approach for treating multidrug-resistant Staphylococcus aureus(S.aureus)infection.Functioning as the indispensable specific cellular receptor for a-toxin(Hla),a-disintegrin and metalloproteinase 10(ADAM10)is exploited to accelerate S.aureus infection through diverse mechanisms.The extraordinary contribution of ADAM10 to S.aureus pathogenesis renders it an attractive HDT target for combating S.aureus infection.Our study is the first to demonstrate the indispensable role of ADAM10 in S.aureus-induced necroptosis,and it enhances our knowledge of the role of ADAM10 in S.aureus infection.Using a fluorogenic substrate assay,we further identified kaempferol as a potent ADAM10 inhibitor that effectively protected mice from S.aureus infection by suppressing Hla-mediated barrier disruption and necroptosis.Collectively,our work presents a novel hostdirected therapeutic strategy for using the promising candidate kaempferol to treat S.aureus infection and other diseases relevant to the disordered upregulation of ADAM10.展开更多
BACKGROUND Mucoepidermoid carcinoma of the lung is a rare malignant tumor,accounting for 0.1%–0.2%of all lung malignancies.It is a primary salivary gland tumor of the lung.Surgical resection is the primary treatment ...BACKGROUND Mucoepidermoid carcinoma of the lung is a rare malignant tumor,accounting for 0.1%–0.2%of all lung malignancies.It is a primary salivary gland tumor of the lung.Surgical resection is the primary treatment for pulmonary mucoepidermoid carcinoma,for which there has been no standardized treatment strategy.This article reports a case of a young woman with pulmonary mucoepidermoid carcinoma with hemoptysis as the first symptom.CASE SUMMARY A 24-year-old female patient presented with"4 d of hemoptysis"as the chief complaint.She had no special history and denied any smoking or drinking history.Physical examination revealed that the vital signs were stable and scattered small wet rales were heard in the left lung.After admission,the lung tumor markers were checked,and no abnormalities were found.After completing the bronchoscopy,a spherical lesion was observed at the main bronchus 1.5 cm away from the protubercle,with obvious pulsation and little blood seepage on the surface,and histopathological biopsy results showed acute and chronic inflammation.She was transferred to the Department of Thoracic Surgery for surgical treatment on the 16th day after admission.After exclusion of surgical conjunctures,the patient underwent resection of the tumor in the left main bronchus with single-pore video-assisted thoracic surgery on the 19th day after admission.The postoperative histopathological biopsy results showed mucoepidermoid carcinoma of the lung.The patient and her family refused to complete genetic testing and she was discharged from the hospital on the 8th day after surgery.During the follow-up period,the patient experienced shortness of breath after feeling active and had no special discomfort.CONCLUSION We have documented a case of moderately differentiated mucoepidermoid lung cancer with hemoptysis as the first symptom to improve clinicians'understanding of the disease and provide a new dimension of thinking for its future diagnosis and treatment.展开更多
文摘Objective:To analyze the intervention effect of respiratory care on asthma patients.Methods:49 asthma patients admitted to the hospital between December 1,2018 and November 30,2022 were selected for this study.The patients were divided into Group A(25 cases)and Group B(24 cases).The patients in Group A received respiratory care,while the patients in Group B received routine care,and the nursing effects of both groups were compared.Results:Group A demonstrated a better nursing effect compared to Group B;the patients in Group A were generally more satisfied with the care given compared to those of Group B.Furthermore,Group A showed better improvements in respiratory function compared to Group B(P<0.05).Before care,there was no difference in quality-of-life scores between the two groups(P>0.05).After care,Group A’s quality of life score was lower than Group B’s(P<0.05).Conclusion:Respiratory care for asthma patients can improve the quality of care and patient satisfaction.Besides,it also leads to a better improvement in respiratory function and the quality of life of the patients.
基金Supported by The Youth Fund project of the Natural Science Foundation of Zhejiang Province,No.LQ20H15010Zhejiang Traditional Chinese Medicine Science and Technology Planning Project,No.2023ZL575.
文摘Acute respiratory distress syndrome(ARDS)is a common and clinically devastating disease that causes respiratory failure.Morbidity and mortality of patients in intensive care units are stubbornly high,and various complications severely affect the quality of life of survivors.The pathophysiology of ARDS includes increased alveolar–capillary membrane permeability,an influx of protein-rich pulmonary edema fluid,and surfactant dysfunction leading to severe hypoxemia.At present,the main treatment for ARDS is mechanical treatment combined with diuretics to reduce pulmonary edema,which primarily improves symptoms,but the prognosis of patients with ARDS is still very poor.Mesenchymal stem cells(MSCs)are stromal cells that possess the capacity to self-renew and also exhibit multilineage differentiation.MSCs can be isolated from a variety of tissues,such as the umbilical cord,endometrial polyps,menstrual blood,bone marrow,and adipose tissues.Studies have confirmed the critical healing and immunomodulatory properties of MSCs in the treatment of a variety of diseases.Recently,the potential of stem cells in treating ARDS has been explored via basic research and clinical trials.The efficacy of MSCs has been shown in a variety of in vivo models of ARDS,reducing bacterial pneumonia and ischemia-reperfusion injury while promoting the repair of ventilator-induced lung injury.This article reviews the current basic research findings and clinical applications of MSCs in the treatment of ARDS in order to emphasize the clinical prospects of MSCs.
基金Hainan Innovation Team Project of Hainan(820CXTD448)Hainan Province Key R&D Program International Science and Technology Cooperation Project(GHYF2022011)+8 种基金Key R&D Projects in Hainan ProvincZDYF2020223Hainan Provincial Major Science and Technology Project(ZDKJ2021036)Hainan Provincial Natural Science Foundation of High-level Talent Project 2019RC212Chinese Academy of Medical Sciences Medical and Health Science and Technology Innovation Engineering Project(2019-12M-5-023)Major Science and Technology Project of Hainan Province(ZDKJ2021039,ZDKJ202004)Key Topics of Hainan Medical College's Educational and Scientific Research Projects(HYZD202111)National Natural Science Foundation of China(81860001,82011530049 and 82160012)Open Project of the Key Laboratory of Tropical Disease Prevention and Control of the NHC(2021NHCTDCKFKT21008)Hainan Provincial Clinical Medical Center Construction Project Fund。
文摘With the influence of many factors such as the aging of the population,the younger smokers,and the serious air pollution,the incidence of chronic respiratory diseases is increasing year by year.In the treatment of respiratory diseases,clinical intervention is still mainly based on drug control of pulmonary symptoms.However,systemic drugs have disadvantages such as many adverse reactions and severe systemic side effects.In recent years,the research and development of local drug delivery systems for the respiratory tract has brought new changes to the treatment of respiratory diseases.Locally delivered drugs can directly act on the airways and have the characteristics of fast onset,good curative effect and small side effects.It is a simple,efficient and safe treatment method,which has a very significant effect,and has become a hot topic of current research and promotion.This paper briefly reviews the development track and latest research progress of respiratory local drug delivery systems at home and abroad,in order to provide reference for clinical workers in drug selection and application.
文摘BACKGROUND Sepsis,as a non-limiting host infection disease,can be accompanied by serious complications such as organ failure,which seriously threatens patient quality of life.AIM To investigate the effect of early stepwise cardiopulmonary rehabilitation on cardiopulmonary function and quality of life in patients evacuated from mechanical ventilation with sepsis.METHODS A total of 80 patients with sepsis who were hospitalized in our hospital from January 2021 to January 2022 were selected and divided into the observation group(n=40)and the control group(n=40)according to the random number table method.The observation group was treated with early stepwise cardiopulmonary rehabilitation,and the control group was treated with a conventional treatment regimen.Cardiac function indexes(central venous pressure,cardiac troponin I,B-type brain natriuretic peptide),lung function indicators(diaphragmatic mobility,changes in central venous oxygen saturation,oxygenation index),and quality of life(Quality of Life Evaluation Scale)were compared between the two groups after treatment.RESULTS After treatment,the central venous pressure,diaphragm mobility,central venous oxygen saturation,oxygenation index,and Quality of Life Evaluation Scale scores in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The observation group was less than that of the control group for other parameters,and the differences were statistically significant(P<0.05).CONCLUSION Early stepwise cardiopulmonary rehabilitation can effectively enhance cardiac and pulmonary function and improve the quality of life in patients evacuated from mechanical ventilation with sepsis.
基金the Science and Technology Research Foundations of Guizhou Province,No.QKHJC-ZK(2022)YB642Zunyi Science and Technology Plan Project,No.ZSKHHZ(2022)344,No.ZSKHHZ(2022)360,and No.ZYK160+2 种基金Hubei Province Central Leading Local Science and Technology Development Special Project,No.2022BCE030Changzhou Science and Technology Projects,No.CE20225054Bijie City Science and Planning Bureau,No.BKH(2022)8.
文摘BACKGROUND Uridine diphosphate glucuronosyltransferase 1A1(UGT1A1)plays a crucial role in metabolizing and detoxifying endogenous and exogenous substances.However,its contribution to the progression of liver damage remains unclear.AIM To determine the role and mechanism of UGT1A1 in liver damage progression.METHODS We investigated the relationship between UGT1A1 expression and liver injury through clinical research.Additionally,the impact and mechanism of UGT1A1 on the progression of liver injury was analyzed through a mouse model study.RESULTS Patients with UGT1A1 gene mutations showed varying degrees of liver damage,while patients with acute-onchronic liver failure(ACLF)exhibited relatively reduced levels of UGT1A1 protein in the liver as compared to patients with chronic hepatitis.This suggests that low UGT1A1 levels may be associated with the progression of liver damage.In mouse models of liver injury induced by carbon tetrachloride(CCl_(4))and concanavalin A(ConA),the hepatic levels of UGT1A1 protein were found to be increased.In mice with lipopolysaccharide or liver steatosis-mediated liver-injury progression,the hepatic protein levels of UGT1A1 were decreased,which is consistent with the observations in patients with ACLF.UGT1A1 knockout exacerbated CCl_(4)-and ConA-induced liver injury,hepatocyte apoptosis and necroptosis in mice,intensified hepatocyte endoplasmic reticulum(ER)stress and oxidative stress,and disrupted lipid metabolism.CONCLUSION UGT1A1 is upregulated as a compensatory response during liver injury,and interference with this upregulation process may worsen liver injury.UGT1A1 reduces ER stress,oxidative stress,and lipid metabolism disorder,thereby mitigating hepatocyte apoptosis and necroptosis.
基金supported by grants from the Priority Project on Infectious Disease Control and Prevention(2012ZX10004215,2013ZX10004610)from Ministry of Health,China,and the Science Foundation for the State Key Laboratory for Infectious Disease Prevention and Control from China(Grant No.2015SKLID508)the National Natural Science Foundation of China(Grant No.81671985)and(Grant No.81170009)
文摘Objective Lower respiratory tract infections continue to pose a significant threat to human health. It is important to accurately and rapidly detect respiratory bacteria. To compensate for the limits of current respiratory bacteria detection methods, we developed a combination of multiplex polymerase chain reaction(PCR) and capillary electrophoresis(MPCE) assay to detect thirteen bacterial pathogens responsible for lower respiratory tract infections, including Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus, Mycoplasma pneumoniae, Legionella spp., Bordetella pertussis, Mycobacterium tuberculosis complex, Corynebacterium diphtheriae, and Streptococcus pyogenes. Methods Three multiplex PCR reactions were built, and the products were analyzed by capillary electrophoresis using the high-throughput DNA analyzer. The specificity of the MPCE assay was examined and the detection limit was evaluated using DNA samples from each bacterial strain and the simulative samples of each strain. This assay was further evaluated using 152 clinical specimens and compared with real-time PCR reactions. For this assay, three nested-multiplex-PCRs were used to detect these clinical specimens. Results The detection limits of the MPCE assay for the 13 pathogens were very low and ranged from 10^(-7) to 10^(-2) ng/μL. Furthermore, analysis of the 152 clinical specimens yielded a specificity ranging from 96.5%-100.0%, and a sensitivity of 100.0% for the 13 pathogens. Conclusion This study revealed that the MPCE assay is a rapid, reliable, and high-throughput method with high specificity and sensitivity. This assay has great potential in the molecular epidemiological survey of respiratory pathogens.
基金Grants from the Science and Technology Development Plan of Shandong Province and Taishan Scholar project of Shandong Province
文摘AIM:To implement high-throughput 16S rDNA sequencing to study microbial diversity in the fecal matter of rats with acute lung injury/acute respiratory distress syndrome(ALI/ARDS).METHODS:Intratracheal instillation of lipopolysaccharide was used to induce ALI,and the pathological changes in the lungs and intestines were observed.D-lactate levels and diamine oxidase(DAO)activities were determined by enzymatic spectrophotometry.The fragments encompassing V4 16S rDNA hypervariable regions were PCR amplified from fecal samples,and the PCR products of V4 were sequenced by Illumina MiSeq.RESULTS:Increased D-lactate levels and DAO activities were observed in the model group(P<0.01).Sequencing results revealed the presence of 3780 and4142 species in the control and model groups,respectively.The percentage of shared species was 18.8419%.Compared with the control group,the model group had a higher diversity index and a lower number of species of Fusobacteria(at the phylum level),Helicobacter and Roseburia(at the genus level)(P<0.01).Differences in species diversity,structure,distribution and composition were found between the control group and early ARDS group.CONCLUSION:The detection of specific bacteria allows early detection and diagnosis of ALI/ARDS.
基金supported by Natural Science Foundation of China(No.82060010)Guizhou Provincial Natural Science Foundation Project([2018]5623)+2 种基金Guizhou Provincial Respiratory Critical Disease Clinical Research and Prevention and Treatment Talent Base Project([2020]8)Zunyi Respiratory Medicine Talent Base Project([2019]69)Science and Technology Bureau Project of Zunyi City(Zunshi Kehe HZ[2020]3 and[2020]292).
文摘Respiratory syncytial virus(RSV)infection is known as a risk factor for chronic obstructive pulmonary disease(COPD).RSV infection induces the upregulation of Toll-like receptor 3(TLR3).This study aimed to investigate the association of TLR3 with RSV induced acute exacerbations of chronic obstructive pulmonary disease(AECOPD).Serum/sputum samples from AECOPD patients,stable chronic obstructive pulmonary disease(SCOPD)patients,and healthy controls were collected.Nested PCR was used to detect RSV.The lung function parameters were assessed by blood gas and lung function analysis.The expression levels of inflammatory factors in sputum and serum samples were determined by enzyme-linked immunosorbent assay.BEAS-2B cell lines were infected with RSV,and the expression of TLR3 mRNA was determined by PCR and the levels of inflammatory factors were also investigated.The presence of RSV was detected in 3 SCOPD and 8 AECOPD patients,but not in healthy patients.The expression levels of TNF-αand IRF-3 in both sputum and serum samples of RSV-positive group were significantly higher than in RSV-negative group.TLR3 mRNA levels in RSV-positive group were significantly higher than those in RSVnegative group.Interestingly,the level of TLR3 mRNA expression was negatively correlated with oxygenation index and lung function parameters.Furthermore,BEAS-2B cells infected with RSV led to significant increase of the expression of TLR3 mRNA and inflammatory factors IFN-β,IL-13,IL-32,and TNF-α.Our observations indicate that AECOPD is associated with RSV infection and the upregulation of TLR3.
基金Supported by Science and Technology Plan of Jiangxi Provincial Health Commission,No.202130095.
文摘BACKGROUND Acute respiratory distress syndrome(ARDS)is an acute,diffuse,inflammatory lung injury.Previous studies have shown prone position ventilation(PPV)to be associated with improvement in oxygenation.However,its role in patients with ARDS caused by sepsis remains unknown.AIM To analyze the clinical effects of PPV in patients with ARDS caused by sepsis.METHODS One hundred and two patients with ARDS were identified and divided into a control group(n=55)and a PPV treatment group(n=47).Outcomes included oxygenation index,lung compliance(Cst)and platform pressure(Pplat),which were compared between the two groups after ventilation.Other outcomes included heart rate(HR),mean arterial pressure(MAP),central venous pressure(CVP),left ventricular ejection fraction(LVEF),the length of mechanical ventilation time and intensive care unit(ICU)stay,and levels of C-reactive protein(CRP),procalcitonin(PCT),and interleukin-6(IL-6)after ventilation.Finally,mortality rate was also compared between the two groups.RESULTS On the first day after ventilation,the oxygenation index and Cst were higher and Pplat level was lower in the PPV group than in the conventional treatment group(P<0.05).There were no significant differences in oxygenation index,Cst,and Pplat levels between the two groups on the 2^(nd),4^(th),and 7^(th) day after ventilation(P>0.05).There were no significant differences in HR,MAP,CVP,LVEF,duration of mechanical ventilation and ICU stay,and the levels of CRP,PCT,and IL-6 between the two groups on the first day after ventilation(all P>0.05).The mortality rates on days 28 and 90 in the PPV and control groups were 12.77% and 29.09%,and 25.53% and 45.45%,respectively(P<0.05).CONCLUSION PPV may improve respiratory mechanics indices and may also have mortality benefit in patients with ARDS caused by sepsis.Finally,PPV was not shown to cause any adverse effects on hemodynamics and inflammation indices.
基金This study was supported by the National Natural Science Foundation of China(Grant No.81870076)the Suzhou Medical Key Discipline Funding Project(Grant No.SZXK201821).
文摘Objective:To investigate the application of peripheral blood triggering receptor expressed on myeloid cells-1(TREM-1)for sequential treatment switching points in patients with chronic obstructive pulmonary disease(COPD)complicated with respiratory failure.Methods:A total of 120 cases of COPD patients with respiratory failure from June 2017 to December 2018 were randomly divided into two groups:60 cases in the control group and 60 cases in the observation group.The control group received spontaneous breathing trials for 2 h to select the time for non-invasive positive pressure ventilation,while the observation group received peripheral blood TREM-1(≤90.0 pg/mL)to select the time for non-invasive positive pressure ventilation.The stress hormones,clinical pulmonary infection score and vital signs of two groups after 24 h of mechanical ventilation were detected.The treatment time and the adverse reactions of the two groups were recorded.Results:There was no significant difference in rennin,adrenaline,noradrenaline and angiotensin II between two groups(P>0.05).Compared with the control group,the clinical pulmonary infection score was decreased in the observation group(P<0.05).There was no significant difference in heart rate,respiratory rate,pH,partial pressure of carbon dioxide and partial pressure of oxygen between two groups(P>0.05).There was no significant difference in intensive care monitoring time between two groups(P>0.05).Compared with the control group,the observation group had no significant difference in invasive ventilation time and total mechanical ventilation.The time of hospitalization and hospitalization had significantly decreased(P<0.05).There was no significant difference in mortality,ventilator-associated pneumonia and re-intubation between two groups(P>0.05).Conclusion:TREM-1 can be used as a switching point during invasive-noninvasive sequential ventilation for COPD patients with respiratory failure,which can shorten the time of invasive ventilation,total mechanical ventilation and hospitalization.
基金supported by grants from Guangdong Provincial Key Lab of Translational Medicine in Lung Cancer (Grant No. 2017B030314120)General Research Project of Guangzhou Science and Technology Bureau (Grant No. 201607010391)+1 种基金National Key Research and Development Program of China (Grant No. 2016YFC1303800)Guangdong Provincial Applied S&T R&D Program (Grant No. 2016B020237006)
文摘Next-generation sequencing(NGS) technology is capable of sequencing millions or billions of DNA molecules simultaneously.Therefore, it represents a promising tool for the analysis of molecular targets for the initial diagnosis of disease, monitoring of disease progression, and identifying the mechanism of drug resistance. On behalf of the Tumor Biomarker Committee of the Chinese Society of Clinical Oncology(CSCO) and the China Actionable Genome Consortium(CAGC), the present expert group hereby proposes advisory guidelines on clinical applications of NGS technology for the analysis of cancer driver genes for precision cancer therapy. This group comprises an assembly of laboratory cancer geneticists, clinical oncologists, bioinformaticians,pathologists, and other professionals. After multiple rounds of discussions and revisions, the expert group has reached a preliminary consensus on the need of NGS in clinical diagnosis, its regulation, and compliance standards in clinical sample collection. Moreover, it has prepared NGS criteria, the sequencing standard operation procedure(SOP), data analysis, report, and NGS platform certification and validation.
基金Supported by the Major Program of Chinese Herbal Modernism Science of Jilin Provincial Science and Technology Department,China(No.20030906-01)
文摘The effects of different solvents on the extraction of effective components from the cell wall tissues of Chinese traditional medicines were studied by the histochemical methods, such as the bare-handed section, swelling ratio, paraffin section, IR spectrum and cell wall component analysis. The results show that the ethanol-alkali solvent could increase the swelling ratio as well as the swelling speed. The effective components of cell wall tissues extracted by ethanol-alkali solvent become loose shown by the paraffin section. According to the IR spectrum analysis and the results of cell wall tissue component analysis, it was found that the ethanol-alkali solvent could decrease the contents of pectin and hemicellulose in the cell wall to make the wall broken, and therefore the effective components can be extracted easily by the solvent and the extraction rate is increased.
基金the Science and Technology Planning Project of Science and Technology Department of Sichuan Province(2021YJ0465)the 2020 Xinglin Scholars Scientific Research Promotion Plan of Chengdu University of Traditional Chinese Medicine,and the Hundred Talents Plan Project of Hospital of Chengdu University of Traditional Chinese Medicine(20-Q07).
文摘Chronic obstructive pulmonary disease is a common,highly disabling,and burdensome disease.Anti-inflammatory glucocorticoid medication plays a key role in its treatment;however,glucocorticoid resistance in patients with chronic obstructive pulmonary disease considerably weakens the effects of the treatment.Despite recent advances in determining the mechanism of glucocorticoid resistance in patients with chronic obstructive pulmonary disease,the role of traditional Chinese medicine in treating such patients remains unclear.In this review,we reviewed the mechanism of chronic obstructive pulmonary disease-related glucocorticoid resistance with reference to the glucocorticoid receptor,the important signaling pathways(phosphatidylinositol-3-kinase/protein kinase B signaling pathway,p38 mitogen-activated protein kinase signaling pathway,and interferon-γ/Janus kinase/stransducer and activator of transcription signaling pathway),histone deacetylase,nuclear transcription factor-κB,exosomes,and microRNA.Moreover,the methods of establishing the glucocorticoid resistance model associated with chronic obstructive pulmonary disease and advances in therapeutic approaches including traditional Chinese medicine to restore chronic obstructive pulmonary disease glucocorticoid sensitivity have also been reviewed.This review shows that traditional Chinese medicine reverses glucocorticoid resistance mainly by regulating the expression of glucocorticoid receptor,p38 mitogen-activated protein kinase signaling,histone deacetylase 2,and nuclear transcription factor-κB in chronic obstructive pulmonary disease models.Future research is suggested to evaluate traditional Chinese medicine understanding of chronic obstructive pulmonary disease-related glucocorticoid resistance in relation to exosomes,microRNA,and other signaling pathways.
文摘Objective:To evaluate the applicable value of respiratory impedance for the stage 0 of chronic obstructive pulmonary disease （COPD）. Methods:Respiratory impedance was measured by impulse oscillometry （IOS） in 41 cases at stage 0 of COPD （NHLBI/WHO, 2001 Standard） and their conventional pulmonary function values were compared with 42 healthy subjects. Both groups had no significant deviation in age, stature and avoirdupois, etc. Master-Screen pulmonary function test system （Jaeger Co, Germany） were used to determine IOS parameters including viscous resistance of 5Hz, 20 Hz and 35Hz （R5, R 20, R 35）, reactance of 5Hz, 35 Hz （X5, X 35 ）, resonant frequency （Fres） ,total respiratory impedance （Zrs） and routine pulmonary function values including forced expiratory volume in one second to predicted value （FEV1%）, forced expiratory volume in one second to forced vital capacity ratio（ FEV1/FVC%）, maximal mid-expiratory flow （MMEF%）,V 25% and V 50%. Results:Both groups had no significant deviation in FEV1%, FEV1/FVC% and X 35 （P>0.05）. It was increased significantly in viscous resistance of 5Hz, 20 Hz and 35Hz （R5, R 20, R 35） in COPD group than that in healthy group （P<0.01）. So were Fres and Zrs （P<0.01）. MMEF%,V 25%,V 50% and reactance of 5Hz （X5） in COPD group were marked lower than that in healthy group （P<0.01）. The sensitivity of MMEF%, V 25%,V 50% was higher than others, but its specificity was lower. In parameters of IOS, Fres was the most sensitive index for diagnosis of the small airway function and its specificity was higher than that of MMEF%, V 25%,V 50%. Conclusion:In the risk case at the stage 0 of COPD, MMEF%, V 25% and V 50% could be decreased, but Fres, R5,R 5-20 could be increased in spite of FEV1% and FEV1/FVC% in normal range.
文摘Objective:To explore the effect of adjuvant tiotropium bromide therapy on the oxygenation function and inflammatory response in patients with COPD and type Ⅱ respiratory failure. Methods:a total of 58 patients with COPD and type II respiratory failure treated in our hospital between August 2012 and January 2016 were collected and divided into observation group (n=29) and control group (n=29) according to the single blind randomized control method. Control group of patients received clinical routine treatment, and observation group of patients received adjuvant tiotropium bromide treatment on the basis of routine treatment. Before treatment and 30d after treatment, spirometer was used to determine pulmonary ventilation function;blood gas analyzer was used to test oxygenation function indexes;enzyme-linked immunosorbent assay (ELISA) was used to detect serum inflammatory factor levels.Results: Before treatment, differences in pulmonary ventilation function, oxygenation function and serum inflammatory factor levels were not statistically significant between two groups of patients. 30 d after treatment, FEV1, FEF75%, PEF, PaO2/FiO2, DO2 and O2ER levels of observation group were significantly higher than those of control group while VO2 level was significantly lower than that of control group;serum IL-1β, IL-18, IL-27 and CRP levels were significantly lower than those of control group.Conclusion:Adjuvant tiotropium bromide treatment can optimize the pulmonary ventilation and oxygenation function and reduce systemic inflammatory response in patients with COPD and type II respiratory failure.
文摘Objective:To explore the value of arterial blood lactate and early lactate clearance in evaluating the prognosis in patients with COPD merged with respiratory failure.Methods:A total of 78 patients with COPD merged with respiratory failure were included in the study. The arterial blood lactate level 1 d before treatment and 6 h after treatment was detected. The early lactate clearance was evaluated. The patients were divided into the severe elevation group, mild elevation group, and normal control group according to the blood lactate level. APACHEⅡ score, 28 d death rate, and other clinical related indicators in the three groups were compared. According to the early lactate clearance, the patients were divided into the high lactate clearance group and low lactate clearance group. The arterial blood lactate level, APACHEⅡ score, death rate, and arterial blood gas indicators in the two groups were compared. The multiple-factor analysis of prognosis was performed.Results:With the increasing of blood lactate concentration before treatment, APACHEⅡ score, mechanical ventilation time, ventilation rate, hospitalization time, and death rate were gradually elevated, and the comparison among the three groups was not statistically significant. When compared with before treatment, the arterial blood lactate level, APACHEⅡ score, and PaCO2 in the high lactate clearance group were significantly reduced, but PaO2 and pH were significantly elevated, while PaO2 in the low lactate clearance group was significantly elevated. The death rate in the high lactate clearance group was significantly lower than that in the low lactate clearance group. The early lactate clearance was a factor in protecting the prognosis in patients with COPD merged with respiratory failure.Conclusions:The arterial blood lactate level and early lactate clearance can affect the prognosis in patients with COPD merged with respiratory failure. Dynamic monitoring of early blood lactate level can better evaluate the disease severity degree and prognosis.
文摘Background:Ulcerative colitis(UC)is a chronic disease that often presents with abdominal pain,diarrhea,hematochezia,and significant morbidity.Gancao Xiexin decoction(GXD),a traditional Chinese medicine,has been applied for the clinical treatment of UC,while its action mechanisms are unclear.Methods:The active ingredients and their targets of GXD,and UC-related targets,were derived from public databases.Protein-protein interaction,Gene Ontology(GO),and the Kyoto Encyclopedia of Genes and Genomes(KEGG)were used to analyze the important active compounds,key targets,and signaling pathways.Then,molecular docking and animal experiments were performed to verify the findings.A total of 213 active compounds and 89 common targets of GXD for UC were obtained.Results:The hub gene network showed ALB,AKT1,IL6,TNF,VEGFA,TP53,CXCL8,MAPK1,PTGS2,and IL1βmay be potential targets of GXD against UC.GO and KEGG pathway enrichment analyses suggested that the action of GXD against UC was mainly related to response to oxygen levels,lipopolysaccharide,and molecule of bacterial origin,etc.,and achieved by advanced glycation endproducts/receptors for advanced glycation endproducts signaling pathway in diabetic complications,hypoxia-inducible factor(HIF)-1 signaling pathway,interleukin-17/HIF-1 signaling pathway,TNF signaling pathway,etc.Molecular docking results showed that the GXD had good potency of action with the hub target.In vivo experiments showed that GXD significantly alleviated the symptoms of UC and down-regulated the expression of inflammatory factors,nuclear factor-κB and signal transducer and activator of transcription 3.Conclusions:The anti-UC action of GXD is mainly attributed to its anti-oxidative stress,antiinflammatory,and immunomodulatory functions.
基金This project was supported by the Education Department of Hainan Province(grant No.:Hnky2022ZD-11)Hainan Provincial Natural Science Foundation of China(grant No.:822MS176)+1 种基金Hainan Provincial Natural Science Foundation of China(grant No.:GHYF2022011,ZDKJ2021036,ZDYF2020223 and 820CXTD448)the National Natural Science Foundation of China(grant No.82160012,82260001).
文摘Objective:To evaluate the clinical safety and efficacy of Lianhuaqingwen(LHQW)capsules in patients with high-risk common type COVID-19 pneumonia.Methods:A retrospective multicenter study on 383 high-risk common type COVID-19 pneumonia cases was conducted.Patients were categorized as the standard treatment(SDT)group(n=168)and the LHQW+SDT group(n=215).The primary endpoint was the rate of symptom(fever,fatigue,coughing)recovery and the secondary endpoints included the time to symptom recovery,the proportion of patients with improvement in chest CT images,the proportion of patients with clinical cure,the timing and rate of negative conversion of SARS-CoV-2 RNA assay.Results:The recovery rate was significantly higher in the LHQW+SDT group as compared with the SDT group(89.7%vs.72.0%,P<0.01).The combined use of LHQW+SDT also showed shorter time for symptom recovery,as well as shorter time for individual symptom of fever,fatigue and coughing recovery than use of SDT alone.A higher proportion of patients in the LHQW+SDT group with improvements in chest CT images and clinical cure(77.7%vs.57.1%,P<0.01)but the proportion of patients deteriorating to severe cases(1%vs.25%,P<0.01)in this group was significant lower than those in the SDT group.No significant difference in negative conversion rate of viral assay results was observed(76.8%vs.75.0%,P>0.05).No serious adverse events were reported.Conclusions:LHQW capsules could be recommended to ameliorate clinical symptoms and reduce the rate of deteriorating to severe cases for high-risk common type COVID-19 pneumonia.
基金supported by the National Natural Science Foundation of China(U22A20523,32172912,and 32102722)the Interdisciplinary Integration and Innovation Project of Jilin University(JLUXKJC2021QZ04)。
文摘Host-directed therapy(HDT)is an emerging novel approach for treating multidrug-resistant Staphylococcus aureus(S.aureus)infection.Functioning as the indispensable specific cellular receptor for a-toxin(Hla),a-disintegrin and metalloproteinase 10(ADAM10)is exploited to accelerate S.aureus infection through diverse mechanisms.The extraordinary contribution of ADAM10 to S.aureus pathogenesis renders it an attractive HDT target for combating S.aureus infection.Our study is the first to demonstrate the indispensable role of ADAM10 in S.aureus-induced necroptosis,and it enhances our knowledge of the role of ADAM10 in S.aureus infection.Using a fluorogenic substrate assay,we further identified kaempferol as a potent ADAM10 inhibitor that effectively protected mice from S.aureus infection by suppressing Hla-mediated barrier disruption and necroptosis.Collectively,our work presents a novel hostdirected therapeutic strategy for using the promising candidate kaempferol to treat S.aureus infection and other diseases relevant to the disordered upregulation of ADAM10.
文摘BACKGROUND Mucoepidermoid carcinoma of the lung is a rare malignant tumor,accounting for 0.1%–0.2%of all lung malignancies.It is a primary salivary gland tumor of the lung.Surgical resection is the primary treatment for pulmonary mucoepidermoid carcinoma,for which there has been no standardized treatment strategy.This article reports a case of a young woman with pulmonary mucoepidermoid carcinoma with hemoptysis as the first symptom.CASE SUMMARY A 24-year-old female patient presented with"4 d of hemoptysis"as the chief complaint.She had no special history and denied any smoking or drinking history.Physical examination revealed that the vital signs were stable and scattered small wet rales were heard in the left lung.After admission,the lung tumor markers were checked,and no abnormalities were found.After completing the bronchoscopy,a spherical lesion was observed at the main bronchus 1.5 cm away from the protubercle,with obvious pulsation and little blood seepage on the surface,and histopathological biopsy results showed acute and chronic inflammation.She was transferred to the Department of Thoracic Surgery for surgical treatment on the 16th day after admission.After exclusion of surgical conjunctures,the patient underwent resection of the tumor in the left main bronchus with single-pore video-assisted thoracic surgery on the 19th day after admission.The postoperative histopathological biopsy results showed mucoepidermoid carcinoma of the lung.The patient and her family refused to complete genetic testing and she was discharged from the hospital on the 8th day after surgery.During the follow-up period,the patient experienced shortness of breath after feeling active and had no special discomfort.CONCLUSION We have documented a case of moderately differentiated mucoepidermoid lung cancer with hemoptysis as the first symptom to improve clinicians'understanding of the disease and provide a new dimension of thinking for its future diagnosis and treatment.
