Dear Editor,Inguinal hernia repair(IHR)performed during childhood is a prevalent etiological factor for obstructive azoospermia(OA)attributed to vasal injury.OA couples can achieve pregnancy through intracytoplasmic s...Dear Editor,Inguinal hernia repair(IHR)performed during childhood is a prevalent etiological factor for obstructive azoospermia(OA)attributed to vasal injury.OA couples can achieve pregnancy through intracytoplasmic sperm injection or natural pregnancy after microsurgical anastomosis.Recent advancements have highlighted the potential utility of laparoscopy-assisted vasovasostomy for treating OA caused by childhood herniorrhaphy.展开更多
BACKGROUND The degree of obstruction plays an important role in decision-making for obstructive colorectal cancer(OCRC).The existing assessment still relies on the colorectal obstruction scoring system(CROSS)which is ...BACKGROUND The degree of obstruction plays an important role in decision-making for obstructive colorectal cancer(OCRC).The existing assessment still relies on the colorectal obstruction scoring system(CROSS)which is based on a comprehensive analysis of patients’complaints and eating conditions.The data collection relies on subjective descriptions and lacks objective parameters.Therefore,a scoring system for the evaluation of computed tomography-based obstructive degree(CTOD)is urgently required for OCRC.AIM To explore the relationship between CTOD and CROSS and to determine whether CTOD could affect the short-term and long-term prognosis.METHODS Of 173 patients were enrolled.CTOD was obtained using k-means,the ratio of proximal to distal obstruction,and the proportion of nonparenchymal areas at the site of obstruction.CTOD was integrated with the CROSS to analyze the effect of emergency intervention on complications.Short-term and long-term outcomes were compared between the groups.RESULTS CTOD severe obstruction(CTOD grade 3)was an independent risk factor[odds ratio(OR)=3.390,95%confidence interval(CI):1.340-8.570,P=0.010]via multivariate analysis of short-term outcomes,while CROSS grade was not.In the CTOD-CROSS grade system,for the non-severe obstructive(CTOD 1-2 to CROSS 1-4)group,the complication rate of emergency interventions was significantly higher than that of non-emergency interventions(71.4%vs 41.8%,P=0.040).The postoperative pneumonia rate was higher in the emergency intervention group than in the non-severe obstructive group(35.7%vs 8.9%,P=0.020).However,CTOD grade was not an independent risk factor of overall survival and progression-free survival.CONCLUSION CTOD was useful in preoperative decision-making to avoid unnecessary emergency interventions and complications.展开更多
Male infertility has seen an increase in prevalence with cases of azoospermia estimated to affect 10%–15%of infertile men.Confirmation of azoospermia subsequently necessitates an early causal differentiation between ...Male infertility has seen an increase in prevalence with cases of azoospermia estimated to affect 10%–15%of infertile men.Confirmation of azoospermia subsequently necessitates an early causal differentiation between obstructive azoospermia(OA)and nonobstructive azoospermia(NOA).Although less common when compared to NOA,OA can represent upward 20%–40%of cases of azoospermia.While there are a multitude of etiologies responsible for causing NOA and OA,correctly distinguishing between the two types of azoospermia has profound implications in managing the infertile male.This review represents an amalgamation of the current guidelines and literature which will supply the reproductive physician with a diagnostic armamentarium to properly distinguish between NOA and OA,therefore providing the best possible care to the infertile couple.展开更多
Objective:To investigate the clinical efficacy of levofloxacin combined with ambroxol in the treatment of elderly patients with chronic obstructive pulmonary disease(COPD)and pulmonary infection.Methods:A total of 80 ...Objective:To investigate the clinical efficacy of levofloxacin combined with ambroxol in the treatment of elderly patients with chronic obstructive pulmonary disease(COPD)and pulmonary infection.Methods:A total of 80 elderly COPD patients with pulmonary infection,treated between December 2022 and November 2023,were randomly divided into a control group and an observation group,with 40 cases in each group.The control group was treated with levofloxacin hydrochloride,while the observation group received ambroxol hydrochloride injection in addition to the treatment in the control group.Laboratory indices(white blood cell count,procalcitonin,C-reactive protein,and apolipoprotein E levels),imaging-based pulmonary lesion absorption time,hospital stay,and incidence of adverse reactions were compared between the two groups.Results:After treatment,the biochemical indices of the observation group were significantly lower than those of the control group,with highly significant differences(P<0.001).Compared to the control group,the imaging-based pulmonary lesion absorption time and hospital stay of the observation group were significantly shorter(P<0.001).Additionally,the incidence of adverse reactions in the observation group was significantly lower than in the control group(P<0.05).Conclusion:Levofloxacin combined with ambroxol demonstrates advantages in improving biochemical indices,shortening imaging-based pulmonary lesion absorption time and hospital stay,and reducing adverse reaction rates in elderly COPD patients with pulmonary infection.It holds significant clinical application value.展开更多
BACKGROUND Malignant obstructive jaundice(MOJ)is characterized by the presence of malignant tumors infiltrating or compressing the bile duct,causing poor bile drainage,generalized yellowing,pain,itching,and malaise.MO...BACKGROUND Malignant obstructive jaundice(MOJ)is characterized by the presence of malignant tumors infiltrating or compressing the bile duct,causing poor bile drainage,generalized yellowing,pain,itching,and malaise.MOJ is burdensome for both the society and the families of affected patients and should be taken seriously.AIM To evaluate the clinical effect of stent placement during endoscopic retrograde cholangiopancreatography for relieving MOJ and the efficacy of percutaneous transhepatic biliary drainage in terms of liver function improvement,complication rates,and long-term patient outcomes.METHODS The clinical data of 59 patients with MOJ who were admitted to our hospital between March 2018 and August 2019 were retrospectively analyzed.According to the treatment method,the patients were divided into an observation group(29 patients)and a control group(30 patients).General data,liver function indices,complications,adverse effects,and 3-year survival rates after different surgical treatments were recorded for the two groups.RESULTS There were no significant differences in baseline information(sex,age,tumor type,or tumor diameter)between the two groups(P>0.05).Alanine aminotransferase,aspartate aminotransferase,and total bilirubin levels were significantly better in both groups after surgery than before surgery(P<0.05).The overall incidence of biliary bleeding,gastrointestinal bleeding,pancreatitis,and cholangitis was 6.9%in the observation group and 30%in the control group(P<0.05).No significant differences in the rates of blood transfusion,intensive care unit admission,or death within 3 years were observed between the two groups at the 1-month follow-up(P>0.05).The 3-year survival rates were 46.06%and 39.71%in the observation and control groups,respectively.CONCLUSION Endoscopic biliary stenting effectively relieves MOJ and significantly improves liver function,with minimal complications.This technique is a promising palliative approach for patients ineligible for radical surgery.However,further research is needed to optimize current treatment strategies and to explore their potential in treating nonmalignant cases of obstructive jaundice.展开更多
Objective:To explore the obstructive factors in the behavior of medical staff during the implementation of respiratory rehabilitation process,and to provide a basis for the rehabilitation management intervention of CO...Objective:To explore the obstructive factors in the behavior of medical staff during the implementation of respiratory rehabilitation process,and to provide a basis for the rehabilitation management intervention of COPD.Methods:A descriptive nature research method was adopted.An interview outline was formulated based on the theoretical domain framework.From October to December 2024,15 medical staff from the respiratory department of a tertiary hospital in Shaanxi Province were selected for semi-structured interviews.The interview data were analyzed using the Colaizzi 7-step analysis method.Result:The analysis of this study found that the obstructive factors for medical staff to implement respiratory rehabilitation include five theoretical domains.The problems are respectively the lack of knowledge about respiratory rehabilitation and insufficient training intensity,the insufficient self-recognition of implementing respiratory rehabilitation,the low awareness rate of patients and the low cooperation degree,the insufficient provision of instruments and facilities,the lack of rehabilitation training venues and respiratory rehabilitation clinics,and the lack of scientific and standardized respiratory rehabilitation management processes.Conclusion:There are many obstructive factors affecting the implementation of respiratory rehabilitation by medical staff.Clinical managers should take corresponding measures,continuously improve the rehabilitation management strategies for COPD,and promote the clinical application of the best evidence for respiratory rehabilitation.展开更多
This special issue of the Asian Journal of Andrology is fully dedicated to the thematic area of non-obstructive azoospermia(NOA),one of the most complex and challenging conditions in the realm of andrology,urology,and...This special issue of the Asian Journal of Andrology is fully dedicated to the thematic area of non-obstructive azoospermia(NOA),one of the most complex and challenging conditions in the realm of andrology,urology,and reproductive medicine.展开更多
Obstructive sleep apnea-hypopnea syndrome(OSAHS)is a common form of sleep breathing disorder characterized by apnea and hypopnea resulting from recurrent upper airway obstruction during sleep.This leads to intermitten...Obstructive sleep apnea-hypopnea syndrome(OSAHS)is a common form of sleep breathing disorder characterized by apnea and hypopnea resulting from recurrent upper airway obstruction during sleep.This leads to intermittent hypoxia in the brain and disruptions in sleep architecture,ultimately causing cognitive impairment.In OSAHS patients,cognitive dysfunction manifests mainly as diminished attention,memory,and executive function.These effects impact an individual’s daily and social abilities,significantly reducing their quality of life.This article primarily reviews four aspects of OSAHS patients’cognitive function,namely,characteristics,pathogenesis,assessment tools,influencing factors,and heterogeneity,to provide a theoretical basis for healthcare professionals to identify high-risk groups for cognitive impairment among OSAHS patients at an early stage and to construct a more objective and feasible intervention program to further prevent the occurrence and development of dementia.展开更多
This article discusses Wang et al’s essay.Endoscopic biliary stenting,a less invasive alternative to surgery,is effective for malignant obstructive jaundice.This article summarizes the pathophysiology of biliary obst...This article discusses Wang et al’s essay.Endoscopic biliary stenting,a less invasive alternative to surgery,is effective for malignant obstructive jaundice.This article summarizes the pathophysiology of biliary obstruction,the technical aspects of stenting,and the clinical outcomes.By comparison of endoscopic stenting with percutaneous biliary drainage,improvements and complications are focused on.Additionally,patient selection for stenting and future advancements in stent technology are important.Overall,endoscopic biliary stenting is a valuable palliative option for patients with malignant jaundice,especially those ineligibles for surgery.展开更多
BACKGROUND The correlation conclusions between self-management,frailty,and quality of life(QoL)of chronic obstructive pulmonary disease(COPD)patients are inconsistent.AIM To comprehensively assess the current status o...BACKGROUND The correlation conclusions between self-management,frailty,and quality of life(QoL)of chronic obstructive pulmonary disease(COPD)patients are inconsistent.AIM To comprehensively assess the current status of self-management,psychological cognitive impairment,and QoL in elderly patients with COPD.METHODS Convenient sampling was employed to select 312 elderly patients with COPD who were receiving treatment in the respiratory and critical care medicine department of a tertiary grade A hospital from November 2023 to February 2024.The study utilized demographic information and clinical characteristics,selfmanagement behavior,occurrence of psychological cognitive impairment,and QoL as evaluated through general information questionnaires,the COPD patient self-management scale,simple frailty scale,simple mental status scale,clinical dementia assessment scale,and the clinical COPD assessment test questionnaire.This research aims to describe the current status and correlations among selfmanagement behavior,cognitive impairment occurrence,and QoL.RESULTS The average score for self-management behavior in elderly COPD patients was 136.00(119.00,164.50),indicating a moderate level overall.There were 98 cases of cognitive impairment,accounting for 31.4%,with a mental status score of 3(2,3.75).The average QoL score was 24(19,28),indicating a low level.Additionally,there was a negative correlation between total self-management behavior score and cognitive impairment occurrence(r=-0.589,P<0.001),and QoL total score(r=-0.409,P<0.001).Cognitive impairment occurrence was positively correlated with QoL total score(r=0.345,P<0.001).Disease course and self-management behavior score were independent factors affecting the total QoL score in elderly COPD patients(P<0.05).CONCLUSION The self-management behavior of elderly patients with COPD is at a moderate level.However,the occurrence of cognitive impairment is high and significantly influenced by disease course,level of self-management,and mental status.The QoL is low,emphasizing the urgent need to intervene in the self-management behaviors of elderly COPD patients,actively reduce the occurrence of cognitive impairment,and mitigate the impact of the disease on QoL.展开更多
Self-management interventions for chronic obstructive pulmonary disease(COPD)patients using mobile health technology are beneficial for relieving disease symptoms,improving patients’adherence to rehabilitation self-m...Self-management interventions for chronic obstructive pulmonary disease(COPD)patients using mobile health technology are beneficial for relieving disease symptoms,improving patients’adherence to rehabilitation self-management,and improving quality of life.This paper reviews the application of mobile health technology in self-management of patients with chronic obstructive pulmonary disease,introduces the application form of mobile health technology in self-management of patients with chronic obstructive pulmonary disease,summarizes its application effect in self-management of patients with chronic obstructive pulmonary disease,analyzes the problems and proposes solutions in the process of research and implementation at this stage,with a view to providing a theory for the application of mobile health technology in pulmonary rehabilitation and management of patients with chronic obstructive pulmonary disease This study summarize the effect of its application in the self-management of patients with chronic obstructive pulmonary disease.展开更多
In this article,we comment on the study by Yang et al,which demonstrated significant cross-sectional associations between heart rate variability(HRV)indices,depressive symptoms,and lung function in patients with chron...In this article,we comment on the study by Yang et al,which demonstrated significant cross-sectional associations between heart rate variability(HRV)indices,depressive symptoms,and lung function in patients with chronic obstructive pulmonary disease(COPD).Building on these findings,we further explore the underlying mechanisms,particularly inflammatory-autonomic-oxidative stress pathways,as key causal mediators.Moreover,analyzing genetic polymorphisms alongside environmental factors may uncover susceptibility pathways explaining interindividual differences in HRV and comorbidity risk.Additionally,longitudinal studies tracking HRV trajectories could identify thresholds predictive of accelerated lung function decline or cardiovascular events,informing personalized prevention strategies.Integrating longitudinal HRV data with multi-omics biomarkers and machine learning models could enable real-time prediction of depression relapses or COPD exacerbations,facilitating proactive interventions such as personalized biofeedback training or precision anti-inflammatory therapies.By synthesizing these perspectives,this integrative approach promises to advance precision medicine for COPD patients,particularly those with comorbid depression,by addressing both mechanistic insights and clinical translation.展开更多
Obstructive uropathy represents a major risk of acute kidney injury.From an epidemiological point of view,it is responsible for 5%to 10%of cases of acute renal failure and 4%of cases of end-stage kidney disease.Althou...Obstructive uropathy represents a major risk of acute kidney injury.From an epidemiological point of view,it is responsible for 5%to 10%of cases of acute renal failure and 4%of cases of end-stage kidney disease.Although obstructive uropathy is a recognized disease,there is a significant lack of detailed research on this topic from both a nephrological and urological perspective.The majority of published research focuses on the pathophysiology of the topic and neglects a comprehensive analysis of diagnostic and treatment approaches supported by current data.In this context,it is crucial to assess the overall hemodynamic status,especially in the presence of urosepsis.Once clinical stability is assured,it is important to focus on symptom management,usually by controlling pain.Ultimately,it is crucial to decide immediately whether the patient should receive a prompt urinary diversion.Urinary diversion is an essential part of the treatment of obstructive uropathy and should be initiated promptly and without unnece-ssary delay once the diagnosis has been confirmed.Functional recovery of the obstructed kidney after decompression of the urinary tract depends on the degree of obstruction,the duration of the obstruction and the presence of a concomitant urinary tract infection.The timing and proper treatment of this condition determines the recovery of kidney function after an obstruction and prevents the development of chronic kidney disease.In this editorial,we emphasized the pathophysiological role and clinical significance of obstructive uropathy in the context of acute kidney injury.展开更多
BACKGROUND Sarcopenia is a clinical syndrome presented with progressive and generalized skeletal muscle loss and function dysfunction.Usually,it is considered an agerelated process influenced by genetic,lifestyle fact...BACKGROUND Sarcopenia is a clinical syndrome presented with progressive and generalized skeletal muscle loss and function dysfunction.Usually,it is considered an agerelated process influenced by genetic,lifestyle factors,and diseases.Obstructive jaundice is one of the most common pathophysiological changes in patients needing hepatobiliary or pancreatic operations that can adversely affect the tissue and organ function throughout the human body.However,the effects of obstructive jaundice on the occurrence of sarcopenia remain unclear.AIM To investigate the incidence of sarcopenia in patients with surgical obstructive jaundice and the association of sarcopenia with postoperative outcome.METHODS This cross-sectional study was conducted from December 2019 to January 2024.Data retrieved included patient demographics,disease entities,sarcopenia-related parameters(including grip strength,6-m walking time,and limb skeletal muscle mass index),postoperative complications,and length of hospital stay.Sarcopenia was confirmed using Asian Working Group standards.Logistic regression was used to analyze the relationship between total bilirubin level and sarcopenia.The factors influencing sarcopenia in patients with surgical obstructive jaundice and association of sarcopenia with postoperative complications were also investigated.RESULTS Overall,1708 patients met the inclusion criteria,with a mean age of 60.09±13.52 years(sex:52.28%male).There were 383 patients(22.42%)with obstructive jaundice and 1325(77.58%)without jaundice.Sarcopenia,low walking speed,low grip strength,and low limb skeletal muscle index were more prevalent in patients with obstructive jaundice than nonobstructive jaundice.The odds ratio(OR)for sarcopenia in patients with obstructive jaundice was 1.689[95%confidence interval(CI):1.295-2.203,P<0.001],indicating that jaundice is a significant risk factor for sarcopenia.The occurrence of sarcopenia was higher in patients with severe obstructive jaundice than mild obstructive jaundice(39.3%vs 22.8%,P<0.05).Obstructive jaundice was positively correlated with reduced walking speed(OR=1.627,95%CI:1.185-2.234,P=0.003)and decreased grip strength(OR=1.669,95%CI:1.212-2.300,P=0.002).Age(OR=1.077,95%CI:1.040-1.114,P<0.001)and body mass index(OR=0.703,95%CI:0.630-0.784,P<0.001)were independent risk factors of sarcopenia in patients with obstructive jaundice.Patients with obstructive jaundice and sarcopenia had a higher rate of postoperative complications(46.3%vs 33.1%,P=0.032),longer postoperative hospital stays(11.33±6.75 days vs 9.19±7.32 days,P=0.016),and longer total hospital stays(17.10±7.69 days vs 15.98±8.55 days,P=0.032)than those without sarcopenia.CONCLUSION Sarcopenia is more prevalent in patients with obstructive jaundice and is positively correlated with the degree of jaundice.Sarcopenia prolongs hospital stays and is associate with postoperative complications.展开更多
Skeletal muscle dysfunction is a common extrapulmonary comorbidity of chronic obstructive pulmonary disease(COPD) and is associated with decreased quality-of-life and survival in patients. The autophagy lysosome pathw...Skeletal muscle dysfunction is a common extrapulmonary comorbidity of chronic obstructive pulmonary disease(COPD) and is associated with decreased quality-of-life and survival in patients. The autophagy lysosome pathway is one of the proteolytic systems that significantly affect skeletal muscle structure and function. Intriguingly, both promoting and inhibiting autophagy have been observed to improve COPD skeletal muscle dysfunction, yet the mechanism is unclear. This paper first reviewed the effects of macroautophagy and mitophagy on the structure and function of skeletal muscle in COPD, and then explored the mechanism of autophagy mediating the dysfunction of skeletal muscle in COPD. The results showed that macroautophagy-and mitophagy-related proteins were significantly increased in COPD skeletal muscle. Promoting macroautophagy in COPD improves myogenesis and replication capacity of muscle satellite cells, while inhibiting macroautophagy in COPD myotubes increases their diameters. Mitophagy helps to maintain mitochondrial homeostasis by removing impaired mitochondria in COPD. Autophagy is a promising target for improving COPD skeletal muscle dysfunction, and further research should be conducted to elucidate the specific mechanisms by which autophagy mediates COPD skeletal muscle dysfunction, with the aim of enhancing our understanding in this field.展开更多
Chronic obstructive pulmonary disease(COPD)is a persistent airflow obstructive disease caused by airway and/or alveolar abnormalities and has become the third leading cause of death worldwide.Dupilumab,the first fully...Chronic obstructive pulmonary disease(COPD)is a persistent airflow obstructive disease caused by airway and/or alveolar abnormalities and has become the third leading cause of death worldwide.Dupilumab,the first fully humanized monoclonal antibody targeting the IL-4 receptor subunit alpha(IL-4Rα),is mainly used to treat COPD patients with elevated blood eosinophils that cannot be effectively controlled by traditional drugs.Studies have shown that dupilumab effectively improves pulmonary function,reduces airway inflammation and exacerbation rate,and significantly improves quality of life in COPD patients by blocking interleukin-4(IL-4)and interleukin-13(IL-13)signaling.Several clinical trials and real-world studies have shown that dupilumab significantly reduces the rate of exacerbations,particularly in patients with high baseline eosinophil or FeNO levels.In addition,dupilumab showed positive efficacy in improving lung function,reducing airway inflammation and improving the quality of life of patients.Although the preliminary efficacy of dupilumab in the treatment of COPD is promising,its safety and efficacy need to be further validated,particularly in long-term use and in different patient subgroups.Future studies should focus on the precise classification of COPD,the exploration of relevant biomarkers,and the use of dupilumab at different stages of treatment in order to achieve personalized treatment.展开更多
Chronic obstructive pulmonary disease(COPD)is a respiratory condition characterized by several symptoms.The pathogenesis of COPD is complex and involves multiple factors.A fantastic drug from traditional Chinese medic...Chronic obstructive pulmonary disease(COPD)is a respiratory condition characterized by several symptoms.The pathogenesis of COPD is complex and involves multiple factors.A fantastic drug from traditional Chinese medicine,Isodon Suzhouensis(ISZ)is a perennial herb belonging to the Labiaceae family.It has the functions of resolving phlegm,removing stasis,promoting blood circulation and eliminating qi stagnation.ISZ has been found to possess great potential against COPD.Present study is focused on identifying micro RNA(mi RNA)biomarkers for COPD and determining the role of ISZ leaf extract in regulating the disease through mi RNA expression in serum exosomes.The Sprague Dawley(SD)rats were randomly divided into control group,COPD group and COPD+ISZ group.After the establishment of the model,the rats were sacrificed,and the results were compared with the control group.Then the total RNA of rat serum was extracted and identified by nanoparticle tracker.Finally,high-throughput screening and sequencing were performed to screen mi RNAs with significant differential expression.Then,different databases were used to figure out the possible target genes,and their functions were assessed by employing Gene Ontology(GO)as well as Kyoto Encyclopedia of Genes and Genomes(KEGG)analyses.The sequencing results were then further verified by q RT-PCR.The results pointed out that these 17 differentially expressed mi RNAs may have the potential of diagnostic and prognostic biomarkers against COPD.Interestingly,it was also found that ISZ leaf extract may regulate the occurrence of COPD by affecting the expression of mi RNAs.This study identified the biomarkers of COPD and clarified the mechanism of the treatment of COPD by ISZ leaf extract,which is helpful to improve the level of early diagnosis and treatment of COPD.展开更多
This letter responds to Wang et al's recent publication on endoscopic biliary stenting for malignant obstructive jaundice(MOJ)by offering constructive feedback and suggestions for future research.We commend the au...This letter responds to Wang et al's recent publication on endoscopic biliary stenting for malignant obstructive jaundice(MOJ)by offering constructive feedback and suggestions for future research.We commend the authors for their comprehensive study design and execution,which included a clear delineation of study groups and a robust set of outcome measures.We suggest that future studies incorporate additional biomarkers,such as serum levels of liver enzymes and bilirubin,to provide a more nuanced understanding of liver function changes post-intervention.The study's focus on short-term survival rates is appreciated,but we recommend exploring longer-term follow-up periods to capture the full spectrum of survival outcomes.Additionally,the inclusion of quality of life assessments using validated instruments could offer a more holistic view of patient outcomes.From a critical care perspective,we advocate for the integration of advanced imaging techniques to better characterize biliary anatomy and potentially predict treatment response or complications.We believe that incor-porating these suggestions could enhance the understanding of endoscopic biliary stenting's role in MOJ management and its impact on patient outcomes,influ-encing future clinical guidelines and practice.展开更多
Background:Chronic obstructive pulmonary disease(COPD)is a progressive chronic inflammatory disease characterized by irreversible airflow limitation.Fritillaria thunbergii Miq.Zhebeimu(ZBM)has a long history in treati...Background:Chronic obstructive pulmonary disease(COPD)is a progressive chronic inflammatory disease characterized by irreversible airflow limitation.Fritillaria thunbergii Miq.Zhebeimu(ZBM)has a long history in treating COPD,but the underlying mechanism is still unclear.Methods:This study explored the pathological mechanism of COPD through RNA-Seq analysis and single-cell sequencing data analysis.And the mechanism of ZBM and blood entering sRNAs for COPD was verified with network pharmacology analysis and in vitro experiments.Results:The results showed that inflammation and oxidative stress exacerbated the progression of COPD,and the expression of HSP90AA1,PTGS2,and AGRN genes significantly increased in the lung tissue of patients.Network pharmacology analysis suggests that the natural products contained in ZBM may directly target HSP90AA1,PTGS2,and AGRN for the treatment of COPD.Analysis of the blood entering sRNA contained in the decoction of ZBM revealed its excellent antioxidant and anti-macrophage polarization effects.Meanwhile,ZBM decoction,sRNA2,and sRNA5 reduce oxidative stress and inflammation by acting on prostaglandin-endoperoxide synthase 2(PTGS2),nitric oxide synthase 2(NOS2),ATP-binding cassette,subfamily C member 1(ABCC1),and xeroderma pigmentosum complementation group C(XPC)genes.Conclusion:Our study demonstrated that ZBM extract and ZBM derived sRNA2 and sRNA5 can relieve COPD by regulating PTGS2-NOS2-XPC-ABCC1 axis.展开更多
BACKGROUND Depression is a common comorbidity in patients with chronic obstructive pulmonary disease(COPD).Research indicates that COPD affects cardiac au-tonomic control,and heart rate variability(HRV)serves as a sim...BACKGROUND Depression is a common comorbidity in patients with chronic obstructive pulmonary disease(COPD).Research indicates that COPD affects cardiac au-tonomic control,and heart rate variability(HRV)serves as a simple,non-invasive measure of autonomic nerve activity.However,the relationship between HRV and lung function,as well as the impact of depressive symptoms,remains un-clear.METHODS A retrospective cross-sectional study involving 120 COPD patients hospitalized from January 2018 to January 2024 at our institution was conducted.Demographic and clinical characteristics were collected,and depressive symptoms were asse-ssed using the Beck Depression Inventory(BDI).Patients were categorized into a depressed group(BDI≥16)and a non-depressed group(BDI<16).A control group consisting of 60 healthy volunteers who underwent check-ups at the same institution was also included.Statistical analyses were performed using SPSS 26.0 software.Pearson correlation coefficients were calculated to determine and compare the relationships between HRV parameters,lung function measures,and RESULTS Of the 120 patients with COPD,35.8%(43/120)were diagnosed with depression,compared to 5.0%(3/60)in the control group.The HRV index in COPD patients was significantly lower than that in the control group(P<0.05),and the value in the depressed group was significantly lower than that in the non-depressed group(P<0.05).Similarly,the COPD group had a significantly lower pulmonary forced vital capacity(FVC),first-second expiratory volume(FEV1)and FEV1/FVC ratios than the control group(P<0.05),and the depressed group was significantly lower than that in the non-depressed group(P<0.05).Pearson correlation analysis revealed that the standard deviation of normal R-R intervals,standard deviation of the mean of 5-minute normal R-R intervals,root mean square of successive differences of normal R-R intervals,percentage of normal R-R intervals greater than 50 ms,high-frequency,and low-frequency indices showed positive correlations with lung function parameters(P<0.05)and negative correlations with BDI scores(P<0.05).CONCLUSION Compared to patients without COPD,the incidence of depressive symptoms is higher among patients with COPD and is negatively correlated with the patients’HRV indices.In contrast,HRV indices are positively correlated with the patients’pulmonary function parameters.Patients and healthcare professionals should enhance their awareness of depression,actively conduct depression assessment screenings,and incorporate HRV indices into disease management.This approach aims to improve the psychological health of patients and ultimately enhance their prognosis and quality of life.展开更多
基金supported by the National Key R&D Program of China(No.2022YFC2702701)Shanghai Scientific and Technological Project(No.20Y11907600)Clinical Research Innovation Plan of Shanghai General Hospital(No.CTCCR-2021C17).
文摘Dear Editor,Inguinal hernia repair(IHR)performed during childhood is a prevalent etiological factor for obstructive azoospermia(OA)attributed to vasal injury.OA couples can achieve pregnancy through intracytoplasmic sperm injection or natural pregnancy after microsurgical anastomosis.Recent advancements have highlighted the potential utility of laparoscopy-assisted vasovasostomy for treating OA caused by childhood herniorrhaphy.
基金the Youth Foundation of Fujian Provincial Health Commission,No.2021QNA014the Construction Project of Fujian Province Minimally Invasive Medical Center,No.[2021]76.
文摘BACKGROUND The degree of obstruction plays an important role in decision-making for obstructive colorectal cancer(OCRC).The existing assessment still relies on the colorectal obstruction scoring system(CROSS)which is based on a comprehensive analysis of patients’complaints and eating conditions.The data collection relies on subjective descriptions and lacks objective parameters.Therefore,a scoring system for the evaluation of computed tomography-based obstructive degree(CTOD)is urgently required for OCRC.AIM To explore the relationship between CTOD and CROSS and to determine whether CTOD could affect the short-term and long-term prognosis.METHODS Of 173 patients were enrolled.CTOD was obtained using k-means,the ratio of proximal to distal obstruction,and the proportion of nonparenchymal areas at the site of obstruction.CTOD was integrated with the CROSS to analyze the effect of emergency intervention on complications.Short-term and long-term outcomes were compared between the groups.RESULTS CTOD severe obstruction(CTOD grade 3)was an independent risk factor[odds ratio(OR)=3.390,95%confidence interval(CI):1.340-8.570,P=0.010]via multivariate analysis of short-term outcomes,while CROSS grade was not.In the CTOD-CROSS grade system,for the non-severe obstructive(CTOD 1-2 to CROSS 1-4)group,the complication rate of emergency interventions was significantly higher than that of non-emergency interventions(71.4%vs 41.8%,P=0.040).The postoperative pneumonia rate was higher in the emergency intervention group than in the non-severe obstructive group(35.7%vs 8.9%,P=0.020).However,CTOD grade was not an independent risk factor of overall survival and progression-free survival.CONCLUSION CTOD was useful in preoperative decision-making to avoid unnecessary emergency interventions and complications.
文摘Male infertility has seen an increase in prevalence with cases of azoospermia estimated to affect 10%–15%of infertile men.Confirmation of azoospermia subsequently necessitates an early causal differentiation between obstructive azoospermia(OA)and nonobstructive azoospermia(NOA).Although less common when compared to NOA,OA can represent upward 20%–40%of cases of azoospermia.While there are a multitude of etiologies responsible for causing NOA and OA,correctly distinguishing between the two types of azoospermia has profound implications in managing the infertile male.This review represents an amalgamation of the current guidelines and literature which will supply the reproductive physician with a diagnostic armamentarium to properly distinguish between NOA and OA,therefore providing the best possible care to the infertile couple.
文摘Objective:To investigate the clinical efficacy of levofloxacin combined with ambroxol in the treatment of elderly patients with chronic obstructive pulmonary disease(COPD)and pulmonary infection.Methods:A total of 80 elderly COPD patients with pulmonary infection,treated between December 2022 and November 2023,were randomly divided into a control group and an observation group,with 40 cases in each group.The control group was treated with levofloxacin hydrochloride,while the observation group received ambroxol hydrochloride injection in addition to the treatment in the control group.Laboratory indices(white blood cell count,procalcitonin,C-reactive protein,and apolipoprotein E levels),imaging-based pulmonary lesion absorption time,hospital stay,and incidence of adverse reactions were compared between the two groups.Results:After treatment,the biochemical indices of the observation group were significantly lower than those of the control group,with highly significant differences(P<0.001).Compared to the control group,the imaging-based pulmonary lesion absorption time and hospital stay of the observation group were significantly shorter(P<0.001).Additionally,the incidence of adverse reactions in the observation group was significantly lower than in the control group(P<0.05).Conclusion:Levofloxacin combined with ambroxol demonstrates advantages in improving biochemical indices,shortening imaging-based pulmonary lesion absorption time and hospital stay,and reducing adverse reaction rates in elderly COPD patients with pulmonary infection.It holds significant clinical application value.
文摘BACKGROUND Malignant obstructive jaundice(MOJ)is characterized by the presence of malignant tumors infiltrating or compressing the bile duct,causing poor bile drainage,generalized yellowing,pain,itching,and malaise.MOJ is burdensome for both the society and the families of affected patients and should be taken seriously.AIM To evaluate the clinical effect of stent placement during endoscopic retrograde cholangiopancreatography for relieving MOJ and the efficacy of percutaneous transhepatic biliary drainage in terms of liver function improvement,complication rates,and long-term patient outcomes.METHODS The clinical data of 59 patients with MOJ who were admitted to our hospital between March 2018 and August 2019 were retrospectively analyzed.According to the treatment method,the patients were divided into an observation group(29 patients)and a control group(30 patients).General data,liver function indices,complications,adverse effects,and 3-year survival rates after different surgical treatments were recorded for the two groups.RESULTS There were no significant differences in baseline information(sex,age,tumor type,or tumor diameter)between the two groups(P>0.05).Alanine aminotransferase,aspartate aminotransferase,and total bilirubin levels were significantly better in both groups after surgery than before surgery(P<0.05).The overall incidence of biliary bleeding,gastrointestinal bleeding,pancreatitis,and cholangitis was 6.9%in the observation group and 30%in the control group(P<0.05).No significant differences in the rates of blood transfusion,intensive care unit admission,or death within 3 years were observed between the two groups at the 1-month follow-up(P>0.05).The 3-year survival rates were 46.06%and 39.71%in the observation and control groups,respectively.CONCLUSION Endoscopic biliary stenting effectively relieves MOJ and significantly improves liver function,with minimal complications.This technique is a promising palliative approach for patients ineligible for radical surgery.However,further research is needed to optimize current treatment strategies and to explore their potential in treating nonmalignant cases of obstructive jaundice.
基金Shaanxi Provincial People’s Hospital Science and Technology Development Incubation Fund Program 2023(Project No.:2023HL-12)。
文摘Objective:To explore the obstructive factors in the behavior of medical staff during the implementation of respiratory rehabilitation process,and to provide a basis for the rehabilitation management intervention of COPD.Methods:A descriptive nature research method was adopted.An interview outline was formulated based on the theoretical domain framework.From October to December 2024,15 medical staff from the respiratory department of a tertiary hospital in Shaanxi Province were selected for semi-structured interviews.The interview data were analyzed using the Colaizzi 7-step analysis method.Result:The analysis of this study found that the obstructive factors for medical staff to implement respiratory rehabilitation include five theoretical domains.The problems are respectively the lack of knowledge about respiratory rehabilitation and insufficient training intensity,the insufficient self-recognition of implementing respiratory rehabilitation,the low awareness rate of patients and the low cooperation degree,the insufficient provision of instruments and facilities,the lack of rehabilitation training venues and respiratory rehabilitation clinics,and the lack of scientific and standardized respiratory rehabilitation management processes.Conclusion:There are many obstructive factors affecting the implementation of respiratory rehabilitation by medical staff.Clinical managers should take corresponding measures,continuously improve the rehabilitation management strategies for COPD,and promote the clinical application of the best evidence for respiratory rehabilitation.
文摘This special issue of the Asian Journal of Andrology is fully dedicated to the thematic area of non-obstructive azoospermia(NOA),one of the most complex and challenging conditions in the realm of andrology,urology,and reproductive medicine.
基金supported by the 2023 Jinzhou Medical University Education and Teaching Research and Reform Project(YB2023004).
文摘Obstructive sleep apnea-hypopnea syndrome(OSAHS)is a common form of sleep breathing disorder characterized by apnea and hypopnea resulting from recurrent upper airway obstruction during sleep.This leads to intermittent hypoxia in the brain and disruptions in sleep architecture,ultimately causing cognitive impairment.In OSAHS patients,cognitive dysfunction manifests mainly as diminished attention,memory,and executive function.These effects impact an individual’s daily and social abilities,significantly reducing their quality of life.This article primarily reviews four aspects of OSAHS patients’cognitive function,namely,characteristics,pathogenesis,assessment tools,influencing factors,and heterogeneity,to provide a theoretical basis for healthcare professionals to identify high-risk groups for cognitive impairment among OSAHS patients at an early stage and to construct a more objective and feasible intervention program to further prevent the occurrence and development of dementia.
文摘This article discusses Wang et al’s essay.Endoscopic biliary stenting,a less invasive alternative to surgery,is effective for malignant obstructive jaundice.This article summarizes the pathophysiology of biliary obstruction,the technical aspects of stenting,and the clinical outcomes.By comparison of endoscopic stenting with percutaneous biliary drainage,improvements and complications are focused on.Additionally,patient selection for stenting and future advancements in stent technology are important.Overall,endoscopic biliary stenting is a valuable palliative option for patients with malignant jaundice,especially those ineligibles for surgery.
文摘BACKGROUND The correlation conclusions between self-management,frailty,and quality of life(QoL)of chronic obstructive pulmonary disease(COPD)patients are inconsistent.AIM To comprehensively assess the current status of self-management,psychological cognitive impairment,and QoL in elderly patients with COPD.METHODS Convenient sampling was employed to select 312 elderly patients with COPD who were receiving treatment in the respiratory and critical care medicine department of a tertiary grade A hospital from November 2023 to February 2024.The study utilized demographic information and clinical characteristics,selfmanagement behavior,occurrence of psychological cognitive impairment,and QoL as evaluated through general information questionnaires,the COPD patient self-management scale,simple frailty scale,simple mental status scale,clinical dementia assessment scale,and the clinical COPD assessment test questionnaire.This research aims to describe the current status and correlations among selfmanagement behavior,cognitive impairment occurrence,and QoL.RESULTS The average score for self-management behavior in elderly COPD patients was 136.00(119.00,164.50),indicating a moderate level overall.There were 98 cases of cognitive impairment,accounting for 31.4%,with a mental status score of 3(2,3.75).The average QoL score was 24(19,28),indicating a low level.Additionally,there was a negative correlation between total self-management behavior score and cognitive impairment occurrence(r=-0.589,P<0.001),and QoL total score(r=-0.409,P<0.001).Cognitive impairment occurrence was positively correlated with QoL total score(r=0.345,P<0.001).Disease course and self-management behavior score were independent factors affecting the total QoL score in elderly COPD patients(P<0.05).CONCLUSION The self-management behavior of elderly patients with COPD is at a moderate level.However,the occurrence of cognitive impairment is high and significantly influenced by disease course,level of self-management,and mental status.The QoL is low,emphasizing the urgent need to intervene in the self-management behaviors of elderly COPD patients,actively reduce the occurrence of cognitive impairment,and mitigate the impact of the disease on QoL.
基金supported by the 2025 Hangzhou Normal University Teaching Development and Reform Project(Project No.JG2025320)。
文摘Self-management interventions for chronic obstructive pulmonary disease(COPD)patients using mobile health technology are beneficial for relieving disease symptoms,improving patients’adherence to rehabilitation self-management,and improving quality of life.This paper reviews the application of mobile health technology in self-management of patients with chronic obstructive pulmonary disease,introduces the application form of mobile health technology in self-management of patients with chronic obstructive pulmonary disease,summarizes its application effect in self-management of patients with chronic obstructive pulmonary disease,analyzes the problems and proposes solutions in the process of research and implementation at this stage,with a view to providing a theory for the application of mobile health technology in pulmonary rehabilitation and management of patients with chronic obstructive pulmonary disease This study summarize the effect of its application in the self-management of patients with chronic obstructive pulmonary disease.
文摘In this article,we comment on the study by Yang et al,which demonstrated significant cross-sectional associations between heart rate variability(HRV)indices,depressive symptoms,and lung function in patients with chronic obstructive pulmonary disease(COPD).Building on these findings,we further explore the underlying mechanisms,particularly inflammatory-autonomic-oxidative stress pathways,as key causal mediators.Moreover,analyzing genetic polymorphisms alongside environmental factors may uncover susceptibility pathways explaining interindividual differences in HRV and comorbidity risk.Additionally,longitudinal studies tracking HRV trajectories could identify thresholds predictive of accelerated lung function decline or cardiovascular events,informing personalized prevention strategies.Integrating longitudinal HRV data with multi-omics biomarkers and machine learning models could enable real-time prediction of depression relapses or COPD exacerbations,facilitating proactive interventions such as personalized biofeedback training or precision anti-inflammatory therapies.By synthesizing these perspectives,this integrative approach promises to advance precision medicine for COPD patients,particularly those with comorbid depression,by addressing both mechanistic insights and clinical translation.
文摘Obstructive uropathy represents a major risk of acute kidney injury.From an epidemiological point of view,it is responsible for 5%to 10%of cases of acute renal failure and 4%of cases of end-stage kidney disease.Although obstructive uropathy is a recognized disease,there is a significant lack of detailed research on this topic from both a nephrological and urological perspective.The majority of published research focuses on the pathophysiology of the topic and neglects a comprehensive analysis of diagnostic and treatment approaches supported by current data.In this context,it is crucial to assess the overall hemodynamic status,especially in the presence of urosepsis.Once clinical stability is assured,it is important to focus on symptom management,usually by controlling pain.Ultimately,it is crucial to decide immediately whether the patient should receive a prompt urinary diversion.Urinary diversion is an essential part of the treatment of obstructive uropathy and should be initiated promptly and without unnece-ssary delay once the diagnosis has been confirmed.Functional recovery of the obstructed kidney after decompression of the urinary tract depends on the degree of obstruction,the duration of the obstruction and the presence of a concomitant urinary tract infection.The timing and proper treatment of this condition determines the recovery of kidney function after an obstruction and prevents the development of chronic kidney disease.In this editorial,we emphasized the pathophysiological role and clinical significance of obstructive uropathy in the context of acute kidney injury.
基金Supported by Shandong Province Biliary Pancreatic Cancer Clinical Quality Specialty Construction Fund,No.SLCZDZK-2401.
文摘BACKGROUND Sarcopenia is a clinical syndrome presented with progressive and generalized skeletal muscle loss and function dysfunction.Usually,it is considered an agerelated process influenced by genetic,lifestyle factors,and diseases.Obstructive jaundice is one of the most common pathophysiological changes in patients needing hepatobiliary or pancreatic operations that can adversely affect the tissue and organ function throughout the human body.However,the effects of obstructive jaundice on the occurrence of sarcopenia remain unclear.AIM To investigate the incidence of sarcopenia in patients with surgical obstructive jaundice and the association of sarcopenia with postoperative outcome.METHODS This cross-sectional study was conducted from December 2019 to January 2024.Data retrieved included patient demographics,disease entities,sarcopenia-related parameters(including grip strength,6-m walking time,and limb skeletal muscle mass index),postoperative complications,and length of hospital stay.Sarcopenia was confirmed using Asian Working Group standards.Logistic regression was used to analyze the relationship between total bilirubin level and sarcopenia.The factors influencing sarcopenia in patients with surgical obstructive jaundice and association of sarcopenia with postoperative complications were also investigated.RESULTS Overall,1708 patients met the inclusion criteria,with a mean age of 60.09±13.52 years(sex:52.28%male).There were 383 patients(22.42%)with obstructive jaundice and 1325(77.58%)without jaundice.Sarcopenia,low walking speed,low grip strength,and low limb skeletal muscle index were more prevalent in patients with obstructive jaundice than nonobstructive jaundice.The odds ratio(OR)for sarcopenia in patients with obstructive jaundice was 1.689[95%confidence interval(CI):1.295-2.203,P<0.001],indicating that jaundice is a significant risk factor for sarcopenia.The occurrence of sarcopenia was higher in patients with severe obstructive jaundice than mild obstructive jaundice(39.3%vs 22.8%,P<0.05).Obstructive jaundice was positively correlated with reduced walking speed(OR=1.627,95%CI:1.185-2.234,P=0.003)and decreased grip strength(OR=1.669,95%CI:1.212-2.300,P=0.002).Age(OR=1.077,95%CI:1.040-1.114,P<0.001)and body mass index(OR=0.703,95%CI:0.630-0.784,P<0.001)were independent risk factors of sarcopenia in patients with obstructive jaundice.Patients with obstructive jaundice and sarcopenia had a higher rate of postoperative complications(46.3%vs 33.1%,P=0.032),longer postoperative hospital stays(11.33±6.75 days vs 9.19±7.32 days,P=0.016),and longer total hospital stays(17.10±7.69 days vs 15.98±8.55 days,P=0.032)than those without sarcopenia.CONCLUSION Sarcopenia is more prevalent in patients with obstructive jaundice and is positively correlated with the degree of jaundice.Sarcopenia prolongs hospital stays and is associate with postoperative complications.
基金supported by the National Natural Science Foundation of China(No.82172551)the Health Discipline Leader Project of Shanghai Municipal Health Commission(No.2022XD044),China.
文摘Skeletal muscle dysfunction is a common extrapulmonary comorbidity of chronic obstructive pulmonary disease(COPD) and is associated with decreased quality-of-life and survival in patients. The autophagy lysosome pathway is one of the proteolytic systems that significantly affect skeletal muscle structure and function. Intriguingly, both promoting and inhibiting autophagy have been observed to improve COPD skeletal muscle dysfunction, yet the mechanism is unclear. This paper first reviewed the effects of macroautophagy and mitophagy on the structure and function of skeletal muscle in COPD, and then explored the mechanism of autophagy mediating the dysfunction of skeletal muscle in COPD. The results showed that macroautophagy-and mitophagy-related proteins were significantly increased in COPD skeletal muscle. Promoting macroautophagy in COPD improves myogenesis and replication capacity of muscle satellite cells, while inhibiting macroautophagy in COPD myotubes increases their diameters. Mitophagy helps to maintain mitochondrial homeostasis by removing impaired mitochondria in COPD. Autophagy is a promising target for improving COPD skeletal muscle dysfunction, and further research should be conducted to elucidate the specific mechanisms by which autophagy mediates COPD skeletal muscle dysfunction, with the aim of enhancing our understanding in this field.
文摘Chronic obstructive pulmonary disease(COPD)is a persistent airflow obstructive disease caused by airway and/or alveolar abnormalities and has become the third leading cause of death worldwide.Dupilumab,the first fully humanized monoclonal antibody targeting the IL-4 receptor subunit alpha(IL-4Rα),is mainly used to treat COPD patients with elevated blood eosinophils that cannot be effectively controlled by traditional drugs.Studies have shown that dupilumab effectively improves pulmonary function,reduces airway inflammation and exacerbation rate,and significantly improves quality of life in COPD patients by blocking interleukin-4(IL-4)and interleukin-13(IL-13)signaling.Several clinical trials and real-world studies have shown that dupilumab significantly reduces the rate of exacerbations,particularly in patients with high baseline eosinophil or FeNO levels.In addition,dupilumab showed positive efficacy in improving lung function,reducing airway inflammation and improving the quality of life of patients.Although the preliminary efficacy of dupilumab in the treatment of COPD is promising,its safety and efficacy need to be further validated,particularly in long-term use and in different patient subgroups.Future studies should focus on the precise classification of COPD,the exploration of relevant biomarkers,and the use of dupilumab at different stages of treatment in order to achieve personalized treatment.
基金supported by the National Natural Science Foundation of China(82170481,82570069)Anhui Natural Science Foundation(2008085J39 and 2108085MH314)+1 种基金Anhui Province Innovation Team of Authentic Medicinal Materials Development and High Value Utilization(2022AH010080)Suzhou University Joint Cultivation Postgraduate Research Innovation Fund Project(2023KYCX04)。
文摘Chronic obstructive pulmonary disease(COPD)is a respiratory condition characterized by several symptoms.The pathogenesis of COPD is complex and involves multiple factors.A fantastic drug from traditional Chinese medicine,Isodon Suzhouensis(ISZ)is a perennial herb belonging to the Labiaceae family.It has the functions of resolving phlegm,removing stasis,promoting blood circulation and eliminating qi stagnation.ISZ has been found to possess great potential against COPD.Present study is focused on identifying micro RNA(mi RNA)biomarkers for COPD and determining the role of ISZ leaf extract in regulating the disease through mi RNA expression in serum exosomes.The Sprague Dawley(SD)rats were randomly divided into control group,COPD group and COPD+ISZ group.After the establishment of the model,the rats were sacrificed,and the results were compared with the control group.Then the total RNA of rat serum was extracted and identified by nanoparticle tracker.Finally,high-throughput screening and sequencing were performed to screen mi RNAs with significant differential expression.Then,different databases were used to figure out the possible target genes,and their functions were assessed by employing Gene Ontology(GO)as well as Kyoto Encyclopedia of Genes and Genomes(KEGG)analyses.The sequencing results were then further verified by q RT-PCR.The results pointed out that these 17 differentially expressed mi RNAs may have the potential of diagnostic and prognostic biomarkers against COPD.Interestingly,it was also found that ISZ leaf extract may regulate the occurrence of COPD by affecting the expression of mi RNAs.This study identified the biomarkers of COPD and clarified the mechanism of the treatment of COPD by ISZ leaf extract,which is helpful to improve the level of early diagnosis and treatment of COPD.
文摘This letter responds to Wang et al's recent publication on endoscopic biliary stenting for malignant obstructive jaundice(MOJ)by offering constructive feedback and suggestions for future research.We commend the authors for their comprehensive study design and execution,which included a clear delineation of study groups and a robust set of outcome measures.We suggest that future studies incorporate additional biomarkers,such as serum levels of liver enzymes and bilirubin,to provide a more nuanced understanding of liver function changes post-intervention.The study's focus on short-term survival rates is appreciated,but we recommend exploring longer-term follow-up periods to capture the full spectrum of survival outcomes.Additionally,the inclusion of quality of life assessments using validated instruments could offer a more holistic view of patient outcomes.From a critical care perspective,we advocate for the integration of advanced imaging techniques to better characterize biliary anatomy and potentially predict treatment response or complications.We believe that incor-porating these suggestions could enhance the understanding of endoscopic biliary stenting's role in MOJ management and its impact on patient outcomes,influ-encing future clinical guidelines and practice.
文摘Background:Chronic obstructive pulmonary disease(COPD)is a progressive chronic inflammatory disease characterized by irreversible airflow limitation.Fritillaria thunbergii Miq.Zhebeimu(ZBM)has a long history in treating COPD,but the underlying mechanism is still unclear.Methods:This study explored the pathological mechanism of COPD through RNA-Seq analysis and single-cell sequencing data analysis.And the mechanism of ZBM and blood entering sRNAs for COPD was verified with network pharmacology analysis and in vitro experiments.Results:The results showed that inflammation and oxidative stress exacerbated the progression of COPD,and the expression of HSP90AA1,PTGS2,and AGRN genes significantly increased in the lung tissue of patients.Network pharmacology analysis suggests that the natural products contained in ZBM may directly target HSP90AA1,PTGS2,and AGRN for the treatment of COPD.Analysis of the blood entering sRNA contained in the decoction of ZBM revealed its excellent antioxidant and anti-macrophage polarization effects.Meanwhile,ZBM decoction,sRNA2,and sRNA5 reduce oxidative stress and inflammation by acting on prostaglandin-endoperoxide synthase 2(PTGS2),nitric oxide synthase 2(NOS2),ATP-binding cassette,subfamily C member 1(ABCC1),and xeroderma pigmentosum complementation group C(XPC)genes.Conclusion:Our study demonstrated that ZBM extract and ZBM derived sRNA2 and sRNA5 can relieve COPD by regulating PTGS2-NOS2-XPC-ABCC1 axis.
基金Supported by the Zhangjiakou City Science and Technology Research Plan,No.1821110D.
文摘BACKGROUND Depression is a common comorbidity in patients with chronic obstructive pulmonary disease(COPD).Research indicates that COPD affects cardiac au-tonomic control,and heart rate variability(HRV)serves as a simple,non-invasive measure of autonomic nerve activity.However,the relationship between HRV and lung function,as well as the impact of depressive symptoms,remains un-clear.METHODS A retrospective cross-sectional study involving 120 COPD patients hospitalized from January 2018 to January 2024 at our institution was conducted.Demographic and clinical characteristics were collected,and depressive symptoms were asse-ssed using the Beck Depression Inventory(BDI).Patients were categorized into a depressed group(BDI≥16)and a non-depressed group(BDI<16).A control group consisting of 60 healthy volunteers who underwent check-ups at the same institution was also included.Statistical analyses were performed using SPSS 26.0 software.Pearson correlation coefficients were calculated to determine and compare the relationships between HRV parameters,lung function measures,and RESULTS Of the 120 patients with COPD,35.8%(43/120)were diagnosed with depression,compared to 5.0%(3/60)in the control group.The HRV index in COPD patients was significantly lower than that in the control group(P<0.05),and the value in the depressed group was significantly lower than that in the non-depressed group(P<0.05).Similarly,the COPD group had a significantly lower pulmonary forced vital capacity(FVC),first-second expiratory volume(FEV1)and FEV1/FVC ratios than the control group(P<0.05),and the depressed group was significantly lower than that in the non-depressed group(P<0.05).Pearson correlation analysis revealed that the standard deviation of normal R-R intervals,standard deviation of the mean of 5-minute normal R-R intervals,root mean square of successive differences of normal R-R intervals,percentage of normal R-R intervals greater than 50 ms,high-frequency,and low-frequency indices showed positive correlations with lung function parameters(P<0.05)and negative correlations with BDI scores(P<0.05).CONCLUSION Compared to patients without COPD,the incidence of depressive symptoms is higher among patients with COPD and is negatively correlated with the patients’HRV indices.In contrast,HRV indices are positively correlated with the patients’pulmonary function parameters.Patients and healthcare professionals should enhance their awareness of depression,actively conduct depression assessment screenings,and incorporate HRV indices into disease management.This approach aims to improve the psychological health of patients and ultimately enhance their prognosis and quality of life.
