Hypoxic pulmonary hypertension(HPH)is a pathophysiological state characterized by diverse clinical symptoms resulting from structural and functional changes in pulmonary vessels induced by hypoxic stimuli,leading to i...Hypoxic pulmonary hypertension(HPH)is a pathophysiological state characterized by diverse clinical symptoms resulting from structural and functional changes in pulmonary vessels induced by hypoxic stimuli,leading to increased pulmonary artery pressure.展开更多
Objective To determine the proportions of drug-resistant tuberculosis(TB),its trends,and the drug resistance-conferring mutations among patients with pulmonary TB aged 10-24 years in China.Methods The data of patients...Objective To determine the proportions of drug-resistant tuberculosis(TB),its trends,and the drug resistance-conferring mutations among patients with pulmonary TB aged 10-24 years in China.Methods The data of patients with pulmonary TB were retrieved from a national drug-resistant TB survey for analysis.Joinpoint regression software was used to analyze time trends.We also used whole genome sequencing to analyze the lineages and drug resistance-conferring mutations of 621 isolates.Results Among 4,235 patients with pulmonary TB,the proportion of new cases of multidrug-resistant tuberculosis(MDR-TB)was 3.18%(95%confidence interval[CI]:2.37-4.15)for adolescents and 3.76%(95%CI:3.03-4.60)for young adults;for previously treated patients,MDR-TB accounted for 11.25%(95%CI:5.28-20.28)of adolescents and 11.05%(95%CI:6.88-16.55)of young adults.The proportion of patients with MDR-TB remained stable among both new and previously treated patients aged 10-24 years during the study period.Through whole genome sequencing,we found that the most common mutations in the MDR-TB strains were Ser315Thr in the katG gene(71.74%)and Ser450Leu in the rpoB gene(50.00%).Conclusion This study revealed a high proportion of MDR-TB among adolescents and young adults,indicating that urgent and comprehensive measures are needed to reduce the emergence and transmission of drug-resistant TB among this population in China.展开更多
Pulmonary diseases have long posed a severe threat to human life and health.The incidence and mortality rates of pulmonary diseases have shown a rising trend year by year,highlighting the urgency of developing safe an...Pulmonary diseases have long posed a severe threat to human life and health.The incidence and mortality rates of pulmonary diseases have shown a rising trend year by year,highlighting the urgency of developing safe and effective therapeutic approaches.In recent years,to address the challenges faced by traditional treatment strategies for pulmonary diseases,the interdisciplinary integration has greatly promoted the rapid development of biomedical polymer materials in the field of pulmonary disease treatment.This review provides a detailed description of the structural characteristics of lung tissue,types of pulmonary diseases,traditional treatment methods,the categories and properties of biomedical polymer materials applied to pulmonary diseases.We systematically elaborate on the applications of biomedical polymer materials in the treatment of different pulmonary diseases and thoroughly discuss their functional roles in pulmonary diseases,particularly in the delivery of therapeutic agents to diseased sites,the formation of pulmonary aerosol formulations,and the facilitation of the effective accumulation of therapeutic agents.The latest research progresses of biomedical polymer materials are also introduced in pulmonary disease treatment.We have highlighted the current challenges and development opportunities of biomedical polymer materials in the treatment of pulmonary diseases,and provide future research directions for biomedical polymer materials in this field.This review will provide valuable reference for the basic research and clinical application of biomedical polymer materials in pulmonary disease treatment.展开更多
In recent years,different drugs therapies for treatment pulmonary fibrosis(PF) have gained much attention due to development of drug delivery technology and urgent clinical needs.PF treatment existed a variety of curr...In recent years,different drugs therapies for treatment pulmonary fibrosis(PF) have gained much attention due to development of drug delivery technology and urgent clinical needs.PF treatment existed a variety of currently clinical problem but PF could be treated with different drugs potentially though drug delivery technology.This review systematically expounds its basic theory,various drug delivery technologies,and future development directions.In the introduction,the relationship between the pathological mechanism of PF and drug delivery,the basic principles of the drug delivery system and the biological barriers faced by pulmonary drug delivery are analyzed.This review details delivery of small molecule drug,macromolecular drug and cells,including chemical synthesis and natural small molecule drug delivery,as well as RNA and cell-based delivery.Finally,the challenges and perspectives of these drugs to treat PF delivery technologies are discussed and key aspects in the development of PF drugs are considered.We hoped that this review can provide comprehensive and in-depth theoretical reference and technical support for the drug treatment of PF.展开更多
Pulmonary fibrosis(PF)is a progressive,fatal fibrotic disease caused by respiratory conditions.The condition can ultimately lead to severe organ failure and mortality,and is associated with multiple risk factors.Growi...Pulmonary fibrosis(PF)is a progressive,fatal fibrotic disease caused by respiratory conditions.The condition can ultimately lead to severe organ failure and mortality,and is associated with multiple risk factors.Growing evidence highlights the immune system’s role in PF,with various immune components participating in inflammatory and fibrotic processes.Different immune cells,including neutrophils,lymphocytes,and macrophages,demonstrate distinct effects on PF progression and development.Furthermore,key immune system cytokines,including the interleukin(IL)family,tumor necrosis factor(TNF)-α,interferon(IFN)-γ,transforming growth factor(TGF)-β,and connective tissue growth factor(CTGF),contribute to PF initiation and progression through independent mechanisms and mutual regulation.Currently,limited effective treatments exist for PF,with several treatments causing severe adverse reactions.Natural products,characterized by multi-target effects,holistic regulation,and low toxicity,have emerged as a research focus.This review compiles the mechanisms,therapeutic potential,and active components of various natural products.These compounds can ameliorate pulmonary inflammation,epithelial-mesenchymal transition,and collagen deposition through diverse immune mechanisms,acting at specific stages or throughout the fibrotic process,thereby supporting PF management.This review examines current scientific understanding of natural products’immunological effects in PF,which is crucial for developing future anti-PF therapeutics.展开更多
Objective:To investigate the quantitative assessment efficacy of chest CT combined with serum Vanin-1 and SPP1 in determining the progression stage of chronic obstructive pulmonary disease(COPD).Methods:A total of 100...Objective:To investigate the quantitative assessment efficacy of chest CT combined with serum Vanin-1 and SPP1 in determining the progression stage of chronic obstructive pulmonary disease(COPD).Methods:A total of 100 COPD subjects from our hospital from January 2020 to December 2023 were included and randomly divided into a healthy control group and an experimental group(50 cases each).The healthy control group underwent slow vital capacity measurement using a spirometer,while the experimental group underwent high-resolution thin-slice CT scans and serum Vanin-1 and SPP1 concentration measurements.Pulmonary function parameters,symptom burden,biomarker concentrations,and imaging characteristics were compared between the two groups.Results:The FEV1/FVC ratio in the experimental group(58.3±7.2)was lower than that in the healthy control group(92.1±4.8);the total CAT score(22.4±3.5)was higher than that in the healthy control group(3.1±1.2);both Vanin-1(18.7±2.3μg/L)and SPP1(25.6±4.1μg/L)levels were higher than those in the healthy control group;LAA%-950(38.7±6.2%)and WA%(68.5±5.3%)were significantly higher than those in the healthy control group(all p<0.001).Conclusion:Chest CT combined with serum Vanin-1 and SPP1 can accurately quantify the pathological progression of COPD,providing a dual basis for clinical staging and individualized intervention.展开更多
This study explored the therapeutic targets and molecular mechanisms of Huangqi Guizhi Decoction (HGD) in alleviatingpulmonary embolism (PE) by employing network pharmacology and molecular docking techniques. Firstly,...This study explored the therapeutic targets and molecular mechanisms of Huangqi Guizhi Decoction (HGD) in alleviatingpulmonary embolism (PE) by employing network pharmacology and molecular docking techniques. Firstly, the effective activecomponents of the Chinese herbs in HGD were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database(TCMSP), and their potential therapeutic targets were predicted using the Swiss Target Prediction platform. Subsequently, PErelatedtarget genes were obtained from the Online Mendelian Inheritance in Man (OMIM) database and GeneCards database.Then, the Wei Sheng Xin tool was used to generate a Venn diagram for identifying the common targets between the herb-relatedtargets and PE-related targets. After screening these common targets, a “drug-component-target network” and a protein-proteininteraction (PPI) network were constructed. Furthermore, Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia ofGenes and Genomes (KEGG) enrichment analysis were conducted on the intersecting targets, and molecular docking verificationwas performed using AutoDockTools and PyMol software. Finally, 20 active components were screened from Astragali Radix, 7from Cinnamomi Ramulus, 13 from Paeoniae Radix Alba, 5 from Zingiberis Rhizoma Recens, and 29 from Jujubae Fructus, witha total of 983 therapeutic targets. Among these targets, 134 were associated with PE, and protein kinase B1 (AKT1), mitogenactivatedprotein kinase 1 (MAPK1), and transformation-related protein 53 (TP53) served as the core targets. The results of GOand KEGG enrichment analyses indicated that the alleviation of PE by HGD is mainly related to pathways including immuneresponse, regulation of gene expression, atherosclerosis, and tumorigenesis. Molecular docking results showed that the keyactive components in HGD could bind to the core targets spontaneously and stably. This study revealed that HGD may alleviatesymptoms in PE patients by regulating signaling pathways, modulating platelet function to exert anticoagulant effects, andregulating the expression of anti-inflammatory genes, which provided a direction for subsequent experimental research.展开更多
Chronic obstructive pulmonary disease(COPD)is one of the leading causes of death and disability worldwide.Its complex etiology involves factors such as smoking,air pollution,genetic susceptibility,and social environme...Chronic obstructive pulmonary disease(COPD)is one of the leading causes of death and disability worldwide.Its complex etiology involves factors such as smoking,air pollution,genetic susceptibility,and social environment.With the accelerating global aging population and urbanization,the incidence and burden of COPD continue to rise.Current treatment strategies for COPD are relatively conservative,primarily focusing on bronchodilators,inhaled corticosteroids,and long-term oxygen therapy.Although these approaches can alleviate symptoms and slow disease progression to some ex-tent,they fail to effectively target the underlying mechanisms of the disease,leaving an unmet clinical need for more-effective therapies.This highlights the urgency of de-veloping innovative drugs that are both safe and efficacious to address the challenges in COPD treatment.As a traditional Chinese medicine with a long history,Colla corii asini has garnered significant attention for its diverse pharmacological effects and fa-vorable safety profile.Research has shown that Colla corii asini possesses multiple bio-logical activities,including hematopoiesis,nourishing the lungs,enhancing immunity,anti-infection,antiaging,antitumor,and antifatigue effects.Moreover,it has demon-strated potential in regulating oxidative stress,immune imbalance,and inflammatory responses.Recent evidence suggests that Colla corii asini may play a protective role in lung function through multitarget and multipathway mechanisms.Based on previ-ous research findings,this paper explores the potential therapeutic value of Colla corii asini in COPD treatment by addressing the current clinical management challenges and identifying potential therapeutic targets.It also integrates the pharmacological effects of Colla corii asini into a broader treatment context,providing new perspec-tives for comprehensive COPD management and laying the theoretical foundation for its modernization and innovative application.展开更多
BACKGROUND Alagille syndrome is a multisystem disease that results in various vascular anomalies,commonly involving the cardiac and pulmonary systems.To the best of our knowledge,there is no literature regarding the c...BACKGROUND Alagille syndrome is a multisystem disease that results in various vascular anomalies,commonly involving the cardiac and pulmonary systems.To the best of our knowledge,there is no literature regarding the cardiovascular outcomes of these patients in association with coronavirus disease 2019(COVID-19).CASE SUMMARY A 34-year-old woman with a history of Alagille syndrome who underwent successful atrial septal defect with partial anomalous pulmonary veins and patent ductus arteriosus repair,as well as left pulmonary artery catheterization and stenting in childhood due to pulmonary stenosis.The patient was without any respiratory symptoms and was a dancer prior to contracting COVID-19.Several weeks after her COVID-19 infection,she developed left pulmonary artery stent thrombosis and subsequent symptomatic pulmonary hypertension.A treatment strategy of anticoagulation alongside pharmacological agents for pulmonary hypertension for 3 months followed by balloon pulmonary artery angioplasty to reopen the stenosis was unsuccessful.CONCLUSION In the era of COVID-19,patients with pulmonary vascular malformations and endovascular stents are at an increased risk for chronic thromboembolic disease.Patients may benefit from prophylactic antiplatelet or anticoagulation therapy.Stent thrombosis is a devastating phenomenon and should be treated urgently and aggressively with balloon pulmonary angioplasty,and/or a thrombolytic agent.展开更多
Pulmonary vein stenosis(PVS) is rare condition characterized by a challenging diagnosis and unfavorable prognosis at advance stages. At present, injury from radiofrequency ablation for atrial fibrillation has become t...Pulmonary vein stenosis(PVS) is rare condition characterized by a challenging diagnosis and unfavorable prognosis at advance stages. At present, injury from radiofrequency ablation for atrial fibrillation has become the main cause of the disease. PVS is characterized by a progressive lumen size reduction of one or more pulmonary veins that, when hemodynamically significant, may raise lobar capillary pressure leading to signs and symptoms such as shortness of breath, cough, and hemoptysis. Image techniques(transesophageal echocardiography, computed tomography, magnetic resonance and perfusion imaging) are essential to reach a final diagnosis and decide an appropriate therapy. In this regard, series from referral centers have shown that surgical and transcatheter interventions may improve prognosis. The purpose of this article is to review the etiology, assessment and management of PVS.展开更多
Hemoptysis is a severe complication of pulmonary hypertension (PH) with a low in- cidence of 6%-11%.^([1-4])Although occurring in all forms of PH,it is more commonly seen in pulmonary arterial hypertension (PAH),assoc...Hemoptysis is a severe complication of pulmonary hypertension (PH) with a low in- cidence of 6%-11%.^([1-4])Although occurring in all forms of PH,it is more commonly seen in pulmonary arterial hypertension (PAH),associated with congenital heart disease (PAH-CHD).^([5,6])Since enlarged bronchial arteries are a frequent source of pulmonary bleeding,the primary treatment focuses on bronchial artery embolization (BAE),especially for chronic thromboembolic pulmonary hypertension (CTEPH) patients^([7,8]).However,there is disagreement regarding medical therapy,which has received little attention in the recently published PH guidelines.^([5,6])展开更多
Silicosis,a major persistent occupational disease in China,is a progressive and irreversible pulmonary fibrosis disease with unclear pathogenesis.Cellular senescence,a state of stable cell cycle arrest that is recogni...Silicosis,a major persistent occupational disease in China,is a progressive and irreversible pulmonary fibrosis disease with unclear pathogenesis.Cellular senescence,a state of stable cell cycle arrest that is recognized as a key underlying factor in age-related fibroproliferative disorders,plays an important role in chronic lung diseases,particularly pulmonary fibrosis.We previously reported that SiO2-stimulated mice and alveolar type II epithelial cells develop cellular senescence,which is involved in silicosis formation in alveolar type II epithelial cells[1].Cellular senescence may play an important role in silicosis development;however,the exact underlying mechanisms are not fully understood.展开更多
Pulmonary tumour thrombotic microangiopathy(PTTM)is a rare but under-recognised cause of rapidly progressive pulmonary hypertension(PH)and cor pulmonale,characterised by diffuse obstruction of small pulmonary arteries...Pulmonary tumour thrombotic microangiopathy(PTTM)is a rare but under-recognised cause of rapidly progressive pulmonary hypertension(PH)and cor pulmonale,characterised by diffuse obstruction of small pulmonary arteries by metastatic tumour cells.These tumour emboli lead to obstructive intimal proliferation and in situ thrombosis within the pulmonary vasculature,further compromising the overall permeability of the pulmonary vascular bed and exacerbating PH.[1]The clinical and imaging manifestations of PTTM often overlap with those of other causes of PH,including chronic thromboembolic PH,pulmonary veno-occlusive disease and pulmonary capillary haemangiomatosis,often leading to diagnostic delays.展开更多
Pulmonary artery remodeling is a critical pathological feature of pulmonary arterial hypertension(PAH),a fatal lung disease without cure,resulting in poor pulmonary hemodynamics and compliance.The remodeling could be ...Pulmonary artery remodeling is a critical pathological feature of pulmonary arterial hypertension(PAH),a fatal lung disease without cure,resulting in poor pulmonary hemodynamics and compliance.The remodeling could be aggravated by various factors,particularly by the hyperproliferation of pulmonary artery smooth muscle cells(PASMCs)and perivascular inflammation.Meanwhile,the hyperproliferation of PASMCs can be driven by the overexpression of miR138.In this study,we developed anti-inflammatory baicalein-assisted anti-miR138 gene therapy against PAH.The system was fabricated by anchoring the nucleic acid onto the nanocrystals through electrostatic interaction,followed by glucuronic acid(GA)coating for targeting the glucose transport-1(GLUT-1)receptor.The results demonstrated that the system had a 201-nm in diameter with a rod shape and allowed a 12-fold increase in pulmonary artery(PA)targeting versus free drug administration.The preparation injection reduced the PA thickness by 20%via effectively promoting PASMC apoptosis,likely by strengthening the pathway of Bcl-2 associated X protein/B-cell lymphoma-2/caspase 3(Bax/Bcl-2/Cas-3).The in vivo efficacy in the monocrotaline(MCT)-PAH model demonstrated significant improvement in the pulmonary hemodynamics,e.g.,a 50%decrease in mean pulmonary artery pressure(mPAP),61%increase in pulmonary artery acceleration time(PAAT),and 82%increase in cardiac output(CO).In conclusion,targeted codelivery of the inflammation inhibitor and anti-miR138 to PAs is promising to combat PAH.Rod-shaped nanomedicines represent an effective PA-targeting strategy.展开更多
Sodium-glucose cotransporter-2(SGLT-2)inhibitors represent a cutting-edge class of oral antidiabetic therapeutics that operate through selective inhibition of glucose reabsorption in proximal renal tubules,consequentl...Sodium-glucose cotransporter-2(SGLT-2)inhibitors represent a cutting-edge class of oral antidiabetic therapeutics that operate through selective inhibition of glucose reabsorption in proximal renal tubules,consequently augmenting urinary glucose excretion and attenuating blood glucose levels.Extensive clinical investigations have demonstrated their profound cardiovascular efficacy.Parallel basic science research has elucidated the mechanistic pathways through which diverse SGLT-2 inhibitors beneficially modulate pulmonary vascular cells and arterial remodeling.Specifically,these inhibitors exhibit promising potential in enhancing pulmonary vascular endothelial cell function,suppressing pulmonary smooth muscle cell proliferation and migration,reversing pulmonary arterial remodeling,and maintaining hemodynamic equilibrium.This comprehensive review synthesizes current literature to delineate the mechanisms by which SGLT-2 inhibitors enhance pulmonary vascular cell function and reverse pulmonary remodeling,thereby offering novel therapeutic perspectives for pulmonary vascular diseases.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
High-altitude pulmonary hypertension(HAPH)occurs when blood pressure in the pulmonary arteries rises due to exposure to high altitudes above 2,500 m.At these elevations,reduced atmospheric pressure leads to lower oxyg...High-altitude pulmonary hypertension(HAPH)occurs when blood pressure in the pulmonary arteries rises due to exposure to high altitudes above 2,500 m.At these elevations,reduced atmospheric pressure leads to lower oxygen levels,triggering a series of physiological responses,including pulmonary artery constriction,which elevates blood pressure.This review explored the complex pathophysiological mechanisms of HAPH and reviewed current pharmaceutical interventions for its management.Meanwhile,this review particularly emphasized on the emerging research concerning Chinese medicinal plants as potential treatments for HAPH.Traditional Chinese medicines are rich in diverse natural ingredients that show significant promise in alleviating HAPH symptoms.We reviewed both in vitro and in vivo studies to assess the efficacy,safety,and mechanisms of these natural medicines,along with their potential adverse effects.Additionally,this review highlighted new alternative natural remedies,underscoring the need for ongoing research to expand available treatment options for HAPH.展开更多
BACKGROUND Cardiac arrest caused by acute pulmonary embolism(PE)is the most serious clinical circumstance,necessitating rapid identification,immediate cardiopulmonary resuscitation(CPR),and systemic thrombolytic thera...BACKGROUND Cardiac arrest caused by acute pulmonary embolism(PE)is the most serious clinical circumstance,necessitating rapid identification,immediate cardiopulmonary resuscitation(CPR),and systemic thrombolytic therapy.Extracorporeal CPR(ECPR)is typically employed as a rescue therapy for selected patients when conventional CPR is failing in settings where it can be implemented.CASE SUMMARY We present a case of a 69-year-old male who experienced a prolonged cardiac arrest in an ambulance with pulseless electrical activity.Upon arrival at the emergency department with ongoing manual chest compressions,bedside pointof-care ultrasound revealed an enlarged right ventricle without contractility.Acute PE was suspected as the cause of cardiac arrest,and intravenous thrombolytic therapy with 50 mg tissue plasminogen activator was administered during mechanical chest compressions.Despite 31 minutes of CPR,return of spontaneous circulation was not achieved until 8 minutes after initiation of Veno-arterial extracorporeal membrane oxygenation(ECMO)support.Under ECMO support,the hemodynamic status and myocardial contractility significantly improved.However,the patient ultimately did not survive due to intracerebral hemorrhagic complications,leading to death a few days later in the hospital.CONCLUSION This case illustrates the potential of combining systemic thrombolysis with ECPR for refractory cardiac arrest caused by acute PE,but it also highlights the increased risk of significant bleeding complications,including fatal intracranial hemorrhage.展开更多
Repairing the endothelial barrier is essential for maintaining pulmonary fuid balance and regulating leukocyte infiltration during sepsis[1].Tissue kallikrein-related peptidases(KLKs)are secreted serine proteases invo...Repairing the endothelial barrier is essential for maintaining pulmonary fuid balance and regulating leukocyte infiltration during sepsis[1].Tissue kallikrein-related peptidases(KLKs)are secreted serine proteases involved in angiogenesis[2].However,their involvement in regulating endothelial regeneration remains largely unknown.展开更多
INTRODUCTION Pulmonary hypertension(PH)is a complex syndrome arising from diverse underlying conditions and characterized by elevated pulmonary arterial pressure.Current clinical guidelines classify PH into five categ...INTRODUCTION Pulmonary hypertension(PH)is a complex syndrome arising from diverse underlying conditions and characterized by elevated pulmonary arterial pressure.Current clinical guidelines classify PH into five categories based on pathophysiology,clinical presentation,and hemodynamic characteristics.展开更多
基金supported by General Program of the Natural Science Foundation of Hebei Province(No.H2024110033,China).
文摘Hypoxic pulmonary hypertension(HPH)is a pathophysiological state characterized by diverse clinical symptoms resulting from structural and functional changes in pulmonary vessels induced by hypoxic stimuli,leading to increased pulmonary artery pressure.
基金funded by the National Key Research and Development Program of China(grant number 2022YFC2305204).
文摘Objective To determine the proportions of drug-resistant tuberculosis(TB),its trends,and the drug resistance-conferring mutations among patients with pulmonary TB aged 10-24 years in China.Methods The data of patients with pulmonary TB were retrieved from a national drug-resistant TB survey for analysis.Joinpoint regression software was used to analyze time trends.We also used whole genome sequencing to analyze the lineages and drug resistance-conferring mutations of 621 isolates.Results Among 4,235 patients with pulmonary TB,the proportion of new cases of multidrug-resistant tuberculosis(MDR-TB)was 3.18%(95%confidence interval[CI]:2.37-4.15)for adolescents and 3.76%(95%CI:3.03-4.60)for young adults;for previously treated patients,MDR-TB accounted for 11.25%(95%CI:5.28-20.28)of adolescents and 11.05%(95%CI:6.88-16.55)of young adults.The proportion of patients with MDR-TB remained stable among both new and previously treated patients aged 10-24 years during the study period.Through whole genome sequencing,we found that the most common mutations in the MDR-TB strains were Ser315Thr in the katG gene(71.74%)and Ser450Leu in the rpoB gene(50.00%).Conclusion This study revealed a high proportion of MDR-TB among adolescents and young adults,indicating that urgent and comprehensive measures are needed to reduce the emergence and transmission of drug-resistant TB among this population in China.
基金the National Key Research and Development Program of China(No.2021YFB3800900)Natural Science Foundation of Xiamen,China(No.3502Z202371004)+2 种基金National Natural Science Foundation of China(Nos.52473150,51925305,52173115,51873208,51833010,and 52203183)Fundamental Research Funds for the Central Universities(No.20720230004)the Talent Cultivation Project Funds for the Innovation Laboratory for Sciences and Technologies of Energy Materials of Fujian Province(No.HRTP-[2022]52).
文摘Pulmonary diseases have long posed a severe threat to human life and health.The incidence and mortality rates of pulmonary diseases have shown a rising trend year by year,highlighting the urgency of developing safe and effective therapeutic approaches.In recent years,to address the challenges faced by traditional treatment strategies for pulmonary diseases,the interdisciplinary integration has greatly promoted the rapid development of biomedical polymer materials in the field of pulmonary disease treatment.This review provides a detailed description of the structural characteristics of lung tissue,types of pulmonary diseases,traditional treatment methods,the categories and properties of biomedical polymer materials applied to pulmonary diseases.We systematically elaborate on the applications of biomedical polymer materials in the treatment of different pulmonary diseases and thoroughly discuss their functional roles in pulmonary diseases,particularly in the delivery of therapeutic agents to diseased sites,the formation of pulmonary aerosol formulations,and the facilitation of the effective accumulation of therapeutic agents.The latest research progresses of biomedical polymer materials are also introduced in pulmonary disease treatment.We have highlighted the current challenges and development opportunities of biomedical polymer materials in the treatment of pulmonary diseases,and provide future research directions for biomedical polymer materials in this field.This review will provide valuable reference for the basic research and clinical application of biomedical polymer materials in pulmonary disease treatment.
基金funded by the National Natural Science Foundation of China (No.NSFC82400096)Science and Technology Department of Sichuan Province (No.2025ZNSFSC1538)Xihua University Internal Talent Introduction Project with Scientific Research Funding (No.ZX20250087)。
文摘In recent years,different drugs therapies for treatment pulmonary fibrosis(PF) have gained much attention due to development of drug delivery technology and urgent clinical needs.PF treatment existed a variety of currently clinical problem but PF could be treated with different drugs potentially though drug delivery technology.This review systematically expounds its basic theory,various drug delivery technologies,and future development directions.In the introduction,the relationship between the pathological mechanism of PF and drug delivery,the basic principles of the drug delivery system and the biological barriers faced by pulmonary drug delivery are analyzed.This review details delivery of small molecule drug,macromolecular drug and cells,including chemical synthesis and natural small molecule drug delivery,as well as RNA and cell-based delivery.Finally,the challenges and perspectives of these drugs to treat PF delivery technologies are discussed and key aspects in the development of PF drugs are considered.We hoped that this review can provide comprehensive and in-depth theoretical reference and technical support for the drug treatment of PF.
基金supported by the National Natural Science Foundation of China(No.82260820)the Natural Science Foundation of Jilin Province,Jilin,China(No.YDZJ202201ZYTS155).
文摘Pulmonary fibrosis(PF)is a progressive,fatal fibrotic disease caused by respiratory conditions.The condition can ultimately lead to severe organ failure and mortality,and is associated with multiple risk factors.Growing evidence highlights the immune system’s role in PF,with various immune components participating in inflammatory and fibrotic processes.Different immune cells,including neutrophils,lymphocytes,and macrophages,demonstrate distinct effects on PF progression and development.Furthermore,key immune system cytokines,including the interleukin(IL)family,tumor necrosis factor(TNF)-α,interferon(IFN)-γ,transforming growth factor(TGF)-β,and connective tissue growth factor(CTGF),contribute to PF initiation and progression through independent mechanisms and mutual regulation.Currently,limited effective treatments exist for PF,with several treatments causing severe adverse reactions.Natural products,characterized by multi-target effects,holistic regulation,and low toxicity,have emerged as a research focus.This review compiles the mechanisms,therapeutic potential,and active components of various natural products.These compounds can ameliorate pulmonary inflammation,epithelial-mesenchymal transition,and collagen deposition through diverse immune mechanisms,acting at specific stages or throughout the fibrotic process,thereby supporting PF management.This review examines current scientific understanding of natural products’immunological effects in PF,which is crucial for developing future anti-PF therapeutics.
基金Baoding Science and Technology Plan Project(Project No.:2341ZF214)。
文摘Objective:To investigate the quantitative assessment efficacy of chest CT combined with serum Vanin-1 and SPP1 in determining the progression stage of chronic obstructive pulmonary disease(COPD).Methods:A total of 100 COPD subjects from our hospital from January 2020 to December 2023 were included and randomly divided into a healthy control group and an experimental group(50 cases each).The healthy control group underwent slow vital capacity measurement using a spirometer,while the experimental group underwent high-resolution thin-slice CT scans and serum Vanin-1 and SPP1 concentration measurements.Pulmonary function parameters,symptom burden,biomarker concentrations,and imaging characteristics were compared between the two groups.Results:The FEV1/FVC ratio in the experimental group(58.3±7.2)was lower than that in the healthy control group(92.1±4.8);the total CAT score(22.4±3.5)was higher than that in the healthy control group(3.1±1.2);both Vanin-1(18.7±2.3μg/L)and SPP1(25.6±4.1μg/L)levels were higher than those in the healthy control group;LAA%-950(38.7±6.2%)and WA%(68.5±5.3%)were significantly higher than those in the healthy control group(all p<0.001).Conclusion:Chest CT combined with serum Vanin-1 and SPP1 can accurately quantify the pathological progression of COPD,providing a dual basis for clinical staging and individualized intervention.
基金supported by Research Project on Traditional Chinese Medicine in Heilongjiang Province in 2025(Research on the pharmacological substance basis of Huangqi Guizhi decoction in improving acute pulmonary embolism and lung injury based on the theory of“Diaphoresis and expanding meridian”No.ZHY2025-043).
文摘This study explored the therapeutic targets and molecular mechanisms of Huangqi Guizhi Decoction (HGD) in alleviatingpulmonary embolism (PE) by employing network pharmacology and molecular docking techniques. Firstly, the effective activecomponents of the Chinese herbs in HGD were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database(TCMSP), and their potential therapeutic targets were predicted using the Swiss Target Prediction platform. Subsequently, PErelatedtarget genes were obtained from the Online Mendelian Inheritance in Man (OMIM) database and GeneCards database.Then, the Wei Sheng Xin tool was used to generate a Venn diagram for identifying the common targets between the herb-relatedtargets and PE-related targets. After screening these common targets, a “drug-component-target network” and a protein-proteininteraction (PPI) network were constructed. Furthermore, Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia ofGenes and Genomes (KEGG) enrichment analysis were conducted on the intersecting targets, and molecular docking verificationwas performed using AutoDockTools and PyMol software. Finally, 20 active components were screened from Astragali Radix, 7from Cinnamomi Ramulus, 13 from Paeoniae Radix Alba, 5 from Zingiberis Rhizoma Recens, and 29 from Jujubae Fructus, witha total of 983 therapeutic targets. Among these targets, 134 were associated with PE, and protein kinase B1 (AKT1), mitogenactivatedprotein kinase 1 (MAPK1), and transformation-related protein 53 (TP53) served as the core targets. The results of GOand KEGG enrichment analyses indicated that the alleviation of PE by HGD is mainly related to pathways including immuneresponse, regulation of gene expression, atherosclerosis, and tumorigenesis. Molecular docking results showed that the keyactive components in HGD could bind to the core targets spontaneously and stably. This study revealed that HGD may alleviatesymptoms in PE patients by regulating signaling pathways, modulating platelet function to exert anticoagulant effects, andregulating the expression of anti-inflammatory genes, which provided a direction for subsequent experimental research.
基金The National Natural Science Foundation of China,Grant/Award Number:82074104 and 8247143489the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences,Grant/Award Number:2022-I2M-2-002。
文摘Chronic obstructive pulmonary disease(COPD)is one of the leading causes of death and disability worldwide.Its complex etiology involves factors such as smoking,air pollution,genetic susceptibility,and social environment.With the accelerating global aging population and urbanization,the incidence and burden of COPD continue to rise.Current treatment strategies for COPD are relatively conservative,primarily focusing on bronchodilators,inhaled corticosteroids,and long-term oxygen therapy.Although these approaches can alleviate symptoms and slow disease progression to some ex-tent,they fail to effectively target the underlying mechanisms of the disease,leaving an unmet clinical need for more-effective therapies.This highlights the urgency of de-veloping innovative drugs that are both safe and efficacious to address the challenges in COPD treatment.As a traditional Chinese medicine with a long history,Colla corii asini has garnered significant attention for its diverse pharmacological effects and fa-vorable safety profile.Research has shown that Colla corii asini possesses multiple bio-logical activities,including hematopoiesis,nourishing the lungs,enhancing immunity,anti-infection,antiaging,antitumor,and antifatigue effects.Moreover,it has demon-strated potential in regulating oxidative stress,immune imbalance,and inflammatory responses.Recent evidence suggests that Colla corii asini may play a protective role in lung function through multitarget and multipathway mechanisms.Based on previ-ous research findings,this paper explores the potential therapeutic value of Colla corii asini in COPD treatment by addressing the current clinical management challenges and identifying potential therapeutic targets.It also integrates the pharmacological effects of Colla corii asini into a broader treatment context,providing new perspec-tives for comprehensive COPD management and laying the theoretical foundation for its modernization and innovative application.
文摘BACKGROUND Alagille syndrome is a multisystem disease that results in various vascular anomalies,commonly involving the cardiac and pulmonary systems.To the best of our knowledge,there is no literature regarding the cardiovascular outcomes of these patients in association with coronavirus disease 2019(COVID-19).CASE SUMMARY A 34-year-old woman with a history of Alagille syndrome who underwent successful atrial septal defect with partial anomalous pulmonary veins and patent ductus arteriosus repair,as well as left pulmonary artery catheterization and stenting in childhood due to pulmonary stenosis.The patient was without any respiratory symptoms and was a dancer prior to contracting COVID-19.Several weeks after her COVID-19 infection,she developed left pulmonary artery stent thrombosis and subsequent symptomatic pulmonary hypertension.A treatment strategy of anticoagulation alongside pharmacological agents for pulmonary hypertension for 3 months followed by balloon pulmonary artery angioplasty to reopen the stenosis was unsuccessful.CONCLUSION In the era of COVID-19,patients with pulmonary vascular malformations and endovascular stents are at an increased risk for chronic thromboembolic disease.Patients may benefit from prophylactic antiplatelet or anticoagulation therapy.Stent thrombosis is a devastating phenomenon and should be treated urgently and aggressively with balloon pulmonary angioplasty,and/or a thrombolytic agent.
文摘Pulmonary vein stenosis(PVS) is rare condition characterized by a challenging diagnosis and unfavorable prognosis at advance stages. At present, injury from radiofrequency ablation for atrial fibrillation has become the main cause of the disease. PVS is characterized by a progressive lumen size reduction of one or more pulmonary veins that, when hemodynamically significant, may raise lobar capillary pressure leading to signs and symptoms such as shortness of breath, cough, and hemoptysis. Image techniques(transesophageal echocardiography, computed tomography, magnetic resonance and perfusion imaging) are essential to reach a final diagnosis and decide an appropriate therapy. In this regard, series from referral centers have shown that surgical and transcatheter interventions may improve prognosis. The purpose of this article is to review the etiology, assessment and management of PVS.
基金supported by Liaoning Xingliao Talent Project (Grant No. XLYC2007020)。
文摘Hemoptysis is a severe complication of pulmonary hypertension (PH) with a low in- cidence of 6%-11%.^([1-4])Although occurring in all forms of PH,it is more commonly seen in pulmonary arterial hypertension (PAH),associated with congenital heart disease (PAH-CHD).^([5,6])Since enlarged bronchial arteries are a frequent source of pulmonary bleeding,the primary treatment focuses on bronchial artery embolization (BAE),especially for chronic thromboembolic pulmonary hypertension (CTEPH) patients^([7,8]).However,there is disagreement regarding medical therapy,which has received little attention in the recently published PH guidelines.^([5,6])
文摘Silicosis,a major persistent occupational disease in China,is a progressive and irreversible pulmonary fibrosis disease with unclear pathogenesis.Cellular senescence,a state of stable cell cycle arrest that is recognized as a key underlying factor in age-related fibroproliferative disorders,plays an important role in chronic lung diseases,particularly pulmonary fibrosis.We previously reported that SiO2-stimulated mice and alveolar type II epithelial cells develop cellular senescence,which is involved in silicosis formation in alveolar type II epithelial cells[1].Cellular senescence may play an important role in silicosis development;however,the exact underlying mechanisms are not fully understood.
文摘Pulmonary tumour thrombotic microangiopathy(PTTM)is a rare but under-recognised cause of rapidly progressive pulmonary hypertension(PH)and cor pulmonale,characterised by diffuse obstruction of small pulmonary arteries by metastatic tumour cells.These tumour emboli lead to obstructive intimal proliferation and in situ thrombosis within the pulmonary vasculature,further compromising the overall permeability of the pulmonary vascular bed and exacerbating PH.[1]The clinical and imaging manifestations of PTTM often overlap with those of other causes of PH,including chronic thromboembolic PH,pulmonary veno-occlusive disease and pulmonary capillary haemangiomatosis,often leading to diagnostic delays.
基金supported by the National Natural Science Foundation of China(Nos.81872823,82073782,and 82241002)the Shanghai Science and Technology Committee(No.19430741500).
文摘Pulmonary artery remodeling is a critical pathological feature of pulmonary arterial hypertension(PAH),a fatal lung disease without cure,resulting in poor pulmonary hemodynamics and compliance.The remodeling could be aggravated by various factors,particularly by the hyperproliferation of pulmonary artery smooth muscle cells(PASMCs)and perivascular inflammation.Meanwhile,the hyperproliferation of PASMCs can be driven by the overexpression of miR138.In this study,we developed anti-inflammatory baicalein-assisted anti-miR138 gene therapy against PAH.The system was fabricated by anchoring the nucleic acid onto the nanocrystals through electrostatic interaction,followed by glucuronic acid(GA)coating for targeting the glucose transport-1(GLUT-1)receptor.The results demonstrated that the system had a 201-nm in diameter with a rod shape and allowed a 12-fold increase in pulmonary artery(PA)targeting versus free drug administration.The preparation injection reduced the PA thickness by 20%via effectively promoting PASMC apoptosis,likely by strengthening the pathway of Bcl-2 associated X protein/B-cell lymphoma-2/caspase 3(Bax/Bcl-2/Cas-3).The in vivo efficacy in the monocrotaline(MCT)-PAH model demonstrated significant improvement in the pulmonary hemodynamics,e.g.,a 50%decrease in mean pulmonary artery pressure(mPAP),61%increase in pulmonary artery acceleration time(PAAT),and 82%increase in cardiac output(CO).In conclusion,targeted codelivery of the inflammation inhibitor and anti-miR138 to PAs is promising to combat PAH.Rod-shaped nanomedicines represent an effective PA-targeting strategy.
基金Supported by Science and Technology Department of Yunnan Province-Kunming Medical University,Kunming Medical Joint Special Project-Surface Project,No.202401AY070001-164Yunnan Provincial Clinical Research Center Cardiovascular Diseases-New Technology Research for Development Project for Diagnosis and Treatment Cardiovascular Diseases,No.202102AA310002the Key Technology Research and Device Development Project for Innovative Diagnosis and Treatment of Structural Heart Disease in the Southwest Plateau Region,No.202302AA310045.
文摘Sodium-glucose cotransporter-2(SGLT-2)inhibitors represent a cutting-edge class of oral antidiabetic therapeutics that operate through selective inhibition of glucose reabsorption in proximal renal tubules,consequently augmenting urinary glucose excretion and attenuating blood glucose levels.Extensive clinical investigations have demonstrated their profound cardiovascular efficacy.Parallel basic science research has elucidated the mechanistic pathways through which diverse SGLT-2 inhibitors beneficially modulate pulmonary vascular cells and arterial remodeling.Specifically,these inhibitors exhibit promising potential in enhancing pulmonary vascular endothelial cell function,suppressing pulmonary smooth muscle cell proliferation and migration,reversing pulmonary arterial remodeling,and maintaining hemodynamic equilibrium.This comprehensive review synthesizes current literature to delineate the mechanisms by which SGLT-2 inhibitors enhance pulmonary vascular cell function and reverse pulmonary remodeling,thereby offering novel therapeutic perspectives for pulmonary vascular diseases.
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.
基金supported by the National Natural Science Foundation of China(Grant Nos.:32270690 and 32070671).
文摘High-altitude pulmonary hypertension(HAPH)occurs when blood pressure in the pulmonary arteries rises due to exposure to high altitudes above 2,500 m.At these elevations,reduced atmospheric pressure leads to lower oxygen levels,triggering a series of physiological responses,including pulmonary artery constriction,which elevates blood pressure.This review explored the complex pathophysiological mechanisms of HAPH and reviewed current pharmaceutical interventions for its management.Meanwhile,this review particularly emphasized on the emerging research concerning Chinese medicinal plants as potential treatments for HAPH.Traditional Chinese medicines are rich in diverse natural ingredients that show significant promise in alleviating HAPH symptoms.We reviewed both in vitro and in vivo studies to assess the efficacy,safety,and mechanisms of these natural medicines,along with their potential adverse effects.Additionally,this review highlighted new alternative natural remedies,underscoring the need for ongoing research to expand available treatment options for HAPH.
基金Supported by Scientific Research Projects from Wuhan Municipal Health Commission of China,No.WX23B42.
文摘BACKGROUND Cardiac arrest caused by acute pulmonary embolism(PE)is the most serious clinical circumstance,necessitating rapid identification,immediate cardiopulmonary resuscitation(CPR),and systemic thrombolytic therapy.Extracorporeal CPR(ECPR)is typically employed as a rescue therapy for selected patients when conventional CPR is failing in settings where it can be implemented.CASE SUMMARY We present a case of a 69-year-old male who experienced a prolonged cardiac arrest in an ambulance with pulseless electrical activity.Upon arrival at the emergency department with ongoing manual chest compressions,bedside pointof-care ultrasound revealed an enlarged right ventricle without contractility.Acute PE was suspected as the cause of cardiac arrest,and intravenous thrombolytic therapy with 50 mg tissue plasminogen activator was administered during mechanical chest compressions.Despite 31 minutes of CPR,return of spontaneous circulation was not achieved until 8 minutes after initiation of Veno-arterial extracorporeal membrane oxygenation(ECMO)support.Under ECMO support,the hemodynamic status and myocardial contractility significantly improved.However,the patient ultimately did not survive due to intracerebral hemorrhagic complications,leading to death a few days later in the hospital.CONCLUSION This case illustrates the potential of combining systemic thrombolysis with ECPR for refractory cardiac arrest caused by acute PE,but it also highlights the increased risk of significant bleeding complications,including fatal intracranial hemorrhage.
基金supported by the National Natural Science Foundation of China(Grant Nos.:32171124,31871156,31971101,32271180,82272229,and 81471852)Hunan Provincial Natural Science Foundation of China(Grant No.:2021JJ31058).
文摘Repairing the endothelial barrier is essential for maintaining pulmonary fuid balance and regulating leukocyte infiltration during sepsis[1].Tissue kallikrein-related peptidases(KLKs)are secreted serine proteases involved in angiogenesis[2].However,their involvement in regulating endothelial regeneration remains largely unknown.
文摘INTRODUCTION Pulmonary hypertension(PH)is a complex syndrome arising from diverse underlying conditions and characterized by elevated pulmonary arterial pressure.Current clinical guidelines classify PH into five categories based on pathophysiology,clinical presentation,and hemodynamic characteristics.
