Chronic obstructive pulmonary disease(COPD),a disease responsible for early mortality worldwide,is well accepted to be associated with periodontitis epidemiologically.Although both of the diseases are the multi-microb...Chronic obstructive pulmonary disease(COPD),a disease responsible for early mortality worldwide,is well accepted to be associated with periodontitis epidemiologically.Although both of the diseases are the multi-microbial inflammatory disease,the precise underlying mechanisms by which periodontitis influences the progression of COPD remains largely unknown.Here,we established COPD accompanied with periodontitis mouse models and observed the pronounced progress in pulmonary symptoms and histopathology,cha racterized by poorer respiratory function,thicke ned bronchial walls,and increased neutrophils infiltration in lung tissue.Mechanistically,periodontitis pathogen Porphyromonas gingivalis(P.gingivalis)relocated in the lung through the respiratory tract and LPS from P.gingivalis promoted the secretion of chemokines CXCL2 and G-CSF of alveolar epithelial cells through NF-κB and p38 MAPK pathways to recruit neutrophils.Furthermore,exposure to P.gingivalis of infiltrated neutrophils released matrix metallopeptidase-8(MMP-8)and neutrophil elastase(NE),which aggravated airway inflammation and tissue damage.These findings indicated that periodontitis could exacerbate COPD via its pathogen P.gingivalis,which translocated in the lung and stimulated neutrophil chemotaxis and activation in the lung.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 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
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
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
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
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
A recent study on the rapid imaging of pulmonary ventilation using hyperpolarized ^(129)Xe MRI has demonstrated the ability to achieve isotropic 3D ventilation imaging with a spatial resolution of 3×3×3mm^(3...A recent study on the rapid imaging of pulmonary ventilation using hyperpolarized ^(129)Xe MRI has demonstrated the ability to achieve isotropic 3D ventilation imaging with a spatial resolution of 3×3×3mm^(3) in humans,within an acquisition time of just 3.5 seconds(https://doi.org/10.1002/mrm.30120).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
Objective:To explore the application value of artificial intelligence-assisted diagnostic systems in the computed tomography(CT)diagnosis of pulmonary nodules.Methods:A total of 80 patients with pulmonary nodules,trea...Objective:To explore the application value of artificial intelligence-assisted diagnostic systems in the computed tomography(CT)diagnosis of pulmonary nodules.Methods:A total of 80 patients with pulmonary nodules,treated from June 2023 to May 2024,were included.All patients underwent pathological examination and CT scans,with pathological results serving as the gold standard.The diagnostic performance of CT alone and CT combined with the artificial intelligence-assisted diagnostic system was analyzed,and differences in CT imaging features and evaluation results of benign and malignant pulmonary nodules were compared.Results:The sensitivity,specificity,and accuracy of CT combined with the artificial intelligence-assisted diagnostic system were significantly higher than those of CT alone(P<0.05).Moreover,the false-positive and false-negative rates were significantly lower for the combined approach compared to CT alone(P<0.05).Conclusion:The artificial intelligence-assisted diagnostic system effectively identifies malignant features in pulmonary nodules,providing valuable clinical reference data and enhancing diagnostic accuracy and efficiency.展开更多
BACKGROUND Lung cancer(LC)is one of the most prevalent cancers globally,with a high incidence among the elderly population.Elderly patients,particularly those with diabetes mellitus,are at an increased risk of postope...BACKGROUND Lung cancer(LC)is one of the most prevalent cancers globally,with a high incidence among the elderly population.Elderly patients,particularly those with diabetes mellitus,are at an increased risk of postoperative complications,in-cluding pulmonary infections,due to weakened immune function and metabolic abnormalities.Postoperative pulmonary infection(PPI)is a predominant com-plication after thoracoscopic radical resection of LC,significantly affecting patient outcomes and increasing healthcare burdens.Determining risk factors for PPI in this vulnerable population is crucial for improving surgical outcomes and redu-cing infection rates.AIM To develop and validate a predictive model for PPI in elderly patients with dia-betes undergoing thoracoscopic radical resection for LC and to assess its reliability and validity.METHODS This retrospective study included 212 patients with LC who received treatment at our hospital from March 2015 to March 2022.General clinical information,sur-gical treatment details,and laboratory test results were collected and analyzed.Patients were grouped according to infection occurrence during the postoperative hospitalization period.Risk factors for PPIs were determined through logistic regression analysis,and a nomogram prediction model was established using R software to assess its predictive accuracy and performance.RESULTS Among the 212 patients[median age:72 years(interquartile range:60-82 years)],41 developed PPI(19.34%),with Gram-negative bacteria being the predominant pathogens(64.14%).Factors,such as age of≥70 years,presence of respiratory diseases,maximum tumor diameter of≥4 cm,stages II-III,receiving neoadjuvant chemotherapy of≥2 times preoperatively,surgery duration of≥3 hours,chest drainage tube placement duration of≥3.5 days,preoperative fasting blood glucose levels,hemoglobin A1c(HbA1c)levels,and multi-leaf resection,were markedly higher in the infection group than in the non-infection group.Conversely,forced expiratory volume in 1 second(FEV1)of≥80%and albumin(Alb)levels were lower in the infection group.Multivariate logistic regression analysis revealed that receiving neoadjuvant chemotherapy of≥2 times[odds ratio(OR)=2.987;P=0.036],maximum tumor diameter of≥4 cm(OR=3.959;P=0.013),multi-leaf resection(OR=3.18;P=0.036),preoperative FEV1 of≤80%(OR=3.305;P=0.029),and high HbA1c levels(OR=2.39;P=0.003)as key risk factors for PPI,whereas high Alb levels(OR=0.507;P<0.001)was protective.The nomogram model demonstrated excellent diagnostic ability(area under the curve=0.901,0.915),and calibration curves and decision curve analysis revealed good predictive performance and clinical applicability of the model.CONCLUSION The primary pathogens of PPI in elderly patients with diabetes and LC undergoing thoracoscopic radical resection are Gram-negative bacteria.The nomogram model,based on preoperative neoadjuvant chemotherapy cycles,maximum tumor diameter,range of resection,and preoperative FEV1,Alb,and HbA1c levels,shows high clinical value in predicting the risk of PPI in this patient population.展开更多
Background:Under hypoxia,exaggerated compensatory responses may lead to acute mountain sickness.The excessive vasodilatory effect of nitric oxide(NO)can lower the hypoxic pulmonary vasoconstriction(HPV)and peripheral ...Background:Under hypoxia,exaggerated compensatory responses may lead to acute mountain sickness.The excessive vasodilatory effect of nitric oxide(NO)can lower the hypoxic pulmonary vasoconstriction(HPV)and peripheral blood pressure.While NO is catalyzed by various nitric oxide synthase(NOS)isoforms,the regulatory roles of these types in the hemodynamics of pulmonary and systemic circulation in living hypoxic animals remain unclear.Therefore,this study aims to investigate the regu-latory effects of different NOS isoforms on pulmonary and systemic circulation in hypoxic rats by employing selective NOS inhibitors and continuously monitoring hemodynamic parameters of both pulmonary and systemic circulation.Methods:Forty healthy male Sprague–Dawley(SD)rats were randomly divided into four groups:Control group(NG-nitro-D-arginine methyl ester,D-NAME),L-NAME group(non-selective NOS inhibitor,NG-nitro-L-arginine methyl ester),AG group(in-ducible NOS inhibitor group,aminoguanidine),and 7-NI group(neurological NOS in-hibitor,7-nitroindazole).Hemodynamic parameters of rats were monitored for 10 min after inhibitor administration and 5 min after induction of hypoxia[15%O2,2200 m a.sl.,582 mmHg(76.5 kPa),Xining,China]using the real-time dynamic monitoring model for pulmonary and systemic circulation hemodynamics in vivo.Serum NO concentra-tions and blood gas analysis were measured.Results:Under normoxia,mean arterial pressure and total peripheral vascular resist-ance were increased,and ascending aortic blood flow and serum NO concentration were decreased in the L-NAME and AG groups.During hypoxia,pulmonary arterial pressure and pulmonary vascular resistance were significantly increased in the L-NAME and AG groups.Conclusions:This compensatory mechanism activated by inducible NOS and en-dothelial NOS effectively counteracts the pulmonary hemodynamic changes induced by hypoxic stress.It plays a crucial role in alleviating hypoxia-induced pulmonary arte-rial hypertension.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
Pulmonary nodules represent an early manifestation of lung cancer.However,pulmonary nodules only constitute a small portion of the overall image,posing challenges for physicians in image interpretation and potentially...Pulmonary nodules represent an early manifestation of lung cancer.However,pulmonary nodules only constitute a small portion of the overall image,posing challenges for physicians in image interpretation and potentially leading to false positives or missed detections.To solve these problems,the YOLOv8 network is enhanced by adding deformable convolution and atrous spatial pyramid pooling(ASPP),along with the integration of a coordinate attention(CA)mechanism.This allows the network to focus on small targets while expanding the receptive field without losing resolution.At the same time,context information on the target is gathered and feature expression is enhanced by attention modules in different directions.It effectively improves the positioning accuracy and achieves good results on the LUNA16 dataset.Compared with other detection algorithms,it improves the accuracy of pulmonary nodule detection to a certain extent.展开更多
This study examines hemodynamic behavior in particular cases of pulmonary hypertension without treatment. Pulmonary hypertension represents an anomalous hemodynamic state and is characterized by an excessively high bl...This study examines hemodynamic behavior in particular cases of pulmonary hypertension without treatment. Pulmonary hypertension represents an anomalous hemodynamic state and is characterized by an excessively high blood pressure in the pulmonary artery. To simulate the hemodynamic abnormalities in pulmonary hypertension under different causes and pathologies, we construct a localized parameter circuit model governed by nonlinear ordinary derivative equations of the human circulatory system. Thus, two special cases are considered, namely pulmonary the artery stenosis and the left ventricular diastolic dysfunction. For each case of pulmonary hypertension development, we determine the relationships between blood pressure and chamber and vessel pressure-volume. When the pulmonary hypertension is due to pulmonary artery stenosis, it appears that the right ventricular pressure increases up to 90 mm Hg, likewise the rise in pulmonary artery resistance induces direct increment in pulmonary artery pressure. However, when the pulmonary hypertension is due to left ventricular diastolic dysfunction, we note that the left atrial pressure and the pulmonary vein pressure augment, leading to the growth of the pulmonary artery blood pressure. The established results within this paper are useful for understanding the hemodynamic mechanism of particular pulmonary hypertension.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
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
Pulmonary embolism(PE)is a rare but devastating complication of shoulder surgery.Apart from increased morbidity and mortality rates,it may significantly impair postoperative recovery and functional outcome.Its frequen...Pulmonary embolism(PE)is a rare but devastating complication of shoulder surgery.Apart from increased morbidity and mortality rates,it may significantly impair postoperative recovery and functional outcome.Its frequency accounts for up to 5.7%of all shoulder surgery procedures with a higher occurrence in women and patients older than 70 years.It is most commonly associated with thrombophilia,diabetes mellitus,obesity,smoking,hypertension,and a history of malignancy.PE usually occurs secondary to upper or lower-extremity deep vein thrombosis(DVT).However,in rare cases,the source of the thrombi cannot be determined.Prophylaxis for PE following shoulder surgery remains a topic of debate,and the standard of care does not routinely require prophylactic medication for DVT prophylaxis.Early ambulation and elastic stockings are important preventative measures for DVT of the lower extremity and medical agents such as aspirin,low-molecular-weight heparin,and vitamin K antagonists are indicated for high-risk patients,long-lasting operations,or concomitant severe acute respiratory syndrome coronavirus 2 infection.The most common symptoms of PE include chest pain and shortness of breath,but PE can also be asymptomatic in patients with intrinsic tolerance of hypoxia.Patients with DVT may also present with swelling and pain of the respective extremity.The treatment of PE includes inpatient or outpatient anticoagulant therapy if the patient is hemodynamically unstable or stable,respectively.Hemodynamic instability may require transfer to the intensive care unit,and cardiovascular arrest can be implicated in fatal events.An important issue for patients with PE in the postoperative period after shoulder surgery is residual stiffness due to a delay in rehabilitation and a prolonged hospital stay.Early physiotherapy and range-of-motion exercises do not adversely affect the prognosis of PE and are highly recommended to preserve shoulder mobility and function.展开更多
基金supported by National High Level Hospital Clinical Research Funding,grant nos.BJ-2025-122,BJ2023-126CAMS Innovation Fund for Medical Sciences(CIFMS),grant no.2021-I2M-1050National Natural Science Foundation of China,grant no.82170956。
文摘Chronic obstructive pulmonary disease(COPD),a disease responsible for early mortality worldwide,is well accepted to be associated with periodontitis epidemiologically.Although both of the diseases are the multi-microbial inflammatory disease,the precise underlying mechanisms by which periodontitis influences the progression of COPD remains largely unknown.Here,we established COPD accompanied with periodontitis mouse models and observed the pronounced progress in pulmonary symptoms and histopathology,cha racterized by poorer respiratory function,thicke ned bronchial walls,and increased neutrophils infiltration in lung tissue.Mechanistically,periodontitis pathogen Porphyromonas gingivalis(P.gingivalis)relocated in the lung through the respiratory tract and LPS from P.gingivalis promoted the secretion of chemokines CXCL2 and G-CSF of alveolar epithelial cells through NF-κB and p38 MAPK pathways to recruit neutrophils.Furthermore,exposure to P.gingivalis of infiltrated neutrophils released matrix metallopeptidase-8(MMP-8)and neutrophil elastase(NE),which aggravated airway inflammation and tissue damage.These findings indicated that periodontitis could exacerbate COPD via its pathogen P.gingivalis,which translocated in the lung and stimulated neutrophil chemotaxis and activation in the lung.
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.
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.
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 the National Natural Science Foundation of China(81930049 and 82171926).
文摘A recent study on the rapid imaging of pulmonary ventilation using hyperpolarized ^(129)Xe MRI has demonstrated the ability to achieve isotropic 3D ventilation imaging with a spatial resolution of 3×3×3mm^(3) in humans,within an acquisition time of just 3.5 seconds(https://doi.org/10.1002/mrm.30120).
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.
基金supported by Chengdu University of Traditional Chinese Medicine“Xinglin Scholars”Subject Talent Scientific Research Enhancement Plan(No.YYZX2022056).
文摘Objective:To explore the application value of artificial intelligence-assisted diagnostic systems in the computed tomography(CT)diagnosis of pulmonary nodules.Methods:A total of 80 patients with pulmonary nodules,treated from June 2023 to May 2024,were included.All patients underwent pathological examination and CT scans,with pathological results serving as the gold standard.The diagnostic performance of CT alone and CT combined with the artificial intelligence-assisted diagnostic system was analyzed,and differences in CT imaging features and evaluation results of benign and malignant pulmonary nodules were compared.Results:The sensitivity,specificity,and accuracy of CT combined with the artificial intelligence-assisted diagnostic system were significantly higher than those of CT alone(P<0.05).Moreover,the false-positive and false-negative rates were significantly lower for the combined approach compared to CT alone(P<0.05).Conclusion:The artificial intelligence-assisted diagnostic system effectively identifies malignant features in pulmonary nodules,providing valuable clinical reference data and enhancing diagnostic accuracy and efficiency.
文摘BACKGROUND Lung cancer(LC)is one of the most prevalent cancers globally,with a high incidence among the elderly population.Elderly patients,particularly those with diabetes mellitus,are at an increased risk of postoperative complications,in-cluding pulmonary infections,due to weakened immune function and metabolic abnormalities.Postoperative pulmonary infection(PPI)is a predominant com-plication after thoracoscopic radical resection of LC,significantly affecting patient outcomes and increasing healthcare burdens.Determining risk factors for PPI in this vulnerable population is crucial for improving surgical outcomes and redu-cing infection rates.AIM To develop and validate a predictive model for PPI in elderly patients with dia-betes undergoing thoracoscopic radical resection for LC and to assess its reliability and validity.METHODS This retrospective study included 212 patients with LC who received treatment at our hospital from March 2015 to March 2022.General clinical information,sur-gical treatment details,and laboratory test results were collected and analyzed.Patients were grouped according to infection occurrence during the postoperative hospitalization period.Risk factors for PPIs were determined through logistic regression analysis,and a nomogram prediction model was established using R software to assess its predictive accuracy and performance.RESULTS Among the 212 patients[median age:72 years(interquartile range:60-82 years)],41 developed PPI(19.34%),with Gram-negative bacteria being the predominant pathogens(64.14%).Factors,such as age of≥70 years,presence of respiratory diseases,maximum tumor diameter of≥4 cm,stages II-III,receiving neoadjuvant chemotherapy of≥2 times preoperatively,surgery duration of≥3 hours,chest drainage tube placement duration of≥3.5 days,preoperative fasting blood glucose levels,hemoglobin A1c(HbA1c)levels,and multi-leaf resection,were markedly higher in the infection group than in the non-infection group.Conversely,forced expiratory volume in 1 second(FEV1)of≥80%and albumin(Alb)levels were lower in the infection group.Multivariate logistic regression analysis revealed that receiving neoadjuvant chemotherapy of≥2 times[odds ratio(OR)=2.987;P=0.036],maximum tumor diameter of≥4 cm(OR=3.959;P=0.013),multi-leaf resection(OR=3.18;P=0.036),preoperative FEV1 of≤80%(OR=3.305;P=0.029),and high HbA1c levels(OR=2.39;P=0.003)as key risk factors for PPI,whereas high Alb levels(OR=0.507;P<0.001)was protective.The nomogram model demonstrated excellent diagnostic ability(area under the curve=0.901,0.915),and calibration curves and decision curve analysis revealed good predictive performance and clinical applicability of the model.CONCLUSION The primary pathogens of PPI in elderly patients with diabetes and LC undergoing thoracoscopic radical resection are Gram-negative bacteria.The nomogram model,based on preoperative neoadjuvant chemotherapy cycles,maximum tumor diameter,range of resection,and preoperative FEV1,Alb,and HbA1c levels,shows high clinical value in predicting the risk of PPI in this patient population.
基金This work was supported by the National Natural Science Foundation of China(grant numbers 81560301 and 81160012)the Natural Science Foundation of Qinghai Province(grant number 2022-ZJ-905)‘2022 Qinghai Province Kunlun Talents High-end Innovation and Entrepreneurship Talents’Outstanding Talent Project.
文摘Background:Under hypoxia,exaggerated compensatory responses may lead to acute mountain sickness.The excessive vasodilatory effect of nitric oxide(NO)can lower the hypoxic pulmonary vasoconstriction(HPV)and peripheral blood pressure.While NO is catalyzed by various nitric oxide synthase(NOS)isoforms,the regulatory roles of these types in the hemodynamics of pulmonary and systemic circulation in living hypoxic animals remain unclear.Therefore,this study aims to investigate the regu-latory effects of different NOS isoforms on pulmonary and systemic circulation in hypoxic rats by employing selective NOS inhibitors and continuously monitoring hemodynamic parameters of both pulmonary and systemic circulation.Methods:Forty healthy male Sprague–Dawley(SD)rats were randomly divided into four groups:Control group(NG-nitro-D-arginine methyl ester,D-NAME),L-NAME group(non-selective NOS inhibitor,NG-nitro-L-arginine methyl ester),AG group(in-ducible NOS inhibitor group,aminoguanidine),and 7-NI group(neurological NOS in-hibitor,7-nitroindazole).Hemodynamic parameters of rats were monitored for 10 min after inhibitor administration and 5 min after induction of hypoxia[15%O2,2200 m a.sl.,582 mmHg(76.5 kPa),Xining,China]using the real-time dynamic monitoring model for pulmonary and systemic circulation hemodynamics in vivo.Serum NO concentra-tions and blood gas analysis were measured.Results:Under normoxia,mean arterial pressure and total peripheral vascular resist-ance were increased,and ascending aortic blood flow and serum NO concentration were decreased in the L-NAME and AG groups.During hypoxia,pulmonary arterial pressure and pulmonary vascular resistance were significantly increased in the L-NAME and AG groups.Conclusions:This compensatory mechanism activated by inducible NOS and en-dothelial NOS effectively counteracts the pulmonary hemodynamic changes induced by hypoxic stress.It plays a crucial role in alleviating hypoxia-induced pulmonary arte-rial hypertension.
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.
文摘Pulmonary nodules represent an early manifestation of lung cancer.However,pulmonary nodules only constitute a small portion of the overall image,posing challenges for physicians in image interpretation and potentially leading to false positives or missed detections.To solve these problems,the YOLOv8 network is enhanced by adding deformable convolution and atrous spatial pyramid pooling(ASPP),along with the integration of a coordinate attention(CA)mechanism.This allows the network to focus on small targets while expanding the receptive field without losing resolution.At the same time,context information on the target is gathered and feature expression is enhanced by attention modules in different directions.It effectively improves the positioning accuracy and achieves good results on the LUNA16 dataset.Compared with other detection algorithms,it improves the accuracy of pulmonary nodule detection to a certain extent.
文摘This study examines hemodynamic behavior in particular cases of pulmonary hypertension without treatment. Pulmonary hypertension represents an anomalous hemodynamic state and is characterized by an excessively high blood pressure in the pulmonary artery. To simulate the hemodynamic abnormalities in pulmonary hypertension under different causes and pathologies, we construct a localized parameter circuit model governed by nonlinear ordinary derivative equations of the human circulatory system. Thus, two special cases are considered, namely pulmonary the artery stenosis and the left ventricular diastolic dysfunction. For each case of pulmonary hypertension development, we determine the relationships between blood pressure and chamber and vessel pressure-volume. When the pulmonary hypertension is due to pulmonary artery stenosis, it appears that the right ventricular pressure increases up to 90 mm Hg, likewise the rise in pulmonary artery resistance induces direct increment in pulmonary artery pressure. However, when the pulmonary hypertension is due to left ventricular diastolic dysfunction, we note that the left atrial pressure and the pulmonary vein pressure augment, leading to the growth of the pulmonary artery blood pressure. The established results within this paper are useful for understanding the hemodynamic mechanism of particular pulmonary hypertension.
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 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.
文摘Pulmonary embolism(PE)is a rare but devastating complication of shoulder surgery.Apart from increased morbidity and mortality rates,it may significantly impair postoperative recovery and functional outcome.Its frequency accounts for up to 5.7%of all shoulder surgery procedures with a higher occurrence in women and patients older than 70 years.It is most commonly associated with thrombophilia,diabetes mellitus,obesity,smoking,hypertension,and a history of malignancy.PE usually occurs secondary to upper or lower-extremity deep vein thrombosis(DVT).However,in rare cases,the source of the thrombi cannot be determined.Prophylaxis for PE following shoulder surgery remains a topic of debate,and the standard of care does not routinely require prophylactic medication for DVT prophylaxis.Early ambulation and elastic stockings are important preventative measures for DVT of the lower extremity and medical agents such as aspirin,low-molecular-weight heparin,and vitamin K antagonists are indicated for high-risk patients,long-lasting operations,or concomitant severe acute respiratory syndrome coronavirus 2 infection.The most common symptoms of PE include chest pain and shortness of breath,but PE can also be asymptomatic in patients with intrinsic tolerance of hypoxia.Patients with DVT may also present with swelling and pain of the respective extremity.The treatment of PE includes inpatient or outpatient anticoagulant therapy if the patient is hemodynamically unstable or stable,respectively.Hemodynamic instability may require transfer to the intensive care unit,and cardiovascular arrest can be implicated in fatal events.An important issue for patients with PE in the postoperative period after shoulder surgery is residual stiffness due to a delay in rehabilitation and a prolonged hospital stay.Early physiotherapy and range-of-motion exercises do not adversely affect the prognosis of PE and are highly recommended to preserve shoulder mobility and function.
