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 Pulmonary arterial hypertension (PAH) is a progressive condition with a poorprognosis in children. Lung transplantation (Ltx) remains the ultimate option when patients are refractory toPAH-speciffc therapy....Background Pulmonary arterial hypertension (PAH) is a progressive condition with a poorprognosis in children. Lung transplantation (Ltx) remains the ultimate option when patients are refractory toPAH-speciffc therapy. Reverse Potts shunt (RPS) has been introduced to treat suprasystemic PAH. This studyaims to investigate the clinical outcomes of suprasystemic PAH in children. Methods Embase, Pubmed,and the Cochrane Library databases were searched for related studies that reported the clinical outcomes ofsuprasystemic PAH following RPS in children. To investigate the clinical outcomes of RPS, meta-analyses ofthe early and overall mortalities were performed. Results Nine studies were included in this study. Theestimated early mortality was 14.4% (95% CI, 7.1% to 23.1%), and the overall mortality/Ltx was 23.2% (95%CI, 14.4% to 32.9%). The estimated 1-year survival was 86.3% (95% CI, 75.9% to 88.7%). A qualitative reviewshowed that the median value of 5-year survival free from Ltx of patients undergoing RPS was 68.6% (range:65% to 92.3%). Compared to Ltx, RPS did not signiffcantly increase the early mortality (OR, 2.48, 95% CI0.75 to 8.24, p = 0.14). RPS also signiffcantly improved the New York Heart Association/World HealthOrganization functional class, reduced the BNP/NT-pro BNP levels, decreased the PAH-speciffc therapy,and increased the six-minute-walking distance. Conclusions RPS may serve as an alternative treatmentfor suprasystemic drug-refractory PAH. Further large-scale and prospective cohort studies are needed tovalidate these ffndings.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
Traditional Chinese medicine(TCM)auscultation has a long history,and with advancements in equipment and analytical methods,the quantitative analysis of auscultation parameters has determined.However,the complexity and...Traditional Chinese medicine(TCM)auscultation has a long history,and with advancements in equipment and analytical methods,the quantitative analysis of auscultation parameters has determined.However,the complexity and diversity of auscultation,along with variations in devices,analytical methods,and applications,bring challenges to its standardization and deeper application.This review presents the advancements in auscultation equipment and systems,auscultation characteristic parameters,and their application in the diagnosis of pulmonary diseases and syndromes over the past 10 years,while also exploring the progress and challenges of current digital research of auscultation.This review also proposes the establishment of standardized protocols for the collection and analysis of auscultation data,the incorporation of advanced artificial intelligence(AI)auscultation analysis methods,and an exploration of the diagnostic utility of auscultatory features in pulmonary diseases and syndromes,so as to provide more precise decision support for intelligent diagnosis of pulmonary diseases and syndromes.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
OBJECTIVE： To evaluate clinical efficacy of point application or adjuvant therapy on chronic obstruc- tive pulmonary disease in stationary phase and ef- fects on pulmonary functions. METHODS： Computer retrieved CNKI...OBJECTIVE： To evaluate clinical efficacy of point application or adjuvant therapy on chronic obstruc- tive pulmonary disease in stationary phase and ef- fects on pulmonary functions. METHODS： Computer retrieved CNKI, VIR CBM and other databanks and manual operations retrieved correlative literatures to find randomized con- trolled trials （RCTs） about comparison between point application or adjuvant therapy and no-point-applications for treatment of chronic ob- structive pulmonary disease in stationary phase in China. RevMan 5.0 software was used for Meta anal- ysis. RESULTS： Among 3481 cases in the inclusive 32 RCTS, 1780 cases were in the test group and 1701 cases in the control group. Meta analysis indicated： I） clinical efficacy： the groups containing point ap- plication therapy all were better than the groups ofno-point-application; 2） force vital capacity （FVC）： There was no statistically significant difference be- tween the group of point application plus Western Medicine and the Western Medicine group; 3） force expiratory volume 1 （FEVl）： The groups containing point application therapy were better than the no-point-application; 4） FEV1% ： the groups of point application plus Western Medicine were bet- ter than the Western Medicine groups; 5） FEVl/FVC： there was a significant difference between the group of point application plus Chinese drugs and the group of Chinese drug. CONCLUSION： Point application can increase clini- cal efficacy of chronic obstructive pulmonary dis- ease in stationary phase in varying degrees, and dif- ferent combinations of point application with Chi- nese drugs or Western Medicines have incomplete same actions in improvement of pulmonary func- tion and therapeutic effect.展开更多
AIM: To assess the impact of transjugular intrahepatic portosystemic shunt (TIPS) on pulmonary gas exchange and to evaluate the use of TIPS for the treatment of hepatopulmonary syndrome (HPS).METHODS: Seven patients, ...AIM: To assess the impact of transjugular intrahepatic portosystemic shunt (TIPS) on pulmonary gas exchange and to evaluate the use of TIPS for the treatment of hepatopulmonary syndrome (HPS).METHODS: Seven patients, three of them with advanced HPS, in whom detailed pulmonary function tests were performed before and after TIPS placementat the University of Alabama Hospital and at the Hospital Clinic, Barcelona, were considered.RESULTS: TIPS patency was confirmed by hemodynamic evaluation. No changes in arterial blood gases were observed in the overall subset of patients. Transient arterial oxygenation improvement was observed in only one HPS patient, early after TIPS, but this was not sustained 4 mo later.CONCLUSION: TIPS neither improved nor worsened pulmonary gas exchange in patients with portal hypertension. This data does not support the use of TIPS as a specific treatment for HPS. However, it does reinforce the view that TIPS can be safely performed for the treatment of other complications of portal hypertension in patients with HPS.展开更多
OBJECTIVE:To evaluate the efficacy and safety of Suhuang Zhike capsule(苏黄止咳胶囊)in the adjuvant treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).METHODS:The database including PubMe...OBJECTIVE:To evaluate the efficacy and safety of Suhuang Zhike capsule(苏黄止咳胶囊)in the adjuvant treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).METHODS:The database including PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure Database,China Science and Technology Journal Database,Chinese Biomedical Literature Database and Wanfang Data was searched.The retrieval time was from database establishment to May 2021.Randomized controlled trial(RCT)of Suhuang zhike capsule adjuvant treatment for AECOPD was included.The quality of the studies was independently evaluated and cross-checked by two reviewers,and Meta-analysis was performed by using RevMan5.3 software.RESULTS:Thirteen RCT results were included with a total sample number of 1195 cases,including 597 in the experimental group and 598 in the control group.The results showed that Suhuang zhike capsule adjuvant treatment of AECOPD could improve the total clinical effect rate compared with conventional treatment.Suhuang zhike capsule adjuvant treatment could improve forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC,peak expiratory flow(PEF)and other pulmonary function indexes;decrease Creactive protein(CRP),white blood cells,neutrophils and other infectious indicators;besides,the 1-year recurrence rate of the disease was decreased(all P<0.05).CONCLUSIONS:Suhuang Zhike capsule can improve the lung function and clinical efficacy of AECOPD,thus increasing the exercise endurance,and reducing the infection and recurrence rate in AECOPD patients.展开更多
OBJECTIVE:To systematically evaluate the efficacy and safety of Chinese herbal medicine(CHM) combined with conventional Western Medicine(CWM) on acute exacerbation of chronic obstructive pulmonary disease(AECOPD) base...OBJECTIVE:To systematically evaluate the efficacy and safety of Chinese herbal medicine(CHM) combined with conventional Western Medicine(CWM) on acute exacerbation of chronic obstructive pulmonary disease(AECOPD) based on high-quality randomized placebocontrolled trials.METHODS:We searched PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure Database,Chinese Biomedical Literature Database,China Science and Technology Journal Database,and Wanfang databases for randomized placebo-controlled trials of CHM treatment for AECOPD from inception to June 4,2021.The Cochrane Collaboration’s tool and the Grading of Recommendations,Assessment,Development and Evaluation were used to assess the risk of bias and the evidence quality of the included studies.Revman 5.3 software was used for Meta-analysis.RESULTS:A total of 9 trials involving 1591 patients were included.The Meta-analysis showed that based on CWM treatment,CHM group had significant advantages over the placebo group in ameliorating clinical total effective rate [RR = 1.29,95% CI(1.07,1.56),P = 0.007,low quality] and TCM symptom scores [MD =-2.99,95% CI(-4.46,-1.53),P < 0.0001,moderate quality],improving arterial blood gas results [PaO_(2):MD = 4.51,95% CI(1.97,7.04),P = 0.0005,moderate quality;PaCO_(2):MD =-2.87,95% CI(-4.28,-1.46),P < 0.0001,moderate quality],reducing CAT scores [MD =-2.08,95% CI(-2.85,-1.31),P < 0.000 01,moderate quality],length of hospitalization [MD =-1.87,95% CI(-3.33,-0.42),P = 0.01,moderate quality],and acute exacerbation rate [RR = 0.60,95% CI(0.43,0.83),P = 0.002,moderate quality].No serious CHM-related adverse events were reported.CONCLUSIONS:The current evidence indicates that CHM is an effective and well-tolerated adjunct therapy for AECOPD patients receiving CWM.However,considering the high heterogeneity,this conclusion requires confirmation.展开更多
OBJECTIVE:To evaluate the preventive and therapeutic effects of Sanfu acupoint herbal patching(SAHP)in adjuvant treatment in patients with stable chronic obstructive pulmonary disease(COPD).METHODS:We had searched eig...OBJECTIVE:To evaluate the preventive and therapeutic effects of Sanfu acupoint herbal patching(SAHP)in adjuvant treatment in patients with stable chronic obstructive pulmonary disease(COPD).METHODS:We had searched eight electronic databases and six major trial registries from their inception to July 2017 for randomized controlled trials(RCTs).We utilized RevMan 5.3 to evaluate the methodological quality and to perform data analyses.RESULTS:A total of 28 RCTs involving 1615 records were included in the descriptive analysis,and 25 RCTs were performed for Meta-analysis.Lung function such as forced vital capacity rate of one second FEV1/predicted%,forced vital capacity(FVC)%found no significant difference.The results of Meta-analysis showed that SAHP plus conventional therapy(CT)in the treatment of stable COPD were better than CT,in second sessions'data of FEV1,in third sessions'data of FEV1/FVC,in three sessions'data of SGRQ,in third session's data of Modified Medical Research Council and 6MWT.The symptoms of SAHP's adverse reactions seem to be mild and the incidence of that seems to be low.Descriptive analysis shows that SAHP with CT seems to improve clinical effective rate and had a certain preventive effect on acute exacerbation of COPD,which the curative effect may be better with the increase of treatment course.CONCLUSION:SAHP with CT appears to be more effective than CT or CT plus placebo only on improving the quality of life,but the effect on lung function is not obvious.Improve clinical effective rate and preventive effect is uncertainty.SAHP with CT may be used in any Grade to safely treat patients with stable COPD.The more exactly clinical effect still needs to be proved by more high-quality,large sampling,multilingual RCTs.展开更多
OBJECTIVE： To evaluate the efficacy of Jianpi thera- py in Traditional Chinese Medicine （TCM） for treat- ment of chronic obstructive pulmonary disease （COPD） in stable phase by performing a systematic review and ...OBJECTIVE： To evaluate the efficacy of Jianpi thera- py in Traditional Chinese Medicine （TCM） for treat- ment of chronic obstructive pulmonary disease （COPD） in stable phase by performing a systematic review and meta-analysis. METHODS： The literatures concerning randomized controlled trials （RCTs） and quasi-RCTs comparing TCM treatment plus Western Medicine （WM） treat- ment with TCM alone, orTCM treatment vs no treatment, placebo for stable phase of COPD were searched in PubMed （1990-December 2010）, in Eng- lish and using Chinese National Knowledge Infra- structure （CNKI, 1990-December 2010）, Chinese Bio- medical Database （1990-December 2010）, Wang- fang Database （1990-December 2010）, and Weipu （VlP） Database in Chinese. The quality assessment and data extraction for RCTs were conducted by two reviewers independently. Jadad scale and allo-cation concealment were used to assess the quality of the included studies, and meta-analyses were conducted with the Collaboration＇s Revman 5.0 software. RESULTS： Seventeen RCTs or quasi-RCTs involving 1269 patients were included. The methodological quality was poor in all trials except one trial （Jadad score=4）. In the meta-analysis, TCM-WM treatment was significantly superior to WM treatment in cure rate [0R=3.82, 95%C/（2.45, 5.95）], and the effective rate between TCM treatment and placebo also had significant difference [0R=4.31, 95%C/（2.35, 7.91）]. Moreover, pulmonary function of the patients in TCM-WM group and TCM group was significantly improved [forced vital capacity （FVC）, P=O.01, quali- ty of life, P〈O.O01 ]. CONCLUSION： The experience in TCM-WM treat- ment of COPD in stable phase was encouraging. The current evidence shows that TCM-WM treat- ment might be more efficient in effective rate, qual- ity of life, and FVC than WM treatment alone. But for forced expiratory volume in one second （FEVl） and FEV1/FVC, no matter TCM-WM treatment com- pared with WM treatment alone or TCM treatment compared with placebo, there was no significant difference, with no obvious adverse reactions. Due to the low methodological quality of trials includ- ed, more RCTs of high quality in large scale are re- quired.展开更多
BACKGROUND Chronic obstructive pulmonary disease(COPD)is a common public health issue that has been linked to cognitive dysfunction.AIM To investigate the relationship between COPD and a risk of mild cognitive impairm...BACKGROUND Chronic obstructive pulmonary disease(COPD)is a common public health issue that has been linked to cognitive dysfunction.AIM To investigate the relationship between COPD and a risk of mild cognitive impairment(MCI)and dementia.METHODS A comprehensive literature search of the PubMed,Embase,Google Scholar,and Cochrane Library electronic databases was conducted.Pooled odds ratios(OR)and mean differences(MD)with 95%confidence intervals(CIs)were calculated using a random or fixed effects model.Studies that met the inclusion criteria were assessed for quality using the Newcastle Ottawa Scale.RESULTS Twenty-seven studies met all the inclusion criteria.Meta-analysis yielded a strong association between COPD and increased risk of MCI incidence(OR=2.11,95%CI:1.32-3.38).It also revealed a borderline trend for an increased dementia risk in COPD patients(OR=1.16,95%CI:0.98-1.37).Pooled hazard ratios(HR)using adjusted confounders also showed a higher incidence of MCI(HR=1.22,95%CI:-1.18 to-1.27)and dementia(HR=1.32,95%CI:-1.22 to-1.43)in COPD patients.A significant lower mini-mental state examination score in COPD patients was noted(MD=-1.68,95%CI:-2.66 to-0.71).CONCLUSION Our findings revealed an elevated risk for the occurrence of MCI and dementia in COPD patients.Proper clinical management and attention are required to prevent and control MCI and dementia incidence in COPD patients.展开更多
OBJECTIVE: To evaluate the efficacy and safety of tonifying kidney therapy(Bushen, TK) for stable chronic obstructive pulmonary disease(COPD).METHODS: Randomized controlled trials(RCTs) of TK use for treatment of stab...OBJECTIVE: To evaluate the efficacy and safety of tonifying kidney therapy(Bushen, TK) for stable chronic obstructive pulmonary disease(COPD).METHODS: Randomized controlled trials(RCTs) of TK use for treatment of stable COPD were searched in four databases including Pub Med, the Cochrane Library, Chinese Biomedical Literature Database,and China National Knowledge Infrastructure Database from inception to December 2017. Two reviewers independently screened the literature, extracted the data, and assessed the risk of bias in the included studies. Rev Man 5.3 software was used for the Meta-analysis.RESULTS: Eight RCTs involving 809 patients with stable COPD were included. Compared with the conventional Western Medicine(CWM) group, the TK group(TK combined with CWM) showed significant improvements in the effectiveness rates(RR =1.37, 95% CI 1.22 to 1.53, P < 0.000 01) and 6-min walk distance in meters(MD 11.92, 95% CI 3.52 to20.32, P = 0.005), this study also showed that the TK group can decrease The Traditional Chinese Medicine Syndrome Score(MD-8.01, 95% CI-12.89 to-3.13, P = 0.001). The lung function [forced expiratory volume in one second%(FEV1%), FEV1/forced vital capacity] showed no difference between the TK and control groups.CONCLUSION: For patients with stable COPD, TK can improve the clinical effectiveness and exercise capacity but fail to improve the patient's symptoms. Because of the low methodological quality of the included trials, additional high-quality and large-scale RCTs are required.展开更多
Chitosan and β-cyclodextrin were used to prepare microspheres with theophylline for pulmonary delivery by spray drying method. The characteristics, mucociliotoxicity, permeation rate and drug release were studied. Th...Chitosan and β-cyclodextrin were used to prepare microspheres with theophylline for pulmonary delivery by spray drying method. The characteristics, mucociliotoxicity, permeation rate and drug release were studied. The drug entrapments of microspheres Ⅰ, Ⅱ and Ⅲ were from 35.70% to 21.09% and 13.33%, while yields and encapsulation efficiencies were higher than 45% and about 90% respectively. The microspheres possessed low tap densities （0.34-0.48 g/cm^3）, appropriate diameters （3.35-3.94 μm） and theoretical aerodynamics diameters （2.20-3.04 μm）. SEM images showed the microspheres were spherical with smooth or wrinkled surface surfaces. FT-IR demonstrated theophylline had formed hydrogen bonds with chitosan and fl-cyclodextrin. The microspheres could effectively reduce the ciliotoxicity and easy to penetrate the memberine. The in vitro release of the microspheres was related to the ratio of drug/polymer and microspheres Ⅱ had a prolong release, providing the release of 72.00% in 12 h. The results suggestes that chitosan/β-cyclodextrin microspheres Ⅱ are a promising carrier as sustained release for pulmonary delivery.展开更多
The effects of 3,4-DHAP on hypoxic pulmonary and systemic vascular responses were studied in anaesthetized dogs. The percentage change in pulmonary vascular resistance(△PVR%)and that in systemic vascular resistance(...The effects of 3,4-DHAP on hypoxic pulmonary and systemic vascular responses were studied in anaesthetized dogs. The percentage change in pulmonary vascular resistance(△PVR%)and that in systemic vascular resistance(△SVR%)induced by 5 min hypoxia decreased significantly.3,4-DHAP in doses of 1 mg/kg,3mg/kg,and 10 mg/kg i.v caused a decrease in b PVR% from the control value of 47.27±22.27% to 24.62±21.76%,18.15±18.73%,and 24.10±19.76% respectively, and a decrease in △SVR% from the control value of 12.91±7.39% to -0.34±12.7%,-2.11±12.76%,and -2.37±15.52% respectively.The results showed that 3,4-DHAP could decrease the hypoxic responses of pulmonary and systemic blood vessels.But it did not change △PVR% or △SVR% in dose of 30mg/kg,neither did it influence the heart rate,cardiac output or cerebral blood flow during hypoxia in all the doses used.展开更多
Objective： This review aimed to examine the effectiveness of clinical nurse specialist （CNS） interventions in patients with chronic obstructive pulmonary disease （COPD）. COPD significantly affects p...Objective： This review aimed to examine the effectiveness of clinical nurse specialist （CNS） interventions in patients with chronic obstructive pulmonary disease （COPD）. COPD significantly affects people＇s health worldwide. With the development in nursing, CNSs are playing increasingly important roles in different departments. However, the studies on the effectiveness of CNSs in COPD are not as well organized as the studies on the effectiveness of CNSs in bronchiectasis and asthma. Therefore, this review aims to find some updated evidence on the CNS interventions for patients with COPD and on whether these interventions are effective.Methods： A narrative analysis of the data was performed for the eligible studies. Four databases were chosen： CINAHL, MEDLINE, British Nursing Index, and Cochrane Library. Other websites such as the National Institute for Health and Clinical Excellence, National Health Service Evidence, Association of Respiratory Nurse Specialists, and National Association of Clinical Nurse Specialist were searched as well. Two reviewers performed study identification independently, and all the retrieved articles were stored using the EndNote X7 software. The risk of bias in the included studies was assessed using the Cochrane Collaboration＇s risk of bias tool. Results： A total of nine studies were included in this review. There were five current interventions by CNSs for patients with COPD. These interventions were home nursing support, CNS]s supported discharge, multidisciplinary cooperation programs, nurse-led care programs, and self-care management education. The effectiveness of these five interventions was evaluated individually. There is low- to moderate-quality evidence indicating that home nursing support interventions may have a positive effect on mortality and quality of life. No significant difference in quality of life has been found between the CNS-supported discharge intervention and the usual service. The multidisciplinary cooperation program probably had a positive effect on quality ot life in patients with COPD. Both nurse-led care and self-care management education intervention had a positive effect on mortality of patients with COPD.Conclusions： The findings of this review provide updated evidence on the effectiveness of CNS interventions for patients with COPD. Although nine trials were included and five types of interventions were identified, there is still lack of high-quality evidence.展开更多
Pulmonary delivery is an effective drug delivery strategy for the treatment of local respiratory diseases.However,the rapid systemic absorption through the lung due to the thin barrier and persistent lung clearances i...Pulmonary delivery is an effective drug delivery strategy for the treatment of local respiratory diseases.However,the rapid systemic absorption through the lung due to the thin barrier and persistent lung clearances influence the drug retention in the lung.In this study,we designed a lipid-coated genistein nanocrystals(Lipo-NCs)formulation to achieve enhanced efficiency of local pulmonary delivery.The LipoNCs were fabricated by modifying genistein nanocrystals(NCs)with phospholipid membrane through thin film hydration following the homogenization method.The prepared Lipo-NCs exhibited a decreased drug release rate compared with the naked NCs.Our results demonstrated that intracellular uptake and transcellular transport of NCs by the Calu-3 epithelial layer were reduced after lipid coating.Furthermore,the macrophages clearance was also impeded by this Lipo-NCs formulation.In vivo lung retention and distribution revealed that more genistein was retained in the lung after intratracheal administration of Lipo-NCs.The pharmacokinetic study displayed that the AUC((0-t))values of Lipo-NCs were 1.59-fold lesser than those of the NCs group,indicating a reduced systemic absorption.In conclusion,this research indicated that Lipo-NCs could be a suitable formulation for reducing systemic absorption and macrophages clearance,and thus enhancing drug concentration in lung by pulmonary delivery.展开更多
Objective To examine the presence of gender differences in pulmonary inflammation evoked by acute systemic cadmium administration in rats. Methods Presence of basic indicators of lung inflammation （inflammatory cytok...Objective To examine the presence of gender differences in pulmonary inflammation evoked by acute systemic cadmium administration in rats. Methods Presence of basic indicators of lung inflammation （inflammatory cytokine lung content, leukocyte infiltration and activity of cells recovered from lungs by enzyme digestion） was analyzed and compared in animals of the two sexes. Results Intraperitoneal administration of cadmium （1.0 mg/kg） resulted in higher cadmium content in lungs of female rats. Higher tumor necrosis factor （TNF） content was noted in lung homogenates of male rats, while interleukin-6 （IL-6） content was slightly, but signifaicantly greater in lungs of female rats. Increased leukocyte infiltration was observed in lungs of male rats, mainly due to neutrophils. Increased responsiveness to phorbol myristate acetate （PMA） stimulation was noted in cells recovered from lungs of male rats. Rise in intracellular content of myeloperoxidase （MPO） was noted in lung cells from cadmium-treated rats of both sexes, but higher in cells from male rats. Conclusion Presented data documented a more intense pulmonary inflammatory response to systemic cadmium administration in males, with higher IL-6 levels in lungs of female individuals. These sex differences in proinflamatory activity of cadmium in lungs should be taken into consideration in studying the remote toxicity of this heavy metal.展开更多
Based on different mechanisms of blood coagulation, coexistence of venous thromboembolism and arterial thrombosis in a single individual is extremely rare in clinical practice. Both antiplatelet and anticoagulation th...Based on different mechanisms of blood coagulation, coexistence of venous thromboembolism and arterial thrombosis in a single individual is extremely rare in clinical practice. Both antiplatelet and anticoagulation therapy should be adopted for patients with arteriovenous embolism. Balancing the risk of ischemia and hemorrhage is especially challenging in these patients in order to achieve an optimal clinical benefit. We report on a 55-year-old female with acute pulmonary embolism （PE）, subsequently diagnosed as having acute myocardial infarction （AMI） and a cerebral infarction. Examinations had been carried out, excluding potential arteriovenous shunts, cancer, an- tiphospholipid syndrome and other common hypercoagulable states. A combination of an anticoagulant drug （rivaroxaban, an Xa inhibitor） and an antiplatelet agent （clopidogrel, an ADP receptor inhibitor） was prescribed with a β-blocker and atorvastatin. The embolus was gradually shrunk during the next 10 months, and then it turned back into expanding. During the 16 months＇ follow-up, an aneurysm of left ventricular apex was found through an echocardiogram and an angiotensin-converting enzyme inhibitor was administered. We conclude that combined anticoagulation and antiplatelet therapy significantly relieved the symptoms and improved the prognosis in patients suffering from arteriovenous embolism without any major clinical bleeding events.展开更多
In order to investigate the role of the MexA-MexB-OprM efflux pump system in the pathogenesis of Pseudomonas aeruginosa(PA)-induced pulmonary infection,pulmonary infection models were established by intratracheal inje...In order to investigate the role of the MexA-MexB-OprM efflux pump system in the pathogenesis of Pseudomonas aeruginosa(PA)-induced pulmonary infection,pulmonary infection models were established by intratracheal injection of K767(wild type),nalB(MexA-MexB-OprM up-regulated mutant),and △m exB(knockout) strains,separately.All mice were treated with Meropenem(intraperitoneal injection,100 mg/kg body weight,twice every day),and strain-related pathology,bacteria count,cytokine level,myeloperoxidase(MPO,indicator of neutrophil recruitment) activity,and macrophage inflammatory protein-2(MIP-2) expression were evaluated at early(3rd day post-infection) and late(7th and 14th day post-infection) stages of infection.E-test showed that △mexB was more significantly sensitive to panipenan(ETP),meropenem(MP) and imipenem(IP) than K767 and nalB strains.There was no significant difference in sensitivity to cefepime(TM) among the three stains.In contrast to the K767 and nalB groups,the △ mexB group showed decreased bacteria burden over time and less extensive pathological change.Additionally,MPO activity and levels of inflammatory cytokines(IL-1b,IL-12,and TNF-α) were increased at the early stage(day 3) and decreased at the later stage(day 14).Serum MIP-2 expression level was steadily increased in all three groups from early to late stages,but significantly higher in △m exB group than in K767 and nalB groups(P<0.05).In conclusion,the MexA-MexB-OprM efflux pump system might play an important role in PA-induced chronic pulmonary infection.High expression of the MexA-MexB-OprM efflux pump could increase antibacterial resistance and promote infection.展开更多
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.
基金Chongqing Medical University Program for Youth Innovation in Future Medicine(W0204)Natural Science Foundation Project of Chongqing,Chongqing Science and Technology Commission(CSTB2023NSCQ-BHX0010)+1 种基金Chongqing Postdoctoral Research Project Special Support(2023CQBSHTB3074)Science and Technology Research Program of Chongqing Municipal Education Commission(KJQN202400421).
文摘Background Pulmonary arterial hypertension (PAH) is a progressive condition with a poorprognosis in children. Lung transplantation (Ltx) remains the ultimate option when patients are refractory toPAH-speciffc therapy. Reverse Potts shunt (RPS) has been introduced to treat suprasystemic PAH. This studyaims to investigate the clinical outcomes of suprasystemic PAH in children. Methods Embase, Pubmed,and the Cochrane Library databases were searched for related studies that reported the clinical outcomes ofsuprasystemic PAH following RPS in children. To investigate the clinical outcomes of RPS, meta-analyses ofthe early and overall mortalities were performed. Results Nine studies were included in this study. Theestimated early mortality was 14.4% (95% CI, 7.1% to 23.1%), and the overall mortality/Ltx was 23.2% (95%CI, 14.4% to 32.9%). The estimated 1-year survival was 86.3% (95% CI, 75.9% to 88.7%). A qualitative reviewshowed that the median value of 5-year survival free from Ltx of patients undergoing RPS was 68.6% (range:65% to 92.3%). Compared to Ltx, RPS did not signiffcantly increase the early mortality (OR, 2.48, 95% CI0.75 to 8.24, p = 0.14). RPS also signiffcantly improved the New York Heart Association/World HealthOrganization functional class, reduced the BNP/NT-pro BNP levels, decreased the PAH-speciffc therapy,and increased the six-minute-walking distance. Conclusions RPS may serve as an alternative treatmentfor suprasystemic drug-refractory PAH. Further large-scale and prospective cohort studies are needed tovalidate these ffndings.
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National Natural Science Foundation of China(82104738)National Administration of Traditional Chinese Medicine(TCM)High-level Key Discipline Construction Project:TCM Diagnostics(ZYYZDXK-2023069).
文摘Traditional Chinese medicine(TCM)auscultation has a long history,and with advancements in equipment and analytical methods,the quantitative analysis of auscultation parameters has determined.However,the complexity and diversity of auscultation,along with variations in devices,analytical methods,and applications,bring challenges to its standardization and deeper application.This review presents the advancements in auscultation equipment and systems,auscultation characteristic parameters,and their application in the diagnosis of pulmonary diseases and syndromes over the past 10 years,while also exploring the progress and challenges of current digital research of auscultation.This review also proposes the establishment of standardized protocols for the collection and analysis of auscultation data,the incorporation of advanced artificial intelligence(AI)auscultation analysis methods,and an exploration of the diagnostic utility of auscultatory features in pulmonary diseases and syndromes,so as to provide more precise decision support for intelligent diagnosis of pulmonary diseases and syndromes.
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OBJECTIVE： To evaluate clinical efficacy of point application or adjuvant therapy on chronic obstruc- tive pulmonary disease in stationary phase and ef- fects on pulmonary functions. METHODS： Computer retrieved CNKI, VIR CBM and other databanks and manual operations retrieved correlative literatures to find randomized con- trolled trials （RCTs） about comparison between point application or adjuvant therapy and no-point-applications for treatment of chronic ob- structive pulmonary disease in stationary phase in China. RevMan 5.0 software was used for Meta anal- ysis. RESULTS： Among 3481 cases in the inclusive 32 RCTS, 1780 cases were in the test group and 1701 cases in the control group. Meta analysis indicated： I） clinical efficacy： the groups containing point ap- plication therapy all were better than the groups ofno-point-application; 2） force vital capacity （FVC）： There was no statistically significant difference be- tween the group of point application plus Western Medicine and the Western Medicine group; 3） force expiratory volume 1 （FEVl）： The groups containing point application therapy were better than the no-point-application; 4） FEV1% ： the groups of point application plus Western Medicine were bet- ter than the Western Medicine groups; 5） FEVl/FVC： there was a significant difference between the group of point application plus Chinese drugs and the group of Chinese drug. CONCLUSION： Point application can increase clini- cal efficacy of chronic obstructive pulmonary dis- ease in stationary phase in varying degrees, and dif- ferent combinations of point application with Chi- nese drugs or Western Medicines have incomplete same actions in improvement of pulmonary func- tion and therapeutic effect.
基金Supported by FIS 02/0692 and 02/0739 from the Fondo de In-vestigaciones Sanitarias, SGR 2001 SGR00286 from the Gener-alitat de Catalunya (DURSI), and CO 3/02 and CO 3/11 from the Instituto de Salud Carlos Ⅲ
文摘AIM: To assess the impact of transjugular intrahepatic portosystemic shunt (TIPS) on pulmonary gas exchange and to evaluate the use of TIPS for the treatment of hepatopulmonary syndrome (HPS).METHODS: Seven patients, three of them with advanced HPS, in whom detailed pulmonary function tests were performed before and after TIPS placementat the University of Alabama Hospital and at the Hospital Clinic, Barcelona, were considered.RESULTS: TIPS patency was confirmed by hemodynamic evaluation. No changes in arterial blood gases were observed in the overall subset of patients. Transient arterial oxygenation improvement was observed in only one HPS patient, early after TIPS, but this was not sustained 4 mo later.CONCLUSION: TIPS neither improved nor worsened pulmonary gas exchange in patients with portal hypertension. This data does not support the use of TIPS as a specific treatment for HPS. However, it does reinforce the view that TIPS can be safely performed for the treatment of other complications of portal hypertension in patients with HPS.
基金Supported by National Natural Science Foundation of China:Study on the Protective Effect and Mechanism of ACE2-Ang (1-7)-MasR Signaling Pathway Modulation by Jing Fang Si Ni Decoction on Endothelial Injury in Sepsis (No. 81703895)。
文摘OBJECTIVE:To evaluate the efficacy and safety of Suhuang Zhike capsule(苏黄止咳胶囊)in the adjuvant treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).METHODS:The database including PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure Database,China Science and Technology Journal Database,Chinese Biomedical Literature Database and Wanfang Data was searched.The retrieval time was from database establishment to May 2021.Randomized controlled trial(RCT)of Suhuang zhike capsule adjuvant treatment for AECOPD was included.The quality of the studies was independently evaluated and cross-checked by two reviewers,and Meta-analysis was performed by using RevMan5.3 software.RESULTS:Thirteen RCT results were included with a total sample number of 1195 cases,including 597 in the experimental group and 598 in the control group.The results showed that Suhuang zhike capsule adjuvant treatment of AECOPD could improve the total clinical effect rate compared with conventional treatment.Suhuang zhike capsule adjuvant treatment could improve forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC,peak expiratory flow(PEF)and other pulmonary function indexes;decrease Creactive protein(CRP),white blood cells,neutrophils and other infectious indicators;besides,the 1-year recurrence rate of the disease was decreased(all P<0.05).CONCLUSIONS:Suhuang Zhike capsule can improve the lung function and clinical efficacy of AECOPD,thus increasing the exercise endurance,and reducing the infection and recurrence rate in AECOPD patients.
基金Supported by the National Natural Science:Research on Key Technology of Outcome Measurement and Evaluation of Syndrome Differentiation and Treatment Based on Clinical Trials of COPD (No. 81830116)the Chinese Medicine Inheritance and Innovation “Hundred and Ten Million” Talent ProjectChief Scientist of Qi-Huang Project [(2020) No. 219]the Zhong-yuan Scholars and Scientists Project (No. 2018204)。
文摘OBJECTIVE:To systematically evaluate the efficacy and safety of Chinese herbal medicine(CHM) combined with conventional Western Medicine(CWM) on acute exacerbation of chronic obstructive pulmonary disease(AECOPD) based on high-quality randomized placebocontrolled trials.METHODS:We searched PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure Database,Chinese Biomedical Literature Database,China Science and Technology Journal Database,and Wanfang databases for randomized placebo-controlled trials of CHM treatment for AECOPD from inception to June 4,2021.The Cochrane Collaboration’s tool and the Grading of Recommendations,Assessment,Development and Evaluation were used to assess the risk of bias and the evidence quality of the included studies.Revman 5.3 software was used for Meta-analysis.RESULTS:A total of 9 trials involving 1591 patients were included.The Meta-analysis showed that based on CWM treatment,CHM group had significant advantages over the placebo group in ameliorating clinical total effective rate [RR = 1.29,95% CI(1.07,1.56),P = 0.007,low quality] and TCM symptom scores [MD =-2.99,95% CI(-4.46,-1.53),P < 0.0001,moderate quality],improving arterial blood gas results [PaO_(2):MD = 4.51,95% CI(1.97,7.04),P = 0.0005,moderate quality;PaCO_(2):MD =-2.87,95% CI(-4.28,-1.46),P < 0.0001,moderate quality],reducing CAT scores [MD =-2.08,95% CI(-2.85,-1.31),P < 0.000 01,moderate quality],length of hospitalization [MD =-1.87,95% CI(-3.33,-0.42),P = 0.01,moderate quality],and acute exacerbation rate [RR = 0.60,95% CI(0.43,0.83),P = 0.002,moderate quality].No serious CHM-related adverse events were reported.CONCLUSIONS:The current evidence indicates that CHM is an effective and well-tolerated adjunct therapy for AECOPD patients receiving CWM.However,considering the high heterogeneity,this conclusion requires confirmation.
基金National Natural Science Foundation of China:Study on the Intervention mechanism of"Tonifying Qi and Yin,Promoting Blood Circulation and Dredging Collaterals"Treatment Method on Idiopathic Pulmonary Fibrosis Based on the TGF-β1/Smads Signaling Pathway(No.81373579)Youth Program of National Natural Science Foundation of China:the Mechanism of Qingluoyin Coordinating Th1/Th2 cytokine balance to intervene Idiopathic Pulmonary Fibrosis Based on the Theory of"Structure and Function of Lung Collaterals"and"Lung Heat and Collaterals Stasis"(No.81403290)High Level Innovation Team of Liaoning Province's"plan of rejuvenating Liaoning talents":Innovation Team of Construction and Application of Lung Collateral Disease's Syndrome and Treatment System(XLYC1808011)。
文摘OBJECTIVE:To evaluate the preventive and therapeutic effects of Sanfu acupoint herbal patching(SAHP)in adjuvant treatment in patients with stable chronic obstructive pulmonary disease(COPD).METHODS:We had searched eight electronic databases and six major trial registries from their inception to July 2017 for randomized controlled trials(RCTs).We utilized RevMan 5.3 to evaluate the methodological quality and to perform data analyses.RESULTS:A total of 28 RCTs involving 1615 records were included in the descriptive analysis,and 25 RCTs were performed for Meta-analysis.Lung function such as forced vital capacity rate of one second FEV1/predicted%,forced vital capacity(FVC)%found no significant difference.The results of Meta-analysis showed that SAHP plus conventional therapy(CT)in the treatment of stable COPD were better than CT,in second sessions'data of FEV1,in third sessions'data of FEV1/FVC,in three sessions'data of SGRQ,in third session's data of Modified Medical Research Council and 6MWT.The symptoms of SAHP's adverse reactions seem to be mild and the incidence of that seems to be low.Descriptive analysis shows that SAHP with CT seems to improve clinical effective rate and had a certain preventive effect on acute exacerbation of COPD,which the curative effect may be better with the increase of treatment course.CONCLUSION:SAHP with CT appears to be more effective than CT or CT plus placebo only on improving the quality of life,but the effect on lung function is not obvious.Improve clinical effective rate and preventive effect is uncertainty.SAHP with CT may be used in any Grade to safely treat patients with stable COPD.The more exactly clinical effect still needs to be proved by more high-quality,large sampling,multilingual RCTs.
基金Supported by Program for Changjiang Scholars and Innovative Research Team in University, Ministry of Education ofChina (NO. IRT0977)
文摘OBJECTIVE： To evaluate the efficacy of Jianpi thera- py in Traditional Chinese Medicine （TCM） for treat- ment of chronic obstructive pulmonary disease （COPD） in stable phase by performing a systematic review and meta-analysis. METHODS： The literatures concerning randomized controlled trials （RCTs） and quasi-RCTs comparing TCM treatment plus Western Medicine （WM） treat- ment with TCM alone, orTCM treatment vs no treatment, placebo for stable phase of COPD were searched in PubMed （1990-December 2010）, in Eng- lish and using Chinese National Knowledge Infra- structure （CNKI, 1990-December 2010）, Chinese Bio- medical Database （1990-December 2010）, Wang- fang Database （1990-December 2010）, and Weipu （VlP） Database in Chinese. The quality assessment and data extraction for RCTs were conducted by two reviewers independently. Jadad scale and allo-cation concealment were used to assess the quality of the included studies, and meta-analyses were conducted with the Collaboration＇s Revman 5.0 software. RESULTS： Seventeen RCTs or quasi-RCTs involving 1269 patients were included. The methodological quality was poor in all trials except one trial （Jadad score=4）. In the meta-analysis, TCM-WM treatment was significantly superior to WM treatment in cure rate [0R=3.82, 95%C/（2.45, 5.95）], and the effective rate between TCM treatment and placebo also had significant difference [0R=4.31, 95%C/（2.35, 7.91）]. Moreover, pulmonary function of the patients in TCM-WM group and TCM group was significantly improved [forced vital capacity （FVC）, P=O.01, quali- ty of life, P〈O.O01 ]. CONCLUSION： The experience in TCM-WM treat- ment of COPD in stable phase was encouraging. The current evidence shows that TCM-WM treat- ment might be more efficient in effective rate, qual- ity of life, and FVC than WM treatment alone. But for forced expiratory volume in one second （FEVl） and FEV1/FVC, no matter TCM-WM treatment com- pared with WM treatment alone or TCM treatment compared with placebo, there was no significant difference, with no obvious adverse reactions. Due to the low methodological quality of trials includ- ed, more RCTs of high quality in large scale are re- quired.
文摘BACKGROUND Chronic obstructive pulmonary disease(COPD)is a common public health issue that has been linked to cognitive dysfunction.AIM To investigate the relationship between COPD and a risk of mild cognitive impairment(MCI)and dementia.METHODS A comprehensive literature search of the PubMed,Embase,Google Scholar,and Cochrane Library electronic databases was conducted.Pooled odds ratios(OR)and mean differences(MD)with 95%confidence intervals(CIs)were calculated using a random or fixed effects model.Studies that met the inclusion criteria were assessed for quality using the Newcastle Ottawa Scale.RESULTS Twenty-seven studies met all the inclusion criteria.Meta-analysis yielded a strong association between COPD and increased risk of MCI incidence(OR=2.11,95%CI:1.32-3.38).It also revealed a borderline trend for an increased dementia risk in COPD patients(OR=1.16,95%CI:0.98-1.37).Pooled hazard ratios(HR)using adjusted confounders also showed a higher incidence of MCI(HR=1.22,95%CI:-1.18 to-1.27)and dementia(HR=1.32,95%CI:-1.22 to-1.43)in COPD patients.A significant lower mini-mental state examination score in COPD patients was noted(MD=-1.68,95%CI:-2.66 to-0.71).CONCLUSION Our findings revealed an elevated risk for the occurrence of MCI and dementia in COPD patients.Proper clinical management and attention are required to prevent and control MCI and dementia incidence in COPD patients.
基金Supported by Tianshan Innovation Team Plan of XinjiangTraditional Chinese Medicine Research Team on Prevention and Treatment of Chronic Obstructive Pulmonary Disease(No.2017D14013)。
文摘OBJECTIVE: To evaluate the efficacy and safety of tonifying kidney therapy(Bushen, TK) for stable chronic obstructive pulmonary disease(COPD).METHODS: Randomized controlled trials(RCTs) of TK use for treatment of stable COPD were searched in four databases including Pub Med, the Cochrane Library, Chinese Biomedical Literature Database,and China National Knowledge Infrastructure Database from inception to December 2017. Two reviewers independently screened the literature, extracted the data, and assessed the risk of bias in the included studies. Rev Man 5.3 software was used for the Meta-analysis.RESULTS: Eight RCTs involving 809 patients with stable COPD were included. Compared with the conventional Western Medicine(CWM) group, the TK group(TK combined with CWM) showed significant improvements in the effectiveness rates(RR =1.37, 95% CI 1.22 to 1.53, P < 0.000 01) and 6-min walk distance in meters(MD 11.92, 95% CI 3.52 to20.32, P = 0.005), this study also showed that the TK group can decrease The Traditional Chinese Medicine Syndrome Score(MD-8.01, 95% CI-12.89 to-3.13, P = 0.001). The lung function [forced expiratory volume in one second%(FEV1%), FEV1/forced vital capacity] showed no difference between the TK and control groups.CONCLUSION: For patients with stable COPD, TK can improve the clinical effectiveness and exercise capacity but fail to improve the patient's symptoms. Because of the low methodological quality of the included trials, additional high-quality and large-scale RCTs are required.
基金the National Natural Science Foundation of China(No.30670566)Natural Science Foundation of Shandong Province
文摘Chitosan and β-cyclodextrin were used to prepare microspheres with theophylline for pulmonary delivery by spray drying method. The characteristics, mucociliotoxicity, permeation rate and drug release were studied. The drug entrapments of microspheres Ⅰ, Ⅱ and Ⅲ were from 35.70% to 21.09% and 13.33%, while yields and encapsulation efficiencies were higher than 45% and about 90% respectively. The microspheres possessed low tap densities （0.34-0.48 g/cm^3）, appropriate diameters （3.35-3.94 μm） and theoretical aerodynamics diameters （2.20-3.04 μm）. SEM images showed the microspheres were spherical with smooth or wrinkled surface surfaces. FT-IR demonstrated theophylline had formed hydrogen bonds with chitosan and fl-cyclodextrin. The microspheres could effectively reduce the ciliotoxicity and easy to penetrate the memberine. The in vitro release of the microspheres was related to the ratio of drug/polymer and microspheres Ⅱ had a prolong release, providing the release of 72.00% in 12 h. The results suggestes that chitosan/β-cyclodextrin microspheres Ⅱ are a promising carrier as sustained release for pulmonary delivery.
文摘The effects of 3,4-DHAP on hypoxic pulmonary and systemic vascular responses were studied in anaesthetized dogs. The percentage change in pulmonary vascular resistance(△PVR%)and that in systemic vascular resistance(△SVR%)induced by 5 min hypoxia decreased significantly.3,4-DHAP in doses of 1 mg/kg,3mg/kg,and 10 mg/kg i.v caused a decrease in b PVR% from the control value of 47.27±22.27% to 24.62±21.76%,18.15±18.73%,and 24.10±19.76% respectively, and a decrease in △SVR% from the control value of 12.91±7.39% to -0.34±12.7%,-2.11±12.76%,and -2.37±15.52% respectively.The results showed that 3,4-DHAP could decrease the hypoxic responses of pulmonary and systemic blood vessels.But it did not change △PVR% or △SVR% in dose of 30mg/kg,neither did it influence the heart rate,cardiac output or cerebral blood flow during hypoxia in all the doses used.
文摘Objective： This review aimed to examine the effectiveness of clinical nurse specialist （CNS） interventions in patients with chronic obstructive pulmonary disease （COPD）. COPD significantly affects people＇s health worldwide. With the development in nursing, CNSs are playing increasingly important roles in different departments. However, the studies on the effectiveness of CNSs in COPD are not as well organized as the studies on the effectiveness of CNSs in bronchiectasis and asthma. Therefore, this review aims to find some updated evidence on the CNS interventions for patients with COPD and on whether these interventions are effective.Methods： A narrative analysis of the data was performed for the eligible studies. Four databases were chosen： CINAHL, MEDLINE, British Nursing Index, and Cochrane Library. Other websites such as the National Institute for Health and Clinical Excellence, National Health Service Evidence, Association of Respiratory Nurse Specialists, and National Association of Clinical Nurse Specialist were searched as well. Two reviewers performed study identification independently, and all the retrieved articles were stored using the EndNote X7 software. The risk of bias in the included studies was assessed using the Cochrane Collaboration＇s risk of bias tool. Results： A total of nine studies were included in this review. There were five current interventions by CNSs for patients with COPD. These interventions were home nursing support, CNS]s supported discharge, multidisciplinary cooperation programs, nurse-led care programs, and self-care management education. The effectiveness of these five interventions was evaluated individually. There is low- to moderate-quality evidence indicating that home nursing support interventions may have a positive effect on mortality and quality of life. No significant difference in quality of life has been found between the CNS-supported discharge intervention and the usual service. The multidisciplinary cooperation program probably had a positive effect on quality ot life in patients with COPD. Both nurse-led care and self-care management education intervention had a positive effect on mortality of patients with COPD.Conclusions： The findings of this review provide updated evidence on the effectiveness of CNS interventions for patients with COPD. Although nine trials were included and five types of interventions were identified, there is still lack of high-quality evidence.
基金supported by the Multi-Year Research Grants from the University of Macao(No.MYRG2019–00032-ICMS)Natural Science Foundation of Jiangsu Province(No.BK20210912)+1 种基金the startup grant of Xuzhou Medical University(D2021004)Macao Science and Technology Development Fund(No.0017/2019/AKP)。
文摘Pulmonary delivery is an effective drug delivery strategy for the treatment of local respiratory diseases.However,the rapid systemic absorption through the lung due to the thin barrier and persistent lung clearances influence the drug retention in the lung.In this study,we designed a lipid-coated genistein nanocrystals(Lipo-NCs)formulation to achieve enhanced efficiency of local pulmonary delivery.The LipoNCs were fabricated by modifying genistein nanocrystals(NCs)with phospholipid membrane through thin film hydration following the homogenization method.The prepared Lipo-NCs exhibited a decreased drug release rate compared with the naked NCs.Our results demonstrated that intracellular uptake and transcellular transport of NCs by the Calu-3 epithelial layer were reduced after lipid coating.Furthermore,the macrophages clearance was also impeded by this Lipo-NCs formulation.In vivo lung retention and distribution revealed that more genistein was retained in the lung after intratracheal administration of Lipo-NCs.The pharmacokinetic study displayed that the AUC((0-t))values of Lipo-NCs were 1.59-fold lesser than those of the NCs group,indicating a reduced systemic absorption.In conclusion,this research indicated that Lipo-NCs could be a suitable formulation for reducing systemic absorption and macrophages clearance,and thus enhancing drug concentration in lung by pulmonary delivery.
基金supported by the Ministry of Science and Technological development of the Republic of Serbia,Grant #153038
文摘Objective To examine the presence of gender differences in pulmonary inflammation evoked by acute systemic cadmium administration in rats. Methods Presence of basic indicators of lung inflammation （inflammatory cytokine lung content, leukocyte infiltration and activity of cells recovered from lungs by enzyme digestion） was analyzed and compared in animals of the two sexes. Results Intraperitoneal administration of cadmium （1.0 mg/kg） resulted in higher cadmium content in lungs of female rats. Higher tumor necrosis factor （TNF） content was noted in lung homogenates of male rats, while interleukin-6 （IL-6） content was slightly, but signifaicantly greater in lungs of female rats. Increased leukocyte infiltration was observed in lungs of male rats, mainly due to neutrophils. Increased responsiveness to phorbol myristate acetate （PMA） stimulation was noted in cells recovered from lungs of male rats. Rise in intracellular content of myeloperoxidase （MPO） was noted in lung cells from cadmium-treated rats of both sexes, but higher in cells from male rats. Conclusion Presented data documented a more intense pulmonary inflammatory response to systemic cadmium administration in males, with higher IL-6 levels in lungs of female individuals. These sex differences in proinflamatory activity of cadmium in lungs should be taken into consideration in studying the remote toxicity of this heavy metal.
基金Project supported by the National Natural Science Foundation of China （Nos. 31171392 and 31371475）
文摘Based on different mechanisms of blood coagulation, coexistence of venous thromboembolism and arterial thrombosis in a single individual is extremely rare in clinical practice. Both antiplatelet and anticoagulation therapy should be adopted for patients with arteriovenous embolism. Balancing the risk of ischemia and hemorrhage is especially challenging in these patients in order to achieve an optimal clinical benefit. We report on a 55-year-old female with acute pulmonary embolism （PE）, subsequently diagnosed as having acute myocardial infarction （AMI） and a cerebral infarction. Examinations had been carried out, excluding potential arteriovenous shunts, cancer, an- tiphospholipid syndrome and other common hypercoagulable states. A combination of an anticoagulant drug （rivaroxaban, an Xa inhibitor） and an antiplatelet agent （clopidogrel, an ADP receptor inhibitor） was prescribed with a β-blocker and atorvastatin. The embolus was gradually shrunk during the next 10 months, and then it turned back into expanding. During the 16 months＇ follow-up, an aneurysm of left ventricular apex was found through an echocardiogram and an angiotensin-converting enzyme inhibitor was administered. We conclude that combined anticoagulation and antiplatelet therapy significantly relieved the symptoms and improved the prognosis in patients suffering from arteriovenous embolism without any major clinical bleeding events.
基金supported by grants from the National Natural Science Foundation of China (No. 30873189)the Natural Science Foundation of Hubei Province,China (No.2008CDB165)
文摘In order to investigate the role of the MexA-MexB-OprM efflux pump system in the pathogenesis of Pseudomonas aeruginosa(PA)-induced pulmonary infection,pulmonary infection models were established by intratracheal injection of K767(wild type),nalB(MexA-MexB-OprM up-regulated mutant),and △m exB(knockout) strains,separately.All mice were treated with Meropenem(intraperitoneal injection,100 mg/kg body weight,twice every day),and strain-related pathology,bacteria count,cytokine level,myeloperoxidase(MPO,indicator of neutrophil recruitment) activity,and macrophage inflammatory protein-2(MIP-2) expression were evaluated at early(3rd day post-infection) and late(7th and 14th day post-infection) stages of infection.E-test showed that △mexB was more significantly sensitive to panipenan(ETP),meropenem(MP) and imipenem(IP) than K767 and nalB strains.There was no significant difference in sensitivity to cefepime(TM) among the three stains.In contrast to the K767 and nalB groups,the △ mexB group showed decreased bacteria burden over time and less extensive pathological change.Additionally,MPO activity and levels of inflammatory cytokines(IL-1b,IL-12,and TNF-α) were increased at the early stage(day 3) and decreased at the later stage(day 14).Serum MIP-2 expression level was steadily increased in all three groups from early to late stages,but significantly higher in △m exB group than in K767 and nalB groups(P<0.05).In conclusion,the MexA-MexB-OprM efflux pump system might play an important role in PA-induced chronic pulmonary infection.High expression of the MexA-MexB-OprM efflux pump could increase antibacterial resistance and promote infection.
