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
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
Exercise training in pulmonary arterial hypertension(PAH)has been gaining popularity with guidelines now recommending it as an important adjunct to medical therapy.Despite improvements in function and quality of life,...Exercise training in pulmonary arterial hypertension(PAH)has been gaining popularity with guidelines now recommending it as an important adjunct to medical therapy.Despite improvements in function and quality of life,an understanding of metabolic changes and their mechanisms remain unexplored.The objective of this study was therefore to understand the metabolic basis of exercise in a monocrotaline model of PAH.24 male Wistar rats(age:8–12 weeks and mean body weight:[262.16±24.49]gms)were assigned to one of the four groups(i.e.,Control,PAH,Exercise and PAH t Exercise).The exercise groups participated in treadmill running at 13.3 m/min,five days a week for five weeks.Demographic and clinical characteristics were monitored regularly.Following the intervention,LC-MS based metabolomics were performed on blood samples from all groups at the end of five weeks.Metabolite profiling,peak identification,alignment and isotope annotation were also performed.Statistical inference was carried out using dimensionality reducing techniques and analysis of variance.Partial-least-squares discrimination analysis and variable importance in the projection scores showed that the model was reliable,and not over lifting.The analysis demonstrated significant perturbations to lipid and amino acid metabolism,arginine and homocysteine pathways,sphingolipid(p<0.05),glycerophospholipid(p<0.05)and nucleotide metabolism in PAH.Exercise,however,was seen to restore arginine(p<0.05)and homocysteine(p<0.0001)levels which were independent effects,irrespective of PAH.Dysregulated arginine and homocysteine pathways are seen in PAH.Exercise restores these dysregulated pathways and could potentially impact severity and outcome in PAH.展开更多
BACKGROUND Pulmonary arterial hypertension(PAH)is a debilitating and progressive pulmonary pathology that often leads to death.Guidelines recommend the use of palliative care(PC)early in the treatment course to ease t...BACKGROUND Pulmonary arterial hypertension(PAH)is a debilitating and progressive pulmonary pathology that often leads to death.Guidelines recommend the use of palliative care(PC)early in the treatment course to ease the burden of symptoms;however,uptake remains low.AIM To evaluate barriers to PC uptake and determine its association with mortality in patients with PAH.METHODS All studies discussing PC in PAH were selected in our review and analysis.Clinical and cross-sectional studies were included.Barriers were described in a qualitative fashion.A random-effects meta-analysis was also conducted,in which the odds ratio for mortality was pooled and reported,along with 95%confidence intervals.RESULTS A total of 19 studies were included in the review.The most common barriers identified included feeling like the patients were“not sick enough”,belief that PC is only appropriate for end-of-life care,belief that it would burden family members,and general feelings of hopelessness.Physicians identified structural causes,such as a lack of funding and low levels of PC-related knowledge,as barriers to recommending PC.The meta-analysis showed no statistically significant difference in mortality across four included studies(Log odds ratio=0.89,95%confidence intervals:-3.06-1.28).Heterogeneity was high(I2=80.32%).CONCLUSION Uptake of PC in PAH is low due to patient and physician-level barriers,which can be overcome with systematic PC integration.Long-term studies are also needed to investigate the impact of PC on outcomes in PAH,as the current limited data show no significant difference.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
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
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 Pulmonary arterial hypertension(PAH)poses a growing global health challenge,yet comprehensive epidemiological data remain limited.This study aims to assess the burden of PAH from 1990 to 2021 and project tre...Objective Pulmonary arterial hypertension(PAH)poses a growing global health challenge,yet comprehensive epidemiological data remain limited.This study aims to assess the burden of PAH from 1990 to 2021 and project trends to 2040,addressing critical gaps in incidence,mortality,and disability-adjusted life years(DALYs)across diverse socio-demographic contexts.Methods Using data from the Global Burden of Disease(GBD)2021 study,we analyzed PAH burden across 204 countries and territories,stratified by age,sex,region,and socio-demographic index(SDI).Age-standardized rates(per 100,000 populations)for incidence(ASIR),mortality(ASMR),and DALYs(ASDR)were calculated.Future trends were projected via a Bayesian age-period-cohort(BAPC)model.Results In 2021,there were 43,251(95%uncertainty interval[UI]:34,705,52,441)global incident PAH cases(age standardized incidence rate[ASIR]:0.52).From 1990 to 2021,PAH incidence rose by 85.62%,with the steepest increase in high-middle SDI regions(average annual percentage change[AAPC]:+0.19%).Despite a 48.36%rise in deaths,the age-standardized mortality rate(ASMR)declined annually by 0.84%,reflecting improved management.Central Europe had the highest ASMR(1.06 per 100,000),while low SDI regions showed reduced ASIR(−0.31%AAPC),likely due to underdiagnosis.PAH caused 642,104 DALYs globally in 2021,with infants(<1 year)bearing the highest DALY rate.Projections indicate 75,000 annual cases by 2040,emphasizing an escalating burden.Conclusion PAH burden is increasing disproportionately in aging populations and high-middle SDI regions,while low SDI areas face underdiagnosis and healthcare disparities.Targeted interventions,equitable resource allocation,and enhanced diagnostic capacity are urgently needed to mitigate future PAH-related morbidity and mortality.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 determine the proportions of drug-resistant tuberculosis(TB),its trends,and the drug resistance-conferring mutations among patients with pulmonary TB aged 10-24 years in China.Methods The data of patients...Objective To determine the proportions of drug-resistant tuberculosis(TB),its trends,and the drug resistance-conferring mutations among patients with pulmonary TB aged 10-24 years in China.Methods The data of patients with pulmonary TB were retrieved from a national drug-resistant TB survey for analysis.Joinpoint regression software was used to analyze time trends.We also used whole genome sequencing to analyze the lineages and drug resistance-conferring mutations of 621 isolates.Results Among 4,235 patients with pulmonary TB,the proportion of new cases of multidrug-resistant tuberculosis(MDR-TB)was 3.18%(95%confidence interval[CI]:2.37-4.15)for adolescents and 3.76%(95%CI:3.03-4.60)for young adults;for previously treated patients,MDR-TB accounted for 11.25%(95%CI:5.28-20.28)of adolescents and 11.05%(95%CI:6.88-16.55)of young adults.The proportion of patients with MDR-TB remained stable among both new and previously treated patients aged 10-24 years during the study period.Through whole genome sequencing,we found that the most common mutations in the MDR-TB strains were Ser315Thr in the katG gene(71.74%)and Ser450Leu in the rpoB gene(50.00%).Conclusion This study revealed a high proportion of MDR-TB among adolescents and young adults,indicating that urgent and comprehensive measures are needed to reduce the emergence and transmission of drug-resistant TB among this population in China.展开更多
Pulmonary diseases have long posed a severe threat to human life and health.The incidence and mortality rates of pulmonary diseases have shown a rising trend year by year,highlighting the urgency of developing safe an...Pulmonary diseases have long posed a severe threat to human life and health.The incidence and mortality rates of pulmonary diseases have shown a rising trend year by year,highlighting the urgency of developing safe and effective therapeutic approaches.In recent years,to address the challenges faced by traditional treatment strategies for pulmonary diseases,the interdisciplinary integration has greatly promoted the rapid development of biomedical polymer materials in the field of pulmonary disease treatment.This review provides a detailed description of the structural characteristics of lung tissue,types of pulmonary diseases,traditional treatment methods,the categories and properties of biomedical polymer materials applied to pulmonary diseases.We systematically elaborate on the applications of biomedical polymer materials in the treatment of different pulmonary diseases and thoroughly discuss their functional roles in pulmonary diseases,particularly in the delivery of therapeutic agents to diseased sites,the formation of pulmonary aerosol formulations,and the facilitation of the effective accumulation of therapeutic agents.The latest research progresses of biomedical polymer materials are also introduced in pulmonary disease treatment.We have highlighted the current challenges and development opportunities of biomedical polymer materials in the treatment of pulmonary diseases,and provide future research directions for biomedical polymer materials in this field.This review will provide valuable reference for the basic research and clinical application of biomedical polymer materials in pulmonary disease treatment.展开更多
Pulmonary fibrosis(PF)is a progressive,fatal fibrotic disease caused by respiratory conditions.The condition can ultimately lead to severe organ failure and mortality,and is associated with multiple risk factors.Growi...Pulmonary fibrosis(PF)is a progressive,fatal fibrotic disease caused by respiratory conditions.The condition can ultimately lead to severe organ failure and mortality,and is associated with multiple risk factors.Growing evidence highlights the immune system’s role in PF,with various immune components participating in inflammatory and fibrotic processes.Different immune cells,including neutrophils,lymphocytes,and macrophages,demonstrate distinct effects on PF progression and development.Furthermore,key immune system cytokines,including the interleukin(IL)family,tumor necrosis factor(TNF)-α,interferon(IFN)-γ,transforming growth factor(TGF)-β,and connective tissue growth factor(CTGF),contribute to PF initiation and progression through independent mechanisms and mutual regulation.Currently,limited effective treatments exist for PF,with several treatments causing severe adverse reactions.Natural products,characterized by multi-target effects,holistic regulation,and low toxicity,have emerged as a research focus.This review compiles the mechanisms,therapeutic potential,and active components of various natural products.These compounds can ameliorate pulmonary inflammation,epithelial-mesenchymal transition,and collagen deposition through diverse immune mechanisms,acting at specific stages or throughout the fibrotic process,thereby supporting PF management.This review examines current scientific understanding of natural products’immunological effects in PF,which is crucial for developing future anti-PF therapeutics.展开更多
Objective:To investigate the quantitative assessment efficacy of chest CT combined with serum Vanin-1 and SPP1 in determining the progression stage of chronic obstructive pulmonary disease(COPD).Methods:A total of 100...Objective:To investigate the quantitative assessment efficacy of chest CT combined with serum Vanin-1 and SPP1 in determining the progression stage of chronic obstructive pulmonary disease(COPD).Methods:A total of 100 COPD subjects from our hospital from January 2020 to December 2023 were included and randomly divided into a healthy control group and an experimental group(50 cases each).The healthy control group underwent slow vital capacity measurement using a spirometer,while the experimental group underwent high-resolution thin-slice CT scans and serum Vanin-1 and SPP1 concentration measurements.Pulmonary function parameters,symptom burden,biomarker concentrations,and imaging characteristics were compared between the two groups.Results:The FEV1/FVC ratio in the experimental group(58.3±7.2)was lower than that in the healthy control group(92.1±4.8);the total CAT score(22.4±3.5)was higher than that in the healthy control group(3.1±1.2);both Vanin-1(18.7±2.3μg/L)and SPP1(25.6±4.1μg/L)levels were higher than those in the healthy control group;LAA%-950(38.7±6.2%)and WA%(68.5±5.3%)were significantly higher than those in the healthy control group(all p<0.001).Conclusion:Chest CT combined with serum Vanin-1 and SPP1 can accurately quantify the pathological progression of COPD,providing a dual basis for clinical staging and individualized intervention.展开更多
This study explored the therapeutic targets and molecular mechanisms of Huangqi Guizhi Decoction (HGD) in alleviatingpulmonary embolism (PE) by employing network pharmacology and molecular docking techniques. Firstly,...This study explored the therapeutic targets and molecular mechanisms of Huangqi Guizhi Decoction (HGD) in alleviatingpulmonary embolism (PE) by employing network pharmacology and molecular docking techniques. Firstly, the effective activecomponents of the Chinese herbs in HGD were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database(TCMSP), and their potential therapeutic targets were predicted using the Swiss Target Prediction platform. Subsequently, PErelatedtarget genes were obtained from the Online Mendelian Inheritance in Man (OMIM) database and GeneCards database.Then, the Wei Sheng Xin tool was used to generate a Venn diagram for identifying the common targets between the herb-relatedtargets and PE-related targets. After screening these common targets, a “drug-component-target network” and a protein-proteininteraction (PPI) network were constructed. Furthermore, Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia ofGenes and Genomes (KEGG) enrichment analysis were conducted on the intersecting targets, and molecular docking verificationwas performed using AutoDockTools and PyMol software. Finally, 20 active components were screened from Astragali Radix, 7from Cinnamomi Ramulus, 13 from Paeoniae Radix Alba, 5 from Zingiberis Rhizoma Recens, and 29 from Jujubae Fructus, witha total of 983 therapeutic targets. Among these targets, 134 were associated with PE, and protein kinase B1 (AKT1), mitogenactivatedprotein kinase 1 (MAPK1), and transformation-related protein 53 (TP53) served as the core targets. The results of GOand KEGG enrichment analyses indicated that the alleviation of PE by HGD is mainly related to pathways including immuneresponse, regulation of gene expression, atherosclerosis, and tumorigenesis. Molecular docking results showed that the keyactive components in HGD could bind to the core targets spontaneously and stably. This study revealed that HGD may alleviatesymptoms in PE patients by regulating signaling pathways, modulating platelet function to exert anticoagulant effects, andregulating the expression of anti-inflammatory genes, which provided a direction for subsequent experimental research.展开更多
Chronic obstructive pulmonary disease(COPD)is one of the leading causes of death and disability worldwide.Its complex etiology involves factors such as smoking,air pollution,genetic susceptibility,and social environme...Chronic obstructive pulmonary disease(COPD)is one of the leading causes of death and disability worldwide.Its complex etiology involves factors such as smoking,air pollution,genetic susceptibility,and social environment.With the accelerating global aging population and urbanization,the incidence and burden of COPD continue to rise.Current treatment strategies for COPD are relatively conservative,primarily focusing on bronchodilators,inhaled corticosteroids,and long-term oxygen therapy.Although these approaches can alleviate symptoms and slow disease progression to some ex-tent,they fail to effectively target the underlying mechanisms of the disease,leaving an unmet clinical need for more-effective therapies.This highlights the urgency of de-veloping innovative drugs that are both safe and efficacious to address the challenges in COPD treatment.As a traditional Chinese medicine with a long history,Colla corii asini has garnered significant attention for its diverse pharmacological effects and fa-vorable safety profile.Research has shown that Colla corii asini possesses multiple bio-logical activities,including hematopoiesis,nourishing the lungs,enhancing immunity,anti-infection,antiaging,antitumor,and antifatigue effects.Moreover,it has demon-strated potential in regulating oxidative stress,immune imbalance,and inflammatory responses.Recent evidence suggests that Colla corii asini may play a protective role in lung function through multitarget and multipathway mechanisms.Based on previ-ous research findings,this paper explores the potential therapeutic value of Colla corii asini in COPD treatment by addressing the current clinical management challenges and identifying potential therapeutic targets.It also integrates the pharmacological effects of Colla corii asini into a broader treatment context,providing new perspec-tives for comprehensive COPD management and laying the theoretical foundation for its modernization and innovative application.展开更多
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
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supported by the Senior Research Fellowship from the Indian Council of Medical Research,Govt of India through the research grant to ASBsupported by an extramural research grant from the Indian Council of Medical Research to ASB(5/4/1-9/2019-NCD-Ⅱ)financially supported by Dr.TMA Pai Fellowship from Manipal Academy of Higher Education,Manipal.
文摘Exercise training in pulmonary arterial hypertension(PAH)has been gaining popularity with guidelines now recommending it as an important adjunct to medical therapy.Despite improvements in function and quality of life,an understanding of metabolic changes and their mechanisms remain unexplored.The objective of this study was therefore to understand the metabolic basis of exercise in a monocrotaline model of PAH.24 male Wistar rats(age:8–12 weeks and mean body weight:[262.16±24.49]gms)were assigned to one of the four groups(i.e.,Control,PAH,Exercise and PAH t Exercise).The exercise groups participated in treadmill running at 13.3 m/min,five days a week for five weeks.Demographic and clinical characteristics were monitored regularly.Following the intervention,LC-MS based metabolomics were performed on blood samples from all groups at the end of five weeks.Metabolite profiling,peak identification,alignment and isotope annotation were also performed.Statistical inference was carried out using dimensionality reducing techniques and analysis of variance.Partial-least-squares discrimination analysis and variable importance in the projection scores showed that the model was reliable,and not over lifting.The analysis demonstrated significant perturbations to lipid and amino acid metabolism,arginine and homocysteine pathways,sphingolipid(p<0.05),glycerophospholipid(p<0.05)and nucleotide metabolism in PAH.Exercise,however,was seen to restore arginine(p<0.05)and homocysteine(p<0.0001)levels which were independent effects,irrespective of PAH.Dysregulated arginine and homocysteine pathways are seen in PAH.Exercise restores these dysregulated pathways and could potentially impact severity and outcome in PAH.
文摘BACKGROUND Pulmonary arterial hypertension(PAH)is a debilitating and progressive pulmonary pathology that often leads to death.Guidelines recommend the use of palliative care(PC)early in the treatment course to ease the burden of symptoms;however,uptake remains low.AIM To evaluate barriers to PC uptake and determine its association with mortality in patients with PAH.METHODS All studies discussing PC in PAH were selected in our review and analysis.Clinical and cross-sectional studies were included.Barriers were described in a qualitative fashion.A random-effects meta-analysis was also conducted,in which the odds ratio for mortality was pooled and reported,along with 95%confidence intervals.RESULTS A total of 19 studies were included in the review.The most common barriers identified included feeling like the patients were“not sick enough”,belief that PC is only appropriate for end-of-life care,belief that it would burden family members,and general feelings of hopelessness.Physicians identified structural causes,such as a lack of funding and low levels of PC-related knowledge,as barriers to recommending PC.The meta-analysis showed no statistically significant difference in mortality across four included studies(Log odds ratio=0.89,95%confidence intervals:-3.06-1.28).Heterogeneity was high(I2=80.32%).CONCLUSION Uptake of PC in PAH is low due to patient and physician-level barriers,which can be overcome with systematic PC integration.Long-term studies are also needed to investigate the impact of PC on outcomes in PAH,as the current limited data show no significant difference.
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.
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 the Hubei Provincial Natural Science Foundation of China(Grant No.2025AFB068)Jin-zhu Zhao was supported by the Wuhan Natural Science Foundation Exploration Program(Chen Guang Program,Grant No.2024040801020344).
文摘Objective Pulmonary arterial hypertension(PAH)poses a growing global health challenge,yet comprehensive epidemiological data remain limited.This study aims to assess the burden of PAH from 1990 to 2021 and project trends to 2040,addressing critical gaps in incidence,mortality,and disability-adjusted life years(DALYs)across diverse socio-demographic contexts.Methods Using data from the Global Burden of Disease(GBD)2021 study,we analyzed PAH burden across 204 countries and territories,stratified by age,sex,region,and socio-demographic index(SDI).Age-standardized rates(per 100,000 populations)for incidence(ASIR),mortality(ASMR),and DALYs(ASDR)were calculated.Future trends were projected via a Bayesian age-period-cohort(BAPC)model.Results In 2021,there were 43,251(95%uncertainty interval[UI]:34,705,52,441)global incident PAH cases(age standardized incidence rate[ASIR]:0.52).From 1990 to 2021,PAH incidence rose by 85.62%,with the steepest increase in high-middle SDI regions(average annual percentage change[AAPC]:+0.19%).Despite a 48.36%rise in deaths,the age-standardized mortality rate(ASMR)declined annually by 0.84%,reflecting improved management.Central Europe had the highest ASMR(1.06 per 100,000),while low SDI regions showed reduced ASIR(−0.31%AAPC),likely due to underdiagnosis.PAH caused 642,104 DALYs globally in 2021,with infants(<1 year)bearing the highest DALY rate.Projections indicate 75,000 annual cases by 2040,emphasizing an escalating burden.Conclusion PAH burden is increasing disproportionately in aging populations and high-middle SDI regions,while low SDI areas face underdiagnosis and healthcare disparities.Targeted interventions,equitable resource allocation,and enhanced diagnostic capacity are urgently needed to mitigate future PAH-related morbidity and mortality.
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.
基金funded by the National Key Research and Development Program of China(grant number 2022YFC2305204).
文摘Objective To determine the proportions of drug-resistant tuberculosis(TB),its trends,and the drug resistance-conferring mutations among patients with pulmonary TB aged 10-24 years in China.Methods The data of patients with pulmonary TB were retrieved from a national drug-resistant TB survey for analysis.Joinpoint regression software was used to analyze time trends.We also used whole genome sequencing to analyze the lineages and drug resistance-conferring mutations of 621 isolates.Results Among 4,235 patients with pulmonary TB,the proportion of new cases of multidrug-resistant tuberculosis(MDR-TB)was 3.18%(95%confidence interval[CI]:2.37-4.15)for adolescents and 3.76%(95%CI:3.03-4.60)for young adults;for previously treated patients,MDR-TB accounted for 11.25%(95%CI:5.28-20.28)of adolescents and 11.05%(95%CI:6.88-16.55)of young adults.The proportion of patients with MDR-TB remained stable among both new and previously treated patients aged 10-24 years during the study period.Through whole genome sequencing,we found that the most common mutations in the MDR-TB strains were Ser315Thr in the katG gene(71.74%)and Ser450Leu in the rpoB gene(50.00%).Conclusion This study revealed a high proportion of MDR-TB among adolescents and young adults,indicating that urgent and comprehensive measures are needed to reduce the emergence and transmission of drug-resistant TB among this population in China.
基金the National Key Research and Development Program of China(No.2021YFB3800900)Natural Science Foundation of Xiamen,China(No.3502Z202371004)+2 种基金National Natural Science Foundation of China(Nos.52473150,51925305,52173115,51873208,51833010,and 52203183)Fundamental Research Funds for the Central Universities(No.20720230004)the Talent Cultivation Project Funds for the Innovation Laboratory for Sciences and Technologies of Energy Materials of Fujian Province(No.HRTP-[2022]52).
文摘Pulmonary diseases have long posed a severe threat to human life and health.The incidence and mortality rates of pulmonary diseases have shown a rising trend year by year,highlighting the urgency of developing safe and effective therapeutic approaches.In recent years,to address the challenges faced by traditional treatment strategies for pulmonary diseases,the interdisciplinary integration has greatly promoted the rapid development of biomedical polymer materials in the field of pulmonary disease treatment.This review provides a detailed description of the structural characteristics of lung tissue,types of pulmonary diseases,traditional treatment methods,the categories and properties of biomedical polymer materials applied to pulmonary diseases.We systematically elaborate on the applications of biomedical polymer materials in the treatment of different pulmonary diseases and thoroughly discuss their functional roles in pulmonary diseases,particularly in the delivery of therapeutic agents to diseased sites,the formation of pulmonary aerosol formulations,and the facilitation of the effective accumulation of therapeutic agents.The latest research progresses of biomedical polymer materials are also introduced in pulmonary disease treatment.We have highlighted the current challenges and development opportunities of biomedical polymer materials in the treatment of pulmonary diseases,and provide future research directions for biomedical polymer materials in this field.This review will provide valuable reference for the basic research and clinical application of biomedical polymer materials in pulmonary disease treatment.
基金supported by the National Natural Science Foundation of China(No.82260820)the Natural Science Foundation of Jilin Province,Jilin,China(No.YDZJ202201ZYTS155).
文摘Pulmonary fibrosis(PF)is a progressive,fatal fibrotic disease caused by respiratory conditions.The condition can ultimately lead to severe organ failure and mortality,and is associated with multiple risk factors.Growing evidence highlights the immune system’s role in PF,with various immune components participating in inflammatory and fibrotic processes.Different immune cells,including neutrophils,lymphocytes,and macrophages,demonstrate distinct effects on PF progression and development.Furthermore,key immune system cytokines,including the interleukin(IL)family,tumor necrosis factor(TNF)-α,interferon(IFN)-γ,transforming growth factor(TGF)-β,and connective tissue growth factor(CTGF),contribute to PF initiation and progression through independent mechanisms and mutual regulation.Currently,limited effective treatments exist for PF,with several treatments causing severe adverse reactions.Natural products,characterized by multi-target effects,holistic regulation,and low toxicity,have emerged as a research focus.This review compiles the mechanisms,therapeutic potential,and active components of various natural products.These compounds can ameliorate pulmonary inflammation,epithelial-mesenchymal transition,and collagen deposition through diverse immune mechanisms,acting at specific stages or throughout the fibrotic process,thereby supporting PF management.This review examines current scientific understanding of natural products’immunological effects in PF,which is crucial for developing future anti-PF therapeutics.
基金Baoding Science and Technology Plan Project(Project No.:2341ZF214)。
文摘Objective:To investigate the quantitative assessment efficacy of chest CT combined with serum Vanin-1 and SPP1 in determining the progression stage of chronic obstructive pulmonary disease(COPD).Methods:A total of 100 COPD subjects from our hospital from January 2020 to December 2023 were included and randomly divided into a healthy control group and an experimental group(50 cases each).The healthy control group underwent slow vital capacity measurement using a spirometer,while the experimental group underwent high-resolution thin-slice CT scans and serum Vanin-1 and SPP1 concentration measurements.Pulmonary function parameters,symptom burden,biomarker concentrations,and imaging characteristics were compared between the two groups.Results:The FEV1/FVC ratio in the experimental group(58.3±7.2)was lower than that in the healthy control group(92.1±4.8);the total CAT score(22.4±3.5)was higher than that in the healthy control group(3.1±1.2);both Vanin-1(18.7±2.3μg/L)and SPP1(25.6±4.1μg/L)levels were higher than those in the healthy control group;LAA%-950(38.7±6.2%)and WA%(68.5±5.3%)were significantly higher than those in the healthy control group(all p<0.001).Conclusion:Chest CT combined with serum Vanin-1 and SPP1 can accurately quantify the pathological progression of COPD,providing a dual basis for clinical staging and individualized intervention.
基金supported by Research Project on Traditional Chinese Medicine in Heilongjiang Province in 2025(Research on the pharmacological substance basis of Huangqi Guizhi decoction in improving acute pulmonary embolism and lung injury based on the theory of“Diaphoresis and expanding meridian”No.ZHY2025-043).
文摘This study explored the therapeutic targets and molecular mechanisms of Huangqi Guizhi Decoction (HGD) in alleviatingpulmonary embolism (PE) by employing network pharmacology and molecular docking techniques. Firstly, the effective activecomponents of the Chinese herbs in HGD were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database(TCMSP), and their potential therapeutic targets were predicted using the Swiss Target Prediction platform. Subsequently, PErelatedtarget genes were obtained from the Online Mendelian Inheritance in Man (OMIM) database and GeneCards database.Then, the Wei Sheng Xin tool was used to generate a Venn diagram for identifying the common targets between the herb-relatedtargets and PE-related targets. After screening these common targets, a “drug-component-target network” and a protein-proteininteraction (PPI) network were constructed. Furthermore, Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia ofGenes and Genomes (KEGG) enrichment analysis were conducted on the intersecting targets, and molecular docking verificationwas performed using AutoDockTools and PyMol software. Finally, 20 active components were screened from Astragali Radix, 7from Cinnamomi Ramulus, 13 from Paeoniae Radix Alba, 5 from Zingiberis Rhizoma Recens, and 29 from Jujubae Fructus, witha total of 983 therapeutic targets. Among these targets, 134 were associated with PE, and protein kinase B1 (AKT1), mitogenactivatedprotein kinase 1 (MAPK1), and transformation-related protein 53 (TP53) served as the core targets. The results of GOand KEGG enrichment analyses indicated that the alleviation of PE by HGD is mainly related to pathways including immuneresponse, regulation of gene expression, atherosclerosis, and tumorigenesis. Molecular docking results showed that the keyactive components in HGD could bind to the core targets spontaneously and stably. This study revealed that HGD may alleviatesymptoms in PE patients by regulating signaling pathways, modulating platelet function to exert anticoagulant effects, andregulating the expression of anti-inflammatory genes, which provided a direction for subsequent experimental research.
基金The National Natural Science Foundation of China,Grant/Award Number:82074104 and 8247143489the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences,Grant/Award Number:2022-I2M-2-002。
文摘Chronic obstructive pulmonary disease(COPD)is one of the leading causes of death and disability worldwide.Its complex etiology involves factors such as smoking,air pollution,genetic susceptibility,and social environment.With the accelerating global aging population and urbanization,the incidence and burden of COPD continue to rise.Current treatment strategies for COPD are relatively conservative,primarily focusing on bronchodilators,inhaled corticosteroids,and long-term oxygen therapy.Although these approaches can alleviate symptoms and slow disease progression to some ex-tent,they fail to effectively target the underlying mechanisms of the disease,leaving an unmet clinical need for more-effective therapies.This highlights the urgency of de-veloping innovative drugs that are both safe and efficacious to address the challenges in COPD treatment.As a traditional Chinese medicine with a long history,Colla corii asini has garnered significant attention for its diverse pharmacological effects and fa-vorable safety profile.Research has shown that Colla corii asini possesses multiple bio-logical activities,including hematopoiesis,nourishing the lungs,enhancing immunity,anti-infection,antiaging,antitumor,and antifatigue effects.Moreover,it has demon-strated potential in regulating oxidative stress,immune imbalance,and inflammatory responses.Recent evidence suggests that Colla corii asini may play a protective role in lung function through multitarget and multipathway mechanisms.Based on previ-ous research findings,this paper explores the potential therapeutic value of Colla corii asini in COPD treatment by addressing the current clinical management challenges and identifying potential therapeutic targets.It also integrates the pharmacological effects of Colla corii asini into a broader treatment context,providing new perspec-tives for comprehensive COPD management and laying the theoretical foundation for its modernization and innovative application.
文摘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.
