Objective To evaluate the efficacy of the bacterial lysate Broncho-vaxom on chronic obstructive pulmonary disease(COPD)in elderly patients.Methods A total of 150 patients with stable COPD were randomized into the Broncho-vaxom group(n=78)treated with Broncho-vaxom as add-on to conventional treatment and the control group(n=72)treated with conventional treatment.The number of acute exacerbation of COPD per patient per year,quality of life,lung function,T cell subsets were evaluated for the therapeutic effects.Results After one year of treatment,the number of acute exacerbation per patient per year was lower in Broncho-vaxom group than in control group[(1.44 ± 1.05) times/y vs.(1.82 ± 0.61) times/y,t =2.754,P =0.007].The proportions of acute exacerbationfree patients were higher in Broncho-vaxom group than in control group(20.5％ or 16/78 vs.4.2％ or 3/72,x2 =9.043,P =0.003).There were significant differences in the forced vital capacity(FVC),forced expiratory volume in one second(FEV1),and forced expiratory volume in one second/predicted value ratio(FEV1 ％)between the two groups at 5 different time points(before,at 3,6,9 and 12 months after treatment) (Broncho-vaxom group:F =90.819,50.674 and 51.233,P =0.000;control group:F =84.928,90.654 and 86.117,P =0.000).After treatment,the symptom scores were lower in Broncho-vaxom group than in control group,and the ratios of CD4/CD8 T-cell were increased and level of CD8 T-cell was decreased in Broncho-vaxom group(all P ＜ 0.05).The rate of adverse reactions had no significant difference between Broncho-vaxom group and control group(3/78 or 3.8％ vs.2/ 72 or 2.8％,x2 =0.132,P=0.717).Conclusions The oral administration of Broncho-vaxom for six months can modulate and enhance immune functions,significantly decrease acute exacerbation frequency,improve quality of life and delay the deterioration in lung function in elderly patients with stable COPD.

OBJECTIVE To investigate the intervention effect of Dabufei decoction on acute lung injury in rats with high altitude hypoxia by regulating the expression of the HIF-1α/NLRP3 signaling pathway and related molecules. METHODS Sixty SPF SD rats were randomly divided into blank group, model group, positive drug group, Dabufei decoction high-dose, medium-dose, and low-dose groups with 10 rats in each group. After 3 d of adaptation to feeding, the rats in the blank group and model group were given the same amount of normal saline by gavage, and the rats in Dabufei decoction high-dose, medium-dose, and low-dose groups were given gavage for 14 d, respectively. The positive drug group was given dexamethasone by intraperitoneal injection for three consecutive days before entering the chamber. Except for the blank group, the rats in each group were exposed to hypoxia in the experimental animal low-pressure simulation chamber from the 15th day for three consecutive days. At the end of the experiment, the wet to dry ratio(W/D) of the rat lung tissue was detected. The morphology of lung tissue was observed by HE staining. ELISA detected the levels of IL-1β and IL-18 in serum. Western blotting and RT-qPCR were used to detect the protein and mRNA expressions of HIF-1α, NLRP3, GSDMD, and caspase-1 in the lung tissue of rats. RESULTS The W/D value showed that compared with the blank group, the W/D of the model group was significantly increased(P<0.01). Compared with the model group, the W/D of rats in the positive drug group, Dabufei decoction high-dose group, medium-dose, and low-dose groups was significantly decreased(P<0.01 or P<0.05). HE results showed that compared with the blank group, alveolar septum thickening, pulmonary interstitial congestion, edema, inflammatory cell infiltration, and a small amount of exudation in the alveolar cavity were seen in the lung tissue of the model group. Compared with the model group, the thickening of alveolar walls in the positive drug group, Dabufei decoction high-dose group, medium-dose, and low-dose groups were reduced, and the pulmonary interstitial congestion, edema, and inflammatory cell infiltration were significantly reduced. ELISA results showed that IL-1β and IL-18 in rat serum were significantly higher in the model group than in the blank group(P<0.01). Compared with the model group, the levels of IL-1β and IL-18 in the serum of the rats in the positive drug group, Dabufei decoction high-dose group, medium-dose, and low-dose groups were significantly decreased(P<0.05 or P<0.01). Moreover, the results of Western blotting and RT-qPCR showed that compared with the blank group, the relative protein and mRNA expressions of HIF-1α, NLRP3, GSDMD, and caspase-1 in the lung tissue of the model group were significantly increased(P<0.01). Compared with the model group, the relative protein and mRNA of HIF-1α, NLRP3, caspase-1 and GSDMD in the positive drug group and Dabufei decoction high-dose group were significantly decreased(P<0.05 or P<0.01), the relative protein of HIF-1α, NLRP3, caspase-1 and GSDMD in Dabufei decoction medium-dose group were significantly decreased and HIF-1α, caspase-1 mRNA were significantly decreased(P<0.05), the relative protein of HIF-1α and GSDMD in the low-dose group was decreased(P<0.05). The positive drug group and Dabufei decoction high-dose group had the more significant effect. CONCLUSION Dabufei decoction can regulate the HIF-1α/NLRP3 signaling pathway, inhibit pyroptosis and reduce inflammation, and has a certain protective effect on acute lung injury in rats with high altitude hypoxia.