1.The Effects of Qufeng Tongqiao Cough-Relieving Decoction (祛风通窍止咳方) on Cough Sensitivity,TRPV4 in Lung and Nasal Mucosal Tissues,and Neurogenic Inflammation in a Guinea Pig Model of Upper Airway Cough Syndrome
Jingshu LUO ; Jianling MA ; Liqing SHI ; Kun JI ; Song LIU ; Yuhan FAN ; Xianli LI ; Zhaodi GUO
Journal of Traditional Chinese Medicine 2025;66(5):518-525
ObjectiveTo investigate the potential mechanism of action of the Qufeng Tongqiao Cough-relieving Decoction (祛风通窍止咳方, QTCD) in the treatment of upper airway cough syndrome (UACS). MethodsTwenty-four guinea pigs were randomly divided into blank group, model group, traditional Chinese medicine (TCM) group, and inhibitor group, with six guinea pigs in each group. Except for the blank group, guinea pigs were sensitized with ovalbumin and aluminum hydroxide via intraperitoneal injection, followed by ovalbumin nasal drops combined with smoke exposure to establish the UACS model. After modeling, the TCM group was administered QTCD 0.9 g/(100 g·d) by gavage, the inhibitor group received the transient receptor potential vanilloid receptor 4 (TRPV4) inhibitor GSK2193874 1 mmol/L, 5 min by nebulisation, and the blank group and model group were given 2 ml/(100 g·d) normal saline by gavage once daily. After 7 days of treatment, a cough provocation test was performed using 0.4 mol/L citric acid. The levels of IgE in serum and inflammatory cytokines, including interleukin-6 (IL-6), interleukin-8 (IL-8) in serum, bronchoalveolar lavage fluid (BALF), and nasal lavage fluid (NLF) were detected by enzyme-linked immunosorbent assay (ELISA). Histopathological changes in lung and nasal mucosal tissues were observed by hematoxylin-eosin (HE) staining. Immunohistochemistry was used to detect the protein levels of TRPV4, substance P (SP), and calcitonin gene-related peptide (CGRP) in lung and nasal mucosal tissues. Real-time polymerase chain reaction (Real-time PCR) was used to detect the mRNA expression of TRPV4, SP, and CGRP in lung tissues. ResultsHE staining showed significant structural damage and infiltration of inflammatory cells in the lung and nasal mucosal tissues in the model group, while the TCM group and inhibitor group showed improved pathological changes. Compared with the blank group, the model group showed increased cough frequency, serum IgE level, and IL-6 and IL-8 levels in serum, BALF, and NLF. The protein levels of TRPV4, SP, and CGRP in lung and nasal mucosal tissues and their mRNA expression were elevated (P<0.05 or P<0.01). Compared with the model group, the TCM group and inhibitor group showed reduced cough frequency, serum IgE level, and TRPV4 and SP mRNA expression in lung tissues. The TCM group showed reduced IL-6 and IL-8 levels in serum, BALF, and NLF, and reduced TRPV4 and CGRP protein levels in lung and nasal mucosal tissues. The inhibitor group showed reduced IL-6 and IL-8 levels in serum, BALF, and NLF, reduced IL-6 in BALF, reduced IL-8 in NLF, and decreased TRPV4, SP, and CGRP protein levels in lung tissues and SP and CGRP protein levels in nasal mucosal tissues (P<0.05 or P<0.01). Compared with the TCM group, the inhibitor group had increased serum IgE, IL-6, and IL-8 levels, increased IL-6 level in BALF, and increased IL-8 levle in NLF, but decreased SP protein level in lung tissues and increased TRPV4 and SP mRNA expression in lung tissues (P<0.01). ConclusionQTCD effectively reduces cough frequency in the UACS guinea pig model. Its mechanism may involve inhibiting the activation of the TRPV4 pathway, improving airway neurogenic inflammation, alleviating inflammatory responses, and reducing cough hypersensitivity.
2.Therapeutic Effect of Wenweishu Granules on Functional Dyspepsia Rats with Spleen-stomach Deficiency Cold Syndrome Based on Bioinformatics Analysis and Experimental Validation
Xinyu YANG ; Xiaoyi JIA ; Zihua XUAN ; Shuangying GUI ; Yanfang WU ; Yuhan MA ; Qin RUAN ; Jia ZHENG ; Zhiyong JIAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):30-40
ObjectiveThis study aims to investigate the therapeutic effects of Wenweishu granule (WWSG) on functional dyspepsia (FD) with spleen-stomach deficiency cold syndrome in rats by integrating network pharmacology, molecular docking, and animal experiments. MethodsActive components and corresponding targets of WWSG were collected from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and the Bioinformatics Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine (BATMAN-TCM). Disease-related targets for FD with spleen-stomach deficiency cold syndrome were screened using GeneCards and the Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine (TCMIP). Core therapeutic targets were identified via Cytoscape and validated by molecular docking. A rat model of FD with spleen-stomach deficiency cold syndrome was established using vinegar gavage combined with tail-clamping. The rats were randomly divided into a model group, low-, medium-, and high-dose WWSG groups (2.0, 4.0, 8.0 g·kg-1), a domperidone group (3.0 mg·kg-1), a Fuzi Lizhong pillwan (0.8 g·kg-1), and a normal control group (n=10 per group). Drugs were administered once daily by gavage for 14 consecutive days. After treatment, body weight, symptom scores, and gastrointestinal motility indices were recorded. Gastric and duodenal pathologies changes were observed via hematoxylin-eosin (HE) staining. Brain-gut peptides were measured in serum and tissue using enzyme-linked immunosorbent assay (ELISA). Immunohistochemistry and Western blot were performed to assess stem cell factor (SCF) and receptor tyrosine kinase (c-Kit) protein expression in gastric tissues. ResultsA total of 305 drug targets, 1 140 disease targets, and 116 overlapping targets were identified. Cytoscape analysis revealed 104 core targets. Enrichment analysis indicated that the SCF/c-Kit signaling pathway was the key mechanism. Molecular docking confirmed a strong binding affinity between active components of WWSG and SCF/c-Kit proteins (binding energy<-5.1 kcal·mol-1). Compared with the normal group, model rats exhibited slower weight gain (P<0.05), reduced gastric emptying and intestinal propulsion (P<0.01), mild gastric mucosal shedding, duodenal inflammatory cell infiltration, decreased levels of gastrin (GAS), 5-hydroxytryptamine (5-HT), and vasoactive intestinal peptide (VIP) (P<0.05, P<0.01), and elevated somatostatin (SS) expression (P<0.05, P<0.01). WWSG treatment ameliorated weight gain, symptom scores, and low-grade inflammation in gastric/duodenal tissues. High-dose WWSG significantly improved gastric emptying and intestinal propulsion, upregulated GAS, 5-HT, and VIP, and downregulated SS expression in serum and tissues (P<0.05, P<0.01). Immunohistochemistry and Western blot demonstrated that SCF and c-Kit protein expression was decreased in the model group (P<0.05, P<0.01), which was reversed by WWSG intervention (P<0.05). ConclusionWWSG exerts therapeutic effects on FD with spleen-stomach deficiency cold syndrome in rats, potentially by regulating the SCF/c-Kit signaling pathway to enhance gastrointestinal motility.
3.Dynamic changes of diaphragm and limb skeletal muscle in patients with sepsis assessed by bedside ultrasound and their correlation with blood urea/creatinine ratio
Jinlan MA ; Yuhan XIA ; Ting WANG ; Jing CHEN ; Hongxiao YANG ; Huan DING
Chinese Critical Care Medicine 2024;36(6):643-648
Objective:To investigate the dynamic changes of diaphragm and limb skeletal muscle in patients with sepsis by bedside ultrasound and their correlation with the ratio of blood urea/creatinine ratio (UCR) in 7 days after intensive care unit (ICU) admission.Methods:A prospective observational study was conducted. A total of 55 patients with sepsis admitted to ICU of General Hospital of Ningxia Medical University from June 2022 to February 2023 were selected as the research objects. General information, laboratory indicators [urea, serum creatinine (SCr), and UCR] on days 1, 4, and 7 of ICU admission, and prognostic indicators were observed. Bedside ultrasound was used to assess the dynamic changes of diaphragm morphology [including diaphragmatic excursion (DE), end-inspiratory diaphragm thickness (DTei), and end-expiratory diaphragm thickness (DTee)] on days 1, 4, and 7 of ICU admission, as well as limb skeletal muscle (quadriceps femoris) morphology [including rectus femoris-muscle layer thickness (RF-MLT), vastus intermedius-muscle layer thickness (VI-MLT), and rectus femoris-cross sectional area (RF-CSA)]. Diaphragm thickening fraction (DTF) and RF-CSA atrophy rate were calculated, and the incidence of diaphragm and limb skeletal muscle dysfunction was recorded. The correlation between ultrasound morphological parameters of diaphragm and quadriceps and UCR at each time points in 7 days after ICU admission was analyzed by Pearson correlation.Results:A total of 55 patients with sepsis were included, of which 29 were in septic shock. As the duration of ICU admission increased, the incidence of diaphragm dysfunction in patients with sepsis increased first and then decreased (63.6%, 69.6%, and 58.6% on days 1, 4, and 7 of ICU admission, respectively), while the incidence of limb skeletal muscle dysfunction showed an increasing trend (54.3% and 62.1% on days 4 and 7 of ICU admission, respectively), with a probability of simultaneous occurrence on days 4 and 7 of ICU admission were 32.6% and 34.5%, respectively. The UCR on day 7 of ICU admission was significantly higher than that on day 1 [121.77 (95.46, 164.55) vs. 97.00 (70.26, 130.50)], and RF-CSA atrophy rate on day 7 was significantly higher than that on day 4 [%: -39.7 (-52.4, -22.1) vs. -26.5 (-40.2, -16.4)]. RF-CSA was significantly lower on day 7 compared to day 1 [cm 2: 1.3 (1.0, 2.5) vs. 2.1 (1.7, 2.9)], with all differences being statistically significant (all P < 0.05). Pearson correlation analysis showed that RF-CSA on day 7 of ICU admission was negatively associated with the UCR on the same day ( r = -0.407, P = 0.029). Conclusions:Diaphragmatic dysfunction in patients with sepsis occurred early and can be improved. Limb skeletal muscle dysfunction occurred relatively later and progresses progressively. The RF-CSA on day 7 of ICU admission may be a reliable measure of limb skeletal muscle dysfunction in patients with sepsis, can be an indicator of early identification and diagnosis of ICU-acquired weakness (ICU-AW). Continuous loss of muscle mass occurring in septic patients is mainly associated with persistent organismal catabolism, and undergoes significant changes around a week in ICU.
4.Relationship between the ratio of small dense low density lipoprotein and high-density lipoprotein and contrast nephropathy after emergency percutaneous coronary intervention in patients with acute STEMI and type 2 diabetes mellitus
Di ZHENG ; Kai MA ; Wenhua LI ; Yuhan LI
China Modern Doctor 2024;62(20):63-67
Objective To explore the relationship between the ratio of small dense low density lipoprotein(HDL-C)and high-density lipoprotein(HDL-C)and contrast nephropathy(CIN)after emergency percutaneous coronary intervention(PCI)in patients with acute ST segment elevation myocardial infarction(STEMI)complicated with type 2 diabetes mellitus(T2DM).Method Totally 187 patients with STEMI complicated with T2DM from May 2021 to November 2023 were selected for emergency percutaneous coronary intervention.The creatinine level was measured within 48-72 hours after operation,which was divided into 52 cases in CIN group and 135 cases in non CIN group.The levels of sdLDL and HDL-c in all patients were measured,and the ratio between them was calculated.The difference of sdLDL/HDL-c between the two groups was compared,and its relationship with contrast nephropathy after emergency percutaneous coronary intervention was analyzed.Results SdLDL-C(1.283±0.432)mmol/L in CIN group was higher than that in non CIN group(0.884±0.436)mmol/L.HDL-C(0.822±0.213)mmol/L in CIN group was lower than that in non CIN group(1.013±0.224)mmol/L.sdLDL/HDL-C(1.712±0.793)in CIN group was higher than that in non CIN group(0.843±0.484).The difference was statistically significant(P<0.05).Logistic regression analysis showed that among the risk factors of coronary heart disease,sdLDL-C/HDL-C was an independent risk factor for CIN after emergency intervention in STEMI patients with T2DM[OR=9.003,95%CI:3.510-23.089,P<0.001].ROC curve showed that the area under the curve of sdLDL-C/HDL-C to predict the occurrence of CIN in STEMI patients with T2DM was 0.836,optimal truncation was 1.159,the sensitivity was 76.1%,and the specificity was 83.7%.Conclusion SdLDL-C/HDL-C is closely related to the occurrence of CIN after emergency percutaneous coronary intervention in patients with STEMI complicated with T2DM.It may be used as an indicator for predicting the risk of CIN and has clinical guiding significance.
5.Feasibility of low-dose CT brain perfusion scanning based on deep learning reconstruction algorithm: a preliminary study
Limin LEI ; Yuhan ZHOU ; Xiaoxu GUO ; Hui WANG ; Jinping MA ; Zhihao WANG ; Weimeng CAO ; Yuan GAO ; Yuming XU ; Songwei YUE
Chinese Journal of Radiological Medicine and Protection 2024;44(7):613-621
Objective:To compare image quality and diagnostic parameters of whole-brain CT perfusion scans under different scanning conditions and assess the utility of deep learning image reconstruction algorithm (DLIR) in reducing tube current during low-dose scans.Methods:Method A total of 105 patients with suspected acute ischemic stroke (AIS) were prospectively enrolled in the First Affiliated Hospital of Zhengzhou University from March, 2022 to March, 203 and their baseline information was recorded. All patients underwent head non-contrast CT and CT perfusion (CTP) examinations. CTP scanning was performed at 80 kV in two groups with the tube current of 150 mA (regular dose) and 100 mA (low dose), respectively. The CTP images of 150 mA group were reconstructed using filtered back-projection algorithm as well as adaptive statistical iterative reconstruction-V (ASIR-V) at 40% and 80% strength levels, which were denoted as groups A-C. The CTP images of 100 mA group were reconstructed using ASIR-V80%, DLIR-M, and DLIR-H, which were denoted as groups D-F. Clinical baseline characteristics and radiation doses were compared between the two groups under different scanning conditions. Furthermore, we assessed the subjective and objective image quality, conventional perfusion parameters, and abnormal perfusion parameters of AIS patients across the six groups of reconstructed CTP images.Results:Under the scanning conditions of 150 mA and 100 mA, 47 and 48 patients were diagnosed with AIS, respectively. There were no significant differences in the baseline characteristics between the two groups. However, there was a significant difference in the mean effective radiation dose (5.71 mSv vs. 3.80 mSv, t = 2 768.30, P < 0.001). The standard deviation (SD) of noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of gray matter (GM) and white matter (WM) were significantly different among the six groups of reconstructed images ( F = 40.58-212.13, P < 0.001). In GM, the SD values in groups C, D, and F were lower than those in other groups ( P < 0.05), and the SNR values in groups C and F were higher than those in other groups ( P < 0.05). In WM, the SD and SNR values in groups C and F were significantly different from those in other groups ( P < 0.05). Additionally, CNR values in groups C and F were higher than those in other groups ( P < 0.05). There was no significant difference in subjective scores among groups B, C, and F ( P > 0.05). Regarding perfusion parameters in the brain GM, groups D and E had lower cerebral blood volume (CBV) values compared to groups A to C ( P < 0.05), and group F had lower CBV values than group B ( P < 0.05). In the brain WM, group D had consistently lower mean transit time (MTT) values compared to the other groups ( P < 0.05). Notably, there were no significant differences in AIS lesion detection rates and relevant diagnostic parameters across the six image groups. Conclusions:Low-tube current CTP scan combined with the DLIR-H algorithm can enhance image quality without affecting perfusion parameters such as CBV and MTT, while reducing radiation dose by 30%. This algorithm can be routinely applied in brain CTP examinations.
6.Effect of Yiqi Tongmai Formula in Intervening in Liver Inflammation and Lipidosis in ApoE-∕- Mice Based on NF-κB/NLRP3 Signaling Pathway
Yuhan CHEN ; Quanna REN ; Kun WANG ; Tingting SU ; Yanhua YANG ; Ming MA ; Yu ZHANG ; Xu ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(15):64-72
ObjectiveTo investigate the effect of Yiqi Tongxin formula (YQTM) on liver inflammation in apolipoprotein E-∕- (ApoE-∕-) mice by regulating the nuclear transcription factor-κB (NF-κB)/NOD-like receptor protein 3 (NLRP3) signaling pathway. MethodForty ApoE-∕- mice were randomly divided into a model group, an atorvastatin group (positive drug group), and low-, medium-, and high-dose YQTM groups (0.39, 0.78, 1.56 g·kg-1). Each drug administration group was given the corresponding concentration of the drug by gavage on the basis of high-fat feeding for 12 consecutive weeks. Eight C57BL/6J mice were used as a blank group and fed with normal chow. After 12 weeks, oil red O staining and Masson staining were used to observe the aortic lesions in mice and to determine whether the modeling was successful. Oil red O staining was used to observe the lipidosis in the livers of mice. Hematoxylin-eosin (HE) staining was used to observe the tissue lesions in the livers of mice. Masson staining was used to observe the distribution of collagen fibers in the livers of mice. Enzyme markers were used to detect the total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL-C), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) in mouse serum, as well as total cholesterol (TC) and triglyceride (TG) in the liver. Interleukin-1β (IL-1β) and IL-18 were detected in mouse liver by enzyme-linked immunosorbent assay (ELISA). Immunohistochemistry (IHC) was utilized to observe the expression regions of NF-κB and NLRP3 in the livers of mice. Western blot was employed to detect the protein expression levels of NF-κB, NF-κB inhibitory protein (IκB), IκB kinase β (IKKβ), phosphorylated NF-κB (p-NF-κB), phosphorylated IκB (p-IκB), phosphorylated IKK β (p-IKKβ), NLRP3, and Caspase-1 in the livers of mice. ResultCompared with the blank group, the model group showed severe aortic lipidosis, and the intracellular fat droplets in the livers aggregated in large quantities. The cytoplasm was filled with fat vacuoles(P<0.01). The serum levels of TG, TC, LDL-C, AST, and ALT were significantly elevated in the mice(P<0.01). TG and TC levels were elevated in the liver(P<0.01). The levels of IL-1β and IL-18 in liver tissue, as well as the protein expression levels of NF-κB, IκB, IKKβ, p-NF-κB, p-IκB, p-IKKβ, NLRP3, and Caspase-1 in the liver were significantly elevated(P<0.01). Compared with the model group, the aortic arch plaques of mice in each YQTM group were attenuated, and the fat aggregation in the liver was reduced. The inflammatory cell infiltration was alleviated(P<0.05,P<0.01). The serum levels of TG, TC, LDL-C, AST, and ALT were significantly reduced(P<0.05,P<0.01). TG and TC levels in the liver were reduced. The IL-1β and IL-18 levels in liver tissue, as well as protein expression levels of NF-κB, IκB, IKKβ, p-NF-κB, p-IκB, p-IKKβ, NLRP3, and Caspase-1 in the liver were significantly reduced(P<0.05,P<0.01). ConclusionThe intervention mechanism of YQTM on liver inflammation in ApoE-∕- mice may be related to the down-regulation of the NF-κB/NLRP3 signaling pathway.
7.Effects of Yiqi tongmai formula on atherosclerosis in ApoE-/- mice and its mechanism
Quanna REN ; Yuhan CHEN ; Kun WANG ; Ming MA ; Yanhua YANG ; Yu ZHANG ; Xu ZHAO
China Pharmacy 2024;35(18):2232-2237
OBJECTIVE To investigate the effects of Yiqi tongmai formula on atherosclerosis (AS) in ApoE-/- mice and its mechanism. METHODS Forty ApoE-/- mice were randomly divided into model group, positive control group [atorvastatin calcium, 2.6 mg/(kg·d)], and low-dose, medium-dose and high-dose groups of Yiqi tongmai formula [0.46, 0.91, 1.82 g/(kg·d), by raw material], with 8 mice in each group. Eight C57BL/6J mice were selected as the normal group. Except for the normal group, the other groups were given a high-lipid diet and relevant drug or normal saline intragastrically, once a day, for 12 consecutive weeks. After the last medication, the serum levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) as well as the contents of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and monocyte chemoattractant protein-1 (MCP-1) were measured in mice. The proportion of aortic plaque area in each group of mice was detected and calculated, and the pathological morphological changes of the aortic sinus were observed; the protein phosphorylation levels of aortic phosphoinositide 3-kinase (PI3K), protein kinase B (aka Akt) and mammalian target of rapamycin (mTOR) were examined. RESULTS Compared with the model group, the serum levels of TC, TG and LDL-C and the contents of TNF-α, IL-1β and MCP-1 (including low-dose group) were decreased significantly in medium-dose and high-dose groups of Yiqi tongmai formula, while the content of HDL-C in high-dose group was increased significantly (P<0.05 or P<0.01); aortic plaques of the mice were reduced in Yiqi tongmai formula groups to different extents, and pathological changes such as lipid deposition and inflammatory cell infiltration were relieved to different extents; the proportion of aortic plaque area, the protein phosphorylation levels of PI3K, Akt and mTOR in aortic tissue were significantly reduced in medium-dose and high-dose groups of Yiqi tongmai formula (P<0.05 or P<0.01). CONCLUSIONS Yiqi tongmai formula can improve lipid metabolism, reduce inflammatory response, and delay plaque development in AS mice. Its effect may be related to the inhibition of PI3K/Akt/mTOR signaling pathway activation.
8.TCM Pharmacology Based on Bibliometrics and Patent Analysis: A Case Study of Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences
Lin ZHANG ; Yuhan DENG ; Yanwen LI ; Luming QIU ; Sijia MA ; Tuo LIU ; Zhiyong LI ; Yujie LI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(23):8-18
ObjectiveTo analyze the literature related to traditional Chinese medicine (TCM) pharmacology of Institute of Chinese Materia and Medica, China Academy of Chinese Medical Sciences (hereinafter referred to as "Institute of Chinese Materia and Medica"), and evaluate the research status, development trend, influence of discipline members, and patent technology of this field. MethodThe papers from 2002 to 2024 in the databases of CNKI and Web of Science (WOS) were searched, whose first authors or corresponding authors are from the Institute of Chinese Materia and Medica, and CiteSpace 6.3.R6 was adopted for visual analysis of the annual number of publications and keywords. Additionally, the total number of published papers, citation times, and other measurement parameters of discipline members of TCM pharmacology in the institute were counted. After obtaining the h index, the academic track was calculated, and the academic influence of discipline members was quantitatively evaluated from the aspects of the academic track T and highly cited papers. Meanwhile, patent data from 2005 to 2024 of TCM pharmacology in the studied institute were retrieved from the HimmPat patent database, and Excel 2022 and Origin 2021 were utilized to conduct visual analysis on the overall patent application trend and technology composition. ResultIn the past 20 years or more, the annual publication of academic papers has been on the rise generally, and the key words include "animal model", "mechanism of action", "network pharmacology" and so on. The studies focus on the innovative methods of TCM pharmacological mechanisms, basic research on TCM prevention and treatment of major non-infectious diseases, and the prevention and treatment of respiratory viral diseases. The academic track T of the discipline members of TCM pharmacology in the Institute of Chinese Materia and Medica is positive, with sound personal influence. In recent years, the patent application trend has increased significantly, mainly concentrating on A61K patents and G01N subcategories, and IPC large-group analysis shows that the main technical applications are mainly in A61K36, A61K31, and other fields. ConclusionTCM pharmacology in the institute develops steadily and the academic influence of the discipline members is still sound, with fruitful patent achievements. In the future, research on pharmacological discipline innovation and new drug research and development can be enhanced, and multidisciplinary integration studies should be carried out to promote TCM modernization.
9.Single versus bilateral lung transplantation for end-stage chronic obstructive pulmonary disease: A systematic review and meta-analysis
Yuhan GENG ; Long MA ; Yongming MA ; Jingyang SUN ; Bin LIU ; Yi YANG ; Gang JIN ; Zijiang ZHU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(11):1637-1644
Objective To systematically evaluate the efficacy and safety of single and bilateral lung transplantation in the treatment of end-stage chronic obstructive pulmonary disease (COPD). Methods Chinese and English databases were searched by computer, including PubMed, Web of Science, The Cochrane Library, EMbase, CNKI, Wanfang database, VIP database and CBM. Case-control studies on single lung transplantation or bilateral lung transplantation for COPD were collected from the inception to July 31, 2022. We evaluated the quality of the literature via Newcastle-Ottawa Scale (NOS). All results were analyzed using Review Manager V5.3 and STATA 17.0. Results A total of 8 studies were included covering 14076 patients, including 8326 patients in the single lung transplantation group and 5750 patients in the bilateral lung transplantation group. NOS scores were≥6 points. The results of meta-analysis showed that there was no statistical difference in the postoperative 1-year survival between the two groups (P=0.070). The 2-year survival rate (P=0.002), 3-year survival rate (P<0.001), 5-year survival rate (P<0.001), overall survival rate (P<0.001), postoperative forced expiratory volume in one second/predicted value (P<0.001), postoperative forced vital capacity (P<0.001), and postoperative 6-minute walking distance (P=0.002) were lower or shorter than those in the bilateral lung transplantation group, the postoperative intubation time (P=0.030) was longer than that in the bilateral lung transplantation group. Bilateral lung transplantation group showed better surgical results. There was no statistical difference in the mortality, obliterative bronchiolitis, length of hospitalization, primary graft dysfunction, or postoperative adverse events (P>0.05). Conclusion Bilateral lung transplantation is associated with better long-term survival and postoperative lung function compared with single lung transplantation. In-hospital mortality and postoperative complications are similar between them.
10.Value of different assessment scales in the diagnosis of drug-induced liver injury
Jiaxi MA ; Tiantian YAO ; Hao CHENG ; Dan LIU ; Yuhan ZHANG ; Siyuan DU ; Linfei DONG ; Linhui HU ; Yan WANG ; Guiqiang WANG
Journal of Clinical Hepatology 2024;40(6):1203-1208
Objective To determine the scores of patients with a confirmed diagnosis of drug-induced liver injury(DILI)using Roussel Uclaf Causality Assessment Method(RUCAM),Maria&Victorino assessment scale,and Revised Electronic Causality Assessment Method(RECAM),to compare the accuracy of the three scales in diagnosis,and to investigate their clinical significance in the diagnosis of DILI.Methods A total of 98 patients with a confirmed diagnosis of DILI who were hospitalized in Peking University First Hospital from January 2011 to December 2022 were enrolled,with liver biopsy results supporting DILI and a clear history of medication.Clinical data were collected from all subjects,and the above causality assessment scales were used for scoring.The chi-square test was used to analyze the diagnostic accuracy of the causality assessment scales,and the weighted kappa coefficient was used to analyze the consistency between the three scales.Results For all patients with DILI enrolled,RECAM had the highest accuracy,with a significant difference compared with RUCAM(χ2=5.667,P=0.017).RUCAM and RECAM had moderate consistency in diagnosis(κw=0.469),while RECAM and Maria&Victorino scale had poor consistency(κw=0.156).For the patients with acute DILI,RECAM,RUCAM,and Maria&Victorino scales had a diagnostic inconsistency rate of 3.7%,11.1%,and 42.6%,respectively;for the patients with hepatocellular type DILI,the three scales of a diagnostic inconsistency rate of 8.9%,21.4%,and 62.5%,respectively;for the patients with cholestasis type or mixed type DILI,the three scales of a diagnostic inconsistency rate of 10.0%,22.5%,and 47.5%,respectively.Conclusion The use of RECAM and RUCAM scales in acute DILI can improve diagnostic rate,and for hepatocellular type DILI and DILI with the clinical manifestation of cholestasis(cholestasis type DILI and mixed type DILI),the use of RECAM and RUCAM scales can also improve diagnostic rate.The selection of causality assessment scales with a relatively high accuracy based on the course and clinical classification of the disease may help to further improve clinical diagnostic rate.

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