Based on the theory of "shaoyang（少阳） resembling the pivot" and collateral diseases， this article proposes that pulmonary fibrosis （PF） can be divided into three stages including wind bi （痹）， constraint bi， and atrophy bi. The core pathogenesis of PF is the obstruction of the pivot and pulmonary collateral obstruction. In terms of treatment， the basic principles are to harmonize and regulate the pivot， and to promote the circulation of the lung collaterals. Depending on the different characteristics of the "essence-attribute-function"， treatment methods such as harmonizing and regulating the pivot， resolving phlegm and removing stasis， supplementing deficiency and harmonizing collaterals are suggested. This approach ensures the regulation of the pivot， smooth circulation of qi and blood， unblocking of the lung collaterals and nourishing the lung body， achieving the goals of balancing the ascending and descending of qi， removing phlegm and stasis， and relieving cough and wheezing.

ObjectiveTo observe the efficacy of Sangmei Pingfeng granules combined with western medicine in the treatment of patients with allergic asthma in the chronic persistent stage， diagnosed with lung-spleen Qi deficiency syndrome in traditional Chinese medicine （TCM）. MethodsA retrospective analysis was conducted on 420 patients with allergic asthma in the chronic persistent stage and TCM-diagnosed lung-spleen Qi deficiency syndrome， treated at the Third Affiliated Hospital of Beijing University of Chinese Medicine from January 2017 to September 2024. Patients were divided into an exposed group （320 cases） and a non-exposed group （100 cases） based on whether they used Sangmei Pingfeng granules. The non-exposed group received conventional western medicine treatment， while the exposed group took Sangmei Pingfeng Granules in addition to conventional western medicine. The following indicators were observed： recurrence rate per 100 patients per year， pulmonary function tests， fractional exhaled nitric oxide （FeNO） and fractional nasal nitric oxide （FnNO） tests， serum total IgE （TIgE） detection， TCM syndrome score， and changes in asthma control test （ACT） scores between the two groups. ResultsThe annual recurrence rate per 100 people was 8.4 times/100 person-years in the exposed group， lower than the 13 times/100 person-years in the unexposed group. After treatment， the exposed group showed increases in forced vital capacity percentage predicted （FVC%pred）， forced expiratory volume in one second percentage predicted （FEV₁%pred）， the ratio of forced expiratory volume in one second to forced vital capacity （FEV₁/FVC）， and peak expiratory flow percentage predicted （PEF%pred） （P0.05）. Lung function indicators in the non-exposed group showed no statistically significant differences after treatment. Residual volume as a percentage of total lung capacity （RV%TLC） showed no statistically significant difference after treatment in either group. Compared with the non-exposed group， the exposed group had increased FVC%pred， FEV₁%pred， FEV₁/FVC， and PEF%pred， without statistically significant differences. After treatment， fractional exhaled nitric oxide （FeNO）， fractional nasal nitric oxide （FnNO）， and total immunoglobulin E （TIgE） decreased in the exposed group. FeNO decreased in the non-exposed group （P0.05）. FnNO decreased， and TIgE increased in the non-exposed group， without statistically significant differences. After treatment， compared with the non-exposed group， the treatment group had decreased FeNO （P0.05）. After treatment， traditional Chinese medicine （TCM） syndrome scores decreased， and asthma control test （ACT） scores increased in both groups （P0.01）. After treatment， compared with the non-exposed group， the exposed group had decreased TCM syndrome scores and increased ACT scores （P0.01）. ConclusionCombining Sangmei Pingfeng granules with Western medicine significantly reduces recurrence rates， enhances clinical efficacy， improves lung function， lowers serum TIgE and FeNO levels， and reduces reliance on Western medications in patients with allergic asthma. This integrated approach is worthy of clinical promotion and application.

Objective:To establish reference ranges for left and right ventricular structure and function parameters using cardiovascular magnetic resonance (CMR) in healthy Tibetan natives residing at ultra-high altitudes, and analyze their influencing factors.Methods:This prospective study enrolled Tibetan healthy volunteers who underwent CMR examinations between September 2021 and August 2022. Participants were stratified into four age groups: 20-29, 30-39, 40-49, and 50-59 years. CMR-derived parameters included left ventricular ejection fraction (LVEF), right ventricular ejection fraction (RVEF), left/right ventricular end-diastolic volumes (LVEDV/RVEDV), left/right ventricular end-systolic volumes (LVESV/RVESV), and end-diastolic left ventricular mass (LVM at ED). Normally distributed data were compared between genders using independent samples t-test and among age groups using ANOVA. Non-normally distributed data were analyzed with Kruskal-Wallis test. Linear regression assessed relationships between parameters and gender, age, residential altitude, body surface area (BSA), and body mass index (BMI). Results:The study included 66 volunteers (27 males, 39 females), distributed as follows: 21 (20-29 years), 15 (30-39 years), 15 (40-49 years), and 15 (50-59 years). Reference values were: LVEF (62.6±5.7)%, RVEF (55.0±7.1)%, BSA-indexed LVEDV (60.6±12.1)ml/m2, RVEDV (65.5±14.8)ml/m2, LVESV (22.7±5.9)ml/m2, RVESV (29.6±8.1)ml/m2, and LVM at ED (39.1±8.0)g/m2. Gender and age significantly affected RVEF, RVESV, and LVM at ED ( P<0.05). Multivariate regression revealed:Gender independently predicted RVEF ( β=-5.556, P=0.003), RVESV ( β=5.421, P=0.007), and LVM at ED ( β=8.338, P<0.001). Age negatively influenced RVESV ( β=-0.202, P=0.019). BSA positively correlated with LVM at ED ( β=19.980, P=0.041). No significant associations were found with residential altitude or BMI ( P>0.05). Conclusion:This study establishes preliminary reference ranges for ventricular parameters in Tibetan ultra-high altitude natives, with gender, age, and BSA identified as key determinants of cardiac structural/functional indices.

Objective:To establish reference ranges for left and right ventricular structure and function parameters using cardiovascular magnetic resonance (CMR) in healthy Tibetan natives residing at ultra-high altitudes, and analyze their influencing factors.Methods:This prospective study enrolled Tibetan healthy volunteers who underwent CMR examinations between September 2021 and August 2022. Participants were stratified into four age groups: 20-29, 30-39, 40-49, and 50-59 years. CMR-derived parameters included left ventricular ejection fraction (LVEF), right ventricular ejection fraction (RVEF), left/right ventricular end-diastolic volumes (LVEDV/RVEDV), left/right ventricular end-systolic volumes (LVESV/RVESV), and end-diastolic left ventricular mass (LVM at ED). Normally distributed data were compared between genders using independent samples t-test and among age groups using ANOVA. Non-normally distributed data were analyzed with Kruskal-Wallis test. Linear regression assessed relationships between parameters and gender, age, residential altitude, body surface area (BSA), and body mass index (BMI). Results:The study included 66 volunteers (27 males, 39 females), distributed as follows: 21 (20-29 years), 15 (30-39 years), 15 (40-49 years), and 15 (50-59 years). Reference values were: LVEF (62.6±5.7)%, RVEF (55.0±7.1)%, BSA-indexed LVEDV (60.6±12.1)ml/m2, RVEDV (65.5±14.8)ml/m2, LVESV (22.7±5.9)ml/m2, RVESV (29.6±8.1)ml/m2, and LVM at ED (39.1±8.0)g/m2. Gender and age significantly affected RVEF, RVESV, and LVM at ED ( P<0.05). Multivariate regression revealed:Gender independently predicted RVEF ( β=-5.556, P=0.003), RVESV ( β=5.421, P=0.007), and LVM at ED ( β=8.338, P<0.001). Age negatively influenced RVESV ( β=-0.202, P=0.019). BSA positively correlated with LVM at ED ( β=19.980, P=0.041). No significant associations were found with residential altitude or BMI ( P>0.05). Conclusion:This study establishes preliminary reference ranges for ventricular parameters in Tibetan ultra-high altitude natives, with gender, age, and BSA identified as key determinants of cardiac structural/functional indices.

Objective To investigate the value of combined serum levels of neutrophil gelatinase-associated lipocalin(NGAL)and growth differentiation factor 15(GDF-15)in diagnosis of renal injury in elderly patients with H-type hypertension.Methods A total of 177 patients with H-type hypertension admitted to Department of Neurology and Department of General Medicine of the Affiliated Hospital of Chengde Medical College from April 2021 to June 2022 were enrolled,and based on their estimated glomerular filtration rate(eGFR),they were divided into the renal im-pairment group(81 cases)and normal renal function group(96 cases).General data and laboratory indicators were collected in the two groups.ROC curve analysis was used to evaluate the diagnos-tic value of combined NGAL and GDF-15 levels for renal injury in the elderly patients with H-type hypertension,and Pearson correlation analysis was performed to analyze the correlation between serum NGAL and GDF-15 levels and renal injury in the patients.Results SBP level was significantly higher in the renal impairment group than the normal renal function group[148.53±14.62 mm Hg(1 mm Hg=0.133 kPa)vs 138.75±13.36 mm Hg,P＜0.01],but no such difference was observed in DBP level between the two groups(P＞0.05).The levels of creatinine(Cr),urea nitrogen(BUN),β2-microglobulin(β2-MG),cystatin C(Cys C),urinary microalbumin(MA),NGAL and GDF-15 levels were obviously higher in the renal impairment group than the group with normal renal function(P＜0.01).ROC curve analysis showed that the combined detection of NGAL and GDF-15 levels was significantly higher than that of the two indicators alone(P＜0.01).Pearson correlation analysis indicated that serum NGAL and GDF-15 levels were positively correlated with Cr,BUN,β2-MG,Cys C and MA levels(P＜0.01).Conclusion Serum NGAL and GDF-15 levels are elevated in elderly H-type hypertension patients.Combined detection of the two indicators has higher value in the diagnosis of renal injury in elderly H-type hypertension patients.

Lipid metabolism disorders contribute to hyperlipidemia and hepatic steatosis. It is ideal to develop drugs simultaneous improving both hyperlipidemia and hepatic steatosis. Nitazoxanide is an FDA-approved oral antiprotozoal drug with excellent pharmacokinetic and safety profile. We found that nitazoxanide and its metabolite tizoxanide induced mild mitochondrial uncoupling and subsequently activated AMPK in HepG2 cells. Gavage administration of nitazoxanide inhibited high-fat diet (HFD)-induced increases of liver weight, blood and liver lipids, and ameliorated HFD-induced renal lipid accumulation in hamsters. Nitazoxanide significantly improved HFD-induced histopathologic changes of hamster livers. In the hamsters with pre-existing hyperlipidemia and hepatic steatosis, nitazoxanide also showed therapeutic effect. Gavage administration of nitazoxanide improved HFD-induced hepatic steatosis in C57BL/6J mice and western diet (WD)-induced hepatic steatosis in Apoe ^-/- mice. The present study suggests that repurposing nitazoxanide as a drug for hyperlipidemia and hepatic steatosis treatment is promising.

Objective To evaluate the effect of dexmedetomidine on endoplasmic reticulum stress during intestinal ischemia-reperfusion (I/R) in mice.Methods Thirty SPF healthy male C57BL/6 mice,aged 8 weeks,were divided into 3 groups (n=10 each) using a random number table method:sham operation group (S group),intestinal I/R group (I/R group) and dexmedetomidine group (DEX group).The superior mesenteric artery was only isolated but not clamped in S group.The model of intestinal I/R injury was established by clamping superior mesenteric artery for 20 min followed by 24 h of reperfusion in I/R group and DEX group.Dexmedetomidine 25 μg/kg was intraperitoneally injected at 30 min before ischemia in DEX group,while the equal volume of normal saline was given instead of dexmedetomidine in S group and I/R group.Mice were sacrificed at 24 h of reperfusion,and small intestinal tissues was obtained for examination of the pathological changes and ultrastructure of intestinal epithelial cells and for determination of cell apoptosis,expression of CCAAT-enhancer binding protein homologous protein (CHOP),transcription factors (ATF4),and X-4 box binding protein 1 (XBP1) mRNA (by real-time polymerase chain reaction),and expression of CHOP,Bcl-2,Bax and caspase-3 in intestinal tissues (by Western bolt).The apoptosis index (AI) and ratio of Bcl-2 to Bax were calculated.Intestinal damage was assessed and scored according to Chiu.Results Compared with S group,Chiu's score and AI were significantly increased,the expression of CHOP,ATF4 and XBP-1 mRNA,CHOP,Bax and caspase-3 was up-regulated,and the expression of Bcl-2 was down-regulated,and Bcl-2/Bax ratio was decreased in I/R group and DEX group (P＜0.05).Compared with I/R group,Chiu's score and AI were significantly decreased,the expression of CHOP,ATF4 and XBP-1 mRNA,CHOP,Bax and caspase-3 was down-regulated,and the expression of Bcl-2 was up-regulated,and Bcl-2/Bax ratio was increased in DEX group (P＜0.05).Conclusion The mechanism by which dexmedetomidine reduces intestinal I/R injury may be related to regulating endoplasmic reticulum stress and inhibiting cell apoptosis in mice.

Objective To explore the influence of health education and treatment compliance on COPD patients' outcome.Methods 258 subjects (186 males,72 females,average age 75.2±8.5 years) were enrolled from patients diagnosed with COPD between June 2013 to June 2014 in huashan hospital north compus.Study began in July 2014,health condition assessment and grading、telephone follow-up and education were performed once every half a year together with COPD lectures,the number of patients participated in education sessions,and status of smoking cessation,exercise\home oxygen therapy and medication were recorded as indicators for health education compliance.Clinic/hospital stay and cost,condition change were also recorded.The study ended in December 2015 with final assessments of conditions and classification of patient outcome.Multiple logistic regression was used to analyze factors influencing the COPD patient's outcome;Independent sample t test was applied to compare different compliance in patients with outpatient and hospitalization per-time cost difference.Results Higher reimbursement ratio,the better adherence for health education,no complications and the low grade of disease classification at the beginning of the study were protective factors (OR=10.35,2.147,5.791,4.51,P＜0.05);Underweight to normal weight,5 times or more acute attacks during during the study,poor health education compliance were risk factors for disease progression (OR=0.031,0.131,0.010,P＜ 0.05);Never exercise and never participating in health education management are the risk of illness/death((OR=6.793,P=0.005,95％CI:1.766～26.125) vs.(OR=11.872,P=0.002,95％CI:2.525～55.815));for mild COPD patients,these never participating in health education management had a higher per hospitalization than patients with health education management (6 619 yuan,t=2.681,P=0.010).The outpatient cost of more severe COPD patients who are smoking or quitted smoking in less than 5 years was higher than these quitted smoking more than 5 years (985 yuan,t=-2.225,P=0.028).Conclusions Health education management can help medical staff to provide guidance to patients to quit smoking,encouraging the regular use of home oxygen therapy,doing more exercise,taking prescription of preventive drugs,these will in turn improve patient compliance for disease control and prevention.These efforts can effectively slow disease progression and improve patient outcomes,reduce medical costs,reduce the burden of the family and society.

The cognitive impairment of type 2 diabetes patients caused by long-term metabolic disorders has been the current focus of attention. In order to find the related electroencephalogram (EEG) characteristics to the mild cognitive impairment (MCI) of diabetes patients, this study analyses the EEG synchronization with the method of multichannel synchronization analysis--S estimator based on phase synchronization. The results showed that the S estimator values in each frequency band of diabetes patients with MCI were almost lower than that of control group. Especially, the S estimator values decreased significantly in the delta and alpha band, which indicated the EEG synchronization decrease. The MoCA scores and S value had a significant positive correlation in alpha band.
Cognitive Dysfunction ; diagnosis ; Cortical Synchronization ; Diabetes Mellitus, Type 2 ; Electroencephalography ; Humans

The liver injury induced by Polygonum multiflorum Thunb. (PM) was investigated based on idiosyncratic hepatotoxicity model co-treated with lipopolysaccharide (LPS) at a non-hepatotoxic dose. Sprague-Dawley (SD) rats were intragastrically administered with three doses (18.9, 37.8, 75.6 g crude drug per kg body weight) of 50% alcohol extracts of PM alone or co-treated with non-toxic dose of LPS (2.8 mg·kg(-1)) via tail vein injection. The plasma alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities were assayed and the isolated livers were evaluated for histopathological changes. The dose-toxicity relationships of single treatment of PM or co-treatment of LPS were investigated comparatively to elucidate the idiosyncratic hepatotoxicity of PM. The results showed that no significant alterations of plasma ALT and AST activities were observed in the groups of solo-administration of LPS (2.8 mg·kg(-1), i.v.) or different dosage (18.9, 37.8 and 75.6 g·kg(-1), i.g.) of PM, compared to normal control group (P > 0.05); while significant elevations were observed in the co-administration groups of PM and LPS. Treatment with LPS alone caused slight infiltration of inflammatory cells in portal area but no evident hepatocytes injury. Co-treatment with LPS and PM (75.6 g·kg(-1), i.g.) caused hepatocyte focal necrosis, loss of central vein intima and a large number of inflammatory cell infiltration in portal areas. When further reduce the dosage of PM, significant increases of plasma ALT and AST activities (P < 0.05) were still observed in co-administration groups of LPS and PM (1.08 or 2.16 g·kg(-1)), but not in LPS or PM solo-administration groups. Nevertheless, the co-treatment of low dosage of PM (0.54 g·kg(-1)) with LPS did not induce any alteration of plasma ALT and AST. In conclusion, intragastric administration with 75.6 g·kg(-1) of PM did not induce liver injury in normal rats model; while the 2 folds of clinical equivalent dose of PM (1.08 g·kg(-1)) could result in liver injury in the LPS-based idiosyncratic hepatotoxicity model, which could be used to evaluate the idiosyncratic hepatotoxicity of PM.