Objective To investigate the temporal predictive value of soluble triggering receptor expressed on myeloid cells-1(sTREM-1),procalcitonin(PCT),and myeloid-related protein 8/14(MRP8/14)for secondary acute respiratory distress syndrome(ARDS)in patients with severe pulmonary tuberculosis.Methods A retro-spective cohort study was conducted among patients with severe pulmonary tuberculosis admitted between January 2021 and December 2024.Patients were randomly assigned in an 8∶2 ratio to a training set(n=148)and a valida-tion set(n=37).Serum sTREM-1,PCT,and MRP8/14 were extracted from the electronic medical record at three time points:on admission(day 0),day 3,and day 7.Multivariable logistic regression was used to identify risk factors,and predictive performance was evaluated using receiver operating characteristic(ROC)curves.Results A total of 185 patients were included.In the training set(n=148),27 developed ARDS and 121 did not;in the validation set(n=37),7 developed ARDS and 30 did not.In the training set,serum sTREM-1,PCT,and MRP8/14 levels showed significant temporal changes(P<0.05).At admission,day 3,and day 7,levels of sTREM-1,PCT,and MRP8/14 were higher in the ARDS group than in the non-ARDS group(all P<0.05).At each time point,sTREM-1,PCT,and MRP8/14 were independently associated with the development of ARDS(P<0.05).In the training set,the combination of sTREM-1,PCT,and MRP8/14 at admission yielded the largest area under the ROC curve[AUC=0.976;95%confidence interval(CI),0.952～1.000],with a sensitivity of 88.9%and a specificity of 98.3%.In the validation set,the same combination achieved an AUC of 0.957(95%CI,0.895～1.000),with a sensitivity of 100.0%and a specificity of 86.7%.Conclusion Dynamic changes in sTREM-1,PCT,and MRP8/14 provide temporal predictive value for ARDS in patients with severe pulmonary tuberculosis,and the combined assessment improves early warning accuracy.

Objective To investigate the temporal predictive value of soluble triggering receptor expressed on myeloid cells-1(sTREM-1),procalcitonin(PCT),and myeloid-related protein 8/14(MRP8/14)for secondary acute respiratory distress syndrome(ARDS)in patients with severe pulmonary tuberculosis.Methods A retro-spective cohort study was conducted among patients with severe pulmonary tuberculosis admitted between January 2021 and December 2024.Patients were randomly assigned in an 8∶2 ratio to a training set(n=148)and a valida-tion set(n=37).Serum sTREM-1,PCT,and MRP8/14 were extracted from the electronic medical record at three time points:on admission(day 0),day 3,and day 7.Multivariable logistic regression was used to identify risk factors,and predictive performance was evaluated using receiver operating characteristic(ROC)curves.Results A total of 185 patients were included.In the training set(n=148),27 developed ARDS and 121 did not;in the validation set(n=37),7 developed ARDS and 30 did not.In the training set,serum sTREM-1,PCT,and MRP8/14 levels showed significant temporal changes(P<0.05).At admission,day 3,and day 7,levels of sTREM-1,PCT,and MRP8/14 were higher in the ARDS group than in the non-ARDS group(all P<0.05).At each time point,sTREM-1,PCT,and MRP8/14 were independently associated with the development of ARDS(P<0.05).In the training set,the combination of sTREM-1,PCT,and MRP8/14 at admission yielded the largest area under the ROC curve[AUC=0.976;95%confidence interval(CI),0.952～1.000],with a sensitivity of 88.9%and a specificity of 98.3%.In the validation set,the same combination achieved an AUC of 0.957(95%CI,0.895～1.000),with a sensitivity of 100.0%and a specificity of 86.7%.Conclusion Dynamic changes in sTREM-1,PCT,and MRP8/14 provide temporal predictive value for ARDS in patients with severe pulmonary tuberculosis,and the combined assessment improves early warning accuracy.

BACKGROUND:Animal and cel studies have shown that the Kidney Recipe can prevent and treat osteoporosis and improve bone metabolism, but this recipe is complicated. Recent studies on compound Chinese medicine mainly focused on serum drug metabolism and pharmacokinetics, which has limitations, and the effective ingredient and pharmaceutical material basis are uncertain. OBJECTIVE:In the different concentrations and time, by using different compatibility proportion of active ingredients of Kidney Recipe, osteoblasts from neonatal Sprague-Dawley rats were subjected to culture intervention. The proliferation and differentiation of osteoblasts were determined so as to identify time-effect and dose-effect relationship of Kidney Recipe on osteoblasts and to provide experimental evidences for prevention and treatment of osteoporosis. METHODS:Primary neonatal 24-hour osteoblasts of Sprague-Dawley rats were cultured in vitro. Herbs“tonic”and“cathartic”active chemical components of different proportion were used. The experiment contained three groups:Tonics Medicine (T)>Cathartic Medicine (C) group, TC group and TC group (P<0.05). At mass concentration of 20μg/L, no significant difference was detected in the T>C and TC group (P<0.05), and the proliferation became weak at 72 hours. At mass concentration of 10μg/L and 72 hours of culture, alkaline phosphatase secretion could be promoted in the T>C group. At mass concentration of 20μg/L and 24 hours of culture, the promoting effect on alkaline phosphatase secretion was most significant in the TC group (P<0.05). Results confirm that active ingredients of Kidney Recipe compatibility proportion can promote osteoblasts proliferation and differentiation most strongly in the T>C group in the time-effect and the dose-effect relationship.

BACKGROUND:Chinese nourishing kidney herbs can prevent osteoporosis and improve bone metabolism, which has been proved in animal and cel experiments. But there are few reports on the compatibility of Chinese nourishing kidney herbs, and it is difficult to screen the optimal compatibility, as the interaction of active ingredients and drug substance basis are uncertain. OBJECTIVE: To determine the proliferation, differentiation and Smad4 mRNA expression of neonatal Sprague-Dawley rat osteoblasts cultured by Chinese nourishing kidney herbs with different compatibility so as to find out the optimal compatibility of Chinese nourishing kidney herbs. METHODS: Passage 5 osteoblasts were divided into five groups: group A, 1×10-5mol/L icarin; group B, 1×10-5mol/L icarin+1×10-5 mol/L naringin; group C, 1×10-5mol/L icarin+1×10-5 mol/L diosgenin; group D, 1×10-5mol/L icarin+ 1×10-5mol/L catalpol; group E, 10 μL normal saline (control group). There were six wels in each group. RESULTS AND CONCLUSION: Compared with the group E, the proliferative ability of osteoblasts and expression of Smad4 mRNA were increased in the groups B and C; until the 72nd hour, the proliferative ability of osteoblasts in the group B reached the peak. At 48 hours of culture, the activity of alkaline phosphatase in groups B and C was higher than that in group E; at 72 hours of culture, the activity of alkaline phosphatase in groups B and D was higher than that in group E. These findings indicate that the compatibility of Chinese nourishing kidney herbs can influence the activity of osteoblasts, and icarin+naringin has the strongest effect.