ObjectiveTo investigate the preventive and therapeutic effects of Qingfei Paidu decoction (QFPDD) on acute lung injury (ALI) in mice and its underlying molecular mechanisms based on miRNA sequencing technology. MethodsTwenty-four 4-week-old male KM mice were randomly divided into a control group, a model group, and a QFPDD group (n = 8 per group). After one week of acclimatization, mice in the control and model groups were intragastrically administered ultrapure water (0.2 mL per dose), whereas mice in the QFPDD group were intragastrically administered QFPDD (1.6 g crude drug/mL, 0.2 mL per dose), twice daily for 8 consecutive days. On days 2–8, mice in the model and QFPDD groups were exposed to aerosolized lipopolysaccharide (LPS) solution (2.5 g/L, 4 mL per exposure) for 7 consecutive days. On day 9, blood was collected via the retro-orbital venous plexus under deep anesthesia, and lung tissues were harvested. Body weight and lung weight were measured, and the lung coefficient was calculated. Serum levels of inflammatory cytokines tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, and IL-6 were detected by ELISA. Lung histopathological changes were observed by HE staining of paraffin-embedded sections. miRNA expression profiles in lung tissues were analyzed using the Illumina HiSeq 2500 sequencing platform. Target genes of differentially expressed miRNAs were predicted using bioinformatics databases, and functional enrichment analysis of these target genes was performed using gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) databases. Differentially expressed miRNAs were validated by reverse transcription quantitative real-time PCR (RT-qPCR). ResultsCompared with the control group, the model group showed a consistent body weight growth trend but a significantly increased lung coefficient (P < 0.01). ELISA results showed that serum levels of TNF-α and IL-6 were significantly elevated in the model group compared with the control group (P < 0.01), whereas QFPDD treatment significantly reduced serum TNF-α and IL-6 levels compared with the model group (P < 0.05). HE staining showed that, compared with the control group, the model group exhibited widened alveolar septa, massive inflammatory cell infiltration, partial alveolar expansion, and mild capillary dilation with congestion. In contrast, the QFPDD group showed only slightly widened alveolar septa and mild inflammatory cell infiltration compared with the model group. Intersection analysis of miRNA sequencing data identified 13 differentially expressed miRNAs common to both the model vs. control and QFPDD vs. model comparisons. Among them, 6 miRNAs (mmu-miR-203-3p, mmu-miR-181b-5p_R-1, hsa-miR-4286_R+1, mmu-miR-1843b-5p_L+1R-1_2, mmu-miR-22-3p, and mmu-miR-1964-3p) were significantly up-regulated in the model group (P < 0.05) and significantly down-regulated after QFPDD treatment (P < 0.05), showing a therapeutic reversal trend. GO analysis revealed that the target genes of the differentially expressed miRNAs were mainly enriched in biological processes such as RNA polymerase Ⅱ transcriptional regulation. KEGG analysis indicated that target genes were mainly enriched in signaling pathways including the mitogen-activated protein kinase (MAPK) pathway. RT-qPCR validation result for mmu-miR-203-3p was consistent with the sequencing analysis results. ConclusionQFPDD may exert preventive and therapeutic effects against ALI by regulating the expression of mmu-miR-203-3p and other miRNAs, thereby modulating inflammatory responses and the MAPK signaling pathway and participating in the pathological process of lung injury.

Objective:To systematically review and integrate the caring experience of caregivers of lung transplant patients.Methods:Qualitative studies on the caregiving experience of caregivers of lung transplant patients were searched by computer from PubMed, Web of Science, Embase, Cochrane Library, China Biology Medicine disc, China National Knowledge Infrastructure and Wanfang data, and the search period was from establishment of the databases to April 30, 2023. The qualitative research quality evaluation criteria (2016 edition) of the Joanna Briggs Institute Evidence Based Health Care Center in Australia were used to evaluate the quality of the included literature, and the Meta-synthesis was used to integrate the literature results.Results:A total of ten articles were included, and 33 clear research results were extracted, which were summarized into eight new categories, and finally summarized into four integrated results, such as heavy burden experience, strong demand, positive experience and satisfaction with the medical service system.Conclusions:Medical workers should attach importance to and pay attention to the burden and needs of caregivers of lung transplant patients, provide professional and emotional support to caregivers, improve their caring ability and quality, and ultimately improve the quality of life of lung transplant patients.

Objective:To analyze the risk factors for rotator cuff tear and evaluate the corresponding prediction efficacy.Methods:A case-control study was conducted in 69 patients with rotator cuff tear admitted to Affiliated Hospital of Qingdao University from June 2020 to June 2021 (rotator cuff tear group) and 51 normal volunteers or medical examiners (normal control group). There were 55 males and 65 females, with the age range of 34-77 years [(58.2±7.2)years]. Body mass index (BMI) ranged from 19.5-32.4 kg/m 2 [(25.4±2.5)kg/m 2]. Univariate analysis was performed for the correlation of gender, age, history of hypertension, history of smoking, history of diabetes, BMI, angle of humeral greater tuberosity and notch angle of humeral greater tuberosity with rotator cuff tear in the two groups. Factors with statistically significant differences were included in multivariate Logistic regression analysis to determine the independent risk factors for rotator cuff tear. Spearman correlation analysis was used to find factor correlation between the two groups. The receiver operating characteristic (ROC) curve of relevant factors for the diagnosis and prediction of rotator cuff tear was analyzed. Results:Univariate analysis showed that age, angle of humeral greater tuberosity and notch angle of humeral greater tuberosity related to rotator cuff tear (all P<0.05). On the contrary, gender, history of hypertension, history of smoking, history of diabetes and BMI were not correlated with rotator cuff tear (all P>0.05). Multivariate Logistic regression analysis showed significant correlations of angle of humeral greater tuberosity and notch angle of humeral greater tuberosity with rotator cuff tear (all P<0.05). Spearman correlation analysis showed that age was not correlated with angle of humeral greater tuberosity and notch angle of humeral greater tuberosity ( r=0.09, 0.13, all P>0.05), but there was significant positive correlation between angle of humeral greater tuberosity and notch angle of humeral greater tuberosity ( r=0.76, P<0.01). When the optimal cutoff values of angle of humeral greater tuberosity and notch angle of humeral greater tuberosity were 70.05° and 150.55°, the area under the ROC curve (AUC) for predicting rotator cuff tear was 0.79 (95% CI 0.71-0.87, P<0.01) and 0.81 (95% CI 0.74- 0.89, P<0.01). Conclusions:Angle of humeral greater tuberosity and notch angle of humeral greater tuberosity are independent factors for rotator cuff tear, and larger angles suggest higher prevalence of rotator cuff tear. Besides, the notch angle of humeral greater tuberosity has relatively better predictive performance.