ObjectiveTo explore the regulatory effect of Ganluqingwen prescription on inflammation and immunity by observing the clinical efficacy of Ganluqingwen prescription in the treatment of community-acquired pneumonia （CAP）， so as to provide a clinical basis for the treatment of CAP by traditional Chinese medicine （TCM）. MethodsA randomized controlled trial was conducted by selecting patients who were diagnosed with CAP and identified as wind-heat attacking lungs in Xinjiang Uygur Autonomous Region Hospital of TCM from January 2024 to May 2024 and assigning the patients to a control group （treated by western medicine treatment） or an experimental group （treated by Ganluqingwen prescription combined with western medicine）. The data of the enrolled patients before treatment， for three-day treatment， for seven-day treatment， and for 14-day treatment were collected， including basic information， medical history， pneumonia severity index （PSI） classification， and distribution and difference of laboratory and imaging information indexes. The peripheral blood specimens were collected from the patients. and the changes of inflammatory factors in peripheral blood were detected by using enzyme-linked immunosorbent assay （ELISA） reagent kits and flow-type multifactor microarrays to evaluate the clinical safety and efficacy of Ganluqingwen prescription in CAP. ResultsCompared with those in the groups before treatment， the total scores of TCM syndromes significantly decreased in both groups （P<0.05）. Compared with those in the control group after treatment， the total scores of TCM syndromes decreased more significantly in the experimental group （P<0.05）. Compared with the control group after treatment， the experimental group displayed a significantly reduced number of days of fever in patients （P<0.05）. Compared with those in the groups before treatment， the leukocyte， neutrophil counts， C-reactive protein （CRP）， procalcitonin （PCT）， interleukin （IL）-6， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， creatinine （Cr）， creatine kinase （CK）， and creatine kinase isoenzymes （CK-MB） in both groups decreased （P<0.05） after treatment. Compared with that in the control group after treatment， the decrease of leukocyte， neutrophil counts， CRP， PCT， IL-6， ALT， AST， Cr， CK， and CK-MB was more pronounced in the experimental group （P<0.05）. Compared with those in the group before treatment， the partial pressure of carbon dioxide increased in the experimental group for 3 d of treatment （P<0.05）， and the standard alkali residual， actual alkali residual， standard bicarbonate concentration， and actual bicarbonate concentration increased in the experimental group for 7 d of treatment （P<0.05）. Compared with that in the group before treatment， D-dimer decreased in the control group for 7 d of treatment （P<0.05）. D-dimer and activated partial thromboplastin time （APTT） decreased in the experimental group for 3 d of treatment （P<0.05）， and D-dimer， fibrinogen （FIB）， and APTI significantly decreased in the group for 7 d of treatment （P<0.05）. Compared with the group for 3 d of treatment， the experimental group for 7 d of treatment showed decreased FIB （P<0.05）. Compared with those in the groups before treatment， the levels of inflammatory factors IL-4， IL-10， and IL-13 were elevated in the peripheral blood of the two groups after treatment， and the levels of B lymphocyte chemoattractant （BLC）， interferon gamma-induced protein 10 （IP-10）， tumor necrosis factor-alpha （TNF-α）， interferon-gamma （IFN-γ）， monocyte chemoattractant protein-1 （MCP-1）， CRP， IL-2， IL-6， IL-8， IL-17， IL-22， and IL-23p19 were significantly reduced （P<0.01）. Compared with the control group after treatment， the experimental group exhibited more significant improvement in indexes above （P<0.01）. ConclusionThe group treated by Ganluqingwen prescription combined with western medicine shows more significant effects on reducing total scores of TCM syndromes， lowering the ability of leukocyte and neutrophil counts， decreasing BLC， IP-10， TNF-α， IFN-γ， MCP-1， CRP， IL-2， IL-6， IL-8， IL-17， IL-22， and IL-23p19 in the peripheral blood of the patients， and elevating levels of IL-4， IL-10， and IL-13 than the group treated by western drugs alone.

ObjectiveTo explore the regulatory effect of Ganluqingwen prescription on inflammation and immunity by observing the clinical efficacy of Ganluqingwen prescription in the treatment of community-acquired pneumonia （CAP）， so as to provide a clinical basis for the treatment of CAP by traditional Chinese medicine （TCM）. MethodsA randomized controlled trial was conducted by selecting patients who were diagnosed with CAP and identified as wind-heat attacking lungs in Xinjiang Uygur Autonomous Region Hospital of TCM from January 2024 to May 2024 and assigning the patients to a control group （treated by western medicine treatment） or an experimental group （treated by Ganluqingwen prescription combined with western medicine）. The data of the enrolled patients before treatment， for three-day treatment， for seven-day treatment， and for 14-day treatment were collected， including basic information， medical history， pneumonia severity index （PSI） classification， and distribution and difference of laboratory and imaging information indexes. The peripheral blood specimens were collected from the patients. and the changes of inflammatory factors in peripheral blood were detected by using enzyme-linked immunosorbent assay （ELISA） reagent kits and flow-type multifactor microarrays to evaluate the clinical safety and efficacy of Ganluqingwen prescription in CAP. ResultsCompared with those in the groups before treatment， the total scores of TCM syndromes significantly decreased in both groups （P<0.05）. Compared with those in the control group after treatment， the total scores of TCM syndromes decreased more significantly in the experimental group （P<0.05）. Compared with the control group after treatment， the experimental group displayed a significantly reduced number of days of fever in patients （P<0.05）. Compared with those in the groups before treatment， the leukocyte， neutrophil counts， C-reactive protein （CRP）， procalcitonin （PCT）， interleukin （IL）-6， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， creatinine （Cr）， creatine kinase （CK）， and creatine kinase isoenzymes （CK-MB） in both groups decreased （P<0.05） after treatment. Compared with that in the control group after treatment， the decrease of leukocyte， neutrophil counts， CRP， PCT， IL-6， ALT， AST， Cr， CK， and CK-MB was more pronounced in the experimental group （P<0.05）. Compared with those in the group before treatment， the partial pressure of carbon dioxide increased in the experimental group for 3 d of treatment （P<0.05）， and the standard alkali residual， actual alkali residual， standard bicarbonate concentration， and actual bicarbonate concentration increased in the experimental group for 7 d of treatment （P<0.05）. Compared with that in the group before treatment， D-dimer decreased in the control group for 7 d of treatment （P<0.05）. D-dimer and activated partial thromboplastin time （APTT） decreased in the experimental group for 3 d of treatment （P<0.05）， and D-dimer， fibrinogen （FIB）， and APTI significantly decreased in the group for 7 d of treatment （P<0.05）. Compared with the group for 3 d of treatment， the experimental group for 7 d of treatment showed decreased FIB （P<0.05）. Compared with those in the groups before treatment， the levels of inflammatory factors IL-4， IL-10， and IL-13 were elevated in the peripheral blood of the two groups after treatment， and the levels of B lymphocyte chemoattractant （BLC）， interferon gamma-induced protein 10 （IP-10）， tumor necrosis factor-alpha （TNF-α）， interferon-gamma （IFN-γ）， monocyte chemoattractant protein-1 （MCP-1）， CRP， IL-2， IL-6， IL-8， IL-17， IL-22， and IL-23p19 were significantly reduced （P<0.01）. Compared with the control group after treatment， the experimental group exhibited more significant improvement in indexes above （P<0.01）. ConclusionThe group treated by Ganluqingwen prescription combined with western medicine shows more significant effects on reducing total scores of TCM syndromes， lowering the ability of leukocyte and neutrophil counts， decreasing BLC， IP-10， TNF-α， IFN-γ， MCP-1， CRP， IL-2， IL-6， IL-8， IL-17， IL-22， and IL-23p19 in the peripheral blood of the patients， and elevating levels of IL-4， IL-10， and IL-13 than the group treated by western drugs alone.

Objective The material basis and pathway of CFTR regulation of sphingolipid metabolism in COPD were discussed,and the theory of lung channel regulation was further elucidated.Methods The mouse model of COPD was established by smoking method,and the CFTR model was established by smoking plus CFTR agonist.The pathological changes of lung tissues were observed and the mouse model was evaluated.Ceramide and sphingosine-1-phosphate expression of sphingolipid metabolites in plasma of the model were detected by LC-MS mass spectrometry.Western blot was used to detect the phosphorylation levels of Sphks,ASM and CFTR proteins in the lung tissue of the mouse model.Quantitative fluorescence PCR was used to detect the mrna transcription levels of Sphks,Smpd and CFTR mRNA in the lung tissue of the mouse model.Results The expression of S1p in COPD group and CFTR intervention group was lower than that in control group(P<0.05),and the expression of S1P in CFTR intervention group was higher than that in COPD group(P<0.05).The protein phosphorylation levels of CFTR and Sphk1 were low in COPD group and CFTR intervention group,the lowest expression in COPD group was different from that in control group and CFTR intervention group(P<0.05),and Sphk2 was different in COPD group and control group(P<0.05).ASM in COPD group and CFTR intervention group was higher than that in control group(P<0.05).CFTR mRNA in COPD group and CFTR intervention group was lower than that in control group,and there were differences between COPD group and control group(P<0.05).Sphk1 mRNA expression was the highest in control group,and there were differences between it and COPD group and CFTR intervention group(P<0.05).SMPD1 mRNA was highly expressed in COPD group and CFTR intervention group,and was different from control group(P<0.05).Conclusion To explore the material changes of pulmonary aqueduct dysfunction in COPD diseases,and to reveal the pathway of CFTR affecting water and fluid metabolism in COPD by participating in the regulation of sphingolipid metabolism.

Objective To assess the methodology,reporting quality and intervention reporting quality of randomised controlled trials(RCT)of acupuncture for chronic obstructive pulmonary disease(COPD).Methods Randomized controlled trials of acupuncture for the treatment of chronic obstructive pulmonary disease from the establishment of the database to March 1,2023 through computer system search of CNKI,Wanfang,VIP,SinoMed,and PubMed databases.Two researchers independently conducted literature search,relevant data extraction,etc.,and assessed the quality of reports using the bias assessment tools ROB2,CONSORT Extended Statement and STRICTA List of Cochrane Systematic Review Manuals.Results After excluding non-compliant articles through the developed exclusion criteria,31 RCT remained.A methodological assessment of the included RCT according to the Cochrane website bias assessment tool ROB2 showed that 9 studies(29.03%)were at high risk of bias and no studies at low risk of bias.The CONSORT extended statement based on non-drug randomized controlled trials evaluated the quality of the literature,indicating that the reporting rate in terms of methods,results,trial protocol registration,etc.was low.The results of the evaluation according to the entries in the STRICTA list show that most of the literature does not describe the details of acupuncture and the background of the therapist in sufficient detail,but the reasonableness of acupuncture treatment is relatively complete.Conclusion At present,the quality of randomized controlled trials of acupuncture for COPD is generally low,and it is recommended that future researchers strictly follow the internationally recognized CONSORT statement and STRICTA list for trial protocol design and study result reporting.

Objective:To optimize the challenge scheme for establishing a stable mouse model of Artemisia annua pollen-induced allergic rhinitis. Methods:BALB/c mice were subcutaneously injected with 0.1 ml allergen extract containing 20 μg/ml Art a1 from Artemisia pollen on 1 d, 4 d and 7 d. One week after the sensitization, these mice were divided into three groups and intranasally challenged with Artemisia annua pollen allergen extract containing 500 μg/ml Art a1 for 7 (7 d group), 10 (10 d group) and 14 (14 d group) consecutive days, respectively. The first challenge was followed by another 7 days of challenge every four weeks. Blank control group was set up through sensitizing and challenging BALB/c mice with normal saline. Behavioral changes and nasal pathological changes were observed. The changes in humoral and cellular responses were also detected. After the first challenge cycle was decided, the challenge frequency was further optimized. Results:After the first challenge, the allergic symptoms of mice in 10 d group were significantly severe than those in 7 d and 14 d groups, and the levels of serum specific IgE antibody in 10 d and 14 d groups were significantly higher than that in 7 d group. After the second challenge, the mice in the three model groups still had obvious allergic symptoms as compared with the blank control group. There were obvious pathological changes in the nose, including epithelial cell proliferation, turbinate enlargement and inflammatory cell increase. Moreover, the level of serum specific IgE antibody increased significantly and the proliferation of antigen-specific IL-4 and IL-6 lymphocytes was significantly up-regulated, especially in 10 d and 14 d groups. The frequency of challenge had a great impact on the stability of the allergic model. The allergic symptoms of sensitized mice challenged every two weeks were significantly severe than those of mice challenged every four weeks and the level of serum antigen-specific antibody was also higher.Conclusions:This study optimized the first challenge cycle and challenge frequency for establishing a mouse model of Artemisia annua pollen-induced allergic rhinitis, which provided reference for the establishment of drug efficacy evaluation system for desensitization therapy.

Objective To investigate the correlation of IL-17 gene polymorphism with chronic obstructive pulmonary diseases (COPD) in Xinjiang area.Methods Five single nucleotide polymorphism (SNP) loci of IL-17A gene,including rs2275913,rs3819024,rs3819025,rs4711998 and rs8193036,and 4 SNP loci of IL-17F gene such as rs12203582,rs1266828,rs7771466 and rs9382084 from 149 COPD patients and 97 healthy controls were performed typing using the multiple single-base extension SNP (SNaPshot) technology,and the risk correlations of different genotypes and alleles of these loci with COPD were analyzed.Results There was no difference in the SNP of 5 IL-17A gene loci and 4 IL-17A gene loci between stable COPD patients and healthy controls,and the mutation and genotype distribution of these loci were not correlated with COPD susceptibility.However,the linkage disequilibrium analysis showed that there was significant difference in the distribution of IL-17A gene haplotype CAA between COPD patients and healthy controls (OR =0.244,95％ CI:0.057-1.043,P ＜ 0.05).Conclusion The IL-17F and IL-17A gene polymorphisms are not correlated with the risk of COPD,but the haplotype CAA of 1L-17A gene may be related to the susceptibility of COPD in Xinjiang area.

Objective To reveal the effects of cold-dryness and modified Zhisou Power on epidermal growth factor receptor (EGFR) and neutrophil elastase (NE) in rats with COPD. Methods COPD model was established with an elastase dose into the trachea combined with exposure to smoking for 90 d; cold-dryness COPD group was further developed by exposure to a cold, dry environment for 90 d. After 90 days, cold-dryness COPD rats was divided into cold-dryness group and Zhisou Power intervention group (treated with modified Zhisou Power for 7 days). On the 97th day, all rats were killed. Pathological changes in lungs were observed. mRNA and protein expression of EGFR were measured by RT-qPCR and Western blot, and the amount of NE in serum and BALF were examined by ELISA. Results EGFR mRNA and protein expression were significantly higher in COPD group, cold-dryness group and Zhisou Power intervention group than in control group. EGFR was significantly lower in Zhisou Power intervention group than in COPD group and cold-dryness group. NE was significantly higher in serum and BALF in COPD group, cold-dryness group and Zhisou Power intervention group than in control group. NE in BALF was significantly higher in cold-dryness group than in COPD group. NE in BALF was significantly lower in Zhisou Power intervention group than in cold-dryness group. Conclusion Modified Zhisou Power can down-regulate the expression of EGFR and the mount of NE in cold-dryness COPD rats to treat COPD.

Objective To observe efficacy and safety of Yiqi Gubiao Pill combined with Pingchuan External Application Ointment for the treatment of COPD (lung-spleen qi deficiency type) at a stable stage. Methods A randomized, double-blind, and placebo-controlled method was used. Totally 266 cases of patients diagnosed with COPD lung-spleen qi deficiency syndrome were randomly divided into four groups. Experimental Ⅰ group (72 cases) was given Yiqi Gubiao Pill, 10 pills each time, three times a day, orally; at the same time, experimental Ⅰ group was given simulated Pingchuan External Application Ointment (blank medical bag), for Feishu (BL13), danzhong (RN17), Pishu (BL20), Fengmen (BL12), and Dingchuan, external application at 11am each day, external heating stickers, 4-6 h each time, twice a week. Experimental Ⅱ group (64 cases) was given simulated Yiqi Gubiao Pill combined with Pingchuan External Application Ointment. Experimental (64 cases) was givenⅢ Yiqi Gubiao Pill combined with Pingchuan External Application Ointment. Control group (66 cases) was given simulated Yiqi Gubiao Pill combined with simulated Pingchuan External Application Ointment. The treatment lasted for three months, and the follow-up was three months. TCM symptom scores, FEV1%, FVC%, CAT, BODE index, mMRC, and 6MWT were observed. Results After three-month treatment and three-month follow-up, the improvement of TCM symptom scores of the 3 experimental groups was better than the control group (P<0.05). The improvement of CAT, mMRC, BODE index, 6MWT, mMRC in the three treatment groups were better than the control group (P<0.05). The improvement of mMRC and BODE in experimental Ⅰ and Ⅱ groups were better than those of experimental group (Ⅲ P<0.05). After three-month treatment, the improvement of FVC% in the three experimental groups was better than the control group (P<0.05). The improvement of FEV1% in the experimental Ⅱ and groups was better than the control groupⅢ(P<0.05). Conclusion Yiqi Gubiao Pill combined with Pingchuan External Application Ointment has obvious efficacy for the treatment of COPD with lung-spleen qi deficiency type.

Objective To observe the clinical application of extraperitoneal cesarean section(ECS) plus forceps vs transperitoneal cesarean sections(TCS) in repeated cesarean section.Methods 98 multiparous women with scar uterus for elective repeated cesarean sections were recruited retrospectively,47 cases for ECS plus forceps(group A),and 51 cases for TCS(group B).The multiparous women with hyperglycemia not controlled,severe preeclampsia,heart disease,placenta previa,premature rupture of membrane,a history of ＞ 1 cesarean section,myoma and/or ovarian neoplasm were excluded.Results Skin incision to baby delivery time and total operation time of group A were (7.7 ± 2.8) min and (42.8 ± 9.7) min,respectively,which were significantly shorter than (9.3 ± 3.2) min and (47.6 ± 9.4) min of group B,(t =2.700,2.497,P =0.008,0.014).There was significant difference in blood loss volume during the operation and postoperative 2 hours,which was (310.4 ± 106.3) mL,(365.3 ± 142.8) mL respectively(t =2.142,P =0.035).The Visual Analog Scale for pain (VAS pain) was (2.8 ± 1.8) in group A and (4.1 ± 1.9) in group B,respectively (t =3.252,P =0.002).The gastrointestinal function recovery mean time of group A was significantly shorter than that of group B (12.5 h versus 16.0h,t =2.771,P =0.007).And the postoperative febrile morbidity was significantly lower in group A than in group B(8.5％ versus 25.5％ ;x2 =4.918,P =0.033).The patients with chronic pelvic pain followed up after operation was 3 versus 12,and the difference was significant (x2 =5.143,P =0.026).There were no differences in neonatal Apgar score at 1 minute,birth asphyxia and wound healing rates.Conclusion ECS plus forceps can be safely used for repeated cesarean section,with the advantages of less operation time,less bleeding volume,lower postoperative morbidity,and fewer complications than TCS.

Objective To investigate the relationship between the expression of glucose regulated protein 78 (GRP78) in the placental trophoblast cells and the pathogenesis of gestational diabetes mellitus (GDM).Methods All the patients were recruited from Qingdao Municipal Hospital from May 2013 to May 2014.Among them, fifty women with GDM were assigned to the GDM group, and fifty healthy women were defined as the control group.All of them received cesarean section because of breech presentation, contracted pelvis, scarred uterus or on mother's demand.Real-time PCR was conducted to analyze the expression of GRP78 mRNA in the trophoblasts.Immunohistochemistry was performed to detect the localization of GRP78 protein in the placentasl trophoblast cells.Results (1) GRP78 mRNA expressed in the cytoplasm of trophoblasts of both the GDM group and the control group.The GRP78 mRNA levels in the GDM group and the control group were 15.6±0.4 and 6.0±0.7, respectively.The relative expression level of GRP78 mRNA in the GDM group was 2.6 times of that in the control group, with statistically significant difference (P＜0.01).(2) The expression of GRP78 protein was found in the cytoplasm of the trophoblasts of the GDM group.It showed in deep, light brown or yellow after staining, according to the expression degree.The expression of GRP78 protein was also found in the cytoplasm of the trophoblasts of the control group, but it mainly showed yellow color (38/50).The strong positive rate of GRP78 protein in the GDM group (96％, 48/50) was higher than that in the control group (22％, 11/50;P＜0.01).Conclusion The expression of GRP78 increased in the placental trophoblast cells of GDM patients.It might suggest that GRP78 had some effect on the pathogenesis of GDM.