Meta-analysis of the treatment of chronic obstructive pulmonary disease by tonifying lung and kidney

Objective:To A randomized controlled trial(RCTS)of lung tonifying and kidney tonifying in the treatment of chronic obstructive pulmonary disease(copd)by meta-analysis.Methods:Computer retrieval of databases such as CNKI、VIP、WanFang、Cochrane Library、EMbase、PubMed.The retrieval time was from the database construction to March 2020,and two evaluators were selected to screen the documents according to the na sorting standards,extract the data with Excel 2010 software,and perform Meta analysis with Rev Man5.3 software.Results:21 RCTS were included.Meta-analysis results show that compared with the conventional treatment,the method of supplementing lung and tonifying kidney can obviously improve lung function(MD=1.69,95%CI[1.36,2.01],P<0.00001)、reduce TCM syndrome score(MD=39.83,95%CI[18.10,61.56],P=0.0003)、improve life quality(MD=-5.90,95%CI[-8.95,-2.85],P=0.0001)、regulates serum immunoglobulin(MD=0.37,95%CI[0.31,0.44],P<0.00001)、improve 6MWD(MD=39.83,95%CI[18.10,61.56],P=0.0003)、improve CAT(MD=-1.68,95%CI[-2.05,-1.30],P<0.00001).The differences were statistically significant.For improved T lymphocyte subsets(MD=0.96,95%CI[-0.10,2.03],P=0.08)not statistically significant.Conclusion:Lung-tonifying kidney-tonifying method had better efficacy in improving lung function,reducing TCM syndrome score,improving quality of life,improving immunoglobulin,improving 6WMD,improving CAT,but the efficacy in improving t-lymphocyte subgroup was similar to that in the control group.Due to the limited quantity and quality of samples included in this paper,more multicenter randomized controlled trials with rigorous design of large samples should be carried out for verification.

Theory discussion on airway remodeling of bronchial asthma

According to modern research,the pathogenesis of asthma mainly includes airway inflammation,airway hyperresponsiveness,airway remodeling,etc.Airway remodeling is the key factor that leads to the progress of asthma,and it is also the main factor that leads to airway hyperresponsiveness and irreversible airflow restriction.Traditional Chinese medicine believes that"phlegm and blood stasis"block the airway and narrow the lumen is the most important factor in the treatment of asthma.

Effect of oleic acid-induced acute lung injury and conventional mechanical ventilation on renal function in piglets

Background Animal models that demonstrate changes of renal function in response to acute lung injury （ALl） and mechanical ventilation （MV） are few. The present study was performed to examine the effect of ALl induced by oleic acid （OA） in combination with conventional MV strategy on renal function in piglets. Methods Twelve Chinese mini-piglets were randomly divided into two groups： the OA group （n=6）, animals were ventilated with a conventional MV strategy of 12 ml/kg and suffered an ALl induced by administration of OA, and the control group （n=6）, animals were ventilated with a protective MV strategy of 6 ml/kg and received the same amount of stedle saline. Results Six hours after OA injection a severe lung injury and a mild-moderate degree of renal histopathological injury were seen, while no apparent histological abnormalities were observed in the control group. Although we observed an increase in the plasma concentrations of creatinine and urea after ALl, there was no significant difference compared with the control group. Plasma concentrations of neutrophil gelatinase-associated lipocalin （NGAL） and cystatin C increased （5.6＋1.3） and （7.4＋1.5） times in the OA group compared to baseline values, and were significantly higher than the values in the control group. OA injection in combination with conventional MV strategy resulted in a dramatic aggravation of hemodynamic and blood gas exchange parameters, while these parameters remained stable during the experiment in the control group. The plasma expression of TNF-a and IL-6 in the OA group were significantly higher than that in the control group. Compared with high expression in the lung and renal tissue in the OA group, TNF-a and IL-6 were too low to be detected in the lung and renal tissue in the control group. Conclusions OA injection in combination with conventional MV strategy not only resulted in a severe lung injury but also an apparent renal injury. The potential mechanisms involved a cytokine response of TNF-a and IL-6 in plasma, lung and renal tissues.

Planar cell polarity regulators in asymmetric organogenesis during development and disease

The phenomenon of planar cell polarity is critically required for a myriad of morphogenetic processes in metazoan and is accurately controlled by several conserved modules.Six“core”proteins,including Friz zled,Flamingo(Celsr),Van Gogh(Vangl),Dishevelled,Prickle,and Diego(Ankrd6),are major components of the Wnt/planar cell polarity pathway.The Fat/Dchs protocadherins and the Scrib polarity complex also function to instruct cellular polarization.In vertebrates,all these pathways are essential for tissue and organ morphogenesis,such as neural tube closure,left-right symmetry breaking,heart and gut morphogenesis,lung and kidney branching,stereociliary bundle orientation,and proximal-distal limb elongation.Mutations in planar polarity genes are closely linked to various congenital diseases.Striking advances have been made in deciphering their contribution to the establishment of spatially oriented pattern in developing or gans and the maintenance of tissue homeostasis.The challenge remains to clarify the complex interplay of different polarity pathways in organogenesis and the link of cell polarity to cell fate specification.Inter disciplinary approaches are also important to understand the roles of mechanical forces in coupling cellular polarization and differentiation.This review outlines current advances on planar polarity regulators in asymmetric organ formation,with the aim to identify questions that deserve further investigation.

Nephrogenic acute respiratory distress syndrome： A narrative review on pathophysiology and treatment

The kidneys have a close functional relationship with other organs especially the lungs. This connection makes the kidney and the lungs as the most organs involved in the multi-organ failure syndrome. The combination of acute lung injury （ALl） and renal failure results a great clinical significance of 80% mortality rate. Acute kidney injury （AKI） leads to an increase in circulating cytokines, chemokines, activated innate immune cells and diffuse of these agents to other organs such as the lungs. These factors initiate pathological cascade that ultimately leads to ALl and acute respiratory distress syndrome （ARDS）. We comprehensively searched the English medical literature focusing on AKI, ALl, organs cross talk, renal failure, multi organ failure and ARDS using the databases of PubMed, Embase, Scopus and directory of open access journals. In this narrative review, we summarized the pathophysiology and treatment of respiratory distress syndrome following AKI. This review promotes knowledge of the link between kidney and lung with mechanisms, diagnostic biomarkers, and treatment involved ARDS induced by AKI.