Mechanisms and Research Progress of Traditional Chinese Medicine Regulating NF-κB in the Treatment of Acute Lung Injury/Acute Respiratory Distress Syndrome

Acute lung injury(ALI)has multiple causes and can easily progress to acute respiratory distress syndrome(ARDS)if not properly treated.Nuclear factorκB(NF-κB)is a key pathway in the treatment of ALI/ARDS.By exploring the relevance of NF-κB and the pathogenesis of this disease,it was found that this disease was mainly associated with inflammation,dysfunction of the endothelial barrier,oxidative stress,impaired clearance of alveolar fluid,and coagulation disorders.Traditional Chinese medicine(TCM)has the characteristics of multitargeting,multipathway effects,and high safety,which can directly or indirectly affect the treatment of ALI/ARDS.This article summarizes the mechanism and treatment strategies of TCM in recent years through intervention in the NF-κB-related signaling pathways for treating ALI/ARDS.It provides an overview from the perspectives of Chinese herbal monomers,TCM couplet medicines,TCM injections,Chinese herbal compounds,and Chinese herbal preparations,offering insights into the prevention and treatment of ALI/ARDS with TCM.

Efficacy and mechanisms of Traditional Chinese Medicine prevention and treatment for respiratory viruses

Respiratory virus infection was the most common viral infection in clinical practice with the greatest impact,including the Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),posing a huge threat to the world's public health and human life safety.Commonly used antiviral drugs have obvious side effects and a narrow scope of application.Respiratory viruses are susceptible to infection,mutation,and prevalence,which also pose challenges to traditional antiviral drugs and vaccine development.Traditional Chinese Medicine(TCM)has a long history of treating infectious diseases,with many herbs and compounds.Its multi-component,multi-target and multi-path characteristics have made it have great advantages and potential in the development of new anti-respiratory virus drugs.This review summarized TCM for the prevention and treatment of common respiratory viruses,and provided new strategies for the research and development of new TCM antiviral drugs and for responding to infectious respiratory virus diseases.

Effectiveness of Participatory Teaching Methods in the Standardized Training of Respiratory Medicine Residents

Objective:To explore and analyze the application effect of participatory teaching method in the standardized training of respiratory medicine residents.Methods:The study period was from May 2022 to May 2023.20 doctors in the standardized training of respiratory medicine residency in our hospital were taken as research subjects and grouped into the participatory group(n=10)and the routine group(n=10)by using the random number lottery method.The participatory group practised participatory teaching methods,and the routine group practised routine teaching methods.The results of discharge assessment,teaching evaluation,and mini-Clinical Evaluation Exercise(mini-CEX)assessment were compared between the groups.Results:The theoretical assessment,operational assessment,and total scores of the participatory group were significantly higher than those of the routine group,and the difference was statistically significant(P<0.05).The teaching evaluation of independent learning,theoretical mastery,teamwork,clinical thinking,communication,and learning interest of the participatory group was significantly higher than that of the routine group,and the difference was statistically significant(P<0.05).The mini-CEX assessments of history inquiry,organizational effectiveness,professionalism,physical examination,clinical diagnosis,communication skills,and overall clinical competence of the participatory group were significantly better than those of the routine group,and the difference was statistically significant(P<0.05).The teaching satisfaction of the participatory group was significantly higher than that of the routine group,the difference was statistically significant(P<0.05).Conclusion:Participatory teaching methods can improve the overall level of doctors in the respiratory medicine residency standardized training,and the teaching satisfaction is improved.

Effects of Integrative Chinese and Western Medicine on Arterial Oxygen Saturation in Patients with Severe Acute Respiratory Syndrome

Objective: To evaluate the effects of treatment of integrative Chinese and Western medicine (ICWM) on arterial oxygen saturation (SaO2) in patients with severe acute respiratory syndrome (SARS). Methods:The non-randomized, controlled trial was conducted on 447 SARS patients treated synchronously with western conventional treatment (WM group, n = 171) alone and ICWM (ICWM group, n = 276). The changes of the cases with normal level (≥95% ) or abnormal level (<95% ) SaO2 were observed dynamically. Results: In the 3rd-14th day of the therapeutic course, the percentage of patients with normal SaO2 in the ICWM group was higher than that in the WM group (OR = 0.5178, P = 0.0038), and this tendency was more evident in patients of the severe type (OR = 0. 18, P = 0. 0001). However, the statistical significance of difference was only shown in patients for whom the ICWM treatment started in the early period after the onset (≤7 days after it, OR = 0.3803, P = 0.006), but not shown in those who received ICWM treatment later in the mid-late period of SARS ( P>0. 05). Conclusion: ICWM treatment, particularly when it is used for intervention in the early stage, is beneficial for maintaining normal SaO2 in SARS patients.

Therapeutic Effects of Integrated Traditional Chinese Medicine and Western Medicine in Treating Severe Acute Respiratory Syndrome

Objective: To improve the effects of treatment of severe acute re spiratory syndrome (SARS) and to explore the clinical significance of integrate d traditional Chinese medicine and western medicine (ICWM) in the treatment of S ARS and its influence on the chief indexes in the process of the disease. Methods: The clinical study involving observation of 135 patients of SARS was conducted in the randomized, synchronously controlled and open way. The patients were divided into two groups, 68 in the ICWM group and 67 in the c ontrol group, all of whom were treated with the same basic treatment of western medicine, but to the ICWM group, Chinese drugs for clearing Heat, detoxifying an d removing Dampness were given additionally. The comprehensive effect on relievi ng fever, cell mediated immunity, pulmonary inflammation and secondary infect ion was compared between the two groups. Results: The therapeutic effect in the ICWM group was better than that in the control group in such aspects as steadily lowering body temperature, alleviating general symptoms, accelerating the absorption of pulmonary infiltra tion and easing cellular immunity suppression. Conclusion: The therapeutic effect of ICWM is better in treating SARS than that of western medicine alone.

Anti-respiratory passage virus of Chinese herbal medicine

Influenza virus and respiratory syncytial virus infection of viral respiratory disease has become a major killer of mankind, but there is no effect of vaccines and therapeuticmdrugs. Chinese herbs can inhibit the proliferation and strengthen the human immune virus, and so on to play a very good antiviral activity. Single- flavor compound in accordance with two different drugs and the object of study, the herbal anti-influenza virus and respiratory syncytial virus, a comprehensive overview of research and clinical outlook of the Chinese herbs to good use.

Traditional Chinese Medicine Nursing Protocols for Fever Caused by Exogenous Pathogens (Upper Respiratory Infection)

Fever caused by exogenous pathogens,also called upper respiratory infection( URI),refers to a classification of exogenous diseases induced by invasion of six pathogenic factors into the body leading to disharmony betw een nutrient Qi and defensive Qi and imbalance of Yin and Yang. As an extremely common symptom or sign,it is frequently seen in various processes of acute and chronic diseases. In recent years,traditional Chinese medicine( TCM) has achieved a certain efficacy in the treatment of fever caused by exogenous pathogens,such as modified formulae,Chinese patent drugs,self-made formulae,acupuncture,moxibustion and so on.This article mainly explored the key points of common syndromes,TCM nursing methods and health guidance of fever caused by exogenous pathogens,in order to further develop the advantages of TCM,improve its efficacy and standardize its nursing behavior.

Advances in traditional Chinese medicine for respiratory disease therapy in 2021

Respiratory diseases are common conditions that endanger human health.Their etiology,pathogenesis,and prognosis are complex,and clinical research has been extensive.This paper reviews studies from the PubMed database to assess the progress of traditional Chinese medicine in the treatment of respiratory diseases in 2021,focusing on related animal and cell models of coronavirus disease 2019.Traditional Chinese medicine extracts,such as polysaccharides and emodin,and classic prescriptions,such as Mahuang decoction,respond to the treatment of influenza by reducing viral infections and regulating the body’s immune response.Chinese herbal extracts,such as schizandra B and andrographolide,treat asthma by inhibiting inflammatory response pathway formation,NLRP3 inflammasome formation,oxidative stress,and autophagy.Traditional Chinese medicine extracts such as fucoxanthin,and proprietary Chinese medicines such as the Xihuang pill is used in the treatment of lung cancer,as it regulates the cell cycle,inhibit tumor cell proliferation,and enhance the body’s immune function.Classic formulas such as the kidney tonic lung formula and proprietary Chinese medicine,such as compound grass stone silkworm granules,relieve airway inflammation and improve lung function in chronic obstructive pulmonary disease.Chinese herbal extracts,such as jostilbene and sage phenol,inhibit epithelial cell-mesenchymal transformation and regulate the levels of inflammatory factors to treat idiopathic pulmonary fibrosis to provide a reliable basis for the treatment of respiratory diseases.

In vitro study on the antiviral activity of 9 extracts of traditional Chinese herbal medicine against the human respiratory syncytial virus

Objective:To study the in vitro virucidal activity of 9 extracts of traditional Chinese herbal medicine(the water extracts of Evodia lepta,Clausena lansium,Clerodendrum cyrtophyllum,Callicarpa nudiflora,Nauclea officinalis and Elaeagnus gonyanthes,the alcohol extracts of Nauclea officinalis,Elaeagnus gonyanthes and Zanthoxylumarmatum)on human respiratory syncytial virus(HRSV).Methods:The cytotoxic effect of the extracts on cells was evaluated by a cell viability assay using the CCK-8 method,a concentration of the extracts with cell viability greater than 50%was selected for the follow-up anti-HRSV effect assay,the 50%effective concentration(EC50)was assessed by an in vitro cell infection model.Results:The EC50s of the water extract from Clerodendrum cyrtophyllum,Callicarpa nudiflora and Elaeagnus gonyanthes were 0.05 mg/mL,0.03 mg/mL and 0.05 mg/mL,and the therapeutic index(TI)of them were 18.60,21.67 and 56.80 respectively.Conclusion:The water extracts of Clerodendrum cyrtophyllum,Callicarpa nudiflora and Elaeagnus gonyanthes possess the activity of anti-HRSV virus.

Give Full Play the Role of Traditional Chinese Medicine to Prevent and Treat Severe Acute Respiratory Syndrome with Integrative Chinese and Western Medicine Approach

Member of Political Bureau of Central Committee of CPC, Vice Premier of State Council concurrently Minister of Health, General Command of National Protecting and Treating Severe Acute Respiratory Syndrome ( SARS) Headquarters Vice premier WU Yi cordially met the well-known TCM specialists, and held a symposium with them. Sixteen specialists including WANG Yong-yan, CHEN Ke-ji, LI Fu-ren, JIAO Shu-de, HE Pu-ren, LIU

Research Progress of Traditional Chinese Medicine in the Treatment of Acute Respiratory Distress Syndrome

Based on the modern pathological research mechanism of ARDS,this paper summarizes the clinical therapeutic effect of traditional Chinese medicine on ARDS from the aspects of reducing inflammatory mediators,cells and factors,regulating signal pathway,regulating aquaporin,anticoagulation and so on.The purpose is to provide new theoretical basis and ideas for scholars in the future,and to improve the internationalization process of traditional Chinese medicine in the treatment of acute respiratory distress syndrome.

A Patient with End-stage Respiratory Failure Gets Recovery from Mechanical Ventilation by Utilization of Chinese Traditional Medicine

Ventilator-assisted ventilation and lung transplantation are the final treatments for the patients with end-stage respiratory failure.A patient,who has been diagnosed as end-stage respiratory failure and received tracheal intubation with mechanical ventilation,received the treatment of Chinese herbal medicine on the principle of TCM and got some recovery gradually.After two months,the patient got rid of mechanical ventilation successfully.This case implies that TCM will be an alternative treatment for the patients with the similar conditions.

Application of PDCA Cycle in Clinical Teaching of Respiratory Medicine During the Outbreak of COVID-19

The study was to analyze the application of PDCA cycle in the clinical teaching of respiratory department during the outbreak of COVID-19.The teaching content focused on the prevention,control,diagnosis and treatment of COVID-19.Methods:Thirty clinical interns who entered the Department of Respiratory Medicine in our hospital from June 2020 to December 2020 were selected as the research objects and were randomly divided into two groups.The control group adopted traditional teaching methods and the experimental group adopted PDCA cycle.The teaching effect of the two group was compared.Results:The experimental group that used the PDCA cycle method had significantly higher theoretical knowledge,treatment skills,and comprehensive quality evaluation of COVID-19 than the traditional teaching method of the control group.Conclusion:The application of the PDCA cycle method in clinical teaching activities can improve the teaching process during the outbreak of COVID-19 and help improve the overall quality of clinical interns.

呼吸与危重症医学科住院医师胜任力评价体系的构建

目的 构建适合中国国情的呼吸与危重症医学科住院医师胜任力评价体系。方法 本研究于2022年8月至2023年7月进行,采用文献综述结合德尔菲法,包括2轮专家函询,筛选、优化呼吸与危重症医学科住院医师胜任力评价指标。结果 两轮函询的有效问卷回收率均为100%,专家权威系数分别为0.905和0.914,专家咨询的肯德尔和谐系数分别为0.193(χ^(2)=237.561,P<0.001)和0.157(χ^(2)=212.459,P<0.001)。研究构建了胜任力评价体系,包括一级指标8项,二级指标38项。结论 本研究初步构建了呼吸与危重症医学科住院医师胜任力评价体系,更加适用于我国呼吸与危重症医学科住院医师规范化培训的实践临床环境,为规范化培训和教学提供了简单可行的胜任力评价方式。

呼吸内科护士实施病人安全进食行为调查分析

目的:调查呼吸内科护士实施病人安全进食行为现状,为临床开展相关培训提供参考依据。方法:采用自行设计的问卷对全国综合性三级甲等医院的300名呼吸内科护士进行调查,分析护士对病人安全进食行为状况及其影响因素。结果:呼吸内科护士对病人安全进食行为得分为[66.00(58.00,73.75)]分。单因素分析显示,呼吸内科护士是否接受过吞咽障碍相关培训对病人实施安全进食行为有影响。结论:呼吸内科护士需加强对病人进食前筛查与评估,从而前瞻性地发现和降低吞咽障碍的风险。医院应对护士积极开展吞咽障碍相关知识教学培训,提高护士的安全进食意识和识别病人发生吞咽障碍的能力。

课程思政在器官系统整合课程教学中的融合与探索

在高等医学院校的临床医学专业中,将思政教育与医学专业知识紧密结合,并实现其在课堂中的全面融合,已成为教育工作者面临的一项重要任务。文章拟通过分析高等医学院校专业课程中融入思政教育的现存问题,结合广州医科大学呼吸系统整合课程思政教育的实践情况以及有效融合,探索课程思政在器官系统整合课程中开展的经验;通过跨学科方式、多元化教学模式、考核评价体系构建等融合课程思政教育与器官系统整合课程,从而切实提高临床专业课程思政教学质量,构建全员、全课、全程的一体化课程思政体系,为医学院校教学模式的改革提供参考。

单元综合安全项目在呼吸科多重耐药感染防控中的应用

目的 探讨基于单元的综合安全项目在呼吸科多重耐药菌感染防控中的应用价值。方法 以某院呼吸科2019年1—12月在院患者1093例为对照组,实施常规管理方案;2020年4月—2021年4月在院患者1028例为观察组,启动单元的综合安全项目(Comprehensive unit-based safety program, CUSP)计划,将一系列循证干预措施纳入临床管理方案。比较两组患者多重耐药菌(Multi-drug Resistant Organism, MDRO)感染发生率、标本送检正确率、标本送检及时率、抗生素使用规范率、医务人员安全文化、MDRO感染患者住院日数及防控措施落实率。结果 观察组MDRO感染发生率低于对照组(χ^(2)=21.380,P<0.001),患者标本送检正确率、送检及时率及抗菌药物使用规范率高于对照组(χ^(2)=58.039,P<0.001;χ^(2)=64.590,P<0.001;χ^(2)=36.169,P<0.001),医务人员安全文化总评分高于对照组(t=-26.666,P<0.001),MDRO感染患者住院日数低于对照组(Z=-2.866,P=0.004),MDRO防控措施落实率高于对照组(χ^(2)=37.854,P<0.001;χ^(2)=21.328,P<0.001;χ^(2)=4.423,P=0.035;χ^(2)=5.985,P=0.014)。结论 在呼吸内科多重耐药菌感染防控中,开展单元的综合安全项目干预能够有效降低MDRO感染发生率,提高病房管理质量,提升病区患者安全文化,缩短MDRO感染患者住院日数及提高病区MDRO防控措施落实率。

慕课联合翻转课堂在呼吸与危重症医学科规范化培训中的应用

目的:探讨慕课结合翻转课堂在呼吸与危重症医学科住院医师规范化培训中的应用价值。方法:选取在安徽医科大学第二附属医院呼吸与危重症医学科参加住院医师规范化培训的84名内科学员,随机分为观察组和对照组。对照组给予常规教学方式,观察组在常规教学方式的基础上,录制慕课教学视频交住培学员自主学习,让住培学员利用自由时间学习慕课资源,随后通过翻转课堂进行实践、交流互动。比较两组出科理论考试成绩、临床技能成绩及住培学员对于教学的满意度。结果:观察组住培学员理论考试和临床技能成绩均优于对照组,且观察组学员对教学的满意度高于对照组(P<0.05)。结论:慕课联合翻转课堂在呼吸与危重症医学科住院医师规范化培训中有着积极意义。

目标教学法结合PDCA循环在呼吸科规培护士临床教学中的应用

目的探讨目标教学法结合计划(plan)、执行(do)、检查(check)和处理(act)(PDCA)管理模式在呼吸内科规培护士临床教学中的应用价值。方法选取2021年1月—2022年12月进入呼吸内科轮转的64名规培护士作为研究对象,根据入科时间分为对照组和试验组,各32名。对照组采用传统临床教学模式,试验组采用目标教学法结合PDCA管理临床教学模式。对比2组规培护士的考核评分、出科综合素质评分及满意度评分。结果试验组的操作成绩[(96.05±1.57)分],高于对照组[(94.91±1.51)分],差异有统计学意义(P<0.05)。试验组规培护士的沟通协调、专业知识、专业技能、安全意识、解决问题应急能力评分高于对照组,差异均有统计学意义(P<0.05)。试验组满意度平均分为(92.31±1.31)分,高于对照组的(91.07±0.59)分,差异有统计学意义(P<0.05)。结论目标教学法结合PDCA管理临床教学模式有助于提高呼吸内科规培护士的临床操作水平,利于高素质护理人才的培养,同时提升了规培护士的满意度。

某三甲医院呼吸内科优质护理服务与护士能力提升效果评价

目的探讨呼吸内科优质护理服务与护士能力提升效果评价的效果。方法选择2023年1月—2023年11月间呼吸内科工作的20名护理人员作为研究对象,将全部纳入研究的护理人员按照随机数字表法的原则分为两个小组,每组10名,研究组护理人员采用优质护理服务,并在日常工作中进行实践,对照组采用常规护理模式,比较6个月后两组护理人员综合能力成绩比较、护士工作能力评分、医生对护士工作满意度及患者及其家属对护士满意度。结果观察组护理人员综合能力得分为(90.11±3.01)分,对照组护理人员综合能力得分为(84.32±5.04)分,两组比较差异有统计学意义,P<0.05;观察组护理人员工作能力评分为(94.25±2.05)分,对照组护理人员工作能力评分为(85.19±3.24)分,两组比较差异有统计学意义,P<0.05;观察组医生对护理人员满意度评分及患者对护理人员满意度得分均明显高于对照组,两组比较差异有统计学意义,P<0.05。结论在呼吸内科护理中采用优质护理服务能提升护理人员的综合成绩以及日常护理工作能力,同时能提高医生及患者对护士的满意度,值得护理工作中推广。