Effect of Maxingganshi decoction on the expression of STAT4 and STAT6 in lung tissues of rats with chronic obstructive pulmonary disease

Objective:To investigate the effect of Maxingganshi decoction on the expression of STAT4 and STAT6 in lung tissues of rats with chronic obstructive pulmonary disease (COPD).Methods:A total of 30 COPD Wistar rat models with phlegm-heat depression and lung depression were established, with half male and half female. The 30 model rats were fed in different cages, weighed and labeled. They were randomly divided into three groups: Maxingganshi decoction group, roxithromycin tablets control group, model control group. At the same time, 10 normal rats were selected as a blank control group. The white blood cell count and other cell count levels in the alveolar lavage fluid of the rats in the four groups, as well as the STAT4 and STAT6 protein levels in the lung tissues, were observed and compared.Results: After treatment, the white cell counts in Maxingganshi decoction group were significantly higher than that of the model control group (P<0.05);lymph, neutral particles and eosinophil levels were significantly lower than those of the model control group (P<0.05). Compared with roxithromycin tablets control group, white blood cell count and other classification level of cell count in Maxingganshi decoction group were not significantly different (P>0.05). After treatment, STAT4 protein levels in roxithromycin tablets control group and Maxingganshi decoction group were lower than that in the model control group (P<0.05), and STAT6 protein levels in roxithromycin tablets control group and Maxingganshi decoction group were higher than that of the model control group (P<0.05), suggesting the two means of intervention in this study could inhabit the STAT4 protein expression in lung tissue of COPD rats and promote effect on STAT6 protein. In addition, the level of STAT4 and STAT6 in the Maxingganshi decoction group was not significantly different from that in the roxithromycin tablets control group (P>0.05), suggesting that the effect of Maxingganshi decoction was similar to that of roxithromycin tablets.Conclusions: The action mechanism of Maxingganshi decoction group treating COPD may be through the STAT4 and STAT6 protein expression level to impose an effect, and thus interfere with IL-12 / STAT4 and IL-4 / STAT6 these two signaling pathways of Th1 cells and Th2 cells in the body of the gene expression, inhibiting the Th1 polarization and adjusting the imbalance of Thl/Th2 cells, so as to lower inflammatory response mediated by T cells and various kinds of pathological damage.

Visual Analysis of Knowledge Map of Traditional Chinese Medicine in Prevention and Treatment of Pulmonary Interstitial Fibrosis Based on CiteSpace

Objective: To analyze the relevant research literature on the prevention and treatment of pulmonary interstitial fibrosis with traditional Chinese medicine (TCM), understand the current research status, hot spots and future development trend in this field, and provide basis and feasible suggestions for further research in this field. Methods: The journal literatures related to the prevention and treatment of pulmonary interstitial fibrosis with TCM in recent 20 years in CNKI database were searched and passed through CiteSpace 5.8.R3 generates the knowledge map of relevant literature authors, document issuing institutions and keywords, and makes visual analysis. Results: A total of 1,576 documents were included, and the annual number of documents showed a fluctuating upward trend, forming a relatively stable research team represented by authors such as LYU Xiaodong, PANG Lijian and LIU Chuang;According to the atlas of document issuing institutions, Shandong University of Traditional Chinese Medicine and its affiliated hospitals ranked first in the number of documents issued, and the cooperation between institutions is dominated by the University of traditional Chinese medicine and its affiliated hospitals;Keyword cluster analysis shows that a large number of studies have been carried out in the field of etiology and pathogenesis, TCM compound, clinic and experiment. Conclusion: The research on the prevention and treatment of pulmonary interstitial fibrosis with TCM has a high degree of attention, but the cooperation network between the research authors and institutions needs to be strengthened. The research on the pathogenesis and improving the quality of life of patients is the trend of development in the future.

Systematic Evaluation and Meta-Analysis of the Efficacy and Safety of Shenfu Injection in the Treatment of Septic Cardiomyopathy

Objective:To evaluate the efficacy and safety of Shenfu injection in the treatment of septic cardiomyopathy.Methods:Literatures on Shenfu injection for the treatment of sepsis published from the establishment of each database to December 31,2020,were searched by computer;Cochrane risk-of-bias tool was used for evaluating the quality of literatures,and Review Manager 5.4 software was used for meta-analysis.Results:Twenty random controlled trials(RCTs)were included,with a total of 1,179 patients;the meta-analysis showed that the routine treatment of Western medicine combined with Shenfu injection can reduce the 28-day mortality,the length of hospital stay,cardiac troponin I(cTnI),and N-terminal pro-brain natriuretic peptide(NT-proBNP)as well as improve the left ventricular ejection fraction(LVEF)with low incidence of adverse reactions.Conclusion:Western medicine combined with Shenfu injection can further reduce myocardial injury in patients with sepsis and improve cardiac function as well as the prognosis of patients with septic cardiomyopathy.

Development of the Scientific,Transparent and Applicable Rankings (STAR) tool for clinical practice guidelines

Background:This study aimed to develop a comprehensive instrument for evaluating and ranking clinical practice guidelines,named Scientific,Transparent and Applicable Rankings tool(STAR),and test its reliability,validity,and usability.Methods:This study set up a multidisciplinary working group including guideline methodologists,statisticians,journal editors,clinicians,and other experts.Scoping review,Delphi methods,and hierarchical analysis were used to develop the STAR tool.We evaluated the instrument’s intrinsic and interrater reliability,content and criterion validity,and usability.Results:STAR contained 39 items grouped into 11 domains.The mean intrinsic reliability of the domains,indicated by Cronbach’sαcoefficient,was 0.588(95%confidence interval[CI]:0.414,0.762).Interrater reliability as assessed with Cohen’s kappa coefficient was 0.774(95%CI:0.740,0.807)for methodological evaluators and 0.618(95%CI:0.587,0.648)for clinical evaluators.The overall content validity index was 0.905.Pearson’s r correlation for criterion validity was 0.885(95%CI:0.804,0.932).The mean usability score of the items was 4.6 and the median time spent to evaluate each guideline was 20 min.Conclusion:The instrument performed well in terms of reliability,validity,and efficiency,and can be used for comprehensively evaluating and ranking guidelines.

Current opinion on the importance of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

Multidisciplinary pulmonary rehabilitation （PR） is a .widely accepted non-pharmacological treatment method that tries to improve exercise tolerance and quality of life in chronic obstructive pulmonary disease （COPD） and non-COPD patients, together with reduction in medical services use.1 The aim of PR is to help respiratory patients to reach and keep a maximal functioning and independence level within community^2 The patients severely affected by other pulmonary diseases than COPD are benefiting of intensive PR and the degree of improvement is similar to that obtained in COPD^3

Tuberculosis screening among children and adolescents in China:insights from a mathematical model

Background Tuberculosis(TB)continues to be prevalent in China also among children and adolescents in China.We built a dynamic mathematical model for TB transmission in China,and applied it to compare the epidemic trends 2021–2030 under a range of screening interventions focusing on children and adolescents.Methods We developed a dynamic mathematical model with a flexible structure.The model can be applied either stochastically or deterministically,and can encompass arbitrary age structure and resistance levels.In the present version,we used the deterministic version excluding resistance but including age structure with six groups:0–5,6–11,12–14,15–17,18–64,and 65 years and above.We parameterized the model by literature data and fitting it to case and death estimates provided by the World Health Organization.We compared the new TB cases and TB-related deaths in each age group over the period 2021–2030 in 10 scenarios that involved intensified screening of particular age groups of children,adolescents,or young adults,or decreased or increased diagnostic accuracy of the screening.Results Screening the entire age class of 18-year-old persons would prevent 517,000 TB cases and 14,600 TB-related deaths between years 2021 and 2030,corresponding to 6.6%and 5.5%decrease from the standard of care projection,respectively.Annual screening of children aged 6–11 and,to a lesser extent,0–5 years,also reduced TB incidence and mortality,particularly among children of the respective ages but also in other age groups.In contrast,intensified screening of adolescents did not have a major impact.Screening with a simpler and less accurate method resulted in worsened outcomes,which could not be offset by more intensive screening.More accurate screening and better sensitivity to detect latent TB could prevent 2.3 million TB cases and 68,500 TB deaths in the coming 10 years.Conclusion Routine screening in schools can efficiently reduce the burden of TB in China.Screening should be intensified particularly among children in primary school age.