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ObjectiveTo investigate the effect of Bufeitang on intestinal flora of rats with lung Qi-deficiency syndrome of chronic obstructive pulmonary disease(COPD), and to explore the mechanism of traditional Chinese medicine in regulating intestinal flora and thus restoring the balance of lung-gut axis. MethodA total of 84 rats were randomly divided into 7 groups, including blank group, model group, fecal bacterial transplantation(FMT) group, dexamethasone group and low, medium and high dose groups of Bufeitang, 12 rats in each group. Except for the blank group, cigarette and sawdust fumigation combined with intratracheal instillation of lipopolysaccharide(LPS) were used to establish the COPD rat model with lung Qi-deficiency syndrome in all other groups. The low, medium and high dose groups of Bufeitang were intragastric administrated with Bufeitang(3.645, 7.29, 14.58 g·kg-1), the FMT group was given fecal bacteria liquid enema(10 mL·kg-1), dexamethasone group was given dexamethasone acetate tablet suspension by gavage(0.135 mg·kg-1), the blank group and model group were given equal amount of distilled water. Fresh feces were collected after 28 d of continuous intervention for 16S rRNA gene sequencing. Lung and colon tissues were stained with hematoxylin-eosin(HE) for pathomorphological observation, and enzyme-linked immunosorbent assay (ELISA) was performed to detect the contents of tumor necrosis factor-α(TNF-α) and interleukin-8(IL-8) in lung tissues. ResultCompared with the blank group, the model group showed severe abnormal lung tissue structure with alveolar atrophy and collapse accompanied by severe inflammatory cell infiltration. Compared with the model group, the extent of injury was significantly improved, and inflammatory cell infiltration was reduced with basically normal alveolar structure in the high dose group of Bufeitang. Compared with the blank group, the model group had severely abnormal colonic tissue structure, the epithelial cells in the mucosal layer were eroded and shed, the number of inflammatory cells increased, the submucosal layer was edematous and the gap was enlarged. Compared with the model group, the extent of damage was significantly improved in the medium and high dose groups of Bufeitang, the epithelial cells in the mucosal layer were neatly and closely arranged, with only a small amount of inflammatory cell infiltration and no significant degeneration. Compared with the blank group, the TNF-α and IL-8 levels of lung tissue in the model group were significantly increased(P<0.01). Compared with the model group, the TNF-α and IL-8 levels of lung tissues in the low, medium and high dose groups of Bufeitang were significantly decreased(P<0.01). Bufeitang significantly modulated the number of bacteria species as well as alpha and beta diversity of model rats, corrected the return of intestinal flora to normal abundance and diversity, and positively regulated 4 differential phyla(such as Firmicutes, Proteobacteria) and 13 differential genera(such as Turicibacter, Lactobacillus, Anaerobiospirillum, Intestinimonas) in COPD model rats with lung Qi-deficiency syndrome, and down-regulated 2 carbohydrate metabolic pathway functions, including the pentose phosphate pathway(non-oxidative branch) Ⅰ and the Calvin-Benson-Bassham cycle. ConclusionBufeitang can modulate the abundance and diversity of intestinal flora species, affect the function of metabolic pathways, repair the structure of lung and colon tissues, regulate the level of inflammatory factors, and thus improve COPD with lung Qi-deficiency syndrome. The mechanism may be related to its regulation of inflammation-related intestinal flora to restore the balance of lung-gut axis in COPD with lung Qi-deficiency syndrome.
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Objective:To investigate the effect of cumulative serum uric acid (cumSUA) on early-onset ischemic stroke in young adults.Methods:A prospective cohort study was conducted. A total of 15 607 Kailuan workers who participated in at least two physical check-ups in 2006 and 2008 and at the time of the last physical check-up before 2014 were selected as subjects. Cumulative uric acid exposure during the follow-up period was calculated. The subjects were divided into three groups according to the quantile of cumSUA: the first quantile group was cumSUA<1 563 μmol/L·year, the second quantile group was: 1 563 μmol/L·year≤cumSUA<1 996 μmol/L·year, the third group was cumSUA≥1 996 μmol/L·year. The time of the last physical check-up was regarded as the starting point of follow-up, and early-onset ischemic stroke was regarded as the end event. Kaplan-Meier was used to calculate the incidence of early-onset ischemic stroke in different groups, and Log-rank method was used to calculate the differences in the incidence of early-onset ischemic stroke among different groups. Multivariate Cox regression model was used to analyze the risk of early-onset ischemic stroke in different groups. A four-node (5th, 25th, 75th, 95th percentile) restricted cubic spline plot was used to assess the dose-response relationship between cumSUA and early-onset ischemic stroke.Results:A total of 15 607 subjects were followed up for (7.3±1.1) years. 100 cases with early-onset ischemic stroke were observed with an average age of (46±4) years old. The number of events in the first, second, and third quartile groups was 18, 35, and 47, respectively, and the cumulative incidence rates in the first, second, and third quartile groups were 0.40%, 0.77%, and 1.07%, respectively. The difference in cumulative incidence of endpoint events between the groups was statistically significant by Log-rank test ( χ2=14.96, P=0.003). The results of Cox regression analysis showed that after correcting for confounders, the HR(95% CI) for early-onset ischemic stroke in the second and third quartile groups was [1.67(0.92,3.00), P=0.090; 2.05(1.48,3.69), P=0.020]. Restricted cubic spline results showed a nonlinear correlation between cumSUA and early-onset ischemic stroke after adjysted for confounders. Conclusion:Cumulative serum uric acid is positively correlated with the risk of early-onset ischemic stroke in young adults.
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Objective:To identify the risk factors for acute kidney injury (AKI) after non-cardiac surgery.Methods:Medical records of patients who underwent non-cardiac surgery with general anesthesia in our hospital from October 1, 2016 to March 31, 2021 were collected.AKI was diagnosed using the Kidney Disease Improving Global Outcomes definition of AKI.Multi-factor logistic regression analysis was used to screen the risk factors affecting AKI.Generalized linear regression was used to analyze the factors influencing the difference in serum creatinine before and after surgery.Results:A total of 2 214 patients were eventually enrolled, and the incidence of AKI was 5.15%.The results of multi-factor logistic regression analysis showed that preoperative hypertension, American Society of Anesthesiologists Physical Status classification ≥ Ⅲ, intraoperative bleeding >300 ml, emergency surgery, and grade IV surgery were independent risk factors for AKI after non-cardiac surgery ( P<0.05). The results of generalized line regression analysis showed that preoperative hyponatremia, intraoperative bleeding >300 ml, emergency surgery, and duration of anesthesia were positively correlated with increased difference in serum creatinine before and after surgery ( P<0.05). Conclusions:Preoperative hypertension, American Society of Anesthesiologists Physical Status classification ≥ Ⅲ, intraoperative bleeding >300 ml, emergency surgery and grade IV surgery are independent risk factors for AKI after non-cardiac surgery.
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Objective To study and explore the effect of Prunella vulgaris on TSH 、TGAb 、TPOAb and Th cell-associated cytokines IFN-γ ,TNF-α ,IL-4 and IL-17 in autoimmune thyroiditis (AIT ) rats .Methods Di-vide forty female Sprague-Dawley rats into four group :blank group ,model group ,western medicine control group (selenium yeast group) ,Prunella vulgaris group ,10 rats in each group ,The rats in the model group and the rats in the model group were treated with PTg injection and high iodine water .The rats in the drug group were treated with sour yeast and Prunella vulgaris .The rats were sacrificed 6 weeks after the intervention . Elisa method was used to detect the rats Serum levels of TSH ,TGAb ,TPOAb and IFN-γ ,TNF-α ,IL-4 and IL-17 were measured .Results The levels of TSH ,TGAb ,TPOAb ,IFN-γ ,TNF-α ,IL-4 and IL-17 in the model group were significantly higher than those in the blank group ,the difference was statistically significant (P<0 .05) .Selenium yeast group and Prunella vulgaris group TSH ,TGAb ,TPOAb ,IFN-γ ,TNF-α ,IL-4 ,IL-17 were lower than the model group ,the difference was statistically significant (P<0 .05) ;The levels of TSH , IFN-γ ,IL-4 and IL-17 in Prunella vulgaris group were lower than those in selenium yeast group ,the difference was statistically significant (P<0 .05) .Conclusion Prunella vulgaris can reduce the expression of autoanti-bodies and Th-related cytokines in AIT rats ,and have immunomodulatory effects ,it is worth to promote the use of clinical .