ABSTRACT
Objective: The objective of this study was to evaluate the efficacy of the combined treatment of Ying-Huang Decoction and San-ao Decoction compared to conventional treatment alone in patients with sepsis-associated acute lung injury (S-ALI) and to assess its potential mechanisms for improving clinical symptoms, reducing inflammatory response, and promoting respiratory function recovery. Methods: We included 84 S-ALI patients admitted to our hospital between January 2021 and January 2023. The patients were divided into a control group and an observation group, with 42 patients in each group. The control group received conventional treatment, while the observation group received the combined treatment of Ying-Huang Decoction and San-ao Decoction in addition to conventional treatment. The study was conducted in accordance with the principles of the Helsinki Declaration and received ethical approval. The main outcome measures assessed included symptom scores, levels of inflammatory factors, lung injury scores (such as LIS scores), respiratory function parameters (such as PVPI and EVLWL levels), and the incidence of adverse reactions. Results: The observation group receiving the combined treatment of Ying-Huang Decoction and San-ao Decoction demonstrated favorable outcomes compared to the control group. Significant improvements were observed in the observation group's symptom scores compared to the control group (P < .05). Patients in the observation group experienced a notable alleviation of clinical symptoms associated with S-ALI. In terms of inflammatory response, the observation group showed significantly lower levels of inflammatory factors, including IL-6, CRP, and IL-17, compared to the control group (P < .01). This suggests that the combined decoction treatment effectively reduced the systemic inflammatory response in S-ALI patients. Lung injury scores, as assessed by the LIS, were significantly reduced in the observation group compared to the control group (P < .05). This indicates that the combined treatment contributed to the mitigation of lung tissue damage in S-ALI patients. Respiratory function parameters, such as PVPI and EVLWL levels, showed significant improvement in the observation group compared to the control group (P < .01), indicating enhanced respiratory function. Conclusion: The combined treatment of Ying-Huang Decoction and San-ao Decoction, in addition to conventional treatment, demonstrated beneficial effects in the management of S-ALI, leading to improved clinical symptoms, reduced inflammatory response, and enhanced respiratory function. These findings suggest the potential integration of traditional Chinese medicine approaches, such as Ying-Huang Decoction and San-ao Decoction, in the treatment of S-ALI, providing additional options for clinicians and potentially improving patient outcomes. It is important to acknowledge the limitations of this study, such as its retrospective design and the need for further research with larger sample sizes to validate the results and minimize potential biases.
ABSTRACT
Background: Sepsis is a potentially lethal organ immune dysfunction induced by infection, with the stomach being the first organ to be attacked. Emodin has anti-inflammatory and gastrointestinal functions, but its therapeutic effect on intestinal injury in sepsis remains unclear. This study sought to investigate the role of emodin in treating intestine damage brought on by sepsis. Methods: Between June 2021 and July 2023, Lipopolysaccharide (LPS) was used to stimulate human intestinal epithelial cells NCM460 to create a septic cell model, and treatment was regulated by rhodopsin. Transient receptor potential melastatin 7 (TRPM7) expression was used to check that the LPS induction conditions were acceptable. About the proliferation of the NCM460 cells, the effects of overexpressing TRPM7 and silencing TRPM7 were assessed. Cell viability was determined using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide test. Tumor necrosis factor (TNF)-α, interleukin (IL)-1ß, and IL-6 expression in the cells was detected using enzyme-linked immunosorbent assays. TRPM7 messenger RNA expression was detected using real-time quantitative polymerase chain reaction (RT-qPCR). Western blot determined the levels of TRPM7, Bcl2-associated X (Bax), and B-cell lymphoma-2 (Bcl2) protein expression levels. The terminal deoxynucleotidyl transferase (TdT)-mediated 2'-deoxyuridine 5'-triphosphate (dUTP) nick-end labeling (TUNEL) technique was used to measure the apoptosis rate. Results: The levels of the inflammatory factors and Bax expression in the cells and the cell apoptosis rate steadily increased as the LPS-induced concentration increased. In contrast, cell viability and the Bcl2 expression levels gradually decreased. In this study, we treated the cells with LPS at a concentration of 25 µg/mL for 12 hours. It was detected that the knockdown of TRPM7 expression decreased the effect of LPS induction, while boosting the expression of TRPM7 boosted the effectiveness. Treatment with emodin lowered TRPM7 expression, increasing cell survival, and Bcl2 expression levels while decreasing the apoptosis rate, inflammatory factors, and Bax expression levels. Conclusion: Emodin may alleviate sepsis-induced intestinal injury by down-regulating the TRPM7 gene. These findings suggest that emodin may hold promise as a therapeutic agent for treating intestinal injury in sepsis. If further validated through additional research and clinical trials, emodin or similar compounds could potentially be developed into safe and effective medications for sepsis patients.
ABSTRACT
Video-assisted thoracoscopic surgery (VATS) has without doubt been the most important advance in thoracic surgery. The general anesthesia before the tracheal intubation for VATS was often accompanied with tracheal mucosa and lung injuries, which were typically manifested as painful throat, nausea, vomiting, and other symptoms. However, the non-intubated anesthesia VATS can avoid these shortcomings due to its shorter anesthesia time, simpler steps, and quicker post-operative recovery. A total of 63 patients underwent VATS lobectomy under non-intubated anesthesia from July 2012 to July 2013. Good teamwork, proper pre-operative visit, and comfortable intra-operative position had ensured the success of these operations. In conclusion, adequate pre-operative preparation, careful nursing, and close cooperation can achieve a successful non-intubated anesthesia VATS.
