Blood eosinophil count-guided corticosteroid therapy and as a prognostic biomarker of exacerbations of chronic obstructive pulmonary disease: a systematic review and meta-analysis.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterized by persistent respiratory symptoms and dyspnea, as well as an increase in the number of leukocytes in the airways, lungs, and pulmonary vessels. A 'One size fits all' approach to COPD patients with different clinical features may be considered outdated. The following are the two major objectives of this meta-analysis: the first is to determine if blood eosinophil counts (BEC) can serve as a prognostic biomarker of COPD outcomes, and the second is to determine which level of BEC is effective for inhaled corticosteroid (ICS) treatment. METHODS: We searched articles published before 15 May 2021 in the following four electronic databases: Web of Science, Cochrane Library, EMBASE, and PubMed. RESULTS: A total of 42 studies, comprising a sampling of 188,710 subjects, were summarized and compared in this meta-analysis. The rate ratio (RR) of exacerbations of COPD (ECOPD) between ICS and non-ICS treatment was statistically significant for the COPD patients with a baseline BEC ⩾ 2% or ⩾ 200 cells/µl, RR = 0.82 (0.73, 0.93) or 0.79 (0.70, 0.89) respectively, while the RR of ECOPD between ICS and non-ICS treatment was statistically insignificant for the COPD patients with baseline BEC < 2% or <200 cells/µl, RR = 0.97 (0.87, 1.08) or 0.97 (0.86, 1.08), suggested that ICS therapy was beneficial to the improvement of ECOPD in patients with a baseline BEC ⩾ 2% or BEC ⩾ 200 cells/µl. CONCLUSION: Our research shows that a BEC ⩾ 200 cells/µl or ⩾2% is likely to become the cutoff value of ICS treatment for ECOPD. Moreover, we believe that the baseline BEC can be used as a biomarker for predicting ECOPD. The stability of BEC requires special attention.

[Study on therapeutic mechanism of Rehmanniae Radix Praeparata- Corni Fructus in sequelae of ischemic stroke based on network pharmacology technology].

In ischemic stroke sequela phase, Rehmanniae Radix Praeparata-Corni Fructus drug pair has the effect in protecting damaged neurons, but its mechanism has not been clear. In this study, network pharmacology was used to predict the mechanism of Rehmanniae Radix Praeparata-Corni Fructus in the treatment of ischemic stroke sequela. Through database search and literature retrie-val, 40 active ingredients of Rehmanniae Radix Praeparata and Corni Fructus were obtained, and their targets were obtained through STITCH and TCMSP databases. The targets of ischemic stroke sequela were obtained through OMIM,GAD,TTD and DrugBank databases. By screening the intersections of active ingredients targets and stroke treatment targets, 21 potential targets were obtained. The DAVID database was used for GO enrichment analysis and KEGG pathway analysis of potential targets. GO enrichment analysis showed that Rehmanniae Radix Praeparata-Corni Fructus were mainly involved in regulation of blood pressure, negative regulation of extrinsic apoptotic signaling and positive regulation of angiogenesis. KEGG pathway analysis showed that Rehmanniae Radix Praeparata-Corni Fructus could inhibit inflammatory response and apoptosis signaling pathway by regulating HIF-VEGFA signaling pathway in neural stem cell proliferation, TNF signaling pathway and NF-kappaB signaling pathway. Molecular docking technique was used to verify that Rehmanniae Radix Praeparata-Corni Fructus component has a good binding activity with potential targets. The results showed that in ischemic stroke sequela phase, Rehmanniae Radix Praeparata-Corni Fructus drug pair could play an important role in recovering neural function, promoting the proliferation of neural stem cells, angiogenesis, preventing neural cells apoptosis and regulating inflammatory factors.

[Smoking cessation among rural populations in Beijing].

OBJECTIVE: To survey the smoking cessation among rural populations in Beijing. METHODS: One natural village in Beijing suburb was sampled and all the 1901 villagers were surveyed by face-to-face interview to collect information on smoking status and smoking cessation. The potential factors related with smoking prevalence and smoking cessation were analzyed. RESULTS: The response rate was 91.2%. The ever-smoking rate was 35.8%. Among the 621 ever-smokers, 35.5% had tried or were trying to quit smoking. The vast majority (93.9%) of smoking cessation methods was self-service method. The overall rate of abstinence was 12.4%, and the success rate was higher in those groups of elder age, lower educational level, lower income level, having respiratory symptoms, and/or without nicotine dependence. There were 291 responders (46.9%) had the willingness to quit. Responders at older age, having respiratory symptoms, or with nicotine dependence had higher willingness to quit. CONCLUSIONS: The tobacco control efforts in rural areas should be strengthened. In part of motivated intervention, the advice should be given from the family, friends, doctors to young, asymptomatic smokers.

Drosophila miR-5 suppresses Hedgehog signaling by directly targeting Smoothened.

Hedgehog (Hh) signaling plays many important roles in developmental processes and cancers. Smoothened (Smo) is an important signal transducer in the Hh pathway, and its expression is tightly regulated by several different post-transcriptional mechanisms. However, whether microRNAs (miRNAs) are involved in Smo regulation is still unclear. Here, we found that miR-5 acts as a suppressor of the Hh pathway by targeting Smo. Through in vivo sensor assay and in vitro luciferase assay, we found that miR-5 downregulates Smo through directly binding to its 3'UTR. Moreover, our data indicated Costal-2 (Cos2) and Fused (Fu) do not play a role in the reduction of Smo mediated by miR-5. Furthermore, we determined that miR-5 not involved in Notch or Dpp signaling pathways by detecting target gene expression. Together, our results indicate that miR-5 can specifically suppress Hh signaling by directly targeting Smo in Drosophila.

[Exploration of vibration response imaging in evaluating airway resistance of asthmatics].

OBJECTIVE: To explore the value of vibration response imaging (VRI) system in evaluating airway resistance of asthmatics. METHODS: The asthmatic group had 64 patients with a FEV1 of (56 +/- 18)% predicted before bronchodilator, and a FEV1 of (69 +/- 18)% predicted after bronchodilator. The control group had 20 patients with COPD with a FEV1 of (64 +/- 17)% predicted before bronchodilator, and a FEV1 of (66 +/- 19)% predicted after bronchodilator. All patients underwent VRI examination in close proximity of each spirometric recording before and after bronchodilator. VRI outcomes were evaluated to determine whether the VRI technology could detect changes in airway resistance in asthmatics. The statistical analysis in comparison between VRI outcomes before and after bronchodilator was performed using a matched pairs signed rank test. Linear regression was used to describe the relation between the improvements of VRI parameters and the increase in FEV1. ROC curve was used to evaluate the accuracy of this examination. RESULTS: After bronchodilator, VRI outcomes including flow graph characteristics, dynamic appearance, shape of the maximal energy frame and rale counts had significant improvements after bronchodilator (M = 7.5, 14.5, 12.5, 7.5, respectively, all P<0.05). Outcomes in the control group showed no significant improvements (M = 0.5, 2.0, 0.5, 1.0, respectively, all P>0.05). y = 0.12784 + 0.06767x1 + 0.04723x2 + 0.04919x3 + 0.00391x4 was the model of the linear regression between improvements of VRI parameters (x1, x2, x3, x4) and the observed changes in FEV1 (y), F = 10.16, P<0.01. According to the bronchodilation test, the sensitivity was 81.3%, and the specificity was 55.0%. The area under the ROC curve was 0.704. CONCLUSION: VRI outcomes including graph characteristics, dynamic appearance, shape of the MEF and rale counts may be a promising method to evaluate changes of airway resistance in asthmatics.