益气活血法治疗特发性肺纤维化的临床疗效和安全性的系统评价及Meta分析

目的对以中医益气活血理论为指导的组方或中药治疗特发性肺纤维化(IPF)的临床疗效及安全性进行系统评价。方法计算机检索中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、中文科技期刊全文数据库(VIP)和外文数据库PubMed、EMbase数据库,以及百度学术、谷歌学术两大搜索引擎,采用改良Jadad量表及Cochrane偏倚风险表对符合纳入和排除标准的文献进行质量评估,并提取有效数据,使用RevMan 5.3进行统计分析。结果纳入符合标准的文献11篇,包含IPF患者共660例,其中试验组339例、对照组321例。试验组总有效率明显高于对照组,并且在改善IPF患者主要症状与体征(咳嗽、气短、胸闷、Velcro啰音)、呼吸问卷(SGRQ)生活质量评分(总评分、活动受限、疾病影响)、血气分析(PaO2)、6 min步行试验疗效优于对照组;漏斗图提示结果具有可信性。结论对于IPF的治疗,中医益气活血法具有良好的疗效和安全性,可为临床上治疗IPF提供重要的理论参考和辨治方向。     

MYOFIBROBLAST: A PROGNOSTIC MARKER AND TARGET CELL IN PROGRESSIVE RENAL DISEASE

Myofibroblasts play an important role in many tissue injuries, and particularly in renal disease. The myofibroblast differentiation is an early event in the development of fibrosis. Myofibroblast-like cells express smooth muscle (SM) cytoskeletal markers (α-SM actin in particular) and participate actively in the production of extracellular matrix. Identification of early risk factors, particularly histological criteria, could be useful to identify patients at risk of progressive renal failure and needing a treatment. The evaluation of myofibroblast differentiation in renal tissue may reflect the intensity of tissue injury, predict long term outcome of chronic renal disease and help physicians to select therapeutic choices. More than a disease activity indicator, myofibroblasts appear to be a pivotal target for future therapies in progressive renal disease.     

Toxic acute hepatitis and hepatic fibrosis after consumption of chaparral tablets

In this report we describe a young, previously healthy woman who developed severe acute hepatitis after consumption of chaparral tablets, a commonly used herbal product. In this case, the elimination-rechallenge event and the exclusion of other possible aetiologic factors strongly supported true causality between the herbal product and the liver damage. Primary liver biopsy showed severe toxic hepatitis consistent with previous reports of chaparral-induced liver damage. Later, 6 months after the liver function tests had normalized, permanent hepatic fibrosis could still be seen.     

Acquired coropulmonary and bronchopulmonary anastomoses occurring in association with pulmonary arterial occlusion and veno-occlusive disease generating potential coronary steal

The development of collateral circulation is a general vascular response which is well characterised in the heart. The most common precipitant of this is ischaemia and the most common manifestation is intra coronary collateralisation. Collateral flow between the heart and other thoracic structures is also documented albeit rarely and can be congenital or acquired. In this case report we define a unique case of collateral flow between the coronary and pulmonary circulations in a complex case of mediastinal fibrosis.     

Influence of Liver Fibrosis on Hepatic Artery Doppler Resistance Index in Chronic Hepatitis of Viral Origin

Background: Hepatic arterial Doppler sonography is increasingly being used in liver diagnostics. The determinants of the elevation of hepatic artery impedance indexes in chronic liver disease, however, have still not been fully clarified. The aim of the present study was to investigate the relationship between histological alterations and liver circulation in chronic hepatitis. Methods: Hepatic artery resistance index and portal flow velocity were measured using Doppler sonography in 47 patients with chronic hepatitis of viral origin diagnosed at histopathology. The patients were divided into two groups, those with mild and those with severe alterations, in accordance with the various histological parameters of the Knodell scoring system. Results:     

Promising Pharmacological Directions in the World of Lysophosphatidic Acid Signaling

Lysophosphatidic acid (LPA) is a signaling lipid that binds to six known lysophosphatidic acid receptors (LPARs), named LPA₁-LPA₆. These receptors initiate signaling cascades relevant to development, maintenance, and healing processes throughout the body. The diversity and specificity of LPA signaling, especially in relation to cancer and autoimmune disorders, makes LPA receptor modulation an attractive target for drug development. Several LPAR-specific analogues and small molecules have been synthesized and are efficacious in attenuating pathology in disease models. To date, at least three compounds have passed phase I and phase II clinical trials for idiopathic pulmonary fibrosis and systemic sclerosis. This review focuses on the promising therapeutic directions emerging in LPA signaling toward ameliorating several diseases, including cancer, fibrosis, arthritis, hydrocephalus, and traumatic injury.