2018年 · 第04卷第02期

Chronic lung diseases have been recognized as one of the world's leading causes of death in recent decades. Lacking effective treatments brings the patients not only bad quality of life but also higher risk for lung cancer development. By increasing the understanding of deeper mechanism of how lung develops and regenerates, researchers now focus on studying lung regenerative medicine, aiming to apply different and more efficient therapies to treat chronic lung diseases. This review will provide a wide picture of both basic lung developmental, regeneration mechanism and different designed strategies for treating chronic lung diseases in the future decades.

Air pollution is a global health threat and causes millions of human deaths annually. The late onset of respiratory diseases in children and adults due to prenatal or perinatal exposure to air pollutants is emerging as a critical concern in human health. Pregnancy and fetal development stages are highly susceptible to environmental exposure and tend to develop a long-term impact in later life. In this review, we briefly glance at the direct impact of outdoor and indoor air pollutants on lung diseases and pregnancy disorders. We further focus on lung complications in later life with early exposure to air pollutants. Epidemiological evidence is provided to show the association of prenatal or perinatal exposure to air pollutants with various adverse birth outcomes, such as preterm birth, lower birth weight, and lung developmental defects, which further associate with respiratory diseases and reduced lung function in children and adults. Mechanistic evidence is also discussed to support that air pollutants impact various cellular and molecular targets at early life, which link to the pathogenesis and altered immune responses related to abnormal respiratory functions and lung diseases in later life.

The health impact of airborne particulate matter (PM) has long been a concern to clinicians, biologists, and the general public. With many epidemiological studies confirming the association of PM with allergic respiratory diseases, an increasing number of follow-up empirical studies are being conducted to investigate the mechanisms underlying the toxic effects of PM on asthma and allergic rhinitis. In this review, we have briefly introduced the characteristics of PM and discussed its effects on public health. Subsequently, we have focused on recent studies to elucidate the association between PM and the allergic symptoms of human respiratory diseases. Specifically, we have discussed the mechanism of action of PM in allergic respiratory diseases according to different subtypes: coarse PM (PM_2.5-10), fine PM (PM_2.5), and ultrafine PM.

The DNA repair capacity (DRC) of tumor cells is an important contributor to resistance to radiation and platinum-based drugs. Because DRC may be affected by tumor cell metabolism, we measured DRC in lymphocytes from patients with non-small-cell lung cancer (NSCLC) and compared the findings with the maximum standardized uptake value (SUV_max) on ¹⁸F- fluorodeoxyglucose positron emission tomography (FDG PET) after (chemo)radiation therapy.

This study included 151 patients with stage IA-IV NSCLC who had FDG PET at a single institution and donated blood samples before chemotherapy. We assessed the correlation of DRC, measured in peripheral T lymphocytes by a host-cell reactivation assay with SUV_max and their associations with overall survival (OS) time by hazards ratios calculated with a Cox proportional hazards regression model.

SUV_max of the primary tumor at diagnosis was inversely associated with lymphocyte DRC (r = -0.175, P = 0.032), particularly among patients with advanced disease (r = -0.218, P = 0.015). However, ΔSUV_max of primary tumor was not significantly associated with DRC (r = 0.005, P = 0.968). SUV_max of regional lymph nodes at diagnosis (r = -0.307, P = 0.0008) and after (chemo)radiation treatment (r = -0.329, P = 0.034) and SUV_max of the primary tumor after (chemo)radiation treatment (r = -0.253, P = 0.045) were also inversely associated with OS time.

DRC was inversely associated with primary tumor SUV_max before treatment but not with ΔSUV_max after (chemo)radiation.

Previous studies have clearly demonstrated that XueZhiKang (XZK), an extract of cholestin, can decrease low-density lipoprotein cholesterol (LDL-C) and cardiovascular events. However, the mechanism of the effects of XZK on atherosclerosis (AS) in humans has been reported less frequently. In the present study, we investigated the impact of XZK on lipoprotein subfractions, oxidized LDL (oxLDL), and interleukin-6 (IL-6).

From October 2015 to July 2016, 40 subjects were enrolled in this study. Of them, 20 subjects with dyslipidemia received XZK 1200 mg/day for 8 weeks (XZK group); 20 additional healthy subjects who did not receive therapy acted as controls. The plasma lipoprotein subfractions, oxLDL, and IL-6 were examined at baseline and again at 8 weeks.

Data showed that XZK could significantly decrease not only plasma LDL-C levels (87.26 ± 24.45 vs. 123.34 ± 23.99, P < 0.001), total cholesterol (4.14 ± 0.87 vs. 5.08 ± 1.03, P < 0.001), triglycerides (0.95 ± 0.38 vs. 1.55 ± 0.61, P < 0.05), and apolipoprotein B (1.70 ± 0.35 vs. 1.81 ± 0.72, P < 0.05), but also oxLDL (36.36 ± 5.31 vs. 49.20 ± 15.01, P < 0.05) and IL-6 (8.50 ± 7.40 vs. 10.40 ± 9.49, P < 0.05). At the same time, XZK reduced the concentration of small LDL-C (1.78 ± 2.17 vs. 6.33 ± 7.78, P < 0.05) and the percentage of the small LDL subfraction (1.09 ± 1.12 vs. 3.07 ± 3.09, P < 0.05).

Treatment with 1200 mg/day XZK for 8 weeks significantly decreased the atherogenic small LDL subfraction and reduced oxidative stress and inflammatory markers, in addition to affecting the lipid profile, suggesting multiple beneficial effects in coronary artery disease.

Limited data are available on the direct costs of hospitalization owing to thromboembolism and bleeding in patients with atrial fibrillation (AF) in China. Such data are essential for policy development, service planning, and cost-effectiveness analysis of new therapeutic strategies. This study aimed to provide detailed data regarding in-hospital direct costs for these patients, compare the costs at different scenarios, and identify independent factors that may predict the costs.

We collected data regarding in-hospital direct costs among patients with AF who were hospitalized owing to ischemic stroke (IS), transient ischemic attack (TIA), intracranial hemorrhage (ICH), or major gastrointestinal bleeding. All data were collected from 7 representative tertiary referral hospitals and 3 secondary care hospitals from December 2009 to October 2014.

In total, 312 eligible patients with thromboembolism and 143 patients with major bleeding were identified, and their hospital charts were reviewed. The median in-hospital direct costs were 17,857 Chinese Yuan (CNY) for IS and 16,589 CNY for TIA (equivalent to 2907 US dollars and 2701 US dollars, respectively). For patients with major bleeding, the costs were 27,924 CNY for ICH and 18,196 CNY for major gastrointestinal bleeding (equivalent to 4546 US dollars and 2962 US dollars, respectively). The direct costs were mainly driven by medications, which accounted for approximately 33.4%-36.1% in different groups of patients. The direct costs were highly related to the hospital level and National Institutes of Health Stroke Scale scores in patients with thromboembolism; in patients with ICH, the factors included hospital level, warfarin treatment before admission, and prior hospitalization for stroke.

Given the high prevalence, AF-related thromboembolism and bleeding impose considerable economic burden on the Chinese society. Efforts to improve the management of AF may confer substantial economic benefits.

线粒体（单数，mitochondrion）是处于能量产生和信息处理中心的重要细胞器。它们主要被称为细胞的发电站，因为它们产生细胞各种活动所需的大部分能量。这是通过产生细胞能量流三磷酸腺苷（ATP）来完成的。除了产生能量外，线粒体作为信号细胞器在调节信号转导中起着核心作用。线粒体控制Ca²⁺稳态、活性氧（ROS）的产生和消除、细胞分化和程序性细胞死亡（凋亡）。它们参与许多信号通路，包括钙、丝裂原活化蛋白激酶(MAPK)、磷脂酰肌醇3-激酶(PI3K)-Akt、雷帕霉素的哺乳动物靶标(mTOR)、无翼-int(Wnt)、Ras和胰岛素信号通路。越来越多的证据表明线粒体功能障碍与多种疾病和衰老有关。线粒体已经在许多领域得到了广泛的研究。本文并不打算对每个研究领域进行全面的回顾，而是提出一个信息-能量转换的假设，作为未来研究的新观点。