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World Journal of Stem Cells 2025年第1期17卷 66-70页

作者： Zhao Zhang Xin-Yun Shan Ce Liang Lan Zhao Xiao-Qian Shan The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine Tianjin 300381China Shandong Medical College Jinan 276000Shandong ProvinceChina Hebei Normal University of Science and Technology Qinhuangdao 066004Hebei ProvinceChina Tianjin Institute of Acupuncture and Moxibustion The First Teaching Hospital of Tianjin University of Traditional Chinese MedicineTianjin 300381China

Pulmonary fibrosis significantly contributes to the pathogenesis of acute respiratory distress syndrome(ARDS),markedly increasing patient *** the established anti-fibrotic effects of mesenchymal stem cells(MSCs),numerous challenges hinder their clinical application.A recent study demon-strated that microvesicles(MVs)from MSCs(MSC-MVs)could attenuate ARDS-related pulmonary fibrosis and enhance lung function via hepatocyte growth factor mRNA *** discovery presents a promising strategy for managing ARDS-associated pulmonary *** article initially examines the safety and efficacy of MSCs from both basic science and clinical perspectives,subsequently exploring the potential and obstacles of employing MSC-MVs as a novel therapeutic ***,it provides perspectives on future research into the application of MSC-MVs in ARDS-associated pulmonary fi-brosis.

关键词： Microvesicles derived from mesenchymal stem cells acute respiratory distress syndrome Pulmonary fibrosis Hepatocyte growth factor Mesenchymal stromal cells

acute respiratory distress syndrome and severe pneumonitis after atezolizumab plus bevacizumab for hepatocellular carcinoma treatment:A case report

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World Journal of Gastrointestinal Oncology 2023年第5期15卷 892-901页

作者： Su Hyeon Cho Ga Ram You Chan Park Sang-Geon Cho Jong Eun Lee Sung Kyu Choi Sung Bum Cho Jae Hyun Yoon Department of Gastroenterology and Hepatology Chonnam National University Hospital and Medical SchoolGwangju 61469South Korea Department of Gastroenterology and Hepatology Hwasun Chonnam National University Hospital and Medical SchoolHwasun 58128South Korea Department of Radiology Chonnam National University Hospital and Medical SchoolGwangju 61469South Korea Department of Nuclear Medicine Chonnam National University HospitalHwasun 58128South Korea

BACKGROUND Hepatocellular carcinoma(HCC)is one of the most common cancers worldwide and has a high ***,the treatment options for advanced HCC are limited to tyrosine kinase inhibitors,such as sorafenib and *** previous regimens have an insufficient efficacy,the combination therapy of atezolizumab and bevacizumab(Ate/Bev)has been investigated,which showed an improvement in progression-free and overall ***,the adverse events of this combination therapy in advanced HCC have not been ***,we report a novel case of an unresectable HCC and acute respiratory distress syndrome(ARDS)after a combination therapy of Ate/*** SUMMARY An 82-year-old male visited our outpatient clinic for an incidentally detected liver *** magnetic resonance imaging and enhanced chest computed tomography(CT)were performed,which showed arterial hyperenhancement with washout in delayed phase suggesting HCC,and a well-defined metastatic solid nodule,respectively.F-18 fluorodeoxyglucose positron emission tomography(PET)-CT exhibited multiple hypermetabolic lesions in the iliac bone,lumbar vertebrae,and *** of the high burden of the intrahepatic tumor,transarterial radioembolization was initially performed;after 37 d,a combination therapy of Ate/Bev was *** patient visited the emergency department three days after Ate/Bev treatment complaining of *** was diagnosed with severe pneumonitis based on *** administering oxygen via a high-flow nasal cannula,the P/F ratio was only 74;therefore,the patient was diagnosed with ARDS based on the overall examination *** tidal volume with high positive end-expiratory pressure,sedative agents combined with a neuromuscular blocker,and a systemic steroid were promptly applied to manage the ***,the patient did not recover from the hypoxia and expired 31 h after being *** Clinicians should be aware of severe pneumonitis due to the immune-

关键词： Hepatocellular carcinoma Systemic therapy Adverse events Pneumonitis Atezolizumab acute respiratory distress syndrome

acute respiratory distress syndrome:focusing on secondary injury

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Chinese Medical Journal 2021年第17期134卷 2017-2024页

作者： Pan Pan Long-Xiang Su Da-Wei Liu Xiao-Ting Wang on behalf of the Chinese Critical Ultrasound Study Group(CCUSG) College of Pulmonary and Critical Care Medicine The General Hospital of the People’s Liberation ArmyBeijing 100091China Department of Critical Care Medicine Peking Union Medical College and Chinese Academy of Medical SciencesBeijing 100730China 不详

acute respiratory distress syndrome(ARDS)is one of the most common severe diseases seen in the clinical *** the continuous exploration of ARDS in recent decades,the understanding of ARDS has *** is not a simple lung disease but a clinical syndrome with various etiologies and pathophysiological ***,in the intensive care unit,ARDS often occurs a few days after primary lung injury or after a few days of treatment for other severe extrapulmonary *** such conditions,ARDS often progresses rapidly to severe ARDS and is difficult to *** occurrence and development of ARDS in these circumstances are thus not related to primary lung injury;the real cause of ARDS may be the“second hit”caused by inappropriate *** view of the limited effective treatments for ARDS,the strategic focus has shifted to identifying potential or high-risk ARDS patients during the early stages of the disease and implementing treatment strategies aimed at reducing ARDS and related organ *** research should focus on the prevention of ARDS.

关键词： acute respiratory distress syndrome Secondary lung injury Spontaneous breathing Pulmonary circulation Sedation

Driving pressure in acute respiratory distress syndrome for developing a protective lung strategy:A systematic review

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World Journal of Critical Care Medicine 2025年第2期14卷 158-169页

作者： Hassan A Alzahrani Nadia Corcione Saeed M Alghamdi Abdulghani O Alhindi Ola A Albishi Murad M Mawlawi Wheb O Nofal Samah M Ali Saad A Albadrani Meshari A AlJuaid Abdullah M Alshehri Mutlaq Z Alzluaq Department of respiratory Care Medical Cities at the Minister of InteriorRiyadh 13321Saudi Arabia Interventional Pulmonology Antonio Cardarelli HospitalNaplesItaly Department of Clinical Technology Respiratory Care ProgramUmm-Al Qura UniversityMakkah al Mukarramah 21599Saudi Arabia respiratory Therapy Unit Security Forced Hospital ProgramMakkah al Mukarramah 26955Saudi Arabia Department of Medical Affairs Security Forced Hospital ProgramMakkah al Mukarramah 25911Saudi Arabia Department of Intensive Care Unit and Medical Affairs Security Forced Hospital ProgramMakkah al Mukarramah 23455Saudi Arabia Department of Pharmacy Security Forced Hospital ProgramMakkah al Mukarramah 23455Saudi Arabia Department of Internal Medicine Security Forced Hospital ProgramMakkah al Mukarramah 21955Saudi Arabia Department of respiratory Therapy King Faisal Medical ComplexTaif 29167Saudi Arabia Department of respiratory Therapy King FahadGeneral HospitalTaif 29167Saudi Arabia Department of respiratory Therapy East Jeddah HospitalFirst Jeddah ClusterJeddah 23235Saudi Arabia

BACKGROUND acute respiratory distress syndrome(ARDS)is a critical condition characterized by acute hypoxemia,non-cardiogenic pulmonary edema,and decreased lung *** Berlin definition,updated in 2012,classifies ARDS severity based on the partial pressure of arterial oxygen/fractional inspired oxygen fraction *** various treatment strategies,ARDS remains a significant public health concern with high mortality *** To evaluate the implications of driving pressure(DP)in ARDS management and its potential as a protective lung *** We conducted a systematic review using databases including EbscoHost,MEDLINE,CINAHL,PubMed,and Google *** search was limited to articles published between January 2015 and September ***-three peer-reviewed articles were selected based on inclusion criteria focusing on adult ARDS patients undergoing mechanical ventilation and DP *** literature review was conducted and reported according to PRISMA 2020 *** DP,the difference between plateau pressure and positive end-expiratory pressure,is crucial in ARDS *** indicate that lower DP levels are significantly associated with improved survival rates in ARDS *** is a better predictor of mortality than tidal volume or positive end-expiratory pressure *** DP by optimizing lung compliance and minimizing overdistension and collapse can reduce ventilator-induced lung *** DP is a valuable parameter in ARDS management,offering a more precise measure of lung stress and strain than traditional *** DP as a threshold for safety can enhance protective ventilation strategies,po-tentially reducing mortality in ARDS *** research is needed to refine DP measurement techniques and validate its clinical application in diverse patient populations.

关键词： acute respiratory distress syndrome Mechanical ventilation Driving pressure respiratory care Intensive care unit Pulmonary disease

acute respiratory distress syndrome associated with severe ulcerative colitis

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World Journal of Gastroenterology 2010年第19期16卷 2440-2442页

作者： Shiho Sagara Yasuo Horie Yumiko Anezaki Hideaki Miyazawa Masahiro Iizuka Health Care Center Akita Red Cross Hospital Akita 010-0001 Japan Department of Internal Medicine Akita University School of Medicine Akita 010-8543 Japan Department of Surgery Akita University School of Medicine Akita 010-8543 Japan

Various extraintestinal manifestations including pulmonary abnormalities have been reported in patients with ulcerative colitis. acute respiratory distress syndrome (ARDS) is a serious and fatal pulmonary manifestation. We have experienced a 67-year-old male patient with ARDS associated with a severe type of ulcerative colitis (UC). Severe dyspnea symptoms occurred during the treatment of UC in a previous hospital and the patient was transferred to our hospital on June 27, 2007. Both blood and sputa cultures for bacteria and fungi were negative. Cytomega-lovirus antigenemia was also not detected. From the clinical and radiological [Chest X-ray, computed tomography (CT)] findings, the patient was diagnosed with ARDS on the basis of the def inition of ARDS developed by the European-American Consensus Conference on ARDS. Both colonic inflammations and ARDS symptoms of the patient were resistant to any medical treatment includingcorticosteroids and antibiotics. However, ARDS symptoms were dramatically improved after surgical colectomy. We believe that severe colonic inflammation from UC was closely associated with the onset of ARDS of the patient. Our case report suggests that a severe type of ulcerative colitis might be taken into consideration as one of the predisposing factors of ARDS.

关键词： acute respiratory distress syndrome Ulcerative colitis Inflammatory bowel disease Extra-intestinal manifestation

acute respiratory distress syndrome： Challenge for Diagnosis and Therapy

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Chinese Medical Journal 2018年第10期131卷 1220-1224页

作者： Chun Pan Ling Liu Jian-Feng Xie Hai-Bo Qiu Department of Critical Care Medicine Zhongda Hospital School of Medicine Southeast University Nanjing Jiangsu 210009 China

Objective：acute respiratory distress syndrome （ARDS） is a devastating clinical syndrome whose diagnosis and therapy are still in *** aim of this review was to discuss the current challenge for the diagnosis and treatment of *** Sources：Data sources were the published articles in English through December 2017 in PubMed using the following key words：＂acute respiratory distress syndrome,＂＂definition＂,＂diagnosis,＂＂therapy,＂＂lung protective strategy,＂＂right ventricular dysfunction,＂ and ＂molecular mechanism.＂Study Selection：The selection of studies focused on both preclinical studies and clinical studies of therapy of ***：The incidence of ARDS is still high,and ARDS causes high intensive care units admissions and high *** Berlin Definition proposed in 2012 is still controversial owing to lack of sensitivity and *** is still under recognition and it is associated with high *** protective strategies with low tidal volume （VT） and lung recruitment should consider the physiology of ARDS because ARDS presents lung inhomogeneity;the same low VT might increase local stress and strain in some patients with low compliance,and lung recruitment could injure lungs in ARDS patients with low recruitability and hemodynamic *** cor pulmonale is common in severe *** itself and some treatments could worsen acute cor *** understanding of the pathogenic contributors to ARDS has improved,but the molecular-associated treatments are still under ***：ARDS is a devastating clinical syndrome whose incidence and mortality has remained high over the past 50 *** definition and treatments are still confronted with challenges,and early recognition and intervention are crucial for improving the outcomes of *** clinical studies are needed to improve early diagnosis and appropriate therapy.

关键词： acute respiratory distress syndrome Diagnosis Mechanical Ventilation Therapy

Nanomedicine for acute respiratory distress syndrome: The latest application, targeting strategy, and rational design

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Acta Pharmaceutica Sinica B 2021年第10期11卷 3060-3091页

作者： Qi Qiao Xiong Liu Ting Yang Kexin Cui Li Kong Conglian Yang Zhiping Zhang Tongji School of Pharmacy Huazhong University of Science and TechnologyWuhan 430030China National Engineering Research Center for Nanomedicine Huazhong University of Science and TechnologyWuhan 430030China Hubei Engineering Research Center for Novel Drug Delivery System Huazhong University of Science and TechnologyWuhan 430030China

acute respiratory distress syndrome(ARDS)is characterized by the severe inflammation and destruction of the lung aireblood barrier,leading to irreversible and substantial respiratory function *** with coronavirus disease 2019(COVID-19)have been encountered with a high risk of ARDS,underscoring the urgency for exploiting effective ***,proper medications for ARDS are still lacking due to poor pharmacokinetics,non-specific side effects,inability to surmount pulmonary barrier,and inadequate management of *** increased lung permeability in the pathological environment of ARDS may contribute to nanoparticle-mediated passive targeting *** has demonstrated unique advantages in solving the dilemma of ARDS drug therapy,which can address the shortcomings and limitations of traditional anti-inflammatory or antioxidant drug *** passive,active,or physicochemical targeting,nanocarriers can interact with lung epithelium/endothelium and inflammatory cells to reverse abnormal changes and restore homeostasis of the pulmonary environment,thereby showing good therapeutic activity and reduced *** article reviews the latest applications of nanomedicine in pre-clinical ARDS therapy,highlights the strategies for targeted treatment of lung inflammation,presents the innovative drug delivery systems,and provides inspiration for strengthening the therapeutic effect of nanomedicine-based treatment.

关键词： acute respiratory distress syndrome Nanomedicine Anti-inflammatory therapy Drug delivery Targeting strategy acute lung injury COVID-19 Pathophysiologic feature

Effects of fluid balance on prognosis of acute respiratory distress syndrome patients secondary to sepsis

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World Journal of Emergency Medicine 2020年第4期11卷 216-222页

作者： Yu-ming Wang Yan-jun Zheng Ying Chen Yun-chuan Huang Wei-wei Chen Ran Ji Li-li Xu Zhi-tao Yang Hui-qiu Sheng Hong-ping Qu En-qiang Mao Er-zhen Chen Department of Emergency Ruijin Hospital Affi liated to Shanghai Jiao Tong University School of MedicineShanghaiChina Department of Critical Care Medicine Ruijin Hospital Affi liated to Shanghai Jiao Tong University School of MedicineShanghaiChina

BACKGROUND:Fluid management is crucial to acute respiratory distress syndrome(ARDS)secondary to ***,choices of fluid resuscitation strategies and fluid input volumes remain a thorny *** study aimed to elucidate the relationship between fluid balance and prognosis of ARDS patients secondary to ***:Our study included 322 sepsis patients from Ruijin Hospital between 2014 and 2018,and 84 patients were diagnosed as ARDS within 72 hours after onset of sepsis according to Berlin ARDS Defi ***:Among the 322 sepsis patients,84(26.1%)were complicated with ARDS within 72 *** patients had a lower oxygenation index(PaO2/FiO2166.4±71.0 vs.255.0±91.2,P<0.05),longer duration of mechanical ventilation(11[6-24]days vs.0[0-0]days,P<0.05)than those without *** patients with ARDS showed daily positive net fl uid balance during seven days compared with those without ARDS who showed daily negative net fluid balance since the second day with signifi cant statistical *** the 84 sepsis patients with ARDS,58(69.0%)*** daily fl uid input volumes were much lower in survivors than in non-survivors(43.2±16.7 mL/kg vs.51.0±25.2 mL/kg,P<0.05)while output volumes were much higher in survivors(45.2±19.8 mL/kg vs.40.2±22.7 mL/kg,P<0.05).Using binary logistic regression analysis,we found that the mean daily fl uid balance was independently associated with mortality of sepsis patients complicating with ARDS(P<0.05).CONCLUSIONS:Early negative fluid balance is independently associated with a better prognosis of sepsis patients complicated with ARDS.

关键词： Sepsis acute respiratory distress syndrome Fluid balance Prognosis

Effi cacy and safety of low-dose corticosteroids for acute respiratory distress syndrome:A systematic review and meta-analysis

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World Journal of Emergency Medicine 2021年第3期12卷 207-213页

作者： Yu-qing Cui Xian-fei Ding Huo-yan Liang Dong Wang Xiao-juan Zhang Li-feng Li Quan-cheng Kan Le-xin Wang Tong-wen Sun General ICU the First Affi liated Hospital of Zhengzhou UniversityHenan Key Laboratory of Critical Care MedicineZhengzhou Key Laboratory of SepsisHenan Engineering Research Center for Critical Care MedicineZhengzhou 450052China Biotherapy Center the First Affi liated Hospital of Zhengzhou UniversityZhengzhou 450052China Department of Pharmacy the First Affi liated Hospital of Zhengzhou UniversityZhengzhou 450052China School of Biomedical Sciences Charles Sturt UniversityWagga Wagga 2650Australia

BACKGROUND:There are confl icting results regarding whether corticosteroids have better effi cacy than placebo in acute respiratory distress syndrome(ARDS)***,we aim to further evaluate the effi cacy and safety of corticosteroids in adult ARDS ***:The databases,including Medline,EMBASE,and Cochrane Central Register of Controlled Trials(CENTRAL)in the Cochrane Library,were searched from their inception to May 2,*** controlled trials(RCTs)and observational cohort studies were selected to assess the use of corticosteroids in adult ARDS *** quality of the results was judged by the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)*** inverse-variance method with random or fixed effects modeling was used to compute pooled odds ratio(OR),standardized mean diff erence(SMD),and their 95%confi dence interval(CI).RESULTS:Eight eligible RCTs and six cohort studies were *** use of corticosteroids was associated with reduced mortality(OR 0.57,95%CI 0.43-0.76,I2=35.1%,P=0.148)in ARDS patients,and the result was confirmed in the included cohort studies(OR 0.51,95%CI 0.27-0.95,I2=66.7%,P=0.010).The subgroup analysis stratified by the initiation time and duration of corticosteroid use showed that early ARDS and prolonged corticosteroid use had signifi cant survival benefits in the *** low-dose corticosteroid use was also associated with significantly more ventilator-free days and a reduced rate of new infections in ARDS ***:The low-dose corticosteroid therapy may be safe and reduce mortality,especially in patients with prolonged treatment and early ARDS.

关键词： Low-dose Corticosteroid acute respiratory distress syndrome Mortality Systematic review Meta-analysis

Xuebijing Injection Ameliorates H_(2)S-Induced acute respiratory distress syndrome by Promoting Claudin-5 Expression

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Chinese Journal of Integrative Medicine 2022年第2期28卷 116-123页

作者： GENG Ping LING Bing-yu ZHANG Hong-liang XIONG Jia-li WANG Ying YU Fen TAN Ding-yu XU Ji-yang WANG Hui-hui Department of Emergency Clinical Medical College of Yangzhou UniversityNorthern Jiangsu People's HospitalYangzhouJiangsu Province(225001)China The First Clinical Medical College of Dalian Medical University DalianLiaoning Province(116044)China

Objective:To investigate the protective effects and underlying mechanisms of Xuebijing Injection(XBJ)on the lung endothelial barrier in hydrogen sulfide(H2S)-induced acute respiratory distress syndrome(ARDS).Methods:Sprague-Dawley rats were exposed to H2S(300 ppm)to establish ARDS model,while human pulmonary microvascular endothelial cells(HPMECs)were incubated with NaHS(a H2S donor,500μmol/L)to establish cell model.H2S and XBJ were concurrently administered to the rat and cell *** hematoxylin and eosin staining,immunohistochemistry,transmission electron microscopy and wet/dry ratio measurement were used to confirm ARDS induced by H2S in *** expression levels of claudin-5,phosphorylated protein kinase B(p-AKT)/t-AKT and p-forkhead box transcription factor O1(FoxO1)/t-FoxO1 in vivo and in vitro were also *** permeability and transepithelial electrical resistance(TEER)were measured to evaluate endothelial barrier function in the cell ***:The morphological investigation showed that XBJ attenuated H2S-induced ARDS in *** significantly ameliorated both the reduction in TEER and the increased paracellular permeability observed in NaHS-treated HPMECs(P<0.05).The protective effects of XBJ were blocked by LY294002,a phosphatidylinositol 3-kinase(PI3K)/AKT/FoxO1 pathway antagonist(P<0.05).Furthermore,XBJ promoted the expression of claudin-5 and increased the levels of p-AKT and p-FoxO1 in vivo and in vitro(P<0.05).Conclusion:XBJ ameliorated H2S-induced ARDS by promoting claudin-5 expression via the PI3K/AKT/FoxO1 signaling pathway.

关键词： acute respiratory distress syndrome Xuebijing Injection hydrogen sulfide claudin-5 phosphatidylinositol 3-kinase