Chronic obstructive pulmonary disease(COPD),a disease responsible for early mortality worldwide,is well accepted to be associated with periodontitis epidemiologically.Although both of the diseases are the multi-microb...Chronic obstructive pulmonary disease(COPD),a disease responsible for early mortality worldwide,is well accepted to be associated with periodontitis epidemiologically.Although both of the diseases are the multi-microbial inflammatory disease,the precise underlying mechanisms by which periodontitis influences the progression of COPD remains largely unknown.Here,we established COPD accompanied with periodontitis mouse models and observed the pronounced progress in pulmonary symptoms and histopathology,cha racterized by poorer respiratory function,thicke ned bronchial walls,and increased neutrophils infiltration in lung tissue.Mechanistically,periodontitis pathogen Porphyromonas gingivalis(P.gingivalis)relocated in the lung through the respiratory tract and LPS from P.gingivalis promoted the secretion of chemokines CXCL2 and G-CSF of alveolar epithelial cells through NF-κB and p38 MAPK pathways to recruit neutrophils.Furthermore,exposure to P.gingivalis of infiltrated neutrophils released matrix metallopeptidase-8(MMP-8)and neutrophil elastase(NE),which aggravated airway inflammation and tissue damage.These findings indicated that periodontitis could exacerbate COPD via its pathogen P.gingivalis,which translocated in the lung and stimulated neutrophil chemotaxis and activation in the lung.展开更多
Objective:To assess whether there is a correlation between CT scan severity score and pulmonary function in Interstitial Lung Disease,and provide a more reliable basis for clinical diagnosis and treatment.Materials an...Objective:To assess whether there is a correlation between CT scan severity score and pulmonary function in Interstitial Lung Disease,and provide a more reliable basis for clinical diagnosis and treatment.Materials and Methods:Sixty patients with clinical diagnosis of Interstitial Lung Disease(ILD)were collected,and chest CT and pulmonary function tests were performed at the same time.Here DLCO%and FEV1%were used as the pulmonary function indexes.The severity of the patients was assessed by CT scores as mild(range,1~10),moderate(range 11~20),and severe(range 21~30).Correlation analysis was carried out between CT score and pulmonary function index,and the lung function parameters of patients at three grades were compared between groups and pairwise among the means.Results:As per the CT severity classification,there were 13 mild cases,31 moderate cases,and 16 severe cases.CT score was negatively correlated with DLCO%and FEV1%.R value was-0.814 and-0.797,respectively;The comparison of the mean value of DLCO%and FEV1%among the three groups and the pairings of the mean value of DLCO%and FEV1%were statistically significant.Conclusion:There was good correlation between CT score of ILD and the pulmonary function index.The pulmonary function index of patients with different CT severity grading was statistically significant,which can provide a new basis for the clinical evaluation and diagnosis of the disease.展开更多
BACKGROUND Esophageal cancer surgery is associated with a high risk of postoperative pulmonary complications,particularly pneumonia.Although conventional respiratory rehabilitation strategies–such as preoperative ins...BACKGROUND Esophageal cancer surgery is associated with a high risk of postoperative pulmonary complications,particularly pneumonia.Although conventional respiratory rehabilitation strategies–such as preoperative inspiratory muscle training–have demonstrated limited efficacy,the low-intensity traditional Chinese Qigong practice"Liuzijue"(Six-Character Formula)shows promise.However,robust clinical evidence supporting its use in patients undergoing esophagectomy remains lacking.AIM To evaluate the effects of early postoperative"Liuzijue"training on pulmonary function and pneumonia incidence following radical esophagectomy.METHODS This retrospective study included 306 patients who underwent esophagectomy.The control group(n=163)received standard care,consisting of abdominal breathing,incentive spirometry,and early ambulation.The intervention group(n=143)received the same standard care plus twice-daily"Liuzijue"training for 14 days.Primary outcomes were the incidence of pneumonia(defined by Centers for Disease Control and Prevention criteria)and changes(Δ)in forced vital capacity(FVC),forced expiratory volume in 1 second(FEV_(1)),and maximum voluntary ventilation(MVV)from baseline to postoperative day 14.RESULTS The"Liuzijue"intervention was associated with a significantly lower incidence of pneumonia(11.9%vs 24.5%,P=0.005;relative risk=0.48).Significant improvements were observed inΔFVC(+502.1 mL vs+326.5 mL,P<0.001),ΔFEV_(1)(+701.7 mL vs+434.4 mL,P<0.001),andΔMVV(+19.4 L/minute vs+14.4 L/minute,P<0.001).Absolute FEV_(1) values on postoperative day 14 were higher in the intervention group(2270.8 mL vs 2066.1 mL,P=0.021),along with significantly lower Borg dyspnea/fatigue scores(P=0.045).No significant differences were observed in changes in diffusing capacity of the lung for carbon monoxide,total lung capacity,or 6-minute walk distance.CONCLUSION Early initiation of"Liuzijue"training after esophagectomy is associated with reduced pneumonia incidence and accelerated recovery of key pulmonary function parameters.These findings support the integration of"Liuzijue"into enhanced recovery after surgery protocols for esophageal cancer patients.展开更多
BACKGROUND Patients with connective tissue disease-associated interstitial lung disease(CTDILD)experience not only progressive respiratory impairment but also a significant psychological burden.The prevalence and impa...BACKGROUND Patients with connective tissue disease-associated interstitial lung disease(CTDILD)experience not only progressive respiratory impairment but also a significant psychological burden.The prevalence and impact of anxiety and depression and their intricate relationship with dyspnea severity and pulmonary function decline remain inadequately characterized in this population,hindering comprehensive care.AIM To explore the incidence of anxiety and depression in CTD-ILD and its relationship with dyspnea severity and pulmonary function index.METHODS Data of 100 patients with CTD-ILD(January 2022-June 2024)were retrospectively analyzed.Baseline demographic,pulmonary function[forced vital capacity(FVC%)and diffusing capacity of the lungs for carbon monoxide(DLCO%)],modified medical research council(mMRC)score,and psychological scale[generalized anxiety disorder-7(GAD-7)and patient health questionnaire-9(PHQ-9)]were collected.Pulmonary function was reviewed every 3 months,and highresolution computed tomography was performed every 6 months following standardized treatment(glucocorticoids+immunosuppressive+anti-fibrosis agents).Pearson/Spearman correlation analysis,linear mixed effect model,and Cox regression were used to analyze the correlation between anxiety and depression and physiological indicators as well as the prognosis.RESULTS Baseline prevalence of moderate-to-severe anxiety(GAD-7≥10)and depression(PHQ-9≥10)was 38%and 42%,respectively.Following 24 weeks of treatment,pulmonary function(FVC%:72.11±13.08 vs 67.89±12.73;DLCO%:60.67±13.76 vs 55.32±13.95,both P<0.05),psychological scores(GAD-7 and PHQ-9,P<0.05),and inflammatory markers[C-reactive protein(CRP)and erythrocyte sedimentation,P<0.05]significantly improved.The levels of inflammatory indicators were significantly decreased(P<0.05).The GAD-7/PHQ-9 scores negatively correlated with FVC%and DLCO%(P<0.05)and positively correlated with the mMRC scores and CRP(P<0.05).The mixed model showed that for each one-point increase in GAD-7/PHQ-9,FVC%decreased by 0.412%/0.426%(P<0.01).Cox regression analysis showed that for every liter of GAD-7 and PHQ-9,the risk of pulmonary function deterioration increased by 12.8%and 14.2%,respectively(hazard ratio=1.128 and 1.142,P<0.01).CONCLUSION Anxiety and depression in patients with CTD-ILD constituted a bidirectional negative feedback loop involving pulmonary function impairment,inflammatory activity,and dyspnea.Psychological disorders were identified as independent risk factors for deterioration of pulmonary function.Psychological evaluation and intervention should be integrated clinically to block brain–lung axis-mediated neuroendocrine–immune network imbalance and improve prognosis.展开更多
The high comorbidity rates of depression and chronic obstructive pulmonary disease(COPD)have garnered widespread attention.As a refractory disease,its long-term stress effects exacerbate the coexistence of depression....The high comorbidity rates of depression and chronic obstructive pulmonary disease(COPD)have garnered widespread attention.As a refractory disease,its long-term stress effects exacerbate the coexistence of depression.Depression is linked to a decline in lung function in patients with COPD through reduced heart rate variability,increased inflammatory cytokines,dysregulation of the hypothalamic-pituitary-adrenal axis,and the interplay of various biological and psychological factors.Sole reliance on biomedical treatment cannot fully counteract these negative effects,which are detrimental to improving patients’quality of life and long-term prognosis.Antidepressant medications and traditional Chinese medicine combined with conventional COPD therapy,psychotherapy(e.g.,cognitive behavioral therapy,mindfulness training),and lifestyle adjustments(e.g.,yoga,qigong,or walking)can not only alleviate depression and compensate for the limitations of biomedical approaches but also help improve heart rate variability and lung function.In this editorial,we suggest that clinicians,when prescribing antidepressants,must carefully weigh the benefit-risk ratio based on the patient’s specific physical condition to ensure precise medication use.展开更多
BACKGROUND Depression is a common comorbidity in patients with chronic obstructive pulmonary disease(COPD).Research indicates that COPD affects cardiac au-tonomic control,and heart rate variability(HRV)serves as a sim...BACKGROUND Depression is a common comorbidity in patients with chronic obstructive pulmonary disease(COPD).Research indicates that COPD affects cardiac au-tonomic control,and heart rate variability(HRV)serves as a simple,non-invasive measure of autonomic nerve activity.However,the relationship between HRV and lung function,as well as the impact of depressive symptoms,remains un-clear.METHODS A retrospective cross-sectional study involving 120 COPD patients hospitalized from January 2018 to January 2024 at our institution was conducted.Demographic and clinical characteristics were collected,and depressive symptoms were asse-ssed using the Beck Depression Inventory(BDI).Patients were categorized into a depressed group(BDI≥16)and a non-depressed group(BDI<16).A control group consisting of 60 healthy volunteers who underwent check-ups at the same institution was also included.Statistical analyses were performed using SPSS 26.0 software.Pearson correlation coefficients were calculated to determine and compare the relationships between HRV parameters,lung function measures,and RESULTS Of the 120 patients with COPD,35.8%(43/120)were diagnosed with depression,compared to 5.0%(3/60)in the control group.The HRV index in COPD patients was significantly lower than that in the control group(P<0.05),and the value in the depressed group was significantly lower than that in the non-depressed group(P<0.05).Similarly,the COPD group had a significantly lower pulmonary forced vital capacity(FVC),first-second expiratory volume(FEV1)and FEV1/FVC ratios than the control group(P<0.05),and the depressed group was significantly lower than that in the non-depressed group(P<0.05).Pearson correlation analysis revealed that the standard deviation of normal R-R intervals,standard deviation of the mean of 5-minute normal R-R intervals,root mean square of successive differences of normal R-R intervals,percentage of normal R-R intervals greater than 50 ms,high-frequency,and low-frequency indices showed positive correlations with lung function parameters(P<0.05)and negative correlations with BDI scores(P<0.05).CONCLUSION Compared to patients without COPD,the incidence of depressive symptoms is higher among patients with COPD and is negatively correlated with the patients’HRV indices.In contrast,HRV indices are positively correlated with the patients’pulmonary function parameters.Patients and healthcare professionals should enhance their awareness of depression,actively conduct depression assessment screenings,and incorporate HRV indices into disease management.This approach aims to improve the psychological health of patients and ultimately enhance their prognosis and quality of life.展开更多
Objective To observe the therapeutic effects of warming needle moxibustion on pulmonary function of elderly patients with stable chronic obstructive pulmonary disease. Method Eighty elderly patients with stable chroni...Objective To observe the therapeutic effects of warming needle moxibustion on pulmonary function of elderly patients with stable chronic obstructive pulmonary disease. Method Eighty elderly patients with stable chronic obstructive pulmonary disease were divided randomly into an acupuncture group and a drug group, with forty cases in each group. The patients in the acupuncture group were treated with warming needle moxibustion on specific acupoints. Main acupoints include Zusanli （足三里 ST 36）, Feishu （肺俞 BL 13） and Dingchuan （定喘 EX-B 1）. Matching acupoints include Gaohuang （膏肓 BL 43）, Xinshu （心俞 BL 15）, Dazhui （大椎 GV 14） and Fangmen （风门 BE 12）. The acupoints were punctured with even reinforcing and reducing method. Meanwhile, two moxa stick of warming needle moxibustion were applied separately at the acupoints at back and ST 36. The needles were retained for approximately 0.5 h each time. The treatment was given every other day, 3 times a week and the course of treatment was 8 weeks. Patients in the drug group were treated by seretide inhalation （50 μg salmeterol and 250 μg fluticasone propionate）, twice a day for 8 weeks. The improvement in pulmonary function and the symptom of chills and fever were compared between the two groups. Results After treatment, pulmonary function indices [forced expiratory volume in one second （FEV1）, forced expiratory volume in one second to forced vital capacity （FEVl/FVC）, forced expiratory volume in one second to predicted value ratio （FEV1%） and peak expiratory flow （PEF）] of the patients in both groups were improved significantly compared with that before treatment （P〈0.05）. There was no statistically significant difference between the two groups （all P〉0.05）. Improvement in comprehensive scores of the symptom of chill and fever in the acupuncture group was significantly superior to that in the drug group after 4 and 8 weeks of the treatment, respectively （P〈0.05）. Conclusion Warming needle moxibustion was obviously effective on the improvement in pulmonary function of elderly patients with stable chronic obstructive pulmonary disease.展开更多
OBJECTIVE:To observe the impact of xinfeng xapsule(XFC) on pulmonary function in a rat model of adjuvant arthritis(AA) and to investigate the mechanism of action.METHODS:Forty rats were randomly divided into four grou...OBJECTIVE:To observe the impact of xinfeng xapsule(XFC) on pulmonary function in a rat model of adjuvant arthritis(AA) and to investigate the mechanism of action.METHODS:Forty rats were randomly divided into four groups of ten:normal control(NC);model control(MC);tripterygium glycosides tablet(TPT);and xinfeng capsule(XFC).Except for the NC group,AA was induced in all rats by intracutaneous injection of 0.1 mL Freund's complete adjuvant in the right paw on the 19th day.NC and MC groups were given(0.9%) physiological saline.The TPT and XFC groups were given TPT(10 mg/kg) and XFC(1.2 g/kg),respectively.Thirty days after administration,changes in paw edema(E),the arthritis index(AI),pulmonary function,levels of regulatory T-cells(Treg),ultrastructure of lung tissue,and expression of Notch receptors and ligands in lung tissue were observed.RESULTS:In the MC group,E and the AI were increased and pulmonary function significantly decreased;the structure of alveolar type-II cells was damaged;ratios of Treg in peripheral blood were reduced;and expression of Notch receptors such as Notch3 and Notch4 and ligands such as Delta1 in lung tissue were significantly increased whereas expression of Notch1,Jagged1 and Jagged2 were significantly decreased.After intervention with XFC,E and the AI were decreased;pulmonary function was enhanced;the structure of alveolar type-II cells was improved;and expression of Treg,Notch1,Jagged1,Jagged2 was elevated,whereas that of Notch3,Notch4 and Delta1 was reduced.CONCLUSION:XFC can not only inhibit E and the AI and improve joint symptoms,it can also improve pulmonary function and reduce inflammation in lung tissue.These actions could be carried out through increases in the expression of Treg,Notch receptors(Notch1) and ligands(Jagged1,Jagged2),and reductions in the expression of Notch3,Notch4 and Delta1.These phenomena would reduce the deposition of immune complexes and the inflammatory response in lung tissue,thereby improving joint symptoms and pulmonary function.展开更多
BACKGROUND Chronic obstructive pulmonary disease(COPD)is a chronic respiratory disease with worldwide occurrence and high disability and mortality rate.It occurs mostly in the elderly population with pulmonary heart d...BACKGROUND Chronic obstructive pulmonary disease(COPD)is a chronic respiratory disease with worldwide occurrence and high disability and mortality rate.It occurs mostly in the elderly population with pulmonary heart disease,type II respiratory failure,and other serious complications.AIM To investigate the correlation of plasma brain natriuretic peptide(BNP)and platelet parameters with cardiac function and pulmonary hypertension in patients with COPD and pulmonary heart disease.METHODS From June 2016 to June 2019,52 patients with COPD-pulmonary heart disease(pulmonary heart disease group),30 patients with COPD(COPD group),and 30 healthy individuals(control group)in our hospital were enrolled in the study.The pulmonary heart disease group was further divided into subgroups according to cardiac function classification and pulmonary artery pressure.Plasma BNP and platelet parameters were estimated and compared among each group and subgroup.The correlation of plasma BNP and platelet parameters with cardiac function classification and pulmonary artery pressure was then analyzed.RESULTS In the pulmonary heart disease group,the COPD group,and the control group,the levels of plasma BNP,platelet distribution width(PDW),and mean platelet volume(MPV)showed a decreasing trend(P<0.05),while an increasing trend was found in platelet count(PLT)and plateletcrit(PCT)levels among the three groups(P<0.05).In the pulmonary hypertension mild,moderate,and severe subgroups,the levels of plasma BNP,PDW,and MPV showed an increasing trend(P<0.05),while a decreasing trend was observed in PLT levels(P<0.05);however,PCT levels showed no significant difference among the three subgroups(P>0.05).In the cardiac function grade I,II,III,and IV subgroups,the levels of plasma BNP,PDW,and MPV showed an increasing trend(P<0.05),while a decreasing trend was noted in PLT and PCT levels among the four subgroups(P<0.05).Correlation analysis showed that the levels of plasma BNP,PDW,and MPV in patients with pulmonary heart disease were positively correlated with their pulmonary artery pressure(P<0.05),while PLT was negatively correlated with their pulmonary artery pressure(P<0.05).Moreover,plasma BNP,PDW,and MPV levels were positively correlated with cardiac function grade(P<0.05)of these patients,while PLT and PCT levels were negatively correlated with their cardiac function grade(P<0.05).CONCLUSION Plasma BNP and PLT parameters are significantly correlated with the cardiac function and pulmonary hypertension in patients with COPD and pulmonary heart disease,indicating that these parameters have high clinical relevance in reflecting the health condition of these patients and for guiding their treatment.展开更多
Background:Enterotoxigenic Escherichia coli(ETEC)F4 commonly colonizes the small intestine and releases enterotoxins that impair the intestinal barrier function and trigger inflammatory responses.Although Bacillus lic...Background:Enterotoxigenic Escherichia coli(ETEC)F4 commonly colonizes the small intestine and releases enterotoxins that impair the intestinal barrier function and trigger inflammatory responses.Although Bacillus licheniformis(B.licheniformis)has been reported to enhance intestinal health,it remains to be seen whether there is a functional role of B.licheniformis in intestinal inflammatory response in intestinal porcine epithelial cell line(IPEC-J2)when stimulated with ETEC F4.Methods:In the present study,the effects of B.licheniformis PF9 on the release of pro-inflammation cytokines,cell integrity and nuclear factor-κB(NF-κB)activation were evaluated in ETEC F4-induced IPEC-J2 cells.Results:B.licheniformis PF9 treatment was capable of remarkably attenuating the expression levels of inflammation cytokines tumor necrosis factor-α(TNF-α),interleukin(IL)-8,and IL-6 during ETEC F4 infection.Furthermore,the gene expression of Toll-like receptor 4(TLR4)-mediated upstream related genes of NF-κB signaling pathway has been significantly inhibited.These changes were accompanied by significantly decreased phosphorylation of p65 NF-κB during ETEC F4 infection with B.licheniformis PF9 treatment.The immunofluorescence and western blotting analysis revealed that B.licheniformis PF9 increased the expression levels of zona occludens 1(ZO-1)and occludin(OCLN)in ETEC F4-infected IPEC-J2 cells.Meanwhile,the B.licheniformis PF9 could alleviate the injury of epithelial barrier function assessed by the trans-epithelial electrical resistance(TEER)and cell permeability assay.Interestingly,B.licheniformis PF9 protect IPEC-J2 cells against ETEC F4 infection by decreasing the gene expressions of virulence-related factors(including luxS,estA,estB,and elt)in ETEC F4.Conclusions:Collectively,our results suggest that B.licheniformis PF9 might reduce inflammation-related cytokines through blocking the NF-κB signaling pathways.Besides,B.licheniformis PF9 displayed a significant role in the enhancement of IPEC-J2 cell integrity.展开更多
BACKGROUND Lung cancer is a malignant tumor with high morbidity and mortality among cancers.Surgery is currently one of the primary methods of treating lung cancer.Although it can slow down the progression of the dise...BACKGROUND Lung cancer is a malignant tumor with high morbidity and mortality among cancers.Surgery is currently one of the primary methods of treating lung cancer.Although it can slow down the progression of the disease by removing the lesion,this invasive surgery inevitably damages the integrity of the patient’s chest.Moreover,the patient’s pulmonary function may have a low compensatory capacity after surgery,causing various respiratory diseases such as atelectasis,respiratory function decline,and even serious cardiovascular disease.All of these have great negative impacts on the surgical effect and the prognosis of patients.With the continuous exploration and development of nursing,continuous nursing and respiratory exercise nursing have been gradually applied in the nursing of patients after lung cancer surgery,and have achieved good nursing results.AIM To investigate the effect of continuous nursing combined with respiratory exercise nursing on the pulmonary function of postoperative patients with lung cancer.METHODS A total of 80 patients with lung cancer who underwent surgery in our hospital from January 2021 to December 2021 were selected as the study subjects.All subjects were randomly divided into the control group(n=40 cases)and the experimental group(n=40 cases).Patients with lung cancer in the control group were given conventional nursing after surgery,while the experimental group was given continuous nursing combined with respiratory exercise nursing based on conventional nursing.The recovery of pulmonary function and respiratory symptoms was observed before and after 3 mo of intervention in both groups.The pulmonary function parameters,blood gas analysis,MD Anderson Symptom Inventory-lung cancer module(MDASI-LC)scores,incidence of pulmonary complications,and Morisky compliance scores were compared between the two groups before and after 3 mo of intervention.RESULTS There was no significant difference in pulmonary function and blood gas analysis between the two groups before intervention(P>0.05).3 mo after the intervention,the pulmonary function parameters in the experimental group(SpO2,VC,MVV,FEV1,FEV1%pred,and FEV1/FVC)were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in blood gas analysis between the two groups before intervention(P>0.05).PaO2 in the experimental group was significantly higher than that in the control group,and PaCO_(2) was significantly lower than that in the control group 3 mo after the intervention.The difference had statistical significance(P<0.05).3 mo after the intervention,the MDASI score of respiratory symptoms in the experimental group was significantly lower than that in the control group(P<0.05),and the incidence of pulmonary complications was lower than that in the control group(P<0.05).In addition,the treatment compliance and nursing satisfaction of patients in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05).CONCLUSION Continuous nursing combined with respiratory exercise nursing can significantly accelerate the recovery of respiratory function in postoperative lung cancer patients,reduce the incidence of postoperative complications of lung cancer as well as improve the treatment compliance of patients.展开更多
Objective. To investigate the changes and influencing factors of early postoperative pulmonary functionof thoracotomy.Methods. Pre-and early postoperative pulmonary function was studied in 64 consecutive cases withopt...Objective. To investigate the changes and influencing factors of early postoperative pulmonary functionof thoracotomy.Methods. Pre-and early postoperative pulmonary function was studied in 64 consecutive cases withoptimal thoracotomy. Pain assessment was done before pulmonary function test, and the chief complaintsof patients were recorded after the procedure. The changing curves of pulmonary function were done andthe differences associated with groups, surgical styles, pain assessment, epidural analgesia, chief com-plaint and preoperative conditions were analyzed.Results. Pulmonary function was severely lowered to about 40% of the base line on the first day,and it was rehabilitated to about 60% of the base line on the eighth day. There was a greater gradienton the recovery curve on the 3rd and 4th days. Epidural analgesia was able to improve pain relaxationand pulmonary function in some degree. Single-factor analysis showed that postoperative pain, postopera-tive day and surgical style were the significant influencing factors for early postoperative pulmonary func-tion. By multiple-factor analysis, preoperative pulmonary function, age and postoperative pain were themain factors, while surgical style had only weak effect on it.Conclusions. Early postoperative pulmonary function is severely impaired by thoracotomy. It rehabili-tate gradually with time. Improvement of preoperative pulmonary function, reducing surgical procedure in-juries, especially injury to respiratory muscle system, and enough postoperative pain relief are the mostimportant means that would reduce pulmonary function impairment and consequently reduce postoperativepulmonary complications.展开更多
OBjECTIVE:To observe the relationship between reduced pulmonary function and regulatory T cells(Tregs)and helper T cells(Th)1/Th2 drift in a rat model of adjuvant arthritis(AA),and to study the impact of Xinfeng capsu...OBjECTIVE:To observe the relationship between reduced pulmonary function and regulatory T cells(Tregs)and helper T cells(Th)1/Th2 drift in a rat model of adjuvant arthritis(AA),and to study the impact of Xinfeng capsule(XFC)on pulmonary function and investigate the mechanism of action.METHODS:Forty rats were randomly divided into normal control group(NC),model control group(MC),Tripterygium glycosides tablet group(TPT),and XFC group,with 10 in each.Except for the NCgroup,AA was induced in all rats by intracutaneous injection of 0.1 mL Freund's complete adjuvant in the right paw.On the 19th day after modeling,the NC and MC groups were given physiological saline(0.9%),while the TPT and XFC groups were given TPT(10 mg/kg)and XFC(2.4 g/kg),once daily,respectively.Thirty days after administration,changes in paw swelling,arthritis index(AI),pulmonary function,levels of serumγ-interferon(IFN-γ)and interleukin(IL)-4,Tregs in peripheral blood,and IFN-γ,IL-4,Forkhead box transcription factor 3(FoxP3)in lung tissue were observed by enzyme-linked immunosorbent assay,flow cytometry,polymerase chain reaction,and western blot.RESULTS:Compared with the NC group,paw swelling,AI,IFN-γ,and Th1/Th2 were increased,and pulmonary function parameters,IL-4,FoxP3 were decreased significantly in the MC group(P<0.05 or P<0.01).Pulmonary function parameters,Treg,IL-4,FoxP3(and mRNA)were higher,and paw swelling,AI,and IFN-γ(and mRNA)were lower in the XFC group than those in the MC group.The XFC group was also much better than theTPT group in improving pulmonary function,FoxP3 mRNA,IFN-γ,IL-4,Th1/Th2,and IL-10(P<0.05 or P<0.01).CONCLUSION:Xinfeng capsule can improve pulmonary function by regulating the levels of Tregs,inhibiting the activation of Th1 to Th2 cells,inducing drift,maintaining cell immune suppression,correcting the imbalance of Th1/Th2,and reducing inflammatory mediators.展开更多
BACKGROUND Idiopathic pulmonary fibrosis(IPF)is classified under fibrotic interstitial pneumonia,characterized by a chronic and progressive course.The predominant clinical features of IPF include dyspnea and pulmonary...BACKGROUND Idiopathic pulmonary fibrosis(IPF)is classified under fibrotic interstitial pneumonia,characterized by a chronic and progressive course.The predominant clinical features of IPF include dyspnea and pulmonary dysfunction.AIM To assess the effects of pirfenidone in the early treatment of IPF on lung function in patients.METHODS A retrospective analysis was performed on 113 patients with IPF who were treated in our hospital from November 2017 to January 2023.These patients were divided into two groups:control group(n=53)and observation group(n=60).In the control group,patients received routine therapy in combination with methylprednisolone tablets,while those in the observation group received routine therapy together with pirfenidone.After applying these distinct treatment approaches to the two groups,we assessed several parameters,including the overall effectiveness of clinical therapy,the occurrence of adverse reactions(e.g.,nausea,vomiting,and anorexia),symptom severity scores,pulmonary function index levels,inflammatory marker levels,and the 6-min walk distance before and after treatment in both groups.RESULTS The observation group exhibited significantly higher rates than the control group after therapy,with a clear distinction(P<0.05).After treatment,the observation group experienced significantly fewer adverse reactions than the control group,with a noticeable difference(P<0.05).When analyzing the symptom severity scores between the two groups of patients after treatment,the observation group had significantly lower scores than the control group,with a distinct difference(P<0.05).When comparing the pulmonary function index levels between the two groups of patients after therapy,the observation group displayed significantly higher levels than the control group,with a noticeable difference(P<0.05).Evaluating the inflammatory marker data(C-reactive protein,interleukin-2[IL-2],and IL-8)between the two groups of patients after therapy,the observation group exhibited significantly lower levels than the control group,with significant disparities(P<0.05).Comparison of the 6-min walking distance data between the two groups of patients after treatment showed that the observation group achieved significantly greater distances than the control group,with a marked difference(P<0.05).CONCLUSION Prompt initiation of pirfenidone treatment in individuals diagnosed with IPF can enhance pulmonary function,elevate inflammatory factor levels,and increase the distance covered in the 6-min walk test.This intervention is conducive to effectively decreasing the occurrence of adverse reactions in patients.展开更多
Objective To evaluate the effect of the cardiopulmonary bypass (CPB) on the pulmonary function in infants with or withoutpulmonary hypertension in congential ventricular septal defect (VSD). MethodsTwenty infants with...Objective To evaluate the effect of the cardiopulmonary bypass (CPB) on the pulmonary function in infants with or withoutpulmonary hypertension in congential ventricular septal defect (VSD). MethodsTwenty infants with VSD were enrolled in the study fromJan. to Dec.2004. They were divided into two groups: pulmonary hypertension group and non-pulmonary hypertension group, ten infantsrespectively. Pulmonary function parameters were measured before CPB and 3, 6, 9, 12, 15, 18, 21, 24h after CPB, the following datawere recorded: duration for mechanical ventilation (Tmv) and staying in the cardiac intensive care unit (Tcicu) after cardiac surgery.Results Before CPB, the pulmonary function parameters in non-pulmonary hypertension group were more superior than in pulmonary hy-pertension group (P<0.01). By contraries, the pulmonary function parameters in every time stage after CPB statistically significant de-creased in non-pulmonary hypertension group (P<0.05), especially at 6, 9, and 15h after CPB (P<0.01). In pulmonary hyperten-sion group, the pulmonary function parameters in 3h after CPB were more improved than before CPB, though there was no statistical sig-nificance. But they had statistically significant decreased at9, 12, 15h after CPB (P<0.05). There was a similar change in pulmonaryfunction between two groups at 21, 24h after CPB. Conclusion Exposure to CPB adversely affects pulmonary function after surgicalrepair of VSD in infants. We consider that the benefits of the surgical correction in infants with pulmonary hypertension outweight the neg-ative effects of CPB on pulmonary function. We should improve cardiac function to avoid the presence of the nadir trough in pulmonaryfunction. The infants with pulomonary hypertension also have ability to wean from mechanical ventilation as soon as possible, if the hemo-dynamics is stable, and without the responsive pulmonary hypertension or pulmonary hypertension crisis after surgical repair.展开更多
In the current meta-analysis, we aimed to investigate the therapeutic effects of statins on pulmonary function in patients with chronic obstructive pulmonary disease （COPD）. MEDLINE, EMBASE and Cochrane Central Regi...In the current meta-analysis, we aimed to investigate the therapeutic effects of statins on pulmonary function in patients with chronic obstructive pulmonary disease （COPD）. MEDLINE, EMBASE and Cochrane Central Register of clinical trials were systematically searched until January 2017 for RCTs of statins. Only trials with COPD patients were included. The I2 statistic was used to measure heterogeneity between trials and calculated mean differences for pulmonary function parameters with fixed-effect meta-analysis. Eight eligible studies with 534 participants were identified. Statin therapy had no remarkable influence on FEV1 （SMD -0.01, 95% CI -0.204 to 0.184, 12 = 0.0%, P = 0.922, n = 409）, FEV1/FVC （SMD 0.163, 95% CI -0.044 to 0.369, 12 = 0.0%, P = 0.123, n = 364）, 6MWD, heart rate or CRP. However, exercise time on treadmill was remarkably improved by statin therapy （SMD 1.271, 95% CI 0.930 to 1.612, 12 = 0.0%, P = 0.000, n = 160）. Subgroup analysis showed significant, ameliorative effect ofpravastatin on FEV1/FVC （SMD 0.362, 95% CI 0.049 to 0.674, 12 = 0.0%, P = 0.023）. The results of this meta-analysis showed non-significant effect of statins on pulmonary function in COPD patients. Based on the studies reviewed, it is not recommended to prescribe statins for COPD patients without CVD risk factors due to lack of clearly defined benefit.展开更多
Objective. To study the difference of interstitial lung diseases (ILDs) in high-resolution computerized tomography and pulmonary function test among different connective tissue diseases (CTDs). Methods. 209 patients w...Objective. To study the difference of interstitial lung diseases (ILDs) in high-resolution computerized tomography and pulmonary function test among different connective tissue diseases (CTDs). Methods. 209 patients with different CTDs were recruited and underwent lung HRCT and PFT. Eerythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum ferritin (SF), anti-SSA, and so on were tested. Based on HRCT, a patient was classified into ILD group (CTD+ILD) or non-ILD group (CTD-ILD). HRCT, PFT, and laboratory markers were compared according to CTDs and CTD-associated ILDs. Results. The incidences of ILD were 79.6%, 82.0%, 89.7%, and 97.1% respectively for Rheumatoid arthritis (RA), primary Sjogren’s symptom (pSS), dermatomyositis/polymyositis (DM/PM), and systemic sclerosis (SSc) groups. RA and pSS patients exhibited more nodules, patching, ground-glass opacity, and cord shadow foci in HRCT, DM/PM and SSc patients exhibited more reticular opacity and honeycombing foci. RA and pSS patients exhibited more obstructive ventilatory disorder, small airway dysfunction and emphysema in PFT, and DM/PM and SSc patients exhibited more restrictive ventilatory disorder, mixed ventilatory disorder. ESR, CRP and SF were significantly higher in total CTD+ILD group than in total CTD-ILD group (P = 0.047, 0.006, 0.004, respectively), and higher in different CTD+ ILD groups than in comparable CTD-ILD groups (P = 0.049, 0.048, and 0.023, pSS+ILD, SSc+ILD and RA+ILD compared to pSS-ILD, SSc-ILD and RA-ILD, respectively for ESR, CRP, SF). The positive rate of anti-SSA was significantly higher in DM/PM+ILD group than in DM/PM-ILD group (P = 0.025). Conclusions. The manifestations and incidences of ILDs differ among different CTDs in HRCT and PFT, and inflammation and anti-SSA are positively correlated with ILDs in different CTDs, which provide important evidences for judging disease condition and prognosis.展开更多
<strong>Background:</strong> A dual bronchodilator, long-acting anticholine drugs (glycopyrronium, LAMA) and the long running <em>β</em>-<sub>2</sub> stimulant (indacaterol, LABA),...<strong>Background:</strong> A dual bronchodilator, long-acting anticholine drugs (glycopyrronium, LAMA) and the long running <em>β</em>-<sub>2</sub> stimulant (indacaterol, LABA), are effective for the treatment of chronic obstructive pulmonary disease (COPD). To evaluate the effectiveness of the perioperative intervention of LAMA/LABA, a randomized prospective trial was performed for the lung cancer patients receiving a lobectomy with normal pulmonary function and COPD. <strong>Methods:</strong> Based on the results of the preoperative pulmonary function test, 25 patients were diagnosed with COPD [% forced expiratory volume in 1 second (%FEV<sub>1</sub>) < 70%]. Thirty-seven patients were enrolled as non-obstructive patients (70% ≤ %FEV<sub>1</sub>), who were randomized into two groups, the LAMA/LABA (n = 19) and the Control group (n = 18). The LAMA/LABA and the COPD groups daily received inhaled LAMA (50 μg) and LABA (110 μg) for 1 week before surgery and for least 4 weeks after surgery. The Control group had no treatment of the dual bronchodilator. The actual values were measured during the perioperative pulmonary function at three points of the preoperative baseline, the postoperative 1 week and the postoperative 4 weeks;these changes and changed ratios were then calculated. The patient-reported outcomes of the quality of life (PRO-QOL) were evaluated by the Cancer Dyspnea Scale (CDS), the COPD assessment test, and the St. George’s Respiratory Questionnaire. <strong>Results:</strong> Regarding the value of FEV<sub>1</sub> at the baseline, that in the LAMA/LABA group was 79.2% ± 6.4% and that in the Control group was 80.9% ± 6.4%, but that in the COPD groups was 57.9% ± 8.7%;there was a significant difference between the COPD and the Control group (p < 0.0001). At the postoperative 1 week point, the FEV<sub>1</sub> value in the Control group was 1.3 ± 0.5 L and that in the LAMA/LABA group was 1.7 ± 0.5 L. On the other hand, that in the COPD group was 1.7 ± 0.5 L, which was significantly higher compared to that in the Control group (p = 0.0251 and p = 0.0369). The intervention of LAMA/LABA for the COPD and non-obstructive patients resulted in the less decreased degree of the pulmonary function in FEV<sub>1</sub> compared to that in the Control group. Based on the PRO-QOL by the CDS, the intervention of LAMA/LABA significantly reduced the total dyspnea in the LAMA/LABA group compared to that in the Control group (p = 0.0348). <strong>Conclusion:</strong> The perioperative intervention of LAMA/LABA should lead to maintaining the postoperative pulmonary function of the FEV<sub>1</sub> during the lobectomy with COPD and non-obstructive patients and the improvement of PRO-QOL.展开更多
Background Early and accurate assessment of right ventricular changes in patients with Chronic obstructive pulmonary disease(COPD)is of great value,because these changes are important factors affecting the prognosis o...Background Early and accurate assessment of right ventricular changes in patients with Chronic obstructive pulmonary disease(COPD)is of great value,because these changes are important factors affecting the prognosis of patients with COPD. This study aimed to investigate the changes of right ventricular structure and function by electrocardiography in COPD patients,and to evaluate the correlations of pulmonary function,COPD assessment test(CAT)score with the changes. Methods According to the"ABCD"2016 Global initiative for chronic obstructive pulmonary disease(GOLD)update,stable COPD patients were divided into four groups:GOLD A group,GOLD B group,GOLD C group,and GOLD D group. There were 30 patients of each group enrolled from December 2016 to December 2017 in Guangdong General Hospital. During the same period,30 physical examination volunteers were enrolled as the healthy control group. Pulmonary function and echocardiography were performed in all subjects. All COPD patients completed CAT test. One-way ANOVA and SNK-q test were used to analyze the differences in parameters of right ventricular structure and function between different GOLD groups and healthy controls. Pearson correlation analysis was used to analyze the relation between CAT score,forced expiratory volume in one second(FEV1)and echocardiographic parameters. Results Compared with control group,right ventricular wall thickness(RVWT)was significantly thicker in patients of GOLD A,B and C groups(P<0.001),but not for GOLD D group. In sharp contrast,only in the patients of GOLD D group,right ventricular basal diameter(RV basal diameter)and right ventricular outflow tract(RVOT)(2.84±0.56 cm and 4.63±0.54 cm)were significantly longer than those in healthy controls and other GOLD groups(P<0.001).The patients of GOLD C and D groups had higher E/A ratio and E/e′ ratio compared with control group,GOLD A and B groups(P<0.001). But only in GOLD D group,the fractional area change(FAC)and tricuspid annular plane systolic excursion(TAPSE)were decreased significantly,compared with control group and other GOLD groups(P<0.001). The right ventricular index of myocardial performance(RIMP)in GOLD B,C and D groups was increased significantly compared with healthy control and GOLD A group(P<0.001). Moreover,correlation analysis showed that no correlations were found between FEV1 and all parameters of right ventricular structure and function,but CAT was positively correlated with RIMP(r=0.696,P=0.019). Conclusions Echocardiography could be a good assessment for right ventricular structure and function in COPD patients. Right ventricular wall thickening and diastolic dysfunction occur in the early stage of COPD,followed by right ventricular volume enlargement and systolic dysfunction.展开更多
Objective:To explore the clinical effect of ambroxol hydrochloride combined with rehabilitation training on COPD and its effect on pulmonary function.Methods:92 patients with COPD from May 2017 to may 2019 were random...Objective:To explore the clinical effect of ambroxol hydrochloride combined with rehabilitation training on COPD and its effect on pulmonary function.Methods:92 patients with COPD from May 2017 to may 2019 were randomly divided into control group(n=46)and observation group(n=46).The control group was treated with oxygen inhalation,expectorant,antispasmodic,anti infection and so on.The observation group was treated with ambroxol hydrochloride combined with rehabilitation training on this basis.Blood gas,lung function and inflammatory factors were compared before and after treatment.Results:the levels of SaO2 and PaO2 in the two groups were significantly higher than those before treatment P There was significant difference between the two groups(P<0.05-0.01).Besides,the level of lung function related indexes in the observation group was significantly higher than that in the control group(P<0.05).Conclusion:ambroxol hydrochloride combined with rehabilitation training has a significant clinical effect on COPD,which can effectively improve the blood gas index and reduce the level of blood gas inflammatory factors,thus affecting the lung function of COPD patients.展开更多
基金supported by National High Level Hospital Clinical Research Funding,grant nos.BJ-2025-122,BJ2023-126CAMS Innovation Fund for Medical Sciences(CIFMS),grant no.2021-I2M-1050National Natural Science Foundation of China,grant no.82170956。
文摘Chronic obstructive pulmonary disease(COPD),a disease responsible for early mortality worldwide,is well accepted to be associated with periodontitis epidemiologically.Although both of the diseases are the multi-microbial inflammatory disease,the precise underlying mechanisms by which periodontitis influences the progression of COPD remains largely unknown.Here,we established COPD accompanied with periodontitis mouse models and observed the pronounced progress in pulmonary symptoms and histopathology,cha racterized by poorer respiratory function,thicke ned bronchial walls,and increased neutrophils infiltration in lung tissue.Mechanistically,periodontitis pathogen Porphyromonas gingivalis(P.gingivalis)relocated in the lung through the respiratory tract and LPS from P.gingivalis promoted the secretion of chemokines CXCL2 and G-CSF of alveolar epithelial cells through NF-κB and p38 MAPK pathways to recruit neutrophils.Furthermore,exposure to P.gingivalis of infiltrated neutrophils released matrix metallopeptidase-8(MMP-8)and neutrophil elastase(NE),which aggravated airway inflammation and tissue damage.These findings indicated that periodontitis could exacerbate COPD via its pathogen P.gingivalis,which translocated in the lung and stimulated neutrophil chemotaxis and activation in the lung.
基金providing by the Shenzhen City Nanshan District Science and Technology Plan Project(Medical and Health Category)(Grant No.2018073)。
文摘Objective:To assess whether there is a correlation between CT scan severity score and pulmonary function in Interstitial Lung Disease,and provide a more reliable basis for clinical diagnosis and treatment.Materials and Methods:Sixty patients with clinical diagnosis of Interstitial Lung Disease(ILD)were collected,and chest CT and pulmonary function tests were performed at the same time.Here DLCO%and FEV1%were used as the pulmonary function indexes.The severity of the patients was assessed by CT scores as mild(range,1~10),moderate(range 11~20),and severe(range 21~30).Correlation analysis was carried out between CT score and pulmonary function index,and the lung function parameters of patients at three grades were compared between groups and pairwise among the means.Results:As per the CT severity classification,there were 13 mild cases,31 moderate cases,and 16 severe cases.CT score was negatively correlated with DLCO%and FEV1%.R value was-0.814 and-0.797,respectively;The comparison of the mean value of DLCO%and FEV1%among the three groups and the pairings of the mean value of DLCO%and FEV1%were statistically significant.Conclusion:There was good correlation between CT score of ILD and the pulmonary function index.The pulmonary function index of patients with different CT severity grading was statistically significant,which can provide a new basis for the clinical evaluation and diagnosis of the disease.
基金Supported by Xuhui District Health Commission,No.SHXH202214.
文摘BACKGROUND Esophageal cancer surgery is associated with a high risk of postoperative pulmonary complications,particularly pneumonia.Although conventional respiratory rehabilitation strategies–such as preoperative inspiratory muscle training–have demonstrated limited efficacy,the low-intensity traditional Chinese Qigong practice"Liuzijue"(Six-Character Formula)shows promise.However,robust clinical evidence supporting its use in patients undergoing esophagectomy remains lacking.AIM To evaluate the effects of early postoperative"Liuzijue"training on pulmonary function and pneumonia incidence following radical esophagectomy.METHODS This retrospective study included 306 patients who underwent esophagectomy.The control group(n=163)received standard care,consisting of abdominal breathing,incentive spirometry,and early ambulation.The intervention group(n=143)received the same standard care plus twice-daily"Liuzijue"training for 14 days.Primary outcomes were the incidence of pneumonia(defined by Centers for Disease Control and Prevention criteria)and changes(Δ)in forced vital capacity(FVC),forced expiratory volume in 1 second(FEV_(1)),and maximum voluntary ventilation(MVV)from baseline to postoperative day 14.RESULTS The"Liuzijue"intervention was associated with a significantly lower incidence of pneumonia(11.9%vs 24.5%,P=0.005;relative risk=0.48).Significant improvements were observed inΔFVC(+502.1 mL vs+326.5 mL,P<0.001),ΔFEV_(1)(+701.7 mL vs+434.4 mL,P<0.001),andΔMVV(+19.4 L/minute vs+14.4 L/minute,P<0.001).Absolute FEV_(1) values on postoperative day 14 were higher in the intervention group(2270.8 mL vs 2066.1 mL,P=0.021),along with significantly lower Borg dyspnea/fatigue scores(P=0.045).No significant differences were observed in changes in diffusing capacity of the lung for carbon monoxide,total lung capacity,or 6-minute walk distance.CONCLUSION Early initiation of"Liuzijue"training after esophagectomy is associated with reduced pneumonia incidence and accelerated recovery of key pulmonary function parameters.These findings support the integration of"Liuzijue"into enhanced recovery after surgery protocols for esophageal cancer patients.
基金Supported by Construction of a High-level Research-oriented Traditional Chinese Medicine Hospital,No.YC-2023-0901.
文摘BACKGROUND Patients with connective tissue disease-associated interstitial lung disease(CTDILD)experience not only progressive respiratory impairment but also a significant psychological burden.The prevalence and impact of anxiety and depression and their intricate relationship with dyspnea severity and pulmonary function decline remain inadequately characterized in this population,hindering comprehensive care.AIM To explore the incidence of anxiety and depression in CTD-ILD and its relationship with dyspnea severity and pulmonary function index.METHODS Data of 100 patients with CTD-ILD(January 2022-June 2024)were retrospectively analyzed.Baseline demographic,pulmonary function[forced vital capacity(FVC%)and diffusing capacity of the lungs for carbon monoxide(DLCO%)],modified medical research council(mMRC)score,and psychological scale[generalized anxiety disorder-7(GAD-7)and patient health questionnaire-9(PHQ-9)]were collected.Pulmonary function was reviewed every 3 months,and highresolution computed tomography was performed every 6 months following standardized treatment(glucocorticoids+immunosuppressive+anti-fibrosis agents).Pearson/Spearman correlation analysis,linear mixed effect model,and Cox regression were used to analyze the correlation between anxiety and depression and physiological indicators as well as the prognosis.RESULTS Baseline prevalence of moderate-to-severe anxiety(GAD-7≥10)and depression(PHQ-9≥10)was 38%and 42%,respectively.Following 24 weeks of treatment,pulmonary function(FVC%:72.11±13.08 vs 67.89±12.73;DLCO%:60.67±13.76 vs 55.32±13.95,both P<0.05),psychological scores(GAD-7 and PHQ-9,P<0.05),and inflammatory markers[C-reactive protein(CRP)and erythrocyte sedimentation,P<0.05]significantly improved.The levels of inflammatory indicators were significantly decreased(P<0.05).The GAD-7/PHQ-9 scores negatively correlated with FVC%and DLCO%(P<0.05)and positively correlated with the mMRC scores and CRP(P<0.05).The mixed model showed that for each one-point increase in GAD-7/PHQ-9,FVC%decreased by 0.412%/0.426%(P<0.01).Cox regression analysis showed that for every liter of GAD-7 and PHQ-9,the risk of pulmonary function deterioration increased by 12.8%and 14.2%,respectively(hazard ratio=1.128 and 1.142,P<0.01).CONCLUSION Anxiety and depression in patients with CTD-ILD constituted a bidirectional negative feedback loop involving pulmonary function impairment,inflammatory activity,and dyspnea.Psychological disorders were identified as independent risk factors for deterioration of pulmonary function.Psychological evaluation and intervention should be integrated clinically to block brain–lung axis-mediated neuroendocrine–immune network imbalance and improve prognosis.
文摘The high comorbidity rates of depression and chronic obstructive pulmonary disease(COPD)have garnered widespread attention.As a refractory disease,its long-term stress effects exacerbate the coexistence of depression.Depression is linked to a decline in lung function in patients with COPD through reduced heart rate variability,increased inflammatory cytokines,dysregulation of the hypothalamic-pituitary-adrenal axis,and the interplay of various biological and psychological factors.Sole reliance on biomedical treatment cannot fully counteract these negative effects,which are detrimental to improving patients’quality of life and long-term prognosis.Antidepressant medications and traditional Chinese medicine combined with conventional COPD therapy,psychotherapy(e.g.,cognitive behavioral therapy,mindfulness training),and lifestyle adjustments(e.g.,yoga,qigong,or walking)can not only alleviate depression and compensate for the limitations of biomedical approaches but also help improve heart rate variability and lung function.In this editorial,we suggest that clinicians,when prescribing antidepressants,must carefully weigh the benefit-risk ratio based on the patient’s specific physical condition to ensure precise medication use.
基金Supported by the Zhangjiakou City Science and Technology Research Plan,No.1821110D.
文摘BACKGROUND Depression is a common comorbidity in patients with chronic obstructive pulmonary disease(COPD).Research indicates that COPD affects cardiac au-tonomic control,and heart rate variability(HRV)serves as a simple,non-invasive measure of autonomic nerve activity.However,the relationship between HRV and lung function,as well as the impact of depressive symptoms,remains un-clear.METHODS A retrospective cross-sectional study involving 120 COPD patients hospitalized from January 2018 to January 2024 at our institution was conducted.Demographic and clinical characteristics were collected,and depressive symptoms were asse-ssed using the Beck Depression Inventory(BDI).Patients were categorized into a depressed group(BDI≥16)and a non-depressed group(BDI<16).A control group consisting of 60 healthy volunteers who underwent check-ups at the same institution was also included.Statistical analyses were performed using SPSS 26.0 software.Pearson correlation coefficients were calculated to determine and compare the relationships between HRV parameters,lung function measures,and RESULTS Of the 120 patients with COPD,35.8%(43/120)were diagnosed with depression,compared to 5.0%(3/60)in the control group.The HRV index in COPD patients was significantly lower than that in the control group(P<0.05),and the value in the depressed group was significantly lower than that in the non-depressed group(P<0.05).Similarly,the COPD group had a significantly lower pulmonary forced vital capacity(FVC),first-second expiratory volume(FEV1)and FEV1/FVC ratios than the control group(P<0.05),and the depressed group was significantly lower than that in the non-depressed group(P<0.05).Pearson correlation analysis revealed that the standard deviation of normal R-R intervals,standard deviation of the mean of 5-minute normal R-R intervals,root mean square of successive differences of normal R-R intervals,percentage of normal R-R intervals greater than 50 ms,high-frequency,and low-frequency indices showed positive correlations with lung function parameters(P<0.05)and negative correlations with BDI scores(P<0.05).CONCLUSION Compared to patients without COPD,the incidence of depressive symptoms is higher among patients with COPD and is negatively correlated with the patients’HRV indices.In contrast,HRV indices are positively correlated with the patients’pulmonary function parameters.Patients and healthcare professionals should enhance their awareness of depression,actively conduct depression assessment screenings,and incorporate HRV indices into disease management.This approach aims to improve the psychological health of patients and ultimately enhance their prognosis and quality of life.
文摘Objective To observe the therapeutic effects of warming needle moxibustion on pulmonary function of elderly patients with stable chronic obstructive pulmonary disease. Method Eighty elderly patients with stable chronic obstructive pulmonary disease were divided randomly into an acupuncture group and a drug group, with forty cases in each group. The patients in the acupuncture group were treated with warming needle moxibustion on specific acupoints. Main acupoints include Zusanli （足三里 ST 36）, Feishu （肺俞 BL 13） and Dingchuan （定喘 EX-B 1）. Matching acupoints include Gaohuang （膏肓 BL 43）, Xinshu （心俞 BL 15）, Dazhui （大椎 GV 14） and Fangmen （风门 BE 12）. The acupoints were punctured with even reinforcing and reducing method. Meanwhile, two moxa stick of warming needle moxibustion were applied separately at the acupoints at back and ST 36. The needles were retained for approximately 0.5 h each time. The treatment was given every other day, 3 times a week and the course of treatment was 8 weeks. Patients in the drug group were treated by seretide inhalation （50 μg salmeterol and 250 μg fluticasone propionate）, twice a day for 8 weeks. The improvement in pulmonary function and the symptom of chills and fever were compared between the two groups. Results After treatment, pulmonary function indices [forced expiratory volume in one second （FEV1）, forced expiratory volume in one second to forced vital capacity （FEVl/FVC）, forced expiratory volume in one second to predicted value ratio （FEV1%） and peak expiratory flow （PEF）] of the patients in both groups were improved significantly compared with that before treatment （P〈0.05）. There was no statistically significant difference between the two groups （all P〉0.05）. Improvement in comprehensive scores of the symptom of chill and fever in the acupuncture group was significantly superior to that in the drug group after 4 and 8 weeks of the treatment, respectively （P〈0.05）. Conclusion Warming needle moxibustion was obviously effective on the improvement in pulmonary function of elderly patients with stable chronic obstructive pulmonary disease.
基金Supported by The National Natural Science Foundation Project(grant number 81173211)National Administration of Traditional Scientific Research Special Foundation of China(2004-2005LP27)+3 种基金Eleventh Five-Year key Program of Anhui Province(07010300204)Anhui Science and Technology Key Research Program(NO.06023068)Anhui Traditional Chinese Medicine Applied Basic Research and Development of Provincial Experimental Room Program([2008]150)Anhui Education Department Natural Science Key Research Program(KJ2008A165)
文摘OBJECTIVE:To observe the impact of xinfeng xapsule(XFC) on pulmonary function in a rat model of adjuvant arthritis(AA) and to investigate the mechanism of action.METHODS:Forty rats were randomly divided into four groups of ten:normal control(NC);model control(MC);tripterygium glycosides tablet(TPT);and xinfeng capsule(XFC).Except for the NC group,AA was induced in all rats by intracutaneous injection of 0.1 mL Freund's complete adjuvant in the right paw on the 19th day.NC and MC groups were given(0.9%) physiological saline.The TPT and XFC groups were given TPT(10 mg/kg) and XFC(1.2 g/kg),respectively.Thirty days after administration,changes in paw edema(E),the arthritis index(AI),pulmonary function,levels of regulatory T-cells(Treg),ultrastructure of lung tissue,and expression of Notch receptors and ligands in lung tissue were observed.RESULTS:In the MC group,E and the AI were increased and pulmonary function significantly decreased;the structure of alveolar type-II cells was damaged;ratios of Treg in peripheral blood were reduced;and expression of Notch receptors such as Notch3 and Notch4 and ligands such as Delta1 in lung tissue were significantly increased whereas expression of Notch1,Jagged1 and Jagged2 were significantly decreased.After intervention with XFC,E and the AI were decreased;pulmonary function was enhanced;the structure of alveolar type-II cells was improved;and expression of Treg,Notch1,Jagged1,Jagged2 was elevated,whereas that of Notch3,Notch4 and Delta1 was reduced.CONCLUSION:XFC can not only inhibit E and the AI and improve joint symptoms,it can also improve pulmonary function and reduce inflammation in lung tissue.These actions could be carried out through increases in the expression of Treg,Notch receptors(Notch1) and ligands(Jagged1,Jagged2),and reductions in the expression of Notch3,Notch4 and Delta1.These phenomena would reduce the deposition of immune complexes and the inflammatory response in lung tissue,thereby improving joint symptoms and pulmonary function.
文摘BACKGROUND Chronic obstructive pulmonary disease(COPD)is a chronic respiratory disease with worldwide occurrence and high disability and mortality rate.It occurs mostly in the elderly population with pulmonary heart disease,type II respiratory failure,and other serious complications.AIM To investigate the correlation of plasma brain natriuretic peptide(BNP)and platelet parameters with cardiac function and pulmonary hypertension in patients with COPD and pulmonary heart disease.METHODS From June 2016 to June 2019,52 patients with COPD-pulmonary heart disease(pulmonary heart disease group),30 patients with COPD(COPD group),and 30 healthy individuals(control group)in our hospital were enrolled in the study.The pulmonary heart disease group was further divided into subgroups according to cardiac function classification and pulmonary artery pressure.Plasma BNP and platelet parameters were estimated and compared among each group and subgroup.The correlation of plasma BNP and platelet parameters with cardiac function classification and pulmonary artery pressure was then analyzed.RESULTS In the pulmonary heart disease group,the COPD group,and the control group,the levels of plasma BNP,platelet distribution width(PDW),and mean platelet volume(MPV)showed a decreasing trend(P<0.05),while an increasing trend was found in platelet count(PLT)and plateletcrit(PCT)levels among the three groups(P<0.05).In the pulmonary hypertension mild,moderate,and severe subgroups,the levels of plasma BNP,PDW,and MPV showed an increasing trend(P<0.05),while a decreasing trend was observed in PLT levels(P<0.05);however,PCT levels showed no significant difference among the three subgroups(P>0.05).In the cardiac function grade I,II,III,and IV subgroups,the levels of plasma BNP,PDW,and MPV showed an increasing trend(P<0.05),while a decreasing trend was noted in PLT and PCT levels among the four subgroups(P<0.05).Correlation analysis showed that the levels of plasma BNP,PDW,and MPV in patients with pulmonary heart disease were positively correlated with their pulmonary artery pressure(P<0.05),while PLT was negatively correlated with their pulmonary artery pressure(P<0.05).Moreover,plasma BNP,PDW,and MPV levels were positively correlated with cardiac function grade(P<0.05)of these patients,while PLT and PCT levels were negatively correlated with their cardiac function grade(P<0.05).CONCLUSION Plasma BNP and PLT parameters are significantly correlated with the cardiac function and pulmonary hypertension in patients with COPD and pulmonary heart disease,indicating that these parameters have high clinical relevance in reflecting the health condition of these patients and for guiding their treatment.
基金supported by the Agriculture and Agri-Food Canada,AAFC’s IOP project,Manitoba Pork and Swine Innovation PorcCanada Foundation for Innovation(CFI)supported by the Chinese Scholarship Council(CSC).
文摘Background:Enterotoxigenic Escherichia coli(ETEC)F4 commonly colonizes the small intestine and releases enterotoxins that impair the intestinal barrier function and trigger inflammatory responses.Although Bacillus licheniformis(B.licheniformis)has been reported to enhance intestinal health,it remains to be seen whether there is a functional role of B.licheniformis in intestinal inflammatory response in intestinal porcine epithelial cell line(IPEC-J2)when stimulated with ETEC F4.Methods:In the present study,the effects of B.licheniformis PF9 on the release of pro-inflammation cytokines,cell integrity and nuclear factor-κB(NF-κB)activation were evaluated in ETEC F4-induced IPEC-J2 cells.Results:B.licheniformis PF9 treatment was capable of remarkably attenuating the expression levels of inflammation cytokines tumor necrosis factor-α(TNF-α),interleukin(IL)-8,and IL-6 during ETEC F4 infection.Furthermore,the gene expression of Toll-like receptor 4(TLR4)-mediated upstream related genes of NF-κB signaling pathway has been significantly inhibited.These changes were accompanied by significantly decreased phosphorylation of p65 NF-κB during ETEC F4 infection with B.licheniformis PF9 treatment.The immunofluorescence and western blotting analysis revealed that B.licheniformis PF9 increased the expression levels of zona occludens 1(ZO-1)and occludin(OCLN)in ETEC F4-infected IPEC-J2 cells.Meanwhile,the B.licheniformis PF9 could alleviate the injury of epithelial barrier function assessed by the trans-epithelial electrical resistance(TEER)and cell permeability assay.Interestingly,B.licheniformis PF9 protect IPEC-J2 cells against ETEC F4 infection by decreasing the gene expressions of virulence-related factors(including luxS,estA,estB,and elt)in ETEC F4.Conclusions:Collectively,our results suggest that B.licheniformis PF9 might reduce inflammation-related cytokines through blocking the NF-κB signaling pathways.Besides,B.licheniformis PF9 displayed a significant role in the enhancement of IPEC-J2 cell integrity.
文摘BACKGROUND Lung cancer is a malignant tumor with high morbidity and mortality among cancers.Surgery is currently one of the primary methods of treating lung cancer.Although it can slow down the progression of the disease by removing the lesion,this invasive surgery inevitably damages the integrity of the patient’s chest.Moreover,the patient’s pulmonary function may have a low compensatory capacity after surgery,causing various respiratory diseases such as atelectasis,respiratory function decline,and even serious cardiovascular disease.All of these have great negative impacts on the surgical effect and the prognosis of patients.With the continuous exploration and development of nursing,continuous nursing and respiratory exercise nursing have been gradually applied in the nursing of patients after lung cancer surgery,and have achieved good nursing results.AIM To investigate the effect of continuous nursing combined with respiratory exercise nursing on the pulmonary function of postoperative patients with lung cancer.METHODS A total of 80 patients with lung cancer who underwent surgery in our hospital from January 2021 to December 2021 were selected as the study subjects.All subjects were randomly divided into the control group(n=40 cases)and the experimental group(n=40 cases).Patients with lung cancer in the control group were given conventional nursing after surgery,while the experimental group was given continuous nursing combined with respiratory exercise nursing based on conventional nursing.The recovery of pulmonary function and respiratory symptoms was observed before and after 3 mo of intervention in both groups.The pulmonary function parameters,blood gas analysis,MD Anderson Symptom Inventory-lung cancer module(MDASI-LC)scores,incidence of pulmonary complications,and Morisky compliance scores were compared between the two groups before and after 3 mo of intervention.RESULTS There was no significant difference in pulmonary function and blood gas analysis between the two groups before intervention(P>0.05).3 mo after the intervention,the pulmonary function parameters in the experimental group(SpO2,VC,MVV,FEV1,FEV1%pred,and FEV1/FVC)were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in blood gas analysis between the two groups before intervention(P>0.05).PaO2 in the experimental group was significantly higher than that in the control group,and PaCO_(2) was significantly lower than that in the control group 3 mo after the intervention.The difference had statistical significance(P<0.05).3 mo after the intervention,the MDASI score of respiratory symptoms in the experimental group was significantly lower than that in the control group(P<0.05),and the incidence of pulmonary complications was lower than that in the control group(P<0.05).In addition,the treatment compliance and nursing satisfaction of patients in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05).CONCLUSION Continuous nursing combined with respiratory exercise nursing can significantly accelerate the recovery of respiratory function in postoperative lung cancer patients,reduce the incidence of postoperative complications of lung cancer as well as improve the treatment compliance of patients.
文摘Objective. To investigate the changes and influencing factors of early postoperative pulmonary functionof thoracotomy.Methods. Pre-and early postoperative pulmonary function was studied in 64 consecutive cases withoptimal thoracotomy. Pain assessment was done before pulmonary function test, and the chief complaintsof patients were recorded after the procedure. The changing curves of pulmonary function were done andthe differences associated with groups, surgical styles, pain assessment, epidural analgesia, chief com-plaint and preoperative conditions were analyzed.Results. Pulmonary function was severely lowered to about 40% of the base line on the first day,and it was rehabilitated to about 60% of the base line on the eighth day. There was a greater gradienton the recovery curve on the 3rd and 4th days. Epidural analgesia was able to improve pain relaxationand pulmonary function in some degree. Single-factor analysis showed that postoperative pain, postopera-tive day and surgical style were the significant influencing factors for early postoperative pulmonary func-tion. By multiple-factor analysis, preoperative pulmonary function, age and postoperative pain were themain factors, while surgical style had only weak effect on it.Conclusions. Early postoperative pulmonary function is severely impaired by thoracotomy. It rehabili-tate gradually with time. Improvement of preoperative pulmonary function, reducing surgical procedure in-juries, especially injury to respiratory muscle system, and enough postoperative pain relief are the mostimportant means that would reduce pulmonary function impairment and consequently reduce postoperativepulmonary complications.
基金Supported by the National Natural Science Foundation Project(No.81173211)Medical Key Subjects Chinese Paraly-sis Disease in the National School Construction Projects[Tra-ditional Chinese Medicine(2009)No.30]+3 种基金Anhui Science and Technology Office of Scientific Research Program(09020304046)Anhui Provincial Health Department of Tra-ditional Chinese Medicine Research Projects(No.2009-ZY05)Anhui Modern Chinese Medicine Basic and Applied Research and Development Projects Provincial Laboratory(2008 No.150)Anhui Medical and Technological Innovation Team project(No.2010TD005)
文摘OBjECTIVE:To observe the relationship between reduced pulmonary function and regulatory T cells(Tregs)and helper T cells(Th)1/Th2 drift in a rat model of adjuvant arthritis(AA),and to study the impact of Xinfeng capsule(XFC)on pulmonary function and investigate the mechanism of action.METHODS:Forty rats were randomly divided into normal control group(NC),model control group(MC),Tripterygium glycosides tablet group(TPT),and XFC group,with 10 in each.Except for the NCgroup,AA was induced in all rats by intracutaneous injection of 0.1 mL Freund's complete adjuvant in the right paw.On the 19th day after modeling,the NC and MC groups were given physiological saline(0.9%),while the TPT and XFC groups were given TPT(10 mg/kg)and XFC(2.4 g/kg),once daily,respectively.Thirty days after administration,changes in paw swelling,arthritis index(AI),pulmonary function,levels of serumγ-interferon(IFN-γ)and interleukin(IL)-4,Tregs in peripheral blood,and IFN-γ,IL-4,Forkhead box transcription factor 3(FoxP3)in lung tissue were observed by enzyme-linked immunosorbent assay,flow cytometry,polymerase chain reaction,and western blot.RESULTS:Compared with the NC group,paw swelling,AI,IFN-γ,and Th1/Th2 were increased,and pulmonary function parameters,IL-4,FoxP3 were decreased significantly in the MC group(P<0.05 or P<0.01).Pulmonary function parameters,Treg,IL-4,FoxP3(and mRNA)were higher,and paw swelling,AI,and IFN-γ(and mRNA)were lower in the XFC group than those in the MC group.The XFC group was also much better than theTPT group in improving pulmonary function,FoxP3 mRNA,IFN-γ,IL-4,Th1/Th2,and IL-10(P<0.05 or P<0.01).CONCLUSION:Xinfeng capsule can improve pulmonary function by regulating the levels of Tregs,inhibiting the activation of Th1 to Th2 cells,inducing drift,maintaining cell immune suppression,correcting the imbalance of Th1/Th2,and reducing inflammatory mediators.
文摘BACKGROUND Idiopathic pulmonary fibrosis(IPF)is classified under fibrotic interstitial pneumonia,characterized by a chronic and progressive course.The predominant clinical features of IPF include dyspnea and pulmonary dysfunction.AIM To assess the effects of pirfenidone in the early treatment of IPF on lung function in patients.METHODS A retrospective analysis was performed on 113 patients with IPF who were treated in our hospital from November 2017 to January 2023.These patients were divided into two groups:control group(n=53)and observation group(n=60).In the control group,patients received routine therapy in combination with methylprednisolone tablets,while those in the observation group received routine therapy together with pirfenidone.After applying these distinct treatment approaches to the two groups,we assessed several parameters,including the overall effectiveness of clinical therapy,the occurrence of adverse reactions(e.g.,nausea,vomiting,and anorexia),symptom severity scores,pulmonary function index levels,inflammatory marker levels,and the 6-min walk distance before and after treatment in both groups.RESULTS The observation group exhibited significantly higher rates than the control group after therapy,with a clear distinction(P<0.05).After treatment,the observation group experienced significantly fewer adverse reactions than the control group,with a noticeable difference(P<0.05).When analyzing the symptom severity scores between the two groups of patients after treatment,the observation group had significantly lower scores than the control group,with a distinct difference(P<0.05).When comparing the pulmonary function index levels between the two groups of patients after therapy,the observation group displayed significantly higher levels than the control group,with a noticeable difference(P<0.05).Evaluating the inflammatory marker data(C-reactive protein,interleukin-2[IL-2],and IL-8)between the two groups of patients after therapy,the observation group exhibited significantly lower levels than the control group,with significant disparities(P<0.05).Comparison of the 6-min walking distance data between the two groups of patients after treatment showed that the observation group achieved significantly greater distances than the control group,with a marked difference(P<0.05).CONCLUSION Prompt initiation of pirfenidone treatment in individuals diagnosed with IPF can enhance pulmonary function,elevate inflammatory factor levels,and increase the distance covered in the 6-min walk test.This intervention is conducive to effectively decreasing the occurrence of adverse reactions in patients.
文摘Objective To evaluate the effect of the cardiopulmonary bypass (CPB) on the pulmonary function in infants with or withoutpulmonary hypertension in congential ventricular septal defect (VSD). MethodsTwenty infants with VSD were enrolled in the study fromJan. to Dec.2004. They were divided into two groups: pulmonary hypertension group and non-pulmonary hypertension group, ten infantsrespectively. Pulmonary function parameters were measured before CPB and 3, 6, 9, 12, 15, 18, 21, 24h after CPB, the following datawere recorded: duration for mechanical ventilation (Tmv) and staying in the cardiac intensive care unit (Tcicu) after cardiac surgery.Results Before CPB, the pulmonary function parameters in non-pulmonary hypertension group were more superior than in pulmonary hy-pertension group (P<0.01). By contraries, the pulmonary function parameters in every time stage after CPB statistically significant de-creased in non-pulmonary hypertension group (P<0.05), especially at 6, 9, and 15h after CPB (P<0.01). In pulmonary hyperten-sion group, the pulmonary function parameters in 3h after CPB were more improved than before CPB, though there was no statistical sig-nificance. But they had statistically significant decreased at9, 12, 15h after CPB (P<0.05). There was a similar change in pulmonaryfunction between two groups at 21, 24h after CPB. Conclusion Exposure to CPB adversely affects pulmonary function after surgicalrepair of VSD in infants. We consider that the benefits of the surgical correction in infants with pulmonary hypertension outweight the neg-ative effects of CPB on pulmonary function. We should improve cardiac function to avoid the presence of the nadir trough in pulmonaryfunction. The infants with pulomonary hypertension also have ability to wean from mechanical ventilation as soon as possible, if the hemo-dynamics is stable, and without the responsive pulmonary hypertension or pulmonary hypertension crisis after surgical repair.
基金The Science and Technology Project of Traditional Chinese Medicine of Jiangsu Province(Grant No.YB2015073,Wang J)
文摘In the current meta-analysis, we aimed to investigate the therapeutic effects of statins on pulmonary function in patients with chronic obstructive pulmonary disease （COPD）. MEDLINE, EMBASE and Cochrane Central Register of clinical trials were systematically searched until January 2017 for RCTs of statins. Only trials with COPD patients were included. The I2 statistic was used to measure heterogeneity between trials and calculated mean differences for pulmonary function parameters with fixed-effect meta-analysis. Eight eligible studies with 534 participants were identified. Statin therapy had no remarkable influence on FEV1 （SMD -0.01, 95% CI -0.204 to 0.184, 12 = 0.0%, P = 0.922, n = 409）, FEV1/FVC （SMD 0.163, 95% CI -0.044 to 0.369, 12 = 0.0%, P = 0.123, n = 364）, 6MWD, heart rate or CRP. However, exercise time on treadmill was remarkably improved by statin therapy （SMD 1.271, 95% CI 0.930 to 1.612, 12 = 0.0%, P = 0.000, n = 160）. Subgroup analysis showed significant, ameliorative effect ofpravastatin on FEV1/FVC （SMD 0.362, 95% CI 0.049 to 0.674, 12 = 0.0%, P = 0.023）. The results of this meta-analysis showed non-significant effect of statins on pulmonary function in COPD patients. Based on the studies reviewed, it is not recommended to prescribe statins for COPD patients without CVD risk factors due to lack of clearly defined benefit.
文摘Objective. To study the difference of interstitial lung diseases (ILDs) in high-resolution computerized tomography and pulmonary function test among different connective tissue diseases (CTDs). Methods. 209 patients with different CTDs were recruited and underwent lung HRCT and PFT. Eerythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum ferritin (SF), anti-SSA, and so on were tested. Based on HRCT, a patient was classified into ILD group (CTD+ILD) or non-ILD group (CTD-ILD). HRCT, PFT, and laboratory markers were compared according to CTDs and CTD-associated ILDs. Results. The incidences of ILD were 79.6%, 82.0%, 89.7%, and 97.1% respectively for Rheumatoid arthritis (RA), primary Sjogren’s symptom (pSS), dermatomyositis/polymyositis (DM/PM), and systemic sclerosis (SSc) groups. RA and pSS patients exhibited more nodules, patching, ground-glass opacity, and cord shadow foci in HRCT, DM/PM and SSc patients exhibited more reticular opacity and honeycombing foci. RA and pSS patients exhibited more obstructive ventilatory disorder, small airway dysfunction and emphysema in PFT, and DM/PM and SSc patients exhibited more restrictive ventilatory disorder, mixed ventilatory disorder. ESR, CRP and SF were significantly higher in total CTD+ILD group than in total CTD-ILD group (P = 0.047, 0.006, 0.004, respectively), and higher in different CTD+ ILD groups than in comparable CTD-ILD groups (P = 0.049, 0.048, and 0.023, pSS+ILD, SSc+ILD and RA+ILD compared to pSS-ILD, SSc-ILD and RA-ILD, respectively for ESR, CRP, SF). The positive rate of anti-SSA was significantly higher in DM/PM+ILD group than in DM/PM-ILD group (P = 0.025). Conclusions. The manifestations and incidences of ILDs differ among different CTDs in HRCT and PFT, and inflammation and anti-SSA are positively correlated with ILDs in different CTDs, which provide important evidences for judging disease condition and prognosis.
文摘<strong>Background:</strong> A dual bronchodilator, long-acting anticholine drugs (glycopyrronium, LAMA) and the long running <em>β</em>-<sub>2</sub> stimulant (indacaterol, LABA), are effective for the treatment of chronic obstructive pulmonary disease (COPD). To evaluate the effectiveness of the perioperative intervention of LAMA/LABA, a randomized prospective trial was performed for the lung cancer patients receiving a lobectomy with normal pulmonary function and COPD. <strong>Methods:</strong> Based on the results of the preoperative pulmonary function test, 25 patients were diagnosed with COPD [% forced expiratory volume in 1 second (%FEV<sub>1</sub>) < 70%]. Thirty-seven patients were enrolled as non-obstructive patients (70% ≤ %FEV<sub>1</sub>), who were randomized into two groups, the LAMA/LABA (n = 19) and the Control group (n = 18). The LAMA/LABA and the COPD groups daily received inhaled LAMA (50 μg) and LABA (110 μg) for 1 week before surgery and for least 4 weeks after surgery. The Control group had no treatment of the dual bronchodilator. The actual values were measured during the perioperative pulmonary function at three points of the preoperative baseline, the postoperative 1 week and the postoperative 4 weeks;these changes and changed ratios were then calculated. The patient-reported outcomes of the quality of life (PRO-QOL) were evaluated by the Cancer Dyspnea Scale (CDS), the COPD assessment test, and the St. George’s Respiratory Questionnaire. <strong>Results:</strong> Regarding the value of FEV<sub>1</sub> at the baseline, that in the LAMA/LABA group was 79.2% ± 6.4% and that in the Control group was 80.9% ± 6.4%, but that in the COPD groups was 57.9% ± 8.7%;there was a significant difference between the COPD and the Control group (p < 0.0001). At the postoperative 1 week point, the FEV<sub>1</sub> value in the Control group was 1.3 ± 0.5 L and that in the LAMA/LABA group was 1.7 ± 0.5 L. On the other hand, that in the COPD group was 1.7 ± 0.5 L, which was significantly higher compared to that in the Control group (p = 0.0251 and p = 0.0369). The intervention of LAMA/LABA for the COPD and non-obstructive patients resulted in the less decreased degree of the pulmonary function in FEV<sub>1</sub> compared to that in the Control group. Based on the PRO-QOL by the CDS, the intervention of LAMA/LABA significantly reduced the total dyspnea in the LAMA/LABA group compared to that in the Control group (p = 0.0348). <strong>Conclusion:</strong> The perioperative intervention of LAMA/LABA should lead to maintaining the postoperative pulmonary function of the FEV<sub>1</sub> during the lobectomy with COPD and non-obstructive patients and the improvement of PRO-QOL.
基金supported by the National Nature Science Fund(No.81300034)
文摘Background Early and accurate assessment of right ventricular changes in patients with Chronic obstructive pulmonary disease(COPD)is of great value,because these changes are important factors affecting the prognosis of patients with COPD. This study aimed to investigate the changes of right ventricular structure and function by electrocardiography in COPD patients,and to evaluate the correlations of pulmonary function,COPD assessment test(CAT)score with the changes. Methods According to the"ABCD"2016 Global initiative for chronic obstructive pulmonary disease(GOLD)update,stable COPD patients were divided into four groups:GOLD A group,GOLD B group,GOLD C group,and GOLD D group. There were 30 patients of each group enrolled from December 2016 to December 2017 in Guangdong General Hospital. During the same period,30 physical examination volunteers were enrolled as the healthy control group. Pulmonary function and echocardiography were performed in all subjects. All COPD patients completed CAT test. One-way ANOVA and SNK-q test were used to analyze the differences in parameters of right ventricular structure and function between different GOLD groups and healthy controls. Pearson correlation analysis was used to analyze the relation between CAT score,forced expiratory volume in one second(FEV1)and echocardiographic parameters. Results Compared with control group,right ventricular wall thickness(RVWT)was significantly thicker in patients of GOLD A,B and C groups(P<0.001),but not for GOLD D group. In sharp contrast,only in the patients of GOLD D group,right ventricular basal diameter(RV basal diameter)and right ventricular outflow tract(RVOT)(2.84±0.56 cm and 4.63±0.54 cm)were significantly longer than those in healthy controls and other GOLD groups(P<0.001).The patients of GOLD C and D groups had higher E/A ratio and E/e′ ratio compared with control group,GOLD A and B groups(P<0.001). But only in GOLD D group,the fractional area change(FAC)and tricuspid annular plane systolic excursion(TAPSE)were decreased significantly,compared with control group and other GOLD groups(P<0.001). The right ventricular index of myocardial performance(RIMP)in GOLD B,C and D groups was increased significantly compared with healthy control and GOLD A group(P<0.001). Moreover,correlation analysis showed that no correlations were found between FEV1 and all parameters of right ventricular structure and function,but CAT was positively correlated with RIMP(r=0.696,P=0.019). Conclusions Echocardiography could be a good assessment for right ventricular structure and function in COPD patients. Right ventricular wall thickening and diastolic dysfunction occur in the early stage of COPD,followed by right ventricular volume enlargement and systolic dysfunction.
基金Capital medical development research fund (2017-3147)
文摘Objective:To explore the clinical effect of ambroxol hydrochloride combined with rehabilitation training on COPD and its effect on pulmonary function.Methods:92 patients with COPD from May 2017 to may 2019 were randomly divided into control group(n=46)and observation group(n=46).The control group was treated with oxygen inhalation,expectorant,antispasmodic,anti infection and so on.The observation group was treated with ambroxol hydrochloride combined with rehabilitation training on this basis.Blood gas,lung function and inflammatory factors were compared before and after treatment.Results:the levels of SaO2 and PaO2 in the two groups were significantly higher than those before treatment P There was significant difference between the two groups(P<0.05-0.01).Besides,the level of lung function related indexes in the observation group was significantly higher than that in the control group(P<0.05).Conclusion:ambroxol hydrochloride combined with rehabilitation training has a significant clinical effect on COPD,which can effectively improve the blood gas index and reduce the level of blood gas inflammatory factors,thus affecting the lung function of COPD patients.
