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
BACKGROUND Small intestinal bacterial overgrowth(SIBO)is suspected and excluded frequently in functional gastrointestinal(GI)disorders.Children presenting with various esophago-gastro-duodenal(upper GI)symptoms are ra...BACKGROUND Small intestinal bacterial overgrowth(SIBO)is suspected and excluded frequently in functional gastrointestinal(GI)disorders.Children presenting with various esophago-gastro-duodenal(upper GI)symptoms are rarely subjected to investig-ations for SIBO.AIM To estimate the frequency of SIBO in children having functional upper GI sym-ptoms(as cases)and to compare the result of the SIBO status to that of the con-trols.METHODS Children aged 6 to 18 who presented with upper GI symptoms were selected for the study.All children were subjected to upper GI endoscopy before being advised of any proton pump inhibitors(PPIs).Children with normal endoscopy were assigned as cases,and children having any endoscopic lesion were design-ated as controls.Both groups were subjected to a glucose-hydrogen breath test by Bedfont Gastrolyser.RESULTS A total of 129 consecutive children who were naive to PPIs and had normal ba-seline investigations were included in the study.Among them,67 patients had endoscopic lesions and served as the control group,with six cases being excluded due to the presence of Helicobacter pylori in gastric biopsies.Sixty-two children with normal endoscopy results formed the case group.In the case group,35 children(59%)tested positive for hydrogen breath tests,compared to 13 children(21%)in the control group.The calculated odds ratio was 5.38(95%confidence interval:2.41-12.0),which was statistically significant.Further analysis of symptoms revealed that nausea,halitosis,foul-smelling eructation,and epigastric fullness were positive predictors of SIBO.CONCLUSION It is worthwhile to investigate and treat SIBO in all children presenting with upper GI symptoms that are not explained by endoscopy findings.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
AIM To compare high-resolution computed tomography(HRCT) findings between humoral primary immunodeficiencies(hPIDs) subtypes; to correlate these findings to pulmonary function tests(PFTs).METHODS We retrospectively id...AIM To compare high-resolution computed tomography(HRCT) findings between humoral primary immunodeficiencies(hPIDs) subtypes; to correlate these findings to pulmonary function tests(PFTs).METHODS We retrospectively identified 52 consecutive adult patients with hPIDs who underwent 64-row HRCT and PFTs at the time of diagnosis. On a per-patient basis, an experienced radiologist recorded airway abnormalities(bronchiectasis,airway wall thickening, mucus plugging, tree-in-bud, and air-trapping) and parenchymal-interstitial abnormalities(consolidations, ground-glass opacities,linear and/or irregular opacities, nodules, and bullae/cysts) found on HRCT.The chi-square test was performed to compare the prevalence of each abnormality among patients with different subtypes of hPIDs. Overall logistic regression analysis was performed to assess whether HRCT findings predicted obstructive and/or restrictive PFTs results(absent-to-mild vs moderate-tosevere).RESULTS Thirty-eight of the 52 patients with hPIDs showed common variable immunodeficiency disorders(CVID), while the remaining 14 had CVID-like conditions(i.e., 11 had isolated IgG subclass deficiencies and 3 had selective IgA deficiencies). The prevalence of most HRCT abnormalities was not significantly different between CVID and CVID-like patients(P > 0.05), except for linear and/or irregular opacities(prevalence of 31.6% in the CVID group and 0 in the CVID-like group; P = 0.0427). Airway wall thickening was the most frequent HRCT abnormality found in both CVID and CVID-like patients(71% of cases in both groups). The presence of tree-in-bud abnormalities was an independent predictor of moderate-to-severe obstructive defects at PFTs(Odds Ratio, OR, of 18.75, P < 0.05), while the presence of linear and/or irregular opacities was an independent predictor of restrictive defects at PFTs(OR = 13.00; P < 0.05).CONCLUSION CVID and CVID-like patients showed similar HRCT findings. Tree-in-bud and linear and/or irregular opacities predicted higher risks of, respectively,obstructive and restrictive defects at PFTs.展开更多
AIM:To investigate pulmonary involvement via pulmonary function tests (PFT) and high-resolution computed tomocjraphy (HRCT) in patients with chronic hepatitis C virus (HCV) infection. METHODS:Thirty-four patients with...AIM:To investigate pulmonary involvement via pulmonary function tests (PFT) and high-resolution computed tomocjraphy (HRCT) in patients with chronic hepatitis C virus (HCV) infection. METHODS:Thirty-four patients with chronic HCV infection without diagnosis of any pulmonary diseases and 10 healthy cases were enrolled in the study,PFT and HRCT were performed in all cases. RESULTS:A decrease lower than 80% of the predicted value was detected in vital capacity in 9/34 patients,in forced expiratory volume in one second in 8/34 patients,and in forced expiratory flow 25-75 in 15/34 patients,respectively.Carbon monoxide diffusing capacity (DLCO) was decreased in 26/34 patients.Findings of interstitial pulmonary involvement were detected in the HRCT of 16/34 patients.Significant difference was found between controls and patients with HCV infection in findings of HRCT (X^2=4.7,P=0.003).Knodell histological activity index (KHAI) of 28/34 patients in whom liver biopsy was applied was 9.0±4.7.HRCT findings,PFT values and DLCO were not affected by KHAI in patients with HCV infection.In these patients,all the parameters were related with age. CONCLUSION:We suggest that chronic hepatitis C virus infection may cause pulmonary interstitial involvement without evident respiratory symptoms.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
BACKGROUND Insulin resistance is a cardiometabolic risk factor characterized by elevated insulin levels.It is associated with fatty liver disease and elevated liver function tests(LFT)in cross-sectional studies,but da...BACKGROUND Insulin resistance is a cardiometabolic risk factor characterized by elevated insulin levels.It is associated with fatty liver disease and elevated liver function tests(LFT)in cross-sectional studies,but data from cohort studies are scarce.AIM To investigate the association between insulin and pathological LFT,liver disease,and cirrhosis in a populationbased retrospective cohort study.METHODS Anthropometric and cardiometabolic factors of 857 men and 1228 women from prospective cohort studies were used.LFT were obtained at two time points 8 years to 24 years after baseline.Liver disease diagnoses were obtained from nationwide registries.The association between insulin levels and the development of elevated LFT or liver disease and cirrhosis was analyzed.RESULTS Total follow-up was 54054 person-years for women and 27556 person-years for men.Insulin levels were positively correlated with elevated LFT during follow-up,whereas physical activity and coffee consumption were negatively correlated.Individuals with both insulin levels in the upper tertile and alcohol consumption above MASLD thresholds had an increased risk for both liver disease,adjusted hazard ratio(aHR)of 4.3(95%CI:1.6-14.6)and cirrhosis(aHR=4.8,95%CI:1.6-14.6).CONCLUSION This population-based study provides evidence that high insulin levels are a risk factor for development of elevated liver enzymes and clinically manifest liver disease.The results support the concept of metabolic dysfunction associated liver disease.展开更多
This study aims to construct a virtual twin testing framework for the safety of the intended functionality of intelligent connected vehicles to address the safety requirements of intelligent driving and transportation...This study aims to construct a virtual twin testing framework for the safety of the intended functionality of intelligent connected vehicles to address the safety requirements of intelligent driving and transportation systems.The research methods include the construction of a theoretical model of safety for intelligent connected vehicles based on the concept of virtual twins,the correlation study between key concepts and functional safety,and the application research of virtual twin technology in the safety testing of intelligent connected vehicles.The results reveal that the virtual twin testing framework can effectively enhance the functional safety of intelligent connected vehicles,reduce development costs,and shorten the product launch cycle.The conclusion suggests that this framework provides strong support for the healthy development of the intelligent connected vehicle industry and has a positive impact on the safety and efficiency of intelligent transportation systems.展开更多
The accurate and timely detection of biochemical coagulation indicators is pivotal in pulmonary and critical care medicine.Despite their reliability,traditional laboratories often lag in terms of rapid diagnosis.Point...The accurate and timely detection of biochemical coagulation indicators is pivotal in pulmonary and critical care medicine.Despite their reliability,traditional laboratories often lag in terms of rapid diagnosis.Point-of-care testing(POCT)has emerged as a promising alternative,which is awaiting rigorous validation.We assessed 226 samples from patients at the First Affiliated Hospital of Guangzhou Medical University using a Beckman Coulter AU5821 and a PUSHKANG POCT Biochemistry Analyzer MS100.Furthermore,350 samples were evaluated with a Stago coagulation analyzer STAR MAX and a PUSHKANG POCT Coagulation Analyzer MC100.Metrics included thirteen biochemical indexes,such as albumin,and five coagulation indices,such as prothrombin time.Comparisons were drawn against the PUSHKANG POCT analyzer.Bland-Altman plots(MS100:0.8206-0.9995;MC100:0.8318-0.9911)evinced significant consistency between methodologies.Spearman correlation pinpointed a potent linear association between conventional devices and the PUSHKANG POCT analyzer,further underscored by a robust correlation coefficient(MS100:0.713-0.949;MC100:0.593-0.950).The PUSHKANG POCT was validated as a dependable tool for serum and whole blood biochemical and coagulation diagnostics.This emphasizes its prospective clinical efficacy,offering clinicians a swift diagnostic tool and heralding a new era of enhanced patient care outcomes.展开更多
Objective: The aim of this preliminary study was to evaluate the feasibility of exercise testing (ET) for predicting postoperative complications in patients with impaired pulmonary function. Methods: Thirteen patients...Objective: The aim of this preliminary study was to evaluate the feasibility of exercise testing (ET) for predicting postoperative complications in patients with impaired pulmonary function. Methods: Thirteen patients were prospectively enrolled. The enrollment criteria were FEV1.0% 8 by the Goddard classification or interstitial pneumonia on chest computed tomography. Patients underwent testing for pulmonary function, six-minute walking test (6MWT), and stair-climbing test (SCT). Postoperative cardiopulmonary complications (PCPCs) were recorded. Results: Four patients developed PCPCs. There were no significant differences between the patients with PCPCs (n = 4) and those without PCPCs (n = 9) for background data and PFT. The distances achieved in the 6MWT were 503 ± 72.7 m for patients without PCPCs and 369 ± 50.7 m for patients with PCPCs (p = 0.011). The SCT climbing heights were 20.4 ± 5.3 m for patients without PCPCs and 14.9 ± 4.0 m for patients with PCPCs (P = 0.187). Cut-off points, including a 6MFT distance of less than 400 m, SCT height lower than 15 m, and SCT climbing speed less than 8.5 m/min, were predictive of CPCP. Conclusions: Exercise testing is more feasible for predicting postoperative cardiopulmonary complications than stationary pulmonary function testing.展开更多
We retrospectively assessed long-term pulmonary function in adults surviving for ≥5 years after myeloablative allogeneic hematopoietic stem cell transplantation and identified risk factors for late-onset noninfectiou...We retrospectively assessed long-term pulmonary function in adults surviving for ≥5 years after myeloablative allogeneic hematopoietic stem cell transplantation and identified risk factors for late-onset noninfectious pulmonary complications. Among 174 patients undergoing transplantation for hematologic malignancies between May 1994 and December 2004, 81 long-term survivors were evaluated. Pulmonary function tests (PFTs) were performed before conditioning, 3 months and 1 year after transplantation, and then annually. Eight patients (10%) had abnormal pulmonary function before transplantation, but this was not associated with late changes in PFTs. Patients with chronic graft-versus-host disease (GVHD) showed a significant decline of lung function after 3 years when compared with patients without chronic GVHD. Abnormal pretransplantation lung function was associated with pulmonary chronic GVHD according to National Institutes of Health criteria (score 0, n = 58;score 1, n = 14;score 2, n = 6;score 3, n = 3). Five patients with late-onset noninfectious pulmonary complications showed a decline of lung function at 1 year after transplantation. Only chronic GVHD was significantly related to late-onset noninfectious pulmonary complications. In conclusion, abnormal lung function before transplantation may be associated with a decline in pulmonary function within 1 year after transplantation, but late-onset noninfectious pulmonary complications could not be predicted from pretransplantation lung function.展开更多
Workers involved in hydraulic fracking processes are exposed to various types of chemicals and dusts in their workplaces, such as proppants, which hold open the fissures created in the fracking process. Recently, cera...Workers involved in hydraulic fracking processes are exposed to various types of chemicals and dusts in their workplaces, such as proppants, which hold open the fissures created in the fracking process. Recently, ceramic proppants have been developed that may be less hazardous to workers than traditional proppants. Pulmonary function testing of workers producing ceramic proppant was used to assess the potential inhalation hazards of ceramic proppant. 100 male workers from a producer of ceramic proppant were evaluated with pulmonary function test data collected and evaluated using The American Thoracic Society (ATS) acceptability criteria. A comparison group was selected from the Third National Health and Nutrition Examination Survey (NHANES III) spirometry laboratory subset. No pulmonary function deficits were found in the worker group in comparison to the NHANES III population. Mean FEV1 and FVC values in workers were 3.8 and 4.8 liters respectively, and were greater as compared to the NHANES III population of similar demographics. An FEV1/FVC ratio of less than 0.8, when compared to the NHANES III group, produced an odds ratio of 0.44 in worker group, indicating less risk of preclinical pulmonary dysfunction. Overall, exposure to ceramic proppant was not found to produce an adverse impact on pulmonary function in workers engaged in the manufacture of ceramic proppant.展开更多
Pulmonary rehabilitation(PR)aims to improve lung function in patients with chronic respiratory disease(CRD).In recent years,significant advancements have been made in pulmonary rehabilitation technologies,demonstratin...Pulmonary rehabilitation(PR)aims to improve lung function in patients with chronic respiratory disease(CRD).In recent years,significant advancements have been made in pulmonary rehabilitation technologies,demonstrating their potential for enhancing lung function in patients with respiratory diseases.The purpose of this study is to outline recent developments in the field of pulmonary rehabilitation guided by pulmonary rehabilitation robots,which has not been previously addressed in earlier reviews.To fill this gap,this paper first provides a systematic summary of the monitoring and actuation technologies of pulmonary rehabilitation robot systems and evaluates these technologies from multiple dimensions,including portability,wearability potential,invasiveness,and clinical applications,analyzing the potential for integrating various technologies into pulmonary rehabilitation robot systems.Furthermore,three technical directions are proposed:real-time precise monitoring,suitable structure and actuation strategies,and the intelligence of pulmonary rehabilitation robot systems.On the basis of these directions,this paper presents a comprehensive technical outlook for a soft wearable pulmonary rehabilitation robot system,providing reference and guidance for future research.To our knowledge,this is the first review of pulmonary rehabilitation robot systems and their key technologies.Additionally,the review section on respiratory assistive technologies simultaneously covers key technologies such as mechanical ventilation(MV),exoskeleton robots,and functional electrical stimulation(FES)for the first time.It also summarizes the respiratory assistive technology paradigm from the innovative perspectives of respiratory assistive modalities,targeted body sites,and types of ventilation for the first time.This study offers a broader perspective and a deeper understanding of pulmonary re-habilitation robots,with a technical outlook encompassing multimodal data fusion perception,respiratory event detection and intention recognition,full-phase assistance strategies,modeling,decoupling,and quantification of multipleinput multiple-output(MIMO)systems,as well as model-based interactive control strategies.展开更多
Objective: To explore the application effect of pulmonary rehabilitation nursing intervention in patients with stable chronic obstructive pulmonary disease (COPD) and evaluate its impact on nursing satisfaction. Metho...Objective: To explore the application effect of pulmonary rehabilitation nursing intervention in patients with stable chronic obstructive pulmonary disease (COPD) and evaluate its impact on nursing satisfaction. Methods: A total of 120 patients with stable COPD admitted to our hospital from February 2023 to February 2025 were selected and divided into a control group and an observation group according to the order of admission, with 60 cases in each group. The control group received routine nursing care, while the observation group received systematic pulmonary rehabilitation nursing intervention on this basis. Pulmonary function indicators, 6-minute walk test (6MWT) distance, COPD Assessment Test (CAT) scores, incidence of acute exacerbations, and nursing satisfaction were compared between the two groups after nursing. Results: After nursing, the FEV1, FVC, and FEV1/FVC in the observation group were significantly higher than those in the control group, the 6MWT distance significantly increased, and the CAT scores significantly decreased, with statistically significant differences (p < 0.05). The incidence of acute exacerbations in the observation group was lower than that in the control group, and the nursing satisfaction score was higher (p < 0.05). Conclusion: Pulmonary rehabilitation nursing intervention can effectively improve pulmonary function, exercise tolerance, and symptom control in patients with stable COPD, and significantly enhance nursing satisfaction, making it worthy of further clinical promotion.展开更多
In this paper,the authors propose a class of test procedures to check the fitness of parametric forms of the variance function in regression models when the mean function is unknown.By evaluating the unknown mean func...In this paper,the authors propose a class of test procedures to check the fitness of parametric forms of the variance function in regression models when the mean function is unknown.By evaluating the unknown mean function with the classical kernel estimator,the proposed test statistics are built upon a modified minimum distance between a nonparametric fit and a parametric estimator under the null hypothesis for the variance function.Asymptotic properties of the estimator of the parameters in the variance function are discussed,and the large sample distribution of the test statistics under the null hypothesis is established,as well as the consistency and the power under some local alternative hypotheses.Extensive numerical studies demonstrate that the proposed test procedures have satisfactory finite sample performance.Finally,two real data examples further showcase the effectiveness of the proposed test in real applications.展开更多
Connective tissue growth factor(CTGF) is a key driver in the pathogenesis of idiopathic pulmonary fibrosis(IPF). This study presents a groundbreaking supramolecular cryoshock bone marrow mononuclear cell system for ta...Connective tissue growth factor(CTGF) is a key driver in the pathogenesis of idiopathic pulmonary fibrosis(IPF). This study presents a groundbreaking supramolecular cryoshock bone marrow mononuclear cell system for targeted drug delivery in IPF. We incorporated antisense oligonucleotides(ASO) to inhibit CTGF and simultaneously encapsulated nintedanib using the ZMO-E5-NPs carrier for synergistic delivery. The cryoshock treatment enhances cellular structural integrity and preserves receptor functionality,thereby extending cell viability. By modifying the E5 peptide and conjugating it with DSPEPEG-MAL, we developed a composite carrier, ZMO-E5-NPs, which demonstrates efficient lung-targeting capability. This system enables rapid nanoparticle capture by fibroblasts through matrix metalloproteinase 2(MMP2) recognition, ensuring precise delivery of both ASO and nintedanib. In a bleomycin-induced pulmonary fibrosis mouse model, ZMOE5-NPs-ASO(nintedanib-containing group) significantly attenuated fibrosis progression,improved lung function, and exhibited excellent biocompatibility and safety, highlighting its potential as a novel therapeutic strategy for respiratory diseases.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.
文摘BACKGROUND Small intestinal bacterial overgrowth(SIBO)is suspected and excluded frequently in functional gastrointestinal(GI)disorders.Children presenting with various esophago-gastro-duodenal(upper GI)symptoms are rarely subjected to investig-ations for SIBO.AIM To estimate the frequency of SIBO in children having functional upper GI sym-ptoms(as cases)and to compare the result of the SIBO status to that of the con-trols.METHODS Children aged 6 to 18 who presented with upper GI symptoms were selected for the study.All children were subjected to upper GI endoscopy before being advised of any proton pump inhibitors(PPIs).Children with normal endoscopy were assigned as cases,and children having any endoscopic lesion were design-ated as controls.Both groups were subjected to a glucose-hydrogen breath test by Bedfont Gastrolyser.RESULTS A total of 129 consecutive children who were naive to PPIs and had normal ba-seline investigations were included in the study.Among them,67 patients had endoscopic lesions and served as the control group,with six cases being excluded due to the presence of Helicobacter pylori in gastric biopsies.Sixty-two children with normal endoscopy results formed the case group.In the case group,35 children(59%)tested positive for hydrogen breath tests,compared to 13 children(21%)in the control group.The calculated odds ratio was 5.38(95%confidence interval:2.41-12.0),which was statistically significant.Further analysis of symptoms revealed that nausea,halitosis,foul-smelling eructation,and epigastric fullness were positive predictors of SIBO.CONCLUSION It is worthwhile to investigate and treat SIBO in all children presenting with upper GI symptoms that are not explained by endoscopy findings.
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.
基金funded by Department of Medicine, University of Udine (Udine, Italy) in accordance with Good Publication Practice (GPP3) guidelines (http://www.ismpp.org/gpp3)
文摘AIM To compare high-resolution computed tomography(HRCT) findings between humoral primary immunodeficiencies(hPIDs) subtypes; to correlate these findings to pulmonary function tests(PFTs).METHODS We retrospectively identified 52 consecutive adult patients with hPIDs who underwent 64-row HRCT and PFTs at the time of diagnosis. On a per-patient basis, an experienced radiologist recorded airway abnormalities(bronchiectasis,airway wall thickening, mucus plugging, tree-in-bud, and air-trapping) and parenchymal-interstitial abnormalities(consolidations, ground-glass opacities,linear and/or irregular opacities, nodules, and bullae/cysts) found on HRCT.The chi-square test was performed to compare the prevalence of each abnormality among patients with different subtypes of hPIDs. Overall logistic regression analysis was performed to assess whether HRCT findings predicted obstructive and/or restrictive PFTs results(absent-to-mild vs moderate-tosevere).RESULTS Thirty-eight of the 52 patients with hPIDs showed common variable immunodeficiency disorders(CVID), while the remaining 14 had CVID-like conditions(i.e., 11 had isolated IgG subclass deficiencies and 3 had selective IgA deficiencies). The prevalence of most HRCT abnormalities was not significantly different between CVID and CVID-like patients(P > 0.05), except for linear and/or irregular opacities(prevalence of 31.6% in the CVID group and 0 in the CVID-like group; P = 0.0427). Airway wall thickening was the most frequent HRCT abnormality found in both CVID and CVID-like patients(71% of cases in both groups). The presence of tree-in-bud abnormalities was an independent predictor of moderate-to-severe obstructive defects at PFTs(Odds Ratio, OR, of 18.75, P < 0.05), while the presence of linear and/or irregular opacities was an independent predictor of restrictive defects at PFTs(OR = 13.00; P < 0.05).CONCLUSION CVID and CVID-like patients showed similar HRCT findings. Tree-in-bud and linear and/or irregular opacities predicted higher risks of, respectively,obstructive and restrictive defects at PFTs.
文摘AIM:To investigate pulmonary involvement via pulmonary function tests (PFT) and high-resolution computed tomocjraphy (HRCT) in patients with chronic hepatitis C virus (HCV) infection. METHODS:Thirty-four patients with chronic HCV infection without diagnosis of any pulmonary diseases and 10 healthy cases were enrolled in the study,PFT and HRCT were performed in all cases. RESULTS:A decrease lower than 80% of the predicted value was detected in vital capacity in 9/34 patients,in forced expiratory volume in one second in 8/34 patients,and in forced expiratory flow 25-75 in 15/34 patients,respectively.Carbon monoxide diffusing capacity (DLCO) was decreased in 26/34 patients.Findings of interstitial pulmonary involvement were detected in the HRCT of 16/34 patients.Significant difference was found between controls and patients with HCV infection in findings of HRCT (X^2=4.7,P=0.003).Knodell histological activity index (KHAI) of 28/34 patients in whom liver biopsy was applied was 9.0±4.7.HRCT findings,PFT values and DLCO were not affected by KHAI in patients with HCV infection.In these patients,all the parameters were related with age. CONCLUSION:We suggest that chronic hepatitis C virus infection may cause pulmonary interstitial involvement without evident respiratory symptoms.
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BACKGROUND Insulin resistance is a cardiometabolic risk factor characterized by elevated insulin levels.It is associated with fatty liver disease and elevated liver function tests(LFT)in cross-sectional studies,but data from cohort studies are scarce.AIM To investigate the association between insulin and pathological LFT,liver disease,and cirrhosis in a populationbased retrospective cohort study.METHODS Anthropometric and cardiometabolic factors of 857 men and 1228 women from prospective cohort studies were used.LFT were obtained at two time points 8 years to 24 years after baseline.Liver disease diagnoses were obtained from nationwide registries.The association between insulin levels and the development of elevated LFT or liver disease and cirrhosis was analyzed.RESULTS Total follow-up was 54054 person-years for women and 27556 person-years for men.Insulin levels were positively correlated with elevated LFT during follow-up,whereas physical activity and coffee consumption were negatively correlated.Individuals with both insulin levels in the upper tertile and alcohol consumption above MASLD thresholds had an increased risk for both liver disease,adjusted hazard ratio(aHR)of 4.3(95%CI:1.6-14.6)and cirrhosis(aHR=4.8,95%CI:1.6-14.6).CONCLUSION This population-based study provides evidence that high insulin levels are a risk factor for development of elevated liver enzymes and clinically manifest liver disease.The results support the concept of metabolic dysfunction associated liver disease.
文摘This study aims to construct a virtual twin testing framework for the safety of the intended functionality of intelligent connected vehicles to address the safety requirements of intelligent driving and transportation systems.The research methods include the construction of a theoretical model of safety for intelligent connected vehicles based on the concept of virtual twins,the correlation study between key concepts and functional safety,and the application research of virtual twin technology in the safety testing of intelligent connected vehicles.The results reveal that the virtual twin testing framework can effectively enhance the functional safety of intelligent connected vehicles,reduce development costs,and shorten the product launch cycle.The conclusion suggests that this framework provides strong support for the healthy development of the intelligent connected vehicle industry and has a positive impact on the safety and efficiency of intelligent transportation systems.
基金supported by the National Natural Science Foundation of China(No.82302607)the Guangdong Basic and Applied Basic Research Foundation(Nos.2022A1515110555 and 2023A1515010932)+3 种基金the State Key Laboratory of Respiratory Disease(No.SKLRD-Z-202410)the Precision Medicine Joint Foundation of Basic and Applied Basic Research Foundation of Guangdong Province(No.2021B1515230008)the Independent Project of Guangdong-Hong Kong-Macao Joint Laboratory for Respiratory Infectious Diseases(No.GHMJLRID-Z-202102)the Guangdong Zhong Nanshan Medical Foundation(No.ZNSXS-20220015).
文摘The accurate and timely detection of biochemical coagulation indicators is pivotal in pulmonary and critical care medicine.Despite their reliability,traditional laboratories often lag in terms of rapid diagnosis.Point-of-care testing(POCT)has emerged as a promising alternative,which is awaiting rigorous validation.We assessed 226 samples from patients at the First Affiliated Hospital of Guangzhou Medical University using a Beckman Coulter AU5821 and a PUSHKANG POCT Biochemistry Analyzer MS100.Furthermore,350 samples were evaluated with a Stago coagulation analyzer STAR MAX and a PUSHKANG POCT Coagulation Analyzer MC100.Metrics included thirteen biochemical indexes,such as albumin,and five coagulation indices,such as prothrombin time.Comparisons were drawn against the PUSHKANG POCT analyzer.Bland-Altman plots(MS100:0.8206-0.9995;MC100:0.8318-0.9911)evinced significant consistency between methodologies.Spearman correlation pinpointed a potent linear association between conventional devices and the PUSHKANG POCT analyzer,further underscored by a robust correlation coefficient(MS100:0.713-0.949;MC100:0.593-0.950).The PUSHKANG POCT was validated as a dependable tool for serum and whole blood biochemical and coagulation diagnostics.This emphasizes its prospective clinical efficacy,offering clinicians a swift diagnostic tool and heralding a new era of enhanced patient care outcomes.
文摘Objective: The aim of this preliminary study was to evaluate the feasibility of exercise testing (ET) for predicting postoperative complications in patients with impaired pulmonary function. Methods: Thirteen patients were prospectively enrolled. The enrollment criteria were FEV1.0% 8 by the Goddard classification or interstitial pneumonia on chest computed tomography. Patients underwent testing for pulmonary function, six-minute walking test (6MWT), and stair-climbing test (SCT). Postoperative cardiopulmonary complications (PCPCs) were recorded. Results: Four patients developed PCPCs. There were no significant differences between the patients with PCPCs (n = 4) and those without PCPCs (n = 9) for background data and PFT. The distances achieved in the 6MWT were 503 ± 72.7 m for patients without PCPCs and 369 ± 50.7 m for patients with PCPCs (p = 0.011). The SCT climbing heights were 20.4 ± 5.3 m for patients without PCPCs and 14.9 ± 4.0 m for patients with PCPCs (P = 0.187). Cut-off points, including a 6MFT distance of less than 400 m, SCT height lower than 15 m, and SCT climbing speed less than 8.5 m/min, were predictive of CPCP. Conclusions: Exercise testing is more feasible for predicting postoperative cardiopulmonary complications than stationary pulmonary function testing.
文摘We retrospectively assessed long-term pulmonary function in adults surviving for ≥5 years after myeloablative allogeneic hematopoietic stem cell transplantation and identified risk factors for late-onset noninfectious pulmonary complications. Among 174 patients undergoing transplantation for hematologic malignancies between May 1994 and December 2004, 81 long-term survivors were evaluated. Pulmonary function tests (PFTs) were performed before conditioning, 3 months and 1 year after transplantation, and then annually. Eight patients (10%) had abnormal pulmonary function before transplantation, but this was not associated with late changes in PFTs. Patients with chronic graft-versus-host disease (GVHD) showed a significant decline of lung function after 3 years when compared with patients without chronic GVHD. Abnormal pretransplantation lung function was associated with pulmonary chronic GVHD according to National Institutes of Health criteria (score 0, n = 58;score 1, n = 14;score 2, n = 6;score 3, n = 3). Five patients with late-onset noninfectious pulmonary complications showed a decline of lung function at 1 year after transplantation. Only chronic GVHD was significantly related to late-onset noninfectious pulmonary complications. In conclusion, abnormal lung function before transplantation may be associated with a decline in pulmonary function within 1 year after transplantation, but late-onset noninfectious pulmonary complications could not be predicted from pretransplantation lung function.
文摘Workers involved in hydraulic fracking processes are exposed to various types of chemicals and dusts in their workplaces, such as proppants, which hold open the fissures created in the fracking process. Recently, ceramic proppants have been developed that may be less hazardous to workers than traditional proppants. Pulmonary function testing of workers producing ceramic proppant was used to assess the potential inhalation hazards of ceramic proppant. 100 male workers from a producer of ceramic proppant were evaluated with pulmonary function test data collected and evaluated using The American Thoracic Society (ATS) acceptability criteria. A comparison group was selected from the Third National Health and Nutrition Examination Survey (NHANES III) spirometry laboratory subset. No pulmonary function deficits were found in the worker group in comparison to the NHANES III population. Mean FEV1 and FVC values in workers were 3.8 and 4.8 liters respectively, and were greater as compared to the NHANES III population of similar demographics. An FEV1/FVC ratio of less than 0.8, when compared to the NHANES III group, produced an odds ratio of 0.44 in worker group, indicating less risk of preclinical pulmonary dysfunction. Overall, exposure to ceramic proppant was not found to produce an adverse impact on pulmonary function in workers engaged in the manufacture of ceramic proppant.
基金supported by the National Key Research and Development Project(2022YFB4703200)。
文摘Pulmonary rehabilitation(PR)aims to improve lung function in patients with chronic respiratory disease(CRD).In recent years,significant advancements have been made in pulmonary rehabilitation technologies,demonstrating their potential for enhancing lung function in patients with respiratory diseases.The purpose of this study is to outline recent developments in the field of pulmonary rehabilitation guided by pulmonary rehabilitation robots,which has not been previously addressed in earlier reviews.To fill this gap,this paper first provides a systematic summary of the monitoring and actuation technologies of pulmonary rehabilitation robot systems and evaluates these technologies from multiple dimensions,including portability,wearability potential,invasiveness,and clinical applications,analyzing the potential for integrating various technologies into pulmonary rehabilitation robot systems.Furthermore,three technical directions are proposed:real-time precise monitoring,suitable structure and actuation strategies,and the intelligence of pulmonary rehabilitation robot systems.On the basis of these directions,this paper presents a comprehensive technical outlook for a soft wearable pulmonary rehabilitation robot system,providing reference and guidance for future research.To our knowledge,this is the first review of pulmonary rehabilitation robot systems and their key technologies.Additionally,the review section on respiratory assistive technologies simultaneously covers key technologies such as mechanical ventilation(MV),exoskeleton robots,and functional electrical stimulation(FES)for the first time.It also summarizes the respiratory assistive technology paradigm from the innovative perspectives of respiratory assistive modalities,targeted body sites,and types of ventilation for the first time.This study offers a broader perspective and a deeper understanding of pulmonary re-habilitation robots,with a technical outlook encompassing multimodal data fusion perception,respiratory event detection and intention recognition,full-phase assistance strategies,modeling,decoupling,and quantification of multipleinput multiple-output(MIMO)systems,as well as model-based interactive control strategies.
文摘Objective: To explore the application effect of pulmonary rehabilitation nursing intervention in patients with stable chronic obstructive pulmonary disease (COPD) and evaluate its impact on nursing satisfaction. Methods: A total of 120 patients with stable COPD admitted to our hospital from February 2023 to February 2025 were selected and divided into a control group and an observation group according to the order of admission, with 60 cases in each group. The control group received routine nursing care, while the observation group received systematic pulmonary rehabilitation nursing intervention on this basis. Pulmonary function indicators, 6-minute walk test (6MWT) distance, COPD Assessment Test (CAT) scores, incidence of acute exacerbations, and nursing satisfaction were compared between the two groups after nursing. Results: After nursing, the FEV1, FVC, and FEV1/FVC in the observation group were significantly higher than those in the control group, the 6MWT distance significantly increased, and the CAT scores significantly decreased, with statistically significant differences (p < 0.05). The incidence of acute exacerbations in the observation group was lower than that in the control group, and the nursing satisfaction score was higher (p < 0.05). Conclusion: Pulmonary rehabilitation nursing intervention can effectively improve pulmonary function, exercise tolerance, and symptom control in patients with stable COPD, and significantly enhance nursing satisfaction, making it worthy of further clinical promotion.
基金supported by the National Natural Science Foundation of China under Grant No.12071267。
文摘In this paper,the authors propose a class of test procedures to check the fitness of parametric forms of the variance function in regression models when the mean function is unknown.By evaluating the unknown mean function with the classical kernel estimator,the proposed test statistics are built upon a modified minimum distance between a nonparametric fit and a parametric estimator under the null hypothesis for the variance function.Asymptotic properties of the estimator of the parameters in the variance function are discussed,and the large sample distribution of the test statistics under the null hypothesis is established,as well as the consistency and the power under some local alternative hypotheses.Extensive numerical studies demonstrate that the proposed test procedures have satisfactory finite sample performance.Finally,two real data examples further showcase the effectiveness of the proposed test in real applications.
基金supported by The National Natural Science Foundation of China (Grant Numbers 82400094, 82270069, 82370073)National High Level Hospital Clinical Research Funding (2022-PUMCH-B-108)。
文摘Connective tissue growth factor(CTGF) is a key driver in the pathogenesis of idiopathic pulmonary fibrosis(IPF). This study presents a groundbreaking supramolecular cryoshock bone marrow mononuclear cell system for targeted drug delivery in IPF. We incorporated antisense oligonucleotides(ASO) to inhibit CTGF and simultaneously encapsulated nintedanib using the ZMO-E5-NPs carrier for synergistic delivery. The cryoshock treatment enhances cellular structural integrity and preserves receptor functionality,thereby extending cell viability. By modifying the E5 peptide and conjugating it with DSPEPEG-MAL, we developed a composite carrier, ZMO-E5-NPs, which demonstrates efficient lung-targeting capability. This system enables rapid nanoparticle capture by fibroblasts through matrix metalloproteinase 2(MMP2) recognition, ensuring precise delivery of both ASO and nintedanib. In a bleomycin-induced pulmonary fibrosis mouse model, ZMOE5-NPs-ASO(nintedanib-containing group) significantly attenuated fibrosis progression,improved lung function, and exhibited excellent biocompatibility and safety, highlighting its potential as a novel therapeutic strategy for respiratory diseases.
