Objective:To investigate the clinical efficacy of levofloxacin combined with ambroxol in the treatment of elderly patients with chronic obstructive pulmonary disease(COPD)and pulmonary infection.Methods:A total of 80 ...Objective:To investigate the clinical efficacy of levofloxacin combined with ambroxol in the treatment of elderly patients with chronic obstructive pulmonary disease(COPD)and pulmonary infection.Methods:A total of 80 elderly COPD patients with pulmonary infection,treated between December 2022 and November 2023,were randomly divided into a control group and an observation group,with 40 cases in each group.The control group was treated with levofloxacin hydrochloride,while the observation group received ambroxol hydrochloride injection in addition to the treatment in the control group.Laboratory indices(white blood cell count,procalcitonin,C-reactive protein,and apolipoprotein E levels),imaging-based pulmonary lesion absorption time,hospital stay,and incidence of adverse reactions were compared between the two groups.Results:After treatment,the biochemical indices of the observation group were significantly lower than those of the control group,with highly significant differences(P<0.001).Compared to the control group,the imaging-based pulmonary lesion absorption time and hospital stay of the observation group were significantly shorter(P<0.001).Additionally,the incidence of adverse reactions in the observation group was significantly lower than in the control group(P<0.05).Conclusion:Levofloxacin combined with ambroxol demonstrates advantages in improving biochemical indices,shortening imaging-based pulmonary lesion absorption time and hospital stay,and reducing adverse reaction rates in elderly COPD patients with pulmonary infection.It holds significant clinical application value.展开更多
In this article,we comment on the study by Yang et al,which demonstrated significant cross-sectional associations between heart rate variability(HRV)indices,depressive symptoms,and lung function in patients with chron...In this article,we comment on the study by Yang et al,which demonstrated significant cross-sectional associations between heart rate variability(HRV)indices,depressive symptoms,and lung function in patients with chronic obstructive pulmonary disease(COPD).Building on these findings,we further explore the underlying mechanisms,particularly inflammatory-autonomic-oxidative stress pathways,as key causal mediators.Moreover,analyzing genetic polymorphisms alongside environmental factors may uncover susceptibility pathways explaining interindividual differences in HRV and comorbidity risk.Additionally,longitudinal studies tracking HRV trajectories could identify thresholds predictive of accelerated lung function decline or cardiovascular events,informing personalized prevention strategies.Integrating longitudinal HRV data with multi-omics biomarkers and machine learning models could enable real-time prediction of depression relapses or COPD exacerbations,facilitating proactive interventions such as personalized biofeedback training or precision anti-inflammatory therapies.By synthesizing these perspectives,this integrative approach promises to advance precision medicine for COPD patients,particularly those with comorbid depression,by addressing both mechanistic insights and clinical translation.展开更多
BACKGROUND The correlation conclusions between self-management,frailty,and quality of life(QoL)of chronic obstructive pulmonary disease(COPD)patients are inconsistent.AIM To comprehensively assess the current status o...BACKGROUND The correlation conclusions between self-management,frailty,and quality of life(QoL)of chronic obstructive pulmonary disease(COPD)patients are inconsistent.AIM To comprehensively assess the current status of self-management,psychological cognitive impairment,and QoL in elderly patients with COPD.METHODS Convenient sampling was employed to select 312 elderly patients with COPD who were receiving treatment in the respiratory and critical care medicine department of a tertiary grade A hospital from November 2023 to February 2024.The study utilized demographic information and clinical characteristics,selfmanagement behavior,occurrence of psychological cognitive impairment,and QoL as evaluated through general information questionnaires,the COPD patient self-management scale,simple frailty scale,simple mental status scale,clinical dementia assessment scale,and the clinical COPD assessment test questionnaire.This research aims to describe the current status and correlations among selfmanagement behavior,cognitive impairment occurrence,and QoL.RESULTS The average score for self-management behavior in elderly COPD patients was 136.00(119.00,164.50),indicating a moderate level overall.There were 98 cases of cognitive impairment,accounting for 31.4%,with a mental status score of 3(2,3.75).The average QoL score was 24(19,28),indicating a low level.Additionally,there was a negative correlation between total self-management behavior score and cognitive impairment occurrence(r=-0.589,P<0.001),and QoL total score(r=-0.409,P<0.001).Cognitive impairment occurrence was positively correlated with QoL total score(r=0.345,P<0.001).Disease course and self-management behavior score were independent factors affecting the total QoL score in elderly COPD patients(P<0.05).CONCLUSION The self-management behavior of elderly patients with COPD is at a moderate level.However,the occurrence of cognitive impairment is high and significantly influenced by disease course,level of self-management,and mental status.The QoL is low,emphasizing the urgent need to intervene in the self-management behaviors of elderly COPD patients,actively reduce the occurrence of cognitive impairment,and mitigate the impact of the disease on QoL.展开更多
Self-management interventions for chronic obstructive pulmonary disease(COPD)patients using mobile health technology are beneficial for relieving disease symptoms,improving patients’adherence to rehabilitation self-m...Self-management interventions for chronic obstructive pulmonary disease(COPD)patients using mobile health technology are beneficial for relieving disease symptoms,improving patients’adherence to rehabilitation self-management,and improving quality of life.This paper reviews the application of mobile health technology in self-management of patients with chronic obstructive pulmonary disease,introduces the application form of mobile health technology in self-management of patients with chronic obstructive pulmonary disease,summarizes its application effect in self-management of patients with chronic obstructive pulmonary disease,analyzes the problems and proposes solutions in the process of research and implementation at this stage,with a view to providing a theory for the application of mobile health technology in pulmonary rehabilitation and management of patients with chronic obstructive pulmonary disease This study summarize the effect of its application in the self-management of patients with chronic obstructive pulmonary disease.展开更多
Skeletal muscle dysfunction is a common extrapulmonary comorbidity of chronic obstructive pulmonary disease(COPD) and is associated with decreased quality-of-life and survival in patients. The autophagy lysosome pathw...Skeletal muscle dysfunction is a common extrapulmonary comorbidity of chronic obstructive pulmonary disease(COPD) and is associated with decreased quality-of-life and survival in patients. The autophagy lysosome pathway is one of the proteolytic systems that significantly affect skeletal muscle structure and function. Intriguingly, both promoting and inhibiting autophagy have been observed to improve COPD skeletal muscle dysfunction, yet the mechanism is unclear. This paper first reviewed the effects of macroautophagy and mitophagy on the structure and function of skeletal muscle in COPD, and then explored the mechanism of autophagy mediating the dysfunction of skeletal muscle in COPD. The results showed that macroautophagy-and mitophagy-related proteins were significantly increased in COPD skeletal muscle. Promoting macroautophagy in COPD improves myogenesis and replication capacity of muscle satellite cells, while inhibiting macroautophagy in COPD myotubes increases their diameters. Mitophagy helps to maintain mitochondrial homeostasis by removing impaired mitochondria in COPD. Autophagy is a promising target for improving COPD skeletal muscle dysfunction, and further research should be conducted to elucidate the specific mechanisms by which autophagy mediates COPD skeletal muscle dysfunction, with the aim of enhancing our understanding in this field.展开更多
Chronic obstructive pulmonary disease(COPD)is a respiratory condition characterized by several symptoms.The pathogenesis of COPD is complex and involves multiple factors.A fantastic drug from traditional Chinese medic...Chronic obstructive pulmonary disease(COPD)is a respiratory condition characterized by several symptoms.The pathogenesis of COPD is complex and involves multiple factors.A fantastic drug from traditional Chinese medicine,Isodon Suzhouensis(ISZ)is a perennial herb belonging to the Labiaceae family.It has the functions of resolving phlegm,removing stasis,promoting blood circulation and eliminating qi stagnation.ISZ has been found to possess great potential against COPD.Present study is focused on identifying micro RNA(mi RNA)biomarkers for COPD and determining the role of ISZ leaf extract in regulating the disease through mi RNA expression in serum exosomes.The Sprague Dawley(SD)rats were randomly divided into control group,COPD group and COPD+ISZ group.After the establishment of the model,the rats were sacrificed,and the results were compared with the control group.Then the total RNA of rat serum was extracted and identified by nanoparticle tracker.Finally,high-throughput screening and sequencing were performed to screen mi RNAs with significant differential expression.Then,different databases were used to figure out the possible target genes,and their functions were assessed by employing Gene Ontology(GO)as well as Kyoto Encyclopedia of Genes and Genomes(KEGG)analyses.The sequencing results were then further verified by q RT-PCR.The results pointed out that these 17 differentially expressed mi RNAs may have the potential of diagnostic and prognostic biomarkers against COPD.Interestingly,it was also found that ISZ leaf extract may regulate the occurrence of COPD by affecting the expression of mi RNAs.This study identified the biomarkers of COPD and clarified the mechanism of the treatment of COPD by ISZ leaf extract,which is helpful to improve the level of early diagnosis and treatment of COPD.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 Patients with chronic obstructive pulmonary disease(COPD)frequently experience exacerbations requiring multiple hospitalizations over prolonged disease courses,which predispose them to generalized anxiety d...BACKGROUND Patients with chronic obstructive pulmonary disease(COPD)frequently experience exacerbations requiring multiple hospitalizations over prolonged disease courses,which predispose them to generalized anxiety disorder(GAD).This comorbidity exacerbates breathing difficulties,activity limitations,and social isolation.While previous studies predominantly employed the GAD 7-item scale for screening,this approach is somewhat subjective.The current literature on predictive models for GAD risk in patients with COPD is limited.AIM To construct and validate a GAD risk prediction model to aid healthcare professionals in preventing the onset of GAD.METHODS This retrospective analysis encompassed patients with COPD treated at our institution from July 2021 to February 2024.The patients were categorized into a modeling(MO)group and a validation(VA)group in a 7:3 ratio on the basis of the occurrence of GAD.Univariate and multivariate logistic regression analyses were utilized to construct the risk prediction model,which was visualized using forest plots.The model’s performance was evaluated using Hosmer-Lemeshow(H-L)goodness-of-fit test and receiver operating characteristic(ROC)curve analysis.RESULTS A total of 271 subjects were included,with 190 in the MO group and 81 in the VA group.GAD was identified in 67 patients with COPD,resulting in a prevalence rate of 24.72%(67/271),with 49 cases(18.08%)in the MO group and 18 cases(22.22%)in the VA group.Significant differences were observed between patients with and without GAD in terms of educational level,average household income,smoking history,smoking index,number of exacerbations in the past year,cardiovascular comorbidities,disease knowledge,and personality traits(P<0.05).Multivariate logistic regression analysis revealed that lower education levels,household income<3000 China yuan,smoking history,smoking index≥400 cigarettes/year,≥two exacerbations in the past year,cardiovascular comorbidities,complete lack of disease information,and introverted personality were significant risk factors for GAD in the MO group(P<0.05).ROC analysis indicated that the area under the curve for predicting GAD in the MO and VA groups was 0.978 and 0.960.The H-L test yieldedχ^(2) values of 6.511 and 5.179,with P=0.275 and 0.274.Calibration curves demonstrated good agreement between predicted and actual GAD occurrence risks.CONCLUSION The developed predictive model includes eight independent risk factors:Educational level,household income,smoking history,smoking index,number of exacerbations in the past year,presence of cardiovascular comorbidities,level of disease knowledge,and personality traits.This model effectively predicts the onset of GAD in patients with COPD,enabling early identification of high-risk individuals and providing a basis for early preventive interventions by nursing staff.展开更多
Chronic obstructive pulmonary disease(COPD)is a persistent airflow obstructive disease caused by airway and/or alveolar abnormalities and has become the third leading cause of death worldwide.Dupilumab,the first fully...Chronic obstructive pulmonary disease(COPD)is a persistent airflow obstructive disease caused by airway and/or alveolar abnormalities and has become the third leading cause of death worldwide.Dupilumab,the first fully humanized monoclonal antibody targeting the IL-4 receptor subunit alpha(IL-4Rα),is mainly used to treat COPD patients with elevated blood eosinophils that cannot be effectively controlled by traditional drugs.Studies have shown that dupilumab effectively improves pulmonary function,reduces airway inflammation and exacerbation rate,and significantly improves quality of life in COPD patients by blocking interleukin-4(IL-4)and interleukin-13(IL-13)signaling.Several clinical trials and real-world studies have shown that dupilumab significantly reduces the rate of exacerbations,particularly in patients with high baseline eosinophil or FeNO levels.In addition,dupilumab showed positive efficacy in improving lung function,reducing airway inflammation and improving the quality of life of patients.Although the preliminary efficacy of dupilumab in the treatment of COPD is promising,its safety and efficacy need to be further validated,particularly in long-term use and in different patient subgroups.Future studies should focus on the precise classification of COPD,the exploration of relevant biomarkers,and the use of dupilumab at different stages of treatment in order to achieve personalized treatment.展开更多
Background:Chronic obstructive pulmonary disease(COPD)is a progressive chronic inflammatory disease characterized by irreversible airflow limitation.Fritillaria thunbergii Miq.Zhebeimu(ZBM)has a long history in treati...Background:Chronic obstructive pulmonary disease(COPD)is a progressive chronic inflammatory disease characterized by irreversible airflow limitation.Fritillaria thunbergii Miq.Zhebeimu(ZBM)has a long history in treating COPD,but the underlying mechanism is still unclear.Methods:This study explored the pathological mechanism of COPD through RNA-Seq analysis and single-cell sequencing data analysis.And the mechanism of ZBM and blood entering sRNAs for COPD was verified with network pharmacology analysis and in vitro experiments.Results:The results showed that inflammation and oxidative stress exacerbated the progression of COPD,and the expression of HSP90AA1,PTGS2,and AGRN genes significantly increased in the lung tissue of patients.Network pharmacology analysis suggests that the natural products contained in ZBM may directly target HSP90AA1,PTGS2,and AGRN for the treatment of COPD.Analysis of the blood entering sRNA contained in the decoction of ZBM revealed its excellent antioxidant and anti-macrophage polarization effects.Meanwhile,ZBM decoction,sRNA2,and sRNA5 reduce oxidative stress and inflammation by acting on prostaglandin-endoperoxide synthase 2(PTGS2),nitric oxide synthase 2(NOS2),ATP-binding cassette,subfamily C member 1(ABCC1),and xeroderma pigmentosum complementation group C(XPC)genes.Conclusion:Our study demonstrated that ZBM extract and ZBM derived sRNA2 and sRNA5 can relieve COPD by regulating PTGS2-NOS2-XPC-ABCC1 axis.展开更多
Chronic obstructive pulmonary disease(COPD)is a common chronic respiratory disease that severely affects patients’quality of life.Current clinical treatments primarily rely on medication,with limited rehabilitation o...Chronic obstructive pulmonary disease(COPD)is a common chronic respiratory disease that severely affects patients’quality of life.Current clinical treatments primarily rely on medication,with limited rehabilitation options and uncertain efficacy.Home-based exercise rehabilitation,as a non-pharmacological therapy,can promote the improvement of respiratory muscle function and cardiopulmonary endurance,exerting a positive preventive effect on COPD.However,due to factors such as the home environment and lack of health knowledge,COPD patients face numerous difficulties in accepting home-based exercise rehabilitation.This article reviews domestic and international research on the feasibility and effectiveness of home-based exercise rehabilitation for COPD,aiming to provide references for medical workers to better implement home-based exercise rehabilitation for COPD,assist patients in performing rehabilitation exercises at home,improve their quality of life,reduce hospitalization rates,and lower medical costs.展开更多
Objective:To explore nursing measures for elderly patients with chronic obstructive pulmonary disease(COPD)and analyze the effect of continuous nursing pathways on improving the accuracy of aerosol use.Methods:From Ap...Objective:To explore nursing measures for elderly patients with chronic obstructive pulmonary disease(COPD)and analyze the effect of continuous nursing pathways on improving the accuracy of aerosol use.Methods:From April 2023 to April 2024,76 elderly COPD patients admitted to our hospital were randomly selected for nursing research.They were divided into two groups using a computer double-blind method,with 38 patients in each group.The control group received routine nursing,while the observation group applied the continuous nursing pathway.The nursing effects of the two groups were investigated and compared,including(1)aerosol accuracy;(2)cardiopulmonary function;(3)subjective well-being and self-care ability;(4)quality of life;and(5)nursing satisfaction.Results:Compared with the control group,the observation group had a significantly higher accuracy rate of aerosol use(P<0.05).Before nursing,there were no significant differences in cardiopulmonary function indicators,MUNSH scores,and ESCA scores between the two groups(P>0.05).After nursing,the patient's cardiopulmonary function improved significantly,and their subjective well-being and self-care ability increased.The observation group was significantly better than the control group in all the above indicators(P<0.05).The quality of life scores of the observation group were significantly higher than those of the control group(P<0.05).Conclusion:In the nursing of elderly patients with chronic obstructive pulmonary disease,the application of the continuous nursing pathway can effectively improve the accuracy of aerosol use and improve patients'cardiopulmonary function.展开更多
Objective We employed Mendelian randomization(MR)to test the traditional Chinese medicine(TCM)theory of emotional pathogenesis concept and explore the causal relation-ship between negative emotions and chronic obstruc...Objective We employed Mendelian randomization(MR)to test the traditional Chinese medicine(TCM)theory of emotional pathogenesis concept and explore the causal relation-ship between negative emotions and chronic obstructive pulmonary disease(COPD).Methods Data of negative emotions,bronchitis,emphysema,and C-reactive protein(CRP)levels were downloaded from genome-wide association study(GWAS)public database for a two-sample MR analysis.Independent single-nucleotide polymorphisms(SNPs)associated with negative emotions,bronchitis,and emphysema were selected as instrumental variables.Primary causal estimates were derived using inverse-variance weighting(IVW),supplement-ed by weighted median(WM),and simple mode(SM)methods.Sensitivity analyses included MR-Egger regression and MR-PRESSO to assess pleiotropy,Cochran’s Q test for heterogene-ity,and multivariate MR to adjust for smoking.Mediation analysis evaluated the role of in-flammatory markers.Reverse MR was tested for bidirectional causality.Weak instrument bias was mitigated via F-statistic thresholds(>10).All analyses were conducted in RStudio.Results MR analysis identified significant causal effects of several negative emotions on COPD.Genetically,the IVW analysis of seen doctors for nerves anxiety tension or depression[OR_(IVW)=1.006,95%CI=(1.002,1.010),P=0.002],sensitivity/hurt feelings[OR_(IVW)=1.024,95%CI=(1.004,1.044),P=0.017],and irritability[OR_(IVW)=1.019,95%CI=(1.003,1.035),P=0.019] were robustly associated with increased risks of COPD.No heterogeneity was detected among the different instrumental variables(IVs)for depression(P=0.655)and irritability(P=0.163).MR-Egger regression intercepts for all emotional exposures were close to zero and sta-tistically non-significant,indicating no evidence of directional pleiotropy.The horizontal pleiotropy results showed that except for worry(MR-PRESSO P=0.006),other emotion expo-sures confirming no substantial pleiotropic bias.Multivariable MR demonstrated that anxiety remained independently associated with COPD after adjusting for smoking(P=0.002),while associations with other negative emotions were attenuated post-adjustment.The mediation analysis revealed that CRP mediated 3.93%of the total effect of anxiety on COPD.However,reverse MR analysis found no evidence of reverse causality.Conclusion This study confirmed the causal effects of negative emotions on COPD through MR analysis and revealed that negative emotions may trigger CRP production,which plays an essential mediating role in this relationship.This study provides a reliable modern theoretical basis for emotion theory in TCM.展开更多
Objective To investigate the relationship between physical activity and genetic risk and their combined effects on the risk of developing chronic obstructive pulmonary disease.Methods This prospective cohort study inc...Objective To investigate the relationship between physical activity and genetic risk and their combined effects on the risk of developing chronic obstructive pulmonary disease.Methods This prospective cohort study included 318,085 biobank participants from the UK.Physical activity was assessed using the short form of the International Physical Activity Questionnaire.The participants were stratified into low-,intermediate-,and high-genetic-risk groups based on their polygenic risk scores.Multivariate Cox regression models and multiplicative interaction analyses were used.Results During a median follow-up period of 13 years,9,209 participants were diagnosed with chronic obstructive pulmonary disease.For low genetic risk,compared to low physical activity,the hazard ratios(HRs)for moderate and high physical activity were 0.853(95%confidence interval[CI]:0.748–0.972)and 0.831(95%CI:0.727–0.950),respectively.For intermediate genetic risk,the HRs were 0.829(95%CI:0.758–0.905)and 0.835(95%CI:0.764–0.914),respectively.For participants with high genetic risk,the HRs were 0.809(95%CI:0.746–0.877)and 0.818(95%CI:0.754–0.888),respectively.A significant interaction was observed between genetic risk and physical activity.Conclusion Moderate or high levels of physical activity were associated with a lower risk of developing chronic obstructive pulmonary disease across all genetic risk groups,highlighting the need to tailor activity interventions for genetically susceptible individuals.展开更多
Objective This study was aimed to explore the prolonged therapeutic profile and underlying mechanisms of Yiqi Zishen Formula(YZF)in chronic obstructive pulmonary disease(COPD)management.Methods A COPD rat model was es...Objective This study was aimed to explore the prolonged therapeutic profile and underlying mechanisms of Yiqi Zishen Formula(YZF)in chronic obstructive pulmonary disease(COPD)management.Methods A COPD rat model was established through exposure to tobacco smoke and Klebsiella pneumoniae infections from weeks 1 to 8,followed by treatment with YZF from weeks 9 to 20.No treatment was administered from weeks 21 to 31.At week 32,all rats were euthanized,and lung tissue samples and blood specimens were collected for subsequent analyses.Then,comprehensive multiomics profiling—encompassing transcriptomics,proteomics,andmetabolomics—was conducted to identify differentially expressed molecules in lung tissues and elucidate the underlying molecular mechanisms.Results By week 32,sustained therapeutic efficacy became apparent,characterized by diminished inflammatory cytokine expression,mitigation of protease–antiprotease dysregulation,and reduced collagen deposition.These differentially expressed molecules were predominantly enriched in pathways related to oxidoreductase activity,antioxidant homeostasis,focal adhesion,tight junction formation,adherens junction dynamics,and lipid metabolism regulation.Integrative analysis of predicted targets,transcriptomic,proteomic,and metabolomic datasets revealed that differentially expressed molecules in YZF-treated rats and YZF-targeted proteins collectively participated in lipid metabolism,inflammatory responses,oxidative stress,and focal adhesion pathways.Conclusion YZF provides sustained therapeutic benefits in COPD rat models,potentially through systemic regulation of lipid metabolism,inflammatory responses,oxidative stress,and focal adhesion pathways.展开更多
BACKGROUND Chronic obstructive pulmonary disease(COPD)is a progressive respiratory condition often associated with a high incidence of osteoporosis.Studies indicate that patients with COPD present with a significant d...BACKGROUND Chronic obstructive pulmonary disease(COPD)is a progressive respiratory condition often associated with a high incidence of osteoporosis.Studies indicate that patients with COPD present with a significant decrease in bone mineral density(BMD),potentially related to inflammation and corticosteroid use.AIM To investigate the relationship between BMD and lung function,mainly the forced expiratory volume in the forced expiratory volume in 1 second(FEV1)/forced vital capacity percentage(FVC%),in patients with COPD using quantitative computed tomography(QCT).METHODS This prospective cross-sectional study included 85 patients with COPD treated at Gansu Provincial People's Hospital.Exposure variables included lung function parameter(FEV1/FVC%),age,sex,body mass index,smoking status,tea-drinking habits,and physical activity.BMD was measured using QCT.Linear regression and generalized additive models were employed to analyze the relationship between exposure variables and BMD.RESULTS Linear regression analysis revealed a significant positive relationship between BMD and FEV1/FVC%(β=0.1,95%confidence interval[CI]:0.1-0.1;P<0.0001).Non-linear analysis identified a unique BMD breakpoint of 128.08 mg/cm³.Before the breakpoint,BMD was significantly positively correlated with FEV1/FVC%(β=0.245;P=0.0019);while after the breakpoint,the relationship was negative and showed no statistical significance(β=-0.136;P=0.0753).This finding underscores the critical role of BMD in COPD management and highlights the importance of individualized clinical interventions in improvement of lung function and overall health status in patients.CONCLUSION There is a complex non-linear relationship between BMD and lung function in patients with COPD,highlighting the importance of monitoring change in bone density during the management of COPD.展开更多
Objective:To review the current status of research on kinesiophobia,assessment tools,influencing factors,and intervention strategies in patients with chronic obstructive pulmonary disease,aiming to provide a reference...Objective:To review the current status of research on kinesiophobia,assessment tools,influencing factors,and intervention strategies in patients with chronic obstructive pulmonary disease,aiming to provide a reference for promoting pulmonary rehabilitation in these patients.Methods:A scoping review framework was employed to search databases including CNKI,Wanfang,VIP,China Biology Medicine(CBM),PubMed,Web of Science,and Wiley Online Library.The search time frame spanned from the database inception to May 20,2024.Two researchers independently screened the literature,summarized,and analyzed the data.Results:A total of 18 articles were included.Commonly used assessment tools included the Tampa Scale for kinesiophobia and the dyspnea beliefs questionnaire.Influencing factors encompassed demographic,disease-related,psychosocial,and BMI-related factors.Intervention methods included inspiratory muscle training,narrative nursing,and cognitive interventions combined with active cycle of breathing techniques.Conclusion:The incidence of kinesiophobia in COPD patients is relatively high and varies among individuals,influenced by multiple factors.There is a need to develop localized assessment tools to identify kinesiophobia in a timely and accurate manner and to further refine intervention strategies.展开更多
Objective:To explore the rehabilitation effect of pulmonary rehabilitation training in elderly patients with chronic obstructive pulmonary disease(COPD).Methods:Elderly COPD patients hospitalized from June 2024 to Dec...Objective:To explore the rehabilitation effect of pulmonary rehabilitation training in elderly patients with chronic obstructive pulmonary disease(COPD).Methods:Elderly COPD patients hospitalized from June 2024 to December 2024 were selected as subjects for a quasi-experimental study.The study randomly assigned patients into two equal groups of 50 each.One group served as the control and received standard treatment and nursing care,while the other group,the intervention group,was given additional pulmonary rehabilitation exercises alongside the conventional care.The lung function indexes[forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),FEV1/FVC],6-minute walk distance(6MWD),Borg’s Category Scale for perceived exertion(BCSS),COPD Assessment Test(CAT),Barthel Index for activities of daily living,blood oxygen saturation,and Modified Medical Research Council(MMRC)dyspnea scale were compared between the two groups before and after intervention.Results:Following the intervention,the intervention group demonstrated improved lung function compared to the control group(P<0.05).However,no significant difference was observed in the 6-minute walk distance(6MWD)(P>0.05).The intervention group had lower Bronchitis Severity Scale(BCSS)scores(P<0.05)and better quality of life scores(P<0.05)than the control group.No notable differences were found in activities of daily living scores or blood oxygen saturation(P>0.05).Additionally,the intervention group exhibited a lower proportion of residual severe dyspnea(P<0.05).Conclusion:Pulmonary rehabilitation can enhance respiratory function in individuals with COPD,leading to beneficial therapeutic outcomes and ultimately improving their overall quality of life.展开更多
BACKGROUND Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is often combined with respiratory failure,which increases the patient's morbidity and mortality.Diaphragm ultrasound(DUS)has developed...BACKGROUND Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is often combined with respiratory failure,which increases the patient's morbidity and mortality.Diaphragm ultrasound(DUS)has developed rapidly in the field of critical care in recent years.Studies with DUS monitoring diaphragm-related rapid shallow breathing index have demonstrated important results in guiding intensive care unit patients out of the ventilator.Early prediction of the indications for withdrawal of non-invasive ventilator and early evaluation of patients to avoid or reduce disease progression are very important.AIM To explore the predictive value of DUS indexes for non-invasive ventilation outcome in patients with AECOPD.METHODS Ninety-four patients with AECOPD who received mechanical ventilation in our hospital from January 2022 to December 2023 were retrospectively analyzed,and they were divided into a successful ventilation group(68 cases)and a failed ventilation group(26 cases)according to the outcome of ventilation.The clinical data of patients with successful and failed noninvasive ventilation were compared,and the independent predictors of noninvasive ventilation outcomes in AECOPD patients were identified by multivariate logistic regression analysis.RESULTS There were no significant differences in gender,age,body mass index,complications,systolic pressure,heart rate,mean arterial pressure,respiratory rate,oxygen saturation,partial pressure of oxygen,oxygenation index,or time of inspiration between patients with successful and failed mechanical ventilation(P>0.05).The patients with successful noninvasive ventilation had shorter hospital stays and lower partial pressure of carbon dioxide(PaCO_(2))than those with failed treatment,while potential of hydrogen(pH),diaphragm thickening fraction(DTF),diaphragm activity,and diaphragm movement time were significantly higher than those with failed treatment(P<0.05).pH[odds ratio(OR)=0.005,P<0.05],PaCO_(2)(OR=0.430,P<0.05),and DTF(OR=0.570,P<0.05)were identified to be independent factors influencing the outcome of mechanical ventilation in AECOPD patients.CONCLUSION The DUS index DTF can better predict the outcome of non-invasive ventilation in AECOPD patients.展开更多
Background Chronic obstructive pulmonary disease(COPD),a common respiratory disease,can be effectively treated by traditional Chinese medicine(TCM).Qingfei Huatan,a TCM formula,has been reported to effectively allevia...Background Chronic obstructive pulmonary disease(COPD),a common respiratory disease,can be effectively treated by traditional Chinese medicine(TCM).Qingfei Huatan,a TCM formula,has been reported to effectively alleviate the clinical symptoms of COPD patients.However,there is a lack of multi-centre,randomised,double-blind,controlled clinical trials documenting the clinical efficacy and safety of this formula in the treatment of acute exacerbation of COPD(AECOPD).Objective This study evaluated the efficacy and safety of Qingfei Huatan formula in the treatment of AECOPD,thereby providing high-quality clinical evidence.Design,setting,participants and interventions A total of 276 patients with AECOPD were included in this multi-centre,randomised,double-blind,placebo-controlled trial and were randomised into treatment and control groups at a ratio of 1:1.Patients in the treatment and control groups took Qingfei Huatan granules or simulated Qingfei Huatan granules twice a day,for 14 days,in addition to Western medicine treatment.All patients were followed up for 3 months.Main outcome measures The primary outcome was time taken to symptom stabilisation.The secondary outcomes included duration of antibiotic use,clinical symptom and sign score,TCM syndrome score,dyspnoea score,and quality of life(QOL)score.Meanwhile,the safety of the formula was assessed through routine urine and stool tests,electrocardiograms,liver and kidney function tests,and the observation of adverse events throughout the trial.Results The time taken for effective stabilisation(P<0.05)and obvious stabilisation(P<0.01),and the duration of antibiotic use(P<0.05)were significantly shorter in the treatment group than in the control group.On days 6,9,12 and 14 of treatment,clinical symptom and sign score decreased in both groups,particularly in the treatment group(P<0.01).On days 9,12 and 14 of treatment,the TCM syndrome scores of both groups were reduced(P<0.01),with more significant reductions in the treatment group.At 3 months after the end of treatment,the treatment group continued to have lower clinical symptom and sign score and TCM syndrome score than the control group(P<0.01).On days 6,9,12 and 14 of treatment,dyspnoea and QOL scores were markedly reduced in the two groups(P<0.05 and P<0.01,respectively),especially in the treatment group.At 3 months after the end of treatment,dyspnoea and QOL scores were lower in the treatment group than those in the control group(P<0.01).No serious adverse events were observed in either group.Conclusion The Qingfei Huatan formula can effectively shorten the duration of AECOPD and antibiotic use,significantly relieve clinical symptoms,and increase QOL for AECOPD patients,with a favourable safety profile.These results suggest that this formula can be used as a complementary treatment for AECOPD patients.展开更多
文摘Objective:To investigate the clinical efficacy of levofloxacin combined with ambroxol in the treatment of elderly patients with chronic obstructive pulmonary disease(COPD)and pulmonary infection.Methods:A total of 80 elderly COPD patients with pulmonary infection,treated between December 2022 and November 2023,were randomly divided into a control group and an observation group,with 40 cases in each group.The control group was treated with levofloxacin hydrochloride,while the observation group received ambroxol hydrochloride injection in addition to the treatment in the control group.Laboratory indices(white blood cell count,procalcitonin,C-reactive protein,and apolipoprotein E levels),imaging-based pulmonary lesion absorption time,hospital stay,and incidence of adverse reactions were compared between the two groups.Results:After treatment,the biochemical indices of the observation group were significantly lower than those of the control group,with highly significant differences(P<0.001).Compared to the control group,the imaging-based pulmonary lesion absorption time and hospital stay of the observation group were significantly shorter(P<0.001).Additionally,the incidence of adverse reactions in the observation group was significantly lower than in the control group(P<0.05).Conclusion:Levofloxacin combined with ambroxol demonstrates advantages in improving biochemical indices,shortening imaging-based pulmonary lesion absorption time and hospital stay,and reducing adverse reaction rates in elderly COPD patients with pulmonary infection.It holds significant clinical application value.
文摘In this article,we comment on the study by Yang et al,which demonstrated significant cross-sectional associations between heart rate variability(HRV)indices,depressive symptoms,and lung function in patients with chronic obstructive pulmonary disease(COPD).Building on these findings,we further explore the underlying mechanisms,particularly inflammatory-autonomic-oxidative stress pathways,as key causal mediators.Moreover,analyzing genetic polymorphisms alongside environmental factors may uncover susceptibility pathways explaining interindividual differences in HRV and comorbidity risk.Additionally,longitudinal studies tracking HRV trajectories could identify thresholds predictive of accelerated lung function decline or cardiovascular events,informing personalized prevention strategies.Integrating longitudinal HRV data with multi-omics biomarkers and machine learning models could enable real-time prediction of depression relapses or COPD exacerbations,facilitating proactive interventions such as personalized biofeedback training or precision anti-inflammatory therapies.By synthesizing these perspectives,this integrative approach promises to advance precision medicine for COPD patients,particularly those with comorbid depression,by addressing both mechanistic insights and clinical translation.
文摘BACKGROUND The correlation conclusions between self-management,frailty,and quality of life(QoL)of chronic obstructive pulmonary disease(COPD)patients are inconsistent.AIM To comprehensively assess the current status of self-management,psychological cognitive impairment,and QoL in elderly patients with COPD.METHODS Convenient sampling was employed to select 312 elderly patients with COPD who were receiving treatment in the respiratory and critical care medicine department of a tertiary grade A hospital from November 2023 to February 2024.The study utilized demographic information and clinical characteristics,selfmanagement behavior,occurrence of psychological cognitive impairment,and QoL as evaluated through general information questionnaires,the COPD patient self-management scale,simple frailty scale,simple mental status scale,clinical dementia assessment scale,and the clinical COPD assessment test questionnaire.This research aims to describe the current status and correlations among selfmanagement behavior,cognitive impairment occurrence,and QoL.RESULTS The average score for self-management behavior in elderly COPD patients was 136.00(119.00,164.50),indicating a moderate level overall.There were 98 cases of cognitive impairment,accounting for 31.4%,with a mental status score of 3(2,3.75).The average QoL score was 24(19,28),indicating a low level.Additionally,there was a negative correlation between total self-management behavior score and cognitive impairment occurrence(r=-0.589,P<0.001),and QoL total score(r=-0.409,P<0.001).Cognitive impairment occurrence was positively correlated with QoL total score(r=0.345,P<0.001).Disease course and self-management behavior score were independent factors affecting the total QoL score in elderly COPD patients(P<0.05).CONCLUSION The self-management behavior of elderly patients with COPD is at a moderate level.However,the occurrence of cognitive impairment is high and significantly influenced by disease course,level of self-management,and mental status.The QoL is low,emphasizing the urgent need to intervene in the self-management behaviors of elderly COPD patients,actively reduce the occurrence of cognitive impairment,and mitigate the impact of the disease on QoL.
基金supported by the 2025 Hangzhou Normal University Teaching Development and Reform Project(Project No.JG2025320)。
文摘Self-management interventions for chronic obstructive pulmonary disease(COPD)patients using mobile health technology are beneficial for relieving disease symptoms,improving patients’adherence to rehabilitation self-management,and improving quality of life.This paper reviews the application of mobile health technology in self-management of patients with chronic obstructive pulmonary disease,introduces the application form of mobile health technology in self-management of patients with chronic obstructive pulmonary disease,summarizes its application effect in self-management of patients with chronic obstructive pulmonary disease,analyzes the problems and proposes solutions in the process of research and implementation at this stage,with a view to providing a theory for the application of mobile health technology in pulmonary rehabilitation and management of patients with chronic obstructive pulmonary disease This study summarize the effect of its application in the self-management of patients with chronic obstructive pulmonary disease.
基金supported by the National Natural Science Foundation of China(No.82172551)the Health Discipline Leader Project of Shanghai Municipal Health Commission(No.2022XD044),China.
文摘Skeletal muscle dysfunction is a common extrapulmonary comorbidity of chronic obstructive pulmonary disease(COPD) and is associated with decreased quality-of-life and survival in patients. The autophagy lysosome pathway is one of the proteolytic systems that significantly affect skeletal muscle structure and function. Intriguingly, both promoting and inhibiting autophagy have been observed to improve COPD skeletal muscle dysfunction, yet the mechanism is unclear. This paper first reviewed the effects of macroautophagy and mitophagy on the structure and function of skeletal muscle in COPD, and then explored the mechanism of autophagy mediating the dysfunction of skeletal muscle in COPD. The results showed that macroautophagy-and mitophagy-related proteins were significantly increased in COPD skeletal muscle. Promoting macroautophagy in COPD improves myogenesis and replication capacity of muscle satellite cells, while inhibiting macroautophagy in COPD myotubes increases their diameters. Mitophagy helps to maintain mitochondrial homeostasis by removing impaired mitochondria in COPD. Autophagy is a promising target for improving COPD skeletal muscle dysfunction, and further research should be conducted to elucidate the specific mechanisms by which autophagy mediates COPD skeletal muscle dysfunction, with the aim of enhancing our understanding in this field.
基金supported by the National Natural Science Foundation of China(82170481,82570069)Anhui Natural Science Foundation(2008085J39 and 2108085MH314)+1 种基金Anhui Province Innovation Team of Authentic Medicinal Materials Development and High Value Utilization(2022AH010080)Suzhou University Joint Cultivation Postgraduate Research Innovation Fund Project(2023KYCX04)。
文摘Chronic obstructive pulmonary disease(COPD)is a respiratory condition characterized by several symptoms.The pathogenesis of COPD is complex and involves multiple factors.A fantastic drug from traditional Chinese medicine,Isodon Suzhouensis(ISZ)is a perennial herb belonging to the Labiaceae family.It has the functions of resolving phlegm,removing stasis,promoting blood circulation and eliminating qi stagnation.ISZ has been found to possess great potential against COPD.Present study is focused on identifying micro RNA(mi RNA)biomarkers for COPD and determining the role of ISZ leaf extract in regulating the disease through mi RNA expression in serum exosomes.The Sprague Dawley(SD)rats were randomly divided into control group,COPD group and COPD+ISZ group.After the establishment of the model,the rats were sacrificed,and the results were compared with the control group.Then the total RNA of rat serum was extracted and identified by nanoparticle tracker.Finally,high-throughput screening and sequencing were performed to screen mi RNAs with significant differential expression.Then,different databases were used to figure out the possible target genes,and their functions were assessed by employing Gene Ontology(GO)as well as Kyoto Encyclopedia of Genes and Genomes(KEGG)analyses.The sequencing results were then further verified by q RT-PCR.The results pointed out that these 17 differentially expressed mi RNAs may have the potential of diagnostic and prognostic biomarkers against COPD.Interestingly,it was also found that ISZ leaf extract may regulate the occurrence of COPD by affecting the expression of mi RNAs.This study identified the biomarkers of COPD and clarified the mechanism of the treatment of COPD by ISZ leaf extract,which is helpful to improve the level of early diagnosis and treatment of COPD.
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.
基金Supported by the Henan Provincial Health Commission,No.232102310145.
文摘BACKGROUND Patients with chronic obstructive pulmonary disease(COPD)frequently experience exacerbations requiring multiple hospitalizations over prolonged disease courses,which predispose them to generalized anxiety disorder(GAD).This comorbidity exacerbates breathing difficulties,activity limitations,and social isolation.While previous studies predominantly employed the GAD 7-item scale for screening,this approach is somewhat subjective.The current literature on predictive models for GAD risk in patients with COPD is limited.AIM To construct and validate a GAD risk prediction model to aid healthcare professionals in preventing the onset of GAD.METHODS This retrospective analysis encompassed patients with COPD treated at our institution from July 2021 to February 2024.The patients were categorized into a modeling(MO)group and a validation(VA)group in a 7:3 ratio on the basis of the occurrence of GAD.Univariate and multivariate logistic regression analyses were utilized to construct the risk prediction model,which was visualized using forest plots.The model’s performance was evaluated using Hosmer-Lemeshow(H-L)goodness-of-fit test and receiver operating characteristic(ROC)curve analysis.RESULTS A total of 271 subjects were included,with 190 in the MO group and 81 in the VA group.GAD was identified in 67 patients with COPD,resulting in a prevalence rate of 24.72%(67/271),with 49 cases(18.08%)in the MO group and 18 cases(22.22%)in the VA group.Significant differences were observed between patients with and without GAD in terms of educational level,average household income,smoking history,smoking index,number of exacerbations in the past year,cardiovascular comorbidities,disease knowledge,and personality traits(P<0.05).Multivariate logistic regression analysis revealed that lower education levels,household income<3000 China yuan,smoking history,smoking index≥400 cigarettes/year,≥two exacerbations in the past year,cardiovascular comorbidities,complete lack of disease information,and introverted personality were significant risk factors for GAD in the MO group(P<0.05).ROC analysis indicated that the area under the curve for predicting GAD in the MO and VA groups was 0.978 and 0.960.The H-L test yieldedχ^(2) values of 6.511 and 5.179,with P=0.275 and 0.274.Calibration curves demonstrated good agreement between predicted and actual GAD occurrence risks.CONCLUSION The developed predictive model includes eight independent risk factors:Educational level,household income,smoking history,smoking index,number of exacerbations in the past year,presence of cardiovascular comorbidities,level of disease knowledge,and personality traits.This model effectively predicts the onset of GAD in patients with COPD,enabling early identification of high-risk individuals and providing a basis for early preventive interventions by nursing staff.
文摘Chronic obstructive pulmonary disease(COPD)is a persistent airflow obstructive disease caused by airway and/or alveolar abnormalities and has become the third leading cause of death worldwide.Dupilumab,the first fully humanized monoclonal antibody targeting the IL-4 receptor subunit alpha(IL-4Rα),is mainly used to treat COPD patients with elevated blood eosinophils that cannot be effectively controlled by traditional drugs.Studies have shown that dupilumab effectively improves pulmonary function,reduces airway inflammation and exacerbation rate,and significantly improves quality of life in COPD patients by blocking interleukin-4(IL-4)and interleukin-13(IL-13)signaling.Several clinical trials and real-world studies have shown that dupilumab significantly reduces the rate of exacerbations,particularly in patients with high baseline eosinophil or FeNO levels.In addition,dupilumab showed positive efficacy in improving lung function,reducing airway inflammation and improving the quality of life of patients.Although the preliminary efficacy of dupilumab in the treatment of COPD is promising,its safety and efficacy need to be further validated,particularly in long-term use and in different patient subgroups.Future studies should focus on the precise classification of COPD,the exploration of relevant biomarkers,and the use of dupilumab at different stages of treatment in order to achieve personalized treatment.
文摘Background:Chronic obstructive pulmonary disease(COPD)is a progressive chronic inflammatory disease characterized by irreversible airflow limitation.Fritillaria thunbergii Miq.Zhebeimu(ZBM)has a long history in treating COPD,but the underlying mechanism is still unclear.Methods:This study explored the pathological mechanism of COPD through RNA-Seq analysis and single-cell sequencing data analysis.And the mechanism of ZBM and blood entering sRNAs for COPD was verified with network pharmacology analysis and in vitro experiments.Results:The results showed that inflammation and oxidative stress exacerbated the progression of COPD,and the expression of HSP90AA1,PTGS2,and AGRN genes significantly increased in the lung tissue of patients.Network pharmacology analysis suggests that the natural products contained in ZBM may directly target HSP90AA1,PTGS2,and AGRN for the treatment of COPD.Analysis of the blood entering sRNA contained in the decoction of ZBM revealed its excellent antioxidant and anti-macrophage polarization effects.Meanwhile,ZBM decoction,sRNA2,and sRNA5 reduce oxidative stress and inflammation by acting on prostaglandin-endoperoxide synthase 2(PTGS2),nitric oxide synthase 2(NOS2),ATP-binding cassette,subfamily C member 1(ABCC1),and xeroderma pigmentosum complementation group C(XPC)genes.Conclusion:Our study demonstrated that ZBM extract and ZBM derived sRNA2 and sRNA5 can relieve COPD by regulating PTGS2-NOS2-XPC-ABCC1 axis.
文摘Chronic obstructive pulmonary disease(COPD)is a common chronic respiratory disease that severely affects patients’quality of life.Current clinical treatments primarily rely on medication,with limited rehabilitation options and uncertain efficacy.Home-based exercise rehabilitation,as a non-pharmacological therapy,can promote the improvement of respiratory muscle function and cardiopulmonary endurance,exerting a positive preventive effect on COPD.However,due to factors such as the home environment and lack of health knowledge,COPD patients face numerous difficulties in accepting home-based exercise rehabilitation.This article reviews domestic and international research on the feasibility and effectiveness of home-based exercise rehabilitation for COPD,aiming to provide references for medical workers to better implement home-based exercise rehabilitation for COPD,assist patients in performing rehabilitation exercises at home,improve their quality of life,reduce hospitalization rates,and lower medical costs.
文摘Objective:To explore nursing measures for elderly patients with chronic obstructive pulmonary disease(COPD)and analyze the effect of continuous nursing pathways on improving the accuracy of aerosol use.Methods:From April 2023 to April 2024,76 elderly COPD patients admitted to our hospital were randomly selected for nursing research.They were divided into two groups using a computer double-blind method,with 38 patients in each group.The control group received routine nursing,while the observation group applied the continuous nursing pathway.The nursing effects of the two groups were investigated and compared,including(1)aerosol accuracy;(2)cardiopulmonary function;(3)subjective well-being and self-care ability;(4)quality of life;and(5)nursing satisfaction.Results:Compared with the control group,the observation group had a significantly higher accuracy rate of aerosol use(P<0.05).Before nursing,there were no significant differences in cardiopulmonary function indicators,MUNSH scores,and ESCA scores between the two groups(P>0.05).After nursing,the patient's cardiopulmonary function improved significantly,and their subjective well-being and self-care ability increased.The observation group was significantly better than the control group in all the above indicators(P<0.05).The quality of life scores of the observation group were significantly higher than those of the control group(P<0.05).Conclusion:In the nursing of elderly patients with chronic obstructive pulmonary disease,the application of the continuous nursing pathway can effectively improve the accuracy of aerosol use and improve patients'cardiopulmonary function.
基金2024 National “Flagship” Department Construction Project of Traditional Chinese and Western Medicine CooperationShandong Province Rural Revitalization Foundation Xiulan ZHANG Charity FundKey Discipline of Shanghai Health System in 2024 (2024ZDXK0026)。
文摘Objective We employed Mendelian randomization(MR)to test the traditional Chinese medicine(TCM)theory of emotional pathogenesis concept and explore the causal relation-ship between negative emotions and chronic obstructive pulmonary disease(COPD).Methods Data of negative emotions,bronchitis,emphysema,and C-reactive protein(CRP)levels were downloaded from genome-wide association study(GWAS)public database for a two-sample MR analysis.Independent single-nucleotide polymorphisms(SNPs)associated with negative emotions,bronchitis,and emphysema were selected as instrumental variables.Primary causal estimates were derived using inverse-variance weighting(IVW),supplement-ed by weighted median(WM),and simple mode(SM)methods.Sensitivity analyses included MR-Egger regression and MR-PRESSO to assess pleiotropy,Cochran’s Q test for heterogene-ity,and multivariate MR to adjust for smoking.Mediation analysis evaluated the role of in-flammatory markers.Reverse MR was tested for bidirectional causality.Weak instrument bias was mitigated via F-statistic thresholds(>10).All analyses were conducted in RStudio.Results MR analysis identified significant causal effects of several negative emotions on COPD.Genetically,the IVW analysis of seen doctors for nerves anxiety tension or depression[OR_(IVW)=1.006,95%CI=(1.002,1.010),P=0.002],sensitivity/hurt feelings[OR_(IVW)=1.024,95%CI=(1.004,1.044),P=0.017],and irritability[OR_(IVW)=1.019,95%CI=(1.003,1.035),P=0.019] were robustly associated with increased risks of COPD.No heterogeneity was detected among the different instrumental variables(IVs)for depression(P=0.655)and irritability(P=0.163).MR-Egger regression intercepts for all emotional exposures were close to zero and sta-tistically non-significant,indicating no evidence of directional pleiotropy.The horizontal pleiotropy results showed that except for worry(MR-PRESSO P=0.006),other emotion expo-sures confirming no substantial pleiotropic bias.Multivariable MR demonstrated that anxiety remained independently associated with COPD after adjusting for smoking(P=0.002),while associations with other negative emotions were attenuated post-adjustment.The mediation analysis revealed that CRP mediated 3.93%of the total effect of anxiety on COPD.However,reverse MR analysis found no evidence of reverse causality.Conclusion This study confirmed the causal effects of negative emotions on COPD through MR analysis and revealed that negative emotions may trigger CRP production,which plays an essential mediating role in this relationship.This study provides a reliable modern theoretical basis for emotion theory in TCM.
基金supported by the Construction of High-level University of Guangdong(G624330242)the National Natural Science Foundation of China (82425052) to Dr. Chen Maothe Postdoctoral Fellowship Program of CPSF(GZC20231052) to Dr. Jin Yang
文摘Objective To investigate the relationship between physical activity and genetic risk and their combined effects on the risk of developing chronic obstructive pulmonary disease.Methods This prospective cohort study included 318,085 biobank participants from the UK.Physical activity was assessed using the short form of the International Physical Activity Questionnaire.The participants were stratified into low-,intermediate-,and high-genetic-risk groups based on their polygenic risk scores.Multivariate Cox regression models and multiplicative interaction analyses were used.Results During a median follow-up period of 13 years,9,209 participants were diagnosed with chronic obstructive pulmonary disease.For low genetic risk,compared to low physical activity,the hazard ratios(HRs)for moderate and high physical activity were 0.853(95%confidence interval[CI]:0.748–0.972)and 0.831(95%CI:0.727–0.950),respectively.For intermediate genetic risk,the HRs were 0.829(95%CI:0.758–0.905)and 0.835(95%CI:0.764–0.914),respectively.For participants with high genetic risk,the HRs were 0.809(95%CI:0.746–0.877)and 0.818(95%CI:0.754–0.888),respectively.A significant interaction was observed between genetic risk and physical activity.Conclusion Moderate or high levels of physical activity were associated with a lower risk of developing chronic obstructive pulmonary disease across all genetic risk groups,highlighting the need to tailor activity interventions for genetically susceptible individuals.
基金supported by the National Natural Science Fund of China(81130062).
文摘Objective This study was aimed to explore the prolonged therapeutic profile and underlying mechanisms of Yiqi Zishen Formula(YZF)in chronic obstructive pulmonary disease(COPD)management.Methods A COPD rat model was established through exposure to tobacco smoke and Klebsiella pneumoniae infections from weeks 1 to 8,followed by treatment with YZF from weeks 9 to 20.No treatment was administered from weeks 21 to 31.At week 32,all rats were euthanized,and lung tissue samples and blood specimens were collected for subsequent analyses.Then,comprehensive multiomics profiling—encompassing transcriptomics,proteomics,andmetabolomics—was conducted to identify differentially expressed molecules in lung tissues and elucidate the underlying molecular mechanisms.Results By week 32,sustained therapeutic efficacy became apparent,characterized by diminished inflammatory cytokine expression,mitigation of protease–antiprotease dysregulation,and reduced collagen deposition.These differentially expressed molecules were predominantly enriched in pathways related to oxidoreductase activity,antioxidant homeostasis,focal adhesion,tight junction formation,adherens junction dynamics,and lipid metabolism regulation.Integrative analysis of predicted targets,transcriptomic,proteomic,and metabolomic datasets revealed that differentially expressed molecules in YZF-treated rats and YZF-targeted proteins collectively participated in lipid metabolism,inflammatory responses,oxidative stress,and focal adhesion pathways.Conclusion YZF provides sustained therapeutic benefits in COPD rat models,potentially through systemic regulation of lipid metabolism,inflammatory responses,oxidative stress,and focal adhesion pathways.
基金Supported by National Natural Science Foundation of China(NSFC)of China,No.82360358Internal Medicine Research Project of Gansu Provincial People's Hospital,No.22GSSYD-77Natural Science Foundation of Gansu Province,No.22JR5RA659.
文摘BACKGROUND Chronic obstructive pulmonary disease(COPD)is a progressive respiratory condition often associated with a high incidence of osteoporosis.Studies indicate that patients with COPD present with a significant decrease in bone mineral density(BMD),potentially related to inflammation and corticosteroid use.AIM To investigate the relationship between BMD and lung function,mainly the forced expiratory volume in the forced expiratory volume in 1 second(FEV1)/forced vital capacity percentage(FVC%),in patients with COPD using quantitative computed tomography(QCT).METHODS This prospective cross-sectional study included 85 patients with COPD treated at Gansu Provincial People's Hospital.Exposure variables included lung function parameter(FEV1/FVC%),age,sex,body mass index,smoking status,tea-drinking habits,and physical activity.BMD was measured using QCT.Linear regression and generalized additive models were employed to analyze the relationship between exposure variables and BMD.RESULTS Linear regression analysis revealed a significant positive relationship between BMD and FEV1/FVC%(β=0.1,95%confidence interval[CI]:0.1-0.1;P<0.0001).Non-linear analysis identified a unique BMD breakpoint of 128.08 mg/cm³.Before the breakpoint,BMD was significantly positively correlated with FEV1/FVC%(β=0.245;P=0.0019);while after the breakpoint,the relationship was negative and showed no statistical significance(β=-0.136;P=0.0753).This finding underscores the critical role of BMD in COPD management and highlights the importance of individualized clinical interventions in improvement of lung function and overall health status in patients.CONCLUSION There is a complex non-linear relationship between BMD and lung function in patients with COPD,highlighting the importance of monitoring change in bone density during the management of COPD.
文摘Objective:To review the current status of research on kinesiophobia,assessment tools,influencing factors,and intervention strategies in patients with chronic obstructive pulmonary disease,aiming to provide a reference for promoting pulmonary rehabilitation in these patients.Methods:A scoping review framework was employed to search databases including CNKI,Wanfang,VIP,China Biology Medicine(CBM),PubMed,Web of Science,and Wiley Online Library.The search time frame spanned from the database inception to May 20,2024.Two researchers independently screened the literature,summarized,and analyzed the data.Results:A total of 18 articles were included.Commonly used assessment tools included the Tampa Scale for kinesiophobia and the dyspnea beliefs questionnaire.Influencing factors encompassed demographic,disease-related,psychosocial,and BMI-related factors.Intervention methods included inspiratory muscle training,narrative nursing,and cognitive interventions combined with active cycle of breathing techniques.Conclusion:The incidence of kinesiophobia in COPD patients is relatively high and varies among individuals,influenced by multiple factors.There is a need to develop localized assessment tools to identify kinesiophobia in a timely and accurate manner and to further refine intervention strategies.
基金Hohhot Health Science and Technology Program Project(Project No.:2024-HHWK-041)。
文摘Objective:To explore the rehabilitation effect of pulmonary rehabilitation training in elderly patients with chronic obstructive pulmonary disease(COPD).Methods:Elderly COPD patients hospitalized from June 2024 to December 2024 were selected as subjects for a quasi-experimental study.The study randomly assigned patients into two equal groups of 50 each.One group served as the control and received standard treatment and nursing care,while the other group,the intervention group,was given additional pulmonary rehabilitation exercises alongside the conventional care.The lung function indexes[forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),FEV1/FVC],6-minute walk distance(6MWD),Borg’s Category Scale for perceived exertion(BCSS),COPD Assessment Test(CAT),Barthel Index for activities of daily living,blood oxygen saturation,and Modified Medical Research Council(MMRC)dyspnea scale were compared between the two groups before and after intervention.Results:Following the intervention,the intervention group demonstrated improved lung function compared to the control group(P<0.05).However,no significant difference was observed in the 6-minute walk distance(6MWD)(P>0.05).The intervention group had lower Bronchitis Severity Scale(BCSS)scores(P<0.05)and better quality of life scores(P<0.05)than the control group.No notable differences were found in activities of daily living scores or blood oxygen saturation(P>0.05).Additionally,the intervention group exhibited a lower proportion of residual severe dyspnea(P<0.05).Conclusion:Pulmonary rehabilitation can enhance respiratory function in individuals with COPD,leading to beneficial therapeutic outcomes and ultimately improving their overall quality of life.
文摘BACKGROUND Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is often combined with respiratory failure,which increases the patient's morbidity and mortality.Diaphragm ultrasound(DUS)has developed rapidly in the field of critical care in recent years.Studies with DUS monitoring diaphragm-related rapid shallow breathing index have demonstrated important results in guiding intensive care unit patients out of the ventilator.Early prediction of the indications for withdrawal of non-invasive ventilator and early evaluation of patients to avoid or reduce disease progression are very important.AIM To explore the predictive value of DUS indexes for non-invasive ventilation outcome in patients with AECOPD.METHODS Ninety-four patients with AECOPD who received mechanical ventilation in our hospital from January 2022 to December 2023 were retrospectively analyzed,and they were divided into a successful ventilation group(68 cases)and a failed ventilation group(26 cases)according to the outcome of ventilation.The clinical data of patients with successful and failed noninvasive ventilation were compared,and the independent predictors of noninvasive ventilation outcomes in AECOPD patients were identified by multivariate logistic regression analysis.RESULTS There were no significant differences in gender,age,body mass index,complications,systolic pressure,heart rate,mean arterial pressure,respiratory rate,oxygen saturation,partial pressure of oxygen,oxygenation index,or time of inspiration between patients with successful and failed mechanical ventilation(P>0.05).The patients with successful noninvasive ventilation had shorter hospital stays and lower partial pressure of carbon dioxide(PaCO_(2))than those with failed treatment,while potential of hydrogen(pH),diaphragm thickening fraction(DTF),diaphragm activity,and diaphragm movement time were significantly higher than those with failed treatment(P<0.05).pH[odds ratio(OR)=0.005,P<0.05],PaCO_(2)(OR=0.430,P<0.05),and DTF(OR=0.570,P<0.05)were identified to be independent factors influencing the outcome of mechanical ventilation in AECOPD patients.CONCLUSION The DUS index DTF can better predict the outcome of non-invasive ventilation in AECOPD patients.
基金supported by Research on the Modernisation of Traditional Chinese Medicine in National Key R&D Programmes(No.2018YFC1704804 and 2018YFC1704800)the Sixth Special Support Program for Innovative Leading Talents in Anhui(No.T000614).
文摘Background Chronic obstructive pulmonary disease(COPD),a common respiratory disease,can be effectively treated by traditional Chinese medicine(TCM).Qingfei Huatan,a TCM formula,has been reported to effectively alleviate the clinical symptoms of COPD patients.However,there is a lack of multi-centre,randomised,double-blind,controlled clinical trials documenting the clinical efficacy and safety of this formula in the treatment of acute exacerbation of COPD(AECOPD).Objective This study evaluated the efficacy and safety of Qingfei Huatan formula in the treatment of AECOPD,thereby providing high-quality clinical evidence.Design,setting,participants and interventions A total of 276 patients with AECOPD were included in this multi-centre,randomised,double-blind,placebo-controlled trial and were randomised into treatment and control groups at a ratio of 1:1.Patients in the treatment and control groups took Qingfei Huatan granules or simulated Qingfei Huatan granules twice a day,for 14 days,in addition to Western medicine treatment.All patients were followed up for 3 months.Main outcome measures The primary outcome was time taken to symptom stabilisation.The secondary outcomes included duration of antibiotic use,clinical symptom and sign score,TCM syndrome score,dyspnoea score,and quality of life(QOL)score.Meanwhile,the safety of the formula was assessed through routine urine and stool tests,electrocardiograms,liver and kidney function tests,and the observation of adverse events throughout the trial.Results The time taken for effective stabilisation(P<0.05)and obvious stabilisation(P<0.01),and the duration of antibiotic use(P<0.05)were significantly shorter in the treatment group than in the control group.On days 6,9,12 and 14 of treatment,clinical symptom and sign score decreased in both groups,particularly in the treatment group(P<0.01).On days 9,12 and 14 of treatment,the TCM syndrome scores of both groups were reduced(P<0.01),with more significant reductions in the treatment group.At 3 months after the end of treatment,the treatment group continued to have lower clinical symptom and sign score and TCM syndrome score than the control group(P<0.01).On days 6,9,12 and 14 of treatment,dyspnoea and QOL scores were markedly reduced in the two groups(P<0.05 and P<0.01,respectively),especially in the treatment group.At 3 months after the end of treatment,dyspnoea and QOL scores were lower in the treatment group than those in the control group(P<0.01).No serious adverse events were observed in either group.Conclusion The Qingfei Huatan formula can effectively shorten the duration of AECOPD and antibiotic use,significantly relieve clinical symptoms,and increase QOL for AECOPD patients,with a favourable safety profile.These results suggest that this formula can be used as a complementary treatment for AECOPD patients.
