BACKGROUND:To investigate the eff ects of early standardized enteral nutrition(EN)on the crosssectional area of erector spine muscle(ESMcsa),plasma growth diff erentiation factor-15(GDF-15),and 28-day mortality of acu...BACKGROUND:To investigate the eff ects of early standardized enteral nutrition(EN)on the crosssectional area of erector spine muscle(ESMcsa),plasma growth diff erentiation factor-15(GDF-15),and 28-day mortality of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)patients with invasive mechanical ventilation(MV).METHODS:A total of 97 AECOPD patients with invasive MV were screened in the ICUs of the First People's Hospital of Lianyungang.The conventional EN group(stage Ⅰ)and early standardized EN group(stage Ⅱ)included 46 and 51 patients,respectively.ESMcsa loss and GDF-15 levels on days 1 and 7 of ICU admission and 28-day survival rates were analyzed.RESULTS:On day 7,the ESMcsa of the early standardized EN group was significantly higher than that of the conventional EN group,while the plasma GDF-15 levels were significantly lower than those in the conventional EN group(ESMcsa:28.426±6.130 cm^(2) vs.25.205±6.127 cm^(2);GDF-15:1661.608±558.820 pg/mL vs.2541.000±634.845 pg/mL;all P<0.001).The 28-day survival rates of the patients in the early standardized EN group and conventional EN group were 80.40%and 73.90%,respectively(P=0.406).CONCLUSION:ESMcsa loss in AECOPD patients with MV was correlated with GDF-15 levels,both of which indicated acute muscular atrophy and skeletal muscle dysfunction.Early standardized EN may prevent acute muscle loss and intensive care unit-acquired weakness(ICU-AW)in AECOPD patients.展开更多
BACKGROUND At present,understanding of the most effective ventilation methods for treating chronic obstructive pulmonary disease(COPD)patients experiencing acute worsening symptoms and respiratory failure remains rela...BACKGROUND At present,understanding of the most effective ventilation methods for treating chronic obstructive pulmonary disease(COPD)patients experiencing acute worsening symptoms and respiratory failure remains relatively limited.This report analyzed the efficiency and side effects of various ventilation techniques used for individuals experiencing an acute COPD exacerbation.AIM To determine whether pressure-controlled ventilation(PCV)can lower peak airway pressures(PAPs)and reduce the incidence of barotrauma compared to volume-controlled ventilation(VCV),without compromising clinical outcomes and oxygenation parameters.METHODS We have evaluated 600 patients who were hospitalized due to a severe COPD exacerbation,with 400 receiving mechanical ventilation for the respiratory failure.The participants were divided into two different groups,who were administered either VCV or PCV,along with appropriate management.We thereafter observed patients'attributes,clinical factors,and laboratory,radiographic,and arterial blood gas evaluations at the start and during their stay in the intensive care unit(ICU).We have also employed appropriate statistical methods for the data analysis.RESULTS Both the VCV and PCV groups experienced significant enhancements in the respiratory rate,tidal volume,and arterial blood gas values during their time in the ICU.However,no significant distinctions were detected between the groups in terms of oxygenation indices(partial pressures of oxygen/raction of inspired oxygen ratio)and partial pressures of carbon dioxide improvements.There was no considerable disparity observed between the VCV and PCV groups in the hospital mortality(32%vs 28%,P=0.53),the number of days of ICU stay[median interquartile range(IQR):9(6-14)d vs 8(5-13)d,P=0.41],or the duration of the mechanical ventilation[median(IQR):6(4-10)d vs 5(3-9)d,P=0.47].The PCV group displayed lower PAPs compared to the VCV group(P<0.05)from the beginning of mechanical ventilation until extubation or ICU departure.The occurrence of barotrauma was considerably lower in the PCV group in comparison to the VCV group(6%vs 16%,P=0.03).CONCLUSION Both VCV and PCV were found to be effective in treating patients with acute COPD exacerbation.However,PCV was associated with lower PAPs and a significant decrease in barotrauma,thus indicating that it might be a safer ventilation method for this group of patients.However,further large-scale study is necessary to confirm these findings and to identify the best ventilation approach for patients experiencing an acute COPD exacerbation.展开更多
BACKGROUND In December 2019,the first patient with 2019-novel coronavirus(2019-nCoV)was reported in Wuhan,China,and the disease spread rapidly across the country and surrounding countries within 2 mo.As of February 29...BACKGROUND In December 2019,the first patient with 2019-novel coronavirus(2019-nCoV)was reported in Wuhan,China,and the disease spread rapidly across the country and surrounding countries within 2 mo.As of February 29,2020,a total of 91 confirmed cases had been reported in Gansu Province.This case report of the diagnosis and treatment of an elderly patient with 2019-nCoV pneumonia complicated by acute exacerbation of chronic obstructive pulmonary disease in Gansu Province aims to provide a better reference for the treatment of patients in the future.CASE SUMMARY The patient,a 94-year-old female,lived in Maiji District of Tianshui,Gansu Province,China.On January 30,2020,she was admitted to the Fourth People’s Hospital of Tianshui after 9 d of close contact with a patient with 2019-nCoV pneumonia.She was subsequently admitted to Gansu Provincial Hospital of Traditional Chinese Medicine for isolation and transferred to Tianshui Gansu Provincial Hospital of Infectious Diseases on February 3,2020 for treatment.Upon initial examination,her body temperature was 36.7°C,pulse was 80,breathing was 20,and blood pressure was 130/80 mmHg.She was conscious with normal development and normal nutrition.The pharynx was not red,and bilateral tonsils were not red and swollen.The lungs sounded slightly coarse with no dry or wet rales.The first symptoms were cough and fatigue on 2 February.The patient was hospitalized for 12 d.After active treatment,she was discharged on February 14 with a good prognosis.CONCLUSION A history of exposure to the affected area or patient is a major cause of 2019-nCoV infection,and population clustering is a high risk factor for transmission.Patients may not necessarily have respiratory system symptoms as the only clinical manifestation but may also have concomitant or first onset digestive symptoms.Attention should be paid to the prevention and treatment of multiple organ dysfunction syndrome.Nucleic acid testing is extremely important and needs to be repeated several times.Laboratory and auxiliary examination indicators during the first week of admission are extremely important.It is feasible to carry out dynamic and continuous index monitoring,which can predict and guide the prevention and treatment of multiple organ dysfunction and the prognosis of the disease.展开更多
BACKGROUND Noninvasive ventilation(NIV)reduces intubation rates,mortalities,and lengths of hospital and intensive care unit stays in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).He...BACKGROUND Noninvasive ventilation(NIV)reduces intubation rates,mortalities,and lengths of hospital and intensive care unit stays in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Helmet-based NIV is better tolerated than oronasal mask-based ventilation,and thus,allows NIV to be conducted for prolonged periods at higher pressures with minimal air leaks.CASE SUMMARY A 73-year-old man with a previous diagnosis of COPD stage 4 was admitted to our medical intensive care unit with chief complaints of cough,sputum,and dyspnea of several days’duration.For 10 mo,he had been on oxygen at home by day and had used an oronasal mask-based NIV at night.At intensive care unit admission,he breathed using respiratory accessory muscles.Hypercapnia and signs of infection were detected,and infiltration was observed in the right lower lung field by chest radiography.Thus,we diagnosed AECOPD by communityacquired pneumonia.After admission,respiratory distress steadily deteriorated and invasive mechanical ventilation became necessary.However,the patient refused this option,and thus,we selected helmet-based NIV as a salvage treatment.After 3 d of helmet-based NIV,his consciousness level and hypercapnia recovered to his pre-hospitalization level.CONCLUSION Helmet-based NIV could be considered as a salvage treatment when AECOPD patients refuse invasive mechanical ventilation and oronasal mask-based NIV is ineffective.展开更多
Objective: To observe the effectiveness and safety of ivabradine in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and heart failure. Methods:Patients who were admitted to hospital ...Objective: To observe the effectiveness and safety of ivabradine in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and heart failure. Methods:Patients who were admitted to hospital with AECOPD during the period from August 2017 to July 2018. Then those both had heart failure with reduced ejection fraction(HFrEF) and a resting heart rate>70 beats/min were enrolled. A total of 86 cases were screened and completed, which were randomly divided into two groups for treatment. The control group(41 cases) received standard treatments, such as oxygen, anti-infection, anti-spasmodic, hormone, diuretic, ACEI/ARB, recombinant human brain natriuretic peptide (rhBNP), etc. The bisoprolol was given 2.5~5 mg orally once a day to control heart rate, and the test group(45 cases) was further treated with ivabradine 2.5~5 mg orally twice a day on the basis of the control group. The average heart rate, cardiac function, lung function, and 6-minute walking test were compared between the two groups. Results: After treatment, the average heart rate of the test group was lower than the control group, and the heart rate control rate(<70 beats/min%) of the test group was superior to the control group. The level of N-terminal B-type natriuretic peptide(NT-proBNP) in test group was significantly lower than that in control group. The distance of the 6-minute walking test in e test group was significantly longer than that in control group. Conclusion: Ivabradine combined with bisoprolol could help patients with AECOPD and heart failure to further reduce the heart rates, improve heart function and exercise tolerance. Moreover, the therapeutic safety was acceptable during the short term.展开更多
Objective:The clinical diagnostic accuracy of C-reactive protein(CRP)for bacterial infections in acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is still controversial.This study evaluated its accur...Objective:The clinical diagnostic accuracy of C-reactive protein(CRP)for bacterial infections in acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is still controversial.This study evaluated its accuracy through Meta-analysis.Methods:Studies on the diagnostic value of CRP for bacterial infections in AECOPD were searched form Web of Science,PubMed,Cochrane library,EMBASE,WANFANG DATA,CNKI and China Biology Medicine disc.The included studies were evaluated according to QUADAS-2 assessment tool.Stata 12.0 software was used for meta analyses to summarize the sensitivity and the specificity of the included studies,and the heterogeneity test was conducted.The symmetric receiver operating characteristic curves(SROC)was drawn and the area under the curve(AUC)was calculated,and the funnel plot was drawn to determine publication bias.Results:664 studies were initially identified,20 of which met the inclusion criteria(9 in English and 11 in Chinese).Meta-analysis results showed that the summary sensitivity and specificity of CRP in diagnosing bacterial infections in AECOPD were 0.84,95%CI(0.77-0.90)and 0.76,95%CI(0.67-0.82),respectively.The AUC of SROC was 0.87,95%CI(0.83-0.89).Conclusion:CRP has high accuracy,sensitivity and specificity in distinguishing AECOPD bacterial infections from non-bacterial infection.展开更多
Objective To explore themechanism of Sangbaipi Decoction(SBPD)in the treatment of acute exacer-bation of chronic obstructive pulmonary disease(AECOPD).Methods The active compounds of SBPD and targets of those active c...Objective To explore themechanism of Sangbaipi Decoction(SBPD)in the treatment of acute exacer-bation of chronic obstructive pulmonary disease(AECOPD).Methods The active compounds of SBPD and targets of those active compounds were collectedfrom the TCMSP database.Then we built the AECOPD target database by OMIM,GeneCards,PharmGKB and DrugBank.The intersectional targets arethep-otentialtargets of SBPD in the treatment ofAECOPD.We built"Potential Active Compounds-Drug-AECOPDTargets"Network via Cytoscape software.Weconstruct the Protein-Protein Inter-action(PPI)network through STRING database.We analyze the PPI network and“Potential Active Compounds-Drug-AECOPD Targets”Network via CytoNCA,then we got the core targets and key active compounds of SBPDin the treatment ofAE-COPD.TheGeneOntology(GO)function enrichment and KEGG pathway enrichment on the intersection targets were analyzed by R software.The key active compounds is molecularly docked with the core target protein receptors through AutoDock Vina soft-ware,and the 2D ligand-protein interaction diagramsare drawn through LigPlot 2.2 software.ResultsThere were 109 active compounds,205 targets of SBPD.2837 targetsrelated to AECOPD were picked out.157 intersectional targets were obtained from the two datas.We get 3 coretargets(TP53,JUN,VEGFA)and five key active compounds(quercetin,luteolin,kaempferol,wogonin,arachidonic acid)of SBPD.The GO function enrichment analysis showed that 2552 entries(P<0.05),of which there were 2261 biological processes(BP)items,and 84 related items of cell composition(CC),and 207 molecular function(MF)items.KEGG pathway enrichment analysis showed that 167 signaling path-ways(P<0.05),mainly including IL 17 signaling pathway,TNF signaling pathway,HIF-1 signaling pathway.The molecular dock-ing structure shows that the key active compounds of SBPD have good affinities with the core targets.ConclusionSBPD may treatAECOPD by anti-inflammatory,anti-oxidation,airway mucus secretion reduction,and pulmonary vascular remodeling reduction.展开更多
Objective:To investigate the change and relativity of noninvasive positive pressure ventilation(NIPPV)on the gene expression of ubiquitin system of skeletal muscle in patient with acute exacerbation of chronic obstruc...Objective:To investigate the change and relativity of noninvasive positive pressure ventilation(NIPPV)on the gene expression of ubiquitin system of skeletal muscle in patient with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:80 patients with AECOPD were divided into two groups based on whether the NIPPV treatment was given or not,38 cases in the study group and 42 in the control group.The blood gas analysis and pulmonary function were monitored and recorded before and 14 days after treatment.A skeletal muscle biopsy was performed 14 days after therapy.The mRNA expression of ribosomal protein S21(RPS21)and ubiquitin in skeletal muscle cell were measured by RT-PCR.Results:After 14 days treatment,the levels of PaCO_(2),PaO_(2),PH and FEV_(1)% in the NIPPV group improved much better than in the control group(p<.05).The gene expression of RPS21 and ubiquitin was obviously lower in the study group than in the control group(p<.05).The level of RPS21 was negatively related with PaO_(2),PH and FEV1%,and the level of ubiquitin was negatively related with PaO_(2) and FEV1%,but positively correlated with PaCO_(2).The area under the ROC curves of RPS21,ubiquitin,PaCO_(2) and FEV_(1)% were 0.771,0.885,0.821 and 0.734 respectively in the study group.The cut-off points were 103.978,8.128,45.350 and 51.350 respectively.The sensitivity evaluation of acid poisoning was 90.9%,and the specificities for each were 75%,75%,50% and 50%.Conclusions:NIPPV is effective for AECOPD patients through the gene expression of ubiquitin system of skeletal muscle.展开更多
BACKGROUND: This study aimed to investigate the prevalence rate of critical illness-related corticosteroid insuffi ciency(CIRCI) and the effect of low-dose glucocorticoid on prognosis of CIRCI in patients with acute e...BACKGROUND: This study aimed to investigate the prevalence rate of critical illness-related corticosteroid insuffi ciency(CIRCI) and the effect of low-dose glucocorticoid on prognosis of CIRCI in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).METHODS: Since January 2010 to December 2012, 385 patients, who met the criteria of AECOPD, were enrolled in the Intensive Care Unit(ICU) of the First People's Hospital and Municipal Central Hospital of Xiangtan City. The AECOPD patients complicated with CIRCI screened by an adrenalcorticotrophic hormone test within 12 hours after admission to ICU were divided into a treatment group(n=32) and a control group(n=31) for a prospective, randomized and controlled clinical trial. Hydrocortisone(150 mg/d) or normal saline was injected intravenously for 7 days. The patients were followed up for 28 days after injection. The endpoint included 28-day survival time, non-shock time, ICU stay and the period of non-mechanical ventilation. The markers ofinfl ammation C-reactive protein, tumor necrosis factor-α, interleukin 6 and procalcitonin were measured at baseline and 7 days after treatment. The variables were analyzed by Student's t test, the non-parametric statistical test, the Chi-square test or the Kaplan-Meier method with SPSS18.0 statistic software. A P value <0.05 was considered statistically signifi cant.RESULTS: Totally 63 patients were diagnosed with CIRCI by an adrenalcorticotrophic hormone test and the prevalence rate was 16.4%. The shock rate of the AECOPD patients complicated with CIRCI was higher than that of the AECOPD patients without CIRCI(23.8% vs. 8.7%, P<0.01). KaplanMeier analysis revealed that the 28-day survival time of the treatment group was obviously longer than that of the control group(P<0.05). Compared with the control group, shock-free days within 28 days was longer in the treatment group(18.2±9.5 vs. 25.8±4.1, P<0.05). Treatment with low-dose glucocorticoid obviously decreased the markers ofinfection and inflammation(P<0.01), such as C-reactive protein(13.2±5.5 mg/L vs. 8.3±3.1 mg/L for the control group; 13.5±5.9 mg/L vs. 5.1±2.3 mg/L for the treatment group), tumor necrosis factor-α(26.1±16.2 g/L vs. 17.5±11.7 g/L for the control group; 25.0±14.8 g/L vs. 10.4±7.8 g/L for the treatment group) and procalcitonin(3.88 g/L vs. 2.03 g/L for the control group; 3.77 g/L vs. 1.26 g/L for the treatment group). Furthermore, the markers in the treatment group decreased more obviously than those in the control group(P<0.01).CONCLUSION: The prevalence rate of CIRCI was higher in the patients with AECOPD in the department of critical medicine, and low-dose glucocorticoid treatment for one week reduced the 28-day mortality, shock time and markers ofinfection and infl ammation.展开更多
BACKGROUND Eosinophil counts are a promising guide to systemic steroid administration for chronic obstructive pulmonary disease(COPD).AIM To study the role of peripheral eosinophilia in hospitalized patients with acut...BACKGROUND Eosinophil counts are a promising guide to systemic steroid administration for chronic obstructive pulmonary disease(COPD).AIM To study the role of peripheral eosinophilia in hospitalized patients with acute exacerbation of COPD(AECOPD).METHODS From January 2014 to May 2017,patients with AECOPD hospitalized in Taipei Tzu Chi Hospital were retrospectively stratified into two groups according to their peripheral eosinophil count:The EOS group(eosinophil count≥2%)and the non-EOS group(eosinophil count<2%).Demographics,comorbidities,laboratory data,steroid use,length of hospital stay,and COPD-related readmissions were compared between the groups.RESULTS A total of 625 patients were recruited,with 176 patients(28.2%)in the EOS group.The EOS group showed a lower prevalence of infection,lower cumulative doses of prednisolone equivalents,shorter length of hospital stay,and higher number of COPD-related readmissions than the non-EOS group.There were significantly linear correlations between eosinophil percentage and number of readmissions and between eosinophil percentage and length of hospital stay P<0.001,and a lower percent-predicted value of forced expiratory volume in one second(FEV1)were associated with shorter time to first COPD-related readmission[adjusted hazard ratio(adj.HR)=1.488,P<0.001;adj.HR=0.985,P<0.001,respectively].CONCLUSION The study findings suggest that the EOS group had the features of a shorter length of hospital stay,and lower doses of systemic steroids,but more frequent readmissions.The EOS group and lower percent-predicted FEV1 values were risk factors for shorter time to first COPD-related readmission.展开更多
BACKGROUND Under physiological conditions,sputum produced during acute exacerbation of chronic obstructive pulmonary disease(AECOPD)can move passively with the cilia in the airway;the sputum is gradually excreted from...BACKGROUND Under physiological conditions,sputum produced during acute exacerbation of chronic obstructive pulmonary disease(AECOPD)can move passively with the cilia in the airway;the sputum is gradually excreted from the depth of the airways through the stimulation of the coughing reflex on the sensory nerve on the surface of the airway.However,when the sputum is thick,the cough is weak,or the tracheal cilia are abnormal,sputum accumulation may occur and affect the exchange of oxygen and carbon dioxide in the lung.Furthermore,the presence of pathogenic microorganisms in sputum may cause or aggravate the symptoms of pulmonary infection in patients,which is the main factor leading to AECOPD.Therefore,promoting effective drainage of sputum and maintaining airway opening are key points requiring clinical attention.AIM To explore the effect of refined nursing strategies in patients with AECOPD and dysphagia.METHODS We selected 126 patients with AECOPD and difficulty of expectoration at our hospital,and divided them into a refined care group and a routine care group,with 63 cases each,using a random number table.The two groups of patients were treated with expectorant,anti-infection,oxygen inhalation,and other basic treatment measures;patients in the refined care group were given refined nursing intervention during hospitalization,and the routine care group received conventional nursing intervention.The differences in sputum expectoration,negative pressure suction rate,blood gas parameters,dyspnea score measured through the tool developed by the Medical Research Council(MRC),and quality of life were compared between the two groups.RESULTS After 7 d of intervention,the sputum expectoration effect of the refined care group was 62.30%,the effective rate was 31.15%,and the inefficiency rate was 6.56%.The sputum expectoration effect of the routine care group was 44.07%,the effective rate was 42.37%,and the inefficiency rate was 13.56%.The refined care group had better sputum expectoration than the routine care group(P<0.05).The negative pressure suction rate in the refined care group was significantly lower than that of the routine care group during the treatment(22.95%vs 44.07%,P<0.05).Before the intervention,the arterial oxygen saturation(PaO2)and arterial carbon dioxide saturation(PaCO2)values were not significantly different between the two groups(P>0.05);the PaO2 and PaCO2 values in the refined care group were comparable to those in the routine care group after 7 d of intervention(P>0.05).Before the intervention,there was no significant difference in the MRC score between the two groups(P>0.05);the MRC score of the refined care group was lower than that of the routine care group after 7 d of intervention,but the difference was not statistically significant(P>0.05).Before intervention,there was no significant difference in the symptoms,activities,disease impact,or St.George’s Respiratory questionnaire(SGRQ)total scores between the two groups(P>0.05).After 7 days of intervention,the symptoms,activities,and total score of SGRQ of the refined care group were higher than those of the routine care group,but the difference was not statistically significant(P>0.05).CONCLUSION AECOPD with thick sputum,weak coughing reflex,and abnormal tracheal cilia function will lead to sputum accumulation and affect the exchange of oxygen and carbon dioxide in the lung.Patients with AECOPD who have difficulty expectorating sputum may undergo refined nursing strategies that will promote expectoration,alleviate clinical symptoms,and improve the quality of life.展开更多
Respiratory syncytial virus(RSV)infection is known as a risk factor for chronic obstructive pulmonary disease(COPD).RSV infection induces the upregulation of Toll-like receptor 3(TLR3).This study aimed to investigate ...Respiratory syncytial virus(RSV)infection is known as a risk factor for chronic obstructive pulmonary disease(COPD).RSV infection induces the upregulation of Toll-like receptor 3(TLR3).This study aimed to investigate the association of TLR3 with RSV induced acute exacerbations of chronic obstructive pulmonary disease(AECOPD).Serum/sputum samples from AECOPD patients,stable chronic obstructive pulmonary disease(SCOPD)patients,and healthy controls were collected.Nested PCR was used to detect RSV.The lung function parameters were assessed by blood gas and lung function analysis.The expression levels of inflammatory factors in sputum and serum samples were determined by enzyme-linked immunosorbent assay.BEAS-2B cell lines were infected with RSV,and the expression of TLR3 mRNA was determined by PCR and the levels of inflammatory factors were also investigated.The presence of RSV was detected in 3 SCOPD and 8 AECOPD patients,but not in healthy patients.The expression levels of TNF-αand IRF-3 in both sputum and serum samples of RSV-positive group were significantly higher than in RSV-negative group.TLR3 mRNA levels in RSV-positive group were significantly higher than those in RSVnegative group.Interestingly,the level of TLR3 mRNA expression was negatively correlated with oxygenation index and lung function parameters.Furthermore,BEAS-2B cells infected with RSV led to significant increase of the expression of TLR3 mRNA and inflammatory factors IFN-β,IL-13,IL-32,and TNF-α.Our observations indicate that AECOPD is associated with RSV infection and the upregulation of TLR3.展开更多
OBJECTIVE: To observe the effects of Suhuang Zhike Capsule on pulmonary function, blood gas analysis index, serum PCT and CRP expression in patients with acute exacerbation of chronic obstructive pulmonary disease. ME...OBJECTIVE: To observe the effects of Suhuang Zhike Capsule on pulmonary function, blood gas analysis index, serum PCT and CRP expression in patients with acute exacerbation of chronic obstructive pulmonary disease. METHODS: A total of 88 patients with acute exacerbation of chronic obstructive pulmonary disease admitted to the Department of Respiratory Medicine, Xuancheng People's Hospital of Anhui Province from December 2014 to December 2016 were randomly divided into the observation group and the control group, with 44 cases in each group. The control group was given routine clinical treatment, and the observation group was given Suhuang Zhike Capsule on the basis of the treatment method of the control group. After 7 days' treatment, the improvement of lung function indexes were observed and evaluated before and after treatment(forced expiratory volume in one second(FEV_1), forced expiratory volume occupancy in the 1^(st) second percentage of vital capacity(FEVl/FVC), peak expiatory flow(PEF)), blood gas analysis index(Arterial oxygen partial pressure(PaO_2) and arterial blood carbon dioxide partial pressure(PaCO_2), oxygenation index(OI)) and serum cytokine levels(procalcitonin(PCT) and C reactive protein(CRP). RESULTS: The total effective rate of the observation group was significantly higher than that of the control group(P < 0.05). The FEV_1, FEV_1/FVC and PEF in 2 groups were significantly increased after the treatment(P < 0.05), and the above lung function indexes in the observation group were significantly higher than the control group(P < 0.05). PaO_2 and OI were significantly increased after the treatment(P < 0.05), PaCO_2 was significantly decreased after the treatment(P < 0.05), and the improvement of above blood gas analysis indexes were significantly superior of the observation group than the control group(P < 0.05). The serum PCT and CRP levels in 2 groups were significantly decreased after the treatment(P < 0.05), and the improvement in the observation group were more significant than that in the control group(P < 0.05). CONCLUSION: Suhuang Zhike Capsule can inhibit serum inflammatory cytokine levels in patients with acute exacerbation of chronic obstructive pulmonary disease, improve blood gas analysis indicators, and improve lung functions.展开更多
Chronic obstructive pulmonary disease </span><span style="font-family:""><span style="font-family:Verdana;">(COPD) is a major chronic respiratory disease worldwide. Inflammat...Chronic obstructive pulmonary disease </span><span style="font-family:""><span style="font-family:Verdana;">(COPD) is a major chronic respiratory disease worldwide. Inflammatory cells reflect the </span><span style="font-family:Verdana;">inflammatory situation both in peripheral blood and induced sputum. </span></span><span style="font-family:""><span style="font-family:Verdana;">Their correlation has not been reported. </span><span style="font-family:Verdana;">The correlation between neutrophils (Neu), eosinophils (Eos), and lymphocyte (Lym) in induced sputum and that in peripheral blood of COPD </span><span style="font-family:Verdana;">patients was evaluated </span><span><span style="font-family:Verdana;">to explore the </span><span style="font-family:Verdana;">consistency of inflammatory cells in peripheral blood and induced sputum. Peripheral blood and induced sputum were collected from 437 </span><span style="font-family:Verdana;">patients with acute exacerbation of COPD</span></span><span style="font-family:Verdana;"> (AECOPD) who were hospitalized in the Department of respiratory and critical care medicine, Inner Mongolia People’s Hospital. </span><span style="font-family:Verdana;">The correlation analysis was performed by Spearman correlation analysis. </span><span style="font-family:Verdana;">The r</span><span style="font-family:Verdana;">atios of Neu, Eos, and Lym in induced sputum were (79.15 ± 22.60)%, (5.23 ± 12.74)%, and (1.69 ± 2.66)%. The ratios of </span><span style="font-family:Verdana;">Neu, Eos, and Lym in </span><span style="font-family:Verdana;">peripheral blood were (63.29 ± 11.44)%, (2.99 ± 3.60)%, and (25.16 ± 10.19)%. The results showed that the ratios of Neu and Eos in induced sputum were significantly correlated with the proportion of </span><span style="font-family:Verdana;">corresponding cells in peripheral blood (P < 0.05). </span><span style="font-family:Verdana;">There was no correlation between the ratio of Lym and Leu in induced sputum and corresponding cells in </span><span style="font-family:Verdana;">peripheral blood (P > 0.05). In patients with AECOPD, the tendency of Neu and Eos in induced sputum was </span><span style="font-family:Verdana;">consistent with the corresponding cells in peripheral blood. Neu and Eos in </span><span style="font-family:Verdana;">induced sputum and peripheral blood reflected the degree of inflammation to guide the individualized medication of patients.展开更多
Background:Although intensively studied in patients with cardiovascular diseases(CVDs),the prognostic value of diastolic blood pressure(DBP)has little been elucidated in patients with acute exacerbation of chronic obs...Background:Although intensively studied in patients with cardiovascular diseases(CVDs),the prognostic value of diastolic blood pressure(DBP)has little been elucidated in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).This study aimed to reveal the prognostic value of DBP in AECOPD patients.Methods:Inpatients with AECOPD were prospectively enrolled from 10 medical centers in China between September 2017 and July 2021.DBP was measured on admission.The primary outcome was all-cause in-hospital mortality;invasive mechanical ventilation and intensive care unit(ICU)admission were secondary outcomes.Least absolute shrinkage and selection operator(LASSO)and multivariable Cox regressions were used to identify independent prognostic factors and calculate the hazard ratio(HR)and 95%confidence interval(CI)for adverse outcomes.Results:Among 13,633 included patients with AECOPD,197(1.45%)died during their hospital stay.Multivariable Cox regression analysis showed that low DBP on admission(<70 mmHg)was associated with increased risk of in-hospital mortality(HR=2.16,95%CI:1.53–3.05,Z=4.37,P<0.01),invasive mechanical ventilation(HR=1.65,95%CI:1.32–2.05,Z=19.67,P<0.01),and ICU admission(HR=1.45,95%CI:1.24–1.69,Z=22.08,P<0.01)in the overall cohort.Similar findings were observed in subgroups with or without CVDs,except for invasive mechanical ventilation in the subgroup with CVDs.When DBP was further categorized in 5-mmHg increments from<50 mmHg to≥100 mmHg,and 75 to<80 mmHg was taken as reference,HRs for in-hospital mortality increased almost linearly with decreased DBP in the overall cohort and subgroups of patients with CVDs;higher DBP was not associated with the risk of in-hospital mortality.Conclusion:Low on-admission DBP,particularly<70 mmHg,was associated with an increased risk of adverse outcomes among inpatients with AECOPD,with or without CVDs,which may serve as a convenient predictor of poor prognosis in these patients.Clinical Trial Registration:Chinese Clinical Trail Registry,No.ChiCTR2100044625.展开更多
OBJECTIVE:To evaluate the efficacy and safety of Suhuang Zhike capsule(苏黄止咳胶囊) in the adjuvant treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).METHODS:The database including PubM...OBJECTIVE:To evaluate the efficacy and safety of Suhuang Zhike capsule(苏黄止咳胶囊) in the adjuvant treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).METHODS:The database including PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure Database,China Science and Technology Journal Database,Chinese Biomedical Literature Database and Wanfang Data was searched.The retrieval time was from database establishment to May 2021.Randomized controlled trial(RCT) of Suhuang zhike capsule adjuvant treatment for AECOPD was included.The quality of the studies was independently evaluated and cross-checked by two reviewers,and Meta-analysis was performed by using RevMan5.3 software.RESULTS:Thirteen RCT results were included with a total sample number of 1195 cases,including 597 in the experimental group and 598 in the control group.The results showed that Suhuang zhike capsule adjuvant treatment of AECOPD could improve the total clinical effect rate compared with conventional treatment.Suhuang zhike capsule adjuvant treatment could improve forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC,peak expiratory flow(PEF) and other pulmonary function indexes;decrease Creactive protein(CRP),white blood cells,neutrophils and other infectious indicators;besides,the 1-year recurrence rate of the disease was decreased(all P < 0.05).CONCLUSIONS:Suhuang Zhike capsule can improve the lung function and clinical efficacy of AECOPD,thus increasing the exercise endurance,and reducing the infection and recurrence rate in AECOPD patients.展开更多
OBJECTIVE:To systematically evaluate the efficacy and safety of Chinese herbal medicine(CHM) combined with conventional Western Medicine(CWM) on acute exacerbation of chronic obstructive pulmonary disease(AECOPD) base...OBJECTIVE:To systematically evaluate the efficacy and safety of Chinese herbal medicine(CHM) combined with conventional Western Medicine(CWM) on acute exacerbation of chronic obstructive pulmonary disease(AECOPD) based on high-quality randomized placebocontrolled trials.METHODS:We searched PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure Database,Chinese Biomedical Literature Database,China Science and Technology Journal Database,and Wanfang databases for randomized placebo-controlled trials of CHM treatment for AECOPD from inception to June 4,2021.The Cochrane Collaboration’s tool and the Grading of Recommendations,Assessment,Development and Evaluation were used to assess the risk of bias and the evidence quality of the included studies.Revman 5.3 software was used for Meta-analysis.RESULTS:A total of 9 trials involving 1591 patients were included.The Meta-analysis showed that based on CWM treatment,CHM group had significant advantages over the placebo group in ameliorating clinical total effective rate [RR = 1.29,95% CI(1.07,1.56),P = 0.007,low quality] and TCM symptom scores [MD =-2.99,95% CI(-4.46,-1.53),P < 0.0001,moderate quality],improving arterial blood gas results [PaO_(2):MD = 4.51,95% CI(1.97,7.04),P = 0.0005,moderate quality;PaCO_(2):MD =-2.87,95% CI(-4.28,-1.46),P < 0.0001,moderate quality],reducing CAT scores [MD =-2.08,95% CI(-2.85,-1.31),P < 0.000 01,moderate quality],length of hospitalization [MD =-1.87,95% CI(-3.33,-0.42),P = 0.01,moderate quality],and acute exacerbation rate [RR = 0.60,95% CI(0.43,0.83),P = 0.002,moderate quality].No serious CHM-related adverse events were reported.CONCLUSIONS:The current evidence indicates that CHM is an effective and well-tolerated adjunct therapy for AECOPD patients receiving CWM.However,considering the high heterogeneity,this conclusion requires confirmation.展开更多
Objective:Previous research has demonstrated that pulmonary Daoyin could be an efficacious way to ameliorate the physical and psychological state of sufferers with chronic obstructive pulmonary disease(COPD)and bolste...Objective:Previous research has demonstrated that pulmonary Daoyin could be an efficacious way to ameliorate the physical and psychological state of sufferers with chronic obstructive pulmonary disease(COPD)and bolster the quality of life.However,the results are not consistent.Thus,the objective of this research is to assess the impacts of pulmonary Daoyin in individuals with COPD.Methods:Relevant articles were searched in Web of Science,Cochrane Library,PubMed,EMBASE,SinoMed,CNKI,Wanfang,and VIP from database inception to January 2024.Results:There were a total of 15 randomized controlled trials(RCTs)included in this meta-analysis involving 1732 patients,of which 864 participated in the intervention group and 868 in the control group.When comparing with the control group,the COPD patients practicing pulmonary Daoyin demonstrated a significant improvement in 6 min walking distance(mean difference[MD]=24.53,95%confidence interval[CI][18.55,30.52],P<0.00001),forced expiratory volume in the 1 s(FEV_(1))(MD=0.39,95%CI[0.18,0.59],P=0.0002),percentage of FEV_(1)to the predicted value(FEV_(1)%)(MD=5.35,95%CI[3.22,7.48],P<0.0001),the forced vital capacity(FVC)(MD=0.39,95%CI[0.06,0.73],P=0.02),percentage of FVC to the predicted value(FVC%)(MD=7.52,95%CI[4.91,10.13],P<0.00001),the ratio of FEV_(1)/FVC(MD=4.95,95%CI[0.91,8.99],P=0.02),peak expiratory flow rate(standardized MD=0.98,95%CI[0.74,1.22],P<0.00001),modified Medical Research Council(mMRC)scale(MD=-0.47,95%CI[-0.89,-0.04],P=0.03),and Borg scale(MD=-0.65,95%CI[-0.75,-0.55],P<0.00001).Conclusions:Our findings may illuminate the influence of pulmonary Daoyin on exercise ability,breathlessness,and pulmonary function in COPD patients.More rigorous RCTs with larger samples and longer-term interventions will be required moving forward.展开更多
BACKGROUND Most patients with acute exacerbation chronic obstructive pulmonary disease(AECOPD)have respiratory failure that necessitates active correction and the improvement of oxygenation is particularly important d...BACKGROUND Most patients with acute exacerbation chronic obstructive pulmonary disease(AECOPD)have respiratory failure that necessitates active correction and the improvement of oxygenation is particularly important during treatment.High flow nasal cannula(HFNC)oxygen therapy is a non-invasive respiratory aid that is widely used in the clinic that improves oxygenation state,reduces dead space ventilation and breathing effort,protects the loss of cilia in the airways,and improves patient comfort.AIM To compare HFNC and non-invasive positive pressure ventilation in the treatment of patients with AECOPD.METHODS Eighty AECOPD patients were included in the study.The patients were in the intensive care department of our hospital from October 2019 to October 2021.The patients were divided into the control and treatment groups according to the different treatment methods with 40 patients in each group.Differences in patient comfort,blood gas analysis and infection indices were analyzed between the two groups.RESULTS After treatment,symptoms including nasal,throat and chest discomfort were significantly lower in the treatment group compared to the control group on the 3rd and 5th days(P<0.05).Before treatment,the PaO_(2),PaO_(2)/FiO_(2),PaCO_(2),and SaO_(2)in the two groups of patients were not significantly different(P>0.05).After treatment,the same indicators were significantly improved in both patient groups but had improved more in the treatment group compared to the control group(P<0.05).After treatment,the white blood cell count,and the levels of C-reactive protein and calcitonin in patients in the treatment group were significantly higher compared to patients in the control group(P<0.05).CONCLUSION HFNC treatment can improve the ventilation of AECOPD patients whilst also improving patient comfort,and reducing complications.HFNC is a clinically valuable technique for the treatment of AECOPD.展开更多
Chronic Obstructive Pulmonary Disease(COPD)is characterized by persistent respiratory symptoms and airflow limitation.Acute exacerbation of COPD(AECOPD)is an acute worsening of respiratory symptoms,which needs additio...Chronic Obstructive Pulmonary Disease(COPD)is characterized by persistent respiratory symptoms and airflow limitation.Acute exacerbation of COPD(AECOPD)is an acute worsening of respiratory symptoms,which needs additional treatment and can result in worsening health status,increasing risks of hospitalization and mortal-ity.Therefore,it is necessary to early recognize and diagnose exacerbations of COPD.This review introduces the updated definition of COPD exacerbations,the current clinical assessment tools,and the current potential biomarkers.The application of mobile health care in COPD management for early identification and diagnosis is also included in this review.展开更多
基金funded by the Social Development Project of Jiangsu Provincial Department of Science and Technology(BE2020670)the Social Development Project of Lianyungang Science and Technology(SF2117).
文摘BACKGROUND:To investigate the eff ects of early standardized enteral nutrition(EN)on the crosssectional area of erector spine muscle(ESMcsa),plasma growth diff erentiation factor-15(GDF-15),and 28-day mortality of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)patients with invasive mechanical ventilation(MV).METHODS:A total of 97 AECOPD patients with invasive MV were screened in the ICUs of the First People's Hospital of Lianyungang.The conventional EN group(stage Ⅰ)and early standardized EN group(stage Ⅱ)included 46 and 51 patients,respectively.ESMcsa loss and GDF-15 levels on days 1 and 7 of ICU admission and 28-day survival rates were analyzed.RESULTS:On day 7,the ESMcsa of the early standardized EN group was significantly higher than that of the conventional EN group,while the plasma GDF-15 levels were significantly lower than those in the conventional EN group(ESMcsa:28.426±6.130 cm^(2) vs.25.205±6.127 cm^(2);GDF-15:1661.608±558.820 pg/mL vs.2541.000±634.845 pg/mL;all P<0.001).The 28-day survival rates of the patients in the early standardized EN group and conventional EN group were 80.40%and 73.90%,respectively(P=0.406).CONCLUSION:ESMcsa loss in AECOPD patients with MV was correlated with GDF-15 levels,both of which indicated acute muscular atrophy and skeletal muscle dysfunction.Early standardized EN may prevent acute muscle loss and intensive care unit-acquired weakness(ICU-AW)in AECOPD patients.
文摘BACKGROUND At present,understanding of the most effective ventilation methods for treating chronic obstructive pulmonary disease(COPD)patients experiencing acute worsening symptoms and respiratory failure remains relatively limited.This report analyzed the efficiency and side effects of various ventilation techniques used for individuals experiencing an acute COPD exacerbation.AIM To determine whether pressure-controlled ventilation(PCV)can lower peak airway pressures(PAPs)and reduce the incidence of barotrauma compared to volume-controlled ventilation(VCV),without compromising clinical outcomes and oxygenation parameters.METHODS We have evaluated 600 patients who were hospitalized due to a severe COPD exacerbation,with 400 receiving mechanical ventilation for the respiratory failure.The participants were divided into two different groups,who were administered either VCV or PCV,along with appropriate management.We thereafter observed patients'attributes,clinical factors,and laboratory,radiographic,and arterial blood gas evaluations at the start and during their stay in the intensive care unit(ICU).We have also employed appropriate statistical methods for the data analysis.RESULTS Both the VCV and PCV groups experienced significant enhancements in the respiratory rate,tidal volume,and arterial blood gas values during their time in the ICU.However,no significant distinctions were detected between the groups in terms of oxygenation indices(partial pressures of oxygen/raction of inspired oxygen ratio)and partial pressures of carbon dioxide improvements.There was no considerable disparity observed between the VCV and PCV groups in the hospital mortality(32%vs 28%,P=0.53),the number of days of ICU stay[median interquartile range(IQR):9(6-14)d vs 8(5-13)d,P=0.41],or the duration of the mechanical ventilation[median(IQR):6(4-10)d vs 5(3-9)d,P=0.47].The PCV group displayed lower PAPs compared to the VCV group(P<0.05)from the beginning of mechanical ventilation until extubation or ICU departure.The occurrence of barotrauma was considerably lower in the PCV group in comparison to the VCV group(6%vs 16%,P=0.03).CONCLUSION Both VCV and PCV were found to be effective in treating patients with acute COPD exacerbation.However,PCV was associated with lower PAPs and a significant decrease in barotrauma,thus indicating that it might be a safer ventilation method for this group of patients.However,further large-scale study is necessary to confirm these findings and to identify the best ventilation approach for patients experiencing an acute COPD exacerbation.
文摘BACKGROUND In December 2019,the first patient with 2019-novel coronavirus(2019-nCoV)was reported in Wuhan,China,and the disease spread rapidly across the country and surrounding countries within 2 mo.As of February 29,2020,a total of 91 confirmed cases had been reported in Gansu Province.This case report of the diagnosis and treatment of an elderly patient with 2019-nCoV pneumonia complicated by acute exacerbation of chronic obstructive pulmonary disease in Gansu Province aims to provide a better reference for the treatment of patients in the future.CASE SUMMARY The patient,a 94-year-old female,lived in Maiji District of Tianshui,Gansu Province,China.On January 30,2020,she was admitted to the Fourth People’s Hospital of Tianshui after 9 d of close contact with a patient with 2019-nCoV pneumonia.She was subsequently admitted to Gansu Provincial Hospital of Traditional Chinese Medicine for isolation and transferred to Tianshui Gansu Provincial Hospital of Infectious Diseases on February 3,2020 for treatment.Upon initial examination,her body temperature was 36.7°C,pulse was 80,breathing was 20,and blood pressure was 130/80 mmHg.She was conscious with normal development and normal nutrition.The pharynx was not red,and bilateral tonsils were not red and swollen.The lungs sounded slightly coarse with no dry or wet rales.The first symptoms were cough and fatigue on 2 February.The patient was hospitalized for 12 d.After active treatment,she was discharged on February 14 with a good prognosis.CONCLUSION A history of exposure to the affected area or patient is a major cause of 2019-nCoV infection,and population clustering is a high risk factor for transmission.Patients may not necessarily have respiratory system symptoms as the only clinical manifestation but may also have concomitant or first onset digestive symptoms.Attention should be paid to the prevention and treatment of multiple organ dysfunction syndrome.Nucleic acid testing is extremely important and needs to be repeated several times.Laboratory and auxiliary examination indicators during the first week of admission are extremely important.It is feasible to carry out dynamic and continuous index monitoring,which can predict and guide the prevention and treatment of multiple organ dysfunction and the prognosis of the disease.
文摘BACKGROUND Noninvasive ventilation(NIV)reduces intubation rates,mortalities,and lengths of hospital and intensive care unit stays in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Helmet-based NIV is better tolerated than oronasal mask-based ventilation,and thus,allows NIV to be conducted for prolonged periods at higher pressures with minimal air leaks.CASE SUMMARY A 73-year-old man with a previous diagnosis of COPD stage 4 was admitted to our medical intensive care unit with chief complaints of cough,sputum,and dyspnea of several days’duration.For 10 mo,he had been on oxygen at home by day and had used an oronasal mask-based NIV at night.At intensive care unit admission,he breathed using respiratory accessory muscles.Hypercapnia and signs of infection were detected,and infiltration was observed in the right lower lung field by chest radiography.Thus,we diagnosed AECOPD by communityacquired pneumonia.After admission,respiratory distress steadily deteriorated and invasive mechanical ventilation became necessary.However,the patient refused this option,and thus,we selected helmet-based NIV as a salvage treatment.After 3 d of helmet-based NIV,his consciousness level and hypercapnia recovered to his pre-hospitalization level.CONCLUSION Helmet-based NIV could be considered as a salvage treatment when AECOPD patients refuse invasive mechanical ventilation and oronasal mask-based NIV is ineffective.
文摘Objective: To observe the effectiveness and safety of ivabradine in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and heart failure. Methods:Patients who were admitted to hospital with AECOPD during the period from August 2017 to July 2018. Then those both had heart failure with reduced ejection fraction(HFrEF) and a resting heart rate>70 beats/min were enrolled. A total of 86 cases were screened and completed, which were randomly divided into two groups for treatment. The control group(41 cases) received standard treatments, such as oxygen, anti-infection, anti-spasmodic, hormone, diuretic, ACEI/ARB, recombinant human brain natriuretic peptide (rhBNP), etc. The bisoprolol was given 2.5~5 mg orally once a day to control heart rate, and the test group(45 cases) was further treated with ivabradine 2.5~5 mg orally twice a day on the basis of the control group. The average heart rate, cardiac function, lung function, and 6-minute walking test were compared between the two groups. Results: After treatment, the average heart rate of the test group was lower than the control group, and the heart rate control rate(<70 beats/min%) of the test group was superior to the control group. The level of N-terminal B-type natriuretic peptide(NT-proBNP) in test group was significantly lower than that in control group. The distance of the 6-minute walking test in e test group was significantly longer than that in control group. Conclusion: Ivabradine combined with bisoprolol could help patients with AECOPD and heart failure to further reduce the heart rates, improve heart function and exercise tolerance. Moreover, the therapeutic safety was acceptable during the short term.
文摘Objective:The clinical diagnostic accuracy of C-reactive protein(CRP)for bacterial infections in acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is still controversial.This study evaluated its accuracy through Meta-analysis.Methods:Studies on the diagnostic value of CRP for bacterial infections in AECOPD were searched form Web of Science,PubMed,Cochrane library,EMBASE,WANFANG DATA,CNKI and China Biology Medicine disc.The included studies were evaluated according to QUADAS-2 assessment tool.Stata 12.0 software was used for meta analyses to summarize the sensitivity and the specificity of the included studies,and the heterogeneity test was conducted.The symmetric receiver operating characteristic curves(SROC)was drawn and the area under the curve(AUC)was calculated,and the funnel plot was drawn to determine publication bias.Results:664 studies were initially identified,20 of which met the inclusion criteria(9 in English and 11 in Chinese).Meta-analysis results showed that the summary sensitivity and specificity of CRP in diagnosing bacterial infections in AECOPD were 0.84,95%CI(0.77-0.90)and 0.76,95%CI(0.67-0.82),respectively.The AUC of SROC was 0.87,95%CI(0.83-0.89).Conclusion:CRP has high accuracy,sensitivity and specificity in distinguishing AECOPD bacterial infections from non-bacterial infection.
文摘Objective To explore themechanism of Sangbaipi Decoction(SBPD)in the treatment of acute exacer-bation of chronic obstructive pulmonary disease(AECOPD).Methods The active compounds of SBPD and targets of those active compounds were collectedfrom the TCMSP database.Then we built the AECOPD target database by OMIM,GeneCards,PharmGKB and DrugBank.The intersectional targets arethep-otentialtargets of SBPD in the treatment ofAECOPD.We built"Potential Active Compounds-Drug-AECOPDTargets"Network via Cytoscape software.Weconstruct the Protein-Protein Inter-action(PPI)network through STRING database.We analyze the PPI network and“Potential Active Compounds-Drug-AECOPD Targets”Network via CytoNCA,then we got the core targets and key active compounds of SBPDin the treatment ofAE-COPD.TheGeneOntology(GO)function enrichment and KEGG pathway enrichment on the intersection targets were analyzed by R software.The key active compounds is molecularly docked with the core target protein receptors through AutoDock Vina soft-ware,and the 2D ligand-protein interaction diagramsare drawn through LigPlot 2.2 software.ResultsThere were 109 active compounds,205 targets of SBPD.2837 targetsrelated to AECOPD were picked out.157 intersectional targets were obtained from the two datas.We get 3 coretargets(TP53,JUN,VEGFA)and five key active compounds(quercetin,luteolin,kaempferol,wogonin,arachidonic acid)of SBPD.The GO function enrichment analysis showed that 2552 entries(P<0.05),of which there were 2261 biological processes(BP)items,and 84 related items of cell composition(CC),and 207 molecular function(MF)items.KEGG pathway enrichment analysis showed that 167 signaling path-ways(P<0.05),mainly including IL 17 signaling pathway,TNF signaling pathway,HIF-1 signaling pathway.The molecular dock-ing structure shows that the key active compounds of SBPD have good affinities with the core targets.ConclusionSBPD may treatAECOPD by anti-inflammatory,anti-oxidation,airway mucus secretion reduction,and pulmonary vascular remodeling reduction.
文摘Objective:To investigate the change and relativity of noninvasive positive pressure ventilation(NIPPV)on the gene expression of ubiquitin system of skeletal muscle in patient with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:80 patients with AECOPD were divided into two groups based on whether the NIPPV treatment was given or not,38 cases in the study group and 42 in the control group.The blood gas analysis and pulmonary function were monitored and recorded before and 14 days after treatment.A skeletal muscle biopsy was performed 14 days after therapy.The mRNA expression of ribosomal protein S21(RPS21)and ubiquitin in skeletal muscle cell were measured by RT-PCR.Results:After 14 days treatment,the levels of PaCO_(2),PaO_(2),PH and FEV_(1)% in the NIPPV group improved much better than in the control group(p<.05).The gene expression of RPS21 and ubiquitin was obviously lower in the study group than in the control group(p<.05).The level of RPS21 was negatively related with PaO_(2),PH and FEV1%,and the level of ubiquitin was negatively related with PaO_(2) and FEV1%,but positively correlated with PaCO_(2).The area under the ROC curves of RPS21,ubiquitin,PaCO_(2) and FEV_(1)% were 0.771,0.885,0.821 and 0.734 respectively in the study group.The cut-off points were 103.978,8.128,45.350 and 51.350 respectively.The sensitivity evaluation of acid poisoning was 90.9%,and the specificities for each were 75%,75%,50% and 50%.Conclusions:NIPPV is effective for AECOPD patients through the gene expression of ubiquitin system of skeletal muscle.
文摘BACKGROUND: This study aimed to investigate the prevalence rate of critical illness-related corticosteroid insuffi ciency(CIRCI) and the effect of low-dose glucocorticoid on prognosis of CIRCI in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).METHODS: Since January 2010 to December 2012, 385 patients, who met the criteria of AECOPD, were enrolled in the Intensive Care Unit(ICU) of the First People's Hospital and Municipal Central Hospital of Xiangtan City. The AECOPD patients complicated with CIRCI screened by an adrenalcorticotrophic hormone test within 12 hours after admission to ICU were divided into a treatment group(n=32) and a control group(n=31) for a prospective, randomized and controlled clinical trial. Hydrocortisone(150 mg/d) or normal saline was injected intravenously for 7 days. The patients were followed up for 28 days after injection. The endpoint included 28-day survival time, non-shock time, ICU stay and the period of non-mechanical ventilation. The markers ofinfl ammation C-reactive protein, tumor necrosis factor-α, interleukin 6 and procalcitonin were measured at baseline and 7 days after treatment. The variables were analyzed by Student's t test, the non-parametric statistical test, the Chi-square test or the Kaplan-Meier method with SPSS18.0 statistic software. A P value <0.05 was considered statistically signifi cant.RESULTS: Totally 63 patients were diagnosed with CIRCI by an adrenalcorticotrophic hormone test and the prevalence rate was 16.4%. The shock rate of the AECOPD patients complicated with CIRCI was higher than that of the AECOPD patients without CIRCI(23.8% vs. 8.7%, P<0.01). KaplanMeier analysis revealed that the 28-day survival time of the treatment group was obviously longer than that of the control group(P<0.05). Compared with the control group, shock-free days within 28 days was longer in the treatment group(18.2±9.5 vs. 25.8±4.1, P<0.05). Treatment with low-dose glucocorticoid obviously decreased the markers ofinfection and inflammation(P<0.01), such as C-reactive protein(13.2±5.5 mg/L vs. 8.3±3.1 mg/L for the control group; 13.5±5.9 mg/L vs. 5.1±2.3 mg/L for the treatment group), tumor necrosis factor-α(26.1±16.2 g/L vs. 17.5±11.7 g/L for the control group; 25.0±14.8 g/L vs. 10.4±7.8 g/L for the treatment group) and procalcitonin(3.88 g/L vs. 2.03 g/L for the control group; 3.77 g/L vs. 1.26 g/L for the treatment group). Furthermore, the markers in the treatment group decreased more obviously than those in the control group(P<0.01).CONCLUSION: The prevalence rate of CIRCI was higher in the patients with AECOPD in the department of critical medicine, and low-dose glucocorticoid treatment for one week reduced the 28-day mortality, shock time and markers ofinfection and infl ammation.
基金Supported by Taipei Tzu Chi Hospital,No.TCRD-TPE-108-RT-4 and No.TCRD-TPE-108-4.
文摘BACKGROUND Eosinophil counts are a promising guide to systemic steroid administration for chronic obstructive pulmonary disease(COPD).AIM To study the role of peripheral eosinophilia in hospitalized patients with acute exacerbation of COPD(AECOPD).METHODS From January 2014 to May 2017,patients with AECOPD hospitalized in Taipei Tzu Chi Hospital were retrospectively stratified into two groups according to their peripheral eosinophil count:The EOS group(eosinophil count≥2%)and the non-EOS group(eosinophil count<2%).Demographics,comorbidities,laboratory data,steroid use,length of hospital stay,and COPD-related readmissions were compared between the groups.RESULTS A total of 625 patients were recruited,with 176 patients(28.2%)in the EOS group.The EOS group showed a lower prevalence of infection,lower cumulative doses of prednisolone equivalents,shorter length of hospital stay,and higher number of COPD-related readmissions than the non-EOS group.There were significantly linear correlations between eosinophil percentage and number of readmissions and between eosinophil percentage and length of hospital stay P<0.001,and a lower percent-predicted value of forced expiratory volume in one second(FEV1)were associated with shorter time to first COPD-related readmission[adjusted hazard ratio(adj.HR)=1.488,P<0.001;adj.HR=0.985,P<0.001,respectively].CONCLUSION The study findings suggest that the EOS group had the features of a shorter length of hospital stay,and lower doses of systemic steroids,but more frequent readmissions.The EOS group and lower percent-predicted FEV1 values were risk factors for shorter time to first COPD-related readmission.
文摘BACKGROUND Under physiological conditions,sputum produced during acute exacerbation of chronic obstructive pulmonary disease(AECOPD)can move passively with the cilia in the airway;the sputum is gradually excreted from the depth of the airways through the stimulation of the coughing reflex on the sensory nerve on the surface of the airway.However,when the sputum is thick,the cough is weak,or the tracheal cilia are abnormal,sputum accumulation may occur and affect the exchange of oxygen and carbon dioxide in the lung.Furthermore,the presence of pathogenic microorganisms in sputum may cause or aggravate the symptoms of pulmonary infection in patients,which is the main factor leading to AECOPD.Therefore,promoting effective drainage of sputum and maintaining airway opening are key points requiring clinical attention.AIM To explore the effect of refined nursing strategies in patients with AECOPD and dysphagia.METHODS We selected 126 patients with AECOPD and difficulty of expectoration at our hospital,and divided them into a refined care group and a routine care group,with 63 cases each,using a random number table.The two groups of patients were treated with expectorant,anti-infection,oxygen inhalation,and other basic treatment measures;patients in the refined care group were given refined nursing intervention during hospitalization,and the routine care group received conventional nursing intervention.The differences in sputum expectoration,negative pressure suction rate,blood gas parameters,dyspnea score measured through the tool developed by the Medical Research Council(MRC),and quality of life were compared between the two groups.RESULTS After 7 d of intervention,the sputum expectoration effect of the refined care group was 62.30%,the effective rate was 31.15%,and the inefficiency rate was 6.56%.The sputum expectoration effect of the routine care group was 44.07%,the effective rate was 42.37%,and the inefficiency rate was 13.56%.The refined care group had better sputum expectoration than the routine care group(P<0.05).The negative pressure suction rate in the refined care group was significantly lower than that of the routine care group during the treatment(22.95%vs 44.07%,P<0.05).Before the intervention,the arterial oxygen saturation(PaO2)and arterial carbon dioxide saturation(PaCO2)values were not significantly different between the two groups(P>0.05);the PaO2 and PaCO2 values in the refined care group were comparable to those in the routine care group after 7 d of intervention(P>0.05).Before the intervention,there was no significant difference in the MRC score between the two groups(P>0.05);the MRC score of the refined care group was lower than that of the routine care group after 7 d of intervention,but the difference was not statistically significant(P>0.05).Before intervention,there was no significant difference in the symptoms,activities,disease impact,or St.George’s Respiratory questionnaire(SGRQ)total scores between the two groups(P>0.05).After 7 days of intervention,the symptoms,activities,and total score of SGRQ of the refined care group were higher than those of the routine care group,but the difference was not statistically significant(P>0.05).CONCLUSION AECOPD with thick sputum,weak coughing reflex,and abnormal tracheal cilia function will lead to sputum accumulation and affect the exchange of oxygen and carbon dioxide in the lung.Patients with AECOPD who have difficulty expectorating sputum may undergo refined nursing strategies that will promote expectoration,alleviate clinical symptoms,and improve the quality of life.
基金supported by Natural Science Foundation of China(No.82060010)Guizhou Provincial Natural Science Foundation Project([2018]5623)+2 种基金Guizhou Provincial Respiratory Critical Disease Clinical Research and Prevention and Treatment Talent Base Project([2020]8)Zunyi Respiratory Medicine Talent Base Project([2019]69)Science and Technology Bureau Project of Zunyi City(Zunshi Kehe HZ[2020]3 and[2020]292).
文摘Respiratory syncytial virus(RSV)infection is known as a risk factor for chronic obstructive pulmonary disease(COPD).RSV infection induces the upregulation of Toll-like receptor 3(TLR3).This study aimed to investigate the association of TLR3 with RSV induced acute exacerbations of chronic obstructive pulmonary disease(AECOPD).Serum/sputum samples from AECOPD patients,stable chronic obstructive pulmonary disease(SCOPD)patients,and healthy controls were collected.Nested PCR was used to detect RSV.The lung function parameters were assessed by blood gas and lung function analysis.The expression levels of inflammatory factors in sputum and serum samples were determined by enzyme-linked immunosorbent assay.BEAS-2B cell lines were infected with RSV,and the expression of TLR3 mRNA was determined by PCR and the levels of inflammatory factors were also investigated.The presence of RSV was detected in 3 SCOPD and 8 AECOPD patients,but not in healthy patients.The expression levels of TNF-αand IRF-3 in both sputum and serum samples of RSV-positive group were significantly higher than in RSV-negative group.TLR3 mRNA levels in RSV-positive group were significantly higher than those in RSVnegative group.Interestingly,the level of TLR3 mRNA expression was negatively correlated with oxygenation index and lung function parameters.Furthermore,BEAS-2B cells infected with RSV led to significant increase of the expression of TLR3 mRNA and inflammatory factors IFN-β,IL-13,IL-32,and TNF-α.Our observations indicate that AECOPD is associated with RSV infection and the upregulation of TLR3.
文摘OBJECTIVE: To observe the effects of Suhuang Zhike Capsule on pulmonary function, blood gas analysis index, serum PCT and CRP expression in patients with acute exacerbation of chronic obstructive pulmonary disease. METHODS: A total of 88 patients with acute exacerbation of chronic obstructive pulmonary disease admitted to the Department of Respiratory Medicine, Xuancheng People's Hospital of Anhui Province from December 2014 to December 2016 were randomly divided into the observation group and the control group, with 44 cases in each group. The control group was given routine clinical treatment, and the observation group was given Suhuang Zhike Capsule on the basis of the treatment method of the control group. After 7 days' treatment, the improvement of lung function indexes were observed and evaluated before and after treatment(forced expiratory volume in one second(FEV_1), forced expiratory volume occupancy in the 1^(st) second percentage of vital capacity(FEVl/FVC), peak expiatory flow(PEF)), blood gas analysis index(Arterial oxygen partial pressure(PaO_2) and arterial blood carbon dioxide partial pressure(PaCO_2), oxygenation index(OI)) and serum cytokine levels(procalcitonin(PCT) and C reactive protein(CRP). RESULTS: The total effective rate of the observation group was significantly higher than that of the control group(P < 0.05). The FEV_1, FEV_1/FVC and PEF in 2 groups were significantly increased after the treatment(P < 0.05), and the above lung function indexes in the observation group were significantly higher than the control group(P < 0.05). PaO_2 and OI were significantly increased after the treatment(P < 0.05), PaCO_2 was significantly decreased after the treatment(P < 0.05), and the improvement of above blood gas analysis indexes were significantly superior of the observation group than the control group(P < 0.05). The serum PCT and CRP levels in 2 groups were significantly decreased after the treatment(P < 0.05), and the improvement in the observation group were more significant than that in the control group(P < 0.05). CONCLUSION: Suhuang Zhike Capsule can inhibit serum inflammatory cytokine levels in patients with acute exacerbation of chronic obstructive pulmonary disease, improve blood gas analysis indicators, and improve lung functions.
文摘Chronic obstructive pulmonary disease </span><span style="font-family:""><span style="font-family:Verdana;">(COPD) is a major chronic respiratory disease worldwide. Inflammatory cells reflect the </span><span style="font-family:Verdana;">inflammatory situation both in peripheral blood and induced sputum. </span></span><span style="font-family:""><span style="font-family:Verdana;">Their correlation has not been reported. </span><span style="font-family:Verdana;">The correlation between neutrophils (Neu), eosinophils (Eos), and lymphocyte (Lym) in induced sputum and that in peripheral blood of COPD </span><span style="font-family:Verdana;">patients was evaluated </span><span><span style="font-family:Verdana;">to explore the </span><span style="font-family:Verdana;">consistency of inflammatory cells in peripheral blood and induced sputum. Peripheral blood and induced sputum were collected from 437 </span><span style="font-family:Verdana;">patients with acute exacerbation of COPD</span></span><span style="font-family:Verdana;"> (AECOPD) who were hospitalized in the Department of respiratory and critical care medicine, Inner Mongolia People’s Hospital. </span><span style="font-family:Verdana;">The correlation analysis was performed by Spearman correlation analysis. </span><span style="font-family:Verdana;">The r</span><span style="font-family:Verdana;">atios of Neu, Eos, and Lym in induced sputum were (79.15 ± 22.60)%, (5.23 ± 12.74)%, and (1.69 ± 2.66)%. The ratios of </span><span style="font-family:Verdana;">Neu, Eos, and Lym in </span><span style="font-family:Verdana;">peripheral blood were (63.29 ± 11.44)%, (2.99 ± 3.60)%, and (25.16 ± 10.19)%. The results showed that the ratios of Neu and Eos in induced sputum were significantly correlated with the proportion of </span><span style="font-family:Verdana;">corresponding cells in peripheral blood (P < 0.05). </span><span style="font-family:Verdana;">There was no correlation between the ratio of Lym and Leu in induced sputum and corresponding cells in </span><span style="font-family:Verdana;">peripheral blood (P > 0.05). In patients with AECOPD, the tendency of Neu and Eos in induced sputum was </span><span style="font-family:Verdana;">consistent with the corresponding cells in peripheral blood. Neu and Eos in </span><span style="font-family:Verdana;">induced sputum and peripheral blood reflected the degree of inflammation to guide the individualized medication of patients.
基金National Natural Science Foundation of China(No.82170013)Sichuan Science and Technology Program(No.2022YFS0262)National Key Research Program of China(No.2016YFC1304202)
文摘Background:Although intensively studied in patients with cardiovascular diseases(CVDs),the prognostic value of diastolic blood pressure(DBP)has little been elucidated in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).This study aimed to reveal the prognostic value of DBP in AECOPD patients.Methods:Inpatients with AECOPD were prospectively enrolled from 10 medical centers in China between September 2017 and July 2021.DBP was measured on admission.The primary outcome was all-cause in-hospital mortality;invasive mechanical ventilation and intensive care unit(ICU)admission were secondary outcomes.Least absolute shrinkage and selection operator(LASSO)and multivariable Cox regressions were used to identify independent prognostic factors and calculate the hazard ratio(HR)and 95%confidence interval(CI)for adverse outcomes.Results:Among 13,633 included patients with AECOPD,197(1.45%)died during their hospital stay.Multivariable Cox regression analysis showed that low DBP on admission(<70 mmHg)was associated with increased risk of in-hospital mortality(HR=2.16,95%CI:1.53–3.05,Z=4.37,P<0.01),invasive mechanical ventilation(HR=1.65,95%CI:1.32–2.05,Z=19.67,P<0.01),and ICU admission(HR=1.45,95%CI:1.24–1.69,Z=22.08,P<0.01)in the overall cohort.Similar findings were observed in subgroups with or without CVDs,except for invasive mechanical ventilation in the subgroup with CVDs.When DBP was further categorized in 5-mmHg increments from<50 mmHg to≥100 mmHg,and 75 to<80 mmHg was taken as reference,HRs for in-hospital mortality increased almost linearly with decreased DBP in the overall cohort and subgroups of patients with CVDs;higher DBP was not associated with the risk of in-hospital mortality.Conclusion:Low on-admission DBP,particularly<70 mmHg,was associated with an increased risk of adverse outcomes among inpatients with AECOPD,with or without CVDs,which may serve as a convenient predictor of poor prognosis in these patients.Clinical Trial Registration:Chinese Clinical Trail Registry,No.ChiCTR2100044625.
基金Supported by National Natural Science Foundation of China:Study on the Protective Effect and Mechanism of ACE2-Ang (1-7)-MasR Signaling Pathway Modulation by Jing Fang Si Ni Decoction on Endothelial Injury in Sepsis (No. 81703895)。
文摘OBJECTIVE:To evaluate the efficacy and safety of Suhuang Zhike capsule(苏黄止咳胶囊) in the adjuvant treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).METHODS:The database including PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure Database,China Science and Technology Journal Database,Chinese Biomedical Literature Database and Wanfang Data was searched.The retrieval time was from database establishment to May 2021.Randomized controlled trial(RCT) of Suhuang zhike capsule adjuvant treatment for AECOPD was included.The quality of the studies was independently evaluated and cross-checked by two reviewers,and Meta-analysis was performed by using RevMan5.3 software.RESULTS:Thirteen RCT results were included with a total sample number of 1195 cases,including 597 in the experimental group and 598 in the control group.The results showed that Suhuang zhike capsule adjuvant treatment of AECOPD could improve the total clinical effect rate compared with conventional treatment.Suhuang zhike capsule adjuvant treatment could improve forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC,peak expiratory flow(PEF) and other pulmonary function indexes;decrease Creactive protein(CRP),white blood cells,neutrophils and other infectious indicators;besides,the 1-year recurrence rate of the disease was decreased(all P < 0.05).CONCLUSIONS:Suhuang Zhike capsule can improve the lung function and clinical efficacy of AECOPD,thus increasing the exercise endurance,and reducing the infection and recurrence rate in AECOPD patients.
基金Supported by the National Natural Science:Research on Key Technology of Outcome Measurement and Evaluation of Syndrome Differentiation and Treatment Based on Clinical Trials of COPD (No. 81830116)the Chinese Medicine Inheritance and Innovation “Hundred and Ten Million” Talent ProjectChief Scientist of Qi-Huang Project [(2020) No. 219]the Zhong-yuan Scholars and Scientists Project (No. 2018204)。
文摘OBJECTIVE:To systematically evaluate the efficacy and safety of Chinese herbal medicine(CHM) combined with conventional Western Medicine(CWM) on acute exacerbation of chronic obstructive pulmonary disease(AECOPD) based on high-quality randomized placebocontrolled trials.METHODS:We searched PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure Database,Chinese Biomedical Literature Database,China Science and Technology Journal Database,and Wanfang databases for randomized placebo-controlled trials of CHM treatment for AECOPD from inception to June 4,2021.The Cochrane Collaboration’s tool and the Grading of Recommendations,Assessment,Development and Evaluation were used to assess the risk of bias and the evidence quality of the included studies.Revman 5.3 software was used for Meta-analysis.RESULTS:A total of 9 trials involving 1591 patients were included.The Meta-analysis showed that based on CWM treatment,CHM group had significant advantages over the placebo group in ameliorating clinical total effective rate [RR = 1.29,95% CI(1.07,1.56),P = 0.007,low quality] and TCM symptom scores [MD =-2.99,95% CI(-4.46,-1.53),P < 0.0001,moderate quality],improving arterial blood gas results [PaO_(2):MD = 4.51,95% CI(1.97,7.04),P = 0.0005,moderate quality;PaCO_(2):MD =-2.87,95% CI(-4.28,-1.46),P < 0.0001,moderate quality],reducing CAT scores [MD =-2.08,95% CI(-2.85,-1.31),P < 0.000 01,moderate quality],length of hospitalization [MD =-1.87,95% CI(-3.33,-0.42),P = 0.01,moderate quality],and acute exacerbation rate [RR = 0.60,95% CI(0.43,0.83),P = 0.002,moderate quality].No serious CHM-related adverse events were reported.CONCLUSIONS:The current evidence indicates that CHM is an effective and well-tolerated adjunct therapy for AECOPD patients receiving CWM.However,considering the high heterogeneity,this conclusion requires confirmation.
基金This research was funded by the Traditional Chinese Medicine Appropriate Technology Development and Promotion Project of Guangxi province(GZSY23-41)the Administration of Traditional Chinese Medicine of Guangxi Self-funded Research Projects(GXZYA20230107)the Administration of Traditional Chinese Medicine of Guangxi Self-funded Research Projects(GXZYA20220095).
文摘Objective:Previous research has demonstrated that pulmonary Daoyin could be an efficacious way to ameliorate the physical and psychological state of sufferers with chronic obstructive pulmonary disease(COPD)and bolster the quality of life.However,the results are not consistent.Thus,the objective of this research is to assess the impacts of pulmonary Daoyin in individuals with COPD.Methods:Relevant articles were searched in Web of Science,Cochrane Library,PubMed,EMBASE,SinoMed,CNKI,Wanfang,and VIP from database inception to January 2024.Results:There were a total of 15 randomized controlled trials(RCTs)included in this meta-analysis involving 1732 patients,of which 864 participated in the intervention group and 868 in the control group.When comparing with the control group,the COPD patients practicing pulmonary Daoyin demonstrated a significant improvement in 6 min walking distance(mean difference[MD]=24.53,95%confidence interval[CI][18.55,30.52],P<0.00001),forced expiratory volume in the 1 s(FEV_(1))(MD=0.39,95%CI[0.18,0.59],P=0.0002),percentage of FEV_(1)to the predicted value(FEV_(1)%)(MD=5.35,95%CI[3.22,7.48],P<0.0001),the forced vital capacity(FVC)(MD=0.39,95%CI[0.06,0.73],P=0.02),percentage of FVC to the predicted value(FVC%)(MD=7.52,95%CI[4.91,10.13],P<0.00001),the ratio of FEV_(1)/FVC(MD=4.95,95%CI[0.91,8.99],P=0.02),peak expiratory flow rate(standardized MD=0.98,95%CI[0.74,1.22],P<0.00001),modified Medical Research Council(mMRC)scale(MD=-0.47,95%CI[-0.89,-0.04],P=0.03),and Borg scale(MD=-0.65,95%CI[-0.75,-0.55],P<0.00001).Conclusions:Our findings may illuminate the influence of pulmonary Daoyin on exercise ability,breathlessness,and pulmonary function in COPD patients.More rigorous RCTs with larger samples and longer-term interventions will be required moving forward.
文摘BACKGROUND Most patients with acute exacerbation chronic obstructive pulmonary disease(AECOPD)have respiratory failure that necessitates active correction and the improvement of oxygenation is particularly important during treatment.High flow nasal cannula(HFNC)oxygen therapy is a non-invasive respiratory aid that is widely used in the clinic that improves oxygenation state,reduces dead space ventilation and breathing effort,protects the loss of cilia in the airways,and improves patient comfort.AIM To compare HFNC and non-invasive positive pressure ventilation in the treatment of patients with AECOPD.METHODS Eighty AECOPD patients were included in the study.The patients were in the intensive care department of our hospital from October 2019 to October 2021.The patients were divided into the control and treatment groups according to the different treatment methods with 40 patients in each group.Differences in patient comfort,blood gas analysis and infection indices were analyzed between the two groups.RESULTS After treatment,symptoms including nasal,throat and chest discomfort were significantly lower in the treatment group compared to the control group on the 3rd and 5th days(P<0.05).Before treatment,the PaO_(2),PaO_(2)/FiO_(2),PaCO_(2),and SaO_(2)in the two groups of patients were not significantly different(P>0.05).After treatment,the same indicators were significantly improved in both patient groups but had improved more in the treatment group compared to the control group(P<0.05).After treatment,the white blood cell count,and the levels of C-reactive protein and calcitonin in patients in the treatment group were significantly higher compared to patients in the control group(P<0.05).CONCLUSION HFNC treatment can improve the ventilation of AECOPD patients whilst also improving patient comfort,and reducing complications.HFNC is a clinically valuable technique for the treatment of AECOPD.
基金This study was supported by Capital Health Development Program(No.2020-2Z-40917)National Natural Science Foundation of China(Nos.82090014 and 81970037)Chronic Non-Communicable Diseases Prevention and Control Research Granted by National Key Research and Development Program of China(No.2016YFC1304301).
文摘Chronic Obstructive Pulmonary Disease(COPD)is characterized by persistent respiratory symptoms and airflow limitation.Acute exacerbation of COPD(AECOPD)is an acute worsening of respiratory symptoms,which needs additional treatment and can result in worsening health status,increasing risks of hospitalization and mortal-ity.Therefore,it is necessary to early recognize and diagnose exacerbations of COPD.This review introduces the updated definition of COPD exacerbations,the current clinical assessment tools,and the current potential biomarkers.The application of mobile health care in COPD management for early identification and diagnosis is also included in this review.
