Objective:To explore the potential biological mechanism of chronic obstructive pulmonary disease(COPD)qi deficiency syndrome,we used the integrated pharmacology network computing platform and carried out experimental ...Objective:To explore the potential biological mechanism of chronic obstructive pulmonary disease(COPD)qi deficiency syndrome,we used the integrated pharmacology network computing platform and carried out experimental verification.Methods:Using an integrated pharmacology strategy to analyze the potential biological targets of COPD qi deficiency syndrome.Based on the established qi deficiency syndrome rat model of COPD,the biological targets of lung and skeletal muscle were detected by electron microscopy,adenosine triphosphate(ATP)content assays,and western blotting.Results:According to the integrated pharmacological results,it was found that the locations of cell components related to COPD qi deficiency syndrome were mainly mitochondria.Electron microscopy results using lung tissue showed that mitochondria in the lipopolysaccharide(LPS group)and pulmonary instillation of LPS combined with cigarette smoke(LPStCS group)were swollen,deformed,and fragmented,with disappearing or broken crista.Results also showed that the total content of ATP in the lung and skeletal muscle of both groups was significantly lower than that in the control group at the 12th week(P<.05).At the 12th week,the expression of dynamin-related protein 1(DRP1)and mitofusin 1(MFN1)protein was significantly difference than that of the control group(P<.05).At the 10th and 14th weeks,changes in fission and fusion proteins in mitochondria of the lung and skeletal muscle were further detected.There was also a significant difference in the expression between the two groups compared to that in the control group at the 10th week and 14th week(P<.05).Conclusion:These findings suggest that the changes in mitochondrial morphology and ATP content and the unbalanced expression of DRP1 and MFN1 might be the key mechanisms underlying qi deficiency syndrome in rats with COPD.展开更多
BACKGROUND:The study aimed to evaluate the predictive role of interleukin-6(IL-6)and chronic obstructive pulmonary disease(COPD)assessment test(CAT)score in mechanical ventilation(MV)in COPD patients at the acute exac...BACKGROUND:The study aimed to evaluate the predictive role of interleukin-6(IL-6)and chronic obstructive pulmonary disease(COPD)assessment test(CAT)score in mechanical ventilation(MV)in COPD patients at the acute exacerbation stage in the emergency department(ED).METHODS:For a one-year period,among adult patients in the ED who met the criteria of acute exacerbation of COPD,158 who received MV within 48 hours after admission were compared to 294 who didn't require MV within the same period after admission.IL-6 level and CAT score were compared between the two groups.The predicted value of IL-6 and CAT score was assessed by logistic regression analysis and a receiver operating characteristic(ROC)curve.RESULTS:The IL-6 and CAT scores in the 158 MV patients were much higher than those without.IL-6 and CAT scores were independent predictors of MV within 48 hours using logistic regression analysis(IL-6:odds ratio[OR]1.053,95%confidence interval[CI]1.039–1.067,P<0.001;CAT score:OR 1.122,95%CI 1.086–1.159,P<0.001).The combination of IL-6 and CAT scores(area under ROC curve[AUC]0.826,95%CI 0.786–0.866,P<0.001)improved the accuracy of predicting MV within 48 hours when compared with IL-6(AUC 0.752,95%CI 0.703–0.800,P<0.001)and CAT scores alone(AUC 0.739,95%CI 0.692–0.786,P<0.001).The sensitivity and specificity were 69.6%,74.1%,75.32%and 63.6%,respectively.CONCLUSION:The combined of IL-6 and CAT scores is useful for evaluating the risk of COPD patients at acute exacerbation in ED,and can provide a predictive value for MV or not within 48 hours.展开更多
Objective: To investigate the risk factors of chronic obstructive pulmonary disease(COPD) in Li and Han ethnic group in Hainan, China. Methods: All subjects were randomly selected from various regions in Hainan. Gener...Objective: To investigate the risk factors of chronic obstructive pulmonary disease(COPD) in Li and Han ethnic group in Hainan, China. Methods: All subjects were randomly selected from various regions in Hainan. General characteristics were compared between COPD cases and healthy control cases in both Li and Han ethnic groups. The odds ratio(OR), the corresponding 95% confidence interval(CI) of COPD were calculated by logistic regression.Results: A total of 277 Li COPD cases, 307 Li healthy control subjects, 290 Han COPD cases and 301 Han healthy control were included in this study. In both the Li and Han groups, the average age exceeded 65 years, and the cigarette number smoked per day and the smoking duration were correlated with risk of COPD. In the Li COPD subjects, low weight, smoking, and recurrent infection of respiratory tract were mainly risk factors; while the mainly risk factor of Han COPD subjects was family history of respiratory disease. Conclusions: The risk factors are different in COPD subjects of Han and Li nationalities in Hainan of China. The age and smoking are strongly correlated with COPD risk.展开更多
Chronic obstructive pulmonary disease (COPD) is the most prevalent chronic respiratory disease, leading toa great number of death and a huge disease burden to China. Recently, as the promulgation of a series of nation...Chronic obstructive pulmonary disease (COPD) is the most prevalent chronic respiratory disease, leading toa great number of death and a huge disease burden to China. Recently, as the promulgation of a series of national healthpolicies, the diagnosis and treatment of COPD has gradually gained attention. The prevention and treatment capacity ofCOPD in China has been greatly improved, but there are still problems of insufficient diagnosis and irregular treatment. Theproblem is mainly related to the lack of universal pulmonary function test, insufficient number and level of doctors, and thenonstandard use of drugs. The prevention and treatment of COPD in primary medical institutions is particularly lacking. Inorder to promote the prevention and treatment of COPD, China has innovatively adopted a number of measures, including"Happy Breathing" project, standardized diagnosis and treatment system and capacity building for respiratory diseases inprimary medical institutions, el at. Effective progress has been made through these methods, and great improvement of theprevention, diagnosis and treatment of COPD has been achieved.展开更多
[Objectives]To evaluate the intervention effect and safety of self-created Lung Health Breathing Exercise on TCM syndromes,6-min walk test(6MWT)and quality of life in patients with stable chronic obstructive pulmonary...[Objectives]To evaluate the intervention effect and safety of self-created Lung Health Breathing Exercise on TCM syndromes,6-min walk test(6MWT)and quality of life in patients with stable chronic obstructive pulmonary disease(COPD).[Methods]76 cases of outpatient or inpatient patients who were diagnosed with stable COPD in Nanchong Traditional Chinese Medicine Hospital from January 2020 to March 2021 were selected,randomly divided into experimental group and control group,38 cases in each group.Both groups were given conventional western medicine treatment and nursing measures.The experimental group was added with the self-created Lung Health Breathing Exercise.After 12 weeks of treatment,the TCM syndrome score,6MWT distance,quality of life score and the incidence of adverse events were observed in the both groups.[Results]After treatment,the 6MWT distance and quality of life scores in both groups were significantly improved(P<0.01),and the TCM syndrome scores were significantly lower than those before treatment(P<0.01).[Conclusions]Lung Health Breathing Exercise can benefit patients in terms of symptom improvement,quality of life and exercise ability,and is a safe and effective rehabilitation measure for patients with stable COPD.展开更多
[Objectives] To investigate the effects of TCM nursing based on syndrome differentiation on pulmonary function and quality of life in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD)....[Objectives] To investigate the effects of TCM nursing based on syndrome differentiation on pulmonary function and quality of life in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). [Methods] A total of 92 patients with AECOPD who came to Nanchong Chinese Medicine Hospital from March 2022 to February 2023 were selected for the study, and the intervention group (TCM nursing based on syndrome differentiation, 46 cases) and the conventional group (basic nursing, 46 cases) were selected for the study, and the pulmonary function and quality of life of the two groups were compared. [Results] Before nursing, there was no significant difference in levels of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and percentage of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) between the intervention group and conventional group ( P >0.05). After 3 months of nursing, the levels of FVC, FEV1 and FEV1/FVC in the intervention group were higher than those in the conventional group ( P <0.05). Before nursing, there was no significant difference in the scores of health, emotion and social functions between the two groups ( P >0.05). At three months of nursing, the scores of health, emotion, and social functions in the intervention group were higher than those in the conventional group ( P <0.05). [Conclusions] The implementation of TCM nursing based on syndrome differentiation in patients with AECOPD can effectively improve the pulmonary function and quality of life of patients, and has significant clinical implementation value.展开更多
Chronic obstructive pulmonary disease(COPD)is a serious chronic respiratory disease.Improving the ability to identify patients with COPD in primary medical institutions is important to prevent and treat the disease.Wi...Chronic obstructive pulmonary disease(COPD)is a serious chronic respiratory disease.Improving the ability to identify patients with COPD in primary medical institutions is important to prevent and treat the disease.With the continuous development of medical digitization,the application of big data informatization in the medical and health fields has become possible.Recently,applying innovative technologies such as big data analysis,machine learning,and artificial intelligence-assisted decision-making in the medical field has become an interdisciplinary research hotspot.Based on the identification and diagnosis of COPD in the high-risk population,this study proposes a convenient and effective clinical decision support system to help identify patients with COPD in primary health institutions.The results of the preliminary experiments show that the proposed method is convenient and effective compared with the existing methods.展开更多
Background:The incidence of chronic obstructive pulmonary disease(COPD)complicated with invasive pulmonary aspergillosis(IPA)has increased in the last two decades.The mechanism underpinning susceptibility to and high ...Background:The incidence of chronic obstructive pulmonary disease(COPD)complicated with invasive pulmonary aspergillosis(IPA)has increased in the last two decades.The mechanism underpinning susceptibility to and high mortality of COPD complicated with IPA is unclear,and the role of T helper cells 17(Th17 cells)in the compound disease remains unknown.Therefore,this study aimed to assess the function of Th17 cells in COPD combined with IPA.Methods:COPD,IPA,and COPD+IPA mouse models were established in male wild type C57/BL6 mice.The amounts of Th17 cells and retinoic acid-related orphan receptorsγt(RORyt)were tested by flow cytometry.Then,serum interleukin(IL)-17 and IL-23.levels were detected by enzyme-linked immunosorbent assay(ELISA)in the control,COPD,IPA and COPD+IPA groups.In addition,COPD+IPA was induced in IL-17 knockout(KO)mice,for determining the role of Th17 cells in COPD+IPA.Results:Compared with the COPD group,the COPD+IPA group showed higher amounts of blood RORyt([35.09±16.12]%vs.[17.92±4.91]%,P=0.02)and serum IL-17(17.96±9.59 pg/mL vs.8.05±4.44 pg/mL,P=0.02),but blood([5.18±1.09]%vs.[4.15±0.87]%,P=0.28)and lung levels of Th17 cells(1.98±0.83]%vs.[2.03±0.98]%,P=0.91),lung levels of RORyt([9.58±6.93]%vs.[9.63±5.98]%,P=0.49)and serum IL-23(51.55±27.82 pg/mL us.68.70±15.20 pg/mL,P=0.15)showed no significant differences.Compared with the IPA group,the COPD+IPA group displayed lower amounts of blood([5.18±1.09]%vs.[9.21±3.56]%,P=0.01)and lung Th17 cells([1.98±0.83]%vs.[6.29±1.11]%,P=0.01)and serum IL-23(51.55±27.82 pg/mL vs.154.90±64.60 pg/mL,P=0.01)and IL-17(17.96±9.59 pg/mL uUs.39.81±2.37 pg/mL,P=0.02),while comparable blood([35.09±16.12]%Vs.[29.86±15.42]%,P=0.25)and lung levels of RORγt(9.58±6.93]%VUS,[15.10±2.95]%,P=0.18)were found in these two groups.Finally,Aspergillus load in IL-17 KO COPD+IPA mice was almost 2 times that of COPD+IPA mice(1,851,687.69±944,480.43"vs.892,958.10±686,808.80,t=2.32,P=0.02).Conclusion:These findings indicate that Th17 cells might be involved in the pathogenesis of COPD combined with IPA,with L-17 likely playing an antifungal role.展开更多
Susceptibility of patients with chronic obstructive pulmonary disease(COPD)to cardiovascular autonomic dysfunction asso-ciated with exposure to metals in ambient fine particles(PM2.5,particulate matter with aerodynami...Susceptibility of patients with chronic obstructive pulmonary disease(COPD)to cardiovascular autonomic dysfunction asso-ciated with exposure to metals in ambient fine particles(PM2.5,particulate matter with aerodynamic diameter≤2.5µm)remains poorly evidenced.Based on the COPDB(COPD in Beijing)panel study,we aimed to compare the associations of heart rate(HR,an indicator of cardiovascular autonomic function)and exposure to metals in PM2.5 between 53 patients with COPD and 82 healthy controls by using linear mixed-effects models.In all participants,the HR levels were significantly associated with interquartile range increases in the average concentrations of Cr,Zn,and Pb,but the strength of the associations differed by exposure time(from 1.4%for an average 9 days(d)Cr exposure to 3.5%for an average 9 d Zn exposure).HR was positively associated with the average concentrations of PM2.5 and certain metals only in patients with COPD.Associations between HR and exposure to PM2.5,K,Cr,Mn,Ni,Cu,Zn,As,and Se in patients with COPD significantly differed from those in health controls.Furthermore,association between HR and Cr exposure was robust in COPD patients.In conclusion,our findings indicate that COPD could exacerbate difference in HR following exposure to metals in PM2.5.展开更多
Over the last 20 years, it has become possible to use a precision medicine approach to the management of chronic obstructive pulmonary disease (COPD). Clinical and physiological features as well as a blood biomarker c...Over the last 20 years, it has become possible to use a precision medicine approach to the management of chronic obstructive pulmonary disease (COPD). Clinical and physiological features as well as a blood biomarker can be used to target treatments to patients most likely to benefit and avoid treatment in patients less likely to benefit. Future advances in a precision medicine approach to COPD will depend on more precise characterization of individual patients, possibly using quantitative imaging, new physiological techniques, novel biomarkers and genetic profiling. Precision medicine has led to significant improvements in the management of COPD and clinicians should use all available information to optimize the treatment of individual patients.展开更多
Objective:To construct a risk prediction model for in-hospital cardiac arrest(IHCA)in patients with chronic obstructive pulmonary disease(COPD)complicated with respiratory failure.Methods:The clinical data of 550 pati...Objective:To construct a risk prediction model for in-hospital cardiac arrest(IHCA)in patients with chronic obstructive pulmonary disease(COPD)complicated with respiratory failure.Methods:The clinical data of 550 patients with COPD complicated with respiratory failure in our hospital from January 2016 to June 2022 were retrospectively analyzed.According to the occurrence of IHCA,they were divided into the IHCA group and non-IHCA group.The general data and clinical indicators of the two groups were compared,and logistic regression analysis was performed,R software was used to establish the risk prediction model(nomogram model)for predicting the occurrence of IHCA in patients with COPD complicated with respiratory failure.The risk prediction model(line graph model)for patients with IHCA was validated by the Bootstrap method,and the predictive value was analyzed by applying the receiver operating characteristic(ROC)curve.Results:Among 550 COPD patients complicated with respiratory failure,95 cases(17.27%)had IHCA.There were significant differences in age,old myocardial infarction,heart failure,moderate and severe chronic kidney disease,assisted breathing mode,state of consciousness,body temperature,heart rate,respiratory rate,systolic blood pressure,lactic acid,Sa O,Pa CO,serum creatinine,albumin,and prealbumin between the non-IHCA group and IHCA group(P<0.05).Logistic regression analysis showed that age,heart failure,heart rate,respiratory rate,systolic blood pressure,unclear state of consciousness,serum creatinine and prealbumin were independent influencing factors of IHCA in COPD patients complicated with respiratory failure(P<0.05).According to the results of binary logistic regression analysis,a nomogram model for predicting the incidence of IHCA in COPD patients complicated with respiratory failure was constructed.The fitting degree of the model was determined by the H-L test.The calibration curve showed that the incidence of IHCA in COPD patients complicated with respiratory failure predicted by nomogram was in good agreement with the actual incidence of IHCA in patients with COPD complicated with respiratory failure(χ~2=2.017,P=0.334).The ROC curve showed an AUC of 0.627(95%CI:0.593-0.689,P<0.005),and the optimal cut point value for diagnosis was 0.69,at which the sensitivity and specificity were 42.57%and 96.03%,respectively.Conclusion:According to the independent influencing factors of IHCA in COPD patients complicated with respiratory failure,the establishment of a risk prediction nomogram model has high predictive value,which is worthy of clinical promotion.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
Chronic obstructive pulmonary disease(COPD)is a chronic inflammatory airway disease that affects the quality of life of nearly one-tenth of the global population.Due to irreversible airflow obstruction and progressive...Chronic obstructive pulmonary disease(COPD)is a chronic inflammatory airway disease that affects the quality of life of nearly one-tenth of the global population.Due to irreversible airflow obstruction and progressive lung function decline,COPD is characterized by high mortality and disability rates,which imposes a huge economic burden on society.In recent years,the importance of intervention in the early stage of COPD has been recognized and the concept of early COPD has been proposed.Identifying and intervening in individuals with early COPD,some of whom have few or no symptoms,might halt or reverse the progressive decline in lung function,improve the quality of life,and better their prognosis.However,understanding of early COPD is not yet well established,and there are no unified and feasible diagnostic criteria,which complicates clinical research.In this article,we review evolution of the definition of early COPD over the past 20 years,describe the changes in awareness of this concept,and propose future research directions.展开更多
基金This work was supported by the National Key Research and Development Project(2017YFC1700105).
文摘Objective:To explore the potential biological mechanism of chronic obstructive pulmonary disease(COPD)qi deficiency syndrome,we used the integrated pharmacology network computing platform and carried out experimental verification.Methods:Using an integrated pharmacology strategy to analyze the potential biological targets of COPD qi deficiency syndrome.Based on the established qi deficiency syndrome rat model of COPD,the biological targets of lung and skeletal muscle were detected by electron microscopy,adenosine triphosphate(ATP)content assays,and western blotting.Results:According to the integrated pharmacological results,it was found that the locations of cell components related to COPD qi deficiency syndrome were mainly mitochondria.Electron microscopy results using lung tissue showed that mitochondria in the lipopolysaccharide(LPS group)and pulmonary instillation of LPS combined with cigarette smoke(LPStCS group)were swollen,deformed,and fragmented,with disappearing or broken crista.Results also showed that the total content of ATP in the lung and skeletal muscle of both groups was significantly lower than that in the control group at the 12th week(P<.05).At the 12th week,the expression of dynamin-related protein 1(DRP1)and mitofusin 1(MFN1)protein was significantly difference than that of the control group(P<.05).At the 10th and 14th weeks,changes in fission and fusion proteins in mitochondria of the lung and skeletal muscle were further detected.There was also a significant difference in the expression between the two groups compared to that in the control group at the 10th week and 14th week(P<.05).Conclusion:These findings suggest that the changes in mitochondrial morphology and ATP content and the unbalanced expression of DRP1 and MFN1 might be the key mechanisms underlying qi deficiency syndrome in rats with COPD.
基金supported by grants from Dongzhimen Hospital Fund of Special Talent(2018RC01)Beijing University of Chinese Medicine Fund of Project(2019-JYB-XJSJJ-025)
文摘BACKGROUND:The study aimed to evaluate the predictive role of interleukin-6(IL-6)and chronic obstructive pulmonary disease(COPD)assessment test(CAT)score in mechanical ventilation(MV)in COPD patients at the acute exacerbation stage in the emergency department(ED).METHODS:For a one-year period,among adult patients in the ED who met the criteria of acute exacerbation of COPD,158 who received MV within 48 hours after admission were compared to 294 who didn't require MV within the same period after admission.IL-6 level and CAT score were compared between the two groups.The predicted value of IL-6 and CAT score was assessed by logistic regression analysis and a receiver operating characteristic(ROC)curve.RESULTS:The IL-6 and CAT scores in the 158 MV patients were much higher than those without.IL-6 and CAT scores were independent predictors of MV within 48 hours using logistic regression analysis(IL-6:odds ratio[OR]1.053,95%confidence interval[CI]1.039–1.067,P<0.001;CAT score:OR 1.122,95%CI 1.086–1.159,P<0.001).The combination of IL-6 and CAT scores(area under ROC curve[AUC]0.826,95%CI 0.786–0.866,P<0.001)improved the accuracy of predicting MV within 48 hours when compared with IL-6(AUC 0.752,95%CI 0.703–0.800,P<0.001)and CAT scores alone(AUC 0.739,95%CI 0.692–0.786,P<0.001).The sensitivity and specificity were 69.6%,74.1%,75.32%and 63.6%,respectively.CONCLUSION:The combined of IL-6 and CAT scores is useful for evaluating the risk of COPD patients at acute exacerbation in ED,and can provide a predictive value for MV or not within 48 hours.
基金financially supported by the National Natural Science Foundation of China(No.81160008 and 81660013)
文摘Objective: To investigate the risk factors of chronic obstructive pulmonary disease(COPD) in Li and Han ethnic group in Hainan, China. Methods: All subjects were randomly selected from various regions in Hainan. General characteristics were compared between COPD cases and healthy control cases in both Li and Han ethnic groups. The odds ratio(OR), the corresponding 95% confidence interval(CI) of COPD were calculated by logistic regression.Results: A total of 277 Li COPD cases, 307 Li healthy control subjects, 290 Han COPD cases and 301 Han healthy control were included in this study. In both the Li and Han groups, the average age exceeded 65 years, and the cigarette number smoked per day and the smoking duration were correlated with risk of COPD. In the Li COPD subjects, low weight, smoking, and recurrent infection of respiratory tract were mainly risk factors; while the mainly risk factor of Han COPD subjects was family history of respiratory disease. Conclusions: The risk factors are different in COPD subjects of Han and Li nationalities in Hainan of China. The age and smoking are strongly correlated with COPD risk.
基金CAMS Innovation Fund for Medical Sciences (CIFMS)(No. 2018-I2M-1-001)National Key R&D Program of China, Ministry ofScience and Technology of China(No. 2016YFC1303901)。
文摘Chronic obstructive pulmonary disease (COPD) is the most prevalent chronic respiratory disease, leading toa great number of death and a huge disease burden to China. Recently, as the promulgation of a series of national healthpolicies, the diagnosis and treatment of COPD has gradually gained attention. The prevention and treatment capacity ofCOPD in China has been greatly improved, but there are still problems of insufficient diagnosis and irregular treatment. Theproblem is mainly related to the lack of universal pulmonary function test, insufficient number and level of doctors, and thenonstandard use of drugs. The prevention and treatment of COPD in primary medical institutions is particularly lacking. Inorder to promote the prevention and treatment of COPD, China has innovatively adopted a number of measures, including"Happy Breathing" project, standardized diagnosis and treatment system and capacity building for respiratory diseases inprimary medical institutions, el at. Effective progress has been made through these methods, and great improvement of theprevention, diagnosis and treatment of COPD has been achieved.
基金Science and Technology Research Project of Sichuan Provincial Administration of Traditional Chinese Medicine(2020LC0151):"Clinical Study on the Effect of Lung Health Breathing Exercise on Pulmonary Function and Quality of Life in Patients with Stable Chronic Obstructive Pulmonary Disease"Project of Famous Old Chinese Physicians Case Research Center of Nanchong City Key Research Base of Philosophy and Social Sciences"Study on Chief Physician Xu Shihong s Clinical Experience and Academic Thoughts of Syndrome Differentiation in the Treatment of COPD"(YAZX19-Y-07).
文摘[Objectives]To evaluate the intervention effect and safety of self-created Lung Health Breathing Exercise on TCM syndromes,6-min walk test(6MWT)and quality of life in patients with stable chronic obstructive pulmonary disease(COPD).[Methods]76 cases of outpatient or inpatient patients who were diagnosed with stable COPD in Nanchong Traditional Chinese Medicine Hospital from January 2020 to March 2021 were selected,randomly divided into experimental group and control group,38 cases in each group.Both groups were given conventional western medicine treatment and nursing measures.The experimental group was added with the self-created Lung Health Breathing Exercise.After 12 weeks of treatment,the TCM syndrome score,6MWT distance,quality of life score and the incidence of adverse events were observed in the both groups.[Results]After treatment,the 6MWT distance and quality of life scores in both groups were significantly improved(P<0.01),and the TCM syndrome scores were significantly lower than those before treatment(P<0.01).[Conclusions]Lung Health Breathing Exercise can benefit patients in terms of symptom improvement,quality of life and exercise ability,and is a safe and effective rehabilitation measure for patients with stable COPD.
基金Supported by Special Research Project of Science and Technology Bureau of Nanchong City,Sichuan Province"Effects of TCM Nursing Based on Syndrome Differentiation on Pulmonary Function and Quality of Life in Patients with Acute Exacerbation of COPD"(22YYJCYJ0057)Science and Technology Program of Sichuan Province"Effects of TCM Nursing Based on Syndrome Differentiation on Pulmonary Function and Quality of Life in Patients with Acute Exacerbation of COPD"(2021YFS0270).
文摘[Objectives] To investigate the effects of TCM nursing based on syndrome differentiation on pulmonary function and quality of life in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). [Methods] A total of 92 patients with AECOPD who came to Nanchong Chinese Medicine Hospital from March 2022 to February 2023 were selected for the study, and the intervention group (TCM nursing based on syndrome differentiation, 46 cases) and the conventional group (basic nursing, 46 cases) were selected for the study, and the pulmonary function and quality of life of the two groups were compared. [Results] Before nursing, there was no significant difference in levels of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and percentage of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) between the intervention group and conventional group ( P >0.05). After 3 months of nursing, the levels of FVC, FEV1 and FEV1/FVC in the intervention group were higher than those in the conventional group ( P <0.05). Before nursing, there was no significant difference in the scores of health, emotion and social functions between the two groups ( P >0.05). At three months of nursing, the scores of health, emotion, and social functions in the intervention group were higher than those in the conventional group ( P <0.05). [Conclusions] The implementation of TCM nursing based on syndrome differentiation in patients with AECOPD can effectively improve the pulmonary function and quality of life of patients, and has significant clinical implementation value.
基金This work was supported by the Major Research Program of the National Natural Science Foundation of China(No.91843302).
文摘Chronic obstructive pulmonary disease(COPD)is a serious chronic respiratory disease.Improving the ability to identify patients with COPD in primary medical institutions is important to prevent and treat the disease.With the continuous development of medical digitization,the application of big data informatization in the medical and health fields has become possible.Recently,applying innovative technologies such as big data analysis,machine learning,and artificial intelligence-assisted decision-making in the medical field has become an interdisciplinary research hotspot.Based on the identification and diagnosis of COPD in the high-risk population,this study proposes a convenient and effective clinical decision support system to help identify patients with COPD in primary health institutions.The results of the preliminary experiments show that the proposed method is convenient and effective compared with the existing methods.
基金This study was supported by a grant from the National Natural Science Foundation of China(No.81400003).
文摘Background:The incidence of chronic obstructive pulmonary disease(COPD)complicated with invasive pulmonary aspergillosis(IPA)has increased in the last two decades.The mechanism underpinning susceptibility to and high mortality of COPD complicated with IPA is unclear,and the role of T helper cells 17(Th17 cells)in the compound disease remains unknown.Therefore,this study aimed to assess the function of Th17 cells in COPD combined with IPA.Methods:COPD,IPA,and COPD+IPA mouse models were established in male wild type C57/BL6 mice.The amounts of Th17 cells and retinoic acid-related orphan receptorsγt(RORyt)were tested by flow cytometry.Then,serum interleukin(IL)-17 and IL-23.levels were detected by enzyme-linked immunosorbent assay(ELISA)in the control,COPD,IPA and COPD+IPA groups.In addition,COPD+IPA was induced in IL-17 knockout(KO)mice,for determining the role of Th17 cells in COPD+IPA.Results:Compared with the COPD group,the COPD+IPA group showed higher amounts of blood RORyt([35.09±16.12]%vs.[17.92±4.91]%,P=0.02)and serum IL-17(17.96±9.59 pg/mL vs.8.05±4.44 pg/mL,P=0.02),but blood([5.18±1.09]%vs.[4.15±0.87]%,P=0.28)and lung levels of Th17 cells(1.98±0.83]%vs.[2.03±0.98]%,P=0.91),lung levels of RORyt([9.58±6.93]%vs.[9.63±5.98]%,P=0.49)and serum IL-23(51.55±27.82 pg/mL us.68.70±15.20 pg/mL,P=0.15)showed no significant differences.Compared with the IPA group,the COPD+IPA group displayed lower amounts of blood([5.18±1.09]%vs.[9.21±3.56]%,P=0.01)and lung Th17 cells([1.98±0.83]%vs.[6.29±1.11]%,P=0.01)and serum IL-23(51.55±27.82 pg/mL vs.154.90±64.60 pg/mL,P=0.01)and IL-17(17.96±9.59 pg/mL uUs.39.81±2.37 pg/mL,P=0.02),while comparable blood([35.09±16.12]%Vs.[29.86±15.42]%,P=0.25)and lung levels of RORγt(9.58±6.93]%VUS,[15.10±2.95]%,P=0.18)were found in these two groups.Finally,Aspergillus load in IL-17 KO COPD+IPA mice was almost 2 times that of COPD+IPA mice(1,851,687.69±944,480.43"vs.892,958.10±686,808.80,t=2.32,P=0.02).Conclusion:These findings indicate that Th17 cells might be involved in the pathogenesis of COPD combined with IPA,with L-17 likely playing an antifungal role.
基金the National Natural Science Foundation of China(41121004,21190051,41421064 and 81571130100)the National Basic Research Program of China(2015CB553401)。
文摘Susceptibility of patients with chronic obstructive pulmonary disease(COPD)to cardiovascular autonomic dysfunction asso-ciated with exposure to metals in ambient fine particles(PM2.5,particulate matter with aerodynamic diameter≤2.5µm)remains poorly evidenced.Based on the COPDB(COPD in Beijing)panel study,we aimed to compare the associations of heart rate(HR,an indicator of cardiovascular autonomic function)and exposure to metals in PM2.5 between 53 patients with COPD and 82 healthy controls by using linear mixed-effects models.In all participants,the HR levels were significantly associated with interquartile range increases in the average concentrations of Cr,Zn,and Pb,but the strength of the associations differed by exposure time(from 1.4%for an average 9 days(d)Cr exposure to 3.5%for an average 9 d Zn exposure).HR was positively associated with the average concentrations of PM2.5 and certain metals only in patients with COPD.Associations between HR and exposure to PM2.5,K,Cr,Mn,Ni,Cu,Zn,As,and Se in patients with COPD significantly differed from those in health controls.Furthermore,association between HR and Cr exposure was robust in COPD patients.In conclusion,our findings indicate that COPD could exacerbate difference in HR following exposure to metals in PM2.5.
文摘Over the last 20 years, it has become possible to use a precision medicine approach to the management of chronic obstructive pulmonary disease (COPD). Clinical and physiological features as well as a blood biomarker can be used to target treatments to patients most likely to benefit and avoid treatment in patients less likely to benefit. Future advances in a precision medicine approach to COPD will depend on more precise characterization of individual patients, possibly using quantitative imaging, new physiological techniques, novel biomarkers and genetic profiling. Precision medicine has led to significant improvements in the management of COPD and clinicians should use all available information to optimize the treatment of individual patients.
文摘Objective:To construct a risk prediction model for in-hospital cardiac arrest(IHCA)in patients with chronic obstructive pulmonary disease(COPD)complicated with respiratory failure.Methods:The clinical data of 550 patients with COPD complicated with respiratory failure in our hospital from January 2016 to June 2022 were retrospectively analyzed.According to the occurrence of IHCA,they were divided into the IHCA group and non-IHCA group.The general data and clinical indicators of the two groups were compared,and logistic regression analysis was performed,R software was used to establish the risk prediction model(nomogram model)for predicting the occurrence of IHCA in patients with COPD complicated with respiratory failure.The risk prediction model(line graph model)for patients with IHCA was validated by the Bootstrap method,and the predictive value was analyzed by applying the receiver operating characteristic(ROC)curve.Results:Among 550 COPD patients complicated with respiratory failure,95 cases(17.27%)had IHCA.There were significant differences in age,old myocardial infarction,heart failure,moderate and severe chronic kidney disease,assisted breathing mode,state of consciousness,body temperature,heart rate,respiratory rate,systolic blood pressure,lactic acid,Sa O,Pa CO,serum creatinine,albumin,and prealbumin between the non-IHCA group and IHCA group(P<0.05).Logistic regression analysis showed that age,heart failure,heart rate,respiratory rate,systolic blood pressure,unclear state of consciousness,serum creatinine and prealbumin were independent influencing factors of IHCA in COPD patients complicated with respiratory failure(P<0.05).According to the results of binary logistic regression analysis,a nomogram model for predicting the incidence of IHCA in COPD patients complicated with respiratory failure was constructed.The fitting degree of the model was determined by the H-L test.The calibration curve showed that the incidence of IHCA in COPD patients complicated with respiratory failure predicted by nomogram was in good agreement with the actual incidence of IHCA in patients with COPD complicated with respiratory failure(χ~2=2.017,P=0.334).The ROC curve showed an AUC of 0.627(95%CI:0.593-0.689,P<0.005),and the optimal cut point value for diagnosis was 0.69,at which the sensitivity and specificity were 42.57%and 96.03%,respectively.Conclusion:According to the independent influencing factors of IHCA in COPD patients complicated with respiratory failure,the establishment of a risk prediction nomogram model has high predictive value,which is worthy of clinical promotion.
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.
基金This study was supported by grants from the National Natural Science Foundation of China(Nos.82090014 and 81970037)Capital Health Development Research Project(No.2020-2Z-40917)+1 种基金Dr.Curtis is supported by R01 HL144718,R01 HL144849,and U01 HL137880 from the National Heart,Lung,and Blood Institute,National Institutes of Healthby Merit Review awards I01 CX002377 and I01 CX001562 from the Department of Veterans Affairs.
文摘Chronic obstructive pulmonary disease(COPD)is a chronic inflammatory airway disease that affects the quality of life of nearly one-tenth of the global population.Due to irreversible airflow obstruction and progressive lung function decline,COPD is characterized by high mortality and disability rates,which imposes a huge economic burden on society.In recent years,the importance of intervention in the early stage of COPD has been recognized and the concept of early COPD has been proposed.Identifying and intervening in individuals with early COPD,some of whom have few or no symptoms,might halt or reverse the progressive decline in lung function,improve the quality of life,and better their prognosis.However,understanding of early COPD is not yet well established,and there are no unified and feasible diagnostic criteria,which complicates clinical research.In this article,we review evolution of the definition of early COPD over the past 20 years,describe the changes in awareness of this concept,and propose future research directions.
