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Objective To observe any curative effect of applying comprehensive pulmonary rehabilitation in moderate and severe cases of chronic obstructive pulmonary disease (COPD).Methods A total of 135 persons hospitalized with moderate or severe COPD were randomly divided into a rehabilitation group of 75 and acontrol group of 60.Both groups were given routine treatment,while the rehabilitation group was additionally provided with a comprehensive pulmonary rehabilitation regimen,including health education,exercise training,respiratory function training,respiratory muscle training,psychological support and nutritional intervention for six months.Before and after the treatment,both groups were evaluated using their walking distance within 6 minutes (6MWD),an anhelation index,a COPD assessment test (CAT),the Beck anxiety and depression scale,a nutritional assessment and indexes of pulmonary function and blood gases.Results After the intervention the average 6 MWD,anhelation index,CAT score,Beck anxiety and depression scores,forced expiratory volume,forced vital capacity and PaO2 of the rehabilitation group were all significantly better than before the treatment and better than those of the control group.Conclusion For moderate and severe COPD patients,comprehensive pulmonary rehabilitation effectively strengthens their moving ability,pulmonary function and arterial partial pressure of oxygen,while relieving anhelation,anxiety and depression.
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Objective To investigate the influence of nasal continuous positive airway pressure (nCPAP) treatment on cardiovascular risk factors in patients with obstructive sleep apnea-hypopnea Syndrome (OSAHS). Methods Thirty-one patients with newly diagnosed OSAHS were divided into 3 groups based on the status of nC-PAP treatment: group 1,10 patients with nCPAP > 4 hrs/night;group 2:9 patients with nCPAP < 4 hrs/night;group 3:12 patients without nCPAP treatment. Serum cardiovascular risk factors (i. e. ,C-reactive protein(CRP), total cholesterol, triglycerides, highdensity lipaprntein cholesterol (HDL-C), low-density lipoprotein cholesterol, apo-lipoprotein A-I (ApoA-1), and apolipoprotein B (ApoB) ) were measured at baseline and 6 months after nCPAP treatment. Results ① There was no significant difference on age,body mass index,blcod pressure,Epworth sleepi-ness scale (ESS) and saturation of blood oxygen (SPO_2) between the 3 groups (P>0.05). ②In group 1, ESS, SPO_2 minimum SPO_2 were significantly improved (3.20±2.80,93.80±2.01 and 84.10±6.17, respectively) compared to baseline (13.30±5.20,88.60±4.14 and 69.60±11.80, respectively) (P<0.01). Moreover, in group 2, there were significant improvement on ESS, SPO_2 and minimum SPO2 (4.95±2.67,94.20±1.46 and 85.20±4.97, respectively) compared to baseline (12.80±5.50,89.10±5.11 and 73.70±12.50, respectively) (P<0.01). ③In group 1 ,significant decreases in the levels of CRP,total cholesterol was observed (P=0.021 and 0.038). ④In group 2, group 3 there were slightly decrease of CRP after treatment, but the difference did not reach statistieal significance. Conclusions Good compliance to nCPAP treatment decreases the serum levels of cardiovas-cular risk factors, indicating a beneficial effect on the overall cardiovascular disease prevention and control.
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Objective To examine the difference in myocardial protection provided by continuous and intermittent warm blood cardioplegia during coronary artery bypass (CAB) .Methods Thirty ASA Ⅰ-Ⅱ patients undergoing CAB with warm CPB were randomly divided into two groups : (A) continuous warm blood cardioplegia ( n = 15) and (B) intermittent warm blood cardioplegia ( n = 15) . During CPB the body temperature was maintained at 33℃ -34℃ . Arterial blood samples were taken before skin incision (T0) , 1 h after going on CPB (T1 ) and 6h , 24h after coming off CPB (T2, T3 ), for determination of plasma concentration of cardiac troponin T (cTnT) using ELISA method. A small piece of myocardium was obtained from right ventricle (about 1g ) before aortic crass-clamping and after the aortic clamp was removed for determination of myocardial ATP content and ultrastractural examination. Results The demographic data were comparable between the two groups. Plasma cTnT level increased significantly at T1 and T2 as compared with the baseline values (T0) and then returned to normal level at T3 in both groups. The cTnT level was significantly higher in group B than that in group A at T2 (6h after weaning from CPB)The myocardial ATP content decreased significantly after aortic clamp was removed as compared with that before cross-clamping of aorta, but myocardial ATP content in group A was significantly higher than that in group B after release of arotic clamp. Mitochondria score was significantly higher after release of aortic cross-clamp than that before aortic cross-clamping.Conclusion Continuous warm blood cardiaplegia is superior to intermittent warm blood cardioplegia during CPB in terms of myocardial protection.