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Objective :To explore therapeutic effect of upper and lower extremity active and passive rehabilitation treadmill combined occupational therapy on patients with chronic obstructive pulmonary disease (COPD) during sta—ble period .Methods : A total of 92 COPD patients were randomly and equally divided into occupational therapy group and treadmill + occupational therapy group .Both groups received routine nursing care ,treatment and com—prehensive rehabilitation therapy ,occupational therapy group also received occupational therapy ,while treadmill +occupational therapy group received upper and lower extremity active and passive treadmill training based on occupa—tional therapy group .After eight—week treatment ,pulmonary function ,exercise function ,daily living capacity and quality of life were analyzed and compared between two groups .Results : Compared with before treatment ,after treatment ,there were significant improvements in pulmonary function ,exercise function ,score of activity of daily living scale (ADL) and quality of life (SGRQ) in two groups , P＜ 0. 05 or ＜ 0. 01. Compared with occupational therapy group after treatment ,there was significant reduction in modified Medical Research Council dyspnea scale (mMRC) [ (2. 7 ± 0. 4) grade vs.(2. 4 ± 0.6) grade] ,and significant rise in 6min walking distance [ (291. 4 ± 28. 9) m vs.(307. 8 ± 30. 4) m] and ADL score [(56.0 ± 11.4) scores vs .(62. 0 ± 10.9) scores] in treadmill + occupation—al therapy group ( P＜0.05 or ＜0. 01) ,but there were no significant differences in pulmonary function indexes and quality of life (SGRQ) between two groups , P＞0.05 all.Conclusion : Upper and lower extremity active and passive treadmill training combined occupational therapy can significantly improve pulmonary function and exercise function and daily living capacity in patients with chronic obstructive pulmonary disease .
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Objective To compare the efficacy and safety of levofloxacin 750 mg for 5 days versus 500 mg for 7‐14 days intravenous (IV ) infusion in the treatment of community‐acquired pneumonia (CAP ) . Methods This study was a multi‐center , randomized , open‐label , non‐inferiority , controlled clinical trial .The CAP patients were randomized to receive levofloxacin 750 mg IV daily for 5 days or levofloxacin 500 mg IV daily for 7‐14 days .The clinical symptoms , laboratory tests , imaging results and microbiology data were collected and compared between the two treatment groups in terms of efficacy and safety .Results A total of 241 patients were enrolled in this clinical trial from 10 study centers .Among these patients ,223 were eligible for full analysis set (FAS) analysis ,including 111 in 750 mg group and 112 in 500 mg group .Of the 223 patients in FAS ,211 were eligible for per‐protocol set (PPS) analysis ,including 107 in 750 mg group and 104 in 500 mg group .Two hundred and forty‐one patients were included in safety set (SS) ,including 121 patients in 750 mg group and 120 in 500 mg group .The median treatment duration was 5 .0 days in 750 mg and 9 .0 days in 500 mg group .The median total dose was 3 750 mg in 750 mg group and 4 500 mg in 500 mg group .The overall efficacy rate was 86 .2% in 750 mg group and 84 .7% in 500 mg group in terms of FAS at visit 4 ,which suggested that the efficacy of 750 mg group was non‐inferior to 500 mg group .Of the 111 FAS patients in 750 mg group ,40 were bacteriological evaluable ,and 41 strains of pathogens were isolated .Forty‐nine of the 112 FAS patients in 500 mg group were bacteriological evaluable ,and 51 bacterial strains were obtained .The bacterial eradication rate was 100% in both groups .The clinical treatment efficacy rate for atypical pathogens was 100% in both groups .In 750 mg group ,the most common clinical adverse drug reactions (ADRs) were injection site adverse reactions including injection site pruritus ,pain and hyperemia .The other common ADRs were insomnia ,nausea ,skin rash .The most common drug‐related laboratory abnormalities were neutrophil percentage decreased , decreased white blood cell (WBC ) count , alanine aminotransferase (ALT) and aspartate aminotransferase (AST) elevation .Most of the ADRs were mild in severity and well‐tolerated .The safety profile of the two treatments was comparable in terms of the drug‐related treatment discontinuation and the incidence of ADRs .Conclusions The short‐course regimen of levofloxacin 750 mg IV for 5 days is at least as effective and well tolerated as the long‐course regimen of 500 mg IV for 7‐14 days in treatment of CAP .
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Objective To investigate the association among daytime sleepiness,serum tumor necrosis factor(TNF)-α levels and microarousal in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Forty male patients with OSAHS conformed by apnea hypopnea index(AHI)during sleep monitoring of polysomnography were selected as OSAHS group,15 healthy subjects were selected as control group.The level of serum TNF-α was measured by ELISA.The Epworth sleepiness(EP)scale was used in two groups.Results The level of serum TNF-α in OSAHS group[(18.42±6.23)ng/L]was significantly higher than that in control group[(9.75±3.12)ng/L],P＜0.01.The EP scale and micmarousal index were signifieand yhigher in OSAHS group than those in control group[(16.9±4.7)acores vs(4.5±2.3)dcores,(33.6±16.9)times/h vs(11.3±7.3)times/h,P＜0.01].The EP scale in OSAHS group was positively correlated with the levels of serum TNF-α(r=0.461,P＜0.01),AHI(r=0.443,P＜0.01)and microarousal index(r=0.751,P＜0.01)respectively.The levels of serum'INF-α in patients with OSAHS were also positively correlated with microarousal index(r=0.373,P＜0.01).Conclusions The levels of serum TNF-α and mieroarousal index are increased in patients with 0SAHS.The microarousal related to OSAHS plays an important role on the daytime sleepiness,the unusual levels of serum TNF-α maybe lead to interferen of sleepiness.
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Objective To observe the effects of cigarette smoke extract (CSE) on the proliferation and secretion of hydrogen peroxide (H2O2) in human lung fibroblasts (HLFs) induced by transforming growth faetor-β1(TGF-β1).Methods Cultured HLFs were divided into a normal group and a model group induced by TGF-β1 (5 ng/mL),then intervened with CSE at different concentrations (0% ,2.5% ,5%, 10%, respectively).Brdu ELISA assay was used to detect cell proliferation.H2O2release from cultured cells was assayed using a fluorimetric method.Cellular localization of H2O2 and expression of α-SMA were performed using a fluorescent-labeling strategy.Results TGF-β1 stimulated group showed positive expression of α-SMA, implying TGF-β1 had induced fibroblasts to differentiate into myofibroblasts.In TGF-β1 stimulated group,2.5% and 5% CSE promoted cell proliferation (P < 0.01 or 0.05), while 10% CSE inhibited cell proliferation (P < 0.01).In the normal group, both low and high concentration of CSE inhibited cell proliferation (P < 0.01 or P < 0.05), and the inhibition effect was dose-dependent.HLF induced by TGF-β1 generated low constitutive levels of extracellular H2O2 that was markedly enhanced by CSE treatment (P < 0.01).Pretreatment with DPI, an inhibitor of NADPH oxidase, abolished secretion of H2O2.Cellular localization of H2O2 by a fluorescent-labeling strategy demonstrated that extracellular secretion of H2O2 is specific to the myofibroblast.Conclusions Low concentration of CSE can promote myofibroblast proliferation, and markedly increase extracellular secretion of H2O2.CSE possibly take part in the development and progress of idiopathic pulmonary fibrosis by increasing oxidative stress.
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Objective: To observe the change of the levels of tumor necrosis factor-?(TNF-?),interferon-?(IFN-?) and interleukin-10(IL-10) in bronchial alveolar lavage fluid(BALF) from rats with pulmonary fibrosis induced by bleomycin and investigate the intervention by IFN-? on it. Methods: The SD rats were randomly divided into three groups: the normal control group(Group N),the bleomycin-A_5 group(Group B),and the interferon-? treated group(Group I).The pulmonary fibrosis model was established by a single intratracheal injection of 5 mg/kg of bleomycin.The rats were sacrificed at day 17,21,28 after modeling in batch.Semi-quantitative analysis of the histopathologic changes stained with Haematoxylin-eosin(H-E) was performed.The levels of TNF-?,IFN-? and IL-10 in BALF were measured with ELISA.The content of hydroxyproline in the lungs was determined by digestion method.Results:①The scores of pulmonary alveolitis and pulmonary fibrosis in Group I and Group B were significantly higher from 17d after bleomycin administration compared with Group N(all P
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To evaluate the efficacy and safety of Azithromycin in the treatment of the bacterial infections. Method s: 94 patients with lower respiratory tract infection were randomly d ivided into 2 groups(47 for each gruop). The treated group were given Azithrom ycin 500mg in 5% glucose injection 500mL, iv drip, bid, for 5-7 days. Another 12 patients (including 4 patients with pelvic inflammatory disease and 8 patients with lower respiratory tract infection) were treated with Azithromycin as the op en group. Results: The treated group yielded a recovery ra te 61.7%, aeffective rate 91.5% and abacterial clearance rate 95.8%, which wer e higher than the controlled group [31.9%, 70.2%, and 76.6% (P＜0.01)]0,res pectively. The total response rate and the cure rate in 59 patients treated with Azithromycin were 93.2% and 62.7%, respectively. The incidence of clinical adve rse drug reactions in the treated group was 12.8%, being lower than 34.0% in the controlled group (P＜0.05). Conclusion: Azithromycin is an effective agent in the treatment of the acquired lower respiratory tract infection, urogenital and urogenital tract infection with slight adverse reaction .
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Objective:To investigate the effects of interferon-? on bleomycin-induced pulmonary fibrosis in rats and to study the mechanism of its effects.Methods:60 SD rats were randomly divided into 3 groups of 20:normal control group(Group N), model control group(Group M) and interferon-?(IFN-?)treated group(Group R). The pulmonary fibrosis model was established by a single intratracheal injection of 5 mg/kg of bleomycin. The rats were sacrificed at days 3,7,14,28 after modeling in batch. Lung tissues were restored to analyze the pathological changes, the content of hydroxyproline,mRNA expression of IFN-? and transforming growth factor-?(TGF-?).Results:The scores of alveolitis in Group M and R were higher than that in Group N at each poin-in-time after modeling.The scores of alveolitis in Group R were higher than that in Group M. The scores of pulmonary fibrosis and the content of hydroxyproline in lung tissues in Group M and R were higher than that in Group N at day 14 and 28. The expression of IFN-? mRNA in lung tissues at day 3,7,14,28 and TGF-? mRNA at day 3 in Group R were higher than that in Group M(P