Endothelial function and T-lymphocyte subsets in patients with overlap syndrome of chronic obstructive pulmonary disease and obstructive sleep apnea / 中华医学杂志(英文版)

BACKGROUND@#The coexistence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is termed overlap syndrome (OS). COPD and OSA both have increased risks of developing cardiovascular diseases. This study aimed to explore if patients with OS exhibited a higher prevalence of cardiovascular complications, and if patients with OS exhibited vascular endothelial dysfunction and abnormalities in the cellular immune function of T lymphocytes.@*METHODS@#Totally 25 patients with stable COPD (COPD group), 25 patients with OSA (OSA group), 25 patients with OS (OS group), and 20 healthy adults (control group) were enrolled between January 2017 and December 2017 from the Respiratory Department of Tianjin Medical University General Hospital. The clinical characteristics of the four groups were collected and the expression levels of soluble vascular cell adhesion molecule-1 (sVCAM-1), tumor necrosis factor-α (TNF-α), and T-lymphocyte subsets were detected. One-way analysis of variance, χ test and Pearson correlation were used to manage the data.@*RESULTS@#The prevalence of hypertension and coronary heart disease was significantly higher in the OS group than in the control, OSA, and COPD groups (χ = 20.69, P < 0.05 and χ = 11.03, P < 0.05, respectively). The levels of sVCAM-1 and TNF-α were significantly higher in the OS group than in other groups (F = 127.40, P < 0.05 and F = 846.77, P < 0.05, respectively). The percentage of CD4+ lymphocytes and CD4+/CD8+ were both significantly lower in the OS group than in any other group (F = 25.40, P < 0.05 and F = 75.08, P < 0.05, respectively). There were significantly negative correlations in the levels of sVCAM-1 and TNF-α with CD4+/CD8+ lymphocytes (r = -0.77, P < 0.05 and r = -0.83, P < 0.05, respectively).@*CONCLUSIONS@#The prevalence of hypertension and coronary heart disease was higher in patients with OS than in patients with either OSA or COPD alone. Patients with OS exhibited more severe vascular endothelial injury, stronger inflammatory response, and lower cellular immune function.

Endothelial function and T-lymphocyte subsets in patients with overlap syndrome of chronic obstructive pulmonary disease and obstructive sleep apnea / 中华医学杂志(英文版)

Background@#The coexistence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is termed overlap syndrome (OS). COPD and OSA both have increased risks of developing cardiovascular diseases. This study aimed to explore if patients with OS exhibited a higher prevalence of cardiovascular complications, and if patients with OS exhibited vascular endothelial dysfunction and abnormalities in the cellular immune function of T lymphocytes.@*Methods@#Totally 25 patients with stable COPD (COPD group), 25 patients with OSA (OSA group), 25 patients with OS (OS group), and 20 healthy adults (control group) were enrolled between January 2017 and December 2017 from the Respiratory Department of Tianjin Medical University General Hospital. The clinical characteristics of the four groups were collected and the expression levels of soluble vascular cell adhesion molecule-1 (sVCAM-1), tumor necrosis factor-α (TNF-α), and T-lymphocyte subsets were detected. One-way analysis of variance, χ2 test and Pearson correlation were used to manage the data.@*Results@#The prevalence of hypertension and coronary heart disease was significantly higher in the OS group than in the control, OSA, and COPD groups (χ2 = 20.69, P < 0.05 and χ2 = 11.03, P < 0.05, respectively). The levels of sVCAM-1 and TNF-α were significantly higher in the OS group than in other groups (F = 127.40, P < 0.05 and F = 846.77, P < 0.05, respectively). The percentage of CD4+ lymphocytes and CD4+/CD8+ were both significantly lower in the OS group than in any other group (F = 25.40, P < 0.05 and F = 75.08, P < 0.05, respectively). There were significantly negative correlations in the levels of sVCAM-1 and TNF-α with CD4+/CD8+ lymphocytes (r = –0.77, P < 0.05 and r = –0.83, P < 0.05, respectively).@*Conclusions@#The prevalence of hypertension and coronary heart disease was higher in patients with OS than in patients with either OSA or COPD alone. Patients with OS exhibited more severe vascular endothelial injury, stronger inflammatory response, and lower cellular immune function.

Pulmonary Embolism in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease / 中华医学杂志(英文版)

Objective@#In most countries, nearly 6% of the adults are suffering from chronic obstructive pulmonary disease (COPD), which puts a huge economic burden on the society. Moreover, COPD has been considered as an independent risk factor for pulmonary embolism (PE). In this review, we summarized the existing evidence that demonstrates the associations between COPD exacerbation and PE from various aspects, including epidemiology, pathophysiological changes, risk factors, clinical features, management, and prognosis.@*Data Sources@#We searched the terms "chronic obstructive pulmonary disease," "pulmonary embolism," "exacerbations," and "thromboembolic" in PubMed database and collected the results up to April 2018. The language was limited to English.@*Study Selection@#We thoroughly examined the titles and abstracts of all studies that met our search strategy. The data from prospective studies, meta-analyses, retrospective studies, and recent reviews were selected for preparing this review.@*Results@#The prevalence of PE in patients with COPD exacerbation varied a lot among different studies, mainly due to the variations in race, sample size, study design, research setting, and enrollment criteria. Overall, whites and African Americans showed significantly higher prevalence of PE than Asian people, and the hospitalized patients showed higher prevalence of PE compared to those who were evaluated in emergency department. PE is easily overlooked in patients with COPD exacerbation due to the similar clinical symptoms. However, several factors have been identified to contribute to the increased risk of PE during COPD exacerbation. Obesity and lower limb asymmetry were described as independent predictors for PE. Moreover, due to the high risk of PE, thromboprophylaxis has been used as an important treatment for hospitalized patients with COPD exacerbation.@*Conclusions@#According to the previous studies, COPD patients with PE experienced an increased risk of death and prolonged length of hospital stay. Therefore, the thromboembolic risk in patients with acute exacerbation of COPD, especially in the hospitalized patients, should carefully be evaluated.

Comparative study of laparoscopy-assisted Vechitti vaginoplasty and vaginoplasty with peritoneum / 中华整形外科杂志

<p><b>OBJECTIVE</b>To compare the therapeutic effect of laparoscopy-assisted Vechitti vaginoplasty and vaginoplasty with peritoneum.</p><p><b>METHODS</b>From Jan. 2005 to Mar. 2011, 43 cases of congenital absence of vagina were treated by laparoscopy-assisted modified Vechitti vaginoplasty (n = 26) and by laparoscopy-assisted vaginoplasty with peritoneum (n = 17). The duration of operation, the intraoperative blood loss, and the length, appearance of reconstructed vagina were compared between the two groups.</p><p><b>RESULTS</b>All the patients were successfully treated with no complication. The mould fell out in one case in Vechitti group one month after operation, which was put back after 3 days of expansion with a smaller mould. The perineum appearance was not affected. The reconstructed vagina in both groups were wide with pink mucosa, good elasticity and smoothness. The intercourse process was satisfied. The duration of operation and intraoperative blood loss were less in Vechitti group than those in peritoneum group, but the reconstructed vagina length was (7.8 +/- 0.4) cm in Vechitti group, and (8.8 +/- 0.6) cm in peritoneum group, showing a significant difference (t = 6.45, P < 0.01).</p><p><b>CONCLUSIONS</b>Compared with Vechitti vaginoplasty, the laparoscopy-assisted vaginoplasty with peritoneum is comparatively complicated with longer operative duration, but the reconstructed vagina is longer with better long-term effect.</p>

Effect of different intermittent hypoxia patterns on interleukin-6 and interleukin-8 levels of human umbilical vein endothelial cells / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of different patterns of intermittent hypoxia on the levels of interleukin-6 (IL-6) and interleukin-8 (IL-8) of vascular endothelial cell.</p><p><b>METHODS</b>The human umbilical vein endothelial cells of the line ECV304 were used to set up the cells model. The experiment cell strains contained one control group and eight experimental groups, 1 constance normoxia group (control group), 3 different intermittent hypoxia (IH) degree groups (10% O₂ group, 1.5% O₂ group, 0.5% O₂ group with 12 times/h), 4 different IH frequency groups (40 times/h, 20 times/h, 12 times/h, 9 times/h and 6 times/h with 0.5%O2). The specimen were put into a program-controlled gas delivery system with different level and frequency of IH respectively. Then enzyme linked immunosorbent assay (ELISA) was used to examine the levels of IL-6 and IL-8.</p><p><b>RESULTS</b>Higher level of IL-6 and IL-8 were found in 3 different IH degree groups than in control group (F were 1961.100 and 103.855 respectively, P all < 0.001). The level of IL-6 and IL-8 was gradually increased with the decreasing of IH degree. The difference of IL-6 and IL-8 levels between each two different groups in IH degree was significant (P all < 0.05). The level of IL-6 and IL-8 groups was significantly different in severe IH exposure (F were 544.396 and 149.328 respectively, P all < 0.001 in both groups). There was a trend as the IH frequency decreased, the level of IL-6 and IL-8 was tenderly increased in 20/hour group (P < 0.05), highest in 12/hour group (P < 0.05), decreased in 9/hour group (P < 0.05), and decreased further in 6/hour group (P < 0.05) in severe IH expose. There was statistical significance between each two different frequency IH groups (P < 0.05).</p><p><b>CONCLUSIONS</b>Intermittent hypoxia caused significant inflammatory reaction in vascular endothelial cells. The secreted level of IL-6 and IL-8 depended on the degree of hypoxia. There was a trend as the level of IH frequency decreased, the level of IL-6 and IL-8 gradually increased at first, and then decreased in the same way.</p>

A study on the respiratory mechanics and inflammatory status in elderly patients with stable chronic obstructive pulmonary diseases / 中华老年医学杂志

Objective To evaluate the respiratory mechanics and inflammatory status in elderly patients with stable chronic obstructive pulmonary diseases (COPD).Methods The arterial blood gases (ABGs),respiratory drive and its derivatives,mechanics of respiratory muscles,resistance and compliance of airway,interleukin-8 (IL-8)and interferon-?(IFN-?)were measured in 42 cases withstable COPD and 40 subjects of normal control.Results The elderly patients with stable COPD had great changes in the following parameters while compared with the control group:peak inspiratory pressure(PIMAX) [(4.48?2.11)vs(6.10?2.91)kPa],maximum expiratory pressure (PEMAX)[(6.30?3.20)vs(9.15?93.30)kPa],0.1s mouth occlusion pressure(P_(0.1)) with its correction index,airway resistance,compliance,ABGs,the levels of IL-8[(218.46?91.14) vs (161.84?14.40)ng/L]and IFN-?[(2435.82?639.92)vs(1652.40?95.08)ng/L],which might aggravate the progress of COPD consistently.Conclusions The elderly patiends with stable COPD has marked changes in respiratory drive,airway resistance,and airway compliance,respiratory mechanic and inflammatory status.The intervention should be performed in the elderly stable COPD patients.