ABSTRACT
In China， about 100 million people currently have chronic obstructive pulmonary disease （COPD）. At the same time， COPD is a multisystem disease， not only affecting the function of musculoskeletal， cardiovascular， kidney and immune systems in patients， but also causing intestinal dysfunction as its extrapulmonary manifestations. From the perspective of traditional Chinese medicine （TCM）， after COPD is formed， deficiency， phlegm stasis and toxicity were accumulated in the lungs， which leads to dysfunction of lung in dispersing and descending， and eventually causes ascending and descending disorder of Qi activities， disorder of fluid supply and distribution， and stagnation of blood stasis. The viscera disease would affect the bowels， and the large intestine is thus affected. Modern medical discovers that， the lungs and intestines have common origins and similar physiological structures， in pathological circumstances， their common mucosal immune system may lead to similar immune factors and inflammatory manifestations in the lungs and intestines. At the same time， the studies have confirmed that there is also a close relationship between intestinal flora and lung， that is "lung-gut axis". These theories partially illustrate the mechanism of COPD in inducing intestinal injury. The specific manifestations of COPD intestinal dysfunction， ① Flora disorder， with increased abundance of intestinal gram-negative bacilli， and inhibited reproduction of Bifidobacterium， Lactobacillus and short-chain fatty acid-producing bacteria. ② Intestinal barrier damage： characterized by the destruction of intestinal epithelium tight connectivity， increased intestinal permeability， and thinning of the mucus layer. ③ Intestinal motility disorder： mostly manifested as weight loss and malnutrition. At present， for the intestinal dysfunction in COPD patients， most of the relevant discussions and targeted treatment methods in TCM are scattered and unsystematic. Guided by the idea of treating different diseases with the same treatment， we summarized the etiology and pathogenesis of COPD intestinal dysfunction by learning from the experience of TCM in treating intestinal flora disorders and inflammatory bowel disease， and proposed preliminary formulation with Tiaoqi Qushi，Tongfu Tongluo as its basic treatment principles in this paper， hoping to provide new ideas for the treatment of COPD.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of long-term treatment with arotinolol in patients with idiopathic dilated cardiomyopathy (IDCM).</p><p><b>METHODS</b>Sixty-three patients with IDCM were evaluated at baseline and after 12-month therapy with arotinolol. The conventional therapy for congestive heart failure was continued throughout the study with arotinolol as the only beta-blocker. Left ventricular function was assessed with the New York Heart Association functional class and two-dimensional echocardiography.</p><p><b>RESULTS</b>After 12-month arotinolol treatment, there was a significant improvement in left ventricular systolic function. Left ventricular end-systolic dimension significantly decreased from 59.52 +/- 8.83 mm to 50.89 +/- 8.17 mm (P < 0.001). Left ventricular ejection fraction significantly increased from 27.39% +/- 7.94% to 41.13% +/- 9.45% ( P < 0.001). Left ventricular mass index decreased from 150.47 +/- 42.42 g/m2 to 141.58 +/- 34.36 g/m2 (P < 0.01). No adverse events leading to premature discontinuation of study drug occurred.</p><p><b>CONCLUSION</b>In this preliminary study, 12-month arotinolol treatment has a favorable effect on left ventricular function in patients with IDCM, and it is safe and well tolerated.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Adrenergic beta-Antagonists , Pharmacology , Therapeutic Uses , Cardiomyopathy, Dilated , Drug Therapy , Echocardiography , Propanolamines , Pharmacology , Therapeutic Uses , Ventricular Function, LeftABSTRACT
<p><b>BACKGROUND</b>Pulmonary thromboembolism (PTE) has become a common disease that severely endangers people's health. This study analysed the changes in proportion and mortality of PTE in hospitalized patients to provide data for prevention and management of the disease.</p><p><b>METHODS</b>The data of 763 hospitalized patients with PTE from 1974 to 2005 in Fuwai Hospital were analysed.</p><p><b>RESULTS</b>During the 1970s, 0.27% of patients in a cardiovascular hospital had PTE (< 5 cases per year); while so far this century the proportion is 0.94% (48 to 113 per year). The mortality of hospitalized PTE patients fell from 20.00% in the 1970s to 4.10% this century. Prior to 1990, the mortality of hospitalized PTE patients was 12.50%, and in the years after 1990 only 3.40%. The difference was statistically significant (P < 0.005). People with this disease were mostly between the ages of 30 and 69 years. Men were most susceptible between the ages of 30 and 69 years, while women between the ages of 40 and 69 years. Men contracted PTE 10 years earlier than women. The mortality of male PTE patients was 4.70%, not significantly different from female patients, 5.06% (0.50 < P < 0.75). There were not any significant differences between the mortality of patients in the different age groups overall (< or = 39, 40 - 49, 50 - 59, and > or = 60 years, P > 0.1). More people contracted the disease in winter than in other seasons (P < 0.05). There was no obvious difference between the mortality in different seasons overall (0.75 < P < 0.90).</p><p><b>CONCLUSION</b>PTE is an increasingly significant disease and deserves adequate attention.</p>