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Objective:To investigate the significance and level of serum GRP78 and GRP94 in the early stage ofacute pulmonary embolism.Methods:Ninety APE patients (APE group) and forty healthy controls (control group) in Affiliated Zhongshan Hospital of Dalian University from January 2018 to March 2020 were recruited. The level of serum D-Dimer, GRP78 and GRP94 were compared between the two groups. The pulmonary embolism group was divided into three groups according to guidelines for the diagnosis and treatment of pulmonary embolism in ESC in 2019: low risk, medium risk, high risk, The level of serum D-Dimer, GRP78, GRP94, blood gas, pulmonary arterial pressure, PESI mark of three groups were compared.Results:Two groups had no significant difference in sex, age, body mass index ( P>0.05), but the level of serum D-Dimer, GRP78 and GRP94 in control group and APE group were higher than those in the control group: (3.86 ± 1.82) mg/L vs. (0.31 ± 0.15) mg/L, (2.68 ± 0.71) μg/L vs. (1.64 ± 0.38) μg/L, (1.31 ± 0.29) μg/L vs. (0.98 ± 0.13) μg/L ( P<0.05). The levels of serum D-Dimer, GRP78, GRP94, pulmonary arterial pressure, PO2, PESI score of different degree group (low risk, medium risk, high risk) were higher than those of low risk group and medium risk group: (5.63 ± 1.75) mg/L vs. (2.29 ± 0.51) and (3.64 ± 1.02) mg/L, (3.24 ± 0.76) μg/L vs. (2.17 ± 0.41) μg/L and (2.64 ± 0.47) μg/L, (1.57 ± 0.33) μg/L vs. (1.12 ± 0.13) and (1.26 ± 0.14) μg/L, (47.75 ± 6.98) mmHg (1 mmHg = 0.133 kPa) vs. (26.15 ± 4.63) and (35.21 ± 5.85) mmHg, (123.5 ± 20.59) scores vs. (85.5 ± 14.31) and (102.5 ± 13.32) scores ( P<0.05), and that of medium risk group were higher than those of low risk group ( P<0.05). But PO 2 of high risk group was lower than that of low risk group and medium risk group ( P<0.05), and PO 2 of medium risk group was lower than that of low risk group ( P< 0.05). pH of three group had no significant difference ( P>0.05). PCO 2 of high risk group was lower than that of low risk group and medium risk group ( P<0.05), and PCO 2 of medium risk group and low risk group had no significant difference ( P>0.05). The level of serum D-Dimer, GRP78, GRP94 were positively correlated withPESI score ( r = 0.610, 0.622, 0.627, P<0.01). After treatment, the levels of D-Dimer, GRP78 and GRP94 were significantly decreased ( P<0.05). Conclusions:The level of serum GRP78 and GRP94 are connected with acute pulmonary embolism, and it can reflect the severity of the disease.
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Objective:To observe the effects of bundled pulmonary rehabilitation on static pulmonary function, cardiopulmonary exercise function and inflammatory factors in patients with moderate or severe stable chronic obstructive pulmonary disease (COPD).Methods:Sixty moderate or severe COPD patients in stable phase from December 2017 to October 2018 in Affiliated Zhongshan Hospital of Dalian University were selected. The patients were divided into control group and rehabilitation group by random digits table with 30 cases each. The patients of control group received routine medicine therapy, and the patients of rehabilitation group received bundled pulmonary rehabilitation besides routine medicine therapy. Pulmonary function, cardiopulmonary exercise function and inflammatory factors in each group were tested before treatment and 3, 6 month after treatment.Results:In control group, there were no statistical differences in the pulmonary function, including the forced expired volume in one second (FEV 1), FEV 1 as percentage of predicted (FEV 1%pred), FEV 1/forced vital capacity (FVC); cardiopulmonary exercise function, including the peak load, peak VO 2, peak VO 2 as percentage of predicted (peak VO 2% pred), peak VO 2/kg, peak VE 3 and 6 months after treatment compared with those before treatment ( P>0.05); in rehabilitation group, there were no statistical differences in the indexes 3 months after treatment compared with those before treatment ( P>0.05), the indexes 6 months after treatment were significantly improved compared with those before treatment and 3 months after treatment ( P < 0.05). In control group, the C-reactive protein (CRP) and interleukin (IL-6) before treatment and 3 months after treatment and tumor necrosis factor-α (TNF-α) before treatment and 3, 6 months after treatment had no significant difference ( P > 0.05); the CRP and IL-6 6 months after treatment were significantly lower than those before treatment and 3 months: (5.48 ± 0.91) mg/L vs. (6.26 ± 0.99) and (6.09 ± 0.97) mg/L, (9.17 ± 1.04) ng/L vs. (10.83 ± 1.79) and (10.29 ± 1.53) ng/L, P < 0.05. In rehabilitation group, the CRP, IL-6 and TNF-α 3 and 6 months after treatment were significantly lower than previous phase: (5.21 ± 0.87) and (5.67 ± 0.91) mg/L vs. (6.15 ± 0.92) mg/L, (8.56 ± 1.17) and (10.03 ± 1.61) ng/L vs. (11.06 ± 2.01) ng/L, (7.16 ± 1.33) and (8.05 ± 1.62) ng/L vs. (8.97 ± 2.05) ng/L, P < 0.05. In rehabilitation group, the CRP, IL-6 and TNF-α before and after treatment were negatively correlated with pulmonary function (FEV 1, FEV 1% pred and FEV 1/FVC) and cardiopulmonary exercise function (peak load, peak VO 2, peak VO 2% pred, peak VO 2/kg and peak VE) ( r=- 0.641 to - 0.884, P < 0.01). Conclusions:Bundled pulmonary rehabilitation in patients with moderate or severe stable COPD can improve pulmonary function and cardiopulmonary exercise function and reduce inflammatory factors.
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Objective To explore the clinical characteristics of chronic obstructive pulmonary disease (COPD)in the patients with pulmonary interstitial fibrosis.Methods Twenty-seven COPD patients with pulmonary fibrosis and thirty patients with COPD who were diagnosed from July 2001 to October 2010 were analyzed for their clinical symptoms,physical signs,pulmonary function,arterial blood-gas,radiographic features,CT and high resolution computed tomography(HRCT)of the chest.Results The clinical features of COPD with pulmonary fibrosis shared that of the two diseases.Eighteen cases of COPD with pulmonary fibrosis had mixed ventilatory dysfunction(P ＜ 0.01).COPD were all obstructive ventilatory dysfunction(P ＜ 0.01).For arterial blood-gas test,PF-COPD showed progressing hypoxemia and little PaCO2 retention,but no significant difference was observed.Chest X-ray showed that 30 cases in the COPD group had an increased anteroposterior diameter of the thorax,while it was 14 cases in the PF-COPD group(P ＜0.05).Twenty four cases in the PF-COPD group showed nodular,meshy or honeycomb-like lesions,but none in COPD group(P ＜ 0.01).Chest CT and HRCT showed that there were higher chances of frosted glass-like and grid-like nodular lesions in the lungs of PF-COPD group than in COPD group(9 vs.0,19 vs.0 ;x2 =10.85,17.36,P ＜ 0.01).Conclusions Patients with chronic obstructive pulmonary disease and pulmonary fibrosis sharing the clinical features of both diseases.Chest HRCT can provide important information for clinical diagnosis.