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Objective To study the relationship between bronchial asthma and smoking status in Chinese people.Methods Asthma epidemiological survey and stratified-cluster-random method survey were performed in residents over 14 years in 8 provinces (cities) of China from February 2010 to August 2012.Asthma was diagnosed based upon case history,clinical signs and lung function test.Smoking status was investigated by questionnaire.Results Sampling population was 180 099 and 164 215 were valid.A total of 2 034 subjects were diagnosed as asthma including 79 692 men and 84 523 women.The overall prevalence rate of asthma was 1.24％ (2 034/164 215).Smokers were 23.8％ (39 137/164 215) in the whole population.Smokers were 34.5％ (702/2 034) in asthmatic patients,compared with 23.7％ (38 435/ 162 181) in no-asthmatic population.The incidence of asthma was 1.79％ and 1.06％ in smokers and nonsmokers respectively (P ＜0.001),suggesting that OR of smoking was 1.70 (95％ CI 1.55-1.86,P ＜ 0.001).According to asthma control test (ACT) score,the level of asthma control in non smoking group was higher than that in smoking group(43.2％ vs 35.3％).The times of hospitalization due to acute exacerbations (0.51 vs 0.41 events/person/year),total hospitalization rate (27.35 ％ vs 20.12％),annual emergency room visits (0.80 vs 0.60 events/person/year) and emergency room visit rate (31.77％ vs 24.47％) were all much higher in smoking asthmatic patients than those in non smoking asthmatic patients,indicating that the level of asthma control in smoking patients was significantly worse than in non smoking patients.Conclusions The smoking rate in Chinese people over 14 years is still high.The prevalence rate of asthma in smokers is significantly higher than that of non-smokers.The level of asthma control in smokers is significantly worse than that in non smokers.
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Objective:To analyze the clinical efficacy of Seretide combined with noninvasive positive pressure ventilation (NIPPV) in the treatment of chronic obstructive pulmonary disease (COPD) complicated with type 2 respiratory failure (RF).Methods:120 patients of COPD complicated with type 2 RF were randomly divided into the observation group and the control group.All patients were treated with routine,symptomatic and supportive treatment,based on that NIPPV was used in the control group,and the observation group was treated with Seretide on the basis of NIPPV.The levels of arterial blood gas,inflammatory factors,pulmonary function and CAPS score before and after treatment were compared and analyzed.Results:After treatment,the pH,PaO2 and SaO2 of both groups were significantly increased,PaCO2 levels weresignificantly decreased,serum IL-33,TNF-oα and sICAM-1 levels were significantly decreased,FVC,PEFR,FEV1％ and FEV1/FVC were significantly decreased,and the CAPS scores were significantly decreased;the changes of all the index mentioned above in the observation group were more statistically significant (P＜0.05).Conclusion:Seretide com bined with NIPPV could more effectively decrease the levels of inflammatory factors and improve the blood gas and lung function in the patients of COPD with type 2 respiratory failure.
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Objective To evaluate the efficacy and safety of S-1 combined with synchronous three-dimensional conformal radiotherapy in the treatment of elderly patients with esophageal cancer.Methods 80 elderly patients with esophageal cancer were randomly divided into control group and the combination group,40 cases in each group.Three-dimensional conformal radiotherapy was applied in the two groups with a total dose of DT 60-64 Gy/ 30-32f.Patients in the combination group received S-1 chemotherapy concurrent with the radiotherapy on the first day.S-1 was orally given 80mg/m2 daily after meals from d1 to d14,21 days as a cycle and treated for 2 cycles.Results The total effective rate (CR + PR) of the combination group was 87.5％,that was 62.5％ of the control group,and there was statistically significant difference between the two groups (x2 =6.667,P =0.01).The one year overall survival rate of the two groups was 77.5 ％ and 57.5 ％,respectively,the difference was not significant (P =0.056).The incidence rate of hematological toxicity was higher in the combination group than that in the control group,but the toxic reaction was mild and tolerable.Conclusion The short-term curative effect of S-1 combined with three-dimensional conformal radiotherapy is feasible for elderly patients with esophageal cancer,and the toxicity is tolerable.
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Objective To evaluate the control status and knowledge level about disease in asthmatic patients in region level cities of Shaanxi province for effect appraisal of patient education.Methods Eight hospitals were selected from six region level cities, where questionnaire survey was completed in out-patients with asthma (≥ 14 years old).Results A total of 523 patients completed the questionnaire with a ratio of male to female of 1: 1.14,and an average age of (44.3±15.5) years old.The percentage of controlled, partly controlled and uncontrolled by self-evaluation was respectively 26.4%, 52.4% and 11.1%.48% insisted on using inhaled corticosteroids (ICS).The average score was 17.88±4.43 by asthma control test (ACT).The first three medicines used daily were ICS (26.6%), sustained-release theophyline (25.2%) and combination ICS/long-acting β2-agonists (21.8%).12.6% had no medicine and 5.2% used non-orthodox medicines.68.6% patients had omen before exacerbation, and those were sneezing, chest distress and cough.73.6% knew asthma is a disease of airway inilammatian,and 33.3% selected ICS as the leader medicine.Only 32.1% attended the lecture about asthma in hospitals and 85.0% longed for such education.Conclusions The control status and knowledge level about disease in asthmatic patients in cities still need to be improved in Shaanxi province, and too much work need to be done in order to realize the total control in all patients.
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Objective: To evaluate the inhibitory effect of Yichuanping capsule (易喘平胶囊) on the airway mucus overproduction in asthmatic mice and its mechanism. Methods: Thirty-two male BALB/c mice were randomly divided into normal control group, asthma group, dexamethasone group and Yichuanping capsule (YC) group (n=8 in each group). Asthmatic mouse model was established by intraperitoneal injection of ovalbumin. The number of goblet cells and secretion of mucus were detected with periodic acid-Schiff (PAS) staining, and mucus protein MUC5AC mRNA was detected with reverse transcription-polymerase chain reaction (RTCD*2PCR). Number of total cells and eosinophil in bronchoalveolar lavage fluid (BALF) were counted with special staining. The contents of interleukinCD*24 (ILCD*24) and ?CD*2interferon (IFNCD*2?) in lung tissue were assessed by enzyme-linked immunoadsorbent assay (ELISA). Results: Compared with asthma group, the number of goblet cells, MUC5AC mRNA levels and secretion of mucus in airway were reduced in dexamethasone group and YC group(all P
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BACKGROUND: The pathological characteristics of pulmonary interstitial fibrosis are the proliferation of a large number of fibroblasts and the increasing deposition of matrix collagen that takes the place of normal lung structure. Fluvastatin can inhibit the proliferation of fibroblasts and many other cells.OBJECTIVE: To investigate the effects of fluvastatin in inhibiting the proliferation of rat lung fibroblasts cultured in vitro and its influence on bleomycin-induced pulmonary fibrosis and ventilation function.DESIGN: A randomized controlled trial.SETTING: Department of Respiratory Diseases, Xijing Hospital, Fourth Military Medical University of Chinese PLA; Teaching and Research Section of Pathology, Department of Basic Medicine, Fourth Military Medical University of Chinese PLA; Research Institute ofOrthopedics, Xijing Hospital,Fourth Military Medical University of Chinese PLA.PARTICIPANTS: The study was conducted in the laboratory of Department of Respiratory Diseases, Xijing Hospital of Fourth Military Medical University of Chinese PLA from January to December 2001. Thirty-one healthy adult male Sprague-Dawley(SD) rats of grade Ⅰ were selected in this study.INTERVENTIONS: The fibroblasts derived from the lung normal of one rat were cultured in vitro in media containing fluvastatin. The effect of fluvastatin on the growth curve and the effect of its different concentrations(0, 1 × 10-7,1 ×10-6, 1 ×10-5, 1 ×10-4, 1 ×10 3and 1 ×10-2 mol/L, fluvastatin of 0 mol/L was taken as the blank control group) in inhibiting the cultured cells were observed with MTT colorimetry. The effect of fluvastatin on the division index of the fibroblasts was analyzed by direct cell counting Hydroxyproline colorimetry was used to detect the influence of fluvastatin on the collagen secretion in the media. The other 30 SD rats were divided into six groups: normal control group, bleomycin-induced group and fluvastatin-treated groups(TH 1,TE1, TH15 and TL15 groups) named according to the date of giving fluvastatin,i. e. the 1st day and the 15th day, after the rats were given bleomycin A5. All the rats were killed 28 days later. The number of fibroblasts, the thickness of alveolar wall and the area of mesenchyma in lung tissue were measured by HE staining. The extracellular matrix and collagen in lung tissue were observed by Masson and sirius red staining, and hydroxyproline in lung tissue homogenates was measured.MAIN OUTCOME MEASURES: Fibroblast growth curve and division index of rat lung, hydroxyproline in the media and lung tissue homogenates,number of fibroblasts and the thickness of alveolar wall, the area of mesenchyma, extracellular matrix and collagen contents in lung tissue.RESULTS: Fluvastatin could inhibit the proliferation of the rat lung fibroblasts cultured in vitro(t=4.20 to 17.52, P < 0.01), and its inhibitory effect was increased with the increased dose of fluvastatin, which showed a dose-dependent effect. The 1 × 10-4 mol/L fluvastatin could completely inhibit the proliferation of the cultured cells, and the A490 value from the 2nd day on the fibroblasts by MTT colorimetry was not insignificantly different from those on the 1st day( P > 0.05) . The division index of the fibroblasts and secretion of collagen were obviously decreased by fluvastatin( t = 8. 037,P <0.01; t =3.99 to 10. 84, P <0.05 or P <0.01). In vivo, the number of fibroblasts, the thickness of lung alveolar wall, the area of mesenchyma and the content of hydroxyproline in lung tissue were significantly higher in bleomycin group than in control group( t =4. 62 to 11.93, P < 0. 01), while those in the fluvastatin-treated groups were lower than those in bleomycin group in different degrees( t = 2.69 to 7.65, P < 0.05 to 0.01 ) . The distribution of extracellular matrix and types Ⅰ and Ⅲ collagen in lung tissue were obviously increased in bleomycin group as compared with that in control group, but decreased in different degrees in fluvastatin-treated groups.CONCLUSION: Fluvastatin can significantly inhibit the proliferation of rat lung fibroblasts in vitro, suggesting that it may be an effective drug for pulmonary fibrosis. Treatment at earlier stage is more effective than at advanced stage.
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AIM: To observe dose-effect relationship of spinal anesthesia with 0.75% ropivacaine in caesarean section.METHODS: According to the dosage of 0.75% ropivacaine,120 full-term and single-birth puerperants were randomly divided into four groups of 30 people each.The dosage of group Ⅰ,Ⅱ,Ⅲ and Ⅳ were 1.5,1.8,2.1 and 2.4 mL respectively.The sensory and motor block of each group within 30 minutes after the injection were observed,and the hemodynamic changes and adverse effects were recorded.RESULTS:(1) Within 30 minutes after the injection,the intermediate zone of pain disappeared highest block level of group I-IV were T10,T8,T6 and T5 respectively.(2) During the period of the first 30 minutes,there were 3 cases in group Ⅲ(10%) and 8 cases in group Ⅳ(27%) appeared chest distress and dyspnea,and the blood pressure of 5 cases in group Ⅲ(17%) and 12 cases in group Ⅳ(40%) dropped to 90 mm Hg(1 mm Hg=0.133 kPa).There were significant difference compared with group IV(P0.05),there were significant difference between group IV and other groups(P
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<p><b>BACKGROUND</b>To observe and explore the effects and mechanisms of fibronectin (FN) on invasion of different types of lung cancers.</p><p><b>METHODS</b>Using tumor invasion models in vitro of plates coated with FN and Boyden chambers with FN filter, differences of adhesion and migration between small cell lung cancer cell line (054A) and adenocarcinoma cell line (A549) were investigated, and proliferative effects of FN on cells were examined. In the meantime the invasive capability changes were observed after cell suspensions were preincubated with anti-α5, anti-α3 and anti-β1 integrin antibodies, respectively.</p><p><b>RESULTS</b>FN could improve the adhesion, migration and proliferation of A549 more markedly than that of 054A. The number of adhesive cells in A549 cell line changed from 34.7± 5.1 to 189.4±12.3 with time from 2h to 12h compared with that from 19.8±7.9 to 159.2±11.9 in 054A cell line (P < 0.05 or P < 0.01). A549 cell line had 142.7±5.9 migration cells while 054A cell line had 89.4±4.7 (P < 0.01). FN could improved the proliferation in A549 cell line from 0.250±0.019 to 0.754±0.025 (P < 0.01) in concentration-dependent way, but in 054A from 0.205±0.026 to 0.286±0.029. And these effects were mediated mainly by α3β1 and α5β1 receptors in A549, but α3β1 in 054A.</p><p><b>CONCLUSIONS</b>Lung cancers with different origins express so different types and extents of integrin receptors that effects of FN on tumors are various, which is one of important reasons of different invasive capability of lung cancers.</p>
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Objective To explore the therapeutic efficacy of a self-made occluder used for bronchoscopic lung volume reduction(BLVR).Methods Two patients with severe chronic obstructive pulmonary disease(COPD)in stable phase were selected for the present study.One or two nitinol occluders were placed,guided by brochoscopy,into the target bronchi of the two patients.Examination of pulmonary functions,chest computed tomography,complications,blood gas analysis,and evaluation of life quality with St George's respiratory questionnaire(SGRQ)were carried out before and 7 months after the bronchoscopic lung volume reduction.Results No dislodging or shifting of all the inserted occluders occurred.Only slight proliferation of granulation tissue was found in mucous membrane around the occluder,and atelectasis was observed at the target sites of lung.Before and 7 months after BLVR,ventilatory capacity(VC)of case 1 rose from 3.08L to 3.57L,and that of case 2 was elevated from 2.19L to 2.58L.Forced vital capacity(FVC)of case 1 was elevated from 2.87L to 3.57L,and that of case 2 from 2.60L to 2.58L.SGRQ showed a remarkable improvement of patients' dyspnea with a decrease of scores from 62 to 26 in case 1 and from 48 to 23 in case 2.No evident changes were found on arterial oxygen blood partial pressure(PaO2)in both patients,and no severe complications such as obstructive pneumonia or pneumothorax occurred yet in either case 1 or case 2.Conclusion The present study has demonstrated that the self-made occluder is convenient for insertion with satisfactory stability and therapeutic efficacy.Application of such occluder is safe with few complications,and may serve the purpose of reducing lung volume and improving lung function.
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Objective To evaluate the ability of goblet cell in the airway in rat with asthma to synthesize granulocyte-macrophage colony-stimulating factor (GM-CSF),and the role of calcium-activated chloride channel (CLCA) in the synthesis. Methods A model of asthma was replicated in male BALB/c mice with ovalbumin sensitization. The goblet cells in small bronchi were identified with AB-PAS staining,and the expression of GM-CSF in the same airway was assessed with immunohistochemistry staining. The recombinant plasmid of pIRES2-EFGP/hCLCA1 was transfected stably into the human mucoepidermoid cell NCI-H292. The expression and transcription levels of GM-CSF in transfected cells were determined with immunohistochemistry staining and RT-PCR assay. The non-transfected cell and the transfected cell exposed to niflumic acid (NFA),which was a CLCA inhibitor,were designated as two control groups. Results Positive staining of GM-CSF expression could be seen in the goblet cells of small bronchi. The cells with expression of hCLCA1 showed much higher levels of GM-CSF expression and transcription than those of two control groups. It was also found that NFA could effectively reduce the levels of GM-CSF in transfected cells. Conclusion The goblet cell of asthmatic airway can synthesize GM-CSF,and one of mechanisms is the increased expression of CLCA.
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AIM: To investigate the effects of fluvastatin on the airway remodeling in a guinea pig model of asthma. METHODS: Asthmatic guinea pig model was established by intraabdominal injection of ovalbumin and aluminium hydroxide and challenged with ovalbumin once every other day for 60 days. 30 guinea pigs were randomly divided into three groups: control group ( n= 10), asthma group ( n= 10) and fluvastatin plus asthma group ( n= 10) in which fluvastatin was inhaled at concentration of 0.5 g/L 30 min before every challenging. The thickness of airway smooth muscle layers of every three groups were compared after Haematin-Eosin staining by image analysis system. The level of ras mRNA in airway were examined by Dot-blot molecular hybridization. The expression levels of ras p21 were also examined by immunohistochemical technique. RESULTS: The mean thickness of airway smooth muscle in asthma group was (74 27?3 30) micrometer, greater than that of control group [(38 57?3 37) micrometer ( P
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AIM: To observe the preventive effect of DNA vaccine based on human calcium-activated chloride channel 1 (hCLCA1) on airway hyperresponsiveness in asthmatic mice.METHODS: The DNA vaccine was constructed by inserting the hCLCA1 gene into pSecTag-2A, and then BALB/c mice were vaccinated by im. once every two weeks. Serum antibody was checked with the antigen of mCLCA3 by ELISA analysis. Asthma was induced with ovalbumin in the vaccinated mice. The airway pressure time index (APTI), the contractile responsiveness of isolated tracheal rings and the number of eosinophil in bronchoalveolar lavage (BAL) were investigated. Mice injected with pSecTag-2A, saline or normal mice were regarded as control groups. RESULTS: The title of antiserum binding to mCLCA3 in vaccine group was 1∶800 to 1∶(1 000) after three times vaccination. Compared with normal group, APTI, contractile responsiveness and number of eosinophil in vaccine group, pSecTag-2A or saline group were increased markedly (P
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AIM: Niflumic acid (NFA) is known as a kind of inhibitor of calcium-activated chloride channel. The inhibition and mechanism of NFA on the proliferation of airway smooth muscle cells (ASMCs) were investigated. METHODS: Using [ 3H]-TdR incorporation method, we examined the effect of NFA (at concentration of 10 and 50 ?mol/L) on the proliferation of primarily ASMCs from BALB/c mouse. With confocal laser scanning microscope the [Ca 2+ ]i in ASMCs exposed to histamine was observed, and the opposed effects of NFA and nifedipine on histamine were also checked. Finally the effect of NFA on expression of MAPK in ASMCs was examined by indirect immunofluorescent assay. RESULTS: Compared with control group, the proliferation of NFA group was reduced markedly with dependent concentration. Histamine significantly improved the [Ca 2+ ]i in ASMCs, but NFA and nifedipine showed the inhibition on the effect of histamine. NFA reduced the level of MAPK expression in ASMCs. CONCLUSION: It is demonstrated that NFA inhibits the proliferation of ASMCs by reducing [Ca 2+ ]i and the expression level of MAPK. [
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Objective To explore the inhibitory effects of SB203580, a specific inhibitor of p38 mitogen activated protein kinase (p38 MAPK) on hyper secretion of airway mucus in mice with asthma. Methods Forty BABL/C mice were randomly allocated into asthma group, SB203580 treatment group, dexamethasone treatment group and control group (sham-challenged group). Mice in SB203580 treatment group were intraperitoneally injected with SB203580 (10mg/kg), while those in dexamethasone treatment group were injected with dexamethasone (1mg/kg) before provocation. The number of goblet cells in small bronchi of all groups was determined after Alcian blue-periodic acid Schiff (AB-PAS) staining. The contents of MUC5AC in bronchoalveolar lavarge fluid (BALF) were evaluated with ELISA asssy. The levels of MUC5AC mRNA expression were determined with reverse transcription-polymerase chain reaction (RT-PCR) assay, and gray-scale analysis was done with image analysis method. Results Compared with the normal group, the number of airway goblet cells, the contents of MUC5AC in BALF and the level of lung MUC5AC mRNA expression in asthma group were raised significantly (P