Effect of Exercise on Chronic Obstructive Pulmonary Disease Systemic Inflammation and Skeletal Muscle Dysfunction: A Systematic Review / 中国康复理论与实践

Objective To systematically review the effects of exercise on systemic inflammation of chronic obstructive pulmonary disease (COPD) and skeletal muscle dysfunction. Methods The literature about the effect of exercise on COPD systemic inflammation and skeletal muscle dysfunction were retrieved from PubMed, Web of Science, CNKI, VIP and Wanfang data, until June, 2021, supplemented by reference review and manual retrieval. Results A total of 192 literatures were retrieved and eight were included, involving 245 subjects. The comprehensive results showed that exercise could decrease the level of pro-inflammatory factors and increase the level of anti-inflammatory factors. Exercise can improve the motor ability and skeletal muscle structure of patients with COPD. Exercise can improve systemic inflammation of COPD, which is related to the mode, intensity and duration of exercise. Exercise may affect ubiquitin-protease, insulin-like growth factors -1/phosphatidylinositol 3 kinase/Akt and other pathways by regulating the inflammatory response, and improve skeletal muscle dysfunction. Conclusion Exercise has certain effect on reducing systemic inflammation and improving skeletal muscle dysfunction.

Effect of Exercise on Chronic Obstructive Pulmonary Disease Systemic Inflammation and Skeletal Muscle Dysfunction: A Systematic Review / 中国康复理论与实践

Objective To systematically review the effects of exercise on systemic inflammation of chronic obstructive pulmonary disease (COPD) and skeletal muscle dysfunction. Methods The literature about the effect of exercise on COPD systemic inflammation and skeletal muscle dysfunction were retrieved from PubMed, Web of Science, CNKI, VIP and Wanfang data, until June, 2021, supplemented by reference review and manual retrieval. Results A total of 192 literatures were retrieved and eight were included, involving 245 subjects. The comprehensive results showed that exercise could decrease the level of pro-inflammatory factors and increase the level of anti-inflammatory factors. Exercise can improve the motor ability and skeletal muscle structure of patients with COPD. Exercise can improve systemic inflammation of COPD, which is related to the mode, intensity and duration of exercise. Exercise may affect ubiquitin-protease, insulin-like growth factors -1/phosphatidylinositol 3 kinase/Akt and other pathways by regulating the inflammatory response, and improve skeletal muscle dysfunction. Conclusion Exercise has certain effect on reducing systemic inflammation and improving skeletal muscle dysfunction.

Changes in retinal structure after short-pulse laser treatment / 眼科新进展

Objective To observe the changes in retinal structure after shortpulse laser technique and conventional laser surgery.Methods Oburg fundus photography,spectral domain optical coherence tomography (SD-OCT) and fundus autofluorescence (FAF) examination were performed in 16 patients (22 eyes) receiving shortpulse laser surgery,following 19 patients (25 eyes) undergoing conventional laser surgery to observe the spot situation with the time for postoperative 1 h,1-2 weeks,1-3months,＞3-6 months,＞ 6-12 months.Results After 1 h of short-pulse laser,fundus color displayed light spot of the center was white and gray,which surrounded by gray dizzy;SD-OCT images showed spot ellipsoid area formed a ring out of band,but the inner retina and retinal pigment epithelium (RPE) had no significant change.FAF showed multiple spontaneous fluorescence signals to reduce the circular area;at 1-2weeks after laser surgery,fundus photography showed spot center for white and gray,and the surrounded gray dizzy became larger,and FAF spontaneous fluorescence signal in light spot center was enhanced,while SD-OCT showed that the outer nerve sensory layer was pulled to the photocoagulation spot center.From 1 month to 3 months,some of the epithelial layers of the nerves were restored to normal,and ＞ 3-6 months,the epithelial layer of the nerve was basically restored to normal;and ＞ 6-12 months,the nerve epithelium was back to normal.As for conventional laser surgery,1 h later,fundus photography and FAF performance were similar to the short-pulse laser,and the SD-OCT showed that the whole retinal layer had dropsy in the spot place;after 1-2 weeks,the spot center was gray and white,and the surrounded gray halo turned enlargement,and FAF spontaneous fluorescence signal in light spot center was enhanced,while SD-OCT showed that the outer nerve sensory layer was pulled to the spot center with adhesion;after 1-3 months,fundus photography and FAF performance were similar to those of short-pulse laser,while SD-OCT presented the RPE cells hyperplasia and ring atrophy around the spot,and the RPE atrophy around the spot was gradually enlarged,plus the whole layer of the nerve epithelium was adhesion ＞ 3-6 months after surgery.＞6-12 months later,the results showed the RPE layer atrophy and nerve epithelium layer adhesion.The results of FAF in all follow-up groups were consistent with that of OCT results.Conclusion OCT and FAF are the important methods to observe the postoperative retinal laser structure changes,which can provide objective basis for the confirmation that short-pulse laser has less damage than the conventional laser treatment,and this provides a new research idea to optimize the laser parameters.

Clinical study of different sedative methods in critically ill patients after heart surgery / 天津医药

Objective To study the effect of light sedation and traditional sedation (moderate sedation with daily sedation interruption) on hemodynamic indexes and prognosis in critically ill patients after cardiac surgery. Methods A total of 134 patients who were ventilated delay after heart surgery in our hospital from January to June 2017 were enrolled in this study. The patients were randomly divided into light sedation group (RASS score-1-1, n=65) and traditional sedation group (RASS score -3--2, n=69). All patients received sufentanil for postoperative analgesia. The light sedation group received propofol and/or dexmedetomidine as sedative drugs after operation, and the conventional sedation group used midazolam for postoperative sedation. The hemodynamic indexes, the first time of weaning off the ventilator, the duration of mechanical ventilation and ICU stay were compared between the two groups. Patients with low cardiac output syndrome after surgery were analyzed in subgroups. Results (1) There were no significant differences in heart function, operative complications and other indicators between the two groups after surgery (all P＞0.05). The low cardiac output syndrome was found in 12 patients in the light sedation group and 10 cases in the traditional sedation group. (2) Hemodynamic monitoring results displayed that the sedation/central venous oxygen saturation (SvO2/ScvO2) and cardiac index (CI) were higher after sedation than before sedation in both groups (all P＜0.05), but there was no significant difference between the two groups (all P＞0.05). Subgroup analysis showed that the SvO2/ScvO2index was higher in patients with low cardiac output syndrome in the traditional sedative group than that in the light sedation group (P＜0.05). There was no difference in the SvO2/ScvO2 index in patients with non-low cardiac output syndrome between two groups. (3) Compared with the traditional sedation group, the first off-line time, the total mechanical ventilation after surgery and the ICU stay time were significantly shortened, and the incidence of postoperative delirium was decreased in the light sedation group (all P＜0.05). Subgroup analysis showed that in patients with non-low cardiac output syndrome, the first off-line time, total postoperative mechanical ventilation time and total ICU stay were significantly shorter in the light sedation group than those in the traditional sedation group (all P＜0.05). There was no significant difference in patients with low cardiac output syndrome between the two groups (P＞0.05). Conclusion Patients with non-low cardiac output syndrome after cardiac surgery benefit significantly from the superficial sedative strategy, and the postoperative mechanical ventilation time and ICU residence time are reduced. The moderate sedation may contribute to the early cardiac function recovery in patients with low cardiac output syndrome.

Analysis of the related risk factors of postoperative delirium in patients with Stanford type A aortic dissection / 天津医药

Objective To analyze the related risk factors of postoperative delirium(POD)in patients with Stanford type A aortic dissection, and to guide clinical practices. Methods The clinical data of 118 cases [81 males and 37 females, average age (55.0 ± 10.3) years] with Stanford type A aortic dissection in Tianjin Chest Hospital from January 2016 to December 2017 were analysed in this study. According to whether developed delirium after surgery, the patients were divided into POD group(n=56)and Non-POD group(n=62).The preoperative,perioperative,and postoperative clinical data were collected.The univariate and multivariate Logistic regression analysis was used to investigate the risk factors of POD in patients with the Stanford type A aortic dissection. Results Single factor analysis showed that the proportions of drinking and cerebrovascular history significantly increased,the proportions of early electrolyte disorder and hypoxemia significantly increased, the levels of granulocytes / lymphocytes, circulatory time and blood volume during operation increased significantly, and the duration from onset to operation was decreased, but fibrinogen level decreased significantly in POD group than those of Non-POD group (P < 0.05). Multivariate Logistic analysis indicated that the more intraoperative consumption of blood (OR=1.733, 95% CI:1.409-2.129) and early postoperative electrolyte disorder (OR=10.500, 95% CI:2.930-37.622)were independent risk factors of POD,while the higher level of preoperative fibrinogen(OR=0.157,95% CI:0.050-0.635) and longer time from onset to surgery (OR=0.871, 95% CI:0.808-0.943) were protective factors of POD in patients with Stanford type A aortic dissection.Conclusion The early identification of risk factors of POD,and the active intervention of POD have a positive significance to reduce the occurrence of POD.

Dynamic study and screening of new markers of spermatogonial stem cells by iTRAQ protein mass spectrometry / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the dynamic changes in the protein marker expression in the spermatogonial stem cells (SSCs) of mice at different ages by iTRAQ protein mass spectrometry and to screen new markers using the bioinformatic proteome database.</p><p><b>METHODS</b>Based on the postnatal weeks, we divided 80 healthy male C57BL/6 mice into eight age groups of equal number, harvested their testicular tissues, extracted proteins following purification of the SSCs by compound enzyme digestion and magnetic-activated cell sorting. Then we analyzed and identified proteins using two-dimensional electrophoresis, protein mass spectrometry, and protein database information.</p><p><b>RESULTS</b>Totally, 248,510 mass spectra were obtained from the MS experiment and 1132 proteins were identified. By the criteria of >1.2-fold for protein abundance difference and P value <0.05, we identified 298 differentially expressed proteins and 9 currently known makers of SSCs (PCNA, GFRalpha1, CDH1, Annexin A7, UCHL1, VASA, CD49f, CD29, and PLZf). Compara- tive analysis showed different expressions of the proteins in the SSCs of the mice of different ages, and the differences in the expressions of GFRalpha1, CD49f, and CD29 were consistent with the findings in other published literature. Ten proteins (P63, CD71, CD98, K19, ACE, K18, K15, K17, SH2, and SH3) were selected as SSC markers to be further studied.</p><p><b>CONCLUSION</b>The proteins in SSCs are differentially expressed in mice of different ages. The technology of iTRAQ protein mass spectrometry can be used to analyze and compare the proteome information of mouse SSCs, obtain differentially expressed proteins in mice of different ages, and thus offers a new ap- proach to further analysis and study of the function and roles of these differential proteins.</p>

Effect of pericardial suction blood re-transfusion in off-pump coronary artery bypass grafting on inflammatory cytokines, myocardial injury and pulmonary function / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of pericardial suction blood re-transfusion in off-pump coronary artery bypass grafting (CABG) on inflammatory cytokines, myocardial injury and lung function.</p><p><b>METHODS</b>31 patients of off-pump CABG were divided into two study groups (OPCABG1 group and OPCABG2 group) according to the amount of pericardial suction blood re-transfusion beyond or less than 600 ml. 13 patients of on-pump CABG were control group. Serum samples from vein were collected for measurement of IL-6, IL-8, IL-10 and TNF-alpha pre-operation and 1, 4, 24, 48 hours post-operation respectively. The results of CK-MB, TnI, AaDO2 and PaO2/FiO2 were recorded.</p><p><b>RESULTS</b>Patients of the three groups had no significant difference in terms of gender, age, bodyweight, history of hypertension and cardiac infarction and diabetes, EF and left ventricular end diastolic of pre-operation, the amount of bypass graft and shed blood. Of the three groups, IL-6, IL-8 and IL-10 reached peak level one hour after the operation, and dropped to the pre-operation level 72 hours after the operation. One hour after the operation, the level of IL-6 and IL-8 in OPCABG1 group was higher than in OPCABG2 group (P < 0.05) and about the same in CABG group (P > 0.05). Four hours after the operation, the level of CK-MB in OPCABG1 group was lower than that of CABG group (P < 0.05) and about the same in OPCABG2 group (P >0.05). 4 and 24 hours after the operation, the level of TnI in OPCABG1 group was lower than that of CABG group (P < 0.05) and about the same in OPCABG2 group (P > 0.05). Among the three groups, there was no significant difference in AaDO2 and PaO2/FiO2.</p><p><b>CONCLUSIONS</b>Re-transfusion of large amount of pericardial suction blood can increase serum level of IL-6, IL-8, but it can not cause myocardial injury and affect the gas exchange function of lung significantly.</p>

Effect of hypertension on cell proliferation and apoptosis in benign prostatic hyperplasia / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the effect of hypertension on cell proliferation and apoptosis in benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>The techniques of immunohistochemistry and terminal deoxynucleotidyl transferase-mediated dUTP biotin nick end labeling(TUNEL) were used to detect the proliferative index (PI) and apoptotic index (AI) in both epithelium and stroma of simple BPH (40 cases) and BPH with hypertension (40 cases), respectively.</p><p><b>RESULTS</b>In both the groups of simple BPH and BPH with hypertension, the value of PI was significantly higher than that of AI in epithelium and stroma (P < 0.05), and PI was closely related to the prostate volume (P < 0.05). As compared with the simple BPH group, PI was significantly increased in epithelium and stroma in the group of BPH with hypertension( P < 0.05), in which the disease history of hypertension was positively associated with PI in epithelium and stroma (p < 0.05).</p><p><b>CONCLUSION</b>Hypertension, particularly persistent hypertension state, may enhance cell proliferation in both epithelium and stroma of BPH, and consequently lead to the enlargement of the prostate.</p>

Association study between benign prostatic hyperplasia and primary hypertension / 中华外科杂志

<p><b>OBJECTIVE</b>To assess whether primary hypertension affects the occurrence and progression of benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>A total of 423 cases of BPH, undergoing transurethral resection of prostate (TURP) or open surgery due to severe low urinary tract symptoms, were reviewed and analyzed. All cases were verified to be BPH postoperatively following histopathological examination.</p><p><b>RESULTS</b>Of 423 patients, 295 cases (69.7%) were simple BPH (group BPH-NT); 128 cases (30.3%) were BPH with hypertension (group BPH-HT). The mean age and the incidence of haematuria were significantly higher in group BPH-HT than those in group BPH-NT (P < 0.05). The time of BPH occurrence and surgical treatment in group BPH-HT with mean diastolic blood pressure >/= 90 mmHg was significantly earlier than those with diastolic blood pressure < 90 mmHg (P < 0.05; P < 0.01). As compared with group BPH-NT, the time of BPH occurrence was significantly earlier in group BPH-HT with more than 10 years hypertension; the rate of urinary retention and haematuria was significantly higher and prostatic volume was significantly greater in group BPH-HT with more than 20 years hypertension; (all P < 0.05). Additionally, prostatic volume was positively correlated with the years of hypertension in group BPH-HT (Rsq = 0.056, P = 0.009).</p><p><b>CONCLUSIONS</b>The present results demonstrate that BPH may be frequently accompanied by the disease of hypertension. A long-term hypertension, particularly the condition of high diastolic blood pressure may improve the occurrence and clinical progression of BPH.</p>

Correlation of benign prostatic hyperplasia with hyperlipemia / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate relationship between benign prostatic hyperplasia (BPH) and hyperlipemia, and to clear out possible factors related to BPH etiology.</p><p><b>METHODS</b>A total of 462 cases of BPH diagnosed by pathological examination were studied retrospectively.</p><p><b>RESULTS</b>Of 462 cases, BPH with hyperlipemia was noted in 232 cases (50.22%). In comparison with the data of simple BPH, both prostate volume (P = 0.029) and residual urine (P = 0.03) were significantly increased in the BPH patients with hyperlipemia. Statistical analysis regarding the effects of different components of serum lipid on BPH clinical factors showed that the level of high density lipoprotein was significantly associated with both the enlargement of prostate volume (P < 0.05) and increasing of serum PSA (P < 0.05) Further study indicated that hypertension was demonstrated in 39.2% patients of BPH with hyperlipemia. Hyperlipemia accompanied with hypertension in BPH patients was significantly related to increased IPSS (P = 0.004).</p><p><b>CONCLUSION</b>The situation of BPH with hyperlipemia is frequently noted in clinics, and the decreased level of high-density lipoprotein is significantly associated with the enlargement of prostate volume. Co-existence of hypertension with hyperlipemia in BPH patients greatly worsens the lower urinary tract symptoms (LUTS) of BPH. Hyperlipemia may be one of the risk factors in the processes of BPH growth and progression.</p>

Clinical and pathological study on the correlation between serum prostate specific antigen and benign prostatic hyperplasia / 中华泌尿外科杂志

Objective To evaluate the clinical and pathological factors that may influence serum prostate specific antigen(PSA)level in patients with benign prostatic hyperplasia(BPH).Methods A total of 561 cases of BPH diagnosed by pathological examination following operation were analyzed retrospec- tively.The patients'mean age was(68.3?6.3)years.The International Prostate Symptom Score(IPSS)was 21.1?7.4;the quality of life(QOL)was 4.5?0.8;Qmax was(7.3?3.3)ml/s;prostate volume(PV) was(69.8?36.8)ml;andpost-void residue(PVR)was(81.9?105.8)ml.Results Of 561 cases,223 cases(39.8%)had serum PSA level at 4-10 ng/ml,and 91 cases(16.2%),over 10 ng/ml.The level of serum PSA was not significantly associated with age,IPSS,QOL,Qmax and PVR(r=0.08,0.03,0.06,0.04 and 0.09,respectively;P＞0.05),but significantly associated with prostate volume of BPH(r=0.42,P＜0.01).The level of serum PSA was significantly elevated in BPH patients with enlarged prostate volume (F=93.45,P＜0.05)and the history of acute urinary retention(x~2= 59.1,P＜0.01).Additionally,a significantly increased PSA level was noted in tissue specimens with glandular hyperplasia(x~2=16.14,P＜0.01)or necrotic loci in BPH patients(x~2=36.06,P＜0.01).Conclusions An elevated serum PSA level was observed in more than 50% of BPH patients undergoing surgical resection.Enlarged prostate volume,the history of acute urinary,retention,and tissue specimens with glandular hyperplasia or necrotic foci are considered to be the main causes leading to elevated PSA level in BPH patients.