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OBJECTIVE@#To investigate the association of the time of initial diagnosis with the severity of chronic obstructive pulmonary disease (COPD).@*METHODS@#A total of 803 patients who were diagnosed to have COPD for the first time in our hospital between May 2015 to February 2018 were enrolled in this study.The diagnoses of COPD and asthma COPD overlap (ACO) were made according GOLD guidelines and european consensus definition.Lung function of the patients was graded according to the GOLD guidelines.@*RESULTS@#The patients with COPD had a mean age of 61.8±9.9 years,including 726 male and 77 female patients.The course of the patients (defined as the time from symptom onset to the establishment of a diagnosis) was 3(0.5,8) years.Among these patients,85.2% had a moderate disease severity (FEV1%<80%),and 48.3% had severe or very severe conditions (FEV1%<50%);47.0% of them were positive for bronchial dilation test.In the overall patients,295(36.7%) were also diagnosed to have ACO,and the mean disease course of ACO[3(1,9) years]was similar to that of COPD[3(0.5,8) years](>0.05).A significant correlation was found between the disease course and the lung function of the patients.Multiple linear regression analysis showed that an older age and a longer disease course were associated with poorer lung functions and a greater disease severity.@*CONCLUSIONS@#The delay of the initial diagnosis is significantly related to the severity of COPD.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Age Factors , Asthma , Diagnosis , Delayed Diagnosis , Disease Progression , Lung , Pulmonary Disease, Chronic Obstructive , Diagnosis , Severity of Illness Index , Time FactorsABSTRACT
BACKGROUND: Qinggong changchun dan (QGCCD) capsule has efficacy in profiting kidney-yang and bettering muscle or bone, it could treat debility, deficiency of energy, forgettery and tiredness and the ache of waist or knee in clinic.OBJECTIVE: To study the effect of QGCCD capsule on stress capability of mice with kidney-yang deficiency.DESIGN: Completely randomized controlled trial.SETTING: Institute of Traditional Chinese Medicine, Chengde Medical College (Key Laboratory of Research and Exploiture of Traditional Chinese Medicine in Hebei Province).MATERIALS: Totally 60 stirp Kunming mice, weighting 19-21 g, of either gender, of grade Ⅱ, were selected in this study.METHODS: The experiment was conducted in the Department of Pharmacology and Toxicology, Institute of Traditional Chinese Medicine of Chengde Medical College from February 2002 to December 2002. Totally 160 Kunming mice of either gender were randomly divided into three groups:Swimming endurance group (n=60), tolerance of hypoxia at normal pressure group (n=50) and single macrophage function group (n=50); and mice in each group were divided into 5 subgroups, including 0.25, 0.5,1.0 g/kg QGCCD groups, model control group and normal control group.Mice were fasted for 12 hours and injected with 25 mg/kg hydrocortisone for 7 successive days to establish yang-deficiency model. Various dosages of QGCCD were given with the same volume of 20 mL/kg for 7 successive days. Mice in model control group were treated with the same volume of saline. Forty minutes later, testes of swimming tolerance, tolerance time of anoxia and engulfment capability of macrophage were performed on mice [To take 20 μL blood in the eyepit vein plexus after the mice were injected 2 minutes and 10 minutes later respectively, and to count the charcoal particle expurgation index (K) of macrophage] to observe effect of various dosages of QGCCD on swimming tolerance, tolerance time of anoxia and engulfment capability of macrophage.RESULTS: Data of totally 160 mice was entered the final analysis without normal control group were longer than those of mice in model control group [(10.94±3.79), (13.68±5.62), (14.58±5.49), (16.12±2.35), (6.45±4.87) minutes;ia of mice in 0.25, 0.5, 1.0 g/kg QGCCD groups and normal control group were longer than those of mice in model control group [(19.45 ±4.63),(21.18±4.25), (22.58±5.21), (23.12±4.78), (12.35±4.89) minutes; t=1.566,macrophage and K index of mice in 0.25, 0.5, 1.0 g/kg QGCCD groups and normal control group were higher than those of mice in model control group (0.023 6±0.010 6, 0.029 1±0.0092, 0.030 8±0.008 6, 0.031 8±0.010 1, 0.012 5±0.008 1; t=2.63, 4.282, 4.898, 4.714, P ＜ 0.05-0.01).CONCLUSION: QGCCD can prolong the swimming time of mice obviously, prolong tolerance time of anoxia according to dosage dependence,increase engulfment capability of macrophags, and strengthen stress capability of mice with kidney-yang deficiency.
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Objective To study the relationship between analgesic effect of total alkaloids in Papaver nudicaule(TAPN) and prostaglandins(PGs) with opium receptors.Methods The analgesic effect of TAPN was studied by hot-plate, writhing,electric-evoked methods of mice.The analgesic mechanisms of TAPN and PGs with opium receptors were studied by the writhing numbers induced by different substances(Ach,AA,MgSO_4),the PGE_2 level in celiac fluid in mice after treated by AA writhing test and the antagonistic experiment of Naloxone.Results The inhibitory effect of TAPN on the writhing induced by Ach and AA in mice was stronger than that induced by MgSO_4.TAPN could also lower the PGE_2 level in celiac fluid.In the antagonistic experiment of Naloxone,no antagonism to the analgesic effect of TAPN had been found by ip or icv Naloxone.Conclusion It may be the mainly peripheral analgesic mechanism that TAPN could lower the PGE_2 level in celiac fluid.Its central analgesic mechanisms are not related to opium receptors.
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Objective To study the analgesic sites and mechanism of total alkaloids in Papaver nudicaule (TAPN). Methods The sites of analgesic action of TAPN were observed by adopting Formalin test and two different routes of intracerebroventricular (icv), intrathecal (ith) in mice and rats and comparing ED 50 of TAPN in writhing reaction in mice induced by acetic acid by ip and iv administration. Results TAPN significantly lowered pain score of the early and late phase of Formalin response and was more sensitive in the late phase. Inhibition of TAPN at the same dose by ip administration in writhing reaction in mice induced by acetic acid was stronger than that by iv. The ED 50 value of TAPN at any time by ip administration was lower than that by iv administration. By means of central microinjection, TAPN by icv administration induced remarkable analgesic effect in mice, but TAPN by ith administration had no significant analgesic effect. Conclusion The sites of analgesic action of TAPN are mainly at periphery. TAPN has also central analgesic effect, and the site may be at the level above the spinal cord.