Research progress of anti-fibrotic drugs that inhibit epithelial-mesenchymal transition in pulmonary fibrosis / 中华劳动卫生职业病杂志

Pulmonary fibrosis is the end-stage pathological change of lung diseases, which seriously affects the respiratory function of human body. A large number of studies at home and abroad have confirmed that epithelial-mesenchymal transition (EMT) is an important intermediate stage in the development of pulmonary fibrosis. Inhibition of multiple pathways upstream and downstream of EMT, such as the classical Smads pathway and non-Smads pathway of TGF-1 can effectively inhibit the process of EMT and alleviate pulmonary fibrosis. This article will review the main conclusions of the mechanism of action of EMT as a target to improve the pathology of pulmonary fibrosis so far, and provide a theoretical basis and research direction for further research and development of anti-pulmonary fibrosis drugs.

The clinical characteristics and airway inflammatory phenotypes in 35 patients with severe asthma / 中华内科杂志

Objective@#To analyze the clinical features and airway inflammatory phenotypes in patients with severe asthma.@*Methods@#Patients with severe asthma were recruited in this cross-sectional study in our center. History of asthma, blood and sputum samples, and respiratory function were tested and recorded. The phenotypes of inflammation in airway were evaluated.@*Results@#A total of 35 asthmatic patients with the mean age 41.4 years were involved in this study from January 2013 to December 2013. The disease duration were (14.3±13.6) years with mostly male in China-Japan Friendship Hospital. Thirteen patients reported the history of smoking. Twenty-one patients had the complications such as allergic rhinitis, followed by chronic rhinosinusitis of 11 cases, nasal polyp of 7 cases, gastroesophageal reflux disease of 5. The forced expiratory volume in one second/predicted value ratio (FEV1%pred) in 29 patients was lower than 80%.Twenty-one participants did not react in bronchial reversibility test. Sixteen patients were administrated with oral cortical steroids (OCS). The average annual cost per patient was 22 thousand RMB. Sixteenrefractory asthmatics were diagnosed as eosinophilic asthma.@*Conclusions@#The clinical features associated with severe asthma include male gender, smoking, persistent airway limitation. Systemic use of corticosteroids is common and treatment costs are high. The eosinophilic asthma is the main inflammatory phenotype in patients with severe asthma.

The clinical characteristics and airway inflammatory phenotypes in 35 patients with severe asthma / 中华内科杂志

To analyze the clinical features and airway inflammatory phenotypes in patients with severe asthma. Methods Patients with severe asthma were recruited in this cross?sectional study in our center. History of asthma, blood and sputum samples, and respiratory function were tested and recorded. The phenotypes of inflammation in airway were evaluated. Results A total of 35 asthmatic patients with the mean age 41.4 years were involved in this study from January 2013 to December 2013. The disease duration were (14.3 ± 13.6) years with mostly male in China?Japan Friendship Hospital. Thirteen patients reported the history of smoking. Twenty?one patients had the complications such as allergic rhinitis, followed by chronic rhinosinusitis of 11 cases, nasal polyp of 7 cases, gastroesophageal reflux disease of 5. The forced expiratory volume in one second/predicted value ratio (FEV1%pred) in 29 patients was lower than 80%.Twenty?one participants did not react in bronchial reversibility test. Sixteen patients were administrated with oral cortical steroids (OCS). The average annual cost per patient was 22 thousand RMB. Sixteenrefractory asthmatics were diagnosed as eosinophilic asthma. Conclusions The clinical features associated with severe asthma include male gender, smoking, persistent airway limitation. Systemic use of corticosteroids is common and treatment costs are high. The eosinophilic asthma is the main inflammatory phenotype in patients with severe asthma.

The relationship between smoking status and epidermiology of asthma in people aged over 14 years in China / 中华内科杂志

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.

Comparison of the Effectiveness of Different Supraglottic Ventilation Methods during Bronchial Thermoplasty / 中国医学科学院学报

<p><b>OBJECTIVE</b>To compare the effectiveness of high-frequency jet ventilation via Wei jet nasal airway and controlled ventilation with improved laryngeal mask airway during bronchial thermoplasty.</p><p><b>METHODS</b>Twenty-eight patients undergoing bronchial thermoplasty were equally divided into two groups: group A (high-frequency jet ventilation through Wei jet nasal airway) and group B (controlled ventilation with improved laryngeal mask airway). Pulse oxygenation,heart rate,and mean arterial blood pressure were recorded after entering the operating room (T0), 1 minute after administration/induction (T1), bronchoscope inserting (T2), 15 minutes (T3)/30 minutes (T4)/45 minutes (T5) after ventilation,at the end of the operation (T6), and at the recovery of patients' consciousness (T7). The pH,arterial oxygen partial pressure,and arterial carbon dioxide partial pressure were recorded at T0, T4, and T6. The endoscope indwelling duration,operative time,patients' awakening time,adverse events during anesthesia,satisfactions of patients and operators, anesthesic effectiveness were also recorded.</p><p><b>RESULTS</b>The arterial carbon dioxide partial pressur in group A at T4 and T6 were significantly higher than in group B (P<0.05). The pH in group A at T4 and T6 was significantly lower than in group B (P<0.05). The endoscope indwelling duration and the operative time in group B were significantly shorter than in group A (P<0.05) while the recovery of consciousness in group B was significantly longer than in group A (P<0.05). The satisfaction for operators and the efficacy of anesthesia in group B were better than in group A (P<0.05). The number of adverse events in group B was significantly smaller than in group A (P<0.05).</p><p><b>CONCLUSION</b>The improved laryngeal mask airway with controlled ventilation is more suitable for bronchial thermoplasty.</p>

An investigation on asthma education by respiratory specialists in the remote suburban districts and counties of Beijing / 中华全科医师杂志

Objectives To investigate current status in asthma education in the remote suburban districts and counties of Beijing and to provide basis to draw up and modify the work plan for asthma education. Methods Ten district or county hospitals in the remote suburban areas of Beijing were investigated, and 81 professionals in respiratory disease subspecialty of internal medicine were selected to answer the questionnaire and their practical performance was observed, including 35 residents, 27 attending physicians and 19 chief or deputy chief physicians. Results Only 8.6% (7/81) of them could correctly answer the question "What is the GINA?" And, 55.6% (45/81) of them could correctly answer the question "Is the Guidelines for Prevention and Treatment of Asthma in China formulated by Chinese Society of Respiratory Disease, Chinese Medical Association? " About one fifths of the interviewee (22.2% , 18/81) could correctly master the six steps in manipulation of metered-dose inhaler. Nearly two thirds of the interviewee (31.7% , 50/81) could correctly answer that "Inhalation of glucocosteroids is the most important treatment to control persistent episodes and chronic symptoms in asthma patients and to prevent asthma attack. About two thirds of physicians (61.7% ,50/81) did not attend any lectures or workshops on asthma during the recent year, and only 22 of them attended lectures or workshops on asthma sponsored by the medical association, reflecting its influence in asthma education. Only 15 of 81 physicians (18.5%) could instruct a few patients to use the peak airflow meter to monitor their conditions, and other 81.5% of the physicians "never heard about peak airflow meter" or "having ever heard about it but never instructed the patients to use it". Conclusions Asthma education by the respiratory disease specialists in the hospitals at remote suburban districts and counties hasn't improved obviously. It is worthy to have a try in changing and modifying asthma education model and going round the remote suburban districts and counties to provide asthma education.