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Objective To analyze the feasibility of body surface electrodes instead of multipair esophageal electrodes for the evaluation of neural respiratory drive in patients with COPD. Methods Diaphragm electromyo-gram(EMG)from body surface electrodes and multipair esophageal electrodes,was recorded in 29 patients with stable COPD recruited from outpatient clinic. Changes of neural respiratory drive of two kinds of electrodes during resting and maximal isocapnic ventilation (MIV) were observed before and after inhalation of bronchodilators. Results Ventilation significantly improved ,RMS-sur and RMS-eso significantly decreased after the inhalation of bronchodilators during resting and MIV. RMS-sur and RMS-eso were significantly correlated(r=0.660,P<0.01). Conclusion EMG from the surface electrodes may be a useful and noninvasive technique to evaluate neural respi-ratory drive in patients with COPD.
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Objective To explore the efficacy of noninvasive positive pressure ventilation technology com-bined with respiratory stimulant in the treatment of pulmonary encephalopathy in patients with COPD.Methods For-ty -eight COPD patients with early pulmonary encephalopathy were included.They were randomly divided into the treatment group and control group.The treatment group was treated by not only regular treatment and noninvasive posi-tive pressure ventilation technology,but also respiratory stimulant.The control group was only treated by regular treat-ment and noninvasive positive pressure ventilation technology.The indexes were recorded,including tracheal intubation rate,clinical recovery rate,mortality,Glasgow coma score,arterial blood gas analysis and adverse reactions.Results Compared with the control group,the arterial blood gas analysis of treatment group on the 2h,24h and 72h were statis-tically significant different(P <0.05).The GCS score on the 24h and 72h were also statistically significant different [24h,(13.4 ±1.6)vs.(11.8 ±2.1),P <0.05;72h,(14.6 ±1.5)vs.(12.4 ±2.4),P <0.05].The treatment group had lower tracheal intubation rate(12% vs.56.5%,P =0.001),shorter consciousness recovery time[(3.0 ± 0.5)h vs.(5.6 ±0.7)h,P =0.023],shorter hospitalization time in ICU[(12.6 ±1.5)d vs.(19.2 ±1.8)d,P =0.004]and better clinical recovery(22 /25 vs.10 /23,P =0.001)than the control group.But the mortality rate had no significant difference between the two groups(1 /25 vs.4 /23,P =0.129).Conclusion NIPPV combined with respiratory stimulant is an effective,safe and simple method for treatment of COPD complicated with pulmonary encephalopathy.It can significantly improve the clinical symptoms and the index of arterial blood gas analysis,and it can shorten consciousness recovery time and decrease tracheal intubation rate.But close observation must be carried out,and the invasive mechanical ventilation should be promptly executed in case of emergency or exacerbation.
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Objective To detect the plasma level of tissue factor (TF) in non-small cell lung cancer (NSCLC) patients,and to discuss its association with hypercoagulation,venous thromboembolism and prognosis of lung cancer.Methods Sixty-one impatients in our hospital with confirmed lung cancer were enrolled as the study group.Thirteen patients with benign pulmonary diseases and 14 healthy volunteers were selected as the control groups.Bseline and follow-up clinical data were collected from participants.Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of TF in plasma of all subjects.Results The levels of TF in plasma from NSCLC patients and participants with benign pulmonary diseases was significantly higher than that in healthy controls((550.88 ± 201.58) ng/L vs (510.77 ± 201.20) ng/L vs (178.34 ±66.73) ng/L,P ＜0.05).According to the plasma levels of TF,which have been detected in all subjects,the patients were divided into two groups:low level group (range from 103.73 ng/L to 476.22 ng/L) and high level group (range from 476.221 ng/L to 1003.00 ng/L).Statistical analysis showed that there was a positive correlation between plasma TF levels and TNM stages in NSCLC patients (P =0.026).Patient with metastasis had a higher plasma TF level than other patients (P =0.020).The log-rank test revealed that there was no significant difference in survival between the high level group and low level group (x2 =0.145,P =0.704).Multivariate Cox proportional hazards regression analysis indicated that plasma TF levels did not predicted for death(RR =1.001,95％CI0.998-1.004,P=0.452).Conclusion The plasma TF level in NSCLC patients was correlated with TNM stages;it had no significant relationship with hypercoagulation state and survival rate in NSCLC patients.Limitations should be aware of while evaluating the clinical course and prediction of prognosis of NSCLC patients using plasma TF levels.
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Objective To investigate the feasibility and efficiency of monitoring noninvasive respiratory effort and respiratory load-capacity ratio in patients undergoing weaning from mechanical ventilation by mean inspiratory pressure(Pi) which were calculated on the basis of the formula, Pi = 5 × P 0.1 × Ti, as well as the noninvasire tension index calculated from Pi(TTIi). Method Totally 12 patients undergoing weaning from mechanical ventilation were enrolled in the study and their underlying diseases included COPD( n = 9), ARDS( n = 2) and status asthmaticus(n = 1) respectively. Esophageal pressure(PesoM) was monitored via the insertion of esophageal balloon and corrected esophageal pressure(Peso) was acquired by subtracting elastic pressure of chest wall from PesoM. P 0.1, Maximal inspiratory pressure on esophageal pressure curve(MIPeso) and on airway pressure curve(MIPaw) was measured with conventional technique. Pi was calculated on Pi = 5 × P 0.1 × Ti. Pi and MIPaw were used to calculate the noninvasive tension-time index TTIi, whereas Peso and MIPeso were used to calculate the invasive counterpart TTIeso. Comparisons, Correlation and Bland-Altman agreement analysis were made between P0.1 and Peso as well as between TIIi and TTIeso. Results There were no significant differences between Pi and Peso as well as between TTIi and TTIeso(P > 0.05) ,and the correlation coefficients were 0.974 and 0.957 respectively. In the agreement analysis, the mean difference between Pi and Peso, and between TTIi and TTIeso were lower than the minimal values of(Peso + PiSB )/2 and of(TIIi + TTIeso)/2, respectively. Conclusions There is a good correlation between Pi and Peso as well as between TTIi and TTIeso, in which Pi is calculated calculated from P 0.1 and in turn the TTIi is calculated from Pi. The noninvasive indices including Pi and TTIi can be used to monitor respiratory effort and respiratory load-capacity in patients undergoing weaning from mechanical ventilation.
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Objective To investigate the methods of recording EMGscm and its significance in monitoring of central drive.Methods Three methods of collecting EMGscm were compared.The subjects were asked to re-breath until the highest PCO2-ET was reached and the EMGscm,Flow,VT(tidal volume),Ttot(Total time of respiratory cycle),and PCO2-ET were measured during the re-breathe.Results (1)The EMGscm did not appeared until the PCO2-ET reached the value of(48.2?2.6)mm Hg.The value of PCO2-EThighest was(81.2?6.6)mm Hg.(2)As the PETCO2 increased,the Ttot became shorter and shorter,from(2.91?0.85)s to(1.92?0.39)s,while the VT became higher and higher,from(0.68?0.27)L to(2.21?0.37)L.There was a statistical relationship between the Ttot(or VT)and the PCO2-ET,and their correlative coefficient was respectively(0.86?0.12)and(0.89?0.13)(both P
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Objective To evaluate the feasibility of measuring phrenic nerve conduction time(PNCT)and elicited compound muscle action potential(CMAP)of diaphragm with surface electrodes.Methods PNCT and amplitude of diaphragm CMAP elicited by unilateral magnetic stimulation(UMS)of the phrenic nerve were measured with surface electrodes and the results were compared with those measured with oesophageal electrodes.Results (1)PNCT measured with oesophageal electrode was similar to those measured with surface electrode;the amplitude of CMAP measured with oesophageal electrode was higher than those with surface electrode.(2)There was a significant relationship between the amplitudes of right CMAP measured with oesophageal electrode and those with surface electrodes,whereas there was no such relationship for the left side.(3)The PNCT and the amplitude of CMAP were not related to age,height,weight and perimeter of abdomen no matter measured with oesophageal or surface electrodes.Conclusion Surface electrodes is a useful and noninvasive method to evaluate the function of phrenic nerve and diaphragm.
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A new flow-injection chemiluminescence method for the determinstion of trace amounts of sulfide was developed. It is based on the catalysis of sulfide to chemilumincence reacion between luminol and hydrogen peroxid. The linear range extends from 2.0 × 10-9 to 8.0 × 10-7 g/mL and the detection limit is 5.6 × 10-10 g/mL.The relative standard deviation (RSD) is less than 5% for 1.0 × 10-7 g/mL sulfide solution in eleven repeated measurements. The method has the advantages of simplicity, rapidity, sensitivity and has also been applied to the determination of trace amounts of sulfide in water samples.
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Objective To evaluate the effects of inhaled bronchodilators on dynamic PEEPi in COPD patients.Methods Twenty moderate to severe COPD subjects were divided into three groups.Lung functions,PEEPi,dyn and Borg score were measured at baseline and 30 min after inhaled placebo,and after inhalation of salbutamol 400 ?g(or ipratropium 80 ?g),ipratropium 80 ?g(or salbutamol 400 ?g)in sequence at interval as specified in different groups.Results In comparison with placebo,PEEPi,dyn decreased after inhalied bronchodilators(P
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AIM: To investigate the application of phrenic nerve conduction time(PNCT) in the recovery of general anaesthesia. METHODS: Pdi (t) and PNCT were measured by cervical magnetic stimulation of phrenic nerves in 8 patients before and after the administration of muscle relaxant. RESULTS: Pdi (t) was reduced from (23.7?2.4) cmH 2O to (11.5?3.4) cmH 2O (reduction rate: 51.5%, P
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Objective To develop a new flow-injection chemiluminescence(FI-CL) method for the determination of omeprazole.Methods Strong chemiluminescence(CL) signal was found generated when omeprazole was injected into the reaction mixture of KMnO4 and luminol.The experimental conditions that affected the CL reaction were optimized by using FI mode.Results Under the optimum experimental conditions(150cm of mixing tubing,0.15mol/L NaOH,7.0?10-5mol/L luminol,2.0?10-5mol/L KMnO4 and 2.8mL/min of flow rate),CL intensity was linearly related to the concentration within the range of 2.0?10-8-1.0?10-5g/mL.The detection limit was 3?10-9g/mL omeprazole,and the relative standard deviations(n=11) were 1.0% and 2.6% for 1.0?10-7g/mL and 1.0?10-6g/mL omeprazole solutions,respectively.Conclusion The proposed method is simple,rapid,sensitive,and suitable for determining omeprazole content in pharmaceutical preparations.