Neoadjuvant immune checkpoint inhibitor therapy and chemotherapy improve pulmonary ventilation and diffusion function in patients with lung cancer / 浙江大学学报·医学版

OBJECTIVES@#To investigate changes of pulmonary ventilation function and diffusion function in lung cancer patients after neoadjuvant immune checkpoint inhibitors (ICIs) therapy combined with chemotherapy treatment.@*METHODS@#Patients with newly diagnosed lung cancer (Ⅱa-Ⅲb) admitted to Zhejiang Cancer Hospital from October 2021 to July 2022, who received ICIs combined with chemotherapy for more than two courses were enrolled. Patients underwent pulmonary ventilation function and diffusion function assessments before and after treatment. The demographic information, sizes and locations of cancer lesions, doses and duration of ICIs used, pulmonary function results before and after treatment, and the tumor regression were documented. The changes of pulmonary function parameters before and after the treatment were analyzed with paired t test and Wilcoxon rank-sum test. The factors influencing the pulmonary function changes were analyzed by multiple linear Lasso regression and ridge regression.@*RESULTS@#Among the 52 patients, 50 cases were males (96.15%) and 43 cases were squamous carcinoma (82.69%). The medium age of the patients was 67 years. After neoadjuvant therapy, 36 patients (69.23%) showed remission of tumor lesions. After treatment, the parameters of pulmonary ventilation inspiratory vital capacity (IVC) and the area under the expiratory flow-volume curve (AREAex), and the parameter of pulmonary diffusion total lung capacity increased compared with the baseline (all P<0.05). Forced vital capacity (FVC) and forced expiratory volume in first second (FEV1) also showed an increasing trend. Multivariate linear Lasso regression and ridge regression showed that baseline IVC had a significant negative effect on IVC improvement (Beta=－0.435, t=－2.968, P<0.01), baseline TLC had a significant negative effect on the improvement of TLC (Beta=－0.266, t=－2.474, P<0.05), and the remission of obstructive pneumonia favored the improvement of TLC (Beta=0.308, t=2.443, P<0.05).@*CONCLUSIONS@#After ICIs neoadjuvant treatment combined with chemotherapy, the lung ventilation and diffusion function can be improved in lung cancer patients, particularly for those with reduced baseline ventilation and diffusion function.

Normal standard for ventilatory function test in adult Filipinos

To establish reference values for lung function test in Filipinos, 283 (130 males and 153 females) normal non-smoking ( Multiple linear regressions with backward elimination was done. The data obtained was regressed against independent variables of age height, weight, and body surface area for each sex. Analysis of variance (ANOVA) of the regression equations for most parameters were significant at = 0.01. In a few parameters were significance was = 0.05. Only in Raw was the regression model not significant. The coefficient of determination (R) of our regression equations were low (

Lung function reference values and prediction equations in children and adolescents of the Han nationality in Heilongjiang Province / 基础医学与临床

Objective To establish lung function reference values and prediction equations in children and adolescents of the Han nationality in Heilongjiang province.Methods A survey in 588 healthy children and adolescents (292 males,296 females)aged 10 to 18 years old was carried out in Heilongjiang province in 2008.Eight flowvolume tests parameters were measured.Stepwise multiple regression was carried out to establish prediction equations for the parameters mentioned above.Results FVC and FEV1,were found,regardless of sex,to tend to go up with the increase of age(P ＜0.001).Beginning from the age of 14,male FVC and FEV1 became significantly higher than those of the female(P ＜0.001),the period of a fast increase of the male FVC and FEV1 taking place during the age of 13～14,while that of the female taking place in the age of 12 ～ 13,one age bracket earlier than the male.All lung volumes and flow rates,were found,regardless of sex,to tend to go up with the increase of age,height and weight(P ＜ 0.001).The regression equations of lung function were established.By comparison with the equations derived from our study and other authors' reports,it was found that the difference between measured data and predicted values from other authors was higher than those from our8.Conclusion Reference values and prediction equations for forced expiratory lung function applicable for children and adolescents of the Han nationality in Heilongiiang province were established.

Effect of Spa Therapy on the Six-minute Walk Test in Patients with Chronic Obstructive Pulmonary Disease / 日本温泉気候物理医学会雑誌

Our previous studies have shown that spa therapy can reduce subjective symptoms and improve ventilatory function in patients with chronic obstructive pulmonary disease (COPD). The aim of this study is to measure the effects of spa therapy on walking distance during the six-minute walk test in patients with COPD. Twenty-five COPD patients hospitalized for pulmonary rehabilitation at our hospital were included in this study. Twenty-two patients were male and 3 patients were female. Two patients had stage I, 9 patients had stage II, and 14 patients had stage III COPD, according to the Global Initiative for Chronic Obstructive Lung Disease. We offered complex spa therapy (swimming training in a hot spring pool, inhalation of iodine salt solution, and fango therapy) in all patients for 4 weeks. Ventilatory function, six-minute walk distance, oxygen saturation and Borg scale were measured. Vital capacity (VC) was significantly improved by spa therapy at 4 weeks (p<0.05). The values of forced vital capacity (FVC), forced expiratory volume in one second (FEV_1.0), forced expiratory flow after 75% of expired FVC (FEF₇₅), forced expiratory flow after 50% of expired FVC (FEF₅₀), forced expiratory flow after 25% of expired FVC (FEF₂₅), mean expiratory flow during the middle half of the FVC (FEF_25-75), residual volume (RV), functional residual capacity (FRC), peak expiratory flow (PEF) and diffusing capacity for carbon monoxide (DLco) showed a tendency to increase, however the increase in the 10 parameters was not significant. The values of six-minute walk distance before and after spa therapy were 288±106m and 323±114m, respectively (p<0.05). There was a significant decrease in values of maximum Borg Scale values (p<0.05). The values of minimum oxygen saturation and the values of oxygen saturation at rest slightly increased, but not significantly. The change of six-minute walk distance correlated with change of VC (r=0.545; p<0.05), with change of FVC (r=0.628; p<0.05), with change of FEV_1.0 (r=0.559; p<0.05), with change of FEF₅₀ (r=0.480; p<0.05), with change of minimum oxygen saturation (SpO₂) (r=0.554; p<0.05) and with change of SpO₂ at rest (r=0.445; p<0.05). We found that spa therapy induced improvements in ventilatory dysfunction and six-minute walk distance in patients with COPD. The results from this study reveal that spa therapy may improve disease control and exercise tolerance in patients with COPD.

Teste de permeabilidade de vias aéreas pré-extubação: comparação entre três métodos em ventilação espontânea / Cuff leak test preextubation: comparison between three methods in spontaneous ventilation

JUSTIFICATIVA E OBJETIVOS: O teste de permeabilidade avalia obstrução de via aérea superior e é classicamente realizado em modo assistido-controlado de ventilação mecânica. O objetivo deste estudo foi analisar este teste em ventilação espontânea, através de três diferentes métodos e compará-los. MÉTODO: Vinte pacientes intubados foram submetidos a três diferentes formas do teste de permeabilidade, todos em ventilação espontânea: com o ventilômetro e o paciente conectado ao ventilador (teste 1); através do display do ventilador mecânico (teste 2); e com o ventilômetro e o paciente desconectado do ventilador (teste 3). O vazamento ao redor do tubo traqueal (TT) foi definido como a porcentagem decorrente da diferença entre o volume-corrente inspirado (balonete insuflado) e expirado (balonete desinsuflado). Foram avaliadas as diferenças entre os três testes, bem como correlacionado a porcentagem de vazamento entre os testes com três variáveis: pressão do balonete, diâmetro do TT e tempo de intubação. RESULTADOS: Houve diferença significativa (p < 0,05) de vazamento entre os testes 1 e 2 em relação ao teste 3 no geral e relacionado à intubação, com período inferior a 48h e pressão de balonete abaixo de 20 cmH2O. Em relação ao diâmetro do tubo, houve diferença apenas entre os testes 2 e 3 para tubos de 8,5 mm. CONCLUSÕES: O teste de permeabilidade em ventilação espontânea parece ser mais fidedigno quando realizado com o paciente conectado ao ventilador mecânico, mas novos estudos devem ser realizados para a determinação da real contribuição do teste em ventilação espontânea para a predição de edema de laringe.

BACKGROUND AND OBJECTIVES: The cuff leak test aims to evaluate the presence of airway obstruction and normally is carried through in the controlled mode of mechanical ventilation. The objective of this study was to evaluate the cuff leak in patients breathing spontaneously, across three different methods, and to compare them. METHODS: Twenty intubated patients had been submitted to three different forms of cuff leak test, all of them in spontaneous respiration: measuring air leak buy using a ventilometer and with the patient connected to the mechanical ventilator (test 1); through the display of the mechanical ventilator (test 2); and with ventilometer and the patient detached from the mechanical ventilator (test 3). The air leak around the tracheal tube (TT) was defined as the percentage difference between the inspired tidal volume (insufflated cuff) and exhaled (deflated cuff). The air leak differences between the three tests were evaluated, as well as their correlations to three variables: cuff pressure, TT diameter and intubation time. RESULTS: Statistically significant (p < 0.05) air leak difference was observed between the tests 1 and 2 in relation to the test 3 in the general and regarding time intubation below 48h and cuff pressure below 20 cmH2O. Regarding the tube diameter, it had been difference only between tests 2 and 3 for 8.5 mm tubes. CONCLUSIONS: The cuff leak test in spontaneous ventilation seems to be more accurate when the patient is connected to the mechanical ventilator, and that additional studies are needed to determine the real contribution of the test in this ventilation mode to predict laryngeal edema.

Clinical analysis of asthma patients with wheezing despite normal ventilatory function / 천식및알레르기

BACKGROUND: Wheezing is one of the characteristics of asthma, Intensity of wheezing is correlated with the severity of airway obstruction. However, some asthmatic patients may show wheezing despite normal ventilatory function. OBJECTIVE: To determine the cause of wheezing in asthmatic patients with normal ventilatory function. METHODS: Thirty-eight consecutive asthmatic patients with wheezing despite FEV1> or =80% of predicted value were retrospectively examined for clinical data. RESULTS: Twenty-seven patients (71.1%) were women. Sixteen patients (42.1%) showed airway obstruction based on the Intermountain Thoracic Society criteria. Patients with airway obstruction had significantly lower FEF50% than did those without it (P1 suggesting upper airway obstruction was observed in 7 of 16 (43.8%) patients. Associated diseases were rhinitis in 21 (55.3%) patients, sinusitis in 18 (47.4%), and postnasal drip syndrome in 3 (7.9%). CONCLUSIONS: Wheezing despite normal ventilatory function in asthma occurs more often in women. It may be related to reversible airway obstruction in nearly half patients and to upper airway obstruction such as rhinitis. in considerable numbers of the remaining patients.

Establishing the reference values of ventilatory function on healthy Vietnamses

234 healthy persons aged from 16-70 (142 males and 92 females) measured ventilatory function were studied during 1994-1996 using Spiroanalyser ST 300 of Japan. The result: In men aged from 16-25, Coefficient A of regression equation of IVC, FVC, FEV1 was positive, meaning values of criteria increased according to age. In women, Coefficient A of regression equation of FVC, FEV1, MMF, PEF, V75, V50, V25, MVV was positive, their values increased according to age, except IVC and MEFR, their coefficient A was negative, decreased according to age. However in both sexes, these ventilatory function values increased according to high. In group of persons aged from 16-70 for both sexes, this values increased with high but decreased when age advanced

Pulmonary function in type 2 diabetes and its related factors / 医学研究生学报

Objective: To explore the changes of pulmonary function in type 2 diabetes and its related factors.Methods: The pulmonary functions of 72 patients with type 2 diabetes and 22 healthy objects were measured,and the related factors,such as duration of DM,HbA1c,BMI,were analysed with linear regression analysis.Ninteen of them underwent a 12-week-long intensive insulin therapy and pulmonary function tests before and after the treatment.Results: Vital capacity(VC),forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),total lung capacity(TLC) and carbon monoxide diffusion in the lung(DLco) were significantly decreased in the diabetes patients.Correlation analysis revealed that DLco was negatively correlated with the duration of DM.which was shown by linear regression analysis to be the only significant predictor.After a 12-week-long intensive insulin therapy,DLco and DLco/VA decreased significantly.Conclusion:Patients with type 2 diabetes have abnormal pulmonary ventilatory function and impaired pulmonary diffusive function,and the latter is related to the time of hyperglycemia,and can not ameliorated by short-term glycemic control.

The Effect of Silica Dust on Ventilatory Function in Foundry Workers / 대한산업의학회지

In order to study the exposure level of silica dust and the effects of silica dust on ventilatory function, respirable dust samples were collected by personal air samplers using NIOSH method 0500 from the selected foundry operations, and ventilatory function tests were performed on 209 male foundry workers and 239 male control subjects. Ventilatory indices such as forced vital capacity (FVC) , one-second forced expiratory volume (FEV1), ratio of FEV1 to FVC(FEV1 %), maximal mid-expiratory flow(MMF), peak expiratory flow rate (PEFR) and maximal expiratory flow at 25, 50 and 75 % of expired FVC (FEF25, FEF50, FEF75 were obtained by analyzing forced expiratory spirogram and maximal expiratory flow-volume curve which were simultaneously measured by Vitalography in standing position. The results were as follows : 1. The average quartz concentrations of respirable dust were the highest in melting operation (0.079 mg/m3) and followed by molding operation (0.051 mg/m3), finishing operation (0.041 mg/m3) and coremaking operation (0.023 mg/m3) in the descending order. 2. No significant differences for mean values of all ventilatory indices expressed as percent of predicted value were demonstrated between smokers and nonsmokers In foundry workers and control subjects. 3. Mean values of all ventilatory indices except FVC of foundry workers were significantly lower than those of control subjects. 4. Mean values of FEV1 %, MMF, FEF25, FEF50 and FEF75 expressed as percent of predicted value tended to decrease with increasing cumulative dust exposure. 5. In foundry workers, proportions of workers with low MMF, FEF50 and FEF75 were markedly higher than those with other indices, and were significantly increased with increasing cumulative dust exposure. 6. In foundry workers, 2 workers(1.0 %) were diagnosed as silicosis and the profusion of radiographic opacities were category 1/0 and q type. With the above considerations in mind, it suggested that increasing exposure of silica dust be associated with progressive deterioration in ventilatory function of an obstructive nature and that MMF, FEF50 and FEF75 be more sensitive indices in the detection of the early obstructive changes of air flow of workers exposed to silica dust.

Respiratory Gas Exchange and Ventilatory Functions at Maximal Exercise / 결핵

BACKGROUND: Although graded exercise stress tests are widely used for the evaluation of cardiorespiratory performance, normal standards on respiratory gas exchange and ventilatory functions at maximal exercise in Koreans have not been well established. The purpose of this study is to provide reference values on these by sex and age, along with derivation of some of their prediction equations. METHOD: Symptom-limited maximal exercise test was carried out by Bruce protocol in 1,000 healthy adults consisting of 603 males and 397 females, aged 20~66 years. Among them VC, FEV1 and MVV were also determined in 885 cases. All the subjects were members of a health center, excluding athletes. During the exercise, subjects were allowed to hold on to front hand rail of the treadmill for safety purpose. RESULTS: The VO2 max/m2, VCO2 max/m2 and VE max/m2 were greater in males than in females and decreased with age. The RR max in men and women was similar but decreased slightly with age. The VT max was markedly greater in men but showed no significant changes with age in either gender. The mean of VT max/VC, VE max/MVV and BR revealed that there were considerable ventilatory reserves at maximal exercise even in older females. The regression equations of the cardinal parameters obtained using exercise time(ET, min), age(A, yr), height(Ht, cm), weight(W, kg), sex(S, 0=male; l=female), VC(L), FEV1(L) and VE max(L) as variables are as follows: VO2 max/m2(L/min)=1.449+0.073 ET-0.007A+0.010W-0.006Ht-0.209S, VCO2 max/m2(L/min)= 1.672+0.063ET-0.008A + 0.010W -0.005Ht -0.319S, VE max/m2(L/min)=58.161 +1.503ET - 0.315A-9.871S or VE max/m2(L/min)=47.873+6.548 FEV1-5.715 S, and VT max(L)=1.497+ 0.223VC-0.493S. CONCLUSION: Respiratory gas exchange and ventilatory variables at maximal exercise were studied in 1,000 non-athletes by Bruce protocol. During exercise, the subjects were allowed to hold on to hand rail of the treadmill for safety purpose. We feel that our results would provide ideal target values for patients and healthy individuals to be achieved, since our study subjects were members of a health center whose physical fitness levels were presumably higher than ordinary population.

Comparison of pharmacodynamics of epidural and intravenous midazolam / 中华麻醉学杂志

To determine the differences in analgesic, hemodynamic and ventilatory effects between epidural and intravenous midazolam (MID), 44 adult patients, ASA grade Ⅰ to Ⅱ, scheduled for elective upper abdominal surgery. were randomly allocated to receiving epidural MID 0.05 mg/kg (group E_1) or 0.1 mg/kg (group E_2). or intravenous MID 0.05 mg/kg (group V_1) or 0.1 mg/kg (group V_2), respectively, The analegic effect was evaluated by pin-prink test, following MID administration. The hemodynamie and ventilatory values were measured by impedance cardiogra phy and side stream spirometry, before and 1.3, 5, 10, 15 and 20 mins after MID administration. Tbe results showed that the segmental spinal analgesia occured with MID in group E_1 and E_2, but no analgesia was produced with WID in group V_1 and V_2. Following MID administration in four groups, HR increased during first 5 mins (P0.05); CI, SI. LVWI, MAP, RPP and indices of myocardial eonstraction, cardiae peak flow and blood ejection velocity decreased slightly(P0.05). After MID administration, SpO_2 and VT were reduced (P0.05), and the inspiratory end-tidal oxygen content difference was elevated transiently (P0.05) and went down in group E_2 and V2(P0.05).

Epidural morphine on ventilatory function in chest trauma and thoracotomy patients

Epidural morphine injection was done in nineteen patients who had been admitted from March to August 1990 to the Intensive Care Unit, Severance Hospital, Yonsei Medical Center for respiratory care including ventilator care. Morphine suplphate, 2.67 +/- 0.27 mg was injected one to three times to four patients after chest trauma, and to fifteen patients after thoracotomy. Tidal volume and vital capacity were increased from 4.45 +/- 0.48 and 8.31 +/- 0.50 to 6.91 +/- 0.41 and 12.81 +/- 0.73 mg/kg. However, respiratory rates decreased from 26.07 +/- 1.41 to 20.07 +/- 1.16/min. Inspiratory force increased from -13.40 +/- 1.31 to -26.53 +/- 1.82 cmH2O. Pain score decreased from 9.22 +/- 0.57 to 3.56 +/- 0.83 during this period. PaCO2 did not differ significantly (39.33 +/- 1.13 and 39.48 +/- 1.42 mmHg). Side effects such as pruritis and urinary retention were treated with naloxone 7 approximately 10 ng/kg/min. Mean arterial pressure and pulse rates stayed stable during the study periods. Ventilator hours and ICU stays differed from the control group. However, the duration was not statistically significant. The control group consisted of patients who were admitted during the six months from September 1989 to February 1990 to the ICU for respiratory care, without epidural morphine injection.

ASTHMATIC CHILDREN AND SWIMMING / 体力科学

In 31 asthmatic children, we investigated the change of the structure on the time of living, an amount of exercise by pedmeter and measured pulmonary ventilatory function during 28 weeks swimming training.<BR>The result showed 58.07% of contribution factor to the structure on the time of living on children with asthma and dynamic play time after school were significantly shorter in asthmatic than non-asthmatic children (p<0.05) . After 28 weeks, we could not find any significantly differences of dynamic play time between asthmatic and nonasthmatic children.<BR>An amount of exercise in daily life from the point of view of walking step number by pedmeter were significantly less in aged 6-9 years boys and girls, and aged 10-12 years boys than non-asthmatic children (respectively, p<0.05, p<0.01) . However, after 28 weeks, we could not find any differences between asthmatic and non-asthmatic children.<BR>Forced vital capacity (FVC) and rate of forced expiratory volume on one second (% FEV<SUB>1.0</SUB>) were increased after 28 weeks than the begining of swimming, and we found the strength of their breathing muscles.<BR>On according to perform the great swimming distances (averages 220m in boys, 325m in girls), all asthmatic children became very lively and actively.