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Objective To analyze the positive rate of serum mycoplasma pneumoniae antibody IgM in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Liangjiang New Area of Chongqing and the related risk factors, so as to provide a theoretical basis for clinical diagnosis and treatment of AECOPD. Methods Retrospective analysis of 728 cases of AECOPD patients from January 2020 to December 2021 in Chongqing Liangjiang New Area Third Class Hospital. ELISA was used to determine Mycoplasma pneumoniae IgM antibodies. According to the detection of Mycoplasma pneumoniae IgM antibodies, the patients were divided into infection group and non-MP infection group. Clinical data such as gender, age, length of stay, place of residence, smoking status, home oxygen therapy, GOLD grade of COPD, number of acute exacerbations in the previous year, mechanical ventilation, and application of anti-infective drugs were collected. Univariate analysis and logistic regression were used to analyze the risk factors of MP infection in AECOPD patients. Results The positive rate of MP-IgM in 728 AECOPD patients was 15.38% (112/728), including 67 males and 45 females. There was no significant difference in the positive rate of MP-IgM in AECOPD patients between different seasons (χ2=2.840, P>0.05). Age ≥60 (OR=3.243), smoking (OR=2.559) and GOLD grade 3-4 (OR=3.760) were independent risk factors for MP infection in AECOPD patients. Conclusion The incidence of MP infection in AECOPD patients in Liangjiang New Area of Chongqing is relatively high, especially in AECOPD patients with age ≥ 60, smoking, GOLD grade 3-4, which should be warned of the possibility of mycoplasma pneumoniae infection , and targeted treatment measures can improve the cure rate.
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Objective:To regulate autophagy protein p62 of airway epithelial cells in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) rats with Qingjin Huatantang, in order to explore its effect on interleukin (IL) -1β and tumor necrosis, tumor necrosis factor-α (TNF-α), leukotriene B4 (LTB4), and leukotriene C4 (LTC4). Method:Airway epithelial cells and AECOPD airway epithelial cells were cultured. Sixty SPF male SD rats were randomly divided into 6 groups, namely high, medium and low-dose Qingjin Huatantang groups, western medicine group, model group and normal group. Except for the normal group, the remaining groups were included into the AECOPD model by lipopolysaccharide (LPS) tracheal instillation method + fumigation method. After modeling, the dosage of the high-dose traditional Chinese medicine group was 30 g·kg-1·d-1, that of the middle-dose group was 15 g·kg-1·d-1, that of the low-dose group was 7.5 g·kg-1·d-1, the positive control group was given luo erythromycin (0.017 5 g·kg-1·d-1), the model group and the blank control group were orally given normal saline with the volume of 20 mL·kg-1·d-1. Serum was extracted two weeks after administration, and the cells were intervened with drug-containing serum. The content of interleukin IL-1β, TNF-α, and LTB4 in cell supernatants were detected by enzyme-linked immunosorbent assay (ELISA). And LTC4 content, p62 mRNA and protein expressions in lung airway epithelial cells were detected by quantitative real-time fluorescence polymerase chain reaction (Real-time PCR) and Western blot. Result:Compared with the normal group, ELISA results showed that IL-1β, TNF-α, LTB4, and LTC4 in the model group were significantly increased (P<0.01). Compared with the model group, IL-1β, TNF-α, LTB4, LTC4 in cell supernatants in each administration group were significantly reduced (P<0.01), mRNA and protein expressions in p62 showed that compared with the normal group, mRNA and protein expressions in p62 of model group significantly decreased (P<0.01). Compared with the model group, the mRNA and protein expressions of p62 in each administration group significantly increased to different degrees (P<0.01). The expression of autophagy in Qingjin Huatantang high-dose group and western medicine group was comparable. Conclusion:Qingjin Huatantang can reduce the inflammatory response in airway epithelial cells, which may be related to the regulation of autophagy protein p62.
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Studies regarding clinical profile of Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) is extremely rare from the north-eastern part of India. This necessitates the present study. Aim: The present study aimed to describe the clinical profile of Acute Exacerbation of COPD (AECOPD) patients admitted in the Department of Respiratory Medicine, JNIMS, Imphal. Methods: The hospital records of all Acute Exacerbations of COPD patients admitted during the period Sept 2015 to Aug 2016 in the IPD of the Department of Respiratory Medicine, JNIMS were recorded retrospectively and analyzed by using descriptive statistics. Results: A total of 100 patients were admitted during the study period of one year. The mean age (SD) of the patients was found to be 71.3 (10.567) years. Female patients outnumbered male patients (M:F=1:1.08). The last quarter of the year (Sept-Dec) showed the least number of patients admitted while remaining months of the year had variable but relatively higher number of patients admitted with a peak in August. Dyspnoea was the commonest symptom which was found in almost all the patients (99%). Co-amoxiclav, Cephalosporin, Macrolide and Fluoroquinolone were the antibiotics most frequently used. In addition to the antibiotics mentioned above, steroids were needed and administered in 74 cases (74%). Methylprednisolone and Hydrocortisone were the main steroidal preparations used. Ventilation support was needed by two (2%) patients. And altogether three patients died during the study period (3%). The period of stay in IPD by all the patients ranged from 2-35 days with a mean (SD) of 8.51 (6.268) days. Conclusion: COPD exacerbation was seen in ageing population of both sexes. Dyspnoea was commonest symptom and mean hospital stay was 8.51 days. Antibiotics and steroid commonly prescribed were Coamoxiclav and methylprednisolone respectively. 3% of study population expired.
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Objective: To observe the clinical effect of clustered non-invasive mechanical ventilation strategy in the treatment for patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) complicated with hypercapnia encephalopathy(HE) so as to evaluate the safety and effectiveness of the scheme. Methods: According to the inclusion criteria, 164 patients with AECOPD complicated with HE were divided into the observation group(74 cases) and the control group (90 cases) as the random method. The patients of observation group were treated with clustered non-invasive ventilation(NIV), and the patients of control group were treated with invasive mechanical ventilation(IMV). The blood gas indexes of the two groups before and after 2 hours of treatment were observed, and the improved situations of the two groups were evaluated by KPS score. Besides, the hospitalization time and the mechanical ventilation time of the two groups were observed, and the incidence of adverse events and case fatality rate of 1 year in the two groups were counted and analyzed, and the reliability of the clustered NIV scheme was further evaluated. Results: Before treatment, there were no significant differences in pH, oxygenation index(PaO2/FiO2), partial pressure of carbon dioxide in artery (PaCO2) level and KPS score between the two groups(t=1.021, t=1.301, t=0.985, t=1.017, P>0.05). Although these indicators were obviously improved after these patients of two groups were treated, the differences of them between before and after treatment were no significant(t=2.017, t=1.825, t=1.163, t=1.520, P>0.05). On the other hand, the differences of time of mechanical ventilation, the hospitalization time and the times of intubation between the observation group and the control group were significant(t=7.018, t=8.523, t=7.954, P<0.05). In the observation group, there were 12 cases were failure, and 4 patients died in hospital, while the number of died in hospital were 18 cases in control group, and the difference of the number of died in hospital between the two groups was significant(x2=5.631, P<0.05). Besides, the difference of complication between the two groups was significant(x2=7.014, P<0.05). And the difference of case fatality rate of 1 year between the two groups was no significant. Conclusion: It is safe and effective for patients with AECOPD complicated with HE to implement cluster noninvasive mechanical ventilation strategy on the basis of meeting the condition of non-invasive mechanical ventilation. And it has clinical application value.
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Objective To guide the treatment of acute exacerbation of chronic obstructive puhnonary diseases (AECO- PD) through studing the principally related factors of AECOPD.Methods 190 AECOPD patients were investigated through retrospective study.First,we studied the thirty-two possible factors with single-factor analysis,then procee- ded to perform multiple-factor analysis with Logistic regression among the factors which P value was below 0.2 in single -factor analysis,and analyzed the principally related factors with two-factor correlation.Results According to Mul- tiple-factor analysis with Logistic regression analysis,there were eight factors that showed significance,which were us- age of respiratory excitant,LBC,usage of antioxidant,heart failure,Cr,selection of antibiotics respectively,WBC and Hb.Correlative analysis of the principally related factors showed no correlation between WBC and LBC.Conclusion The principally related factors of AECOPD prognosis were their recited in results.