Clinical Efficacy Evaluation of Tanreqing Injection Combined with Ceftazidime in Treatment of Phlegm Heat Obstructing Lung Syndrome in Acute Exacerbation of Chronic Obstructive Pulmonary Disease / 中国实验方剂学杂志

ObjectiveTo explore the effect of Tanreqing injection combined with Ceftazide on the clinical efficacy， lung function， and laboratory inflammatory index of patients suffering from phlegm heat obstructing lung syndrome in acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. MethodFrom June 2021 to June 2023， 76 patients diagnosed with phlegm heat obstructing lung syndrome in AECOPD were enrolled in the respiratory and critical medical department of Jieshou Hospital of Traditional Chinese Medicine. They were randomly divided into a control group and an observation group with 38 cases each. The control group used Ceftazidime intravenous drip and other conventional oxygen inhalation and antispasmodic treatment measures of western medicine. The observation group received Tanreqing injection intravenous drip based on the treatment of the control group， with a course of 10 days. The changes of laboratory indicators such as hs-CRP， calcitonin （PCT）， and interleukin-6 （IL-6） before and after treatment were analyzed， and the improvement of forced expiratory volume in the first second （FEV1）， forced vital capacity （FVC）， one second rate （FEV1/FVC）， assessment and improvement of the British Medical Research Society’s dyspnea index （mMRC）， self-evaluation test of chronic obstructive pulmonary disease patients （CAT）， and traditional Chinese medicine syndrome score was compared. In addition， the total effective rate between the two groups after treatment was compared. ResultAfter treatment， the hs-CRP， PCT， IL-6， FEV1， FVC， FEV1/FVC， mMRC， CAT scores， and traditional Chinese medicine syndrome evaluation of both groups improved （P<0.01）. After treatment， compared with the control group， the observation group showed more significant improvements in hs-CRP， PCT， IL-6， FEV1， FVC， FEV1/FVC， mMRC， CAT scores， and traditional Chinese medicine syndrome evaluation， and the difference was statistically significant （P<0.05，P<0.01）. The total clinical effective rate of the control group was 86.84% （33/38）， while that of the observation group was 94.74% （36/38）. The therapeutic effect of the observation group was better than that of the control group （χ2=8.471， P<0.05）. ConclusionTanreqing injection combined with Ceftazidime has obvious efficacy in the treatment of phlegm heat obstructing lung syndrome in AECOPD， which is better than the treatment of Ceftazidime antibiotics alone. It can reduce the risk of acute exacerbation， alleviate clinical symptoms， and delay the decline of lung function.

Secuelas respiratorias clínicas, funcionales y tomográficas de pacientes hospitalizados por Covid-19 al año del diagnóstico: ESTUDIO SECUELAR-19 / Clinical, functional and tomographic respiratory sequels of patients hospitalized for COVID-19 at one year of diag nosis: SECUELAR-19 TRIAL

Resumen Introducción : Hay información escasa sobre evolución a largo plazo de pacientes hospitalizados por neumo nía COVID-19 moderada (NM) y grave (NG). El objetivo del estudio fue determinar impacto clínico, funcional respiratorio y tomográfico (TACAR) luego del alta a 12 meses del diagnóstico. Métodos : análisis según grupos NM y NG, desatura dores (PD) en prueba de caminata 6 min (PC6M) y patrón tomográfico símil fibrótico (SF). Comparamos resultados a 3 y 12 meses de seguimiento. Resultados : 194 pacientes enrolados, evaluados al año: 103 (53% ): masculinos (62.4%), edad 57.7 ± 10.9 años, comorbilidades (hipertensión arterial 38.8%, dia betes 29.6%, antecedentes respiratorios-AR- 18.4%). Com paramos variables a los 3 y 12 meses (media/DE): CVF 84%(19) a 88(19) (p = 0.01); 27% tuvo CVF<80% al año. En PC6M: 426 metros (108) a 447(92) (p = < 0.01). El 12.8% fue PD al año. NG tuvo mayor SF (40% vs. 27.9% p = 0.021). SF se relacionó con CVF <80% (p = 0.004) en toda la co horte, y NG (p < 0.001). Al año en análisis multivariado se asoció a CVF <80%, AR (OR 4.32, 1.15-16.25), diabetes (OR 2.96, 1.02-8.57) y patrón SF (OR 3.51, 1.25-9.88). PD se asoció a AR (OR 12.2, 2.41-61.85). Discusión : Se observó mejoría en todas las variables al año. Pero al año persisten alteraciones funcionales y tomográficas en <50% de los pacientes. El subgrupo de PD se relacionó a AR. Es importante el seguimiento protocolizado de los pacientes hospitalizados, especial mente los grupos NG, PD y SF.

Abstract Introduction : There is scarce information on longterm evolution of hospitalized patients with moderate (MP) and severe (SP) COVID-19 pneumonia. Objective: to de termine clinical, respiratory function, and tomographic (HRCT) impact after being discharged 12 months after diagnosis. Methods : Analysis according to MP and SP, desatura tor patients (DP) in 6-minute walking test (6MWT) and HRCT fibrotic-like pattern (FLP). Results compared at 3 and 12 months of follow-up. Results : 194 patients enrolled and one year later 103 (53%) were evaluated: gender male (62.4%), age 57.7 ± 10.9 years, comorbidities (arterial hypertension 38.8%, diabetes 29.6%, and respiratory diseases-RD-18.4%). Variables compared 3 months to 12 months (mean/SD): FVC: 84%( 19) to 88%( 19) (p= 0.01). A 27% of patients had FVC<80% at one year. In 6MWT:426 (108) to 447 (92) (p = <0.01). 12.8% are DP in one year. SP had a greater FLP than MP (40% vs. 27.9%, p = 0.021). The FLP group was related to FVC < 80% (p = 0.004) in all patients but only in SP (p < 0.001). After one year, in multivariate analysis, FVC < 80% was associated with RD (OR 4.32, 1.15-16.25), diabetes (OR 2.96, 1.02-8.57) and FLP (OR 3.51, 1.25-9.88). DP were associated with RD (OR 12.2, 2.41-61.85). Discussion : Improvement was observed in all vari ables when comparing 3 to 12 months. However, after one year, functional and tomographic alterations persist in less than 50% of patients. DP subgroup was related to RD. Protocolled follow-up of hospitalized patients is important, especially in SP, DP, and FLP groups.

COMPARISON OF LUNG FUNCTION IN PATIENTS WITH BRONCHIECTASIS DURING ACUTE EXACERBATION AND IN CONVALESCENCE - A PROSPECTIVE STUDY

Background- Bronchiectasis is a common chronic respiratory disease. A noticeable drop in lung function during exacerbations and recovery during convalescence has been revealed in patients with asthma or chronic obstructive pulmonary disease (COPD). Hence this study was planned with the objectives to compare lung functions during acute exacerbation and convalescence in patients with bronchiectasis. This was a prospective cohort study Methods- conducted in 50 patients over a duration of 18 months. Measurement of exacerbations and convalescence visits comprised of spirometry, sputum bacteriology, serum and sputum biomarker. Student's paired t test, Fischer's exact test or Chi square test was used to analyze the signicance of difference. P value <0.05 was considered as statistically signicant. In this study, Results- there was a signicant association of mMRC dyspnoea score in exacerbation and in convalescence. (p <0.0001). The analysis showed that mMRC dyspnoea score was shifted to lower scores in convalescence compared to that in exacerbation. FEV1, FVC and FEV1/FVC) and 6 MWT distance were signicantly lower in patients in exacerbation as compared in convalescence. Conclusion- There was marked improvement in lung functions in convalescence as compared to patients in acute exacerbation

Pulmonary function tests in compressed natural gas pump workers in Surat city

Background: Various studies have known abatements in lung function and several other health problems associated with longstanding air pollution exposure. One of the most cost-effective and environmental alternative of conventional fuels (petrol and diesel) is compressed natural gas (CNG). The increasing use of CNG as a fuel (as it is safe and cheap as compare to the conventional fuels) can add one more bug to the list of work-related disease. Aims and Objectives: This study is to evaluate the respiratory functions of CNG pump workers. Materials and Methods: The present study was held on 82 male subjects. The study group included of non-smoking healthy adult males, age group of 20–40 years working in different CNG stations in Surat city for >6 months and 8 h per day. The control group included of non-smoking healthy adult males, age group of 20–30 years working or studying in the Surat Municipal Institute of Medical Education and Research (SMIMER). Results: Out of 82 male subjects, 30 subjects were control and 52 subjects were CNG station workers. The study group comprised of 52 healthy non-smokers in the age group of 20–40 years working in different CNG station in Surat city for >6 months and 8 h/day. The control group comprised of 30 healthy non-smokers males between the age group of 20–30 years working or studying in the SMIMER. Conclusion: In this study, we have not found statistically significant deterioration in pulmonary functions of CNG pump workers when compared to controls.

Efectos de la menopausia temprana en la función pulmonar: revisión integrativa / Effects of early menopause on lung function: an integrative review

La menopausia provoca cambios hormonales y alteraciones sistémicas. La menopausia normal sucede entre los 45-55 años y la menopausia temprana (MT) se desarrolla antes de los 45 años. Revisar la evidencia que señala posibles asociaciones entre la MT y la función pulmonar, analizando específicamente aquellos componentes que se encuentran alterados. Se eligieron estudios transversales y revisiones sistemáticas, en inglés, portugués y español. La búsqueda se realizó de marzo a noviembre de2022, en PubMed y Scopus, aemás de búsquedas manuales. La calidad metodológica fue analizada utilizando la escala Strengthening the Reporting of Observational Studies in Epidemiology para los estudios observacionales, y el Ameasurement Tool to Assess Systematic Review para las revisiones. Se encontraron 698 estudios, 12 seleccionados para calificación metodológica, cinco excluidos. Al final del análisis metodológico, se obtuvieron seis estudios transversales y una revisión sistemática, llevados a cabo en Reino Unido, Europa y Asia. Hay una tendencia para asociación de la MT a un patrón ventilatorio restrictivo. Sin embargo la evidencia sigue siendo escasa y se sugiere la realización de nuevos estudios.

Menopause causes hormonal changes and systemic alterations. Normal menopause is when this event occurs between the ages of 45 and 55, and early menopause (EM) when it develops earlier than 45 years. To review the evidence that indicates possible associations between EM and lung function, specifically analyzing those components that are altered. Cross-sectional and systematic reviews studies, published from 2000-2022, in English, Portuguese and Spanish were selected from March to November 2022, in PubMed and Scopus and through manual searches. Methodological quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology scale for observational studies, and the Measurement Tool to Assess Systematic Review for reviews. 698 studies were found, 12 were selected for methodological quality review and 5 were excluded. At the end of methodological analysis, 6 cross-sectional studies and 1 systematic review were obtained, carried out in United Kingdom, Europe and Asia. There is a tendency for EM to be associated with restrictive ventilatory pattern. However, the evidence is scarce and further studies are suggested.

Evaluation of pulmonary function in patients of non-specific low back pain / Avaliação da função pulmonar em pacientes com dor lombar inespecífica

INTRODUCTION: Diaphragm is the primary inspiratory muscle and it plays an essential role in controlling the spine during postural control. In nonspecific low back pain, the diaphragm muscle becomes weak, due to which the pulmonary functions may decrease. To the best of our knowledge there is a scarcity of literature in regard to the effect of low back pain on pulmonary parameters. Thus, the study is aimed to evaluate the pulmonary function in patients with non-specific low back pain. METHODS: One hundred and thirteen patients with non-specific low back pain and 113 BMI matched normal individuals as a comparison group aged 18-40 years of male and female genders were recruited by purposive sampling method for this prospective cross-sectional study. The non-specific back pain group included participants diagnosed with non-specific low back pain with pain intensity > 3 on VAS scale and duration > 3 months. After initial screening and assessment, anthropometric characteristics were recorded. Then, the pulmonary function test (FEV1, FVC, FEV1/ FVC, PEFR, SVC, MVV) were recorded in both groups. RESULT: Kolmogorov-Smirnov test was used for normality assessment and data was found to be not normally distributed. Non parametric data was represented as median and IQR (Inter Quartile Range). Between groups data analysis was performed by using MannWhitney U test and the effect size was computed for the study variables. P < 0.05 was considered as statistically significant. There was a significant difference in pulmonary function values of FEV1, FEV1/FVC, PEFR, SVC, MVV. There was no significant difference in age and BMI of the participants of both groups. CONCLUSION: There exist significant differences in pulmonary function in patients with non-specific low back pain.

INTRODUÇÃO: O diafragma é o principal músculo inspiratório e desempenha um papel essencial no controle da coluna durante o controle postural. Na dor lombar inespecífica, o músculo diafragma torna-se fraco, podendo as funções pulmonares diminuir. Até onde sabemos, há escassez de literatura a respeito do efeito da dor lombar nos parâmetros pulmonares. Assim, o estudo tem como objetivo avaliar a função pulmonar em pacientes com dor lombar inespecífica. MÉTODOS: Cento e treze pacientes com dor lombar inespecífica e 113 indivíduos normais pareados com IMC como grupo de comparação com idades entre 18 e 40 anos, dos gêneros masculino e feminino, foram recrutados por método de amostragem proposital para este estudo transversal prospectivo. O grupo de dor nas costas inespecífica incluiu participantes com diagnóstico de dor lombar inespecífica com intensidade de dor > 3 na escala VAS e duração > 3 meses. Após triagem e avaliação inicial, as características antropométricas foram registradas. Em seguida, foram registrados os testes de função pulmonar (VEF1, CVF, VEF1/CVF, PFE, CVL, VVM) em ambos os grupos. RESULTADO: O teste de Kolmogorov-Smirnov foi utilizado para avaliação da normalidade e os dados não apresentaram distribuição normal. Os dados não paramétricos foram representados como mediana e IQR (intervalo interquartil). A análise dos dados entre grupos foi realizada pelo teste U de Mann-Whitney e o tamanho do efeito foi calculado para as variáveis do estudo. < 0,05 foi considerado estatisticamente significativo. Houve diferença significativa nos valores de função pulmonar de VEF1, VEF1/CVF, PFE, CVL, VVM. Não houve diferença significativa na idade e no IMC dos participantes de ambos os grupos. CONCLUSÃO: Existem diferenças significativas na função pulmonar em pacientes com dor lombar inespecífica.

Fisiología respiratoria. Neumología de altura: saturación de oxígeno, edema pulmonar y pruebas de función pulmonar / Respiratory physiology - High -altitude pneumology: oxygen saturation, pulmonary edema and pulmonary function tests

En las alturas, sobre todo a 2500 metros sobre el nivel del mar, la cantidad absoluta de oxígeno va decreciendo y por lo tanto la cantidad disponible para el intercambio gaseoso disminuye, produciéndose una vasoconstricción hipóxica pulmonar (VHP). La VHP asociada a la hipoxia hipobárica de la altura produce un aumento de la presión pulmonar que es mayor en los lactantes y a mayores alturas. No hay valores únicos de saturación de oxígeno (SatO2) en la altura, porque ésta va disminuyendo según el mayor nivel de altura, aumenta con la edad, y la brecha entre la vigilia y sueño es grande (sobre todo en los primeros meses de vida). El 25% de los niños sanos que viven en altura tienen valores de SatO2 significativamente menores que el 75% restante. Los valores normales de los índices de apnea/hipopnea son distintos a los de nivel del mar. El edema pulmonar de las alturas es una patología frecuente, que se produce por un incremento desproporcionado en la VHP reflejando una hiperactividad del lecho vascular pulmonar ante la exposición aguda a la hipoxia hipobárica. Tiene cuatro fenotipos, es infrecuente en menores de 5 años y rara vez es mortal, la sospecha clínica y el manejo oportuno con oxigeno es la clave. Finalmente, en la altura los valores normales de la función pulmonar de la espirometría, oscilometría de impulso y capacidad de difusión son distintos que a nivel del mar.

At high altitude, especially > 2,500 meters above sea level, the absolute amount of oxygen decreases and therefore the amount available for gas exchange decreases, producing hypoxic pulmonary vasoconstriction (VHP). VHP associated with high-altitude hypobaric hypoxia produces an increase in pulmonary pressure that is greater in infants and at higher altitudes. There are no single values of oxygen saturation (SatO2) at altitude, because it decreases with the highest level of altitude, increases with age, and the gap between wakefulness and sleep is large (especially in the first months of life). Around 25% of healthy children living at altitude have SatO2 values significantly lower than the remaining 75%. The normal values of the apnea/hypopnea indices are different from those at sea level. High altitude pulmonary edema is a frequent pathology that is produced by a disproportionate increase in VHP reflecting hyperactivity of the pulmonary vascular bed in the face of acute exposure to hypobaric hypoxia, it has four phenotypes, it is uncommon in children under 5 years of age, and it is rarely fatal, the clinical suspicion and timely management with oxygen is the key. Finally, at high altitude, the normal values of lung function from spirometry, impulse oscillometry, and diffusing capacity are different from those at sea level.

Diagnostic value of fractional exhaled nitric oxide combined with small airway function test for chronic cough / 中国基层医药

Objective:To investigate the value of fractional exhaled nitric oxide (FeNO) combined with small airway function test to replace bronchial provocation test and induced sputum test in differentiating cough variant asthma (CVA) from eosinophilic bronchitis (EB).Methods:The clinical data of 105 patients with chronic cough admitted to The Third People's Hospital of Hubei, Jianghan University from January 2018 to December 2021 were retrospectively analyzed. These patients consisted of 40 patients with CVA (CVA group), 25 patients with EB (EB group), and 40 patients with other chronic coughs (other chronic cough group). FeNO and lung function were compared between groups. The value of FeNO, small airway function, and their combination in differentiating CVA from EB were analyzed using the receiver operating characteristic curves.Results:FeNO level was the highest in the CVA group [33.0 (30.0, 37.8) ppb], followed by the EB group [28.0 (25.5, 32.0) ppb], and the lowest in other chronic cough group [13.0 (11.0, 15.0) ppb]. There was significant difference in FeNO level between groups ( H value = 79.00, P < 0.05). There were no significant differences in forced vital capacity (FVC), forced expiratory volume in 1 second (FEV 1), FEV 1/FVC, peak expiratory flow (PEF) between groups (all P > 0.05). Maximal mid-expiratory flow (MMEF) [74 (66.0, 77.4) in the CVA group, 80 (79.0, 83.3) in the EB group, 88.0 (86.4, 90.0) in other chronic coughs group], FEF25 (%) [70.0 (60.3, 75.1) in the CVA group, 78.0 (74.1, 85.0) in the EB group, 81.7 (78.9, 86.3) in other chronic coughs group], FEF50 (%) [75.2 (67.1, 80.8) in the CVA group, 80.6 (75.7, 85.9) in the EB group, 89.4 (87.0, 90.5) in other chronic coughs group], FEF75 (%) [76.4 (68.7, 85.8) in the CVA group, 80.9 (77.4, 89.7) in the EB group, 90.8 (87.2, 94.2) in other chronic coughs group] were significantly lower in the CVA group than those in other chronic coughs group. With the exception of FEF25 (%), MMEF (%), FEF50 (%), and FEF75 (%) were significantly lower in the EB group compared with other chronic coughs group. MMEF (%) and FEF25 (%) in the CVA group were significantly lower compared with the EB group. There were significant differences in MMEF (%), FEF50 (%), and FEF75 (%) between groups ( H = 62.82, 47.04, 47.41, 49.11, all P < 0.01). There were significant differences in FEF50 (%) and FEF75 (%) between CVA and EB groups (both P > 0.05). In binary logistic regression equation, FeNO and MMEF (%) were important indexes to distinguish CVA from EB ( P < 0.05). Bronchial provocation test and induced sputum test were used as the gold standard to distinguish CVA from EB. When FeNO and MMEF (%) were used separately to distinguish CVA from EB, the optimal threshold value was 30.0 ppb and 77.7 respectively, the area under the receiver operating characteristic curve was 0.77 and 0.82 respectively, the diagnostic sensitivity was 70% and 77.5% respectively, and the diagnostic specificity was 72% and 88% respectively. When FeNO and MMEF (%) were used in combination to distinguish CVA from EB, the area under the receiver operating characteristic curve was 0.89, and the diagnostic sensitivity and specificity was 75% and 96% respectively. Conclusion:FeNO and MMEF (%) can be used to distinguish CVA from EB. FeNO combined with MMEF (%) has a higher value in distinguishing CVA from EB than FeNO and MMEF alone.

Study of Lung Function Disorders of Headstone and Stone Mortar Crafters and Factors That Affect Them

@#Introduction: Dust is one of the chemical substances that cause occupational disease, especially among stone crafters. Its deposition for a long period can lead to various health problems, hence, there is a need for early detection. Therefore, this study aims to assess the occurrence of lung function disorder in headstone and stone mortar crafters. Methods: A cross-sectional design was used and the sample population consists of all headstone and stone mortar crafters in Allakuang Village, Sidrap Regency, Indonesia. They were selected using a purposive sampling method, and 33 out of 148 people met the criteria. Subsequently, their lung function was measured once using spirometry as well as FVC and FEV1 parameters. The data obtained were then analyzed using Chi-Square. Results: 18 of 33 respondents with lung function disorders. They had a long tenure, a normal working time, bad exercise habits, as well as a normal and overweight nutritional status based on their BMI category. The statistical test results showed that tenure, working time, and exercise habits had an effect on the disease condition with p=0.000. Meanwhile, other factors, such as age and nutritional status had no effect with p-values of 0.981 and 0.14, respectively. Conclusion: Based on the results, the majority of headstone and stone mortar crafters have lung function disorders, and the influential factors include tenure, working time, and exercise habits.

Effect of body mass index on pulmonary function and quality of life in elderly patients with chronic obstructive pulmonary disease / 公共卫生与预防医学

Objective To analyze the effect of body mass index (BMI) on pulmonary function and quality of life in elderly patients with chronic obstructive pulmonary disease (COPD), and to provide theoretical basis for the diagnosis and treatment of COPD. Methods A total of 1 278 patients who visited the respiratory department of our hospital from January 2019 to June 2022 were selected as the research objects, including 368 COPD patients, 225 of whom were in stable stage and 143 of whom were in acute exacerbation stage. According to BMI, they were divided into low group (n=31, BMI2), normal group (n=198,18.5kg/m2≤BMI2), overweight group (n=106, 24kg/m2≤BMI2) and obese group (n=33,BMI≥28 kg/m2). Health-related quality of life (HRQOL) was used to evaluate the quality of life of patients. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC were measured by pulmonary function instrument to evaluate the pulmonary function grade of patients. Logistic regression was used to analyze the risk factors of pulmonary function and quality of life in COPD patients. Results There were significant differences in age, smoking, BMI and hyperlipidemia between stable COPD patients and acute exacerbation COPD patients with different BMI groups (P<0.05). There were significant differences in the proportion of pulmonary function Ⅲ/Ⅳ, FEV1/FVC, FEV1pred and HRQOL scores among different BMI groups (P<0.05) . The FEV1/FVC and FEV1pred in patients with acute exacerbation and stable COPD from high to low were obese group, overrecombination group, normal group and too low group, and the differences were statistically significant (P<0.05). The HRQOL scores of COPD patients in acute exacerbation and stable stage from high to low were obese group, overweight group, normal group and too low group, and the difference was statistically significant (P<0.05). Low body mass index was a risk factor for pulmonary function in COPD patients at stable stage (OR=2.52) and acute exacerbation stage (OR=2.83) (P<0.05). High body mass index was a risk factor for quality of life in patients with stable COPD (OR=2.43) and acute exacerbation (OR=2.65) (P<0.05). Conclusion BMI can affect pulmonary function and quality of life in COPD patients. Patients should maintain normal BMI, which can improve pulmonary function and quality of life.

Functional effect of aerobic combined with resistance exercise on old patients with coronary heart disease and hypertension using WHO-FICs framework / 中国康复理论与实践

ObjectiveTo analyze the effect of moderate intensity aerobic combined with low intensity resistance exercise on old patients with coronary heart disease and hypertension. MethodsFrom November, 2021 to May, 2022, 16 patients with coronary heart disease and hypertension in Wuhan Donghu Hospital were divided into control group (n = 8) and experimental group (n = 8). Based on the World Health Organization Family of International Classification (WHO-FICs), the exercise intervention program was constructed. The control group accepted routine treatment, and the experimental group accepted moderate intensity aerobic combined with low intensity resistance exercise in addition, for eight weeks. They were measured lung function and cardiac function with cardiopulmonary exercise test system, and assessed with Timed 'Up and Go' Test, 6-Minute Walk Distance, 2-Minute Step Test, 30-Second Sit to Stand Test and grip strength before and after intervention. ResultsThe vital capacity, forced vital capacity, forced expiratory volume in the first second, forced expiratory volume in the one second as percentage of predicted volume, peak expiratory flow and maximal voluntary ventilation improved in the experimental after intervention (|t| > 2.391, P < 0.05), and the vital capacity, force vital capacity and maximal voluntary ventilation were more in the experimental group than in the control group (|t| > 2.207, P < 0.05). Peak oxygen uptake, anaerobic subthreshold oxygen uptake, metabolic equivalents, oxygen pulse, maximum work load and exercise load time improved in the experimental group after intervention (|t| > 2.823, P < 0.05), and they all were better in the experimental group than in the control group (|t| > 2.295, P < 0.05). Systolic blood pressure improved in both the groups (|t| > 4.608, P < 0.01), and diastolic blood pressure improved in the experimental group (t = 5.964, P < 0.01); while systolic blood pressure was less in the experimental group than in the control group (t = -3.654, P < 0.01). The performances of Timed 'Up and Go' Test, 6-Minute Walk Distance, 2-Minute Step Test, 30-Second Sit to Stand Test and grip strength improved in the experimental group after intervention (|t| > 2.996, P < 0.05), and all the performances were better in the experimental group than in the control group (|t| > 2.220, P < 0.05). ConclusionThe moderate intensity aerobic combined with low resistance exercise developed based on WHO-FICs can improve the cardiac function, lung function, cardiac load and motor function of old patients with coronary heart disease and hypertension.

Effect of lung distension stabilization formula combined with Liu Zi Jue exercise on the rehabilitation of COPD patients in stable stage with lung and kidney deficiency syndrome / 国际中医中药杂志

Objective:To observe the effect of lung distension stabilization formula combined with Liu Zi Jue exercise on the rehabilitation of patients with lung and kidney deficiency syndrome in stable phase of chronic obstructive pulmonary disease (COPD).Methods:Randomized controlled trial. A total of 179 patients with lung and kidney deficiency syndrome in stable COPD (admitted from April 2019 to April 2022) were enrolled in this study. The patients were randomly divided into western medicine conventional treatment group, combined treatment group and Liu Zi Jue group by random number table method. All the patients in the group received conventional western medicine treatment, and 59 patients in the Liu Zi Jue group received Liu Zi Jue treatment. Combined treatment group to take Liu Zi Jue + Lung distension stabilization formula. Data observation: clinical curative effect and TCM syndrome and total integral change before and after the treatment level of interleukin 8 (IL-8), pulmonary function index changes, COPD patients self-assessment scale (CAT) score, st George's hospital respiratory questionnaire (SGRQ) scores change were observed.Results:The total response rate was 66.67% (40/60) in the conventional treatment group, 83.05% (49/59) in the Liu Zi Jue group and 96.67% (58/60) in the combined treatment group. The total response rate in the combined treatment group was significantly higher than that in the conventional treatment group and the Liu Zi Jue group ( Z=3.76, P<0.01). The Liu Zi Jue group was significantly higher than the conventional western medicine group ( χ2=4.24, P=0.040). After treatment, the symptom score of combined treatment group was significantly lower than that of Liu Zi Jue group and conventional treatment group ( F=14.87, P<0.01), and that of Liu Zi Jue group was significantly lower than that of conventional treatment group ( t=5.87, P<0.01). The scores of CAT and SGRQ were significantly lower than those in the Liu Zi Jue group and conventional treatment group ( F values were 76.72 and 312.36, P<0.01), and those in Liu Zi Jue group were significantly lower than that of the conventional treatment group ( t=4.97, P<0.01). After treatment, the serum IL-8 level of the combined treatment group was significantly lower than that of the Liu Zi Jue group and the conventional treatment group ( F=154.64, P<0.01), and the Liu Zi Jue group was significantly lower than that of the conventional treatment group ( t=11.35, P<0.01). FVC [(2.93±0.60) L vs. (2.49±0.65) L, (2.25±0.63) L, F=20.62], FEV1 [(2.20±0.42) L vs. (1.88±0.41) L, (1.72±0.40) L, F=21.30] and FEV1% [(42.34±4.86) % vs. (38.85±5.00) %, (36.95±4.91) %, F=18.49] were significantly higher than those in the Liu Zi Jue group and conventional treatment group ( P<0.01). The Liu Zi Jue group was higher than that of the conventional treatment group ( t values were 3.76, 2.87, 5.15, P<0.01). Conclusion:Lung distension stabilization formula combined with Liu Zi Jue exercisecan promote the rehabilitation of COPD patients with lung and kidney deficiency syndrome in stable phase, improve the curative effect of patients, improve lung function, relieve symptoms, and improve the quality of life.

Effects of modified Maxing Shigan Decoction combined with acupoint application of Traditional Chinese Medicine on inflammatory indicators and pulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease with syndrome of phlegm-heat accumulated in the lung / 国际中医中药杂志

Objective:To observe the clinical effects of modified Maxing Shigan Decoction combined with acupoint application of Traditional Chinese Medicine (TCM) on inflammatory indicators and pulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with syndrome of phlegm-heat accumulated in the lung.Methods:Prospective cohort study. Eighty AECOPD patients with syndrome of phlegm-heat accumulated in the lung, who met the inclusion criteria in our hospital from October 2020 to January 2022 were included, and randomized into two groups by random number table methods, 40 in each group. The control group received conventional therapy of Western medicine, while the treatment group received modified Maxing Shigan Decoction combined with acupoint application of TCM on the basic treatment of control group. Both groups were treated for a course of 14 days. The white blood count (WBC) and percentage of neutrophil (NE%) were detected by automatic blood cell analyzer. Levels of C-reactive protein (CRP) were measured by enzyme linked immunosorbent assay (ELISA). Pulmonary function parameters including forced expiratory volume in one second (FEV1), percentage of forced expiratory volume in one second (FEV1%), forced vital capacity (FVC) and FEV1/FVC were detected by spirometry. Meantime, the adverse reactions and clinical responsive rate were recorded in both groups.Results:The overall responsive rate was 90.0% (36/40) in treatment group, which had statistically significant difference with 70.0% (28/40) in control group (χ 2=5.00, P=0.025). After treatment, plasma WBC [(4.15±1.02)×10 9/L vs. (7.53±1.27)×10 9/L, t=13.12], NE% [(0.50±0.12)% vs. (0.65±0.13)%, t=5.36] and serum CRP [(8.12±5.58)mg/L vs. (25.15±8.50)mg/L, t=10.59] in the treatment group were significantly lower than those in the control group ( P<0.05). The FEV1 [(1.94±0.23)L vs. (1.71±0.35)L, t=3.47], FEV1% [(88.25±9.21)% vs. (74.10±8.13)%, t=7.29], FVC [(3.85±0.31)L vs. (3.12±0.23)L, t=12.29] and FEV1/FVC [(86.12±7.18)% vs. (75.30±8.32)%, t=6.23] in the treatment group were significantly higher than those in the control group ( P<0.05). The adverse reaction rate during treatment period yielded no significant difference between two groups ( P>0.05). Conclusion:Application of modified Maxing Shigan Decoction combined with acupoint application of TCM in the treatment of AECOPD with syndrome of phlegm-heat accumulated in the lung can effectively attenuate inflammation response and ameliorate the pulmonary function.

Relationship between cadmium exposure and pulmonary function level and chronic obstructive pulmonary disease / 中华劳动卫生职业病杂志

Objective: To analyze the levels and distribution characteristics of blood cadmium and urinary cadmium in American adults, to analyze the relationship between blood cadmium and urinary cadmium and pulmonary function dose response, and to explore the effect of this index on the risk of chronic obstructive pulmonary disease. Methods: In March 2022, 3785 patients from 2007 to 2012 in NHANES database were selected as the subjects. Collect demography data such as gender and age, and test data such as lung function, blood cadmium concentration and Urine cadimium concentration. The relationship between blood and urine cadmium levels and lung function and pulmonary function and chronic obstructive pulmonary diease (COPD) was analyzed by Mann-Whitney U test or Kruskal-Wallis H test, multivariate linear regression and restricted cubic spline method. Results: The geometric mean of blood cadmium and urine cadmium in American adults was 0.37 g/L and 0.28 g/L, FEV(1) and FEV(1)/FVC among different cadmium exposure groups was statistically significant, and there was a negative linear dose-response relationship between serum Cd and urine Cd concentrations and FEV(1)/FVC levels (P(overall)<0.001, P(non-linear)=0.152; P(overall)<0.001, P(non-linear)=0.926). Compared with the lowest quartile concentration (Q1), the highest quartile blood cadmium concentration (Q4) (OR=1.934, P(trend)=0.000) and urinary cadmium concentration (OR=1.683, P(trend)=0.000) may increased the risk of chronic obstructive pulmonary disease. Conclusion: There is a negative correlation between blood cadmium, urinary cadmium levels and lung function in American adults, and cadmium may increase the risk of chronic obstructive pulmonary disease.

Analysis on characteristic of stage Ⅰ occupational cement pneumoconiosis patients / 中华劳动卫生职业病杂志

Objective: To analyze the clinical and imaging characteristics of stage Ⅰ occupational cement pneumoconiosis patients. Methods: In October 2021, the data of patients with occupational cement pneumoconiosis diagnosed by the Third Hospital of Peking University from 2014 to 2020 were collected, and the data of the patients' initial exposure age, dust exposure duration, diagnosis age, incubation period, chest X-ray findings, lung function and other data were analyzed retrospectively. Spearman grade correlation was used for correlation analysis of grade count data. The influencing factors of lung function were analyzed by binary logistic regression. Results: A total of 107 patients were enrolled in the study. There were 80 male patients and 27 female patients. The inital exposure age was (26.2±7.7) years, the diagnosis age was (59.4±7.9) years, the dust exposure duration was (17.9±8.0) years, and the incubation period was (33.1±10.3) years. The initial dust exposure age and the dust exposure duration in female patients were less than those in men, and the incubation period was longer than that in men (P<0.05). The imaging analysis showed the small opacities as"pp"accounted for 54.2%. 82 patients (76.6%) had small opacities distributed in two lung areas. The lung areas distribution of small opacities in female patients was less than that in male patients (2.04±0.19 vs 2.41±0.69, P<0.001). There were 57 cases of normal pulmonary function, 41 cases of mild abnormality and 9 cases of moderate abnormality. The number of lung regions with small opacities on X-ray was the risk factor for abnormal lung function in cement pneumoconiosis patients (OR=2.491, 95%CI=1.197-5.183, P=0.015) . Conclusion: The patients with occupational cement pneumoconiosis had long dust exposure duration and incubation period, light imaging changes and pulmonary function damage. The abnormal lung function was related to the range of pulmonary involvement.

Effect of respiratory filter on pulmonary function in occupational health examination / 中华劳动卫生职业病杂志

Objective: To explore the influence and significance of respiratory filter on the judgment of pulmonary function and the conclusion of occupational health examination in occupational health examination. Methods: From August to November 2020, 252 occupational health examinees were randomly selected as the research objects, and the lung function was examined with the respiratory filter bite and the straight cylinder bite without filter, respectively. The lung function examination indexes and the qualification rate of lung function examination were analyzed and compared between the two groups, and the diagnostic criteria of lung function examination was corrected. Results: 252 subjects were 36 (30, 42) years old. The qualified rate of lung function examination with respiratory filter bite (28.17%, 71/252) was lower than that with straight cylinder bite (34.92%, 88/252) , the difference was statistically significant (P<0.05) . The percentage of forced vital capacity in normal predicted value (FVC%) , percentage of forced expiratory volume in the first second in normal predicted value (FEV(1)%) , and percentage of forced expiratory volume in the first second in forced vital capacity (FEV(1)/FVC%) of subjects using respiratory filter bite were lower than those using the straight cylinder bite (P<0.05) . The corrected diagnostic criteria of pulmonary function were FVC%>78%, FEV(1)%>77%, FEV(1)/FVC%>68%. There was no significant difference between the qualified rate of the respiratory filter bite lung function test calculated according to the corrected diagnostic criteria (35.71%, 90/252) and the qualified rate of the straight cylinder bite lung function test calculated according to the original diagnostic criteria (34.92%, 88/252) (P>0.05) . Conclusion: In occupational health examination, the use of respiratory filter may affect the results of pulmonary function examination. The diagnostic criteria of pulmonary function can be corrected according to different filtering effects to ensure the accuracy of the conclusions of occupational health examination.

Analysis of related factors for postoperative recurrence of antrochoanal polyps in children / 临床耳鼻咽喉头颈外科杂志

Objective:To analyze the correlation between nasal resistance and lung function in children with allergic rhinitis（AR）, and explore whether AR children with increased nasal resistance are accompanied by potential lower respiratory tract involvement. Methods:A total of 88 children diagnosed with AR from December 2021 to December 2022 were selected as the study group, while 20 normal children were selected as the control group during the same period. Both the study group and the control group children underwent lung function tests, bronchodilator tests, and nasal resistance measurements. Spearman correlation analysis and multiple linear regression analysis were performed on the results of nasal resistance and lung function tests to explore the relationship and influencing factors between the two groups.According to the results of nasal resistance measurement, children with increased nasal resistance and abnormal lung function were divided into a mild increase in nasal resistance with abnormal lung function group and a moderate to severe increase in nasal resistance with abnormal lung function group. The degree of increased nasal resistance was analyzed to determine whether it would affect lung function. Results:The FEF25, FEF50, and FEF75 levels in the study group were significantly lower than those in the control group（P<0.05）. The FEV1of children with moderate to severe increase in AR nasal resistance was significantly lower than that of children with mild increase in AR nasal resistance（P<0.05）. There was a correlation between nasal resistance and FEV1/FVC, R20 in AR children, and FEV1/FVC, R20 were the influencing factors of nasal resistance in AR children（P<0.05）. There was no correlation between total serum IgE, lung function, and bronchodilation test in AR patients（P>0.05）. Conclusion:The nasal ventilation function of AR patients has changed, and there is a downward trend in small airway function. Children with moderate to severe increase in AR nasal resistance have a more significant decrease in lung ventilation function than those with mild increase. The nasal resistance of AR children is influenced by FEV1/FVC and R20, and FEV1/FVC and R20 decrease as the nasal resistance value increases. The improvement rate of lung function and FEV1 are not influencing factors for the elevation of total serum IgE.

Development of a Multi-parameter Pulmonary Function Test System / 中国医疗器械杂志

To comprehensively evaluate the human body's respiratory, circular metabolism and other functions, and to diagnose lung disease, an accurate and reliable pulmonary function test (PFT) is developed. The system is divided into two parts:hardware and software. It realizes the collection of respiratory, pulse oxygen, carbon dioxide, oxygen and other signals, and draws flow-volume curve (FV curve), volume-time curve (VT curve), respiratory waveform, pulse wave, carbon dioxide and oxygen waveform in real time on the upper computer of the PFT system, and conducts signal processing and parameter calculation for each signal. The experimental results prove that the system is safe and reliable, it can accurately measure the basic functions of human body, and provide reliable parameters, and has good application prospects.

Comparative analysis of pulmonary function in children born preterm and full-term at 6-9 years of age / Análise comparativa da função pulmonar em crianças de 6 a 9 anos de idade nascidas pré-termo e a termo

Abstract Objective: To compare pulmonary function parameters and the prevalence of altered pulmonary function in children born preterm and full-term, using the Global Lung Initiative reference values. Methods: This is a cross-sectional study with 6-9-year-old children submitted to measurement of airway resistance (Rint) and spirometry according to the American Thoracic Society and European Respiratory Society Technical Statement. The inclusion criteria were, among the preterm group: gestational age <37 weeks and birth weight <2000g; among the full-term group: schoolchildren born full-term with birth weight >2500g, recruited at two public schools in São Paulo, Brazil, matched by sex and age with the preterm group. As exclusion criteria, congenital malformations, cognitive deficit, and respiratory problems in the past 15 days were considered. Results: A total of 112 children were included in each group. Preterm children had gestational age of 30.8±2.8 weeks and birth weight of 1349±334g. Among them, 46.6% were boys, 46.4% presented respiratory distress syndrome, 19.6% bronchopulmonary dysplasia, and 65.2% were submitted to mechanical ventilation in the neonatal unit. At study entry, both groups were similar in age and anthropometric parameters. Parameters of pulmonary function (Z scores) in preterm and full-term groups were: Rint (0.13±2.24 vs. -1.02±1.29; p<0.001); forced vital capacity (FVC) (-0.39±1.27 vs. -0.15±1.03; p=0.106), forced expiratory volume in one second (FEV1)/FVC (-0.23±1.22 vs. 0.14±1.11; p=0.003), FEV1 (-0.48±1.29 vs. -0.04±1.08; p=0.071), and forced expiratory flow between 25% and 75% of vital capacity (FEF25-75) (1.16±1.37 vs. 2.08±1.26; p=0.005), respectively. The prevalence values of altered airway resistance (16.1 vs. 1.8%; p<0.001) and spirometry (26.8 vs. 13.4%, p=0.012) were higher in preterm infants than in full-term ones. Conclusions: Preterm children had higher prevalence of altered pulmonary function, higher Z scores of airway resistance, and lower Z scores of FEV1/FVC and FEF25-75 compared with those born full-term.

RESUMO Objetivo: Comparar parâmetros de função pulmonar e a prevalência de função pulmonar alterada em crianças nascidas pré-termo e a termo, utilizando a referência Global Lung Function Initiative. Métodos: Estudo transversal com crianças de 6-9 anos submetidas à medida de resistência de vias aéreas (Rint) segundo o American Thoracic Society and the European Respiratory Society Technical Statement. Como critérios de inclusão, entre o grupo pré-termo, estavam os nascidos com idade gestacional <37 semanas e peso <2000g; e entre o grupo termo, escolares de duas escolas públicas do município de São Paulo, nascidos a termo com peso >2500g, pareados por sexo e idade com o grupo pré-termo. Excluíram-se malformações congênitas, déficit cognitivo e problemas respiratórios havia menos de 15 dias. Resultados: Incluíram-se 112 crianças em cada grupo. Os prematuros (46,4% masculinos) apresentaram idade gestacional de 30,8±2,8 semanas e peso de 1349±334g. Entre eles, 46,4% tiveram síndrome de desconforto respiratório, 19,6% displasia broncopulmonar, e 65,2% receberam ventilação mecânica na unidade neonatal. À inclusão no estudo, os dois grupos apresentaram idade e dados antropométricos semelhantes. Os valores (escores Z) em nascidos pré-termo e a termo foram, respectivamente: Rint (0,13±2,24 vs. -1,02±1,29; p<0,001), capacidade vital forçada (CVF) (-0,39±1,27 vs. -0,15±1,03; p=0,106), volume expiratório forçado no primeiro segundo (VEF1)/CVF (-0,23±1,22 vs. 0,14±1,11; p=0,003), VEF1 (-0,48±1,29 vs. -0,04±1,08; p=0,071) e fluxo expiratório forçado em 25-75% da capacidade vital (FEF25-75) (1,16±1,37 vs. 2,08±1,26; p=0,005). A prevalência de alterações na resistência de vias aéreas (16,1 vs. 1,8%, p<0,001) e na espirometria (26,8 vs. 13,4%, p=0,012) foi maior nos prematuros. Conclusões: As crianças nascidas pré-termo apresentaram maior prevalência de alteração pulmonar, maiores escores Z de resistência de vias aéreas e menores escores Z de VEF1/CVF e FEF25-75 quando comparadas às nascidas a termo.

Secuelas respiratorias clínicas, funcionales y tomográficas de pacientes hospitalizados por COVID-19 a seis meses del diagnóstico: estudio SECUELAR-19 / Clinical, functional and tomographic respiratory sequels of patients hospitalized for COVID-19 at six month of diagnosis: SECUELAR-19 trial

Resumen Introducción: Hay información escasa sobre la evolución de los enfermos hospitalizados por neumonía por COVID-19 a mediano plazo. El objetivo de este estudio fue determinar en pacientes con neumonía moderada (NM) o grave (NG) por COVID-19, el impacto clínico, funcional respiratorio y tomográfico a los 6 meses. Métodos: Se realizó análisis según grupos de NM y NG, desaturadores (PD) en la prueba de cami nata de 6 minutos y presencia del patrón tomográfico de alta resolución (TACAR) símil fibrótico. Se compararon los resultados a los 3 y 6 meses. Resultados: Se incluyeron 129 pacientes, edad 57±11 años, comorbilidades frecuentes (hipertensión arterial 38.1%, diabetes 30.4% y respiratorias 18.6%). Al comparar 3 y 6 meses se ob servó mejoría de la calidad de vida en NM y NG. Los PD presentaron menor metraje caminado, peor calidad de vida y mayor presencia de patrón símil fibrótico. Este patrón se relacionó con la caída de la FVC 80% en NM y NG (p = 0.048 y p = 0.007), y con PD (p = 0.002). En el análisis multivariado, el patrón símil fibrótico s e asoció a la reducción de la CVF con OR = 4.44 (1.94-10.18, p<0.01) y a la desaturación, OR = 5.01 (1.63-15.42, p<0.01). En esta cohorte se observó mayor compromiso funcional y tomográfico en los PD. El patrón símil fibrótico se relacionó con peor evolución funcional y oximétrica. Discusión: Es importante el seguimiento de los pacientes con NG, los PD y los que presentan patrón fibrótico al alta de neumonía por COVID-19.

Abstract Introduction: There is scarce information about middle-term evolution of hospitalized patients who suffer from pneumonia caused by COVID-19. The objective of this study is to determine the clinical, respiratory, tomographic and functional impact on COVID-19 patients with moderate (MP) to severe (SP) pneumonia after six months of acute infection. Methods: Analysis was carried out by MP and SP groups, desaturators during the 6-minute-walking test and the presence of fibrotic like pattern on HRCT. Outcomes at 3 and 6 months were compared. Results: The analysis included 129 patients, between 57 ± 11 years old. Frequent comorbidities were: arterial hypertension 38.1%, diabetes 30.4%, respiratory 18.6%). Comparing 3 and 6 months, improvement in quality of life was observed in MP and SP. The DP walked less meters in the MWT, worsened life quality and more fibrotic like pattern. The fibrotic pattern was related to the fall of CVF < 80% on MP and SP (p = 0.048 and p = 0.007), and with DP (p = 0.002). On multivariated analysis, the fibrotic like pattern was associated to the reduction of CVF with OR = 4.44 (1.94-10.18, p<0.01) and desaturation OR = 5.01(1.63-15.42, p < 0.01). On this cohort it was observed more functional and tomographic compromise on the DP The fibrotic like pattern was related to worse functional evolution and oximetry. Discussion: Follow-up after discharge of COVID-19 patients with SP, DP or fibrotic changes in HCRT is underlined.