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1.
Rev. bras. med. esporte ; 28(3): 192-194, May-June 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1365704

ABSTRACT

ABSTRACT Introduction: Chronic obstructive pulmonary disease (COPD) is one of the most common diseases in the lungs. Objective: To evaluate the clinical effect of respiratory rehabilitation training combined with Traditional Chinese and western medicine on the clinical treatment of motor function in patients with COPD. Methods: 156 patients with chronic obstructive pulmonary disease admitted to a hospital from December 2013 to June 2015 were selected as study subjects and randomly divided into groups for treatment. Results: comparing blood gas exchange rates of patients in the four groups, the experimental group, trained using integrated Chinese and Western medicine, was significantly better than the control groups A, B and C, in aspects such as PaCO2, PaO2, SaO2, pH, etc., the difference was statistically significant (p < 0.05). The improvement of lung function in the experimental group was significantly better than in the other three groups, with statistical significance (p < 0.05). Conclusions: Applying Chinese and Western Medicine combined with comprehensive respiratory rehabilitation training has a significant clinical effect. It effectively improved patients' related clinical indicators and should be widely promoted. Level of evidence II; Therapeutic studies - investigation of treatment results.


RESUMO Introdução: A doença pulmonar obstrutiva crônica (DPOC) é uma das doenças pulmonares mais comuns. Objetivo: Avaliar os efeitos clínicos de treino para reabilitação respiratória somado ao uso de medicina ocidental e medicina tradicional chinesa combinadas, no tratamento da função motora de pacientes com DPOC. Métodos: 156 pacientes com DPOC, hospitalizados entre dezembro de 2013 e junho de 2015, foram selecionados como objetos de estudo e aleatoriamente divididos em grupos de tratamento. Resultados: Quanto aos níveis de troca gasosa dos pacientes nos quatro grupos, o grupo experimental, treinado por meio de práticas de medicina ocidental e de medicina tradicional chinesa combinadas teve uma performance significativamente melhor que a dos grupos A, B, e C, em aspectos tais como PaCO2, PaO2, SaO2, pH, etc., com significância estatística (p<0,05). A melhoria da função pulmonar no grupo experimental também foi significativamente maior que nos outros grupos, mais uma vez com significância estatística (p<0,05). Conclusões: A aplicação da medicina chinesa e da medicina ocidental combinadas, somadas a um treino de reabilitação respiratória abrangente, teve um efeito clínico significativo, efetivamente melhorando indicadores clínicos relevantes. Tal aplicação deveria ser largamente promovida. Nível de evidência II; Estudos terapêuticos - investigação de resultados de tratamento.


RESUMEN Introducción: La enfermedad pulmonar obstructiva crónica (EPOC) es una de las enfermedades pulmonares más comunes. Objetivo: Evaluar los efectos clínicos de entrenamiento para rehabilitación respiratoria sumado al uso de medicina occidental y medicina tradicional china combinadas en el tratamiento de la función motora de pacientes con EPOC. Métodos: 156 pacientes con EPOC, hospitalizados entre diciembre de 2013 y junio de 2015, fueron seleccionados como objetos de estudio y aleatoriamente divididos en grupos de tratamiento. Resultados: En cuanto a los niveles de intercambio gaseoso de los pacientes de los cuatro grupos, el grupo experimental, entrenado mediante prácticas combinadas de medicina occidental y medicina tradicional china, obtuvo un rendimiento significativamente mejor que los grupos A, B y C, en aspectos como PaCO2, PaO2, SaO2, pH, etc., con significancia estadística (p<0,05). La mejora de la función pulmonar en el grupo experimental también fue significativamente mayor que en los otros grupos, una vez más con significancia estadística (p<0,05). Conclusiones: La aplicación de la medicina china y de la medicina occidental combinadas, sumadas a un entrenamiento de rehabilitación respiratorio abarcativo, tuvo un efecto clínico significativo, efectivamente mejorando indicadores clínicos relevantes. Tal aplicación debería ser largamente promovida. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados de tratamiento.

2.
Rev. Assoc. Med. Bras. (1992) ; 68(4): 502-506, Apr. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1376148

ABSTRACT

SUMMARY OBJECTIVE: The NELSON study demonstrated a positive association between computed tomography scanning and reduced mortality associated with lung cancer. The COPD-LUCSS-DLCO is a tool designed to improve screening selection criteria of lung cancer for chronic obstructive pulmonary disease patients. The aim of this study was to examine and compare the discriminating value of both scores in a community-based cohort of chronic obstructive pulmonary disease patients. METHODS: A retrospective study of chronic obstructive pulmonary disease patients followed in pulmonology consultation for a period of 10 years (2009-2019) was conducted. The NELSON criteria and COPD-LUCSS-DLCO score were calculated for each patient at the time of the study inclusion. The lung cancer incidence was calculated for each of the subgroups during the follow-up period. RESULTS: A total of 103 patients were included in the study (mean age 64.7±9.2 years, 88.3% male). Applying the COPD-LUCSS-DLCO score, high-risk patients have a 5.9-fold greater risk of developing lung cancer versus the low risk. In contrast, there was no significant association between NELSON selection criteria and lung cancer incidence. The area under the curve was 0.69 for COPD-LUCSS-DLCO and 0.59 for NELSON criteria. Comparing test results showed no differences. CONCLUSIONS: The use of the COPD-LUCSS-DLCO score in clinical practice can help to detect chronic obstructive pulmonary disease patients in greater risk of developing lung cancer with better performance than NELSON criteria. Therefore, models that include a risk biomarker strategy can improve selection criteria and consequently can enhance a better lung cancer prediction.

3.
Medicina (B.Aires) ; 82(1): 154-158, feb. 2022. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1365142

ABSTRACT

Resumen La hiperplasia difusa idiopática de células neuroendocrinas es una entidad extremadamente infrecuente caracterizada por una proliferación generalizada de células neuroendocrinas, sin proceso primario que lo justifique, generalmente, aunque también están descriptas formas asintomáticas. Se describen los casos de dos mujeres y un hombre, edad promedio 63 años (rango 57-71) que consultaron por presentar nodulillos pulmonares bilaterales. Promedio de seguimiento: 1 año, 3 meses (rango 1 mes-3 años). Las dos mujeres presentaban tos, disnea progresiva y obstrucción al flujo aéreo en el estudio espirométrico, fueron tra tadas por asma y enfermedad pulmonar obstructiva crónica respectivamente con poco alivio de los síntomas. El tercer paciente, varón, consultó por hallazgo incidental en una tomografía de tórax, de nódulos pulmonares, con razonable sospecha de enfermedad metastásica de origen desconocido. En sendas biopsias se diagnosticaron: en el primer y tercer caso hiperplasia neuroendócrina difusa idiopática-tumorlets; y en el segundo caso tumor carcinoide típico e hiperplasia neuroendocrina difusa idiopática. En el primer caso los síntomas se controlaron con tratamiento broncodilatador máximo. La segunda paciente tuvo en el postoperatorio, insuficiencia respiratoria que requirió asistencia respiratoria mecánica y fibrilación auricular con alta respuesta ventricular, interpretados ambos signos como síndromes paraneoplásicos, que respondieron favorablemente a la administración empírica de octeotride. El tercer paciente se halla asintomático y en control. La hiperplasia difusa de células neuroendó crinas representa un desafío diagnóstico. La biopsia pulmonar en pacientes con nodulillos pulmonares múltiples, bilaterales e historia clínica de tos y disnea progresiva debe ser considerada para confirmar esta entidad.


Abstract Diffuse idiopathic hyperplasia of neuroendocrine cells is an extremely rare condition. It is a widespread proliferation of neuroendocrine cells, without primary process justifying it. Usually symptomatic in most cases, asymptomatic forms are also described. We describe three cases, 2 women and 1 man, average age 63 years (range 57-71) who presented with bilateral pulmonary nodules. Average follow-up: one year and three months (range 1 month-3 years). The two women had cough, progressive dyspnea and airflow obstruction in the spirometry, and were treated for asthma and chronic obstructive pulmonary disease, respectively, with little relief of symptoms. The remaining patient consulted for diagnosis of pulmonary nodules of unknown cause and a suspicion of metastatic disease. The biopsies diagnostic were: in the first and third case diffuse idiopathic hyperplasia of euroendocrine cells - tumorlets; and in the second case typical carcinoid tumor and diffuse idiopathic hyperplasia of neuroendo crine cells. The first patient controlled the symptoms with maximum bronchodilator therapy. The second patient presented immediate postoperative severe bronchospasm and respiratory failure which required ventilatory as sistance, atrial fibrillation with rapid ventricular response (both signs interpreted as paraneoplastic syndromes) which responded favorably to the empirical octeotride management. The third patient is asymptomatic and in control. The diffuse neuroendocrine cell hyperplasia represents a diagnostic challenge because of the rarity of this condition. Lung biopsy in patients with multiple, bilateral pulmonary nodules and clinical history of cough and progressive dyspnea should be considered to confirm this entity.

4.
Organ Transplantation ; (6): 246-2022.
Article in Chinese | WPRIM | ID: wpr-920856

ABSTRACT

Objective To evaluate the feasibility and safety of tracheal extubation in operating room for patients with end-stage chronic obstructive pulmonary disease (COPD) after single-lung transplantation. Methods Clinical data of 57 recipients who underwent single-lung transplantation due to end-stage COPD were retrospectively analyzed. According to the evaluation indexes of tracheal extubation in operating room established by our hospital, 17 recipients eligible for tracheal extubation in operating room were assigned into the operating room extubation group (OR extubation group) and 40 recipients receiving tracheal extubation in intensive care unit (ICU) were allocated in the ICU extubation group. The evaluation results of intraoperative tracheal extubation and postoperative recovery were compared between two groups. Results Compared with the ICU extubation group, recipients in the OR extubation group had higher oxygenation index, lower arterial partial pressure of carbon dioxide (PaCO2), lower blood lactic acid level, less fluctuation range of blood pressure and fewer cases receiving extracorporeal membrane oxygenation (ECMO) during operation (all P < 0.05). Two recipients in the OR extubation group received repeated tracheal intubation at 6 and 8 h after returning to ICU, and tracheal extubation at postoperative 6 and 9 d. In the OR extubation group, time of postoperative mechanical ventilation, length of postoperative ICU and hospital stay of the recipients were shorter than those in the ICU extubation group (all P < 0.05). The incidence of grade 3 primary graft dysfunction (PGD), atrial tachyarrhythmia, continuous renal replacement therapy and 1-year survival rate did not significantly differ between two groups (all P > 0.05). Conclusions The tracheal extubation regimen in the operating room for COPD patients after single-lung transplantation established by our hospital is safe and feasible, which shortens the time of postoperative mechanical ventilation, the length of postoperative ICU and hospital stay, whereas does not increase the incidence of postoperative complications.

5.
Article in Chinese | WPRIM | ID: wpr-920821

ABSTRACT

@#Objective    To provide clinical reference for the perioperative management of esophageal cancer patients with different stages of chronic obstructive pulmonary disease (COPD) through investigating the impact of COPD on postoperative complications and survival in esophageal cancer patients undergoing oesophagectomy. Methods    The clinical data of 163 patients who underwent radical resection of esophageal cancer in our department from January 2015 to January 2018 were retrospectively analyzed, including 124 males and 39 females, with a median age of 64 years (IQR: 23.8 years). They were divided into a COPD group (n=87) and a non-COPD group (n=76) according to the presence of COPD before operation. The clinical data were collected and the postoperative complications and 2-year survival between the two groups were compared and analyzed. Results    The incidence of major postoperative complications (pulmonary infection, respiratory failure, arrhythmia and anastomotic leakage) in the COPD group were higher than those in the non-COPD group (all P<0.05). Spearman correlation analysis showed that the severity of preoperative COPD was positively correlated with the incidence of postoperative complications in patients with esophageal cancer (r=0.437, P<0.001). The incidence of postoperative respiratory failure and mortality in patients with severe COPD were significantly higher than those in patients without COPD and those with mild or moderate COPD. The 2-year survival rate of patients with esophageal cancer in the COPD group was lower than that in the non-COPD group (56.1%vs. 78.5.%, P=0.001), and the severity of COPD was negatively correlated to the survival rate. Conclusion    COPD significantly increases the incidence of postoperative complications in patients with esophageal cancer, which is not conducive to the prognosis of patients, and the severity of COPD is correlated with postoperative complications and 2-year survival rate.

6.
Organ Transplantation ; (6): 19-2022.
Article in Chinese | WPRIM | ID: wpr-907028

ABSTRACT

In recent years, the quantity of lung transplantation has been gradually increased in China along with the accumulation of surgical techniques and postoperative management experience of lung transplantation. Multiple lung allograft complications may occur after lung transplantation, mainly including primary graft dysfunction (PGD) caused by ischemia-reperfusion injury (IRI) of the lung allograft, acute and chronic rejection, opportunistic infection or lymphoproliferative disorder of lymphoid tissues induced by the decrease of host immunity due to postoperative use of immunosuppressants, etc. The diagnosis of complications after lung transplantation mainly relies on biopsy of the lung allograft. In this article, the brief history of lung allograft pathology, main approaches and pathological processing techniques of lung allograft biopsy, major complications after lung transplantation and pathological diagnostic criteria were elucidated, aiming to provide reference for targeted management of these complications in clinical practice.

7.
Article in English | WPRIM | ID: wpr-906678

ABSTRACT

@#BACKGROUND: To investigate effects of Maxingloushi decoction on lung inflammation and programmed death markers (programmed death-1 [PD-1], programmed death-ligand 1 [PD-L1]) in the lung tissue, peripheral blood, and bronchoalveolar lavage fluid (BLF) in a mouse model of chronic obstructive pulmonary disease (COPD). METHODS: Thirty-six mature male BALB/C mice were randomly divided into normal group (group A, n=6), COPD model group (group B, n=10), Maxingloushi decoction + COPD group (group C, n=10), and PD-1 inhibitor + COPD group (group D, n=10). The COPD model was established by smoke inhalation combined with lipopolysaccharide (LPS). Levels of PD-1 and PD-L1 in plasma and BLF were measured by enzyme-linked immunosorbent assay (ELISA). Histopathological techniques were used to semi-quantitatively analyze the immuno-fluorescence optical density (IOD) value of the lung tissue. RESULTS: In plasma and BLF, the expression of PD-1 in the group B was higher than that in the group A, and the expression of PD-L1 was lower than that in the group A. The expression of PD-1 and PD-L1 in the lung tissue was normalized in the group C in comparison with the group B (P<0.05) and the group D (P<0.05), and inflammatory cell infiltration in the lung tissue was also improved. CONCLUSIONS: These findings reveal that COPD causes an immune imbalance in the peripheral blood and lung tissue, and that both Maxingloushi decoction and PD-1 inhibitor treatment can mitigate lung inflammation in COPD by reducing PD-1 expression and increasing PD-L1 expression. The treatment effect of Maxingloushi decoction may be superior to that of PD-1 inhibitor.

8.
Article in Chinese | WPRIM | ID: wpr-940812

ABSTRACT

ObjectiveThis study aimed to predict the pharmacodynamic material basis and core targets of Bailing capsules in the treatment of chronic obstructive pulmonary disease (COPD) based on network pharmacology and molecular docking, which were further verified by cell experiments to explore the mechanism. MethodThe main active ingredients and related targets of Bailing capsules were screened in Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and SwissTargetPrediction. The main COPD targets were searched from GeneCards, DrugBank, Online Mendelian Inheritance in Man (OMIM) and Therapeutic Target Database (TTD). The protein-protein interaction (PPI) network was constructed by STRING and Cytoscape 3.6.1. Gene Ontology (GO) function annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed by the Database for Annotation, Visualization and Integrated Discovery (DAVID). Molecular docking verification was carried out using AutoDock Vina. The cell viability was detected by 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay, and the mRNA level of the targets was detected by real-time polymerase chain reaction (Real-time PCR). ResultA total of 11 active ingredients of Bailing capsules such as cerevisterol, 270 related drug targets, and 1 020 COPD target proteins were obtained, with 74 intersection targets. The visualization analysis of the PPI network showed that the core targets of Bailing capsules in the treatment of COPD were tumor protein P53 (TP53), catenin beta 1 (CTNNB1), tumor necrosis factor (TNF), interleukin-6 (IL-6) and insulin (INS). Further, 20 signaling pathways were screened by KEGG enrichment analysis as the main pathways for Bailing capsules to treat COPD, involving phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt), cyclic adenosine monophosphate (cAMP), forkhead box O (FoxO), TNF, and hypoxia inducible factor-1 (HIF-1) signaling pathways. Molecular docking validation demonstrated that four active ingredients had stable binding to IL-6, with the lowest energy. Bailing capsules could reduce the mRNA level of IL-6 in RAW264.7 cells induced by lipopolysaccharide (LPS) (P<0.01) compared with the control group. ConclusionThe pharmacological mechanism of Bailing capsules in the treatment of COPD might be that its main active ingredients improved the inflammatory response by acting on TP53, CTNNB1, TNF, IL-6 and other targets and regulating PI3K/Akt, cAMP and other signaling pathways, thereby ameliorating COPD symptoms. This study provided experimental basis for subsequent in-depth research, and provided a diagnosis and treatment direction for disease-related clinical treatment.

9.
Article in Chinese | WPRIM | ID: wpr-940810

ABSTRACT

ObjectiveTo explore the syndrome and treatment rules of traditional Chinese medicine (TCM) in treating chronic obstructive pulmonary disease (COPD) based on the medical literature and cases with the help of TCM inheritance support system platform (V2.5), thus providing new ideas for TCM to treat COPD. MethodThe medical cases of TCM treating COPD were retrieved from China national knowledge infrastructure (CNKI), Wanfang Database, and VIP China Science and Technology Journal Database. The medical cases that met the inclusion literature were collected in a new Word document, and then input into the TCM inheritance support system platform (V2.5) after data standardization. With the help of the algorithm carried by this software, the frequency statistics of "symptoms, syndrome types of TCM, Chinese medicine, and meridians of Chinese medicine" in the included COPD medical cases were performed, and the correlation analysis of the "prescription rules" in the included medical cases was carried out, thus excavating the potential core drug pairs and new prescriptions for the treatment of COPD. ResultA total of 103 articles were included with 126 medical cases and 131 diagnoses and treatments. According to statistics, the common symptoms of COPD were cough, expectoration, chest tightness, and asthma, and the common TCM syndromes included phlegm-heat obstructing lung, phlegm and blood stasis blocking lung, and lung-spleen Qi deficiency. The common TCM treatment methods included clearing heat and resolving phlegm, banking up earth to generate metal, and descending adverse and relieving dyspnea, among which the high-frequency Chinese medicines for the treatment of COPD were Pinelliae Rhizoma, Armeniacae Semen Amarum, Ephedrae Herba, Citri Reticulatae Pericarpium, and so on. The commonly used drug pairs included Asari Radix et Rhizoma-Pinelliae Rhizoma, Pinelliae Rhizoma-Schisandrae Chinensis Fructus-Glycyrrhizae Radix et Rhizoma, etc. Twelve new prescriptions for the treatment of COPD were found. ConclusionTCM believes that COPD is a lung disease formed by external evil, phlegm, blood stasis, and other pathological factors, with cough, phlegm, and asthma as the main symptoms. The main syndromes of COPD are phlegm-heat obstructing lung, phlegm and blood stasis blocking lung, and lung-spleen qi deficiency. "Strengthening the upright and dispelling evil" is the basic principle of the treatment COPD. In clinical, TCM methods with dispelling phlegm and removing blood stasis, and tonifying lung, spleen, and kidney should be adopted to treat COPD.

10.
Article in Chinese | WPRIM | ID: wpr-940553

ABSTRACT

ObjectiveTo observe the effects of Bufei Yishen prescription on airway mucus hypersecretion and Notch signaling pathway related protein Notch3 and enhancer of split homologue 1 (HES1) in rats with chronic obstructive pulmonary disease (COPD) and to explore its action mechanism. MethodForty-eight SD rats were randomly divided into the control group, model group, Bufei Yishen prescription group, and aminophylline (APL) group,with 12 rats in each group. The stable COPD rat model was established via cigarette smoking exposure combined with Klebsiella bacterial infection for 12 weeks, and the corresponding drugs (3.7 g·kg-1·d-1 Bufei Yishen prescription and 54 mg·kg-1·d-1 APL) were administered by gavage during the next eight weeks. After the last administration at week 20, the lung tissue was sampled for observing the pathological changes and the rat lung function was detected. The tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and mucoprotein 5AC (MUC5AC) in bronchial alveolar lavage fluid and the mRNA and protein expression levels of Notch3, HES1, and MUC5AC in lung tissues were assayed. ResultCompared with the control group, the model group exhibited significantly weakened pulmonary function (P<0.05,P<0.01), reduced average number of alveoli (P<0.01), elevated mean linear intercept (P<0.01), and up-regulated TNF-α, IL-6, and MUC5AC in bronchial alveolar lavage fluid and Notch3, HES1, and MUC5AC mRNA and protein expression in lung tissue (P<0.05,P<0.01). Compared with the model group, Bufei Yishen prescription and APL remarkably enhanced pulmonary function, alleviated its pathological injury (P<0.05,P<0.01), and down-regulated TNF-α, IL-6, and MUC5AC in bronchial alveolar lavage fluid and the mRNA and protein expression levels of Notch3, HES1, and MUC5AC in lung tissues (P<0.05,P<0.01). ConclusionThe mechanism of Bufei Yishen prescription in inhibiting airway mucus hypersecretion of COPD rats was related to its regulation of Notch3 and HES1.

11.
Article in Chinese | WPRIM | ID: wpr-940373

ABSTRACT

Chronic obstructive pulmonary disease (COPD) is a common and frequently-occurring disease of the respiratory system, characterized by persistent respiratory symptoms and airflow restriction, which is prone to attack repeatedly and affect patients' quality of life seriously. At present, the combination of bronchodilators and inhaled corticosteroids is commonly used in clinic. Although these drugs can alleviate the symptoms of COPD patients, there are certain limitations of the difficulty in controlling the course of the disease effectively and reversing the decline of patients' lung function. Therefore, searching for safer and more effective therapeutic drugs has become a hot research topic nowadays. Traditional Chinese medicine (TCM) has remarkable curative effects and advantages in the prevention and therapy of COPD recently. Based on the increasing research and application of the active components of TCM in the therapy of COPD, studies on their pharmacodynamic mechanism are also more in depth. More and more studies have found that the active components of TCM can treat COPD patients effectively, and the mechanism involved mainly includes the anti-inflammatory, the antioxidant, and the inhibition of apoptosis. By searching and screening the domestic and foreign literatures on the treatment of COPD with the active components of TCM in recent years, the active components of TCM including flavonoids, terpenoids, phenols and saponins have been studied as the research objects, and their effects in improving the pulmonary function and oxidative stress, relieving inflammation and inhibiting apoptosis are expounded. Besides, the mechanism of action, signaling pathways and index molecules have been emphatically summarized, in order to provide the ideas for the clinical therapy and the basic research of COPD.

12.
Article in Chinese | WPRIM | ID: wpr-940219

ABSTRACT

ObjectiveTo investigate the effects of Asari Radix et Rhizoma-Zingiberis Rhizoma herb pair (XGHP) on lung and liver lipid metabolism in rats with chronic obstructive pulmonary disease (COPD). MethodForty SD male rats were divided into a normal group (10 rats) and a model group (30 rats). The method of cigarette smoke + tracheal injection of lipopolysaccharide(LPS) + cold stimulation was used to replicate COPD model with the syndrome of cold phlegm obstruction in lung. A COPD group, a XGHP group (5.4 g·kg-1·d-1), and an aminophylline group (0.5 g·kg-1·d-1) were established after successfully inducing the model, with 10 rats in each group. After treatment, the serum triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels of rats in each group were measured. Gas chromatography-mass spectrometer (GC-MS) was used to detect the differential metabolites in the lung and liver tissues of rats in each group, and the relevant targets of the differential metabolites were predicted by network pharmacology. Molecular docking was used to verify the binding ability of key components in XGHP to the relevant targets in network pharmacology. The mRNA and protein expression levels of peroxisome proliferator-activated receptor α (PPARα) and fatty acid binding protein 4 (FABP4) in lung and liver tissues of rats in each group were detected by real-time polymerase chain reaction (PCR) and Western blot. ResultXGHP significantly increased the levels of TG, TC, and LDL-C in serum (P<0.05), and decreased the level of HDL-C (P<0.05) in rats with COPD. GC-MS results showed that there were 8 lung differential metabolites and 17 liver differential metabolites in the COPD group and XGHP group. Network pharmacology predicted 59 common targets for the two differential metabolites, mainly enriched in the PPAR signaling pathway. Molecular docking results showed that the main components in XGHP were well combined with both PPARα and FABP4. Real-time PCR showed that XGHP effectively up-regulated the expression levels of PPARα and FABP4 mRNA (P<0.05), and Western blot showed that XGHP effectively up-regulated the expression levels of PPARα and FABP4 proteins (P<0.05) in lung and liver tissues of rats with COPD. ConclusionXGHP effectively improves the blood lipid levels of rats with COPD, which may be related to the increase of the expression levels of PPARα and FABP4 mRNA and proteins in the PPAR signaling pathway, thus regulating lung and liver lipid metabolism.

13.
Article in Chinese | WPRIM | ID: wpr-940122

ABSTRACT

ObjectiveTo investigate the effects of Asari Radix et Rhizoma-Zingiberis Rhizoma herb pair (XGHP) on lung and liver lipid metabolism in rats with chronic obstructive pulmonary disease (COPD). MethodForty SD male rats were divided into a normal group (10 rats) and a model group (30 rats). The method of cigarette smoke + tracheal injection of lipopolysaccharide(LPS) + cold stimulation was used to replicate COPD model with the syndrome of cold phlegm obstruction in lung. A COPD group, a XGHP group (5.4 g·kg-1·d-1), and an aminophylline group (0.5 g·kg-1·d-1) were established after successfully inducing the model, with 10 rats in each group. After treatment, the serum triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels of rats in each group were measured. Gas chromatography-mass spectrometer (GC-MS) was used to detect the differential metabolites in the lung and liver tissues of rats in each group, and the relevant targets of the differential metabolites were predicted by network pharmacology. Molecular docking was used to verify the binding ability of key components in XGHP to the relevant targets in network pharmacology. The mRNA and protein expression levels of peroxisome proliferator-activated receptor α (PPARα) and fatty acid binding protein 4 (FABP4) in lung and liver tissues of rats in each group were detected by real-time polymerase chain reaction (PCR) and Western blot. ResultXGHP significantly increased the levels of TG, TC, and LDL-C in serum (P<0.05), and decreased the level of HDL-C (P<0.05) in rats with COPD. GC-MS results showed that there were 8 lung differential metabolites and 17 liver differential metabolites in the COPD group and XGHP group. Network pharmacology predicted 59 common targets for the two differential metabolites, mainly enriched in the PPAR signaling pathway. Molecular docking results showed that the main components in XGHP were well combined with both PPARα and FABP4. Real-time PCR showed that XGHP effectively up-regulated the expression levels of PPARα and FABP4 mRNA (P<0.05), and Western blot showed that XGHP effectively up-regulated the expression levels of PPARα and FABP4 proteins (P<0.05) in lung and liver tissues of rats with COPD. ConclusionXGHP effectively improves the blood lipid levels of rats with COPD, which may be related to the increase of the expression levels of PPARα and FABP4 mRNA and proteins in the PPAR signaling pathway, thus regulating lung and liver lipid metabolism.

14.
Article in Chinese | WPRIM | ID: wpr-939757

ABSTRACT

A lung diffusion function detection system is designed. Firstly, the controllable collection of air, test gas source and calibration gas source was based on single-breath method measurement principle. Secondly, pulmonary diffusing capacity for carbon monoxide (DlCO) was calculated by gas concentration measured by the non-dispersive infrared sensor to measure, the gas flow measured by the differential pressure sensor, and the temperature, humidity and atmospheric pressure sensors to test and evaluate the quantitative detection and evaluation of lung diffusion function. Moreover, a preliminary verification of the lung diffusion function detection system was implemented, and the results showed that the error of the lung carbon monoxide diffusion and the alveolar volume did not exceed 5%. Therefore, the system has high accuracy and is of great value for early screening and accurate assessment of COPD.


Subject(s)
Carbon Monoxide , Lung , Pulmonary Diffusing Capacity/methods
15.
Journal of Preventive Medicine ; (12): 715-719, 2022.
Article in Chinese | WPRIM | ID: wpr-934890

ABSTRACT

Objective @#To investigate the prevalence of comorbid chronic obstructive pulmonary disease (COPD) and osteoporosis (OP) and its influencing factors among residents aged 40 years and older in Zhangjiagang City, Jiangsu Province, so as to provide insights into prevention of comorbid COPD and OP. @*Methods@#Permanent residents aged 40 years and older were sampled using a multi-stage stratified cluster random sampling method in Zhangjiagang City in 2019, and their pulmonary functions and bone mineral density were measured. The prevalence of comorbid COPD with OP was estimated. The demographic features, smoking, diet, exercises and physical examinations were collected, and factors affecting the prevalence of comorbid COPD with OP were identified using a logistic regression model.@*Results@#Totally 3 140 subjects were enrolled, including 1 315 men (41.88%) and 1 825 women (58.12%), and a mean age of (62.89±9.13) years. A total of 137 subjects were detected with comorbid COPD and OP, with prevalence of 4.36%. The patients with COPD alone included 19 cases with mild, 133 cases with moderate, 87 cases with severe and 26 cases with very severe COPD, and the patients with comorbid COPD and OP included 10 cases with mild, 56 cases with moderate, 56 cases with severe and 15 cases with very severe COPD. The grade of pulmonary functions was higher in patients with comorbid COPD and OP than in patients with COPD alone (Z=-12.304, P<0.001). Multivariable logistic regression analysis identified ages of 65 years and older (OR=2.703, 95%CI: 1.862-3.923), women (OR=2.897, 95%CI: 1.915-4.384) and physical labor (OR=1.540, 95%CI: 1.083-2.189) as factors affecting the development of comorbid COPD and OP.@*Conclusion@#The prevalence of comorbid COPD and OP was 4.36% among residents at ages of 40 years and older in Zhangjiagang City, and moderate and severe degree was the predominant grade of pulmonary functions. The elderly, women and physical labors are at a high risk of developing comorbid COPD and OP.

16.
Article in Chinese | WPRIM | ID: wpr-934038

ABSTRACT

Eosinophil extracellular traps (EETs), an important pathway of eosinophil to exert its effects, are composed of DNA fibers, histone and eosinophil granule proteins. Recently, many researches have shown that EETs play an important role in the genesis and development of respiratory diseases including asthma, allergic bronchopulmonary aspergillosis and chronic obstructive pulmonary disease. EETs can directly damage airway epithelial cells, promote airway inflammation and airway hypersecretion, increase the stickiness of secretions and induce the generation of autoantibody, helping eosinophils and their products participate in a cascade of events leading to inflammation and disease. Researches on EETs can also be helpful in investigating new targets for the treatment of chronic airway diseases.

17.
Clinical Medicine of China ; (12): 123-128, 2022.
Article in Chinese | WPRIM | ID: wpr-932156

ABSTRACT

Objective:To explore the changes of peripheral blood Th17/Treg and serum cytokines in AECOPD patients with secondary pulmonary fungal infection.Methods:Selected the clinical data of 27 AECOPD patients who were admitted between January 2018 to March 2020 in the Department of Respiratory Medicine, Hai'an People's Hospital Affiliated to Nantong University with fungal infection (fungal infection group), and 58 AECOPD patients without fungal infection (non-fungal infection group) who received treatment in the hospital during the same period. Compared the general clinical data, peripheral blood Th17 and Treg cell levels, Th17/Treg ratio, interleukin-17 (IL-17), interleukin-23 (IL-23), interferon-γ (interferon-γ, IFN-γ), and transforming growth factor-β (TGF-β) levels. Meanwhile, compared the levels of Th17 and Treg cells in peripheral blood, the ratio of Th17/Treg and serum cytokines in patients with different infection severity in fungal infection group. The measurement data with normal distribution were compared by independent samplet t-test between the two groups, one-way ANOVA between multiple groups, LSD-t test for pairwise comparision, and χ 2 test for counting data. Results:In the 27 AECOPD patients with fungal infection group, the pathogen distribution was 65.52% (19/27) of candida albicans, 10.34% (3/27) of candida tropicalis,10.34% (3/27) of candida albicans, and 6.90% (2/27) of Aspergillus. The level of Th17 [(16.18±3.15) % and (12.34±2.64) %, t=5.87, P<0.001)], the ratio of Th17/Treg [(4.70±0.85) and (2.41±0.51), t=22.87, P<0.001] in Patients with fungal infection group were higher than those in the non-fungal group. The level of Treg [(3.42±0.42) % and (5.13±0.51) %, t=20.77, P<0.001] in Patients with fungal infection group was lower than those in the non-fungal group. The levels of IL-17 [(85.67±21.51) μg/L and (53.64±14.36) μg/L, t= 8.12, P<0.001], and IL-23 [(61.38±16.58) μg/L and (38.29±12.60) μg/L, t=7.10, P<0.001] in Patients with fungal infection group were higher than those in non-fungal infection group, but the levels of IFN-γ ((47.75±17.72) μg/L and (62.37±19.06) μg/L, t=3.37, P=0.001) and TGF-β ((110.34±26.03) μg/L and (131.40±35.03) μg/L, t=2.87, P=0.007) were lower than those in non-fungal infection group, and the differences were statistically significant. There were statistically significant differences in the ratio of Th17/Treg, and the levels of Th17, Treg cells and cytokine among patients with different infection severity in the fungal infection group. With the increase of infection severity, the levels of Th17 ((13.06±1.98)%, (15.94±2.11)%, (17.75±2.20)%, F=10.19, P<0.001), the ratios of Th17/Treg ((5.01±0.60), (5.66±0.69), (6.52±0.65), F=10.77, P<0.001), the levels of IL-17 ((63.39±11.64) μg/L,(78.66±12.82) μg/L, F=9.01, P=0.001), and IL-23 ((42.52±13.11) μg/L, (59.97±15.25) μg/L, (69.75±14.30) μg/L, F=7.41, P=0.003) were increase, the levels of Treg ((4.33±0.39)%, (3.32±0.42)%, (2.50±0.35)%, F=44.42, P<0.001), IFN-γ ((57.78±10.52) μg/L, (48.82±10.39) μg/L, (38.90±10.56) μg/L, F=6.50, P=0.006), TGF-β ((126.62±18.94) μg/L, (115.34±13.66) μg/L, (102.52±17.73) μg/L, F=4.25, P=0.026) were significantly decreased. Conclusion:The imbalance of Th17/Treg ratio and related serum cytokines play an important role in the process of lung fungal infection in AECOPD patients, and their imbalance is related to the severity of fungal infection. Therefore, the levels of Th17/Treg and serum cytokines should be closely monitored in AECOPD patients.

18.
Clinical Medicine of China ; (12): 108-113, 2022.
Article in Chinese | WPRIM | ID: wpr-932154

ABSTRACT

Objective:To study the characteristics of breath sound spectroscopy in chronic obstructive pulmonary disease(COPD) patients with different lung function grades, to preliminarily determine the characteristic parameters and indicators of breath sound spectrograms with different lung function grades of COPD, and to explore the visualization and measurability of the differences in respiratory auscultation in patients with different lung function grades.Methods:Patients diagnosed and treated in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Chongming Branch from October 2018 to December 2020 were selected. Fifty-two patients with COPD (22 patients with moderate to moderate obstructive ventilation dysfunction (mild to moderate group), 30 patients with severe obstructive ventilation dysfunction (severe group)) and 36 normal controls (control group) were selected. The respiratory sounds were sampled with an electronic stethoscope and transmitted to the audit audio software to calculate the relevant data of respiratory sound pressure level (SPL) and the ratio to minute ventilation (VE) of samples with different lung function grades. A retrospective case-control study was used. The data with normal distribution were analyzed by one-way ANOVA, and the pairwise comparison was performed by SNK- q test. Results:The breathing audio frequency of mild-moderate, severe COPD patients and the control group has a sound pressure difference of (-0.5±2.2) dB and (-1.6±6.1) dB, (0.7±4.0) dB, and there was significant difference between each group ( F=2.64, P=0.038). The sound pressure level per minute ventilation (SPL 50-200/VE) of respiratory sound inspiratory phase in COPD patients with mild to moderate and severe obstructive ventilation dysfunction and the control group were (5.7±1.8) dB/L, (6.1±2.3) dB/L and (5.4±0.9) dB/L, respectively. The expiratory SPL 50-200/VE were (5.8±1.7), (6.3±2.2) and (5.3±1.2) respectively. There was significant difference among the three groups ( Finhalation=3.26, P=0.048; Frespiration=2.44, P=0.045). ROC curve results showed that SPL 50-200/VE in the inspiratory phase, SPL 50-200/VE in the expiratory phase, and sound pressure difference to assess different grades of obstructive ventilatory dysfunction had diagnostic value (AUC values were 0.697, 0.725 and 0.686, respectively; and P values were 0.015, 0.005 and 0.022, respectively). In some patients with COPD, abnormally high energy levels may appear in the time-frequency diagram of breath sounds. Conclusion:There are significant differences in respiratory audio spectrum analysis between patients with different degrees of obstructive ventilation dysfunction and those with normal ventilation function, which can provide a basis for auxiliary judgment of obstructive ventilation dysfunction.

19.
Article in Chinese | WPRIM | ID: wpr-930110

ABSTRACT

Objective:To explore the correlation between Traditional Chinese Medicine (TCM) excessive patterns and clinical characteristics of acute exacerbation of chronic obstructive pulmonary disease (COPD) complicated with chronic pulmonary heart disease (CPHD) in high altitude environment.Methods:Patients with acute exacerbation of COPD complicated with CPHD admitted to the Pulmonology Department of Qinghai Provincial Hospital of Traditional Chinese Medicine from December 2016 to November 2017 were selected. Demographic data and clinical medical characteristics data of the patients were collected, and TCM patterns differentiation was conducted. The correlation between each pattern type and clinical characteristics and all collected laboratory indexes were analyzed by multivariate logistic regression.Results:Phlegm obstructing lung pattern showed a negative correlation relationship with mMRC score [ OR=0.419, 95% CI (0.219-0.802), P=0.009], PCT [ OR=8.132×10 -11, 95% CI (1.632×10 -16-4.1×10 -5), P<0.001], Hb [ OR=0.971, 95% CI (0.952-0.989), P=0.002] and PaCO 2[ OR=0.914, 95% CI (0.853-0.980), P=0.011]; turbid phlegm obstructing lung pattern showed a negative correlation relationship with gender(0 male, 1 female) [ OR=0.427, 95% CI (0.204-0.892), P=0.024], Hb [ OR=0.960, 95% CI (0.945-0.975), P<0.001], and there was a positive correlation relationship with LVEF [ OR=1.061, 95% CI (1.006-1.118), P=0.028]; phlegm-heat obstructing lung pattern showed a negative correlation relationship with Hb [ OR=0.950, 95% CI (0.927-0.974), P<0.001]and cardiac function grade [ OR=0.468, 95% CI (0.248,0.881), P=0.019], and there was a positive correlation relationship with PCT [ OR=1.118×10 8, 95% CI (1.466×10 4-8.523×10 11), P<0.001] and D-D [ OR=2.283, 95% CI (1.300-4.010), P=0.004]; there was a negative correlation between phlegm and stasis blocking lung pattern with cardiac function grade[ OR=0.309, 95% CI (0.167-0.570), P<0.001], and there was a positive correlation relationship with Hb[ OR=1.060, 95% CI (1.042-1.078), P<0.001]; there was a negative correlation between wet phlegm and blood stasis heat pattern with PCT [ OR=1.266×10 -13, 95% CI (1.658×10 -21-0.1×10 -4), P<0.001], SaO 2 [ OR=0.934, 95% CI (0.892-0.979), P=0.004], LVEF [ OR=0.896, 95% CI (0.826-0.971), P=0.008], D-D [ OR=0.030, 95% CI (0.002-0.508), P=0.015], and there was a positive correlation relationship with CRP [ OR=1.042, 95% CI (1.018-1.067), P<0.001], RBC [ OR=3.411, 95% CI (1.684-6.910), P<0.001], cardiac function grade [ OR=8.573, 95% CI (2.410-30.504), P<0.001], pulmonary arterial pressure difference [ OR=2.091, 95% CI (1.243-3.516), P=0.005]. Conclusions:Male patients are more prone to phlegm and turbidities than female patients. PCT and D-D were the main risk factors of phlegm-heat obstruction syndrome. Elevated hemoglobin is a risk factor for patients with phlegm stasis and lung syndrome. Heart function classification is the main risk factor of phlegm-dampness-stasis heat syndrome.

20.
Article in Chinese | WPRIM | ID: wpr-929678

ABSTRACT

ObjectiveIn view of the problems of large errors and poor accuracy in pulmonary function testing in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), a predictive classification model of pulmonary function in patients with AECOPD was proposed by comparing the prediction performance of different machine learning models to find the optimal model. MethodsFrom January, 2018 to February, 2020, 90 patients with different degrees of COPD from the Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University were collected. Six machine learning model algorithms (K-nearest neighbor, logistic regression, support vector machine, naive Bayes, decision tree and random forest) were used to establish AECOPD predictive classification models. Their area under the curve of receiver operating characteristic (AUC-ROC) and accuracy were compared. Ten-fold cross-validation method was used to validate the data set. ResultsThe model based on random forest worked best in predicting and classifying AECOPD patients, with an accuracy rate of 0.844 and an AUC-ROC of 0.916. ConclusionRandom forest-based predictive model is a powerful tool for identifying patients with AECOPD, providing decision support when it is difficult to give a definitive diagnosis.

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