Spirometric Reference Equations for Elderly Chinese in Jinan Aged 60-84 Years / 中华医学杂志(英文版)

<p><b>Background</b>The interpretation of spirometry varies on different reference values. Older people are usually underrepresented in published predictive values. This study aimed at developing spirometric reference equations for elderly Chinese in Jinan aged 60-84 years and to compare them to previous equations.</p><p><b>Methods</b>The project covered all of Jinan city, and the recruitment period lasted 9 months from January 1, 2017 to September 30, 2017, 434 healthy people aged 60-84 years who had never smoked (226 females and 208 males) were recruited to undergo spirometry. Vital capacity (VC), forced VC (FVC), forced expiratory volume in 1 s (FEV), FEV/FVC, FEV/VC, FEV, peak expiratory flow, and forced expiratory flow at 25%, 50%, 75%, and 25-75% of FVC exhaled (FEF, FEF, FEF, and FEF) were analyzed. Reference equations for mean and the lower limit of normal (LLN) were derived using the lambda-mu-sigma method. Comparisons between new and previous equations were performed by paired t-test.</p><p><b>Results</b>New reference equations were developed from the sample. The LLN of FEV/FVC, FEFcomputed using the 2012-Global Lung Function Initiative (GLI) and 2006-Hong Kong equations were both lower than the new equations. The biggest degree of difference for FEV/FVC was 19% (70.46% vs. 59.29%, t = 33.954, P < 0.01) and for maximal midexpiratory flow (MMEF, equals to FEF) was 22% (0.82 vs. 0.67, t = 21.303, P < 0.01). The 1990-North China and 2009-North China equations predicted higher mean values of FEV/FVC and FEFthan the present model. The biggest degrees of difference were -4% (78.31% vs. 81.27%, t = -85.359, P < 0.01) and -60% (2.11 vs. 4.68, t = -170.287, P < 0.01), respectively.</p><p><b>Conclusions</b>The newly developed spirometric reference equations are applicable to elderly Chinese in Jinan. The 2012-GLI and 2006-Hong Kong equations may lead to missed diagnoses of obstructive ventilatory defects and the small airway dysfunction, while traditional linear equations for all ages may lead to overdiagnosis.</p>

Effect of Low Dose Dexamethasone on Blood Glucose Concentration in Patients Undergoing Craniotomy / 中国康复理论与实践

@#ObjectiveTo evaluate the effect of low dose of dexamethasone on the blood glucose concentration in patients undergoing craniotomy. Methods20 consecutive patients undergoing craniotomy without a preexisting metabolic disorder were prospectively randomized into 1 of 2 groups: Dexamethasone (group D, n=10) and Normal Saline (group S, n=10), who were given dexamethasone 10 mg intravenous bolus or a saline placebo preoperatively. Arterial glucose concentrations were measured immediately before and after treatment and hourly for 5 hours intraoperatively. ResultsThe arterial glucose concentration in group D increased significantly(F=3.133,P<0.05), while those in group S keep stable. Compared with group S, arterial glucose concentration in group D increased significantly 180 min after dosing(P<0.01). ConclusionIf dexamethasone is used during craniotomy, perioperative blood glucose level should be carefully monitored and controled.