Résumé
Objective:To determine the prevalence and risk factors of asthma among adults. Methods:A total of 37 670 adults aged 18 years and above was enrolled in Songjiang District， Shanghai using a multi-stage stratified sampling method between April 2016 and October 2017. Statistical analysis， such as t-test and Chi-square test， was performed to check the difference between the participants with asthma and non-asthma participants. Risk factors for asthma were examined by logistic regression analysis in all participants. Results:Overall， 36 698 subjects were enrolled in the study， in which 752 had asthma. The overall prevalence of asthma was determined to be 2.05%. The prevalence in females was 2.16%， and that in males was 1.88%， which didn’t achieve significance（P>0.05）. Compared to non-asthma participants， those with asthma were more likely to be older （［60.3±9.48］ years vs. ［56.29±11.31］ years）， widowed （6.91%>4.45%，P<0.05）， with educational level of primary school and below （58.64%>46.55%， P<0.01）， higher level of total cholesterol （TC） and low-density lipoprotein cholesterol （LDL-C） （P<0.05）， had more co-morbidities， such as hypertension （42.00%>15.00%，P<0.001）， chronic obstructive pulmonary disease （COPD） （6.25%>0.41%，P<0.001）， chronic bronchitis （51.33%>6.32%，P<0.001） and tuberculosis （2.66%>0.96%，P<0.05）， depression（2.13%>0.41%，P<0.05）， and Parkinson's disease （0.93%>0.39%，P<0.05）. Multivariable analysis showed that family history of asthma， history of hypertension， chronic bronchitis， COPD， depression and educational level of primary school and below were the risks factors associated with adult asthma （P<0.05）. Conclusion:Prevalence of adult asthma in Shanghai has increased in recent years. Targeted health education may be strengthened for improving adult awareness towards asthma and reducing the disease burden.
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Objective To discuss the effect of applying midnight-midday ebb-flow acupoint massage to patients of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Selected 60 patients of AECOPD in the respiratory department. They were divided into two groups randomly, the observed group and the compared group, with 30 patients in each group. The compared group applied regular treatment and care, while the observed group combined midnight-midday ebb-flow acupoint and bladder meridian between 3 pm. to 5 pm. The treatment lasted seven days. Compared the evaluation of the patients′main symptoms such as coughs,expectoration,gasp, panting and the changes of PaO2, PaCO2, and SaO2 before and after treatment, and compared the overall efficiency of treatment and average length of stay in hospital. Results After treatment, the ratings of symptoms of the observed group in coughs, expectoration, gasp, panting were (1.51 ± 0.23), (1.12 ± 0.74), (2.05 ± 0.29), (0.25 ± 0.18) points, while the compared group were (2.41 ± 0.25), (2.62 ± 0.64), (3.66 ± 0.24), (2.24 ± 0.32) points. The difference in two groups was valid in terms of statistics (t=2.884-4.147, P<0.05). After treatment, the index of PaO2,PaCO2,and SaO2 in the observed group were (80.80 ± 2.16) mmHg (1 mmHg=0.133 kPa), (50.38 ± 6.67) mmHg,0.982 ± 0.014. The compared group was (71.38 ± 1.24) mmHg, (58.42 ± 4.89) mmHg, 0.873±0.027.The difference was valid in terms of statistics (t=2.358, 3.543, 4.152, P<0.05);the overall efficiency of the the observed group was 93.3%, and the compared group was 83.3%. The difference was valid in terms of statistics (χ2=2.466, P<0.05);in terms of average length of stay in hospital, the observed group was (11.4 ± 1.8)days, and the compared group was (15.6 ± 2.0) days, and the observed group was apparently lower than the compared group (t=2.694, P<0.05). Conclusions The massage of midnight-midday ebb-flow acupoint massage can relieve the symptoms of patients of AECOPD, improve patients' index in arterial blood gas analysis and care effect, shorten the stay in hospital and better the life quality.
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Objective To study the correlation between CT features and pulmonary function indexes in dif-ferent chronic obstructive pulmonary diseases(COPD).Methods Collection of COPD patients with 80 cases were collected,,the correlation analysis of COPD CT features (pixel index)and pulmonary function,including one second forced expiratory volume (FEV1 ),one second forced expiratory volume accounted for the percentage of forced vital capacity (FVC)and residual volume /lung total ratio (RV /TLC)were examined by pulmonary function testing (PFT)and multislice spiral CT (MSCT).Results According to CT,the regional area of lung density (LAA%)and airway wall thickness/lumen area were measured,COPD was divided into 56 cases of emphysema phenotype,13 case of airway phenotype and 11 case of mixed phenotype.The emphysema phenotype index,FEV1 ,FEV1 /FVC pixels,RV /TLC =27.68%,(32.19 ±16.78)%,(43.69 ±11.23),(55.67 ±15.49 ),airway phenotype were 5.23%, (55.67 ±23.12)%,(52.30 ±10.67),(49.48 ±13.27),respectively,mixed phenotype were 22.47% (41.23 ± 12.55)%,(47.31 ±9.98),(54.19 ±16.29),FEV1 ,FEV1 /FVC,pixel index,RV /TLC COPD CT in different phe-notypic differences were statistically significant (χ2 =19.013,F =6.234,7.854,6.389,all P 0.05).Conclusion CT features can be regarded as the reference to diagnosis the COPD pheno-type and evaluate the effect of treatment,it is necessary to re -examine PFT in emphysema and airway phenotypes.
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Objective To investigate the effect of Ambroxol on NF?B activation of macrophage in the induced sputum in patients with stable COPD.Methods Induced sputum was taken from 47 stable COPD patients,who were divided into two groups randomly.Macrophages were collected,and NF-?B activation and IL-8 of induced sputum were determined by immunohistochemistry;SOD and MDA were determined synchronously.Results NF-?B activation in macrophage and IL-8 in the treated group were significantly decreased in patients of stable group than those in the controls.Conclusion Ambroxol can decrease NF-?B activation in macrophage in stable COPD patients.