Misdiagnosis analysis of 5 cases of pneumonia type lung cancer / 中国综合临床

The clinical data of 5 patients with pneumonia type lung cancer from January 2017 to January 2020 were retrospectively analyzed.The results showed that the clinical symptoms of the 5 patients were cough and expectoration.The infection index was mildly abnormal, and the tumor marker index was increased.After anti infection treatment, the effect was not good.The diagnosis of pneumonia type lung cancer was confirmed by improving the fiberoptic bronchoscopy biopsy.Due to the lack of specificity of clinical manifestations, if the early diagnosis of pneumonia type lung cancer can not be confirmed, the chest imaging can be reviewed after anti infection treatment, and the pathological basis can be obtained by timely improvement of fiberoptic bronchoscopy, bronchoalveolar lavage and lung biopsy.

Add-on Tiotropium in Chinese Patients With Moderate Asthma: A Pooled Subgroup Analysis of MezzoTinA-Asthma 1 and 2

PURPOSE: Asthma affects approximately 30 million patients in China; however, tiotropium data for Chinese patients is limited. This study aimed to assess the efficacy and safety of tiotropium in Chinese patients with moderate symptomatic asthma. METHODS: A post hoc subgroup analysis was conducted on 430 Chinese patients pooled from two 24-week, replicate phase 3 trials (NCT01172808 and NCT01172821), in which they received once-daily tiotropium 2.5 µg (Tio R2.5) or 5 µg (Tio R5) (n = 106 or 109, respectively), twice-daily salmeterol 50 µg (Sal 50) (n = 110), or placebo (n = 105), while maintaining inhaled corticosteroids (ICS). The co-primary endpoints assessed in week 24 were forced expiratory volume in 1 second (FEV1) peak0–3h response, trough FEV1 response, and responder rate as assessed using the Asthma Control Questionnaire (ACQ). RESULTS: For both FEV1 peak0–3h responses and trough FEV1 responses, the mean treatment differences were greater for Tio R2.5, Tio R5, and Sal 50 compared with placebo at 0.249 L, 0.234 L, and 0.284 L, and 0.172 L, 0.180 L, and 0.164 L, respectively (P< 0.001). The ACQ responder rate in placebo, Tio R2.5, Tio R5, and Sal 50 was 58.7%, 62.3%, 59.3%, and 69.1%, respectively. Furthermore, 11 (2.6%) of 430 patients had serious adverse events (Tio R5, n = 4; Tio R2.5, n = 1; Sal 50, n = 1; and placebo, n = 5). CONCLUSIONS: Once-daily tiotropium, as add-on to medium-dose ICS, was effective and well tolerated for Chinese patients with moderate symptomatic asthma, consistent with the main analysis.

Effect of dexamethasone and formoterol on expression of TLR4 in macrophages differentiated from THP-1 cell line / 中国医师杂志

Objective Inhaled corticosteroids combined with long β2-adrenoceptor agonist are widely used in treatment of chronic obstructive pulmonary disease,but mechanisms remain unclear.Methods Macrophage cells differentiated from THP-1 cell line were stimulated with dexamethasone and/or formoterol with or without lipopolysaccharide (LPS).TLR4 mRNA and protein were examined by reverse transcriptase polymerase chain reaction (RT-PCR) and Western blotting.Results A dose-dependent up regulation in TLR4 mRNA and protein expression in the presence of LPS was found.Treatment with dexamethasone (10-10 ～ 10-6mol/L) resulted in a dose-dependent reduction in TLR4 mRNA and protein.Stimulation with formeterol (10-7 mol/L and 10-6 mol/L) caused up regulation of TLR4.Formoterol (10-6mol/L)partially reversed the inhibitory effect of dexamethasone (10-6 mol/L) on TLR4 expression in the presence of LPS.Conclusions Modulation of TLR4 in macrophages by dexamethasone and/or formoterol may be one of the mechanisms for combination and have important implications for the treatment of airway inflammation in response to gram-negative bacteria.

Cardiac and Pulmonary Response to Peak Exercise in Patients with Chronic Obstructive Pulmonary Disease / 中国运动医学杂志

Objective To study the effects of cardiac and pulmonary response in pailents with chronic obstructive pulmonary disease(COPD) on their exercise capacity.Methods Thirty four patients with COPD(including 8 patients in stage Ⅰ,15 patients in stage Ⅱ,10 patents in stage Ⅲ and 1 patent in stage Ⅳ and 24 healthy controls performed incremental exercise testing.Oxygen uptake(VO_2) and carbon dioxide output(VCO_2)were measured breath-by-breath.Arterial blood samples were drawn both at rest and peak exercise.Results The VO_2 at peak exercise was significantly lower in COPD group than in control group(15.81±3.65ml/min/kg vs 18.96±6.10ml/min/kg,P=0.042).The respiration reserve was lower in COPD patients compared to controls.The rBorg dyspnea score at the peak exercise for COPD patents was 4.24±2.01,significantly higher than that for controls(1.754±1.50).Oxygen pulse and heart rate reserve had not statistically difference between COPD group and control group.Significant increase of PO_2 and PCO_2 were found during exercise,which were 26.374±15.40 vs 10.26±22.65 mmHg and 42.33±3.65 vs 40.29±4.46 mmHg respectively compared to at rest.Conclusion Abnormal pulmonary response to exercise might be the main cause inducing exercise intolerance in patents with COPD.

Cardiac response to exercise in mild-to-moderate chronic obstructive pulmonary disease / 老年心脏病学杂志（英文版）

Objective Chronic obstructive pulmonary disease (COPD) increases the risk of cardiovascular problem.The symptom of dyspnea on exertion may be associated with pulmonary dysfunction or heart failure, or both. The study objective was to determine whether cardiac dysfunction adds to the mechanism of dyspnea caused mainly by impaired lung function in patients with mild-to-moderate COPD. Methods Patients with COPD and healthy controls performed incremental and constant work rate exercise testing. Venous blood samples were collected in 19 COPD patients and 10 controls before and during constant work exercise for analysis of N-terminal-pro-BNP (NT-pro-BNP). Results Peak oxygen uptake and constant work exercise time (CWET) were significantly lower in COPD group than in control group (15.81±3.65 vs 19.19a±6.16 ml/min kg, P=0.035 and 7.78±6.53 rain vs 14.77±7.33 min, P=0.015, respectively). Anaerobic threshold, oxygen pulse and heart rate reserve were not statistically significant between COPD group and control group. The NT-pro-BNP levels both at rest and during constant work exercise were higher in COPD group compared to control group, but without statistical significance. The correlations between CWET and NT-proBNP at rest or during exercise in patients with COPD were not statistically significant. Conclusions Heart failure does not contribute to exercise intolerance in mild-to-moderate COPD.

Diagnosis and treatment of allergic bronchopulmonary aspergillosis: clinical features of eight cases and literature reviews / 中华全科医师杂志

Objective To study clinical features, diagnosis and treatment of allergic bronchopulmonary aspergillosis (ABPA) . Methods Clinical data and auxiliary examinations of eight patients with ABPA were analyzed, as well as relevant literatures were reviewed. Results All patients had symptom of cough, expectoration, out of breath and wheezing tale, seven of them with history of asthma, and all of them had increased peripheral blood eosinophil (EOS) count, serum levels of total immunoglobulin E (IgE) and lgE specific for Aspergillus fumigatus and showed positive prick test specific for Aspergillas fumigatus. Six of them showed infiltration shadows and six of them showed bronchiectasis in their chest CT images. Lung function test indicated obstructive ventilation dysfunction or mixed ventilation dysfunction with reversible airflow obstruction after administration of bronchodilator. Conclusions Diagnosis for ABPA should be made by integration of clinical features, increased blood eosinophil count and serum level of IgE, and result of prick test specific for Aspergillus fumigatus. Corticosteroid is a mainstay therapy for ABPA, ancillary with anti-fungi therapy. Patients with ABPA should be followed-up to prevent its recurrence.

Evaluation of SF-36 in measuring health-related quality of life in Chinese patients with COPD / 中国医师进修杂志

Objective To study the value of SF-36 in evaluating the life quality of Chinese patients with chronic obstructive pulmonary disease(COPD). Methods The SF-36,MRC score and spirometry were collected from 50 patients with COPD,the validity was documented by performing correlation analysis and stepwise multiple regression analysis. Pearson correlation coefficients were calculated. Results The MRC score was significantly correlated with seven of the eight components(P

Immune status in patients with chronic obstructive pulmonary disease during acute exacerbations and medication intervention / 中国实用内科杂志

Objective To investigate immune changes in patients with chronic obstructive pulmonary disease during exacerbations(ECOPD).Methods A randomized,prospective clinical trial was done in 65 patients with ECOPD from Feb.2004 to Oct.2004.They were divided into two groups:one group with general treatment and another with general treatment plus Pidotimod which was given 800mg orally twice daily for 15 days and then 800mg orally once daily for 15 days.Twenty healthy individuals sevred as the control.Levels of CD_ 14 、CD_ 158b 、CD~+_3、CD~+_4、CD~+_8、CD~+_4/CD~+_8 in peripheral blood were measured by flow cytometry at baseline(D1)and then again at(D15)and at the end of treatments(D30),in the meanwhile clinical picture was observed to evaluate patients' conditions.Results Totally 60 patients completed the trial correctly(30 in pidotimod group and 30 in control group).The two groups were satistically homogeneous.The positive rate of sputum bacteriological examination was 42.67%.On D1,the percentage of CD_ 14 、CD_ 158b in two groups was not different from healthy volunteers.On D15,the above immunologic parameters of the control group was decreased compared with pidotimod group,and CD_ 14 was satistically low(P

Immunological functions of T-lymphocyte in the elderly with chronic obstructive pulmonary disease during acute exacerbations and medication intervention / 中华老年医学杂志

Objective To investigate the adaptive immune responses in elderly patients with chronic obstructive pulmonary disease during acute exacerbations (ECOPD) and effects of the immunostimulating agent Pidotimod in ECOPD patients. Methods A randomized, prospective clinical trial was held, and 103 patients with ECOPD were recruited into the study. Seventy-five patients aged 65 years and over were divided into two groups: 38 patients with general treatment as a control group and 37 patients with general treatment plus pidotimod as an experimental group. Another non-elderly groups comprised 28 patients younger than 65, and 20 healthy individuals served as the healthy elderly control. Levels of CD3+ , CD4+ , CD8+ , CD4+ /CD8+ in peripheral blood were measured by flow cytometry at baseline (the 1st day) and at the 15th and 30th treatment day, meanwhile, the clinical conditions were evaluated. Results Ninety-one patients completed the trial (32 in experimental group,34 in control group and 25 in non-eldely group). The experimental group and control group were statistically homogeneous. The aged COPD intervention group and aged COPD control had a more decreased CD4+ level, CD4+/CD8+ ratio and more increased CD8+ level, while compared with aged health control and non-elderly COPD control (all P