Evaluation of health-related quality of life and the related factors in a group of Chinese patients with interstitial lung diseases.

INTRODUCTION: Interstitial lung diseases (ILDs) include a wide variety of chronic progressive pulmonary diseases characterized by lung inflammation, fibrosis and hypoxemia and can progress to respiratory failure and even death. ILDs are associated with varying degrees of quality of life impairments in affected people. Studies on the quality of life in patients with ILDs are still limited, and there are few studies with long-term follow-up periods in these patients. METHODS: Data from patients who were clinically diagnosed with ILDs in the Respiratory Department, Beijing Chaoyang Hospital, Capital Medical University from January 2017 to February 2018 were collected. Clinical status and HRQoL were assessed at baseline and subsequently at 6- and 12-month intervals with the LCQ, mMRC, HADS, SF-36, and SGRQ. Multivariate linear regression was used to evaluate the determinants of the decline in HRQoL. RESULTS: A total of 139 patients with idiopathic interstitial pneumonia (IIP) and 30 with connective tissue disease-associated ILD (CTD-ILD) were enrolled, 140 of whom completed the follow-up. The mean age was 63.7 years, and 92 patients were men. At baseline, the decline in HRQoL assessed by the SF-36 and SGRQ was significantly associated with the mMRC, LCQ and HADS depression score. In the follow-up, changes in FVC%, DLco%, mMRC and LCQ were significantly associated with changes in HRQoL. CONCLUSIONS: HRQoL in both IIP and CTD-ILD patients deteriorates to varying degrees, and the trend suggests that poor HRQoL in these patients is associated with many determinants, primarily dyspnea, cough and depression. Improving HRQoL is the main aim when treating patients living with ILDs.

Toxicity of concurrent chemoradiotherapy with cetuximab for locoregionally advanced nasopharyngeal carcinoma.

Overexpression of the epidermal growth factor receptor can be found in 80 % of patients with locoregionally advanced nasopharyngeal carcinoma (NPC) and is associated with shorter survival. In this work, we evaluated the feasibility of adding cetuximab to concurrent cisplatin and radiotherapy (RT) in locoregionally advanced NPC. Twenty-eight patients with locoregionally advanced NPC who received the combination therapy were retrospectively reviewed and short-term efficacy was evaluated. Grade 3-4 oral mucositis occurred in 20 (71.4 %) patients. Grade 3 radiotherapy-related dermatitis occurred in seven patients (25 %). Three patients (14.3 %) had grade 3 and one patient (3.6 %) had grade 4 cetuximab-related acneiform rashes. These grade 3-4 skin and mucosal toxic effects were manageable and reversible. At a median follow-up of 33.4 months (95 % CI 29.2-38.1 months), the 2-year progression-free survival was 89.3 % (95 % CI 76.4-98.1 %). In conclusion, concurrent administration of cetuximab, cisplatin and RT is a feasible strategy against locoregionally advanced NPC. Preliminary survival data compare favorably with historic data and further follow-up is warranted.

Polycyclic aromatic hydrocarbons in household dust near diesel transport routes.

A river-dredging project has been undertaken in Nantou, Taiwan. A large number of diesel vehicles carrying gravel and sand shuttle back and forth on the main roads. Ten stations along major thoroughfares were selected as the exposure sites for testing, while a small village located about 9 km from a main traffic route was selected as the control site. Levels of household dust loading at the exposure sites (60.3 mg/m(2)) were significantly higher than those at the control site (38.2 mg/m(2)). The loading (µg/m(2)) of t-PAHs (total polycyclic aromatic hydrocarbons) in the household dust at the exposure sites was significantly higher (P < 0.05) than was the case at the control site. The diagnostic ratios of PAHs showed that diesel emissions were the dominant source of PAHs at the exposure sites. The lack of a significant correlation between the concentrations of Fe and t-PAHs suggested that the t-PAHs in household dust might come from diverse sources. However, a significant correlation (P = 0.003) between the concentrations of Mo and t-PAHs implied that the most of the t-PAHs in the household dust might have resulted from diesel emissions. The lifetime cancer risks of BaP(eq) from household dust exposure were markedly higher than those resulting from inhalation exposure.

Effect of carbon dioxide inhalation on pulmonary hypertension induced by increased blood flow and hypoxia.

There is now increasing evidence from the experimental and clinical setting that therapeutic hypercapnia from intentionally inspired carbon dioxide (CO(2)) or lower tidal volume might be a beneficial adjunct to the strategies of mechanical ventilation in critical illness. Although previous reports indicate that CO(2) exerts a beneficial effect in the lungs, the pulmonary vascular response to hypercapnia under various conditions remains to be clarified. The purpose of the present study is to characterize the pulmonary vascular response to CO(2) under the different conditions of pulmonary hypertension secondary to increased pulmonary blood flow and secondary to hypoxic pulmonary vasoconstriction. Isolated rat lung (n = 32) was used to study (1) the vasoactive action of 5% CO(2) in either N(2) (hypoxic-hypercapnia) or air (normoxic-hypercapnia) at different pulmonary arterial pressure levels induced by graded speed of perfusion flow and (2) the role of nitric oxide (NO) in mediating the pulmonary vascular response to hypercapnia, hypoxia, and flow-associated pulmonary hypertension. The results indicated that inhaled CO(2) reversed pulmonary hypertension induced by hypoxia but not by flow alteration. Endogenous NO attenuates hypoxic pulmonary vasoconstriction but does not augment the CO(2)-induced vasodilatation. Acute change in blood flow does not alter the endogenous NO production.