Gender Differences in Chronic Obstructive Pulmonary Disease Symptom Clusters.

Purpose: Previous research has indicated that female and male patients may experience different levels of symptoms. However, no studies of chronic obstructive pulmonary disease (COPD) patients have compared the number and types of symptom clusters identified in male and female patients. Therefore, the purpose of this study was to investigate gender differences in symptom clusters among COPD patients. Patients and Methods: A total of 371 eligible patients were enrolled in the study. We assessed nine COPD symptoms, namely, dyspnea, cough, sputum, chest tightness, sleep quality, fatigue, frailty, anxiety, and depression. Exploratory factor analyses were used to explore the underlying clusters of the COPD symptoms. Results: Underlying the nine symptoms, female patients had 2 clusters, and male patients had 3 clusters. Specifically, the three general symptoms poor sleep, fatigue, and frailty loaded on the same symptom cluster with anxiety and depression in female patients, while the same 3 general symptoms loaded on the same symptom cluster with chest tightness and dyspnea in male patients. Moreover, cough and sputum not only were more common in male patients but also loaded together on a separate symptom cluster. Conclusion: Our findings suggest that in order to improve fatigue, frailty, and poor sleep quality, symptom management strategies should more closely address anxiety and depression in female patients as well as chest tightness and dyspnea in male patients. Smoking cessation is particularly important in male COPD patients because they account for a much higher proportion of smokers and are more likely to have cough and sputum. These findings signify the importance of identifying and implementing gender-tailored symptom management strategies to relieve symptom burden in COPD patients to enhance their quality of life.

Particulate matter 2.5 induced bronchial epithelial cell injury via activation of 5'-adenosine monophosphate-activated protein kinase-mediated autophagy.

The impact of particulate matter 2.5 (PM2.5) on the respiratory system is a worldwide concern. However, the mechanisms by which PM2.5 causes disease are still unclear. In this study, we investigated the effect of PM2.5 on autophagy and studied the effect of PM2.5-induced autophagy and 5'-adenosine monophosphate-activated protein kinase (AMPK) on cell proliferation, cell cycle, apoptosis, reactive oxygen species (ROS), and airway inflammation using human bronchial epithelial cells 16HBE140 cells. Results showed that exposure of cells to PM2.5 at a concentration of 100 µg/mL for 24 hours was most effective for inhibiting cell viability. PM2.5 induced cell arrest in the G0/G1 phase and increased mitochondrial membrane potential, ROS, and cell apoptosis with increasing concentration. PM2.5 downregulated cyclin D and matrix metallopeptidase-9 (MMP-9) expression but upregulated tissue inhibitor of metalloproteinases-1 (TIMP-1) expression, significantly promoted interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) production, and enhanced the level and activation of AMPK. The levels of autophagy-related protein 5 (ATG5), Beclin-1, and LC3II/I were significantly increased by PM2.5. The activation of Unc-51-like autophagy activating kinase 1 was significantly inhibited by PM2.5. Moreover, ATG5 knockdown inhibited PM2.5-induced autophagy, ROS, and cell apoptosis significantly. The expression of cyclin D, MMP-9, and TIMP-1 was reversed by ATG5 suppression. PM2.5-induction of IL-6 and TNF-α was significantly inhibited by knockdown of ATG5. Thus, inhibition of autophagy protected the cells from PM2.5-induced injury. PM2.5 induced injury in human bronchial epithelial cells via activation of AMPK-mediated autophagy, suggesting possible therapeutic targets for the treatment of respiratory diseases.

Association of hip joint effusion volume with early osteonecrosis of the femoral head.

This study aimed to examine the association between hip joint effusion volume and osteonecrosis of the femoral head (ONFH) using the Association Research Circulation Osseous (ARCO) classification. Patients (n = 403) who were diagnosed with ONFH were enrolled between February 2005 and December 2008. Only patients (n = 109) with complete clinical and imaging data and at early to mid ARCO stage (I - III) were eligible for further analysis, including 94 males and 15 females. All the included patients had hip joint radiographic examinations (anteroposterior and frog-leg views) and magnetic resonance imaging scans (axial and coronal views). Out of 109 patients included in this study, 185 hip joints were involved (unilateral disease in 33 patients and bilateral diseases in 76 patients). The patients had a mean age of 39 ± 11 years (range, 13-70). All the affected hip joints exhibited effusion, classified as grade 1 (n = 70, 37.8%), grade 2 (n = 62, 33.5%), and grade 3 (n = 53, 28.7%). The volume of joint effusion varied significantly among stage I, II, and III (X2 = 29.210, P < 0.05). The effusion volume did not differ significantly among stage IIA, IIB, and IIC (X2 = 0.103, P > 0.05), whereas it differed significantly among stage IIIA, IIIB, and IIIC (X2 =11.556, P < 0.05). The volume of hip joint effusion was associated with the ARCO stage, and increased over the staging.

[Diagnostic value of transbronchial needle aspiration and endobronchial ultrasound-guided transbronchial needle aspiration for hilar and mediastinal lymph nodes in lung cancer patients].

BACKGROUND AND OBJECTIVE: Transbronchial needle aspiration (TBNA) and endobronchial ultrasound-guided TBNA (EBUS-TBNA) have been applied to the diagnosis for mediastinal lymph nodes. The aim of this study is to evaluate the clinical value and safety of TBNA and EBUS-TBNA on hilar and mediastinal lymph nodes of lung cancer patients. METHODS: Two hundred fifty patients with suspected lung cancer were enrolled. All petients with hilar and/or m lymphoadenopa-ediastinal thy found by CT scan received TBNA, biopsy and brushing. EBUS-TBNA was performed in 15 patients among them. RESULTS: Lung cancer were confirmed in 180 patients by TBNA, biopsy and brushing. The positive rates were 82.86%, 51.24% and 45.45%. Fifteen patients after EBUS-TBNA had a positive rate of 91.67%. CONCLUSION: TBNA and EBUS-TBNA were proved to be safe procedure with a high yield for the diagnosis ofhilar and mediastinal lymph nodes in lung cancer patients.

[The relationship of angiotensin I-converting enzyme gene polymorphism with diabetic retinopathy and diabetes myocardial infarction].

OBJECTIVE: To investigate the relationship of angiotensin I-converting enzyme (ACE) gene polymorphism to diabetic retinopathy and diabetes myocardial infarction. METHODS: ACE insertion/deletion(I/D) polymorphism was determined by PCR. RESULTS: No evidence showed that ACE gene was associated with diabetic retinopathy. By comparison of the type 2 diabetes patients with myocardial infarction versus those without-myocardial infarction, it was found that the frequencies of homozygote DD (41.2% versus 33.2%) and of allele D (64.7% versus 55.0%) increased remarkably; the difference was statistically significant (P<0.05). CONCLUSION: Allele D(RR=1.50) and genotype DD(RR=1.33) seemed to be a genetic risk factor for type 2 diabetes myocardial infarction.