Pub Date : 2020-03-20DOI: 10.3760/CMA.J.CN131368-20190312-00334
Y. Duan, Jizu Ling, Xinhui Yuan, Lifang Li, Qin Yu
Objective To investigate the effect of intermittent hypoxia (IH) on myocardial oxidative stress injury and its possible mechanism by establishing IH rat model, and to further understand the intervention effect of edaravone, provide new ideas for the research and prevention of obstructive sleep apnea-hypopnea syndrome and related cardiovascular complications. Methods Eighty healthy male Wistar rats were randomly divided into normal control (NC) group, IH group, IH+ edaravone group, and IH+ normal saline (NS) group, 20 rats in each group.The IH rat model was established by using a gas control device to fill the closed simulation chamber with nitrogen, oxygen and compressed air.After four weeks of modeling, the serum levels of lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase-MB (CK-MB) and malondialdehyde (MDA), superoxide dismutase (SOD) and hydroxyl radicals were measured.The mitochondrial adenosine triphosphate (ATP) level in cardiomyocytes was measured.Myocardial morphology and ultrastructure were observed by light microscopy and transmission electron microscopy.Transcription-polymerase chain reaction technique was used to detect the expressions of Bcl-2, Bax and Caspase-3 mRNA in myocardial tissue. Results (1)Compared with the NC group, the levels of LDH, CK, CK-MB, MDA and hydroxyl radicals, the expressions of Bax and Caspase-3 mRNA were significantly increased, while the SOD activity, ATP content, and the expression of Bcl-2 mRNA were significantly decreased in the IH group and the IH+ NS group (all P<0.05). (2)Under light microscope and transmission electron microscope, no obvious damage was found in myocardial tissue of NC group, but the morphology and ultrastructure of myocardial tissue in IH group and IH+ NS group were damaged.(3)After intervention with edaravone, serum LDH, CK, CK-MB and myocardial tissue MDA, hydroxyl radicals, Bax and Caspase-3 mRNA expressions decreased, SOD activity and ATP content increased, Bcl-2 mRNA expression level was elevated (all P<0.05), and the degree of myocardial tissue damage under light and electron microscopy was alleviated.(4)Caspase-3 mRNA expression in cardiomyocytes was positively related with CK (r=0.575), CK-MB (r=0.460), MDA (r=0.643), hydroxyl radical (r=0.454), and Bax mRNA (r=0.741), negatively related with ATP (r=-0.525) and Bcl-2 mRNA (r=-0.578). Conclusions (1)IH can induce myocardial oxidative stress damage in rats by increasing oxidants, reducing antioxidants and activating Bcl-2, Bax and Caspase-3.(2)The myocardial oxidation stress injury induced by IH may be achieved by mitochondria-mediated apoptosis.(3)Edaravone has an intervention effect on myocardial injury induced by IH. Key words: Intermittent hypoxia; Oxidative stress; Myocardial injury; Adenosine triphosphate; Edaravone; Apoptosis
{"title":"Changes of myocardial oxidative stress injury and intervention of edaravone in intermittent hypoxic rat model","authors":"Y. Duan, Jizu Ling, Xinhui Yuan, Lifang Li, Qin Yu","doi":"10.3760/CMA.J.CN131368-20190312-00334","DOIUrl":"https://doi.org/10.3760/CMA.J.CN131368-20190312-00334","url":null,"abstract":"Objective \u0000To investigate the effect of intermittent hypoxia (IH) on myocardial oxidative stress injury and its possible mechanism by establishing IH rat model, and to further understand the intervention effect of edaravone, provide new ideas for the research and prevention of obstructive sleep apnea-hypopnea syndrome and related cardiovascular complications. \u0000 \u0000 \u0000Methods \u0000Eighty healthy male Wistar rats were randomly divided into normal control (NC) group, IH group, IH+ edaravone group, and IH+ normal saline (NS) group, 20 rats in each group.The IH rat model was established by using a gas control device to fill the closed simulation chamber with nitrogen, oxygen and compressed air.After four weeks of modeling, the serum levels of lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase-MB (CK-MB) and malondialdehyde (MDA), superoxide dismutase (SOD) and hydroxyl radicals were measured.The mitochondrial adenosine triphosphate (ATP) level in cardiomyocytes was measured.Myocardial morphology and ultrastructure were observed by light microscopy and transmission electron microscopy.Transcription-polymerase chain reaction technique was used to detect the expressions of Bcl-2, Bax and Caspase-3 mRNA in myocardial tissue. \u0000 \u0000 \u0000Results \u0000(1)Compared with the NC group, the levels of LDH, CK, CK-MB, MDA and hydroxyl radicals, the expressions of Bax and Caspase-3 mRNA were significantly increased, while the SOD activity, ATP content, and the expression of Bcl-2 mRNA were significantly decreased in the IH group and the IH+ NS group (all P<0.05). (2)Under light microscope and transmission electron microscope, no obvious damage was found in myocardial tissue of NC group, but the morphology and ultrastructure of myocardial tissue in IH group and IH+ NS group were damaged.(3)After intervention with edaravone, serum LDH, CK, CK-MB and myocardial tissue MDA, hydroxyl radicals, Bax and Caspase-3 mRNA expressions decreased, SOD activity and ATP content increased, Bcl-2 mRNA expression level was elevated (all P<0.05), and the degree of myocardial tissue damage under light and electron microscopy was alleviated.(4)Caspase-3 mRNA expression in cardiomyocytes was positively related with CK (r=0.575), CK-MB (r=0.460), MDA (r=0.643), hydroxyl radical (r=0.454), and Bax mRNA (r=0.741), negatively related with ATP (r=-0.525) and Bcl-2 mRNA (r=-0.578). \u0000 \u0000 \u0000Conclusions \u0000(1)IH can induce myocardial oxidative stress damage in rats by increasing oxidants, reducing antioxidants and activating Bcl-2, Bax and Caspase-3.(2)The myocardial oxidation stress injury induced by IH may be achieved by mitochondria-mediated apoptosis.(3)Edaravone has an intervention effect on myocardial injury induced by IH. \u0000 \u0000 \u0000Key words: \u0000Intermittent hypoxia; Oxidative stress; Myocardial injury; Adenosine triphosphate; Edaravone; Apoptosis","PeriodicalId":10004,"journal":{"name":"Chinese Journal of Asthma","volume":"8 1","pages":"442-449"},"PeriodicalIF":0.0,"publicationDate":"2020-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75129769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-20DOI: 10.3760/CMA.J.CN131368-20190327-00438
Zuogang Wang, Zi-Long Zhao, Y. Huang, Liang Yu, Qinhua Zhao, S. Gong, P. Yuan, Jinming Liu
Objective To evaluate the sex differences of cardiopulmonary exercise testing (CPET) parameters in cardiac output (CO) prediction for patients with chronic thromboembolic pulmonary hypertension (CTEPH). Methods From May 2010 to February 2016, 73 cases (32 males and 41 females) with CTEPH were enrolled from Shanghai Pulmonary Hospital, all of whom underwent both right-heart catheterization and CPET.Multivariate regression analysis was applied to assess the prognostic value of CPET parameters. Results Sex differences were of no significance in both demographic and hemodynamic parameters in total patients, but younger in female patients.Male patients had higher O2 pulse at anaerobic threshold (AT), peak minute ventilation (VE), end-tidal partial pressure of oxygen output (PETO2) at AT, peak O2 pulse, VE at AT and nadir VE/carbon dioxide (VCO2), but lower oxygen uptake efficiency slope compared with female patients (all P<0.05). There was no significant difference in CPET parameters between male event group and male event-free group, but peak oxygen uptake(VO2)in female event group was lower than that in female event-free group (P<0.05). Female event group had lower peak VO2, VE at AT and peak VE compared to the male event group (all P<0.05). Nadir VE/VCO2 and peak PETO2 were independent predictors of CO for male and female CTEPH patients, respectively. Conclusions The independent predictors of CPET parameters are different in the assessment of CO in male and female CTEPH patients, which suggests that sex differences of CPET should be considered to be the better clinical assessment of CTEPH patients. Key words: Chronic thromboembolic pulmonary hypertension; Cardiopulmonary exercise testing; Sex characteristic; Cardiac output
目的探讨慢性血栓栓塞性肺动脉高压(CTEPH)患者心输出量(CO)预测中心肺运动试验(CPET)参数的性别差异。方法选取2010年5月至2016年2月上海肺科医院收治的73例CTEPH患者(男32例,女41例),均行右心导管置管和CPET。采用多因素回归分析评价CPET参数的预后价值。结果患者总体人口学和血流动力学参数性别差异无统计学意义,但女性患者年龄差异明显。男性患者无氧阈值(at) O2脉搏、分钟通气量(VE)峰值、潮汐末氧输出分压(PETO2)、at O2脉搏峰值、VE和最低点VE/ co2 (VCO2)均高于女性患者,但吸氧效率斜率低于女性患者(均P<0.05)。男性事件组与无事件组CPET参数差异无统计学意义,但女性事件组的峰值摄氧量(VO2)低于无事件组(P<0.05)。女性事件组的VO2峰值、at时VE和VE峰值均低于男性事件组(均P<0.05)。Nadir VE/VCO2和峰值PETO2分别是男性和女性CTEPH患者CO的独立预测因子。结论CPET参数的独立预测因子在评价男女CTEPH患者CO时存在差异,提示CPET的性别差异可作为CTEPH患者较好的临床评价指标。关键词:慢性血栓栓塞性肺动脉高压;心肺运动试验;性特征;心输出量
{"title":"Sex differences of cardiopulmonary exercise testing parameters in cardiac output prediction for patients with chronic thromboembolic pulmonary hypertension","authors":"Zuogang Wang, Zi-Long Zhao, Y. Huang, Liang Yu, Qinhua Zhao, S. Gong, P. Yuan, Jinming Liu","doi":"10.3760/CMA.J.CN131368-20190327-00438","DOIUrl":"https://doi.org/10.3760/CMA.J.CN131368-20190327-00438","url":null,"abstract":"Objective \u0000To evaluate the sex differences of cardiopulmonary exercise testing (CPET) parameters in cardiac output (CO) prediction for patients with chronic thromboembolic pulmonary hypertension (CTEPH). \u0000 \u0000 \u0000Methods \u0000From May 2010 to February 2016, 73 cases (32 males and 41 females) with CTEPH were enrolled from Shanghai Pulmonary Hospital, all of whom underwent both right-heart catheterization and CPET.Multivariate regression analysis was applied to assess the prognostic value of CPET parameters. \u0000 \u0000 \u0000Results \u0000Sex differences were of no significance in both demographic and hemodynamic parameters in total patients, but younger in female patients.Male patients had higher O2 pulse at anaerobic threshold (AT), peak minute ventilation (VE), end-tidal partial pressure of oxygen output (PETO2) at AT, peak O2 pulse, VE at AT and nadir VE/carbon dioxide (VCO2), but lower oxygen uptake efficiency slope compared with female patients (all P<0.05). There was no significant difference in CPET parameters between male event group and male event-free group, but peak oxygen uptake(VO2)in female event group was lower than that in female event-free group (P<0.05). Female event group had lower peak VO2, VE at AT and peak VE compared to the male event group (all P<0.05). Nadir VE/VCO2 and peak PETO2 were independent predictors of CO for male and female CTEPH patients, respectively. \u0000 \u0000 \u0000Conclusions \u0000The independent predictors of CPET parameters are different in the assessment of CO in male and female CTEPH patients, which suggests that sex differences of CPET should be considered to be the better clinical assessment of CTEPH patients. \u0000 \u0000 \u0000Key words: \u0000Chronic thromboembolic pulmonary hypertension; Cardiopulmonary exercise testing; Sex characteristic; Cardiac output","PeriodicalId":10004,"journal":{"name":"Chinese Journal of Asthma","volume":"10 1","pages":"411-416"},"PeriodicalIF":0.0,"publicationDate":"2020-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89251621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-20DOI: 10.3760/CMA.J.CN131368-20191011-01395
Yue Zhao, Yuan-yuan Liu, Zhaozhong Cheng
With the increasement of the morbidity and mortality of venous thromboembolism (VTE), and the increasement of social burden, medical staff pay more attention to VTE and improve their awareness of it.As a preventable disease, the prevention of VTE is especially important.VTE prevention mainly includes drug prevention and mechanical prevention.However, drug prevention may cause the risk of bleeding, which limits the application of drug prevention.Mechanical prevention has extensive applications due to non-invasiveness, high patient compliance, fewer complications, simpleness and convenience, and excellent effectiveness.This article mainly summarizes the methods, advantages and disadvantages of mechanical prevention. Key words: Venous thromboembolism; Mechanical prophylaxis; Epidemiology
{"title":"Research progress on mechanical prevention of venous thromboembolism","authors":"Yue Zhao, Yuan-yuan Liu, Zhaozhong Cheng","doi":"10.3760/CMA.J.CN131368-20191011-01395","DOIUrl":"https://doi.org/10.3760/CMA.J.CN131368-20191011-01395","url":null,"abstract":"With the increasement of the morbidity and mortality of venous thromboembolism (VTE), and the increasement of social burden, medical staff pay more attention to VTE and improve their awareness of it.As a preventable disease, the prevention of VTE is especially important.VTE prevention mainly includes drug prevention and mechanical prevention.However, drug prevention may cause the risk of bleeding, which limits the application of drug prevention.Mechanical prevention has extensive applications due to non-invasiveness, high patient compliance, fewer complications, simpleness and convenience, and excellent effectiveness.This article mainly summarizes the methods, advantages and disadvantages of mechanical prevention. \u0000 \u0000Key words: \u0000Venous thromboembolism; Mechanical prophylaxis; Epidemiology","PeriodicalId":10004,"journal":{"name":"Chinese Journal of Asthma","volume":"10 1","pages":"455-459"},"PeriodicalIF":0.0,"publicationDate":"2020-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80108589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-20DOI: 10.3760/CMA.J.CN131368-20190906-01252
Ying Xu, Rui-Xiang Chen, Jun Jin
Objective To observe the effect of probiotics on prevention of ventilator-associated pneumonia (VAP) and intestinal function in critically ill patients. Methods In this prospective, randomized, controlled study, 155 patients who met the conditions for enrollment were randomly divided into control group and test group.The same treatment was given to all patients, in addition, the patients in test group were given probiotics (Bifidobacterium, Lactobacillus mixture) for three weeks.The incidence of VAP, changes in gut microbiota and incidence of gastrointestinal symptoms were compared between the two groups. Results 120 patients finished the study, including 58 cases in the control group and 62 cases in the test group.The incidence of VAP in the test group was lower than that in the control group (38.7% vs 62.1%, χ2=6.541, P<0.05). The total detection rate of microbial colonization in the oropharynx and stomach of the test group was significantly lower than that of the control group (51.6% vs 89.7%, χ2=20.052, P<0.05). The incidences of increased intra-abdominal pressure, diarrhea, and weakened or disappeared bowel sounds were significantly reduced in the test group (χ2=8.439, 10.849, 13.327, all P<0.05). The proportion of lactobacillus in the intestinal tract of the test group was significantly increased.The time of mechanical ventilation and length of stay in intensive care unit in the test group were also significantly shortened compared with the control group (t=8.051, 6.538, all P<0.05). Conclusions Probiotics preparation can significantly increase the proportion of lactobacillus in the intestinal tract, reduce the incidence of VAP in critically ill patients, reduce the incidence of gastrointestinal symptoms, reduce the time of mechanical ventilation and the length of stay in intensive care unit, then have the value of clinical promotion. Key words: Probiotics; Pneumonia, ventilator-associated; Gut microbiota; Lactobacillus
目的观察益生菌对危重患者呼吸机相关性肺炎(VAP)及肠道功能的预防作用。方法采用前瞻性、随机、对照研究,将155例符合入组条件的患者随机分为对照组和试验组。所有患者均给予相同治疗,试验组患者给予益生菌(双歧杆菌、乳酸菌混合物)治疗3周。比较两组患者VAP发生率、肠道菌群变化及胃肠道症状发生率。结果120例患者完成研究,其中对照组58例,试验组62例。试验组VAP发生率低于对照组(38.7% vs 62.1%, χ2=6.541, P<0.05)。试验组口咽、胃微生物定植总检出率显著低于对照组(51.6% vs 89.7%, χ2=20.052, P<0.05)。试验组患者腹内压升高、腹泻、肠音减弱或消失的发生率均显著降低(χ2=8.439、10.849、13.327,均P<0.05)。试验组肠道乳酸菌比例显著升高。试验组机械通气时间、重症监护病房住院时间均显著缩短(t=8.051、6.538,P均<0.05)。结论益生菌制剂可显著提高肠道乳酸菌比例,降低危重症患者VAP发生率,降低胃肠道症状发生率,减少机械通气时间和重症监护病房住院时间,具有临床推广价值。关键词:益生菌;与机械通气相关;肺炎,肠道微生物群;乳酸菌
{"title":"Effect of probiotics on prevention of ventilator-associated pneumonia and intestinal function in critically ill patients","authors":"Ying Xu, Rui-Xiang Chen, Jun Jin","doi":"10.3760/CMA.J.CN131368-20190906-01252","DOIUrl":"https://doi.org/10.3760/CMA.J.CN131368-20190906-01252","url":null,"abstract":"Objective \u0000To observe the effect of probiotics on prevention of ventilator-associated pneumonia (VAP) and intestinal function in critically ill patients. \u0000 \u0000 \u0000Methods \u0000In this prospective, randomized, controlled study, 155 patients who met the conditions for enrollment were randomly divided into control group and test group.The same treatment was given to all patients, in addition, the patients in test group were given probiotics (Bifidobacterium, Lactobacillus mixture) for three weeks.The incidence of VAP, changes in gut microbiota and incidence of gastrointestinal symptoms were compared between the two groups. \u0000 \u0000 \u0000Results \u0000120 patients finished the study, including 58 cases in the control group and 62 cases in the test group.The incidence of VAP in the test group was lower than that in the control group (38.7% vs 62.1%, χ2=6.541, P<0.05). The total detection rate of microbial colonization in the oropharynx and stomach of the test group was significantly lower than that of the control group (51.6% vs 89.7%, χ2=20.052, P<0.05). The incidences of increased intra-abdominal pressure, diarrhea, and weakened or disappeared bowel sounds were significantly reduced in the test group (χ2=8.439, 10.849, 13.327, all P<0.05). The proportion of lactobacillus in the intestinal tract of the test group was significantly increased.The time of mechanical ventilation and length of stay in intensive care unit in the test group were also significantly shortened compared with the control group (t=8.051, 6.538, all P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Probiotics preparation can significantly increase the proportion of lactobacillus in the intestinal tract, reduce the incidence of VAP in critically ill patients, reduce the incidence of gastrointestinal symptoms, reduce the time of mechanical ventilation and the length of stay in intensive care unit, then have the value of clinical promotion. \u0000 \u0000 \u0000Key words: \u0000Probiotics; Pneumonia, ventilator-associated; Gut microbiota; Lactobacillus","PeriodicalId":10004,"journal":{"name":"Chinese Journal of Asthma","volume":"1 1","pages":"437-441"},"PeriodicalIF":0.0,"publicationDate":"2020-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89890959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-20DOI: 10.3760/CMA.J.CN131368-20191018-01433
Xiao-yu Li, Jian-ping Bo
In recent years, the morbidity and mortality of community-acquired pneumonia have increased gradually, with more severe cases.However, in clinical diagnosis and treatment, there are some phenomena such as unclear etiology diagnosis, insufficient understanding of the significance of serological detection, inaccurate severity evaluation and unreasonable use of antibiotics.This paper refers to a large number of the latest literatures on community-acquired pneumonia published at home and abroad in recent years, and reviews in serology, etiology, rational use of antibiotics, whether glucocorticoids should be used, adjuvant therapy and the latest advances of diagnosis and treatment. Key words: Community-acquired pneumonia; Severity score; Treatment; New progress
{"title":"New progress in diagnosis and treatment of community-acquired pneumonia","authors":"Xiao-yu Li, Jian-ping Bo","doi":"10.3760/CMA.J.CN131368-20191018-01433","DOIUrl":"https://doi.org/10.3760/CMA.J.CN131368-20191018-01433","url":null,"abstract":"In recent years, the morbidity and mortality of community-acquired pneumonia have increased gradually, with more severe cases.However, in clinical diagnosis and treatment, there are some phenomena such as unclear etiology diagnosis, insufficient understanding of the significance of serological detection, inaccurate severity evaluation and unreasonable use of antibiotics.This paper refers to a large number of the latest literatures on community-acquired pneumonia published at home and abroad in recent years, and reviews in serology, etiology, rational use of antibiotics, whether glucocorticoids should be used, adjuvant therapy and the latest advances of diagnosis and treatment. \u0000 \u0000Key words: \u0000Community-acquired pneumonia; Severity score; Treatment; New progress","PeriodicalId":10004,"journal":{"name":"Chinese Journal of Asthma","volume":"96 1","pages":"470-476"},"PeriodicalIF":0.0,"publicationDate":"2020-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77621504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-20DOI: 10.3760/CMA.J.CN131368-20171204-01476
Heng Liu, Jing Wang, Yuhong Pi, Sun Zhang, S. Qing, Chunli Liu, Nuofu Zhang
Objective To retrospectively test the validity of modified Padua risk assessment model in identifying high venous thromboembolism (VTE) risk among hospitalized medical patients. Methods A retrospective case-control study was performed among hospitalized medical patients admitted into the First Affiliated Hospital of Guangzhou Medical University from January 2013 to December 2016.A total of 432 patients with definite VTE during hospitalization were recruited and a tota1 of 864 controls were randomly selected from the patients without VTE admitted into the same department within the same period.The medical history, laboratory examination results and other clinical data of two groups was retrospectively collected.The risks of both groups were retrospectively assessed with the Padua risk assessment model and modified Padua risk assessment model and the two risk assessment models were compared. Results The score of the two risk assessment models in VTE group was significant higher than that in control group (Padua: 2.92±0.18 vs 1.25±0.10, t=16.241, P<0.05; modified Padua: 3.27±0.19 vs 1.64±0.11, t=14.245, P<0.05). With the increase in risk score, the occurrence of VTE increased accordingly.By Padua risk assessment model and modified Padua risk assessment model, the risk of VTE of high-risk patients was 12.27 times (95% CI: 9.00-17.98, P<0.05) and 8.17 times (95% CI: 6.00-11.12, P<0.05) as high as that of low-risk patients.The proportion of high-risk patients judged by modified Padua risk assessment model was significant higher than that by Padua risk assessment model (48.61% vs 39.12%, P<0.05). Conclusions Modified Padua risk assessment model can effectively and quantitatively assess the risk of VTE among medical patients based on their individual VTE risk factors. Key words: Modified Padua risk assessment model; Medical patients; Venous thromboembolism; Case-control study
目的回顾性检验改良的Padua风险评估模型在识别住院患者高静脉血栓栓塞(VTE)风险中的有效性。方法对2013年1月至2016年12月广州医科大学第一附属医院住院患者进行回顾性病例对照研究。共招募住院期间确诊静脉血栓栓塞患者432例,从同期同一科室就诊的无静脉血栓栓塞患者中随机抽取对照864例。回顾性收集两组患者的病史、实验室检查结果等临床资料。采用Padua风险评估模型和改进的Padua风险评估模型对两组患者进行回顾性风险评估,并对两种风险评估模型进行比较。结果VTE组两种风险评估模型评分均显著高于对照组(Padua: 2.92±0.18 vs 1.25±0.10,t=16.241, P<0.05;改良Padua: 3.27±0.19 vs 1.64±0.11,t=14.245, P<0.05)。随着风险评分的增加,静脉血栓栓塞的发生率也相应增加。通过Padua风险评估模型和改进的Padua风险评估模型,高危患者的VTE风险分别是低危患者的12.27倍(95% CI: 9.00 ~ 17.98, P<0.05)和8.17倍(95% CI: 6.00 ~ 11.12, P<0.05)。改良Padua风险评估模型判定的高危患者比例显著高于Padua风险评估模型(48.61% vs 39.12%, P<0.05)。结论改进的Padua风险评估模型可以根据患者的个体化静脉血栓栓塞危险因素,有效定量地评估患者静脉血栓栓塞的风险。关键词:修正帕多瓦风险评估模型;医疗的病人;静脉血栓栓塞;病例对照研究
{"title":"Validity of modified Padua risk assessment model in identifying high venous thromboembolism risk among hospitalized medical patients","authors":"Heng Liu, Jing Wang, Yuhong Pi, Sun Zhang, S. Qing, Chunli Liu, Nuofu Zhang","doi":"10.3760/CMA.J.CN131368-20171204-01476","DOIUrl":"https://doi.org/10.3760/CMA.J.CN131368-20171204-01476","url":null,"abstract":"Objective \u0000To retrospectively test the validity of modified Padua risk assessment model in identifying high venous thromboembolism (VTE) risk among hospitalized medical patients. \u0000 \u0000 \u0000Methods \u0000A retrospective case-control study was performed among hospitalized medical patients admitted into the First Affiliated Hospital of Guangzhou Medical University from January 2013 to December 2016.A total of 432 patients with definite VTE during hospitalization were recruited and a tota1 of 864 controls were randomly selected from the patients without VTE admitted into the same department within the same period.The medical history, laboratory examination results and other clinical data of two groups was retrospectively collected.The risks of both groups were retrospectively assessed with the Padua risk assessment model and modified Padua risk assessment model and the two risk assessment models were compared. \u0000 \u0000 \u0000Results \u0000The score of the two risk assessment models in VTE group was significant higher than that in control group (Padua: 2.92±0.18 vs 1.25±0.10, t=16.241, P<0.05; modified Padua: 3.27±0.19 vs 1.64±0.11, t=14.245, P<0.05). With the increase in risk score, the occurrence of VTE increased accordingly.By Padua risk assessment model and modified Padua risk assessment model, the risk of VTE of high-risk patients was 12.27 times (95% CI: 9.00-17.98, P<0.05) and 8.17 times (95% CI: 6.00-11.12, P<0.05) as high as that of low-risk patients.The proportion of high-risk patients judged by modified Padua risk assessment model was significant higher than that by Padua risk assessment model (48.61% vs 39.12%, P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Modified Padua risk assessment model can effectively and quantitatively assess the risk of VTE among medical patients based on their individual VTE risk factors. \u0000 \u0000 \u0000Key words: \u0000Modified Padua risk assessment model; Medical patients; Venous thromboembolism; Case-control study","PeriodicalId":10004,"journal":{"name":"Chinese Journal of Asthma","volume":"40 1","pages":"401-406"},"PeriodicalIF":0.0,"publicationDate":"2020-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90895943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-20DOI: 10.3760/CMA.J.CN131368-20190811-01139
Hongli Yue, Juan Wang, Y. Pei, Chen-yang Zhang, Min Xu
Objective To discuss the anaesthetic management of Montgomery T-tube insertion for subglottic stenosis. Methods The data including characteristics, clinical features, anaesthetic methods, operation procedures and postoperative recovery of 20 patients with subglottic stenosis underwent Montgomery T-tube insertion were reviewed and analyzed. Results The causes of stenosis were tracheal intubation (12 cases), tracheal trauma (four cases), internal and external tracheal tumors (three cases). On the degree of stenosis, there was one case of Myer-Cotton grade Ⅰ, three cases of grade Ⅱ, nine cases of grade Ⅲ, seven cases of grade Ⅳ.Bronchoscopic examination showed tracheal collapse in nine cases.All patients were tracheotomized before operation and used a rigid bronchoscope as working channel during operation.All patients were anaesthetized with total intravenous anaesthesia.The anaesthesia of all patients was stable, and ventilation modes were alternated smoothly.Postoperative complications such as cough (80%), sore throat (45%), fever (45%), difficulty in sputum evacuation (40%), difficulty breathing (25%), infection (10%), airway obstruction (5%), aspiration (5%) were cured after active treatment. Conclusions During montgomery T-tube insertion for subglottic stenosis, total intravenous anaesthesia can ensure depth of anaesthesia and stability of circulatory parameters.Controlled ventilation or high frequency ventilation by tracheotomy tube, T-tube, and laryngeal mask on demand can ensure oxygen supply.Communication closely during perioperation and active treatment of postoperative complications are beneficial for the safety and the recovery of patients. Key words: Acquired subglottic stenosis; Tracheal T-tube; Anesthesia
{"title":"Anaesthetic management of montgomery T-tube insertion for subglottic stenosis","authors":"Hongli Yue, Juan Wang, Y. Pei, Chen-yang Zhang, Min Xu","doi":"10.3760/CMA.J.CN131368-20190811-01139","DOIUrl":"https://doi.org/10.3760/CMA.J.CN131368-20190811-01139","url":null,"abstract":"Objective \u0000To discuss the anaesthetic management of Montgomery T-tube insertion for subglottic stenosis. \u0000 \u0000 \u0000Methods \u0000The data including characteristics, clinical features, anaesthetic methods, operation procedures and postoperative recovery of 20 patients with subglottic stenosis underwent Montgomery T-tube insertion were reviewed and analyzed. \u0000 \u0000 \u0000Results \u0000The causes of stenosis were tracheal intubation (12 cases), tracheal trauma (four cases), internal and external tracheal tumors (three cases). On the degree of stenosis, there was one case of Myer-Cotton grade Ⅰ, three cases of grade Ⅱ, nine cases of grade Ⅲ, seven cases of grade Ⅳ.Bronchoscopic examination showed tracheal collapse in nine cases.All patients were tracheotomized before operation and used a rigid bronchoscope as working channel during operation.All patients were anaesthetized with total intravenous anaesthesia.The anaesthesia of all patients was stable, and ventilation modes were alternated smoothly.Postoperative complications such as cough (80%), sore throat (45%), fever (45%), difficulty in sputum evacuation (40%), difficulty breathing (25%), infection (10%), airway obstruction (5%), aspiration (5%) were cured after active treatment. \u0000 \u0000 \u0000Conclusions \u0000During montgomery T-tube insertion for subglottic stenosis, total intravenous anaesthesia can ensure depth of anaesthesia and stability of circulatory parameters.Controlled ventilation or high frequency ventilation by tracheotomy tube, T-tube, and laryngeal mask on demand can ensure oxygen supply.Communication closely during perioperation and active treatment of postoperative complications are beneficial for the safety and the recovery of patients. \u0000 \u0000 \u0000Key words: \u0000Acquired subglottic stenosis; Tracheal T-tube; Anesthesia","PeriodicalId":10004,"journal":{"name":"Chinese Journal of Asthma","volume":"31 1","pages":"450-454"},"PeriodicalIF":0.0,"publicationDate":"2020-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75135832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To analyze the clinical characteristics of 68 non-human immunodeficiency virus immunosuppressed patients with cytomegalovirus pneumonia, and the risk factors related to death, so as to provide reference for clinical diagnosis and treatment. Methods A retrospective case analysis study was used.The clinical data of 68 patients with cytomegalovirus pneumonia admitted to the Second Department of Respiratory Medicine of the Second Hospital of Hebei Medical University were collected.According to the patient′s 28d outcome, the patients were divided into the survival group and the death group.The general conditions and clinical data of the two groups were compared, and risk factors were analyzed. Results The top three underlying diseases were kidney disease, rheumatic disease, and blood system disease.In the death group, the acute physiology and chronic health evaluation Ⅱ scores, hypersensitive C-reactive protein, the smallest absolute counts of white blood cells, neutrophil percentage were higher than those in the survival group (all P<0.05), and the absolute counts of lymphocyte, CD3+ lymphocyte, CD4+ lymphocyte were lower (all P<0.05). Long-term (more than three months) application of glucocorticoids or combination with immunosuppressive agents were significantly more in the death group (all P<0.05). The immunosuppressed patients who suffered from dermatological disease, had gram-positive coccal pneumonia or bloodstream infections, needed mechanical ventilation had a poor prognosis (all P<0.05). Conclusions Cytomegalovirus pneumonia patients who received long-term (more than three months) application of glucocorticoids or combination with immunosuppressive agents, had gram-positive coccal pneumonia or bloodstream infections, and needed mechanical ventilation have a poor prognosis. Key words: Cytomegalovirus pneumonia; Respiratory insufficiency; T lymphocyte subsets; Prognosis
{"title":"Analysis of clinical features and related risks of prognosis in 68 non-human immunodeficiency virus immunosuppressed patients with cytomegalovirus pneumonia","authors":"Wensen Pan, Ranran Xiao, Xin Liu, X. Gong, J. Zhao, Jing Yu","doi":"10.3760/CMA.J.CN131368-20190923-01323","DOIUrl":"https://doi.org/10.3760/CMA.J.CN131368-20190923-01323","url":null,"abstract":"Objective \u0000To analyze the clinical characteristics of 68 non-human immunodeficiency virus immunosuppressed patients with cytomegalovirus pneumonia, and the risk factors related to death, so as to provide reference for clinical diagnosis and treatment. \u0000 \u0000 \u0000Methods \u0000A retrospective case analysis study was used.The clinical data of 68 patients with cytomegalovirus pneumonia admitted to the Second Department of Respiratory Medicine of the Second Hospital of Hebei Medical University were collected.According to the patient′s 28d outcome, the patients were divided into the survival group and the death group.The general conditions and clinical data of the two groups were compared, and risk factors were analyzed. \u0000 \u0000 \u0000Results \u0000The top three underlying diseases were kidney disease, rheumatic disease, and blood system disease.In the death group, the acute physiology and chronic health evaluation Ⅱ scores, hypersensitive C-reactive protein, the smallest absolute counts of white blood cells, neutrophil percentage were higher than those in the survival group (all P<0.05), and the absolute counts of lymphocyte, CD3+ lymphocyte, CD4+ lymphocyte were lower (all P<0.05). Long-term (more than three months) application of glucocorticoids or combination with immunosuppressive agents were significantly more in the death group (all P<0.05). The immunosuppressed patients who suffered from dermatological disease, had gram-positive coccal pneumonia or bloodstream infections, needed mechanical ventilation had a poor prognosis (all P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Cytomegalovirus pneumonia patients who received long-term (more than three months) application of glucocorticoids or combination with immunosuppressive agents, had gram-positive coccal pneumonia or bloodstream infections, and needed mechanical ventilation have a poor prognosis. \u0000 \u0000 \u0000Key words: \u0000Cytomegalovirus pneumonia; Respiratory insufficiency; T lymphocyte subsets; Prognosis","PeriodicalId":10004,"journal":{"name":"Chinese Journal of Asthma","volume":"246 1","pages":"430-436"},"PeriodicalIF":0.0,"publicationDate":"2020-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88630373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To observe the pathological changes of the digestive tract of rats with chronic obstructive pulmonary disease (COPD), as well as to provide a theoretical basis for exploring the mechanism of COPD dystrophy. Methods The COPD rat model was established by cigarette smoke (CS) exposure.Lung functions were measured using Buxco lung function measurement system.Arterial blood gas parameters were examined with GEM3000 blood gas analyzer.The inflammatory cells were counted and the level of interlukin-6 (IL-6), monocyte chemo-attractant protein-1 (MCP-1) and IL-10 in bronchoalveolar lavage fluid (BALF) were assayed with enzyme-linked immunosorbent assay.Pathological changes of lung tissue, liver, spleen, stomach, small intestine were observed. Results At the end of modeling, the weight of the model group rats were significantly lower than those of the control group.Compared with control rats, the CS exposed rats presented typical COPD-like lung function decline indicated by increases in functional residual volume (FRC), total lung capacity (TLC), Chord compliance (Cchord), as well as a decrease in the FEV50/FVC ratio.Damaged alveolar walls and pulmonary bullae were observed in rats′ lungs exposed to CS.In alveolar lavage fluid, the total number of inflammatory cells and the categorical counts (neutrophils, macrophages, and lymphocytes) were higher than those of the control group, as well as the levels of IL-6 and MCP-1 as proinflammatory mediators.The anti-inflammatory cytokine IL-10 was lower than that of the control group.Moreover, the histological staining showed that a little congestion in the central hepatic lobule with inflammatory cell infiltration and mild hepatic edema, a small amount of congestion in the spleen, mild erosion in the stomach, small intestine mucosal atrophy with a small amount of inflammatory cell infiltration. Conclusions In COPD, gastrointestinal pathological changes including hyperemia, edema, congestion, erosion, and inflammatory cell infiltration are observed in the digestive tract tissues including liver, spleen, gastric mucosa, and small intestinal mucosa. Key words: Pulmonary disease, chronic obstructive; Inflammation; Pathological changes in the digestive tract
{"title":"Pathological characteristics of digestive tract in rats with chronic obstructive pulmonary disease induced by tobacco smoke","authors":"Difei Li, Defu Li, Zeguang Zheng, Wenju Lu, Jieying Hu, Rongchang Chen","doi":"10.3760/CMA.J.ISSN.1673-436X.2020.05.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-436X.2020.05.001","url":null,"abstract":"Objective \u0000To observe the pathological changes of the digestive tract of rats with chronic obstructive pulmonary disease (COPD), as well as to provide a theoretical basis for exploring the mechanism of COPD dystrophy. \u0000 \u0000 \u0000Methods \u0000The COPD rat model was established by cigarette smoke (CS) exposure.Lung functions were measured using Buxco lung function measurement system.Arterial blood gas parameters were examined with GEM3000 blood gas analyzer.The inflammatory cells were counted and the level of interlukin-6 (IL-6), monocyte chemo-attractant protein-1 (MCP-1) and IL-10 in bronchoalveolar lavage fluid (BALF) were assayed with enzyme-linked immunosorbent assay.Pathological changes of lung tissue, liver, spleen, stomach, small intestine were observed. \u0000 \u0000 \u0000Results \u0000At the end of modeling, the weight of the model group rats were significantly lower than those of the control group.Compared with control rats, the CS exposed rats presented typical COPD-like lung function decline indicated by increases in functional residual volume (FRC), total lung capacity (TLC), Chord compliance (Cchord), as well as a decrease in the FEV50/FVC ratio.Damaged alveolar walls and pulmonary bullae were observed in rats′ lungs exposed to CS.In alveolar lavage fluid, the total number of inflammatory cells and the categorical counts (neutrophils, macrophages, and lymphocytes) were higher than those of the control group, as well as the levels of IL-6 and MCP-1 as proinflammatory mediators.The anti-inflammatory cytokine IL-10 was lower than that of the control group.Moreover, the histological staining showed that a little congestion in the central hepatic lobule with inflammatory cell infiltration and mild hepatic edema, a small amount of congestion in the spleen, mild erosion in the stomach, small intestine mucosal atrophy with a small amount of inflammatory cell infiltration. \u0000 \u0000 \u0000Conclusions \u0000In COPD, gastrointestinal pathological changes including hyperemia, edema, congestion, erosion, and inflammatory cell infiltration are observed in the digestive tract tissues including liver, spleen, gastric mucosa, and small intestinal mucosa. \u0000 \u0000 \u0000Key words: \u0000Pulmonary disease, chronic obstructive; Inflammation; Pathological changes in the digestive tract","PeriodicalId":10004,"journal":{"name":"Chinese Journal of Asthma","volume":"387 1","pages":"321-326"},"PeriodicalIF":0.0,"publicationDate":"2020-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74925387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-05DOI: 10.3760/CMA.J.ISSN.1673-436X.2020.05.011
Wang Luo, Y. Qiao, C. Ye, S. Cai, H. Dong
Bronchial asthma (asthma) is a heterogeneous disease characterized by chronic airway inflammation.It is one of the most common chronic diseases in the world which causes huge medical burden.Although the symptoms of most asthma patients can be effectively controlled by inhaled glucocorticoids and bronchodilators, some patients with severe asthma are still unable to achieve ideal control under conventional treatment.Therefore, more and more attention has been paid to targeted drugs at the molecular level.The purpose of this review is to discuss the current research progress in accurate treatment of asthma and to explore the application value of targeted therapy drugs in the treatment of severe asthma. Key words: Asthma; Precise treatment; Targeted therapy
{"title":"Research progress on accurate treatment of bronchial asthma","authors":"Wang Luo, Y. Qiao, C. Ye, S. Cai, H. Dong","doi":"10.3760/CMA.J.ISSN.1673-436X.2020.05.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-436X.2020.05.011","url":null,"abstract":"Bronchial asthma (asthma) is a heterogeneous disease characterized by chronic airway inflammation.It is one of the most common chronic diseases in the world which causes huge medical burden.Although the symptoms of most asthma patients can be effectively controlled by inhaled glucocorticoids and bronchodilators, some patients with severe asthma are still unable to achieve ideal control under conventional treatment.Therefore, more and more attention has been paid to targeted drugs at the molecular level.The purpose of this review is to discuss the current research progress in accurate treatment of asthma and to explore the application value of targeted therapy drugs in the treatment of severe asthma. \u0000 \u0000 \u0000Key words: \u0000Asthma; Precise treatment; Targeted therapy","PeriodicalId":10004,"journal":{"name":"Chinese Journal of Asthma","volume":"44 1","pages":"382-385"},"PeriodicalIF":0.0,"publicationDate":"2020-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86844192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}