Pub Date : 2024-06-28eCollection Date: 2024-01-01DOI: 10.1155/2024/2803044
Erkan Topkan, Ahmet Kucuk, Duriye Ozturk, Emine Elif Ozkan, Ali Ayberk Besen, Berrin Pehlivan, Ugur Selek
Objectives: We explored the prognostic utility of the unique combination of C-reactive-protein-to-albumin ratio (CAR) and significant weight loss (WL > 5%) over the preceding 6 months, namely, the CARWL score, in stage IIIC non-small-cell lung cancer (NSCLC) patients who underwent concurrent chemoradiotherapy (CCRT).
Methods: For each patient, the CAR was calculated using C-reactive protein and albumin measurements obtained on the first day of CCRT: CAR = C-reactive protein ÷ albumin. The availability of an ideal CAR cutoff that may categorize patients into two distinct progression-free (PFS) and overall survival (OS) outcomes was explored by employing receiver operating characteristic (ROC) curve analysis. Patients were additionally divided into two groups based on their status of significant WL according to the well-recognized Delphi criteria. Then, the CARWL score was created by combining all feasible combinations of the CAR and significant WL groupings. The potential links between pretreatment CARWL groups and the post-CCRT OS and PFS outcomes were determined as the primary and secondary endpoints.
Results: This retrospective cohort study comprised a total of 651 stage IIIC NSCLC patients. ROC curve analysis indicated that rounded 3.0 was the ideal CAR cutoff (area under the curve (AUC): 70.1%; sensitivity: 67.8%; specificity: 65.9%), which categorized the patients into CAR < 3.0 (N = 324) and CAR ≥ 3.0 (N = 327) groups. There were 308 (47.3%) and 343 (52.7%) patients without and with significant WL, respectively. The created CARWL groups were CARWL-0: CAR < 3.0 and WL ≤ 5.0%; CARWL-1: CAR < 3.0 and WL > 5.0%, or CAR ≥ 3.0 and WL ≤ 5.0%; and CARWL-2: CAR > 3.0 and WL > 5.0%. The Kaplan-Meier curves showed that the PFS (14.2 vs. 11.4 vs. 7.5 months; P < 0.001) and OS (37.3 vs. 23.6 vs. 12.8 months; P < 0.001) durations were gradually and significantly lowered from the CARWL-0 to CARWL-2 groups. The CARWL score's significant impacts on PFS and OS outcomes were found to be independent of the other variables in the multivariate analysis (P < 0.001, for each).
Conclusions: Our findings indicate that the novel CARWL score, which accounts for pretreatment CAR and significant WL during the preceding 6 months, can reliably stratify newly diagnosed stage IIIC NSCLC patients into three groups with significantly different PFS and OS after definitive CCRT.
研究目的我们探讨了在接受同期化疗（CCRT）的IIIC期非小细胞肺癌（NSCLC）患者中，C反应蛋白与白蛋白比值（CAR）和前6个月体重显著下降（WL > 5%）的独特组合，即CARWL评分的预后效用：方法：每位患者的 CAR 分值均根据 CCRT 第一天获得的 C 反应蛋白和白蛋白测量值计算得出：CAR = C 反应蛋白 ÷ 白蛋白。通过接收器操作特征曲线（ROC）分析，探讨了是否有一个理想的CAR分界线，可将患者分为两种不同的无进展（PFS）和总生存（OS）结果。此外，根据公认的德尔菲（Delphi）标准，根据患者的显著 WL 状态将其分为两组。然后，结合 CAR 和显著 WL 分组的所有可行组合，得出 CARWL 评分。将治疗前CARWL分组与CCRT后OS和PFS结果之间的潜在联系作为主要和次要终点：这项回顾性队列研究共纳入了 651 例 IIIC 期 NSCLC 患者。ROC曲线分析表明，圆形 3.0 是理想的 CAR 临界值（曲线下面积 (AUC)：70.1%；灵敏度：67.0%）：70.1%；灵敏度：67.8%；特异性：65.9%），将患者分为 CAR N = 324 组和 CAR ≥ 3.0 组（N = 327）。无明显 WL 和有明显 WL 的患者分别为 308 人（47.3%）和 343 人（52.7%）。创建的 CARWL 组为 CARWL-0：CAR 5.0%，或 CAR ≥ 3.0 且 WL ≤ 5.0%；CARWL-2：CAR > 3.0 且 WL > 5.0%。Kaplan-Meier曲线显示，从CARWL-0组到CARWL-2组，PFS（14.2个月 vs. 11.4个月 vs. 7.5个月；P < 0.001）和OS（37.3个月 vs. 23.6个月 vs. 12.8个月；P < 0.001）持续时间逐渐显著缩短。在多变量分析中发现，CARWL评分对PFS和OS结果的显著影响与其他变量无关（P<0.001）：我们的研究结果表明，新的CARWL评分考虑了治疗前的CAR和前6个月的显著WL，可以可靠地将新诊断的IIIC期NSCLC患者分为三组，三组患者在接受明确的CCRT治疗后的PFS和OS显著不同。
{"title":"Prognostic Value of Novel CARWL Score in Stage IIIC Non-Small-Cell Lung Cancer Patients Undergoing Concurrent Chemoradiotherapy.","authors":"Erkan Topkan, Ahmet Kucuk, Duriye Ozturk, Emine Elif Ozkan, Ali Ayberk Besen, Berrin Pehlivan, Ugur Selek","doi":"10.1155/2024/2803044","DOIUrl":"10.1155/2024/2803044","url":null,"abstract":"<p><strong>Objectives: </strong>We explored the prognostic utility of the unique combination of C-reactive-protein-to-albumin ratio (CAR) and significant weight loss (WL > 5%) over the preceding 6 months, namely, the CARWL score, in stage IIIC non-small-cell lung cancer (NSCLC) patients who underwent concurrent chemoradiotherapy (CCRT).</p><p><strong>Methods: </strong>For each patient, the CAR was calculated using C-reactive protein and albumin measurements obtained on the first day of CCRT: CAR = C-reactive protein ÷ albumin. The availability of an ideal CAR cutoff that may categorize patients into two distinct progression-free (PFS) and overall survival (OS) outcomes was explored by employing receiver operating characteristic (ROC) curve analysis. Patients were additionally divided into two groups based on their status of significant WL according to the well-recognized Delphi criteria. Then, the CARWL score was created by combining all feasible combinations of the CAR and significant WL groupings. The potential links between pretreatment CARWL groups and the post-CCRT OS and PFS outcomes were determined as the primary and secondary endpoints.</p><p><strong>Results: </strong>This retrospective cohort study comprised a total of 651 stage IIIC NSCLC patients. ROC curve analysis indicated that rounded 3.0 was the ideal CAR cutoff (area under the curve (AUC): 70.1%; sensitivity: 67.8%; specificity: 65.9%), which categorized the patients into CAR < 3.0 (<i>N</i> = 324) and CAR ≥ 3.0 (<i>N</i> = 327) groups. There were 308 (47.3%) and 343 (52.7%) patients without and with significant WL, respectively. The created CARWL groups were CARWL-0: CAR < 3.0 and WL ≤ 5.0%; CARWL-1: CAR < 3.0 and WL > 5.0%, or CAR ≥ 3.0 and WL ≤ 5.0%; and CARWL-2: CAR > 3.0 and WL > 5.0%. The Kaplan-Meier curves showed that the PFS (14.2 vs. 11.4 vs. 7.5 months; <i>P</i> < 0.001) and OS (37.3 vs. 23.6 vs. 12.8 months; <i>P</i> < 0.001) durations were gradually and significantly lowered from the CARWL-0 to CARWL-2 groups. The CARWL score's significant impacts on PFS and OS outcomes were found to be independent of the other variables in the multivariate analysis (<i>P</i> < 0.001, for each).</p><p><strong>Conclusions: </strong>Our findings indicate that the novel CARWL score, which accounts for pretreatment CAR and significant WL during the preceding 6 months, can reliably stratify newly diagnosed stage IIIC NSCLC patients into three groups with significantly different PFS and OS after definitive CCRT.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2024 ","pages":"2803044"},"PeriodicalIF":2.1,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11226337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Context. Ferroptosis is known to influence the pathogenesis of pulmonary fibrosis. Astragalus and Panax notoginseng are used to treat pulmonary fibrosis; however, the therapeutic mechanisms require further elucidation. Objective. To investigate the mechanism through which Astragalus and Panax notoginseng decoction (APD) facilitates the treatment of ferroptosis-mediated pulmonary fibrosis. Materials and Methods. First, the electromedical measurement systems were used to measure respiratory function in mice; the lungs were then collected for histological staining. Potential pharmacologic targets were predicted via network pharmacology. Finally, tests including immunohistochemistry, reverse transcription-quantitative polymerase chain reaction, and western blotting were used to evaluate the relative expression levels of collagen, transforming growth factor β, α-smooth muscle actin, hydroxyproline, and ferroptosis-related genes (GPX4, SLC7A11, ACSL4, and PTGS2) and candidates involved in the mediation of pathways associated with ferroptosis (Hif-1α and EGFR). Results. APD prevented the occurrence of restrictive ventilation dysfunction induced by ferroptosis. Extracellular matrix and collagen fiber deposition were significantly reduced when the APD group compared with the model group; furthermore, ferroptosis was attenuated, expression of PTGS2 and ACSL4 increased, and expression of GPX4 and SLC7A11 decreased. In the APD group, the candidates related to the mediation of ferroptosis (Hif-1α and EGFR) decreased compared with the model group. Discussion and Conclusions. APD may ameliorate restrictive ventilatory dysfunction through the inhibition of ferroptosis. This was achieved through the attenuation of collagen deposition and inflammatory recruitment in pulmonary fibrosis. The underlying mechanisms might involve Hif-1α and EGFR.
{"title":"Ferroptosis Mediates Pulmonary Fibrosis: Implications for the Effect of Astragalus and Panax notoginseng Decoction","authors":"Jing Wen, Cui Wang, Li-yun Song, Yin-ying Wang, Peng-tao Liang, Wen-lin Pang, Wen Yin, Qiang Zhang, Wei-tian Zhao, Xue-ping Sun, Jin-yuan Yan, Zhong-shan Yang","doi":"10.1155/2024/5554886","DOIUrl":"https://doi.org/10.1155/2024/5554886","url":null,"abstract":"<i>Context</i>. Ferroptosis is known to influence the pathogenesis of pulmonary fibrosis. <i>Astragalus</i> and <i>Panax notoginseng</i> are used to treat pulmonary fibrosis; however, the therapeutic mechanisms require further elucidation. <i>Objective</i>. To investigate the mechanism through which <i>Astragalus</i> and <i>Panax notoginseng</i> decoction (APD) facilitates the treatment of ferroptosis-mediated pulmonary fibrosis. <i>Materials and Methods</i>. First, the electromedical measurement systems were used to measure respiratory function in mice; the lungs were then collected for histological staining. Potential pharmacologic targets were predicted via network pharmacology. Finally, tests including immunohistochemistry, reverse transcription-quantitative polymerase chain reaction, and western blotting were used to evaluate the relative expression levels of collagen, transforming growth factor <i>β</i>, <i>α</i>-smooth muscle actin, hydroxyproline, and ferroptosis-related genes (GPX4, SLC7A11, ACSL4, and PTGS2) and candidates involved in the mediation of pathways associated with ferroptosis (Hif-1<i>α</i> and EGFR). <i>Results</i>. APD prevented the occurrence of restrictive ventilation dysfunction induced by ferroptosis. Extracellular matrix and collagen fiber deposition were significantly reduced when the APD group compared with the model group; furthermore, ferroptosis was attenuated, expression of PTGS2 and ACSL4 increased, and expression of GPX4 and SLC7A11 decreased. In the APD group, the candidates related to the mediation of ferroptosis (Hif-1<i>α</i> and EGFR) decreased compared with the model group. <i>Discussion and Conclusions</i>. APD may ameliorate restrictive ventilatory dysfunction through the inhibition of ferroptosis. This was achieved through the attenuation of collagen deposition and inflammatory recruitment in pulmonary fibrosis. The underlying mechanisms might involve Hif-1<i>α</i> and EGFR.","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"4281 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140325059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jill A. Ohar, Donald A. Mahler, Gabrielle N. Davis, David A. Lombardi, Edmund J. Moran, Glenn D. Crater
<i>Introduction</i>. Many patients with chronic obstructive pulmonary disease (COPD) may derive inadequate benefit from dry powder inhalers (DPIs) because of suboptimal peak inspiratory flow (sPIF). <i>Objectives</i>. To assess the clinical burden of COPD by characterizing the clinical characteristics of participants with sPIF against medium-low resistance DPIs versus those with optimal PIF (oPIF) from two phase 3 clinical trials. <i>Methods</i>. Baseline data were collected from two randomized, controlled, phase 3 trials (NCT03095456; NCT02518139) in participants with moderate-to-severe COPD. oPIF (60 L/min) against the medium-low resistance DPIs was used as the threshold for defining the PIF subgroups (<60 L/min (sPIF) vs ≥60 L/min (oPIF)). <i>Results</i>. Most participants included in this analysis were White (92%) and male (63%); the mean (range) age was 65 (43–87) years. Participants with sPIF had significantly greater dyspnea than those with oPIF as measured using the modified Medical Research Council scoring (mean (95% CI): 2.1 (2.0–2.2) vs 1.6 (1.4–1.7); <span><svg height="9.2729pt" style="vertical-align:-0.6370001pt" version="1.1" viewbox="-0.0498162 -8.6359 21.464 9.2729" width="21.464pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"></path></g><g transform="matrix(.013,0,0,-0.013,13.833,0)"></path></g></svg><span></span><span><svg height="9.2729pt" style="vertical-align:-0.6370001pt" version="1.1" viewbox="25.0461838 -8.6359 28.182 9.2729" width="28.182pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,25.096,0)"></path></g><g transform="matrix(.013,0,0,-0.013,31.336,0)"></path></g><g transform="matrix(.013,0,0,-0.013,34.3,0)"><use xlink:href="#g113-49"></use></g><g transform="matrix(.013,0,0,-0.013,40.54,0)"><use xlink:href="#g113-49"></use></g><g transform="matrix(.013,0,0,-0.013,46.78,0)"></path></g></svg>)</span></span> and baseline dyspnea index (mean (95% CI): 5.1 (4.9–5.4) vs 6.1 (5.8–6.3); <span><svg height="9.2729pt" style="vertical-align:-0.6370001pt" version="1.1" viewbox="-0.0498162 -8.6359 21.464 9.2729" width="21.464pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g113-81"></use></g><g transform="matrix(.013,0,0,-0.013,13.833,0)"><use xlink:href="#g117-91"></use></g></svg><span></span><span><svg height="9.2729pt" style="vertical-align:-0.6370001pt" version="1.1" viewbox="25.0461838 -8.6359 28.182 9.2729" width="28.182pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,25.096,0)"><use xlink:href="#g113-49"></use></g><g transform="matrix(.013,0,0,-0.013,31.336,0)"><use xlink:href="#g113-47"></use></g><g transform="matrix(.013,0,0,-0.013,34.3,0)"><use xlink:href="#g113-49"></use></g><g transform="matrix(.013,0,0,-0.013,40.5
简介。许多慢性阻塞性肺病（COPD）患者由于吸气峰值流量（sPIF）不达标，可能无法从干粉吸入器（DPI）中获得足够的益处。目的：评估慢性阻塞性肺病的临床负担。通过分析两项三期临床试验中使用中低阻力干粉吸入器的 sPIF 患者与使用最佳吸入峰值流量 (oPIF) 患者的临床特征，评估慢性阻塞性肺病的临床负担。研究方法以针对中低阻力DPIs的oPIF（60 L/min）作为阈值来定义PIF亚组（<60 L/min (sPIF) vs ≥60 L/min (oPIF)）。结果。参与分析的大多数参与者为白人（92%）和男性（63%）；平均年龄（范围）为 65（43-87）岁。根据修改后的医学研究委员会评分（平均值（95% CI）：2.1 (2.0-2.2) vs 1.6 (1.4-1.7)；）和基线呼吸困难指数（平均值（95% CI）：5.1 (4.9-5.4) vs 6.1 (5.8-6.3)；），sPIF 参与者的呼吸困难程度明显高于 oPIF 参与者。根据慢性阻塞性肺病评估测试评分，sPIF 参与者的慢性阻塞性肺病症状负担高于 oPIF 参与者（平均值（95% CI）：21.5 (19.7-23.3) vs 19.5 (18.6-20.4)；5）。结论在这些试验中，与使用 oPIF 的慢性阻塞性肺病患者相比，使用中低阻力 DPIs 的慢性阻塞性肺病患者呼吸困难更严重，健康状况更差。这些结果表明，从患者报告的结果来看，sPIF 与更高的临床负担相关。
{"title":"Clinical Burden of Chronic Obstructive Pulmonary Disease in Patients with Suboptimal Peak Inspiratory Flow","authors":"Jill A. Ohar, Donald A. Mahler, Gabrielle N. Davis, David A. Lombardi, Edmund J. Moran, Glenn D. Crater","doi":"10.1155/2024/8034923","DOIUrl":"https://doi.org/10.1155/2024/8034923","url":null,"abstract":"<i>Introduction</i>. Many patients with chronic obstructive pulmonary disease (COPD) may derive inadequate benefit from dry powder inhalers (DPIs) because of suboptimal peak inspiratory flow (sPIF). <i>Objectives</i>. To assess the clinical burden of COPD by characterizing the clinical characteristics of participants with sPIF against medium-low resistance DPIs versus those with optimal PIF (oPIF) from two phase 3 clinical trials. <i>Methods</i>. Baseline data were collected from two randomized, controlled, phase 3 trials (NCT03095456; NCT02518139) in participants with moderate-to-severe COPD. oPIF (60 L/min) against the medium-low resistance DPIs was used as the threshold for defining the PIF subgroups (<60 L/min (sPIF) vs ≥60 L/min (oPIF)). <i>Results</i>. Most participants included in this analysis were White (92%) and male (63%); the mean (range) age was 65 (43–87) years. Participants with sPIF had significantly greater dyspnea than those with oPIF as measured using the modified Medical Research Council scoring (mean (95% CI): 2.1 (2.0–2.2) vs 1.6 (1.4–1.7); <span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 21.464 9.2729\" width=\"21.464pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,13.833,0)\"></path></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"25.0461838 -8.6359 28.182 9.2729\" width=\"28.182pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,25.096,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,31.336,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,34.3,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,40.54,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,46.78,0)\"></path></g></svg>)</span></span> and baseline dyspnea index (mean (95% CI): 5.1 (4.9–5.4) vs 6.1 (5.8–6.3); <span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 21.464 9.2729\" width=\"21.464pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,13.833,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"25.0461838 -8.6359 28.182 9.2729\" width=\"28.182pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,25.096,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,31.336,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,34.3,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,40.5","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"160 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140201185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<i>Objective</i>. To observe the changes of serum adiponectin (AP) levels in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and explore the correlation between serum AP and polysomnography (PSG) parameters in patients with OSAHS. <i>Methods</i>. The data of subjects who underwent PSG at the hospital between January 2021 and December 2022 were collected retrospectively and divided into simple snoring group (AHI < 5 times/h, <i>n</i> = 45), mild OSAHS group (5 ≤ AHI < 15 times/h, <i>n</i> = 63), moderate OSAHS group (15 ≤ AHI ≤ 30 times/h, <i>n</i> = 52), and severe OSAHS group (AHI > 30 times/h, <i>n</i> = 60). The general data, PSG indices, and serological indices of the subjects were collected and compared between groups. Pearson correlation analysis and partial correlation analysis were employed to examine the correlation between serum AP level and PSG parameters. Ordered logistic regression was employed to analyze the risk factors influencing the severity of OSAHS. The predictive capability of the serum AP level in determining the occurrence of OSAHS was assessed using ROC. The serum AP levels of subjects with different subtypes of PSG indicators were compared. <i>Results</i>. In the simple snoring group, mild OSAHS group, moderate OSAHS group, and severe OSAHS group, there were statistically significant differences in microarousal count, MAI, AHI, times of blood oxygen decreased by ≥ 3%, L-SaO<sub>2</sub>, and TS90% among the 4 groups (<span><svg height="9.2729pt" style="vertical-align:-0.6370001pt" version="1.1" viewbox="-0.0498162 -8.6359 19.289 9.2729" width="19.289pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"></path></g><g transform="matrix(.013,0,0,-0.013,11.658,0)"></path></g></svg><span></span><span><svg height="9.2729pt" style="vertical-align:-0.6370001pt" version="1.1" viewbox="22.8711838 -8.6359 21.918 9.2729" width="21.918pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,22.921,0)"></path></g><g transform="matrix(.013,0,0,-0.013,29.161,0)"></path></g><g transform="matrix(.013,0,0,-0.013,32.125,0)"><use xlink:href="#g113-49"></use></g><g transform="matrix(.013,0,0,-0.013,38.365,0)"></path></g></svg>).</span></span> The level of serum AP was positively correlated with L-SaO<sub>2</sub> and negatively correlated with the proportion of REM, microarousal count, MAI, AHI, times of blood oxygen decreased by ≥ 3%, TS90%, and LP (<span><svg height="9.2729pt" style="vertical-align:-0.6370001pt" version="1.1" viewbox="-0.0498162 -8.6359 19.289 9.2729" width="19.289pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g113-81"></use></g><g transform="matrix(.013,0,0,-0.013,11.658,0)"><use xlink:href="#g117-91"></use></g></svg><span></span><span><svg height="9.2729pt" style="vertical-al
目的观察阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者血清脂肪连接蛋白（AP）水平的变化，探讨 OSAHS 患者血清 AP 与多导睡眠图（PSG）参数的相关性。研究方法回顾性收集2021年1月至2022年12月期间在该院接受PSG检查的受试者资料，分为单纯打鼾组（AHI < 5次/h，n = 45）、轻度OSAHS组（5 ≤ AHI < 15次/h，n = 63）、中度OSAHS组（15 ≤ AHI ≤ 30次/h，n = 52）和重度OSAHS组（AHI > 30次/h，n = 60）。收集受试者的一般数据、PSG 指数和血清学指数，并进行组间比较。采用皮尔逊相关分析和偏相关分析来研究血清 AP 水平与 PSG 参数之间的相关性。采用有序逻辑回归分析影响 OSAHS 严重程度的风险因素。使用 ROC 评估了血清 AP 水平对 OSAHS 发生的预测能力。比较了不同亚型 PSG 指标受试者的血清 AP 水平。结果显示在单纯打鼾组、轻度 OSAHS 组、中度 OSAHS 组和重度 OSAHS 组中，4 组的微鼾声计数、MAI、AHI、血氧下降≥3% 的次数、L-SaO2 和 TS90% 的差异有统计学意义（）。血清 AP 水平与 L-SaO2 呈正相关，与快速动眼期比例、微动眼次数、MAI、AHI、血氧下降≥3% 的次数、TS90% 和 LP 呈负相关（）。高 AHI 是影响 OSAHS 严重程度的危险因素（95% CI：1.446-4.170）。血清 AP 水平诊断 OSAHS 的 AUC 为 0.906（95% CI：0.8601-0.9521），当 Youden 指数为 0.678 时，敏感性为 88.9%，特异性为 78.9%（）。在微动阙计数高、AHI高、血氧下降时间≥3%和TS90%高的人群中，血清AP水平低于低水平人群（）。在高 L-SaO2 的人群中，血清 AP 水平高于低水平人群（）。结论血清 AP 水平随着 OSAHS 患者疾病严重程度的增加而降低，对 OSAHS 的发生具有显著的预测能力。监测血清 AP 水平可有效预测 OSAHS 的风险。此外，血清 AP 水平的变化与 OSAHS 患者的低氧血症和唤醒频率增加有关。
{"title":"Changes of Serum Adiponectin Level in Patients with Obstructive Sleep Apnea Hypopnea Syndrome and Its Relationship with Sleep Monitoring Indexes","authors":"Ji Li, Kejing Zhou, Xing Chen","doi":"10.1155/2024/4071131","DOIUrl":"https://doi.org/10.1155/2024/4071131","url":null,"abstract":"<i>Objective</i>. To observe the changes of serum adiponectin (AP) levels in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and explore the correlation between serum AP and polysomnography (PSG) parameters in patients with OSAHS. <i>Methods</i>. The data of subjects who underwent PSG at the hospital between January 2021 and December 2022 were collected retrospectively and divided into simple snoring group (AHI < 5 times/h, <i>n</i> = 45), mild OSAHS group (5 ≤ AHI < 15 times/h, <i>n</i> = 63), moderate OSAHS group (15 ≤ AHI ≤ 30 times/h, <i>n</i> = 52), and severe OSAHS group (AHI > 30 times/h, <i>n</i> = 60). The general data, PSG indices, and serological indices of the subjects were collected and compared between groups. Pearson correlation analysis and partial correlation analysis were employed to examine the correlation between serum AP level and PSG parameters. Ordered logistic regression was employed to analyze the risk factors influencing the severity of OSAHS. The predictive capability of the serum AP level in determining the occurrence of OSAHS was assessed using ROC. The serum AP levels of subjects with different subtypes of PSG indicators were compared. <i>Results</i>. In the simple snoring group, mild OSAHS group, moderate OSAHS group, and severe OSAHS group, there were statistically significant differences in microarousal count, MAI, AHI, times of blood oxygen decreased by ≥ 3%, L-SaO<sub>2</sub>, and TS90% among the 4 groups (<span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"></path></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 21.918 9.2729\" width=\"21.918pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"></path></g></svg>).</span></span> The level of serum AP was positively correlated with L-SaO<sub>2</sub> and negatively correlated with the proportion of REM, microarousal count, MAI, AHI, times of blood oxygen decreased by ≥ 3%, TS90%, and LP (<span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-al","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"38 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140148995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zhixiang Chen, Lei Zha, Bin Hu, Bin Xu, Lin Zuo, Jun Yang, Zhuhua Chu, Lingling Ma, Fangfang Hu
Introduction. Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) contributes to a poor prognosis. Reliable biomarkers to predict adverse outcomes during hospitalization are important. Aim. To investigate the relationship between the serum cholinesterase (ChE) level and adverse clinical outcomes, including hypoxemia severity, hypercapnia, duration of hospital stay (DoHS), and noninvasive ventilation (NIV) requirement, in patients with AECOPD. Methods. Patients hospitalized with AECOPD in the Wuhu Hospital of Traditional Chinese Medicine between January 2017 and December 2021 were included. Results. A total of 429 patients were enrolled. The serum ChE level was significantly lower in patients with hypercapnia, who required NIV during hospitalization and who had a DoHS of >10 days, with an oxygenation index < 300. The ChE level was correlated negatively with the C-reactive protein level and neutrophil-to-lymphocyte ratio and correlated positively with the serum albumin level. Multivariate logistic regression analysis indicated that a serum ChE level of ≤4116 U/L (OR = 2.857, 95% CI = 1.46–5.58, ) was associated significantly with NIV requirement. Conclusions. The serum ChE level was correlated significantly with complicating severe hypoxemia, hypercapnia, prolonged DoHS, and the need for NIV in patients hospitalized with AECOPD. The serum ChE level is a clinically important risk-stratification biomarker in patients hospitalized with AECOPD.
导言。慢性阻塞性肺疾病（AECOPD）的急性加重会导致不良预后。预测住院期间不良后果的可靠生物标志物非常重要。研究目的研究 AECOPD 患者血清胆碱酯酶（ChE）水平与不良临床结果（包括低氧血症严重程度、高碳酸血症、住院时间（DoHS）和无创通气（NIV）需求）之间的关系。方法纳入2017年1月至2021年12月期间在芜湖市中医院住院治疗的AECOPD患者。结果共纳入 429 例患者。高碳酸血症、住院期间需要 NIV、DoHS 为 >10 天、氧合指数为 < 300 的患者血清 ChE 水平明显较低。ChE 水平与 C 反应蛋白水平和中性粒细胞与淋巴细胞比率呈负相关，与血清白蛋白水平呈正相关。多变量逻辑回归分析表明，血清 ChE 水平≤4116 U/L（OR = 2.857，95% CI = 1.46-5.58）与 NIV 需求显著相关。结论血清胆碱酯酶水平与 AECOPD 住院患者并发严重低氧血症、高碳酸血症、DoHS 延长以及 NIV 需求显著相关。血清胆碱酯酶水平是对 AECOPD 住院患者具有重要临床意义的风险分级生物标志物。
{"title":"Use of the Serum Level of Cholinesterase as a Prognostic Marker of Nonfatal Clinical Outcomes in Patients Hospitalized with Acute Exacerbations of Chronic Obstructive Pulmonary Disease","authors":"Zhixiang Chen, Lei Zha, Bin Hu, Bin Xu, Lin Zuo, Jun Yang, Zhuhua Chu, Lingling Ma, Fangfang Hu","doi":"10.1155/2024/6038771","DOIUrl":"https://doi.org/10.1155/2024/6038771","url":null,"abstract":"<i>Introduction</i>. Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) contributes to a poor prognosis. Reliable biomarkers to predict adverse outcomes during hospitalization are important. <i>Aim</i>. To investigate the relationship between the serum cholinesterase (ChE) level and adverse clinical outcomes, including hypoxemia severity, hypercapnia, duration of hospital stay (DoHS), and noninvasive ventilation (NIV) requirement, in patients with AECOPD. <i>Methods</i>. Patients hospitalized with AECOPD in the Wuhu Hospital of Traditional Chinese Medicine between January 2017 and December 2021 were included. <i>Results</i>. A total of 429 patients were enrolled. The serum ChE level was significantly lower in patients with hypercapnia, who required NIV during hospitalization and who had a DoHS of >10 days, with an oxygenation index < 300. The ChE level was correlated negatively with the C-reactive protein level and neutrophil-to-lymphocyte ratio and correlated positively with the serum albumin level. Multivariate logistic regression analysis indicated that a serum ChE level of ≤4116 U/L (OR = 2.857, 95% CI = 1.46–5.58, <span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.34882 18.973 11.7782\" width=\"18.973pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,11.342,0)\"></path></g></svg><span></span><span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"22.555183800000002 -8.34882 28.184 11.7782\" width=\"28.184pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.605,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,28.845,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,31.809,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.049,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.289,0)\"></path></g></svg>)</span></span> was associated significantly with NIV requirement. <i>Conclusions</i>. The serum ChE level was correlated significantly with complicating severe hypoxemia, hypercapnia, prolonged DoHS, and the need for NIV in patients hospitalized with AECOPD. The serum ChE level is a clinically important risk-stratification biomarker in patients hospitalized with AECOPD.","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"37 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140105290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. The effectiveness of definitive radiotherapy (RT) for patients with clinical stage IIIB or IIIC lung adenocarcinoma and epidermal growth factor receptor (EGFR) mutations who received first- or second-generation EGFR tyrosine kinase inhibitors (TKIs) is unclear. Methods. Taiwan Cancer Registry data were used in this retrospective cohort study to identify adult patients diagnosed with EGFR-mutated stage IIIB or IIIC lung adenocarcinoma between 2011 and 2020. Patients treated with first- or second-generation EGFR TKIs were classified into RT and non-RT groups. Propensity score (PS) weighting was applied to balance covariates between groups. The primary outcome was overall survival (OS), and the incidence of lung cancer mortality (ILCM) was considered as a supplementary outcome. Additional supplementary analyses were conducted to assess the robustness of the findings. Results. Among 270 eligible patients, 41 received RT and 229 did not. After a median follow-up of 46 months, PS-weighted analysis showed the PS-weighted hazard ratio of death for the RT group compared to the non-RT group was 0.94 (95% CI: 0.61–1.45, ). ILCM rates did not differ significantly between the two groups. Supplementary analyses yielded consistent results. Conclusion. The addition of definitive RT to first- or second-generation EGFR TKI treatment does not significantly improve OS of patients with EGFR-mutated stage IIIB or IIIC lung adenocarcinoma. NCT03521154NCT05167851.
{"title":"Efficacy of Definitive Radiotherapy for Patients with Clinical Stage IIIB or IIIC Lung Adenocarcinoma and Epidermal Growth Factor Receptor (EGFR) Mutations Treated Using First- or Second-Generation EGFR Tyrosine Kinase Inhibitors","authors":"Chih-Yen Tu, Te-Chun Hsia, Ying-Chun Lin, Ji-An Liang, Chia-Chin Li, Chun-Ru Chien","doi":"10.1155/2024/8889536","DOIUrl":"https://doi.org/10.1155/2024/8889536","url":null,"abstract":"<i>Background</i>. The effectiveness of definitive radiotherapy (RT) for patients with clinical stage IIIB or IIIC lung adenocarcinoma and epidermal growth factor receptor (EGFR) mutations who received first- or second-generation EGFR tyrosine kinase inhibitors (TKIs) is unclear. <i>Methods</i>. Taiwan Cancer Registry data were used in this retrospective cohort study to identify adult patients diagnosed with EGFR-mutated stage IIIB or IIIC lung adenocarcinoma between 2011 and 2020. Patients treated with first- or second-generation EGFR TKIs were classified into RT and non-RT groups. Propensity score (PS) weighting was applied to balance covariates between groups. The primary outcome was overall survival (OS), and the incidence of lung cancer mortality (ILCM) was considered as a supplementary outcome. Additional supplementary analyses were conducted to assess the robustness of the findings. <i>Results</i>. Among 270 eligible patients, 41 received RT and 229 did not. After a median follow-up of 46 months, PS-weighted analysis showed the PS-weighted hazard ratio of death for the RT group compared to the non-RT group was 0.94 (95% CI: 0.61–1.45, <span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.34882 18.973 11.7782\" width=\"18.973pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,11.342,0)\"></path></g></svg><span></span><span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"22.555183800000002 -8.34882 21.921 11.7782\" width=\"21.921pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.605,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,28.845,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,31.809,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,38.051,0)\"></path></g></svg>).</span></span> ILCM rates did not differ significantly between the two groups. Supplementary analyses yielded consistent results. <i>Conclusion</i>. The addition of definitive RT to first- or second-generation EGFR TKI treatment does not significantly improve OS of patients with EGFR-mutated stage IIIB or IIIC lung adenocarcinoma. NCT03521154NCT05167851.","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"9 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140032398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Anlotinib is an effective targeted therapy for advanced non-small-cell lung cancer (NSCLC) and has been found to mediate chemoresistance in many cancers. However, the underlying molecular mechanism of anlotinib mediates cisplatin (DDP) resistance in NSCLC remains unclear. Methods. Cell viability was assessed by the cell counting kit 8 assay. Cell proliferation, migration, and invasion were determined using the colony formation assay and transwell assay. The mRNA expression levels of mesenchymal-epithelial transition factor (MET) and myeloid cell leukemia-1 (MCL-1) were measured by quantitative real-time PCR. Protein expression levels of MET, MCL-1, and STAT3/Akt pathway-related markers were examined using western blot analysis. Results. Our data showed that anlotinib inhibited the DDP resistance of NSCLC cells by regulating cell proliferation and metastasis. Moreover, MET and MCL-1 expression could be decreased by anlotinib treatment. Silencing of MET suppressed the activity of the STAT3/Akt pathway and MCL-1 expression. Furthermore, MET overexpression reversed the inhibitory effect of anlotinib on the DDP resistance of NSCLC cells, and this effect could be eliminated by MCL-1 knockdown or ACT001 (an inhibitor for STAT3/Akt pathway). Conclusion. Our results confirmed that anlotinib inhibited DDP resistance in NSCLC cells, which might decrease MCL-1 expression via mediating the MET/STAT3/Akt pathway.
{"title":"Anlotinib Inhibits Cisplatin Resistance in Non-Small-Cell Lung Cancer Cells by Inhibiting MCL-1 Expression via MET/STAT3/Akt Pathway","authors":"Lile Wang, Lu Xu, Shuhua Han, Xiaoli Zhu","doi":"10.1155/2024/2632014","DOIUrl":"https://doi.org/10.1155/2024/2632014","url":null,"abstract":"<i>Background</i>. Anlotinib is an effective targeted therapy for advanced non-small-cell lung cancer (NSCLC) and has been found to mediate chemoresistance in many cancers. However, the underlying molecular mechanism of anlotinib mediates cisplatin (DDP) resistance in NSCLC remains unclear. <i>Methods</i>. Cell viability was assessed by the cell counting kit 8 assay. Cell proliferation, migration, and invasion were determined using the colony formation assay and transwell assay. The mRNA expression levels of mesenchymal-epithelial transition factor (MET) and myeloid cell leukemia-1 (MCL-1) were measured by quantitative real-time PCR. Protein expression levels of MET, MCL-1, and STAT3/Akt pathway-related markers were examined using western blot analysis. <i>Results</i>. Our data showed that anlotinib inhibited the DDP resistance of NSCLC cells by regulating cell proliferation and metastasis. Moreover, MET and MCL-1 expression could be decreased by anlotinib treatment. Silencing of MET suppressed the activity of the STAT3/Akt pathway and MCL-1 expression. Furthermore, MET overexpression reversed the inhibitory effect of anlotinib on the DDP resistance of NSCLC cells, and this effect could be eliminated by MCL-1 knockdown or ACT001 (an inhibitor for STAT3/Akt pathway). <i>Conclusion</i>. Our results confirmed that anlotinib inhibited DDP resistance in NSCLC cells, which might decrease MCL-1 expression via mediating the MET/STAT3/Akt pathway.","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"24 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140026315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives. The purpose of this study was to retrospectively assess cystic changes in findings on follow-up CT scans of patients with fibrotic nonspecific interstitial pneumonia (NSIP). Methods. The initial and last high-resolution CT scans of 58 patients with pathologically proven fibrotic NSIP were evaluated retrospectively. The median follow-up periods were 48 months (range, 12–183 months). The pattern, extent, and distribution of abnormal CT findings were compared with findings in the same region on previous and subsequent CT scans with a focus on cystic lesions. Results. Cystic lesions in a cluster were shown in 16 patients (28%) with fibrotic NSIP on the last CT scans. Focal clustered cysts were found in 5 cases and diffuse clustered cysts were seen in 11 cases. Focal clustered cysts mimicked honeycombing seen in usual interstitial pneumonia (UIP). Diffuse cysts were uniform in size in 7 of the 11 cases. Traction bronchiectasis in a cluster was seen in 3 of the 7 cases. The clustered cystic changes on CT during the course of NSIP mainly consisted of traction bronchiectasis and bronchiolectasis. Conclusions. Long-standing NSIP did not form honeycombing. The clustered cysts in patients with fibrotic NSIP were mainly remodeling of bronchiectasis.
{"title":"Clustered Cystic Changes in Long-Term Follow-Up Thin-Section Computed Tomographic Findings in Fibrotic Nonspecific Interstitial Pneumonia","authors":"Masanori Akira, Narufumi Suganuma","doi":"10.1155/2024/6665568","DOIUrl":"https://doi.org/10.1155/2024/6665568","url":null,"abstract":"<i>Objectives</i>. The purpose of this study was to retrospectively assess cystic changes in findings on follow-up CT scans of patients with fibrotic nonspecific interstitial pneumonia (NSIP). <i>Methods</i>. The initial and last high-resolution CT scans of 58 patients with pathologically proven fibrotic NSIP were evaluated retrospectively. The median follow-up periods were 48 months (range, 12–183 months). The pattern, extent, and distribution of abnormal CT findings were compared with findings in the same region on previous and subsequent CT scans with a focus on cystic lesions. <i>Results</i>. Cystic lesions in a cluster were shown in 16 patients (28%) with fibrotic NSIP on the last CT scans. Focal clustered cysts were found in 5 cases and diffuse clustered cysts were seen in 11 cases. Focal clustered cysts mimicked honeycombing seen in usual interstitial pneumonia (UIP). Diffuse cysts were uniform in size in 7 of the 11 cases. Traction bronchiectasis in a cluster was seen in 3 of the 7 cases. The clustered cystic changes on CT during the course of NSIP mainly consisted of traction bronchiectasis and bronchiolectasis. <i>Conclusions</i>. Long-standing NSIP did not form honeycombing. The clustered cysts in patients with fibrotic NSIP were mainly remodeling of bronchiectasis.","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2672 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139768882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diana Calaras, Aliona David, Eirini Vasarmidi, Katerina Antoniou, Alexandru Corlateanu
Hypersensitivity pneumonitis (HP) is a complex interstitial lung disease caused by chronic inhalation of a wide variety of antigens in susceptible and sensitized individuals, commonly associated with an occupational exposure. An impressive number of inciting antigens causing hypersensitivity pneumonitis have been found to cover a wide range of occupations. As working practices have changed over time, especially in industrialized countries, new names for occupational HP have emerged. This review emphasizes the main diagnostic issues arising from the high variability of clinical presentation and the broad spectrum of causal antigens. Furthermore, it provides an overview of current methods to unveil possible causes of hypersensitivity pneumonitis, highlights HP’s current diagnostic and treatment challenges and the remaining areas of uncertainty, and presents prevention strategies.
{"title":"Hypersensitivity Pneumonitis: Challenges of a Complex Disease","authors":"Diana Calaras, Aliona David, Eirini Vasarmidi, Katerina Antoniou, Alexandru Corlateanu","doi":"10.1155/2024/4919951","DOIUrl":"https://doi.org/10.1155/2024/4919951","url":null,"abstract":"Hypersensitivity pneumonitis (HP) is a complex interstitial lung disease caused by chronic inhalation of a wide variety of antigens in susceptible and sensitized individuals, commonly associated with an occupational exposure. An impressive number of inciting antigens causing hypersensitivity pneumonitis have been found to cover a wide range of occupations. As working practices have changed over time, especially in industrialized countries, new names for occupational HP have emerged. This review emphasizes the main diagnostic issues arising from the high variability of clinical presentation and the broad spectrum of causal antigens. Furthermore, it provides an overview of current methods to unveil possible causes of hypersensitivity pneumonitis, highlights HP’s current diagnostic and treatment challenges and the remaining areas of uncertainty, and presents prevention strategies.","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"1 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139499524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective. To develop a novel scale to assess humidification during noninvasive ventilation (NIV). Methods. This study was performed in an ICU of a teaching hospital. Three ICU practitioners with more than 10 years of clinical experience developed an oral humidification scale with a range of 1–4 points. Each studied the current literature on humidification and examined 50 images of mouths of NIV patients with different levels of humidification. Then, through discussion, a consensus scale was developed. Next, 10 practitioners and 33 NIV patients were recruited to validate the scale. Finally, the patients rated the dryness of their mouths using the 1–4 visual scale just after the practitioners’ assessment. Talking and discussion were forbidden during the assessment, and the scorers were blinded to each other. Results. We performed 36 assessments in 33 NIV patients. Three patients were assessed twice each more than 2 days apart. The interitem correlation coefficients between the 10 practitioners ranged from 0.748 to 0.917. Fleiss’s kappa statistic was 0.516, indicating moderate agreement among practitioners. Of the 33 patients, 5 (15%) were unable to make an assessment using the 1–4 visual scale. Among the remainder, 55.7% provided scores that matched those given by the practitioners; 13.7% of scores were 1 point higher than that rated by the practitioners, and 20.7% were 1 point lower. Only 10% were beyond a 1-point difference. The kappa coefficient was 0.483 between patients and practitioners. Conclusions. The oral humidification scale showed moderate agreement between practitioners. It was also highly accurate in reflecting the level of humidification assessed by patients.
{"title":"A Novel Scale to Assess Humidification during Noninvasive Ventilation: A Prospective Observational Study","authors":"Longfang Pan, Yueling Hong, Xiaoqing Zhong, Jiao He, Zuli Zhang, Qianru Zhao, Linfu Bai, Mengyi Ma, Jun Duan","doi":"10.1155/2023/9958707","DOIUrl":"https://doi.org/10.1155/2023/9958707","url":null,"abstract":"<i>Objective</i>. To develop a novel scale to assess humidification during noninvasive ventilation (NIV). <i>Methods</i>. This study was performed in an ICU of a teaching hospital. Three ICU practitioners with more than 10 years of clinical experience developed an oral humidification scale with a range of 1–4 points. Each studied the current literature on humidification and examined 50 images of mouths of NIV patients with different levels of humidification. Then, through discussion, a consensus scale was developed. Next, 10 practitioners and 33 NIV patients were recruited to validate the scale. Finally, the patients rated the dryness of their mouths using the 1–4 visual scale just after the practitioners’ assessment. Talking and discussion were forbidden during the assessment, and the scorers were blinded to each other. <i>Results</i>. We performed 36 assessments in 33 NIV patients. Three patients were assessed twice each more than 2 days apart. The interitem correlation coefficients between the 10 practitioners ranged from 0.748 to 0.917. Fleiss’s kappa statistic was 0.516, indicating moderate agreement among practitioners. Of the 33 patients, 5 (15%) were unable to make an assessment using the 1–4 visual scale. Among the remainder, 55.7% provided scores that matched those given by the practitioners; 13.7% of scores were 1 point higher than that rated by the practitioners, and 20.7% were 1 point lower. Only 10% were beyond a 1-point difference. The kappa coefficient was 0.483 between patients and practitioners. <i>Conclusions</i>. The oral humidification scale showed moderate agreement between practitioners. It was also highly accurate in reflecting the level of humidification assessed by patients.","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"95 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139055798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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