Anti-inflammatory effect of methoxyphenamine compound in rat model of chronic obstructive pulmonary disease

AIM: To evaluate the anti-inflammatory effect of methoxyphenamine compound (MC) on chronic obstructive pulmonary disease (COPD) in rats by measurement of proinflammatory cytokines, total and differential white cell counts (WCC) of bronchroalveolar lavage fluid (BALF). METHODS: Adult rat model of COPD (COPD group) was induced by intratracheal instillation of lipopolysaccharides and exposure to cigarette smoke. Treatment groups received different dosage of MC (3, 9, and 27 mg daily, MC group) or prednisone (0.25 mg daily, P group) respectively. Tumor necrosis factor alpha (TNF-α), interleukin 1beta (IL-113), interleukin-6 (IL-6), transforming growth factor β (TGF-β) of BALF were determined by ELISA. Total and differential WCC were performed after Giemsa staining. RESULTS: The levels of TNF-α, IL-1β, IL-6, TGF-β, total and differential WCC in BALF of MC groups were significantly decreased than that of COPD group (P<0.01), and there was no significant difference among MC groups. There was no significa     

慢性阻塞性肺病患者生存质量与中医证候的关系研究

探讨慢性阻塞性肺病(COPD)中医证候与患者生存质量的关系及其规律.采用生存质量综合评定问卷-74(GQOLI-74)对114例COPD不同中医证候患者的生存质量进行评价研究.结果不同中医证候COPD患者的QOL均明显受损,瘀血证、肺肾气虚证对COPD患者QOL的影响有统计学意义(P＜0.05);血瘀证患者QOL变化主要体现在工作与学习、运动与感觉、负性情感、进食、人际交往和性功能等方面.提示COPD证候与患者QOL存在着一定关系.     

胃肠造瘘术在全梗阻型食管癌放疗中的应用

目的　评价胃肠造瘘术在全梗阻型食管癌放疗中的临床应用价值。方法　 98例全梗阻食管癌放疗病人 ,5 3例于疗前及疗中行胃肠造瘘术 ,其中照射剂量DT>5 0Gy为 2 7例 ,余 2 6例放疗剂量DT<5 0Gy ;45例于疗中仅予输液支持以维持放疗。结果　行胃肠造瘘术组kanofsky评分较对照组明显提高 ,体重亦维持或增加明显 ,两者比较P <0 0 0 5 ;胃肠造瘘术组与对照组其 1年及 3年生存率分别为 :33 9%、2 8 8%和 15 0 %、4 4% ,两组间生存率差异有显著性意义 ( χ2 =7 2 5 ,P =0 0 0 71) ;胃肠造瘘术组中放疗DT>5 0Gy与DT<5 0Gy病人其 1年及 3年生存率分别为 :48 1%、19 2 %及 2 2 2 %、7 7% ,两组间生存率统计学有显著差异 ( χ2 =4 2 0 ,P =0 0 40 4)。结论　全梗阻型食管癌疗前或疗中行胃肠造瘘术 ,可在改善病人体质状况、维持或增加体重基础上 ,明显提高患者 1年及3年的生存率 ,且放疗剂量DT 应 >5 0Gy。     

The use of an ambulatory,automatic sleep recording device (QUISI™ Version 1.0) in the evaluation of primary snoring and obstructive sleep apnoea

The use of an ambulatory, automatic sleep recording device (QUISI? Version 1.0) in the evaluation of primary snoring and obstructive sleep apnoea Electroencephalogram (EEG) evaluation with polysomnography (PSG) according to the Rechtschaffen & Kales (R&K) rules is time and cost consumptive, but ambulatory polygraphy systems do not allow EEG recording routinely. As a consequence, the number of sleep disordered events cannot be calculated exactly. QUISI is a one‐channel, self‐applicable ambulatory EEG recording device. The present study was designed as a prospective, non‐randomized clinical trial. This investigation evaluated the results of 40 patients with primary snoring and obstructive sleep apnoea measured with level 1 PSG and QUISI simultaneously. Fifteen patients (37.5%) were primary snorers with normal sleep profiles, whereas 25 patients (62.5%) suffered from obstructive sleep apnoea (OSA) with a Respiratory Disturbance Index (RDI) of 38.6 ± 23.8. The mean total sleeping time (TST) was underestimated by 4.5%, while Sleep Efficiency Index (SEI) was understimated by 4.6% by the QUISI device compared with PSG. The correlation between the QUISI and the PSG estimates for single sleep stages demonstrated only moderate correlation. The statistical significance for sleep stage 2 was r = 0.42, P = 0.002; for sleep stage 3/4, r = 0.31, P = 0.02; and for WAKE, r = 0.33, P = 0.01. Sleep stage 2 as well as sleep stage 3/4 were underestimated by QUISI substantially (difference: ?5.6% and ?10.3%), while WAKE was overestimated by QUISI to a larger amount (difference: +10.4%). Sensitivity and specificity of QUISI to recognize pathological sleep profiles compared with PSG/R&K were 0.92 and 0.96 respectively. QUISI is able to evaluate normal versus altered sleep profiles in patients with primary snoring and OSA. Comparing the quartile ranges, we found substantial differences between QUISI and PSG/R&K. QUISI gives an impression of sleep architecture and objective verification of a sleep disturbance in an ambulant setting but cannot replace the sleep laboratory‐based PSG.     

Quantitative computer‐assisted digital‐imaging upper airway analysis for obstructive sleep apnoea*

This was a prospective study of a new objective method which quantitatively analyses the upper airways in patients with obstructive sleep apnoea (OSA). Video‐nasopharyngoscopic examinations of the upper airways of 45 patients were carried out with an endoscopic calibrator. Images of the upper airway during quiet respiration and Mueller's manoeuvre in erect and supine positions were digitized by computer to generate the actual dimensions of obstructive sites. Measurements by the new method were validated by comparing 90 pairs of videoendoscopic images with upper airway magnetic resonance imaging (MRI) measurements at two identical levels. Quantitative precision is 100% for the retropalatal level and 95.6% for the retrolingual level with a tolerance of 0.5 cm² between the two methods. The absolute mean of the difference between the two methods of measurement is 0.08 cm² at the retropalatal level and 0.18 cm² at the retrolingual level. The agreement between the digital‐imaging videoendoscopic and MRI measurements was 93.3% for the retropalatal level and 95.6% for the retrolingual level. Quantitative computer‐assisted digital imaging is a reliable, cost‐effective clinical method of upper airway evaluation in OSA patients. This method allows us to examine the dynamic and static morphology objectively, measure surgical outcomes of upper airway, opening up new avenues for OSA management.     

Assessing the Quality of Life of Adults with Chronic Respiratory Diseases in Routine Primary Care: Construction and First Validation of the 10-Item Respiratory Illness Questionnaire-Monitoring 10 (RIQ-MON10)

BACKGROUND: As doctors' judgements about the burden of a disease often differ from patients' own assessments a manageable method to incorporate the latter into routine care might support patient-centered decision-making. For this purpose we shortened the 55-Item Quality of Life for Respiratory Illness Questionnaire (QoL-RIQ). METHODS: Secondary analyses of the data of 3 controlled studies (n = 328, 502 and 555). PROCEDURES: inter-item correlations, scale distributions, Cronbach's alpha and factor analysis. Dyspnoea, forced expiratory volume in 1 s (FEV1), COOP/WONCA charts, the Medical Research Council-ECCS symptoms questionnaire and the MOS-SF 36 served as criteria to test validity and responsiveness. RESULTS: Item-reduction resulted in a 10-item short form (alpha's 0.87-0.90), consisting of 2 5-item factors: (1) physical and emotional complaints and (2) physical and social limitations. The correlations of the short form with dyspnoea (r from 0.57 to 0.60), the generic health status instruments (r from 0.39 to 0.59) and lung function (r from 0.10 to 0.15) fulfilled the criteria. FURTHER RESULTS: a clinical relevant score difference (> 0.5) between upper and lower quartiles of the convergent instruments, an intraclass correlation between repeated scores in a stable group of 0.82 and a standardised response mean of 0.86 in an improved group of patients. CONCLUSIONS: The short form (RIQ-MON10) maintained the psychometric properties of the original instrument and is promising for assessing quality of life (QoL) during routine primary care visits.     

继续教育对基层医务人员有关慢性阻塞性肺疾病相关认知的影响研究

目的了解基层医务人员对慢性阻塞性肺疾病的认知、过去一年继续教育情况及继续教育对慢性阻塞性肺疾病相关认知的影响。方法选取2019年10月1—31日2372名来自社区卫生服务中心(站)、乡镇卫生院和村卫生室的医务人员自愿在线填写了调查问卷,内容包括个人基本特征,对慢性阻塞性肺疾病危险因素和诊断的认知及继续教育情况。结果基层医务人员熟知吸烟、二手烟、长期呼吸道疾病史、室外空气污染和职业性粉尘等危险因素,但是对室内空气污染和遗传因素认知不足,并且仍有12.1%的基层医务人员知晓吸烟是危险因素,但正在吸烟或戒烟6个月以内。80%的调查对象知道肺功能是诊断慢性阻塞性肺疾病的金标准,但仅60.7%的调查对象能正确判读肺功能结果。过去一年中仅44.3%的基层医务人员接受了相关继续教育。继续教育对提升基层医务人员慢性阻塞性肺疾病危险因素和诊断相关认知的影响差异有显著性(OR=1.524,95%CI 1.289～1.802;OR=1.528,95%CI 1.289～1.812)。结论加大继续教育的惠及范围,有针对性地加强基层医务人员对室内空气污染和遗传因素的认知,同时在基层配备肺功能仪的前提下,开展以实操...     

慢性阻塞性肺疾病急性加重期使用激素治疗与低血钾的关系分析

目的 探讨慢性阻塞性肺疾病(COPD)患者在病情加重时使用激素治疗与低血钾的关系.方法 回顾性分析73例COPD急性加重期使用激素治疗患者,按体重指数(BMI)进行分类比较,了解其与低血钾的关系.结果 超重患者低血钾发生率为31%, 不超重患者为6%,经χ2检验P＜0.05.结论 超重患者出现低血钾的机会较大,应多监测,及时补充和纠正,避免严重心律失常事件的发生.     

鼻部相关手术对治疗阻塞性睡眠呼吸暂停低通气综合征的有效性

目的：探讨鼻部相关手术对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）治疗的有效性。方法：回顾性分析94例OSAHS合并鼻部相关疾病的患者,均经PSG、鼻内镜、鼻咽纤维镜检查确诊,因种种原因只行鼻部相关手术而未行其他任何治疗。鼻部相关手术包括鼻中隔矫正术,双下鼻甲等离子射频消融术,鼻息肉、慢性鼻窦炎患者行功能性鼻内镜手术。术后2个月、1年复查PSG。结果：94例患者鼻部手术后有效19例,术前AHI11．7±5．2,最低SaO287．6±2．7,平均SaO287．8±5．4,术后2个月AHI5．5±5．0,最低SaO292．5±5．3,平均SaO294．5±3．7,术后1年AHI6．1±4．2,最低SaO291．8±4．2,平均SaO292．8±4．1,有效率20．21％（19／94）,均为轻度Ⅰ型患者,占轻度患者的38．00％（19／50）,经PSG随访1年无复发。其余75例无效。结论：伴有鼻部相关疾病的OSAHS患者,单纯鼻部手术仅对部分以鼻部阻塞为主的Ⅰ型患者有效。