Changes in Control Status of COPD Over Time and Their Consequences: A Prospective International Study

IntroductionControl status may be a useful tool to assess response to treatment at each clinical visit in COPD. Control status has demonstrated to have long-term predictive value for exacerbations, but there is no information about the short-term predictive value of the lack of control and changes in control status over time.MethodProspective, international, multicenter study aimed at describing the short-term (6 months) prognostic value of control status in patients with COPD. Patients with COPD were classified as controlled/uncontrolled at baseline and at 3,6-month follow-up visits using previously validated criteria of control. Moderate and severe exacerbation rates were compared between controlled and uncontrolled visits and between patients persistently controlled, uncontrolled and those changing control status over follow-up.ResultsA total of 267 patients were analyzed: 80 (29.8%) were persistently controlled, 43 (16%) persistently uncontrolled and 144 (53.7%) changed control status during follow-up. Persistently controlled patients were more frequently men, with lower (not increased) body mass index and higher FEV₁(%). During the 6 months following an uncontrolled patient visit the odds ratio (OR) for presenting a moderate exacerbation was 3.41 (95% confidence interval (CI) 2.47–4.69) and OR = 4.25 (95%CI 2.48–7.27) for hospitalization compared with a controlled patient visit.ConclusionsEvaluation of control status at each clinical visit provides relevant prognostic information about the risk of exacerbation in the next 6 months. Lack of control is a warning signal that should prompt investigation and action in order to achieve control status.     

桂龙咳喘宁胶囊联合福多司坦治疗慢性阻塞性肺疾病急性加重期的临床研究

目的探讨慢性阻塞性肺疾病急性加重期应用桂龙咳喘宁胶囊联合福多司坦治疗的效果。方法 2015年2月-2018年4月天津市宝坻区人民医院呼吸科收治的114例慢性阻塞性肺疾病急性加重期患者,随机分成对照组(n=57)和治疗组(n=57)。对照组口服福多司坦片,0.4 g/次,3次/d,餐后服用。治疗组患者在对照组基础上口服桂龙咳喘宁胶囊,3粒/次,3次/d。两组均连续治疗14 d。比较两组临床疗效和呼吸系统症状体征的缓解时间,治疗前后肺功能参数[第1秒用力呼气容积(FEV1)占预计值百分比(FEV1占预计值%)、FEV1与用力肺活量(FVC)比值(FEV1/FVC)、呼气峰值流量(PEF)]值、慢性阻塞性肺疾病患者自我评估测试问卷(CAT)评分、外周血嗜酸性粒细胞绝对值(EOS#)及中性粒细胞(NEUT)与淋巴细胞(LYM)比值(NLR)和血清学相关指标[嗜酸性粒细胞阳离子蛋白(ECP)、白介素(IL)-13、8-羟基脱氧鸟苷(8-OHdG)、总抗氧化能力(TAC)]水平变化,不良反应发生情况。结果对照组和治疗组的总有效率分别是86.0%、96.5%,两组比较差异有统计学意义(P<0.05)。与对照组相比,治疗组咳嗽、咳痰等急性加重的呼吸系统症状体征的缓解时间均显著更短(P<0.05)。与治疗前对比,两组治疗后FEV1占预计值%、FEV1/FVC及PEF值均显著增高(P<0.05),CAT评分则均显著降低(P<0.05);但治疗后,治疗组上述肺功能参数值较对照组同期均显著更高(P<0.05),而CAT评分显著更低(P<0.05)。两组治疗后外周血EOS#、NLR值及血清ECP、IL-13、8-OHdG水平均显著低于治疗前(P<0.05),血清TAC水平则均显著升高(P<0.05);且治疗后,治疗组以上指标(EOS#、NLR、ECP、IL-13、8-OHdG、TAC)的改善效果均更显著(P<0.05)。两组均无严重不良反应发生。结论桂龙咳喘宁胶囊联合福多司坦治疗慢性阻塞性肺疾病急性加重期的整体疗效显著,能有效缩短稳定患者病情的时间,改善肺通气功能,缓解气道炎症及全身炎症状态,纠正氧化/抗氧化失衡,具有一定的临床推广应用价值。     

Geographical differences in semen characteristics: Comparing semen parameters of infertile men of the United States and Iraq

The declining trend of male fecundity is a major global health and social concern. Among numerous other confounding factors, variations in male fertility parameters in different regions have repeatedly been suggested to be influenced by geographic locations. The impact of overall lifestyle, behavioural patterns, ethnicity, work stress and associated factors upon health differ greatly between developed and developing countries. These factors, individually or in combination, affect male reproductive functions ensuing the discrepancies in semen qualities in connection with geographic variations. However, reports comparing semen characteristics between developed and developing countries are sparse. The present study finds its novelty in presenting a comparison in semen parameters of infertile men in the United States (n = 76) that fairly represents the population of a highly developed region and Iraq (n = 102), the representative of male populations of a developing region. Samples were collected and analysed according to WHO (WHO laboratory manual for the examination and processing of human semen, WHO; 2010) criteria by means of the Mann–Whitney test. The US population demonstrated lower sperm concentration, total count, and total and progressive sperm motility with a higher seminal total antioxidant capacity (TAC) as compared to the Iraqi population. This report encourages further investigations concerning the confounding factors leading to such alterations in semen qualities between these two geographic areas.     

Thoracic Aortic Calcification: Diagnostic,Prognostic, and Management Considerations

Thoracic aortic calcification (TAC) is associated with adverse cardiovascular outcomes, and for the cardiovascular imager, is predominantly encountered in 4 settings: 1) incidentally, for example, during a coronary artery calcium scan; 2) as part of dedicated screening; 3) in the evaluation of an embolic event; or 4) in procedural planning. This review focuses on TAC in these contexts. Within atherosclerosis, TAC is common, variable in extent, and begins in the intima with a patchy distribution. In metabolic disorders, aortitis, and radiation-associated cardiovascular disease, calcification preferentially involves the media and is often more concentric. As an incidental finding, atherosclerotic TAC provides limited incremental discriminative value, and current data do not support screening. After an embolic event, the demonstration of thoracic atheroma provides diagnostic clarity, but has limited treatment implications. Before any procedure, the plan often changes if the most severe form of TAC, a porcelain aorta, is discovered.     

低浓度混合苯作业女工血清总抗氧化能力及超氧化物歧化酶的变化

目的探讨作业场所空气中低浓度苯、甲苯和二甲苯对作业女工血液脂质过氧化的影响。方法选择47名低浓度混苯作业女工为接触组，另选择65名从未接触混苯及其他职业性有毒物质的女工为对照组。对两组人员进行职业流行病学调查、体检（包括鼻出血、牙龈出血、黏膜出血和柬臂实验阳性率）及血清总抗氧化能力（TAC）和超氧化物歧化酶（SOD）活力测定，同时采集末梢血用常规方法测定血红蛋白（Hb）含量和白细胞（WBC）计数，并对检测结果进行统计分析。结果接触组Hb含量为130．85±12．89g／L，WBC数为（7．25±1．88）×10^9／L，血清SOD活力为（99．31±39．97）NU／ml，TAC为（15．91±5．42）U／L；对照组Hb含量为（134．97±15．63）g／L，WBC数为（7．69±1．94）×10^9／L，血清SOD活力为（82．96±34．88）NU／ml，TAC为（18．75±5．33）U／L。两组比较，WBC计数和Hb含量等指标差异均无统计学意义（P〉0．05）；接触组血清SOD活力增高而TAC降低，差异均有统计学意义（P〈0．05）。结论低浓度混苯环境下作业可致作业女工血清SOD活力明显增高（P〈0．05）和TAC明显降低（P〈0．01），并且这种改变出现在显示造血系统损害的指标和症状之前，可考虑将血清中SOD活力和TAC作为低浓度混苯作业女工机体的早期生物监测指标之一。     

染苯大鼠脂质过氧化和抗氧化能力的观察

目的 探讨苯对大鼠脂质过氧化及酶促体系和非酶促体系的抗氧化反应的影响。方法 健康SD大鼠48只,分成4组,设一对照组,其余3组按126mg/kg(低剂量组）,190mg/kg（中剂量组）、380mg/kg(高剂量组）量作灌胃染毒,于第1次染毒后第10天、第45天、第90天采血,取血清分别检测TAC、MDA含量及SOD活性。结果 低、中剂量组,在染毒第45天时,SOD活性下降,在染毒第90天时,SOD活性回升;高剂量组,随着染毒时间的延长,SOD活性及TAC含量均逐渐降低;低、中、高剂量组,MDA含量均随染毒时间的延长而升高,TAC与MDA含量均值间的相关系数r=0.7514,TAC含量与SOD活性均值间的相关系数r=0.8207。结论 苯能诱导大鼠产生脂质过氧化反应,使其抗氧化能力降低。     

TAC‐302 promotes neurite outgrowth of isolated peripheral neurons and prevents bladder denervation related bladder dysfunctions following bladder outlet obstruction in rats

Aims

To evaluate the ability of TAC‐302, a cyclohexenoic fatty alcohol derivative, to enhance neurite outgrowth in cultured rat dorsal root ganglion (DRG) neurons, and the preventive effects of TAC‐302 on bladder denervation‐related storage and voiding dysfunctions in rats with bladder outlet obstruction (BOO).

Methods

Rat DRG neurons were cultured in the presence of TAC‐302. Cell numbers and neurite lengths were quantified after a 24 h culture. BOO was achieved by partial ligature of the proximal urethra in female rats. BOO rats were divided into three groups and orally treated with vehicle of 3 or 30 mg/kg TAC‐302 twice a day for 4 weeks. Cystometry was performed under conscious conditions. Immunohistochemical staining using anti‐PGP9.5 of the bladder muscle layer was performed, and the innervation area was scored.

Results

TAC‐302 significantly and dose‐dependently increased neurite outgrowth in cultured DRG neurons. BOO rats showed a decreased innervation area in the urinary bladder compared to sham‐operated rats. BOO‐induced denervation of the urinary bladder was partially prevented by oral treatment with TAC‐302. TAC‐302 significantly reduced the frequency of non‐voiding contraction (NVC) and residual urine volume (RUV) compared with the BOO vehicle group (P < 0.05). The innervation area score exhibited significant negative correlations with NVC and RUV, indicating that they increased according to the progression of denervation.

Conclusions

Our data indicate that TAC‐302 promotes neurite outgrowth in vitro. In addition, TAC‐302 prevents BOO‐induced bladder dysfunction in rats, and has a protective effect on bladder denervation.