ObjectiveTo explore the relationship between morning symptoms and other clinical characteristics in patients with chronic obstructive pulmonary disease (COPD), and to look for related risk factors affecting morning symptoms.MethodsThis cross-sectional observational study included 153 patients with stable COPD. Morning symptoms were evaluated with the Chinese-version of Chronic Obstructive Pulmonary Disease Morning Symptom Diary (Ch-COPD-MSD). And modified version of the British medical association respiratory questionnaire (mMRC), COPD assessment test (CAT), questionnaire clinical COPD questionnaire (CCQ) score were scored, and the BODEx index was calculated.ResultsA total of 153 stable COPD patients were included. The patients aged 59.6±7.6 years with a mean forced expiratory volume in one second of (52.0±20.7)% predicted (FEV1%pred). The median score of morning symptoms was 31.00. Morning symptoms severity was different between GOLD groups A to D: median (interquartile range) score in GOLD A was 23.50 (20.00 - 27.25), in GOLD B was 31.00 (26.00 - 38.00), in GOLD C was 30.00 (23.75 - 35.75), and in GOLD D was 36.50 (27.00 - 47.50) (P<0.001). Meanwhile, under different mMRC, CAT, CCQ scores, the difference in the median score of morning symptoms was statistically significant (all P=0.000). Score of morning symptoms was negatively correlated with the FEV1%pred (r=–0.24, P<0.001), and positively correlated with the score of mMRC, CAT, CCQ, and the BODEx index (r value was 0.50, 0.60, 0.53, 0.40, respectively, P<0.001). Multiple linear regression analysis showed that CAT score was the important factor associated with morning symptoms severity in COPD (B=0.829, P<0.001).ConclusionsMorning symptoms are associated with multiple clinical indicators for assessing the severity of COPD, and health status is the most strongly associated with morning symptoms. Clinical evaluation of morning symptoms in patients with COPD can be helpful in comprehensive assessment of the patient’s condition.
Objective To study the role of E-selection and macrophage inflammatory protein-2（MIP-2） in the airway inflammation in a rat model of chronic obstructive pulmonary disease（COPD）.Methods Twenty-four male SD rats were randomly divided into a normal control group and a COPD group.The rat model of COPD was established by exposure to cigarette smoking.Lung function，pathologic features of lung tissues and inflammatory cell differentials in bronchoalveolar lavage fluid（BALF） were investigated.Immunohistochemistry was employed to examine the expression of E-selection in lung tissue.The levels of MIP-2 in BALF，serum and lung tissues were measured with ELISA.Results The changes in histopathology and pathophysiology in the rat COPD model were similar to those in COPD patients.The expression of E-selection on bronchopulmonary vein endothelial cells of the COPD group significantly increased as compared with the normal control group（Plt;0.05） and was positively correlated with the neutrophil counts in BALF in the COPD group（ｒ=0.809，Plt;0.01）.The levels of MIP-2 in BALF and lung tissues in the rats with COPD were signicantly higher than those in normal rats，both of which were positively correlated with the neutrophil counts in BALF in the COPD group（r=0.893，Plt;0.01；r=0.716，Plt;0.05）.Conclusion Both E-selection and MIP-2 may be involved in the process of airway inflammation in COPD.
ObjectiveTo systematically review the efficacy of treatments for β-coronaviruses.MethodsPubMed, EMbase, Web of Science, The Cochrane Library, SinoMed, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs) of treatments for β-coronaviruses from inception to June 17th, 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using Stata 14.0 software.ResultsA total of 109 studies invoving 23 210 patients were included. The results of the systematic review showed that compared with standard of care, corticosteroids could reduce mortality and increase cure rate for COVID-19. However, chloroquine could decrease cure rate. In severe acute respiratory syndrome (SARS) patients, corticosteroids could decrease the cure rate. In Middle East respiratory syndrome (MERS) patients, ribavirin/interferon/both drugs showed higher mortality.ConclusionsThe currently limited evidence shows that corticosteroids may be effective to COVID-19 patients while having limited effects on SARS patients. Hydroxychloroquine or chloroquine may have negative effects on COVID-19 patients. Ribavirin/interferon may be harmful to MERS patients. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusions.