Objective To determine the efficacy of forced expiratory volume in six seconds( FEV6 ) as an alternative for forced vital capacity( FVC) in the diagnosis for mild-moderate chronic obstructive pulmonary disease( COPD) .Methods A total of 402 mild-moderate COPD and 217 non-COPD patients’ spirometric examinations were retrospectively analyzed. The correlation between FEV6 and FVC, FEV1 /FVC and FEV1 /FEV6 was evaluated by the Spearman test. Considering FEV1 /FVC lt;70% as being the ‘golden standard’ for airway obstruction, a ROC curve was used to determine the best cut-off point for the FEV1 /FEV6 ratio in the diagnosis for COPD. Results The Spearman correlation test revealed the FEV1 and FEV6 , FEV1 /FEV6 and FEV1 /FVC ratios were highly correlated ( r = 0. 992, 0. 980, respectively, P = 0. 000) . Using FEV1 /FEV6 lt; 70% as the diagnosis standard, 12. 69% of the 402 patients could not be diagnosed as COPD. The FEV1 /FVC ratio of these patients was very close to 70% . The best cut-off point for the FEV1 /FEV6 ratio in the diagnosis of mild-moderate COPD was 72% while the sensitivity and specificity were 94. 7% and 92. 2% , respectively. Conclusions There is a b correlation between FEV1 /FVC and FEV1 /FEV6 . The FEV6 can be a valid alternative for FVC in the diagnosis for mild-moderate COPD, although it may result in false negative. The best cut-off point for the FEV1 /FEV6 ratio is 72% .
ObjectiveTo investigate the expression of SIR2-related enzyme 1 (SIRT1) in serum of patients with chronic obstructive pulmonary disease (COPD) and its clinical significance.MethodsForty patients with acute exacerbation of COPD (acute-COPD group) and 30 patients with stable COPD (stable-COPD group) were selected as study groups. Twenty healthy subjects were recruited as a control group. Serum SIRT1, nuclear factor (NF) -κB, and matrix metalloproteinases (MMP) -9 levels were detected by enzyme-linked immunosorbent assay and Western blot.ResultsCompared with the control group, the FEV1%pred and FEV1/FVC were significantly decreased in the acute COPD patients and the stable COPD patients (P<0.05). Compared with the stable-COPD group, FEV1%pred and FEV1/FVC were significantly decreased in the acute-COPD group (P<0.05). Compared with control group, the serum SIRT1 in the stable-COPD group and the acute-COPD group were significantly decreased, while NF-κB and MMP-9 were significantly increased (P<0.05). Compared with the stable-COPD group, SIRT1 in the acute-COPD group was significantly decreased, while NF-κB and MMP-9 were significantly increased (P<0.05). SIRT1 were positively correlated with FEV1%pred (P<0.05) and FEV1/FVC (P<0.05) in the COPD patients by Pearson linear correlation analysis. SIRT1 was negatively correlated with NF-κB (P<0.05) and MMP-9 (P<0.05).ConclusionIn COPD patients, decreased levels of serum SIRT1 is associates with decreased lung function, which may be used as a potential biomarker of COPD.
ObjectiveTo investigate the efficacy of Orem's self-care model in school-age children with asthma. MethodsSeventy-four children with asthma treated between March 2012 and June 2014 were divided into observation group (n=37) and control group (n=37) randomly. Orem's self-care model was applied in the observation group, while routine nursing was carried out in the control group. We observed the pulmonary function, therapeutic compliance and quality of life in children of both the two groups before and one year after treatment. ResultsOne year after treatment, forced expiratory volume in one second and peak expiratory flow increased significantly (P<0.05), and increase in the observation group was significantly more than that in the control group (P<0.05). Compared with the control group, the observation group showed significant increased treatment compliance rate (P<0.05). Pediatric asthma quality of life questionare scale results showed that one year after treatment, the two groups got significantly increased scores in the dimensions of emotion, symptom and activity (P<0.05), and the scores were significantly higher in the observation group (P<0.05). ConclusionOrem's self-care model has a significant curative effect for the improvement of lung function in school-age children with asthma, which can promot the treatment compliance and quality of life of the patients.
Objective To investigate the rate of pulmonary function test, medication treatment, and relevant factors among patients with chronic obstructive pulmonary disease (COPD) aged 40 years or older in community of Guangdong Province, and to provide evidences for targeted intervention of COPD. Methods A multistage stratified cluster sampling was conducted in the community residents, who participated in the COPD surveillance project of in Guangdong Province during 2019 to 2020. A total of 3384 adults completed questionnaire and pulmonary function test. The Rao-Scott χ2 test based on complex sampling design, and non-conditional Logistic regression were used to explore possible influencing factors of pulmonary function test and medication treatment in COPD patients. Results Out of the 3384 adults, 288 patients with COPD were confirmed, including 253 males (87.8%) and 35 females (12.2%), and 184 patients (60.4%) were over 60 years old or more. The pulmonary function test rate was 10.7% [95% confidence interval (CI) 6.8% - 14.6%], and medication treatment rate was 10.6% (95%CI 7.0% - 14.1%). The results showed that wheezing, awareness of COPD related knowledge and pulmonary function test were related to whether COPD patients had pulmonary function test (P<0.05). Wheezing and personal history of respiratory diseases were related to medication treatment rate (P<0.05). Conclusions The rates of pulmonary function test and medication treatment among COPD patients aged 40 years or older are low. Health education about COPD should be actively carried out, and the screening of individuals with a history of respiratory diseases and respiratory symptoms should be strengthened so as to reduce the burden of COPD diseases.
Abstract: Objective To investigate the clinical effect of using zerobalanced ultrafiltration on postoperative lung function of coronary artery bypass grafting (CABG) patients under cardiopulmonary bypass (CPB). Methods Forty coronary artery bypass grafting patients in the First Affiliated Hospital of China Medical University from June 2006 to December 2008 were enrolled in this study, and were divided into two groups based on different ultrafiltration procedures. Patients in the experimental group (n=20), 14 males and 6 females, with an age of 65.43±8.31 years, underwent zerobalanced ultrafiltration and conventional ultrafiltration after CPB was carried out. Patients in the control group (n=20), 15 males and 5 females, with an age of 66.51±7.62 years, only underwent conventional ultrafiltration after temperature restoration. Preoperative pulmonary function and arterial blood gas were tested routinely. Airway resistance (Raw), oxygenation index (OI) and alveolar arterial oxygen difference ［P(Aa)O2］ were measured at the following points: before CPB, at the end of CPB, 6 hours, and 12 hours after operation. Postoperative mechanical ventilation time was also recorded. Results There was no significantly statistical difference between the two groups of patients in pulmonary function and arterial blood gas indexes before operation, and Raw, OI and P(Aa)O2 before CPB (Pgt;0.05). Nevertheless, at the points of 6 hours and 12 hours after operation, Raw ［2.22±0.31 cm H2O/(L·s) vs. 2.94±0.42 cm H2O/(L·s), F=0.061, Plt;0.05; 1.89±0.51 cm H2O/(L·s) vs. 2.52±0.29 cm H2O/(L·s), F=0.096, Plt;0.05］ and P(Aa)O2 (86.74±7.63 mm Hg vs. 111.66±7.49 mm Hg, F=0.036, Plt;0.05; 74.82±5.67 mm Hg vs. 95.23±6.78 mm Hg, F=0.059, Plt;0.05) of patients in the experimental group were significantly lower than those of patients in the control group. At the same points, OI of patients in the experimental group was significantly higher than that of patients in the control group (384.33±30.67 vs. 324.63±31.22, F=0.033, Plt;0.05; 342.24±23.43 vs. 293.67±25.44, F=0.047, Plt;005). Ventilator support time of the experimental group was shorter than the control group (15.44±3.93 h vs. 20.68±5.77 h,Plt;0.05). Conclusion Zerobalanced ultrafiltration can improve pulmonary function after coronary artery bypass grafting and shorten postoperative mechanical ventilation time.
Abstract： Objective To find out goodness and weakness by comparing totally thoracoscopic surgery （TTS）and median sternotomy （MS）with cardiopulmonary bypass for pediatric open heart operation. Methods One hundred and fortyseven patients with ventricular septal defect(VSD) and atrial septal defect(ASD) were randomly divided into two groups according to operative methods, TTS group: patients were operated by totally thoracoscopy; MS group: patients were operated by median sternotomy with cardiopulmonary bypass. The clinical records from two groups were compared on operative effect, complications, hospitalization, ventilation time,variations of main data of blood routine test, drainage of pleura cavity, blood loss and transfusion, and pulmonary function. Results There were no death in two groups. There was VSD residual leak the same day after operation which was cured by TTS in one patient of TTS group. There was one case which bleeding was stopped by second operation in MS group. Followup visit were made to 41 patients for 3 months, no heart murmur was detected. The ultrasonic cardiography (UCG) showed that correcting of VSD and ASD were good and had no residual leak. The hospitalization,aortic clampping time, ventilation time and variations of main data of blood routine test, drainage of pleura cavity, blood transfusion and blood loss in TTS group had no significant difference to those in MS group (Pgt;0.05). Operating times was longer in TTS group than that in MS group, while stays in the intensive care unit were shorter in TTS group than that in MS group (Plt;0.01). Preoperative and 3 months postoperative pulmonary function of both teams had no statistically significant difference in two groups (Pgt;0.05). Conclusion TTS is a safe and effective method to pediatric VSD and ASD as MS is.
【Abstract】 Objective To study the short-term effects of thoracoscopic anterior spine release combined with posterior correction on the pulmonary function in patients with idiopathic scoliosis (IS). Methods Between April 2004 and June 2008, 21 cases of IS underwent thoracoscopic anterior spine release combined with posterior correction. There were 9 males and 12 females with a mean age of 15.6 years (range, 12 to 24 years). Of 11 patients, 2 had left protrusion deformity and 19 had right protrusion deformity, including 12 cases of Lenke type I and 9 cases of Lenke type II, with an average coronal Cobb’s angle of 79.6° (range, 65-125°). The disease duration ranged from 1 year and 6 months to 9 years (mean, 2.5 years). The results of pulmonary function tests (PFTs) were compared between pre-operation and postoperative 6th month, including lung capacity, ventilation function, and thoracic compliance. Results The opening time of the chest was 90 to 150 minutes (mean, 127 minutes) at the thoracoscopic anterior spine release and all incisions healed by first intention with no chest cavity infection. All the patients were followed up from 6 to 36 months (mean, 13.5 months). The average coronal Cobb’s angle was 43.7° (range, 36-75°) at 1 week after posterior correction. At 6 months after operation, the vital capacity and total capacity were significantly increased (P lt; 0.05), but no significant change was observed in the percentage of actual value and expected one when compared with pre-operation (P gt; 0.05). The functional residual capacity and the percentage of actual value and expected one of residual volume was significantly decreased when compared with those at pre-operation (P lt; 0.05). The forced expiratory volume in one second (FEV1) and FEV1/FEV were not significantly improved (P gt; 0.05) , but the maximum ventilatory volume was significantly increased when compared with the preoperative value (P lt; 0.05). In addition, the Raw Total, Raw Insp, and Raw Exp decreased significantly after operation (P lt; 0.05). Conclusion Although the thoracoscopic anterior spine release combined with posterior correction might disturb the function of the thoracic cavity, the PFTs of the patients could be improved at different aspects because of the shape changes of the thoracic cavity, and the pulmonary function still needed further observation.
ObjectiveTo analyze the clinical characteristics of patients with amyopathic dermatomyositis with organizing pneumonia (ADM-OP).MethodsThe clinical data of 8 patients hospitalized with ADM-OP from June 2014 to June 2018 were retrospectively reviewed and simultaneously compared with those of 8 patients of cryptogenic organizing pneumonia (COP).ResultsThe incidence of skin lesion, Gottron’s sign, mechanic’s hand and positive anti-synthase antibodies in the ADM-OP patients were 87.5%, 87.5% 75.0% and 87.5% respectively. Gender, smoking, respiratory symptoms and signs, arterial partial pressure of oxygen, arterial partial pressure of carbon dioxide and treatment strategy were no statistical difference between ADM-OP and COP patients, but the onset age and Chest CT fibrosis scores (CTFS) on admission existed differences. After treatment for 3 months, CTFS, rate of change and forced vital capacity (FVC) existed differences. After treatment for 6 months, CTFS, rate of change, FVC and diffusing capacity of the lung for carbon monoxide existed differences.ConclusionsSkin lesion, Gottron’s sign, mechanic’s hand and positive anti-synthase antibodies are more common in ADM-OP patients. Their response to treatment is good but the improvement rates in CTFS and pulmonary function are slower than those of COP patients.
ObjectivesTo investigate the prevalence of respiratory diseases and lung function of school-age children in Chongqing and to compare them with that of children in 25 years ago and to explore the possible causes of this change.MethodsAccording to the air quality data of Chongqing from 1998 to 2016, the annual variation of air quality days and pollutant concentrations were plotted. 2 126 school-age children in two districts of Chongqing were selected by random cluster sampling for questionnaires. 771 children were randomly selected from the children who completed the questionnaire for pulmonary function tests. The results were compared with that of 25 years ago.ResultsFrom 1998 to 2016, the number of days with good air quality in Chongqing increased annually, and the concentration of SO2 decreased significantly. The main air pollution composition changed from SO2 to PM10 and PM2.5. The prevalence of bronchitis (P<0.05) was higher than that of 25 years ago. After adjusting for confounding factors by multivariate logistic regression, the OR value of bronchitis in children was 1.667 (P<0.05) compared with 25 years ago. After adjusting for age, sex, height and weight by multiple linear regression, the results showed that the subjects' lung function indexes (FVC, FEV1, PEF and FEV3) were lower than that of 25 years ago. In this survey, there were differences in lung function indexes between children with different frequency of eating fruits and dairy products (P<0.05), and those with high frequency consumption were higher than low frequency. In terms of exercise time, subjects exercising ≥1 hour/day had greater FVC and FEV3 values than those exercising <1 hour/day (P<0.05).ConclusionsThe overall air quality in Chongqing has improved from 1998 to 2016; The respiratory health of children has decreased when compared with that of 25 years ago. Changes in the composition of air pollutants may endanger children's respiratory health, and fruit and dairy foods and exercise may be protective factors for children's respiratory health.
Objective To explore the effect of smoking on pulmonary function parameters of male patients with chronic obstructive pulmonary disease (COPD) and to analyze the correlation between smoking and pulmonary function parameters. Methods From January 2014 to October 2015, the pulmonary function parameters of 223 male outpatients or hospitalized patients with COPD in the Department of Respiratory Medicine were retrospectively analyzed by using SPSS 17.0 software. The patients were randomly divided into smoking group (n=98), smoking cessation group (n=82) and non-smoking group (n=43). Results Various degrees of damage or abnormality of lung capacity, ventilatory function, gas exchange function and airway resistance (Raw) existed in the patients with COPD. Compared with smoking cessation group and non-smoking group, residual volume/ total lung capacity (RV/TLC) and Raw were significantly higher (P< 0.05), maximum ventilatory volume, ventilation reserve percent, forced vital capacity, the percent of first second forced expiratory volume compared its predicted value (FEV1%pred), maximum mid-expiratory flow (MMEF), forced expiratory flow 50%, forced expiratory flow 75% and diffusing capacity of carbon monoxide were significantly lower (P<0.05) in the smoking group. There was a negative relationship between MMEF, FEV1%pred and smoking index (r=–0.352, –0.381, P<0.05), and a positive relationship between Raw, RV/TLC and smoking index (r=0.403, 0.378, P<0.05). Conclusions Most of the male COPD patients smoke or used to smoke. Smoking leads to ventilation and gas exchange function decrease, small airway limitation aggravation, airway resistance and emphysema degree increase in COPD patients. Smoking index has a negative relationship with MMEF, FEV1%pred and a positive relationship with Raw and RV/TLC.