Objective Using nerve growth factor ( NGF) and anti-NGF microspheres injected directly into the asthmatic rat adrenal gland, to explore the possible role of anti-NGF microsphere treatment in asthma.Methods 32 male SD rats were randomly divided into a normal control group, an asthma group, a NGF microspheres group, and an anti-NGF microspheres group. The behavior of rats, lung function testing, light microscopy of lung biopsy, electron microscopy of adrenal medulla cell ultrastructure changes, NGF and phenylethanolamine N-methyltransferase ( PNMT) expressions in the adrenal gland were assayed by immunohistochemistry method, and serum NGF, cortisol, corticosterone, epinephrine and norepinephrine concentrations were detected by ELISA. Results Behavior in the asthma rats showed varying degrees of sneezing, runny nose, wheezing, scratching the head and face, irritability holes, incontinence, increased aggression and other acts, while in the anti-NGF rats showed relatively slighter symptoms. The rats in the asthma, anti-NGF and NGF groups showed significant airway hyperresponsiveness, while RL value reduced and Cdyn value increased in the anti-NGF group compared with the asthma group. HE staining of lung tissue revealed obvious bronchoconstriction, inflammatory cell infiltration around small vessels and alveolar spaces and in interstitum, bronchial epithelial cells desquamation in the asthma group. In anti-NGF group, tracheal epithelium was relatively complete, inflammatory exudation, bronchoconstriction and inflammatory cell infiltration were milder compared to the asthma group. Electron microscopy showed vacuolated changes of adrenal medulla cells, uneven distribution of chromaffin granules in the asthma group and the NGFgroup, and the quantity and concentration of chromaffin granules were significantly lower than normal. There were villous clubbing processes on the adrenal medulla cell membrane in the NGF group. While the anti-NGF group had no significant vacuolar changes in chromaffin granules and the concentration was close to normal. Image analysis showed that mean gray values of PNMT and NGF in the anti-NGF group were significantly different fromthe asthma group. The ELISA results showed that: ( 1) The average concentrations of epinephrine in each group were as follows, ie. the control group gt; anti-NGF group gt; asthma group gt; NGF group. ( 2) The average concentrations of norepinephrine in each group were as follows, ie. the NGF group gt; asthma group gt; anti-NGF group gt; control group. ( 3) There was no significant difference among the groups in the average concentration of cortisol. ( 4) The average concentrations of norepinephrine in each group were as follows, ie. , the control group gt; anti-NGF group gt; asthma group gt; NGF group. Conclusions Local embedding of anti-NGF microspheres can alleviate inflammatory infiltration in lung tissue and improve lung function of rat model with asthma. The mechanismmay be the anti-NGF antagonists the NGF receptor and reverse adrenal medulla cell transdifferentiation process primined by NGF.
ObjectiveTo explore the influence of respiratory function training on pulmonary function of patients with pneumoconiosis. MethodsOne hundred patients with pneumoconiosis hospitalized in our department between June 2011 and September 2012 were chosen as the research subjects. According to the method of random digits table, they were equally and randomly divided into contrast group and observation group. Patients in both the two groups were given routine treatment and nursing and health education, while patients in the observation group adopted respiratory training with lung functional exerciser in addition. Then we observed the forced expiratory volume in one second (FEV1), vital capacity, maximal voluntary ventilation, forced vital capacity, classification of conscious shortness of breath and shortness of breath as well as classification of activities of daily living in the patients before and after training in both the two groups. ResultsAfter 6 months, lung function index, classification of conscious shortness of breath and shortness of breath as well as classification of activities of daily living of patients in the observation group improved a lot, which was significantly better than that in the contrast group (P<0.05). Compared with the contrast group, the FEV1 [(2.75±0.43) L], vital capacity [(3.29± 0.45)L] of patients in the observation group were significantly higher (P<0.05). Compared with the contrast group, classification of conscious shortness of breath and shortness of breath (2.10±0.67), classification of activities of daily living (2.19±0.66) were also significantly different (P<0.05). ConclusionRespiratory function training with lung functional exerciser can improve lung function of patients with pneumoconiosis, alleviate the degree of dyspnea, and enhance the quality of life.
Objectives To investigate the pathogenic characteristics and the possible relationship between pathogen and respiratory function in patients with acute exacerbations of COPD (AECOPD).Methods Sixty-four patients with AECOPD were investigated with lung function test，quantitative and qualitative sputum bacteria culture，drug sensitive test，and Mycoplasma pneumoniae and Chlamydia pneumoniae specific antibodies test.The patients were divided into three groups according to FEV1%pred，50%≤FEV1lt;80%pred for the Group One，30%pred≤FEV1lt;50%pred for the Group Two，and FEV1lt;30%pred for the Group Three.Meanwhile according to the result of sputum culture，infective bacteria were divided into four kinds： Gram-positive cocci for kind A，Gram-negtive germ except kind C for kind B，Acinetobacter，Enterobacter and Pseudomonas spp for kind C，and negative result for kind D.Results ⑴Of 64 patients who were conducted quantitative sputum culture，germs isolated were mostly Streptococcus pneumoniae，Enterobacter，Moraxella Catarrhalis，and Pseudomonas.Of 38 patients who were conducted qualitative sputum culture，most of them were found mixed infection，and germs isolated were mostly Streptococcus pneumoniae，Staphylococcus epidermidis，Acinetobacter and Enterobacter.⑵Both quantitative and qualitative sputum culture revealed that Most of Group One patients were not infected by bacteria，and the Group Three patients were mainly by resistant kind A and kind C bacteria (Plt;0.01 and 0.05 respectively).⑶The infection of Mycoplasma pneumoniae or Chlamydia pneumoniae was identified in 29.4% of the cases.Conclusions There is a close correlation between the degree of functional damage and the infected bacterial strains for patients with AECOPD，the more chance of bacteria infection such as S pneumoniae，Acinetobacter，Enterobacter and Pseudomonas，the more damage of lung function.
ObjectiveTo verify the existing domestic and foreign formulas of normal predictive value indicator for adult pulmonary diffusion capacity’s applicability at current stage in Kunming.MethodsBased on the pulmonary diffusion capacity parameters determination of diffusion capacity for carbon monoxide of the lung (DLCO) collected from one-breath breathing test completed by 680 adults with healthy lung function and without any disease which may cause pulmonary diffusion dysfunctions in Kunming, the regression equation of adult DLCO normal predicted value in Kunming was initially established; the fitting degree of DLCO predicted value and measured value was verified; and the correlation between European adults (instrument-inherent ECCS93) and the normal predicted values of adult DLCO in Shanghai, Chongqing and Lhasa were calculated and contrasted.ResultsThe regression equation of adult DLCO normal predicted value in Kunming was initially established: for male, 0.483+0.063×height (cm)+0.041×weight (kg)–0.071×age (years); for female, 1.679+0.055×height (cm)+0.018×weight (kg)–0.060×age (years). The data collected from the one-breath breathing test were similar to the predicted values obtained from the normal adult male and female DLCO prediction formulas in Kunming, the difference was not statistically significant (tM=–0.167, tF=–0.436, both P>0.05), suggesting that the formula for predicting the value established in this study was valid and well fitted. The predicted value of adult DLCO in Kunming area was statistically significant compared with the adult DLCO estimates of European adults and Lhasa, Chongqing and Shanghai in China (FM=713.4, FF=1 442.2, both P<0.001). Lhasa had the highest value; Kunming was the second highest; instrument-inherent European area and Chongqing came to third and fourth; and Shanghai had the lowest predicated adult DLCO value (all P<0.001).ConclusionThe current predictive formulas for adult pulmonary diffusion capacity indicators in China and worldwide are not suitable for the populations in Kunming.
Objective The purpose of this study was to explore the correlation between peripheral blood eosinophil (EOS) count and smoking history, some inflammatory indicators, lung function, efficacy of ICS, risk of respiratory failure and chronic pulmonary heart disease, risk of acute exacerbation within 1 year, readmission rate and mortality in patients with acute exacerbation of COPD. Methods Retrospective analysis of the baseline clinical data of 816 patients with acute exacerbation of chronic obstructive pulmonary disease in the Department of Respiratory and Critical Care Medicine of the First Affiliated Hospital of Shihezi University from January 1,2019 to December 31,2021. The patients were divided into EOS ≥ 200 cells / μL (High Eosinophi, HE) group and EOS<200 cells / μL (low Eosinophi, LE) group according to whether the peripheral blood EOS was greater than 200 cells / μL at admission. Peripheral venous blood data (including blood eosinophil count, white blood cell count, lymphocyte percentage, neutrophil percentage), blood gas analysis value, lung function index and medication regimen of all patients were collected, and the efficacy of ICS was recorded. The patients were followed up for 1 year to observe the acute exacerbation and readmission rate, and the mortality rate was followed up for 1 year and 2 years. Results Neutrophil count, lymphocyte count and peak expiratory flow (PEF) in HE group were positively correlated with EOS value (P<0.05), and smoking was more likely to increase EOS value. HE group was more sensitive to ICS. The risk of acute exacerbation in HEA group was higher than that in LE group. ICS could reduce the rate of acute exacerbation in HE group. EOS value in LE group was inversely proportional to FEV1 / FVC and MMEF values (P<0.05). The risk of chronic pulmonary heart disease in LE group was higher than that in HE group. The 2-year mortality rate in HE group was higher than that in LE group. Conclusions Peripheral blood EOS count is correlated with some inflammatory indicators, acute exacerbation risk, and lung function. ICS can improve the clinical symptoms and prognosis of patients with higher EOS count.
Objective?To investigate the relationship between syndromes of traditional Chinese medicine (TCM) and lung function in patients with chronic obstructive pulmonary disease (COPD) at stable phase. MethodsBased on diagnostic criterion of TCM, five groups of symptoms of TCM about stable COPD were established including lung Qi deficiency, lung and spleen Qi deficiency, lung and kidney Qi deficiency, lung Spleen Kidney Qi deficiency, and deficiency of both Qi and Yin. A total of 300 cases which were up to the standard were differentiated into 5 groups by the symptoms. Some basic details and lung function of the patients were recorded, and then statistical analysis was performed to analyze the differences of lung function among groups. ResultsForced expiratory volume in the first second in descending order was lung Qi deficiency group, lung and spleen Qi deficiency group, lung and kidney Qi deficiency group, and lung spleen kidney Qi deficiency group (P<0.05). ConclusionThese findings suggest that with the progressing of COPD, the symptom type of TCM for COPD patients at stable phase may vary from lung Qi deficiency to lung and spleen Qi deficiency, or to lung and kidney Qi deficiency, and even lung, spleen and kidney Qi deficiency. Lung function tests help reveal substance and pathogenesis of TCM syndromes of patients with stable COPD, and provide evidence for the clinical syndrome.
Objective To explore the correlation between different ultrasound pulmonary artery systolic pressure (PASP) and high-resolution CT (HRCT) pulmonary artery width (PAD) in patients with chronic obstructive pulmonary disease (COPD). Methods A retrospective analysis was conducted on 473 patients with acute exacerbation of chronic obstructive pulmonary disease who were hospitalized in the First Hospital of Lanzhou University from January 2016 to December 2020. They were divided into four groups according to the degree of PASP elevation: PASP normal group: PASP≤36 mm Hg, 182 cases; mildly elevated group: PASP 37 to 50 mm Hg, 164 cases; moderately elevated group: PASP 51 to 70 mm Hg, 89 cases; severely elevated group: PASP>70 mm Hg, 38 cases. The PAD of chest HRCT and the width of the ascending aorta (AAD) on the same plane were measured, and the ratio of PAD to AAD (PAD/AAD) was calculated. The differences of PAD, AAD, PAD/AAD in different PASP groups of COPD were compared. The correlations between PASP, lung function, blood gas analysis and PAD, PAD/AAD were analyzed. Results With the decrease of FEV1%pred, FVC%pred, FEV1/FVC, PaO2 and SaO2 in the patients, PaCO2 increased, PASP gradually increased, PAD and PAD/AAD gradually increased. PAD and PAD/AAD were significantly different between the severely elevated PASP group and the other three groups, and there were significant differences between the moderately elevated group and the normal group, and between the moderately elevated group and the mildly elevated group. PASP and PaCO2 were positively correlated with PAD and PAD/AAD, and FEV1%pred, FVC%pred, FEV1/FVC, PaO2, SaO2 were negatively correlated with PAD and PAD/AAD. Multivariate logistic regression analysis showed that after adjusting for confounding factors, decreased FEV1%pred was an independent risk factor for PAD/AAD>1 in COPD patients. The receiver operating characteristic curve showed that the width of PAD and PAD/AAD had certain predictive value for PASP. Conclusions There is a significant positive correlation between different degrees of ultrasound PASP and PAD and PAD/AAD in patients with COPD. HRCT PAD has certain predictive value for PASP. The heavier the hypoxia and carbon dioxide retention, the worse the pulmonary ventilation function, the higher the pulmonary artery pressure, the greater the possibility of PAD and PAD/AAD.
ObjectiveTo investigate the effects of acute and chronic ozone exposure on inflammation,structure and function in murine lung. Methods32 C57/BL6 mice were randomly divided into a single (acute) ozone exposed group,a single air exposed group,a multiple (chronic) ozone exposed group (every three days over 6 weeks),and a multiple air exposed group with 8 mice in each group.The mice were exposed to 2.5 ppm of ozone or air for 3 hours per time and sacrificed 24 hours after the last time of ozone exposure.Lung volume,low attenuation area (LAA) percentage,lung function,cell counts and malondialdehyde (MDA) in bronchoalveolar lavage fluid (BALF),8-hydroxy-2'-deoxyguanosine (8-OHdG) in serum,inflammation scores and mean linear intercept (Lm) in lung section were assessed. ResultsCompared with the single air exposed group,single (acute) ozone exposure led to increases in inflammatory cells in BALF,inflammation scores in the lung tissue,MDA in BALF and 8-OHdG in serum,but had no effect on lung volume,LAA percentage,airflow or Lm.Compared with the single (acute) ozone exposed group,the single air exposed group and the multiple air exposed group,multiple (chronic) ozone exposure increased inflammatory cells in BALF,lung volume,LAA percentage,total lung capacity and lung compliance,mediated airflow obstruction,and also increased lung inflammation socres and Lm. ConclusionAcute ozone exposure induced airway/lung inflammation and oxidative stress,while chronic ozone exposure induced airway/lung inflammation,emphysema and airflow obstruction.
ObjectiveTo explore the clinical features of atypical bronchial asthma with chief complaint of palpitations. MethodsTwelve cases with unexplained palpitations diagnosed by asthma were analyzed retrospectively. ResultsThe patients were diagnosed with asthma through bronchodilation test,skin prick tests,fractional exhaled nitric oxide (FeNO) and diagnostic treatment.The ratio of male to female cases was 1:5. The ventilation lung function of all patients was in normal range. The median time of misdiagnosis was 13.5(3-120) months. 41.6% of cases had dust mite positive skin prick test. The median value of FeNO was 32.75(18-54) ppb. The symptoms of all patients were relieved completely after standard treatment. ConclusionPalpatation may be a specific presentation of asthma characterized with eosinophilic airway inflammation which may be misdiagnosed as other diseases for a long time,especially in elder women. To improve the knowledge of this kind of atypical asthma,detailed medical history, experimental examinations and diagnostic treatment response are important to confirm the diagnosis in time.
Objective To estimate the degree of the angle between left principal bronchus and trachea, and it is correlative with the pulmonary function in the patients with rheumatic mitral valve disease. Methods According to various degree of angles between left principal bronchus and trachea,53 patients were divided into three groups, group 1: angle between left principal bronchus and trachea less than 50 degree, group 2: between 50 and 64 degree, group 3: between 65 and 79 degree. The pulmonary function tests,ultrasonic cardiography and left principal bronchus X-ray tomographic film were carried out in three groups before operation. Compare pulmonary function data with different angle between left principal bronchus and trachea in three groups. Results Exception of vital capacity ,residual volume and total lung capacity,the rest markers of lung function showed significant differences (Plt;0.05) in three groups. The correlation of the angle between left principal bronchus and trachea and the ratio of residual volume and total lung capacity among three groups were positively correlative, and the other parameters of lung function were negatively correlative (Plt;0.01). Conclusion The degree of the angle between left principal bronchus and trachea is positively correlative with the extent of pulmonary function impairing.