ObjectiveTo investigate the changes of lung function after exposure to fine particulate matter (PM2.5) for 60 days and the expression of miR-146 in mice.MethodsThirty SPF BALB/c mice were treated with noninvasive tracheal instillation of fine particulate matter suspension at different doses (2.5 mg/kg, 5.0 mg/kg, 10.0 mg/kg) for 2 months (two times one week), the blank group and normal saline group were set as control groups. The mice were examined and killed on the next day after the last instillation. Histopathological changes of the lungs, pro-infammatory factors levels in the lung tissues, pulmonary functions and the relative expression of miR-146a and miR-146b in the lung tissues were detected.ResultsPeak inspiratory flow (PIF) and peak expiratory flow (PEF) were decreased significantly after PM2.5 exposure, however, lung resistance increased and maximal voluntary ventilation reduced from the general tendency without significant difference. Hematoxylin-eosin stain showed lymphocyte infiltration and macrophage infiltration by phagocytic particles, alveolar spacer widening, inflammatory response increased with the increase of PM2.5 exposure dosage. Pro-infammatory factors as interleukin-6 in the bronchoalveolar lavage fluid, interferon-γ and tumor necrosis factor-α in the lung homogenate were increased significantly by enzyme linked immunosorbent assay. The relative expressions of miR-146a and miR-146b were up-regulated remarkablely in treatment groups compared to the control group by real-time fluorescence quantitative polymerase chain reaction, which had negative relationships with PIF and PEF.ConclusionsThe lung function of mice decreases significantly after exposure to fine particulate matter, and the expression of miR-146 is up-regulated.
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.
ObjectiveTo compare the influence of intrathoracic and retrosternal esophagogastric anastomosis on pulmonary function in aged patients after esophagectomy.
MethodsForty patients (older than 62 years) with upper or middle thoracic esophageal carcinoma (EC) who underwent esophagectomy in Fengtian Hospital of Shenyang Medical College between February 2009 and May 2011 were enrolled in this study. According to different surgical approach, all the patients were divided into an intrathoracic esophagogastric anastomosis (IEGA) group and a retrosternal esophagogastric anastomosis (REGA) group. There were 20 patients in IEGA group including 16 males and 4 females with their age of 62-79 (64.70±11.47) years, who received cervical anastomosis after EC resection and intrathoracic gastric tube reconstruction. There were 20 patients in REGA group including 17 males and 3 females with their age of 63-77 (65.90±12.72) years, who received cervical anastomosis after EC resection and retrosternal gastric tube reconstruction. Pulmonary function test (PFT) was performed preoperatively and on the 15th and 30th postoperative day, and compared between the 2 groups.
ResultsThere was no statistical difference in preoperative PFT between the 2 groups (P > 0.05). PFT of IEGA group on the 15th and 30th postoperative day was significantly worse than preoperative PFT (P < 0.05). PFT of REGA group on the 15th and 30th postoperative day was not statistically different from preoperative PFT (P > 0.05). PFT of REGA group on the 15th and 30th postoperative day was significantly better than PFT of IEGA group (P < 0.05). In IEGA group, postoperative complications included anastomotic leak in 1 patient, anastomotic stenosis in 1 patient, pneumonia in 5 patients and atelectasis in 1 patient. In REGA group, postoperative complications included anastomotic leak in 1 patient, anastomotic stenosis in 1 patient, gastric outlet obstruction in 1 patient and pneumonia in 3 patients. All the patients were followed up for 1 year. There was no statistical difference between PFT at 1 year after discharge and PFT on the 30th postoperative day in either group.
ConclusionsIEGA can significantly reduce postoperative PFT. REGA has less negative influence on postoperative PFT, is suitable for aged patients and patients with unsatisfactory preoperative PFT, can reduce postoperative complications and improve postoperative quality of life.
ObjectiveTo investigate the correlation between brain natriuretic peptide (BNP) and cardiopulmonary function, as well as explore prognostic value of BNP in patients with interstitial lung disease(ILD).
MethodsThe clinical data of ILD patients admitted between February 2010 and April 2013 were retrospectively analyzed.The relationship between serum BNP level and cardiopulmonary function was analyzed by Pearson's or Spearman's rank correlation test.Meanwhile, the patients were divided into a survivor group and a death group, as well as a pulmonary hypertention (PH) group and a normal group respectively.Clinical data were compared between two groups.
ResultsThere were 38 patients included in the study.BNP concentration was correlated with echocardiographic indices of right heart function, including systolic pressure of pulmonary artery, right atrial inlet diameter, right ventricular inlet diameter, and right ventricular end-diastollc diameter (P < 0.05), but not correlated with echocardiographic parameters of left heart function (P > 0.05).BNP was also correlated with DLCO%pred.BNP and right heart function parameters except right atrial inlet diameter were significantly higher, and DLCO%pred, were significantly lower in the death group and the PH group than those in the survivor group and the normal group (P < 0.05).
ConclusionsSerum BNP concentration can reflect right heart function appropriately, suggesting pulmonary vascular impairment in ILD patients contributes to increased pulmonary vascular resistance.Elevated BNP levels are associated with increased mortality and poor prognosis in patients with ILD.
Objective To explore the effects of different intensity of inspiratory muscle training on pulmonary function, hospitalisation time and quality of life of critically ill patients. Methods A total of 42 patients were included in the intensive care ward, high dependency ward, and cardiac surgery ward of the Southern Theatre General Hospital from January 2023 to June 2023, and were randomly divided into 14 cases in the control group, 14 cases in the low-intensity inspiratory muscle training group, and 14 cases in the moderate-intensity inspiratory muscle training group; conventional treatment was used for the control group, and 20% of the maximum inspiratory pressure (MIP) was added as the starting threshold load for inspiratory muscle training for the patients of the low-intensity inspiratory muscle training group on the basis of conventional treatment. In the control group, conventional treatment was used; in the low-intensity inspiratory muscle training group, 20% of the maximum inspiratory pressure (MIP) was added to the conventional treatment as the starting threshold load for inspiratory muscle training; in the medium-intensity inspiratory muscle training group, 40% of the MIP was added to the conventional treatment as the starting threshold load for inspiratory muscle training; and the maximal inspiratory pressure, exertional lung capacity, diaphragm thickness and mobility, hospital stay and quality of life were evaluated after 6 weeks of training. Results A total of 40 patients completed the training, and the three groups showed statistically significant differences in MIP (P<0.05) and statistically significant differences in exertional lung capacity (P<0.05). There was no statistically significant difference in diaphragm thickness (P=0.566), and diaphragm mobility was lower in the control group than in the low-intensity inspiratory muscle training group (P=0.021), and there was also a difference between the low-intensity inspiratory muscle training group and the moderate-intensity inspiratory muscle training group (P=0.036); there was a difference in the length of stay in the care unit among the three groups (P=0.034), and there was no statistically different (P=0.149), and the duration of hospital stay was significantly shorter in the moderate intensity inspiratory muscle training group compared to the control group (P=0.016). Medium-intensity inspiratory muscle training can significantly improve patients' quality of life compared with the control group and low-intensity inspiratory muscle training group (P<0.05). Conclusions Both low-intensity inspiratory muscle training and moderate-intensity inspiratory muscle training can enhance the lung function of critically ill patients, improve their diaphragm mobility, and promote their pulmonary rehabilitation. Medium-intensity inspiratory muscle training was significantly better than low-intensity inspiratory muscle training in improving the lung function of patients. Moreover, moderate-intensity inspiratory muscle training may have positive significance in improving patients' quality of life and shortening their hospitalisation time.
Objective To investigate the effects of a mixed bacterial lysate (OM-85 BV) on lung function and serum IgE in asthmatic mice under acute attack, and to explore the therapeutic effect of OM-85 BV on acute attack and the application value of OM-85 BV in non-acute attack. Methods A total of 30 SPF Kunming mice aged 4 to 6 weeks were randomly divided into 3 groups, namely a blank control group (Group A), an asthma model group (Group B), and an OM-85 BV intervention group (Group C). The mice in groups B and C were sensitized by intraperitoneal injection of ovalbumin on day 1, 8 and 15, respectively. From day 22, the asthma model was stimulated by inhalation of 5% ovalbumin every day for 30 min for 5 consecutive days. The mice in group C were treated with OM-85 BV dissolved in normal saline from day 1, and each mouse was gavaged continuously for 10 days. The intraperitoneal injection, intragastric administration and aerosol inhalation reagent of mice in group A were all replaced by normal saline, while the intragastric administration of mice in group B was replaced by normal saline. One hour after the last stimulation, the mice were anesthetized, their lung function was measured, blood was collected from the eyeballs and then they were sacrificed, and the blood was centrifuged and the serum was separated and stored. Hematoxylin and eosin staining was used for pathological examination. Serum IgE was determined by enzyme-linked immunosorbent assay. Results Compared with group A, forced vital capacity in 0.15 second (FEV0.15), FEV0.15/forced vital capacity (FVC) and peak expiratory flow (PEF) of mice in group B were significantly decreased. The lung function of group C was improved compared with group B. In group B, the pathological manifestations were dysplasia and collapse of bronchial epithelium, infiltration of inflammatory cells, mainly lymphocytes and eosinophils, a small amount of mucus and shed epithelial cells in the tracheal lumen, and significant thickening of airway wall. The asthma mouse model was well established. The pathological manifestations of airway in group C were less severe than those in group B, the thickness of airway wall was reduced, and the inflammatory cells were also significantly reduced. The serum IgE concentration in groups B and C increased, and the IgE level in group C decreased significantly compared with group B. The differences were statistically significant (all P<0.05). Conclusions Exogenous administration of OM-85 BV in asthmatic mice can effectively reduce the concentration of serum IgE, alleviate airway inflammation, reduce eosinophil infiltration, and improve the pulmonary function performance of asthmatic mice during acute attack, showing that FEV0.15/FVC, FEV0.15 and PEF indicators are significantly improved. OM-85 BV can alleviate the symptoms of bronchial asthma in the acute attack of mice, improve the physiological function of the lung during the acute attack, inhibit airway inflammation, and have certain application value in the stable asthma control.
Objective
Since 2009, assessment of asthma control in Global Initiative for Asthma (GINA) includes current clinical control and future risk. " Current clinical control” is replaced by " symptom control” in GINA 2015, and lung function is excluded from assessment of current clinical control. This study was designed to investigate the agreement in current asthma control assessment between GINA 2009 and 2015, and to explore whether FEV1 monitoring plays an important role in this context.
Methods
A cross-sectional study was conducted among patients with stable asthma (n=138). The levels of asthma control were graded by GINA 2009 and GINA 2015, respectively. Demographic data, spirometry, exacerbations in the past 12 months, peripheral blood cells, induced sputum were collected. Kappa coefficient was used to measure the agreement of the two asthma control tools. Association of the asthma control levels using the two tools with the exacerbations in the past 12 months was examined by Spearman correlations. Additionally, associations of lung function with the exacerbations in the past 12 months were analyzed.
Results
Agreement in assessing current asthma control between GINA 2009 and 2015 was moderate (Kappa=0.595, P<0.001). Compared with GINA 2009, the patients with well-controlled asthma assessed by GINA 2015 had worse FEV1%pred [(89.9±12.9)% vs. (79.9±18.2)%, P=0.013], the partly controlled subjects assessed by GINA 2015 had worse asthma control scores in ACQ-6 score (0.8±0.7 vs. 1.1±0.7, P=0.028) and ACT score (20.7±2.5 vs. 19.4±2.5, P=0.007). Furthermore, asthma control levels assessed by either GINA 2015 or 2009 were related to exacerbations in the past 12 months and stronger relationship was presented in GINA 2015 (r=–0.268 for GINA 2015 vs. r=–0.212 for GINA 2009, respectively). In addition, there were no differences in cell counts in induced sputum or peripheral blood or IgE level in peripheral blood in patients with different asthma control levels assessing by GINA 2009 and 2015.
Conclusions
Our study indicates that it has a moderate agreement of assessing current asthma control between GINA 2015 and 2009. Compared with GINA 2009, absence of FEV1 monitoring from GINA 2015 would result in worse lung function in well-controlled asthma and worse asthma control scores in partly controlled asthma. Addition of FEV1 monitoring to GINA 2015 would weaken the relationship between current asthma control and future asthma outcomes, although it didn't reach statistical significance. Our study supports that GINA 2015 lacking lung function monitoring in current asthma control assessment is applicable in clinical practice.
