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.
Pectus excavatum (PE) is a common congenital chest malformation in children, manifested by inward depression of the anteriorthorax wall, which can compress the normal tissues and organs in the chest and cause adverse effects on the physiology and psychology of patients. Surgery is the most important means of treating PE, and with the invention of Nuss surgery, the surgical treatment of PE has entered the minimally invasive era. At present, there are many indexes to evaluate the severity of thoracic malformations in PE patients, and selecting appropriate evaluation indexes is of great significance for the formulation of surgical protocols. As a physical and mental disease, PE's deformed thoracic appearance not only affects the function of thoracic organs, but also affects the psychological state of patients. Therefore, there is still controversy over whether the role of orthopedic surgery is to improve function or cosmetic plastic surgery. At the same time, the orthopedic efficacy and postoperative complications of the existing modified and novel surgical methods need to be further observed and evaluated. In addition, the design of surgical plan and the selection of surgical timing for PE combined with other diseases are also critical and controversial issues in clinical practice. Therefore, this article explores and reviews the controversial points in the current surgical treatment of PE.
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 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% .
Objective To evaluate the effects of inhaled bronchodilators on respiratory mechanics in moderate and severe chronic obstructive pulmonary disease（COPD） patients during eupnea.Methods Twenty moderate to severe COPD subjects were divided into three groups.Lung function，Borg score，breathing pattern and respiratory mechanics indexes were measured at baseline and 30 min after inhaled placebo，salbutamol 400 μg (or ipratropium 80 μg)，and ipratropium 80 μg (or salbutamol 400 μg) in sequence at interval as specified in different groups.Results In all groups，inhaled bronchodilators improved lung function (FEV1，FVC，IC) (Plt;0.05)，decreased Pdi，Peso，PTPdi，PTPeso and Raw (Plt;0.05，respectively)，in comparison with placebo.The reduction of PTPeso was positively correlated with the reduction of Peso (r=0.713，Plt;0.01）and Raw (r=0.602，Plt;0.01).Borg score decreased after inhaled bronchodilators (Plt;0.05).The reduction of dyspnea was positively correlated with the reduction of inspiratory work of breathing (ΔPTPeso%) (r=0.339，Plt;0.05) and Raw (ΔRaw) (r=0.358，Plt;0.05)，while was not associated with the changes of FEV1，FVC and IC.Conclusions In COPD patients，inhaled bronchodilators can reduce inspiratory work of breathing and airway resistance，the reduction of inspiratory work of breathing contributed to the reduction of airway resistance.Alleviation of dyspnea by inhaled bronchodilators is suggested to be ascribed to reduction of airway resistance and inspiratory work of breathing.
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.
ObjectiveTo analyze the relationship between preoperative pulmonary function indexes and postoperative pneumonia (POP) in patients undergoing upper gastrointestinal surgery.MethodsThe clinical data of 303 patients who underwent lung function examination and upper gastrointestinal surgery in West China Hospital, Sichuan University from September 2020 to January 2021 were prospectively collected and analyzed. There were 217 males and 86 females, with an average age of 61.61±10.42 years. Pulmonary function was evaluated from four aspects including ventilatory function, pulmonary volume, diffusion function and airway resistance. Relevant pulmonary function indicators were displayed as the percentage of actual measured value to predicted value (%pred). The outcome index was pneumonia within 30 days after the surgery. Logistic regression was used to analyze the relationship between preoperative pulmonary function indicators and POP.ResultsA total of 196 patients with gastric cancer and 107 patients with esophageal cancer were included, and the incidence of POP in patients undergoing upper gastrointestinal surgery was 26.7% (81/303). Patients with preoperative low peak expiratory flow (PEF%pred) had a 3.094 times higher risk of developing POP than those with normal PEF%pred [OR=3.094, 95%CI (1.362, 7.032), P=0.007]. The incidence of POP had no correlation with the other preoperative indicators.ConclusionPreoperative PEF%pred may be an important indicator for predicting the occurrence of POP in patients undergoing upper gastrointestinal surgery.
