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.
【Abstract】 Objective To observe the effects of scoliosis on pulmonary function. Methods 31 cases of scoliosis were included and underwent pulmonary function test ( PFT) . The cases were divided into an adolescent group ( 16 cases) and an adult group ( 15 cases) according to age. Predicted value was used as a reference to assess various PFT parameters. Results In both groups, forced expiratory volume in one second, forced vital capacity, and pulmonary diffusion decreased. In the adolescent group, residual volume,functional residual volume, and total lung capacity decreased. In the adult group, vital capacity and maximal voluntary ventilation decreased, the ratio of forced expiratory volume in one second to forced vital capacity decreased, and resonance frequencies increased significantly compared with the adolescent group ( P lt; 0. 05) . Conclusion Scoliosis may lead to restrictive ventilation defect, which is mainly lung volume reduction in adolescent patients and more severe in adult patients.
Objective To evaluate the effect of cardiopulmonary bypass （CPB） on pulmonary function in infants with variable pulmonary arterial pressure resulting from congenital ventricular septal defect （VSD）. Methods Twenty infants with VSD underwent corrective surgery were divided into pulmonary hypertension group （n= 10） and non-pulmonary hypertension group （n= 10） according to with pulmonary hypertension or not. Pulmonary function was measured before CPB , 3h,6h,9h,12h,15h,18h,21h, and 24h after CPB and duration for mechanical ventilation and cardiac intensive care unit stay were recorded. Results Pulmonary function parameters before CPB in nonpulmonary hypertension group were superior to those in pulmonary hypertension group （P〈0.01）, and pulmonary function parameters after CPB deteriorated than those before CPB （P〈0.05）, especially 9h,12h and 15h after CPB （P〈0.01）. Compared to pulmonary function parameters before CPB, pulmonary function parameters of pulmonary hypertension group at 3h after CPB were improved （P〉0.05）, but they deteriorated at 9h,12h and 15h after CPB （P〈0. 05）. Pulmonary function parameters at 21h and 24h after CPB was recoverd to those before CPB in two groups. Conclusions Although exposure to CPB affects pulmonary function after VSD repair in infants, the benefits of the surgical correction to patients with pulmonary hypertension outweigh the negative effects of CPB on pulmonary function. Improvement of cardiac function can avoid the nadir of pulmonary function decreasing. The infants with pulmonary hypertension will be weaned off from mechanical ventilator as soon as possible, if hemodynamics is stable, without the responsive pulmonary hypertension or pulmonary hypertension crisis after operation.
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 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.
Objective To explore the prognostic significance of baseline clinical and pulmonary physiological variables on idiopathic pulmonary fibrosis ( IPF) . Methods Patients diagnosed with IPF according to 2011 ATS/ERS/JRS/ALAT statementwere selected from Nanjing DrumTower Hospital between January 1, 2002 and July 31, 2010. The baseline characteristics were abstracted, including age, gender, smoking history, corticosteroid, delay before diagnosis, body mass index, finger clubbing, oxygenation index ( PaO2 /FiO2 ) , C-reaction protein, erythrocyte sedimentation rate ( ESR) , serum lactate dehydrogenase ( LDH) , albumin, vital capacity ( VC) , forced vital capacity ( FVC) , total lung capacity ( TLC) , and singlebreath diffusing capacity of the lung for carbon monoxide ( DLCO) . The relationships between all factors and survival were examined with a univariate Cox proportional-hazard model. Kaplan-Meier method was used to assess the survival probabilities between groups with different baseline characteristics. Results Eighty-four patients were included in this study, with the median survival time of 34. 7 months. PaO2 /FiO2 , FVC% pred, VC% pred, TLC% pred, and DLCO% pred showed significant associations with the mortality of IPF ( hazard ratios 0. 940-0. 994, P lt; 0. 01) . The Kaplan-Meier analyses for above variables also showed significant differences ( P lt;0. 05) . Besides, the statistical difference of survival probability could be found between the patients with elevated serumLDH and those with normal LDH ( 27. 0 months vs. 43. 1 months, P =0. 014) . Conclusions Baseline oxygenation and pulmonary function parameters may indicate the prognosis of IPF patients. Serum LDH may provide clinicians with additional prognostic information.
Objective To investigate the differences between six parts of China in prediction models of lung function.Methods The predicted values of 360 healthy volunteers underwent pulmonary functiontest in east China were compared with that of north China, northeast China, northwest China, southwest China, south China and Asian American. Results In the male group, the prediction values of east China were as follows: VC ( 4. 19 ±0. 33) L, coefficient correlation( r) to the other five regions were 0. 803-0. 983,the differences to the other five regions were 1. 90% -4. 30% ; FVC ( 4. 06 ±0. 35) L, r to the others were 0. 912-0. 981, the differences to the other four regions were 0-2. 46% except for south China of 8. 10% , to Asian American ×0. 88 and Asian American ×0. 94 were 1. 97% and 4. 68% ; FEV1 ( 3. 34 ±0. 40) L, r to the others were 0. 963-0. 992, the differences to north China and east China were 0. 9% and 3. 59% , to southwest China and south China were gt;5% , to Asian American ×0. 88 and Asian American×0. 94 were 6. 89% and 0. 6% ; FEV1 /FVC ( 80. 87 ±3. 84) % , r to the others were 0. 989-0. 999, the differences to north China, northeast China and south China were 0. 42% -3. 04% , to the others were gt;5% . In the female group, the prediction values of east China were as follows: VC ( 3. 00 ±0. 33) L, r to the other five regions were 0. 899-0. 993, the differences to the other five regions were 0. 33% -3. 67% ; FVC( 2. 92 ±0. 34) L, r to the other five regions were 0. 929-0. 990, the differences to the other five regions were 1. 02% -2. 40%, to Asian American ×0. 88 and Asian American ×0. 94 were 4. 79% and 6. 16% ; FEV1 ( 2. 38 ±0. 39) L, r to the other five regions were 0. 958-0. 994, the differences to northeast China, southwest China, south China were 0. 84% -3. 36% , to north china was 7. 19% , to Asian American ×0. 88 and Asian American ×0. 94 were 2. 10% and 4. 62% ; FEV1 /FVC ( 82. 04 ±3. 94) % , r to the others were 0. 991-1. 000, the differences to the other four regions were 1. 34% -4. 55% except for southwest China was 7. 59% . Conclusions VC and FVC predicted values are coincident between six parts of China. FEV1 /FVC predicted values are coincident in the four parts of China except for westnorth and westsouth China. FEV1 predicted values are different. The oversea predicted values should be used with appropriate conversion factors.
0bjective To evaluate the efficacy of FEV6 and FEV1／FEV6 as surrogates for FVC and FEV1／FVC in the spirometric diagnosis of airway obstruction，and to determine the fixed cut-off point of FEV1／FEV6 which can be used as an alternative for FEV1／FVC lt; 70％.Methods Spirometry measurements were perform ed in 128 participants．FEV1，FEV6，FVC，FEV1％pred，FVC％pred，FEV1／FVC and FEV1／FEV6 were measured and analyzed.FEV1／FVClt;70％ was used as the“gold standard”。Severity of obstruction was based on FEV ％ pred．From ROC curve analysis，the FEV1／FEV6 ratio，which corresponded to optimal combination of sensitivity and specificity，was determined．Correlation between FEV1／FVC and FEV1／FEV6 was studied．Results Of 128 participants，there were 65(51％)with FEV1／FVC ≥70％ ．Of the 63 participants with FEV1／FVC lt;70％ ，there were 5 with FEV1／FEV6 between 70.09％ to 71％。There was no significant difference between the mean value of FVC and that of FEV ．Lifear correlation was revealed between FEV1／FVC and FEV1／FEV6 with the value close to 1(r=0.9979，Plt;0.0001)．From ROC curve analysis，the FEV1／FEV6lt;71.14％ was the best cut-off point coresponding to FEV1／FVC lt;70％ ．Conclusion These results suggest that FEV1／FEV6 is a valid alternative to FEV1／FVC for spirometric diagnosis of airw ay obstruction．There is a b corelation between FEV1／FEV6 and FEV1／FVC．
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.
Objective To evaluate the therapeutic effects of different airway management strategies early used for patients after abdominal surgery in general anesthesia. Methods According to gender, age,and operation location,200 patients after abdominal surgery in general anesthesia were randomly assigned to four groups, ie. a conventional treatment group ( Group A) , an incentive spirometry ( IS) therapy group ( Group B) , an aerosol inhalation group ( Group C) , a combination of inhalation and IS therapy group ( Group D) . Inhalation drugs included Budesonide, Terbutaline, and Ambroxol. The index of pulmonary function test ( FVC, FEV1 , PEF) and arterial blood gases analysis ( ABG) were measured, and the effect of secretions clearance and the improvement of respiratory symptoms were evaluated at 0.5 h,24 h, 48 h after extubation.Intratracheal intubation of the patients after leaving ICUwas followed up. Results FVC, FEV1 , PEF, ABG,sputumvolume, the effect of secretions clearance, clinical efficacy, and intratracheal intubation rate in group B, C and D were improved more significantly than those in group A. And the therapeutic effect was best in group D ( P lt;0. 05) . The secretions clearance was improved more better in group C and D, especially in those high-risk patients with advanced age, smoking history, and pulmonary cormobidities ( P lt; 0. 05) .Conclusions The combined use of IS training and inhalation therapy can improve airway secretions clearance and pulmonary function particularly for those patients after abdominal surgery in general anesthesia, especially for those high-risk patients.
