Recently, many researchers paid more attentions to the association between air pollution and chronic obstructive pulmonary disease (COPD). Haze, a severe form of outdoor air pollution, affected most parts of northern and eastern China in the past winter. In China, studies have been performed to evaluate the impact of outdoor air pollution and biomass smoke exposure on COPD; and most studies have focused on the role of air pollution in acutely triggering symptoms and exacerbations. Few studies have examined the role of air pollution in inducing pathophysiological changes that characterise COPD. Evidence showed that outdoor air pollution affects lung function in both children and adults and triggers exacerbations of COPD symptoms. Hence outdoor air pollution may be considered a risk factor for COPD mortality. However, evidence to date has been suggestive (not conclusive) that chronic exposure to outdoor air pollution increases the prevalence and incidence of COPD. Cross-sectional studies showed biomass smoke exposure is a risk factor for COPD. A long-term retrospective study and a long-term prospective cohort study showed that biomass smoke exposure reductions were associated with a reduced decline in forced expiratory volume in 1 second (FEV1) and with a decreased risk of COPD. To fully understand the effect of air pollution on COPD, we recommend future studies with longer follow-up periods, more standardized definitions of COPD and more refined and source-specific exposure assessments.
The treatment of chronic thoracoabdominal aortic dissection aneurysm remains a major challenge in aortic surgery. Open surgery is the mainstream treatment at present. New devices for endovascular treatment of chronic thoracoabdominal aortic dissection are gradually applied in clinical practice. The hybrid procedure is a combination of open and endovascular procedures. The appropriate treatment should be selected according to the patient's age, anatomy, genetic aortic disease, and comorbidities.
ObjectiveTo explore the feasibility and clinical application value of low attenuation areas (LAA) scoring system in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).MethodsA total of 380 patients with AECOPD were included. Clinical data including general information, laboratory examinations and treatments during hospitalization were collected. According to the high-resolution computed CT (HRCT) imaging performance, the patients were divided into bronchitis phenotype and emphysema phenotype. The clinical data between these two groups were compared to analyze the differences between different phenotypes and the feasibility of LAA scoring system.ResultsIn patients of bronchitis phenotype, the levels of body mass index, C-reactive protein, interleukin-6, procalcitonin, neutrophil-to-lymphocyte ratio, and eosinophil counts on admission were higher than those of emphysema phenotype (P<0.05). Patients with emphysema phenotype had a higher proportion of male, a higher smoking index, higher cystatin C levels and lower bilirubin levels on admission (P<0.05), the rates of using mechanical ventilation and systemic glucocorticoids were higher as also (P<0.05). LAA scores had a positive correlation with the use of mechanical ventilation and systemic glucocorticoids and cystatin C levels, and a negative correlation with interleukin-6 levels (P<0.05).ConclusionsFor patients with AECOPD, using LAA scoring system to classify different phenotype through HRCT has relevant accuracy and clinical practicability. The LAA scoring system might help to evaluate the patient's condition and prognosis to a certain extent.
Objective To evaluate the efficacy and safety of Salviae miltiorrhizae Injection (include Danshen Injection and Fufang Danshen Injection) for chronic cor pulmonale. Design A systematic review of randomized clinical trials. Method Randomized trials comparing Salviae miltiorrhizae Injection plus routine treatment versus muting treatment alone were identified by electronic and manual searches. No blinding and language limitations were applied. The Jadad scale assessed the methodological quality of trials. Results Thirty randomized trials (n=2 161) were identified. The methodological quality of all trials included was low. The combined results (RR and 95%CI) of symptom scores was 1.20 (1.15 to 1.26). Because of the significant heterogeneity, many other markers of the blood rheology can not be combined. The reason for heterogeneity should include the differences among cases and studies. Because of lacking enough studies, the conclusions about mortality and oxidants/antioxidants markers were not b. Only a few studies had reported adverse events. Conclusions Based in the review, Salviae miltiorrhizae Injection may have positive effect on symptom scores in patients with chronic cor pulmonale. But for mortality, the markers of blood rheology and oxidants/antioxidants, there is no reliable conclusion. However, the evidence is not b due to the general low methodological quality, the variations among studies and experimental markers themselves, and lacking of more relevant and important markers. Further large trials are needed.
摘要:目的:應用區域阻抗法測定慢性阻塞性肺疾病（COPD）患者的肺血流灌注及肺通氣分布的變化,與放射性核素肺顯像方法比較,探討肺區域阻抗方法的臨床應用價值。 方法: 測定對象為18例中重度COPD患者,均為男性,平均年齡63.8歲,應用肺區域阻抗法及放射性核素法,分別測定肺血流灌注及肺通氣的分布。〖HTH〗結果〖HTSS〗: 本研究發現肺區域阻抗法在測定肺血流灌注分布方面,僅在左下肺區域高于核素法測得的數值(Plt;0.05),余肺區測定結果相近,無顯著差異。在肺通氣的測定方面,阻抗法所得數值與核素法測得的數值有一定的不同,在左上、右上區域高于核素法測得的數值,在左中肺區測得的數值低于核素法測得的數值(Plt;0.05),余肺區測定結果相近,無顯著差異。結論: 雖然目前區域阻抗方法暫不能取代放射性核素的測定,但作為一種輔助手段,可簡便、快速了解肺內的通氣、血流等生理病理改變。Abstract: Objective: To evaluate the clinical capability of regional electric impedance pneumograph and scintigraphy in measurement of pulmonary perfusion and ventilation in patients with COPD. Methods: Thirtytwo patients with different respiratory diseases underwent regional electric impedance pneumograph and scintigraphy, the pulmonary perfusion and ventilation were obtained and recorded. Results:The pulmonary perfusion results got by regional electric impedance pneumograph in the left lower region was lower than the results measured by scintigraphy, there were significant difference (Plt;0.05), and no difference in other pulmonary region. The pulmonary ventilation results got by regional electric impedance pneumograph in the both upper region were higher and in the left middle region were lower than the results measured by scintigraphy, there were significant difference(Plt;0.05), and no difference in other pulmonary region. Conclusion:The result got by regional electric impedance pneumograph could not replace the result got by scintigraphy at present, but this is a quick, simple,and convenient measurement to get parameter of the pulmonary perfusion and ventilation.
Objective To investigate the current status of health promoting lifestyle in maintenance hemodialysis (MHD) patients and to explore its correlation with chronic illness resource utilization. Methods Patients who underwent outpatient MHD in the Hemodialysis Room of the Department of Nephrology, West China Hospital, Sichuan University between January and March 2023 were selected. Patients were surveyed using the General Information Questionnaire, Chronic Illness Resource Survey, and Health Promoting Lifestyle Profile-Ⅱ Revise. Results A total of 158 patients were surveyed. MHD patients scored 103.37±18.52 on health promoting lifestyle, and 68.95±14.14 on chronic illness resource utilization. The Pearson correlation analysis results showed that there was a positive correlation between the chronic illness resource utilization and the total score of health promoting lifestyle in MHD patients (r=0.765, P<0.001), as well as scores in all dimensions (P<0.05). The results of multiple linear regression analysis showed that the main caregivers being parents [non-standardized partial regression coefficient (b)=8.150, 95% confidence interval (CI) (0.804, 15.497), P=0.030], weekly dialysis times [b=10.701, 95%CI (2.787, 18.615), P=0.008], and chronic illness resource utilization [b=0.936, 95%CI (0.800, 1.072), P<0.001] were influencing factors for health promoting lifestyle. Conclusions MHD patients have an average health promoting lifestyle, and ideal chronic illness resource utilization. Hemodialysis nurses can take targeted measures to enhance chronic illness resource utilization and health promoting lifestyle in MHD patients, which can further improve the quality of life of MHD patients.
ObjectiveTo explore the vascular conditions and the necessity of vascular reconstruction in the treatment of chronic ischemic diseases of lower extremities with tibial transverse transport (TTT) from the perspective of vascular surgery.MethodsA clinical data of 59 patients with chronic ischemic disease of lower extremities treated by TTT between February 2014 and July 2019 were analyzed retrospectively. Among them, there were 41 patients with diabetic foot (DF), including Wagner grade 3-4, Texas grade 2-3, and stage B-D lesions; the disease duration ranged from 0.7 to 2.4 years, with an average of 1.5 years, and 5 cases complicated with arteriosclerosis obliteran (ASO). There were 14 patients with ASO (Fontaine stage Ⅳ and Rutherford stage Ⅲ-Ⅳ) with an average disease duration of 10.8 months (range, 1.5-23.4 months). There were 4 patients with thromboangiitis obliteran (TAO) with an average disease duration of 12.3 months (range, 2.1-18.2 months), and the clinical stages were all in the third stage. In 18 patients that ankle brachial index (ABI) of anterior or posterior tibial artery was less than 0.6 before operation, or the blood flow of the three branches of inferior anterior tibial artery did not reach the ankle by imaging examination, vascular reconstruction was performed before TTT (5 cases of DF combined with ASO, 12 of ASO, 1 of TAO). After operation, the effectiveness was evaluated by ulcer wound healing, skin temperature, pain visual analogue scale (VAS) score, ABI, and CT angiography (CTA) examination.ResultsThe patients with DF were followed up 8-16 months (mean, 12.2 months); the ulcer wounds healed with a healing time of 5.1-9.2 weeks (mean, 6.8 weeks); CTA examination showed that the branches of inferior anterior tibial artery were opened in 5 patients after revascularization; and the tibial osteotomy healed for 5-14 weeks (mean, 8.3 weeks). The patients with ASO were followed up 13-25 months (mean, 16.8 months); the ulcer wounds healed with a healing time of 6.2-9.7 weeks (mean, 7.4 weeks). CTA examination showed that the branches of inferior anterior tibial artery were opened in 12 patients after revascularization; all tibial osteotomy healed, and the healing time was 4.5-14.4 weeks (mean, 10.2 weeks). The patients with TAO were followed up 12-23 months with an average of 12.3 months, and toe/limb amputation was performed after ineffective treatment. The patients were divided into two groups according to whether they were combined with revascularization or not. The ABI, VAS score, and skin temperature in the combined revascularization group significantly improved at 6 months after operation (P<0.05); while there was no significant difference in ABI at 6 months after operation in the TTT group (P>0.05), but the skin temperature and VAS scores significantly improved when compared with those before operation (P<0.05).ConclusionThe ABI of anterior or posterior tibial artery is more than 0.6, radiological examination shows that at least one of the three branches of inferior anterior tibial artery leads to ankle artery, which is a prerequisite for successful TTT in the treatment of chronic ischemic disease of lower extremities. DF is the indication of TTT. ASO can choose TTT, and TAO should use this technique cautiously.
ObjectiveTo investigate the etiology of pediatric pancreatitis and the effect of endoscopic retrograde cholangiopancreatography (ERCP) in it. MethodsPatients hospitalized for pancreatitis in West China Hospital of Sichuan University from Jan. 2008 to Jun. 2023 were included according to the inclusion and exclusion criteria. Totally, 241 cases (207 cases with acute pancreatitis and 34 with chronic pancreatitis) were included. Patients were divided into primary group (n=168) and recurrent group (n=73) according to their previous medical history. ResultsThe duration of hospitalization in the primary group was longer than that in the recurrent group [10.0 (7.0, 16.0) d vs. 7.5 (6.0, 11.8) d, P=0.012]. The proportion of acute pancreatitis in primary group (163/168, 97.0%) was higher than that in the recurrent group (44/73, 60.3%), P<0.001. There was no significant difference in the etiological component ratio between the primary and recurrent groups (χ2=7.504, P=0.347). However, in the primary group, the first etiology was biliary factors (38/163, 23.3%), and the second was biliary pancreatic anatomic abnormality (22/163, 13.5%). In the recurrence group, biliary pancreatic anatomic abnormality (13/44, 29.5%) was the first cause, and biliary factor (7/44, 15.9%) was the second cause. Among 207 cases with acute pancreatitis, there were 114 cases (55.1%) with clear etiology, including 45 cases (21.7%) of biliary factors, 35 cases (16.9%) of abnormal biliary pancreatic structure, 12 cases (5.8%) of traumatic factors, and 10 cases (4.8%) of drug-induced factors. In this study, 66 cases were treated with ERCP for pancreatitis, and a total of 103 ERCP operations were performed with cannulation success rate of 100%. Twenty-three cases (23/37, 62.2%) of acute pancreatitis resulted from biliary and biliary pancreatic structure abnormalities received ERCP. In biliary acute pancreatitis, the removal rate of choledocholithiasis in single ERCP operation was 80.0% (8/10). The clinical symptoms (abdominal pain, jaundice, and fever) of all cases were significantly improved after surgery, and no complications such as cholangitis, bleeding and perforation occurred. ConclusionsBiliary, congenital pancreatic anatomical abnormalities, drugs and trauma are the common causes of acute pancreatitis in children. ERCP is a safe and effective treatment for children with biliary pancreatitis, pancreatic anatomical abnormalities, and chronic pancreatitis.
Objective
To study effects of Helicobacter pylori on oncogenesis and progression of pancreatic cancer.
Method
The current literatures on the relationship between the Helicobacter pylori and the pancreatic cancer were collected and reviewed.
Results
The Helicobacter pylori infection might play a role in the development of the pancreatic cancer. The infection rate of the Helicobacter pylori in the patients with pancreatic cancer is higher than that of the healthy controls; furthermore, in the patients with Helicobacter pylori antibody positive, the infection rate of the Helicobacter pylori in the cytotoxin-associated gene A-negative strains of Helicobacter pylori is significantly higher than that of the healthy controls.
Conclusions
Helicobacter pylori infection is related to occurrence and development of pancreatic cancer. Specific mechanism is still not clarified and further research is need to study.
Objective To estimate healthy life expectancy of residents aged 30 and above in Jianyang, Sichuan province, and comprehensively evaluate the health status of the population, so as to provide reference and basis for the formulation of health-related public policies. Methods The population data, death data and health status data of Jianyang city in 2018 were collected, and the self-rated health life expectancy and life expectancy without chronic diseases of residents aged 30 and above were calculated by Sullivan method, and their proportion in life expectancy was calculated. Results A total of 4 482 residents aged 30 years and above were included in Jinyang city, of whom 3 989 were self-rated healthy, accounting for 89.00% of self-rated health, and 1 988 were suffering from chronic diseases, with a chronic disease prevalence rate of 44.36%. In the age group of 30-64, the self-rated health life expectancy of women was significantly higher than that of men (P<0.05), and in the age group of 40-44, the life expectancy without chronic diseases of women was significantly lower than that of men (P<0.05), and the differences were not statistically significant when comparing different genders in other age groups (P>0.05). With the increase of age, the proportion of residents’ self-rated health and the proportion of life expectancy without chronic diseases in healthy life expectancy gradually declined. Conclusions The chronic disease has become the main factor affecting the health of middle-aged and elderly population, especially female population. It is suggested that active measures should be taken to deal with chronic diseases and the elderly health support system should be strengthened to improve healthy life expectancy of residents in Jianyang city.
