Objective To evaluate the effects of oxidative stress in the airway inflammation and remodeling of high-fat diet induced obese mice with asthma. Methods Sixty female C57 /6J mice were randomly divided into four groups, ie. an asthma group, an obese group, an obese asthma group, and a control group. The mice in the asthma group were sensitized and challenged with ovalbumin ( OVA) and fed with normal diets. The mice in the obese group were fed with high-fat diets. The mice in the obese asthma group were sensitized and challenged as the asthma group, and fed as the obese group. The mice in the control group were sensitized and challenged with normal saline and fed with normal diets. After 12 weeks, bronchoalveolar lavage fluid ( BALF) were collected for total and differential cell count. IL-6 and 8-iso-prostaglandin F2α ( 8-iso-PGF2α) in lung tissue homognate were detected by ELISA. The pathological changes were observed under light microscope by HE staining. Meanwhile the remodeling indices including total bronchial wall area ( WAt) , smooth muscle area ( WAm) , and bronchial basement membrane perimeter ( Pbm) were measured. Results In comparison with the obese group and the asthma group, the leukocytes and eosinophils in BALF, WAt/ Pbm, and IL-6 in lung tissue increased significantly in the obese asthma group ( P lt; 0. 05) . 8-iso-PGF2αin lung tissue increased in sequence of the control group, the obese group, the asthma group, and the obese asthma group significantly. Pearson correlation analysis showed that leukocyte in BALF, WAt/ Pbm, and IL-6 were in positive correlation with 8-iso-PGF2α( r =0. 828, 0. 863, 0. 891, respectively, P lt;0. 01) . Conclusion Oxidative stress is involved in the airway inflammation and remodeling of obese asthma mice with high-fat diets.
Objective To assess the predictive value of alveolar dead space fraction ( ADSF) for severity and reperfusion of acute pulmonary embolism( APE) . Methods 39 consecutive patients with APE were enrolled in a perspective study from July 2004 to March 2007. All patients were divided into a large pulmonary embolism group ( LPE) and a small pulmonary embolism group ( SPE) based to the mass and location of the embolus. The patients of the LPE group received thrombolytic therapy and anticoagulation,while the patients of the SPE group received anticoagulation only. CTPA or lung scintigraphy was performed before and after treatment to confirm the resolve condition of the embolism after treatment. Pressure of endexpired carbon dioxide ( PETCO2 ) and blood gas analysis ( including PaCO2 ) were measured at the time of run-in and 30 days after treatment by bedside. ADSF was calculated by PET CO2 and PaCO2 . Results Among 39 APE patients, there were 18 patients in the LPE group, while 21 in the SPE group. The ADSF of the LPE group before treatment were higher than that of the SPE group ( 0. 34 ±0. 078 vs. 0. 18 ±0. 027,P lt;0. 05) . The ADSF decreased significantly after treatment in the patients with full reperfusion ( 0. 09 ±0. 04 vs. 0. 28 ±0. 11, P lt;0. 01) . Conclusion As a bedside test, ADSF can reflect the mass of embolism and the reperfusion condition, and is useful in monitoring the disease.
Objective To investigate the effects of transforming growth factor beta (TGF-β) on airway remodeling in obese asthmatic mice and intervention effects of pirfenidone. Methods Seventy-five C57BL/6J mice were randomly divided into five groups, namely a blank control group (group A), an obese group (group B), an obese asthmatic group (group C), a budesonide treatment group (group D) and a pirfenidone treatment group (group E). The mice in the B, C, D, and E groups were fed with high fat diets, then the mice in the C, D, and E groups were sensitized and challenged with ovalbumin (OVA) to establish the model of chronic obese asthma. The mice in group A were fed with normal diets, sensitized and challenged with normal saline. The mice in group D were treated with budesonide (0.5 mg/ml), and the mice in group E were treated with pirfenidone (300 mg/kg). After 4 weeks of treatment, the total number of white cells as well as the percentage of leukocytes, eosinophils, neutrophils and macrophage in bronchoalveolar lavage fluid (BALF) were counted. ELISA and Western blot were used to evaluate the expression of TGF-β. The pathological changes of mice were observed under light microscope by HE and periodic acid-Schiff staining. Meanwhile the remodeling indices were measured including total bronchial wall area (WAt), smooth muscle area (WAm), and bronchial basement membrane perimeter (Pbm). Results The levels of leukocyte and eosinophils in BALF, expression of TGF-β, WAt/Pbm and WAm/Pbm in group C were higher than those in group A, B, D, and E (allP<0.05). The levels of eosinophils in BALF, WAt/Pbm in group E were lower than those in group D (allP<0.05). The level of TGF-β decreased in a sequence of group C>D>E>B>A (allP<0.05). The expression of TGF-β was in a positive correlation with eosinophil percentage in BALF (r=0.79,P<0.01). Conclusions The expression of TGF-β in the airway of obese asthmatic mice is closely related to airway inflammation, airway hyper-secretion and airway remodeling. Pirfenidone can effectively inhibit the expression of TGF-β and improve airway remodeling.
ObjectiveTo investigate the disease severity and comorbidities in outpatient with asthma from urban area in China.MethodsA face-to-face, questionnaire-based survey was carried out in outpatient department in 30 general hospitals from 30 provinces in China mainland except for Tibet during October 2015 to May 2016, and asthma patients who meet the including criteria were enrolled. Data of demographic characteristics, smoking status, disease severity, and comorbidities were collected.ResultsA total of 3 875 cases were included. According to GINA criteria, the proportion of diseases severity was as following: intermittent status 52.5% (2 033/3 875), mild persistent 24.5% (951/3 875), moderate persistent 16.9% (656/3 875), and severe persistent 6.1% (235/3 875). The overweight rate was 32.9% (1 274/3 875), the rate of obesity was 10.3% (401/3 875), and the smoking rate was 20.1% (777/3 875). Obesity and smoking were related to poor asthma control. 75.9% (2 941/3 875) of the patients had comorbidities: allergic rhinitis 43.4% (1682/3 875), hypertension 16.4% (634/3 875), nasosinusitis 8.7% (338/3 875), chronic obstructive pulmonary disease 7.3% (283/3 875), bronchiectasis 3.0% (118/3 875), and rhinopolypus 2.9% (114/3 875).ConclusionsThe majority of asthma patients from outpatient department are mild asthma patients. The proportion of allergic rhinitis and bronchiectasis in asthma patients is higher than mean level. Asthma patients with comorbidities of obesity and smoking is related to poor asthma control.
ObjectiveTo analyze the relationship between medication compliance of patients with uncontrolled asthma and lung function,airway inflammation level, asthma control level and quality of life so as to obtain important references for improving patient compliance and asthma control level in the future. MethodsQuestionnaires were performed in asthma patients who did not achieve asthma control and had poor compliance in 32 third-class hospitals in 28 provinces of China mainland. All patients were tested for lung function and airway inflammation levels. So the relevant data of asthma compliance was investigated and analyzed. ResultsA total of 923 patients were investigated and the questionnaire recovery rate was 100%. Two hundred and forty-three (26.33%) answered cognitive related questions about asthma completely correctly. Treatment compliance in asthma patients was positively correlated with lung function and significantly negatively correlated with exhaled nitric oxide. Better treatment compliance in asthma has higher level of asthma control and quality of life. Poor compliance in asthma patients will lead to decreased lung function and elevated levels of airway inflammation, resulting in decreased asthma control and quality of life. ConclusionAsthma treatment compliance is related to lung function, airway inflammation, asthma control level and quality of life.