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find Author "张湘燕" 8 results
  • 浅析新型冠状病毒肺炎并发急性呼吸窘迫综合征的病理及病理生理

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  • 阻塞性睡眠呼吸暂停低通气综合征的流行病学及临床研究进展

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  • Relationship between Gln223Arg polymorphism of leptin receptor gene and obstructive sleep apnea hypopnea syndrome in Han population in Southwest China

    Objective To investigate the relatingship between leptin receptor gene Gln223Arg polymorphism and obstructive sleep apnea hyponea syndrome (OSAHS) in Han population in Southwest China. Methods Two hundred and fifteen cases of subjects (including 116 cases in OSAHS group and 99 cases in control group) were selected in Han population in Southwest China. Polymerase chain reaction (PCR) was used to analyse Gln223Arg leptin receptor gene polymorphism. The levels of serum LEP and TI were determined by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). Simultaneous determination of body mass index (BMI) and neck circumference (NC) and waist circumference (WC) were conducted. Results In the OSAHS group, the leptin receptor gene polymorphism Gln223Arg GG, AA and GA genotype frequency was 0.854, 0.017 and 0.129, respectively. G allele and A allele frequency frequency was 0.918 and 0.082, respectively. In the control group, leptin receptor gene polymorphisms Gln223Arg GG, AA and GA genotype frequency was 0.840, 0.020 and 0.14,respectively. G allele and A allele frequency was 0.90 and 0.10, respectively. Genotype frequencies of the two groups were not statistically significant (χ2=0.784, P>0.05). There were differences in BMI, WC and NC between the OSAHS patients with GG and the OSAHS patients with (GA+AA) genotype (P<0.05), but no difference was found in LEP and TI levels (allP>0.05). In control, mild, moderate and severe OSAHS group, the levels of serum LEP and TI were increased gradually, and the difference was statistically significant (allP<0.05). Conclusions Gln223Arg leptin receptor genotype polymorphisms may be involved in obesity, but they have no relationship with the incidence of OSAHS in Han population in Southwest China. In OSAHS patients, Gln223Arg polymorphism has no relationship with LEP or TI. Patients with OSAHS have hyperleptinemia and hyperinsulinemia.

    Release date:2017-09-25 01:40 Export PDF Favorites Scan
  • Significance of continuous surveillance of anti-endothelial cell antibody in patients with chronic obstructive pulmonary disease

    ObjectiveTo explore the significance of continuous surveillance of anti-endothelial cell antibody (AECA) in patients with chronic obstructive pulmonary disease (COPD) in one year.MethodsThirty-six patients with acute exacerbation of COPD and 93 patients with stable COPD were selected from Guizhou Provincial People's Hospital from October 2019 to February 2020, thirty healthy people in the same period were selected as normal control group. In the stable phase group, >386.17 pg/mL was included in the higher group, and <386.17 pg/mL was included in the lower group according to the AECA median (386.17 pg/mL). According to the grouping criteria, the patient with the AECA median was omitted, the sample size of AECA higher group and lower group accounted for 46 cases, respectively. AECA test, lung function examination, the number of acute exacerbations in the past 1 year and MMRC score were performed for each group; At the same time, all the above contents were followed up dynamically.Results1. Comparison of AECA levels among the three groups: the acute exacerbation COPD group was higher than the stable phase group and the normal control group, and the stable phase group was higher than the normal control group, with statistical significance (all P<0.05). 2. Overall comparison of related indicators before and after follow-up in COPD stable period group: AECA level was higher than baseline after follow-up, and the follow-up after 12 months was higher than that after 6 months; After 12 months, forced expiratory volume in one second (FEV1), the ratio of FEV1 to forced vital capacity (FVC), and FEV1%pred were all lower than baseline, and the first two indexes were lower than those after 6 months follow-up. The number of acute exacerbations and mMRC score after 12 months were higher than that after 6 months follow-up, with statistical significance (all P<0.05). 3. Comparison of related indicators after follow-up between the higher and lower AECA groups: Follow-up after 12 months showed that AECA, the number of acute exacerbations and mMRC score in the higher AECA group were all higher than those in the lower AECA group at the same period, and the number of acute exacerbations and MMRC score in the higher AECA group were higher than those in the lower AECA group at 6-month follow-up. The FEV1, FEV1%pred and FEV1/FVC of the higher AECA group followed up after 12 months were lower than those of the lower AECA group at the same period, and the FEV1 and FEV1%pred of the higher AECA group followed up after 6 months were lower than those of the lower AECA group at the same period, and all the differences were statistically significant (all P<0.05).ConclusionAbnormality of AECA expression in COPD may be associated with continued decline in lung function, number of acute exacerbations in the previous 1 year, and increased mMRC score, and therefore may be associated with continued progression.

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  • 一例疑似合并肺癌伴肺内转移的高毒力肺炎克雷伯菌感染报告及文献复习

    目的 探讨高毒力肺炎克雷伯菌(hypervirulent Klebsilla pneumoniae,hvKP)感染患者的临床特征、诊断方法和治疗过程,提高临床医生对 hvKP的认识。方法 回顾性分析1例hvKP感染患者的一般资料、影像学表现和治疗方案,并进行相关文献复习。结果 患者男,52岁,因发热1+个月入院,入院CT提示:左肺下叶外基底段胸膜下占位伴双肺散在多发结节,周围型肺癌伴转移?炎性?肝S6-7段占位,肝脓肿?痰及肝脓液培养均发现肺炎克雷伯菌,二代测序示肺炎克雷伯菌,故考虑为hvKP感染。根据药敏结果先后调整抗生素为美罗培南(1.0 g 2次/d)联合头孢他啶(3.0 g 2次/d)、左氧氟沙星(0.5 g 1次/d)联合头孢他啶(3.0 g 2次/d)、头孢哌酮钠舒巴坦钠联合阿米卡星治疗,并予引流肝脓肿及胸腔积液后,患者症状、体征和影像学异常均明显好转,随访复查,病灶基本吸收。结论 肺炎克雷伯菌肝脓肿合并脓毒性肺栓塞患者,影像表现疑似肺癌伴肺内转移。针对该类患者,临床医生应考虑肺炎克雷伯菌感染可能,尽早获取病原学证据,同时关注hvKP常见的侵袭部位,结合药敏试验及抗生素药效学/药代动力学特点,选用合适的抗生素,从而改善疾病预后。

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  • The impact of COPD with frequent acute exacerbation and respiratory failure on micro-biology in the respiratory tract

    Objective To investigate the characteristics of micro-biology in the respiratory tract in the patients who were suffering acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with/without their respiratory failures as well as with the high/low frequency of exacerbation. MethodsSixty confirmed subjects in the Department of Respiratory and Critical Care in Guizhou Provincial Hospital from Nov. 2021 to Mar. 2022 were chosen and then divided them into two pairs of sub-groups randomly. Sub-group pairs one were based on the frequency of AECOPD: higher frequency and lower frequency. Sub-group pairs two were based on whether the patients were once with respiratory failure or not. 16S rRNA high-throughput sequencing method was used to detect sputum microecology. The Alpha and Beta diversity of each subgroup, and the differences in bacterial composition and relative abundance, were compared. Results For the AECOPD group with low-frequent of exacerbation, its diversity and abundance of microbiology were higher than those group with high-frequent of exacerbation. The group of AECOPD with respiratory failure had lower bacteria micro diversity but abundancy was higher than those group without respiratory failure. ConclusionThe frequency of AECOPD and whether it is with respiratory failure is related to the change of micro-biology in respiratory tract, so such change plays a great role in this disease.

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  • The Effect of Bacillus Calmette-guerin Polysaccharides Nucleic Acid on Humoral Immunity, Interleukin-8 and Tumor Necrosis Factor-αin Patients with Chronic Obstructive Pulmonary Disease

    ObjectiveTo study the effect of bacillus calmette-guerin(BCG) polysaccharides nucleic acid on humoral immunity, interleukin(IL)-8 and tumor necrosis factor(TNF)-αin patients with chronic obstructive pulmonary disease (COPD), and to provide theoretical basis for evaluation of its clinical effectiveness. MethodsThirty hospitalized elderly patients with AECOPD treated from March 2012 to February 2013 and 60 patients with stable COPD treated at the same time were randomly selected as the study subjects. At the same time, 60 healthy people from our physical examination center were also enrolled and divided into two groups:the elderly healthy group (n=30) and nonelderly healthy group (n=30). IL-8, TNF-α, IgA, IgG and IgM levels were determined. The stable COPD group was randomly divided into two groups:group A (n=30) and group B (n=30). Group A received only routine therapy; group B received both routine therapy and intramuscular injection of BCG polysaccharide nucleic acid (0.35 mg/day, three times a week). IL-8, TNF-α, IgA, IgG and IgM levels in peripheral blood were investigated before treatment and one month later. ResultsThere were no statistically significant differences in IL-8 and TNF-αlevels in peripheral blood between elderly healthy group and nonelderly healthy group (P > 0.05), but the IgA, IgG and IgM levels were lower in the nonelderly healthy group than in the elderly healthy group (P < 0.05). Compared with the elderly healthy grouping, IgG and IgM levels were significantly lower in AECOPD group and stable COPD group (P < 0.05), but IL-8 and TNF-αlevels were significantly higher (P > 0.05). There were statistically significant differences in TNF-α, IgA, IgG and IgM levels between group B before and after treatment (P > 0.05). ConclusionsHuman's humoral immunity decreases with age. Elderly COPD patients are at high risks of abnormal immunologic function, particularly in the acute exacerbation period. The BCG polysaccharides nucleic acid can strength patients' humoral immunity. The levels of inflammatory cytokines can be reduced using BCG polysaccharides nucleic acid.

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  • COVID-19合并或继发细菌感染的诊治研究进展

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