Objective To evaluate the effects of indoor temperature and relative humidity on acute exacerbations of chronic obstructive pulmonary disease（AECOPD）.Methods A total of 70 moderate to very severe COPD patients were recruited.The data including indoor temperature and relative humidity twice daily，increase over their stable symptoms in "major" symptoms（dyspnea，sputum purulence，sputum amount） and "minor" symptoms（nasal discharge/congestion，sore throat，cough），and adjustment of medication were recorded on diary cards.All data were collected from Jan 2005 to Dec 2005 by telephone inquiring or home visiting.Furthermore，the corresponding median outdoor temperature，relative humidity and air pressure from atmosphere bureau were compared with indoors parameters to examine the different effects on AECOPD.Results Fifty-five cases completed the whole investigation.Indoor temperature and relative humidity were both risk factors when logistic regression was used to evaluate the effect.Our research showed that AECOPD was significantly related to indoor and ourdoor environment factors.The correlation coefficient of all factors were r=－0.686（indoor temperature），r=－0.671（outer temperature），r=0.105（indoor humidity），r=－0.115（outer humidity），r=0.545（atmospheric pressure） respectively.Conclusions The indoor temperature and relative humidity，especially low temperature and high relative humidity，had important effects on AECOPD of moderate to very severe patients.It may be helpful to prevent AECOPD by adjusting the indoor temperature and relative humidity.
Objective To investigate the correlation between persistent wheezing and positive result of sputum fungal culture in patients with chronic obstructive pulmonary disease ( COPD) . Methods The COPD patients who hospitalized in the respiratory department of Shanghai First People’s Hospital, Zhongshan Hospital and Huadong Hospital fromJanuary 2005 to December 2007 were analyzed retrospectively. Results Thirty-five cases were enrolled in the persistent wheezing group and 43 cases in the non-wheezing group. In the wheezing group, sputumfungal culture revealed positive yield in 32 cases while Aspergillus were isolated in 12 cases. In the non-wheezing group, sputum fungal culture revealed only 11 cases positive, and none of which were Aspergillus positive. Aspergillus distributions in the two groups were significantly different( P lt;0. 05) . There was also significant difference in the positive result of sputum fungal culture ( 91. 4% vs 25. 6%, P lt;0. 01) , while there was no significant difference in positive result of bacterial culture( 28. 6% vs 39. 5%, P gt; 0. 05) . In the wheezing group, the patients with antifungal treatment showed better prognosis than those without antifungal treatment( 81. 0% vs 36. 4% , P lt;0. 05) . Conclusion The persistent wheezing in the patients with COPD is correlated with the fungi, especially Aspergillus airway colonization.
Objective To investigate the risk factors of positive yield in sputum fungal culture in patients with chronic obstructive pulmonary disease ( COPD) . Methods The patients with COPD who hospitalized in the respiratory departments of Shanghai First People’s Hospital, Zhongshan Hospital, and Huadong Hospital from January 2005 to December 2007 were analyzed retrospectively. Results The 78 patients were grouped according to the results of sputumfungal culture. There were no significant differences in sex, age, history of smoking, diabetes, atomization inhalation, and the accumulated doses of oral corticosteroids between the positive group and the negative group ( P gt; 0. 05) . However, the differences in species of antibiotics, duration of antibiotic therapy, and accumulated doses of intravenous corticosteroidswere significant ( P lt; 0. 01) . The logistic analysis showed that prolonged high-dose of corticosteroids and multiple broad-spectrum antibiotics were risk factors of the positive yield of sputum fungal culture ( P lt;0. 05) . Conclusion Prolonged high-dose of corticosteroids and multiple broad-spectrum antibiotics are riskfactors of fungal colonization in lower respiratory tract of COPD patients.
Objective To review the current state of lung rehabilitation in China and explore the effect of lung rehabilitation on chronic respiratory diseases. Methods Database of CNKI ( 1979-2009) , VIP Chinese Periodical Database ( 1989-2009 ) , and Wanfang Data ( 1982-2009) resources were searched. Studies of lung rehabilitation were collected, and randomized and controlled trials were included. Data were extracted on study population, interfering and evaluating methods. The meta-analyses were performed by using RevMan 4. 2 software. The heterogeneity was analyzed by X2 and P value. Results A total of 3 clinical trials met the inclusion criteria. The study population were all severe and very severe chronic obstructive pulmonary diseases ( COPD) patients. Lung rehabilitation could improve daily activity( WMD:1. 29, 95% CI: 1. 05-1. 54) and dyspnea level ( SMD: - 1. 27, 95% CI: - 1. 67 to - 0. 86) of COPD patients. Conclusion The general level of studies on lung rehabilitation is not satisfied. Meta-analysis comfirmes that lung rehabilitation is beneficial in improving daily activity and dyspnea level of COPD patients.