Objective This study aims to investigate the changes of inflammatory markers of oropharynx and its correlation with prognosis in the stable phase of chronic obstructive pulmonary disease (COPD). Methods Sixty-two patients with COPD in stable stage were divided into smoking and non-smoking groups, and 31 healthy persons were selected as controls. The pharyngeal swabs were collected to determine tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8), collagen type Ⅳ (COL-4), and fibronectin (FN) by an enzyme-linked immunosorbent assay. Meanwhile, eosinophil count and C-reactive protein (CRP) in peripheral blood were measured. The correlations between the above metrics and COPD and the prognosis of the patients were analyzed. Results TNF-α, IL-8, COL-4, FN and CRP levels in patients with COPD were significantly higher compared with control groups (P<0.05), and there were significant differences between smoking and non-smoking groups in inflammatory markers such as TNF-α, IL-8, FN, CRP (P<0.05). The forced expiratory volume in one second (FEV1) and FEV1%pred of patients with COPD were significantly lower than the control group (P<0.05). The smoking index of patients with COPD in smoking group was significantly higher than that in smoking control group (P<0.05). TNF- α and IL-8 were positively associated with blood CRP in patients with COPD. Conclusion The inflammatory markers of oropharynx in patients with COPD are different from those in healthy persons and smoking may promote the increase of inflammatory markers of oropharynx in patients with COPD; the non-invasive detection of paired pharyngeal inflammatory markers may be helpful in determining acute onset and prognosis.
【Abstract】 Objective To investigate the effects of respiratory syncytial virus ( RSV) infection on the dynamic changes of airway hyperresponsiveness ( AHR) in ovalbumin ( OVA) -induced asthma in mice.Methods 60 BALB/c female mice were randomly divided into PBS control group ( A group, n = 6) , OVA group, OVA/RSV group, dexamethasone group ( D group, n =6) . Kinetics of AHR of OVA group mice was carried out on day 21, 25, 29 and 33 ( B1, B2, B3, B4 groups, n =6) , and the same with the OVA /RSV group( C1, C2, C3, C4 groups, n = 6 ) . The mouse asthma model was established by OVA-sensitization of intraperitoneal injection and repeated inhalation of OVA while the mice in OVA/RSV group were treated with combined intranasal inoculation with RSV ( 1. 0 ×106 pfu/mL in 50 μL) . Airway resistance of expiringphase ( RL ) and compliance of throax and lung ( CTL ) with different doses of acetylcholine ( Ach) were measured. Lung tissue sections were stained with hematoxylin and eosin ( HE) and periodic acid-Schiff ( PAS) for general morphology. Results Compared with B1 group, RL increased and CTL decreased in C1 group when Ach dose is above 5 g/L ( P lt; 0. 05, respectively) , and the effects prolonged ( 6 d, 10 d after challenge with OVA, respectively) much more than B1 group ( 2 d after challenge with OVA) . Compared with C1 group, RL decreased and CTL increased in D group and the infiltration of inflammatory cells was obviously alleviated in C1 group after treatment with dexamethasone. Conclusions Airway hyperresponsiveness increases obviously in OVA-sensitized and RSV-infected mice. The prolonged increase inRL and decrease in CTL ( 6 d, 10 d, respectively) may imply that RSV infection aggravates airway inflammation. The small airway inflammation may play a critical role in the persistence of airway hyperresponsiveness.
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 explore the clinical phenotype of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) by cluster analysis and provide a basis for individualized treatment.MethodsA total of 515 patients with acute exacerbation of COPD admitted to this department from January 2014 to December 2016 were enrolled. The age, duration, smoking index, number of hospitalizations in the past 1 year, hospitalization days, treatment costs and other information were collected for cluster analysis.ResultsThe patients were divided into three categories of phenotype: " mild-glucocorticoid resistance-antibiotic dependent”," mild-glucocorticoid sensitive”, and " serious complication”. The patients with the first two phenotypes had a milder condition and lower hospitalization costs. There were differences in the time and cumulative dose of glucocorticoids in different pathways, antibiotic use time and usage rate. The third phenotype was the most serious, with the highest cost of hospitalization, and may merge or co-exist with other diseases such as cardiovascular disease and digestive tract disease.ConclusionCluster analysis may identify different phenotypes of acute exacerbation of COPD to provide a reference for clinical individualized treatment.
ObjectiveTo analyze the features and clinical significance of blood eosinophils (EOS) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).MethodsThe general data, laboratory examination and treatment of patients with AECOPD admitted to this department from January 2014 to December 2016 were analyzed retrospectively. Based on the inclusion of treatment targets for blood EOS according to 2018GOLD, patients were divided into group A (EOS<100 cells/μL), group B (100 cells/μL≤EOS≤300 cells/μL), and group C (EOS>300 cells/μL) with two cut-off levels. The differences in general data, severity, and glucocorticoid use between group A, group B and group C were compared.ResultsA total of 515 patients with AECOPD were enrolled. 10.87% of patients had blood EOS>300 cells/μL, and 39.03% of patients had blood EOS≥100 cells/μL. Patients in group B and C were younger, with shorter disease duration, intensive care unit stay time, non-invasive mechanical ventilation use time. The time of glucocorticoid administration was significantly shortened, and the cumulative dose of venous glucocorticoid, hospitalization cost, and total drug cost were also lower than those of group A (all P<0.05).ConclusionsPatients in group B and C are younger, shorter in disease duration, lower in severity and more responsive to glucocorticoid therapy. Blood EOS can be used as a marker to guide glucocorticoid therapy in patients with AECOPD.
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.