ObjectiveTo explore the status,reasons and precautions of misdiagnosis of pulmonary sequestration. MethodsSeventy-seven articles about pulmonary sequestration published in Wanfang and CNKI databases between January 2005 and December 2013 were retrospectively analyzed,of which 41 articles referring to misdiagnosis rate.The misdiagnosis rate,time,status,consequence,reason and main means of definite diagnosis were analyzed. ResultsThe total number of cases of pulmonary sequestration in the 41 articles was 689,in whom 399 cases were misdiagnosed.Misdiagnosis rate was 57.91%.The minimum misdiagnosis time was 14 days and the maximum was 40 years.Pulmonary sequestration was most often misdiagnosed as pulmonary cyst(23.16%),bronchiectasis(22.73%),lung cancer(20.08%),lung abscess(6.93%)and pneumonia(6.28%).Most misdiagnosed patients did not suffer adverse consequences,except 4 patients were dead and 1 patient undertook unnecessary extended operation.Lack of specificity in clinical manifestations,lack of awareness of the disease,diversity of imaging performance and complications covering the original disease were the most common reasons of misdiagnosis.Postoperative pathological examination(83.77%),intraoperative findings(13.42%)and computed tomography angiography(2.16%)were the main means of definite diagnosis in misdiagnosed cases. ConclusionPulmonary sequestration is lack of specificity in clinical manifestations and easy to be misdiagnosed.Imaging showing the abnormal blood supply vessels is the key to the diagnosis.Improving the awareness of it can reduce misdiagnosis and incorrect treatment.
ObjectiveTo investigate the diagnostic value of oximetry in sleep apnea hypopnea syndrome (SAHS). MethodsAdult patients suspected for SAHS were enrolled between May 2010 and May 2013. The patients underwent both polysomnography (PSG) and oximetry for further diagnosis. Apnea hyponea index (AHI) and oxygen desaturation index four (ODI4) were calculated on a single night. The relationship between AHI and ODI4 were analyzed. ResultsA total of 628 adult patients were recruited.ODI4 was linearly correlated with AHI with a regression coefficient of almost 1. The cut-off values of ODI4 for indentifing SAHS and moderate to severe SAHS were 10 events per hour and 20 events per hour, with specificities of 99.9% and 99.3%, and AUCs of 0.931 and 0.934, respectively. Female, lower weight and less severe SAHS patients were easily misdiagnosed. ConclusionsThere is a high agreement between AHI and ODI4. Oximetry is less likely misdiagnose SAHS.
ObjectiveTo evaluate the effect of long-term systemic education management program on intervention of chronic obstructive pulmonary disease (COPD). MethodsTwo hundred forty-six stable patients were interviewed face-to-face from March to August in 2013.They were divided into a systemic education group, a follow-up group and a control group according to different management program.The investigation contained general conditions, commonly used medicines, the effects of smoking cessation, the frequency of acute exacerbation in the year before investigation, COPD Assessment Test (CAT) and modified British Medical Research Council (mMRC). ResultsThe success rate for smoking cessation in the systemic education group was 97.6%, which was higher than 81.0% in the follow-up group and 73.8% in the control group(P < 0.01).97.6% of patients in the systemic education group and 93.7% of patients in the follow-up group used bronchodilator.Whereas only 65.5% of patients in the control group inhaled bronchodilator, significantly lower than other two groups (P < 0.01).Mucolytic agents were taken by 14.5% and 19.0% of patients in the systemic education group and the follow-up group, and by 36.9% of patients in the control group (P < 0.01).The frequency of acute exacerbation was 0.9±0.9 both in the systemic education group and the follow-up group, which was lower than 1.2±1.0 in the control group (P < 0.05).CAT and mMRC in the systemic education group (10.2±5.7 and 1.5±1.0) and the follow-up group (11.1±5.8 and 1.5±0.9) were significantly lower than those in the control group (15.0±6.6 and 1.9±1.1, P < 0.01). ConclusionsLong-term systemic education management program can improve success rate for smoking cessation and bronchodilator use, reduce the frequency of acute exacerbation, and improve quality of life effectively in COPD patients.
ObjectiveTo understand the prevalence,risk factors,clinical features and the medication of coal worker's pneumoconiosis(CWP) complicated with chronic obstructive pulmonary disease (COPD). MethodsPulmonary function testing results,clinical symptoms,medication of 451 patients with CWP were collected. Then, the risk factors relevant to the incidence of COPD in CWP were analyzed with Cox multivariate regression. ResultsThe prevalence of COPD in CWP was 44.6%,and the incidence was rising with the increasing of CWP phases, exposure duration,smoking index,with the odds ratio of 3.20,1.09,and 1.01,respectively.The patients with CWP and COPD were suffered more symtoms with a CAT score of 25.5 but received less regular medications. ConclusionsThe incidence of COPD in CWP is obviously higher than that in common populaton.Exposure duration, smoking index and phases of CWP are the high risk factors for COPD in the population of CWP. The patients with CWP and COPD are suffered more symtoms but receive irregular medications.