ObjectiveTo evaluate the safety and efficacy of non-invasive positive pressure ventilation (NIPPV) combined with fiberoptic bronchoscopy(FB) on acute exacerbation of chronic obstructive puhmonary disease (AECOPD) patients with acute respiratory failure. MethodsA prospective study was conducted on the AECOPD patients with respiratory failure in respiratory intensive care unit of Tangdu Hospital of Fourth Military Medicine University from February 2010 to February 2011.They were randomly divided into a case group and a control group.The case group was administrated FB and lavage after one hour of NIPPV treatment.The control group was administrated NIPPV without FB and lavage.Other treatment regimen was the same in two groups. ResultsThere were 51 subjects recruited in the study, 25 subjects in the case group and 26 subjects in the control group.All variables at baseline were matched (P > 0.05).All variables improved after one hour of NIPPV before FB, without significant difference between two groups (P > 0.05).During the period of FB, heart rate in the case group was faster than that in the control group (P < 0.05), and other variables were not significantly different between two groups (P > 0.05).Both groups received NIPPV for one hour after FB, the variables including heart rate, respiratory rate, pH, PaO2, PaCO2 were statistically significant between two groups(P < 0.05).At the time of 24 hours after FB, the variables including mean arterial pressure, heart rate, respiratory rate, pH, PaO2 and PaCO2 in the case group were nearly recovered, and differences between two groups were significant (P < 0.05).The positive rate of sputum culture was significantly higher in the case group than that in the control group[88.0%(22/25) vs.58.6%(14/26)].Success rate in the case group were obviously superior to that in control group.The cases of failure, death and refusing in the case group were lower than those in the control group.Complications in two groups had no significant difference (P > 0.05).There was not serious complication such as hear arrest, hemoptysis and apnea during the process of NIPPV combined with early FB. Conclusion It deserves to be used in clinic because of the safety, efficacy and feasible for most of AECOPD patients through NIPPV combined with early FB.
ObjectiveTo investigate the molecular pathogenesis of pulmonary fibrosis induced by bleomycin in a murine model,and provide novel insights for clinical diagnosis and treatment. MethodsFrom Gene Expression Omnibus,we downloaded microarray data extracted from experiments of bleomycin induced pulmonary fibrosis in wild-type mice. With BRB-Array Tools,differentially expressed genes at different time points during disease development were screened,selected and analyzed by DAVID software. ResultsBRB array analysis identified 45101 differentially expressed genes. After induction by bleomycin on 7th day,1164 genes and 735 genes were significantly up-regulated and down-regulated (P<0.05,fold change>2),respectively. On 14th day,731 genes and 390 genes were significantly up-regulated and down-regulated (P<0.05,fold change>2),respectively. DAVID analysis revealed that the up-regulated genes were significantly enriched in cell cycle,p53 signaling and chemokine signaling pathway,damaging reaction and collagen metabolism gene sets. While the down-regulated genes were enriched in the drug metabolism pathway gene set. ConclusionsBioinformatics methodologies are able to efficiently analyze microarray data and extract its underlying information,provide novel insights for major molecular events and shift of cell signaling pathway during pulmonary fibrosis progression,and furthermore,finding molecular markers for early diagnosis and therapeutic targets.