目的 探讨慢性阻塞性肺疾病急性加重（AECOPD）合并肺栓塞（PE）的临床特点。 方法 回顾性分析2009年1月－2012年6月38例AECOPD合并PE患者（栓塞组）的临床资料，并与42例单纯AECOPD（对照组）临床资料进行对比。 结果 栓塞PE组不对称性下肢水肿发生率明显高于对照组（P＜0.05），另外肺动脉高压、D-二聚体及修改的Geneva评分与对照组比较存在一定差异，且差异有统计学意义（P＜0.05）。 结论 AECOPD合并PE的临床表现并不特异，当AECOPD出现不对称性水肿、D-二聚体升高、肺动脉高压及修改的Geneva评分升高等表现不能解释原因时，要考虑PE的可能，并尽快选择CT肺动脉成像或肺动脉造影以明确诊断。
ObjectiveTo investigate the effects of short-time hyperoxia ventilation on lung tissue and pulmonary surfactant proteins C and D (SP-C and SP-D) in rats.MethodsSixteen male Sprague-Dawley rats were randomly divided into two groups (n=8): hyperoxia group (FiO2=0.90), air group (FiO2=0.21). Tracheal intubations were administrated after anesthesia, and rats in two groups were exposed hyperoxia or air ventilation for 4 h. At the same time, carotid artery blood gas was analyzed after 2 h and 4 h of ventilation, then oxygenation index (OI) was calculated. Four hours later, the anterior lobe of right lung was taken to observe the pathological change and the injury level was scored. The middle lobe of right lung was prepared for making tissue homogenate, and the remaining part of the lung was used to measure the wet/dry weight (W/D) ratio. The bronchoalveolar lavage fluid (BALF) was prepared in left lung. The content of SP-C and SP-D were detected in lung tissue homogenate and BALF by ELISA.ResultsComparing with hyperoxia group, the arterial partial pressure of oxygen, lung histopathology score and lung W/D ratio in air group were significantly increased (P<0.05), but OI, the content of SP-C and SP-D in lung tissue homogenate and BALF were significantly decreased (P<0.05).ConclusionHyperoxia ventilation for 4 h in rats can cause lung injury histologically, and reduce the concentration of SP-C and SP-D apparently in the lungs.
Objective To study the predictive value of inspiratory capacity (IC) and total lung capacity (TLC) on acute exacerbation of patients with chronic obstructive pulmonary disease (COPD). Methods The in-patients due to acute exacerbation of COPD (AECOPD) from February 2017 to March 2019 were recruited in the study. Research data were collected during the recovery period and one year follow-up , and the patients were divided into two groups according to whether there was another acute exacerbation. Results A total of 372 patients were included in the study. In the patients with acute exacerbation, the age and TLC as a percentage of the expected value (TLC%pred) were higher, while IC as a percentage of the expected value (IC%pred) and the ratio of IC and TLC (IC/TLC) were lower. Univariate analysis revealed that IC/TLC≤25% was a significant predictor of acute exacerbation (P<0.001) after the AECOPD patients were discharged. Multivariable analysis revealed age (OR=1.25, 95%CI 1.17 to 1.44, P<0.001) and IC/TLC≤25% (OR=1.68, 95%CI 1.36 to 2.07, P<0.001) were independent risk factors of AECOPD.Conclusions Decreased IC/TLC significantly correlates with poor prognosis of COPD. IC/TLC≤25% is an independent risk factor for acute exacerbation.
ObjectiveTo investigate diagnostic and prognostic value of pulmonary embolism severity index (PESI), troponin I (cTnI) and brain natriuretic peptide (BNP) in patients with acute pulmonary embolism (APE). MethodsA total of 96 patients confirmed with APE were collected from January 2010 to January 2013, and 50 cases of non-APE controls were also selected in the same period. According to the PESI scores, patients were divided into low-risk, mid-risk, and highrisk group. According to the results of cTnI and BNP, patients were divided into positive group and negative group. Then, we evaluated the diagnostic and prognostic value of the PESI score, cTnI and BNP for patients with APE. ResultsFor the APE patients, the higher the risk was, the higher the constituent ratio of massive and sub-massive APE was (P<0.01). In the cTnI positive group, massive and sub-massive APE accounted for 82.9%, and in the cTnI negative group, non-massive APE was up to 81.9%; in the BNP positive group, massive and sub-massive APE accounted for 73.3%, and in the BNP negative group, non-massive APE was up to 86.3%. The patients with positive cTnI and BNP had a higher rate of right ventricular dysfunction, cardiogenic shock and mortality than the negative group (P<0.01). ConclusionThe combined detection of cTnI, BNP and PESI score is important in the diagnosis and risk stratification in APE patients.
ObjectiveTo systematically review the detection rate of sub-health status of Chinese college students. MethodsThe CNKI, WanFang Data, CBM, VIP, PubMed, EMbase and Web of Science databases were searched to collect cross-sectional studies on the detection rate of sub-health among Chinese college students from inception to February 1, 2023. Two researchers independently screened the literature, extracted data and evaluated the risk of bias of the included studies. Meta-analysis was performed using Stata 17.0 software. At the same time, GIS technology was used to analyze the spatial distribution of the detection rate of sub-health status of college students in China. ResultsA total of 44 articles were included, with a total sample size of 63 435 cases, including 29 255 cases of sub-health status. The results of meta-analysis showed that the detection rate of sub-health status of Chinese college students was 51.2% (95%CI 44.1 to 58.4). The temporal distribution showed a gradual decrease in the detection rate of sub-health states among college students between 2016 and 2020, with a rebound after 2020. The detection rates of sub-health states among college students in different regions and survey instruments varied significantly, with 74.1%, 61.8%, 58.4%, 56.1%, 47.0%, 42.3% and 21.6% in Southwest, Northeast, South, North, Central, East and Northwest China, respectively. The detection rates of sub-health states among college students in Jilin, Sichuan and Hebei provinces were the top 3, and Shanxi province had the lowest detection rate. ConclusionThe detection rate of university sub-health status in China is high, and the detection rate decreased significantly from 2016 to 2020, with a rebound trend in recent years, and there are differences in the detection rate of university sub-health status in different regions and survey instruments. Due to the limitation of the quality and quantity of the included studies, the above findings need to be verified by more high-quality literature.
【Abstract】 Objective To survey the prevalence and risk factors of chronic obstructive pulmonary disease ( COPD) , and establish database for community intervention of COPD.Methods A cluster-randomsampling survey was carried out. The population aged over 40 years old in eight communities of Chengdu were investigated from August 2007 to August 2009 using the standard protocol and questionnaire. The spirometry was performed for each participant. Results A total of 4315 residents were enrolled in this survey and 3687 case reports were analyzed, including 1529 males and 2148 females, with an average age of 60. 35 ±13. 21 years old. Total prevalence of COPD was 9. 6% . The prevalence of COPD in the males was significantly higher than that in the females ( 14. 0% vs. 6. 4%, P lt;0. 01) . The prevalence of COPD increased with the age. The major risk factors were cigarettes smoking ( OR = 3. 012, 95% CI 2. 390-3. 797, P lt; 0. 01) and indoor cooking smoking ( OR = 2. 546, 95% CI 1. 734-3. 425, P lt; 0. 01) . Conclusion The prevalence of COPD in Chengdu city is significantly higher than average level of the whole country, which warrant moreattention to better prevention and treatment of COPD in communities.
Objective To survey the prevalence of coexisting chronic obstructive pulmonary disease ( COPD) and chronic heart failure in Chengdu communities. Methods A cross-sectional study was performed in the population aged over 40 years in eight communities of Chengdu city. The subjects were selected by stratified cluster random sampling. Using the same protocol and questionnaire, all participants underwent medical history taking, physical examination and spirometry. Results Of 354 participating patients with a diagnosis of COPD, 74 ( 20. 90% ) cases were complicated with chronic heart failure. The prevalence of chronic heart failure in COPD in male was significantly higher than that in female ( 22. 69%vs. 18. 12% , P lt; 0. 05) . The major causes of chronic heart failure were hypertension ( 31. 64% ) , ischaemic heart disease ( 18. 93% ) , chronic pulonary heart disease ( 17. 51% ) and diabetes ( 11. 86% ) .Conclusions The prevalence of coexisting COPD and chronic heart failure in Chengdu city is significantly higher than the average level of the whole country, which warrant more attention in prevention and treatment of COPD in communities.
