ObjectiveTo monitor the airway inflammatory factors in exhaled breath condensate(EBC) of severe stable COPD patients during salmeterol/fluticasone (50/500μg, bid) treatment, and explore their clinical significance. MethodsTwenty-four sever stable COPD patients and 18 healthy controls were included in the study. EBC was collected from COPD patients before treatment (day 0) and 14 days, 28 days, 90 days after treatment. Meanwhile lung function test and SGRQ score were measured.Concentrations of IL-6 and IL-10 were measured by liquid chip and 8-isoprostane by enzyme-linked immunosorbent assay. ResultsLevels of 8-isoprostane, IL-6 and IL-10 in EBC were significantly higher in the sever stable COPD patients before treatment compared with the healthy controls. 8-isoprostane was decreased significantly at day 14 compared with day 0[(11.59±4.12) pg/mL vs. (14.17±4.66) pg/mL, P < 0.05], and kept in low level till day 90 (P > 0.05). IL-6 was significantly decreased at day 28 compared with day 0[(1.46±0.19) pg/mL vs. (1.59±0.19) pg/mL, P < 0.05], but did not change significantly till day 90. IL-10 was in low level but showed increase at day 90 compared with day 28[(1.72±0.19) pg/mL vs. (1.62±0.12) pg/mL, P < 0.05]. FEV1 and FEV1/FVC were improved and SGRQ score was decreased after 90 days treatment (P < 0.05). FEV1 was not correlated with 8-isoprostane, IL-6 or IL-10 level. ConclusionsDynamic observation of EBC 8-isoprostane level in severe COPD patients can help in evaluating drug efficacy. IL-10 may play a role in airway anti-inflammation.
ObjectiveTo explore the effect of non-pharmaceutical therapy in patient with hypertension in Chengdu. MethodsFrom October 2010 to October 2011, a total of 33 general practitioners from 14 community health-care centers in Chengdu were trained by 2009 "Hypertension Guideline" of China for grass-root; each practitioner was required to manage 25 hypertensive patients during one year, based on standardized project. We evaluated the effect of non-pharmaceutical therapy before and after project and the antihypertensive effects from different therapy. ResultsBy the end of 2011, a total of 632 hypertensive patients[aged from 36 to 79 with an average of 65.72±8.55; 263 males with the mean age of (66.41±9.10) years old, 369 females with the mean age of (65.22±8.10) years old], who were eligible for criteria with complete data had been managed for one year. The non-pharmaceutical management includes quitting smoke, limiting alcohol, limiting salt diet, reducing weight and increasing regular physical activity. At the beginning of this project, the acceptance rate of such management were 75.96%, 71.43%, 99.01%, 73.28%, and 85.00%, respectively. After one year of such non-pharmaceutical management, the proportion of patient, who suffered from smoking, alcohol drinking, excess salty diet, overweight and obesity, and lack of physical exercise, decreased from 8.54%, 5.54%, 16.00%, 55.06%, and 23.73% to 3.80%, 1.42%, 2.69%, 34.43%, and 11.39%, respectively with statistical difference (P<0.001). Overweight and obesity is the main risk factor related to lifestyle. During one year management, Systolic blood pressure decreased by 25.81, 23.71, and 27.78 mm Hg (1 mm Hg=0.133 kPa) in the patients with non-pharmaceutical therapy, pharmaceutical therapy, and both, respectively; diastolic blood pressure decreased by 10.23, 3.99, and 10.46 mm Hg, respectively, in the three groups with statistical difference (P<0.05). ConclusionThrough the hypertension management, strengthening the cognition of non-pharmaceutical therapy for general practitioner can reduce both high blood pressure risk and cardiovascular risk significantly and comprehensively.
Objective To investigate the modulating roles of Clara cell secretory 16 kD protein ( CC-16) , transcription factor T-bet, and GATA-3 in airway inflammation of patients with asthma. Methods 25 patients with acute exacerbation of asthma were enrolled as an asthma group and 33 healthy volunteers were enrolled as control. The plasma levels of CC16, IFN-γ, and IL-4 were measured by enzyme-linked immunosorbent assay ( ELISA) . The mRNA expressions of T-bet and GATA-3 in the peripheral bloodmononuclear cells ( PBMCs) were measured by reverse transcription-polymerase chain reaction ( RT-PCR) .Results The levels of CC16 and IFN-γin the asthma group were lower than those in the control group [ ( 21. 96 ±7. 31 ) ng/mL vs. ( 64. 88 ±25. 27) ng/mL, ( 118. 73 ±22. 59) pg/mL vs. ( 145. 53 ±29. 50) pg/mL, both P lt;0. 01] . The IL-4 level in the asthma group was significantly higher than that in the control group [ ( 425. 22 ±4. 37) pg/mL vs. ( 69. 72 ±10. 15 ) pg/mL, P lt; 0. 01] . The T-bet mRNA expression and T-bet /GATA-3 ratio of PBMCs in the asthma group were significantly lower than those in the control group( both P lt; 0. 01) . The expression GATA-3 mRNA was significantly higher than that in the control group( P lt;0. 01) . The level of CC16 was positively correlated with T-bet mRNA expression and the ratio of T-bet /GATA-3 ( r =0. 792, 0. 761, respectively, P lt; 0. 01) . There was no correlation between CC16 and the GATA-3 mRNA expression ( P gt;0. 05) . Conclusions These results suggest that CC16 and T-bet play important protection roles in the pathogenesis of asthma. GATA-3, IFN-γ, and IL-4 also participate in the airway inflammation of asthma.