Objective To determine the efficacy of forced expiratory volume in six seconds( FEV6 ) as an alternative for forced vital capacity( FVC) in the diagnosis for mild-moderate chronic obstructive pulmonary disease( COPD) .Methods A total of 402 mild-moderate COPD and 217 non-COPD patients’ spirometric examinations were retrospectively analyzed. The correlation between FEV6 and FVC, FEV1 /FVC and FEV1 /FEV6 was evaluated by the Spearman test. Considering FEV1 /FVC lt;70% as being the ‘golden standard’ for airway obstruction, a ROC curve was used to determine the best cut-off point for the FEV1 /FEV6 ratio in the diagnosis for COPD. Results The Spearman correlation test revealed the FEV1 and FEV6 , FEV1 /FEV6 and FEV1 /FVC ratios were highly correlated ( r = 0. 992, 0. 980, respectively, P = 0. 000) . Using FEV1 /FEV6 lt; 70% as the diagnosis standard, 12. 69% of the 402 patients could not be diagnosed as COPD. The FEV1 /FVC ratio of these patients was very close to 70% . The best cut-off point for the FEV1 /FEV6 ratio in the diagnosis of mild-moderate COPD was 72% while the sensitivity and specificity were 94. 7% and 92. 2% , respectively. Conclusions There is a b correlation between FEV1 /FVC and FEV1 /FEV6 . The FEV6 can be a valid alternative for FVC in the diagnosis for mild-moderate COPD, although it may result in false negative. The best cut-off point for the FEV1 /FEV6 ratio is 72% .
ObjectiveTo investigate the effects of acute and chronic ozone exposure on inflammation,structure and function in murine lung. Methods32 C57/BL6 mice were randomly divided into a single (acute) ozone exposed group,a single air exposed group,a multiple (chronic) ozone exposed group (every three days over 6 weeks),and a multiple air exposed group with 8 mice in each group.The mice were exposed to 2.5 ppm of ozone or air for 3 hours per time and sacrificed 24 hours after the last time of ozone exposure.Lung volume,low attenuation area (LAA) percentage,lung function,cell counts and malondialdehyde (MDA) in bronchoalveolar lavage fluid (BALF),8-hydroxy-2'-deoxyguanosine (8-OHdG) in serum,inflammation scores and mean linear intercept (Lm) in lung section were assessed. ResultsCompared with the single air exposed group,single (acute) ozone exposure led to increases in inflammatory cells in BALF,inflammation scores in the lung tissue,MDA in BALF and 8-OHdG in serum,but had no effect on lung volume,LAA percentage,airflow or Lm.Compared with the single (acute) ozone exposed group,the single air exposed group and the multiple air exposed group,multiple (chronic) ozone exposure increased inflammatory cells in BALF,lung volume,LAA percentage,total lung capacity and lung compliance,mediated airflow obstruction,and also increased lung inflammation socres and Lm. ConclusionAcute ozone exposure induced airway/lung inflammation and oxidative stress,while chronic ozone exposure induced airway/lung inflammation,emphysema and airflow obstruction.
ObjectiveTo evaluate the effect of perioperative nebulization of ipratropium bromide on preoperative pulmonary function and incidence of postoperative pulmonary complications as well as safety in chronic obstructive pulmonary disease (COPD) patients who underwent lung resection in thoracic surgery. MethodsDuring November 18, 2013 to August 12, 2015, 192 COPD patients with a necessity of selective surgical procedures of lobectomy or right bilobectomy or segmentectomy under general anaesthesia in 10 centers were 1 : 1 randomized to an ipratropium bromide group (96 patients) and a placebo group (96 patients), to compare the effect on preoperative pulmonary function and incidence of postoperative pulmonary complications. The average age of treated patients was 62.90±6.50 years, with 168 male patients and 22 female patients. Results The demographic and baseline characteristics were well-balanced between the two groups. The adjusted mean increase of forced expiratory volume in one second (FEV1) in the ipratropium bromide group was significantly higher than that in the placebo group (169.90±29.07 mL vs. 15.00±29.35 mL, P<0.05). The perioperative use of ipratropium bromide significantly decreased incidence of postoperative pneumonia (2.6% vs. 14.1%, P<0.05). There was no ipratropium bromide related adverse event (AE) observed in this trial. ConclusionThis trial indicates that perioperative nebulization of ipratropium bromide significantly improves preoperative lung function and reduces postoperative pneumonia in COPD patients undergoing lung resection in thoracic surgery, and has good safety profile.
ObjectiveTo investigate the changes of lung function after exposure to fine particulate matter (PM2.5) for 60 days and the expression of miR-146 in mice.MethodsThirty SPF BALB/c mice were treated with noninvasive tracheal instillation of fine particulate matter suspension at different doses (2.5 mg/kg, 5.0 mg/kg, 10.0 mg/kg) for 2 months (two times one week), the blank group and normal saline group were set as control groups. The mice were examined and killed on the next day after the last instillation. Histopathological changes of the lungs, pro-infammatory factors levels in the lung tissues, pulmonary functions and the relative expression of miR-146a and miR-146b in the lung tissues were detected.ResultsPeak inspiratory flow (PIF) and peak expiratory flow (PEF) were decreased significantly after PM2.5 exposure, however, lung resistance increased and maximal voluntary ventilation reduced from the general tendency without significant difference. Hematoxylin-eosin stain showed lymphocyte infiltration and macrophage infiltration by phagocytic particles, alveolar spacer widening, inflammatory response increased with the increase of PM2.5 exposure dosage. Pro-infammatory factors as interleukin-6 in the bronchoalveolar lavage fluid, interferon-γ and tumor necrosis factor-α in the lung homogenate were increased significantly by enzyme linked immunosorbent assay. The relative expressions of miR-146a and miR-146b were up-regulated remarkablely in treatment groups compared to the control group by real-time fluorescence quantitative polymerase chain reaction, which had negative relationships with PIF and PEF.ConclusionsThe lung function of mice decreases significantly after exposure to fine particulate matter, and the expression of miR-146 is up-regulated.
ObjectiveTo explore the influence of respiratory function training on pulmonary function of patients with pneumoconiosis. MethodsOne hundred patients with pneumoconiosis hospitalized in our department between June 2011 and September 2012 were chosen as the research subjects. According to the method of random digits table, they were equally and randomly divided into contrast group and observation group. Patients in both the two groups were given routine treatment and nursing and health education, while patients in the observation group adopted respiratory training with lung functional exerciser in addition. Then we observed the forced expiratory volume in one second (FEV1), vital capacity, maximal voluntary ventilation, forced vital capacity, classification of conscious shortness of breath and shortness of breath as well as classification of activities of daily living in the patients before and after training in both the two groups. ResultsAfter 6 months, lung function index, classification of conscious shortness of breath and shortness of breath as well as classification of activities of daily living of patients in the observation group improved a lot, which was significantly better than that in the contrast group (P<0.05). Compared with the contrast group, the FEV1 [(2.75±0.43) L], vital capacity [(3.29± 0.45)L] of patients in the observation group were significantly higher (P<0.05). Compared with the contrast group, classification of conscious shortness of breath and shortness of breath (2.10±0.67), classification of activities of daily living (2.19±0.66) were also significantly different (P<0.05). ConclusionRespiratory function training with lung functional exerciser can improve lung function of patients with pneumoconiosis, alleviate the degree of dyspnea, and enhance the quality of life.
Objective To establish amedical reference for adult pulmonary function parameters and a normal FEV1 /FVC% pred in population of Shanghai. Methods Subjects who underwent routine physical examination were initially screened and those who met enrollment criteria with age over 18 years old were required to underwent pulmonary function tests in Zhongshan Hospital from June 2009 to February 2010. After screening of 450 subjects, a total of 240 subjects with normal pulmonary function and 120 subjects with mild small airway abnormalities were enrolled in this study according to the prediction equations established in1988. All subjects were assigned into 6 groups according to their age with30 males amd 30 females in each group. Pulmonary function parameters including VC, FVC, FEV1 , FEV1 /FVC, PEF, FEF25% , FEF50% , FEF75% , RV, FRC, TLC, RV /TLC, DLCO, and KCO were collected for analysis. New prediction equations for the above 14 parameters were established by parameters of anthropometry. The medical reference ranges of 14 parameters were calculated according to the newprediction equations. The normal FEV1 /FVC%pred was also calculated. Results New prediction equations for normal adult pulmonary function parameters in Shanghai were established. DLCO =5.206 +4. 314 ×gender ( “male”= 1, “female”=0) - 0. 144 ×age( y) +0. 098 × height( cm) +0. 082 ×weight( kg) , KCO =9. 346 - 0. 026 ×age( y) - 0. 031 ×height( cm) +0. 025 ×weight( kg) .The LLN( P5) of VC, FVC, FEV1 , FEV1 /FVC, the LLN( P2. 5 ) and the upper limit of normal value ( P97. 5) of FRC, TLC, RV, RV/TLC were calculated. The LLN( P5) of FEV1 /FVC = 101. 924 - 0. 144 × age ( y) - 0. 118 ×high( cm) . The lower normal limit of FEV1 /FVC% pred was 92% . Conclusions This is the first time to have the medical reference of FEV1 /FVC% pred in China, and new prediction equations for DLCO in Shanghai. The LLN of FEV1 /FVC or FEV1 /FVC% pred lt;92% can be used as diagnostic criteria for obstructive ventilation disorder. Instead of using FEV1% pred lt; 80% , FEV1 lt; LLN can be used as diagnostic criteria for mild ventilation disorder.
目的 評價健身氣功八段錦對慢性阻塞性肺疾病（COPD）穩定期患者臨床療效及肺功能的影響。 方法 2011年6月－2012年5月將COPD穩定期患者隨機分為試驗組和對照組各40例。在兩組均接受西醫基礎治療基礎上，試驗組同時采用健身氣功八段錦肺康復訓練：每日下午練習氣功八段錦1次，每次30 min，療程90 d。觀察兩組患者的臨床療效及肺功能改善情況。 結果 觀察期（兩組各1例）患者不能堅持而棄之。試驗組總療效、肺功能改善情況優于對照組（P＜0.05）。 結論 通過健身氣功八段錦訓練可在一定程度上改善COPD穩定期患者的臨床療效及肺功能，值得推廣。