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Tumor photodynamic therapy (PDT) relies on intratumoral free radicals, while the limited oxygen source and the depletion of tissue oxygen may exacerbate the hypoxia. As the treatment progresses, there will eventually be a problem of insufficient free radicals. Here, it is found that Au@CeO2 nano-rods (Au@Ce NRs), assembled by gold nano-rods (Au NRs) and ceria nanoparticles (CeO2 NPs), can efficaciously absorb near-infrared light (NIR) to promote the release of oxygen and free radicals. Au@Ce NRs exhibit a higher proportion of Ce3+ (Ce2O3) after oxygen release, while Ce3+ is subsequently oxidized to Ce4+ (CeO2) by trace H2O2. Interestingly, Au@Ce NRs re-oxidized by trace H2O2 can re-releasing oxygen and free radicals again upon NIR treatment, achieving oxygenation/oxygen evolution, similar to charging/discharging. This loop maximizes the conversion of limited oxygen source into highly cytotoxic free radicals. As a result, when B16-F10 cells are treated by NIR/Au@Ce NRs, more tumor cells undergo apoptosis, consistent with the higher level of free radicals. Importantly, NIR/Au@Ce NRs successfully suppresses tumor growth and promotes the generation of epidermal collagen fibers in the transplanted tumor model. Therefore, the rod-shaped Au@Ce NRs provide an ideal platform for maximizing the utilization of intratumoral oxygen sources and improving the treatment of melanoma.
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Nitrogen heterocycles have drawn considerable attention because of their structurally novel and significant biological activities. Marine-derived fungi, especially the Aspergillus species, possess unique metabolic pathways to produce secondary metabolites with novel structures and potent biological activities. This review prioritizes the structural diversity and biological activities of nitrogen heterocycles that are produced by marine-derived Aspergillus species from January 2019 to January 2024, and their relevant biological activities. A total of 306 new nitrogen heterocycles, including seven major categories-indole alkaloids, diketopiperazine alkaloids, quinazoline alkaloids, isoquinoline alkaloids pyrrolidine alkaloids, cyclopeptide alkaloids, and other heterocyclic alkaloids-are presented in this review. Among these nitrogen heterocycles, 52 compounds had novel skeleton structures. Remarkably, 103 compounds showed various biological activities, such as cytotoxic, antimicrobial, anti-inflammatory, antifungal, anti-virus, and enzyme-inhibitory activities, and 21 compounds showed potent activities. This paper will guide further investigations into the structural diversity and biological activities of nitrogen heterocycles derived from the Aspergillus species and their potential contributions to the future development of new natural drug products in the medicinal and agricultural fields.
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Alcaloides , Organismos Acuáticos , Aspergillus , Aspergillus/metabolismo , Alcaloides/farmacología , Alcaloides/química , Compuestos Heterocíclicos/farmacología , Compuestos Heterocíclicos/química , Nitrógeno/química , Animales , Productos Biológicos/farmacología , Productos Biológicos/química , Humanos , Descubrimiento de Drogas/métodos , Relación Estructura-ActividadRESUMEN
The quality of railroad wheelsets is an important guarantee for the safe operation of wagons, and mastering the production information of wheelsets plays a vital role in vehicle scheduling and railroad transportation safety. However, when using objection detection methods to detect the production information of wheelsets, there are situations that affect detection such as character tilting and unfixed position. Therefore, this paper proposes a deep learning-based method for accurately detecting and recognizing tilted character information on railroad wagon wheelsets. It covers three parts. Firstly, we construct a tilted character detection network based on Faster RCNN for generating a wheelset's character candidate regions. Secondly, we design a tilted character correction network to classify and correct the orientation of flipped characters. Finally, a character recognition network is constructed based on convolutional recurrent neural network (CRNN) to realize the task of recognizing a wheelset's characters. The result shows that the method can quickly and effectively detect and identify the information of tilted characters on wheelsets in images.
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In recent years, polymeric materials have been used in a wide range of applications in a variety of fields. In particular, in the field of bioengineering, the use of natural biomaterials offers a possible new avenue for the development of products with better biocompatibility, biodegradability, and non-toxicity. This paper reviews the structural and physicochemical properties of alginate and hyaluronic acid, as well as the applications of the modified cross-linked derivatives in tissue engineering and drug delivery. This paper summarizes the application of alginate and hyaluronic acid in bone tissue engineering, wound dressings, and drug carriers. We provide some ideas on how to replace or combine alginate-based composites with hyaluronic-acid-based composites in tissue engineering and drug delivery to achieve better eco-economic value.
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A case study is used to understand how Western international branch campuses (IBCs) in China represent themselves through web-based branding materials. Drawing on colonial discourse analysis and the theoretical framework of Whiteness as futurity, this study examined the case of Wenzhou-Kean University, a Sino-US cooperative institution to understand how Western IBCs in China interpret and promote internationalization in higher education. By examining how Whiteness through the discourse of world-class education has been mobilized and reproduced, this study argued that the operation of IBCs perpetuated Western supremacy in the global higher education landscape at the expense of local people and knowledges.
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Objective: To observe the effectiveness and safety of Lianhua Qingwen granule in the treatment of non-influenza viral pneumonia. Methods: This study was a multicenter, randomized, double-blind, placebo-controlled trial. Subjects who met the inclusion and exclusion criteria and were clinically diagnosed with viral pneumonia (negative for influenza virus) were randomly divided into the Lianhua Qingwen granule trial group and placebo control group. Patients in the trial group was given Lianhua Qingwen granule, 2 bags at a time, 3 times a day, and the controls were given placebo, with a treatment course of 7 days. Patients' clinical symptoms and signs, and treatment-associated adverse events were observed. Subjects should be included in the full analysis set (FAS) as long as they were all given the medication and had an effectiveness test performed after randomization. Subjects should be included in the Per Protocol Set (PPS),a subset of the total analysis set, which should contain those with strong compliance, no protocol violations, and complete baseline values for the primary indicators. Results: A total of 169 subjects were enrolled in 12 subcenters, including 151 (76 in the trial group and 75 in the control group) in the FAS and 140 (68 in the trial group and 72 in the control group) in the PPS. After 7 days of treatment, the clinical symptom relief rates were 82.98% (FAS) and 87.12% (PPS) in the trial group, and 75.11% (FAS) and 76.02% (PPS) in the control group, respectively. The clinical symptom relief rates in the trial group were significantly higher than those in the control group (p < 0.001). Significant improvements in single symptoms of cough and expectoration in the trial group were observed compared with the control group (p < 0.05). There were no statistical differences in fever, sputum color change, chest pain, muscle pain, dyspnea, chills, and thirst between the two groups (p > 0.05). Safety: There were no significant differences in body weight, vital signs, blood routine, urine routine, stool routine, and blood biochemical indicators (CK, AST, ALT, Cr, and Bun) between the two groups before and after treatment (p > 0.05). During treatment, there were no significant differences in the incidence of adverse events and serious adverse events between the two groups (p > 0.05). Conclusion: Lianhua Qingwen granules improved the clinical symptoms of patients with non-influenza virus pneumonia, especially ameliorating cough and expectoration. Lianhua Qingwen granules were associated with good safety.
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Rock failure phenomena are accompanied by abundant energy variation, and the energy dissipation can explain the dynamic mechanical characteristics of the rock. In this study, a series of granite specimens (a total of 60) with different aspect ratios were dynamically loaded by a split Hopkinson pressure bar (SHPB) to explain the energy dissipation and the rock-crushing degree under dynamic load. A new index, namely energy time density (wtd), is proposed to evaluate the energy dissipation considering the time factor. The relationships between strain rate, energy time density, and specific energy absorption are analyzed. A metric (Ku) is defined to describe the degree of rock fragmentation quantitatively. The correlations of fractal dimension and Ku with different impact pressures are compared. It was concluded that there is a noticeable peak point in the energy time density curve. The energy time density of the stress equilibrium point is three times that of the peak point. The energy time density declines after the peak point, then the energy consumption density tends to be stable. The linear relationship between strain rate and peak point energy time density is stronger. The new index can describe energy dissipation well under dynamic loading. In addition, the experimental results indicate that the degree of crush Ku can describe the degree of crush, and the effect of fractal dimension to quantify the fracture characteristics of the rocks is less good in this test. The crushing degree of rocks increases with the increase of strain rate. Furthermore, the prediction effect of energy time density is better than that of strain rate about Ku.
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The Split Hopkinson Pressure Bar (SHPB) is an apparatus for testing the dynamic stress-strain response of the cement mortar specimen with pre-set joints at different angles to explore the influence of joint attitudes of underground rock engineering on the failure characteristics of rock mass structure. The nuclear magnetic resonance (NMR) has also been used to measure the pore distribution and internal cracks of the specimen before and after the testing. In combination with numerical analysis, the paper systematically discusses the influence of joint angles on the failure mode of rock-like materials from three aspects of energy dissipation, microscopic damage, and stress field characteristics. The result indicates that the impact energy structure of the SHPB is greatly affected by the pre-set joint angle of the specimen. With the joint angle increasing, the proportion of reflected energy moves in fluctuation, while the ratio of transmitted energy to dissipated energy varies from one to the other. NMR analysis reveals the structural variation of the pores in those cement specimens before and after the impact. Crack propagation direction is correlated with pre-set joint angles of the specimens. With the increase of the pre-set joint angles, the crack initiation angle decreases gradually. When the joint angles are around 30°-75°, the specimens develop obvious cracks. The crushing process of the specimens is simulated by LS-DYNA software. It is concluded that the stresses at the crack initiation time are concentrated between 20 and 40 MPa. The instantaneous stress curve first increases and then decreases with crack propagation, peaking at different times under various joint angles; but most of them occur when the crack penetration ratio reaches 80-90%. With the increment of joint angles in specimens through the simulation software, the changing trend of peak stress is consistent with the test results.
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Development of specific serum biomarkers is essential to improve diagnosis and prognosis of non-small cell lung cancer (NSCLC). Here, we show that serum and tissue levels of miR-519d are significantly decreased in NSCLC patients. The low expression of miR-519d is associated with lymph node metastases, clinical stage, and a poor prognosis in NSCLC patients. In addition, ROC analysis demonstrated that the serum miR-519d levels can distinguish NSCLC patients from healthy controls. MiR-519d inhibits proliferation, migration, and invasion by lung cancer cells, indicating that it may function as a tumor suppressor in lung cancer. Furthermore, our data demonstrate that HER3 is a target gene of miR-519d in lung cancer cells, and show that by targeting HER3, miR-519d inhibits the PI3K/Akt pathway. These findings demonstrate that the miR-519d levels are decreased in serum and tumor tissues of NSCLC patients, and indicate that miR-519d regulates NSCLC progression by targeting HER3. MiR-519d could potentially serve as a novel serum biomarker for NSCLC.
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Biomarcadores de Tumor/sangre , Carcinoma de Pulmón de Células no Pequeñas/sangre , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico , Neoplasias Pulmonares/sangre , Neoplasias Pulmonares/diagnóstico , MicroARNs/sangre , Receptor ErbB-3/metabolismo , Anciano , Carcinoma de Pulmón de Células no Pequeñas/metabolismo , Femenino , Regulación Neoplásica de la Expresión Génica , Humanos , Neoplasias Pulmonares/metabolismo , Masculino , MicroARNs/metabolismo , Persona de Mediana Edad , Sensibilidad y EspecificidadRESUMEN
Although broad knowledge of influenza viral pneumonia has been established, the significance of non-influenza respiratory viruses in community-acquired pneumonia (CAP) and their impact on clinical outcomes remains unclear, especially in the non-immunocompromised adult population.Hospitalised immunocompetent patients with CAP were prospectively recruited from 34 hospitals in mainland China. Respiratory viruses were detected by molecular methods. Comparisons were conducted between influenza and non-influenza viral infection groups.In total, 915 out of 2336 adult patients with viral infection were enrolled in the analysis, with influenza virus (28.4%) the most frequently detected virus, followed by respiratory syncytial virus (3.6%), adenovirus (3.3%), human coronavirus (3.0%), parainfluenza virus (2.2%), human rhinovirus (1.8%) and human metapneumovirus (1.5%). Non-influenza viral infections accounted for 27.4% of viral pneumonia. Consolidation was more frequently observed in patients with adenovirus infection. The occurrence of complications such as sepsis (40.1% versus 39.6%; p=0.890) and hypoxaemia (40.1% versus 37.2%; p=0.449) during hospitalisation in the influenza viral infection group did not differ from that of the non-influenza viral infection group. Compared with influenza virus infection, the multivariable adjusted odds ratios of CURB-65 (confusion, urea >7â mmol·L-1, respiratory rate ≥30â breaths·min-1, blood pressure <90â mmHg (systolic) or ≤60â mmHg (diastolic), age ≥65â years) ≥3, arterial oxygen tension/inspiratory oxygen fraction <200â mmHg, and occurrence of sepsis and hypoxaemia for non-influenza respiratory virus infection were 0.87 (95% CI 0.26-2.84), 0.72 (95% CI 0.26-1.98), 1.00 (95% CI 0.63-1.58) and 1.05 (95% CI 0.66-1.65), respectively. The hazard ratio of 90-day mortality was 0.51 (95% CI 0.13-1.91).The high incidence of complications in non-influenza viral pneumonia and similar impact of non-influenza respiratory viruses relative to influenza virus on disease severity and outcomes suggest more attention should be given to CAP caused by non-influenza respiratory viruses.
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Neumonía Viral/terapia , Infecciones del Sistema Respiratorio/virología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , China/epidemiología , Infecciones Comunitarias Adquiridas/terapia , Infecciones Comunitarias Adquiridas/virología , Femenino , Geografía , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Neumonía Viral/virología , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Sistema de Registros , Infecciones del Sistema Respiratorio/terapia , Sepsis , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Virosis/terapia , Virosis/virología , Adulto JovenRESUMEN
BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality all over the world. Acute exacerbation of COPD (AECOPD) not only accelerates the progression of disease, but also causes hospital administration and death events. Epidemiologic studies have shown air pollution is a high risk factor of AECOPD. However, there are rare technics or treatment strategies recommended to reduce severe air pollution related AECOPD. METHODS: This is a multi-center, prospective, randomized and standard treatment parallel control clinical trial. Seven hundred sixty-four stable COPD patients in group B, C and D according to GOLD 2017 will be recruited and equally divided into two parallel groups, salvational intervention (SI group) and control group (CT group). Original treatments for participants include tiotropium (18µg once q.d), budesonide/formoterol (160µg/4.5µg once or twice b.i.d) or budesonide/formoterol (160µg/4.5µg once or twice b.i.d) with tiotropium (18µg once q.d). The savational intervention for SI group is routine treatment plus budesonide/formoterol (160µg/4.5µg once b.i.d) from the first day after severe air pollution (air quality index, AQI ≥200) to the third day after AQI < 200. CT group will maintain the original treatment. The intervention will last for 2 years. Primary outcome is the frequency of AECOPD per year and the secondary outcomes include the incidence of unplanned outpatient visits, emergency visits, hospitalization, medical cost and mortality associated with AECOPD per year. DISCUSSION: The salvational intervention is a novel strategy for COPD management under severe air pollution. Results of the present study will provide reference information to guide clinical practice in reducing the air pollution related exacerbation of COPD. TRIAL REGISTRATION: This study has been registered at www.ClinicalTrials.gov (registration identifier: NCT03083067 ) in 17 March, 2017.
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Contaminación del Aire/efectos adversos , Broncodilatadores/administración & dosificación , Progresión de la Enfermedad , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , Beijing , Budesonida/administración & dosificación , Femenino , Fumarato de Formoterol/administración & dosificación , Humanos , Masculino , Persona de Mediana Edad , Estudios Multicéntricos como Asunto , Estudios Prospectivos , Ensayos Clínicos Controlados Aleatorios como Asunto , Análisis de Regresión , Bromuro de Tiotropio/administración & dosificaciónRESUMEN
BACKGROUND: Increasingly, studies have shown that application of pulmonary rehabilitation (PR) may improve the quality of life (QOL) of patients with COPD. However, some studies remain controversial and were limited to small number of participants. We designed a systematic review and meta-analysis to evaluate the efficacy of PR in improving the QOL for subjects with COPD. METHODS: We searched the Cochrane Library, PubMed, EMBASE, and Web of Science up to March 29, 2018, to identify relevant randomized controlled trials that analyzed and evaluated the efficacy of PR in subjects with COPD. Participants were randomly assigned to receive PR (intervention group) or usual care (control group). We used Chronic Respiratory Questionnaire scores, which include 4 important domains (ie, Fatigue, Emotion, Mastery, and Dyspnea) as the evaluating indicators of QOL. Mean differences with 95% CI were estimated to compare the outcomes of the groups. We also performed subgroup analysis for the pooled results of PR effects in subjects with COPD. In addition, a sensitivity analysis was performed to examine the stability of the combined results. Two reviewers assessed trial quality and extracted data independently. RESULTS: Seventeen randomized controlled trials (N = 1,649 participants) were identified for the present analysis. In comparing PR groups with usual care groups, we identified significant effects in QOL improvement as measured by the Chronic Respiratory Questionnaire scores for fatigue (Mean difference 0.60, 95% CI 0.36-0.84, P < .001), mastery (Mean difference 0.59, 95% CI 0.32-0.85, P < .001), and dyspnea (Mean difference 0.70, 95% CI 0.46-0.94, P < .001), but no clinically important improvement was found in emotion (Mean difference 0.45, 95% CI 0.23-0.67, P < .001) according to the minimal clinically important difference that we defined as mean difference ≥ 0.5 units. CONCLUSION: PR may constitute an important component of COPD management and may be beneficial in improving QOL.
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Enfermedad Pulmonar Obstructiva Crónica/rehabilitación , Calidad de Vida , Terapia Respiratoria/estadística & datos numéricos , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/psicología , Terapia Respiratoria/métodos , Resultado del TratamientoRESUMEN
Green algal blooms have occurred in the Yellow Sea for 11 consecutive years since 2007. A "seed bank" comprising micro-propagules including gametes, meiospores, and zygotes, played an important role in the rapid formation of a green tide. In the present study, germination differences among zygotes, meiospores, and gametes were examined. The growth ability and maturation period of alternating generations of sexual Ulva prolifera strains were also assessed. The zygote and meiospore germination rate was 91.67% and 80.29%, respectively, approximately three times greater than that of gametes (30%). In addition, the highest daily growth rate of sporophytes and gametophytes was 266.7% and 288.1%, respectively, and the maturation period of sporophytes and gametophytes was 35.7 and 31.3â¯days, respectively. These results indicate that sexual reproduction and vegetative growth are mainly responsible for the rapid expansion of macroalgal blooms in the Yellow Sea.
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Eutrofización , Células Germinativas de las Plantas/fisiología , Germinación , Reproducción Asexuada , Ulva/crecimiento & desarrollo , ChinaRESUMEN
Among patients with primary lung cancer, 75-80% present with non-small cell lung cancer (NSCLC). However, there is a lack of studies into the potential preventive effects of curcumin against the activation of autophagy in NSCLC. Therefore, the present study primarily focused on the protective role of curcumin in NSCLC. It was demonstrated that curcumin decreased the viability of the human lung cancer cells lines, A549 and H1299, in a time-and dose-dependent manner (P<0.05). Treatment with curcumin also suppressed the colony formation capacities of A549 and H1299 cells. Following incubation with 10 µM curcumin for 48 h, cell apoptosis was significantly increased by 2.35- and 3.02-fold in A549 and H1299 cells, respectively, when compared with controls (P<0.01). Furthermore, curcumin treatment markedly increased the number and volume of autophagosomes in A549 and H1299 cells when compared with controls. Treatment with 10 µM curcumin for 48 h also significantly reduced the phosphorylation levels of mechanistic target of rapamycin (mTOR), ribosomal protein S6, phosphoinositide 3-kinase and AKT (protein kinase B) in A549 and H1299 cells (P<0.05). These data indicated that curcumin enhanced autophagy and apoptosis in NSCLC cells by acting as an mTOR complex1/2 inhibitor.
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BACKGROUND: Volume-targeted noninvasive ventilation (VT-NIV), a hybrid mode that delivers a preset target tidal volume (VT) through the automated adjustment of pressure support, could guarantee a relatively constant target VT over pressure-limited noninvasive ventilation (PL-NIV) with fixed-level pressure support. Whether VT-NIV is more effective in improving ventilatory status in subjects with acute hypercapnic respiratory failure (AHRF) remains unclear. Our aim was to verify whether, in comparison with PL-NIV, VT-NIV would be more effective in correcting hypercapnia, hence reducing the need for intubation and improving survival in subjects with AHRF. METHODS: We performed a prospective randomized controlled trial in the general respiratory wards of 8 university-affiliated hospitals in China over a 12-month period. Subjects with AHRF, defined as arterial pH <7.35 and ≥7.25 and PaCO2 >45 mm Hg, were randomly assigned to undergo PL-NIV or VT-NIV. The primary end point was the decrement of PaCO2 from baseline to 6 h after randomization. Secondary end points included the decrement of PaCO2 from baseline to 2 h after randomization as well as outcomes of subjects (eg, need for intubation, in-hospital mortality). RESULTS: A total of 58 subjects were assigned to PL-NIV (29 subjects) or VT-NIV (29 subjects) and included in the analyses. The decrement of PaCO2 from baseline to 6 h after randomization was not statistically different between the PL-NIV group and the VT-NIV group (9.3 ± 12.6 mm Hg vs 11.7 ± 12.9 mm Hg, P = .48). There were no differences between the PL-NIV group and the VT-NIV group in the decrement of PaCO2 from baseline to 2 h after randomization (6.4 ± 12.7 mm Hg vs 5.0 ± 15.8 mm Hg, P = .71) as well as in the need for intubation (17.2% vs 10.3%, P = .70), and in-hospital mortality (10.3% vs 6.9%, P > .99). CONCLUSIONS: Regardless of whether a VT- or PL-NIV strategy is employed, it is possible to provide similar support to subjects with AHRF. (ClinicalTrials.gov registration NCT02538263.).
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Hipercapnia/terapia , Ventilación no Invasiva/métodos , Respiración con Presión Positiva , Insuficiencia Respiratoria/terapia , Enfermedad Aguda , Anciano , Anciano de 80 o más Años , China , Femenino , Mortalidad Hospitalaria , Humanos , Hipercapnia/mortalidad , Masculino , Persona de Mediana Edad , Ventilación no Invasiva/mortalidad , Estudios Prospectivos , Insuficiencia Respiratoria/mortalidad , Volumen de Ventilación Pulmonar , Resultado del TratamientoRESUMEN
OBJECTIVE: The majority of patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have low serum procalcitonin (PCT) values. The aim of this study was to determine whether these patients may benefit from antibiotic treatment. METHODS: A total of 457 patients with AECOPD were screened; 194 patients with AECOPD and PCT <0.1 ng/ml were assigned randomly to an antibiotic group or a control group. In the per-protocol (PP) population, the antibiotic group subjects were required to have used antibiotics for at least 3 days, and the control group subjects were required not to have used antibiotics within the 10 days after admission. The intention-to-treat (ITT) population was defined as the patients who were randomized. The primary outcome was the treatment success rate on day 10 after admission. Secondary outcomes were symptoms assessed on a visual analog scale (VAS), length of hospitalization, mortality, exacerbation rate, and re-hospitalization within 30 days of follow-up (study registered at chictr.org.cn: ChiCTR-TRC-14004726). RESULTS: 95 patients in the antibiotic group and 96 patients in the control group completed the study. In the ITT population, the overall treatment success rate in the control group (95.8%) was similar to that in the antibiotic group (93.7%), with no significant difference (p=0.732). Five patients in the antibiotic group died, either in hospital or within 30 days of discharge. In the control group, two died within 30 days of discharge. Antibiotic use in the control group was 17.7% (17/96), and age ≥75 years was a predictive risk factor for requiring antibiotic therapy in the control group (odds ratio 4.055, 95% confidence interval 1.297-12.678; p=0.012). According to the PP analysis, the treatment success rate on day 10 after admission was 98.7% (78/79) in the control group and 93.7% (89/95) in the antibiotic group, also with no significant difference (p=0.193). No secondary outcome was significantly different between the two groups. CONCLUSION: Antibiotic treatment is no better than placebo in AECOPD with a PCT level <0.1 ng/ml.
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Antibacterianos/uso terapéutico , Calcitonina/sangre , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Enfermedad Aguda/terapia , Adulto , Anciano , Péptido Relacionado con Gen de Calcitonina , Femenino , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Precursores de Proteínas/sangre , Enfermedad Pulmonar Obstructiva Crónica/sangre , Resultado del TratamientoRESUMEN
OBJECTIVE: To explore the proportion and prevention status of venous thromboembolism (VTE) among hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Beijing. METHODS: Based on a multi-center retrospective study, a total of 636 hospitalized AECOPD patients from 17 class 2/3 hospitals in Beijing were examined from September 1, 2011 to March 31, 2012. They fulfilled one of the following criteria: respiratory failure type II, on invasive or non-invasive mechanical ventilation, hospitalization for pulmonary infection, bedridden duration ≥ 3 days and congestive heart failure. All investigators received standardized training and used a standardized questionnaire to collect data on VTE risk factors, the diagnosis of VTE and the utilization of VTE prophylaxis. According to Caprini score, they were categorized into 3 groups of lower risk (Caprini score ≤ 3), moderate risk (Caprini score 4-6) and high risk ( ≥ 7) to compare the intergroup differences in the VTE proportion and the utilization of VTE prophylaxis. RESULTS: A total of 636 patients were assessed. There were 416 males and 220 females with a mean (SD) age of 74.9 ± 9.3 years. Among them, 133 patients received lower extremity venous ultrasonic examination and 92 were diagnosed with deep venous thrombosis (DVT) including 2 patients with pulmonary thromboembolism (PTE). Thus the overall incidence of VTE was 14.5% (92/636) and increased with age (Ptrend = 0.044). The proportion of VTE in asymptomatic patients was higher in those symptomatic ones (21.1% vs 8.0%, P = 0.000). And it was the highest in high risk group, followed by lower risk and moderate risk groups at 17.9% (14/78), 16.0% (26/163) and 13.2% (52/395) respectively, There was no statistical significance (P = 0.450 for group difference, Ptrend = 0.946). Among 544 patients without VTE, only 19.1% (104/544) employed the pharmacologic and/or mechanical methods for preventing VTE. The prevention proportion gradually increased with rising Caprini score, i.e. 17.5%, 18.4% and 26.6% for lower, moderate and higher risk group respectively. There was no statistical significance (P = 0.266 for group difference, Ptrend = 0.201). CONCLUSIONS: The proportion of VTE is relatively higher. However, the preventive methods are significantly underutilized among hospitalized AECOPD patients in Beijing.
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Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Tromboembolia Venosa/epidemiología , Tromboembolia Venosa/prevención & control , Adulto , Anciano , Anciano de 80 o más Años , China/epidemiología , Femenino , Hospitalización , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Estudios Retrospectivos , Medición de RiesgoRESUMEN
OBJECTIVE: To survey the prevalence rate of bronchial asthma in Beijing area among residents aged over 14 years. METHODS: In accordance with stratified cluster random sampling, epidemiological questionnaires were performed in Beijing residents aged over 14 years during household visits from February 2010 to August 2011. Asthma was diagnosed on the basis of case history, clinical signs and lung function test. The statistical software SAS 9.2 was employed to analyze the epidemiological status of asthma. RESULTS: In a sampling population of 61 107, 57 647 questionnaires were effective. Among 687 asthmatics, there were 296 males and 391 females. The overall prevalence rate of asthma was 1.19% (687/57 647). The asthma prevalence rates were 1.09% (418/38 468) and 1.40% (269/19 179) in urban and suburb Beijing respectively and the prevalence rate of asthma in suburb area was significantly higher than that of urban area (χ(2) = 10.850, P = 0.001). The prevalence rates of males and females were 1.06% (296/27 947) and 1.32% (391/29 700) respectively and the prevalence rate of asthma in females was much higher than that of males (χ(2) = 8.098,P = 0.004). Significant differences existed among different age groups (χ(2) = 404.874, P = 0.000) and residents aged at or over 71 years had the highest prevalence rate. The prevalence rates in urban and suburb Beijing area increased by 1.12 and 2.26 folds respectively than that of 2002. And 198 asthmatics were first diagnosed in this survey and accounted for 28.8% (198/687) in all asthma diagnosed asthmatics. CONCLUSIONS: The prevalence rate of asthma in Beijing area among residents aged over 14 years increased greatly from 2010 to 2011. And the epidemiological data may reflect the current distribution status of asthma in Beijing area.
Asunto(s)
Asma/epidemiología , Adulto , Anciano , China/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND: The body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index was shown at predicting the risk of death, exacerbation and disease severity among patients with COPD, but few studies verified relationship between BODE index and health related quality of life (HRQoL) among Chinese COPD patients. The objective of this study was to evaluate the relationship between BODE index and HRQoL in cross-sectional and longitudinal association analyses. METHODS: A multi-center prospective cohort study was initially conducted in 491 stable COPD patients in Beijing, China. Health status (HRQoL) was assessed by St. George's Respiratory Questionnaire (SGRQ); the BODE index was calculated for each patient; dyspnea was assessed using the 5-grade Medical Research Council dyspnea scale. Other measurements included socio-demographic, body mass index (BMI), lung function test and 6-minute-walk test (6MWT). Patients were then followed monthly for 12 months. RESULTS: Only 450 patients completed the 1-year follow up and were enrolled in our present analyses. Mean age was (65.2 +/- 10.6) years, men 309 (68.7%). The BODE index was categorized into 4 subgroups: 0 - 2, 3 - 4, 5 - 6 and 7 - 10. At baseline BODE index was gradually increased with baseline total SGRQ and SGRQ subscales (P trend < 0.001). For individual components of BODE index, with the decrease of airflow limitation, and 6MWD, and with the increase of Medical Research Council (MRC) dyspnea grade, total SGRQ and SGRQ subscales were increased correspondingly, P trend < 0.05, respectively. Similar association patterns were found between baseline BODE index and its individual components and mean SGRQ scores at the end of 1-year follow up. By multiple linear regression analyses, baseline BODE index was not only significantly associated with SGRQ score at baseline but also with SGRQ score at the end of 1-year follow up after adjustment for age, male, current smoking, betas being 0.434 and 0.378, respectively. CONCLUSIONS: BODE index is associated with SGRQ score cross-sectionally and longitudinally among stable COPD patients. BODE index might have potential to be used as a sensitive tool to assess the status of quality of life and to monitor disease progression among stable COPD patients.