Usage, acceptability, and preliminary effectiveness of an mHealth-based integrated modality for smoking cessation interventions in Western China.

INTRODUCTION: Many smokers have not accessed professional smoking cessation assistance due to limited smoking cessation services. We developed a novel mHealth-based integrated modality for smoking cessation (WeChat + Quitline modality, WQ modality) and applied it to a large public welfare project (China Western-QUIT Program) in western China. This study evaluated the usage, acceptability, and preliminary effectiveness of the WQ modality in the population of western China. METHODS: A prospective cohort study was conducted between April and August 2021. Smokers or their relatives were recruited through online advertisements and medical staff referrals. After using the services of the WQ modality for one month, the self-reported awareness, use, and satisfaction with each service among the participants were collected by a telephone interview. We also evaluated the self-reported 7-day point prevalence of abstinence (PPA) and quit attempt rate among baseline current smokers. The usage data of each service were downloaded from quitline and WeChat platforms. RESULTS: Of the 17326 people from western China using the WQ modality, the largest number of users was WeChat official account (11173), followed by WeChat mini program (3734), WeChat group (669), and quitline (541 inbound calls, 605 outbound calls). At one month follow-up, over 70% of participants who completed the baseline survey (n=2221) were aware of WeChat-based services, and over 50% used them. However, the awareness rate (11.1%) and utilization rate (0.5%) of quitline were relatively low. The median satisfaction scores across all services were 9 out of 10 points (IQR: 8-9). Among the baseline current smokers (n=1257), self-reported 7-day PPA was 41.8% (526/1257), and another 225 smokers (17.9%) reported making a quit attempt. CONCLUSIONS: The WQ modality could be well used and accepted, and it has great potential to motivate and aid short-term smoking cessation in smokers from western China.

New biopsy after antibiotic treatment: effect on outcomes of assisted reproduction in patients with infertility and chronic endometritis.

RESEARCH QUESTION: What is the effect of chronic endometritis on patients with infertility, the necessity of endometrial re-examination and the effect of improving chronic endometritis after one cycle of antibiotic treatment on pregnancy outcomes? DESIGN: Infertile patients (n = 4003) who underwent IVF and intracytoplasmic sperm injection treatment were included. Pregnancy outcomes of groups positive for chronic endometritis were compared with groups that were negative (group 1). Patients that were positive were divided into the chronic endometritis new biopsy group (group 2) and chronic endometritis non-re-examination group (group 3). After doxycycline treatment and re-examination, the chronic endometritis new biopsy group was divided into improved chronic endometritis group (ICE) and not-improved chronic endometritis group (NICE), and their general indicators and reproductive outcomes were compared. RESULTS: No significant difference was observed in embryo implantation, early or late pregnancy loss, ectopic pregnancy, clinical pregnancy and live birth rates between groups 2 and 3. The clinical pregnancy and live birth rates in the NICE group were significantly lower than those in the ICE group (P = 0.008 and P = 0.001, respectively). After controlling for potential confounding factors, age, average number of high-quality embryos, endometrial thickness on the day of embryo transfer and number and type of embryo transfer were factors associated with live birth rates. CONCLUSIONS: Endometrial re-examination of women with chronic endometritis treated with doxycycline had no effect on pregnancy outcomes. The first cycle of doxycycline treatment could effectively improve reproductive outcomes of women with five or more CD138+ cells/high-power field.

A Longitudinal Study of Trajectories and Factors Influencing Patient-Reported Outcomes in Chronic Obstructive Pulmonary Disease.

Purpose: To explore the trajectory of patient-reported outcomes and the factors influencing them in patients with COPD. Patients and Methods: The study population, 236 patients with stable COPD who attended the outpatient clinic of the Department of Respiratory and Critical Care Medicine in a tertiary care hospital in Nanning City between October 2020 and November 2021, answered the modified patient-reported outcome scale for COPD (mCOPD-PRO). Patient-reported outcomes were investigated at the time of the patient's outpatient visit (T1), 1 month after the visit (T2), 3 months after the visit (T3), and 6 months after the visit (T4). Latent class growth modeling was used to determine the number and shape of trajectories, and multinomial logistic regression analysis were used to explore influence factors of each class. Results: COPD patients' reported outcome trajectories were classified into 3 categories: health low-level group (14.80%), health risk group (54.70%), and good health group (30.50%). Logistic regression analysis showed that gender, BMI, smoking history, number of comorbidities, whether it was their first visit, and lung function classification were influential factors in patients' reported outcome trajectories (P<0.05). Female, obese, had a history of smoking, number of comorbid diseases >3, first diagnosis, and lung function class IV had a higher probability of entering the healthy low-level group. Conclusion: COPD patients have poor self-reported health levels during the first 6 months after the outpatient visit, and there is group heterogeneity in patient-reported outcome trajectories; medical staff should give patients specific nursing interventions based on their current development of COPD, self-reported changes, and other relevant influencing factors.

Diagnostic and Staging Value of Serum Angiotensin-Converting Enzyme in Sarcoidosis.

OBJECTIVE: To investigate the diagnostic and staging value of serum angiotensin-converting enzyme (sACE) in sarcoidosis. METHODS: Patients with suspected sarcoidosis treated in the Department of Pulmonary and Critical Care Medicine of the China-Japan Friendship Hospital from 2010 to 2020 were included. The data of sACE, erythrocyte sedimentation rate (ESR), complete blood count (CBC), lung function, bronchoalveolar lavage, and biopsy were collected. The differences between the sarcoidosis group and the nonsarcoidosis group and between different stages of sarcoidosis were compared. The receiver operating characteristic (ROC) curve analysis was used for the diagnostic test of sACE in sarcoidosis. RESULTS: A total of 84 cases with suspected sarcoidosis were included, among which 70 cases were confirmed to be sarcoidosis by biopsy. The mean value of sACE in sarcoidosis patients was 56.61 ± 30.80 U/L, which was significantly higher than that in nonsarcoidosis patients (28.07 ± 14.11 U/L, P = 0.001). The level of sACE in sarcoidosis patients with peripheral superficial lymph nodes and multiple system involvement was significantly higher than that in intrathoracic sarcoidosis patients (P = 0.009); the percentage of lymphocytes in bronchoalveolar lavage fluid (BALF) of sarcoidosis patients was 45.39 ± 22.87%, which was significantly higher than that of nonsarcoidosis patients (P < 0.001). There was no correlation between sACE and ESR (correlation coefficient = -0.167). According to ROC curve analysis, when sACE ≥ 44.0 U/L, the sensitivity of sarcoidosis diagnosis was 61.4%, the specificity was 92.9%, and the AUC was 0.819. CONCLUSION: sACE has a good specificity in the diagnosis of sarcoidosis. sACE values in patients with sarcoidosis with systemic involvement were higher than those with simple intrathoracic sarcoidosis.

Puzzling onsets of pneumonia sequentially after each session of bronchial thermoplasty: a case report.

BACKGROUND: Bronchial thermoplasty (BT) is a novel bronchoscopic intervention for severe persistent asthma. An increase in transient respiratory adverse events associated with BT were noted over the treatment periods, however, these events appear sporadic and should not always recur in a single individual and BT-related pneumonia has rarely been reported. CASE PRESENTATION: We present a case of uncontrolled severe asthma who developed puzzling pneumonia sequentially after each session of BT procedures. After each operation of three sequential BT procedures, she developed cough and purulent expectoration when her chest radiology showed new infiltrates right in the treatment regions. After empirical use of antibacterial agents plus physiotherapy and postural sputum drainage, her symptoms vanished and chest imaging resumed normal. CONCLUSION: The originality of our case report is related to the recurrence of pneumonia after three sequential BT procedures. To date, similar report has not been available in the literature. We hope to prompt alerts for post-BT respiratory infections, although most of them, along with other adverse events, are mild and tractable.

A traditional Chinese patent medicine-Suhuang zhike capsule for cough variant asthma in adults: A protocol of systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Many people with cough variant asthma use Traditional Chinese Patent Medicine-Suhuang anti-tussive capsule to help reduce symptoms. However there is no systematic reviews had promising its efficacy and safety for cough variant asthma. METHODS: Four English databases (PubMed, Web of science, EMBASE, and Springer Cochrane Library) and 4 Chinese databases (Wanfang Database, Chinese Scientific Journal Database, China National Knowledge Infrastructure Database, and Chinese Biomedical Literature Database) were researched for the randomized controlled trials of Suhuang anti-tussive capsule for cough variant asthma. The search was limited to human studies, using the search keywords or free-text terms "cough," "cough variant asthma," "Suhuang Zhike capsul,""Suhuang anti-tussive capsul," and "randomized clinical trials." Two reviewers individually extracted data from the included randomized controlled trials (RCTs). Data will be synthesized by either the fixed-effects or random-effects model according to a heterogeneity test. The primary outcomes include the frequency of asthma exacerbations during follow-up, asthmatic symptoms by validated instruments (including symptom scores, Likert scale, visual analogue scale). Lung function, serum immunoglobulin E, blood eosinophil count, phlegm eosinophil count, tumor necrosis factor-a, interleukin-1b, and adverse effects (numbers of participants experiencing each adverse events) will be assessed as the secondary outcome. Meta-analysis will be performed using RevMan5.3.5 software provided by the Cochrane Collaboration. RESULTS: This study will provide high-quality synthesis based on current evidence of Suhuang anti-tussive capsule treatment for cough variant asthma. CONCLUSION: This analysis will provide updated evidence for whether Suhuang anti-tussive capsule is an effective and safe intervention for cough variant asthma. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019139695.

Impact of endometrial thickness during menstruation and endometrial scratching on the pregnancy in frozen-thawed embryo transfer.

AIM: This study aimed to investigate the impact of endometrial thickness (EMT) during menstruation and endometrial scratching on the pregnancy in frozen-thawed embryo transfer (FET). METHODS: About 1298 patients receiving FET were retrospectively analyzed and divided according to EMT on the 4th or 5th day of menstruation. Group A: EMT ≤ 3.0 mm; Group B: EMT 3.1-5.0 mm; Group C: EMT 5.1-7.0 mm and Group D: EMT > 7.0 mm. Patients in Group D were further divided to scratching group and nonscratching group. Endometrial growth was defined as the change in EMT from 4th or 5th day of menstruation to the day of embryo transferred. RESULTS: We found no significant differences in general conditions among four groups (P > 0.05). The average EMT during menstruation and differences in inter-group endometrial growth of four groups had statistical significance (P < 0.05). The pregnancy rate and implantation rate of Group D were significantly lower than other groups (P < 0.001). Pregnancy rate (68.29% vs 53.26%) and implantation rate (52.67% vs 36.34%) in endometrial scratching group were higher than those in nonscratching group (P < 0.05). CONCLUSION: Higher EMT during menstruation adversely affects pregnancy outcomes following FET. Endometrial scratching may improve the receptivity of endometrium and increase the rate of embryo implantation and pregnancy.

Heparin-Binding Epidermal Growth Factor-Like Growth Factor Enhances Aquaporin 3 Expression and Function During Mouse Embryo Implantation.

Aquaporin 3 (AQP3) is highly expressed in peri-implantation blastocyst trophoblastic cells, indicating its role in cytotrophoblast invasion during embryo implantation. However, the mechanism underlying the regulation of AQP3 expression during embryo implantation remains unclear. In this study, an in vitro co-culture system of blastocysts on a monolayer of uterine endometrial cells was used to mimic in vivo process of embryo attachment and invasion to uterine endometrium and treated with different concentrations of heparin-binding epidermal growth factor-like growth factor (HB-EGF). The results showed that HB-EGF enhanced AQP3 expression in blastocysts in a dose-dependent manner and promoted the attachment and outgrowth of blastocysts on the monolayer of uterine endometrial cells. When the AQP3 activity was inhibited by copper sulfate, both the attachment and outgrowth of blastocysts were inhibited. Furthermore, HB-EGF induced the phosphorylation of EGF receptor (EGFR) and extracellular signal-regulated kinase (ERK). PD153035 (EGFR inhibitor) and U0126 (ERK inhibitor) inhibited AQP3 expression and also the attachment and outgrowth of blastocysts. Collectively, our findings provide the first evidence that HB-EGF stimulates EGFR/ERK signaling to promote AQP3 expression in trophoblastic cells, and AQP3 plays a vital role in HB-EGF-induced embryo implantation.

[Comparison of the Effectiveness of Different Supraglottic Ventilation Methods during Bronchial Thermoplasty].

OBJECTIVE: To compare the effectiveness of high-frequency jet ventilation via Wei jet nasal airway and controlled ventilation with improved laryngeal mask airway during bronchial thermoplasty. METHODS: Twenty-eight patients undergoing bronchial thermoplasty were equally divided into two groups: group A (high-frequency jet ventilation through Wei jet nasal airway) and group B (controlled ventilation with improved laryngeal mask airway). Pulse oxygenation,heart rate,and mean arterial blood pressure were recorded after entering the operating room (T0), 1 minute after administration/induction (T1), bronchoscope inserting (T2), 15 minutes (T3)/30 minutes (T4)/45 minutes (T5) after ventilation,at the end of the operation (T6), and at the recovery of patients' consciousness (T7). The pH,arterial oxygen partial pressure,and arterial carbon dioxide partial pressure were recorded at T0, T4, and T6. The endoscope indwelling duration,operative time,patients' awakening time,adverse events during anesthesia,satisfactions of patients and operators, anesthesic effectiveness were also recorded. RESULTS: The arterial carbon dioxide partial pressur in group A at T4 and T6 were significantly higher than in group B (P<0.05). The pH in group A at T4 and T6 was significantly lower than in group B (P<0.05). The endoscope indwelling duration and the operative time in group B were significantly shorter than in group A (P<0.05) while the recovery of consciousness in group B was significantly longer than in group A (P<0.05). The satisfaction for operators and the efficacy of anesthesia in group B were better than in group A (P<0.05). The number of adverse events in group B was significantly smaller than in group A (P<0.05). CONCLUSION: The improved laryngeal mask airway with controlled ventilation is more suitable for bronchial thermoplasty.

[Effectiveness and safety of bronchial thermoplasty in patients with severe asthma].

OBJECTIVE: To assess the effectiveness and safety of bronchial thermoplasty (BT) in patients with severe asthma. METHOD: The China-Japan Friendship Hospital recruited 12 patients with severe asthma who were voluntary to take BT treatment from March 2014 to November 2014. The levels of airway inflammation and biological markers (percentage of blood eosinophils, percentage of sputum eosinophils, serum IgE, fractional exhaled nitric oxide) of the patients were examined before the treatment in order to identify the types of airway inflammation. The numbers of severe exacerbations and related hospitalizations within 1 year before and after BT were obtained for each patient. The occurrence of adverse events within 3 weeks after the treatment was collected. And the patient status within 1 year after the BT treatment was compared with that before the treatment, in terms of the number of severe exacerbations, exacerbation rate, the number of related hospitalizations, hospitalization rate and oral corticosteroid dose. RESULTS: For before and 1 year after the treatment, the numbers of subjects suffering severe exacerbations were 11 and 6, the numbers of total severe exacerbation were 76 and 16, the numbers of patients hospitalized due to acute attacks were 10 and 3, and the numbers of total hospitalizations were 56 and 6, respectively. The severe exacerbation rate, hospitalization rate and oral corticosteroid dose were significantly reduced 1 year after the treatment [(1.3±0.48 vs. 6.3±1.9) events/subject/year, (0.50±0.26 vs. 4.67±1.90) events/subject/year, (8.5±4.6 vs. 22.0±2.6) mg/d, P<0.05]. The most common adverse events within 3 weeks after BT treatment were cough (8 events), expectoration (20 events), temporary PEF reduction (7 events), wheezing (4 events), but most of these symptoms were relieved in 1 week. One subject suffered pneumonia after each of the 3 procedures but also recovered soon after an antibiotic therapy. No adverse events occurred because of BT treatment within 3 weeks after the treatment. Computed tomographic scans from baseline to 1 year after the BT treatment showed no structural abnormalities related to BT. CONCLUSIONS: These data demonstrate the benefits of BT with regard to both asthma control (based on reduction in severe exacerbations and hospitalizations due to acute exacerbations) and safety. BT might offer a new approach to treating severe asthma.

[The effect of a vascular endothelial growth factor receptor inhibitor on airway inflammation and airway remodeling in a murine model of asthma].

OBJECTIVE: To investigate the expression of vascular endothelial growth factor (VEGF) and the effect of a VEGF receptor inhibitor on airway inflammation and remodeling in a murine model of asthma. METHODS: BALB/c mice were randomly divided into three groups: group A (control group, n = 10), group B (asthmatic model group, n = 10) and group C (VEGF receptor inhibitor group, n = 10). The asthmatic model was established by OVA sensitization and challenge. Bronchoalveolar lavage fluid (BALF) cell count and differential were carried out, VEGF levels in BALF and serum were measured by enzyme-linked-immunosorbent assay (ELISA), the pathologic changes of bronchi and the lung tissue were evaluated, and the expression of VEGF was analyzed with immunohistochemistry (ISH). The airway wall thickness (WAt/Pi), the bronchial smooth muscle thickness (WAm/Pi), the bronchial smooth nucleus counts (N/Pi) and vascular counts were measured by using image analysis system. RESULTS: There was a significant increase in the numbers of total cells and eosinophils (EOS) in the BALF of group B [(142 +/- 63) x 10(7)/L, 98.0 +/- 46.9 compared to those of group A (30 +/- 14) x 10(7)/L, 0.7 +/- 1.1, all P < 0.01]. After administration of the VEGF receptor inhibitor, the numbers of total cells and EOS were significantly decreased [(41 +/- 17) x 10(7)/L, 4.9 +/- 3.5, all P < 0.01]. BALF and serum levels of VEGF in group B were [(55 +/- 26) pg/ml, and (72 +/- 26) pg/ml] respectively. They were significantly higher than those in group A [(37 +/- 9) pg/ml, (49 +/- 18) pg/ml, respectively] and in group C [(34 +/- 3) pg/ml, (43 +/- 19) pg/ml, respectively]. ISH showed that expression of VEGF in group B was increased compared with group A and C. WAt/Pi, WAm/Pi, and N/Pi in group B [(17 +/- 5) microm(2)/microm, (6.3 +/- 2.2) microm(2)/microm, (0.050 +/- 0.020)/microm, respectively] were all significantly higher than those in group A [(8 +/- 3) microm(2)/microm, (3.2 +/- 0.8) microm(2)/microm, (0.027 +/- 0.017)/microm respectively, P < 0.01 and P < 0.05]. The vascular count of the airways in group B (19 +/- 3) was significantly increased compared to that of group A (10 +/- 5, P < 0.01). Administration of the VEGF receptor inhibitor reduced WAm/Pi (4.5 +/- 1.3) microm(2)/microm, P < 0.05) and the vascular count (11 +/- 3, P < 0.01). CONCLUSIONS: VEGF was over-expressed in the murine model of asthma, and involved in angiogenesis and airway remodeling. VEGF receptor inhibitors may be effective in reducing allergic airway inflammation and airway remodeling.