ABSTRACT
PURPOSE: Details of patients hospitalized for asthma exacerbation in mainland China are lacking. To improve disease control and reduce economic burden, a large sample survey among this patient population is indispensable. This study aimed to investigate the clinical characteristics and outcomes of such patients.METHODS: A retrospective study was conducted on patients hospitalized for asthma exacerbation in 29 hospitals of 29 regions in mainland China during the period 2013 to 2014. Demographic features, pre-admission conditions, exacerbation details, and outcomes were summarized. Risk factors for exacerbation severity were analyzed.RESULTS: There were 3,240 asthmatic patients included in this study (57.7% females, 42.3% males). Only 28.0% used daily controller medications; 1,287 (39.7%) patients were not currently on inhaled corticosteroids. Acute upper airway infection was the most common trigger of exacerbation (42.3%). Patients with severe to life-threatening exacerbation tended to have a longer disease course, a smoking history, and had comorbidities such as hypertension, chronic obstructive pulmonary disease (COPD), and food allergy. The multivariate analysis showed that smoking history, comorbidities of hypertension, COPD, and food allergy were independent risk factors for more severe exacerbation. The number of patients hospitalized for asthma exacerbation varied with seasons, peaking in March and September. Eight patients died during the study period (mortality 0.25%).CONCLUSIONS: Despite enhanced education on asthma self-management in China during recent years, few patients were using daily controller medications before the onset of their exacerbation, indicating that more educational efforts and considerations are needed. The findings of this study may improve our understanding of hospital admission for asthma exacerbation in mainland China and provide evidence for decision-making.
Subject(s)
Female , Humans , Adrenal Cortex Hormones , Asthma , China , Comorbidity , Disease Progression , Education , Food Hypersensitivity , Hospitalization , Hypertension , Inpatients , Medication Adherence , Mortality , Multivariate Analysis , Pulmonary Disease, Chronic Obstructive , Retrospective Studies , Risk Factors , Seasons , Self Care , Smoke , SmokingABSTRACT
Objective To understand the seasonal distribution of patient hospitalization due to asthma exacerbation in 7 geographic areas in China.Methods This was a retrospective study which involved patients hospitalized for asthma exacerbation in 29 hospitals throughout 7 geographic areas in the mainland of China (northeast,north,central,east,south,northwest and southwest).The numbers of asthmatic patients and total inpatients of the respiratory department of each hospital were recorded.The monthly ratio of asthmatic patients to the total inpatients in every area was calculated and compared.Results During the study period,6 480 patients were admitted for asthma exacerbation,accounting for 3.14％ of all the 206 135 patients admitted to the respiratory departments in the 29 hospitals.The ratio of asthmatic patients to total inpatients in the northeast area (5.61％) was highest,and the ratio in east area was lowest (1.97％).Statistical analysis showed that the difference among different areas was significant (P＜0.000 1).In most areas,both the number and proportion of hospitalized asthmatic patients peaked in spring (February-April) and autumn (September-October).In the northeast area,east area and south area,the peaks in spring were more obvious,while in the north area and southwest area,the peaks in autumn were more obvious.In the northwest area the peaks occurred in winter (December-January) and summer (June-August),respectively.The differences in hospitalization due to asthma among different months were significant in the northeast,north,and southwest areas (P＜0.005).Conclusion The number of patients hospitalized for asthma exacerbation fluctuated with season in different areas in China.In most areas,more asthmatic patients were admitted to hospitals in spring and autumn.
ABSTRACT
Objective To understand the seasonal distribution of patient hospitalization due to asthma exacerbation in 7 geographic areas in China.Methods This was a retrospective study which involved patients hospitalized for asthma exacerbation in 29 hospitals throughout 7 geographic areas in the mainland of China (northeast,north,central,east,south,northwest and southwest).The numbers of asthmatic patients and total inpatients of the respiratory department of each hospital were recorded.The monthly ratio of asthmatic patients to the total inpatients in every area was calculated and compared.Results During the study period,6 480 patients were admitted for asthma exacerbation,accounting for 3.14％ of all the 206 135 patients admitted to the respiratory departments in the 29 hospitals.The ratio of asthmatic patients to total inpatients in the northeast area (5.61％) was highest,and the ratio in east area was lowest (1.97％).Statistical analysis showed that the difference among different areas was significant (P＜0.000 1).In most areas,both the number and proportion of hospitalized asthmatic patients peaked in spring (February-April) and autumn (September-October).In the northeast area,east area and south area,the peaks in spring were more obvious,while in the north area and southwest area,the peaks in autumn were more obvious.In the northwest area the peaks occurred in winter (December-January) and summer (June-August),respectively.The differences in hospitalization due to asthma among different months were significant in the northeast,north,and southwest areas (P＜0.005).Conclusion The number of patients hospitalized for asthma exacerbation fluctuated with season in different areas in China.In most areas,more asthmatic patients were admitted to hospitals in spring and autumn.
ABSTRACT
OBJECTIVE:To provide reference for rational use of antibiotics in the clinic of our hospital. METHODS:Drug re-sistance of Gram-negative bacillus in the inpatients of our hospital were analyzed retrospectively during May 2013-Dec. 2015 as well as the situation of producing metallo-β-lactamase(MBLs). RESTUTS:A total of 2089 strains of Gram-negative bacillus were detected in our hospital during 2013-2015,among which there were 1456 strains of enterobacteria (69.70%) and 633 strains of non-fermentative bacteria,mainly involving Escherichia coli,Pseudomonas aeruginosa,Klebsiella pneumoniae,Acinetobacter bau-mannii and Enterobacter cloacae. A total of 406 strains of carbapenems-resistant bacteria were detected (19.44%),including 367 strains of non-fermentative bacteria and 39 strains of enterobacteria. The resistant rates of carbapenems-resistant strains to 16 antibi-otics were all higher than 50%,but those of non-carbapenems-resistant strains were in relative low level. Except for aztreonam,re-sistant rates of carbapenems-resistant strains to other 15 antbiotics were all higher than those of non-carbapenems-resistant strains, with statistical significance(P<0.05). A total of 36 strains of producing MBLs were detected(8.87%),including 13 strains of pro-ducing MBLs drug-resistant P. aeruginosa and 23 strains of producing MBLs drug-resistant A. baumannii;producing MBLs drug re-sistant enterobacteria had not been found. CONCLUSIONS:Gram-negative bacillus are mainly enterobacteria in our hospital;car-bapenems-resistant strains are mainly non-fermentative bacteria,resistant rate of them are commonly higher than that of non-drug-re-sistant strain. The situation of producing MBLs is serious,and enzyme producing strains are mainly non-fermentative bacteria. It is necessary to strengthen drug resistance of pathogen and enzyme producing strain monitoring,avoid the generation and spreading of drug-resistant strains due to irrational use of antibiotics.
ABSTRACT
Objective To investigate the functions of blood plasma homocysteine (Hcy) and high sensitivity C-response protein (hs-CRP) in the chronic obstructive pulmonary disease (COPD) in pathogenesis plays,and observe whether there was associations with disease severity and the correlations.Methods Forty-one patients with COPD were collected from August 2010 to February 2011,and 35 healthy persons as control group.Blood plasma Hcy,hs-CRP,forced expiratory volume in one second account predicted (FEV1％ predicted),and arterial pressure of oxygen (PaO2,arterial blood gases analysis) were measured in COPD patients and controls.Results Plasma Hcy concentration was (22.07 ± 12.13) μmol/L in COPD patients,but (9.89 ±4.41) μmol/L in controls,there were significant differences between two subjects (t =1.674,P ＜0.01).COPD patients had a higher serum hs-CRP concentration (8.60±3.85) mg/L than control's (4.24 ±0.57) mg/L (t =1.682,P ＜ 0.01).Along the descent of FEV1％ predicted,plasma Hcy and hs-CRP were elevated gradually,both sides show a negative correlation (r =-0.45,-0.49,P ＜ 0.05).And plasma Hcy and hs-CRP present a positive correlation in COPD patients (r =0.68,P ＜ 0.01).Conclusion Plasma Hcy was significantly elevated in COPD patients,positive correlation related to COPD severity and positive correlation related to serum hs-CRP.
ABSTRACT
Objective To investigate the change of MMP-9,TIMP-1,ICAM-1 and VCAM-1 expression in serum from patients with COPD,as well as the correlation between the expressions of these factors and lung function.Methods Enzyme-linked Immunosorbent Assay(ELISA)was used to determine the levels of MMP-9,TIMP-1,ICAM-1 and VCAM-1 in serum from 58 patients with COPD and 30 samples from healthy donors in order to better understand the correlation between the expression of these factors and airflow obstruction.Results The serum levels of MMP-9,TIMP-1,ICAM-1 and VCAM-1[(128.89?115.84),(228.28?107.13),(203.98?70.37) and (352.98?117.73)?g/L]from patients with COPD were statistically and significantly higher than the control group[(30.65?18.43),(133.69?41.41),(148.35?23.77) and (233.57?36.65)?g/L],P
ABSTRACT
<p><b>BACKGROUND</b>To study the levels of expression, coexpression, and clinical significancer of four multidrug resistance factors in lung cancer.</p><p><b>METHODS</b>The P glycoprotein (P-gp), multidrug-resistance-associated protein (MRP), lung resistance protein (LRP), glutathione S-transferase (GST-π) of 60 lung cancer patients were detected by using immunohistochemical method.</p><p><b>RESULTS</b>The positive rate of the drug resistance factor was 53.3% (32/60), 63.3% (38/60), 70.0% (42/60), and 80.0% (48/60) for P-gp, MRP, LRP, and GST-π respectively. Patients with NSCLC had significantly higher expression of the drug resistance factors than those with SCLC. On the other hand, no relationship was observed between the expression of drug resistance factors and TNM stage and cell differentiation. The coexpression rate was as follows: P-gp+MRP, 41.6% ; P-gp+LRP, 35.0%; MRP+LRP, 53.3%; MRP+GST-π, 50.0%; LRP+GST-π, 58.3%; P-gp+GST-π, 45.0%; P-gp+MRP+LRP+GST-π, 20.0%. Among them, a relationship was detected between P-gp and MRP ( rs =0.756, P < 0.01), between P-gp and LRP ( rs =0.686, P < 0.01), between MRP and LRP ( rs =0.669, P < 0.01), between MRP and GST-π( rs =0.546, P < 0.01), between LRP and GST-π ( rs =0.848, P < 0.01), between P-gp and LRP ( rs =0.689, P < 0.01), and between P-gp and GST-π ( rs = 0.535 , P < 0.01).</p><p><b>CONCLUSIONS</b>The MDR in lung cancer patients is affected by various multidrug resistance factors. The drug resistance factors' expression is related to histology, but not to TNM stage and cell differentiation.</p>
ABSTRACT
To cultivate high-quality medical talents,we should strengthen students'medical ethics education.The article discusses the connotation of medical ethics,the necessity of medical ethics education and the application in clinical teaching.Combined with some clinical cases,from three aspects: the principle of respect;the principle of informed consent and the dealing with the relationship between doctors and patients,we discuss the application of the medical ethics in clinical teaching of internal medicine.
ABSTRACT
Objective To investigate the expression and clinical significance of multidrug resistance gene(MDR1),multidrug-resistance-associated protein (MRP),lung resistance protein (LRP),glutathione S-transferase-?(GST-?)mRNA in non-small cell lung cancer. Methods From Oct.1996 to Oct.2001,RT-PCR was used to investigate the mRNA expression of the above four genes.We followed up the survival time one by one and calculated the probability of survival. Results The total positive rate of the four multidrug resistance gene was 53.1%,65.3%,67.3%,83.3%.There was a significant difference between the coexpression and the single positive rate( P 0.05).With the increasing expression of the MDR the curves moved to left,the survival time and probability reduced. Conclusion The coexpression of the MRG results in the MDR and affects the prognosis directly.It can be used as a criterion to evaluate the prognosis.
ABSTRACT
Objective To observe interference effect of Ambroxol (AMB) hydrochloride injection on chronic obstructive pulmonary disease in rats caused by cigarette smoking exposure.Methods Chronic obstructive pulmonary disease (COPD) rat models were established by simple cigarette smoking exposure,interfered with AMB inhalation.Rats were divided into three groups.Cell counts were examined routinely in bronchoalveolar lavage fluid (BALF).The concentrations of Matrix metalloproteinase-9(MMP-9)、interleukin-8 (IL-8) and tumor necrosis factor-? (TNF-?) in BALF were measured.Quantitative analysis of pulmonary mean linear intercept (MLI),mean alveolar numbers (MAN),pulmonary alveolar area (PAA) and the relative area of elastic fibers were measured.Results Concentrations of MMP-9,IL-8 and TNF-? in BALF of COPD rats were positively correlated with total counts of white blood cell (WBC),percentage of neutrophil and absolute counts of neutrophil in BALF.Pulmonary elastic fibers were severely damaged in COPD rats;MLI,PAA were higher than those in control group (P0.05).Conclusion Simple cigarette smoking can cause COPD in rats.MMP-9,IL-8 and TNF-? in airway and alveoli pulmonum probably participate in the destruction of elastic fibers and forming of COPD.AMB inhalation can inhibit release of IL-8 and TNF-? in airway and alveoli pulmonum of COPD rats,alleviate the inflammation of local airway caused by cigarette smoking,playing a role in preventing and curing experimental COPD of rats.
ABSTRACT
Objective To study the clinical significance of the expression of matrix metalloproteinase-9(MMP-9) and E-cadherin(E-cad) in patients with non-small cell lung cancer (NSCLC).Methods Immunohistochemical method (SP) was used to detect the expression of the MMP-9 and E-cad in 62 NSCLC tissues and 18 normal lung tissues.Results The positive expression rate of MMP-9 and the abnormal expression rate of E-cad in NSCLC were closely related to the TNM stages,pathological grades and lymph node involvement (P
ABSTRACT
Objective To detect the clinical value of measuring glycosaminoglycan sulfate segments to the diagnosis of non small cell lung carcinoma(NSCLC).Methods Using the new regent manufactured by the USA POLY labs,LTA emulsion regent,we have measured the distinctive glycosaminoglycan sulfate of the 30 NSCLC serums and 30 normal serums and 26 pneumonia serums.Result The method of using LTA emulsion regent to measure content of the distinctive glycosamingoglycan sulfate had the peculiar quality of 90% and the sensitive quality of 83 33% in NSCLC.The CEA's sensitive quality was 56 67% in the same sample.The unite sensitive quality of LTA and CEA was 93 33%.The pneumonia had no significant effect on the LTA's peculiar quality.Conclusion LTA emulsion regent has higher peculiar and sensitive qualities to the diagnosis of NSCLC by measuring the content of glycosaminoglycan sulfate,combined with CEA,the sensitive quality can be improved and make the diagnosis more accurate.It is quite valuable to the clinical diagnosis.And the prospect is wide in applying to the clinical general investigations.