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Objective To explore clinical effect of small dose of glucocorticoid in the treatment of AECOPD patients with severe disease associated with low levels of cortisol.Methods72 patients with AECOPD in our hospital were randomly divided into control group and treatment group.The control group was treated with conventional AECOPD method,the treatment group was treated on the base of the treatment group with a small dose of corticosteroids,CRP, IL-6, TNF-α, FEV1, PCT and other indicators, as well as patients with ventilation, shock and mortality were compared after the end of treatment.ResultsThe time of non mechanical ventilation, the time of non-mechanical ventilation, and the time of non-shock were increased, the shock and the mortality was lower in the treatment group,(P<0.05);The CRP level of patients in the treatment group was lower(P<0.05);IL-6, TNF-α, PCT levels of patients in the treatment group was lower (P<0.05);FEV1, FVC and FEV1/FVC level in the treatment group were higher(P<0.05).ConclusionSmall dose glucocorticoid can improve the pulmonary function of patients with AECOPD complicated by severe disease, and alleviate the disease, significantly reduce the levels of inflammatory factors, promote the improvement of the lung function.
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Objective To explore the changes of serum CRP and SAA in patients with comprehensive assessment COPD group,and correlation with lung function.Methods We selected 139 cases patients with COPD.According to the guide of GOLD 2015,the COPD patients were divided into group A (23 cases),group B (19 cases),group C (51 cases) and group D (46 cases).Analysis of the correlation between serum CRP and SAA level and injury severity of pulmonary function was perforined.Results Compared with group A,C,the group D had significance and had the highest level of serum CRP,SAA (P ＜ 0.05).Group B was higher than group C.The Lung function damage degree was negatively correlated with the level of CRP and SAA in patients with COPD (P ＜ 0.05).Conclusion The change of the concentration of serum CRP,SAA will contribute to the evaluation of patients with COPD and provide objective basis for the treatment and management of patients with COPD.Detection of CRP,SAA is helpful to evaluate the damage degree of lung function.
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Important/potential value of macrolides has been proved in the management of chronic respiratory diseases by increasing basic and clinical trials.Through three face-to-face discussions,10 experts examined important data and drafted this consensus related to macrolides:(1) mechanism of nonantiinfective effects;(2) clinical use in chronic respiratory diseases;(3) cautions of long-term use.The mechanism out of non-antiinfective effects includes anti-inflammatory effect,modifying airway secretion,immune-regulation related to antibacterial effect,corticoid saving effect and anti-viral effect.The efficacy of long-term use of low-dose macrolides is definitely confirmed in diffuse panbronchiolitis,chronic rhinosinusitis.It is considerably used in bronchiectasia,cystic fibrosis,severe asthma and chronic obstructive pulmonary disease.Further studies should be conducted in cryptogenic organizing pneumonia and respiratory viral infection.It should be paid attention to its possible adverse effects (including drug interactions,cardiac toxicity,ototoxicity and disturbance of intestinal flora) and drug resistance in long-term use.A Chinese consensus for non-antiinfective effects and clinical use of macrolides is developed for the first time,which aims to expand their rational use and the further research.
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Objective To explore the effect of roxithromycin on airway inflammation of smoking asthma though re-searching its effect on expressions of histone deacetylase-2(HDAC2)of cigarette smoking asthma mice. Methods Forty female SPF BALB/c mice were divided randomly into 4 groupscontrol group(C),asthma group(A),smoking asthma group(S)and Roxithromycin group(R). Established asthmatic and smoking asthma models with challenge of OVA and intervention with Roxithromycin. The change of pathematology in different groups were observed. The different cells counts of bronchoalveolar fluid (BALF) were analyzed. The level of HDAC2 in lung homogenate were measured by Western blot. Results The ratios of eosinophil (EOS) to the total cell numbers of BALF in group A and group S were significantly higher than that in group C (both P<0.01), while in group S the ratio of neutrophile (NEU) was higher than the group A (P<0.01). The ratios of EOS and NEU in group R was significantly decreased than these in group S(P<0.01). Western blot showed expressions of HDAC2 in group A and group S were significantly decreased than that in group C(both P<0.01),while the HDAC2 level of group S was lower than that of group A(P<0.01). The HDAC2 level of group R was higher than group S(P<0.01). Conclusion Roxithromycin can decrease the airway inflammation of cigarette smoking asthma mice via increasing the expression of HDAC2.
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AIM: To investigate the effect of phosphatidylinositol 3-kinase (PI3K) inhibitor wortmannin on expression of inducible nitric oxide synthase (iNOS) in bronchiole epithelial cells of asthma rat.METHODS: 24 male Sprague-Dawley rats were randomly divided into 3 group, namely control group, asthma group and PI3K inhibitor wortmannin+asthma group. The numbers of total cells and eosinophil cells in bronchoalveolar lavage fluid (BALF) were counted. The expression of inducible nitric oxide synthase was detected by immunohistochemistry method, and iNOS mRNA was detected by reverse transcription-polymerase chain reaction (RT-PCR). The activity of PI3K, iNOS and content of NO in lung homogenates were tested by spectrophotometry.RESULTS: The numbers of eosinophils and the ratios of eosinophils to total cells in BALF in asthma group were significantly higher than those in control group, while those in wortmannin+asthma group were decreased compared to asthma group. The activity of PI3K, iNOS and content of NO in lung homogenats in asthma group were significantly higher than those in control group, while those in wortmannin+asthma group were decreased compared to asthma group. The expression of iNOS protein in bronchiole epithelial cells and mRNA in lung homogenates in asthma group were markedly increased compared to control group, while those in wortmannin+asthma group were decreased compared to asthma group.CONCLUSION: PI3K regulates the expression of iNOS in airway of asthma rat and affects inflammatory reaction in airway.
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Objective To investigate the effects of P27Kip-1 on proliferation of airway smooth musde and airway remodeling in asthmatic rats.Methodes 30 healthy,male SD rats were randomly and equally divided into three groups :control group(C),asthmatic 4 weeks group(A1),asthmatic 6 weeks group(A2).A rat asthma model was developed by the sensitized with ovalbumin and Al(OH)3,and repeatedly exposed to aerosolized ovalbumin.After the last challenge,The animals were evaluated for AHR,the airway wall thickness(Wat /Pbm)and the bronchial smooth muscle thickness(Wam/Pbm)were measured by image analysis system.The expression of P27Kip-1 and PCNA was determined by immunohis-tochemical staining.Results(1).The expression of P27Kip-1 protein in two asthmatic groups was significantly lower than that of the control group,respectively(P
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AIM: To investigate the effect of roxithromycin on the NF-?B activity,the airway inflammation and bronchial hyperresponsiveness of asthma rats.METHODS: Thirty male adult Sprague-Dawley rats were randomly divided into the control group(Group C,n=10),asthma group(Group A,n=10) and roxithromycin group(Group R,n=10).The asthma model was induced by ovalbumin and Al(OH)3.The airway reactivity was detected and then rats in each group were sacrificed after 24 hours for the last provocation.The concentrations of IL-4,IL-5 and IFN-? in bronchoalveolar lavage fluid(BALF) were measured by ELISA,and the activity of NF-?B protein in bronchial epithelium was detected by immunohistochemistry.RESULTS: Compared with Group C,the airway reactivity in Group A was increased(P
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AIM : To contrastively observe the effects of combinative usage of ipratropium bromide, anti cholinergic inhalant and the small dosage of controlled release theophylline tablets or salbutamol on the patients with COPD. Clinical observation of efficacy of combinative usage of ipratropium bromide and small dosage of theophylline on patients with COPD$$$$ WENG Hai xia, DAI Yuan rong, WU Cheng yun, LIN Jie Department of Respiratory, the Second Affiliated Hospital of Wenzhou Medical College, Wenzhou 325027, Zhejiang, China ABSTRACT AIM : To contrastively observe the effects of combinative usage of ipratropium bromide, anti cholinergic inhalant and the small dosage of controlled release theophylline tablets or salbutamol on the patients with COPD. [WTHZ METHODS : Forty patients with stable COPD were randomly divided into two groups ( n =20 in each): theophylline group or salbutamol group. In theophylline group, each case inhaled 2 puffs of ipratropium bromide ter in die, meanwhile take 0.1 g ophylline capsule orally every 12 hours, measured the maximum and minimum concentration of ophylline. In salbutamol group, each case inhaled 2 puffs of ipratropium bromide and salbutamol ter in die. During 8 weeks trial, the base FEV 1.0 before using medicine and the FEV 1.0 when all the drug were stopped at the end of 1st, 4th, and 8th week was measured, separately. The FEV 1.0 amelioration ratio (△′FEV 1.0 ) compared with base FEV 1.0 was obtained , and another FEV 1.0 amelioration ratio (△FEV 1.0 ) was also detected after bronchodilatation test by salbutamol. Furthermore, PEFR aberration rate was evaluated by measuring peak expiratory flow rate in morning and evening daily. The maximum concentration of ophylline is 8.7 ? 2.1 mg?L -1 , the minimum is 6.1 ? 2.3 mg?L -1 . RESULTS : △FEV 1.0 increased markedly at end of 8th week in theophylline group (P
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AIM: To study the effect of hypoxia and hypercapnia on nitric oxide (NO) in plasma and superoxide dismutase (SOD), catalase (CAT), soluble guanylate cyclase (sGC), cyclic guanosine monophospholate (cGMP) in lung tissue in rats, and to explore the effect of NO- and H_2O_2-sGC pathway on the development of the pulmonary hypertension. METHODS: The model of hypoxic and hypercapnic 1, 2, 4-week group (HH 1 week, HH 2 weeks, HH 4 weeks) and control group was set up. NO content in plasma, CAT and SOD in rat lung were determined by spectrophotometry. The sGC activity in lung tissue was detected by enzyme kinetic analysis. cGMP content in lung tissue was examined with ~ 125 I-radioimmunoassay. RESULTS: The mean pulmonary artery pressure (mPAP) showed significantly higher in HH 1 week, HH 2 weeks and HH 4 weeks groups compared with control group (all P