Prediction of gold stage in patients hospitalized with COPD exacerbations using blood neutrophils and demographic parameters as risk factors.

BACKGROUND: Patients hospitalized with chronic obstructive pulmonary disease (COPD) exacerbations are unable to complete the pulmonary function test reliably due to their poor health conditions. Creating an easy-to-use instrument to identify the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage will offer valuable information that assists clinicians to choose appropriate clinical care to decrease the mortality in these patients. The objective of this study was to develop a prediction model to identify the GOLD stage in the hospitalized exacerbation of chronic obstructive pulmonary disease (ECOPD) patients. METHODS: This prospective study involved 155 patients hospitalized for ECOPD. All participants completed lung function tests and the collection of blood neutrophils and demographic parameters. Receiver operating characteristic (ROC) curve was plotted based on the data of 155 patients, and was used to analyze the disease severity predictive capability of blood neutrophils and demographic parameters. A support vector regression (SVR) based GOLD stage prediction model was built using the training data set (75%), whose accuracy was then verified by the testing data set (25%). RESULTS: The percentage of blood neutrophils (denoted as NEU%) combined with the demographic parameters was associated with a higher risk to severe episode of ECOPD. The area under the ROC curve was 0.84. The SVR model managed to predict the GOLD stage with an accuracy of 90.24%. The root-mean-square error (RMSE) of the forced expiratory volume in one second as the percentage of the predicted value (denoted as FEV1%pred) was 8.84%. CONCLUSIONS: The NEU% and demographic parameters are associated with the pulmonary function of the hospitalized ECOPD patients. The established prediction model could assist clinicians in diagnosing GOLD stage and planning appropriate clinical care.

Two new sesquiterpenes from the stems of Tripterygium wilfordii.

Two new ß-dihydroagarofuran-type sesquiterpenes 1ß,2α,6α,8ß,15- pentaacetoxy- 9α-benzoyloxy- ß-dihydroagarofuran (1) and 1ß,2ß,6α,15-tetraacetoxy-9ß-benzoyloxy- ß-dihydroagarofuran (2), together with five known abietane diterpenoids (3-7) were isolated from ethyl acetate extract of stems of Tripterygium wilfordii. Their structures were elucidated on the basis of detailed spectroscopic and physico-chemical analyses. All the isolates were evaluated for in vitro inhibitory activity against A549, HOS and MCF-7. Among them, compounds 4 and 5 exhibited manifest inhibition on A549, HOS and MCF-7 cancer cell lines.

Prediction models for pulmonary function during acute exacerbation of chronic obstructive pulmonary disease.

OBJECTIVE: The pulmonary function test is an effort-dependent test; however, during acute exacerbation of chronic obstructive pulmonary disease (AECOPD), patients are unable to effectively cooperate due to poor health. The present study aimed to establish prediction models that only require demographic and inflammatory parameters to predict pulmonary function indexes: forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). APPROACH: The goal was to establish prediction models based on multi-output support vector regression. A total of 143 subjects received a peripheral blood examination and pulmonary function test. The demographic and inflammatory parameters were used as input features, and FEV1 and FVC were used as the target features in prediction models. Three models (mixed model, severe model and nonsevere model) were established with FEV1 < 1 l as the threshold of severe episodes of AECOPD. The values of FEV1 and FVC from the pulmonary function tests were compared with the prediction models to validate the performances of the developed prediction models. MAIN RESULTS: The severe and nonsevere models' prediction performances were better than that of the mixed model. The mean squared errors were lower than 0.05 l2, and the decision coefficients (R 2) were higher than 0.40. The two-tailed t-test results showed that for both severe and nonsevere models, the absolute percentage errors of FEV1 and FVC were within 10%. SIGNIFICANCE: Our study shows the feasibility of predicting the pulmonary function indexes FEV1 and FVC with demographic and inflammatory parameters when the pulmonary function test fails to be implemented, which is beneficial for the treatment of AECOPD.

Diacylglycerol acyltransferase inhibitory new meroterpenes from the seeds of Psoralea corylifolia, and their structure-activity relationship study.

Five new meroterpenes, 12α-Psoracorylifol F (1), 7ß,8α-hydroxy-12ß-Psoracorylifol F (2), 8-ketone-Cyclobakuchiol C (3), 7α,8ß-hydroxy-12ß-Cyclobakuchiol C (4) and 8α-hydroxy-Cyclobakuchiol C (5) together with six known compounds (6-11) were isolated from seeds of Psoralea corylifolia, and their structures were elucidated on the basis of spectroscopic and physicochemical analyses. All the isolates were evaluated for in vitro inhibitory activity against DGAT1/2. Among them, compounds 1-6 were found to exhibit selective inhibitory activity on DGAT1 with IC50 values ranging from 61.5 ± 1.1 to 89.1 ± 1.2 µM.