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Erigeron breviscapus, a species within the genus of Erigeron, is mainly distributed in Southwest China. It is cold in property, slightly bitter in taste, and has the effect of dispersing cold table, removing wind and dehumidification, promoting blood circulation and removing blood stasis, relieving pain and inflammation. Breviscapine is the extract of E. breviscapus. It is mainly consisted of flavonoids, lignans, coumarins, terpenes, phytosterols, etc. As the major components of breviscapine, the content of breviscapine b (4′-hydroxybaicalin-7-O-glucuronide) and breviscapine a (apigenin-7-O-glucuronide) is greater than 90%. Modern pharmacological studies have shown that breviscapine has a wide range of pharmacological effects, including anti-oxidation, anti-fibrosis, anti-inflammation, anti-aging, anti-platelet aggregation, lowering blood lipid, increasing blood flow, improving microcirculation, preventing and treating tumors, and resisting brain injury. In clinical, breviscapine has been widely used in the treatment of diabetes, cerebral insufficiency, sequelae caused by cerebral hemorrhage, hypermucolipemia, cerebral thrombosis, kidney disease, liver disease, Alzheimer's disease, and some other complex diseases. Specially, in the treatment of diabetes and its chronic complications, such as diabetic nephropathy, diabetic cardiomyopathy, diabetic foot, diabetic retinopathy, breviscapine has showed significant efficacy. In addition, studies have demonstrated that the combined application of breviscapine, mecobalamine, and micopol can improve the therapeutic effect. In this work, the application of breviscapine in the treatment of chronic complications of diabetes mellitus and its related combination drugs were reviewed, by which we attempted to provide some valuable clues for the clinical application of breviscapine in the treatment of diabetes mellitus and its chronic complications.
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<b>Objective::To study the protective effect and mechanism of Qidong Yixin oral liquid on doxorubicin-induced myocardial toxicity in mice. <b>Method::Ninety male ICR mice were randomly divided into normal group, model(DOX) group, DOX+ Qidong Yixin oral liquid group (9.55, 23.88, 47.75 g·kg<sup>-1</sup>) and high dose group (47.75 g·kg<sup>-1</sup>) with 15 mice in each group. The normal group and model group were given pure water by gavage, and each dose group of Qidong Yixin oral liquid was given different doses of Qidong Yixin oral liquid once a day for 21 days. On the seventh day, normal saline was injected into the abdominal cavity of the normal group and the high dose group of Qidong Yixin oral liquid. Doxorubicin was injected into the abdominal cavity of the other groups (15 mg·kg<sup>-1</sup>). After 21 days, the weight and heart weight of mice were weighed and cardiac index was calculated. Serum was taken for the detection of lactate dehydrogenase (LDH), creatine kinase (CK), aspartate aminotransferase (AST). Heart was taken for hematoxylin-eosin (HE) staining, superoxide dismutase (SOD), glutathione peroxidase (GSH-PX), catalase (CAT) in myocardial tissue were detected. The expression of nuclear factor NF-E2 related factor (Nrf2) and heme oxygenase-1 (HO-1) were detected by Western blot. <b>Result::Compared with normal group, adriamycin could significantly reduce the body weight of mice (<italic>P</italic><0.01), increase the activities of LDH, CK and AST in serum(<italic>P</italic><0.01), and decrease the activities of antioxidant enzymes (<italic>P</italic><0.01). Compared with DOX group, high dose Qidong Yixin oral liquid could significantly increase the weight of mice (<italic>P</italic><0.05, <italic>P</italic><0.01), decrease the level of myocardial three enzymes(<italic>P</italic><0.01), increase the activity of antioxidant enzymes(<italic>P</italic><0.05, <italic>P</italic><0.01), and increase the expression of Nrf2 and HO-1(<italic>P</italic><0.01). <b>Conclusion::Qidong Yixin oral liquid has a good protective effect on doxorubicin myocardial toxicity. Its mechanism may be related to activating Nrf2/HO-1 signaling pathway and alleviating oxidative stress injury.
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To investigate the effect of scutellarin (Scu) on diabetic cardiomyopathy in mice, type 2 diabetes mellitus was induced by intraperitoneal injection of 50 mg∙kg-1 streptozotocin (STZ) into a high-fat diet. Scu was injected intraperitoneally. After 8 weeks, fasting blood glucose and serum biochemical parameters were measured. Masson staining was performed on myocardial tissue. The expression levels of Nrf2, NFκB, AKT and p-AKT in myocardium of mice were observed by Western blot. All the procedures were approved by the Laboratory Animal Ethics Committee of the Peking Union Medical College. The results showed that Scu significantly decreased the heart-body ratio, increased myocardial contractile function, decreased the level of myocardial fibrosis and the expression of collagen I and collagen III in myocardium of diabetic mice. Scu can effectively reduce the levels of lactate dehydrogenase (LDH), creatine kinase isoenzyme (CK-MB), malondialdehyde (MDA) in serum of diabetic mice, increase the level of antioxidant enzymes in serum, and inhibit the release of inflammatory factors. Further studies showed that Scu significantly increased Nrf2 nuclear translocation, inhibited NFκB nuclear translocation and increased AKT phosphorylation. It indicates that Scu has significant effect on diabetic cardiomyopathy in mice.
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The application of chemical fingerprint to evaluate the quality of traditional Chinese medicine has been widely accepted and used in many countries. However,only by analyzing the type and content of its chemical components to evaluate the quality of traditional Chinese medicines,the gold standard of quality evaluation by evaluating pharmacodynamic effects is ignored. The study of Chinese medicinal spectrum-effect relationships combining the chemical composition with the pharmacodynamic activity of traditional Chinese medicine,which can evaluate the quality of traditional Chinese medicine from more comprehensive and different angles,has been applied in many fields of traditional Chinese medicine research. This paper mainly summarizes the research methods of the Chinese medicinal spectrum-effect relationships and its application in the field of traditional Chinese medicine study,and provides reference for the research,development and application of the Chinese medicinal spectrum-effect relationships.
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Medicamentos de Ervas Chinesas , Medicina Tradicional Chinesa , Registros , Projetos de PesquisaRESUMO
Advanced severe lung cancer means the stage IIIB, IIIC, and IV lung cancer patients with a PS score of 2 to 4 points due to various related causes of lung cancer itself or the complication of anti-tumor drugs, with a high probability of benefiting from the existing systemic anti-tumor treatments. The diagnosis and treatment strategies emphasize the implementation of minimally invasive dynamic monitoring mutation targets and curative effects. Every drug that is useful to the patient should be used as possible, and making the best use of every drug as possible with the help of respiratory support therapy. Specific treatment concepts include combination therapy,alternating medication, paying equal attention to systemic therapy and local therapy, PS score assessment, upgrading and downgrading of drug use, and simultaneous treatment of cancer and lung itself.
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<p><b>OBJECTIVE</b>To investigate the effects of inspiratory muscle training followed by non-invasive positive pressure ventilation in patients with severe chronic obstructive pulmonary disease (COPD).</p><p><b>METHODS</b>This investigator-initiated randomized, controlled trial recruited 88 patients with stable GOLD stage IV COPD, who were randomized into 4 equal groups to continue oxygen therapy (control group) or to receive inspiratory muscle training followed by non-invasive positive pressure ventilation (IMT-NPPV group), inspiratory muscle training only (IMT group), or noninvasive positive pressure ventilation only (NPPV group) for at least 8 weeks. The outcomes of the patients were assessed including the quality of life (SRI scores), maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), dyspnea (MRC scores), 6-min walking distance (6MWD) and lung function.</p><p><b>RESULTS</b>s Compared to baseline values, SRI scores, 6MWT and MRC scores increased significantly after 8 weeks in IMT-NPPV, IMT and NPPV groups, and the improvements were significantly greater in IMT-NPPV group than in IMT and NPPV groups (P<0.05 for all). In IMT-NPPV and IMT groups, MIP and MEP increased significantly after the training (P<0.05), and the improvement was more prominent in IMT-NPPV group (P<0.05). No significant changes were found in pulmonary functions in the groups after 8 weeks of treatment (P>0.05).</p><p><b>CONCLUSION</b>Inspiratory muscle training followed by non-invasive positive pressure ventilation, compared with inspiratory muscle training or non-invasive positive pressure ventilation alone, can better enhance the quality of life, strengthen the respiratory muscles, improve exercise tolerance and relieve the dyspnea in patients with COPD.</p>
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Humanos , Dispneia , Terapêutica , Tolerância ao Exercício , Pulmão , Ventilação não Invasiva , Condicionamento Físico Humano , Respiração com Pressão Positiva , Doença Pulmonar Obstrutiva Crônica , Terapêutica , Qualidade de Vida , Músculos RespiratóriosRESUMO
<p><b>BACKGROUND</b>Bacteria-induced respiratory infection has been long considered to be the major cause of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Therefore, a clear picture about the distribution and drug-resistance of pathogenic bacteria in the lower airways should be helpful for treatment of the disease. So far, data on this topic among Chinese are lacking.</p><p><b>METHODS</b>A surveillance study was performed in consecutive patients with AECOPD at five areas in China between October 2006 and April 2008. The sputum from these patients was cultured and isolated for bacteria. Agar dilution method was used to determine the minimal inhibitory concentrations (MICs) of levofoxacin and other 15 antibiotics against these strains.</p><p><b>RESULTS</b>Three hundred and fifty-nine pathogenic bacterial strains were isolated among 884 patients with AECOPD. The predominant bacteria were Pseudomonas aeruginosa (21.7%), Klebsiella pneumoniae (12.3%), Haemophilus influenzae (14.2%) and Streptococcus pneumoniae (11.7%), followed by Haemophilus parainfluenzae (9.5%), Acinetobacter baumannii (7.8%), Moraxella catarrhalis (6.4%) and Escherichia coli (3.6%). The majority of bacterial pathogens isolated in this study were susceptible to fuoroquinolones, ceftazidime, cefepime and imipenem.</p><p><b>CONCLUSIONS</b>Gram-negative bacilli are the leading pathogens in patients with AECOPD in China. Haemophilus parainfluenzae may be one of the most important pathogens in AECOPD. This study provides evidence for local surveillance of AECOPD pathogens and appropriate choice of antimicrobials in China.</p>
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Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença Aguda , Bactérias , Farmacorresistência Bacteriana , Testes de Sensibilidade Microbiana , Doença Pulmonar Obstrutiva Crônica , MicrobiologiaRESUMO
Aconite has the efficacy of reviving yang for resuscitation, dispelling cold and relieving pain, which is widely used in clinic, and shows unique efficacy in treating severe diseases. However, aconite has great toxicity, with obvious cardio-toxicity and neurotoxicity. Its toxicological mechanism main shows in the effect on voltage-dependent sodium channels, release of neurotransmitters and changes in receptors, promotion of lipid peroxidation and cell apoptosis in heart, liver and other tissues. Aconite works to reduce toxicity mainly through compatibility and processing. Besides traditional processing methods, many new modern processing techniques could also help achieve the objectives of detoxification and efficacy enhancement. In order to further develop the medicinal value of aconite and reduce its side effect in clinical application, this article gives comprehensive comments on aconite's toxicity characteristics, mechanism and detoxification methods on the basis of relevant reports for aconite's toxicity and the author's experimental studies.
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Animais , Humanos , Aconitum , Química , Química Farmacêutica , Composição de Medicamentos , Medicamentos de Ervas Chinesas , Química , Toxicidade , Extratos Vegetais , Química , ToxicidadeRESUMO
<p><b>OBJECTIVE</b>Factors associated with smoking cessation interventions initiated by hospital chest physicians in China had not been studied. We examined if the physicians' awareness of emerging evidence regarding negative effects of smoking was associated with the initiation of smoking cessation.</p><p><b>METHODS</b>A cluster randomized cross-sectional survey was conducted from July 2011 to August 2011 in hospital-based chest physicians (n = 354) in Guangzhou, China.</p><p><b>RESULTS</b>Of those who responded (n = 354, 92.2%), 63.8% were aware of emerging evidence regarding negative effects of smoking and 64.5% initiated smoking cessation programs with their patients who smoked. Regarding the related awareness on smoking differed across physicians depending on their affiliation to evidence hospitals(χ(2) = 54.7, P > 0.001), i.e., primary (44.9%), secondary (55.1%)and tertiary hospitals (87.0%)was further supported by the related odds ratio (OR = 1.732, 95%CI:1.072-2.797, P < 0.05). Smoking status of physicians was related to their practice on smoking cessation, supported by the odds ratio (OR = 4.251, 95% CI:1.460-12.380, P = 0.008). Smoking cessation practice by physicians also depended on their affiliated hospitals. Physicians working at primary and secondary hospitals were less aware of the fact that smoking could reduce patients' responsiveness to inhaled corticosteroids than those working at the tertiary hospitals(χ(2) = 37.9, P > 0.001). Furthermore, these physicians would less frequently prescribed medication related to smoking cessation(χ(2) = 137.71, P < 0.001).</p><p><b>CONCLUSION</b>Physicians who were better aware of the health hazards of smoking might more actively provide smoking cessation advice in their clinics. The awareness might correlate with the hospital levels they worked and the smoking status while the the advice they provided might correlate with their educational background, job title, department affiliation and smoking status, but not with the level of hospitals.</p>
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Adulto , Feminino , Humanos , Masculino , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Médicos , Psicologia , Abandono do Hábito de Fumar , Prevenção do Hábito de Fumar , Inquéritos e QuestionáriosRESUMO
<p><b>BACKGROUND</b>Skeletal muscle dysfunction is one of important systemic manifestations of chronic obstructive pulmonary disease (COPD) and is associated with mortality in patients with COPD, thus quantifying its strength is of great clinical interest and of particular value. Quadriceps maximal volitional contraction (MVC) is often used for the routine measurements of this muscle's strength; while twitch tension (TwQ) evoked by magnetic stimulation of the femoral nerve has been employed for measurement of quadriceps strength non-volitionally. We aimed to investigate the prevalence and severity of skeletal muscle dysfunction in COPD patients by measurement of quadriceps strength with volitional and non-volitional techniques, and to probe into some methodological issues.</p><p><b>METHODS</b>We recruited 71 COPD patients and 60 control subjects. Quadriceps strength was measured with both maximality of TwQ and MVC force. The reproducibility for TwQ and MVC was investigated using within-occasion variability from three repeated maneuvers.</p><p><b>RESULTS</b>Maximal TwQ was achieved in 121 participants at a mean of 90% of the stimulator's maximum output. The mean maximality of TwQ was decrease by about 44% - 47% in COPD patients as compared with controls (P < 0.05), so was MVC. There was a significant correlation between quadriceps TwQ and MVC, and the mean ratio of TwQ/MVC was 0.29 in controls and 0.33 in patients. The coefficient of variation showed that TwQ yielded lower within-occasion variability than MVC in both groups.</p><p><b>CONCLUSIONS</b>Quadriceps strength is commonly and substantially impaired in patients with COPD, in terms of MVC as well as TwQ. The magnetic stimulation of the femoral nerve presents a higher reproducibility and is a better technique for measurement of quadriceps strength for the general population, especially for those who are too unwell to perform a full MVC; while it may not be applied to subjects who are over-weighted.</p>
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Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nervo Femoral , Fisiologia , Força Muscular , Fisiologia , Doença Pulmonar Obstrutiva Crônica , Músculo Quadríceps , FisiologiaRESUMO
<p><b>OBJECTIVE</b>To investigate the accuracy and potential error range of noninvasive estimation of CO2 pressure (PCO2), arterial O2 pressure (PaO2), and oxygenation index (OI) by measuring the end-tidal CO2 pressure (PETCO2) and pulse oxygen saturation (SpO2) in patients with chronic obstructive pulmonary disease (COPD) and respiratory failure, and assess the feasibility of this method for dynamic monitoring of arterial CO2 pressure (PaCO2) and PaO2 in the primary care facilities where arterial blood gases analysis is not available.</p><p><b>METHODS</b>All the 30 patients with COPD and respiratory failure received routine clinical treatment including bronchodilators, mucolytics, glucocorticosteroid, antibiotics and oxygen therapy (titrated to keep SpO2 above 90%) for 5-7 days. A subgroup of the patients also received NIPPV treatment. All the patients were tested with both the eupnea method and prolonged expiratory method before and after the treatment to obtain the data of PCO2 and SpO2 were respectively performed before and after treatment.</p><p><b>RESULTS</b>The PETCO2 with eupnea (PETCO2(Q)) was 50.72-/+8.93 mmHg, significantly lower than PaCO2 (71.25-/+9.08 mmHg, Plt;0.01), but the PETCO2(P) (70.35-/+8.91 mmHg) was comparable with PaCO2 (P>0.05). Similar results were obtained after the treatment. The PETCO2(P) before treatment and after treatment was positively correlated to PaCO2 (r=0.96 and 0.97, respectively, P<0.01). The PaO2(Y) before the treatment derived from the oxygen dissociation curve based on SpO2 measurement was close to SpO2 (59.96-/+1.42 mmHg vs 59.07-/+2.22 mmHg, P>0.05). The OI derived from PaO2 and OI(Y) from PaO2 (Y) was also similar (215.70-/+22.77 vs 219.15-/+24.63, P>0.05). Linear regression analysis showed positive correlations between PaO2(Y) to PaO2 (r=0.81, P<0.01) and between OI(Y) and OI (r=0.95, P<0.01).</p><p><b>CONCLUSIONS</b>In patients with COPD (especially those with also type II respiratory failure), the modified monitoring method of PCO2 and maintenance of SpO2 above 90% can precisely estimate PaCO2 and PaO2. This method is feasible for clinical noninvasive and dynamic evaluation of respiratory failure in COPD patients, especially in primary care facilities where arterial blood gases analysis is not available.</p>
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Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Transcutânea dos Gases Sanguíneos , Capnografia , Oximetria , Doença Pulmonar Obstrutiva Crônica , Sangue , Insuficiência Respiratória , Sangue , Volume de Ventilação PulmonarRESUMO
Objective To evaluate the reproducibility of Negative Expiratory Pressure(NEP)technique in detecting expiratory flow limitation (EFL) on chronic obstructive pulmonary disease (COPD) patients. Methods EFL was evaluated with NEP technique in 72 subjects having stable COPD on two occasions. Agreement between testing occasions was assessed with the κ statistic for the 3-point and 5-point EFL scores, and with paired t-test for FL index. Results On the first testing occasion, 18 subjects had no EFL, 18 subjects had EFL in the supine position, and 36 subjects in the sitting and the supine position. Using the 3-point score, agreement was present in 58 of the 72 subjects at time 2 (κ =0.69, P<0.001 ), indicating a substantial agreement was found. Using the 5-point score, agreement was seen in 52 of the 72 subjects (κ =0.65, P<0.001 ), also indicating a substantial agreement. The difference of FL index between the first and the second occasion was significant in both the sitting (P<0.05) and supine (P<0.05) positions. Conclusion Both 3-point and 5-point scores provided a reproducible assessment of EFL on COPD patients but the FL index seemed less reproducible. More research were needed before NEP technique was promoted to be used clinically.
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<p><b>OBJECTIVE</b>To evaluate the relationship between leukotriene expression in blood polymorphonuclear leukocytes (PMNL) and the efficacy of inhaled corticosteroids (ICS) in children with asthma.</p><p><b>METHODS</b>Thirty-two children with asthma (5-12 years) and ten healthy children (control group) were enrolled. The asthmatic children were subdivided into ICS well-controlled and ICS poorly-controlled groups based on their clinical symptoms and lung function. The level of leukotriene C4 synthase (LTC4S) mRNA in PMNL was detected by fluorescence quantitative polymerase chain reaction. The level of LTC4S mRNA was expressed by the value of qCt, and the value of qCt was diversely correlated with the level of LTC4S mRNA expression. The concentration of urinary leukotriene E4 (LTE4) was measured using ELISA.</p><p><b>RESULTS</b>The expression of LTC4S mRNA in PMNL was significantly higher in children with asthma (qCt: 1.12+/-0.27) than that in the control group (qCt: 1.42+/-0.12; P< 0.05). The expression of LTC4S mRNA in PMNL in the ICS poorly-controlled group (qCt: 1.03+/-0.17) was significantly higher than that in the ICS well-controlled group (qCt: 1.24+/-0.33; P< 0.05) and the control group(1.42+/-0.12; P< 0.01). There was no significant difference in the level of urinary LTE4 among the the ICS poorly-controlled, the ICS well-controlled and the control groups.</p><p><b>CONCLUSIONS</b>LTC4S mRNA expression in PMNL in asthmatic children increases, and the LTC4S mRNA expression in the ICS poorly-controlled group is higher than that in the ICS well-controlled group. This suggests that an increased leukotriene expression might be associated with poorly-controlled asthma.</p>
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Criança , Pré-Escolar , Feminino , Humanos , Masculino , Administração por Inalação , Corticosteroides , Asma , Tratamento Farmacológico , Glutationa Transferase , Genética , Leucotrieno E4 , Urina , RNA Mensageiro , SangueRESUMO
<p><b>BACKGROUND</b>Chronic obstructive pulmonary disease (COPD) is associated not only with airway inflammation characterized by mucin hypersecretion but also with systemic inflammation. Tumor necrosis factor alpha (TNF-alpha) is found to take part in systemic inflammation, and ErbB3 plays an important role in mucin hypersecretion of COPD. Since TNF-alpha converting enzyme (TACE) is involved in the activation of both TNF-alpha and ErbB3, we established rat models of COPD to investigate the expressions of TACE, TNF-alpha and ErbB3 and to explore the correlations among TACE, TNF-alpha and ErbB3 respectively.</p><p><b>METHODS</b>Thirty Wistar male rats were randomly divided into COPD group (group C, n = 10), saline solution parallel group (group P, n = 8), and normal control group (group N, n = 8). Group C was challenged with passive cigarette smoking and intratracheal instillation of lipopolysaccharide. Six weeks later pulmonary functions were tested, bronchoalveolar fluid and arterial blood gases were assayed, and histopathological evaluations were performed in turn. The expressions of TACE, TNF-alpha and ErbB3 in lungs of all rats were determined histochemically.</p><p><b>RESULTS</b>The expressions of TACE, TNF-alpha and ErbB3 were significantly higher in group C than in group N (P < 0.01). The contents of TNF-alpha in serum (P < 0.01) and bronchoalveolar lavage fluid (BALF) (P < 0.01) were elevated more significantly in group C than in group N. A positive correlation existed between TACE and TNF-alpha (r = 0.784, P < 0.01) and between TACE and ErbB3 (r = 0.526, P < 0.01) respectively.</p><p><b>CONCLUSIONS</b>TNF-alpha and ErbB3 are involved in the pathogenesis of COPD. TACE contributes to the progress of COPD indirectly through the function of TNF-alpha and ErbB3.</p>
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Animais , Masculino , Ratos , Proteínas ADAM , Fisiologia , Proteína ADAM17 , Líquido da Lavagem Broncoalveolar , Química , Imuno-Histoquímica , Pulmão , Doença Pulmonar Obstrutiva Crônica , Metabolismo , Patologia , Ratos Wistar , Receptor ErbB-3 , Fisiologia , Fator de Necrose Tumoral alfaRESUMO
<p><b>OBJECTIVE</b>To explore feasible and reliable methods for estnbolishment and of acute lung injury model in animal models.</p><p><b>METHODS</b>Twenty-four healthy adult mongrel dogs with oleic acid-induced acute lung injury were evaluated for early-stage physiological response to acute lung injury using a balloon catheter system for measuring esophageal and gastric pressure.</p><p><b>RESULTS</b>In canine models of early-stage oleic acid-induced acute lung injury that sustained spontaneous breathing, in terms of respiratory mechanics, some parameters obviously increased including the respiratory rate (RR), minute ventilation (VE), peak inspiratory volume (Vinsp, peak), mean inspiratory volume (VT/Ti), inspiratory airway resistance (Raw, insp) (P<0.001 for all the parameters), with also significantly increased peak transdiaphragmatic pressure (Pdi, peak, P=0.0185). The tidal volume (VT) and dynamic lung compliance (CL,dyn), however, were significantly decreased (P<0.001), and significant variation occurred in the ratio of inspiratory time to duration of one breath (Ti/Ttot, P=0.163). In terms of gas exchange, the pH, PaO(2), SaO(2), PaO(2)/FiO(2), and end tidal partial pressure of carbon dioxide (PETCO(2)) all evidently declined (P<0.001), but PaCO(2) and ratio of alveolar dead space to tidal volume [VD(alv)/VT] increased significantly (P<0.001).</p><p><b>CONCLUSION</b>Application of balloon catheter system for measuring esophageal and gastric pressures allows objective evaluation of the various physiological responses in early stage of acute lung injury.</p>
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Animais , Cães , Feminino , Masculino , Lesão Pulmonar Aguda , Terapêutica , Cateterismo , Modelos Animais de Doenças , Esôfago , Estudos de Viabilidade , Pressão , Reprodutibilidade dos Testes , Mecânica Respiratória , Fisiologia , Estômago , Fatores de TempoRESUMO
<p><b>OBJECTIVE</b>To investigate the effect of non-invasive positive pressure ventilation (NIPPV) on the work of breathing (WOB) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD).</p><p><b>METHODS</b>Eleven patients with acute exacerbation of COPD received pressure support ventilation (PSV) at different levels during NIPPV. The changes of inspiratory muscle effort and breathing pattern of the patients were observed.</p><p><b>RESULTS</b>The average minute ventilation (VE, P<0.01) and tidal volume (VT, P<0.05) of the patients were significantly higher during routine PSV and high pressure support (H-PS) than those during spontaneous breathing (SB), and the breathing pattern of the patients did not undergo significant changes during high positive end expiratory pressure (H-PEEP). The WOB of the inspiratory muscles was reduced significantly during PSV as compared with that measured in SB (P<0.01), while the WOB of exspiratory muscle increased significantly (P<0.01).</p><p><b>CONCLUSION</b>NIPPV can relieve the load of the inspiratory muscles in patients with acute exacerbation of COPD, and the WOB of the inspiratory muscles can be reduced by PSV, H-PEEP and H-PS (by 75%, 71% and 76%, respectively), but higher PSV during NIPPV can cause higher WOB of the exspiratory muscles.</p>
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Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Expiração , Fisiologia , Inalação , Fisiologia , Pressão , Doença Pulmonar Obstrutiva Crônica , Patologia , Terapêutica , Ventilação Pulmonar , Trabalho Respiratório , FisiologiaRESUMO
<p><b>OBJECTIVE</b>To evaluate the effects of different interventional strategies, namely controlled high-concentration oxygen therapy, continuous positive airway pressure (CPAP) and bi-level positive airway pressure (BiPAP) ventilation, on respiratory response and work of breathing (WOB) in canine models of early-stage acute lung injury (ALI).</p><p><b>METHODS</b>After successful duplication of ALI models with oleic acid (diagnostic criteria: Pa(O2)/Fi(O2)<or=300 mmHg), 24 adult mongrel dogs were randomized into 3 equal groups for treatment with controlled high-concentration oxygen therapy (O2), CPAP, and BiPAP, respectively. The parameters of respiratory response and WOB were recorded continuously at the baseline, early-stage ALI, and 1-4 hours after treatment.</p><p><b>RESULTS</b>BiPAP resulted in the most significant effects in reducing the respiratory rate (RR) and f/V(T) (P<0.001), followed by CPAP and O2 interventions (P<0.001). None of the 3 treatments showed obvious effects on V(E) (P>0.05), which maintained the level of early ALI/ARDS stage. BiPAP greatly improved V(T) and V(T)/Ti, showing better effects than CPAP and O2. No significant differences were noted among the 3 groups in T(I)/T(tot) (P>0.05). BiPAP showed superior effect to CPAP in lowering the peak transdiaphragmatic pressure (Pdi). CPAP and BiPAP both effectively counteracted intrinsic positive end expiratory pressure (PEEPi) (P<0.01), while O2 produced no obvious such effects (P>0.05). BiPAP showed the most evident effects, followed by CPAP, in reducing WOB, but oxygen therapy produced no obvious effects. CPAP (P<0.01) and BiPAP (P>0.05) both effectively reduced the proportion of ingredients in WOB related to PEEPi.</p><p><b>CONCLUSION</b>BiPAP and CPAP can produce favorable effects in relieving dyspnea, reducing WOB and improving respiratory response to control the deterioration of ARDS. BiPAP has more significant therapeutic effects than CPAP and oxygen therapy.</p>
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Animais , Cães , Feminino , Masculino , Doença Aguda , Pressão Positiva Contínua nas Vias Aéreas , Pneumopatias , Terapêutica , Oxigenoterapia , Respiração com Pressão Positiva , Respiração , Respiração Artificial , Métodos , Fatores de TempoRESUMO
<p><b>BACKGROUND</b>Severe acute respiratory syndrome coronavirus (SARS-CoV) is a newly emerging virus that gives rise to SARS patients with high rates of infectivity and fatality. To study the humoral immune responses to SARS-CoV, the authors evaluated IgG and IgM specific antibodies in patients' sera.</p><p><b>METHODS</b>Two methods, enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescent assay (IFA), were used to detect specific serum IgG and IgM against SARS-CoV in 98 SARS patients and 250 controls consisting of patients with pneumonia, health-care professionals and healthy subjects. The serum antibody profiles were investigated at different times over one and a half years in 18 of the SARS patients.</p><p><b>RESULTS</b>The sensitivity and specificity of ELISA for detecting IgG against SARS-CoV were 100.0% and 97.2% and for IgM 89.8% and 97.6% respectively; the figures using IFA for IgG were 100.0% and 100.0% and for IgM 81.8% and 100.0% respectively. During the first seven days of the antibodies trace test, no IgG and IgM were detected, but on day 15, IgG response increased dramatically, reaching a peak on day 60, remaining high up to day 180 and decreasing gradually until day 540. On day 15, IgM was detected, rapidly reached a peak, then declined gradually until day 180 when IgM was undetectable.</p><p><b>CONCLUSION</b>The detection of antibodies against SARS virus is helpful in the clinical diagnosis of SARS.</p>
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Anticorpos Antivirais , Sangue , Ensaio de Imunoadsorção Enzimática , Técnica Indireta de Fluorescência para Anticorpo , Imunoglobulina G , Sangue , Imunoglobulina M , Sangue , Coronavírus Relacionado à Síndrome Respiratória Aguda Grave , Alergia e Imunologia , Síndrome Respiratória Aguda Grave , Alergia e Imunologia , Linfócitos T Citotóxicos , Alergia e ImunologiaRESUMO
A new equipment of a computer multimedia system combined with a bronchoscope is presented here, which is able to provide active images with a high definition, image capture, synchronized video recording and playback during bronchoscopy. Its operation is easy and its quality is reliable. It is an advanced product for endoscopies and is worth while to be applied to clinical application.