Study on predictive models for swallowing risk in patients with AECOPD.

BACKGROUND: Dysphagia is considered a complication in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, AECOPD may have risk factors for dysphagia. METHODS: Through a cross-sectional study, which included 100 patients with AECOPD. General information, Pulmonary function, COPD assessment test (CAT) and modified Medical Research Council (mMRC) were collected by questionnaire. The questionnaires were administered by uniform-trained investigators using standard and neutral language, and swallowing risk was assessed by using a water swallow test (WST) on the day of patient admission. RESULTS: Among the 100 included patients, 50(50%) were at risk of swallowing. Multivariate analysis using logistic regression analysis showed that age ≥ 74 years old, mMRC ≥ level 2, hospitalization days ≥ 7 days and the use of BIPAP assisted ventilation were important influencing factors for swallowing risk in patients with AECOPD. CONCLUSION: Patients with AECOPD are at risk for dysphagia, assessing age, mMRC, hospitalization days and the use of BIPAP assisted ventilation can be used to screen for swallowing risk, thus contributing to the implementation of early prevention measures.

Inhibition of Inflammation and Regulation of AQPs/ENaCs/Na+-K+-ATPase Mediated Alveolar Fluid Transport by Total Flavonoids Extracted From Nervilia fordii in Lipopolysaccharide-induced Acute Lung Injury.

Aims: The occurrence of vascular permeability pulmonary edema in acute lung injury (ALI) is related to the imbalance of alveolar fluid transport. Regulating the active transport of alveolar fluid by aquaporins (AQPs), epithelial sodium channels (ENaCs), and Na+-K+-ATPase can effectively reduce the edema fluid in the alveolar cavity and protect against ALI. We evaluated the therapeutic effects of total flavonoids, extracted from Nervilia fordii (TFENF), and investigated its potential mechanisms of alveolar fluid transport in a rat ALI model. Materials and methods: A model of lipopolysaccharide (LPS, 5 mg/kg)-induced ALI was established in Sprague-Dawley (SD) rats through the arteriae dorsalis penis. SD rats were divided into six groups, including the vehicle, LPS model, TFENF (6 mg/kg, 12 mg/kg, 24 mg/kg), and dexamethasone group (DEX group, 5 mg/kg). The wet-to-dry (W/D) lung weight ratio, oxygenation index, and histopathological observation were used to evaluate the therapeutic effect of TFENF. The mRNA expression of AQPs, ENaCs, and pro-inflammatory cytokines was determined using real-time polymerase chain reaction, whereas protein expression was determined using immunohistochemistry. The Na + -K + -ATPase activity was assessed using enzyme-linked immunosorbent assay. Results: LPS significantly stimulated the production of inflammatory mediators including tumor necrosis factor (TNF)-α and interleukin (IL)-1ß, and disrupted the water transport balance in the alveolar cavity by inhibiting AQPs/ENaCs/Na + -K + -ATPase. Pretreatment with TFENF reduced the pathological damage and W/D ratio of the lungs and ameliorated the arterial blood oxygen partial pressure (PaO2) and oxygenation index. TFENF further decreased the mRNA level of TNF-α and IL-1ß; increased the expression of AQP-1, AQP-5, αENaC, and ßENaC; and increased Na + -K + -ATPase activity. Moreover, the regulation of AQPs, ßENaC, and Na + -K + -ATPase and the inhibition of TNF-α and IL-1ß by TFENF were found to be dose dependent. Conclusion: TFENF protects against LPS-induced ALI, at least in part, through the suppression of inflammatory cytokines and regulation of the active transport capacity of AQPs/ENaCs/Na + -K + -ATPase. These findings suggest the therapeutic potential of TFENF as phytomedicine to treat inflammation and pulmonary edema in ALI.

A health education model based on knowledge, attitude, and practice used as adjunct therapy for metabolic syndrome complicated with acute pancreatitis: A case report.

Herein, a relatively rare case is reported in which a knowledge, attitude, and practice (KAP) health education model was applied in a young female patient with metabolic syndrome (MS) and acute pancreatitis (AP), with a satisfactory effect. The purpose of this report is to provide a reference for a viable health education program in clinical practice for intervention of MS with concurrent AP in the absence of clinical trials. The patient's unhealthy lifestyle led to obesity, diabetes mellitus, severe fatty liver, hyperlipidemia, and AP. We used a KAP health education model in a nursing intervention and evidence-based multidisciplinary cooperation to develop a personalized diet, exercise plan, education plan, and continuous care of the patient after discharge from the hospital. Within 2 months, the patient achieved weight loss, stable blood lipids, controlled blood sugar levels, and decreased glycated hemoglobin level from 9.0% to 5.4%. This KAP-based health education model has clinical importance as an intervention for lifestyle modification in patients with MS and AP. This approach can be adopted to help other patients to effectively control and prevent the recurrence of diseases.