Background Acute exacerbation of chronic obstructive pulmonary disease （COPD） is always associated with a high incidence and mortality. Because of the presence of some concomitant risk factors such as immobilization...Background Acute exacerbation of chronic obstructive pulmonary disease （COPD） is always associated with a high incidence and mortality. Because of the presence of some concomitant risk factors such as immobilization, bronchial superinfection, patients who are admitted for acute exacerbations of COPD are generally considered to be at moderate risk for the development of venous thromboembolism. In this study, we investigated the prevalence and the clinical manifestations of deep venous thrombosis （DVT） in patients with acute exacerbation of COPD.Methods From March 2007 to March 2009, 520 consecutive patients were included in this study. On admission, color Doppler ultrasound of lower extremities in all cases was performed for diagnosing DVT. Patients with DVT were compared with those without DVT from such aspects as demographics, symptoms, physical signs and risk factors.Results Among the 520 patients, DVT was found in 46 cases （9.7%）. In patients with DVT, the duration of hospitalization was longer （P=0.01）, and the mechanical ventilation requirement increased （P 〈0.001）. Other indicators for patients with more possibility of DVT were immobility exceeding 3 days （P 〈0.001）; pneumonia as concomitance （P=0.01）; respiratory failure type Ⅱ （P=0.013）; current smoking （P=0.001）. Lower extremity pain was more common in DVT cases in comparison to those without DVT （34.8% vs. 15.2%, P=0.01 ）.Conclusions The acute exacerbation of COPD patients, who were immobilized for over 3 days, complicated by pneumonia and had respiratory failure type Ⅱ, had a higher risk of DVT. In addition, DVT detection awareness should be increased in cases that had a lower extremity pain.展开更多
Background Idiopathic pulmonary fibrosis （IPF） is a progressive and lethal fibrotic lung disease of unknown etiology. Host susceptibility or genetic factors may be important for the predisposition to it. Transformin...Background Idiopathic pulmonary fibrosis （IPF） is a progressive and lethal fibrotic lung disease of unknown etiology. Host susceptibility or genetic factors may be important for the predisposition to it. Transforming growth factor-β1 （TGF-β1 a potent profibrotic cytokine） and plasminogen activator inhibitor 1 （PAl-1） play important roles in the development of pulmonary fibrosis. The objective of the study was to investigate the association between the gene polymorphisms of TGF-β1 869 T〉C and PAl-1 4G/5G and the susceptibility to IPF in Han ethnicity. Methods Polymerase chain reaction （PCR） and restriction fragment length polymorphism were performed to analyse the gene polymorphisms of TGF-β1 in 869T〉C and PAl-1 4G/5G in 85 IPF patients and 85 healthy controls matched in age, gender, race and smoker status. Results There was a significant difference in 869T〉C genotype distribution of TGF-β1 between IPF cases and controls, a significant negative association between TC genotype and the development of IPF （OR=0.508, 95% CI： 0.275-0.941） and a positive association between CC genotype and the development of IPF （OR=1.967, 95% CI： 1.063-3.641）. There was a significant positive association between PAl-1 5G/5G genotype and the development of IPF （OR=0.418, 95% CI： 0.193-0.904）. Conclusions Gene polymorphisms of TGF-β1 in 869T〉Cand PAl-1 4G/5G may affect the susceptibility to IPF in Han ethnicity. Further investigations are needed to confirm these findings and assess their biological significance in the development of the disease in this ethnic population.展开更多
Background Pneumonia is the most common cause of morbidity and mortality in lung transplant （LT） recipients. The aim of the present study was to evaluate the incidence, etiology, risk factors and prognosis of pneumo...Background Pneumonia is the most common cause of morbidity and mortality in lung transplant （LT） recipients. The aim of the present study was to evaluate the incidence, etiology, risk factors and prognosis of pneumonia in LT recipients. Methods The LT cohort consisted of 28 recipients receiving LT in Beijing Chao-Yang Hospital from August 2005 to April 2011. Data collected included demographic data, underlying disorders, time and type of transplant, follow-up information, date of last follow-up, and patient status. A retrospective analysis was made of observational data that were prospectively collected. Results Twenty-two patients of 28 LT recipients had 47 episodes of pneumonia throughout the study period. Thirty- eight episodes of pneumonia in 19 recipients occurred post-LT with a median follow-up of 257.5 days （1-2104 days）, the incidence of pneumonia was 192.4 episodes per 100 LT/year and its median time of onset was 100.5 days （0-946 days） post-transplantation. Bacteria, virus and fungi accounted for 62%, 16% and 15% of the microbial pathogens, respectively. The most frequent were Pseudomonas aeruginosa （20%）, cytomegalovirus （CMV） （15%）, and Aspergillus fumigatus （10%）. A total of 29% （11/38） of pneumonias occurred in the first month post-LT, and then the incidence decreased gradually. The incidence of CMV pneumonia was 25% （7/28） with a median time of 97 days （10-971 days）. More than one bacterial infection and CMV infection were independent risk factors for aspergillus infection. The incidence of pulmonary tuberculosis （TB） was 18% （5/28）, and the history of TB was a risk factor for TB relapse. There were 58% （7/12） of recipients who died of infection, and 71% （5/7） of these died in the first year after LT. Conclusions Pneumonia is still a major cause of morbidity and mortality in LT recipients. The most frequent microorganisms were Pseudornonas aeruginosa, CMV, and Aspergillus fumigates. The incidence of CMV pneumonia decreases with a delayed median time of onset. More than one incidence of bacterial infection and CMV infection are independent risk factors for aspergillus infection. LT recipients are at high risk for TB, and the history of TB is a risk factor for TB relapse.展开更多
Sarcoidosis is a systemic granulomatous disease of unknown cause. It commonly affects young to middle-aged adults and frequently presents with bilateral hilar lymphadenopathy, pulmonary infiltration, and ocular and sk...Sarcoidosis is a systemic granulomatous disease of unknown cause. It commonly affects young to middle-aged adults and frequently presents with bilateral hilar lymphadenopathy, pulmonary infiltration, and ocular and skin lesions. Pleural involvement is relatively uncommon. Pneumothorax is a rare complication of sarcoidosis, occurring usually in the late fibrotic stages of the disease with associated bullous changes. There are only scattered case reports on pneumothorax as the first manifestation of sarcoidosis in medical literature. The present case study reports a young man who presented first with recurrent spontaneous pneumothorax during the early stage and relapse of sarcoidosis.展开更多
Background Pulmonary capillary hemangiomatosis （PCH） is a rare disease and no Chinese case has been reported yet. The disease is often misdiagnosed and its clinical characteristics are incompletely described. The ai...Background Pulmonary capillary hemangiomatosis （PCH） is a rare disease and no Chinese case has been reported yet. The disease is often misdiagnosed and its clinical characteristics are incompletely described. The aim of this study was to describe two Chinese cases and to clarify the clinical and radiographic parameters of patients with PCH. Methods Two PCH cases were presented and other cases were searched from the English literature. All available clinical and radiographic data were collected from 62 literature reported PCH cases. A pooled analysis of total 64 cases was made. Results Dyspnea and hemoptysis were the most common clinical symptoms of PCH. Pulmonary hypertension （PH） was found in 78% of the reported cases. PCH typically showed characteristic diffuse or patchy ground-glass opacities （GGOs） and/or multiple ill-defined centrilobular nodules in the computed tomography. Conclusions The diagnosis of PCH requires a high clinical suspicion. However, both clinical presentations and radiographic studies often provide clues to the diagnosis, which may prompt early lung biopsy for a definite diagnosis.展开更多
Respiratory medicine in China has made great .progress in the past decades. Today, modemrespiratory and critical care medicine faces tremendous new challenges and is also provided with greater opportunities. Respirato...Respiratory medicine in China has made great .progress in the past decades. Today, modemrespiratory and critical care medicine faces tremendous new challenges and is also provided with greater opportunities. Respiratory diseases are a leading cause of morbidity and mortality that carry a huge economic and social burden in China. Chronic obstructive pulmonary disease （COPD） alone affects 8.2% of people aged 40 and over; nearly 43 million people in China.1 Respiratory diseases, excluding lung cancer, cor pulmonale and respiratory tuberculosis （TB）, are the 4th leading cause of death in China.2展开更多
L ungs are located in the chest and lie on both sides of mediastinum. The major balance the external and internal function of lung is to ‘gas＇ environment and to maintain homeostatic equilibrium. Because lung is clo...L ungs are located in the chest and lie on both sides of mediastinum. The major balance the external and internal function of lung is to ‘gas＇ environment and to maintain homeostatic equilibrium. Because lung is closely interacted with outside surroundings as well as general circulation, it is fair to say that lung is a delicate organ which may be attacked by so many noxious stimuli,展开更多
文摘Background Acute exacerbation of chronic obstructive pulmonary disease （COPD） is always associated with a high incidence and mortality. Because of the presence of some concomitant risk factors such as immobilization, bronchial superinfection, patients who are admitted for acute exacerbations of COPD are generally considered to be at moderate risk for the development of venous thromboembolism. In this study, we investigated the prevalence and the clinical manifestations of deep venous thrombosis （DVT） in patients with acute exacerbation of COPD.Methods From March 2007 to March 2009, 520 consecutive patients were included in this study. On admission, color Doppler ultrasound of lower extremities in all cases was performed for diagnosing DVT. Patients with DVT were compared with those without DVT from such aspects as demographics, symptoms, physical signs and risk factors.Results Among the 520 patients, DVT was found in 46 cases （9.7%）. In patients with DVT, the duration of hospitalization was longer （P=0.01）, and the mechanical ventilation requirement increased （P 〈0.001）. Other indicators for patients with more possibility of DVT were immobility exceeding 3 days （P 〈0.001）; pneumonia as concomitance （P=0.01）; respiratory failure type Ⅱ （P=0.013）; current smoking （P=0.001）. Lower extremity pain was more common in DVT cases in comparison to those without DVT （34.8% vs. 15.2%, P=0.01 ）.Conclusions The acute exacerbation of COPD patients, who were immobilized for over 3 days, complicated by pneumonia and had respiratory failure type Ⅱ, had a higher risk of DVT. In addition, DVT detection awareness should be increased in cases that had a lower extremity pain.
基金This work was supported by grants from-Beijing Municipal Scientific ＆ Technology Commission （No. Z090507006209012, No. PXM2010 014226 07 000097） and Beijing Natural Science Foundation （No. 7082037）.Acknowledgements： The authors are grateful to MA Li and XIN Ping for collecting samples.
文摘Background Idiopathic pulmonary fibrosis （IPF） is a progressive and lethal fibrotic lung disease of unknown etiology. Host susceptibility or genetic factors may be important for the predisposition to it. Transforming growth factor-β1 （TGF-β1 a potent profibrotic cytokine） and plasminogen activator inhibitor 1 （PAl-1） play important roles in the development of pulmonary fibrosis. The objective of the study was to investigate the association between the gene polymorphisms of TGF-β1 869 T〉C and PAl-1 4G/5G and the susceptibility to IPF in Han ethnicity. Methods Polymerase chain reaction （PCR） and restriction fragment length polymorphism were performed to analyse the gene polymorphisms of TGF-β1 in 869T〉C and PAl-1 4G/5G in 85 IPF patients and 85 healthy controls matched in age, gender, race and smoker status. Results There was a significant difference in 869T〉C genotype distribution of TGF-β1 between IPF cases and controls, a significant negative association between TC genotype and the development of IPF （OR=0.508, 95% CI： 0.275-0.941） and a positive association between CC genotype and the development of IPF （OR=1.967, 95% CI： 1.063-3.641）. There was a significant positive association between PAl-1 5G/5G genotype and the development of IPF （OR=0.418, 95% CI： 0.193-0.904）. Conclusions Gene polymorphisms of TGF-β1 in 869T〉Cand PAl-1 4G/5G may affect the susceptibility to IPF in Han ethnicity. Further investigations are needed to confirm these findings and assess their biological significance in the development of the disease in this ethnic population.
文摘Background Pneumonia is the most common cause of morbidity and mortality in lung transplant （LT） recipients. The aim of the present study was to evaluate the incidence, etiology, risk factors and prognosis of pneumonia in LT recipients. Methods The LT cohort consisted of 28 recipients receiving LT in Beijing Chao-Yang Hospital from August 2005 to April 2011. Data collected included demographic data, underlying disorders, time and type of transplant, follow-up information, date of last follow-up, and patient status. A retrospective analysis was made of observational data that were prospectively collected. Results Twenty-two patients of 28 LT recipients had 47 episodes of pneumonia throughout the study period. Thirty- eight episodes of pneumonia in 19 recipients occurred post-LT with a median follow-up of 257.5 days （1-2104 days）, the incidence of pneumonia was 192.4 episodes per 100 LT/year and its median time of onset was 100.5 days （0-946 days） post-transplantation. Bacteria, virus and fungi accounted for 62%, 16% and 15% of the microbial pathogens, respectively. The most frequent were Pseudomonas aeruginosa （20%）, cytomegalovirus （CMV） （15%）, and Aspergillus fumigatus （10%）. A total of 29% （11/38） of pneumonias occurred in the first month post-LT, and then the incidence decreased gradually. The incidence of CMV pneumonia was 25% （7/28） with a median time of 97 days （10-971 days）. More than one bacterial infection and CMV infection were independent risk factors for aspergillus infection. The incidence of pulmonary tuberculosis （TB） was 18% （5/28）, and the history of TB was a risk factor for TB relapse. There were 58% （7/12） of recipients who died of infection, and 71% （5/7） of these died in the first year after LT. Conclusions Pneumonia is still a major cause of morbidity and mortality in LT recipients. The most frequent microorganisms were Pseudornonas aeruginosa, CMV, and Aspergillus fumigates. The incidence of CMV pneumonia decreases with a delayed median time of onset. More than one incidence of bacterial infection and CMV infection are independent risk factors for aspergillus infection. LT recipients are at high risk for TB, and the history of TB is a risk factor for TB relapse.
文摘Sarcoidosis is a systemic granulomatous disease of unknown cause. It commonly affects young to middle-aged adults and frequently presents with bilateral hilar lymphadenopathy, pulmonary infiltration, and ocular and skin lesions. Pleural involvement is relatively uncommon. Pneumothorax is a rare complication of sarcoidosis, occurring usually in the late fibrotic stages of the disease with associated bullous changes. There are only scattered case reports on pneumothorax as the first manifestation of sarcoidosis in medical literature. The present case study reports a young man who presented first with recurrent spontaneous pneumothorax during the early stage and relapse of sarcoidosis.
基金This work was supported by a grant from the Major International Joint Research Project of Natural Science Foundation of China （No. 30810103904）.
文摘Background Pulmonary capillary hemangiomatosis （PCH） is a rare disease and no Chinese case has been reported yet. The disease is often misdiagnosed and its clinical characteristics are incompletely described. The aim of this study was to describe two Chinese cases and to clarify the clinical and radiographic parameters of patients with PCH. Methods Two PCH cases were presented and other cases were searched from the English literature. All available clinical and radiographic data were collected from 62 literature reported PCH cases. A pooled analysis of total 64 cases was made. Results Dyspnea and hemoptysis were the most common clinical symptoms of PCH. Pulmonary hypertension （PH） was found in 78% of the reported cases. PCH typically showed characteristic diffuse or patchy ground-glass opacities （GGOs） and/or multiple ill-defined centrilobular nodules in the computed tomography. Conclusions The diagnosis of PCH requires a high clinical suspicion. However, both clinical presentations and radiographic studies often provide clues to the diagnosis, which may prompt early lung biopsy for a definite diagnosis.
文摘Respiratory medicine in China has made great .progress in the past decades. Today, modemrespiratory and critical care medicine faces tremendous new challenges and is also provided with greater opportunities. Respiratory diseases are a leading cause of morbidity and mortality that carry a huge economic and social burden in China. Chronic obstructive pulmonary disease （COPD） alone affects 8.2% of people aged 40 and over; nearly 43 million people in China.1 Respiratory diseases, excluding lung cancer, cor pulmonale and respiratory tuberculosis （TB）, are the 4th leading cause of death in China.2
基金This work was supported by grants from the National Natural Science Foundation of China （No. 30971312） and the Key Project of Beijing Municipal Education Commission Sci-Tech Development Program （No. KZ201110025026）.
文摘L ungs are located in the chest and lie on both sides of mediastinum. The major balance the external and internal function of lung is to ‘gas＇ environment and to maintain homeostatic equilibrium. Because lung is closely interacted with outside surroundings as well as general circulation, it is fair to say that lung is a delicate organ which may be attacked by so many noxious stimuli,
