数字时代专业群建设的逻辑关系

数字时代商业模式的改变是专业群建设的客观需求,立足服务地方产业的需求是专业群建设的关键所在。专业群建设中的内部逻辑关系包括纵向的逻辑关系和横向的排列式逻辑关系。专业群建设需要打破院校之间的专业建设的封闭性、院内专业建设的分割性两个桎梏。

Asymptomatic patients of chronic obstructive pulmonary disease in China

Background Chronic obstructive pulmonary disease （COPD） has a variable natural history and not all individuals follow the same course. This study aimed to identify the prevalence and characteristics of asymptomatic COPD patients from a population-based survey in China.Methods A multistage cluster sampling strategy was used in a population from seven different provinces/cities. All residents （over 40 years old） were interviewed with a standardized questionnaire and spirometry.Post-bronchodilator forced expiratory volume in 1 second （FEV1）/forced vital capacity （FVC） of less than 70% was defined as the diagnostic criterion of COPD. All COPD patients screened were divided into symptomatic group and asymptomatic group according to the presence or absence of chronic respiratory symptoms. Socio-demographic,personal and exposure variables were collected and analyzed.Results Among the 1668 patients who were diagnosed with COPD from the 25 627 sampling subjects, 589 （35.3%）were asymptomatic. The age, sex, body mass index （BMI）,rural and urban distributions, smoking habit and education levels were similar in the two groups. A total of 64.7% of the asymptomatic patients had no comorbidities. Cardiovascular diseases and lung cancer were more common among symptomatic COPD patients than asymptomatic group.Asymptomatic COPD group were less likely to present with poor ventilation in the kitchen, a family history of respiratory disease and recurrent childhood cough. Asymptomatic COPD patients had significantly higher FEV1 （73.1% vs. 61.0%）, FVC （91.9% vs. 82.0%）, and a higher ratio of FEV1/FVC （62.9% vs.58.7%） （all P 〈0.001） than symptomatic group. More asymptomatic patients were underdiagnosed （91.9% vs.54.3%, P〈0.001） than symptomatic patients.Conclusions This large population-based survey confirmed a high prevalence of asymptomatic COPD patients in China. More use of spirometry screening test may be important to the early detection of COPD.

Small interfering RNA-mediated knockdown of Notch1 in lung T cells of asthmatic mice affects T cell differentiation

Background The immunologic response to allergens mediated by T lymphocytes is an incipient key element in the pathogenesis of asthma, and Thl/Th2 balance is regarded as the core of asthma pathogenesis. Notch is a single-pass transmembrane receptor protein that regulates differentiation, proliferation and apoptosis in a broad range of cells. It is considered that the Notch signal pathway works in every stage of T cell development and differentiation. Whether the pathway of asthma pathogenesis is related to Notch1 remains unknown. This study is aimed to investigate whether the pathway of asthma pathogenesis is related to Notch1 by examining the effect of knockdown of the Notch1 gene by small interfering RNA on T cell differentiation. Methods An OVA-induced asthma mouse model was established. The expression of Notch1 in the tissue and T cells of the lung from asthmatic mice was detected by RT-PCR and Western blotting. The expression of Notch1 and cytokine interleukin （IL）-4 and interferon （IFN）-γ in activated lung T cells was detected by RT-PCR and enzyme-linked immunosorbent assay after blocking Notch1 by small interfering RNA. Results The mRNA and protein expression of Notch1 increased significantly both in the lung tissue and lung T cells of asthmatic mice （both P 〈0.05）. IL-4 decreased and IFN-y increased significantly in active lung T cells after Notch1 was blocked by Notchl-specific small interfering RNA （IL-4： （2.51±0.51） pg/ml vs 0.64±0.27） pg/ml protein; IFN-γ： （21.72±4.24） pg/ml vs （39.79±4.09） pg/ml protein, P 〈0.05）. Conclusion This study demonstrated that the Notch1 signal might play a role in the pathogenesis of asthma by its involvement in Thl/Th2 differentiation.

Relationship of daytime blood pressure and severity of obstructive sleep apnea among Chinese： a multi-center investigation in China

Background Epidemiologic studies have shown an independent and definite association between obstructive sleep apnea （OSA） and hypertension. This study aimed to define the association between daytime blood pressure and severity of OSA in Chinese population in mainland of China. Methods Twenty university hospital sleep centers in mainland of China were invited by the Chinese Medical Association （CMA） to participate in this epidemiologic study and 2297 consecutive patients （aged 18-85 years; 1981 males and 316 females） referred to these twenty sleep centers for evaluation of OSA between January 2004 and April 2006 were prospectively enrolled. Nocturnal polysomnography was performed in each patient, and disease severity was assessed based on the apnea-hypopnea index （AHI）. These patients were classfied into four groups： non-apneic control （control, n=257） with AHI 〈5 episodes/hour; mild sleep apnea （mild, n=402） with AHI 〉5 and 〈15 episodes/hour; moderate sleep apnea （moderate, n=460） with AHI 〉15 and 〈30 episodes/hour and severe sleep apnea （severe, n=1178） with AHI 〉30 episodes/hour. Daytime blood pressure measurements were performed under standardized conditions in each patient at 10 a.m. in office on the day of referring to sleep centers for getting average value. All the patients were requested to quit medications related to blood pressure for three days before the day of assessing. Results Both daytime systolic blood pressure and diastolic blood pressure values were significantly related to AHI positively （r = 0.201 and 0.276, respectively; both P values 〈0.001） and to nadir nocturnal oxygen saturation negatively （r = -0.215 and -0.277, respectively; both P values 〈0.001）, which were the parameters of OSA severity. In two special designed mean plots, means of daytime systolic and diastolic blood pressure increased gradually with increasing AHI. Beyond AHI of 61-65, this increasing trend reached a plateau. Conclusions The results showed that OSA severity was associated with daytime blood pressure until AHI of 61-65, providing evidence for early OSA management, especially in OSA patients with concomitant hypertension.

Elevated nocturnal and morning blood pressure in patients with obstructive sleep apnea syndrome

Background The nocturnal nondipping and elevated morning blood pressure （BP） in patients with obstructive sleep apnea syndrome （OSAS） have not yet been well investigated in Chinese patients. This study aimed to describe the BP profile, and to elucidate the relationships between daytime BP and nighttime BP, and between evening BP and morning BP in patients with OSAS. Methods Twenty teaching hospital sleep centers in China were organized by the Chinese Medical Association to participate in this study and 2297 patients were recruited between January 2004 and April 2006. BP assessments were made at four time points （daytime, evening, nighttime and morning） and polysomnography （PSG） was performed and subjects were classified into four groups by their apnea-hypopnea index （AHI）： control, n=213 with AHI 〈5; mild, n=420 with AHI -〉5 and 〈15; moderate, n=460 with AHI -〉15 and 〈30; and severe, n=1204 with AHI -〉30. SPSS 11.5 software package was used for statistical analysis and figure drawing. Results All the average daytime, nighttime, evening and morning BPs were positively correlated with AHI and negatively correlated with nadir nocturnal oxygen saturation. The ratios of nighttime/daytime and morning/evening average BP were positively correlated with AHI. The ratio of nighttime/daytime systolic BP became a ＂reversed BP dipping＂ pattern until the classification reached severe, while the ratio of nighttime/daytime diastolic BP became reversed at moderate. Similarly, the ratio of morning/evening diastolic BP becomes reversed even at mild. Conclusions OSAS may result in higher BP levels at all four time points. The ratios of nighttime/daytime and morning/evening BP increase with increased AHI. The increasing of diastolic BP, which is inclined to rise more quickly, is not parallel with increasing systolic BP.

Chronic obstructive pulmonary disease assessment test score correlated with dyspnea score in a large sample of Chinese patients

Background The chronic obstructive pulmonary disease assessment test （CAT） is an easy to use health-related quality of life questionnaire, the modified Medical Research Council （mMRC） dyspnea scale is a classic dyspnea scale which is widely used, while the correlation between them is still not clear. This study investigated the use of the Chinese translation of CAT in chronic obstructive pulmonary disease patients and its correlation with the mMRC dyspnea scale. Methods The multicenter cross-sectional study was conducted in 329 hospitals throughout China from March 1 to April 30, 2010. Chronic obstructive pulmonary disease patients completed both the assessment test and the dyspnea scale during a single study visit. Results Six thousand, four hundred and thirty-seven patients were evaluated; 74.9% were male and the mean age was （64.9±10.0） years. Median test scores in dyspnea grades 0 to 4 were 14, 16, 22, 26 and 32, respectively; these differences were statistically significant. The CAT score was moderately correlated with mMRC dyspnea grade （r=0.579, P 〈0.001）. There was no significant difference in mean CAT score between males and females, and patients of high and low socioeconomic status. Primary analysis suggested that CAT scores were higher in older patients （〉65 years） than in younger patients （〈65 years） and increased with duration of formal education, but these findings were repudiated by further analysis of subgroups according to mMRC dyspnea grade. Conclusions There was no obvious confounding factor influencing use of the CAT in Chinese patients. CAT scores were moderately correlated with the mMRC dyspnea scale.

Effect of smoking cessation on airway inflammation of rats with chronic bronchitis

Background Smoking is the major cause of airway inflammation in chronic obstructive pulmonary disease （COPD）, and smoking cessation is regarded as one of the important strategies for prevention and treatment of the inflammation. The inflammation of the chronic airway may be present and deteriorated even if the COPD patients stop smoking. Whether and how early smoking cessation affects the progress of inflammation is still obscure. This study was conducted to find the appropriate time for smoking cessation to terminate the airway inflammation in rats with smoke-induced chronic bronchitis. Methods A rat model of COPD was established by passively inhaling smoke mixture. Fifty-four young male Sprague-Dawley rats were randomly divided into 9 groups with different periods of smoke exposure and different time points of cessation. The inflammation markers to be detected included inflammatory cells in the bronchoalveolar lavage fluid （BALF）, the myeloperoxidose （MPO） activity, the morphologic changes and the expression of ICAM-1 on the airway epithelium. Results When smoking was terminated at early stage, the inflammatory markers and related indexes were different from those of the typical chronic bronchitis group （group M7） （P〈0.01）. The pathologic score of group SC7 （2 weeks of smoking cessation after occurrence of typical chronic bronchitis ） was not different from that of group M7, and the level of ICAM-1 was still up-regulated （compared to group M7, P〉0.05）. Meanwhile, most of inflammatory cells in BALF were neutrophils compared to other groups （P〈0.01）.When smoking was terminated, the MPO activity was significantly lower than that of group M7 （P〈0.01）. Conclusions Smoking cessation at early stage can effectively inhibit the inflammatory reaction of COPD. Once chronic bronchitis occurs, little could be improved by smoking cessation.