Information-motivation-behavioral guided nursing for stroke patients with pulmonary dysfunction:A randomized controlled trial

BACKGROUND Patients with stroke frequently experience pulmonary dysfunction.AIM To explore the effects of information-motivation-behavioral(IMB)skills modelbased nursing care on pulmonary function,blood gas indices,complication rates,and quality of life(QoL)in stroke patients with pulmonary dysfunction.METHODS We conducted a controlled study involving 120 stroke patients with pulmonary dysfunction.The control group received routine care,whereas the intervention group received IMB-model-based nursing care.Various parameters including pulmonary function,blood gas indices,complication rates,and QoL were assessed before and after the intervention.RESULTS Baseline data of the control and intervention groups were comparable.Post-intervention,the IMB model-based care group showed significant improvements in pulmonary function indicators,forced expiratory volume in 1 sec,forced vital capacity,and peak expiratory flow compared with the control group.Blood gas indices,such as arterial oxygen pressure and arterial oxygen saturation,increased significantly,and arterial carbon dioxide partial.pressure decreased significantly in the IMB model-based care group compared with the control group.The intervention group also had a lower complication rate(6.67%vs 23.33%)and higher QoL scores across all domains than the control group.CONCLUSION IMB model-based nursing care significantly enhanced pulmonary function,improved blood gas indices,reduced complication rates,and improved the QoL of stroke patients with pulmonary dysfunction.Further research is needed to validate these results and to assess the long-term efficacy and broader applicability of the model.

Using quantitative CT to predict postoperative pulmonary function in patients with lung cancer

Background At present, the therapy for patients with lung cancer that achieves a high rate of cure is surgical resection at an early stage of the disease. The aim of this study is to evaluate quantitative computed tomography (QCT) for predicting postoperative pulmonary function in patients with lung cancer. Methods The data of thirty-one patients with lung cancer who underwent both pulmonary functional tests and QCT scan before operations were collected. A CT program was used to quantify the volume of whole lung parenchyma with attenuation of -910 HU to -600 HU, which was defined as total functional lung volume (TFLV). Similarly, the volume of lung (lobes or segments) with attenuation of -910 HU to -600 HU was defined as regional functional lung volume (RFLV). Forced vital capacity (FVC), forced expiratory volume in first second (FEV_1), FVC% and FEV_1% (ratio to reference values of the matched population) were obtained from preoperational pulmonary functional tests. According to the formula: predicted FVC (pre-FVC)=preoperative FVC×[1-(RFLV/TFLV)]; predicted FEV_1 (pre-FEV_1)=preoperative FEV_1×[1-(RFLV/TFLV)], we obtained values of predicted FVC, predicted FEV_1, predicted FVC% (pre-FVC/reference values of the matched population), and predicted FEV_1% (pre-FEV_1/reference values of the matched population). The paired t test and Pearson correlation test were used to assess significance of differences and correlations between CT predicted values and postoperative measured results of FVC, FEV_1, FVC% and FEV_1%. Results QCT predicted values correlated well with postoperative FVC, FEV_1, FVC% and FEV_1% ( r =0.873, 0.809, 0.849 and 0.801 respectively, all P <0.01).Conclusions QCT is an effective and accurate way to predict postoperative pulmonary function in patients undergoing pulmonary resection, regardless of the patients’ preoperative pulmonary functional status.

Epidemiologic evidence linking oxidative stress and pulmonary function in healthy populations

Respiratory health in the general population declines regardless of the presence of pulmonary diseases.Oxidative stress has been implicated as one of the mechanisms involved in respiratory dysfunction.This review was to evaluate studies that relate oxidative stress factors with pulmonary function among the general population without prior respiratory illnesses.The search yielded 54 citations.Twenty-one studies qualified for incorporation in this review.Owing to the heterogeneity of the review,studies were discussed based on identified oxidative stress factors responsible for pulmonary dysfunction.Oxidative stress biomarkers,including gene polymorphisms of nuclear factor erythroid 2-related factor 2,heme oxygenase 1,glutathione S transferase,superoxide dismutase,and lipid peroxidation products were involved in lung function decline.In addition,the antioxidant status of individuals in reference to dietary antioxidant intake and exposure to environmental pollutants affected oxidative stress and pulmonary function,as indicated by forced expired volume in one second,forced vital capacity,and forced expiratory flow at 25%-75%.This review indicated that oxidative stress is implicated in the gradual decline of lung function among the general population,and gene polymorphism along the antioxidant defense line and/or their interaction with air pollutants reduce lung function.Different polymorphic forms among individuals explain why the rate of lung function decline differs among people.Dietary antioxidants have respiratory health benefits in antioxidant gene polymorphic forms.Therefore,the genetic composition of an individual may be considered for monitoring and identifying people at risk of respiratory illnesses.

Efficacy of Yiqigubiao pill on chronic obstructive pulmonary disease in rats with the disease induced by lipopolysaccharide and cigarette-smoke fumigation

OBJECTIVE:To investigate the efficacy of Yiqigubiao pill(YQGB)on chronic obstructive pulmonary disease(COPD)in rats with the COPD induced by lipopolysaccharide(LPS)and cigarettesmoke fumigation.METHODS:In this study,six groups of rats were set up,including control group,model group,positive control group(aminophylline)and YQGB(high,medium and low doses)groups.Tracheal injection of lipopolysaccharide(LPS)and cigarette-smoke fumigation induced COPD in rats.The general condition,incubation period and coughing times,lung function,level of inflammatory factors,leukocyte condition and pathological changes of bronchus and lung tissue were observed in rats of each group.RESULTS:In the COPD rats,the latent period of coughing was shortened and the cough frequency was increased significantly;the pulmonary function was significantly decreased,which was manifested by the increased lung tissue resistance and respiratory system resistance,and the decreasing percentage of forced expiratory volume and forced expiratory volume in the 0.3 s(FEV0.3/FVC);the contents of tumor necrosis factor-alpha(TNF-α)and interleukin-4 in serum were obviously increased,and the NEUT%in bronchoalveolar lavage fluid was significantly increase.YQGB could obviously prolong the latent period of cough,and reduce the cough frequency and the content of TNF-αin serum.YQGB can also significantly reduce respiratory resistance and increase FEV0.3/FVC value.The results of histopathology showed that YQGB significantly reduced the pathological changes of tracheal mucosa and lung caused by COPD.YQGB obviously increased level of AQP1,which was down-regulated in the COPD rats.CONCLUSION:YQGB could significantly improve the pulmonary function,reduce inflammation and alleviate lung and bronchial diseases in the COPD rats.

Spirometric Reference Equations for Elderly Chinese in Jinan Aged 60-84 Years

Background：The interpretation of spirometry varies on different reference values.Older people are usually underrepresented in published predictive values.This study aimed at developing spirometric reference equations for elderly Chinese in Jinan aged 60-84 years and to compare them to previous equations.Methods：The project covered all of Jinan city,and the recruitment period lasted 9 months from January 1,2017 to September 30,2017,434 healthy people aged 60-84 years who had never smoked （226 females and 208 males） were recruited to undergo spirometry.Vital capacity （VC）,forced VC （FVC）,forced expiratory volume in 1 s （FEV1）,FEV1/FVC,FEV1/VC,FEV6,peak expiratory flow,and forced expiratory flow at 25%,50%,75%,and 25-75% of FVC exhaled （FEF25%,FEF50%,FEF75%,and FEF25-75%） were analyzed.Reference equations for mean and the lower limit of normal （LLN） were derived using the lambda-mu-sigma method.Comparisons between new and previous equations were performed by paired t-test.Results：New reference equations were developed from the sample.The LLN of FEV1/FVC,FEF25-75% computed using the 2012-Global Lung Function Initiative （GLI） and 2006-Hong Kong equations were both lower than the new equations.The biggest degree of difference for FEV1/FVC was 19% （70.46% vs.59.29%,t =33.954,P 〈 0.01） and for maximal midexpiratory flow （MMEF,equals to FEF25-75%） was 22% （0.82 vs.0.67,t =21.303,P 〈 0.01）.The 1990-North China and 2009-North China equations predicted higher mean values of FEV1/FVC and FEF25-75% than the present model.The biggest degrees of difference were-4% （78.31% vs.81.27%,t =-85.359,P 〈 0.01）and-60% （2.11 vs.4.68,t =-170.287,P 〈 0.01）,respectively.Conclusions：The newly developed spirometric reference equations are applicable to elderly Chinese in Jinan.The 2012-GLI and 2006-Hong Kong equations may lead to missed diagnoses of obstructive ventilatory defects and the small airway dysfunction,while traditional linear equations for all ages may lead to overdiagnosis.