Normal reference value of forced vital capacity of Chinese younger women and geographical factors

Objective To supply a scientific basis for standardizing the normal reference value of forced vital capacity(FVC)of Chinese younger women.Methods We studied the relationship between the normal reference value of 21767 samples of FVC of younger women and eight geographical factors in 157 areas in China.Results It was found that the correlation between geographical factors and the normal reference value of FVC of younger women was quite significant(F=5.884,P=0.000).By adopting the method of mathematical regression analysis,one regression equation was inferred:=3.146+0.00006919X1+0.01315X4-0.006966X6+0.09524X8±0.254.In the above equation,is the normal reference value of younger women’ FVC(L);X1 is the altitude(m);X4 is the annual mean air temperature(℃);X6 is the annual mean relative humidity(%);X8 is the annual mean wind speed(m/s);0.254 is the value of the residual standard deviation.Conclusion If geographical values are obtained in a certain area,the normal reference value of FVC of younger women in this area can be obtained by using the regression equation.Furthermore,according to the geographical factors,China can be divided into eight regions:Northeast China Region,North China Region,Shanxi-Shaanxi-Inner Mongolia Region,middle and lower reaches of the Yangzte River Region,Southeast China Region,Northwest China Region,Southwest China Region,and Qinghai-Tibet Plateau Region.

Body mass index correlated with forced expiratory volume in 1 second/forced vital capacity in a population with a relatively low prevalence of obesity

Background Obesity is the most common metabolic disease in the world. However, the relationship between obesity and lung function is not fully understood. Although several longitudinal studies have shown that increases in body weight can lead to reductions in pulmonary function, whether this is the case with the Japanese population and whether high body mass index （BMI） status alone represents an appropriate predictor of obstructive lung dysfunction remains unclear.The purpose of present study was to estimate the effect of BMI on lung function measured by spirometry of Japanese patients in general clinics. We measured BMI and performed spirometry on screening patients who had consulted general clinics.Methods Subjects comprised 1231 patients ≥40 years of age （mean age （65.0±12.0） years, 525 men, 706 women） who had consulted clinics in Nagasaki Prefecture, Japan, for non-respiratory disease. BMI was calculated and lung function was measured by spirometry.Results BMI was found to be positively correlated with forced expiratory volume in 1 second （FEV1）/forced vital capacity （FVC） in men and with maximum mid-expiratory flow （MMF） in all subjects. Following adjustment for relevant factors, a significant positive correlation between BMI and FEV1/FVC was identified for all subjects. Comparison between subjects with normal BMI （18.5-25.0） and higher BMI （25.1-30.0） also demonstrated that FEV1/FVC and percentage of predicted maximum mid-expiratory flow （%MMF） were significantly higher in the latter subjects.Conclusions In a population without marked respiratory disease, higher BMI subjects showed less obstructive pulmonary dysfunction compared to normal BMI subjects. High BMI status alone may be inappropriate as a predictor of obstructive lung dysfunction, particularly in populations with a low prevalence of obesity.

Diagnostic value of elevated serum carbohydrate antigen 125 level in sarcoidosis

BACKGROUND Sarcoidosis is a multisystem disorder with unknown etiology, and it predominantly affects the lungs and intrathoracic lymph nodes. For patients with atypical clinical manifestations, the diagnosis of sarcoidosis is difficult and specific biomarkers may play an important role in assisting diagnosis. Previous research has demonstrated a correlation between sarcoidosis and increased carbohydrate antigen 125(CA125), but remains a lack of large cohort studies to validate this observation.AIM To compare serum CA125 levels in sarcoidosis patients and healthy controls, and explore whether CA125 can be used as a biomarker for the diagnosis of sarcoidosis.METHODS In this study, the serum CA125 levels were measured by enzyme-linked immunosorbent assay in 108 consecutive sarcoidosis patients between June 2016 and December 2020(31 males, 77 females;age at diagnosis 49.69 ± 9.10 years) and 112 healthy subjects. Data on the C-reactive protein, erythrocyte sedimentation rate, and angiotensin-converting enzyme were also collected. The association of serum CA125 levels with clinical, radiological, and respiratory functional characteristics was analyzed between patient groups with CA125 ≤ 35 U/mL or CA125 >35 U/mL.RESULTS We found that serum CA125 levels were higher in sarcoidosis patients compared to healthy controls(median: 44.78 vs 19.11 U/mL, P < 0.001). The area under the receiver operator characteristic was 0.9833(95%CI: 0.9717-0.9949), and the best cutoff point was 32.33 U/mL. The elevated serum CA125 was notably associated with the percentage of predicted forced vital capacity(FVC%) and neutrophil-to-lymphocyte ratio(P =0.043 and P = 0.038, respectively) in sarcoidosis patients. Multivariate analysis revealed that FVC%was a statistically notable predictor of elevated serum CA125(P = 0.029). Also, our research revealed that compared to patients with Stage I of radiology classification, patients with Stage Ⅱ and Ⅲ showed a higher concentration of serum CA125(46.16 ± 8.32 vs 41.00 ± 6.04 U/mL, P =0.005, and 47.92 ± 10.10 vs 41.00 ± 6.04 U/mL, P = 0.002, respectively).CONCLUSION Serum CA125 was highly increased in sarcoidosis patients and showed high efficiency for noninvasive diagnosis of the disease. In addition, abnormally elevated serum CA125 was correlated with pulmonary function and radiological Scadding’s classification of sarcoidosis.

Association Between Rectus Abdominis Denervation and Ventilation Dysfunction in Patients with Amyotrophic Lateral Sclerosis

Background： Spontaneous potentials in electromyography （EMG） ofparaspinal muscles are associated with diaphragm denervation and, therefore, poor respiratory timction in amyotrophic lateral sclerosis （ALS） is understandable. EMG changes in the rectus abdominis （RA） display an effect similar to those in paraspinal muscles with respect to the function of lower motor neurons in the thoracic spinal cord. The RA denervation was examined to determine its association with ventilation dysfunction in ALS. Methods： We collected the clinical data of 128 patients with sporadic ALS in Department of Neurology of Peking University Third Hospital from 2009 to 2013. EMG, Revised ALS Functional Rating Scale （ALSFRS-R） and forced vital capacity （FVC） were perIbrmed in all patients and the differences in the EMG changes in RA between those with and without FVC 〉 80% were analysed. Results： The mean FVC value was 83.4% ~ 17.1% （range： 45%-I 31%） of the predicted value. A total of 79 patients displayed FVC _〉80%, and 49 patients displayed FVC 〈80%, Compared with the patients displaying a normal FVC （60/79, 75.9%）, spontaneous activity in RA was significantly different among those patients displaying an FVC 〈80% （47/49, 95.9%）. In addition, spontaneous potentials in RA were more frequently detected in patients exhibiting dyspnea （32/33, 97.0%） than in patients without dyspnea （75/95, 78.9%）. Conclusion： Spontaneous potentials in RA are associated with ventilation dysfunction and dyspnea in ALS patients.

Fetal stem cells are effective in the treatment of Grade Ⅰ and Ⅱrespiratory failure in amyotrophic lateral sclerosis and muscular dystrophy

Objectives: To study the effect of fetal stem cell(FSC) therapy on Grade Ⅰ and Ⅱrespiratory failure in patients with amyotrophic lateral sclerosis(ALS) and muscular dystrophy(MD). Methods: A comparative study was conducted on 41 patients with Grade Ⅰ or Ⅱrespiratory failure(RF) resulting from ALS or MD. The patients were divided into 4 groups according to the underlying disease and the degree of RF. Patients underwent combined treatment, including the experimental application of FSC therapy, and were examined before FSC treatment, and 6 months and 12 months after treatment. Results: FSC treatment improved both subjective and objective breathing parameters as early as 6 months post‐treatment. A significant increase in the forced vital capacity(FVC) and forced expiratory volume in 1 second(FEV1) was reported by all patients with grade Ⅰ RF linked to ALS and MD compared to baseline. Patient respiratory improvement was maintained over the next 6 months. Grade Ⅱ RF patients with MD reported a significant improvement in FVC 12 months after treatment. Conclusions: Evidence for respiratory improvement was observed as early as 6 months in all patients after combined treatment including FSC therapy, and this was maintained for a further 6 months after therapy. In MD patients with Grade Ⅱ RF, treatment resulted in a significant FVC and FEV1 increase within 6 months and downgrading to Grade Ⅰ RF within a year after FSC treatment.