AIM： To investigate the incidence of various types of postoperative pulmonary complications （POPCs） and to evaluate the significance of perioperative arterial blood gases in patients with esophageal cancer accompan...AIM： To investigate the incidence of various types of postoperative pulmonary complications （POPCs） and to evaluate the significance of perioperative arterial blood gases in patients with esophageal cancer accompanied with chronic obstructive pulmonary disease （COPD） after esophagectomy. MEHTODS： Three hundred and fifty-eight patients were divided into POPC group and COPD group. We performed a retrospective review of the 358 consecutive patients after esophagectomy for esophageal cancer with or without COPD to assess the possible influence of COPD on postoperative pulmonary complications. We classified COPD into four grades according to percent-predicted forced expiratory volume in 1 s （FEV1） and analyzed the incidence rate of complications among the four grades. Perioperative arterial blood gases were tested in patients with or without pulmonary complications in COPD group and compared with POP（： group. RESULTS： Patients with COPD （29/86, 33.7%）had more pulmonary complications than those without COPD （36/272, 13.2%） （P〈0.001）. Pneumonia （15/29, 51.7%）, atelectasis （13/29, 44.8%）, prolonged 02 supplement （10/29, 34.5%）, and prolonged mechanical ventilation （8/29, 27.6%） were the major complications in COPD group. Moreover, patients with severe COPD （grade Ⅱ B, FEV1 〈 50% of predicted） had more POPCs than those with moderate（gradeⅡA,50%-80% of predicted） and mild （grade Ⅰ≥80% of predicted） COPD （P〈0.05）. PaO2 was decreased and PaCO2 was increased in patients with pulmonary complications in COPD group in the first postoperative week.CONCLUSION： The criteria of COPD are the critical predictor for pulmonary complications in esophageal cancer patients undergoing esophagectomy. Severity of COPD affects the incidence rate of the pulmonary complication,and percent-predicted FEV1 is a good predictive variable for pulmonary complication in patients-with COPD.Arterial blood gases are helpful in directing perioperative management.展开更多
A 79-year-old man presented with progressive dyspnea, gradually worsening over a period of several weeks. His past medical history included hypertension, chronic hepatitis C without cirrhosis, ischemic stroke occurred...A 79-year-old man presented with progressive dyspnea, gradually worsening over a period of several weeks. His past medical history included hypertension, chronic hepatitis C without cirrhosis, ischemic stroke occurred at the age of 68 and chronic obstructive pulmonary disease （COPD） caused by long-term cigarette smoking. The patient was alert and oriented and not in acute distress. The physical examination of the chest revealed decreased breath sounds at the bases of the lungs, without crackles or wheezes. Heart sounds were regular without murmurs. The respiration rate was normal.展开更多
According to the latest World Health Organization report 64 million people suffer from Chronic Obstructive Pulmonary Disease （COPD）, 3 million people died from COPD and it is predicted that COPD will become the thir...According to the latest World Health Organization report 64 million people suffer from Chronic Obstructive Pulmonary Disease （COPD）, 3 million people died from COPD and it is predicted that COPD will become the third leading cause of death worldwide by 2030. The alpha-1 antitrypsin deficiency is a rarely diagnosed hereditary disease caused by a genetic mutation and it is one of the most prevalent genetic disorders primarily affecting the lungs, especially in the form of COPD or emphysema, but in some cases also the liver or skin. The Global Initiative for Chronic Obstructive Lung Disease recommends all patients with COPD at a young age or significant family history to be examined for alpha-1 antitrypsin deficiency. This article presents the case of a 42 year old, female patient, Portuguese, with history of Chronic Obstructive Pulmonary Disease, 40 pack units/year smoker, with unknown family history, coming to her family doctor with breath shortness, especially during physical activities, with unsatisfying response to pharmacological prescribed therapy. Physical examination was normal. Alpha- 1 antitrypsin deficiency was confirmed by blood testing. All patient＇s first degree relatives were investigated showing low alpha-1 antitrypsin blood concentrations thus genetic tests were later performed. This case reinforces the need for primary care physicians to be aware of alphal-antitrypsin deficit as an underdiagnosed clinical entity.展开更多
OBJECTIVE:To explore correlations between the symptoms of constipation and abdominal distention and severity of chronic obstructive pulmonary disease(COPD)in patients with stable disease.METHODS:We studied 191 patient...OBJECTIVE:To explore correlations between the symptoms of constipation and abdominal distention and severity of chronic obstructive pulmonary disease(COPD)in patients with stable disease.METHODS:We studied 191 patients with stable COPD(according to defined criteria)in this cross-sectional study from four three-level class A Chinese medicine hospitals in China.We built an Epidata 3.0 database and performed statistical analysis with SPSS,version 17.0.We analyzed correlations between the frequency of lower gastrointestinal tract symptoms(constipation and abdominal distention)and scores for major pulmonary symptoms(cough,sputum and wheezing)based on the St.George's Respiratory Questionnaire(SGRQ),6-minute walking distance(6MWD)and frequency of acute exacerbations of COPD(AECOPD).RESULTS:In addition to their pulmonary symptoms,39.79%and 40.31%of study patients withstable COPD reported constipation and abdominal distention,respectively.Scores for major pulmonary symptoms(cough,sputum and wheezing),AECOPD and SGRQ values in patients with constipation and abdominal distention were significantly greater,and the 6MWD markedly shorter,than in those without them.According to Pearson's correlation analysis,there were strong correlations between these lower gastrointestinal tract symptoms and scores for pulmonary symptoms,SGRQ,6MWD and AECOPD.CONCLUSION:Lower gastrointestinal tract symptoms such as constipation and abdominal distention can adversely affect pulmonary symptoms,frequency of acute exacerbations and quality of life in patients with stable COPD.展开更多
OBJECTIVE:To evaluate the efficacy and long-term effects of the three therapies for regulating and reinforcing lung and kidney(reinforcing lung and invigorating spleen,reinforcing lung and replenishing kidney,and supp...OBJECTIVE:To evaluate the efficacy and long-term effects of the three therapies for regulating and reinforcing lung and kidney(reinforcing lung and invigorating spleen,reinforcing lung and replenishing kidney,and supplementing Qi and nourishing kidney) in Traditional Chinese Medicine(TCM) on osteoporosis in rats with chronic obstructive pulmonary disease.METHODS:Totally 120 rats were randomly divided into control,model,Bufeijianpi,Bufeiyishen,Yiqizishen,aminophyline groups.Repeated smoke inhalations and bacterial infections were used to duplicate the stable Chronic obstructive pulmonary disease rat model.Normal saline was given to the air control and model groups,while Bufeijianpi granule,Bufeiyishen granule,and Yiqizishen granule,and aminophylline were administrated to rats in the Bufeijianpi,Bufeiyishen,Yiqizishen,and aminophylline groups respectively from weeks 9 through 20.Another 12 weeks without medicines to observe the long-term effect.Rats were sacrificed at week 20 and week 32.Bone mass density(BMD),bone mineral content(BMC),morphology of the femoral head,lung function,and levels of serum interleukin(IL)-1β,IL-6,and tumor necrosis factor-a were detected.RESULTS:At weeks 20 and 32,tidal volume,peak expiratory flow and expiratory flow at 50% tidal volume in the three TCM-treated groups were higher than those in the model group(P < 0.05).Femur weight,BMD,and BMC were significantly higher in the three TCM-treated groups and the aminophylline-treated group compared with the model group(P < 0.01),except for BMC in the Yiqizishen-treated group at week 20.CONCLUSION:Bufeijianpi,Bufeiyishen,and Yiqizishen granules show good effects in the prevention and treatment of osteoporosis,which can alleviate airflow limitations and inflammation,improve BMD and BMC of the femur,and have favorable long-term effects.展开更多
文摘AIM： To investigate the incidence of various types of postoperative pulmonary complications （POPCs） and to evaluate the significance of perioperative arterial blood gases in patients with esophageal cancer accompanied with chronic obstructive pulmonary disease （COPD） after esophagectomy. MEHTODS： Three hundred and fifty-eight patients were divided into POPC group and COPD group. We performed a retrospective review of the 358 consecutive patients after esophagectomy for esophageal cancer with or without COPD to assess the possible influence of COPD on postoperative pulmonary complications. We classified COPD into four grades according to percent-predicted forced expiratory volume in 1 s （FEV1） and analyzed the incidence rate of complications among the four grades. Perioperative arterial blood gases were tested in patients with or without pulmonary complications in COPD group and compared with POP（： group. RESULTS： Patients with COPD （29/86, 33.7%）had more pulmonary complications than those without COPD （36/272, 13.2%） （P〈0.001）. Pneumonia （15/29, 51.7%）, atelectasis （13/29, 44.8%）, prolonged 02 supplement （10/29, 34.5%）, and prolonged mechanical ventilation （8/29, 27.6%） were the major complications in COPD group. Moreover, patients with severe COPD （grade Ⅱ B, FEV1 〈 50% of predicted） had more POPCs than those with moderate（gradeⅡA,50%-80% of predicted） and mild （grade Ⅰ≥80% of predicted） COPD （P〈0.05）. PaO2 was decreased and PaCO2 was increased in patients with pulmonary complications in COPD group in the first postoperative week.CONCLUSION： The criteria of COPD are the critical predictor for pulmonary complications in esophageal cancer patients undergoing esophagectomy. Severity of COPD affects the incidence rate of the pulmonary complication,and percent-predicted FEV1 is a good predictive variable for pulmonary complication in patients-with COPD.Arterial blood gases are helpful in directing perioperative management.
文摘A 79-year-old man presented with progressive dyspnea, gradually worsening over a period of several weeks. His past medical history included hypertension, chronic hepatitis C without cirrhosis, ischemic stroke occurred at the age of 68 and chronic obstructive pulmonary disease （COPD） caused by long-term cigarette smoking. The patient was alert and oriented and not in acute distress. The physical examination of the chest revealed decreased breath sounds at the bases of the lungs, without crackles or wheezes. Heart sounds were regular without murmurs. The respiration rate was normal.
文摘According to the latest World Health Organization report 64 million people suffer from Chronic Obstructive Pulmonary Disease （COPD）, 3 million people died from COPD and it is predicted that COPD will become the third leading cause of death worldwide by 2030. The alpha-1 antitrypsin deficiency is a rarely diagnosed hereditary disease caused by a genetic mutation and it is one of the most prevalent genetic disorders primarily affecting the lungs, especially in the form of COPD or emphysema, but in some cases also the liver or skin. The Global Initiative for Chronic Obstructive Lung Disease recommends all patients with COPD at a young age or significant family history to be examined for alpha-1 antitrypsin deficiency. This article presents the case of a 42 year old, female patient, Portuguese, with history of Chronic Obstructive Pulmonary Disease, 40 pack units/year smoker, with unknown family history, coming to her family doctor with breath shortness, especially during physical activities, with unsatisfying response to pharmacological prescribed therapy. Physical examination was normal. Alpha- 1 antitrypsin deficiency was confirmed by blood testing. All patient＇s first degree relatives were investigated showing low alpha-1 antitrypsin blood concentrations thus genetic tests were later performed. This case reinforces the need for primary care physicians to be aware of alphal-antitrypsin deficit as an underdiagnosed clinical entity.
基金Supported by China National Key Basic Research Plan,(No.2009CB522704)
文摘OBJECTIVE:To explore correlations between the symptoms of constipation and abdominal distention and severity of chronic obstructive pulmonary disease(COPD)in patients with stable disease.METHODS:We studied 191 patients with stable COPD(according to defined criteria)in this cross-sectional study from four three-level class A Chinese medicine hospitals in China.We built an Epidata 3.0 database and performed statistical analysis with SPSS,version 17.0.We analyzed correlations between the frequency of lower gastrointestinal tract symptoms(constipation and abdominal distention)and scores for major pulmonary symptoms(cough,sputum and wheezing)based on the St.George's Respiratory Questionnaire(SGRQ),6-minute walking distance(6MWD)and frequency of acute exacerbations of COPD(AECOPD).RESULTS:In addition to their pulmonary symptoms,39.79%and 40.31%of study patients withstable COPD reported constipation and abdominal distention,respectively.Scores for major pulmonary symptoms(cough,sputum and wheezing),AECOPD and SGRQ values in patients with constipation and abdominal distention were significantly greater,and the 6MWD markedly shorter,than in those without them.According to Pearson's correlation analysis,there were strong correlations between these lower gastrointestinal tract symptoms and scores for pulmonary symptoms,SGRQ,6MWD and AECOPD.CONCLUSION:Lower gastrointestinal tract symptoms such as constipation and abdominal distention can adversely affect pulmonary symptoms,frequency of acute exacerbations and quality of life in patients with stable COPD.
基金Supported by National Natural Science Fund of China(Influence and Long-Term Effects of Three Tiao-Bu Fei-Shen Therapies in Rats with Chronic Obstructive Pulmonary Disease on Regulation of Multidimensional Molecular Network,No.81130062)
文摘OBJECTIVE:To evaluate the efficacy and long-term effects of the three therapies for regulating and reinforcing lung and kidney(reinforcing lung and invigorating spleen,reinforcing lung and replenishing kidney,and supplementing Qi and nourishing kidney) in Traditional Chinese Medicine(TCM) on osteoporosis in rats with chronic obstructive pulmonary disease.METHODS:Totally 120 rats were randomly divided into control,model,Bufeijianpi,Bufeiyishen,Yiqizishen,aminophyline groups.Repeated smoke inhalations and bacterial infections were used to duplicate the stable Chronic obstructive pulmonary disease rat model.Normal saline was given to the air control and model groups,while Bufeijianpi granule,Bufeiyishen granule,and Yiqizishen granule,and aminophylline were administrated to rats in the Bufeijianpi,Bufeiyishen,Yiqizishen,and aminophylline groups respectively from weeks 9 through 20.Another 12 weeks without medicines to observe the long-term effect.Rats were sacrificed at week 20 and week 32.Bone mass density(BMD),bone mineral content(BMC),morphology of the femoral head,lung function,and levels of serum interleukin(IL)-1β,IL-6,and tumor necrosis factor-a were detected.RESULTS:At weeks 20 and 32,tidal volume,peak expiratory flow and expiratory flow at 50% tidal volume in the three TCM-treated groups were higher than those in the model group(P < 0.05).Femur weight,BMD,and BMC were significantly higher in the three TCM-treated groups and the aminophylline-treated group compared with the model group(P < 0.01),except for BMC in the Yiqizishen-treated group at week 20.CONCLUSION:Bufeijianpi,Bufeiyishen,and Yiqizishen granules show good effects in the prevention and treatment of osteoporosis,which can alleviate airflow limitations and inflammation,improve BMD and BMC of the femur,and have favorable long-term effects.
