Positive health:An integrated quantitative approach in patients with chronic gastrointestinal and hepato-pancreatico-biliary disorders

BACKGROUND The concept of positive health(PH)supports an integrated approach for patients by taking into account six dimensions of health.This approach is especially relevant for patients with chronic disorders.Chronic gastrointestinal and hepatopancreatico-biliary(GI-HPB)disorders are among the top-6 of the most prevalent chronically affected organ systems.The impact of chronic GI-HPB disorders on individuals may be disproportionally high because:(1)The affected organ system frequently contributes to a malnourished state;and(2)persons with chronic GIHPB disorders are often younger than persons with chronic diseases in other organ systems.AIM To describe and quantify the dimensions of PH in patients with chronic GI-HPB disorders.METHODS Prospective,observational questionnaire study performed between 2019 and 2021 in 235 patients with a chronic GIHPB disorder attending the Outpatient Department of the Maastricht University Medical Center.Validated questionnaires and data from patient files were used to quantify the six dimensions of PH.Internal consistency was tested with McDonald’s Omega.Zero-order Pearson correlations and t-tests were used to assess associations and differences.A P value<0.05 was considered significant.RESULTS The GI-HPB patients scored significantly worse in all dimensions of PH compared to control data or norm scores from the general population.Regarding quality of life,participation and daily functioning,GI-HPB patients scored in the same range as patients with chronic disorders in other organ systems,but depressive symptoms(in 35%)and malnutrition(in 45%)were more frequent in patients with chronic GI-HPB disorders.Intercorrelation scores between the six dimensions were only very weak to weak,forcing us to quantify each domain separately.CONCLUSION All six dimensions of PH are impaired in the GI-HPB patients.Malnutrition and depressive symptoms are more prevalent compared to patients with chronic disorders in other organ systems.

The susceptibility of T5-TG12 of theCFTR gene in chronic bronchitis occurrence in a Chinese population in Jiangsu province,China

Mutations in the cystic fibrosis transmembrane conductance regulator （CFTR） gene have been implicated in the onset of cystic fibrosis and other clinical respiratory disorders. In the present study, we investigated the role of CFTR variations, poly-T, TG-repeats, and M470V in susceptibility to bronchial asthma and chronic bronchitis in a Chinese population in Jiangsu province, China. A total of 72 bronchial asthma patients, 68 chronic bronchitis pa- tients, and 117 healthy subjects were included in this study. The Tn-TGm haplotype was sequenced and the CFTR variant M470V was detected using restriction fragment length polymorphism （RFLP）. We found that the fre- quency of TS-TG12-V470 in chronic bronchitis patients was 0.07%, which was notably higher than that in healthy subjects （0.01%） and bronchial asthma patients （0.04%）. Thus, the presence of the TS-TG12 haplotype of the CFTR gene is likely to play a role in the development and progression of respiratory conditions, such as chronic bronchitis.

Ambient Temperature and Outpatient Visits for Acute Exacerbation of Chronic Bronchitis in Shanghai: A Time Series Analysis

The association between ambient temperature and acute exacerbation of chronic bronchitis （AECB） was still unknown. Therefore, we performed an epidemiological study in a large hospital of Shanghai to explore the relationship about temperature and outpatient visit for AECB. We adopted a quasi-Poisson generalized additive models and distributed lag nonlinear models to estimate the accumulative effects of temperature on AECB across multiple days. We found significant non-linear effects of cold temperature on hospital visits for AECB, and the potential effect of cold temperature might last more than 2 weeks. The relative risks of extreme cold （first percentiles of temperature throughout the study period） and cold （10th percentile of temperature） temperature over lags 0-14 d were 2.98 [95% confidence intervals （CI）： 1.77, 5.04] and 1.63 （95% Ch 1.21, 2.19）, compared with the 25th percentile of temperature. However, we found no positive association between hospital visits and hot weather. This study showed that exposure to both extreme cold and cold temperatures were associated with increased outpatient visits for AECB in a large hospital of Shanghai.

Effects of Integrated Case Payment on Medical Expenditure and Readmission of Inpatients with Chronic Obstructive Pulmonary Disease： A Nonrandomized, Comparative Study in Xi County, China

In the past few decades, Chinese government attempted to reduce the economic burden of chronic diseases and lower family financial risk of patients by establishing a nationwide coverage of Social Health Insurance system. However, the payment mode of Social Health Insurance varies across Chinese healthcare settings, and the effectiveness of each mode differs. This study aimed to evaluate the effects of integrated case payment on medical expenditure and readmission of inpatients with chronic obstructive pulmonary disease （COPD）, a complex, multicomponent, chronic condition. A nonrandomized, comparative method was used in this study. Inpatients with COPD before （n=1569） and after the integrated case payment reform （n=4764） were selected from the inpatient information database of the New Cooperative Medical Scheme Agency of Xi County. The integrated case payment comprises the case payment （including price-cap case payment and fixed-reimbursement case payment） and clinical pathway （including clinical pathway A, clinical pathway B and clinical pathway C）. Effects of integrated case payment were evaluated with indicators of per capita total medical expense and readmission within 30 days. A multivariate linear regression and a binary logistic regression were used to conduct statistical analysis. The results showed that case payment, comprising price-cap case payment （β=2382.988, P〈0.001） and fixed-reimbursement case payment β=2613.564, P〈0.001）, and clinical pathway C （β=1996.467, P〈0.001） were risk factors of per capita total medical expenses. Clinical pathway A （β=-1443.409, P〈0.001） and clinical pathway B （β=-1583.791, P〈0.001） were protective factors. The interactive effects of case payment with hospital level （β=0.710, P〈0.001） lowered the readmission rate within 30 days. Meanwhile, clinical pathways A （β=18.949, P〈0.001）, B （β=-19.752, P〈0.001） and C （β=-1.882, P〈0.1） were associated with the rate increase. The findings revealed that integrated case payment ensured the quality of care for inpatients with COPD to some extent. However, this payment mode increased the per capita total medical expense. Further, policy-makers should set reasonable reimbursement standards of case payment, unify the type of case payment, and strengthen the supervision of the reform to enhance its function on medical cost control.

Exploring the biological mechanism of qi deficiency syndrome with chronic obstructive pulmonary disease(COPD)based on integrated pharmacology

Objective:To explore the potential biological mechanism of chronic obstructive pulmonary disease(COPD)qi deficiency syndrome,we used the integrated pharmacology network computing platform and carried out experimental verification.Methods:Using an integrated pharmacology strategy to analyze the potential biological targets of COPD qi deficiency syndrome.Based on the established qi deficiency syndrome rat model of COPD,the biological targets of lung and skeletal muscle were detected by electron microscopy,adenosine triphosphate(ATP)content assays,and western blotting.Results:According to the integrated pharmacological results,it was found that the locations of cell components related to COPD qi deficiency syndrome were mainly mitochondria.Electron microscopy results using lung tissue showed that mitochondria in the lipopolysaccharide(LPS group)and pulmonary instillation of LPS combined with cigarette smoke(LPStCS group)were swollen,deformed,and fragmented,with disappearing or broken crista.Results also showed that the total content of ATP in the lung and skeletal muscle of both groups was significantly lower than that in the control group at the 12th week(P<.05).At the 12th week,the expression of dynamin-related protein 1(DRP1)and mitofusin 1(MFN1)protein was significantly difference than that of the control group(P<.05).At the 10th and 14th weeks,changes in fission and fusion proteins in mitochondria of the lung and skeletal muscle were further detected.There was also a significant difference in the expression between the two groups compared to that in the control group at the 10th week and 14th week(P<.05).Conclusion:These findings suggest that the changes in mitochondrial morphology and ATP content and the unbalanced expression of DRP1 and MFN1 might be the key mechanisms underlying qi deficiency syndrome in rats with COPD.

Prevalence of Self-Reported Respiratory Symptoms, Asthma and Chronic Bronchitis in Slum Area of a Rapidly Developing Indian City

Background: Poverty is an important surrogate marker for obstructive airway diseases (OAD). Slum constitutes a habitat wherein various poverty related parameters are perpetually prevalent in the ambience. 1/6th of world population lives in slums yet there is no information regarding their health status in context to asthma and COPD. Aims: We investigated the prevalence of asthma and chronic-bronchitis symptoms and associated risk-factors in slum habitats of Pune city. Methodology: 7062 adult slum-dwellers living in 12 slums of Pune city were cross-sectionally interviewed by local healthcare workers with respiratory health questionnaire which was designed using respiratory symptoms of validated European Community Respiratory Health Survey (ECRHS II) questionnaire and International Union against Tuberculosis and Lung Disease (IUATLD) bronchial symptoms questionnaire. Results: The overall prevalence of selfreported asthma symptoms was 10% (18 - 40 years: 6.5%;>40 years: 13.5%). The overall prevalence of chronic bronchitis was 8.5% [18 - 40 years: 7% (males: 7%, females: 7%);>40 years: 10% (males: 10%, females: 10%)]. Increasing age (p = 0.00), female gender (p = 0.001), unemployment (0.00) current smoking (p = 0.00) and ex-smoking (p = 0.004) emerged as significant risk factor for asthma. While, ex-smoking (p = 0.004) and low-education status (p = 0.00) emerged as significant risk factors for chronic bronchitis. Conclusion: In slums reporting of asthma and chronic-bronchitis symptoms was much higher than what has been reported earlier from India. Asthma was commonly seen in females, old age, unemployed and ever-smokers. While chronic bronchitis was commonly seen in ex-smokers and illiterate subjects. Chronic bronchitis was equally distributed amongst male and females, despite 0% prevalence of smoking in females.

TREATMENT OF CHRONIC BRONCHITIS AND BRONCHIAL ASTHMA WITH MOXIBUSTION IN DOG DAYS

Moxibustion in dog days" is a unique therapy for chronic bronchitis and bronchial asthma by means of drug-seperated moxibustion. In the present paper, therapeutic methods, and clinical short-and long-term therapeutic effects of "moxibustion in dog days" are introduced and it is indicated that "moxibustion in dog days" has very good the short-and long-term therapeutic effects, with the long-term therapeutic effect better than the short-term one, for chronic bronchitis and bronchial asthma. Also, the concrete methods for increase of the short-term therapeutic effect are put forward.

Whether chronic bronchitis is an independent risk factor for cerebral infarction in the elderly 1:1 case paired study

BACKGROUND： The inflammatory reaction already becomes an important risk factor of causing acute cerebral infarction; however, the correlation between chronic bronchitis and senile cerebral infarction is still unclear. OBJECTIVE： To study whether the chronic bronchitis is the risk factor for senile cerebral infarction. DESIGN： 1 ： 1 pair, case contrast, and risk factor study. SETTINGS： Department of Respiratory Medicine, Third Hospital of Tangshan; Department of Neurology, Affiliated Hospital of North China Coal Medical College. PARTICIPANTS： A total of 147 patients with acute cerebral infarction who were regarded as case group were selected from Department of Neurology, the Third Hospital of Tangshan from January 2004 to December 2006. All patients met the diagnostic criteria of the Fourth National Cerebrovascular Diseases Meeting. There were 87 males and 60 females, and their ages ranged from 65 to 83 years. Based on 1 ： 1 pair study, another 147 subjects without cerebrovascular disease were regarded as control group. Except the diseases about infection, there were 73 males and 74 females, and their ages ranged from 62 to 81 years. All subjects provided the confirm consent and agreed with the coordinate experiment. METHODS： ①Questionnaire of risk factor of cerebral infarction was designed to measure the following items： chronic bronchitis, hypertension, diabetes mellitus, hyperlipemia, coronary heart disease, primary cerebral infarction/transient ischemic attack and history of smoking. ②Cerebral infarction was regarded as the dependent variance, while chronic bronchitis, hypertension, diabetes mellitus, hypedipemia, primary cerebral infarction/transient ischemic attack, coronary heart disease and smoking were regarded as the independent variance for multiple regression analysis, MAIN OUTCOME MEASURES： Risk factors of senile cerebral infarction. RESULTS： All 147 patients with acute cerebral infarction and 147 subjects without cerebrovascular diseases were involved in the final analysis. ①Risk factor analysis of senile cerebral infarction： There were no significant differences in age, hyperlipemia and history of smoking between the two groups （P 〉 0.05）. But, chronic bronchitis, diabetes mellitus, hypertension, cerebral infarction/transient ischemic attack and history of coronary heart disease were higher in the case group than those in the control group （33.6% vs. 19.0%, 38.8% vs. 23.3%, 54.3% vs. 36.2%, 29.3% vs. 17.2%, 44.0% vs. 29.3%, P 〈 0.05- 0.01）. ②Multiple Logistic regression analysis of risk factor of senile cerebral infarction Hyperlipemia, smoking and coronary heart disease were not correlated with cerebral infarction （P 〉0.05）, but chronic bronchitis, hypertension, diabetes mellitus and cerebral infarction/transient ischemic attack were risk factors for senile cerebral infarction （OR =2.47, 2.28, 2.18, 2.01, P 〈 0.05 - 0.01）. CONCLUSION： The chronic bronchitis mac become an independent risk factor senile cerebral infarction.

Psychiatric Sequelae of Chronic Pruritic Dermatoses

This comprehensive review investigates the significant psychological impact and profound psychological comorbidities found in individuals suffering from chronic pruritic dermatoses, including atopic dermatitis, chronic urticaria, and prurigo nodularis. Highlighting the complex, reciprocal relationship between pruritus and psychiatric conditions such as depression, anxiety, and sleep disturbances, this paper elucidates the comprehensive impact of dermatological disorders on the skin in addition to the far-reaching effects on an individual’s psychological well-being. By evaluating the efficacy of integrated psychodermatological interventions, including cognitive behavioral therapy, mindfulness practices, pharmacological treatments, and innovative telepsychiatry and digital health solutions, this review aims to lay the foundation for a more holistic approach to treatment of concurrent dermatological and psychiatric conditions. Future research endeavors should delve deeper into the mechanistic foundation of the pruritus-psychiatry interface, the refinement of tailored treatment strategies, and the evaluation of long-term patient outcomes. In doing so, this review seeks to contribute to the optimization of patient care and well-being, underscoring the pivotal role of addressing both dermatological and psychological needs in achieving comprehensive health outcomes.

Emphysema versus Chronic Bronchitis in COPD: Clinical and Radiologic Characteristics

Background and Objectives: In clinical practice, spirometry plays a key role in the diagnosis of chronic obstructive pulmonary disease (COPD), however, it provides no information about structural pulmonary abnormality. The aim of this study was to evaluate whether there is a relation between the clinical criteria and chest radiography or CT studies in differentiating chronic bronchitis from emphysema in COPD. Patients and methods: In a prospective study, data analysis on 165 COPD subjects who were enrolled between September, 2011 and December 2012 was completed. Data were collected including clinical characteristics of stable COPD, pulmonary function tests, chest X-ray and multidetector computerized tomography (MDCT) findings. Results: Emphysema was diagnosed in 90 (55%) of 165 CT scans. The median emphysema score was 58 (range 48 - 72) and significantly correlated with lower FEV1 values (r = 0.542, p = 0.003). In chronic bronchitis, bronchial wall thickening was diagnosed approximately as often in chest radiography (56%) as in CT (64%) as a major finding. Body mass index (BMI), forced expiratory volume in the first second (FEV1), and diffusion capacity of the lung for carbon monoxide (DL,CO) were significantly lower, whereas total lung capacity (TLC) was higher in patients with emphysema. Cardiovascular diseases and obstructive sleep apnea syndrome (OSAS) were more common in chronic bronchitis group. Conclusions: Chest radiography is a valuable, inexpensive means of diagnosing emphysema or bronchial wall thickening in chronic bronchitis. Emphysematous patients show a worse pulmonary function and a greater dyspnea. Greater comorbidity in chronic bronchitis may require specific treatment strategies in this subgroup.

Systematic review of Shufeng Jiedu capsules for acute attack of chronic bronchitis

Objective:To systematically evaluate the efficacy and safety of Shufeng Jiedu Capsules in the treatment of acute attacks of chronic bronchitis.Methods:CNKI,VIP,CBM,WanFang,PubMed,EMbase,Cochrane Library and ChiCTR were searched by computer,and randomized controlled trials of Shufeng Jiedu capsules in the treatment of AECB were integrated.The retrieval time was from the date of establishing the database to December 31,2020.Meta-analysis of outcome indicators[including effective rate,C-reactive protein(CRP),lung function[FEV1%and/or FEV1/FVC],interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)]were carried out by RevMan 5.3 software,and the effective rate was tested by sequential analysis(TSA),and the quality of evidence was evaluated according to GRADE standards.Results:A total of 680 cases in 8 articles were included.Shufeng Jiedu Capsules improved the effective rate of clinicaltreatment[RR=1.20,95%CI(1.13,1.28)],improved lung function[FEV1:MD=0.33,95%CI(0.22,0.45),FEV1/FVC:MD=10.17,95%CI(8.15,12.19)],reduced CRP[MD=-7.32,95%CI(-8.42,-6.22)],IL-8[MD=-63.39,95%CI(-73.49,-53.29)],TNF-α[MD=-7.44,95%CI(-8.35,-6.53)]levels.The above differences were statistically significant(P<0.05),and no serious adverse reactions were reported in all studies.The results of TSA analysis showed that the experimental group had definite evidence for improving the efficiency.According to the GRADE evaluation system,the efficiency,TNF-αwere medium-quality evidences,FEV1 was low-quality evidence,and FEV1/FVC,CRP,and IL-8 were extremely low-quality evidence.Conclusions:The curative effect of Shufeng Jiedu capsule combined with western medicine in the treatment of AECB was better than that of single western medicine.Nevertheless,considering the limited sample size and the quality of included articles,higher quality RCTs are still needed to further confirm its effectiveness and safety.

Pig model of chronic myocardial ischemia and its investigation by ultrasonic integrated backscatter and Doppler tissue imaging

Objective: To construct an animal model of chronic ischemic myocardium, and evaluate it by ultrasonic integrated backscatter (IBS) and Doppler tissue imaging (DTI). Methods: An Ameroid constrictor was placed around the porcine left circumflex coronary artery (LCX). The calibrated average image intensity (%AII), cyclic variation of IBS (CVIB), transmural gradient index (TGI) of CVIB in lateral-posterior wall (LPW), and DTI spectrum of LPW in left ventricular papillary muscle level short axis view (LVPM-SAM) and apical four chamber view (AP-4CV) at normal state, 2, 4, 6 and 8 weeks postoperatively were measured. Results: Normal %AII, CVIB and TGI were 2.29±0.32, 9.69±2.22dB and 0.22±0.08, respectively. The %AII increased gradually postoperatively. The CVIB decreased also gradually, and the decrease was higher in subepicardium than in subendocardium. Most of TGI decrease occurred from 2 to 4 weeks postoperatively and became zero at 8 weeks (P<0.01); Normal V S (peak systolic velocity) of AP-4CV was higher than that of LVPM-SAM (P<0.01). V E (peak early diastolic velocity) of AP-4CV was lower than that of LVPM-SAM (P<0.05). V S and V E were all decreased after operation (P<0.01). The decrease of V S in AP-4CV was greater than that in LVPM-SAM. Conclusion: The pathological changes of the myocardium in human ischemic heart disease (IHD) are similar to that of Ameriod model. IBS and DTI can detect echo changes and ventricular wall motion in chronic ischemic myocardium, and provide more information for clinical investigation and treatment of IHD.

Clinical Observation in 31 Cases of Chronic Bronchitis at Remission Stage Treated with Bufei Keli

To observe the therapeutic effects of a Chinese drug Bufei Keli (补肺颗粒 granules for invigorating the lung) in the treatment of chronic bronchitis at remission stage, 62 cases were randomly divided into a treatment group (treated with Bufei Keli) and a control group (treated with Yupingfeng Keli 玉屏风颗粒). The results turned out to be that the short-term clinically controlled and markedly effective rate was 77.42% and the long-term relapse-resisting markedly effective rate was 74.2% in the treatment group, which were obviously higher than 45.16% and 38.71% respectively in the control group (P<0.05). And the increase in contents of SOD and CD_3 and the decrease in LPO content in the treatment group were also bigger than that in the control group (P<0.01). It is therefore concluded that Bufei Keli can improve qi deficiency syndrome and raise the immunity of patients with chronic bronchitis, hence its effect of resisting relapse of chronic bronchitis.

TCM aerosol inhalation treatment in acute exacerbations of chronic bronchitis： a meta-analysis

Objectives： To determine whether traditional Chinese medicine （TCM） aerosol inhalation treatment is effective inthe treatment of acute exacerbation of chronic bronchitis. Methods： Search double-blind randomised clinical trials（RCT） about the use of TCM aerosol inhalation in patient with acute exacerbation of chronic bronchitis via database including Chinese biomedicine literature database, Wanfang Data, CNKI, Pubmed, EMBASE and CochraneLibrary from the beginning to October 2016. Quality evaluation, data extraction and data analysis of these RCT wascarried out with reference to the Cochrane systematic review. Results： 16 studies with 738 patients in TCM aerosolinhalation group and 675 in control group were included. The results of meta-analysis showed, （1） TCM aerosolinhalation group could improve the total cure rate. （2） TCM aerosol inhalation could increase the expression of IL-2while decrease the expression of IL-8 and MDA in sputum and blood. （3） TCM aerosol inhalation could improvethe symptoms of cough, cough with sputum, cough with dyspnea and lung wet rales. It also improve the symptomsof cough, expectorate and lung wet rales. （4） Shorten the time of cough and lung rale. （5） The adverse reactionswere light only with 1 occurrence of nausea and vomiting. Conclusions： The use of TCM aerosol inhalation in thetreatment of acute exacerbation of chronic bronchitis was effective. However, the inclusion researches quality werenot very high, which only provided limited evidence for clinical application. Higher-quality randomized controlledtrials were needed for further study.

Progress in the treatment of chronic bronchitis with Chinese and western medicine

Chronic bronchitis is a clinical common disease,which is a chronic nonspecific inflammation of the tracheal and bronchial mucosa and its surrounding tissues caused by a variety of factors.It is clinically characterized by symptoms such as cough,excessive phlegm,shortness of breath,and a recurrent chronic process.Chronic bronchitis has a high incidence and severe symptoms in winter.In severe cases,there are long-term clinical symptoms that impact the patient’s spirit and life.At the same time,the disease causes numerous diseases such as emphysema and pulmonary heart disease.Therefore,patients have an essential need for the treatment of chronic bronchitis.This article tells the etiology,treatment methods,process,prevention,and nursing of the disease from the perspective of western medicine and traditional Chinese medicine,respectively.

TREATMENT OF CHRONIC BRONCHITIS WITH FIFTY-YING-ACUPUNCTURE THERAPY

Objective: To observe the clinical effect of Fifty ying acupuncture therapy for treatment of chronic bronchitis, and to explore its underlying mechanisms. Methods: A total of 36 out and in patients with chronic bronchitis including 10 cases of asthma were subjected into this study. Among them, 20 cases were qi deficiency type and 16 qi yin deficiency with phlegm damp type. The changes of symptoms, T lymphocyte subgroups of CD 3 +, CD 4 +, CD 8 +, CD 4 +/CD 8 +, soluble interleuki 2 receptor (SIL 2 R), interleukin 6(IL 6), IgG, IgA and IgM before and after treatment were observed and detected using monoclonal indirect fluorescence method, enzyme linked immunosorbent assay (ELISA) and nephelometry respectively. Results: (1)The effective rate of qi dificiency type was 100% and that of qi yin deficiency with phlegm damp type 87.5%. (2) After acupuncture treatment, in qi deficiency type patients, serum IgG, IgA and IgM contents increased significantly (P<0.001) in comparison with pre treatment and in qi yin deficiency with phlegm damp type patients, IgG level lowered obviously. Serum SIL 2R and CD 4 +/CD 8 + decreased obviously (P<0.01, 0.001), CD 3 +, CD 4 + and CD 8 + increased evidently (P<0.01). Conclusion: The Fifty ying acupuncture therapy can better clinical symptoms of chronic bronchitis patients through its resultant up regulation of the immune system function.

Research on mechanism of Jin-Shui-Liu-Jun-Jian and Acupoint Application combined therapy for chronic bronchitis

Objective:To investigate the influencing mechanism of Jin-Shui-Liu-Jun-Jian and Acupoint Application combined therapy on hemorheology, inflammatory factors and pulmonary functions in patients with chronic bronchitis, thus to offer relevant help for clinical therapies on patients with chronic bronchitis. Methods:120 cases of patients with chronic bronchitis treated in our hospital were selected and randomly divided to be the therapeutic group and the control group, 60 cases each. Patients in control group were provided some basic treatments, such as spasmolysis, anti-inflammation, asthma relieving, oxygen inhalation and dissolve phlegm. For therapeutic group on this basis, Jin-Shui-Liu-Jun-Jian and Acupoint Application combined therapy was provided. Hemorheology, inflammatory factors and pulmonary functions in the two groups of patients were detected before and after treatment. Results:Differences of hemorheology indexes, inflammatory factors and pulmonary function relevant indexes between the two groups of patients with chronic bronchitis before treatment showed no statistical significance (P>0.05). Compared with prior treatment, hemorheology relevant indexes [whole blood high shear viscosity (WHV), whole blood low shear viscosity (WLV), packed cell volume (PCV), plasma viscosity (PV) and red cell assembling index (RCAI)], inflammatory factors [IL-8 (interleukin-8) and TNF-α(tumor necrosis factor-α)] were significantly decreased and pulmonary function relevant indexes [forced vital capacity (FVC), forced expiratory volume in one second (FEV1.0), peak expiratory flow (PEF), maximal voluntary ventilation (MVV) and expiratory flow rate when exhale vital capacity was 0.50], inflammatory factors (IL-4, IL-2) were significantly increased in the two groups of patients with chronic bronchitis after relevant treatments;The differences between the groups showed statistical significance (P<0.05). After combined therapy provided, pulmonary function relevant indexes (FVC, FEV1.0, PEF, MVV and V0.50) and inflammatory factors (IL-4, IL-2) in therapeutic group were significantly higher than control group after basic therapy. Hemorheology relevant indexes (WHV, WLV, PV, PCV and RCAI) and inflammatory factors (IL-8 and TNF-α) in therapeutic group were significantly lower than control group;Differences between the two groups showed statistical significance (P<0.05). Conclusions: Combination of Jin-Shui-Liu-Jun-Jian and Acupoint Application significantly improved the levels of hemorheology, inflammatory factors and pulmonary functions in patients with chronic bronchitis. It has a great important clinical significance on therapies for patients with chronic bronchitis.

STUDY ON INFLAMMATORY CELLS IN BALF OF SMOKE-INDUCED CHRONIC BRONCHITIS RAT MODEL

Objective To establish a smoke-induced chronic bronchitis rat model and evaluate the patho-logical change semi-quantitatively, and study the characteristics of the inflammatory cells in the bronchoalveolar lav-age fluid (BALF) in various stages. Methods Chronic bronchitis sequential rat model was established by passively inhaling smoke mixture. Experiments were performed in 30 young male Sprague-Dawley rats, which comprised 5 groups in random, i.e.,4 chronic bronchitis model groups and 1 control group. After stained with hematoxylin and eosin, the specimens were studied by semi-quantitative method to evaluate the morphologic changes in various stages. Meanwhile, the inflammatory cells of the BALF and the activity of myeloperoxidase (MPO) of lung tissue were analysed. Results During the process of the chronic bronchitis, the pathologic score was increasing as time went on, and the typical morphologic changes of chronic bronchitis emerged in the group 7 weeks. The total number of inflammatory cells in BALF was increasing as time went on, correlated with the pathologic scores (P <0.01). And the percentage of lymphocyte increased as well as positively correlated with pathologic scores (P < 0. 05) , whereas that of macrophage decreased and negatively correlated with pathologic scores (P <0. 05). The MPO lever of lung tissue was correlated with the pathologic scores (P < 0. 01). But the percentage of the neutrophil in the BALF was just in a high level during the first week, then it maintained relatively lower. Conclusion Smoke-induced chronic bronchitis is a slowly progressive inflammation process. The model we established is convenient and simple for the longitudinal study on the inflammatory process of chronic bronchitis and the therapy in the early stage. The semi-quantitative evaluation for the pathological change is with much more value. During the inflammatory sequential process of early stage of chronic bronchitis, the cellular characteristics are similar to that of the common chronic inflammation.

The application of integrated medical and nursing rehabilitation in the management of patients with chronic heart failure and diabetes

Background At present,patients with chronic heart failure complicated with diabetes are often treated with drugs in clinical practice.Most patients cannot adhere to regular and quantitative medication for a long time,and their poor compliance has adverse effects on their rehabilitation.The aim of this study was to explore the application effects of integrated medical and nursing rehabilitation in the management of patients with chronic heart failure and diabetes.Methods A total of 75 patients with chronic heart failure and diabetes,admitted to our center from May 2020 to May 2023,were randomly divided into Group A(n=38)and Group B(n=37)using a random number table.Group A received integrated rehabilitation management,while Group B received conventional rehabilitation management.The left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),fasting blood glucose(FBG),2-hour postprandial blood glucose(2h PG),glycated hemoglobin(Hb Alc),and self-care ability were compared between the two groups before and after intervention.Results After intervention,the LVEDD and LVESD in both groups were lower than before,while LVEF was higher than before(P<0.05).The LVEDD and LVESD in Group A were lower than in Group B after intervention,while LVEF was higher than in Group B(P<0.05).After intervention,the levels of FBG,2h PG,Hb Alc,and the scores of the European Heart Failure Self-care Behavior Scale(EHFSc B-9)in both groups decreased,with Group A being lower than Group B(P<0.05).Conclusions Integrated medical and nursing rehabilitation can effectively improve the cardiac function and blood glucose levels of patients with chronic heart failure and diabetes,control the patients’condition,and enhance their quality of life and self-care ability.[S Chin J Cardiol 2024;25(1):44-49]