Objective: To observe the clinical effect of Yiqi Huoxue (益气活血, YQHX) herbs in treating the patients with chronic cor pulmonale and to explore its mechanism by determining the relationship of oxida-tion/antioxidat...Objective: To observe the clinical effect of Yiqi Huoxue (益气活血, YQHX) herbs in treating the patients with chronic cor pulmonale and to explore its mechanism by determining the relationship of oxida-tion/antioxidation system and how such herbs change on the function of endothelial cells and platelets. Methods: Fifty-eight patients were divided into two groups: conventional therapy group (control group, 28 patients) and convention plus YQHX herbs group (treated group, 30 patients). The control group received conventional management. The treated group were treated with YQHX 150 ml, twice a day, plus the conventional treatment, and the clinical efficacy was recorded. The lipid peroxidation (LPO), superoxide dismutase (SOD), ot-granule membrane protein (GMP140), partial pressure of arterial oxygen (PaO2), partial pressure of carbon dioxide in artery (PaCO2) and circulating endothelial cells (CEC) were measured respectively before and after treatment, and the relationship between various parameters were analyzed. The results were compared with those of 10 healthy subjects got at the same period. Results: (1) The effective rate and PaO2 of the treated group was higher than that of the control group and there were no difference in PaCO2 between the two groups. (2) The levels of LPO, GMP140, CEC in all the patients before therapy were significantly higher than those of the healthy group, and there were marked decrease in the levels of those after treatment (all P<0. 01). On the contrary, the levels of SOD in all the patients before therapy were markedly lower than those in the healthy subjects and increased after treatment, P<0. 01. (3) The increase of SOD in the treated group was significantly more obvious than that of the control group. In the treated group, the decrease of LPO, GMP140, CEC were markedly more obvious than those in the control group (all P<0. 01). (4) The number of CEC, as well as GMP140, was negatively correlated to PaO2(P<0.01) and SOD (P< 0. 01), which was positively correlated to LPO (P<0. 01). There was a positive correlation between CEC and GMP140 (P<0.05). Conclusion: YQHX herbs in treating chronic cor pulmonale proved to be effective by balancing the oxidation and antioxidation, protecting the pulmonary endothelial cells and activated platelets and helpful in treating respiratory failure.展开更多
Arterial blood gases,intraerythrocytic pH (pHi),2,3-diphosphoglycerate,standardP 50 (P 50std) and in vivo P 50 (P 50iv) were determined in 54 patients with cor pulmonale and23 normal subjects.It was found that no sign...Arterial blood gases,intraerythrocytic pH (pHi),2,3-diphosphoglycerate,standardP 50 (P 50std) and in vivo P 50 (P 50iv) were determined in 54 patients with cor pulmonale and23 normal subjects.It was found that no significant change of pHi was observed but the differ-ence of pHi and extraerythrocytic pH was decreased.P 50std was significantly decreased whileP 50iv remained essentially unchanged in those cases showing type I respiratory failure.Thesefindings suggest that P 50std cannot accurately reflect the changes of P 50iv in patients of corpulmonale;P 50iv in cases of cor pulmonale usually keeps relatively stable and coincides withthe ‘optimal P 50’,which indicates the adaptation of the organism to chronic hypoxia;and rel-ative intraerythrocytic alkalosis plays an important role in the relief of hypercapnia in cases ofcor pulmonale.展开更多
Background Cor pulmonale is often associated with changes of structure and function of the right ventricle （RV） and thus further affects functional changes of the left heart.Our study aimed to assess the left ventri...Background Cor pulmonale is often associated with changes of structure and function of the right ventricle （RV） and thus further affects functional changes of the left heart.Our study aimed to assess the left ventricular （LV） and RV function in patients with cor pulmonale using high-definition CT （HDCT）.Methods We prospectively studied 18 cor pulmonale patients determined by the pulmonary function test,clinical examination,chest radiograph,electrocardiogram,and echocardiogram.The subject group was compared to a control group consisting of 18 subjects.The RV and LV functions and RV myocardial mass （MM） were obtained by HDCT in the two groups.The results were compared between the two groups using the independent sample t test.Echocardiographic examination for cardiac function analysis was performed on the same day.Results The RV end-diastolic volume （EDV）,RV end-systolic volume （ESV） and RV myocardial mass were significantly larger in the 18 cor pulmonale patients than in the control group （P〈0.05）.The right ventricular ejection fraction （RVEF） was significantly lower in the 18 cor pulmonale patients than in controls （P〈0.01）.The left ventricular EDV （LVEDV） and LVEF were significantly lower in cor pulmonale patients than in controls （P〈0.01）.There were strong correlations between MDCT and echocardiography,rRVEF=0.839 and rLVEF=0.916,respectively.Conclusions HDCT can accurately quantify RV and LV function.The right ventricular function is impaired in patients with cor pulmonale,while at the same time the left ventricular function is also impaired.展开更多
Background:Increased right ventricle afterload during acute respiratory distress syndrome(ARDS)may induce acute cor pulmonale(ACP),which is associated with a poor clinical outcome.Echocardiography is now considered as...Background:Increased right ventricle afterload during acute respiratory distress syndrome(ARDS)may induce acute cor pulmonale(ACP),which is associated with a poor clinical outcome.Echocardiography is now considered as a rapid and non-invasive tool for diagnosis of ACP.The aims of this study were to investigate the morbidity and mortality rates of ACP in ARDS patients in intensive care units(ICUs)across the mainland of China and to determine the severity and prognosis of ACP in ARDS patients through an ultrasound protocol(TRIP).And the association between ACP related factors and the ICU mortality will be revealed.Methods:This study is a multicenter and cross-sectional study in China which will include ICU participants when diagnosed as ARDS.The ultrasound protocol,known as the TRIP,is proposed as severity assessment for ACP,which includes tricuspid regurgitation velocity(T),right ventricular size(R),inferior vena cava diameter fluctuation(I),and pulmonary regurgitation velocity(P).The 28-day mortality,ICU/hospital mortality,the length of stay in ICU,mechanical ventilation days,hemodynamic parameters and lab parameters of liver function and kidney function are all recorded.Discussion:This large-scale study would give a sufficient epidemic investigation of ACP in ARDS patients in China.In addition,with the TRIP protocol,we expect that we could stratify ACP with more echocardiography parameters.展开更多
Platelet plays an importent role in thromboembolic diseases. It is demonstrated that recurrent pulmonary embolism may cause pulmonary hypertention. In recent years，P-selectin（granule membrane protein，GMP40）was fou...Platelet plays an importent role in thromboembolic diseases. It is demonstrated that recurrent pulmonary embolism may cause pulmonary hypertention. In recent years，P-selectin（granule membrane protein，GMP40）was found to be a surface marker for platelet activation.展开更多
This study explores the diagnostic value of combining the Padua score with the thrombotic biomarker tissue plasminogen activator inhibitor-1(tPAI-1)for assessing the risk of deep vein thrombosis(DVT)in patients with p...This study explores the diagnostic value of combining the Padua score with the thrombotic biomarker tissue plasminogen activator inhibitor-1(tPAI-1)for assessing the risk of deep vein thrombosis(DVT)in patients with pulmonary heart disease.These patients often exhibit symptoms similar to venous thrombosis,such as dyspnea and bilateral lower limb swelling,complicating differential diagnosis.The Padua Prediction Score assesses the risk of venous thromboembolism(VTE)in hospitalized patients,while tPAI-1,a key fibrinolytic system inhibitor,indicates a hypercoagulable state.Clinical data from hospitalized patients with cor pulmonale were retrospectively analyzed.ROC curves compared the diagnostic value of the Padua score,tPAI-1 levels,and their combined model for predicting DVT risk.Results showed that tPAI-1 levels were significantly higher in DVT patients compared to non-DVT patients.The Padua score demonstrated a sensitivity of 82.61%and a specificity of 55.26%at a cutoff value of 3.The combined model had a significantly higher AUC than the Padua score alone,indicating better discriminatory ability in diagnosing DVT risk.The combination of the Padua score and tPAI-1 detection significantly improves the accuracy of diagnosing DVT risk in patients with pulmonary heart disease,reducing missed and incorrect diagnoses.This study provides a comprehensive assessment tool for clinicians,enhancing the diagnosis and treatment of patients with cor pulmonale complicated by DVT.Future research should validate these findings in larger samples and explore additional thrombotic biomarkers to optimize the predictive model.展开更多
Since 1934,when Hirschfelder first reported magnesium(Mg) deficiency syndrome in man, considerable clinicalworks related to hypomagnesemia have appeared in medicalliterature. Recently, it is considered that Mg is a ki...Since 1934,when Hirschfelder first reported magnesium(Mg) deficiency syndrome in man, considerable clinicalworks related to hypomagnesemia have appeared in medicalliterature. Recently, it is considered that Mg is a kind ofnatural antagonist of calcium (Ca). Mg has some effects onthe smooth muscles of the bronchial and pulmonary arteries,and to relax the spasm of them. Therefore, there may exista close relation between Mg and cor pulmonale caused bychronic obstructive pulmonay desease (COPD).展开更多
文摘Objective: To observe the clinical effect of Yiqi Huoxue (益气活血, YQHX) herbs in treating the patients with chronic cor pulmonale and to explore its mechanism by determining the relationship of oxida-tion/antioxidation system and how such herbs change on the function of endothelial cells and platelets. Methods: Fifty-eight patients were divided into two groups: conventional therapy group (control group, 28 patients) and convention plus YQHX herbs group (treated group, 30 patients). The control group received conventional management. The treated group were treated with YQHX 150 ml, twice a day, plus the conventional treatment, and the clinical efficacy was recorded. The lipid peroxidation (LPO), superoxide dismutase (SOD), ot-granule membrane protein (GMP140), partial pressure of arterial oxygen (PaO2), partial pressure of carbon dioxide in artery (PaCO2) and circulating endothelial cells (CEC) were measured respectively before and after treatment, and the relationship between various parameters were analyzed. The results were compared with those of 10 healthy subjects got at the same period. Results: (1) The effective rate and PaO2 of the treated group was higher than that of the control group and there were no difference in PaCO2 between the two groups. (2) The levels of LPO, GMP140, CEC in all the patients before therapy were significantly higher than those of the healthy group, and there were marked decrease in the levels of those after treatment (all P<0. 01). On the contrary, the levels of SOD in all the patients before therapy were markedly lower than those in the healthy subjects and increased after treatment, P<0. 01. (3) The increase of SOD in the treated group was significantly more obvious than that of the control group. In the treated group, the decrease of LPO, GMP140, CEC were markedly more obvious than those in the control group (all P<0. 01). (4) The number of CEC, as well as GMP140, was negatively correlated to PaO2(P<0.01) and SOD (P< 0. 01), which was positively correlated to LPO (P<0. 01). There was a positive correlation between CEC and GMP140 (P<0.05). Conclusion: YQHX herbs in treating chronic cor pulmonale proved to be effective by balancing the oxidation and antioxidation, protecting the pulmonary endothelial cells and activated platelets and helpful in treating respiratory failure.
文摘Arterial blood gases,intraerythrocytic pH (pHi),2,3-diphosphoglycerate,standardP 50 (P 50std) and in vivo P 50 (P 50iv) were determined in 54 patients with cor pulmonale and23 normal subjects.It was found that no significant change of pHi was observed but the differ-ence of pHi and extraerythrocytic pH was decreased.P 50std was significantly decreased whileP 50iv remained essentially unchanged in those cases showing type I respiratory failure.Thesefindings suggest that P 50std cannot accurately reflect the changes of P 50iv in patients of corpulmonale;P 50iv in cases of cor pulmonale usually keeps relatively stable and coincides withthe ‘optimal P 50’,which indicates the adaptation of the organism to chronic hypoxia;and rel-ative intraerythrocytic alkalosis plays an important role in the relief of hypercapnia in cases ofcor pulmonale.
文摘Background Cor pulmonale is often associated with changes of structure and function of the right ventricle （RV） and thus further affects functional changes of the left heart.Our study aimed to assess the left ventricular （LV） and RV function in patients with cor pulmonale using high-definition CT （HDCT）.Methods We prospectively studied 18 cor pulmonale patients determined by the pulmonary function test,clinical examination,chest radiograph,electrocardiogram,and echocardiogram.The subject group was compared to a control group consisting of 18 subjects.The RV and LV functions and RV myocardial mass （MM） were obtained by HDCT in the two groups.The results were compared between the two groups using the independent sample t test.Echocardiographic examination for cardiac function analysis was performed on the same day.Results The RV end-diastolic volume （EDV）,RV end-systolic volume （ESV） and RV myocardial mass were significantly larger in the 18 cor pulmonale patients than in the control group （P〈0.05）.The right ventricular ejection fraction （RVEF） was significantly lower in the 18 cor pulmonale patients than in controls （P〈0.01）.The left ventricular EDV （LVEDV） and LVEF were significantly lower in cor pulmonale patients than in controls （P〈0.01）.There were strong correlations between MDCT and echocardiography,rRVEF=0.839 and rLVEF=0.916,respectively.Conclusions HDCT can accurately quantify RV and LV function.The right ventricular function is impaired in patients with cor pulmonale,while at the same time the left ventricular function is also impaired.
文摘Background:Increased right ventricle afterload during acute respiratory distress syndrome(ARDS)may induce acute cor pulmonale(ACP),which is associated with a poor clinical outcome.Echocardiography is now considered as a rapid and non-invasive tool for diagnosis of ACP.The aims of this study were to investigate the morbidity and mortality rates of ACP in ARDS patients in intensive care units(ICUs)across the mainland of China and to determine the severity and prognosis of ACP in ARDS patients through an ultrasound protocol(TRIP).And the association between ACP related factors and the ICU mortality will be revealed.Methods:This study is a multicenter and cross-sectional study in China which will include ICU participants when diagnosed as ARDS.The ultrasound protocol,known as the TRIP,is proposed as severity assessment for ACP,which includes tricuspid regurgitation velocity(T),right ventricular size(R),inferior vena cava diameter fluctuation(I),and pulmonary regurgitation velocity(P).The 28-day mortality,ICU/hospital mortality,the length of stay in ICU,mechanical ventilation days,hemodynamic parameters and lab parameters of liver function and kidney function are all recorded.Discussion:This large-scale study would give a sufficient epidemic investigation of ACP in ARDS patients in China.In addition,with the TRIP protocol,we expect that we could stratify ACP with more echocardiography parameters.
文摘Platelet plays an importent role in thromboembolic diseases. It is demonstrated that recurrent pulmonary embolism may cause pulmonary hypertention. In recent years，P-selectin（granule membrane protein，GMP40）was found to be a surface marker for platelet activation.
基金Sichuan Province Medical Research Project Plan(Project No.S21113)。
文摘This study explores the diagnostic value of combining the Padua score with the thrombotic biomarker tissue plasminogen activator inhibitor-1(tPAI-1)for assessing the risk of deep vein thrombosis(DVT)in patients with pulmonary heart disease.These patients often exhibit symptoms similar to venous thrombosis,such as dyspnea and bilateral lower limb swelling,complicating differential diagnosis.The Padua Prediction Score assesses the risk of venous thromboembolism(VTE)in hospitalized patients,while tPAI-1,a key fibrinolytic system inhibitor,indicates a hypercoagulable state.Clinical data from hospitalized patients with cor pulmonale were retrospectively analyzed.ROC curves compared the diagnostic value of the Padua score,tPAI-1 levels,and their combined model for predicting DVT risk.Results showed that tPAI-1 levels were significantly higher in DVT patients compared to non-DVT patients.The Padua score demonstrated a sensitivity of 82.61%and a specificity of 55.26%at a cutoff value of 3.The combined model had a significantly higher AUC than the Padua score alone,indicating better discriminatory ability in diagnosing DVT risk.The combination of the Padua score and tPAI-1 detection significantly improves the accuracy of diagnosing DVT risk in patients with pulmonary heart disease,reducing missed and incorrect diagnoses.This study provides a comprehensive assessment tool for clinicians,enhancing the diagnosis and treatment of patients with cor pulmonale complicated by DVT.Future research should validate these findings in larger samples and explore additional thrombotic biomarkers to optimize the predictive model.
文摘Since 1934,when Hirschfelder first reported magnesium(Mg) deficiency syndrome in man, considerable clinicalworks related to hypomagnesemia have appeared in medicalliterature. Recently, it is considered that Mg is a kind ofnatural antagonist of calcium (Ca). Mg has some effects onthe smooth muscles of the bronchial and pulmonary arteries,and to relax the spasm of them. Therefore, there may exista close relation between Mg and cor pulmonale caused bychronic obstructive pulmonay desease (COPD).
