Study on the efficacy of early treatment with pirfenidone on the lung function of patients with idiopathic pulmonary fibrosis

BACKGROUND Idiopathic pulmonary fibrosis(IPF)is classified under fibrotic interstitial pneumonia,characterized by a chronic and progressive course.The predominant clinical features of IPF include dyspnea and pulmonary dysfunction.AIM To assess the effects of pirfenidone in the early treatment of IPF on lung function in patients.METHODS A retrospective analysis was performed on 113 patients with IPF who were treated in our hospital from November 2017 to January 2023.These patients were divided into two groups:control group(n=53)and observation group(n=60).In the control group,patients received routine therapy in combination with methylprednisolone tablets,while those in the observation group received routine therapy together with pirfenidone.After applying these distinct treatment approaches to the two groups,we assessed several parameters,including the overall effectiveness of clinical therapy,the occurrence of adverse reactions(e.g.,nausea,vomiting,and anorexia),symptom severity scores,pulmonary function index levels,inflammatory marker levels,and the 6-min walk distance before and after treatment in both groups.RESULTS The observation group exhibited significantly higher rates than the control group after therapy,with a clear distinction(P<0.05).After treatment,the observation group experienced significantly fewer adverse reactions than the control group,with a noticeable difference(P<0.05).When analyzing the symptom severity scores between the two groups of patients after treatment,the observation group had significantly lower scores than the control group,with a distinct difference(P<0.05).When comparing the pulmonary function index levels between the two groups of patients after therapy,the observation group displayed significantly higher levels than the control group,with a noticeable difference(P<0.05).Evaluating the inflammatory marker data(C-reactive protein,interleukin-2[IL-2],and IL-8)between the two groups of patients after therapy,the observation group exhibited significantly lower levels than the control group,with significant disparities(P<0.05).Comparison of the 6-min walking distance data between the two groups of patients after treatment showed that the observation group achieved significantly greater distances than the control group,with a marked difference(P<0.05).CONCLUSION Prompt initiation of pirfenidone treatment in individuals diagnosed with IPF can enhance pulmonary function,elevate inflammatory factor levels,and increase the distance covered in the 6-min walk test.This intervention is conducive to effectively decreasing the occurrence of adverse reactions in patients.

Early pirfenidone treatment enhances lung function in idiopathic pulmonary fibrosis patients

This editorial comments on the study by Lei et al investigating the efficacy of early treatment with pirfenidone on the lung function of patients with idiopathic pulmonary fibrosis(IPF)published.This study evaluates the efficacy of early treatment with pirfenidone on lung function in patients with IPF.The early and advanced stages of IPF are defined,highlighting the drug's benefits.While prior research indicates pirfenidone's effectiveness in advanced IPF,this study focuses on its advantages in early stages.The study emphasizes the importance of computed tomography imaging alongside biochemical data and lung function tests for a comprehensive analysis of symptom relief.Results show that early intervention with pirfenidone significantly reduces disease progression and preserves lung function,underscoring its potential as a critical treatment strategy in early IPF.

Plasma brain natriuretic peptide, platelet parameters, and cardiopulmonary function in chronic obstructive pulmonary disease

BACKGROUND Chronic obstructive pulmonary disease(COPD)is a chronic respiratory disease with worldwide occurrence and high disability and mortality rate.It occurs mostly in the elderly population with pulmonary heart disease,type II respiratory failure,and other serious complications.AIM To investigate the correlation of plasma brain natriuretic peptide(BNP)and platelet parameters with cardiac function and pulmonary hypertension in patients with COPD and pulmonary heart disease.METHODS From June 2016 to June 2019,52 patients with COPD-pulmonary heart disease(pulmonary heart disease group),30 patients with COPD(COPD group),and 30 healthy individuals(control group)in our hospital were enrolled in the study.The pulmonary heart disease group was further divided into subgroups according to cardiac function classification and pulmonary artery pressure.Plasma BNP and platelet parameters were estimated and compared among each group and subgroup.The correlation of plasma BNP and platelet parameters with cardiac function classification and pulmonary artery pressure was then analyzed.RESULTS In the pulmonary heart disease group,the COPD group,and the control group,the levels of plasma BNP,platelet distribution width(PDW),and mean platelet volume(MPV)showed a decreasing trend(P<0.05),while an increasing trend was found in platelet count(PLT)and plateletcrit(PCT)levels among the three groups(P<0.05).In the pulmonary hypertension mild,moderate,and severe subgroups,the levels of plasma BNP,PDW,and MPV showed an increasing trend(P<0.05),while a decreasing trend was observed in PLT levels(P<0.05);however,PCT levels showed no significant difference among the three subgroups(P>0.05).In the cardiac function grade I,II,III,and IV subgroups,the levels of plasma BNP,PDW,and MPV showed an increasing trend(P<0.05),while a decreasing trend was noted in PLT and PCT levels among the four subgroups(P<0.05).Correlation analysis showed that the levels of plasma BNP,PDW,and MPV in patients with pulmonary heart disease were positively correlated with their pulmonary artery pressure(P<0.05),while PLT was negatively correlated with their pulmonary artery pressure(P<0.05).Moreover,plasma BNP,PDW,and MPV levels were positively correlated with cardiac function grade(P<0.05)of these patients,while PLT and PCT levels were negatively correlated with their cardiac function grade(P<0.05).CONCLUSION Plasma BNP and PLT parameters are significantly correlated with the cardiac function and pulmonary hypertension in patients with COPD and pulmonary heart disease,indicating that these parameters have high clinical relevance in reflecting the health condition of these patients and for guiding their treatment.

THE ANALYSIS OF CHANGES AND INFLUENCING FACTORS OF EARLY POSTTHORACOTOMY PULMONARY FUNCTION

Objective. To investigate the changes and influencing factors of early postoperative pulmonary functionof thoracotomy.Methods. Pre-and early postoperative pulmonary function was studied in 64 consecutive cases withoptimal thoracotomy. Pain assessment was done before pulmonary function test, and the chief complaintsof patients were recorded after the procedure. The changing curves of pulmonary function were done andthe differences associated with groups, surgical styles, pain assessment, epidural analgesia, chief com-plaint and preoperative conditions were analyzed.Results. Pulmonary function was severely lowered to about 40% of the base line on the first day,and it was rehabilitated to about 60% of the base line on the eighth day. There was a greater gradienton the recovery curve on the 3rd and 4th days. Epidural analgesia was able to improve pain relaxationand pulmonary function in some degree. Single-factor analysis showed that postoperative pain, postopera-tive day and surgical style were the significant influencing factors for early postoperative pulmonary func-tion. By multiple-factor analysis, preoperative pulmonary function, age and postoperative pain were themain factors, while surgical style had only weak effect on it.Conclusions. Early postoperative pulmonary function is severely impaired by thoracotomy. It rehabili-tate gradually with time. Improvement of preoperative pulmonary function, reducing surgical procedure in-juries, especially injury to respiratory muscle system, and enough postoperative pain relief are the mostimportant means that would reduce pulmonary function impairment and consequently reduce postoperativepulmonary complications.

Bacillus licheniformis PF9 improves barrier function and alleviates inflammatory responses against enterotoxigenic Escherichia coli F4 infection in the porcine intestinal epithelial cells

Background:Enterotoxigenic Escherichia coli(ETEC)F4 commonly colonizes the small intestine and releases enterotoxins that impair the intestinal barrier function and trigger inflammatory responses.Although Bacillus licheniformis(B.licheniformis)has been reported to enhance intestinal health,it remains to be seen whether there is a functional role of B.licheniformis in intestinal inflammatory response in intestinal porcine epithelial cell line(IPEC-J2)when stimulated with ETEC F4.Methods:In the present study,the effects of B.licheniformis PF9 on the release of pro-inflammation cytokines,cell integrity and nuclear factor-κB(NF-κB)activation were evaluated in ETEC F4-induced IPEC-J2 cells.Results:B.licheniformis PF9 treatment was capable of remarkably attenuating the expression levels of inflammation cytokines tumor necrosis factor-α(TNF-α),interleukin(IL)-8,and IL-6 during ETEC F4 infection.Furthermore,the gene expression of Toll-like receptor 4(TLR4)-mediated upstream related genes of NF-κB signaling pathway has been significantly inhibited.These changes were accompanied by significantly decreased phosphorylation of p65 NF-κB during ETEC F4 infection with B.licheniformis PF9 treatment.The immunofluorescence and western blotting analysis revealed that B.licheniformis PF9 increased the expression levels of zona occludens 1(ZO-1)and occludin(OCLN)in ETEC F4-infected IPEC-J2 cells.Meanwhile,the B.licheniformis PF9 could alleviate the injury of epithelial barrier function assessed by the trans-epithelial electrical resistance(TEER)and cell permeability assay.Interestingly,B.licheniformis PF9 protect IPEC-J2 cells against ETEC F4 infection by decreasing the gene expressions of virulence-related factors(including luxS,estA,estB,and elt)in ETEC F4.Conclusions:Collectively,our results suggest that B.licheniformis PF9 might reduce inflammation-related cytokines through blocking the NF-κB signaling pathways.Besides,B.licheniformis PF9 displayed a significant role in the enhancement of IPEC-J2 cell integrity.

Effect of continuous nursing combined with respiratory exercise nursing on pulmonary function of postoperative patients with lung cancer

BACKGROUND Lung cancer is a malignant tumor with high morbidity and mortality among cancers.Surgery is currently one of the primary methods of treating lung cancer.Although it can slow down the progression of the disease by removing the lesion,this invasive surgery inevitably damages the integrity of the patient’s chest.Moreover,the patient’s pulmonary function may have a low compensatory capacity after surgery,causing various respiratory diseases such as atelectasis,respiratory function decline,and even serious cardiovascular disease.All of these have great negative impacts on the surgical effect and the prognosis of patients.With the continuous exploration and development of nursing,continuous nursing and respiratory exercise nursing have been gradually applied in the nursing of patients after lung cancer surgery,and have achieved good nursing results.AIM To investigate the effect of continuous nursing combined with respiratory exercise nursing on the pulmonary function of postoperative patients with lung cancer.METHODS A total of 80 patients with lung cancer who underwent surgery in our hospital from January 2021 to December 2021 were selected as the study subjects.All subjects were randomly divided into the control group(n=40 cases)and the experimental group(n=40 cases).Patients with lung cancer in the control group were given conventional nursing after surgery,while the experimental group was given continuous nursing combined with respiratory exercise nursing based on conventional nursing.The recovery of pulmonary function and respiratory symptoms was observed before and after 3 mo of intervention in both groups.The pulmonary function parameters,blood gas analysis,MD Anderson Symptom Inventory-lung cancer module(MDASI-LC)scores,incidence of pulmonary complications,and Morisky compliance scores were compared between the two groups before and after 3 mo of intervention.RESULTS There was no significant difference in pulmonary function and blood gas analysis between the two groups before intervention(P>0.05).3 mo after the intervention,the pulmonary function parameters in the experimental group(SpO2,VC,MVV,FEV1,FEV1%pred,and FEV1/FVC)were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in blood gas analysis between the two groups before intervention(P>0.05).PaO2 in the experimental group was significantly higher than that in the control group,and PaCO_(2) was significantly lower than that in the control group 3 mo after the intervention.The difference had statistical significance(P<0.05).3 mo after the intervention,the MDASI score of respiratory symptoms in the experimental group was significantly lower than that in the control group(P<0.05),and the incidence of pulmonary complications was lower than that in the control group(P<0.05).In addition,the treatment compliance and nursing satisfaction of patients in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05).CONCLUSION Continuous nursing combined with respiratory exercise nursing can significantly accelerate the recovery of respiratory function in postoperative lung cancer patients,reduce the incidence of postoperative complications of lung cancer as well as improve the treatment compliance of patients.

Effect of Cardiopulmonary Bypass on Pulmonary Function in Infants

Objective To evaluate the effect of the cardiopulmonary bypass (CPB) on the pulmonary function in infants with or withoutpulmonary hypertension in congential ventricular septal defect (VSD). MethodsTwenty infants with VSD were enrolled in the study fromJan. to Dec.2004. They were divided into two groups: pulmonary hypertension group and non-pulmonary hypertension group, ten infantsrespectively. Pulmonary function parameters were measured before CPB and 3, 6, 9, 12, 15, 18, 21, 24h after CPB, the following datawere recorded: duration for mechanical ventilation (Tmv) and staying in the cardiac intensive care unit (Tcicu) after cardiac surgery.Results Before CPB, the pulmonary function parameters in non-pulmonary hypertension group were more superior than in pulmonary hy-pertension group (P<0.01). By contraries, the pulmonary function parameters in every time stage after CPB statistically significant de-creased in non-pulmonary hypertension group (P<0.05), especially at 6, 9, and 15h after CPB (P<0.01). In pulmonary hyperten-sion group, the pulmonary function parameters in 3h after CPB were more improved than before CPB, though there was no statistical sig-nificance. But they had statistically significant decreased at9, 12, 15h after CPB (P<0.05). There was a similar change in pulmonaryfunction between two groups at 21, 24h after CPB. Conclusion Exposure to CPB adversely affects pulmonary function after surgicalrepair of VSD in infants. We consider that the benefits of the surgical correction in infants with pulmonary hypertension outweight the neg-ative effects of CPB on pulmonary function. We should improve cardiac function to avoid the presence of the nadir trough in pulmonaryfunction. The infants with pulomonary hypertension also have ability to wean from mechanical ventilation as soon as possible, if the hemo-dynamics is stable, and without the responsive pulmonary hypertension or pulmonary hypertension crisis after surgical repair.

The Differences of Interstitial Lung Diseases in High-Resolution Computerized Tomography and Pulmonary Function Test among Different Connective Tissue Diseases, and the Correlated Factors

Objective. To study the difference of interstitial lung diseases (ILDs) in high-resolution computerized tomography and pulmonary function test among different connective tissue diseases (CTDs). Methods. 209 patients with different CTDs were recruited and underwent lung HRCT and PFT. Eerythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum ferritin (SF), anti-SSA, and so on were tested. Based on HRCT, a patient was classified into ILD group (CTD+ILD) or non-ILD group (CTD-ILD). HRCT, PFT, and laboratory markers were compared according to CTDs and CTD-associated ILDs. Results. The incidences of ILD were 79.6%, 82.0%, 89.7%, and 97.1% respectively for Rheumatoid arthritis (RA), primary Sjogren’s symptom (pSS), dermatomyositis/polymyositis (DM/PM), and systemic sclerosis (SSc) groups. RA and pSS patients exhibited more nodules, patching, ground-glass opacity, and cord shadow foci in HRCT, DM/PM and SSc patients exhibited more reticular opacity and honeycombing foci. RA and pSS patients exhibited more obstructive ventilatory disorder, small airway dysfunction and emphysema in PFT, and DM/PM and SSc patients exhibited more restrictive ventilatory disorder, mixed ventilatory disorder. ESR, CRP and SF were significantly higher in total CTD+ILD group than in total CTD-ILD group (P = 0.047, 0.006, 0.004, respectively), and higher in different CTD+ ILD groups than in comparable CTD-ILD groups (P = 0.049, 0.048, and 0.023, pSS+ILD, SSc+ILD and RA+ILD compared to pSS-ILD, SSc-ILD and RA-ILD, respectively for ESR, CRP, SF). The positive rate of anti-SSA was significantly higher in DM/PM+ILD group than in DM/PM-ILD group (P = 0.025). Conclusions. The manifestations and incidences of ILDs differ among different CTDs in HRCT and PFT, and inflammation and anti-SSA are positively correlated with ILDs in different CTDs, which provide important evidences for judging disease condition and prognosis.

Randomized Control Trial on the Efficacy of Dual Bronchodilator of Glycopyrronium/Indacaterol for Lung Cancer Surgery: Improvement of Postoperative Pulmonary Function in Both Patients with Chronic Obstructive Pulmonary Disease and Normal Pulmonary Function

Background: A dual bronchodilator, long-acting anticholine drugs (glycopyrronium, LAMA) and the long running β-2 stimulant (indacaterol, LABA), are effective for the treatment of chronic obstructive pulmonary disease (COPD). To evaluate the effectiveness of the perioperative intervention of LAMA/LABA, a randomized prospective trial was performed for the lung cancer patients receiving a lobectomy with normal pulmonary function and COPD. Methods: Based on the results of the preoperative pulmonary function test, 25 patients were diagnosed with COPD [% forced expiratory volume in 1 second (%FEV1) < 70%]. Thirty-seven patients were enrolled as non-obstructive patients (70% ≤ %FEV1), who were randomized into two groups, the LAMA/LABA (n = 19) and the Control group (n = 18). The LAMA/LABA and the COPD groups daily received inhaled LAMA (50 μg) and LABA (110 μg) for 1 week before surgery and for least 4 weeks after surgery. The Control group had no treatment of the dual bronchodilator. The actual values were measured during the perioperative pulmonary function at three points of the preoperative baseline, the postoperative 1 week and the postoperative 4 weeks;these changes and changed ratios were then calculated. The patient-reported outcomes of the quality of life (PRO-QOL) were evaluated by the Cancer Dyspnea Scale (CDS), the COPD assessment test, and the St. George’s Respiratory Questionnaire. Results: Regarding the value of FEV1 at the baseline, that in the LAMA/LABA group was 79.2% ± 6.4% and that in the Control group was 80.9% ± 6.4%, but that in the COPD groups was 57.9% ± 8.7%;there was a significant difference between the COPD and the Control group (p < 0.0001). At the postoperative 1 week point, the FEV1 value in the Control group was 1.3 ± 0.5 L and that in the LAMA/LABA group was 1.7 ± 0.5 L. On the other hand, that in the COPD group was 1.7 ± 0.5 L, which was significantly higher compared to that in the Control group (p = 0.0251 and p = 0.0369). The intervention of LAMA/LABA for the COPD and non-obstructive patients resulted in the less decreased degree of the pulmonary function in FEV1 compared to that in the Control group. Based on the PRO-QOL by the CDS, the intervention of LAMA/LABA significantly reduced the total dyspnea in the LAMA/LABA group compared to that in the Control group (p = 0.0348). Conclusion: The perioperative intervention of LAMA/LABA should lead to maintaining the postoperative pulmonary function of the FEV1 during the lobectomy with COPD and non-obstructive patients and the improvement of PRO-QOL.

Resistance Measured by Airflow Perturbation Compared with Standard Pulmonary Function Measures

Background: Routine lung function testing requires expensive equipment, or requires maximum expiratory effort. The airflow perturbation device (APD) is a light handheld device, allowing for serial measures of respiratory resistance noninvasively and effortlessly. Methods: In a convenience sample of 398 patients undergoing pulmonary function testing, we compared routine spirometric indices (forced expired volume in 1 second (FEV1), peak expiratory flow (PEF)), and airways resistance (Raw-272 patients), to measures of respiratory resistance measured with the APD including inspiratory (IR), expiratory (ER) and averaged (AR) resistance. Results: Measures of lung function were significantly correlated (p 0.001). On regression analysis, between 7% - 17% of the variance (R2) for FEV1, PEF, and Raw was explained by APD measurements. Approximately 2/3 of the variance in FEV1 was explained by PEF measurements. Conclusions: APD measurements of lung function correlate with conventional measures. Future studies should be directed at exploring the use of the APD device in serial measures of lung function in patients with lung disease.

Effect of sequential assist-control ventilation on cardio-pulmonary function and systemic inflammatory state of chronic pulmonary heart disease complicated with respiratory failure patients

Objective:To discuss the effect of sequential assist-control ventilation on cardio-pulmonary function and systemic inflammatory state of chronic pulmonary heart disease complicated with respiratory failure patients.Method: A total of 90 cases of chronic pulmonary heart disease complicated with respiratory failure patients, who were treated in our hospital between May, 2012 and Feb., 2016, were selected, and were divided into study group (n=45) and control group (n=45) based on random number table. Patients in control group were given auxiliary - control ventilation. (A/C) treatment during the whole course, while patients in study group were given A/C+BiPAP treatment. Cardio-pulmonary function and serum inflammatory factor content difference was compared inboth groups before and after operation.Results: Before treatment, difference ofcardiac function indicator, ABG level and inflammatory factor content in both groups had no statistical significance. After treatment, cardiac function indicator (PASP, RVd) levels in both groups were lower than before treatment, and EFRV levels were higher than before treatment, and changes in study group were more obvious than that in control group;ABG indicator (PaO2) levels in both groups were higher than before treatment, and PaCO2 levels werelower than before treatment, and changes in study group were more obvious than that in control group;serum inflammatory factor (hs-CRP, IL-6, TNF-α) content in both groups was lower than before treatment, and changes in study group were more obvious than that in control group.Conclusion: sequential assist-control ventilation could optimize the cardio-pulmonary function of chronic pulmonary heart disease complicated with respiratory failure patients and reduce the systemic inflammatory response.

Effects of Suhuang Zhike Capsule on Pulmonary Function, Blood Gas Analysis Index, Serum PCT and CRP Expression in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

OBJECTIVE: To observe the effects of Suhuang Zhike Capsule on pulmonary function, blood gas analysis index, serum PCT and CRP expression in patients with acute exacerbation of chronic obstructive pulmonary disease. METHODS: A total of 88 patients with acute exacerbation of chronic obstructive pulmonary disease admitted to the Department of Respiratory Medicine, Xuancheng People's Hospital of Anhui Province from December 2014 to December 2016 were randomly divided into the observation group and the control group, with 44 cases in each group. The control group was given routine clinical treatment, and the observation group was given Suhuang Zhike Capsule on the basis of the treatment method of the control group. After 7 days' treatment, the improvement of lung function indexes were observed and evaluated before and after treatment(forced expiratory volume in one second(FEV_1), forced expiratory volume occupancy in the 1^(st) second percentage of vital capacity(FEVl/FVC), peak expiatory flow(PEF)), blood gas analysis index(Arterial oxygen partial pressure(PaO_2) and arterial blood carbon dioxide partial pressure(PaCO_2), oxygenation index(OI)) and serum cytokine levels(procalcitonin(PCT) and C reactive protein(CRP). RESULTS: The total effective rate of the observation group was significantly higher than that of the control group(P < 0.05). The FEV_1, FEV_1/FVC and PEF in 2 groups were significantly increased after the treatment(P < 0.05), and the above lung function indexes in the observation group were significantly higher than the control group(P < 0.05). PaO_2 and OI were significantly increased after the treatment(P < 0.05), PaCO_2 was significantly decreased after the treatment(P < 0.05), and the improvement of above blood gas analysis indexes were significantly superior of the observation group than the control group(P < 0.05). The serum PCT and CRP levels in 2 groups were significantly decreased after the treatment(P < 0.05), and the improvement in the observation group were more significant than that in the control group(P < 0.05). CONCLUSION: Suhuang Zhike Capsule can inhibit serum inflammatory cytokine levels in patients with acute exacerbation of chronic obstructive pulmonary disease, improve blood gas analysis indicators, and improve lung functions.

Occupational Exposure to Particulate Matter from Biomass Smoke and Its Relationship to Respiratory Symptoms and Pulmonary Function among Rural Women Involved in Cassava Processing in Nigeria

Background: Cassava processing is an important source of livelihood for many rural women and involves prolonged exposure to biomass smoke. The impact of this exposure on respiratory health of these women has not been explored. We aimed to compare the frequency of respiratory symptoms and pulmonary function among cassava processing women to that of petty traders as well as the levels of particulate matter PM2.5 and PM10 at the workplaces of these women. Methods: A comparative cross-sectional design. Questionnaire was administered;spirometry was performed;PM2.5 and PM10 were sampled. Descriptive statistics were used and multiple logistic regressions were performed to assess the relationship between predictors and outcome variables. Results: 528 non-smoking women were recruited (264 cassava processors and 264 petty traders). The women were matched by baseline parameters. PM2.5 levels at the cassava processing plants were (50 ± 10.0 μg/m3) while the levels at the petty traders’ stalls were 13.0 ± 10.0 μg/m3 (P 2.5, having more respiratory symptoms, lower pulmonary function parameters and higher frequency of obstructive pulmonary defect compared to women not occupationally exposed to biomass. Use of more efficient fuel in cassava processing and personal protective equipment may limit the harmful health effects of biomass among these vulnerable women.

Research on variation and significance of immune cells, inflammatory factors and coagulation functions in patients with pulmonary tuberculosis

Objective:To investigate variation of T lymphocyte subsets, inflammatory factors and coagulation functional indexes at different stages for patients with pulmonary tuberculosis and significance of discussion and treatment on mechanism of pulmonary tuberculosis. Methods:48 cases of patients with pulmonary tuberculosis at progressive stage treated in our hospital were selected as the progression group, and 50 cases of patients with pulmonary tuberculosis at remission stage were selected as the remission group. Meanwhile, 48 cases of healthy population in our hospital were selected as the control group. Variations and significances of T lymphocyte subsets (CD3+, CD4+, CD8+ and CD4+/CD8+), inflammatory factors [interleukin-2 (IL-2), interleukin-10 (IL-10), interferon-γ (IFN-γ) and tumor necrosis factor-α(TNF-α)] and coagulation function [Fg (fibrinogen), TT (thrombin time), PLT (platelet) and D-D (D-dimer)] were analyzed.Results: Coagulation function (Fg, TT, PLT and D-D), T lymphocyte subsets CD8+ and inflammatory factors (IL-2, IL-10 and TNF-α) in patients with pulmonary tuberculosis in progression group were significantly higher than in healthy population of control group (P<0.05). T lymphocyte subsets (CD3+, CD4+ andCD4+/CD8+) and IFN-γ were significantly lower than in healthy population of control group (P<0.05). Coagulation function (Fg, TT, PLT and D-D), T lymphocyte subsets CD8+ and inflammatory factors (IL-2, IL-10 and TNF-α) in patients with pulmonary tuberculosis in remission group were significantly lower than in patients of progression group (P<0.05), but significantly higher than in healthy population of control group (P<0.05). T lymphocyte subsets (CD3+, CD4+ and CD4+/CD8+) and IFN-γ in patients with pulmonary tuberculosis in remission group were significantly higher than in patients of progression group (P<0.05), but significantly lower than in healthy population of control group (P<0.05).Conclusions:Significant variations appeared on T lymphocyte subsets, inflammatory factors and coagulation functional indexes at different stages for patients with pulmonary tuberculosis, which had important significance on discussion and treatment of pulmonary tuberculosis mechanism.

Effects of naloxone hydrochloride on pulmonary function, blood gas changes and inflammatory factors in patients with COPD combined with respiratory failure

Objective: To investigate the effects of naloxone hydrochloride on pulmonary function, blood gas changes and inflammatory factors in patients with COPD combined with respiratory failure. Methods: According to random data table method, 80 cases of COPD combined with respiratory failure were randomly divided into the control group (n=40) and observation group (n=40), patients in the control group were treated with noninvasive positive pressure ventilation on the basis of routine symptomatic treatment, on the basis of the treatment of the control group, the observation group received naloxone hydrochloride therapy. The levels of pulmonary function, blood gas changes and inflammatory factors were compared in two groups before and after treatment. Results: The levels of serum FEV1, FVC, PEF, PaCO2, PaO2, PaO2/FiO2, TNF-α and PCT in the two groups before treatment were not statistically significant. After treatment, the levels of FEV1, FVC, PEF in the control group and observation group were (70.01±0.36)%, (2.16±0.41) L, (2.98±0.45) L/s and (81.71±0.53)%, (3.65±0.55) L, (4.36±0.43) L/s, which were significantly higher than those in the same group before treatment, and the levels in observation group were significantly higher than those in the control group;the levels of PaCO2, PaO2 and PaO22/FiO2 in the two groups were (59.62±6.47) mmHg, (65.53±7.36) mmHg, (323.89±10.47) and (46.59±6.64) mmHg, (73.65±8.26) mmHg, (398.64±14.06), compared with the same group before treatment, PaCO2 levels were significantly lower in both groups, and the observation group was significantly lower than the control group, PaO2,PaO2/FiO2 levels were significantly increased in both groups, and the observation group was significantly higher than the control group;the levels of TNF-α, PCT in the two groups were (23.28±4.53) pg/mL, (5.22±2.13) ng/mL and (16.61±4.12) pg/mL, (2.07±1.21) ng/mL, which were significantly lower than those in the same group before treatment, moreover, the observation group levels were significantly lower than those in the control group. Conclusion:Treatment of COPD with respiratory failure by naloxone hydrochloride can effectively reduce the level of inflammatory factors, and improved lung function and blood gas levels, which has important clinical value.

Pulmonary Function by Spirometry in Children with Perinatal HIV Infection

Background: In an age of antiretroviral therapy, the life expectancy of children perinatally infected with Human Immunodeficiency Virus (HIV) has significantly increased. At the same time, however, pulmonary pathologies secondary to opportunistic infections have decreased thanks to increased diagnostics and access to antiretroviral therapy (ART). Despite this, in these children an immune dysregulation is maintained due to chronic infection. There is evidence that these patients have increased probability of presenting with abnormalities in pulmonary function, mainly with chronic obstructive clinical pictures (25% - 40% of perinatally infected adolescents display some anomaly in the spirometry), which predisposes them to increased risk of chronic pulmonary disease. Since lung development occurs mainly during infancy, patients perinatally infected with HIV may suffer consequences. This can be secondary to opportunistic infections, chronic inflammation due to the virus, and immunologic effects of ART, mainly in non-industrialized countries, where late diagnosis is frequent. Methodology: An analytical, observational, cross-sectional study was conducted at Roosevelt Hospital Pediatric infectious disease clinic, from January to December 2019. A sample of 76 patients was obtained, out of a population of 362 patients. A total of 62 subjects, who met the criterion of reproducibility in the spirometry, were analyzed. Results were analyzed with percentages and the association of variables using the chi-squared test (χ2). Results: A decrease in pulmonary function was found in 34% of patients, mild obstructive pattern (16%) predominating. Significant association between basal viral load greater than 100,000 cp/ml and a decrease in Forced expiratory flow 25 - 75 (FEF 25-75) (p 0.046) and in relationship between forced expiratory volume and forced vital capacity (FEV1/ FVC p = 0.024) was observed, as well as a non-statistically significant relationship between advanced clinical stage at diagnosis and decreased pulmonary function. Conclusions: The prevalence of decreased pulmonary function related to advanced clinical stage and elevated basal viral load (>100,000 cps/ml) is higher than that reported in other studies (25%) and has an influence in the long-term decrease in pulmonary function.

Effects of acetylcysteine on micro-inflammation and pulmonary ventilation in chronic obstructive pulmonary disease exacerbation

BACKGROUND Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is a serious complication of chronic obstructive pulmonary disease,often characterized by increased morbidity and mortality.In traditional Chinese medicine,AECOPD is linked to phlegm-heat and blood-stasis,presenting symptoms like thick sputum,fever,and chest pain.It has been shown that acetylcysteine inhalation in conjunction with conventional therapy significantly reduced inflammatory markers and improved lung function parameters in patients with AECOPD,suggesting that acetylcysteine may be an important adjunctive therapy for patients with phlegm-heat-blood stasis type AECOPD.AIM To investigate the effect of acetylcysteine on microinflammation and lung ventilation in patients with phlegm-heat and blood-stasis-type AECOPD.METHODS One hundred patients with phlegm-heat and blood-stasis-type AECOPD were randomly assigned to two groups.The treatment group received acetylcysteine inhalation(10%solution,5 mL,twice daily)along with conventional therapy,whereas the control group received only conventional therapy.The treatment duration was 14 d.Inflammatory markers(C-reactive protein,interleukin-6,and tumor necrosis factor-alpha)in the serum and sputum as well as lung function parameters(forced expiratory volume in one second,forced vital capacity,and peak expiratory flow)were assessed pre-and post-treatment.Acetylcysteine inhalation led to significant reductions in inflammatory markers and improvements in lung function parameters compared to those in the control group(P<0.05).This suggests that acetylcysteine could serve as an effective adjunct therapy for patients with phlegm-heat and blood-stasis-type AECOPD.RESULTS Acetylcysteine inhalation significantly reduced inflammatory markers in the serum and sputum and improved lung ventilation function parameters in patients with phlegm-heat and blood-stasis type AECOPD compared with the control group.These differences were statistically significant(P<0.05).The study concluded that acetylcysteine inhalation had a positive effect on microinflammation and lung ventilation function in patients with this type of AECOPD,suggesting its potential as an adjuvant therapy for such cases.CONCLUSION Acetylcysteine inhalation demonstrated significant improvements in reducing inflammatory markers in the serum and sputum,as well as enhancing lung ventilation function parameters in patients with phlegm-heat and bloodstasis type AECOPD.These findings suggest that acetylcysteine could serve as a valuable adjuvant therapy for individuals with this specific type of AECOPD,offering benefits for managing microinflammation and optimizing lung function.

Impact of Cystic versus Cylindrical Types of Bronchiectasis on Pulmonary and Cardiac Functions

Background: The combination of the clinical features, HRCT score and echocardiographic evidence of pulmonary hypertension help assess the prognosis in bronchiectasis. Aim: To test whether pulmonary and cardiac functions associated with bronchiectasis would differ according to its type (cystic versus cylindrical) utilizing HRCT score, PFTs and echocardiography. Patients and Methods: A cross-sectional study of patients with bronchiectasis was conducted at Chest and Internal Medicine Departments at Assiut University Hospital, Egypt. The diagnosis of bronchiectasis type was based on HRCT findings. PFTs, HRCT score and echocardiography were assessed in all cases. Results: We studied 56 patients with bronchiectasis;31 were cystic (group A) and 25 were cylindrical (group B). Forced vital capacity (FVC%) and Dlco% were significantly lower in group A (P as compared with group B;whereas FEF 25%-75% and FEV1 (0.04) were lower in group B. Global HRCT score, RVD and SPAP were significantly higher in group A (P = 0.002) and correlated with FEV1% (r = ?0.51), and with SPAP (r = 0.16). Conclusions: Airway obstruction and small airway dysfunction were more significantly seen in cylindrical bronchiectasis. Patients with cystic bronchiectasis had significantly, higher global HRCT scores, RVD and SPAP. HRCT scores correlate with FEV 1% and SPAP and could be a predictor of future PH. Routine echocardiographic assessment of patients with bronchiectasis, particularly in those with cystic disease is highly recommended.

Clinical Significance of Pulmonary Function Tests in Long-Term Survivors after Myeloablative Allogeneic Hematopoietic Stem Cell Transplantation

We retrospectively assessed long-term pulmonary function in adults surviving for ≥5 years after myeloablative allogeneic hematopoietic stem cell transplantation and identified risk factors for late-onset noninfectious pulmonary complications. Among 174 patients undergoing transplantation for hematologic malignancies between May 1994 and December 2004, 81 long-term survivors were evaluated. Pulmonary function tests (PFTs) were performed before conditioning, 3 months and 1 year after transplantation, and then annually. Eight patients (10%) had abnormal pulmonary function before transplantation, but this was not associated with late changes in PFTs. Patients with chronic graft-versus-host disease (GVHD) showed a significant decline of lung function after 3 years when compared with patients without chronic GVHD. Abnormal pretransplantation lung function was associated with pulmonary chronic GVHD according to National Institutes of Health criteria (score 0, n = 58;score 1, n = 14;score 2, n = 6;score 3, n = 3). Five patients with late-onset noninfectious pulmonary complications showed a decline of lung function at 1 year after transplantation. Only chronic GVHD was significantly related to late-onset noninfectious pulmonary complications. In conclusion, abnormal lung function before transplantation may be associated with a decline in pulmonary function within 1 year after transplantation, but late-onset noninfectious pulmonary complications could not be predicted from pretransplantation lung function.

Clinical effect of ambroxol hydrochloride combined with rehabilitation training on COPD and its effect on pulmonary function

Objective:To explore the clinical effect of ambroxol hydrochloride combined with rehabilitation training on COPD and its effect on pulmonary function.Methods:92 patients with COPD from May 2017 to may 2019 were randomly divided into control group(n=46)and observation group(n=46).The control group was treated with oxygen inhalation,expectorant,antispasmodic,anti infection and so on.The observation group was treated with ambroxol hydrochloride combined with rehabilitation training on this basis.Blood gas,lung function and inflammatory factors were compared before and after treatment.Results:the levels of SaO2 and PaO2 in the two groups were significantly higher than those before treatment P There was significant difference between the two groups(P<0.05-0.01).Besides,the level of lung function related indexes in the observation group was significantly higher than that in the control group(P<0.05).Conclusion:ambroxol hydrochloride combined with rehabilitation training has a significant clinical effect on COPD,which can effectively improve the blood gas index and reduce the level of blood gas inflammatory factors,thus affecting the lung function of COPD patients.