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.

Functional and psychosocial effects of pulmonary Daoyin on patients with COPD in China:study protocol of a multicenter randomized controlled trial

BACKGROUND： Chronic obstructive pulmonary disease （COPD） is a major public health problem worldwide. Pulmonary rehabilitation （PR） is an established intervention for the management of patients with COPD. Exercise training is an important part of PR, and its effectiveness in patients with COPD is well established. However, alternative methods of PR training such as Daoyin have not been appropriately studied. Hence, alternative forms of exercise training that require less exercise equipment and no specific training place should be evaluated. This paper describes the study protocol of a clinical trial that aims to determine if pulmonary Daoyin training will improve the exercise capacity and psychosocial function of patients with COPD in China. METHODS AND DESIGN： A multicenter, randomized, controlled trial will be conducted. A total of 464 patients meeting the inclusion criteria will be enrolled into this study with 232 patients in each of the trial group and the control group. Based on patient education, patients in the trial group will receive pulmonary Daoyin and continue with their usual therapy for three months. In the control group, patients will continue with their usual therapy. The primary outcome measures are exercise capacity assessed by the six-minute walking distance test and lung function. Secondary outcomes include dyspnea and quality of life. Measurements will be taken at baseline （month 0） and after the study period （month 3）. DISCUSSION： It is hypothesized that pulmonary Daoyin will have beneficial effects in improving exercise capacity and psychosocial function of patients with stable COPD, and will provide an alternative form of exercise training that is accessible for the large number of people with COPD. TRIAL REGISTRATION： This trial has been registered in ClinicalTrials.gov. The identifier is NCT01482000.

Load Assessment of the Static Posture and Weight Holding inTerms of Pulmonary Ventilation and Heart Rate

The aim of this study was to explore appropriate index for load evaluation by analyzing.the changes of pulmonary ventilation (VE) and heart rate (HR)in 35 student volunteers under the condition of static posture and weight holding.Each subject was asked to perform 7 kinds of static postures and 2 kinds of weight holdings. The HR was continuously measured by a remote detecting device. VE was recorded by a ventimeter for an average of 5 min. The results showed that HR was positively correlated to VE under static activities (r=0. 89), which suggested that VE as well as HR could to some degrees reflect the static load. It was better to use VE to indicate the load of weight holdings than to use HR, which, on the other hand, was more sensible in reflection of the posture load. It is better to use relative value of both of VE and HR to reflect the static load. In addition,arm-overheaded posture increase HR more significantly than any other activities.

Efficacy and safety of ivermectin in patients with mild and moderate COVID-19:A randomized controlled trial

Objective:To evaluate the effectiveness and safety of ivermectin in patients with mild and moderate COVID-19.Methods:This study was a single-center,randomized,open-label,controlled trial with a 2-arm parallel-group design on 68 patients with COVID-19.According to the 1:1 ratio between the study groups(ivermectin group and standard treatment group),patients were randomly admitted to each intervention arm.Results:The mean age of the participants in the ivermectin group was(48.37±13.32)years.Eighteen of them were males(54.5%)and the participants in the control group had a mean age of(46.28±14.47)years,with nineteen of them being males(59.4%).As a primary outcome,after 5 days of randomization,there was no significant difference between the ivermectin group and the control group in the length of stay in the hospital(P=0.168).ICU admission(P=0.764),length of stay in ICU(P=0.622),in-hospital mortality(P=0.427),adverse drug reactions,and changes in the mean difference of laboratory data had not any significant difference between the two groups(except for urea change).In addition,the radiologic findings of the two groups of patients were not significantly different.Linear regression analysis showed that for every 10 years increase of age,0.6 day of hospitalization duration was increased.There was no statistically significant association between other variables and clinical outcomes.Conclusions:Among adult hospitalized patients with moderate to severe COVID-19,there was no significant relationship between the administration of ivermectin single dose in a five-day course and clinical improvement,and mortality of the participants.

Dimensionless Study on Secretion Clearance of a Pressure Controlled Mechanical Ventilation System with Double Lungs

A pressure controlled mechanical ventilator with an automatic secretion clearance function can improve secretion clearance safely and efficiently.Studies on secretion clearance by pressure controlled systems show that these are suited for clinical applications.However,these studies are based on a single lung electric model and neglect the coupling between the two lungs.The research methods applied are too complex for the analysis of a multi-parameter system.In order to understand the functioning of the human respiratory system,this paper develops a dimensionless mathematical model of doublelung mechanical ventilation system with a secretion clearance function.An experiment is designed to verify the mathematical model through comparison of dimensionless experimental data and dimensionless simulation data.Finally,the coupling between the two lungs is studied,and an orthogonal experiment designed to identify the impact of each parameter on the system.

Modelling and Simulation of Pressure Controlled Mechanical Ventilation System

A mathematical model of mechanical ventilator describes its behavior during artificial ventilation. This paper purposes to create and simulate Mathematical Model (MM) of Pressure Controlled Ventilator (PCV) signal. This MM represents the respiratory activities and an important controlled parameter during mechanical ventilation—Positive End Expiration Pressure (PEEP). The MM is expressed and modelled using periodic functions with inequalities to control the beginning of inspiration and expiration durations. The created MM of PCV signal is combined with an existing multi compartmental model of respiratory system that is modified and developed in the internal parameters—compliances (C) to test created MM. The created MM and model of respiratory system are constructed and simulated using Simulink package in MATLAB platform. The obtained simulator of mechnical ventilation system could potentially represent the pressure signal of PVC as a complete respiratory cycle and continuance waveform. This simulator is also able to reflect a respiratory mechanic by changing some input variables such as inspiration pressure (IP), PEEP and C, which are monitored in volume, flow, pressure and PV loop waveforms. The obtained simulator has provided a simple environment for testing and monitoring PCV signal and other parameters (volume, flow and dynamic compliance) during artificial ventilation. Furthermore, the simulator may be used for studying in the laboratory and training ventilator’s operators.

Exercise-based rehabilitation programmes for pulmonary hypertension:a systematic review and meta-analysis of randomized controlled trails

Objective Individuals with pulmonary hypertension(PH)have reduced exercise capacity and quality of life.Exercise-based rehabilitation may have beneficial effects to improve the exercise capacity and quality of life in patients with PH.We aim to assess the efficacy and safety of exercised-based rehabilitation for people eith PH by performing a randomized controlled trails(RCTs)meta-analysis of exercised-based rehabilitation for people with PH by performing a randomized controlled trails meta-analysis.

Harmonic excitation of linear respiratory mechanics for physiological dual controlled ventilation

The theoretical approach along with the rationale of harmonic excitation modality (HEM) applied as optimal dual controlled ventilation (DCV) to anaesthetized or severe brain injured patients, whose respiretory mechanics can be properly assumed steady and linear, are presented and discussed. The design criteria of an improved version of the Advanced Lung Ventilation System (ALVS), including HEM in its functional features, are described in details. In particular, the elimination of any undesiderable artificial distortion affecting the respiratory and ventilation pattern waveforms is achieved by maintaining continuous forever the airflow inside the ventilation circuit, ensuring also the highest level of safety for patient in any condition. In such a way, the full-time compatibility of controlled breathings with spontaneous breathing activity of patient during continuous positive airways pressure (CPAP) or bilevel positive airways pressure (BiPAP) ventilation modalities and during assisted/controlled ventilation(A/CV), includeing also synchronized or triggered ventilation modalities, is an intrinsic innovative feature of the system available for clinical application. As expected and according to the clinical requirements, HEM provides for physiological respiratory and ventilation pattern waveforms together with optimal “breath to breath” feedback control of lung volume driven by an improved diagnostic measurement procedure, whose outputs are also vital for adapting all the preset ventilation parameters to the current value of the respiratory parameters of patient. The results produced by software simulations concerning both adult and neonatal patients in different clinical conditions are completely consistent with those obtained by the theoretical treatment, showing that HEM reaches the best performances from both clinical and engineering points of view.

Based on the process management of traditional Chinese medicine comprehensive intervention method on outcomes in patients with mild/moderate chronic obstructive pulmonary disease:study protocol for a practical randomized controlled trial

背景:慢性阻塞性肺疾病(COPD)的患病率、发病率和死亡率都很高,已成为公共卫生问题。慢性阻塞性肺疾病的早期发展在其严重发展之前就受到了广泛的关注。中医药在缓解症状、减少COPD加重方面也有一定优势。方法:设计一项实用的随机对照试验,检验中医辨证论治的临床疗效。本研究共纳入80例轻度/中度COPD患者,治疗组40例,对照组40例。在生活方式干预的基础上,治疗组采用中药配方颗粒,对照组采用安慰剂模拟中药颗粒。肺功能的恶化和改善将作为主要的预后指标。结论:我们认为慢性阻塞性肺病患者可以从中医药治疗中获益。

Development of a Remotely Controlled Testing Platform with Low-drag Air-ventilated Hull

这份报纸探讨发展并且有创新的通气空气的壳的一个遥远地控制的船平台严峻。轮船壳的下侧上的空气洞的申请是一答应为减少水动力学的工具拖和污染物质排出物和增加的海洋的交通效率。尽管有这个概念潜力，设计优化和新奇空气洞轮船的高效的操作仍然是一个挑战性的问题。赫尔建设和模型规模空气洞船的传感器乐器学在纸被描述。壳的模块化的结构允许容易的修正，和一个电的推进单位启用自己推动的操作。船经由一个收音机传播系统遥远地被控制。起始的测试的结果被报导，包括在几的戳，速度，和气流率装载条件。构造平台能被用于优化空气洞系统并且测试另外的创新的壳图案。这个系统能也被开发进一只高效的无人的船。

Efficacy and safety of Kangxian Huanji Granule as adjunctive treatment in acute exacerbation of idiopathic pulmonary fibrosis:An exploratory randomized controlled trial

Background:Acute exacerbation of idiopathic pulmonary fibrosis(AE-IPF)is an important occurrence in the natural history of idiopathic pulmonary fibrosis(IPF),associated with high hospitalization rates,high mortality and poor prognosis.At present,there is no effective treatment for AE-IPF.Chinese herbal medicine has some advantages in treating IPF,but its utility in AE-IPF is unclear.Objective:The treatment of AE-IPF with Kangxian Huanji Granule(KXHJ),a compound Chinese herbal medicine,lacks an evidence-based justification.This study explores the efficacy and safety of KXHJ in patients with AE-IPF.Design,setting,participants and interventions:Wedesigned a randomized,double-blind,placebo-controlled,exploratory clinical trial.A total of 80 participants diagnosed with AE-IPF were randomly assigned to receive KXHJ or a matching placebo;the treatment included a 10 g dose,administered twice daily for 4 weeks,in addition to conventional treatment.Participants were followed up for 12 weeks after the treatment.Main outcome measures:The primary endpoints were treatment failure rate and all-cause mortality.Secondary endpoints included the length of hospitalization,overall survival,acute exacerbation rate,intubation rate,the modified British Medical Research Council(mMRC)score,and the St George’s Respiratory Questionnaire for IPF(SGRQ-I)score.Results:The rate of treatment failure at 4 weeks was lower in the intervention groupcompared to the control group(risk ratio[RR]:0.22;95%confidence interval[CI]:0.051 to 0.965,P=0.023).There was no significant difference in all-causemortality at 16 weeks(RR:0.75;95%CI:0.179 to 3.138;P>0.999)or in the acute exacerbation rate during the 12-week follow-up period(RR:0.69;95%CI:0.334 to 1.434;P=0.317).The intervention group had a shorter length of hospitalization than the control group(mean difference[MD]:–3.30 days;95%CI,–6.300 to–0.300;P=0.032).Significant differences in the mean change from baseline in the mMRC(between-group difference:–0.67;95%CI:–0.89 to–0.44;P<0.001)and SGRQ-I score(between-group difference:–10.36;95%CI:–16.483 to–4.228;P=0.001)were observed after 4 weeks,and also in the mMRC(between-group difference:–0.67;95%CI:–0.91 to–0.43;P<0.001)and SGRQ-I(between-group difference:–10.28;95%CI,–15.838 to–4.718;P<0.001)at 16 weeks.The difference in the adverse events was not significant.Conclusion:KXHJ appears to be effective and safe for AE-IPF and can be considered a complementary treatment in patients with AE-IPF.As a preliminary exploratory study,our results provide a basis for further clinical research.

Effect of different ventilation methods combined with pulmonary surfactant on neonatal acute respiratory distress syndrome

BACKGROUND Acute respiratory distress syndrome precipitates is widespread pulmonary injury in impacted individuals,the neonatal respiratory distress syndrome(NRDS),primarily observed in preterm infants,represents a prevalent critical condition in neonatal clinical settings.AIM To investigate the clinical efficacy of various ventilation strategies combined with pulmonary surfactant(PS)therapy in the treatment of NRDS.METHODS A total of 20 neonates diagnosed with respiratory distress syndrome,admitted between May 2021 and June 2022,were randomly assigned to either a research group or a control group.Neonates in the research group received treatment involving high-frequency oscillatory ventilation(HFOV)in conjunction with PS.In contrast,neonates in the control group were administered either controlled mechanical ventilation or synchronous intermittent mandatory ventilation,combined with PS.Arterial blood samples from the neonates in both groups were collected before treatment,as well as 6 h,12 h,24 h,and 48 h post-treatment.These samples underwent blood gas analysis,with measurements taken for pH value,partial pressures of oxygen(O_(2))and carbon dioxide.Concurrently,data was collected on the duration of ventilator use,length of hospitalization time,O_(2) treatment time,treatment outcomes,and complications of the ventilator.RESULTS From 6-48 h post-treatment,both groups demonstrated significant improvements in arterial blood pH and oxygen partial pressure,along with a significant decrease in carbon dioxide partial pressure compared to pre-treatment values(P<0.05).Although these changes progressed over time,there were no significant differences between the two groups(P>0.05).However,the research group had significantly lower X-ray scores,shorter hospitalization time,and less time on O_(2) therapy compared to the control group(P<0.05).Mortality rates were similar between the two groups(P>0.05),but the research group had a significantly lower incidence of complications(P<0.05).CONCLUSION The integration of HFOV combine with PS has proven to effectively expedite the treatment duration,decrease the occurrence of complications,and secure the therapeutic efficacy in managing NRDS.

Clinical evaluation of ventilation mode on acute exacerbation of chronic obstructive pulmonary disease with respiratory failure

BACKGROUND At present,understanding of the most effective ventilation methods for treating chronic obstructive pulmonary disease(COPD)patients experiencing acute worsening symptoms and respiratory failure remains relatively limited.This report analyzed the efficiency and side effects of various ventilation techniques used for individuals experiencing an acute COPD exacerbation.AIM To determine whether pressure-controlled ventilation(PCV)can lower peak airway pressures(PAPs)and reduce the incidence of barotrauma compared to volume-controlled ventilation(VCV),without compromising clinical outcomes and oxygenation parameters.METHODS We have evaluated 600 patients who were hospitalized due to a severe COPD exacerbation,with 400 receiving mechanical ventilation for the respiratory failure.The participants were divided into two different groups,who were administered either VCV or PCV,along with appropriate management.We thereafter observed patients'attributes,clinical factors,and laboratory,radiographic,and arterial blood gas evaluations at the start and during their stay in the intensive care unit(ICU).We have also employed appropriate statistical methods for the data analysis.RESULTS Both the VCV and PCV groups experienced significant enhancements in the respiratory rate,tidal volume,and arterial blood gas values during their time in the ICU.However,no significant distinctions were detected between the groups in terms of oxygenation indices(partial pressures of oxygen/raction of inspired oxygen ratio)and partial pressures of carbon dioxide improvements.There was no considerable disparity observed between the VCV and PCV groups in the hospital mortality(32%vs 28%,P=0.53),the number of days of ICU stay[median interquartile range(IQR):9(6-14)d vs 8(5-13)d,P=0.41],or the duration of the mechanical ventilation[median(IQR):6(4-10)d vs 5(3-9)d,P=0.47].The PCV group displayed lower PAPs compared to the VCV group(P<0.05)from the beginning of mechanical ventilation until extubation or ICU departure.The occurrence of barotrauma was considerably lower in the PCV group in comparison to the VCV group(6%vs 16%,P=0.03).CONCLUSION Both VCV and PCV were found to be effective in treating patients with acute COPD exacerbation.However,PCV was associated with lower PAPs and a significant decrease in barotrauma,thus indicating that it might be a safer ventilation method for this group of patients.However,further large-scale study is necessary to confirm these findings and to identify the best ventilation approach for patients experiencing an acute COPD exacerbation.

Early use of non-invasive positive pressure ventilation for acute exacerbations of chronic obstructive pulmonary disease:a multicentre randomized controlled trial

Background Respiratory muscle fatigue plays an important role in acute exacerbations of chronic obstructivepulmonary disease (AECOPD)·In previous clinical studies, non-invasive positive pressure ventilation (NPPV)was proved to be successful only for AECOPD patients with severe respiratory failure·We hypothesized that, theoutcomes of AECOPD would be improved if NPPVis early (within 24 to 48 hours of admission) administered inthose patients with respiratory muscle fatigue and mild respiratory insufficiency, especially in patients withoutfulfilling the conventional criteria of mechanical ventilatory support·Methods Aprospective multicentre randomized controlled trial was conducted in19 hospitals in China over16months·Three hundred and forty-two AECOPD patients with pH≥7·25 and PaCO2>45 mmHg were recruitedon general ward and randomly assigned to standard medical treatment (control group) or early administration ofadditional NPPV (NPPV group)·Results The characteristics of two groups on admission were similar·The number of AECOPD patientsrequiring intubations in NPPV group was much fewer than that of the control group (8/171 vs 26/71,P=0·002)·Subgroup analysis showed the needs for intubation in mildly (pH≥7·35) and severe (pH<7·30)acidotic patients in NPPVgroup were both decreased (9/80 vs2/71,P=0·047 and 8/30 vs3/43,P=0·048,respectively)·The mortality in hospital was reduced slightly by NPPV but with no significant difference (7/171vs 12/171,P=0·345)·Respiratory rate (RR),scale for accessory muscle use and arterial pHimproved rapidlyat the first 2 hours only in patients of NPPV group·After 24 hours, the differences of pH, PaO2, scale foraccessory muscle use and RR in NPPV group [(7·36±0·06) mmHg, (72±22) mmHg, (2·5±0·9) /min,(22±4) /min] were statistically significant compared with control group (7·37±0·05) mmHg, (85±34)mmHg, (2·3±1·1) /min, (21±4) /min,P<0·01 for all comparisons]·Conclusions The early use of NPPV on general ward improves arterial blood gas and respiratory pattern,decreases the rate of need for intubation in AECOPD patients·NPPV is indicative for alleviating respiratorymuscle fatigue and preventing respiratory failure from exacerbation·

Respiratory Mechanics, Respiratory Muscle Strength, Control of Ventilation and Gas Exchange in Patients with Autoimmune Liver Disease

Objectives: To assess respiratory elastance and resistive properties in patients with autoimmune liver disorders using the passive relaxation expiration technique and compare findings to a group of patients with non-autoimmune liver disease and control subjects. These findings were then related to control of ventilation and gas exchange. A secondary objective was to assess respiratory muscle strength and gas exchange and their relation to respiratory mechanics. Methods: Measurements included respiratory elastance and resistance using the passive relaxation method. Pulmonary function, gas exchange and control of ventilation were assessed using standard methods. Results: a) Compared to control subjects, Ers in patients with liver disease was on average 50% greater than in controls;b) mean respiratory resistance, expressed as the respiratory constants, K1 and K2 in the Rohrer relationship, Pao/V’ = K1 + K2V’, was not different from control resistance;c) mean maximal inspiratory and maximal expiratory pressures averaged 36% and 55% of their respective control values;d) inspiratory occlusion pressure in 0.1 sec (P0.1) was increased and negatively associated with FVC;and e) increases in P0.1, mean inspiratory flow (Vt/Ti) and presence of respiratory alkalosis confirmed the increase in ventilatory drive. Despite inspiratory muscle weakness in patients, P0.1/Pimax averaged 5-fold higher than in control subjects. Conclusions: Despite inspiratory muscle weakness and a V’E similar to that in normal subjects, central drive is increased in patients with chronic liver disease. The increase in ventilatory drive is related to smaller lung volumes and weakly associated with increase in respiratory elastance. Findings confirm that P0.1 is a reliable measure of central drive and is an approach that can be used in the evaluation of control of ventilation in patients with chronic liver disease.

Observation on the Effect of Non-Invasive Ventilator Combined with Conventional Therapy in the Treatment of Chronic Obstructive Pulmonary Disease Complicated with Respiratory Failure

Objective:To explore the clinical effect of a non-invasive ventilator combined with conventional therapy in the treatment of patients with chronic obstructive pulmonary disease(COPD)combined with respiratory failure.Methods:68 patients with COPD combined with respiratory failure treated in our hospital from September 2021 to October 2023 were selected as the research subjects.Using the random number table method,they were divided into a control group and an experimental group of 34 cases each.The control group received conventional symptomatic treatment,and the experimental group received non-invasive ventilator treatment based on the control group.The clinical effects,blood gas indicators(partial pressure of carbon dioxide(PaCO_(2)),partial pressure of oxygen(PaO_(2)),arterial oxygen saturation(SaO_(2))),lung function(forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),6 min walking distance),complications,and inflammatory factor levels(c-reactive protein(CRP),interleukin-6(IL-6),neutrophil-to-lymphocyte ratio(NLR))of the two groups of patients were observed.Results:(1)The clinical efficacy of the patients in the experimental group(33/97.06%)was more significant as compared with the control group(25/73.53%)(P<0.05);(2)After treatment,the clinical efficacy of the two groups of patients in terms of FEV1,FEV1/FVC,6-minute walking distance,PaO_(2)and SaO_(2)all increased in the experimental group as compared to that of the control group(P<0.05);(3)After treatment,the PaCO_(2),CRP,IL-6,and NLR of the two groups of patients decreased,and the decrease in the experimental group was higher than that of the control group(P<0.05);(4)The patients’complication rate in the experimental group(2/5.88%)was lower as compared to that of the control group(9/26.46%)(P<0.05).Conclusion:Non-invasive ventilators combined with conventional therapy achieved good clinical results in treating patients with COPD and respiratory failure.

Clinical Study on Respiratory Medicine Treatment of Chronic Obstructive Pulmonary Disease Combined with Respiratory Failure

Objective:To explore the respiratory medicine treatment methods for treating chronic obstructive pulmonary disease(COPD)combined with respiratory failure.Methods:70 cases of COPD patients with combined respiratory failure admitted to our hospital from January 2021 to January 2023 were selected as the study subjects,and randomly divided into the control group and the experimental group,each with 35 cases.The control group received only conventional treatment,and the experimental group received non-invasive positive pressure ventilation,and the treatment effects and changes in the levels of IL-18,hs-CRP,and CES2 inflammatory factors were observed and evaluated in the two groups.Results:There was no significant difference between the general data of the two groups(P>0.05);after treatment,the total effective rate of clinical efficacy of the observation group(91.43%)was significantly higher than that of the control group(71.43%),and the difference showed a significant correlation(P<0.05);after treatment,the level of inflammatory factor of the observation group was significantly reduced compared with that of the control group,and the difference showed a highly significant correlation(P<0.001).Conclusion:The non-invasive positive pressure ventilation treatment program significantly improves the therapeutic effect,effectively controls the level of inflammatory factors,and improves the health status of patients when dealing with patients with chronic obstructive pulmonary disease accompanied by respiratory failure,showing a good clinical application prospect.

Acupuncture treatment of lung-spleen Qi deficiency in stable chronic obstructive pulmonary disease: a randomized, open-label, controlled trial

OBJECTIVE:To evaluate the effectiveness and safety of acupuncture that reinforces the spleen to strengthen the lung in patients with stable chronic obstructive pulmonary disease(COPD).METHODS:This was a randomized,open-controlled trial in which the acupuncturist and the participants were not blinded,but the outcome evalu-ators and data analysts were blinded.One-hundred-and-two patients with stable COPD were randomly divided into two groups in a 1∶1 ratio.The acupuncture group received 30-minute sessions of acupuncture therapy at the same acupoints three times weekly for 6 weeks in addition to routine conventional Western Medicine treatment;the control group received routine conventional Western Medicine treatment alone.The primary outcome was the Borg scale score,which was assessed immediately after the 6-minute walk test.The secondary outcomes were the 6-minute walk distance,lung function,and oxygen saturation.Measurements were obtained at baseline and after 6 weeks of treatment.RESULTS:After 6 weeks of treatment,the Borg scale score in the acupuncture group was significantly better than that in the control group(2.02±0.71 versus 5.01±0.34,P<0.05).Furthermore,the post-treatment improvements in the 6-minute walk distance,lung function,and oxygen saturation were significantly greater in the acupuncture group than in the control group,showing that the acupuncture group had better exercise tolerance.CONCLUSION:The findings suggest that acupuncture that aims to reinforce the spleen to strengthen the lung is a safe and effective adjuvant therapy that effectively improves the exercise capacity of patients with stable COPD.

Acupoint Herbal Patching with or without Conventional Treatment for Stable Chronic Obstructive Pulmonary Disease: a Systematic Review of Randomized Controlled Trials

Background: Acupoint herbal patching(AHP) alone or as an adjuvant therapy with conventional treatment(CT) has been widely used for prevention and treatment of chronic obstructive pulmonary disease(COPD). However, current clinical evidence from a systematic review of RCTs is lacking.Objective: To evaluate the effectiveness and safety of AHP with or without CT for people with COPD at stable stage.Methods: We searched randomized controlled trials comparing AHP(with or without CT) with no intervention, placebo, or CT from six databases. Two authors selected studies, extracted data and evaluated risk of bias of included trials. Rev Man 5.2 software was used to analysis data.Results: Twenty one RCTs(2327 participants) were included. AHP of non sanfu applied on no fixed dates with CT significantly decreased the mean frequency of acute exacerbation of COPD(times per year)(MD:-1.24; 95% CI:-2.02 to-0.46; 2 trials), and improved lung function parameters and quality of life. The AHP with CT showed no better effect in 6-minute walking distance(6 MWD) that CT alone. AHP applied at sanfu(specific dates based on lunar calendar) with CT had significant effect for 6 MWD(MD: 11.20; 95% CI: 0.83 to 21.56; I^2= 0%;3 trials). One trial reported skin irritation from AHP. Another trial reported two patients had eye discomfort, which was inferred as the adverse effects of seretide.Conclusion: AHP used as an adjunct to CT, appears to be more effective than CT alone in patients with stable COPD. However, further large,rigorously designed trials are warranted to confirm these potential effects.