Information-motivation-behavioral guided nursing for stroke patients with pulmonary dysfunction:A randomized controlled trial

BACKGROUND Patients with stroke frequently experience pulmonary dysfunction.AIM To explore the effects of information-motivation-behavioral(IMB)skills modelbased nursing care on pulmonary function,blood gas indices,complication rates,and quality of life(QoL)in stroke patients with pulmonary dysfunction.METHODS We conducted a controlled study involving 120 stroke patients with pulmonary dysfunction.The control group received routine care,whereas the intervention group received IMB-model-based nursing care.Various parameters including pulmonary function,blood gas indices,complication rates,and QoL were assessed before and after the intervention.RESULTS Baseline data of the control and intervention groups were comparable.Post-intervention,the IMB model-based care group showed significant improvements in pulmonary function indicators,forced expiratory volume in 1 sec,forced vital capacity,and peak expiratory flow compared with the control group.Blood gas indices,such as arterial oxygen pressure and arterial oxygen saturation,increased significantly,and arterial carbon dioxide partial.pressure decreased significantly in the IMB model-based care group compared with the control group.The intervention group also had a lower complication rate(6.67%vs 23.33%)and higher QoL scores across all domains than the control group.CONCLUSION IMB model-based nursing care significantly enhanced pulmonary function,improved blood gas indices,reduced complication rates,and improved the QoL of stroke patients with pulmonary dysfunction.Further research is needed to validate these results and to assess the long-term efficacy and broader applicability of the model.

Values of high-resolution computed tomography and pulmonary function tests in managements of patients with chronic hepatitis C virus infection

AIM:To investigate pulmonary involvement via pulmonary function tests (PFT) and high-resolution computed tomocjraphy (HRCT) in patients with chronic hepatitis C virus (HCV) infection. METHODS:Thirty-four patients with chronic HCV infection without diagnosis of any pulmonary diseases and 10 healthy cases were enrolled in the study,PFT and HRCT were performed in all cases. RESULTS:A decrease lower than 80% of the predicted value was detected in vital capacity in 9/34 patients,in forced expiratory volume in one second in 8/34 patients,and in forced expiratory flow 25-75 in 15/34 patients,respectively.Carbon monoxide diffusing capacity (DLCO) was decreased in 26/34 patients.Findings of interstitial pulmonary involvement were detected in the HRCT of 16/34 patients.Significant difference was found between controls and patients with HCV infection in findings of HRCT (X^2=4.7,P=0.003).Knodell histological activity index (KHAI) of 28/34 patients in whom liver biopsy was applied was 9.0±4.7.HRCT findings,PFT values and DLCO were not affected by KHAI in patients with HCV infection.In these patients,all the parameters were related with age. CONCLUSION:We suggest that chronic hepatitis C virus infection may cause pulmonary interstitial involvement without evident respiratory symptoms.

Effects of magnesium sulfate on brain mitochondrial respiratory function in rats after experimental traumatic brain injury

To study the effects of magnesium sul fate on brain mitochondrial respiratory function in rats after experimental trau matic brain injury and the possible mechanism. Methods: The middle degree brain injury in rats was made by BIM III multi function impacting machine. The brain mitochondrial respiratory fun ction was measured with oxygen electrode and the ultra structural changes were observed with transmission electron microscope (TEM). Results: 1. The brain mitochondrial respiratory stage III and r espiration control rate reduced significantly in the untreated groups within 24 and 72 hours. But treated Group A showed certain degree of recovery of respirato ry function; treated Group B showed further improvement. 2. Untreated Group, tre ated Groups A and B had different degrees of mitochondrial ultra structural dam age respectively, which could be attenuated after the treatment with magnesium s ulfate.Conclusions: The mitochondrial respiratory function decreases s ignificantly after traumatic brain injury. But it can be apparently improved aft er magnesium sulfate management along with the attenuated damage of mitochondria discovered by TEM. The longer course of treatment can obtain a better improveme nt of mitochondrial respiratory function.

Effect of rapid point pressure on therapeutic efficacy and pulmonary function in patients with chronic persistent bronchial asthma

Objective：To observe the effect of rapid point pressure on clinical effect and pulmonary function of patients with chronic persistent bronchial asthma. 〈br〉 Methods：A total of 60 confirmed chronic persistent bronchial asthma cases were randomly allocated into two groups, 30 in each group. Cases in the treatment group were treated with rapid point pressure, 1 h for the initial treatment, and 40 min for the ensuing treatments. The treatment was done once a day for 40 d. Cases in the control group were treated with Compound Methoxyphenamine Hydrochloride Capsules, 2 capsules for each dose, 3 times a day. The treatment lasted for 7 consecutive days. A 1-year follow-up was made for both groups. 〈br〉 Results：After treatment, the scores of each symptom and total symptom scores for the traditional Chinese medicine （TCM） symptoms in the treatment group were significantly higher than those in the control group （P〈0.05）;the total effective rates in the treatment group were higher than those in the control group in each time frame; and there was a between-group statistical significance in total effective rate after 7 d of treatment （P〈0.01）. After 40-day treatments, there were statistical significances in the forced expiratory volume in 1 s percentage of predicted value （FEV 1%） and inspiratory capacity （IC%） in the treatment group （P〈0.05）; however, there were no statistical significances （P〉0.05） in forced expiratory volume in 1 second to forced vital capacity ratio （FEV1/FVC）, peak expiratory flow rate （PEF%） and maximum midexpiratory flow rate （MMEF%）; and there were no statistical significances in pulmonary function parameters in the control group. In addition, as for pulmonary function parameters, there were no intra-group statistical significances in differences before and after treatment （P〉0.05）. 〈br〉 Conclusion：Rapid point pressure can alleviate patients’ TCM symptoms and improve their FEV%and IC%.

Using quantitative CT to predict postoperative pulmonary function in patients with lung cancer

Background At present, the therapy for patients with lung cancer that achieves a high rate of cure is surgical resection at an early stage of the disease. The aim of this study is to evaluate quantitative computed tomography (QCT) for predicting postoperative pulmonary function in patients with lung cancer. Methods The data of thirty-one patients with lung cancer who underwent both pulmonary functional tests and QCT scan before operations were collected. A CT program was used to quantify the volume of whole lung parenchyma with attenuation of -910 HU to -600 HU, which was defined as total functional lung volume (TFLV). Similarly, the volume of lung (lobes or segments) with attenuation of -910 HU to -600 HU was defined as regional functional lung volume (RFLV). Forced vital capacity (FVC), forced expiratory volume in first second (FEV_1), FVC% and FEV_1% (ratio to reference values of the matched population) were obtained from preoperational pulmonary functional tests. According to the formula: predicted FVC (pre-FVC)=preoperative FVC×[1-(RFLV/TFLV)]; predicted FEV_1 (pre-FEV_1)=preoperative FEV_1×[1-(RFLV/TFLV)], we obtained values of predicted FVC, predicted FEV_1, predicted FVC% (pre-FVC/reference values of the matched population), and predicted FEV_1% (pre-FEV_1/reference values of the matched population). The paired t test and Pearson correlation test were used to assess significance of differences and correlations between CT predicted values and postoperative measured results of FVC, FEV_1, FVC% and FEV_1%. Results QCT predicted values correlated well with postoperative FVC, FEV_1, FVC% and FEV_1% ( r =0.873, 0.809, 0.849 and 0.801 respectively, all P <0.01).Conclusions QCT is an effective and accurate way to predict postoperative pulmonary function in patients undergoing pulmonary resection, regardless of the patients’ preoperative pulmonary functional status.

Influence of acupuncture on pulmonary function of patients with asthma： a review

Asthma is a common disease with recurrent onset which severely affects patients＇ quality of life. Acupuncture can improve pulmonary functions in asthma patients and thus treat this disorder. To summarize the status of acupuncture treatment for asthma, we have collected clinical literatures published in the recent 20 years and analyzed the influence of acupuncture on pulmonary functions in asthma patients from the aspects of frequently used points, needling techniques, manipulation and mechanisms to provide references for treating asthma with acupuncture.

Epidemiologic evidence linking oxidative stress and pulmonary function in healthy populations

Respiratory health in the general population declines regardless of the presence of pulmonary diseases.Oxidative stress has been implicated as one of the mechanisms involved in respiratory dysfunction.This review was to evaluate studies that relate oxidative stress factors with pulmonary function among the general population without prior respiratory illnesses.The search yielded 54 citations.Twenty-one studies qualified for incorporation in this review.Owing to the heterogeneity of the review,studies were discussed based on identified oxidative stress factors responsible for pulmonary dysfunction.Oxidative stress biomarkers,including gene polymorphisms of nuclear factor erythroid 2-related factor 2,heme oxygenase 1,glutathione S transferase,superoxide dismutase,and lipid peroxidation products were involved in lung function decline.In addition,the antioxidant status of individuals in reference to dietary antioxidant intake and exposure to environmental pollutants affected oxidative stress and pulmonary function,as indicated by forced expired volume in one second,forced vital capacity,and forced expiratory flow at 25%-75%.This review indicated that oxidative stress is implicated in the gradual decline of lung function among the general population,and gene polymorphism along the antioxidant defense line and/or their interaction with air pollutants reduce lung function.Different polymorphic forms among individuals explain why the rate of lung function decline differs among people.Dietary antioxidants have respiratory health benefits in antioxidant gene polymorphic forms.Therefore,the genetic composition of an individual may be considered for monitoring and identifying people at risk of respiratory illnesses.

Clinical effect observation on acupuncture for chronic obstructive pulmonary disease

Objective： To observe the clinical effect of acupuncture on chronic obstructive pulmonary disease （COPD）, and the improvements of patients＇ pulmonary ventilation function and 6-minute walk test （6-MWT） distance. Methods： A total of 80 COPD patients [grade 3-4 in Global Initiative for Chronic Obstructive Lung Disease （GOLD）, qi deficiency of the lung and kidney in traditional Chinese medicine （TCM） pattern] were randomly allocated into a treatment group （n=40） and a control group （n=40）. Salmeterol Xinafoate and Fluticasone Propionate powder （Seretide, 50 μg/250 μg） for inhalation was used for basic treatment in both groups （once in the morning and once in the evening）. Patients in the treatment group received acupuncture at Feishu （BL 13）, Shenshu （BL 23）, O.ihai （CV 6）, Guanyuan （CV 4）, Dingchuan （EX-B 1）, Danzhong （CV 17） and Zusanli （ST 36] twice a week for 3 months. After 3 months of treatment, clinical effects, lung ventilation functions and 6-MWT distance were observed and compared in the two groups. Results： After 3 months of treatment, the total effective rate was 95.0% in the treatment group, versus 80.0% in the control group, showing a statistical difference （P〈O.05）; the phlegm expectoration, dyspnea and shortness of breath were more significantly improved in the treatment group than those in the control group （P〈0.01, P〈0.05）; and the 6-MWT distance and forced expiratory volume in 1 second percentage of predicted value （FEV1%） were more significantly improved in the treatment group than those in the control group （P〈0.05, P〈0.01）. Conclusion： Seretide inhaler combined with acupuncture can improve signs and symptoms in COPD patients, increase the 6-MWT distance, imorove FEV1% and obtain better results than Seretide alone.

Efficacy of Yiqigubiao pill on chronic obstructive pulmonary disease in rats with the disease induced by lipopolysaccharide and cigarette-smoke fumigation

OBJECTIVE:To investigate the efficacy of Yiqigubiao pill(YQGB)on chronic obstructive pulmonary disease(COPD)in rats with the COPD induced by lipopolysaccharide(LPS)and cigarettesmoke fumigation.METHODS:In this study,six groups of rats were set up,including control group,model group,positive control group(aminophylline)and YQGB(high,medium and low doses)groups.Tracheal injection of lipopolysaccharide(LPS)and cigarette-smoke fumigation induced COPD in rats.The general condition,incubation period and coughing times,lung function,level of inflammatory factors,leukocyte condition and pathological changes of bronchus and lung tissue were observed in rats of each group.RESULTS:In the COPD rats,the latent period of coughing was shortened and the cough frequency was increased significantly;the pulmonary function was significantly decreased,which was manifested by the increased lung tissue resistance and respiratory system resistance,and the decreasing percentage of forced expiratory volume and forced expiratory volume in the 0.3 s(FEV0.3/FVC);the contents of tumor necrosis factor-alpha(TNF-α)and interleukin-4 in serum were obviously increased,and the NEUT%in bronchoalveolar lavage fluid was significantly increase.YQGB could obviously prolong the latent period of cough,and reduce the cough frequency and the content of TNF-αin serum.YQGB can also significantly reduce respiratory resistance and increase FEV0.3/FVC value.The results of histopathology showed that YQGB significantly reduced the pathological changes of tracheal mucosa and lung caused by COPD.YQGB obviously increased level of AQP1,which was down-regulated in the COPD rats.CONCLUSION:YQGB could significantly improve the pulmonary function,reduce inflammation and alleviate lung and bronchial diseases in the COPD rats.

Effect of breathing and Daoyin exercises on the quality of life in patients with chronic obstructive pulmonary disease

Objective： To observe the effect of breathing and Daoyin exercises on the quality of life in patients with stable chronic obstructive pulmonary disease（COPD） due to deficiency of the lung and kidney（grade II-III）.Methods： A total of 60 eligible cases were randomly allocated into a treatment group（n=30） and a control group（n=30） by random number table. Cases in the control group received routine Western medical treatment, whereas cases in the treatment group conducted breathing and Daoyin exercises in addition to routine Western medical treatment. Patients in both groups were treated for a total of 3 months. Then the observation was made on changes in pulmonary ventilation function, major clinical symptoms, modified Medical Research Council scale（m MRC）, distance in 6-minute walk test（6-MWT）, COPD assessment test（CAT） and efficacy satisfaction questionnaire for COPD（ESQ-COPD） before and after treatment. Results： After treatment, the total effective rate was 80.0% in the treatment group, versus 66.7% in the control group, showing a statistical difference（P〈0.05）. Patients in the treatment group obtained more significant improvement in coughing, sputum production, dyspnea and shortness of breath than those in the control group（P〈0.05）. Patients in the treatment group obtained more significant elevation in the forced expiratory volume in 1 second percentage of predicted value（FEV1%） and peak expiratory flow rate（PEF%） than those in the control group（P〈0.05）. Patients in the treatment group obtained lower m MRC score than those in the control group（P〈0.05）. Patients in the treatment group obtained longer 6-MWT distance than those in the control group（P〈0.05）. Patients in the treatment group obtained lower CAT score（P〈0.01） and higher ESQ-COPD score（P〈0.05） than those in the control group. Conclusion： Breathing and Daoyin exercises combined with routine Western medical treatment are effective for stable COPD（grade II-III） due to deficiency of the lung and kidney and can improve the patients＇ quality of life.

Effect and mechanism of application in canicular days plus enteral nutrition for cough variant asthma in kids

Objective： To observe the clinical efficacy of application in canicular days plus enteral nutrition in treating cough variant asthma （CVA） in kids, and to explore its action mechanism. Methods： Following a randomized controlled single-blind parallel-group design, 138 eligible kids with CVA were randomized into an observation group, a canicular-day application group, and an enteral nutrition group, 46 kids in each group. The canicular-day application group was intervened by application in canicular days, the enteral nutrition group was by enteral feeding, and the observation group was by both canicular-day application and enteral feeding. The therapeutic efficacies were evaluated after a treatment course. Results： The recovery rate and total effective rate were respectively 50.0% and 98.0% in the observation group, versus 23.9% and 91.3% in the canicular-day application group, and 13.0% and 78.6% in the enteral nutrition group. The observation group was significantly superior to the other two groups （both P〈0.05）. In comparing the global symptom score, peak expiratory flow （PEF）, forced expiratory volume in one second （FEVl）, CD3^＋, CD4^＋, CD4^＋/CD8^＋, CD8^＋, hemoglobin （Hb）, total protein （TP）, albumin （ALB）, eosinophil cationic protein （ECP）, lipid peroxide （LPO）, leukotriene （LT）, body weight （BW）, triceps skin-fold （TSF）, and arm muscle circumference （AMC）, the observation group was significantly better than the other two groups （both P〈0.05）. Conclusion： Application in canicular days plus enteral nutrition can significantly improve the pulmonary function and symptoms in children＇s CVA, and the effect is possibly produced by regulating cellular immune system, enhancing Hb, TP, ALB, BW, TSF, AMC, and inhibiting the production of ECP, LPO, and LT.

Spirometric Reference Equations for Elderly Chinese in Jinan Aged 60-84 Years

Background：The interpretation of spirometry varies on different reference values.Older people are usually underrepresented in published predictive values.This study aimed at developing spirometric reference equations for elderly Chinese in Jinan aged 60-84 years and to compare them to previous equations.Methods：The project covered all of Jinan city,and the recruitment period lasted 9 months from January 1,2017 to September 30,2017,434 healthy people aged 60-84 years who had never smoked （226 females and 208 males） were recruited to undergo spirometry.Vital capacity （VC）,forced VC （FVC）,forced expiratory volume in 1 s （FEV1）,FEV1/FVC,FEV1/VC,FEV6,peak expiratory flow,and forced expiratory flow at 25%,50%,75%,and 25-75% of FVC exhaled （FEF25%,FEF50%,FEF75%,and FEF25-75%） were analyzed.Reference equations for mean and the lower limit of normal （LLN） were derived using the lambda-mu-sigma method.Comparisons between new and previous equations were performed by paired t-test.Results：New reference equations were developed from the sample.The LLN of FEV1/FVC,FEF25-75% computed using the 2012-Global Lung Function Initiative （GLI） and 2006-Hong Kong equations were both lower than the new equations.The biggest degree of difference for FEV1/FVC was 19% （70.46% vs.59.29%,t =33.954,P 〈 0.01） and for maximal midexpiratory flow （MMEF,equals to FEF25-75%） was 22% （0.82 vs.0.67,t =21.303,P 〈 0.01）.The 1990-North China and 2009-North China equations predicted higher mean values of FEV1/FVC and FEF25-75% than the present model.The biggest degrees of difference were-4% （78.31% vs.81.27%,t =-85.359,P 〈 0.01）and-60% （2.11 vs.4.68,t =-170.287,P 〈 0.01）,respectively.Conclusions：The newly developed spirometric reference equations are applicable to elderly Chinese in Jinan.The 2012-GLI and 2006-Hong Kong equations may lead to missed diagnoses of obstructive ventilatory defects and the small airway dysfunction,while traditional linear equations for all ages may lead to overdiagnosis.

Clinical study of optimizing acupoint combining in treatment of bronchial asthma with acupoint application

Objective:To observe the therapeutic efficacy of acupoint application at different groups of acupoints in treating bronchial asthma in remission stage.Methods:A total of 120 patients with bronchial asthma in remission stage were recruited and divided by the random number table method into acupoint application group 1,acupoint application group 2 and acupoint application group 3,with 40 cases in each group.In all the three groups,Tiantu(CV 22),Dazhui(GV 14)and Feishu(BL 13)were selected,with Dingchuan(EX-B 1)added in acupoint application group 1,Shenshu(BL 23)added in acupoint application group 2,and Gaohuang(BL 43)added in acupoint application group 3.Before intervention,one month and 3 months after intervention,clinical symptoms,peak expiratory flow(PEF)and forced expiratory volume in 1 second percentage of predicted value(FEV1%)of the three groups were observed,and their clinical efficacies were evaluated.Results:Comparing the therapeutic efficacy regarding traditional Chinese medicine symptoms and signs,after 1-month treatment,the total effective rate was 87.5%in acupoint application group 1,versus 62.5%in acupoint application group 2 and 55.0%in acupoint application group 3,and the between-group differences were statistically significant.After 3-month treatment,the total effective rate was 95.0%in acupoint application group 1,versus 70.0%in acupoint application group 2 and 65.0%in acupoint application group 3,and the between-group differences were statistically significant.After intervention,the three groups all showed significant improvements in pulmonary function with statistical significance;among the three groups,the improvement in acupoint application group 1 was more significant than that in the other two groups.Conclusion:Tiantu(CV 22),Dazhui(GV 14)and Feishu(BL 13)as basic prescription plus Dingchuan(EX-B 1)can improve symptoms of bronchial asthma in remission stage,and it works better in improving pulmonary function than the basic prescription plus Shenshu(BL 23)or Gaohuang(BL 43).

Effect of a Traditional Chinese Medicine combined therapy on adolescent idiopathic scoliosis:a randomized controlled trial

OBJECTIVE:To evaluate the effectiveness of a combined Traditional Chinese Medicine(TCM) therapy versus conventional treatment on adolescent idiopathic scoliosis.METHODS:One hundred twenty outpatients with mild and moderate adolescent idiopathic scoliosis were randomly divided into a TCM group(TCMG)and a brace group(CG).TCMG patients underwent Daoyin,Tuina,and acupotomology therapies.CG patients were treated with a Milwaukee brace.Each patient's Cobb angle was measured after 12 and 24 months of treatment,and pulmonary function was determined after 12 months of treatment.Average electromyogram(AEMG) ratio of the surface electromyogram was measured after 6 and 12 months of treatment and followed-up after 18 and 24 months.RESULTS:The Cobb angle significantly decreased in both groups after 12 months of treatment compared with before treatment(P< 0.05).The percentages of original Cobb angle in TCMG and CG were51.4%and 47.8%(P > 0.05) after 12 months and62.5%and 34.7%(P < 0.05) after 24 months,respectively.Pulmonary function significantly improved after 12 months in TCMG(P < 0.05) but significantly decreased in CG(P < 0.05).The AEMG ratio was significantly lower(P < 0.01) and tended to remain at1 after stopping treatment in TCMG,but increased in CG(P<0.05).CONCLUSION:TCM combined therapy can prevent the progression of scoliosis.The AEMG ratio is a promising index that could replace radiography in the evaluation of treatment effect and progression in scoliosis.