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2014—2023年西安市某三甲综合医院AECOPD住院患者的流行病学特征及费用结构研究
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作者 闫晓婷 任洁 +1 位作者 张文 刘玉钢 《现代医院》 2024年第6期904-909,914,共7页
目的探讨2014—2023年西安市某三甲综合医院慢性阻塞性肺疾病急性加重(AECOPD)住院患者的流行病学特征及费用结构研究。方法收集某院2014年1月—2023年12月的AECOPD住院患者的病案首页信息(n=6748),回顾性分析其人口学特征、临床特征的... 目的探讨2014—2023年西安市某三甲综合医院慢性阻塞性肺疾病急性加重(AECOPD)住院患者的流行病学特征及费用结构研究。方法收集某院2014年1月—2023年12月的AECOPD住院患者的病案首页信息(n=6748),回顾性分析其人口学特征、临床特征的分布及住院费用构成情况,并采用结构变动度分析不同年度住院费用的结构变动情况。结果2014—2023年主诊确诊为AECOPD患者占本机构所有住院患者4.81‰,10年间AECOPD住院患者的构成比呈持续下降趋势(χ2=1083.351,P<0.001);不同年度中AECOPD住院患者的性别、职业、医疗付费方式、来源的分布均有统计学差异(P<0.05);不同年度AECOPD住院患者的季节分布有统计学差异(χ2=157.328,P<0.001);不同年度AECOPD住院患者住院天数分布之间有统计学差异(χ2=83.463,P<0.001);不同年度中AECOPD患者的住院次数、入院病情、是否合并症或并发症、是否有药物过敏史以及是否有再次住院计划的构成比之间均有统计学差异(P<0.05);不同年度AECOPD住院患者的结局之间有统计学差异(χ2=153.367,P<0.001);AECOPD患者次均住院费用呈2014—2016年逐步升高,2016—2023年逐步下降的趋势(P<0.01);不同年度AECOPD患者住院费用中均以药品费用和诊断费用为主;2014—2022年AECOPD住院患者次均费用整体住院的结构变动度(DSV)为41.62%,其中2012年与2013年住院费用的DSV最大(22.69%),2017年与2018年的DSV最小(4.23%)。结论近10年AECOPD住院患者的构成比和病死率整体呈下降趋势;AECOPD住院患者中70~79岁组构成比最高,主要分布在冬季;10年间次均住院费用整体呈下降趋势,费用构成主要以药品费和诊断费用为主,药品费用成逐年下降的趋势,诊断费用呈逐年增加的趋势,说明医疗政策改革在优化住院费用结构、控制费用不合理增长中的作用显著。 展开更多
关键词 aecopd 住院患者 临床特征 住院费用 结构变动度
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以八段锦为基础的早期肺康复对AECOPD患者气道炎症和转归的影响 被引量:1
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作者 雷佩珊 苏晓茵 +1 位作者 古梓莹 韩云 《广东药科大学学报》 CAS 2024年第1期105-110,共6页
目的 探讨以八段锦为基础的早期肺康复对慢性阻塞性肺疾病急性加重(AECOPD)患者气道炎症及转归的影响。方法 选取2021年5月至2022年6月广州市番禺区中医院内三科符合纳入标准AECOPD患者113例,使用随机数字表法分成肺康组54例和对照组59... 目的 探讨以八段锦为基础的早期肺康复对慢性阻塞性肺疾病急性加重(AECOPD)患者气道炎症及转归的影响。方法 选取2021年5月至2022年6月广州市番禺区中医院内三科符合纳入标准AECOPD患者113例,使用随机数字表法分成肺康组54例和对照组59例,肺康组在基础治疗上联合以靶心率和运动中最低血氧饱和度为安全控制指标、以立位/卧位八段锦为基础、结合不同强度肌力训练/踏车训练/踏阶训练为内容的阶梯式早期肺康复治疗,并依据呼吸困难和疲劳评分及运动能力评估将肺康组分成立位肺康组29例和卧位肺康组25例给予对应康复方案。比较随访周期不同时间节点血清炎症指标、肺功能、主观测评、自理能力评分、随访期内再次急性加重次数及全因死亡率,比较肺康组与对照组组间及肺康组内立/卧位肺康组亚组间差异。结果 与对照组比较,肺康组康复7 d的炎症指标CRP测值和PaCO_(2)值更低(P<0.05),SAA值、氧合指数、FEV1%预计值差异无统计学意义(P>0.05);肺康组康复12周的炎症指标CRP值、Borg呼吸困难、Borg疲劳评分中值更低(P<0.01),自理能力评分中值更高(P<0.01),随访期急性加重次数更少(P<0.05)。亚组分析中,卧位肺康组Borg呼吸困难、Borg疲劳评分及自理能力评分康复12周前后差值中值更大(P<0.01);炎症指标测值和随访期间急性加重次数差异无统计学意义(P>0.05)。结论 以八段锦为基础的早期肺康复能减轻AECOPD患者炎症反应,改善CO_(2)潴留,改善患者主观呼吸困难及疲劳感受,提升自理能力,并能减少随访期急性加重事件发生,改善预后,在基线状态更差的病例组别中获益更大。 展开更多
关键词 八段锦 早期肺康复 aecopd 生存质量 预后
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GIDS在老年AECOPD呼吸衰竭患者病情及预后评估中的应用
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作者 刘艳 王红梅 +4 位作者 卢晓丽 杨菊荣 赵娟 杨春波 付晓乐 《检验医学与临床》 CAS 2024年第16期2324-2327,2333,共5页
目的 探讨胃肠道功能障碍评分(GIDS)与老年慢性阻塞性肺疾病急性加重期(AECOPD)呼吸衰竭患者疾病严重程度的相关性及对预后的预测价值,为疾病严重程度和预后评估提供参考依据。方法 收集2020年1月至2023年8月于该院ICU治疗的264例老年AE... 目的 探讨胃肠道功能障碍评分(GIDS)与老年慢性阻塞性肺疾病急性加重期(AECOPD)呼吸衰竭患者疾病严重程度的相关性及对预后的预测价值,为疾病严重程度和预后评估提供参考依据。方法 收集2020年1月至2023年8月于该院ICU治疗的264例老年AECOPD呼吸衰竭患者作为研究对象。根据患者GIDS,将患者分为低GIDS组(0~1分)和高GIDS组(2~4分)。比较不同GIDS组患者急性生理与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分和序贯器官衰竭评估(SOFA)评分,以及患者住院结局指标,包括机械通气时间、ICU入住时间和预后情况。采用Spearman相关分析GIDS与APACHEⅡ评分、SOFA评分的相关性。采用受试者工作特征(ROC)曲线分析GIDS对预后的预测价值。结果 264例老年AECOPD呼吸衰竭患者GIDS为2.00(1.00,3.00)分,其中0分53例(20.1%),1分65例(24.6%),2分53例(20.1%),3分45例(17.0%),4分48例(18.2%)。高GIDS组APACHEⅡ评分和SOFA评分高于低GIDS组(P<0.05)。Spearman相关性分析结果显示,GIDS与APACHEⅡ评分、SOFA评分均呈正相关(r=0.458、0.392,P<0.05)。高GIDS组机械通气时间、ICU入住时间长于低GIDS组,预后不良发生率高于低GIDS组,差异均有统计学意义(P<0.05)。ROC曲线结果显示,GIDS预测老年AECOPD呼吸衰竭患者预后不良的曲线下面积为0.823,灵敏度和特异度分别为93.4%和60.1%。结论 老年AECOPD呼吸衰竭患者GIDS与疾病严重程度密切相关,该评分对患者预后不良具有良好的预测价值。 展开更多
关键词 老年 慢阻肺急性加重期 呼吸衰竭 胃肠道功能障碍评分 疾病严重程度 预后
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AVAPS-AE模式的无创通气对AECOPD合并OSA患者PSG参数、ESS评分及舒适度的影响
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作者 田茂良 韩博学 +2 位作者 王佳梅 宗政 邓治平 《昆明医科大学学报》 CAS 2024年第4期105-112,共8页
目的探讨平均容积保证压力支持-自动呼气压(AVAPS-AE)模式的无创通气对慢性阻塞性肺疾病急性加重期(AECOPD)合并阻塞性睡眠呼吸暂停(OSA)患者多道睡眠监测(PSG)参数、Epworth嗜睡量表(ESS)评分及舒适度的影响。方法选取2020年1月至2022... 目的探讨平均容积保证压力支持-自动呼气压(AVAPS-AE)模式的无创通气对慢性阻塞性肺疾病急性加重期(AECOPD)合并阻塞性睡眠呼吸暂停(OSA)患者多道睡眠监测(PSG)参数、Epworth嗜睡量表(ESS)评分及舒适度的影响。方法选取2020年1月至2022年10月自贡市第一人民医院75例AECOPD合并OSA患者,随机分为3组,各25例,均行无创通气治疗,对照A组予以AVAPS模式,对照B组予以S/T模式,观察组予以AVAPS-AE模式。比较3组治疗前、治疗24 h、48 h及72 h血气分析指标[动脉氧分压(PaO_(2))、动脉血酸碱度(pH)、动脉二氧化碳分压(PaCO_(2))]、PSG参数[微觉醒指数(MAI)、呼吸暂停低通气指数(AHI)、最低脉搏氧饱和度(miniSpO_(2))、睡眠效率(TST/TRT)]、颏舌肌肌电值(GGEMG)各变量[清醒期及睡眠NREM期张力性、峰值、时相性GGEMG]、人机对抗发生率、48 h插管率、ESS、Brog、视觉模拟量表(VAS)及健康相关生存质量(HRQL)评分。结果治疗24 h、48 h及72 h PaO_(2)组间比较:观察组>对照A组>对照B组(P<0.05);PaCO_(2)组间比较:观察组<对照A组<对照B组(P<0.05);TST/TRT、miniSpO_(2)组间比较:观察组>对照A组>对照B组(P<0.05);AHI、MAI组间比较:观察组<对照A组<对照B组(P<0.05);清醒期及睡眠NREM期张力性、峰值、时相性GGEMG组间比较:观察组<对照A组<对照B组(P<0.05);3组人机对抗发生率、48 h插管率比较,差异无统计学意义(P>0.05);ESS、Brog、VAS评分组间比较:观察组<对照A组<对照B组(P<0.05);HRQL评分组间比较:观察组>对照A组>对照B组(P<0.05)。结论AVAPS-AE模式的无创通气用于AECOPD合并OSA有利于改善患者睡眠,减少日间嗜睡,缓解呼吸困难,提高呼吸舒适度及生存质量。 展开更多
关键词 无创通气 OSA aecopd AVAPS-AE PSG ESS
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MLPR、NLR、RDW对老年AECOPD患者合并肺栓塞的评估价值
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作者 邢芳远 郭小霞 郭瑞霞 《分子诊断与治疗杂志》 2024年第4期599-603,共5页
目的探讨单核细胞/大血小板比值(MLPR)、中性粒细胞/淋巴细胞比值(NLR)、红细胞分布宽度(RDW)对老年慢性阻塞性肺疾病急性加重(AECOPD)患者合并慢性阻塞性肺病急性加重的评估价值。方法选取2020年1月至2022年12月邯郸市第一医院收治的11... 目的探讨单核细胞/大血小板比值(MLPR)、中性粒细胞/淋巴细胞比值(NLR)、红细胞分布宽度(RDW)对老年慢性阻塞性肺疾病急性加重(AECOPD)患者合并慢性阻塞性肺病急性加重的评估价值。方法选取2020年1月至2022年12月邯郸市第一医院收治的118例老年AECOPD合并肺栓塞患者作为观察组,并根据FEV1占预计值的百分比(FEV1%pred)水平分为轻度、中度、重度、极重度,选取同期80例老年AECOPD未合并肺栓塞患者为对照组。对比两组一般临床资料,探讨影响老年AECOPD患者合并肺栓塞的危险因素;评估MLPR、NLR、RDW水平对老年AECOPD患者合并肺栓塞的诊断效能及与疾病严重程度的相关性。结果观察组病程、MLPR、NLR、RDW、血小板/淋巴细胞比值(PLR)、纤维蛋白原(FIB)、D-二聚体均高于对照组,差异有统计学意义(t=7.409、17.995、10.733、8.724、13.983、7.829、10.596,P<0.05);Logistic分析显示,病程、MLPR、NLR、RDW、PLR、FIB、D-二聚体均为老年AECOPD患者合并肺栓塞的独立危险因素(P<0.05);MLPR、NLR、RDW三者单独及联合检测诊断AUC分别为0.866、0.835、0.795、0.937,联合检测优于单一检测(P<0.05);老年AECOPD患者合并肺栓塞MLPR、NLR、RDW水平为极重度>重度>中度>轻度,差异有统计学意义(F=126.998、37.074、34.927,P<0.05);Spearman分析显示,MLPR、NLR、RDW与疾病严重程度呈正相关(r=0.865、0.775、0.661,P<0.05)。结论老年AECOPD患者合并肺栓塞时MLPR、NLR、RDW水平升高并与疾病严重程度呈正相关,三者联合检测对老年AECOPD患者合并肺栓塞具有良好的诊断效能。 展开更多
关键词 aecopd 肺栓塞 MLPR NLR RDW
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双相呼吸道正压通气呼吸机参数对AECOPD患者胸肺顺应性及动脉血气指标影响 被引量:2
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作者 刘晓霞 孙娟 米拉瓦·牙生 《中国医学装备》 2024年第1期114-118,共5页
目的:探讨双相呼吸道正压(BiPAP)通气治疗慢性阻塞性肺疾病急性加重期(AECOPD)患者时呼吸机参数对其胸肺顺应性及动脉血气指标的影响。方法:选取2020年4月至2021年4月新疆心脑血管病医院收治的行BiPAP呼吸机无创通气治疗的AECOPD患者78... 目的:探讨双相呼吸道正压(BiPAP)通气治疗慢性阻塞性肺疾病急性加重期(AECOPD)患者时呼吸机参数对其胸肺顺应性及动脉血气指标的影响。方法:选取2020年4月至2021年4月新疆心脑血管病医院收治的行BiPAP呼吸机无创通气治疗的AECOPD患者78例,吸气相正压(IPAP)的常用范围为10~25 cmH_(2)O。根据患者的具体情况和临床需求调整参数,将78例患者中IPAP<15 cmH_(2)O纳入低IPAP组(34例),≥15 cmH_(2)O纳入高IPAP组(44例),分析BiPAP呼吸机参数IPAP与患者治疗效果、胸肺顺应性及动脉血气指标的相关性。结果:高IPAP组患者治疗有效率为93.48%,显著高于低IPAP组的71.88%,两组比较差异有统计学意义(x^(2)=6.766,P<0.05);治疗前,两组间胸廓顺应性(CTh)、肺顺应性(CL)及总顺应性(Ct)等指标差异均无统计学意义(P>0.05);治疗后,高IPAP组患者Ct、CL和CTh均明显高于低IPAP组,两组比较差异有统计学意义(t=2.508、2.027、2.185,P<0.05)。上呼吸机前两组动脉血氧分压(PaO_(2))值比较差异均无统计学意义(P>0.05),上呼吸机2、4、6和8 h时高IPAP组患者PaO2值均显著高于低IPAP组,差异有统计学意义(t=8.531、5.296、3.264、4.623,P<0.05)。两组患者炎性介质中基质金属蛋白酶9(MMP-9)和白细胞介素-8(IL-8)发病时均显著升高,经治疗后该两种介质水平均有所下降,且高IPAP组显著低于低IPAP组,其差异有统计学意义(t=2.251、5.484,P<0.05)。高IPAP组患者腹胀发生率为20.45%,显著高于低IPAP组的5.88%,组间差异有统计学意义(x^(2)=3.623,P<0.05)。结论:BiPAP呼吸机参数中的IPAP对AECOPD患者胸肺顺应性、动脉血气分析、炎性指标均有影响,高IPAP能提高患者治疗有效性,改善胸肺顺应性及动脉血气分析,但是易造成腹胀等不良反应。 展开更多
关键词 慢性阻塞性肺疾病急性加重期(aecopd) 双相呼吸道正压通气(BiPAP) 呼吸机 胸肺顺应性 动脉血气指标
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The role of exosomes in adult neurogenesis:implications for neurodegenerative diseases 被引量:1
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作者 Zhuoyang Yu Yan Teng +1 位作者 Jing Yang Lu Yang 《Neural Regeneration Research》 SCIE CAS CSCD 2024年第2期282-288,共7页
Exosomes are cup-shaped extracellular vesicles with a lipid bilayer that is approximately 30 to 200 nm in thickness.Exosomes are widely distributed in a range of body fluids,including urine,blood,milk,and saliva.Exoso... Exosomes are cup-shaped extracellular vesicles with a lipid bilayer that is approximately 30 to 200 nm in thickness.Exosomes are widely distributed in a range of body fluids,including urine,blood,milk,and saliva.Exosomes exert biological function by transporting factors between different cells and by regulating biological pathways in recipient cells.As an important form of intercellular communication,exosomes are increasingly being investigated due to their ability to transfer bioactive molecules such as lipids,proteins,mRNAs,and microRNAs between cells,and because they can regulate physiological and pathological processes in the central nervous system.Adult neurogenesis is a multistage process by which new neurons are generated and migrate to be integrated into existing neuronal circuits.In the adult brain,neurogenesis is mainly localized in two specialized niches:the subventricular zone adjacent to the lateral ventricles and the subgranular zone of the dentate gyrus.An increasing body of evidence indicates that adult neurogenesis is tightly controlled by environmental conditions with the niches.In recent studies,exosomes released from different sources of cells were shown to play an active role in regulating neurogenesis both in vitro and in vivo,thereby participating in the progression of neurodegenerative disorders in patients and in various disease models.Here,we provide a state-of-the-art synopsis of existing research that aimed to identify the diverse components of exosome cargoes and elucidate the therapeutic potential of exosomal contents in the regulation of neurogenesis in several neurodegenerative diseases.We emphasize that exosomal cargoes could serve as a potential biomarker to monitor functional neurogenesis in adults.In addition,exosomes can also be considered as a novel therapeutic approach to treat various neurodegenerative disorders by improving endogenous neurogenesis to mitigate neuronal loss in the central nervous system. 展开更多
关键词 adult neurogenesis Alzheimer’s disease amyotrophic lateral sclerosis EXOSOME Huntington’s disease neurodegenerative disease neurogenic niches Parkinson’s disease
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SIRT2 as a potential new therapeutic target for Alzheimer's disease 被引量:1
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作者 Noemi Sola-Sevilla Elena Puerta 《Neural Regeneration Research》 SCIE CAS CSCD 2024年第1期124-131,共8页
Alzheimer's disease is the most common cause of dementia globally with an increasing incidence over the years,bringing a heavy burden to individuals and society due to the lack of an effective treatment.In this co... Alzheimer's disease is the most common cause of dementia globally with an increasing incidence over the years,bringing a heavy burden to individuals and society due to the lack of an effective treatment.In this context,sirtuin 2,the sirtuin with the highest expression in the brain,has emerged as a potential therapeutic target for neurodegenerative diseases.This review summarizes and discusses the complex roles of sirtuin 2 in different molecular mechanisms involved in Alzheimer's disease such as amyloid and tau pathology,microtubule stability,neuroinflammation,myelin formation,autophagy,and oxidative stress.The role of sirtuin 2 in all these processes highlights its potential implication in the etiology and development of Alzheimer's disease.However,its presence in different cell types and its enormous variety of substrates leads to apparently contra dictory conclusions when it comes to understanding its specific functions.Further studies in sirtuin 2 research with selective sirtuin2 modulators targeting specific sirtuin 2 substrates are necessary to clarify its specific functions under different conditions and to validate it as a novel pharmacological target.This will contribute to the development of new treatment strategies,not only for Alzheimer's disease but also for other neurodegenerative diseases. 展开更多
关键词 Alzheimer's disease AMYLOID AUTOPHAGY MEMORY neurodegenerative diseases NEUROINFLAMMATION sirtuin 2 TAU
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Antisense therapy:a potential breakthrough in the treatment of neurodegenerative diseases 被引量:1
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作者 Roberta Romano Cecilia Bucci 《Neural Regeneration Research》 SCIE CAS CSCD 2024年第5期1027-1035,共9页
Neurodegenerative diseases are a group of disorders characterized by the progressive degeneration of neurons in the central or peripheral nervous system.Currently,there is no cure for neurodegenerative diseases and th... Neurodegenerative diseases are a group of disorders characterized by the progressive degeneration of neurons in the central or peripheral nervous system.Currently,there is no cure for neurodegenerative diseases and this means a heavy burden for patients and the health system worldwide.Therefore,it is necessary to find new therapeutic approaches,and antisense therapies offer this possibility,having the great advantage of not modifying cellular genome and potentially being safer.Many preclinical and clinical studies aim to test the safety and effectiveness of antisense therapies in the treatment of neurodegenerative diseases.The objective of this review is to summarize the recent advances in the development of these new technologies to treat the most common neurodegenerative diseases,with a focus on those antisense therapies that have already received the approval of the U.S.Food and Drug Administration. 展开更多
关键词 Alzheimer’s disease amyotrophic lateral sclerosis antisense oligonucleotide Huntington’s disease neurodegenerative disorders Parkinson’s disease SIRNA
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Emerging roles of exosomes in oral diseases progression 被引量:1
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作者 Jiayi Wang Junjun Jing +1 位作者 Chenchen Zhou Yi Fan 《International Journal of Oral Science》 SCIE CAS CSCD 2024年第1期36-51,共16页
Oral diseases, such as periodontitis, salivary gland diseases, and oral cancers, significantly challenge health conditions due to their detrimental effects on patient's digestive functions, pronunciation, and esth... Oral diseases, such as periodontitis, salivary gland diseases, and oral cancers, significantly challenge health conditions due to their detrimental effects on patient's digestive functions, pronunciation, and esthetic demands. Delayed diagnosis and non-targeted treatment profoundly influence patients' prognosis and quality of life. The exploration of innovative approaches for early detection and precise treatment represents a promising frontier in oral medicine. 展开更多
关键词 diseaseS diagnosis SALIVARY
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ATP-binding cassette transporters as possible targets for the intervention of neurodegenerative diseases 被引量:1
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作者 Hiu Chuen Lok Glenda M.Halliday Woojin Scott Kim 《Neural Regeneration Research》 SCIE CAS CSCD 2024年第4期721-722,共2页
ATP-binding cassette(ABC)transporters are ubiquitous membrane-bound proteins that are responsible for the translocation of a broad spectrum of substrates across cellular membranes,including lipids,amino acids,nucleosi... ATP-binding cassette(ABC)transporters are ubiquitous membrane-bound proteins that are responsible for the translocation of a broad spectrum of substrates across cellular membranes,including lipids,amino acids,nucleosides,sugars,and xenobiotics.Interestingly,ABC transporters are highly expressed in the brain.While their functions in the brain still need to be elucidated,several members are implicated in the pathogenesis of neurodegenerative diseases,including Alzheimer’s disease(AD),Parkinson’s disease(PD),and frontotemporal dementia.In this perspective,we will review current knowledge of ABC transporters in the central nervous system in terms of physiological functions and pathology in neurodegeneration.Furthermore,we will explore the possibilities of ABC transporters as potential targets in the development of therapeutics for neurodegenerative diseases. 展开更多
关键词 SUGAR DEGENERATIVE diseaseS
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Lactate metabolism in neurodegenerative diseases 被引量:1
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作者 Chaoguang Yang Rui-Yuan Pan +1 位作者 Fangxia Guan Zengqiang Yuan 《Neural Regeneration Research》 SCIE CAS CSCD 2024年第1期69-74,共6页
Lactate,a byproduct of glycolysis,was thought to be a metabolic waste until the discovery of the Warburg effect.Lactate not only functions as a metabolic substrate to provide energy but can also function as a signalin... Lactate,a byproduct of glycolysis,was thought to be a metabolic waste until the discovery of the Warburg effect.Lactate not only functions as a metabolic substrate to provide energy but can also function as a signaling molecule to modulate cellular functions under pathophysiological conditions.The Astrocyte-Neuron Lactate Shuttle has cla rified that lactate plays a pivotal role in the central nervous system.Moreover,protein lactylation highlights the novel role of lactate in regulating transcription,cellular functions,and disease development.This review summarizes the recent advances in lactate metabolism and its role in neurodegenerative diseases,thus providing optimal pers pectives for future research. 展开更多
关键词 Alzheimer's disease Astrocyte-Neuron Lactate Shuttle brain central nervous system glucose metabolism GLYCOLYSIS NEUROINFLAMMATION Parkinson's disease protein lactylation signaling molecule
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HFNC与NIPPV对AECOPD合并Ⅱ型呼吸衰竭患者的临床疗效观察
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作者 应琴丽 周世彬 +3 位作者 李焕根 魏思灿 黄鸣恋 陈伟文 《北京医学》 CAS 2024年第3期204-209,共6页
目的探讨经鼻高流量氧疗(high-flow nasal cannula,HFNC)与无创正压通气(non-invasive positive pressure ventilation,NIPPV)对慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并... 目的探讨经鼻高流量氧疗(high-flow nasal cannula,HFNC)与无创正压通气(non-invasive positive pressure ventilation,NIPPV)对慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并Ⅱ型呼吸衰竭患者的临床疗效。方法选取2021年1月至2023年1月福建医科大学附属泉州第一医院重症医学科AECOPD患者146例,根据治疗方法不同分为NIPPV组(n=47)、HFNC组(n=49)和常规治疗组(n=50)。NIPPV组采用NIPPV治疗,HFNC组采用HFNC治疗,常规治疗组采用常规氧疗和抗感染治疗。比较3组循环指标、血气指标、呼吸支持时间、气道护理次数及舒适(general comfort questionnaire,GCQ)评分。结果146例患者中男76例、女70例,年龄56~77岁,平均(66.2±5.3)岁。与治疗前相比,治疗2 h和治疗24 h时,3组呼吸频率(respiratory rate,RR)和HR较低;治疗6 h和治疗24 h时,HFNC组RR、HR均低于NIPPV组和常规治疗组,差异有统计学意义(P<0.05)。与治疗前相比,治疗7 d后3组PaO_(2)均升高、PaCO_(2)均降低;治疗7 d后,与NIPPV组和常规组相比,HFNC组PaO_(2)较高、PaCO_(2)较低,差异有统计学意义(P<0.05)。3组呼吸支持时间和气道护理次数的差异有统计学意义(P<0.05),其中NIPPV组呼吸支持时间较短,HFNC组气道护理次数较少。结论HFNC可以改善AECOPD合并Ⅱ型呼衰患者的部分循环指标和血气指标,患者舒适度更好,但呼吸支持时间较长。 展开更多
关键词 慢性阻塞性肺疾病急性加重期 呼吸衰竭 经鼻高流量氧疗 无创正压通气
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Mitophagy in neurodegenerative disease pathogenesis 被引量:1
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作者 Kan Yang Yuqing Yan +7 位作者 Anni Yu Ru Zhang Yuefang Zhang Zilong Qiu Zhengyi Li Qianlong Zhang Shihao Wu Fei Li 《Neural Regeneration Research》 SCIE CAS CSCD 2024年第5期998-1005,共8页
Mitochondria are critical cellular energy resources and are central to the life of the neuron.Mitophagy selectively clears damaged or dysfunctional mitochondria through autophagic machinery to maintain mitochondrial q... Mitochondria are critical cellular energy resources and are central to the life of the neuron.Mitophagy selectively clears damaged or dysfunctional mitochondria through autophagic machinery to maintain mitochondrial quality control and homeostasis.Mature neurons are postmitotic and consume substantial energy,thus require highly efficient mitophagy pathways to turn over damaged or dysfunctional mitochondria.Recent evidence indicates that mitophagy is pivotal to the pathogenesis of neurological diseases.However,more work is needed to study mitophagy pathway components as potential therapeutic targets.In this review,we briefly discuss the characteristics of nonselective autophagy and selective autophagy,including ERphagy,aggrephagy,and mitophagy.We then introduce the mechanisms of Parkin-dependent and Parkin-independent mitophagy pathways under physiological conditions.Next,we summarize the diverse repertoire of mitochondrial membrane receptors and phospholipids that mediate mitophagy.Importantly,we review the critical role of mitophagy in the pathogenesis of neurodegenerative diseases including Alzheimer’s disease,Parkinson’s disease,and amyotrophic lateral sclerosis.Last,we discuss recent studies considering mitophagy as a potential therapeutic target for treating neurodegenerative diseases.Together,our review may provide novel views to better understand the roles of mitophagy in neurodegenerative disease pathogenesis. 展开更多
关键词 Alzheimer’s disease amyotrophic lateral sclerosis autophagy mitochondria MITOPHAGY mitophagy receptor PARKIN Parkinson’s disease PINK1
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Causal associations between gastroesophageal reflux disease and essential hypertension: A bidirectional Mendelian randomization study 被引量:1
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作者 Ning Wei Ming-Hui Liu Yu-Hu Song 《World Journal of Clinical Cases》 SCIE 2024年第5期880-890,共11页
BACKGROUND Clinical studies have reported that patients with gastroesophageal reflux disease(GERD)have a higher prevalence of hypertension.AIM To performed a bidirectional Mendelian randomization(MR)analysis to invest... BACKGROUND Clinical studies have reported that patients with gastroesophageal reflux disease(GERD)have a higher prevalence of hypertension.AIM To performed a bidirectional Mendelian randomization(MR)analysis to investi-gate the causal link between GERD and essential hypertension.METHODS Eligible single nucleotide polymorphisms(SNPs)were selected,and weighted median,inverse variance weighted(IVW)as well as MR egger(MR-Egger)re-gression were used to examine the potential causal association between GERD and hypertension.The MR-Pleiotropy RESidual Sum and Outlier analysis was used to detect and attempt to reduce horizontal pleiotropy by removing outliers SNPs.The MR-Egger intercept test,Cochran’s Q test and“leave-one-out”sen-sitivity analysis were performed to evaluate the horizontal pleiotropy,heterogen-eities,and stability of single instrumental variable.RESULTS IVW analysis exhibited an increased risk of hypertension(OR=1.46,95%CI:1.33-1.59,P=2.14E-16)in GERD patients.And the same result was obtained in replication practice(OR=1.002,95%CI:1.0008-1.003,P=0.000498).Meanwhile,the IVW analysis showed an increased risk of systolic blood pressure(β=0.78,95%CI:0.11-1.44,P=0.021)and hypertensive heart disease(OR=1.68,95%CI:1.36-2.08,P=0.0000016)in GERD patients.Moreover,we found an decreased risk of Barrett's esophagus(OR=0.91,95%CI:0.83-0.99,P=0.043)in essential hypertension patients.CONCLUSION We found that GERD would increase the risk of essential hypertension,which provided a novel prevent and therapeutic perspectives of essential hypertension. 展开更多
关键词 Gastroesophageal reflux disease Essential hypertension Hypertensive heart disease Mendelian randomization study
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Metabolic-associated fatty liver disease and sarcopenia:A double whammy 被引量:1
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作者 Aditya Viswanath Sherouk Fouda +1 位作者 Cornelius James Fernandez Joseph M Pappachan 《World Journal of Hepatology》 2024年第2期152-163,共12页
The prevalence of metabolic-associated fatty liver disease(MAFLD)has increased substantially in recent years because of the global obesity pandemic.MAFLD,now recognized as the number one cause of chronic liver disease... The prevalence of metabolic-associated fatty liver disease(MAFLD)has increased substantially in recent years because of the global obesity pandemic.MAFLD,now recognized as the number one cause of chronic liver disease in the world,not only increases liver-related morbidity and mortality among sufferers but also worsens the complications associated with other comorbid conditions such as cardiovascular disease,type 2 diabetes mellitus,obstructive sleep apnoea,lipid disorders and sarcopenia.Understanding the interplay between MAFLD and these comorbidities is important to design optimal therapeutic strategies.Sarcopenia can be either part of the disease process that results in MAFLD(e.g.,obesity or adiposity)or a consequence of MAFLD,especially in the advanced stages such as fibrosis and cirrhosis.Sarcopenia can also worsen MAFLD by reducing exercise capacity and by the production of various muscle-related chemical factors.Therefore,it is crucial to thoroughly understand how we deal with these diseases,especially when they coexist.We explore the pathobiological interlinks between MAFLD and sarcopenia in this comprehensive clinical update review article and propose evidence-based therapeutic strategies to enhance patient care. 展开更多
关键词 Metabolic-associated fatty liver disease SARCOPENIA Sarcopenic obesity Lean metabolic-associated fatty liver disease Cardiovascular disease Liver-muscle axis
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Effects of mesenchymal stem cell on dopaminergic neurons,motor and memory functions in animal models of Parkinson's disease:a systematic review and meta-analysis 被引量:3
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作者 Jong Mi Park Masoud Rahmati +2 位作者 Sang Chul Lee Jae Il Shin Yong Wook Kim 《Neural Regeneration Research》 SCIE CAS CSCD 2024年第7期1584-1592,共9页
Parkinson’s disease is chara cterized by the loss of dopaminergic neurons in the substantia nigra pars com pacta,and although restoring striatal dopamine levels may improve symptoms,no treatment can cure or reve rse ... Parkinson’s disease is chara cterized by the loss of dopaminergic neurons in the substantia nigra pars com pacta,and although restoring striatal dopamine levels may improve symptoms,no treatment can cure or reve rse the disease itself.Stem cell therapy has a regenerative effect and is being actively studied as a candidate for the treatment of Parkinson’s disease.Mesenchymal stem cells are considered a promising option due to fewer ethical concerns,a lower risk of immune rejection,and a lower risk of teratogenicity.We performed a meta-analysis to evaluate the therapeutic effects of mesenchymal stem cells and their derivatives on motor function,memory,and preservation of dopamine rgic neurons in a Parkinson’s disease animal model.We searched bibliographic databases(PubMed/MEDLINE,Embase,CENTRAL,Scopus,and Web of Science)to identify articles and included only pee r-reviewed in vivo interve ntional animal studies published in any language through J une 28,2023.The study utilized the random-effect model to estimate the 95%confidence intervals(CI)of the standard mean differences(SMD)between the treatment and control groups.We use the systematic review center for laboratory animal expe rimentation’s risk of bias tool and the collaborative approach to meta-analysis and review of animal studies checklist for study quality assessment.A total of 33studies with data from 840 Parkinson’s disease model animals were included in the meta-analysis.Treatment with mesenchymal stem cells significantly improved motor function as assessed by the amphetamine-induced rotational test.Among the stem cell types,the bone marrow MSCs with neurotrophic factor group showed la rgest effect size(SMD[95%CI]=-6.21[-9.50 to-2.93],P=0.0001,I^(2)=0.0%).The stem cell treatment group had significantly more tyrosine hydroxylase positive dopamine rgic neurons in the striatum([95%CI]=1.04[0.59 to 1.49],P=0.0001,I^(2)=65.1%)and substantia nigra(SMD[95%CI]=1.38[0.89 to 1.87],P=0.0001,I^(2)=75.3%),indicating a protective effect on dopaminergic neurons.Subgroup analysis of the amphetamine-induced rotation test showed a significant reduction only in the intracranial-striatum route(SMD[95%CI]=-2.59[-3.25 to-1.94],P=0.0001,I^(2)=74.4%).The memory test showed significant improvement only in the intravenous route(SMD[95%CI]=4.80[1.84 to 7.76],P=0.027,I^(2)=79.6%).Mesenchymal stem cells have been shown to positively impact motor function and memory function and protect dopaminergic neurons in preclinical models of Parkinson’s disease.Further research is required to determine the optimal stem cell types,modifications,transplanted cell numbe rs,and delivery methods for these protocols. 展开更多
关键词 ANIMAL animal experimentation mesenchymal stem cells models Parkinson’s disease stem cell transplantation
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Lactate:a prospective target for therapeutic intervention in psychiatric disease 被引量:2
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作者 Yanhui Cai Haiyun Guo +1 位作者 Tianle Han Huaning Wang 《Neural Regeneration Research》 SCIE CAS CSCD 2024年第7期1473-1479,共7页
Although antipsychotics that act via monoaminergic neurotransmitter modulation have considera ble therapeutic effect,they cannot completely relieve clinical symptoms in patients suffering from psychiatric disorde rs.T... Although antipsychotics that act via monoaminergic neurotransmitter modulation have considera ble therapeutic effect,they cannot completely relieve clinical symptoms in patients suffering from psychiatric disorde rs.This may be attributed to the limited range of neurotransmitters that are regulated by psychotropic drugs.Recent findings indicate the need for investigation of psychotropic medications that target less-studied neurotransmitte rs.Among these candidate neurotransmitters,lactate is developing from being a waste metabolite to a glial-neuronal signaling molecule in recent years.Previous studies have suggested that cerebral lactate levels change considerably in numerous psychiatric illnesses;animal experiments have also shown that the supply of exogenous la ctate exerts an antidepressant effect.In this review,we have described how medications targeting newer neurotransmitte rs offer promise in psychiatric diseases;we have also summarized the advances in the use of lactate(and its corresponding signaling pathways)as a signaling molecule.In addition,we have described the alterations in brain lactate levels in depression,anxiety,bipolar disorder,and schizophrenia and have indicated the challenges that need to be overcome before brain lactate can be used as a therapeutic target in psychopharmacology. 展开更多
关键词 ANTIDEPRESSANT ANXIETY bipolar disorder depression LACTATE psychiatric disease PSYCHOPHARMACOLOGY SCHIZOPHRENIA signal molecular THERAPEUTICS
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Genetically predicted fatty liver disease and risk of psychiatric disorders: A mendelian randomization study 被引量:1
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作者 Wei-Ming Xu Hai-Fu Zhang +2 位作者 Yong-Hang Feng Shuo-Jun Li Bi-Yun Xie 《World Journal of Clinical Cases》 SCIE 2024年第14期2359-2369,共11页
BACKGROUND Non-alcoholic fatty liver disease(NAFLD)and alcohol-related liver disease(Ar-LD)constitute the primary forms of chronic liver disease,and their incidence is progressively increasing with changes in lifestyl... BACKGROUND Non-alcoholic fatty liver disease(NAFLD)and alcohol-related liver disease(Ar-LD)constitute the primary forms of chronic liver disease,and their incidence is progressively increasing with changes in lifestyle habits.Earlier studies have do-cumented a correlation between the occurrence and development of prevalent mental disorders and fatty liver.AIM To investigate the correlation between fatty liver and mental disorders,thus ne-cessitating the implementation of a mendelian randomization(MR)study to elu-cidate this association.METHODS Data on NAFLD and ArLD were retrieved from the genome-wide association studies catalog,while information on mental disorders,including Alzheimer's disease,schizophrenia,anxiety disorder,attention deficit hyperactivity disorder(ADHD),bipolar disorder,major depressive disorder,multiple personality dis-order,obsessive-compulsive disorder(OCD),post-traumatic stress disorder(PTSD),and schizophrenia was acquired from the psychiatric genomics consor-tium.A two-sample MR method was applied to investigate mediators in signifi-cant associations.RESULTS After excluding weak instrumental variables,a causal relationship was identified between fatty liver disease and the occurrence and development of some psychia-tric disorders.Specifically,the findings indicated that ArLD was associated with a significantly elevated risk of developing ADHD(OR:5.81,95%CI:5.59-6.03,P<0.01),bipolar disorder(OR:5.73,95%CI:5.42-6.05,P=0.03),OCD(OR:6.42,95%CI:5.60-7.36,P<0.01),and PTSD(OR:5.66,95%CI:5.33-6.01,P<0.01).Meanwhile,NAFLD significantly increased the risk of developing bipolar disorder(OR:55.08,95%CI:3.59-845.51,P<0.01),OCD(OR:61.50,95%CI:6.69-565.45,P<0.01),and PTSD(OR:52.09,95%CI:4.24-639.32,P<0.01).CONCLUSION Associations were found between genetic predisposition to fatty liver disease and an increased risk of a broad range of psychiatric disorders,namely bipolar disorder,OCD,and PTSD,highlighting the significance of preven-tive measures against psychiatric disorders in patients with fatty liver disease. 展开更多
关键词 Non-alcoholic fatty liver disease Alcohol-related liver disease Psychiatric disorders Mendelian randomization Single nucleotide polymorphisms
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无创机械通气联合呼吸训练在AECOPD合并呼吸衰竭患者中的应用评价
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作者 叶宁 罗淼 +1 位作者 秦燕 唐丽娟 《中国医学创新》 CAS 2024年第6期27-31,共5页
目的:探讨无创机械通气联合呼吸训练对慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭患者的效果。方法:前瞻性纳入2019年2月—2022年2月桂林医学院附属医院急诊科收治的AECOPD合并呼吸衰竭患者共67例,采用随机数字表法将患者分为两... 目的:探讨无创机械通气联合呼吸训练对慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭患者的效果。方法:前瞻性纳入2019年2月—2022年2月桂林医学院附属医院急诊科收治的AECOPD合并呼吸衰竭患者共67例,采用随机数字表法将患者分为两组。对照组(n=33)接受间断无创机械通气治疗,观察组(n=34)在对照组基础上增加主动呼吸训练(包括上肢弹力带阻抗训练、缩唇腹式呼吸、呼吸训练器使用)。记录两组2 d内撤机成功率、不良反应发生率,比较两组氧合指数(OI)、动脉血二氧化碳分压(PaCO_(2))、改良版英国医学研究委员会(mMRC)呼吸困难问卷分级、呼吸频率(RR)、自主呼吸潮气量。结果:对照组2 d内撤机成功率为60.6%,观察组为82.4%,观察组的撤机成功率高于对照组(P<0.05);观察组咳痰乏力、呼吸疲劳发生率均低于对照组(P<0.05);与治疗前相比,两组患者治疗2 d后的OI和PaCO_(2)均有显著改善,差异均有统计学意义(P<0.05);治疗2 d后,观察组PaCO_(2)低于对照组(P<0.05),但两组OI比较,差异无统计学意义(P>0.05);与治疗前相比,两组患者治疗2 d后的mMRC呼吸困难问卷分级和RR均有明显下降,自主呼吸潮气量均有明显提升,差异均有统计学意义(P<0.05);治疗2 d后,两组mMRC呼吸困难问卷分级和RR比较,差异均无统计学意义(P>0.05),但观察组患者自主呼吸潮气量明显高于对照组(P<0.05)。结论:AECOPD合并呼吸衰竭患者进行无创机械通气联合呼吸训练,能有效改善呼吸肌疲劳,增加肺通气,提高撤机成功率。 展开更多
关键词 无创机械通气 呼吸训练 慢性阻塞性肺疾病急性加重期 呼吸衰竭
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