Lung function changes in smokers with normal conventional spirometry.

The pulmonary function of 113 copper smelter workers was measured in 1973 and again in 1974 to asses the effects of chronic exposure to sulfur dioxide. Respiratory symptoms, smoking history, occupational history, and pulmonary function as measured by forced vital capacity and 1-sec forced expiratory volume were recorded. Exposures to sulfur dioxide, respirable particulates, sulfates, and copper were sampled at intervals throughout the year by personal monitoring. Exposure to 1.0 to 2.5 ppm of sulfur dioxide was associated with excessive loss of 1-sec forced expiratory volume during the year and an increase in respiratory symptoms, after controlling for smoking. No significant interaction between sulfur dioxide and concurrent exposure to respirable particulates on pulmonary function was found. Workers with 1-sec forced expiratory volume below normal on initial measurements (based on their age and height) showed evidence of even greater losses of pulmonary function related to sulfur dioxide exposure.

Objective To investigate the effects of pulmonary rehabilitation on pulmonary function and diaphragm in patients with chronic obstructive pulmonary diseases (COPD). Methods Thirty COPD patients were recruited and randomly divided into two groups, research group (n=15) and control group (n=15). Conventional medication and lower limb exercise training with MOTOmed instrument were performed invariably in both groups.However, to carry out pulmonary rehabilitation precise diaphragmatic muscle training was used in research group while traditional lip type abdominal breathing training was used in control group.Pulmonary function and diaphragmatic muscle strength were evaluated before training, at day 7 and day 15 of the training in two groups. Results Compared with the pulmonary function parameter forced vital capacity, ratio of forced expiratory volume in first second and forced vital capacity before training, no significant improvement was detected on training day 7 in both groups (all P>0.05), while a significant improvement was found on training day 15 in both groups (all P 0.05). Compared with diaphragmatic muscle strength and peak inspiratory airflow velocity before training, no significant improvement was detected at training day 7 in both groups and at day 15 in control group (all P>0.05), while a significant improvement was found on training day 15 in research groups (P<0.01) with a remarkable difference between two groups (P<0.01). Conclusions Precise diaphragmatic muscle training for pulmonary rehabilitation in COPD patients was superior over traditional lip type abdominal breathing training in improvement of diaphragmatic muscle strength and peak inspiratory airflow velocity. Key words: Chronic obstructive pulmonary disease; Pulmonary rehabilitation; Pulmonary function; Diaphragm

Objective To investigate the level and significance of exhaled nitric oxide (FeNO) and exhaled carbon monoxide (FeCO) in elderly patients with chronic obstructive pulmonary disease (COPD). Methods From January 2016 to December 2017, 40 elderly patients with COPD (COPD group) were selected in Wuxi People′s Hospital, including 20 smokers and 20 non-smokers, 40 healthy volunteers were selected as the control group, including 20 smokers and 20 non-smokers, the FeNO, FeCO, ratio of forced expiratory volume in the forced expiratory volume in one second as a percentage of expected value(FEV1%pred)and ratio of FEV1 to forced vital capacity (FEV1/FVC) were measured. Results FeNO and FeCO in COPD group were (20.44±8.34) ppb and (8.43±2.01) ppb, which were significantly higher than those in control group (t=7.354, 5.960, both P 0.05). FeNO was positively correlated with FEV1%pred in normal group (r=0.433, P<0.05). Conclusions FeNO and FeCO are increase significantly in elderly patients with COPD, while smoking can decrease FeNO, FeNO and FeCO has no significant relationship with lung function in COPD patients. Key words: Pulmonary disease, chronic obstructive; Aged; Exhaled nitric oxide; Expiratory carbon monoxide

Objective To observe the changes of lung function during forming process of acquired pectus excavatum. Methods A total of 40 4-week-old Sprague-Dawley rats were divided randomly into experimental and control groups (n=20 each). The 5-7th couples of rib cartilage were resected parasternum for pectus excavatum model in experimental group but no intervention in control group.Pulmonary functions were detected with animal lung function analysis system at Day 3 and Week 4 after operation including the parameters of inspiratory resistance (Ri), expiratory resistance (Re), compliance of lung (Cl), minute ventilation (MVV), forced vital capacity (FVC), forced expiratory volume in the first 0.2 seconds (FEV0.2), FEV0.2/FVC%, exhaled 50%FVC when the quantity of flow velocity (FEF50%) and forced peak expiratory flow (PEF). The data were compared between groups and analyzed statistically. Results There were faster respiratory rate within 1 week after operation and then funnel chest formed gradually in animal model.As a result of pulmonary function, the values of experimental and control groups at Day 3 after operation were as follows: Ri (1.16±0.21) cmH2O·ml-1·s-1 and (0.73±0.26) cmH2O·ml-1·s-1 (P=0.00), Re (0.86±0.30) cmH2O/ml/s and (0.58±0.16) cmH2O/ml/s (P=0.01), Cl (0.05±0.01) cmH2O/ml and (0.09±0.02) cmH2O/ml (P=0.00), FV(3.69±0.10)ml and (3.89±0.19) ml (P=0.00), FEV0.2 (3.28±0.40) ml and (3.58±0.15) ml (P=0.02). And then, the values were Ri (0.88±0.17) cmH2O·ml-1·s-1 and (0.66±0.10) cmH2O·ml-1·s-1 (P=0.00), FVC (5.76±0.52) ml and (5.47±0.20) ml (P=0.05) at Week 4.The value of Ri was higher in experimental group than that in control with statistical significance at Day 3 or Week 4 after operation (P 0.05). Conclusions The compliance of chest wall and lung decreases with increased inspiratory and expiratory resistance during the forming process of model pectus.And lower thoracic compliance is maintained when pectus deformity forms but pulmonary function remains normal because of re-adaption. Key words: Pectus excavatum; Lung function; Rat

Objectives To investigate the incidence rate of asthma and chronic obstructive pulmonary disease (COPD) overlap syndrome(ACOS)in elderly male patients with stable COPD by following-up, and to explore the characteristics and clinical significance of pulmonary function for ACOS. Methods According to GOLD and Spain's guidelines for the diagnosis and treatment of COPD, we screened ACOS patients in 299 elderly male patients with stable COPD by following up in Beijing Hospital between 2003 and 2014.All patients were divided into 2 groups of 51 ACOS patients and 248 non-ACOS patients with COPD.All patients underwent pulmonary function tests and bronchial dilation test in the stable condition.The differences in pulmonary functions were compared between stable ACOS patients and non-ACOS patients with COPD. Results Among 299 elderly male patients with stable COPD, ACOS patients accounted for 17.1%(51/299). Compared with non-ACOS patients with stable COPD, ACOS patients had significantly lower baseline values in forced expiratory volume in 1 seconds(FEV1)〔(61.0±14.5)% pred vs.(74.4±20.0)% pred〕, in forced expiratory volume in 3 seconds(FEV3) 〔(71.6±14.3)% pred vs.(82.7±19.6)% pred〕and in forced vital capacity(FVC) 〔(84.6±16.4)% pred vs.(93.8±20.6)% pred〕, and also had significantly higher values in residual volume(RV)〔(139.4±55.8)% pred vs.(118.8±46.6)% pred〕and in RV/total lung capacity(TLC)〔(52.7±10.7)% pred vs.(48.1±10.9)% pred〕, all P<0.05. After bronchodilation test, there was no significant difference in FEV1, FEV3 and FVC between the two groups(all P>0.05). Patients with stable ACOS had lower value in forced expiratory flow rat(FEF25%-75%)than those with non-ACOS in baseline 〔FEF25%-75%% pred(26.8±11.5)% vs.(36.1±17.5)%(P<0.05)〕, and the improvement of small airway function was significantly better in ACOS patients than in non-ACOS patients after bronchodilation test(P<0.05). Conclusions ACOS is very common in the elderly patients with COPD, stable ACOS patients have lower time vital capacity as compared with non-ACOS patients with stable COPD.But after bronchodilation test, the two groups have similar ventilation function, and the small airway function in ACOS patients improves more significantly.The ACOS patients have unique characteristics of pulmonary functions and suitable treatment may improve the prognosis. Key words: Asthma; Pulmonary disease, chronic obstructive; Respiratory function tests

Objective To study the effect of external diaphragmatic pacing on lung function and exercise endurance in patients with chronic respiratory failure. Methods There were 120 patients with chronic obstructive pulmonary disease admitted to Daxing Teaching Hospital, Capital Medical University from May 2017 to May 2018 selected as study subjects, and divided into observation group and control group by random number table method, with 60 cases in each group.Patients in the control group were given conventional treatment, and patients in the observation group were treated with extracorporeal diaphragmatic pacing on the basis of the control group.The indexes of forced expiratory volume in the first second, forced expiratory volume in the first second/forced vital capacity, forcad vital capacity, partical pressure of oxygen in artery, arterial oxygen saturation, partical pressure of carbon dioxide in artery, myoglobin, creatine kinase and lactate dehydrogenase before and after treatment in the two groups were compared.Chronic obstructive pulmonary disease assessment test and modified British medical research council (mMRC) scores before and after treatment were compared between the two groups. Results After treatment, the levels of forced expiratory volume in the first second, forced expiratory volume in the first second/forced vital capacity and maximum ventilation per minute in the observation group were significantly higher than those before treatment and after treatment in the control group (all P<0.05). The levels of partical pressure of oxygen in artery and arterial oxygen saturation in the observation group after treatment were significantly higher than those before treatment and after treatment in the control group (all P<0.05). Partical pressure of carbon dioxide in artery in the observation group was significantly lower than that before treatment and after treatment in the control group (all P<0.05). After treatment, the levels of myoglobin, creatine kinase and lactate dehydrogenase in the observation group were significantly lower than those before treatment and after treatment in the control group (all P<0.05). After treatment, the scores of cough, sputum, chest tightness, climbing, housework, confidence in outdoor activities, sleep and spirit in the observation group were significantly lower than those before treatment and after treatment in the control group (all P<0.05). There was no significant difference in mMRC grade between the two groups before treatment (Z=0.283, P=0.963). After treatment, the mMRC grade of the observation group was significantly lower than that of the control group (Z=9.318, P=0.025). Conclusions Extracorporeal diaphragmatic pacing for the treatment of chronic obstructive pulmonary disease can improve the patient′s lung function, relieve the patient′s clinical symptoms, improve exercise endurance, worthy of clinical application. Key words: Pulmonary disease, chronic obstructive; Respiratory function tests; External diaphragmatic pacing; Exercise endurance

Objective To study the effects of pulmonary function training on the lung function and surgical tolerance of lung cancer patients with different degrees of obstructive ventilatory defect. Methods Pulmonary function training was performed with 103 lung cancer patients with obstructive ventilatory defects (26 mild cases, 53 moderate cases, 24 severe cases). The duration of the intensive training was 5-7 days. Vital capacity (VC), vital capacity percentage (VC%), forced vital capacity (FVC), forced vital capacity percentage (FVC%), forced expiratory volume in one second (FEV1), percentage of the forced expiratory volume in one second (FEV1%), maximum voluntary ventilation percentage (MVV%), peak expiratory flow percentage (PEF%), fraction of the forced expiratory volume in one second (FEV1/FVC), and maximum mid-expiratory flow percentage (MMEF%) were measured before and after the training. Any postoperative complications were recorded. Results The average MMEF% improved significantly among the moderate patients after their training. Eventually 19/26 patients (73.08%) in the mild group, 34/53 patients (64.15%) in the moderate group, and 8/24 patients (33.33%) in the severe group met the requirements to undergo lung operations. These were significant differences among the groups. Among those operated on, 27 (44.26%) suffered from postoperative complications, a significantly higher percentage than among the normal controls (20.00%). Conclusion Lung function exercises can improve the operation tolerance of lung cancer patients with obstructive ventilation dysfunction, but the risk of operating is still much higher than for patients with normal ventilation function. Key words: Pulmonary function training; Obstructive ventilatory defects; Lung cancer; Surgical tolerance

Objective To discuss clinical effect of bronchodilator treatment on patients with chronic obstructive pulmonary disease. Methods According to the exclusion criteria, 106 patients were selected and randomly divided into two groups, the control group were given glucocorticoid therapy, the study group was given glucocorticoid+bronchodilator treatment; lung index, including forced expiratory volume in one second, forced vital capacity, and the percentage of forced expiratory volume in one second of forced vital capacity of the two groups were compared, and the patient's clinical curative effect was observed. Results The patients of the study group of three indicators: forced expiratory volume in one second, forced vital capacity, forced expiratory volume in one second of forced vital capacity percentage were(1.6±0.8)L,(3.4±0.4)L,(48.6±2.3)%,which were higher than those of the control group, the differences were statistically significant(P<0.05); The total effective rate of the study group was 96.3%,which was higher than 81.2%of the control group,the difference was statistically significant(P<0.05). Conclusion The clinical effect of glucocorticoid+bronchodilator on patients with chronic obstructive pulmonary disease is good, which can effectively improve patient forced expiratory volume in one second, forced vital capacity, forced expiratory volume in one second percentage of forced vital capacity, and can avoid illness development, significantly improve the treatment efficiency. Key words: Chronic obstructive pulmonary disease; Bronchodilator; Clinical effect

The ventilatory and hemodynamic effects of 20 ml 0.5% intrapleural bupivacaine with and without 5 micrograms/ml epinephrine were studied. Ten patients scheduled for intrapleural block in the treatment of chronic visceral pain had a left-sided intrapleural catheter inserted. In a double-blind, crossover design they received 20 ml 0.5% bupivacaine with and without 5 micrograms/ml epinephrine. Forced vital capacity, vital capacity, and forced expiratory volume in one second were measured before and 30 minutes after the injection. Mean blood pressure, heart rate, and cardiac output were recorded before the injection and at five-minute intervals for 30 minutes. Vital capacity, forced vital capacity, and forced expiratory volume in one second were unchanged in both groups. There were no differences in any of the pulmonary function tests between the groups. When data from both groups are pooled, vital capacity shows a decrease of 7% (p less than 0.05). No changes in heart rate or mean blood pressure were seen in either group. Bupivacaine without epinephrine did not affect the cardiac output, whereas bupivacaine with epinephrine resulted in a rise in cardiac output of 15% at 15 and 20 minutes after the injection. We did not find any major effects of intrapleural injection of 20 ml 0.5% bupivacaine with and without 5 micrograms/ml epinephrine on ventilatory capacity or cardiovascular function in patients treated for chronic visceral pain.

Objective To explore the association between familial aggregation and lung function damage and COPD Assessment Test (CAT) scores in patients with chronic obstructive pulmonary disease (COPD), and the correlation between lung function damage and CAT scores. Methods A prospective analysis was conducted on the patients with COPD in Shengjing Hospital of China Medical University from January 2016 to May 2017.The diagnostic criteria were in line with the 2017 global chronic obstructive pulmonary disease initiative.The gender, age, body mass index, smoking index and family history of the subjects were recorded.The case group was divided into a family history group and a no family history group.CAT score test and lung function test are performed on all subjects (including pulse forced oscillation, plethysmography, pulmonary ventilation, dispersion function detection). We analyzed the association between familial aggregation and lung function and CAT scores in the 2 groups, and the correlation between lung function and CAT scores. Results ①A total of 102 cases were included in the case group, among them, 59 cases were in the family history group (accounting for 57.84%), 43 cases were in the no family history group (accounting for 42.16%). There was no statistically significant difference between the two groups in gender, age, body mass index, smoking index and severity of airway limitation.②There was no statistically significant difference in the other indexes between the two groups except the percentage of the estimated value of carbon monoxide diffusing capacity (P<0.05) and the percentage of the estimated value of carbon monoxide diffusing capacity/alveolar volume (P<0.05). ③There was no statistically significant difference in CAT scores between the family history group and no family history group.④In no family history group, forced expiratory volume in the first second%pred (FEV1%pred) and forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC) were not related to COPD assessment test scores.There was a weak and positive correlation between FEV1%pred, FEV1/FVC and CAT scores in family history group. Conclusions There was no relationship between the familial aggregation of COPD and the lung function and CAT scores.The correlation between lung function and CAT scores is weak. Key words: Chronic obstructive pulmonary disease; Familial aggregation; Lung function; COPD Assessment Test scores

Objective To evaluate the effect of preoperative pulmonary function detection in evaluation of postoperative pulmonary complications in patients undergoing abdominal surgery. Methods The clinical data of 162 cases of abdominal operation at our hospital were retrospectively analyzed. Their pulmonary function [forced vital capacity (FVC), forced expiratory volume in one second (FEV1), a second rate (FEV1/FVC), maximal ventilatory volume (MVV), pulmonary diffusing capacity (DLCO), diffusing capacity (DLCO/VA), ratio of lung volume (TLC), residual volume (RV), the residual total ratio (RV/TLC), maximal the amount of oxygen (VO2max), maximal oxygen uptake (VO2max/kg), maximal oxygen pulse (VO2max/HR), the maximum motor power (WRmax)] was measured before operation. After 1 months’ follow-up, the conditions of pulmonary complications were observed. The patients were divided into a pulmonary complication group and non-pulmonary complication group. The differences of lung function between the two groups were compared and analyzed by logistic multivariate analysis. Lung function indexes were drawn to predict the ROC curve of postoperative pulmonary complications. Results The incidence of pulmonary complications was 25.93% in the 162 patients. The FVC, FEV1, VO2max, VO2max/kg, VO2max/HR, and WRmax were lower in the pulmonary complication group than in the non-pulmonary complication group, with statistical differences (P 0.05). Logistic multivariate analysis showed that FVC, FEV1, VO2max, VO2max/kg, VO2max/HR, and WRmax were the independent factors of postoperative pulmonary complications (P < 0.05). FVC, FEV1, VO2max, VO2max/kg, VO2max/HR and WRmax could predict the postoperative pulmonary complications after abdominal operation; and the areas under ROC curve were 0.798, 0.778, 0.812, 0.803, 0.806, and 0.810, respectively. Conclusions FVC, FEV1, VO2max, VO2max/kg, VO2max/HR, and WRmax are the independent influencing factors of postoperative complications. They can be used to assess pulmonary complications after abdominal surgery and have high clinical value. Key words: Abdominal surgery; Preoperative pulmonary function; Postoperative pulmonary complications

Objective To explore the clinical and electrophysiological features and pulmonary function of 8 Chinese patients with Kennedy's disease (KD) and to enhance the understanding for the disease. Methods Eight patients with KD, admitted to out hospital from July 2010 to December 2013 and confirmed by gene examination, were chosen in our study; their clinical and electrophysiological features, and laboratory characteristics and pulmonary function were compared with those in the healthy volunteers. Results The average age of onset in the 8 patients was (45.13±17.47) years, and the average age of diagnosis was (55.63±12.11) years. The most common complaint was leg weakness. All patients presented hemifacial spasm, tongue muscle atrophy and fibrillation, amyotrophy and gynaecomastia; creatine kinase level was elevated and endocrine disorder appeared in different degrees. The electromyogram characteristics included widespread neurogenic changes accompanied with/without sensory or motor conduction abnormalities. The forced vital capacity, forced expiratory volume in first second, maximal voluntary ventilation and peak expiratory flow rate were significantly lower, and the residual volume in the KD patients was statistically higher than that in the healthy volunteers (P<0.05). Respiratory muscle strength (maximum inspiratory pressure and maximum expiratory pressure) decreased in the KD patients. Conclusion KD is a degenerative disease with slow clinical progression which has its own characteristics of inheritance pattern and natural course; the age of onset, repeat number of CAG sequences, pulmonary function and respiratory muscle strength may be valuable for illness evaluation. Key words: Kennedy's disease; Electromyography; Pulmonary function

The impact of alcohol consumption on pulmonary function was examined in 1,067 men. Subjects were classified according to their average weekly alcohol consumption, and spirometry was performed twice on all subjects over a 5-year interval. A multiple regression analysis indicated that alcohol consumption did not significantly influence baseline levels of forced vital capacity (FVC) or forced expiratory volume in one second (FEV1) after controlling for age, height, cigarette smoking habits, and educational attainment. Similarly, alcohol consumption did not significantly influence follow-up levels of FVC or FEV1 after controlling for age, height, cigarette smoking habits, educational attainment, and baseline pulmonary function. Although these results do not rule out a possible independent effect of alcohol on pulmonary function, any such effect would be relatively small.

Objective To investigate the application value of intercostal nerve cryotherapy on incisional pain after thoracotomy. Methods Seventy-six patients underwent open thoracotomy from October 2014 to July 2016 were randomly divided into two groups, with 38 patients in each group. The control group received intravenous controlled analgesia, the study group received intercostal nerve cryotherapy. The different postoperative time of two groups of pain (VAS) before and after surgery, serum inflammatory factor [interleukin -6 (IL-6), C reactive protein (CRP)] the relevant indicators and stress response (angiotensin, cortisol and beta endorphin), pulmonary function (peak expiratory flow rate PEF 1 s), forced expiratory volume (FEV1), forced vital capacity (EVC) level changes were made statistical comparison. And the incidence of adverse reactions in the two groups was statistically analyzed. Results ① The degree of pain: VAS scores at immediately after surgery, 1 h, 4 h, 8 h, 12 h in study group were lower than those in the control group, the differences were significant (P 0.05), the index levels 1 d after operation in study group were lower than those in the control group, the differences were significant (P 0.05), the index levels in study group 1 d after operation were lower than that in the control group, the differences were significant (P 0.05), every index in research group 1 d after operation was higher than that in the control group, but the differences were not significant (P>0.05), FEV1, EVC, PEF in the study group in study group 3 days after operation were significantly higher than those in control group, the differences were significant (P<0.05); ⑤Adverse reactions: the incidence of adverse reactions in the study group (13.15%) was lower than that in the control group (36.83%), and the difference was significant (P<0.05). Conclusions Intercostal nerve cryotherapy can relieve pain after thoracotomy, relieve the inflammatory response and stress response, improve the pulmonary function and safety. Key words: Intercostal nerve cryosurgery; Thoracotomy; Incision pain; Stress response; Lung function

Objective To evaluate the effect of modified Huangqi decoction combined with routine western medicine on acute exacerbation chronic obstructive pulmonary disease (AECOPD). Methods A total of 84 patients with AECOPD who met the inclusion criteria were randomly divided into 2 groups, 42 in each group. The control group was treated with conventional Western medicine, while the observation group was treated with Huangqi decoction on the basis of the control group. The TCM symptoms and signs of the two groups were scored from cough, sputum expectoration, shortness of breath, wheezing and moist rale. The forced expiratory volume in the first second (FEV1), forced vital capacity (FVC) and the percentage of FEV1 in FVC (FEV1%) of the two groups were measured by automatic lung function analyzer. The blood oxygen partial pressure (PaO2), arterial blood carbon dioxide partial pressure (PaCO2) and arterial partial pressure oxygen (SaO2) were measured by gas analyzer. The serum CRP was detected by ELISA, and the serum procalcitonin (PCT) was detected by immunoluminescence. Results The total effective rate was 90.5% (38/42) in the observation group, which was 73.8% (31/42) in the control group, with significant difference between the two groups (Z=-3.225, P=0.004). After treatment, the scores of cough, sputum expectoration, shortness of breath, wheezing and moist rale in the observation group were significantly lower than those in the control group (t values were 3.225, 3.587, 3.552, 3.421, 3.785, all Ps<0.05), and the levels of FEV1, FVC and FEV1% in the observation group were significantly higher than those in the control group (t values were 3.586, 3.021, 5.026, all Ps<0.05). After treatment, the PaO2 and SaO2 levels in the observation group were significantly higher than those in the control group (t values were 4.022 and 4.251 respectively, all Ps<0.05), and PaCO2 levels in the observation group were significantly lower than those in the control group (t=4.572, P=0.018). The CRP and PCT in the observation group were significantly lower than those in the control group (t=4.635, 3.028, P<0.05). Conclusions The modified Huangqi decoction can improve the pulmonary function and clinical symptoms of AECOPD patients, reduce the levels of CRP and PCT, and improve the clinical efficacy. Key words: Pulmonary disease, chronic obstructive; Acute lung injury; Calcitonin; C-reactive albumin; Blood gas analysis; Huangqi decoction