263 results on '"Rongchang, Chen"'
Search Results
2. Clinical features and associated factors of impaired ventilatory efficiency: findings from the ECOPD study in China
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Zihui Wang, Fan Wu, Rongchang Chen, Ningning Zhao, Pixin Ran, Yumin Zhou, Peiyu Huang, Xiaohui Wu, Qi Wan, Youlan Zheng, Jieqi Peng, Zhishan Deng, Huajing Yang, Shan Xiao, Xiang Wen, Cuiqiong Dai, Lifei Lu, Kunning Zhou, Ruiting Sun, Changli Yang, Gaoying Tang, Suyin Huang, Guannan Cai, and Yongqing Huang
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Medicine ,Diseases of the respiratory system ,RC705-779 - Abstract
Background Impaired ventilatory efficiency during exercise is a predictor of mortality in chronic obstructive pulmonary disease. However, little is known about the clinical features and associated factors of impaired ventilatory efficiency in China.Methods We conducted a cross-sectional community-based study in China and collected demographic and clinical information, cardiopulmonary exercise testing, spirometry, and CT data. Impaired ventilatory efficiency was defined by a nadir ventilatory equivalent for CO2 production above the upper limit of normal. Multivariable linear and logistic regression models were used to explore the clinical features and associated factors of impaired ventilatory efficiency.Results The final analyses included 941 subjects, 702 (74.6%) of whom had normal ventilatory efficiency and 239 (25.4%) had impaired ventilatory efficiency. Participants with impaired ventilatory efficiency had more chronic respiratory symptoms, poorer lung function and exercise capacity, and more severe emphysema (natural logarithm transformation of the low-attenuation area of the lung with attenuation values below −950 Hounsfield units, logLAA−950: 0.19±0.65 vs −0.28±0.63, p
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- 2024
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3. Forsythoside B alleviates cerebral ischemia-reperfusion injury via inhibiting NLRP3 inflammasome mediated by SIRT1 activation.
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Qiaoyu Li, Chongyang Zhang, Xiao Sun, Mengchen Wang, Zhixiu Zhang, Rongchang Chen, and Xiaobo Sun
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Medicine ,Science - Abstract
BackgroundThe inflammatory response is a key factor in the pathogenesis of cerebral ischemia/reperfusion injury (CIRI), and anti-inflammatory interventions may offer a promising therapeutic strategy. Forsythoside B (FB) is a phenylethanoid glycoside isolated from Forsythiae fructus, which has been reported to have anti-inflammatory effects. However, the mechanism of the neuroprotective effect of FB on CIRI remains unclear.MethodsAdult male Sprague-Dawley rats were subjected to transient middle cerebral artery occlusion/reperfusion (MCAO/R). FB was administered intraperitoneally for 3 days prior to MCAO/R. Cerebral infarct volume and neurological deficit score were used as indices to evaluate MCAO/R injury. The serum levels of inflammatory factors and antioxidant enzymes were measured. The activation of silent information regulator 2 homolog 1 (Sirt1) and the inhibition of the nucleotide-binding oligomerization domain-like receptor with a pyrin domain 3 (NLRP3) pathway were assessed through western blot and immunohistochemistry analysis. Furthermore, the rats were treated with Sirt1 shRNA 3 days before MCAO/R by stereotactical injection into the ipsilateral hemispheric region to assess the impact of Sirt1 knockdown on the protection of FB during MCAO/R.ResultsFB reduced cerebral infarct volume and neurological deficit score in MCAO/R rats. FB reduced pathological changes and cell apoptosis in the hippocampal CA1 region and cortex on the ischemic side of rats. FB inhibited the serum levels of inflammatory factors and increased the activities of antioxidant enzymes. Further study showed that FB inhibited the activation of the NLRP3 pathway and induced Sirt1 activation.ConclusionFB demonstrated neuroprotective and anti-inflammatory effects by inhibiting the NLRP3 pathway through Sirt1 activation in CIRI.
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- 2024
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4. Prophylactic antibiotics for preventing ventilator-associated pneumonia: a pairwise and Bayesian network meta-analysis
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Shanshan Zha, Jianyi Niu, Zhenfeng He, Wei Fu, Qiaoyun Huang, Lili Guan, Luqian Zhou, and Rongchang Chen
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Prophylactic antibiotics ,Ventilator-associated pneumonia ,Network meta-analysis ,Medicine - Abstract
Abstract Background The role of prophylactic antibiotics in preventing ventilator-associated pneumonia (VAP) in patients undergoing invasive mechanical ventilation (IMV) remains unclear. This network meta-analysis compared the efficacy and safety of antibiotic prophylaxis in preventing VAP in an IMV population in intensive-care units (ICUs). Methods We searched the PubMed, Web of Science, Embase, and Cochrane Library databases from inception to December 2021, to identify relevant studies assessing the impact of prophylactic antibiotics on the incidence of VAP, the mortality, and the duration of ICU stays and hospitalization to perform a meta-analysis. Results Thirteen studies (2144 patients) were included, 12 of which were selected for the primary analysis, which revealed that treatment with prophylactic antibiotics resulted in a lower VAP rate compared with control groups [risk ratio (RR) = 0.62]. Bayesian network meta-analysis indicated that aerosolized tobramycin and intravenous ampicillin–sulbactam presented the greatest likelihood being the most efficient regimen for reducing VAP. Conclusions Antibiotic prophylaxis may reduce the incidence of VAP, but not the mortality, for adult patients undergoing IMV in ICUs. Tobramycin via nebulization and ampicillin–sulbactam via intravenous administration presented the greatest likelihood of being the most efficient regimen for preventing VAP. However, well-designed randomized studies are warranted before definite recommendations can be made.
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- 2023
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5. Expert consensus on the metaverse in medicine
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Dawei Yang, Jian Zhou, Rongchang Chen, Yuanlin Song, Zhenju Song, Xiaoju Zhang, Qi Wang, Kai Wang, Chengzhi Zhou, Jiayuan Sun, Lichuan Zhang, Li Bai, Yuehong Wang, Xu Wang, Yeting Lu, Hongyi Xin, Charles A. Powell, Christoph Thüemmler, Niels H. Chavannes, Wei Chen, Lian Wu, and Chunxue Bai
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Medical Internet of Things (MIoT) ,Metaverse ,Metaverse in medicine ,Virtuality-reality integration ,Virtuality-reality interconnection ,Medicine - Abstract
Background: Recently, Professor Chunxue Bai and colleagues have proposed a definition of the Metaverse in Medicine as the medical Internet of Things (MIoT) facilitated using AR and/or VR glasses. Methods: A multi-disciplinary panel of doctors and IT experts from Asia, the United States, and Europe analyzed published articles regarding expert consensus on the Medical Internet of Things, with reference to study results in the field of metaverse technology. Findings: It is feasible to implement the three basic functions of the MIoT, namely, comprehensive perception, reliable transmission, and intelligent processing, by applying a metaverse platform, which is composed of AR and VR glasses and the MIoT system, and integrated with the technologies of holographic construction, holographic emulation, virtuality-reality integration, and virtuality-reality interconnection. In other words, through interactions between virtual and real cloud experts and terminal doctors, we will be able to carry out medical education, science popularization, consultation, graded diagnosis and treatment, clinical research, and even comprehensive healthcare in the metaverse. The interaction between virtual and real cloud experts and terminal users (including terminal doctors, patients, and even their family members) could also facilitate different medical services, such as disease prevention, healthcare, physical examination, diagnosis and treatment of diseases, rehabilitation, management of chronic diseases, in-home care, first aid, outpatient attendance, consultation, etc. In addition, it is noteworthy that security is a prerequisite for the Metaverse in Medicine, and a reliable security system is the foundation to ensure the normal operation of such a platform. Conclusion: The application of a Cloud Plus Terminal platform could enable interaction between virtual and real cloud experts and terminal doctors, in order to realize medical education, science popularization, consultation, graded diagnosis and treatment, clinical research, and even comprehensive healthcare in the metaverse.
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- 2022
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6. Noninvasive ventilation with a helmet in patients with acute respiratory failure caused by chest trauma: a randomized controlled trial
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Qi Liu, Mengtian Shan, Hailong Zhu, Jianliang Cao, and Rongchang Chen
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Medicine ,Science - Abstract
Abstract Noninvasive ventilation (NIV) is beneficial in acute respiratory failure (ARF) caused by chest trauma; however, NIV-related complications affect the efficacy. We evaluated whether NIV with helmet decreases the incidence of complications and improves its effects in a single center. Patients with ARF after chest trauma were randomized to receive NIV with helmet or face mask. The primary outcome was the rate of NIV-related complications. Secondary outcomes were PaO2/FiO2, patient’s tolerance, intubation rate, length of intensive care unit (ICU) stay, and ICU mortality. The trial was terminated early after an interim analysis with 59 patients. The incidence of complications was lower in the helmet group [10% (3/29) vs 43% (13/30), P = 0.004], and PaO2/FiO2s were higher at 1 h and at the end of NIV (253.14 ± 64.74 mmHg vs 216.06 ± 43.86 mmHg, 277.07 ± 84.89 mmHg vs 225.81 ± 63.64 mmHg, P = 0.013 and 0.012) compared with them in face mask group. More patients reported excellent tolerance of the helmet vs face mask after 4 h of NIV [83% (24/29) vs 47% (14/30), P = 0.004] and at the end of NIV [69% (20/29) vs 30% (9/30), P = 0.03]. Differences in intubation rate, ICU stay, and mortality were non-significant (P = 0.612, 0.100, 1.000, respectively). NIV with helmet decreased NIV-related complications, increased PaO2/FiO2, and improved tolerance compared with NIV with face mask in patients with chest trauma. Trial registration: Registered in the Chinese Clinical Trial Registry (ChiCTR1900025915), a WHO International Clinical Trials Registry Platform ( http://www.chictr.org.cn/searchprojen.aspx ).
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- 2020
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7. Chinese experts’ consensus on the Internet of Things-aided diagnosis and treatment of coronavirus disease 2019 (COVID-19)
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Li Bai, Dawei Yang, Xun Wang, Lin Tong, Xiaodan Zhu, Nanshan Zhong, Chunxue Bai, Charles A. Powell, Rongchang Chen, Jian Zhou, Yuanlin Song, Xin Zhou, Huili Zhu, Baohui Han, Qiang Li, Guochao Shi, Shengqing Li, Changhui Wang, Zhongmin Qiu, Yong Zhang, Yu Xu, Jie Liu, Ding Zhang, Chaomin Wu, Jing Li, Jinming Yu, Jiwei Wang, Chunling Dong, Yaoli Wang, Qi Wang, Lichuan Zhang, Min Zhang, Xia Ma, Lin Zhao, Wencheng Yu, Tao Xu, Yang Jin, Xiongbiao Wang, Yuehong Wang, Yan Jiang, Hong Chen, Kui Xiao, Xiaoju Zhang, Zhenju Song, Ziqiang Zhang, Xueling Wu, Jiayuan Sun, Yao Shen, Maosong Ye, Chunlin Tu, Jinjun Jiang, Hai Yu, and Fei Tan
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COVID-19 ,Internet of Things ,Cloud plus terminal ,Intelligent assistance ,Quality control ,Medicine - Abstract
The aim is to diagnose COVID-19 earlier and to improve its treatment by applying medical technology, the “COVID-19 Intelligent Diagnosis and Treatment Assistant Program (nCapp)” based on the Internet of Things. Terminal eight functions can be implemented in real-time online communication with the “cloud” through the page selection key. According to existing data, questionnaires, and check results, the diagnosis is automatically generated as confirmed, suspected, or suspicious of 2019 novel coronavirus (2019-nCoV) infection. It classifies patients into mild, moderate, severe or critical pneumonia. nCapp can also establish an online COVID-19 real-time update database, and it updates the model of diagnosis in real time based on the latest real-world case data to improve diagnostic accuracy. Additionally, nCapp can guide treatment. Front-line physicians, experts, and managers are linked to perform consultation and prevention. nCapp also contributes to the long-term follow-up of patients with COVID-19. The ultimate goal is to enable different levels of COVID-19 diagnosis and treatment among different doctors from different hospitals to upgrade to the national and international through the intelligent assistance of the nCapp system. In this way, we can block disease transmission, avoid physician infection, and epidemic prevention and control as soon as possible.
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- 2020
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8. Investigation of the Clinical, Radiological and Biological Factors Associated with Disease Progression, Phenotypes and Endotypes of COPD in China (COMPASS): study design, protocol and rationale
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Zhenyu Liang, Nanshan Zhong, Rongchang Chen, Qianli Ma, Yongchang Sun, Fuqiang Wen, Ruth Tal-Singer, Bruce E. Miller, Julie Yates, Jie Song, Chris Compton, Beulah Ji, Li Wu, Yang Yang, Paul Jones, and Jinping Zheng
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Medicine - Abstract
COPD is heterogeneous, and its presentation varies between countries. The major COPD cohort studies have only been performed in Western populations; the disease is not well characterised in other regions. The COMPASS (Investigation of the Clinical, Radiological and Biological Factors, Humanistic and Healthcare Utilisation Burden Associated with Disease Progression, Phenotypes and Endotypes of COPD in China; NCT04853225) is a prospective, 2.5-year-long, multi-centre, longitudinal, observational study with three aims: 1) to characterise stable and exacerbation phenotypes/endotypes in terms of clinical characteristics, blood and sputum biomarkers, lung microbiome and lung imaging; 2) to understand the relevance of markers of COPD disease progression identified in Western cohorts to Chinese patients; and 3) to characterise treatment pathways and healthcare resource utilisation. COMPASS will recruit 2000 participants, of which 1700 will be in Global Initiative for Chronic Obstructive Lung Disease (GOLD) Grades I–IV (n=700, 700, 200 and 100, respectively), 180 participants with chronic bronchitis without airflow limitation and 120 never-smoker healthy controls. Study visits will be at baseline, 6, 18 and 30 months and at exacerbation. Assessments include lung function, exacerbation frequency, health status, blood biomarkers and, in a sub-cohort of 400 patients, chest high-resolution computed tomography, additional blood and sputum biomarkers, airway micro-, viral- and myco-biome, and physical activity. COMPASS will establish a unique clinical and biological dataset in a well-characterised cohort of individuals with COPD in China, with a particular focus on milder patients. As the first study of its kind attempting to understand the disease in an Asian setting, it will provide valuable insights into regional and ethnic differences in COPD.
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- 2021
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9. Are sputum autoantibodies more clinically relevant in idiopathic pulmonary fibrosis than serum autoantibodies?
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Kuimiao Deng, Qun Luo, Zhenyu Liang, Fei Long, Qian Han, Fengyan Wang, Shuyu Huang, Liyue Liao, Tingting Lin, and Rongchang Chen
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autoantibodies ,autoimmunity ,idiopathic pulmonary fibrosis ,serum ,sputum ,Medicine - Abstract
Background: The adaptive immune system plays a role in the pathogenesis of idiopathic pulmonary fibrosis (IPF) has been reported previously. However, the association between airway and circulating autoantibodies (AAbs) levels is unclear. The aim of this study is to investigate the link between the AAb levels in airway and circulation in stable patients with IPF. Materials and Methods: From June 2016 to March 2017, 21 stable IPF patients and 22 healthy volunteers were recruited. We established Luminex interacting AAbs with bead-antigen complex to detect the immunoglobulin G antibodies levels of ten autoantigens which were matched serum (Se) and sputum (Sp) samples collected from recruited subjects, including Smith (Sm), Anti-ribosomal P antibody (P0), Sjögren syndrome type A antigen (SSA), La/Sjögren syndrome type B antigen (SSB), DNA topoisomerase (Scl-70), histidyl-tRNA synthetase (Jo-1), U1 small nuclear ribonucleoprotein (U1-SnRNP), thyroid peroxidase, Proteinase 3, and Myeloperoxidase. Spearman's rank correlation matrix was applied to explore the associations of Ab profiles between Se and Sp. Results: For IPF patients, Spearman's correlation matrix showed multiple intercorrelations among Sp-AAbs and Sp-AAbs (P < 0.05), while only the levels of AAb against Sm and anti-La in Se were correlated with those Sp-AAb counterparts (P < 0.05). For healthy individuals, only anti-La in Se was associated with those Sp-AAb counterparts (P < 0.05). For IPF patients, there was a positive correlation between carbon monoxide diffusing capacity (DLCO)% predicted and Sp-anti-P0 level (r = 0.464, P = 0.034). Forced vital capacity% predicted was positively correlated with Sp-anti-Scl-70 level (r = 0.466, P = 0.033). Conclusion: Comparing to Se-AAbs, Sp-AAbs are more associated with clinical parameters in the patients with IPF. In order to better understand the role of autoimmunity in the pathogenesis of IPF, detection of Sp-AAbs for local autoimmune responses may be a good choice.
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- 2022
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10. Effect of short-term inhalation of warm saline atomised gas on patients with non-cystic fibrosis bronchiectasis
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Lihong Zhong, Ying Xiong, Zeguang Zheng, Ni Liu, Jieying Hu, Feng Yang, and Rongchang Chen
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Medicine - Abstract
Objective Secretion clearance is advocated in non-cystic fibrosis bronchiectasis, but is often neglected in clinical treatment. The present study aimed to investigate the effect of inhaled 0.9% normal saline by ultrasonic nebuliser with warming (UNW) in stable non-cystic fibrosis bronchiectasis patients with purulent sputum. Methods 27 stable patients were enrolled in a randomised crossover trial comprising 3 months of daily UNW aerosol therapy compared with 3 months of daily oral expectorant treatment. The outcomes were quality of life (assessed via the Leicester cough questionnaire (LCQ)), sputum characteristics, pulmonary function, 6-min walk distance (6MWD) and acute exacerbation frequency. Results Compared with baseline, the sputum viscosity, sputum colour, LCQ score and 6MWD were significantly improved with UNW (p
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- 2020
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11. Correction: Mutation spectrums of TSC1 and TSC2 in Chinese women with lymphangioleiomyomatosis (LAM).
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Jie Liu, Weiwei Zhao, Xiaohua Ou, Zhen Zhao, Changming Hu, Mingming Sun, Feifei Liu, Junhao Deng, Weili Gu, Jiaying An, Qingling Zhang, Xiaoxian Zhang, Jiaxing Xie, Shiyue Li, Rongchang Chen, Shihui Yu, and Nanshan Zhong
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Medicine ,Science - Abstract
[This corrects the article DOI: 10.1371/journal.pone.0226400.].
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- 2020
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12. Mutation spectrums of TSC1 and TSC2 in Chinese women with lymphangioleiomyomatosis (LAM).
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Jie Liu, Weiwei Zhao, Xiaohua Ou, Zhen Zhao, Changming Hu, Mingming Sun, Feifei Liu, Junhao Deng, Weili Gu, Jiaying An, Qingling Zhang, Xiaoxian Zhang, Jiaxing Xie, Shiyue Li, Rongchang Chen, Shihui Yu, and Nanshan Zhong
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Medicine ,Science - Abstract
The aim of our study was to elucidate the landscapes of genetic alterations of TSC1 and TSC2 as well as other possible non-TSC1/2 in Lymphangioleiomyomatosis (LAM) patients. Sixty-one Chinese LAM patients' clinical information was collected. Tumor biopsies and matched leukocytes from these patients were retrospectively analyzed by next generation sequencing (NGS), chromosomal microarray analysis (CMA), and multiplex ligation-dependent probe amplification (MLPA). Eighty-six TSC1/2 variants were identified in 46 of the 61 LAM patients (75.4%) in which TSC2 and TSC1 variants were 88.37% and 11.63% respectively. The 86 variants are composed of (i) 52 single nucleotide variants (SNVs) (including 30 novel variants), (ii) 23 indels (including 21deletions, and 2 insertions), (iii) a germline duplication of exon 31-42 of TSC2, (iv) a 2.68 Mb somatic duplication containing TSC2, and (v) 9 regions with copy-neutral loss of heterogeneity (CN-LOHs) present only in the LAM patients with single TSC1/2 mutations. Sixty-one non-TSC1/2 variants in 31 genes were identified in 37 LAM patients. Combined applications of different techniques are necessary to achieve maximal detection rate of TSC1/2 variants in LAM patients. Thirty novel TSC1/2 variants expands the spectrum of TSC1/2 in LAM patients. Identification of 61 non-TSC1/2 variants suggests that alternative genes might have contributed to the initiation and progression of LAM.
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- 2019
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13. Practice pattern of aerosol therapy among patients undergoing mechanical ventilation in mainland China: A web-based survey involving 447 hospitals.
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Zhongheng Zhang, Peifeng Xu, Qiang Fang, Penglin Ma, Huiling Lin, Jim B Fink, Zongan Liang, Rongchang Chen, Huiqing Ge, and China Union of Respiratory Care (CURC)
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Medicine ,Science - Abstract
Background and objectiveAerosol therapies are widely used for mechanically ventilated patients. However, the practice pattern of aerosol therapy in mainland China remains unknown. This study aimed to determine the current practice of aerosol therapy in mainland China.MethodsA web-based survey was conducted by the China Union of Respiratory Care (CURC) from August 2018 to January 2019. The survey was disseminated via Email or WeChat to members of CURC. A questionnaire comprising 16 questions related to hospital information and 12 questions related to the practice of aerosol therapy. Latent class analysis was employed to identify the distinct classes of aerosol therapy practice.Main resultsA total of 693 valid questionnaires were returned by respiratory care practitioners from 447 hospitals. Most of the practitioners used aerosol therapy for both invasive mechanical ventilation (90.8%) and non-invasive mechanical ventilation (91.3%). Practitioners from tertiary care centers were more likely to use aerosol therapy compared with those from non-tertiary care centers (91.9% vs. 85.4%, respectively; p = 0.035). The most commonly used drugs for aerosol therapy were bronchodilators (64.8%) followed by mucolytic agents (44.2%), topical corticosteroids (43.4%) and antibiotics (16.5%). The ultrasonic nebulizer (48.3%) was the most commonly used followed by the jet nebulizer (39.2%), the metered dose inhaler (15.4%) and the vibrating mesh nebulizer (14.6%). Six latent classes were identified via latent class analysis. Class 1 was characterized by the aggressive use of aerosol therapy without a standard protocol, while class 3 was characterized by the absence of aerosol therapy.ConclusionsSubstantial heterogeneity among institutions with regard to the use of aerosol therapy was noted. The implementation of aerosol therapy during mechanical ventilation was inconsistent in light of recent practice guidelines. Additional efforts by the CURC to improve the implementation of aerosol therapy in mainland China are warranted.
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- 2019
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14. Prevention of IL-6 signaling ameliorates toluene diisocyanate-induced steroid-resistant asthma
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Kai Yang, Shuyu Chen, Difei Li, Shanshan Zha, Li Yu, Zhenyu Liang, Shengming Liu, Zhuoyu Chen, Yao Deng, and Rongchang Chen
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Drug Resistance ,Inflammation ,HMGB1 ,Antibodies, Monoclonal, Humanized ,chemistry.chemical_compound ,Mice ,Tocilizumab ,Respiratory Hypersensitivity ,Immunology and Allergy ,Medicine ,Animals ,Humans ,Toluene diisocyanate ,Neutralizing antibody ,Interleukin 6 ,Goblet cell ,Mice, Inbred BALB C ,biology ,Steroid-resistant asthma ,business.industry ,Interleukin-6 ,General Medicine ,RC581-607 ,Asthma ,respiratory tract diseases ,Disease Models, Animal ,medicine.anatomical_structure ,chemistry ,Immunology ,biology.protein ,Methacholine ,IL-6 signaling ,medicine.symptom ,Toluene 2,4-Diisocyanate ,Immunologic diseases. Allergy ,business ,medicine.drug ,Signal Transduction ,Airway inflammation - Abstract
Background Accumulating evidence indicated the crucial role for interleukin 6 (IL-6) signaling in the development of allergic asthma. Yet, the role of IL-6 signaling in toluene diisocyanate (TDI)-induced mixed granulocytic airway inflammation still remains unclear. Thus, the aims of this study were to dissect the role of IL-6 signaling and to evaluate the effect of tocilizumab on TDI-induced steroid-resistant asthma. Methods TDI-induced asthma model was prepared and asthmatic mice were respectively given IL-6 monoclonal antibody, IL-6R monoclonal antibody (tocilizumab, 5 mg/kg, i.p. after each challenge) for therapeutic purposes or isotype IgG as control. Results TDI exposure just elevated IL-6R expression in the infiltrated inflammatory cells around the airway, but increased glycoprotein 130 expression in the whole lung, especially in bronchial epithelium. Moreover, TDI inhalation increased airway hyperresponsiveness (AHR) to methacholine, coupled with mixed granulocytic inflammation, exaggerated epithelial denudation, airway smooth muscle thickening, goblet cell metaplasia, extensive submucosal collagen deposition, dysregulated Th2/Th17 responses, as well as innate immune responses and raised serum IgE. And almost all these responses except for raised serum IgE were markedly ameliorated by the administration of IL-6 neutralizing antibody or tocilizumab, but exhibited poor response to systemic steroid treatment. Also, TDI challenge induced nucleocytoplasm translocation of HMGB1 and promoted its release in the BALF, as well as elevated lung level of STAT3 phosphorylation, which were inhibited by anti-IL-6 and anti-IL-6R treatment. Conclusions Our data suggested that IL-6 monoclonal antibody and tocilizumab might effectively abrogate TDI-induced airway inflammation and remodeling, which could be used as a clinical potential therapy for patients with severe asthma.
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- 2022
15. Clinical impact of nosocomial infection with pandemic influenza A (H1N1) 2009 in a respiratory ward in Guangzhou
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Rongchang Chen, Wei-jie Guan, Feng Ye, Xiao-juan Chen, Wenda Guan, Yangqing Zhan, Chunguang Yang, Sook-san Wong, and Sihua Pan
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Bronchiectasis ,biology ,business.industry ,virus diseases ,Outbreak ,medicine.disease ,biology.organism_classification ,Group A ,Group B ,Internal medicine ,medicine ,biology.protein ,Infection control ,Original Article ,Penicillium marneffei ,Viral shedding ,business ,Neuraminidase - Abstract
Background Nosocomial outbreaks of pandemic influenza A (H1N1) 2009 virus [A(H1N1)pdm09] easily develop due to its high transmissibility. This study aimed to investigate the clinical impacts of a nosocomial outbreak of A(H1N1)pdm09 between 21 January and 17 February 2016. Methods Patients who developed influenza-like illness (ILI) more than 48 hours after hospitalization in the index ward were enrolled as suspected patients, defined as group A and quarantined. Patients in other wards were defined as group B. A phylogenetic tree was constructed to determine the origins of the hemagglutinin and neuraminidase genes. Results After the implementation of an infection control measure bundle, the outbreak was limited to eight patients with ILIs in group A. Nasal swabs from seven patients were positive for A(H1N1)pdm09. All the patients recovered after treatment. Prolonged viral shedding was observed in a patient with bronchiectasis and Penicillium marneffei infection. Compared to the expected duration of hospitalization in patients without fever, those with fever had a median 7-day delay in discharge and a mean excess cost of 3,358 RMB. The four influenza strains identified were genetically identical to the A/California/115/2015 strain. Six of the 54 patients in group B who underwent bronchoscopy developed transient fever. These patients were hospitalized in various wards of the hospital and recovered after a short-term course of empirical antibiotics. Conclusions After the implementation of infection control measures, the nosocomial A(H1N1)pdm09 outbreak was rapidly contained; infected patients had a delay in discharge and excess costs, but no deaths occurred.
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- 2021
16. Effects of Air Pollutant Exposure on Exacerbation Severity in Asthma Patients with or without Reversible Airflow Obstruction
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Dandan Chen, Wei Fang, Can Yao, Sinian Li, Binbin Li, Yu Zhang, Yin Jiang, Aiming Liu, Rongchang Chen, and Fei Shi
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Pulmonary and Respiratory Medicine ,Pollutant ,medicine.medical_specialty ,Receiver operating characteristic ,Exacerbation ,business.industry ,fixed airflow obstruction ,asthma ,reversible airflow obstruction ,Logistic regression ,medicine.disease ,Pulmonary function testing ,respiratory tract diseases ,Internal medicine ,medicine ,Journal of Asthma and Allergy ,Immunology and Allergy ,Mass index ,air particles ,Family history ,business ,Asthma ,Original Research - Abstract
Wei Fang,1,* Yu Zhang,1,* Sinian Li,1,* Aiming Liu,2,* Yin Jiang,2 Dandan Chen,1 Binbin Li,3 Can Yao,3 Rongchang Chen,1 Fei Shi3 1Key Laboratory of Shenzhen Respiratory Diseases, Institute of Shenzhen Respiratory Diseases, Shenzhen Peopleâs Hospital (The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University), Shenzhen, Guangdong, Peopleâs Republic of China; 2Shenzhen National Climate Observatory, Meteorological Bureau of Shenzhen Municipality, Shenzhen Key Laboratory of Severe Weather in South China, Shenzhen, Guangdong, Peopleâs Republic of China; 3Emergency Department, Institute of Shenzhen Respiratory Diseases, Shenzhen Peopleâs Hospital (The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University), Shenzhen, Guangdong, Peopleâs Republic of China*These authors contributed equally to this workCorrespondence: Rongchang Chen; Fei Shi Email chenrc@vip.163.com; shi.fei@szhospital.comBackground: Reversible airflow obstruction (RO) and fixed airflow obstruction (FO) are two important clinical phenotypes of asthma. However, the relationship between air pollutant exposure and exacerbation of the two phenotypes is unknown.Objective: To study the effects of air pollutant exposure on exacerbation severity in asthma patients with or without FO.Methods: A total of 197 severe asthma patients were enrolled, and divided into two groups: the FO group (n=81) and the RO group (n=116). We collected the demographic data, laboratory parameters, pulmonary function test parameters, and the daily average concentrations of different air particles in Shenzhen on the different lag days of each subject. The receiver operating characteristic (ROC) curve was used to identify the effects of major air pollutants on the severity of asthma patients with RO.Results: Compared with the RO group, the FO group had fewer women, lower body mass index (BMI), longer disease duration, higher smoking history rate, allergic family history rate, FeNO level, and lower levels of large airway parameters. The median exposure levels of PM10 and PM2.5 in the severe RO subgroup were both higher than those in the mild-to-moderate RO subgroup on Lag0, 1 and 3, and the median exposure level of PM1 on Lag0 in the severe RO subgroup was significantly higher than that in the mild-to-moderate RO subgroup. Logistic regression modeling indicated exposure to PM2.5 and PM1.0 on Lag0, and PM10 on Lag0-2 were the independent risk factors for hospital admissions for asthma patients with RO. By performing an ROC curve analysis, PM2.5 on Lag0 (AUC = 0.645, p = 0.027) provided a best performance to predict severe asthma exacerbations with RO, with a sensitivity of 36.0% and a specificity of 91.2%.Conclusion: Short-term exposure to PM10, PM2.5 and PM1 may play a role in exacerbation severity among asthma patients with RO.Keywords: air particles, asthma, reversible airflow obstruction, fixed airflow obstruction
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- 2021
17. Differential expression of sputum and serum autoantibodies in patients with chronic obstructive pulmonary disease
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Jing Xiao, Steven P. Cass, Joshua J.C. McGrath, Anna Dvorkin-Gheva, Christopher S. Stevenson, Rongchang Chen, Quan Zhen Li, Yuqiong Yang, Fengyan Wang, Martin R. Stämpfli, Danya Thayaparan, Tao Peng, Parameswaran Nair, Zhenyu Liang, Manali Mukherjee, and Fei Long
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0301 basic medicine ,Pulmonary and Respiratory Medicine ,Physiology ,Pulmonary disease ,Pulmonary Disease, Chronic Obstructive ,03 medical and health sciences ,0302 clinical medicine ,Physiology (medical) ,Humans ,Medicine ,In patient ,Differential expression ,Lung ,Autoantibodies ,COPD ,Smokers ,business.industry ,Smoking ,Respiratory disease ,Serum autoantibodies ,Sputum ,Autoantibody ,Cell Biology ,medicine.disease ,respiratory tract diseases ,3. Good health ,030104 developmental biology ,Immunoglobulin M ,030228 respiratory system ,Case-Control Studies ,Immunoglobulin G ,Immunology ,Disease Progression ,medicine.symptom ,business - Abstract
Chronic obstructive pulmonary disease (COPD) is a complex and progressive respiratory disease. Autoimmune processes have been hypothesized to contribute to disease progression; however, the presence of autoantibodies in the serum has been variable. Given that COPD is a lung disease, we sought to investigate whether autoantibodies in sputum supernatant would better define pulmonary autoimmune processes. Matched sputum and serum samples were obtained from the Airways Disease Endotyping for Personalized Therapeutics (ADEPT) study and at the Guangzhou Institute of Respiratory Health (GIRH). Samples were collected from patients with varying severity of COPD, asymptomatic smokers, and healthy control subjects. IgG and IgM autoantibodies were detected in sputum and serum of all subjects in both cohorts using a broad-spectrum autoantigen array. No differences were observed in sputum autoantibodies between COPD and asymptomatic smokers in either cohort. In contrast, 16% of detectable sputum IgG autoantibodies were decreased in subjects with COPD compared to healthy controls in the ADEPT cohort. Compared to asymptomatic smokers, approximately 13% of detectable serum IgG and 40% of detectable serum IgM autoantibodies were differentially expressed in GIRH COPD subjects. Of the differentially expressed specificities, anti-nuclear autoantibodies were predominately decreased. A weak correlation between increased serum IgM anti-tissue autoantibodies and a measure of airspace enlargement was observed. The differential expression of specificities varied between the cohorts. In closing, using a comprehensive autoantibody array, we demonstrate that autoantibodies are present in subjects with COPD, asymptomatic smokers, and healthy controls. Cohorts displayed high levels of heterogeneity, precluding the utilization of autoantibodies for diagnostic purposes.
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- 2021
18. Correction: Molecular architecture of the 90S small subunit pre-ribosome
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Qi Sun, Xing Zhu, Jia Qi, Weidong An, Pengfei Lan, Dan Tan, Rongchang Chen, Bing Wang, Sanduo Zheng, Cheng Zhang, Xining Chen, Wei Zhang, Jing Chen, Meng-Qiu Dong, and Keqiong Ye
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Medicine ,Science ,Biology (General) ,QH301-705.5 - Published
- 2017
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19. Molecular architecture of the 90S small subunit pre-ribosome
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Qi Sun, Xing Zhu, Jia Qi, Weidong An, Pengfei Lan, Dan Tan, Rongchang Chen, Bing Wang, Sanduo Zheng, Cheng Zhang, Xining Chen, Wei Zhang, Jing Chen, Meng-Qiu Dong, and Keqiong Ye
- Subjects
ribosome assembly ,cryo-EM ,90S pre-ribosome ,Medicine ,Science ,Biology (General) ,QH301-705.5 - Abstract
Eukaryotic small ribosomal subunits are first assembled into 90S pre-ribosomes. The complete 90S is a gigantic complex with a molecular mass of approximately five megadaltons. Here, we report the nearly complete architecture of Saccharomyces cerevisiae 90S determined from three cryo-electron microscopy single particle reconstructions at 4.5 to 8.7 angstrom resolution. The majority of the density maps were modeled and assigned to specific RNA and protein components. The nascent ribosome is assembled into isolated native-like substructures that are stabilized by abundant assembly factors. The 5' external transcribed spacer and U3 snoRNA nucleate a large subcomplex that scaffolds the nascent ribosome. U3 binds four sites of pre-rRNA, including a novel site on helix 27 but not the 3' side of the central pseudoknot, and crucially organizes the 90S structure. The 90S model provides significant insight into the principle of small subunit assembly and the function of assembly factors.
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- 2017
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20. Optimized combination of circulating biomarkers as predictors of prognosis in AECOPD patients complicated with Heart Failure
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Lingwei Wang, Sinian Li, Binbin Li, Can Yao, Wenwen Liu, Fei Shi, Rongchang Chen, and Mengjie Feng
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Male ,medicine.medical_specialty ,Acute exacerbation of chronic obstructive pulmonary disease ,medicine.drug_class ,heart failure ,acute exacerbation of chronic obstructive pulmonary disease ,Logistic regression ,Gastroenterology ,Risk Assessment ,03 medical and health sciences ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,medicine ,Natriuretic peptide ,platelet-lymphocyte ratio ,Humans ,Hospital Mortality ,neutrophil-lymphocyte ratio ,Aged ,Retrospective Studies ,Aged, 80 and over ,Receiver operating characteristic ,business.industry ,Area under the curve ,Retrospective cohort study ,General Medicine ,medicine.disease ,Symptom Flare Up ,Hospitalization ,Circulating biomarkers ,ROC Curve ,C-reaction protein/albumin ratio ,Heart failure ,Feasibility Studies ,030211 gastroenterology & hepatology ,Female ,prognosis ,business ,Biomarkers ,Research Paper - Abstract
BackgroundSystematic inflammation, nutritional status, and cardiovascular function have been associated with the outcomes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients with heart failure (HF). However, the value of their relevant biomarkers in predicting mortality has not been well defined yet. We aimed to investigate the prognostic value of circulating biomarkers including C-reaction protein (CRP) /albumin (ALB), neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), and N-terminal pro-brain natriuretic peptide (NT-proBNP) for AECOPD patients with HF.Methods A total of 146 cases of AECOPD complicated with HF were enrolled and classified into survivor group (n=94) and non-survivor group (n=52). The baseline characteristics and blood-based biomarkers were collected. The predictors for prognosis were analyzed by multivariate logistic regression, and the ability to predict 28-day mortality was evaluated by receiver operating characteristics curve (ROC) and the area under the curve (AUC).ResultsThe patients in non-survivors had significantly higher levels of CRP, CRP/ALB, NLR, PCT and NT-proBNP, but lower ALB levels compared to the survivors [145.8±110.1 VS. 66.6±70.2mg/L, 5.9±4.9 VS. 2.3±2.6, 22.2 (11.1, 40.1) VS. 12.0 (6.2, 24.8), 2.6 (0.2, 10.3) VS. 0.08 (0.1, 0.5)ng/ml, 17912.5 (9344.0, 34344.5) VS. 9809.0 (4415.9, 16387.2)ng/ml, 26.8±6.4 VS. 31.0±4.6g/L; P < 0.001, P=0.413). The logistic analysis revealed that CRP/ALB (OR=1.303, 95%CI: 1.145-1.483, PP=0.009) and NLR (OR=1.010, 95%CI: 0.999-1.022, PPConclusionsHigh levels of NLR, CRP/ALB and NT-proBNP may be clinical usefully predictors for death in AECOPD patients with HF. Combination of NLR with CRP/ALB and NT-proBNP can provide a higher accuracy for predicting 28-day mortality in these patients.
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- 2021
21. Noninvasive ventilation with a helmet in patients with acute respiratory failure caused by chest trauma: a randomized controlled trial
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Rongchang Chen, Qi Liu, Hailong Zhu, Jianliang Cao, and Mengtian Shan
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Adult ,Male ,China ,Thoracic Injuries ,medicine.medical_treatment ,Science ,Single Center ,Trauma ,Article ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,medicine ,Intubation ,Humans ,In patient ,030212 general & internal medicine ,Respiratory Distress Syndrome ,Multidisciplinary ,Noninvasive Ventilation ,business.industry ,Incidence (epidemiology) ,Masks ,030208 emergency & critical care medicine ,Middle Aged ,Interim analysis ,Intensive care unit ,Clinical trial ,Intensive Care Units ,Anesthesia ,Randomized controlled trials ,Medicine ,Female ,Head Protective Devices ,business ,Respiratory Insufficiency - Abstract
Noninvasive ventilation (NIV) is beneficial in acute respiratory failure (ARF) caused by chest trauma; however, NIV-related complications affect the efficacy. We evaluated whether NIV with helmet decreases the incidence of complications and improves its effects in a single center. Patients with ARF after chest trauma were randomized to receive NIV with helmet or face mask. The primary outcome was the rate of NIV-related complications. Secondary outcomes were PaO2/FiO2, patient’s tolerance, intubation rate, length of intensive care unit (ICU) stay, and ICU mortality. The trial was terminated early after an interim analysis with 59 patients. The incidence of complications was lower in the helmet group [10% (3/29) vs 43% (13/30), P = 0.004], and PaO2/FiO2s were higher at 1 h and at the end of NIV (253.14 ± 64.74 mmHg vs 216.06 ± 43.86 mmHg, 277.07 ± 84.89 mmHg vs 225.81 ± 63.64 mmHg, P = 0.013 and 0.012) compared with them in face mask group. More patients reported excellent tolerance of the helmet vs face mask after 4 h of NIV [83% (24/29) vs 47% (14/30), P = 0.004] and at the end of NIV [69% (20/29) vs 30% (9/30), P = 0.03]. Differences in intubation rate, ICU stay, and mortality were non-significant (P = 0.612, 0.100, 1.000, respectively). NIV with helmet decreased NIV-related complications, increased PaO2/FiO2, and improved tolerance compared with NIV with face mask in patients with chest trauma.Trial registration: Registered in the Chinese Clinical Trial Registry (ChiCTR1900025915), a WHO International Clinical Trials Registry Platform (http://www.chictr.org.cn/searchprojen.aspx).
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- 2020
22. Management of COVID‐19 patients in Fangcang shelter hospital: clinical practice and effectiveness analysis
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Danting Zhan, Lingwei Wang, Wei Wang, Xinke Meng, Hongmei Zhang, Duoyun Li, Rongchang Chen, Xiang Long, and Pei Liu
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Male ,Pulmonary and Respiratory Medicine ,China ,Referral ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Hospitals, Special ,management protocol package ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,COVID‐19 ,Pandemic ,medicine ,Humans ,Immunology and Allergy ,Genetics(clinical) ,030212 general & internal medicine ,Fangcang shelter hospital ,Pandemics ,Genetics (clinical) ,Retrospective Studies ,SARS-CoV-2 ,business.industry ,COVID-19 ,Disease Management ,Effective management ,Original Articles ,Patient data ,Middle Aged ,medicine.disease ,Test (assessment) ,Clinical Practice ,030228 respiratory system ,Female ,Original Article ,Medical emergency ,business ,Mobile Health Units - Abstract
Fangcang shelter (Cabin) hospitals were set up in order to cope with the rapid growth of confirmed cases of coronavirus disease 2019 (COVID‐19) in Wuhan, China at a time when there were insufficient beds in designated hospitals. This paper describes the layout and functioning of a typical Fangcang shelter hospital, Wuhan Dongxihu Fangcang shelter Hospital, where the author has worked, the working mechanism, experience and effectiveness. A set of patient management protocols was employed for daily practice, which included preset criteria and procedure for admission, examination, medication treatment, referral and discharge. WeChat platform with different groups was used for communication, ward round, test appointments and patient data communication. All these procedures and mechanisms of working enabled the effective management of a larger number of patients with relatively few doctors. As a result, 442 mild or moderate COVID‐19 patients in Hall C were successfully managed by a team of 40 doctors, with 246 (56%) patients were cured and discharged from the Fangcang shelter hospital while the remaining 196 (44%) patients were referred on to designated hospitals for further treatment. The reasons for referral included poor resolution in computerized tomography (CT) scan (59%), persistently positive severe acute respiratory syndrome coronavirus 2 by PCR after 9 days of admission (16%), deterioration in CT image (4%), development of dyspnoea (1%) and other (4%) or unclear reasons (16%) due to no record of reasons for referral on the document. There were no deaths and no complaints from the patients in Hall C. In summary, the Fangcang shelter hospital could be run successfully with a set of patient management protocols under conditions of limited facilities and medical staff. It was effective and safe in isolating patients, providing basic medical care and early identification of potential severe cases. This experience may provide a successful example of a working mechanism for the prevention and control of the COVID‐19 pandemic worldwide.
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- 2020
23. The Roles of Bacteria and Viruses in Bronchiectasis Exacerbation: A Prospective Study
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Yan Huang, David de la Rosa-Carrillo, Miguel Ángel Martínez-García, Xiao-Rong Han, Rongchang Chen, Chun-Lan Chen, Jing-Jing Yuan, Nanshan Zhong, Wei-jie Guan, and Hui-min Li
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Bronchiectasis ,Bacteria ,Exacerbation ,business.industry ,Sputum ,General Medicine ,Odds ratio ,medicine.disease ,Culprit ,Interquartile range ,Internal medicine ,Viruses ,Humans ,Medicine ,Prospective Studies ,medicine.symptom ,business ,Prospective cohort study ,Pathogen - Abstract
Exacerbations are crucial events during bronchiectasis progression.To explore the associations between bacterial, viral, and bacterial plus viral isolations and bronchiectasis exacerbations.In this prospective study, we enrolled 108 patients who were followed up every 3-6 months and at onset of exacerbations between March 2017 and November 2018. Spontaneous sputum was split for detection of bacteria (routine culture) and viruses (quantitative polymerase chain reaction). Symptoms and lung function were assessed during exacerbations.The median exacerbation rate was 2.0 (interquartile range: 1.0-2.5) per patient-year. At any visit, viral isolations (V+) occurred more frequently during onset of exacerbations [odds ratio (OR): 3.28, 95% confidence interval (95%CI): 1.76-6.12], as did isolation of new bacteria (NB+) (OR: 2.52, 95%CI: 1.35-4.71) and bacterial plus viral isolations (OR: 2.24, 95%CI: 1.11-4.55). Whilst coryza appeared more common in exacerbations with V+ than in exacerbations with no pathogen isolations and those with NB+, lower airway symptoms were more severe in exacerbations with NB+ (Viral isolations, isolation of new bacteria and bacterial plus viral isolation are associated with bronchiectasis exacerbations. Symptoms at exacerbations might inform clinicians the possible culprit pathogens.Las exacerbaciones son eventos cruciales durante la progresión de la bronquiectasia.Analizar las asociaciones entre el aislamiento de bacterias, virus y virus y bacterias juntas y las exacerbaciones de las bronquiectasias.En este estudio prospectivo se incluyó a 108 pacientes a los que se siguió cada 3-6 meses y al comienzo de las exacerbaciones entre marzo de 2017 y noviembre de 2018. La muestra de esputo espontáneo se dividió para la detección de bacterias (cultivo de rutina) y virus (reacción en cadena de la polimerasa cuantitativa). Se evaluaron los síntomas y la función pulmonar durante las exacerbaciones.La mediana de la tasa de exacerbación fue de 2,0 (rango intercuartil: 1,0-2,5) por paciente/año. En cualquier visita, los aislamientos de virus (V+) tuvieron lugar con mayor frecuencia durante el inicio de las exacerbaciones (Los aislamientos de virus, el aislamiento de nuevas bacterias y el aislamiento de bacterias y virus juntos están asociados a las exacerbaciones de las bronquiectasias. Los síntomas de las exacerbaciones pueden proporcionar información a los médicos sobre los posibles patógenos responsables.
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- 2020
24. Clinical and Inflammatory Characteristics of the Chinese APAC Cough Variant Asthma Cohort
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Kefang Lai, Wenzhi Zhan, Feng Wu, Yunhui Zhang, Lin Lin, Wen Li, Fang Yi, Ziyu Jiang, Yuanrong Dai, Suyun Li, Jiangtao Lin, Yadong Yuan, Yong Jiang, Chen Qiu, Limin Zhao, Meihua Chen, Zhongmin Qiu, Hu Li, Ruchong Chen, Wei Luo, Jiaxing Xie, Chunxing Guo, Mei Jiang, Xiaohong Yang, Guochao Shi, Dejun Sun, Rongchang Chen, Kian Fan Chung, Huahao Shen, and Nanshan Zhong
- Subjects
bronchial hyperresponsiveness ,Medicine (General) ,classic asthma (CA) ,R5-920 ,cough ,Medicine ,cough variant asthma (CVA) ,General Medicine ,airway inflammation ,Original Research ,respiratory tract diseases - Abstract
BackgroundThe AtyPical Asthma in China (APAC) cohort is a multi-center prospective, observational cohort set-up to investigate the clinical, pathophysiological features, prognosis, and mechanisms of cough variant asthma (CVA).ObjectivesTo present the characteristics of newly physician-diagnosed adults with CVA (n = 328) compared to mild-moderate classic asthma (CA, n = 206).Methods and Main ResultsCVA subjects showed a higher proportion of female (67.1 vs. 55.3%, P = 0.0084), abnormal laryngopharyngeal sensations (71 vs. 51%, p < 0.0001) than CA, but presented with near normal spirometry and higher methacholine PD20-FEV1 values [4.2 (1, 8.6) vs. 0.8 (0.4, 4.7), P < 0.0001]. Lower fractional exhaled nitric oxide (FENO) levels [38.5 (19.8, 72.5) vs. 53. (28.5, 92.2), P = 0.0019], blood eosinophil counts [0.2 (0.1, 0.4) vs. 0.3 (0.2, 0.5), P = 0.0014], and sputum eosinophils [2.3 (0.3, 8.0) vs. 12.2 (2, 34.5), p < 0.0001] were found in CVA. Despite lower total serum IgE levels in CVA, there was similar proportion of atopy in both groups. The prevalence of cough in CA was 86.4%, while CVA reported more severe cough on Visual Analog Scale, Cough Evaluation Test, and Leicester Cough Questionnaire, similar anxiety and depression scores but better asthma control scores as reflected by Asthma Control Test compared to CA. No correlation was found between cough assessment outcomes and sputum eosinophil count, blood eosinophil count, FENO, spirometry variables, or PD20-FEV1.ConclusionCough variant asthma is distinctive from classic asthma in regard to clinical features, lung function, and airway inflammation. Quality of life is badly impaired as well in spite of better asthma control scores.
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- 2022
25. Abdominal Muscle Activity during Mechanical Ventilation Increases Lung Injury in Severe Acute Respiratory Distress Syndrome.
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Xianming Zhang, Weiliang Wu, Yongcheng Zhu, Ying Jiang, Juan Du, and Rongchang Chen
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Medicine ,Science - Abstract
It has proved that muscle paralysis was more protective for injured lung in severe acute respiratory distress syndrome (ARDS), but the precise mechanism is not clear. The purpose of this study was to test the hypothesis that abdominal muscle activity during mechanically ventilation increases lung injury in severe ARDS.Eighteen male Beagles were studied under mechanical ventilation with anesthesia. Severe ARDS was induced by repetitive oleic acid infusion. After lung injury, Beagles were randomly assigned into spontaneous breathing group (BIPAPSB) and abdominal muscle paralysis group (BIPAPAP). All groups were ventilated with BIPAP model for 8h, and the high pressure titrated to reached a tidal volume of 6ml/kg, the low pressure was set at 10 cmH2O, with I:E ratio 1:1, and respiratory rate adjusted to a PaCO2 of 35-60 mmHg. Six Beagles without ventilator support comprised the control group. Respiratory variables, end-expiratory volume (EELV) and gas exchange were assessed during mechanical ventilation. The levels of Interleukin (IL)-6, IL-8 in lung tissue and plasma were measured by qRT-PCR and ELISA respectively. Lung injury scores were determined at end of the experiment.For the comparable ventilator setting, as compared with BIPAPSB group, the BIPAPAP group presented higher EELV (427±47 vs. 366±38 ml) and oxygenation index (293±36 vs. 226±31 mmHg), lower levels of IL-6(216.6±48.0 vs. 297.5±71.2 pg/ml) and IL-8(246.8±78.2 vs. 357.5±69.3 pg/ml) in plasma, and lower express levels of IL-6 mRNA (15.0±3.8 vs. 21.2±3.7) and IL-8 mRNA (18.9±6.8 vs. 29.5±7.9) in lung tissues. In addition, less lung histopathology injury were revealed in the BIPAPAP group (22.5±2.0 vs. 25.2±2.1).Abdominal muscle activity during mechanically ventilation is one of the injurious factors in severe ARDS, so abdominal muscle paralysis might be an effective strategy to minimize ventilator-induce lung injury.
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- 2016
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26. Correction: Abdominal Muscle Activity during Mechanical Ventilation Increases Lung Injury in Severe Acute Respiratory Distress Syndrome.
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Xianming Zhang, Weiliang Wu, Yongcheng Zhu, Ying Jiang, Juan Du, and Rongchang Chen
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Medicine ,Science - Published
- 2016
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27. Updated guidance on the management of COVID-19: From an american thoracic society/european respiratory society coordinated international task force (29 July 2020)
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Enrico Storti, Abhijit Duggal, Marcus J. Schultz, Catherine L. Hough, Chin Kook Rhee, Ziqiang Zhang, Wim A. Wuyts, Steven R Holets, George A. Alba, Jordi Rello, May Lee, Xun Wang, Sanjay H. Chotirmall, Ganesh Raghu, Charles Delacruz, Kristina Crothers, Jerry A. Krishnan, Iñigo Ojanguren, Kyeongman Jeon, Ari Moskowitz, Abigail Chua, Hassan Chami, Janice M. Liebler, Gerry N. McElvaney, Carey C. Thomson, Antoni Torres, Yeon Wook Kim, Maximiliano Tamae-Kakazu, Takeshi Johkoh, Richard R. Watkins, Oriol Roca, Margaret M. Hayes, Chunxue Bai, Leo M. A. Heunks, John G. Laffey, Dawei Yang, Francesca J. Torriani, Mathias W. Pletz, Mirko Belliato, Sugeet Jagpal, Robert S. Rogers, Miriam Barrecheguren, Gustavo A. Cortes-Puentes, Anthony O'Regan, Pierre-Régis Burgel, Julio Ramirez, Kevin C. Wilson, Elisabeth Bendstrup, Richard A. Oeckler, Tao Xu, Carlos M. Luna, Leo C. Ginns, Jordi Riera, Charlie Strange, James D. Chalmers, Michael S. Niederman, and Rongchang Chen
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Consensus ,International Cooperation ,Advisory Committees ,Pneumonia, Viral ,MEDLINE ,Reviews ,Context (language use) ,Disease ,Betacoronavirus ,03 medical and health sciences ,0302 clinical medicine ,Pharmacotherapy ,Interim ,Pulmonary Medicine ,medicine ,Humans ,030212 general & internal medicine ,CODIV-19 ,Intensive care medicine ,Pandemics ,Societies, Medical ,Depression (differential diagnoses) ,lcsh:RC705-779 ,SARS-CoV-2 ,business.industry ,COVID-19 ,lcsh:Diseases of the respiratory system ,United States ,Europe ,Clinical trial ,030228 respiratory system ,Anxiety ,medicine.symptom ,Coronavirus Infections ,business - Abstract
Background Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome-coronavirus-2. Consensus suggestions can standardise care, thereby improving outcomes and facilitating future research. Methods An International Task Force was composed and agreement regarding courses of action was measured using the Convergence of Opinion on Recommendations and Evidence (CORE) process. 70% agreement was necessary to make a consensus suggestion. Results The Task Force made consensus suggestions to treat patients with acute COVID-19 pneumonia with remdesivir and dexamethasone but suggested against hydroxychloroquine except in the context of a clinical trial; these are revisions of prior suggestions resulting from the interim publication of several randomised trials. It also suggested that COVID-19 patients with a venous thromboembolic event be treated with therapeutic anticoagulant therapy for 3 months. The Task Force was unable to reach sufficient agreement to yield consensus suggestions for the post-hospital care of COVID-19 survivors. The Task Force fell one vote shy of suggesting routine screening for depression, anxiety and post-traumatic stress disorder. Conclusions The Task Force addressed questions related to pharmacotherapy in patients with COVID-19 and the post-hospital care of survivors, yielding several consensus suggestions. Management options for which there is insufficient agreement to formulate a suggestion represent research priorities., For patients with acute COVID-19 pneumonia who require oxygen support, the International Task Force made suggestions for remdesivir and dexamethasone, but against hydroxychloroquine. Post-discharge management of COVID-19 survivors is a research priority. https://bit.ly/32B96uI
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- 2020
28. The Impact of Lung Function on Extra-Pulmonary Diseases and All-Cause Mortality in US Adult Population with and without COPD
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Shengming Liu, Dandan Chen, Rongchang Chen, Ying Wu, and Kai Yang
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Vital capacity ,COPD ,medicine.medical_specialty ,education.field_of_study ,Epidemiology ,business.industry ,Population ,030204 cardiovascular system & hematology ,medicine.disease ,respiratory tract diseases ,03 medical and health sciences ,FEV1/FVC ratio ,0302 clinical medicine ,Heart failure ,Internal medicine ,medicine ,030212 general & internal medicine ,Metabolic syndrome ,business ,education ,Dyslipidemia ,Kidney disease - Abstract
Objective Spirometric lung function is usually used to evaluate respiratory health. However, the impact of lung function on extra-pulmonary diseases and all-cause mortality has not been fully elucidated, especially in people without chronic obstructive pulmonary disease (COPD). Patients and Methods Participants aged ≥20 and underwent spirometry test from the US National Health and Nutrition Examination Surveys (NHANES) 2007-2012 were analyzed in this study. Multivariate logistic and Cox regressions were used to evaluate the impact of forced expiratory volume in 1 second percent of predicted (FEV1% predicted) and forced vital capacity percent of predicted (FVC% predicted) on 14 extra-pulmonary diseases and all-cause morbidity after adjusting for multiple confounders. Results During 2007-2012, 1800 COPD patients and 11,437 non-COPD subjects were included. The prevalence of hypertension, diabetes mellitus (DM), dyslipidemia, metabolic syndrome (MS), congestive heart failure (CHF), coronary disease, stroke, chronic kidney disease (CKD), arthritis, cancer, underweight and osteoporosis in COPD patients was higher than that in the non-COPD population. After adjusting for confounders, the decrease of FEV1% predicted and FVC% predicted was related with higher odds of having hypertension, DM, obesity, MS, CHF, coronary disease and depression (OR > 1, P
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- 2020
29. Kinetics of viral load and antibody response in relation to COVID-19 severity
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Lijun Kuang, Liyan Wen, Ling Sang, Rongchang Chen, Nanshan Zhong, Feng Ye, Yanjun Zhang, Jingxian Zhao, Xiaofang Huang, Zhao Chen, Airu Zhu, Jieling Liang, Abeer N. Alshukairi, Mian Gan, Haitao Tan, Yanqun Wang, Zhengtu Li, Manal M. Al Gethamy, Tie Song, Yongbo Huang, Jianfen Zhuo, Zhen Zhuang, Ling Luo, Shicong Ruan, Jincun Zhao, Min Li, Yimin Li, Jicheng Huang, J Wang, Lan Tang, Zhaoyong Zhang, Yimin Lin, Jing Sun, J. S. Malik Peiris, Chris Ka Pun Mok, Chunke Chen, Yongliang Jiang, Fang Li, Lu Zhang, Yuming Li, Bei Zhong, Stanley Perlman, Huibin Lv, and Ying Deng
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0301 basic medicine ,viruses ,Pneumonia, Viral ,Antibodies, Viral ,Severe Acute Respiratory Syndrome ,medicine.disease_cause ,Virus ,Betacoronavirus ,03 medical and health sciences ,0302 clinical medicine ,Intensive care ,medicine ,Humans ,Viral shedding ,Pandemics ,COVID-19 Serotherapy ,Coronavirus ,biology ,SARS-CoV-2 ,business.industry ,Immunization, Passive ,COVID-19 ,General Medicine ,Viral Load ,medicine.disease ,Kinetics ,030104 developmental biology ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Antibody Formation ,Immunology ,biology.protein ,Middle East respiratory syndrome ,Antibody ,Coronavirus Infections ,business ,Viral load ,Research Article ,Respiratory tract - Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent for coronavirus 2019 (COVID-19) pneumonia. Little is known about the kinetics, tissue distribution, cross-reactivity, and neutralization antibody response in patients with COVID-19. Two groups of patients with RT-PCR–confirmed COVID-19 were enrolled in this study: 12 severely ill patients in intensive care units who needed mechanical ventilation and 11 mildly ill patients in isolation wards. Serial clinical samples were collected for laboratory detection. Results showed that most of the severely ill patients had viral shedding in a variety of tissues for 20–40 days after onset of disease (8/12, 66.7%), while the majority of mildly ill patients had viral shedding restricted to the respiratory tract and had no detectable virus RNA 10 days after onset (9/11, 81.8%). Mildly ill patients showed significantly lower IgM response compared with that of the severe group. IgG responses were detected in most patients in both the severe and mild groups at 9 days after onset, and remained at a high level throughout the study. Antibodies cross-reactive to SARS-CoV and SARS-CoV-2 were detected in patients with COVID-19 but not in patients with MERS. High levels of neutralizing antibodies were induced after about 10 days after onset in both severely and mildly ill patients which were higher in the severe group. SARS-CoV-2 pseudotype neutralization test and focus reduction neutralization test with authentic virus showed consistent results. Sera from patients with COVID-19 inhibited SARS-CoV-2 entry. Sera from convalescent patients with SARS or Middle East respiratory syndrome (MERS) did not. Anti–SARS-CoV-2 S and N IgG levels exhibited a moderate correlation with neutralization titers in patients’ plasma. This study improves our understanding of immune response in humans after SARS-CoV-2 infection.
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- 2020
30. Multi-omic meta-analysis identifies functional signatures of airway microbiome in chronic obstructive pulmonary disease
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Zhenyu Liang, Zhengzheng Yan, Christopher E. Brightling, Hongwei Zhou, Ruth Tal-Singer, Rongchang Chen, Xinzhu Yi, Wen-Sheng Shu, Boxuan Chen, Yuqiong Yang, Zhang Wang, James R. Brown, Martin R. Stämpfli, Martin Wu, Hai-yue Liu, Bruce E. Miller, Fengyan Wang, and Jin-tian Li
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Disease ,Computational biology ,Biology ,Microbiology ,Article ,Transcriptome ,Pulmonary Disease, Chronic Obstructive ,03 medical and health sciences ,RNA, Ribosomal, 16S ,medicine ,Metabolome ,Humans ,Microbiome ,Gene ,Ecology, Evolution, Behavior and Systematics ,030304 developmental biology ,0303 health sciences ,COPD ,030306 microbiology ,Microbiota ,Sputum ,medicine.disease ,respiratory tract diseases ,Metagenomics ,Metagenome ,medicine.symptom - Abstract
The interaction between airway microbiome and host in chronic obstructive pulmonary disease (COPD) is poorly understood. Here we used a multi-omic meta-analysis approach to characterize the functional signature of airway microbiome in COPD. We retrieved all public COPD sputum microbiome datasets, totaling 1640 samples from 16S rRNA gene datasets and 26 samples from metagenomic datasets from across the world. We identified microbial taxonomic shifts using random effect meta-analysis and established a global classifier for COPD using 12 microbial genera. We inferred the metabolic potentials for the airway microbiome, established their molecular links to host targets, and explored their effects in a separate meta-analysis on 1340 public human airway transcriptome samples for COPD. 29.6% of differentially expressed human pathways were predicted to be targeted by microbiome metabolism. For inferred metabolite-host interactions, the flux of disease-modifying metabolites as predicted from host transcriptome was generally concordant with their predicted metabolic turnover in microbiome, suggesting a synergistic response between microbiome and host in COPD. The meta-analysis results were further validated by a pilot multi-omic study on 18 COPD patients and 10 controls, in which airway metagenome, metabolome, and host transcriptome were simultaneously characterized. 69.9% of the proposed "microbiome-metabolite-host" interaction links were validated in the independent multi-omic data. Butyrate, homocysteine, and palmitate were the microbial metabolites showing strongest interactions with COPD-associated host genes. Our meta-analysis uncovered functional properties of airway microbiome that interacted with COPD host gene signatures, and demonstrated the possibility of leveraging public multi-omic data to interrogate disease biology.
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- 2020
31. Effect of a bundle of intervention strategies for the control of COVID-19 in Henan, a neighboring province of Wuhan, China
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Huan Lu, Rongchang Chen, and Qi Liu
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Mainland China ,Corona virus ,China ,Population ,Pneumonia, Viral ,030204 cardiovascular system & hematology ,Control strategy ,03 medical and health sciences ,Betacoronavirus ,0302 clinical medicine ,Kilometer ,Pandemic ,Medicine ,Humans ,030212 general & internal medicine ,Socioeconomics ,education ,Droplet transmission ,Pandemics ,education.field_of_study ,Infection Control ,Mask ,business.industry ,SARS-CoV-2 ,Outbreak ,COVID-19 ,Main Topic ,General Medicine ,Coronavirus ,Europe ,Bundle ,Landlocked country ,business ,Coronavirus Infections - Abstract
Summary The novel coronavirus disease 2019 (COVID-19) occurred in China (mainly in Wuhan, Hubei Province) at the end of December 2019. Henan province is located in the center of China, borders on Hubei province by land in the south with the nearest distance of 200 kilometers to Wuhan. As the inland provinces in mainland China, frequent communication in transportation and population flow make it difficult to confine the pandemic, which is similar to that in the landlocked countries in Europe. The expected cases in Henan were mainly imported. A bundle of intervention strategies were adopted from 26 January 2020 to cut off the spread between the infected patients and the native residents. The pandemic was controlled 2 month later after the bundle of strategies was adopted although the number of cases continued to increase explosively during the first 10 days. A total of 1273 cases were confirmed, 1251 patients were cured, 22 patients died, and 1 patient was still in hospital until 29 March 2020. The peak of daily increased cases was 109 cases. Our data show that COVID-19 is highly infectious and easy to cause an outbreak, but it can be controlled by early effective interventions. A bundle of strategies according to the specific situation of each country is suggested to be implemented as early as possible.
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- 2020
32. Noninvasive Ventilation as a Weaning Strategy in Subjects with Acute Hypoxemic Respiratory Failure
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Chao Lan, Changju Zhu, Rongchang Chen, Xiaoqian Pang, Mengtian Shan, Qi Liu, and Wei Wang
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Acute hypoxemic respiratory failure ,business.industry ,General Medicine ,Critical Care and Intensive Care Medicine ,law.invention ,Randomized controlled trial ,law ,Relative risk ,Meta-analysis ,Emergency medicine ,Breathing ,Medicine ,Weaning ,Noninvasive ventilation ,business ,Adverse effect - Abstract
BACKGROUND: Weaning through noninvasive ventilation (NIV) after early extubation may facilitate invasive ventilation withdrawal and reduce related complications in patients with hypercapnic respiratory failure. However, the effects of NIV weaning are uncertain in patients with acute hypoxemic respiratory failure (AHRF). We aimed to investigate whether NIV weaning could reduce hospital mortality and other outcomes compared with invasive weaning in subjects with hypoxemic AHRF. METHODS: We searched medical literature databases for relevant articles published from inception to February 2019. Randomized controlled trials that adopted NIV as a weaning strategy compared with invasive weaning in hypoxemic AHRF were included. The primary outcome was hospital mortality. The secondary outcomes included ICU mortality, the ICU stay, weaning time, duration of ventilation, extubation failure, and adverse events. RESULTS: Six relevant studies, which involved 718 subjects, were included. There was no significant effect of NIV weaning on hospital mortality compared with invasive weaning (risk ratio 0.94, 95% CI 0.65–1.36; P = .74), whereas there was a significant effect of NIV weaning on shortening the ICU stay (mean difference −3.95, 95% CI −6.49 to −1.40, P = .002) and on decreasing adverse events without affecting the weaning time (standardized MD −0.04, 95% CI −0.21 to 0.14; P = .68). CONCLUSIONS: The strategy of NIV weaning did not decrease hospital mortality in subjects with hypoxemic AHRF, but it did shorten the ICU lengths of stay and reduce adverse events.
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- 2020
33. Noninvasive ventilation support during fiberoptic bronchoscopy-guided nasotracheal intubation effectively prevents severe hypoxemia
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Chun Yang, Lingbo Nong, Jie Zhang, Rongchang Chen, Dongdong Liu, Yin Xi, Weiqun He, Yimin Li, Weibo Liang, Xiaoqing Liu, Jing Zhou, and Yuheng Yu
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Adult ,Male ,Fiberoptic bronchoscopy ,Critical Illness ,medicine.medical_treatment ,Critical Care and Intensive Care Medicine ,Article ,03 medical and health sciences ,0302 clinical medicine ,Severe hypoxemia ,Preoxygenation ,FiO2, fraction of inspired oxygen ,SpO2, Pulse oxygen saturation ,Bronchoscopy ,Intubation, Intratracheal ,medicine ,Fiber Optic Technology ,Humans ,Intubation ,Prospective Studies ,Hypoxia ,FOB, fiberoptic bronchoscopy ,Aged ,Oxygen saturation (medicine) ,Noninvasive Ventilation ,business.industry ,PaO2, arterial blood partial pressure of oxygen ,Tracheal intubation ,030208 emergency & critical care medicine ,Middle Aged ,Respiration, Artificial ,NIV, noninvasive ventilation ,Oxygen ,Treatment Outcome ,030228 respiratory system ,Respiratory failure ,Anesthesia ,Breathing ,Female ,Noninvasive ventilation ,Respiratory Insufficiency ,business - Abstract
Purpose This study investigated the feasibility and efficacy of continuous noninvasive ventilation (NIV) support with 100% oxygen using a specially designed face mask, for reducing desaturation during fiberoptic bronchoscopy (FOB)-guided intubation in critically ill patients with respiratory failure. Materials and methods This was a single-center prospective randomized study. All patients undergoing FOB-guided nasal tracheal intubation were randomized to bag-valve-mask ventilation or NIV for preoxygenation followed by intubation. The NIV group were intubated through a sealed hole in a specially designed face mask during continuous NIV support with 100% oxygen. Control patients were intubated with removal of the mask and no ventilatory support. Results We enrolled 106 patients, including 53 in each group. Pulse oxygen saturation (SpO2) after preoxygenation (99% (96%–100%) vs. 96% (90%–99%), p = .001) and minimum SpO2 during intubation (95% (87%–100%) vs. 83% (74%–91%), p, Highlights • Our study is the first to evaluate NIV during FOB-guided nasotracheal intubation. • NIV support during FOB-guided nasotracheal intubation was effectively prevented severe desaturation during intubation. • We used a specially-designed intubation face mask to ensure that there was no interruption of NIV support during intubation.
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- 2020
34. The effectiveness, safety and compliance of Zheng’s supine rehabilitation exercise as a rehabilitation programme among elderly patients with AECOPD
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Jie Ying Hu, Zeguang Zheng, Li Hong Zhong, Song Mali, Rongchang Chen, Youxia Li, He Wei, Lu Haonan, Ni Liu, and Xinni Wang
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Male ,Pulmonary and Respiratory Medicine ,Acute exacerbation of chronic obstructive pulmonary disease ,medicine.medical_specialty ,Supine position ,Exacerbation ,medicine.medical_treatment ,Walk Test ,Pulmonary Disease, Chronic Obstructive ,03 medical and health sciences ,0302 clinical medicine ,Supine Position ,medicine ,Humans ,Immunology and Allergy ,Pulmonary rehabilitation ,030212 general & internal medicine ,Genetics (clinical) ,Aged ,Rehabilitation ,Medical treatment ,business.industry ,Recovery of Function ,Middle Aged ,After discharge ,medicine.disease ,Exercise Therapy ,Respiratory Function Tests ,Hospitalization ,Treatment Outcome ,030228 respiratory system ,Rehabilitation exercise ,Case-Control Studies ,Disease Progression ,Physical therapy ,Patient Compliance ,Safety ,business - Abstract
PURPOSE We investigated the effectiveness, safety and compliance of Zheng's Supine Rehabilitation Exercise (ZSRE) as a rehabilitation programme among elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). PATIENTS AND METHODS About 82 elderly patients with AECOPD were divided into a rehabilitation group and control group on their admission day, and both groups received routine medical treatment. Patients in the rehabilitation group started ZSRE on the second day of admission and continued until 8 weeks after discharge. RESULTS At the 9th week after discharge, the COPD Assessment Test (CAT), 6-minute walking distance (6MWD) and Modified Medical Research Council Dyspnea Scale (mMRC) in the rehabilitation group were all significantly better than those in the control group (P
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- 2020
35. Efficacy and Safety of Budesonide/Glycopyrrolate/Formoterol Fumarate Metered Dose Inhaler in Chinese Patients with COPD: A Subgroup Analysis of KRONOS
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Rongchang Chen, Kiernan DeAngelis, Eric Bourne, Huijie He, Pryseley Nkouibert Assam, Ting Yang, Shaila Ballal, Rong Su, Chen Wang, Li Zhao, Paul Dorinsky, and Jian Kang
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Adult ,Male ,Budesonide ,China ,medicine.medical_specialty ,Population ,Chronic obstructive ,Pulmonary function testing ,Pulmonary Disease, Chronic Obstructive ,Double-Blind Method ,Forced Expiratory Volume ,Formoterol Fumarate ,Internal medicine ,Administration, Inhalation ,Clinical endpoint ,Humans ,Medicine ,Pharmacology (medical) ,Metered Dose Inhalers ,Disease exacerbation ,education ,Aged ,Original Research ,Pulmonary function tests ,COPD ,education.field_of_study ,Dose-Response Relationship, Drug ,integumentary system ,business.industry ,General Medicine ,Middle Aged ,Bronchodilator agents ,medicine.disease ,Glycopyrrolate ,Metered-dose inhaler ,Dry-powder inhaler ,Respiratory Function Tests ,Drug Combinations ,Quality of Life ,Female ,Pulmonary disease ,business ,medicine.drug - Abstract
Introduction This pre-specified subgroup analysis evaluated the efficacy and safety of budesonide/glycopyrrolate/formoterol fumarate metered dose inhaler (BGF MDI) triple therapy versus corresponding dual therapies in the China subgroup of the phase III, double-blind KRONOS study in patients with moderate to very severe chronic obstructive pulmonary disease (COPD). Methods Patients were randomized 2:2:1:1 to BGF MDI 320/18/9.6 μg, glycopyrrolate/formoterol fumarate (GFF) MDI 18/9.6 μg, budesonide/formoterol fumarate (BFF) MDI 320/9.6 μg, or budesonide/formoterol fumarate dry powder inhaler (BUD/FORM DPI) 400/12 μg twice daily for 24 weeks. The primary endpoint was change from baseline in morning pre-dose trough forced expiratory volume in 1 s (FEV1) over weeks 12–24. Secondary endpoints included symptoms, health-related quality of life, and safety. Rate of moderate/severe COPD exacerbations was an additional efficacy endpoint. Results In the China subgroup (n = 432; 22.7% of the KRONOS population), BGF MDI demonstrated nominally significant improvements in the primary endpoint versus BFF MDI (least squares mean (LSM) difference 68 mL; P = 0.0035) and BUD/FORM DPI (LSM difference 78 mL; P = 0.0010) but not GFF MDI (LSM difference − 4 mL; P = 0.8316). BGF MDI demonstrated at least numerical improvements versus comparators in secondary lung function and symptom endpoints. BGF MDI reduced the rate of moderate/severe COPD exacerbations versus GFF MDI (rate ratio 0.41; P = 0.0030), with numerical benefits versus BFF MDI and BUD/FORM DPI. All treatments were well tolerated. Conclusions Results demonstrated that BGF MDI showed benefits on lung function (vs inhaled corticosteroid/long-acting β2-agonist), as well as symptoms and exacerbations relative to dual therapies. Findings support BGF MDI use in Chinese patients with moderate to very severe COPD. Clinical Trial Registration ClinicalTrials.gov NCT02497001. Electronic supplementary material The online version of this article (10.1007/s12325-020-01266-5) contains supplementary material, which is available to authorized users.
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- 2020
36. High-flow nasal cannula versus conventional oxygen therapy in patients with dyspnea and hypoxemia before hospitalization
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Changju Zhu, Qi Liu, Chao Lan, and Rongchang Chen
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Pulmonary and Respiratory Medicine ,Respiratory rate ,business.industry ,medicine.medical_treatment ,Public Health, Environmental and Occupational Health ,Oxygenation ,Cochrane Library ,medicine.disease_cause ,respiratory tract diseases ,Hypoxemia ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Anesthesia ,Oxygen therapy ,Breathing ,Immunology and Allergy ,Medicine ,Intubation ,030212 general & internal medicine ,medicine.symptom ,business ,Nasal cannula - Abstract
Introduction: Patients with dyspnea and hypoxemia are common in emergency departments. However, it is unknown whether high-flow nasal cannula (HFNC) reduces the risk of requiring more advanced ventilation support and whether HFNC relieves dyspnea better than conventional oxygen therapy (COT). Areas covered: We searched the PubMed, Cochrane Library, Ovid, and Embase databases from inception to 1 September 2019 to identify relevant-randomized controlled trials comparing the effect of HFNC with COT in emergency departments regarding the severity of dyspnea, hospitalization rate, intubation rate, and hospital mortality. We identified four studies. HFNC was associated with a lower rate of requiring more advanced ventilation. HFNC reduced the rate of dyspnea, lowered the dyspnea scale score, and decreased patients’ respiratory rate significantly. However, there was insufficient evidence to show a significant effect on HFNC regarding patients’ oxygenation and hospital mortality. Expert opinion: For patients with dyspnea and hypoxemia before hospitalization, the short-term effect of HFNC was undeniable. HFNC reduced the risk of requiring more advanced ventilation and relived dyspnea better than COT. HFNC might be considered as a first-line therapy even before making a clear diagnosis for dyspnea. More studies are needed to explore the effect of HFNC on oxygenation and patients’ prognosis.
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- 2020
37. Efficacy And Safety Of Glycopyrrolate/Formoterol Fumarate Metered Dose Inhaler (GFF MDI) Formulated Using Co-Suspension Delivery Technology In Chinese Patients With COPD
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Colin Reisner, Juan Huang, Haoyan Wang, Rongchang Chen, Ubaldo J. Martin, Nanshan Zhong, Li Zhao, Shahid Siddiqui, Xiaodong Mei, Pryseley Nkouibert Assam, Andrea Maes, and Zhiqiang Qin
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Male ,Time Factors ,bronchodilator ,LAMA/LABA ,Severity of Illness Index ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,exacerbations ,Forced Expiratory Volume ,Formoterol Fumarate ,Bronchodilator ,Clinical endpoint ,030212 general & internal medicine ,Lung ,Original Research ,COPD ,education.field_of_study ,integumentary system ,co-suspension delivery technology ,General Medicine ,Middle Aged ,Metered-dose inhaler ,Bronchodilator Agents ,Drug Combinations ,Treatment Outcome ,Anesthesia ,Female ,China ,medicine.drug_class ,Population ,Muscarinic Antagonists ,International Journal of Chronic Obstructive Pulmonary Disease ,Placebo ,03 medical and health sciences ,Double-Blind Method ,Administration, Inhalation ,medicine ,Humans ,Metered Dose Inhalers ,Adverse effect ,education ,Adrenergic beta-2 Receptor Agonists ,Glycopyrrolate ,Aged ,business.industry ,Recovery of Function ,medicine.disease ,030228 respiratory system ,business - Abstract
Rongchang Chen,1 Nanshan Zhong,2 Hao-Yan Wang,3 Li Zhao,4 Xiaodong Mei,5 Zhiqiang Qin,6 Juan Huang,7 Pryseley N Assam,8 Andrea Maes,9 Shahid Siddiqui,10 Ubaldo J Martin,10 Colin Reisner9 1Shenzhen Institute of Respiratory Diseases, Shenzhen People’s Hospital, Shenzhen, Guangdong, People’s Republic of China; 2Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Diseases, National Clinical Research Centre for Respiratory Diseases, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China; 3Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China; 4Sheng Jing Hospital of China Medical University, Shenyang, Liaoning, People’s Republic of China; 5Anhui Provincial Hospital, Hefei, Anhui, People’s Republic of China; 6The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning City, Guangxi Zhuang Autonomous Region, People’s Republic of China; 7Formerly of AstraZeneca, Shanghai, People’s Republic of China; 8AstraZeneca, Shanghai, People’s Republic of China; 9AstraZeneca, Morristown, NJ, USA; 10AstraZeneca, Gaithersburg, MD, USACorrespondence: Nanshan ZhongGuangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Diseases, National Clinical Research Centre for Respiratory Diseases, First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou 510120, Guangdong, People’s Republic of ChinaTel +86 20 83062719Email nanshan@vip.163.comBackground: Glycopyrrolate/formoterol fumarate metered dose inhaler (GFF MDI) is a long-acting muscarinic antagonist/long-acting β2-agonist fixed-dose combination therapy delivered by MDI, formulated using innovative co-suspension delivery technology. The PINNACLE-4 study evaluated the efficacy and safety of GFF MDI in patients with moderate-to-very severe chronic obstructive pulmonary disease (COPD) from Asia, Europe, and the USA. This article presents the results from the China subpopulation of PINNACLE-4.Methods: In this randomized, double-blind, placebo-controlled, parallel-group Phase III study (NCT02343458), patients received GFF MDI 18/9.6 μg, glycopyrrolate (GP) MDI 18 μg, formoterol fumarate (FF) MDI 9.6 μg, or placebo MDI (all twice daily) for 24 weeks. The primary endpoint was change from baseline in morning pre-dose trough forced expiratory volume in 1 second at Week 24. Secondary lung function endpoints and patient-reported outcome measures were also assessed. Safety was monitored throughout the study.Results: Overall, 466 patients from China were included in the intent-to-treat population (mean age 63.6 years, 95.7% male). Treatment with GFF MDI improved the primary endpoint compared to GP MDI, FF MDI, and placebo MDI (least squares mean differences: 98, 104, and 173 mL, respectively; all P≤0.0001). GFF MDI also improved daily total symptom scores and time to first clinically important deterioration versus monocomponents and placebo MDI, and Transition Dyspnea Index focal score versus placebo MDI. Rates of treatment-emergent adverse events were similar across the active treatment groups and slightly higher in the placebo MDI group.Conclusion: GFF MDI improved lung function and daily symptoms versus monocomponents and placebo MDI and improved dyspnea versus placebo MDI. All treatments were well tolerated with no unexpected safety findings. Efficacy and safety results were generally consistent with the global PINNACLE-4 population, supporting the use of GFF MDI in patients with COPD from China.Keywords: bronchodilator, COPD, co-suspension delivery technology, LAMA/LABA, exacerbations
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- 2020
38. Gypenoside XVII protects against myocardial ischemia and reperfusion injury by inhibiting ER stress–induced mitochondrial injury
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Rongchang Chen, Yingli Yu, Min Wang, Guibo Sun, Xiaobo Sun, and Xiao Sun
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0301 basic medicine ,Ischemia/reperfusion ,Apoptosis ,Mitochondrion ,Pharmacology ,Biochemistry, Genetics and Molecular Biology (miscellaneous) ,ER, endoplasmic reticulum ,03 medical and health sciences ,0302 clinical medicine ,medicine ,eNOS, endothelial NOS ,Respiratory function ,[Ca2+]i, intracellular Ca2+ ,OCR, oxygen consumption rate ,GP-17, Gypenoside XVII ,Protein kinase B ,RaH, ranolazine 2-HCl ,PI3K/AKT/mTOR pathway ,Cardioprotection ,Chemistry ,Gypenoside XVII ,Botany ,medicine.disease ,Mitochondria ,030104 developmental biology ,Complementary and alternative medicine ,Mitochondrial permeability transition pore ,QK1-989 ,030220 oncology & carcinogenesis ,Unfolded protein response ,Endoplasmic reticulum stress ,Reperfusion injury ,Biotechnology ,Research Article - Abstract
Background Effective strategies are dramatically needed to prevent and improve the recovery from myocardial ischemia and reperfusion (I/R) injury. Direct interactions between the mitochondria and endoplasmic reticulum (ER) during heart diseases have been recently investigated. This study was designed to explore the cardioprotective effects of gypenoside XVII (GP-17) against I/R injury. The roles of ER stress, mitochondrial injury, and their crosstalk within I/R injury and in GP-17–induced cardioprotection are also explored. Methods Cardiac contractility function was recorded in Langendorff-perfused rat hearts. The effects of GP-17 on mitochondrial function including mitochondrial permeability transition pore opening, reactive oxygen species production, and respiratory function were determined using fluorescence detection kits on mitochondria isolated from the rat hearts. H9c2 cardiomyocytes were used to explore the effects of GP-17 on hypoxia/reoxygenation. Results We found that GP-17 inhibits myocardial apoptosis, reduces cardiac dysfunction, and improves contractile recovery in rat hearts. Our results also demonstrate that apoptosis induced by I/R is predominantly mediated by ER stress and associated with mitochondrial injury. Moreover, the cardioprotective effects of GP-17 are controlled by the PI3K/AKT and P38 signaling pathways. Conclusion GP-17 inhibits I/R-induced mitochondrial injury by delaying the onset of ER stress through the PI3K/AKT and P38 signaling pathways.
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- 2019
39. Sputum Exosomal microRNAs Profiling Reveals Critical Pathways Modulated By Pseudomonas aeruginosa Colonization In Bronchiectasis
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Yan Huang, Wei-jie Guan, Nanshan Zhong, Rongchang Chen, Xiao-Rong Han, Jing-Jing Yuan, Chun-Lan Chen, and Hui-min Li
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Bronchiectasis ,medicine.diagnostic_test ,MicroRNA sequencing ,business.industry ,Pseudomonas aeruginosa ,General Medicine ,medicine.disease ,medicine.disease_cause ,Sputum culture ,Real-time polymerase chain reaction ,microRNA ,Immunology ,Medicine ,Sputum ,Colonization ,medicine.symptom ,business - Abstract
Background Pseudomonas aeruginosa (PA) colonization confers poor prognosis in bronchiectasis. However, the biomarkers and biological pathways underlying these associations are unclear. Objective To identify the roles of PA colonization in bronchiectasis by exploring for sputum exosomal microRNA profiles. Methods We enrolled 98 patients with clinically stable bronchiectasis and 17 healthy subjects. Sputum was split for bacterial culture and exosomal microRNA sequencing, followed by validation with quantitative polymerase chain reaction. Bronchiectasis patients were stratified into PA and non-PA colonization groups based on sputum culture findings. We applied Gene Ontology and Kyoto Encyclopedia of Genes and Genome pathway enrichment analysis to explore biological pathways corresponding to the differentially expressed microRNAs (DEMs) associated with PA colonization. Results Eighty-two bronchiectasis patients and 9 healthy subjects yielded sufficient sputum that passed quality control. We identified 10 overlap DEMs for the comparison between bronchiectasis patients and healthy subjects, and between PA and non-PA colonization group. Both miR-92b-5p and miR-223-3p could discriminate PA colonization (C-statistic >0.60) and independently correlated with PA colonization in multiple linear regression analysis. The differential expression of miR-92b-5p was validated by quantitative polymerase chain reaction (P
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- 2019
40. Epidemiological Characteristics of COVID-19 Resurgence in Areas Initially Under Control
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Yazhen Li, Kai Yang, Rongchang Chen, Shanshan Zha, and Lingwei Wang
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Mainland China ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Population ,Indigenous ,Disease Outbreaks ,Environmental health ,Epidemiology ,preventive strategy ,medicine ,Humans ,epidemiological characteristics ,Epidemics ,education ,Cross Infection ,education.field_of_study ,SARS-CoV-2 ,Public place ,Transmission (medicine) ,infection route ,Public Health, Environmental and Occupational Health ,COVID-19 ,Outbreak ,Brief Research Report ,indigenous patient ,Geography ,Public Health ,Public aspects of medicine ,RA1-1270 - Abstract
Objectives: To investigate the epidemiological characteristics and infection routes of new cases in order to provide information for preventing COVID-19 resurgence in areas initially under control.Methods: The information of new symptomatic and asymptomatic patients in Chinese mainland was collected. The location distribution, epidemic course, infection routes and patients' characteristics of outbreaks were described and analyzed.Results: There were 43 new outbreaks with 3,795 symptomatic patients in Chinese mainland from March 21, 2020 to June 13, 2021. These outbreaks mainly occurred in central, border and coastal port cities. The main infection route of first generation indigenous patients was contact with imported cases and contaminated goods or environments. The infection routes of secondary generation patients mainly included family transmission, indoor social gathering infection, nosocomial infection and other infection routes. Family transmission was the most common infection route, and indoor social gathering was the most important reason for the large-scale outbreaks.Conclusions: Strengthen the management of imported patients and staff in high-risk posts was the key point to avoid the first generation indigenous patients. Adequate family isolation, prompt management policies for indoor public place and monitor of population at risk of infection were key strategies for preventing COVID-19 resurgence in areas initially under control.
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- 2021
41. Epidemiology and Prognosis of Invasive Fungal Disease in Chinese Lung Transplant Recipients
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Jianxing He, Cong Lan, Xin Xu, Qiao-yan Lian, Qingdong Cao, Chun-rong Ju, and Rongchang Chen
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Medicine (General) ,medicine.medical_specialty ,medicine.medical_treatment ,Disease ,Logistic regression ,R5-920 ,Internal medicine ,Epidemiology ,lung transplantation ,medicine ,risk factors ,Lung transplantation ,aspergillosis ,Original Research ,Candida ,invasive fungal infections ,business.industry ,Retrospective cohort study ,General Medicine ,Odds ratio ,medicine.disease ,Transplantation ,Pneumonia ,Medicine ,prophylaxis ,business - Abstract
This study explored the epidemiology, risk factors, and prognosis of invasive fungal disease (IFD) in Chinese lung transplant recipients (LTRs). This retrospective cohort study included patients who received lung transplants at four hospitals in South China between January 2015 and June 2019. The participants were divided into IFD and non-IFD (NIFD) groups. The final analysis included 226 LTRs (83.2% males) aged 55.0 ± 14.2 years old. Eighty-two LTRs (36.3%) developed IFD (proven or probable diagnosis). The most common pathogens were Aspergillus (57.3%), Candida (19.5%), and Pneumocystis jiroveci (13.4%). Multivariate logistic regression revealed that anastomotic disease [odds ratio (OR): 11.86; 95% confidence interval (95%CI): 4.76–29.54; P < 0.001], cytomegalovirus (CMV) pneumonia (OR: 3.85; 95%CI: 1.88–7.91; P = 0.018), and pre-transplantation IFD (OR: 7.65; 95%CI: 2.55–22.96; P < 0.001) were associated with higher odds of IFD, while double-lung transplantation (OR: 0.40; 95%CI: 0.19–0.79; P = 0.009) was associated with lower odds of IFD. Logistic regression analysis showed that anastomotic disease was associated with higher odds of death (OR: 5.01; 95%CI: 1.24–20.20; P = 0.02) and that PJP prophylaxis was associated with lower odds of death (OR: 0.01; 95%CI: 0.001–0.11; P < 0.001). Invasive fungal disease is prevalent among LTRs in southern China, with Aspergillus the most common pathogen. Prophylaxis should be optimized based on likely pathogens.
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- 2021
42. Clinical Evaluation of a Metagenomics-Based Assay for Pneumonia Management
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Yangqing Zhan, Teng Xu, Fusheng He, Wei-jie Guan, Zhengtu Li, Shaoqiang Li, Mingzhou Xie, Xiaolei Li, Rongchang Chen, Linling Cheng, Nanshan Zhong, and Feng Ye
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Microbiology (medical) ,medicine.medical_specialty ,Microbiology ,Internal medicine ,medicine ,pneumonia ,Pneumocystis jirovecii ,Prospective cohort study ,cytomegalovirus ,metagenomic next-generation sequence ,Original Research ,biology ,business.industry ,pathogens ,computer.file_format ,Antimicrobial ,medicine.disease ,biology.organism_classification ,QR1-502 ,pneumocystis jirovecii ,Pneumonia ,Metagenomics ,Cohort ,Etiology ,ICO ,business ,computer - Abstract
Clinical value of metagenomic next-generation sequencing (mNGS) in pneumonia management is still controversial. A prospective study was conducted to evaluate the clinical impact of PneumoSeq in 57 immunocompetent (ICO) and 75 immunocompromised (ICH) pneumonia patients. The value of PneumoSeq for both etiological and clinical impact investigation in pneumonia was assessed. Among the 276 potential pathogens detected with PneumoSeq in our cohort, 251 (90.9%) were cross-validated. Clinical diagnoses of the causative pathogens were obtained for 97 patients, 90.7% of which were supported by PneumoSeq. Compared to conventional testing, PneumoSeq suggested potentially missed diagnoses in 16.7% of cases (22/132), involving 48 additional pathogenic microorganisms. In 58 (43.9%) cases, PneumoSeq data led to antimicrobial treatment de-escalation (n = 12 in ICO, n = 18 in ICH) and targeted treatment initiation (n = 7 in ICO, n = 21 in ICH). The PneumoSeq assay benefited the diagnosis and clinical management of both ICH and ICO pneumonia patients in real-world settings.
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- 2021
43. Investigation of the Clinical, Radiological and Biological Factors Associated with Disease Progression, Phenotypes and Endotypes of COPD in China (COMPASS): study design, protocol and rationale
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Julie C. Yates, Yongchang Sun, Fuqiang Wen, Zhenyu Liang, Li Wu, Qianli Ma, Jinping Zheng, Chris Compton, Bruce E. Miller, Yang Yang, Jie Song, Rongchang Chen, Paul Jones, Ruth Tal-Singer, Nanshan Zhong, and Beulah Ji
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Pulmonary and Respiratory Medicine ,COPD ,Lung microbiome ,medicine.medical_specialty ,Chronic bronchitis ,Study Protocols ,Exacerbation ,business.industry ,Disease ,medicine.disease ,Obstructive lung disease ,respiratory tract diseases ,Internal medicine ,Cohort ,medicine ,Medicine ,business ,Cohort study - Abstract
COPD is heterogeneous, and its presentation varies between countries. The major COPD cohort studies have only been performed in Western populations; the disease is not well characterised in other regions. The COMPASS (Investigation of the Clinical, Radiological and Biological Factors, Humanistic and Healthcare Utilisation Burden Associated with Disease Progression, Phenotypes and Endotypes of COPD in China; NCT04853225) is a prospective, 2.5-year-long, multi-centre, longitudinal, observational study with three aims: 1) to characterise stable and exacerbation phenotypes/endotypes in terms of clinical characteristics, blood and sputum biomarkers, lung microbiome and lung imaging; 2) to understand the relevance of markers of COPD disease progression identified in Western cohorts to Chinese patients; and 3) to characterise treatment pathways and healthcare resource utilisation. COMPASS will recruit 2000 participants, of which 1700 will be in Global Initiative for Chronic Obstructive Lung Disease (GOLD) Grades I–IV (n=700, 700, 200 and 100, respectively), 180 participants with chronic bronchitis without airflow limitation and 120 never-smoker healthy controls. Study visits will be at baseline, 6, 18 and 30 months and at exacerbation. Assessments include lung function, exacerbation frequency, health status, blood biomarkers and, in a sub-cohort of 400 patients, chest high-resolution computed tomography, additional blood and sputum biomarkers, airway micro-, viral- and myco-biome, and physical activity. COMPASS will establish a unique clinical and biological dataset in a well-characterised cohort of individuals with COPD in China, with a particular focus on milder patients. As the first study of its kind attempting to understand the disease in an Asian setting, it will provide valuable insights into regional and ethnic differences in COPD., COMPASS, a prospective, multicentre, observational study of Chinese patients with COPD, will characterise stable and exacerbation phenotypes/endotypes, treatment pathways and HRU, and investigate COPD progression biomarkers' relevance to these patients https://bit.ly/3dyIpf1
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- 2021
44. CONQUEST Quality Standards: For the Collaboration on Quality Improvement Initiative for Achieving Excellence in Standards of COPD Care
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Frank Trudo, Fernando J. Martinez, Paul Dorinsky, Luís Alves, Marc Miravitlles, Mark T. Dransfield, Victoria Carter, Marianna Alacqua, Shigeo Muro, Hana Muellerova, Tamsin Morris, Rachel Pullen, Dave Singh, Rongchang Chen, Christopher Blango, Ruth Murray, Konstantinos Kostikas, David Price, Anita Sharma, John R. Hurst, Tonya A. Winders, Rupert Jones, Amy Couper, Institut Català de la Salut, [Pullen R] Observational and Pragmatic Research Institute, Singapore, Singapore. Optimum Patient Care, Cambridge, UK. [Miravitlles M] Servei de Pneumologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain. [Sharma A] Platinum Medical Centre, Chermside, QLD, Australia. [Singh D] Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Manchester University NHS Foundation Trust, Manchester, UK. [Martinez F] New York-Presbyterian Weill Cornell Medical Center, New York, NY, USA. [Hurst JR] UCL Respiratory, University College London, London, UK, and Vall d'Hebron Barcelona Hospital Campus
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Health Care (Public Health)::Health Care Levels::Secondary Care [PUBLIC HEALTH] ,medicine.medical_specialty ,Quality management ,media_common.quotation_subject ,assessment ,Specialty ,Psychological intervention ,Disease ,International Journal of Chronic Obstructive Pulmonary Disease ,Pulmons - Malalties obstructives - Tractament ,Secondary Care ,Diseases of the respiratory system ,Pulmonary Disease, Chronic Obstructive ,Excellence ,Intervention (counseling) ,medicine ,follow-up ,Hospitals - Serveis de teràpia respiratòria ,Humans ,Quality (business) ,Intensive care medicine ,Serveis sanitaris - Administració ,intervention ,Otros calificadores::/terapia [Otros calificadores] ,media_common ,Original Research ,COPD ,atención a la salud (salud pública)::niveles de atención a la salud::atención secundaria [SALUD PÚBLICA] ,RC705-779 ,Primary Health Care ,Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive [DISEASES] ,administración de los servicios de salud::calidad de la atención sanitaria::mejora de la calidad [ATENCIÓN DE SALUD] ,business.industry ,General Medicine ,Other subheadings::/therapy [Other subheadings] ,medicine.disease ,Quality Improvement ,enfermedades respiratorias::enfermedades pulmonares::enfermedades pulmonares obstructivas::enfermedad pulmonar obstructiva crónica [ENFERMEDADES] ,Quality of Life ,identification ,Health Services Administration::Quality of Health Care::Quality Improvement [HEALTH CARE] ,business - Abstract
Rachel Pullen, 1, 2 Marc Miravitlles, 3 Anita Sharma, 4 Dave Singh, 5 Fernando Martinez, 6 John R Hurst, 7 Luis Alves, 8, 9 Mark Dransfield, 10 Rongchang Chen, 11 Shigeo Muro, 12 Tonya Winders, 13 Christopher Blango, 14 Hana Muellerova, 15 Frank Trudo, 16 Paul Dorinsky, 17 Marianna Alacqua, 15, 18 Tamsin Morris, 19 Victoria Carter, 1, 2 Amy Couper, 1, 2 Rupert Jones, 20 Konstantinos Kostikas, 1, 21 Ruth Murray, 1 David B Price 1, 2, 22 1Observational and Pragmatic Research Institute, Singapore, Singapore; 2Optimum Patient Care, Cambridge, UK; 3Pneumology Dept, Hospital Universitari Vall d’Hebron, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain; 4Platinum Medical Centre, Chermside, QLD, Australia; 5Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Manchester University NHS Foundation Trust, Manchester, UK; 6New York-Presbyterian Weill Cornell Medical Center, New York, NY, USA; 7UCL Respiratory, University College London, London, UK; 8EPI Unit, Institute of Public Health, University of Porto, Porto, Portugal; 9Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal; 10Division of Pulmonary, Allergy, and Critical Care Medicine, Lung Health Center, University of Alabama at Birmingham, Birmingham, AL, USA; 11Key Laboratory of Respiratory Disease of Shenzhen, Shenzhen Institute of Respiratory Disease, Shenzhen People’s Hospital (Second Affiliated Hospital of Jinan University, First Affiliated Hospital of South University of Science and Technology of China), Shenzhen, People’s Republic of China; 12Department of Respiratory Medicine, Nara Medical University, Nara, Japan; 13USA & Global Allergy & Airways Patient Platform, Vienna, Austria; 14Janssen Pharmaceutical Companies of Johnson & Johnson, Philadelphia, PA, USA; 15AstraZeneca, Cambridge, UK; 16AstraZeneca, Wilmington, DE, USA; 17AstraZeneca, Durham, NC, USA; 18CSL Behring SpA, Milan, Italy; 19AstraZeneca, Luton, UK; 20Research and Knowledge Exchange, Plymouth Marjon University, Plymouth, UK; 21Respiratory Medicine Department, University of Ioannina School of Medicine, Ioannina, Greece; 22Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UKCorrespondence: David B PriceCentre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UKTel +65 3105 1489Email dprice@opri.sgBackground: Chronic obstructive pulmonary disease (COPD) are managed predominantly in primary care. However, key opportunities to optimize treatment are often not realized due to unrecognized disease and delayed implementation of appropriate interventions for both diagnosed and undiagnosed individuals. The COllaboratioN on QUality improvement initiative for achieving Excellence in STandards of COPD care (CONQUEST) is the first-of-its-kind, collaborative, interventional COPD registry. It comprises an integrated quality improvement program focusing on patients (diagnosed and undiagnosed) at a modifiable and higher risk of COPD exacerbations. The first step in CONQUEST was the development of quality standards (QS). The QS will be imbedded in routine primary and secondary care, and are designed to drive patient-centered, targeted, risk-based assessment and management optimization. Our aim is to provide an overview of the CONQUEST QS, including how they were developed, as well as the rationale for, and evidence to support, their inclusion in healthcare systems.Methods: The QS were developed (between November 2019 and December 2020) by the CONQUEST Global Steering Committee, including 11 internationally recognized experts with a specialty and research focus in COPD. The process included an extensive literature review, generation of QS draft wording, three iterative rounds of review, and consensus.Results: Four QS were developed: 1) identification of COPD target population, 2) assessment of disease and quantification of future risk, 3) non-pharmacological and pharmacological intervention, and 4) appropriate follow-up. Each QS is followed by a rationale statement and a summary of current guidelines and research evidence relating to the standard and its components.Conclusion: The CONQUEST QS represent an important step in our aim to improve care for patients with COPD in primary and secondary care. They will help to transform the patient journey, by encouraging early intervention to identify, assess, optimally manage and followup COPD patients with modifiable high risk of future exacerbations.Keywords: identification, assessment, intervention, follow-up
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- 2021
45. Initial PCR Testing Negative, but Chest CT Suggesting for Viral Pneumonia Urges for Repeated Testing for COVID-19 Diagnosis
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Lingwei Wang, Danting Zhan, Xiaodi Liu, Kai Yang, Shipin Wu, Heng Zhang, Min Yu, Yimin Zha, Weibin Huang, Lei Li, Rongchang Chen, and Chen Qiu
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2019-20 coronavirus outbreak ,Opinion ,Coronavirus disease 2019 (COVID-19) ,business.industry ,diagnosis ,QH301-705.5 ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Chest ct ,COVID-19 ,chest CT ,PCR test ,medicine.disease ,Biochemistry, Genetics and Molecular Biology (miscellaneous) ,Biochemistry ,Virology ,Pneumonia ,Repeated testing ,Pcr test ,Viral pneumonia ,medicine ,pneumonia ,Molecular Biosciences ,Biology (General) ,business ,Molecular Biology - Published
- 2021
46. Noninvasive Ventilation in Patients With COVID-19-Related Acute Hypoxemic Respiratory Failure: A Retrospective Cohort Study
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Lili Guan, Junmin Wen, Chen Qiu, Lei Liu, Shanshan Zha, Jing Yuan, Yingyun Fu, Zhenghao Lin, Weibo Wu, and Rongchang Chen
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medicine.medical_specialty ,Medicine (General) ,Coronavirus disease 2019 (COVID-19) ,medicine.medical_treatment ,Hypoxemia ,03 medical and health sciences ,coronavirus disease 2019 ,0302 clinical medicine ,R5-920 ,medicine ,Intubation ,030212 general & internal medicine ,Acute hypoxemic respiratory failure ,business.industry ,acute hypoxemic respiratory failure ,noninvasive ventilation ,Retrospective cohort study ,General Medicine ,Odds ratio ,Emergency department ,Brief Research Report ,Confidence interval ,rescue therapy ,030228 respiratory system ,Emergency medicine ,Medicine ,delayed intubation ,medicine.symptom ,business - Abstract
Introduction: Noninvasive ventilation (NIV) has been used to alleviate hypoxemia and dyspnea, but there is no consensus on the application of NIV in patients with coronavirus disease 2019 (COVID-19). Some staff use NIV as the rescue therapy which might lead to the adverse outcomes. This study was to identify early factors associated with intubation to help the medical staff select appropriate patients for receiving NIV treatment.Methods: Patients with laboratory-confirmed COVID-19 who were treated with NIV in emergency department or ICU of the Third People's Hospital (the only designated hospital for treating COVID-19 in Shenzhen) between January 1 and August 31, 2020, were retrospectively analyzed.Results: Thirty-nine patients with COVID-19 treated with NIV were included; of them, 16 (41%) received endotracheal intubation and 3 (8%) died. Significant differences were observed between intubated and non-intubated patients in PaO2/FiO2 before NIV initiation, hospitalization duration, NIV as the rescue therapy, and PaO2/FiO2 of ≤200 mmHg after 1–2 h of NIV initiation. Notably, 1–2 h after NIV initiation, a PaO2/FiO2 of ≤200 mmHg (odds ratio [OR], 9.35; 95% confidence interval [CI], 1.84–47.62; P = 0.007) and NIV as the rescue therapy (OR, 5.43; 95% CI, 1.09–27.12; P = 0.039) were the risk factors for intubation.Conclusions: In patients with COVID-19-related acute hypoxemic respiratory failure receiving NIV, close attention should be paid to PaO2/FiO2 after 1–2 h of NIV initiation. Also, using NIV as rescue therapy should draw our awareness that it might delay escalation of respiratory support and lead to adverse outcomes.
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- 2021
47. Challenges to and opportunities for the implementation of non‐invasive positive pressure ventilation in the Asia‐Pacific region
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Lili Guan, Dandan Chen, Luqian Zhou, Lingwei Wang, Liqiang Song, and Rongchang Chen
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Pulmonary and Respiratory Medicine ,Mechanical ventilation ,Health Services Needs and Demand ,medicine.medical_specialty ,Asia ,Noninvasive Ventilation ,business.industry ,Home therapy ,medicine.medical_treatment ,Non invasive ,Pacific Islands ,Asia pacific region ,Positive-Pressure Respiration ,medicine ,Humans ,Respiratory Insufficiency ,business ,Positive pressure ventilation ,Lagging ,Intensive care medicine ,Procedures and Techniques Utilization ,Staff training - Abstract
Non-invasive positive pressure ventilation (NPPV) is undoubtedly one of the most significant advancements in mechanical ventilation technology in the past 30 years. With accumulating evidence from clinical studies and support from clinical guidelines, NPPV is now widely used in hospitals and increasingly prescribed for home therapy in the Asia-Pacific region. However, in comparison with the developed Western countries, overall use of NPPV in the region is lagging behind. This study reviews this imbalance of NPPV use both in the acute and domiciliary settings in the Asia-Pacific region. Important issues related to NPPV use are also discussed along with speculation around potential strategies that could promote wider implementation of NPPV in the region. We hope this review will stimulate interest in the clinical application and potential research avenues for NPPV in the Asia-Pacific region, and promote education and staff training in the technique.
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- 2019
48. Clinical Features and Prognosis of Pulmonary Lymphoepithelioma-like Carcinoma: Summary of Eighty-five Cases
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Xiaohong Xie, Wei-jie Guan, Xinqing Lin, Rongchang Chen, Zheng Zhu, Nanshan Zhong, Shiyue Li, Guoying Gao, Zhanhong Xie, Chengzhi Zhou, Ouyang Ming, and Yinyin Qin
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Adult ,Male ,0301 basic medicine ,Pulmonary and Respiratory Medicine ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,medicine.medical_treatment ,Respiratory Mucosa ,Gastroenterology ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Carcinoma, Non-Small-Cell Lung ,Internal medicine ,Carcinoma ,Humans ,Medicine ,Progression-free survival ,Lung cancer ,Neoplasm Staging ,Univariate analysis ,Chemotherapy ,Performance status ,business.industry ,Middle Aged ,Prognosis ,medicine.disease ,Survival Analysis ,Gemcitabine ,Treatment Outcome ,030104 developmental biology ,Pemetrexed ,Oncology ,Chemotherapy, Adjuvant ,030220 oncology & carcinogenesis ,Female ,business ,Follow-Up Studies ,medicine.drug - Abstract
Background Pulmonary lymphoepithelioma-like carcinoma (PLELC) is a rare subtype of lung cancer that is less reported and not well-understood. Materials and Methods We investigated the clinical features of 85 patients with PLELC to determine the prognostic factors. Results PLELC preferentially affected the young (71.8%) and nonsmokers (72.9%), without a significant difference in gender. Most (50.6%) patients were at the early stage with opportunity for operation, and patients at advanced stages mainly received multimodality treatment. The median follow-up duration was 17 months (range, 1-39 months) for the whole group, and the 3-year overall survival rate for patients in the early stage was 100%, whereas the 1-year and 2-year overall survival rate for patients in the advanced stage were 93% and 77%, respectively. The tumor stages (P = .031), distant lymph node metastasis (P = .035) and performance status (P = .008) were associated with progression-free survival in the univariate analysis, whereas performance status was an independent prognostic factor in the multivariate analysis (P = .016). The median progression-free survival in the paclitaxel plus platinum (12 months) group and gemcitabine plus platinum (10 months) group were significantly longer than that in the pemetrexed plus platinum (5 months) group (P = .001). Conclusion PLELC had a better prognosis compared with other types of non–small-cell lung cancer and was sensitive to radiotherapy and chemotherapy. Gemcitabine plus platinum and paclitaxel plus platinum should be used as first-line treatment of PLELC, whereas the second-line treatment, if necessary, was always decided by the managing oncologist. The tumor stages and performance status were predictive in the prognosis of patients with PLELC.
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- 2019
49. Blockade of the NLRP3/Caspase-1 Axis Ameliorates Airway Neutrophilic Inflammation in a Toluene Diisocyanate-Induced Murine Asthma Model
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Shushan Wei, Rongchang Chen, Qiaoling He, Peikai Huang, Yiqin Luo, Shuyu Chen, Lihong Yao, Hongbing Guan, Qingling Zhang, Guoyou Peng, Jie Yan, Ailin Tao, and Zehong Zou
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Male ,0301 basic medicine ,Neutrophils ,Caspase 1 ,Inflammation ,Toxicology ,Heterocyclic Compounds, 4 or More Rings ,Mice ,Viral Proteins ,03 medical and health sciences ,chemistry.chemical_compound ,Th2 Cells ,0302 clinical medicine ,Airway resistance ,NLR Family, Pyrin Domain-Containing 3 Protein ,Respiratory Hypersensitivity ,medicine ,Animals ,Sulfones ,Furans ,Receptor ,Serpins ,Sulfonamides ,Goblet cell ,medicine.diagnostic_test ,Toluene diisocyanate ,business.industry ,Interleukin-18 ,respiratory system ,Asthma ,respiratory tract diseases ,Mice, Inbred C57BL ,Disease Models, Animal ,030104 developmental biology ,medicine.anatomical_structure ,Bronchoalveolar lavage ,Indenes ,chemistry ,030220 oncology & carcinogenesis ,Immunology ,Airway Remodeling ,Th17 Cells ,Toluene 2,4-Diisocyanate ,medicine.symptom ,Airway ,business - Abstract
Multiple studies have addressed the vital role of Nod-like receptor protein 3(NLRP3)/caspase-1/IL-1β signaling in asthma. Yet, the role of NLRP3/caspase-1 in toluene diisocyanate (TDI)-induced asthma is still obscure. The aim of this study is to investigate the role of the NLRP3/caspase-1 axis in TDI-induced asthma. Using an established murine model of TDI-induced asthma as described previously, we gave the asthmatic mice a highly selective NLRP3 inhibitor, MCC950, as well as the specific caspase-1 inhibitors VX-765 and Ac-YVAD-CHO for therapeutic purposes. Airway resistance was measured and bronchoalveolar lavage fluid was analyzed. Lungs were examined by histology, immunohistochemistry, Western blotting, and flow cytometry. TDI exposure elevated the expression of NLRP3 and caspase-1 that was coupled with increased airway hyperresponsiveness (AHR), neutrophil-dominated cell infiltration, pronounced goblet cell metaplasia, extensive collagen deposition, and increased TH2/TH17 responses. Both VX-765 and Ac-YVAD-CHO effectively inhibited the activation of caspase-1 in TDI-asthmatic mice that was accompanied by dramatic attenuation of AHR, airway inflammation, and airway remodeling, in addition to a decreased TH2 response and lower levels of IL-18 and IL-1β. MCC950 blocked the activation of NLRP3 and downregulated protein expression of caspase-1, IL-1β, and IL-18 in TDI-exposed mice. Furthermore, MCC950 remarkably alleviated AHR, airway inflammation, airway remodeling, and significantly suppressed TH2/TH17 responses. These findings suggested that blockade of the NLRP3/caspase-1 axis effectively prevents the progression of TDI-induced asthma and could be used as therapeutic targets for asthmatics.
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- 2019
50. Reproducibility of fluid-phase measurements in PBS-treated sputum supernatant of healthy and stable COPD subjects
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Lili Guan, Kuimiao Deng, Luqian Zhou, Jianhua Chen, Weiliang Wu, Yuqiong Yang, Fengyan Wang, Mei Jiang, Weijuan Shi, Rongchang Chen, and Zhenyu Liang
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COPD ,biology ,business.industry ,Autoantibody ,General Medicine ,medicine.disease ,Molecular biology ,Cytokeratin ,Antigen ,biology.protein ,medicine ,Sputum ,Tumor necrosis factor alpha ,Interleukin 8 ,medicine.symptom ,business ,Heat shock protein 47 - Abstract
Purpose The purpose of this study was to investigate the reproducibility of fluid-phase measurements in PBS-treated sputum supernatant, processed using the two-step method, of healthy and stable COPD individuals. Methods Nine healthy subjects and 23 stable COPD patients provided sputum twice within 6 days. A two-step sputum processing method was used to obtain PBS-treated supernatant and sputum cells. Soluble protein markers and IgG and IgM autoantibody profiles in PBS supernatant were analyzed using customized microarrays. Repeatability of measurements was assessed by paired-sample testing and an intraclass correlation coefficient, then graphically reported by Bland-Altman plot. Results There was no significant difference between the repeated detection of 8/10 types of soluble protein markers, all 13 types of IgG autoantibodies, and 12/13 types of corresponding IgM autoantibodies in PBS supernatant. The repeatability of measurements in PBS supernatant was substantial to very good for interleukin 6 (IL6), IL8, IL13, IL10, IL33, vascular endothelial growth factor, soluble receptor for advanced glycation end-products, and tumor necrosis factor-α; for IgG autoantibodies against aggrecan, centromere protein B (CENP-B), collagen II, collagen IV, cytochrome C, elastin, heat shock protein 47 (HSP47), HSP70, and La/Sjogren syndrome type B antigen; for IgM autoantibodies against CENP-B, collagen I, collagen II, collagen IV, cytokeratin 18, and HSP70; and for sputum neutrophils, macrophages and eosinophils count. Bland-Altman plots suggested good consistency within repeated measurements. Stable COPD patients differed from healthy subjects in the proportion of neutrophils and eosinophils; relative fluorescence intensity of anti-cytochrome C IgG, anti-aggrecan IgM, and anti-cytochrome C IgM. There was a significant positive correlation for stable COPD patients between sputum anti-collagen II IgG and post-bronchodilator FEV1%. Conclusion We confirmed fluid-phase measurements in PBS-treated sputum supernatant by high-throughput techniques with good repeatability. We demonstrated the presence of IgG and IgM autoantibodies to multiple antigens in the airways of COPD patients.
- Published
- 2019
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