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Zhishen Ruan,1,* Dan Li,1,* Yuanlong Hu,1 Zhanjun Qiu,1,2 Xianhai Chen1,2 1The First Clinical College, Shandong Chinese Medical University, Ji Nan, People’s Republic of China; 2Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Ji Nan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhanjun Qiu; Xianhai Chen, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Ji Nan, People’s Republic of China, Tel/Fax +86 0531 18660199889, Email qiuzhj227@163.com; chenxianhai18@163.comBackground: Acute respiratory failure (ARF) is a common cause of admission to the intensive care unit (ICU) for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). There is still a lack of effective interventions and treatments. ACE inhibitors (ACEI)/ angiotensin II receptor blockers (ARB) were effective in COPD patients. We aimed to study the effect of ACEI/ARB use on AECOPD combined with ARF and evaluate the effect of in-hospital continuation of medication.Methods: We included patients with AECOPD and ARF from the Medical Information Bank for Intensive Care (MIMIC-III) database. MIMIC III is a large cohort database from Boston, USA. Patients were divided into two groups according to the use of ACEI/ARB before admission. Propensity score matching (PSM) was used to reduce potential bias between the two groups. Cox regression and Kaplan-Meier curves compared 30-day mortality in ACEI/ARB users and non-users. We also defined and analyzed the use of in-hospital ACEI/ARB. Multiple models were used to ensure the robustness of the findings. Subgroup analysis was used to analyze the variability between groups.Results: A total of 544 patients were included in the original study. After PSM, 256 patients were included in the matched cohort. Multivariate Cox regression showed 30-day mortality was significantly lower in ACEI/ARB users compared with controls (HR =

Yuanlong Hu,1,* Xiaomeng Cheng,1,* Zhanjun Qiu,2 Xianhai Chen2 1Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People’s Republic of China; 2The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhanjun Qiu; Xianhai Chen Email qiuzhj227@163.com; chenxianhai18@163.comPurpose: This study aimed to identify the COPD molecular subtypes reflecting pulmonary function damage on the basis of metabolism-related gene expression, which provided the opportunity to study the metabolic heterogeneity and the association of metabolic pathways with pulmonary function damage.Methods: Univariate linear regression and the Boruta algorithm were used to select metabolism-related genes associated with forced expiratory volume in the first second (FEV1) and FEV1/forced vital capacity (FVC) in the Evaluation of COPD to Longitudinally Identify Predictive Surrogate Endpoints (ECLIPSE) cohort. COPD subtypes were further identified by consensus clustering with best-fit. Then, we analyzed the differences in the clinical characteristics, metabolic pathways, immune cell characteristics, and transcription features among the subtypes.Results: This study identified two subtypes (C1 and C2). C1 exhibited higher levels of lower pulmonary function and innate immunity than C2. Ten metabolic pathways were confirmed as key metabolic pathways. The pathways related to N-glycan, hexosamine, purine, alanine, aspartate and glutamate tended to be positively associated with the abundance of adaptive immune cells and negatively associated with the abundance of innate immune cells. In addition, other pathways had opposite trends. All results were verified in Genetic Epidemiology of COPD (COPDGene) datasets.Conclusion: The two subtypes reflect the pulmonary function damage and help to further understand the metabolic mechanism of pulmonar

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Earth, Atmospheric, and Planetary Sciences, 2002., Page 231 blank., Includes bibliographical references (p. 221-230)., In this thesis, we investigate atmospheric water vapor transport through a distinct synoptic phenomenon, namely, the Tropospheric River (TR), which is a local filamentary structure on a daily map of vertically integrated moisture flux. Firstly, an automated procedure for identifying and tracking these rivers (named TRICKS, i.e., the Tropospheric River Identifying and traCKing Scheme) is described and its performance is evaluated. This procedure enables the maxima of moisture flux (so-called TR cores) to be detected and accurately located. The relationships among the adjacent TR cores are then evaluated to construct the axes of rivers. A river is tracked from birth to termination and its life cycle properties are recorded, thus allowing various statistics of TR distributions and movements to be estimated. All these stages of the scheme are performed without intervention once a number of governing constants have been decided upon. We then apply the scheme to the vertically integrated moisture flux calculated from 43 years of 6-hourly NCEP/NCAR reanalyses and present a climatology of mean TR behavior. On average, there are 4 - 5 rivers per analysis in the Northern Hemisphere and 5 in the Southern Hemisphere. Northern Hemisphere TRs form and intensify near the eastern seaboards of Asia and North America. They move eastward and poleward during their lives before weakening in the two principal graveyards: over the Gulf of Alaska and the region to the southeast of Greenland. In comparison, Southern Hemisphere TRs are more evenly distributed and tend to form in a band extending from the southeast coast of South America into the Atlantic, across the Indian Ocean, and throughout much of middle latitudes of the Pacific sector., (cont.) The corresponding genesis regions are also found to be adjacent to (or slightly equatorward to) the maximum SST gradients in these regions. It appears that both TR genesis and termination maxima tend to be displaced near the upstream equatorward flanks of cyclogenesis and lysis maxima. We suggest that the TR formation and termination could be a leading predictor for the occurrence and decaying of extratropical cyclones. TR axis length appears to be longer during the warmer season and in the Southern Hemisphere. The distance traveled by TR systems shows a broad distribution and a sizeable fraction (-25%) of systems travel in excess of 3000 km. One unique feature is that although TRs occur very actively over the Indian ocean sector with highly densed tracks, large translational speeds, and intensities, they contribute little to meridional water vapor transport, while the reverse situation can be found in the South Pacific where southward transport is sometimes comparable to those over or off the east coast of South America. The rivers seem to account for a substantial fraction of the total meridional moisture transport in both middle and subtropical regions. Finally, we complete the TR climatology with an analysis of the variability and trends exhibited by many aspects of rivers during the 43-year period. The annual average number of TRs per analysis has undergone an overall increase during the last couple of decades and is more significant in the Southern Hemisphere. The greatest increases occur in the 50⁰-30⁰S and 50⁰-70⁰N belts ..., by Yuanlong Hu., Ph.D.