163 results on '"Yuanming Luo"'
Search Results
2. A simple clinical risk score (ABCDMP) for predicting mortality in patients with AECOPD and cardiovascular diseases
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Jiarui Zhang, Qun Yi, Chen Zhou, Yuanming Luo, Hailong Wei, Huiqing Ge, Huiguo Liu, Jianchu Zhang, Xianhua Li, Xiufang Xie, Pinhua Pan, Mengqiu Yi, Lina Cheng, Hui Zhou, Liang Liu, Adila Aili, Yu Liu, Lige Peng, Jiaqi Pu, and Haixia Zhou
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AECOPD ,CVDs ,Mortality ,Risk score ,Diseases of the respiratory system ,RC705-779 - Abstract
Abstract Background The morbidity and mortality among hospital inpatients with AECOPD and CVDs remains unacceptably high. Currently, no risk score for predicting mortality has been specifically developed in patients with AECOPD and CVDs. We therefore aimed to derive and validate a simple clinical risk score to assess individuals’ risk of poor prognosis. Study design and methods We evaluated inpatients with AECOPD and CVDs in a prospective, noninterventional, multicenter cohort study. We used multivariable logistic regression analysis to identify the independent prognostic risk factors and created a risk score model according to patients’ data from a derivation cohort. Discrimination was evaluated by the area under the receiver-operating characteristic curve (AUC), and calibration was assessed by the Hosmer–Lemeshow goodness-of-fit test. The model was validated and compared with the BAP-65, CURB-65, DECAF and NIVO models in a validation cohort. Results We derived a combined risk score, the ABCDMP score, that included the following variables: age > 75 years, BUN > 7 mmol/L, consolidation, diastolic blood pressure ≤ 60 mmHg, mental status altered, and pulse > 109 beats/min. Discrimination (AUC 0.847, 95% CI, 0.805–0.890) and calibration (Hosmer‒Lemeshow statistic, P = 0.142) were good in the derivation cohort and similar in the validation cohort (AUC 0.811, 95% CI, 0.755–0.868). The ABCDMP score had significantly better predictivity for in-hospital mortality than the BAP-65, CURB-65, DECAF, and NIVO scores (all P
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- 2024
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3. Low diastolic blood pressure and adverse outcomes in inpatients with acute exacerbation of chronic obstructive pulmonary disease: A multicenter cohort study
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Chen Zhou, Qun Yi, Yuanming Luo, Hailong Wei, Huiqing Ge, Huiguo Liu, Xianhua Li, Jianchu Zhang, Pinhua Pan, Mengqiu Yi, Lina Cheng, Liang Liu, Jiarui Zhang, Lige Peng, Adila Aili, Yu Liu, Jiaqi Pu, Haixia Zhou, Xiangxiang Pan, and Peifang Wei
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Medicine - Abstract
Abstract. Background:. Although intensively studied in patients with cardiovascular diseases (CVDs), the prognostic value of diastolic blood pressure (DBP) has little been elucidated in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This study aimed to reveal the prognostic value of DBP in AECOPD patients. Methods:. Inpatients with AECOPD were prospectively enrolled from 10 medical centers in China between September 2017 and July 2021. DBP was measured on admission. The primary outcome was all-cause in-hospital mortality; invasive mechanical ventilation and intensive care unit (ICU) admission were secondary outcomes. Least absolute shrinkage and selection operator (LASSO) and multivariable Cox regressions were used to identify independent prognostic factors and calculate the hazard ratio (HR) and 95% confidence interval (CI) for adverse outcomes. Results:. Among 13,633 included patients with AECOPD, 197 (1.45%) died during their hospital stay. Multivariable Cox regression analysis showed that low DBP on admission (
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- 2023
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4. Exercise‐induced bronchoconstriction assessed by a ratio of surface diaphragm EMG to tidal volume
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Lishuang Wang, Senrui Wu, Baiting He, Simin Liu, Shanfeng Liang, and Yuanming Luo
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airway hyperresponsiveness ,asthma ,diaphragm electromyogram ,exercise‐induced bronchoconstriction ,Physiology ,QP1-981 - Abstract
Abstract Exercise‐induced bronchoconstriction (EIB) is usually assessed by changes in forced expiratory volume in 1 s (FEV1) which is effort dependent. The purpose of this study was to determine whether the diaphragm electromyogram (EMGdi) recorded from chest wall surface electrodes could be used to reflect changes in airway resistance during an exercise challenge test and to distinguish patients with EIB from those without EIB. Ninety participants with or without asthma history were included in the study. FEV1 was recorded before and 5, 10, 15, and 20 min after exercise. EIB was defined as an FEV1 decline greater than 10% after exercise. A ratio of root mean square of EMGdi to tidal volume (EMGdi/VT) was used to assess changes in airway resistance. Based on changes in FEV1, 25 of 90 participants exhibited EIB; the remainder were defined as non‐EIB participants. EMGdi/VT in EIB increased by 124% (19%–478%) which was significantly higher than that of 21% (−39% to 134%) in non‐EIB participants (p
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- 2023
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5. Domiciliary transcutaneous electrical stimulation in patients with obstructive sleep apnoea and limited adherence to continuous positive airway pressure therapy: a single-centre, open-label, randomised, controlled phase III trialResearch in context
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Deeban Ratneswaran, Michael Cheng, Ebrahim Nasser, Rajiv Madula, Martino Pengo, Kath Hope, Esther I. Schwarz, Yuanming Luo, Georgios Kaltsakas, Michael I. Polkey, John Moxham, and Joerg Steier
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Genioglossus ,CPAP ,Non-CPAP therapy ,Hypoglossal nerve stimulation ,Medicine (General) ,R5-920 - Abstract
Summary: Background: Hypoglossal nerve stimulation (HNS) for obstructive sleep apnoea (OSA) is a novel way to manage the condition. We hypothesised that in patients with OSA and limited adherence to continuous positive airway pressure (CPAP) therapy, domiciliary transcutaneous electrical stimulation (TESLA) would control sleep apnoea and provide health benefits. Methods: We undertook a single-centre, open-label, randomised, controlled phase III trial in patients with OSA (apnoea-hypopnoea-index [AHI] 5–35 h−1), a BMI of 18.5–32 kg∗m−2, and a documented lack of adherence to CPAP therapy (
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- 2023
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6. Polyene Carboxylic Acids from a Streptomyces sp. Isolated from Tibet Soil
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Manyu Zhang, Jinwei Ren, Yuanming Luo, Weidong Xie, and Erwei Li
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polyene carboxylic acid ,secondary metabolites ,bioactivity ,NO production ,Organic chemistry ,QD241-441 - Abstract
Six new polyene carboxylic acids named serpentemycins E–J (1–6), together with three known analogs (7–9), were isolated from the fermentation medium of Streptomyces sp. TB060207, which was isolated from arid soil collected from Tibet, China. The structures of the new compounds were elucidated mainly on the basis of HR-ESI-MS and NMR spectroscopic analyses. The inhibitory activities of compounds 1–9 against NO production in LPS-activated RAW264.7 cells were evaluated. Compound 9 has an inhibition rate of 87.09% to 60.53% at concentrations ranging from 5.0 to 40.0 µM.
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- 2023
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7. Effects of continuous positive airway pressure on depression and anxiety symptoms in patients with obstructive sleep apnoea: results from the sleep apnoea cardiovascular Endpoint randomised trial and meta-analysis
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Danni Zheng, Ying Xu, Shoujiang You, Maree L. Hackett, Richard J. Woodman, Qiang Li, Mark Woodward, Kelly A. Loffler, Anthony Rodgers, Luciano F. Drager, Geraldo Lorenzi-Filho, Xia Wang, Wei Wei Quan, Manjari Tripathi, Olga Mediano, Qiong Ou, Rui Chen, Zhihong Liu, Xilong Zhang, Yuanming Luo, Nigel McArdle, Sutapa Mukherjee, R. Douglas McEvoy, and Craig S. Anderson
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Medicine (General) ,R5-920 - Abstract
Background: Whether continuous positive airway pressure (CPAP) treatment can improve depression or anxiety symptoms in obstructive sleep apnoea (OSA) patients remains uncertain. Methods: Secondary analysis of the Sleep Apnea Cardiovascular Endpoints (SAVE) trial, combined with a systematic review of randomised evidence. The SAVE secondary analyses involved 2410 patients with co-existing moderate–severe OSA and established cardiovascular disease randomly allocated to CPAP treatment plus usual care or usual care alone and followed up for 3·7 (SD 1·6) years. We evaluated the effect of CPAP treatment on depression and anxiety caseness (scores ≥8 on the Hospital Anxiety and Depression Scale depression and anxiety subscales [HADS-D and HADS-A]) for OSA patients. Findings: CPAP treatment was associated with reduced odds of depression caseness (adjusted odds ratio [OR] 0·80, 95% confidence interval [CI] 0·65–0·98, P = 0·031) compared to usual care in the SAVE trial and the treatment effect was greater in those with pre-existing depression symptoms. A systematic review of 20 randomised trials including 4255 participants confirmed a benefit of CPAP in reducing depression symptoms in OSA patients: the overall effect (standardised mean difference) was −0·18 (95% CI −0·24 to −0·12). No effect of CPAP treatment on anxiety caseness was found both in patients of the SAVE study (adjusted OR 0·98, 95% CI 0·78–1·24, P = 0·89) and the systematic review. Interpretation: CPAP reduces depression symptoms in patients with co-existing OSA and CVD independently of improvements in sleepiness. Keywords: Continuous positive airway pressure, Depression, Anxiety, Mood, Obstructive sleep apnoea, OSA, Cardiovascular diseases
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- 2019
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8. High Risk Characteristics for Recurrent Cardiovascular Events among Patients with Obstructive Sleep Apnoea in the SAVE Study
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Weiwei Quan, Danni Zheng, R. Douglas McEvoy, Ferran Barbe, Riu Chen, Zhihong Liu, Kelly Loffler, Geraldo Lorenzi-Filho, Yuanming Luo, Sutapa Mukherjee, Manjari Tripathi, Richard Woodman, Qiang Li, Xia Wang, Hisatomi Arima, Yi Xiao, Xilong Zhang, and Craig S. Anderson
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Medicine (General) ,R5-920 - Abstract
Background: Obstructive sleep apnoea (OSA) is a common comorbidity in patients with cardiovascular (CV) disease. We aimed to identify specific OSA clinical phenotypes relating to risks of serious CV events and response to continuous positive airway pressure (CPAP) treatment. Methods: Post-hoc analyses of the Sleep Apnea Cardiovascular Endpoints (SAVE) study in participants with moderate-to-severe OSA and coronary artery disease (CAD) and/or cerebrovascular disease (CeVD) randomised to CPAP plus usual care or usual care alone. Latent class analysis (LCA) was used to identify OSA clinical phenotypes among 2649 (out of 2687 total) patients with complete data on 19 patient-centered variables, supported by Bayesian information criteria and clinical interpretability. Cox regression models were used to evaluate risks of composite cardiac and stroke outcome events in phenotype groups. Preferential response to CPAP treatment was evaluated using interaction terms as well as the Chi-square test. Findings: LCA identified four OSA clinical phenotypes: CAD alone and with diabetes mellitus (CAD+DM), and CeVD alone and with DM (CeVD+DM), in 39%, 15%, 37% and 9% of participants, respectively. The rates of composite CV events were the highest in CAD+DM phenotype (HR 2.08, 95% CI 1.57–2.76) and for stroke were highest in CeVD+DM phenotype (HR 6.84, 95% CI 3.77–12.42). Adherence to CPAP treatment (nil or
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- 2018
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9. The acute effect of continuous positive airway pressure titration on blood pressure in awake overweight/obese patients with obstructive sleep apnoea
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Culadeeban Ratneswaran, Martino F. Pengo, Sichang Xiao, Yuanming Luo, Gian Paolo Rossi, Michael I. Polkey, John Moxham, and Joerg Steier
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hypertension ,variability ,sympathetic ,cardiovascular ,obesity ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objectives: Continuous positive airway pressure (CPAP) improves upper airway obstruction in patients with obstructive sleep apnoea (OSA), who often are overweight-obese. Although it is thought that CPAP improves long-term blood pressure control (BP), the impact of acute and short-term CPAP use on the cardiovascular system in obese patients has not been described in detail. Methods: Obese patients (body mass index, BMI > 25 kg/m2) with OSA were studied awake, supine during incremental CPAP titration (4–20 cmH2O, +2 cmH2O/3 mins). BP was measured continuously with a beat-to-beat BP monitor (Ohmeda 2300, Finapres Medical Systems, Amsterdam/NL), BP variability (BPV) was calculated as the standard deviation of BP at each CPAP level, the 95% confidence interval (95%CI) was calculated and changes in BP and BPV were reported. Results: 15 patients (12 male, 48 ± 10) years, BMI 38.9 ± 5.8 kg/m2) were studied; the baseline BP was 131.0 ± 10.2/85.1 ± 9.1 mmHg. BP and BPV increased linearly with CPAP titration (systolic BP r = 0.960, p
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- 2018
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10. Rice Plasma Membrane Proteomics Reveals Magnaporthe oryzae Promotes Susceptibility by Sequential Activation of Host Hormone Signaling Pathways
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Jidong Cao, Chao Yang, Lingjuan Li, Lan Jiang, Yao Wu, Chuanwan Wu, Qingyun Bu, Guixian Xia, Xiaoyun Liu, Yuanming Luo, and Jun Liu
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Microbiology ,QR1-502 ,Botany ,QK1-989 - Abstract
Plant plasma membrane (PM) plays important roles in immune response. Here, we utilized quantitative mass spectrometry to explore rice PM protein composition and dynamic changes during Magnaporthe oryzae infection. We report, thus far, the largest rice PM proteome dataset with 3,906 identified proteins, among which 484 proteins were differentially expressed after M. oryzae infection. One third of the identified proteins are predicted to have at least one transmembrane domain. Half of the identified proteins are predicted to have binding functions and over one third of the proteins have enzyme-related functions. In addition, Gene Ontology analyses revealed that abscisic acid (ABA) and cytokinin (CK) signaling were sequentially activated after M. oryzae infection in rice. We found that the activation of ABA signaling and the suppression of rice immune response occurred at the early infection stage, while the activation of CK signaling, the upregulation of sugar transporter genes expression, and the nutrient efflux of infected rice cells occurred at later infection stage. Thus, we further propose that M. oryzae activates ABA signaling to repress rice immune signaling for initial invasion and redirects nutrient efflux of infected cells for massive growth at the later infection stage.
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- 2016
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11. Transcriptome and Zymogram Analyses Reveal a Cellobiose-Dose Related Reciprocal Regulatory Effect on Cellulase Synthesis in Cellulosilyticum ruminicola H1
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Shanzhen Li, Nana Shao, Yuanming Luo, Hongcan Liu, Shichun Cai, and Xiuzhu Dong
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rumen bacterium ,comparative transcriptome ,zymogram ,cellulase synthesis ,cellobiose ,dose-related regulation ,Microbiology ,QR1-502 - Abstract
The rumen bacterium Cellulosilyticum ruminicola H1 efficiently hydrolyzes cellulose. To gain insights into the regulatory mechanisms of cellulase synthesis, comparative transcriptome analysis was conducted for cultures grown on 2% filter paper, 0.5 and 0.05% cellobiose, and 0.5% birchwood xylan. It was found that cellulose induced a majority of (hemi)cellulases, including 33 cellulases and a cellulosomal scaffoldin (1.3- to 22.7-fold); seven endoxylanases, two mannanases, and two pectatelyases (2- to 16-fold); and pyruvate formate-lyase (PFL, 1.5- to 7-fold). Noticeably, 3- and 2.5-fold increased transcription of a cellobiohydrolase and the cellulosomal scaffoldin precursor were detected in 0.05% than in 0.5% cellobiose. Consistently, 9- and 4-fold higher specific cellobiohydrolase activities were detected in the filter paper and 0.05% cellobiose culture. SDS- and native-PAGE zymograms of cellulose-enriched proteins from the filter paper culture displayed cellulase activities, and cellulolytic “complexes” were enriched from the filter paper- and 0.05% cellobiose-cultures, but not from the 0.5% cellobiose culture. LC-MS/MS identified the cellulosomal scaffoldin precursor in the “complexes” in addition to cellulase, hemicellulase, and PFL proteins. The addition of 0.5% cellobiose, but not 0.05% cellobiose remarkably inhibited strain H1 to degrade filter paper. Therefore, this work reveals a cellobiose-dose related regulatory mechanism of cellulase synthesis by lower for induction and higher for repression, which has extended our understanding of the regulation of microbial cellulase synthesis.
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- 2017
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12. Abdominal Binding Improves Neuromuscular Efficiency of the Human Diaphragm during Exercise
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Sara J. Abdallah, David S. Chan, Robin Glicksman, Cassandra T. Mendonca, Yuanming Luo, Jean Bourbeau, Benjamin M. Smith, and Dennis Jensen
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breathlessness ,exercise ,abdominal binding ,neuromuscular efficiency ,diaphragm ,Physiology ,QP1-981 - Abstract
We tested the hypothesis that elastic binding of the abdomen (AB) would enhance neuromuscular efficiency of the human diaphragm during exercise. Twelve healthy non-obese men aged 24.8 ± 1.7 years (mean ± SE) completed a symptom-limited constant-load cycle endurance exercise test at 85% of their peak incremental power output with diaphragmatic electromyography (EMGdi) and respiratory pressure measurements under two randomly assigned conditions: unbound control (CTRL) and AB sufficient to increase end-expiratory gastric pressure (Pga,ee) by 5–8 cmH2O at rest. By design, AB increased Pga,ee by 6.6 ± 0.6 cmH2O at rest. Compared to CTRL, AB significantly increased the transdiaphragmatic pressure swing-to-EMGdi ratio by 85–95% during exercise, reflecting enhanced neuromuscular efficiency of the diaphragm. By contrast, AB had no effect on spirometric parameters at rest, exercise endurance time or an effect on cardiac, metabolic, ventilatory, breathing pattern, dynamic operating lung volume, and perceptual responses during exercise. In conclusion, AB was associated with isolated and acute improvements in neuromuscular efficiency of the diaphragm during exercise in healthy men. The implications of our results are that AB may be an effective means of enhancing neuromuscular efficiency of the diaphragm in clinical populations with diaphragmatic weakness/dysfunction.
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- 2017
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13. Blood Eosinophils and Clinical Outcomes in Inpatients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Prospective Cohort Study
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Jiaqi Pu, Qun Yi, Yuanming Luo, Hailong Wei, Huiqing Ge, Huiguo Liu, Xianhua Li, Jianchu Zhang, Pinhua Pan, Hui Zhou, Chen Zhou, Mengqiu Yi, Lina Cheng, Liang Liu, Jiarui Zhang, Lige Peng, Adila Aili, Yu Liu, and Haixia Zhou
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General Medicine ,International Journal of Chronic Obstructive Pulmonary Disease - Abstract
Jiaqi Pu,1,* Qun Yi,1,2,* Yuanming Luo,3 Hailong Wei,4 Huiqing Ge,5 Huiguo Liu,6 Xianhua Li,7 Jianchu Zhang,8 Pinhua Pan,9 Hui Zhou,10 Chen Zhou,11 Mengqiu Yi,12 Lina Cheng,12 Liang Liu,10 Jiarui Zhang,1 Lige Peng,1 Adila Aili,1 Yu Liu,1 Haixia Zhou1 On behalf of the MAGNET AECOPD Registry Investigators1Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Peopleâs Republic of China; 2Sichuan Cancer Hospital and Institution, Sichuan Cancer Center, Cancer Hospital Affiliate to School of Medicine, UESTC, Chengdu, Peopleâs Republic of China; 3State Key Laboratory of Respiratory Disease, Guangzhou Medical University, Guangzhou, Peopleâs Republic of China; 4Department of Respiratory and Critical Care Medicine, Peopleâs Hospital of Leshan, Leshan, Peopleâs Republic of China; 5Department of Respiratory and Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Peopleâs Republic of China; 6Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Peopleâs Republic of China; 7Department of Respiratory and Critical Care Medicine, the First Peopleâs Hospital of Neijiang City, Neijiang, Peopleâs Republic of China; 8Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Peopleâs Republic of China; 9Department of Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Peopleâs Republic of China; 10Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Chengdu University, Chengdu, Peopleâs Republic of China; 11West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Peopleâs Republic of China; 12Department of Emergency, First Peopleâs Hospital of Jiujiang, Jiu Jiang, Peopleâs Republic of China*These authors contributed equally to this workCorrespondence: Haixia Zhou, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Guo-Xue-Xiang 37#, Wuhou District, Chengdu, Sichuan Province, 610041, Peopleâs Republic of China, Tel/Fax +86-28-85422571, Email zhouhaixia@wchscu.cnPurpose: The prognostic value of blood eosinophils in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) remains controversial. This study aimed to evaluate whether blood eosinophils could predict in-hospital mortality and other adverse outcomes in inpatients with AECOPD.Methods: The patients hospitalized for AECOPD were prospectively enrolled from ten medical centers in China. Peripheral blood eosinophils were detected on admission, and the patients were divided into eosinophilic and non-eosinophilic groups with 2% as the cutoff value. The primary outcome was all-cause in-hospital mortality.Results: A total of 12,831 AECOPD inpatients were included. The non-eosinophilic group was associated with higher in-hospital mortality than the eosinophilic group in the overall cohort (1.8% vs 0.7%, P < 0.001), the subgroup with pneumonia (2.3% vs 0.9%, P = 0.016) or with respiratory failure (2.2% vs 1.1%, P = 0.009), but not in the subgroup with ICU admission (8.4% vs 4.5%, P = 0.080). The lack of association still remained even after adjusting for confounding factors in subgroup with ICU admission. Being consistent across the overall cohort and all subgroups, non-eosinophilic AECOPD was also related to greater rates of invasive mechanical ventilation (4.3% vs 1.3%, P < 0.001), ICU admission (8.9% vs 4.2%, P < 0.001), and, unexpectedly, systemic corticosteroid usage (45.3% vs 31.7%, P < 0.001). Non-eosinophilic AECOPD was associated with longer hospital stay in the overall cohort and subgroup with respiratory failure (both P < 0.001) but not in those with pneumonia (P = 0.341) or ICU admission (P = 0.934).Conclusion: Peripheral blood eosinophils on admission may be used as an effective biomarker to predict in-hospital mortality in most AECOPD inpatients, but not in patients admitted into ICU. Eosinophil-guided corticosteroid therapy should be further studied to better guide the administration of corticosteroids in clinical practice.Keywords: acute exacerbation of chronic obstructive pulmonary disease, peripheral blood eosinophils, inpatients, in-hospital mortality, clinical outcomes
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- 2023
14. Superior Predictive Value of D-Dimer to the Padua Prediction Score for Venous Thromboembolism in Inpatients with AECOPD: A Multicenter Cohort Study
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Chen Zhou, Yujie Guang, Yuanming Luo, Huiqing Ge, Hailong Wei, Huiguo Liu, Jianchu Zhang, Pinhua Pan, Jiarui Zhang, Lige Peng, Adila Aili, Yu Liu, Jiaqi Pu, Xia Zhong, Yixi Wang, Qun Yi, and Haixia Zhou
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Fibrin Fibrinogen Degradation Products ,Cohort Studies ,Inpatients ,Pulmonary Disease, Chronic Obstructive ,Humans ,Anticoagulants ,Venous Thromboembolism ,General Medicine ,International Journal of Chronic Obstructive Pulmonary Disease ,Retrospective Studies - Abstract
Chen Zhou,1,* Yujie Guang,1,* Yuanming Luo,2 Huiqing Ge,3 Hailong Wei,4 Huiguo Liu,5 Jianchu Zhang,6 Pinhua Pan,7 Jiarui Zhang,8 Lige Peng,8 Adila Aili,8 Yu Liu,8 Jiaqi Pu,8 Xia Zhong,1 Yixi Wang,1 Qun Yi,8,9 Haixia Zhou8 On behalf of the MAGNET AECOPD Registry Investigators1West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, Peopleâs Republic of China; 2State Key Laboratory of Respiratory Disease, Guangzhou Medical University, Guangzhou, Guangdong Province, Peopleâs Republic of China; 3Department of Respiratory and Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, Peopleâs Republic of China; 4Department of Respiratory and Critical Care Medicine, Peopleâs Hospital of Leshan, Leshan, Sichuan Province, Peopleâs Republic of China; 5Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, Peopleâs Republic of China; 6Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, Peopleâs Republic of China; 7Department of Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province, Peopleâs Republic of China; 8Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, Peopleâs Republic of China; 9Sichuan Cancer Hospital and Institution, Sichuan Cancer Center, Cancer Hospital Affiliate to School of Medicine, UESTC, Chengdu, Sichuan Province, Peopleâs Republic of China*These authors contributed equally to this workCorrespondence: Haixia Zhou, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Guo-Xue-Xiang 37#, Wuhou District, Chengdu, Sichuan Province, 610041, Peopleâs Republic of China, Tel +86-28-85422571, Fax +86-28-85422571, Email zhouhaixia@wchscu.cnBackground: The optimal tool for risk prediction of venous thromboembolism (VTE) in inpatients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is still unknown. This study aimed to evaluate whether D-dimer could predict the risk of VTE in inpatients with AECOPD compared to the Padua Prediction Score (PPS).Methods: Inpatients with AECOPD were prospectively enrolled from seven medical centers in China between December 2018 and June 2020. On admission, D-dimer was detected, PPS was calculated for each patient, and the incidence of 2-month VTE was investigated. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of D-dimer and PPS on VTE development, and the best cut-off value for both methods was evaluated through the Youden index.Results: Among the 4468 eligible patients with AECOPD, 90 patients (2.01%) developed VTE within 2 months after admission. The area under the receiver operating characteristic curves (AUCs) of D-dimer for predicting VTE were significantly higher than those of the PPS both in the overall cohort (0.724, 95% CI 0.672â 0.776 vs 0.620, 95% CI 0.562â 0.679; P< 0.05) and the subgroup of patients without thromboprophylaxis (0.747, 95% CI 0.695â 0.799 vs 0.640, 95% CI 0.582â 0.698; P< 0.05). By calculating the Youden Index, the best cut-off value of D-dimer was determined to be 0.96 mg/L with an AUC of 0.689, which was also significantly better than that of the PPS with the best cut-off value of 2 (AUC 0.581, P=0.007). After the combination of D-dimer with PPS, the AUC (0.621) failed to surpass D-dimer alone (P=0.104).Conclusion: D-dimer has a superior predictive value for VTE over PPS in inpatients with AECOPD, which might be a better choice to guide thromboprophylaxis in inpatients with AECOPD due to its effectiveness and convenience.Clinical Trial Registration: Chinese Clinical Trail Registry NO. ChiCTR2100044625; URL: http://www.chictr.org.cn/showproj.aspx?proj=121626.Keywords: acute exacerbation of chronic obstructive pulmonary disease, inpatients, D-dimer, Padua Prediction Score, venous thromboembolism
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- 2022
15. Association of local solid mechanical, hemodynamic and morphological characteristics with ruptured intracranial aneurysm
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Xiaodong Zhai, Peng Hu, Yadong Wang, Hongqi Zhang, Lan Cao, Tianming Huang, Jia Lu, and Yuanming Luo
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Computational Theory and Mathematics ,Applied Mathematics ,Modeling and Simulation ,Biomedical Engineering ,Molecular Biology ,Software - Abstract
The rupture of intracranial aneurysms (IAs) is a complicated phenomenon of which the mechanism is not fully understood. The purpose of this study is to associate local solid mechanical, hemodynamic, and morphological characteristics with rupture regions through statistical means, in an attempt to identify the parameters that are indicative of rupture propensity for IAs. Twenty patient-specific ruptured IA models were reconstructed from digital subtraction angiography (DSA), and applied in the analysis of wall tension, wall shear stress (WSS) and curvature. The precise rupture locations were marked out through intraoperative videos. Pearson correlation analysis was employed to investigate the correlations of these three parameters with patient characteristics and global geometric features. Univariate and multivariate logistic regression analysis were further performed on wall tension, WSS and curvature with regards to rupture and nonrupture regions. Receiver operating characteristic (ROC) analysis defining area under the curve (AUC) was performed on these three parameters. The univariate model of wall tension (AUC, 0.9750), WSS (AUC, 0.9300), curvature (0.8150) and their combined multivariate model (AUC, 0.9875) all present high AUC values. The wall tension, WSS and curvature are acceptable parameters relating to rupture regions. The rupture odd is more sensitive to the wall tension and WSS than curvature. Each logistic model is capable in discriminating ruptures from nonrupture regions, while the multivariate model is the most efficient.
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- 2022
16. [Preface for special issue on multi-omics frontier technologies]
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Yuanming, Luo and Fuquan, Yang
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Proteomics ,Metabolomics ,Genomics ,Transcriptome - Abstract
With wide applications of genomics, transcriptomics, proteomics and metabolomics in the post-genome era, functional explanation has become the central task in life science research, and multi-omics data integrative analysis has become an indispensable strategy for uncovering the underlying biological mechanism. This special issue aimed to introduce the related research advances and applications in multi-omics by inviting the domestic experts. In total, 28 papers have been collected in this issue, for researcher's reference in multi-omics.
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- 2022
17. [Multi-omics technology and its applications to life sciences: a review]
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Jingfang, Liu, Weilin, Li, Li, Wang, Juan, Li, Erwei, Li, and Yuanming, Luo
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Proteomics ,Epigenomics ,Technology ,Metabolomics ,Genomics - Abstract
With technological advances in high-throughput sequencing, high resolution mass-spectrometry, and multi-omics data integrative tools and data repositories, the omics research in life sciences are evolving from single-omics strategy to multi-omics strategy. The research of system biology driven by multi-omics will bring a new paradigm in life sciences. This paper briefly summarizes the development of genomics, epigenomics, transcriptomics, proteomics and metabolomics, highlights the composition and function of multi-omics platforms as well as the applications of multi-omics technology, and prospects future applications of multi-omics in synthetic biology and biomedicine.
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- 2022
18. CPAP increases physical activity in obstructive sleep apnea with cardiovascular disease
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Yuanming Luo, David W. Dunstan, Craig S. Anderson, R. Doug McEvoy, Matthew P. Buman, Kelly A. Loffler, David Stevens, Geraldo Lorenzi-Filho, and Ferran Barbé
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Physical activity ,Disease ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Continuous positive airway pressure ,Exercise ,Aged ,Sleep Apnea, Obstructive ,Continuous Positive Airway Pressure ,business.industry ,Australia ,food and beverages ,Middle Aged ,medicine.disease ,Scientific Investigations ,respiratory tract diseases ,Obstructive sleep apnea ,030228 respiratory system ,Neurology ,Cardiovascular Diseases ,Cardiology ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
STUDY OBJECTIVES: Uncertainty exists over whether continuous positive airway pressure (CPAP) treatment improves moderate to vigorous physical activity levels in those with obstructive sleep apnea. We aimed to determine effects of CPAP on moderate to vigorous physical activity among participants with co-occurring cardiovascular disease and obstructive sleep apnea. METHODS: The Sleep Apnea cardioVascular Endpoints (SAVE) trial recruited participants with confirmed cardiovascular disease history and obstructive sleep apnea, 45–75 years old. The 2,687 participants (1,346 randomized to CPAP plus usual care and 1,341 to usual care alone) were followed up for a mean of 3.7 years. Self-reported physical activity was recorded at baseline, 6, 24, and 48 months using the Godin-Shepard Leisure Time Exercise Questionnaire (LTEQ). We also determined effects on any limitation of physical activity reported on the physical functioning subscale of the 36-item short form questionnaire (SF-36) and proportions of participants reaching guideline recommended physical activity levels. RESULTS: Among 2,601 participants with available data, those in the CPAP group reported significantly more physical activity compared to the usual care group, with approximately 20% higher reported moderate activities on the LTEQ during follow-up (adjusted mean 95% confidence interval) scores: 8.7, 7.5–9.9 vs 7.3, 6.1–8.5; P = .003). Those in the CPAP group also reported less limitation in physical activity (adjusted between-group difference in SF-36 physical functioning subscale score 1.66, 95% confidence interval 0.87–2.45; P < 0.001), and more reported sufficient levels of physical activity to meet recommendations. CONCLUSIONS: CPAP has positive effects on improving physical activity levels, consistent with long-term health benefits. CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Name: Continuous Positive Airway Pressure Treatment of Obstructive Sleep Apnea to Prevent Cardiovascular Disease (SAVE); URL: https://clinicaltrials.gov/ct2/show/NCT00738179; Identifier: NCT00738179; and Registry: Australian New Zealand Clinical Trials Registry; Name: Sleep Apnea cardioVascular Endpoints study—An investigation of continuous positive airway pressure for the treatment of obstructive sleep apnea to prevent cardiovascular disease; URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=83062&isReview=true; Identifier: ACTRN12608000409370. CITATION: Stevens D, Loffler KA, Buman MP, et al. CPAP increases physical activity in obstructive sleep apnea with cardiovascular disease. J Clin Sleep Med. 2021;17(2):141–148.
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- 2021
19. Novel method for evaluating the upper airway resistance using the ratio of neural respiratory drive to flow in OSA
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Yongchang Zhang, Ning Zhang, Qin-Miao Huang, Zhigang Liu, Zhihui Qiu, Liteng Yang, and Yuanming Luo
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Male ,medicine.medical_specialty ,Polysomnography ,Electromyography ,03 medical and health sciences ,0302 clinical medicine ,Airway resistance ,Internal medicine ,medicine ,Humans ,Sleep Apnea, Obstructive ,medicine.diagnostic_test ,business.industry ,Airway Resistance ,Snoring ,General Medicine ,medicine.disease ,Sleep in non-human animals ,nervous system diseases ,respiratory tract diseases ,Obstructive sleep apnea ,030228 respiratory system ,Control of respiration ,Breathing ,Cardiology ,Wakefulness ,Sleep Stages ,business ,030217 neurology & neurosurgery - Abstract
Study objectives Sleep is associated with a reduction in ventilation and an increase in upper airway resistance (UAR) in patients with obstructive sleep apnea (OSA). However, there is no consensus on the standard for assessment of UAR and therefore it is important to develop a method to reliably assess UAR in patients with OSA. The purpose of the present study is to determine whether the ratio of neural respiratory drive (NRD) to flow can be used to assess changes in UAR in OSA during sleep. Methods A total of 24 patients (21 men) with OSA and 10 normal subjects (6 males) were studied. The UAR was assessed by the ratio of NRD to flow, which measured by esophageal pressure (Poes), diaphragm electromyography (EMGdi) and superficial diaphragm electromyography (SEMGdi) in various stages including wakefulness, N2 sleep, N2 sleep with snoring, hypopneas, the in the “preapnea” states in OSA versus wakefulness, sleeponset, N2 sleep, N3 sleep in normal subjects. All subjects underwent overnight full polysomnography using standard techniques. Results Our study indicate that UAR was progressively higher from wakefulness to N2 sleep, N2 sleep with snoring, hypopneas, and the in the “preapnea” states in patients with OSA and had obvious difference in statistical significance (p Conclusions It is feasible to use the ratio of neural respiratory drive to flow to assess UAR in patients with OSA during sleep.
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- 2020
20. Absence of dynamic hyperinflation during exhaustive exercise in severe COPD reflects submaximal IC maneuvers rather than a nonhyperinflator phenotype
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Sichang Xiao, Ying-Mei Luo, Zhihui Qiu, John Moxham, Yang Wang, Michael I. Polkey, Joerg Steier, Yuanming Luo, Hua Qin, and Baiting He
- Subjects
Adult ,medicine.medical_specialty ,Physiology ,Copd patients ,Severe copd ,Inspiratory Capacity ,Pulmonary Disease, Chronic Obstructive ,03 medical and health sciences ,0302 clinical medicine ,Forced Expiratory Volume ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Dynamic hyperinflation ,Aged ,business.industry ,Middle Aged ,Phenotype ,Respiratory Function Tests ,030228 respiratory system ,Exercise Test ,Cardiology ,medicine.symptom ,business ,Hypercapnia - Abstract
Approximately 20% of chronic obstructive pulmonary disease (COPD) patients have been considered to have a “nonhyperinflator phenotype.” However, this judgment depends on patients making a fully maximal inspiratory capacity (IC) maneuver at rest, since the IC during exercise is compared with this baseline measurement. We hypothesized that IC maneuvers at rest are sometimes submaximal and tested this hypothesis by measuring IC and associated neural respiratory drive at rest and during inhalation of CO2 and exercise in patients with COPD. Twenty-six COPD patients [age 66 ± 6 yr, mean forced expiratory volume in 1 s (FEV1) 40 ± 11% predicted] and 39 healthy subjects (age 39 ± 14 yr, FEV1 98 ± 12% predicted) were studied. IC and the diaphragm electromyogram (EMGdi) associated with it (EMGdi-IC) and forced inspiratory vital capacity (FIVC) and its corresponding EMGdi (EMGdi-FIVC) were measured during inhalation of 8% CO2 (8% CO2-92% O2) and room air. Incremental exhaustive cycle ergometer exercise was also performed in both patients with COPD and healthy subjects. IC, EMGdi-IC, FIVC, and EMGdi-FIVC during breathing 8% CO2 were significantly greater than those during breathing room air in both patients with COPD and healthy subjects (all P < 0.001). EMGdi-IC in patients with COPD constantly increased during exercise from 145 ± 40 µV at rest to 185 ± 52 µV at the end of exercise but change in IC was variable. Neural respiratory drive and its relevant IC increased during hypercapnia. Exercise-related hypercapnia in patients with COPD raises neural respiratory drives, which compensate for IC reduction, leading to underestimation of dynamic hyperinflation measured by IC at rest breathing room air. NEW & NOTEWORTHY Inspiratory capacity measured during hypercapnia is higher than that during eucapnia. Thus total lung capacity is not always be achieved by a standard inspiratory capacity maneuver, leading to risk of underestimation of dynamic hyperinflation in patients with severe chronic obstructive pulmonary disease after exhaustive exercise.
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- 2020
21. Sleep duration and risk of cardiovascular events: The SAVE study
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Geraldo Lorenzi-Filho, Danni Zheng, Manjari Tripathi, Kelly A. Loffler, R. Doug McEvoy, Richard J. Woodman, Save Investigators, Jingwei Li, Ferran Barbé, Xia Wang, Yuanming Luo, and Craig S. Anderson
- Subjects
Male ,Cardiovascular event ,Sleep Apnea, Obstructive ,medicine.medical_specialty ,business.industry ,Myocardial Infarction ,medicine.disease ,Stroke ,Neurology ,Cardiovascular Diseases ,Risk Factors ,Emergency medicine ,Humans ,Medicine ,Female ,In patient ,Sleep ,business ,Proportional Hazards Models ,Sleep duration - Abstract
Background and aim Controversy exists regarding cardiovascular risk in relation to sleep duration. We determined sleep duration and major recurrent cardiovascular event associations in patients with obstructive sleep apnoea and established cardiovascular disease. Methods Secondary analyses of the international, multicenter, Sleep Apnea Cardiovascular Endpoints trial. Sleep duration was estimated from overnight home oximetry (ApneaLink monitor) used for obstructive sleep apnoea diagnosis. Cox proportional hazards models were used to determine associations of categorized sleep duration (8 h) and major cardiovascular outcomes: primary composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and any hospitalization for unstable angina, heart failure, or transient ischemic attack; secondary composite of cardiac and cerebral (stroke/transient ischemic attack) events. Results Oximetry-derived sleep duration estimates were available in 2687 participants (mean 61.2 years, 80.9% males) who experienced a total of 436 cardiovascular events over a mean follow-up of 3.7 years. Compared to the reference category, sleep duration was not associated with risk of the primary composite cardiovascular outcome (adjusted hazard ratio (HR) 1.00, 95% confidence interval 0.76–1.33, and HR 1.22, 95% confidence interval 0.98–1.52, for sleep duration 8 h, respectively). However, long sleep was associated with increased cerebral events (HR 1.67, 95% confidence interval 1.17–2.39; P = 0.005) and stroke alone (HR 1.79, 95% confidence interval 1.22–2.63; P = 0.003). Conclusions Long sleep duration is associated with an increased risk of stroke but not cardiac events in obstructive sleep apnoea patients with existing cardiovascular disease. Clinical trial registration The trial is registered at ClinicalTrials.gov (NCT00738179).
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- 2020
22. Assessment of respiratory drive with esophageal diaphragmatic electromyography in patients with acute respiratory distress syndrome treated with prone position ventilation
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Yuanming Luo, Zhi-Min Lin, Wen Jiang, Qingwen Sun, Xiao-Cong Li, and Wen-Zheng Huang
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Pulmonary and Respiratory Medicine ,ARDS ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,Supine position ,business.industry ,030232 urology & nephrology ,Diaphragmatic breathing ,Pulmonary compliance ,medicine.disease ,Diaphragm (structural system) ,03 medical and health sciences ,Prone position ,0302 clinical medicine ,Internal medicine ,Breathing ,medicine ,Cardiology ,Original Article ,business ,Feeding tube - Abstract
Background: Prone position ventilation (PPV) is an important strategy for patients with severe acute respiratory distress syndrome (ARDS). This prospective study investigated the use of electromyography of the diaphragm (EMGdi) for monitoring respiratory drive in patients with moderate to severe ARDS during long-term PPV Methods: An integrated nostril-gastric feeding tube containing an esophageal electrode and balloon was placed in 14 patients with severe ARDS prior to PPV. EMGdi and trans-pulmonary pressure (∆PL) data were collected before PPV (baseline), every 2 h during PPV, and 2 h after the restoration of supine position ventilation (post-2 h SPV). Results: In ARDS patients, the static compliance of the chest wall was significantly decreased after PPV. EMGdi levels were slightly lower in the early, middle, and late stages of PPV compared with baseline. Patients who received neuromuscular blocker experienced a greater drop in EMGdi from baseline than those who did not. Conclusions: For ARDS patients, EMGdi was slightly decreased after prolonged PPV. This is contrary to the change in diaphragm electromyography during normal body position changes. Monitoring EMGdi regularly during PPV in ARDS patients is feasible and can be used as a reference for lung protective ventilation strategies.
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- 2019
23. Validation of Risk Assessment Models Predicting Venous Thromboembolism in Inpatients with Acute Exacerbation Of Chronic Obstructive Pulmonary Disease: A Multicenter Cohort Study in China
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Jianchu Zhang, Xia Zhong, Huiguo Liu, Maoyun Wang, Chen Zhou, Lige Peng, Yu Liu, Pinhua Pan, Hailong Wei, Jiarui Zhang, Haixia Zhou, Lan Wang, Yixi Wang, Qun Yi, Yuanming Luo, Yong-Jiang Tang, Huiqing Ge, and Adila Aili
- Subjects
medicine.medical_specialty ,Acute exacerbation of chronic obstructive pulmonary disease ,Risk level ,Inpatients ,business.industry ,Incidence (epidemiology) ,Anticoagulants ,Hematology ,Venous Thromboembolism ,medicine.disease ,Risk Assessment ,Clinical trial ,Cohort Studies ,Pulmonary Disease, Chronic Obstructive ,Risk Factors ,Internal medicine ,medicine ,Population study ,Humans ,cardiovascular diseases ,business ,Risk assessment ,Venous thromboembolism ,Cohort study ,Retrospective Studies - Abstract
Background Inpatients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are at increased risk for venous thromboembolism (VTE); however, the prophylaxis for VTE is largely underused in China. Identifying high-risk patients requiring thromboprophylaxis is critical to reduce the mortality and morbidity associated with VTE. This study aimed to evaluate and compare the validities of the Padua Prediction Score and Caprini risk assessment model (RAM) in predicting the risk of VTE in inpatients with AECOPD in China. Methods The inpatients with AECOPD were prospectively enrolled from seven medical centers of China between September 2017 and January 2020. Caprini and Padua scores were calculated on admission, and the incidence of 3-month VTE was investigated. Results Among the 3,277 eligible patients with AECOPD, 128 patients (3.9%) developed VTE within 3 months after admission. The distribution of the study population by the Caprini risk level was as follows: high, 53.6%; moderate, 43.0%; and low, 3.5%. The incidence of VTE increased by risk level as high, 6.1%; moderate, 1.5%; and low, 0%. According to the Padua RAM, only 10.9% of the study population was classified as high risk and 89.1% as low risk, with the corresponding incidence of VTE of 7.9 and 3.4%, respectively. The Caprini RAM had higher area under curve compared with the Padua RAM (0.713 ± 0.021 vs. 0.644 ± 0.023, p = 0.029). Conclusion The Caprini RAM was superior to the Padua RAM in predicting the risk of VTE in inpatients with AECOPD and might better guide thromboprophylaxis in these patients.
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- 2021
24. Effects of continuous positive airway pressure on depression and anxiety symptoms in patients with obstructive sleep apnoea: results from the sleep apnoea cardiovascular Endpoint randomised trial and meta-analysis
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Xilong Zhang, Danni Zheng, Shoujiang You, Luciano F. Drager, Anthony Rodgers, Qiang Li, Mark Woodward, Nigel McArdle, Sutapa Mukherjee, R. Douglas McEvoy, Xia Wang, Geraldo Lorenzi-Filho, Zhihong Liu, Olga Mediano, Kelly A. Loffler, Rui Chen, Yuanming Luo, Richard J. Woodman, Craig S. Anderson, Ying Xu, Manjari Tripathi, Qiong Ou, Wei Wei Quan, and Maree L. Hackett
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Continuous positive airway pressure ,B760 ,Anxiety ,Hospital Anxiety and Depression Scale ,01 natural sciences ,OSA ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Mood ,medicine ,030212 general & internal medicine ,0101 mathematics ,Depression (differential diagnoses) ,lcsh:R5-920 ,Depression ,business.industry ,010102 general mathematics ,Sleep apnea ,General Medicine ,Odds ratio ,medicine.disease ,3. Good health ,nervous system diseases ,respiratory tract diseases ,Cardiovascular diseases ,Obstructive sleep apnoea ,Meta-analysis ,medicine.symptom ,business ,lcsh:Medicine (General) ,Research Paper - Abstract
Background Whether continuous positive airway pressure (CPAP) treatment can improve depression or anxiety symptoms in obstructive sleep apnoea (OSA) patients remains uncertain. Methods Secondary analysis of the Sleep Apnea Cardiovascular Endpoints (SAVE) trial, combined with a systematic review of randomised evidence. The SAVE secondary analyses involved 2410 patients with co-existing moderate–severe OSA and established cardiovascular disease randomly allocated to CPAP treatment plus usual care or usual care alone and followed up for 3·7 (SD 1·6) years. We evaluated the effect of CPAP treatment on depression and anxiety caseness (scores ≥ 8 on the Hospital Anxiety and Depression Scale depression and anxiety subscales [HADS-D and HADS-A]) for OSA patients. Findings CPAP treatment was associated with reduced odds of depression caseness (adjusted odds ratio [OR] 0·80, 95% confidence interval [CI] 0·65–0·98, P = 0·031) compared to usual care in the SAVE trial and the treatment effect was greater in those with pre-existing depression symptoms. A systematic review of 20 randomised trials including 4255 participants confirmed a benefit of CPAP in reducing depression symptoms in OSA patients: the overall effect (standardised mean difference) was − 0·18 (95% CI − 0·24 to − 0·12). No effect of CPAP treatment on anxiety caseness was found both in patients of the SAVE study (adjusted OR 0·98, 95% CI 0·78–1·24, P = 0·89) and the systematic review. Interpretation CPAP reduces depression symptoms in patients with co-existing OSA and CVD independently of improvements in sleepiness., Highlights • Depression and anxiety are prevalent in patients with chronic conditions, such as obstructive sleep apnoea (OSA) and cardiovascular disease, and they adversely impact on prognosis and quality of life. Whether continuous positive airway pressure (CPAP) treatment can improve depression or anxiety symptoms in OSA patients still remains uncertain. We searched PubMed for studies in English language published before 1 Jan 2019 reporting of CPAP effect on depression and anxiety symptoms using the terms “continuous positive airway pressure”, “obstructive sleep apnoea”, “depression” and “anxiety”. A recent systematic review of randomised trials on the effect of CPAP on depression symptoms had found modest benefit of CPAP treatment for improving depression symptoms, however there was high heterogeneity. Existing findings are variable across studies due, in part, to different study designs, small patient numbers, short periods of follow-up, and from an emphasis on depression over anxiety patterns of abnormal mood. • Added value of this study: Analysis of the Sleep Apnea Cardiovascular Endpoints (SAVE) cohort of over 2400 patients with moderate to severe OSA and concomitant cardiovascular diseases who were followed up for an average of 3.7 years showed that the CPAP reduced depression symptoms within few months of treatment, independently of improvements in daytime sleepiness. The NNT (i.e. 15) for CPAP to prevent depression caseness (as defined by Hospital Anxiety and Depression Scale – Depression subscale score ≥ 8) is comparable to remission rates achieved for some established antidepressant drugs. However, analyses of the SAVE study showed no clear clinical benefit for anxiety symptoms. Systematic review of 20 included randomised controlled studies showed similar results as our SAVE secondary analyses. • Implications of all the available evidence: Our findings provide further support for the broader beneficial effects of CPAP in those with OSA, and especially those at high cardiovascular risk, where there is the potential for enhanced mood to improve long-term cardiovascular outcomes.
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- 2019
25. Domiciliary use of transcutaneous electrical stimulation for patients with obstructive sleep apnoea: a conceptual framework for the TESLA home programme
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Michael Cheng, Baiting He, Martino F. Pengo, Culadeeban Ratneswaran, Nimish Shah, Miral Al-Sherif, Brian D. Kent, Esther I. Schwarz, Athanasius Ishak, Yuanming Luo, Gerrard F. Rafferty, Nicholas Hart, John Moxham, Rukiye Tas, Marianne Beach, Paul Eze-John, Adrian J. Williams, Joerg Steier, Kai Lee, Miriam Nido, He, B, Al-Sherif, M, Nido, M, Tas, R, Beach, M, Schwarz, E, Cheng, M, Ishak, A, Lee, K, Shah, N, Kent, B, Eze-John, P, Ratneswaran, C, Rafferty, G, Williams, A, Hart, N, Luo, Y, Moxham, J, Pengo, M, and Steier, J
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Sleepiness ,Hypoglossal nerve stimulation (HNS) ,medicine.medical_treatment ,Review Article of Sleep Section ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Continuous positive airway pressure ,Sleepine ,business.industry ,Transcutaneous Electrical Stimulation ,respiratory tract diseases ,Clinical trial ,030228 respiratory system ,Conceptual framework ,Dilator ,Physical therapy ,Sleep (system call) ,Ill health ,Continuous positive airway pressure (CPAP) ,Neural stimulation ,business ,Airway ,030217 neurology & neurosurgery ,Compliance - Abstract
Obstructive sleep apnoea (OSA) is a global health problem of increasing prevalence. Effective treatments are available with continuous positive airway pressure (CPAP) therapy and mandibular advancement devices (MAD). However, there is limited long-term adherence to therapy, as CPAP and MAD require permanent usage to avoid recurrence of the symptoms and adverse ill health. Alternative treatments would aid in the treatment cascade to manage OSA effectively whenever standard therapy has been trialled and failed. Hypoglossal nerve stimulation (HNS), an invasive approach to stimulate the pharyngeal dilator muscles of the upper airway during sleep, has been approved for the treatment of OSA by several healthcare systems in recent years. In parallel to the development of HNS, a non-invasive approach has been developed to deliver electrical stimulation. Transcutaneous electrical stimulation in obstructive sleep apnoea (TESLA) uses non-invasive electrical stimulation to increase neuromuscular tone of the upper airway dilator muscles of patients with OSA during sleep. Data from previous feasibility studies and randomised controlled trials have helped to identify a subgroup of patients who are “responders” to this treatment. However, further investigations are required to assess usability, functionality and task accomplishment of this novel treatment. Consideration of these factors in the study design of future clinical trials will strengthen research methodology and protocols, improve patient related outcome measures and assessments, to optimise this emerging therapeutical option. In this review, we will introduce a conceptual framework for the TESLA home programme highlighting qualitative aspects and outcomes.
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- 2019
26. The Effects of Long-term CPAP on Weight Change in Patients With Comorbid OSA and Cardiovascular Disease
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Geraldo Lorenzi-Filho, Qiong Ou, Richard J. Woodman, Luciano F. Drager, Ferran Barbé, Save Investigators, Rui Chen, Michael Hlavac, Nigel McArdle, Baixin Chen, Xilong Zhang, Kelly A. Loffler, R. Doug McEvoy, Olga Mediano, Qian Wang, Yuanming Luo, Craig S. Anderson, and Sutapa Mukherjee
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Epworth Sleepiness Scale ,Weight change ,Sleep apnea ,Anthropometry ,Critical Care and Intensive Care Medicine ,medicine.disease ,respiratory tract diseases ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Apnea–hypopnea index ,Randomized controlled trial ,law ,Internal medicine ,Post-hoc analysis ,medicine ,030212 general & internal medicine ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Weight gain - Abstract
Background Although recent evidence suggests that OSA treatment may cause weight gain, the long-term effects of CPAP on weight are not well established. Methods This study was a post hoc analysis of the Sleep Apnea Cardiovascular Endpoints (SAVE) study, a multicenter, randomized trial of CPAP plus standard care vs standard care alone in adults with a history of cardiac or cerebrovascular events and moderate to severe OSA. Participants with weight, BMI, and neck and waist circumferences measured at baseline and during follow-up were included. Linear mixed models were used to examine sex-specific temporal differences, and a sensitivity analysis compared high CPAP adherers (≥ 4 h per night) with propensity-matched control participants. Results A total of 2,483 adults (1,248 in the CPAP group and 1,235 in the control group) were included (mean 6.1 ± 1.5 measures of weight available). After a mean follow-up of 3.78 years, there was no difference in weight change between the CPAP and control groups, for male subjects (mean [95% CI] between-group difference, 0.07 kg [–0.40 to 0.54]; P = .773) or female subjects (mean [95% CI] between-group difference, –0.14 kg [–0.37 to 0.09]; P = .233). Similarly, there were no significant differences in BMI or other anthropometric measures. Although male participants who used CPAP ≥ 4 h per night gained slightly more weight than matched male control subjects without CPAP (mean difference, 0.38 kg [95% CI, 0.04 to 0.73]; P = .031), there were no between-group differences in other anthropometric variables, nor were there any differences between female high CPAP adherers and matched control subjects. Conclusions Long-term CPAP use in patients with comorbid OSA and cardiovascular disease does not result in clinically significant weight change. Trial Registry ClinicalTrials.gov; No.: NCT00738179 ; URL: www.clinicaltrials.gov .
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- 2019
27. Apnoea-hypopnoea-index comparing the 2007 and 2012 American Academy of Sleep Medicine criteria in chronic obstructive pulmonary disease/obstructive sleep apnoea overlap syndrome
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Yingxin Wu, Miral Al-Sherif, Azza Farag Said, Nashwa Abdel Wahab, Nezar Refat, Yuanming Luo, Sean Higgins, Baiting He, Joerg Steier, Esther I. Schwarz, University of Zurich, and Steier, Joerg
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Pulmonary and Respiratory Medicine ,COPD ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Pulmonary disease ,Retrospective cohort study ,Overlap syndrome ,610 Medicine & health ,Polysomnography ,medicine.disease ,Sleep medicine ,respiratory tract diseases ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Interquartile range ,2740 Pulmonary and Respiratory Medicine ,Internal medicine ,Cohort ,Medicine ,Original Article ,10178 Clinic for Pneumology ,business ,030217 neurology & neurosurgery - Abstract
Background: In 2007 and 2012, the American Academy of Sleep Medicine (AASM) updated their scoring criteria for nocturnal respiratory events. We hypothesised that this could have led to changes in the apnoea-hypopnoea index (AHI) of patients with chronic obstructive pulmonary disease (COPD)/obstructive sleep apnoea (OSA) overlap syndrome. Methods: In a retrospective study, polysomnographic (PSG) recordings of 34 patients with COPD/OSA overlap syndrome were independently analysed using the AASM criteria from 2007 (AASM2007) and 2012 (AASM2012). The primary outcome was the difference in AHI, the secondary outcomes were frequency of hypopnoeas, diagnosis of overlap syndrome and differences between the AASM 2007 recommended (AASM2007Rec) and altered (AASM2007Alt) classifications. Data are presented as mean (standard deviation) if normally distributed, and as median (interquartile range) if non-normally distributed. Results: The PSGs of 34 elderly [aged 67 (7.0) years] and predominantly male (m:f, 31:3) patients with COPD [FEV1%pred 48.4% (19.6%)] were analysed. The AHI using AASM2007Rec criteria was 5.9 (2.0, 15.1) events/hour vs. 20.4 (11.5, 28.0) events/hour using the 2012 criteria (P
- Published
- 2020
28. Ultrasound assessment of upper airway dilator muscle contraction during transcutaneous electrical stimulation in patients with obstructive sleep apnoea
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Michael Cheng, Baiting He, Nashwa Abd-Elwahab, Azza Farag Said, Miral Al-Sherif, Joerg Steier, Esther I. Schwarz, Nezar Refat, Deeban Ratneswaran, Yuanming Luo, University of Zurich, and Steier, Joerg
- Subjects
Pulmonary and Respiratory Medicine ,Genioglossus ,business.industry ,Epworth Sleepiness Scale ,Ultrasound ,Apnea ,610 Medicine & health ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,030228 respiratory system ,Tongue ,2740 Pulmonary and Respiratory Medicine ,Coronal plane ,Dilator ,Medicine ,Original Article ,030212 general & internal medicine ,medicine.symptom ,10178 Clinic for Pneumology ,Nuclear medicine ,business ,Airway - Abstract
Background: Electrical current can be used to stimulate upper airway dilator muscles to treat obstructive sleep apnoea (OSA). Ultrasound devices are widely available and may be used to detect contraction of the upper airway dilator muscles assessing the functionality of electrical stimulation (ES) used for this treatment. Methods: In a physiological sub-study of a randomised controlled trial, patients with OSA underwent ultrasound examination to assess contraction of the upper airway dilator muscles in response to transcutaneous ES. Ultrasound scans were scored according to the picture quality (poor = ‘0’, acceptable = ‘1’ and good = ‘2’). Tongue base thickness was assessed in mid-sagittal and coronal planes with (D2, A2) and without ES (D1, A1), while awake and seated. The primary outcome was to determine the increase in tongue thickness during ES in both views (D2 – D1 = ΔD), as well as any increase in the cross-sectional area (CSA) in the coronal view (A2 – A1 = ΔA). Data were presented as mean and standard deviation (SD). Results: Fourteen patients [eight male, age 57.5 (9.8) years, body mass index (BMI) 29.5 (2.8) kg/m2] with OSA [Apnea-Hypopnea Index (AHI) 19.5 (10.6) × hour-1] were studied. Quality of the ultrasound scans was acceptable or good with 1.5 (0.5) points. In the mid-sagittal plane, ΔD was +0.17 (0.07) cm in midline and +0.21 (0.09) cm in the widest diameter, a percentual change of 12.2% (4%) and 12.8% (5.2%) (P
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- 2020
29. Continuous Positive Airway Pressure Treatment, Glycemia, and Diabetes Risk in Obstructive Sleep Apnea and Comorbid Cardiovascular Disease
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Sutapa Mukherjee, Hooi Shan Yap, Rui Chen, Kelly A. Loffler, Luciano F. Drager, Xilong Zhang, Michael Hlavac, Yuanming Luo, Nigel McArdle, Geraldo Lorenzi-Filho, Emma Heeley, Craig S. Anderson, Carolina Gonzaga Carvalho, Lia Bittencourt, Rosie Meng, R. Doug McEvoy, Lyle J. Palmer, Ruth Freed, and Zhihong Liu
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Blood Glucose ,Male ,medicine.medical_specialty ,Diabetes risk ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,030209 endocrinology & metabolism ,Comorbidity ,Glycemic Control ,Prediabetic State ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Diabetes mellitus ,Internal medicine ,Internal Medicine ,Humans ,Medicine ,Medical history ,030212 general & internal medicine ,Prediabetes ,Continuous positive airway pressure ,Aged ,Glycemic ,Glycated Hemoglobin ,Advanced and Specialized Nursing ,Sleep Apnea, Obstructive ,Continuous Positive Airway Pressure ,business.industry ,Sleep apnea ,Standard of Care ,Middle Aged ,medicine.disease ,respiratory tract diseases ,Treatment Adherence and Compliance ,Obstructive sleep apnea ,Diabetes Mellitus, Type 2 ,Cardiovascular Diseases ,Female ,business - Abstract
OBJECTIVE Despite evidence of a relationship among obstructive sleep apnea (OSA), metabolic dysregulation, and diabetes, it is uncertain whether OSA treatment can improve metabolic parameters. We sought to determine effects of long-term continuous positive airway pressure (CPAP) treatment on glycemic control and diabetes risk in patients with cardiovascular disease (CVD) and OSA. RESEARCH DESIGN AND METHODS Blood, medical history, and personal data were collected in a substudy of 888 participants in the Sleep Apnea cardioVascular Endpoints (SAVE) trial in which patients with OSA and stable CVD were randomized to receive CPAP plus usual care, or usual care alone. Serum glucose and glycated hemoglobin A1c (HbA1c) were measured at baseline, 6 months, and 2 and 4 years and incident diabetes diagnoses recorded. RESULTS Median follow-up was 4.3 years. In those with preexisting diabetes (n = 274), there was no significant difference between the CPAP and usual care groups in serum glucose, HbA1c, or antidiabetic medications during follow-up. There were also no significant between-group differences in participants with prediabetes (n = 452) or new diagnoses of diabetes. Interaction testing suggested that women with diabetes did poorly in the usual care group, while their counterparts on CPAP therapy remained stable. CONCLUSIONS Among patients with established CVD and OSA, we found no evidence that CPAP therapy over several years affects glycemic control in those with diabetes or prediabetes or diabetes risk over standard-of-care treatment. The potential differential effect according to sex deserves further investigation.
- Published
- 2020
30. Apnoea-Hypopnea-Index Comparing the AASM 2007 and 2012 Criteria in COPD/Obstructive Sleep Apnoea Overlap Syndrome
- Author
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A. Farag Said, Joerg Steier, Miral Al-Sherif, Sean Higgins, Esther I. Schwarz, Baiting He, Yuanming Luo, and Y. Y. Wu
- Subjects
COPD ,medicine.medical_specialty ,Index (economics) ,business.industry ,Internal medicine ,medicine ,Cardiology ,Overlap syndrome ,medicine.disease ,business ,Hypopnea ,Sleep in non-human animals - Published
- 2020
31. CPAP treatment, glycemia and diabetes risk in obstructive sleep apnea and comorbid cardiovascular disease
- Author
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SAVE substudy investigators, Luciano F. Drager, R. Doug McEvoy, Craig S. Anderson, Lyle J. Palmer, Xilong Zhang, Hooi Shan Yap, Sutapa Mukherjee, Nigel McArdle, Yuanming Luo, Geraldo Lorenzi-Filho, Zhihong Liu, Michael Hlavac, Rui Chen, Carolina C. Gonzaga Carvalho, Lia R. Bittencourt, Rosie Meng, Ruth Freed, Emma Heeley, and Kelly A. Loffler
- Subjects
respiratory tract diseases - Abstract
Objective: Despite evidence of a relationship between obstructive sleep apnea (OSA), metabolic dysregulation and diabetes mellitus (DM), it is uncertain whether OSA treatment can improve metabolic parameters. We sought to determine effects of long-term continuous positive airway pressure (CPAP) treatment on glycemic control and DM risk in patients with cardiovascular disease (CVD) and OSA. Research Design and Methods: Blood, medical history, and personal data were collected in a substudy of 888 participants in the Sleep Apnea Cardiovascular Endpoints (SAVE) trial in which patients with OSA and stable CVD were randomized to receive CPAP plus Usual Care, or Usual Care alone. Serum glucose and glycated hemoglobin A1c (HbA1c) were measured at baseline, and six months, two- and four years, and incident diabetes diagnoses recorded. Results: Median follow-up was 4.3 years. In those with pre-existing DM (n=274), there was no significant difference between CPAP and Usual Care groups in serum glucose, HbA1c or anti-diabetic medications during follow-up. There were also no significant between-group differences in participants with pre-diabetes (n=452), nor in new diagnoses of DM. Interaction testing suggested that women with diabetes did poorly in the Usual Care group while their counterparts on CPAP therapy remained stable. Conclusions: Among patients with established CVD and OSA, we found no evidence that CPAP therapy over several years affected glycemic control in those with diabetes or pre-diabetes, or DM risk over standard of care treatment. The potential differential effect according to sex deserves further investigation.
- Published
- 2020
32. WSO904913 Supplemental Material1 - Supplemental material for Sleep duration and risk of cardiovascular events: The SAVE study
- Author
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Jingwei Li, Zheng, Danni, Loffler, Kelly A, Wang, Xia, R Doug McEvoy, Woodman, Richard J, Yuanming Luo, Lorenzi-Filho, Geraldo, Barbe, Ferran, Tripathi, Manjari, and Anderson, Craig S
- Subjects
FOS: Clinical medicine ,Cardiology ,Medicine ,110904 Neurology and Neuromuscular Diseases - Abstract
Supplemental material, WSO904913 Supplemental Material1 for Sleep duration and risk of cardiovascular events: The SAVE study by Jingwei Li, Danni Zheng, Kelly A Loffler, Xia Wang, R Doug McEvoy, Richard J Woodman, Yuanming Luo, Geraldo Lorenzi-Filho, Ferran Barbe, Manjari Tripathi, Craig S Anderson and for the SAVE Investigators in International Journal of Stroke
- Published
- 2020
- Full Text
- View/download PDF
33. Protein O-mannosylation affects protein secretion, cell wall integrity and morphogenesis in Trichoderma reesei
- Author
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Guangya Zhao, Zhongfu Wang, Cheng Jin, Jinghua Yang, Shutao Sun, Haomiao Ouyang, Yueqiang Xu, and Yuanming Luo
- Subjects
Glycosylation ,Conidiation ,Biology ,Microbiology ,Mannosyltransferases ,Cell wall ,Fungal Proteins ,03 medical and health sciences ,Cell Wall ,Tandem Mass Spectrometry ,Genetics ,Morphogenesis ,Secretion ,Trichoderma reesei ,030304 developmental biology ,0303 health sciences ,030306 microbiology ,biology.organism_classification ,Transmembrane protein ,Cell biology ,carbohydrates (lipids) ,Protein Transport ,Secretory protein ,Phenotype ,Hypocreales ,Protein folding ,Intracellular - Abstract
Protein O-mannosyltransferases (PMTs) initiate O-mannosylation of proteins in the ER. Trichoderma reesei strains displayed a single representative of each PMT subfamily, Trpmt1, Trpmt2 and Trpmt4. In this work, two knockout strains ΔTrpmt1and ΔTrpmt4were obtained. Both mutants showed retarded growth, defective cell walls, reduced conidiation and decreased protein secretion. Additionally, the ΔTrpmt1strain displayed a thermosensitive growth phenotype, while the ΔTrpmt4 strain showed abnormal polarity. Meanwhile, OETrpmt2 strain, in which the Trpmt2 was over-expressed, exhibited increased conidiation, enhanced protein secretion and abnormal polarity. Using a lectin enrichment method and MS/MS analysis, 173 O-glycoproteins, 295 O-glycopeptides and 649 O-mannosylation sites were identified as the targets of PMTs in T. reesei. These identified O-mannoproteins are involved in various physiological processes such as protein folding, sorting, transport, quality control and secretion, as well as cell wall integrity and polarity. By comparing proteins identified in the mutants and its parent strain, the potential specific protein substrates of PMTs were identified. Based on our results, TrPMT1 is specifically involved inO-mannosylation of intracellular soluble proteins and secreted proteins, specially glycosidases. TrPMT2 is involved inO-mannosylation of secreted proteins and GPI-anchor proteins, and TrPMT4 mainly modifies multiple transmembrane proteins. The TrPMT1-TrPMT4 complex is responsible for O-mannosylation of proteins involved in cell wall integrity. Overexpression of TrPMT2 enhances protein secretion, which might be a new strategy to improve expression efficiency in T. reesei.
- Published
- 2019
34. High Risk Characteristics for Recurrent Cardiovascular Events among Patients with Obstructive Sleep Apnoea in the SAVE Study
- Author
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Yi Xiao, Sutapa Mukherjee, Riu Chen, Xia Wang, Kelly A. Loffler, Zhihong Liu, Xilong Zhang, Richard J. Woodman, Yuanming Luo, R. Douglas McEvoy, Craig S. Anderson, Manjari Tripathi, Danni Zheng, Qiang Li, Ferran Barbé, Weiwei Quan, Geraldo Lorenzi-Filho, and Hisatomi Arima
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Disease ,030204 cardiovascular system & hematology ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Latent class analysis ,Diabetes mellitus ,Internal medicine ,medicine ,Continuous positive airway pressure ,Stroke ,lcsh:R5-920 ,business.industry ,Proportional hazards model ,Sleep apnea ,General Medicine ,Cardiovascular disease ,medicine.disease ,Comorbidity ,respiratory tract diseases ,3. Good health ,Phenotype ,030228 respiratory system ,Obstructive sleep apnoea ,lcsh:Medicine (General) ,business ,Research Paper - Abstract
Background: Obstructive sleep apnoea (OSA) is a common comorbidity in patients with cardiovascular (CV) disease. We aimed to identify specific OSA clinical phenotypes relating to risks of serious CV events and response to continuous positive airway pressure (CPAP) treatment. Methods: Post-hoc analyses of the Sleep Apnea Cardiovascular Endpoints (SAVE) study in participants with moderate-to-severe OSA and coronary artery disease (CAD) and/or cerebrovascular disease (CeVD) randomised to CPAP plus usual care or usual care alone. Latent class analysis (LCA) was used to identify OSA clinical phenotypes among 2649 (out of 2687 total) patients with complete data on 19 patient-centered variables, supported by Bayesian information criteria and clinical interpretability. Cox regression models were used to evaluate risks of composite cardiac and stroke outcome events in phenotype groups. Preferential response to CPAP treatment was evaluated using interaction terms as well as the Chi-square test. Findings: LCA identified four OSA clinical phenotypes: CAD alone and with diabetes mellitus (CAD+DM), and CeVD alone and with DM (CeVD+DM), in 39%, 15%, 37% and 9% of participants, respectively. The rates of composite CV events were the highest in CAD+DM phenotype (HR 2.08, 95% CI 1.57–2.76) and for stroke were highest in CeVD+DM phenotype (HR 6.84, 95% CI 3.77–12.42). Adherence to CPAP treatment (nil or
- Published
- 2018
35. P180 Apnoea-hypopnoea-index comparing the AASM 2007 and 2012 criteria in COPD/obstructive sleep apnoea overlap syndrome
- Author
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Azza Farag Said, E Schwarz, M Sherif, Joerg Steier, Baiting He, Yuanming Luo, and Sean Higgins
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medicine.medical_specialty ,COPD ,business.industry ,Scoring criteria ,Overlap syndrome ,Retrospective cohort study ,medicine.disease ,Sleep medicine ,nervous system diseases ,respiratory tract diseases ,Interquartile range ,Internal medicine ,medicine ,In patient ,Apnoea Hypopnoea Index ,business - Abstract
Background In 2007 and 2012, the American Academy of Sleep Medicine (AASM) updated their scoring criteria for nocturnal respiratory events. We hypothesised that this could have led to changes in the apnoea-hypopnoea index (AHI) and thus diagnosis of COPD associated obstructive sleep apnoea (OSA) overlap syndrome. Patients and methods In a retrospective study, polysomnographical recordings (PSG) of 11 patients with COPD/OSA overlap syndrome were independently analysed using the AASM criteria from 2007 and 2012. The primary outcome was the difference in AHI between the AASM 2012 and the AASM 2007 recommended and alternative scoring rules, secondary outcomes were the percentage of hypopnoeas and the diagnosis of overlap syndrome. Data are presented as mean (standard deviation) if normally distributed, and as median (interquartile range) for non-normally distributed data. Results The PSG of 11 obese, elderly and predominantly male patients with mild-moderate COPD were analysed (table). The AHI using AASM 2007 (recommended) criteria was 12.9 (5.8, 16.9) h-1 vs 18.7 (11.3, 24.7) h-1 using the 2012 criteria (p Conclusion The AHI significantly increases when the AASM 2012 instead of 2007 criteria are used in patients with COPD/OSA overlap syndrome, in parts due to a higher number of arousal-associated hypopnoeas. These observations will impact on the definition of the COPD/OSA overlap syndrome.
- Published
- 2019
36. Tai Chi and Pulmonary Rehabilitation Compared for Treatment-Naive Patients With COPD
- Author
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Yingxin Wu, Bhavin Mehta, Yong-Yi Chen, Zhihui Qiu, Lian Zhou, Nanshan Zhong, Mei Jiang, Michael I. Polkey, Sheng-Peng Ye, Yu-Shan He, Meng-Duo Zhu, Baiting He, and Yuanming Luo
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Physical exercise ,Critical Care and Intensive Care Medicine ,law.invention ,Therapy naive ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,medicine ,Clinical endpoint ,Pulmonary rehabilitation ,030212 general & internal medicine ,COPD ,business.industry ,Minimal clinically important difference ,medicine.disease ,respiratory tract diseases ,030228 respiratory system ,Physical therapy ,Indacaterol ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Background In COPD, functional status is improved by pulmonary rehabilitation (PR) but requires specific facilities. Tai Chi, which combines psychological treatment and physical exercise and requires no special equipment, is widely practiced in China and is becoming increasingly popular in the rest of the world. We hypothesized that Tai Chi is equivalent (ie, difference less than ±4 St. George's Respiratory Questionnaire [SGRQ] points) to PR. Methods A total of 120 patients (mean FEV 1 , 1.11 ± 0.42 L; 43.6% predicted) bronchodilator-naive patients were studied. Two weeks after starting indacaterol 150 μg once daily, they randomly received either standard PR thrice weekly or group Tai Chi five times weekly, for 12 weeks. The primary end point was change in SGRQ prior to and following the exercise intervention; measurements were also made 12 weeks after the end of the intervention. Results The between-group difference for SGRQ at the end of the exercise interventions was –0.48 (95% CI PR vs Tai Chi, –3.6 to 2.6; P = .76), excluding a difference exceeding the minimal clinically important difference. Twelve weeks later, the between-group difference for SGRQ was 4.5 (95% CI, 1.9 to 7.0; P 1 was observed. Conclusions Tai Chi is equivalent to PR for improving SGRQ in COPD. Twelve weeks after exercise cessation, a clinically significant difference in SGRQ emerged favoring Tai Chi. Tai Chi is an appropriate substitute for PR. Trial Registry ClinicalTrials.gov; No.: NCT02665130; URL: www.clinicaltrials.gov.
- Published
- 2018
37. The acute effect of continuous positive airway pressure titration on blood pressure in awake overweight/obese patients with obstructive sleep apnoea
- Author
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Yuanming Luo, Joerg Steier, Michael I. Polkey, Gian Paolo Rossi, Sichang Xiao, Martino F. Pengo, Culadeeban Ratneswaran, John Moxham, Ratneswaran, C, Pengo, M, Xiao, S, Luo, Y, Rossi, G, Polkey, M, Moxham, J, and Steier, J
- Subjects
Adult ,Male ,obesity ,medicine.medical_specialty ,Sleep Apnea ,Time Factors ,medicine.medical_treatment ,Blood Pressure ,Acute effect ,030204 cardiovascular system & hematology ,urologic and male genital diseases ,Positive-Pressure Respiration ,03 medical and health sciences ,0302 clinical medicine ,stomatognathic system ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Hypertension ,cardiovascular ,sympathetic ,variability ,Female ,Middle Aged ,Obesity ,Sleep Apnea, Obstructive ,Wakefulness ,Continuous positive airway pressure ,Obstructive ,business.industry ,Continuous positive airway pressure titration ,Overweight obesity ,1103 Clinical Sciences ,General Medicine ,respiratory system ,Airway obstruction ,medicine.disease ,Sleep in non-human animals ,nervous system diseases ,respiratory tract diseases ,Blood pressure ,Cardiovascular System & Hematology ,030228 respiratory system ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
OBJECTIVES: Continuous positive airway pressure (CPAP) improves upper airway obstruction in patients with obstructive sleep apnoea (OSA), who often are overweight-obese. Although it is thought that CPAP improves long-term blood pressure control (BP), the impact of acute and short-term CPAP use on the cardiovascular system in obese patients has not been described in detail.METHODS: Obese patients (body mass index, BMI > 25 kg/m2) with OSA were studied awake, supine during incremental CPAP titration (4-20 cmH2O, +2 cmH2O/3 mins). BP was measured continuously with a beat-to-beat BP monitor (Ohmeda 2300, Finapres Medical Systems, Amsterdam/NL), BP variability (BPV) was calculated as the standard deviation of BP at each CPAP level, the 95% confidence interval (95%CI) was calculated and changes in BP and BPV were reported.RESULTS: 15 patients (12 male, 48 ± 10) years, BMI 38.9 ± 5.8 kg/m2) were studied; the baseline BP was 131.0 ± 10.2/85.1 ± 9.1 mmHg. BP and BPV increased linearly with CPAP titration (systolic BP r = 0.960, p CONCLUSION: Short-term incremental CPAP leads to significant increases in BP and BPV in obese patients with OSA while awake. Careful titration of pressures is required to minimise the risk of nocturnal awakenings while improving BP control.
- Published
- 2018
38. Increased respiratory neural drive and work of breathing in exercise-induced laryngeal obstruction
- Author
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Emil S. Walsted, Michael I. Polkey, Caroline J. Jolley, Laura L. Swanton, Azmy Faisal, James H. Hull, Matthew J Pavitt, Vibeke Backer, and Yuanming Luo
- Subjects
Adult ,Male ,Larynx ,Physiology ,respiratory neural drive ,Pilot Projects ,laryngeal disorders ,Exertional dyspnea ,Laryngeal Diseases ,03 medical and health sciences ,Work of breathing ,0302 clinical medicine ,Physiology (medical) ,work of breathing ,Humans ,Medicine ,Prospective Studies ,Respiratory system ,030223 otorhinolaryngology ,Laryngoscopy ,exercise ,Electromyography ,business.industry ,11 Medical And Health Sciences ,06 Biological Sciences ,Laryngeal Obstruction ,Laryngeal Disorder ,Dyspnea ,medicine.anatomical_structure ,Inhalation ,030228 respiratory system ,Case-Control Studies ,Anesthesia ,Breathing ,Female ,business ,Research Article - Abstract
Exercise-induced laryngeal obstruction (EILO), a phenomenon in which the larynx closes inappropriately during physical activity, is a prevalent cause of exertional dyspnea in young individuals. The physiological ventilatory impact of EILO and its relationship to dyspnea are poorly understood. The objective of this study was to evaluate exercise-related changes in laryngeal aperture on ventilation, pulmonary mechanics, and respiratory neural drive. We prospectively evaluated 12 subjects (6 with EILO and 6 healthy age- and gender-matched controls). Subjects underwent baseline spirometry and a symptom-limited incremental exercise test with simultaneous and synchronized recording of endoscopic video and gastric, esophageal, and transdiaphragmatic pressures, diaphragm electromyography, and respiratory airflow. The EILO and control groups had similar peak work rates and minute ventilation (V̇e) (work rate: 227 ± 35 vs. 237 ± 35 W; V̇e: 103 ± 20 vs. 98 ± 23 l/min; P > 0.05). At submaximal work rates (140–240 W), subjects with EILO demonstrated increased work of breathing ( P < 0.05) and respiratory neural drive ( P < 0.05), developing in close temporal association with onset of endoscopic evidence of laryngeal closure ( P < 0.05). Unexpectedly, a ventilatory increase ( P < 0.05), driven by augmented tidal volume ( P < 0.05), was seen in subjects with EILO before the onset of laryngeal closure; there were however no differences in dyspnea intensity between groups. Using simultaneous measurements of respiratory mechanics and diaphragm electromyography with endoscopic video, we demonstrate, for the first time, increased work of breathing and respiratory neural drive in association with the development of EILO. Future detailed investigations are now needed to understand the role of upper airway closure in causing exertional dyspnea and exercise limitation. NEW & NOTEWORTHY Exercise-induced laryngeal obstruction is a prevalent cause of exertional dyspnea in young individuals; yet, how laryngeal closure affects breathing is unknown. In this study we synchronized endoscopic video with respiratory physiological measurements, thus providing the first detailed commensurate assessment of respiratory mechanics and neural drive in relation to laryngeal closure. Laryngeal closure was associated with increased work of breathing and respiratory neural drive preceded by an augmented tidal volume and a rise in minute ventilation.
- Published
- 2018
39. Identifying bronchoconstriction from the ratio of diaphragm EMG to tidal volume
- Author
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Joerg Steier, Caroline J. Jolley, Baiting He, Michael L. Polkey, Li-Shuang Wang, Yuanming Luo, Ying-Mei Luo, Yong-Yi Chen, and John Moxham
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,Spirometry ,medicine.medical_specialty ,Adolescent ,Physiology ,Bronchoconstriction ,Diaphragm ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Tidal Volume ,medicine ,Humans ,Respiratory system ,Tidal volume ,Aged ,Asthma ,medicine.diagnostic_test ,Electromyography ,business.industry ,General Neuroscience ,Middle Aged ,medicine.disease ,Histamine Challenge Test ,Bronchodilator Agents ,respiratory tract diseases ,Diaphragm (structural system) ,030228 respiratory system ,Cardiology ,Female ,Bronchial challenge test ,Bronchial Hyperreactivity ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Histamine - Abstract
A fall of ≥ 20 % in forced expiratory volume in the first second (FEV1) with a cumulative dose of histamine ≤ 7.8 μmol is considered to indicate bronchial hyperactivity, but no method exists for patients who cannot perform spirometry properly. Here we hypothesized that increases in respiratory central output measured by chest wall electromyography of the diaphragm (EMGdi-c) expressed as a function of tidal volume (EMGdi-c/VT) would have discriminative power to detect a 'positive' challenge test.In a physiological study EMGdi was recorded from esophageal electrode (EMGdi-e) in 16 asthma patients and 16 healthy subjects during a histamine challenge test. In a second study, EMGdi from chest wall surface electrodes (EMGdi-c) was measured during a histamine challenge in 44 asthma patients and 51 healthy subjects. VT was recorded from a digital flowmeter during both studies.With histamine challenge test the change in EMGdi-e/VT in patients with asthma was significantly higher than that in healthy subjects (104.2 % ± 48.6 % vs 0.03 % ± 17.1 %, p0.001). Similarly there was a significant difference in the change of EMGdi-c/VT between patients with asthma and healthy subjects (90.5 % ± 75.5 % vs 2.4 % ± 21.7 %, p0.001). At the optimal cut-off point (29 % increase in EMGdi-c/VT), the area under the ROC curve (AUC) for detection of a positive test was 0.91 (p0.001) with sensitivity 86 % and specificity 92 %.We conclude that EMGdi-c/VT may be used as an alternative for the assessment of bronchial hypersensitivity and airway reversibility to differentiate patients with asthma from healthy subjects.
- Published
- 2021
40. Coexistence of OSA may compensate for sleep related reduction in neural respiratory drive in patients with COPD
- Author
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Rui Chen, Joerg Steier, Baiting He, John Moxham, Yuanming Luo, Michael I. Polkey, Gan Lu, and Sichang Xiao
- Subjects
Male ,NREM SLEEP ,Respiratory System ,EMPHYSEMA ,Polysomnography ,Sleep apnoea ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Airway resistance ,Tidal volume ,Sleep Apnea, Obstructive ,COPD ,medicine.diagnostic_test ,Overlap syndrome ,Syndrome ,Middle Aged ,Respiratory Muscles ,PREVALENCE ,Respiratory Function Tests ,Hypoventilation ,NOCTURNAL DESATURATION ,Anesthesia ,Breathing ,Female ,medicine.symptom ,Life Sciences & Biomedicine ,Pulmonary and Respiratory Medicine ,APNEA-HYPOPNEA ,Diaphragm ,OBSTRUCTIVE PULMONARY-DISEASE ,Non-rapid eye movement sleep ,COPD ÀÜ Mechanisms ,03 medical and health sciences ,medicine ,Humans ,OXYGEN DESATURATION ,Science & Technology ,Electromyography ,business.industry ,UPPER AIRWAY ,1103 Clinical Sciences ,medicine.disease ,respiratory tract diseases ,030228 respiratory system ,OVERLAP SYNDROME ,Sleep ,business ,030217 neurology & neurosurgery - Abstract
Background The mechanisms underlying sleep-related hypoventilation in patients with coexisting COPD and obstructive sleep apnoea (OSA), an overlap syndrome, are incompletely understood. We compared neural respiratory drive expressed as diaphragm electromyogram (EMGdi) and ventilation during stage 2 sleep in patients with COPD alone and patients with overlap syndrome. Methods EMGdi and airflow were recorded during full polysomnography in 14 healthy subjects, 14 patients with OSA and 39 consecutive patients with COPD. The ratio of tidal volume to EMGdi was measured to indirectly assess upper airway resistance. Results Thirty-five patients with COPD, 12 healthy subjects and 14 patients with OSA completed the study. Of 35 patients with COPD, 19 had COPD alone (FEV1 38.5%±16.3%) whereas 16 had an overlap syndrome (FEV1 47.5±16.2%, AHI 20.5±14.1 events/hour). Ventilation (VE) was lower during stage 2 sleep than wakefulness in both patients with COPD alone (8.6±2.0 to 6.5±1.5 L/min, p
- Published
- 2016
41. Rice Plasma Membrane Proteomics Reveals Magnaporthe oryzae Promotes Susceptibility by Sequential Activation of Host Hormone Signaling Pathways
- Author
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Qingyun Bu, Lingjuan Li, Gui-Xian Xia, Jidong Cao, Chao Yang, Yao Wu, Chuanwan Wu, Lan Jiang, Yuanming Luo, Xiaoyun Liu, and Jun Liu
- Subjects
Proteomics ,0301 basic medicine ,Physiology ,Biology ,Fungal Proteins ,03 medical and health sciences ,chemistry.chemical_compound ,Plant Growth Regulators ,Downregulation and upregulation ,Sugar transporter ,Abscisic acid ,Gene ,Disease Resistance ,Plant Diseases ,Cell Membrane ,food and beverages ,Oryza ,General Medicine ,Magnaporthe ,Transmembrane domain ,030104 developmental biology ,Biochemistry ,chemistry ,Proteome ,Signal transduction ,Agronomy and Crop Science ,Abscisic Acid ,Signal Transduction - Abstract
Plant plasma membrane (PM) plays important roles in immune response. Here, we utilized quantitative mass spectrometry to explore rice PM protein composition and dynamic changes during Magnaporthe oryzae infection. We report, thus far, the largest rice PM proteome dataset with 3,906 identified proteins, among which 484 proteins were differentially expressed after M. oryzae infection. One third of the identified proteins are predicted to have at least one transmembrane domain. Half of the identified proteins are predicted to have binding functions and over one third of the proteins have enzyme-related functions. In addition, Gene Ontology analyses revealed that abscisic acid (ABA) and cytokinin (CK) signaling were sequentially activated after M. oryzae infection in rice. We found that the activation of ABA signaling and the suppression of rice immune response occurred at the early infection stage, while the activation of CK signaling, the upregulation of sugar transporter genes expression, and the nutrient efflux of infected rice cells occurred at later infection stage. Thus, we further propose that M. oryzae activates ABA signaling to repress rice immune signaling for initial invasion and redirects nutrient efflux of infected cells for massive growth at the later infection stage.
- Published
- 2016
42. Insight into Enzymatic Degradation of Corn, Wheat, and Soybean Cell Wall Cellulose Using Quantitative Secretome Analysis of Aspergillus fumigatus
- Author
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Cheng Jin, Bo Shi, Yuanming Luo, Haomiao Ouyang, Yang Lu, Qian Wang, Jinghua Yang, and Prakriti Sharma Ghimire
- Subjects
0301 basic medicine ,Glycoside Hydrolases ,030106 microbiology ,Lignin ,Zea mays ,Biochemistry ,Aspergillus fumigatus ,Microbiology ,Cell wall ,03 medical and health sciences ,chemistry.chemical_compound ,Glycoside hydrolase ,Cellulose ,skin and connective tissue diseases ,Gene ,Triticum ,chemistry.chemical_classification ,biology ,Physiological condition ,food and beverages ,General Chemistry ,biology.organism_classification ,Animal Feed ,030104 developmental biology ,Enzyme ,chemistry ,Soybeans ,Enzymatic degradation - Abstract
Lignocelluloses contained in animal forage cannot be digested by pigs or poultry with 100% efficiency. On contrary, Aspergillus fumigatus, a saprophytic filamentous fungus, is known to harbor 263 glycoside hydrolase encoding genes, suggesting that A. fumigatus is an efficient lignocellulose degrader. Hence the present study uses corn, wheat, or soybean as a sole carbon source to culture A. fumigatus under animal physiological condition to understand how cellulolytic enzymes work together to achieve an efficient degradation of lignocellulose. Our results showed that A. fumigatus produced different sets of enzymes to degrade lignocelluloses derived from corn, wheat, or soybean cell wall. In addition, the cellulolytic enzymes produced by A. fumigatus were stable under acidic condition or at higher temperatures. Using isobaric tags for a relative and absolute quantification (iTRAQ) approach, a total of ∼600 extracellular proteins were identified and quantified, in which ∼50 proteins were involved in lignocellulolysis, including cellulases, hemicellulases, lignin-degrading enzymes, and some hypothetical proteins. Data are available via ProteomeXchange with identifier PXD004670. On the basis of quantitative iTRAQ results, 14 genes were selected for further confirmation by RT-PCR. Taken together, our results indicated that the expression and regulation of lignocellulolytic proteins in the secretome of A. fumigatus were dependent on both nature and complexity of cellulose, thus suggesting that a different enzyme system is required for degradation of different lignocelluloses derived from plant cells. Although A. fumigatus is a pathogenic fungus and cannot be directly used as an enzyme source, as an efficient lignocellulose degrader its strategy to synergistically degrade various lignocelluloses with different enzymes can be used to design enzyme combination for optimal digestion and absorption of corn, wheat, or soybean that are used as forage of pig and poultry.
- Published
- 2016
43. Genetical and O-glycoproteomic analyses reveal the roles of three protein O-mannosyltransferases in phytopathogen Fusarium oxysporum f.sp. cucumerinum
- Author
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Yuanming Luo, Yueqiang Xu, Shaojie Li, Cheng Jin, Shutao Sun, Zhongfu Wang, Guangya Zhao, Hui Zhou, and Jinghua Yang
- Subjects
Signal peptide ,Crops, Agricultural ,Protein Folding ,Mutant ,Genes, Fungal ,Conidiation ,Biology ,Microbiology ,Mannosyltransferases ,Fungal Proteins ,03 medical and health sciences ,Fusarium ,Cell Wall ,Fusarium oxysporum ,Genetics ,Nuclear protein ,030304 developmental biology ,Plant Diseases ,0303 health sciences ,Organisms, Genetically Modified ,Virulence ,030306 microbiology ,food and beverages ,Spores, Fungal ,biology.organism_classification ,Fusarium wilt ,Cell biology ,Secretory protein ,Phenotype ,Membrane protein ,Seeds ,Cucumis sativus ,Gene Deletion - Abstract
Protein O-mannosyltransferases (PMTs) have been identified in fungi but not in plants and nematodes, which makes PMTs become attractive targets for developing a new strategy against phytopathogens. Three PMTs have been identified in Fusarium oxysporum, a fungal pathogen that causes vascular wilt in a broad range of economical crops. By deletion or suppression of the pmt genes, we showed that all mutants displayed retarded growth, reduced conidiation, cell wall defects, ER stress and attenuated virulence in F. oxysporum f.sp. cucumerinum. In addition, the Δpmt1 exhibited reduced thermotolerance, while the Δpmt4 and the pmt2 conditional mutant exhibited abnormal polarized growth. Comparative glycoproteome analysis of these pmt mutants revealed that PMTs preferentially modified random coils with flanking regions rich in Ser, Thr, Ala, Glu, Asp and Lys at the stem region of membrane proteins, the N-terminal region close to signal peptide of secreted proteins, or surface of soluble proteins. PMT1 specifically acted on nuclear proteins and proteins that are responsible for protein folding, which might contribute to thermotolerance. PMT4 specifically acted on the membrane and soluble proteins in secretory pathways, especially the GPI anchoring pathway, which might contribute to synthesis and transportation of GPI anchored proteins and thus polarized growth. PMT2 was responsible for modification of proteins that are required for protein folding and cell wall synthesis, which might make PMT2 essential. Our results gave an insight to understanding of the roles of each O-mannosyltransferase in F. oxysporum f.sp. cucumerinum and provide a new perspective to prevent Fusarium wilt.
- Published
- 2019
44. Effect of Continuous Positive Airway Pressure on Blood Pressure in Obstructive Sleep Apnea with Cardiovascular Disease
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Danni Zheng, Geraldo Lorenzi-Filho, R. Doug McEvoy, Yuanming Luo, Weiwei Quan, Emer Van Ryswyk, Craig S. Anderson, Ferran Barbé, Kelly A. Loffler, and Ji-Guang Wang
- Subjects
Pulmonary and Respiratory Medicine ,Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Blood Pressure ,Disease ,Critical Care and Intensive Care Medicine ,Risk Factors ,Internal medicine ,medicine ,Humans ,Continuous positive airway pressure ,Aged ,Aged, 80 and over ,Sleep Apnea, Obstructive ,Continuous Positive Airway Pressure ,business.industry ,Sleep apnea ,Middle Aged ,medicine.disease ,Obstructive sleep apnea ,Blood pressure ,Cardiovascular Diseases ,Cardiology ,Female ,business - Published
- 2019
45. Local properties and rupture characteristics of thoracic aortic aneurysm tissue
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Yuanming Luo
- Subjects
medicine.medical_specialty ,business.industry ,medicine ,Radiology ,medicine.disease ,business ,Thoracic aortic aneurysm - Published
- 2018
46. Characteristics of thoracic aortic aneurysm rupture in vitro
- Author
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Jia Lu, Stéphane Avril, Yuanming Luo, Ambroise Duprey, Department of mechanical and industrial engineering University of Iowa, University of Iowa [Iowa City], Service de chirurgie cardiovasculaire CHU de Saint-Etienne, INSERM U1059, SAINBIOSE - Santé, Ingénierie, Biologie, Saint-Etienne (SAINBIOSE-ENSMSE), Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Ingénierie et Santé (CIS-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Université de Lyon, LOCURTO, Valérie, Centre Ingénierie et Santé (CIS-ENSMSE), and Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Subjects
Male ,medicine.medical_specialty ,Materials science ,Thoracic Aortic Aneurysms ,Aortic Rupture ,0206 medical engineering ,Biomedical Engineering ,Rupture stress ,Strain (injury) ,02 engineering and technology ,Dissection (medical) ,030204 cardiovascular system & hematology ,Biochemistry ,Thoracic aortic aneurysm ,Biomaterials ,Stress (mechanics) ,03 medical and health sciences ,0302 clinical medicine ,Tensile Strength ,[SPI.MECA.BIOM] Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph] ,medicine.artery ,medicine ,Humans ,Molecular Biology ,Aged ,Aged, 80 and over ,Rupture ,Aorta ,Aortic Aneurysm, Thoracic ,[SPI.MECA.BIOM]Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph] ,Stiffness ,General Medicine ,Middle Aged ,medicine.disease ,020601 biomedical engineering ,Biomechanical Phenomena ,Surgery ,Rupture pattern ,Energy density ,Female ,Stress, Mechanical ,Toughness ,Deformation (engineering) ,medicine.symptom ,Biotechnology ,Biomedical engineering - Abstract
Ascending thoracic aortic aneurysms (ATAAs) are focal dilatations in the aorta that are prone to rupture or dissection. To accurately evaluate the rupture risk, one must know the local mechanical conditions at the rupture site and understand how rupture is triggered in a layered fibrous media. A challenge facing experimental studies of ATAA rupture is that the ATAA tissue is highly heterogeneous; experimental protocols that operate under the premise of tissue homogeneity will have difficulty delineating the location conditions. In this work, we employed a previously established pointwise identification method to characterize wall stress, strain, and property distributions to a sub-millimeter resolution. Based on the acquired field data, we obtained the local mechanical properties at the rupture site in nine ATAA tissue samples. The rupture stress, ultimate strain, energy density, and the toughness of the tested samples were also reported. Our results show that the direction of the rupture is aligned with the direction of maximum stiffness, indicating that higher stiffness is not always related to higher strength. It was also found that the rupture generally occurs at a location of highest stored energy. As a higher stiffness and higher strain energy indicate a larger recruitment of collagen fibers in the tissue at the location and along the direction of rupture, the recruitment of collagen fibers in the deformation of the tissue is probably essential in ATAA rupture.A major challenge in the experimental study of aneurysm properties is that the tissues are heterogeneous. When the specimens are not reasonably homogeneous, traditional tests that work under the premise of tissue homogeneity cannot reliably delineate the local conditions at the rupture site. In this work, we investigated the local characteristics of rupture of human ascending aortic aneurysm tissue. We identified the stress, strain, and elastic properties to a submillimeter resolution. Based on the field values, we determined the local conditions - elastic properties, direction of maximum stiffness, stress, strain, energy consumption - at the rupture site. It was found that the tissues consistently cleave in the direction of the maximum stiffness, and generally occurs at the location of highest energy. Since a higher stiffness and higher strain energy indicate a larger recruitment of collagen fibers in the tissue at the location and along the direction of rupture, the work suggests that the recruitment of collagen fibers in the deformation of the tissue is probably essential in aneurysm rupture.
- Published
- 2016
47. Solving membrane stress on deformed configuration using inverse elastostatic and forward penalty methods
- Author
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Yuanming Luo and Jia Lu
- Subjects
Determinacy ,Property (programming) ,Continuum (topology) ,Mechanical Engineering ,0206 medical engineering ,Mathematical analysis ,Constitutive equation ,Computational Mechanics ,General Physics and Astronomy ,Inverse ,02 engineering and technology ,020601 biomedical engineering ,Computer Science Applications ,Stress (mechanics) ,020303 mechanical engineering & transports ,0203 mechanical engineering ,Mechanics of Materials ,Penalty method ,Sensitivity (control systems) ,Mathematics - Abstract
Wall stress in a curved membrane depends on the surface geometry and applied load, not the constitutive law of the wall material (static determinacy). This remarkable property suggests that the membrane stress can be determined without knowing of the material property. Being able to determine the wall stress without material knowledge is practically significant in numerous applications, particularly in in vivo biomedical stress analysis wherein patient-specific tissue properties are extremely difficult to obtain. In this article, we present two non-traditional methods that utilize the static determinacy to compute the membrane stress. A common theme is to start with a deformed configuration and use artificial material models. In one of these approaches, the equilibrium problem is formulated as an inverse elastostatic problem whereby the stress is determined by way of finding a (fictitious) reference configuration. The other approach utilizes the standard forward analysis, but in a penalty setting using artificially stiff material models. A continuum sensitivity analysis is implemented to quantitatively assess the influence of material parameters. These developments open new pathways of membrane analysis enabling stress prediction without using realistic material parameters. Numerical examples are provided to demonstrate and compare these two methods.
- Published
- 2016
48. mTORC2 promotes type I insulin-like growth factor receptor and insulin receptor activation through the tyrosine kinase activity of mTOR
- Author
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Ting Luo, Qian Wang, Minjing Li, Yancun Yin, Shu Liu, Jiao Wang, Yangfu Jiang, Hui Hua, Qingbin Kong, Yuanming Luo, and Ting Shao
- Subjects
0301 basic medicine ,endocrine system ,Mechanistic Target of Rapamycin Complex 2 ,mTORC1 ,Biology ,mTORC2 ,Receptor, IGF Type 1 ,03 medical and health sciences ,chemistry.chemical_compound ,Cell Line, Tumor ,Humans ,Phosphorylation ,Kinase activity ,Molecular Biology ,PI3K/AKT/mTOR pathway ,Cell Proliferation ,Sirolimus ,TOR Serine-Threonine Kinases ,RPTOR ,nutritional and metabolic diseases ,Tyrosine phosphorylation ,Hep G2 Cells ,Cell Biology ,Protein-Tyrosine Kinases ,Receptor, Insulin ,Insulin receptor ,HEK293 Cells ,Rapamycin-Insensitive Companion of mTOR Protein ,030104 developmental biology ,chemistry ,Multiprotein Complexes ,Cancer research ,biology.protein ,Tyrosine ,Original Article ,Carrier Proteins ,Tyrosine kinase ,hormones, hormone substitutes, and hormone antagonists - Abstract
Mammalian target of rapamycin (mTOR) is a core component of raptor-mTOR (mTORC1) and rictor-mTOR (mTORC2) complexes that control diverse cellular processes. Both mTORC1 and mTORC2 regulate several elements downstream of type I insulin-like growth factor receptor (IGF-IR) and insulin receptor (InsR). However, it is unknown whether and how mTOR regulates IGF-IR and InsR themselves. Here we show that mTOR possesses unexpected tyrosine kinase activity and activates IGF-IR/InsR. Rapamycin induces the tyrosine phosphorylation and activation of IGF-IR/InsR, which is largely dependent on rictor and mTOR. Moreover, mTORC2 promotes ligand-induced activation of IGF-IR/InsR. IGF- and insulin-induced IGF-IR/InsR phosphorylation is significantly compromised in rictor-null cells. Insulin receptor substrate (IRS) directly interacts with SIN1 thereby recruiting mTORC2 to IGF-IR/InsR and promoting rapamycin- or ligand-induced phosphorylation of IGF-IR/InsR. mTOR exhibits tyrosine kinase activity towards the general tyrosine kinase substrate poly(Glu-Tyr) and IGF-IR/InsR. Both recombinant mTOR and immunoprecipitated mTORC2 phosphorylate IGF-IR and InsR on Tyr1131/1136 and Tyr1146/1151, respectively. These effects are independent of the intrinsic kinase activity of IGF-IR/InsR, as determined by assays on kinase-dead IGF-IR/InsR mutants. While both rictor and mTOR immunoprecitates from rictor(+/+) MCF-10A cells exhibit tyrosine kinase activity towards IGF-IR and InsR, mTOR immunoprecipitates from rictor(-/-) MCF-10A cells do not induce IGF-IR and InsR phosphorylation. Phosphorylation-deficient mutation of residue Tyr1131 in IGF-IR or Tyr1146 in InsR abrogates the activation of IGF-IR/InsR by mTOR. Finally, overexpression of rictor promotes IGF-induced cell proliferation. Our work identifies mTOR as a dual-specificity kinase and clarifies how mTORC2 promotes IGF-IR/InsR activation.
- Published
- 2015
49. Laryngeal laser surgery reduces neural respiratory drive and work of breathing in exercise-induced laryngeal obstruction
- Author
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Matthew J Pavitt, Vibeke Backer, Emil S. Walsted, Michael I. Polkey, James H. Hull, Yuanming Luo, and Azmy Faisal
- Subjects
Laser surgery ,business.industry ,medicine.medical_treatment ,Respiratory physiology ,Laryngeal Obstruction ,Incremental exercise ,03 medical and health sciences ,Work of breathing ,0302 clinical medicine ,030228 respiratory system ,Control of respiration ,Anesthesia ,Breathing ,Medicine ,030212 general & internal medicine ,Respiratory system ,business - Abstract
Background: Exercise induced laryngeal obstruction (EILO) is a prevalent cause of exertional dyspnoea and is associated with increased neural respiratory drive (NRD) and work of breathing. Laser surgery can be effective in reducing supra-glottic obstruction and EILO symptoms, however little is known about the physiological impact of this treatment. Case description: We described detailed physiological assessments of laser surgery in two patients with severe EILO: a 31-year old male elite cyclist and a 44-year old female recreational athlete. Prior treatment included optimization of co-morbidities and breathing re-training. Both patients underwent a symptom-limited incremental exercise test with simultaneous and synchronised laryngoscopic video, gastric-, oesophageal- and trans-diaphragmatic pressures, diaphragm electromyography and respiratory airflow to delineate how the condition impacted on respiratory mechanics and NRD. These physiological measures were repeated postoperatively within six months. Results: Surgical intervention led to a marked improvement in peak power, dyspnoea intensity, respiratory mechanics and a reduction of neural respiratory drive (fig. 1). Conclusion: In this small case series, supraglottopasty for severe EILO was associated with a reduction in NRD and respiratory work and this provides a physiological basis for the clinical outcomes reported from this intervention.
- Published
- 2018
50. Histamine challenge test assessed by the ratio of diaphragm EMG recorded from surface electrodes to tidal volume
- Author
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Ying-Mei Luo, Baiting He, Yingxin Wu, John Moxham, Joerg Steier, Caroline J. Jolley, Michael I. Polkey, and Yuanming Luo
- Subjects
medicine.medical_specialty ,Respiratory rate ,medicine.diagnostic_test ,business.industry ,Histamine Challenge Test ,respiratory tract diseases ,Diaphragm (structural system) ,chemistry.chemical_compound ,Airway resistance ,chemistry ,Internal medicine ,Cardiology ,medicine ,Bronchial challenge test ,Respiratory system ,business ,Tidal volume ,Histamine - Abstract
The magnitude of tidal volume (VT) depends on neural respiratory drive overcoming respiratory resistance. We hypothesized that the ratio of EMGdi, an index of neural drive, to VT could detect histamine induced changes in lower airway resistance given the assumption that respiratory resistance (except for the lower airway resistance) is unaffected by histamine. Conventional histamine challenge tests were undertaken in 44 asthma patients (age 47±14 years; FEV1% 76±14) diagnosed by a history of repeated attack of asthma and positive bronchial challenge test and 51 healthy subjects (age 36 ± 13 years; FEV1% 96 ± 11). Diaphragm EMG was recorded from chest wall surface electrodes (EMGdi) under the fixed breathing frequency (18 times/min.) and an additional inspiratory load to improve a signal–noise ratio. Airflow was recorded with a digital output flowmeter. ΔFEV1 correlated with ΔEMGdi /VT (r=0.63). Corresponding to ≥20% fall in FEV1 during histamine challenge test, change in EMGdi/VT in patients with asthma was significantly higher than that in healthy subjects who received maximal dose (7.8 µmol) of histamine (90.5% ± 75.5% vs 2.4% ± 21.7%, p
- Published
- 2018
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