ABSTRACT: COPD has a variable natural history and not all individuals follow the same course. The aim of this study was to assess the prevalence of COPD in the absence of chronic bronchitis (CB) based on a population survey in China, and to identify the determinants of CB in patients with COPD.
A multi-stage cluster sampling strategy was used to survey a population from seven different provinces/cities of China. All residents over 40 years of age were interviewed using a standardized questionnaire and spirometry was measured. A post-bronchodilator FEV(1)/FVC < 70% was defined as the diagnostic criterion for COPD. All COPD patients who were screened were divided into two groups according to the presence or absence of CB.
Of the population of 20,245 that was surveyed, 70% of the 1668 patients who were diagnosed with COPD reported no history of CB. The ages, BMI and comorbidities of COPD patients with or without CB were similar. Male gender, residence in a rural area, having a lower level of education, exposure to tobacco smoke or biomass fuels, poor ventilation in the kitchen and a family history of respiratory disease were all associated with a higher risk of COPD with CB. Patients without CB had less difficulty in walking and higher FEV(1)/FVC values than patients with CB, but were more likely to be underdiagnosed. The strongest predictors of CB were male gender, current smoking and severity of dyspnoea.
This survey confirmed that there is a high prevalence of COPD in the absence of CB in China. It appears that CB is not essential to the diagnosis of COPD.
Respirology 10/2010; 15(7):1072-8. · 2.42 Impact Factor
ABSTRACT: The prevalence of chronic obstructive pulmonary disease (COPD) in China is largely unknown.
To obtain the COPD prevalence in China through a large-population, spirometry-based, cross-sectional survey of COPD.
Urban and rural population-based cluster samples were randomly selected from seven provinces/cities. All residents 40 years of age or older in the selected clusters were interviewed with a standardized questionnaire revised from the international BOLD (Burden of Obstructive Lung Diseases) study. Spirometry was performed on all eligible participants. Patients with airflow limitation (FEV(1)/FVC < 0.70) were further examined by post-bronchodilator spirometry, chest radiograph, and electrocardiogram. Post-bronchodilator FEV(1)/FVC of less than 70% was defined as the diagnostic criterion of COPD.
Among 25,627 sampling subjects, 20,245 participants completed the questionnaire and spirometry (response rate, 79.0%). The overall prevalence of COPD was 8.2% (men, 12.4%; women, 5.1%). The prevalence of COPD was significantly higher in rural residents, elderly patients, smokers, in those with lower body mass index, less education, and poor ventilation in the kitchen, in those who were exposed to occupational dusts or biomass fuels, and in those with pulmonary problems in childhood and family history of pulmonary diseases. Among the patients who had COPD, 35.3% were asymptomatic; only 35.1% reported lifetime diagnosis of bronchitis, emphysema, or other COPD; and only 6.5% have been tested with spirometry.
COPD is prevalent in individuals 40 years of age or older in China.
American Journal of Respiratory and Critical Care Medicine 11/2007; 176(8):753-60. · 11.08 Impact Factor
ABSTRACT: To observe and explore the effects and mechanisms of fibronectin (FN) on invasion of different types of lung cancers.
Using tumor invasion models in vitro of plates coated with FN and Boyden chambers with FN filter, differences of adhesion and migration between small cell lung cancer cell line (054A) and adenocarcinoma cell line (A549) were investigated, and proliferative effects of FN on cells were examined. In the meantime the invasive capability changes were observed after cell suspensions were preincubated with anti-α5, anti-α3 and anti-β1 integrin antibodies, respectively.
FN could improve the adhesion, migration and proliferation of A549 more markedly than that of 054A. The number of adhesive cells in A549 cell line changed from 34.7± 5.1 to 189.4±12.3 with time from 2h to 12h compared with that from 19.8±7.9 to 159.2±11.9 in 054A cell line (P < 0.05 or P < 0.01). A549 cell line had 142.7±5.9 migration cells while 054A cell line had 89.4±4.7 (P < 0.01). FN could improved the proliferation in A549 cell line from 0.250±0.019 to 0.754±0.025 (P < 0.01) in concentration-dependent way, but in 054A from 0.205±0.026 to 0.286±0.029. And these effects were mediated mainly by α3β1 and α5β1 receptors in A549, but α3β1 in 054A.
Lung cancers with different origins express so different types and extents of integrin receptors that effects of FN on tumors are various, which is one of important reasons of different invasive capability of lung cancers.
Zhongguo fei ai za zhi = Chinese journal of lung cancer 04/2004; 7(2):130-3.