Zong-An Liang

Sichuan University, Hua-yang, Sichuan, China

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Publications (18)94.91 Total impact

  • Pei-Jun Li · Zong-An Liang · Ping Fu · Yuan Feng

    No preview · Article · Jan 2016 · The journal of vascular access
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    ABSTRACT: The purpose of our indirect comparison was to explore the optimal switching time to noninvasive ventilation for further weaning in patients with chronic obstructive pulmonary disease (COPD) undergoing invasive mechanical ventilation. A comprehensive literature search was performed to identify randomized controlled trials comparing noninvasive weaning at spontaneous breathing trial (SBT) failure after meeting simple weaning criteria or at the pulmonary infection control window (PIC window) with conventional invasive weaning in COPD patients. Using conventional invasive weaning as a bridge, we indirectly compared the two noninvasive weaning strategies using the Bucher approach. Noninvasive weaning at SBT failure after meeting simple weaning criteria was associated with an extended duration of endotracheal mechanical ventilation (standardized mean difference 1.90, 95% CI 1.27–2.53, P < 0.001) compared with noninvasive weaning at the PIC window. No significant differences in mortality or the rate of ventilator-associated pneumonia were observed. Our study suggests that the PIC window may be a promising switching time for noninvasive weaning in COPD patients.
    No preview · Article · Jan 2016 · Heart and Lung The Journal of Acute and Critical Care
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    ABSTRACT: Background: Assist/control (A/C) ventilation may induce delirium in patients with acute respiratory distress syndrome (ARDS). We conducted a trial to determine whether initial synchronized intermittent mandatory ventilation with pressure support (SIMV + PS) could improve clinical outcomes in these patients. Methods: Intubated patients with moderate ARDS were enrolled and we compared SIMV + PS with A/C. Identical sedation, analgesia and ventilation strategies were performed. The co-primary outcomes were early (≤72 h) partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) and incidence of delirium. The secondary outcomes were all-cause in-hospital mortality, dosages of analgesics and sedatives, incidence of patient-ventilator asynchrony, and duration of mechanical ventilation and hospital stay. Results: We screened 2,684 patients and 40 patients were enrolled in our study. In SIMV + PS, early (≤72 h) PaO2/FiO2 was greater improved than that at baseline and that in A/C (P<0.05) with lower positive end-expiratory pressure (PEEP) (8.7±3.0 vs. 10.3±3.2, P<0.001) and FiO2 (58%±18% vs. 67%±19%, P<0.001). We found more SIMV + PS success (defined as SIMV + PS successfully applied without switching to A/C) (100.0% vs. 16.7%, P<0.001), less male (46.3% vs. 85.7%, P=0.015) and pulmonary etiology of ARDS (53.8% vs. 92.9%, P=0.015), and lower PEEP (9.1±3.1 vs. 10.3±3.3, P=0.004) and FiO2 (58%±19% vs. 71%±19%, P<0.001) in survival patients. However, there were no significant differences in incidence of delirium and mortality, dosages of analgesics and sedatives, incidence of patient-ventilator asynchrony, duration of mechanical ventilation and hospital stay (P>0.05). Conclusions: In patients with moderate ARDS, SIMV + PS can safely and effectively improve oxygenation, but does not decrease mortality, incidence of delirium and patient-ventilator asynchrony, dosages of analgesics and sedatives, and duration of mechanical ventilation and hospital stay.
    No preview · Article · Jan 2016 · Journal of Thoracic Disease
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    ABSTRACT: To evaluate the safety and efficacy of using sildenafil for ≥12 weeks to treat pulmonary arterial hypertension (PAH). Randomized controlled trials (RCTs) of sildenafil therapy in patients with PAH published through May 2013 were identified by searching PubMed, the Cochrane Library, Embase, relevant websites, and reference lists of relevant studies. Two reviewers independently assessed the quality of the trials and extracted information. Meta-analysis was carried out with subsets of 4 trials involving 545 patients. Sildenafil therapy significantly reduced clinical worsening of PAH compared to placebo (RR 0.39, 95% CI 0.21-0.69) and improved the 6-min walk distance (MD 31.3 m, 95% CI 18.01-44.67), WHO functional class, hemodynamic variables and health-related quality of life (HRQoL). Sildenafil did not, however, improve all-cause mortality (RR 0.29, 95% CI 0.02-4.94) or Borg dyspnea score relative to placebo, nor did it significantly affect the incidence of serious adverse events. In fact, sildenafil was associated with higher total incidence of adverse events, but these additional events were mild to moderate in severity and were tolerable. Sildenafil therapy lasting ≥12 weeks improves multiple clinical and hemodynamic outcomes in patients with PAH, but it appears to have no effect on mortality or serious adverse events. The long-term efficacy and safety of sildenafil therapy in PAH requires further study based on large and well-designed RCTs.
    No preview · Article · Jan 2014 · Respiratory medicine
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    ABSTRACT: Background: This is a meta-analysis of the safety and efficacy of indacaterol in chronic obstructive pulmonary disease (COPD) with treatment duration of ≥12 weeks. Methods: Randomized controlled trials (RCTs) reported in English (to September 30, 2012) were identified from PubMed, the Cochrane Library, Embase, websites, reference lists, and manual searches. Two reviewers independently assessed the quality of the trials and extracted information. Results: Five RCTs were eligible. Five involved indacaterol, two salmeterol, one formoterol, and one tiotropium. Four studies had placebos. Using trough forced expiratory volume in 1 s as a measure of therapeutic effect, indacaterol was superior to the other β2-agonists, tiotropium, and placebo at weeks 12, 26, and 52. Indacaterol had a greater effect on the transition dyspnoea index compared with placebo, formoterol, and salmeterol, but not open-label tiotropium. In reducing the as-needed use of salbutamol, indacaterol were superior to placebo, tiotropium, and formoterol, but not salmeterol (5, 95 % confidence interval (CI), -2.15, 12.15). Indacaterol improved St George's Respiratory Questionnaire scores more than placebo and open-label tiotropium, but not formoterol. Indacaterol seemed to cause more adverse events than placebo only at a dose of 600 μg daily and a duration of 52 weeks (risk ratio 1.15; 95 % CI, 1.04, 1.26). The total and serious adverse events and adverse events leading to discontinuation were comparable with open-label tiotropium and the β2-agonists. Conclusions: Indacaterol is effective and well-tolerated as a bronchodilator for the maintenance of moderate to severe COPD.
    No preview · Article · Jan 2013 · Beiträge zur Klinik der Tuberkulose
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    ABSTRACT: The nocturnal nondipping and elevated morning blood pressure (BP) in patients with obstructive sleep apnea syndrome (OSAS) have not yet been well investigated in Chinese patients. This study aimed to describe the BP profile, and to elucidate the relationships between daytime BP and nighttime BP, and between evening BP and morning BP in patients with OSAS. Twenty teaching hospital sleep centers in China were organized by the Chinese Medical Association to participate in this study and 2297 patients were recruited between January 2004 and April 2006. BP assessments were made at four time points (daytime, evening, nighttime and morning) and polysomnography (PSG) was performed and subjects were classified into four groups by their apnea-hypopnea index (AHI): control, n = 213 with AHI < 5; mild, n = 420 with AHI ≥ 5 and < 15; moderate, n = 460 with AHI ≥ 15 and < 30; and severe, n = 1204 with AHI ≥ 30. SPSS 11.5 software package was used for statistical analysis and figure drawing. All the average daytime, nighttime, evening and morning BPs were positively correlated with AHI and negatively correlated with nadir nocturnal oxygen saturation. The ratios of nighttime/daytime and morning/evening average BP were positively correlated with AHI. The ratio of nighttime/daytime systolic BP became a "reversed BP dipping" pattern until the classification reached severe, while the ratio of nighttime/daytime diastolic BP became reversed at moderate. Similarly, the ratio of morning/evening diastolic BP becomes reversed even at mild. OSAS may result in higher BP levels at all four time points. The ratios of nighttime/daytime and morning/evening BP increase with increased AHI. The increasing of diastolic BP, which is inclined to rise more quickly, is not parallel with increasing systolic BP.
    No preview · Article · May 2012 · Chinese medical journal
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    ABSTRACT: There is limited data on the clinical outcome of patients with pandemic H1N1 (pH1N1) pneumonia who received oseltamivir treatment, especially when the treatment was administered more than 48 hours after symptom onset. During the pandemic in 2009, a cohort of pH1N1 influenza pneumonia was built in China, and their clinical information was collected systematically, and analyzed with Cox models. 920 adults and 541 children with pneumonia who didn't receive corticosteroids were analyzed. In-hospital mortality was higher in adults who did not receive antiviral therapy (18.2%) than those with who received oseltamivir ≤ 2 days (2.9%), between 2-5 days (4.6%) and >5 days after illness onset (4.9%), p<0.01. A similar trend was observed in pediatric patients. Cox regression showed that at 60 days after symptoms onset, 11 patients (10.8%) who did not receive antivirals died versus 4 (1.8%), 18 (3.3%), and 23 (3.7%) patients whose oseltamivir treatment was started ≤ 2 days, between 2-5 days, and >5 days, respectively. For males patients, aged ≥ 14 years and baseline PaO(2)/FiO(2)<200, oseltamivir administration reduced the mortality risk by 92.1%, 88% and 83.5%, respectively. Higher doses of oseltamivir (>3.8 mg/kg/d) did not improve clinical outcome (mortality, higher dose 2.5% vs standard dose 2.8%, p>0.05). Antiviral therapy might reduce mortality of patients with pH1N1 pneumonia, even when initiated more than 48 hours after onset of illness. Greater protective effects might be in males, patients aged 14-60 years, and patients with PaO(2)/FiO(2)<200.
    Full-text · Article · Jan 2012 · PLoS ONE
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    ABSTRACT: Observational studies from Asia suggest that maxingshigan-yinqiaosan may be effective in the treatment of acute H1N1 influenza. To compare the efficacy and safety of oseltamivir and maxingshigan-yinqiaosan in treating uncomplicated H1N1 influenza. Prospective, nonblinded, randomized, controlled trial. (ClinicalTrials.gov registration number: NCT00935194) Eleven hospitals from 4 provinces in China. 410 persons [corrected] aged 15 to 69 [corrected] years with laboratory-confirmed H1N1 influenza. Oseltamivir, 75 mg twice daily; maxingshigan-yinqiaosan decoction (composed of 12 Chinese herbal medicines, including honey-fried Herba Ephedrae), 200 mL 4 times daily; oseltamivir plus maxingshigan-yinqiaosan; or no intervention (control). Interventions and control were given for 5 days. Primary outcome was time to fever resolution. Secondary outcomes included symptom scores and viral shedding determined by using real-time reverse transcriptase polymerase chain reaction. Significant reductions in the estimated median time to fever resolution compared with the control group (26.0 hours [95% CI, 24.0 to 33.0 hours]) were seen with oseltamivir (34% [95% CI, 20% to 46%]; P < 0.001), maxingshigan-yinqiaosan (37% [CI, 23% to 49%]; P < 0.001), and oseltamivir plus maxingshigan-yinqiaosan (47% [CI, 35% to 56%]; P < 0.001). Time to fever resolution was reduced by 19% (CI, 0.3% to 34%; P = 0.05) with oseltamivir plus maxingshigan-yinqiaosan compared with oseltamivir. The interventions and control did not differ in terms of decrease in symptom scores (P = 0.38). Two patients who received maxingshigan-yinqiaosan reported nausea and vomiting. Participants were young and had mild H1N1 influenza virus infection. Missing viral data precluded definitive conclusions about viral shedding. Oseltamivir and maxingshigan-yinqiaosan, alone and in combination, reduced time to fever resolution in patients with H1N1 influenza virus infection. These data suggest that maxingshigan-yinqiaosan may be used as an alternative treatment of H1N1 influenza virus infection. Beijing Science and Technology Project and Beijing Nova Program.
    No preview · Article · Aug 2011 · Annals of internal medicine
  • Jun-Li Wang · Jin Xia · Ju-Fen Wang · Chun Luo · Zong-An Liang
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    ABSTRACT: To identify risk factors of obstructive sleep apnea hypopnea syndrome (OSAHS) in female patients, and assess its treatment and health-related quality of life (HRQoL) of the patients. One hundred and ninety three female patients undergoing polysomnography whith sleep breath disorders were recruited and divided into non-OSAHS group and OSAHS group. Age, body mass index (BMI), and prevalence of menopause and hypertension were compared between the two groups. The associations of those variables with apnea hypopnea index (AHI) and lowest pulse oxygen saturation (LSpO2) were analysed. The treatment of OSAHS and its impact on HRQoL assessed by the Calgary quality of life index (SAQLI) were evaluated. The OSAHS group had greater mean age, BMI, and prevalence of menopause and hypertension than the non-OSAHS group (P<0.05). Those variables were significantly correlated with AHI and LSpO2 (P<0.05). Weight control and positional therapy were the most common treatment for sleep breath disorders. Weight loss and continuous positive airway pressure improved the Epworth sleep scale (ESS) of the patients with OSAHS significantly (P<0.05). But positional therapy made no difference (P>0.05). The ESS of the 32.5% of patients who did not undergo any treatment was worsened during the same period of time (P<0.05). No differences were found in the scores of the four domains of SAQLI between the two groups (P>0.05). The stepwise multiple regression analysis identified Pittsburgh sleep quality index (PSQI), ESS and AHI as independent predictors for the total score of SAQLI (P<0.05). Older age, greater BMI, menopause and hypertension are risk factors of OSAHS in female patients. OSAHS was not well managed in female patients. PSQI, ESS and AHI can be used as predictors for HRQoL.
    No preview · Article · Jul 2011 · Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition
  • Xiang Ma · Zong-an Liang · Hui Mao · Ya Liu · Mao-yun Wang
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    ABSTRACT: To detect the expression of CD25 and FOXP3 in mouse asthma model, and the effect of dexamethasone (DXM) on it. BALB/c mice were randomly divided into three groups which were of normal control group, asthmatic group and DXM treatment group. The pathological changes of lungs were detected by HE staining. The expressions of CD25 and FOXP3 from lungs were evaluated by Western blot and RT-PCR. The expression of FOXP3 from bone marrow of asthmatic group and DXM treatment group were detected by RT-PCR. The expression of FOXP3 in asthmatic group and DXM treatment group was significantly higher than that of normal control group (P < 0.05), DXM could promote the expression of FOXP3 (P < 0.05). The expression level of CD25 in asthmatic group and DXM treatment group was higher than that of normal control group (P < 0.05), but no significant difference was observed between asthmatic and DXM treatment groups (P > 0.05). Expressed FOXP3 mRNA in bone marrow were detected in both asthmatic and DXM treatment groups, but higher expression level was observed in DXM treatment group. The expression of CD25 and FOXP3 increased in mouse asthma model, DXM could promote the expression. Cells in bone marrow could express FOXP3, DXM maybe promote the expression of FOXP3.
    No preview · Article · Nov 2010 · Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition
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    ABSTRACT: Epidemiologic studies have shown an independent and definite association between obstructive sleep apnea (OSA) and hypertension. This study aimed to define the association between daytime blood pressure and severity of OSA in Chinese population in mainland of China. Twenty university hospital sleep centers in mainland of China were invited by the Chinese Medical Association (CMA) to participate in this epidemiologic study and 2297 consecutive patients (aged 18 - 85 years; 1981 males and 316 females) referred to these twenty sleep centers for evaluation of OSA between January 2004 and April 2006 were prospectively enrolled. Nocturnal polysomnography was performed in each patient, and disease severity was assessed based on the apneahypopnea index (AHI). These patients were classfied into four groups: nonapneic control (control, n = 257) with AHI < or = 5 episodes/hour; mild sleep apnea (mild, n = 402) with AHI > 5 and < or = 15 episodes/hour; moderate sleep apnea (moderate, n = 460) with AHI > 15 and < or = 30 episodes/hour and severe sleep apnea (severe, n = 1178) with AHI > 30 episodes/hour. Daytime blood pressure measurements were performed under standardized conditions in each patient at 10 a.m. in office on the day of referring to sleep centers for getting average value. All the patients were requested to quit medications related to blood pressure for three days before the day of assessing. Both daytime systolic blood pressure and diastolic blood pressure values were significantly related to AHI positively (r = 0.201 and 0.276, respectively; both P values < 0.001) and to nadir nocturnal oxygen saturation negatively (r = -0.215 and -0.277, respectively; both P values < 0.001), which were the parameters of OSA severity. In two special designed mean plots, means of daytime systolic and diastolic blood pressure increased gradually with increasing AHI. Beyond AHI of 61 - 65, this increasing trend reached a plateau. The results showed that OSA severity was associated with daytime blood pressure until AHI of 61 - 65, providing evidence for early OSA management, especially in OSA patients with concomitant hypertension.
    Full-text · Article · Jan 2010 · Chinese medical journal
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    ABSTRACT: The first case of 2009 pandemic influenza A (H1N1) virus infection in China was documented on May 10. Subsequently, persons with suspected cases of infection and contacts of those with suspected infection were tested. Persons in whom infection was confirmed were hospitalized and quarantined, and some of them were closely observed for the purpose of investigating the nature and duration of the disease. During May and June 2009, we observed 426 persons infected with the 2009 pandemic influenza A (H1N1) virus who were quarantined in 61 hospitals in 20 provinces. Real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) testing was used to confirm infection, the clinical features of the disease were closely monitored, and 254 patients were treated with oseltamivir within 48 hours after the onset of disease. The mean age of the 426 patients was 23.4 years, and 53.8% were male. The diagnosis was made at ports of entry (in 32.9% of the patients), during quarantine (20.2%), and in the hospital (46.9%). The median incubation period of the virus was 2 days (range, 1 to 7). The most common symptoms were fever (in 67.4% of the patients) and cough (69.5%). The incidence of diarrhea was 2.8%, and the incidence of nausea and vomiting was 1.9%. Lymphopenia, which was common in both adults (68.1%) and children (92.3%), typically occurred on day 2 (range, 1 to 3) and resolved by day 7 (range, 6 to 9). Hypokalemia was observed in 25.4% of the patients. Duration of fever was typically 3 days (range, 1 to 11). The median length of time during which patients had positive real-time RT-PCR test results was 6 days (range, 1 to 17). Independent risk factors for prolonged real-time RT-PCR positivity included an age of less than 14 years, male sex, and a delay from the onset of symptoms to treatment with oseltamivir of more than 48 hours. Surveillance of the 2009 H1N1 virus in China shows that the majority of those infected have a mild illness. The typical period during which the virus can be detected with the use of real-time RT-PCR is 6 days (whether or not fever is present). The duration of infection may be shortened if oseltamivir is administered.
    Full-text · Article · Dec 2009 · New England Journal of Medicine
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    ABSTRACT: To investigate respiratory care equipment, operators and conditions of performance in intensive care units (ICU), with the aim of providing data for standardization and developing respiratory care in China. A questionnaire survey was performed in one national and two international conferences in August, 2006. Four hundred and ninety-one doctors and nurses from 320 ICUs in 264 tertiary hospitals responded. Ratios of invasive and noninvasive mechanical ventilators to beds were 0.52:1 (2 189/4 185) and 0.16:1 (672/4 185), respectively. Of 320 ICUs, ratios of ICU equipped with ultrasound, jet nebulizers and MDI were 55.9% (179/320), 33.8% (108/320) and 12.1% (39/320), respectively, and percentages of doctors in charge of setting modes and parameters, weaning and extubation were 92.1%, 93.1%, 83.5%, respectively. Suction (93.9%), humidification (90.2%), aerosol therapy (91.6%) and circuit changing (83.7%) were nurses' duties. Among 491 responders, 40.9% of them implemented spontaneous breathing trials (SBT) before weaning, 13.4% were ignorant of it, and 12.8% never. 27.1% of ICU never monitored air temperature during invasive mechanical ventilation, 34.4% provided humidification by instilling or pumping saline continuously for those patients who were weaned from ventilators but not extubated, 55.6% checked ventilator before use. Ventilator circuits were changed once a week in 48.1%, 1-3 days in 25.0% and 3-5 days in 14.7%. The quantity of ventilators in the ICU has increased, but other practical respiratory care equipment have not been used widely. Most of respiratory care services are still provided by nurses and doctors, lacking professional staffs. The management is evidently variable but without a standardized guideline.
    No preview · Article · May 2009 · Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue
  • Quan-Ying He · Xin Zhou · Can-Mao Xie · Zong-An Liang · Ping Chen · Chang-Gui Wu
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    ABSTRACT: To assess the impact of chronic obstructive pulmonary disease (COPD) on the quality of life and economic burden in Chinese urban areas. COPD patients (n = 723) were interviewed face-to-face in outpatient departments in 6 large cities in China. The questionnaire included social and demographic information, current health status, quality of life (SGRQ), and medical expenditure on outpatient visit, hospitalization, medicine purchasing in medicine stores in the last 12 months, and other expenditures related with COPD were also collected. All the data were analyzed using descriptive method. Of the 723 COPD patients interviewed, 73% were male and the average age was 67 years old. The average symptom score of SGRQ was 49 +/- 24, activity score 57 +/- 23, impact score 46 +/- 23 and total score 50 +/- 21, which were all higher than scores of the healthy populations. The average direct medical cost (including outpatient cost, inpatient cost, and medicine purchasing cost) was 11 744 RMB yuan annually. The direct non-medical cost (including transportation fee, nutrition fee, and nursing fee) was 1570 RMB yuan. 36% of the patients in work had an average of 17 working days lost in the last 12 months because of COPD, while 17% of their relatives had an average of 14 working days lost for caring the patients. COPD has a serious impact on the quality of life of Chinese urban patients and places a heavy economic burden on their family and the society. Management of COPD should be improved for patients at stable conditions, so as to reduce the incidence and exacerbation of COPD.
    No preview · Article · May 2009 · Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases
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    ABSTRACT: To investigate the relationship between clinical features of patients with A/H5N1 infection and their prognosis in mainland China. This study included 28 human cases with A/H5N1 infection in mainland China from October 2005 to May 2008. Data were collected and reviewed from hospital medical records and publishied papers. A database was built by EPIDATA 3.02 and statistical analyses were performed with SPSS 13.0. The median age of the 28 cases was 29 years (range 6-62), and 15 were females. Ten patients survived, and 18 died. The typically clinical manifestations of human influenza A/H5N1 infection included fever and lower respiratory infection. The numbers of peripheral white blood cells, lymphocytes and platelets in the survival and non-survival groups were (4.01 +/- 1.86) x 10(9)/L vs (5.1 +/- 2.9) x 10(9)/L, (1.09 +/- 0.49) x 10(9)/L vs (0.98 +/- 0.44) x 10(9)/L, and (116 +/- 39) x 10(9)/L vs (101 +/- 40) x 10(9)/L, respectively; the differences were not statistically significant between the 2 groups (P>0.05). There was also no statistically significant difference in the increased serum enzymes, such as aspartate aminotransferase [(173 +/- 246) U/L vs (272 +/- 263) U/L], lactate dehydrogenase [(1016 +/- 568) U/L vs (1512 +/- 1052) U/L], creatine kinase [(1099 +/- 1590) U/L vs (2534 +/- 4281) U/L] and MB isoenzyme of creatine kinase [(28 +/- 30) U/L vs (125 +/- 197) U/L] (P>0.05) between the survival and the non-survival groups. However, there was a statistically significant difference in the number of patients with an initial LDH level more than 8 fold of the normal value between the survival and the non-survival groups (none vs 6, P<0.05). All of the 28 cases developed bilateral multiple infiltrates and consolidation in chest radiographs. Acute respiratory distress syndrome occurred in 22 cases, 17 of them died. All the 9 patients with acute kidney injury died. Ten patients received antiviral treatment with oseltamivir, and 6 of them survived. There was a statistical difference in the time of initiating oseltamivir treatment between the survival and the non-survival cases [(6.5 +/- 3.0) d vs (11.8 +/- 3.3) d, Z = 3.70, P<0.05]. Broad spectrum antibiotics and corticosteroids were administered in all of the 28 cases. There was no statistical difference between the survival and the non-survival groups regarding to the corticosteroid treatment (P>0.05). Initial LDH level reaching more than 8 fold of the normal value suggests a poor prognosis for human H5N1 infection. Patients complicated with either ARDS or acute kidney injury had a higher risk of death. Early administration of effective antiviral agents might improve the prognosis and decrease case fatality.
    No preview · Article · May 2009 · Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases
  • Lichuan Ye · Zong-An Liang · Terri E Weaver
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    ABSTRACT: This paper is a report of a study to identify the common symptoms and demographic and physiological factors of obstructive sleep apnoea that are predictive of health-related quality of life in a Chinese population. Health-related quality of life impairment in obstructive sleep apnoea is an increasingly important consideration, but little is known about the factors that influence quality of life in this population. A total of 108 Chinese patients with newly diagnosed obstructive sleep apnoea were recruited in 2003 and assessed for health-related quality of life, daytime sleepiness, depression and anxiety. Associations between symptoms, demographic and physiological factors and quality of life were examined by Pearson linear correlation. Hierarchical multiple regression were used to determine predictors of overall quality of life and its dimensions. Forty-six patients (42.6%) had depressed mood and 21 (19.4%) were anxious. Fifty-nine (54.6%) were hypersomnolent. The severity of symptoms of sleepiness, depression, and anxiety was statistically significantly inversely correlated with each domain and the total score for health-related quality of life. No statistically significant correlation was observed between disease severity and quality of life. Controlling for age and gender, anxiety and sleepiness predicted 45.2% of the variance of overall quality of life (R(2) = 0.452, P < 0.001). Anxiety was the strongest predictor of overall and each domain of health-related quality of life. Assessment of mood in patients with obstructive sleep apnoea should be an essential part of nursing practice. Comprehensive evaluation of symptoms, especially mood disturbance, is important for improving quality of life for these patients.
    No preview · Article · Jul 2008 · Journal of Advanced Nursing
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    ABSTRACT: Bone marrow eosinophilopoiesis induced by IL-5 makes a major contribution to eosinophilic airway inflammation in asthma. Bone marrow CD(34)(+) cells expressing IL-5Ralpha may be eosinophil progenitors. However, research on the effect of blocking IL-5Ralpha expression on bone marrow eosinophilopoiesis has seldom been reported. To explore the effect of inhibiting IL-5Ralpha expression with IL-5Ralpha short hairpin RNA-expressing vector on murine bone marrow eosinophilopoiesisin vitro. We constructed 4 kinds of plasmid vectors that could express small molecule inhibition, short hairpin RNA, which targeted IL-5Ralpha (P-IL-5Ralpha), and selected an effective one by transfecting B lymphoma cells in vitro. We also constructed an adenovirus vector which was inserted into an effective template sequence (Ad-IL-5Ralpha). The bone marrow cells were obtained from healthy Balb/c mice, and cultured and transfected by Ad-IL-5Ralpha in vitro. The expression of IL-5Ralpha and the count of newly produced eosinophils were detected in the cultured bone marrow cells. We found that P-IL-5Ralpha-3 targeted at the sequence of CAG CTG CCT GGT TCG TCT T markedly suppressed the IL-5Ralpha expression in the B lymphoma cellsin vitro. Ad-IL-5Ralpha could suppress the IL-5Ralpha expression of murine bone marrow cellsin vitro and it could also significantly decrease the IL-5-induced eosinophilia in the cultured bone marrow cells. These results indicate that the blocking of IL-5Ralpha expression by small molecule inhibition can help to effectively decrease murine bone marrow eosinophilopoiesis, and that bone marrow may be used as a critical target organ in the diseases involved in eosinophilia, such as asthma.
    No preview · Article · Feb 2007 · Respiration
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    ABSTRACT: Bone marrow eosinophilopoiesis induced by interleukin (IL)-5 is a major contributor to eosinophilic airway inflammation in asthma. However,research on the use of IL-5 receptor alpha (IL-5Ralpha) as the target has seldom been reported. This study was undertaken to explore the effects of inhibition of IL-5Ralpha expression through an IL-5Ralpha short hairpin RNA-expressing vector on bone marrow eosinophilopoiesis and airway inflammation in an asthmatic mouse model. An effective plasmid vector was selected that could express short hairpin RNA targeted at IL-5Ralpha (P-IL-5Ralpha). An adenovirus vector (Ad) was then constructed that was inserted in an effective template sequence (Ad-IL-5Ralpha). An animal model of asthma was established by sensitizing and challenging Balb/c mice with ovalbumin. Animals were treated intravenously with Ad-IL-5Ra and changes in bone marrow eosinophilopoiesis and airway inflammation were detected in asthmatic mice. Investigators found that P-IL-5Ra-3 targeted at the sequence of CAG CTG CCT GGT TCG TCT T markedly suppressed IL-5Ralpha expression in B lymphoma cells in vitro. In addition, Ad-IL-5Ralpha could suppress IL-5Ralpha expression in murine bone marrow cells in vitro and in vivo, and it could significantly decrease IL-5-induced eosinophilia in cultured bone marrow cells. Additional studies indicated that intravenously injected Ad-IL-5Ralpha not only selectively reduced the number of eosinophils in the bone marrow, peripheral blood, and bronchoalveolar lavage fluid, it also relieved airway inflammation in asthmatic mice. Results reported here show that blocking of IL-5Ralpha expression through RNA interference can enhance effective treatment of asthma, and that bone marrow can be used as a key targeted organ in the treatment of asthmatic mice.
    Full-text · Article · Nov 2006 · Advances in Therapy