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Clinical characteristics in lymphangioleiomyomatosis-related pulmonary hypertension: an observation on

Xiuxiu Wu, Wenshuai Xu, Jun Wang, Xinlun Tian, Zhuang Tian, Kaifeng Xu

《医学前沿（英文）》 2019年 第13卷 第2期   页码 259-266 doi: 10.1007/s11684-018-0634-z

摘要： Lymphangioleiomyomatosis (LAM) is a rare diffuse cystic lung disease. Knowledge on LAM-related pulmonary hypertension (PH) is limited. This study aimed to analyze the clinical characteristics of LAM with elevated pulmonary artery pressure (PAP) and evaluate the potential efficacy of sirolimus. The study involved 50 LAM patients who underwent echocardiography. According to the tricuspid regurgitation velocity (TRV), these patients were divided into the TRV≤2.8 m/s group and TRV>2.8 m/s group. Both groups comprised 25 females with an average age of 38.6±8.1 and 41.5±8.9 years. In the TRV>2.8 m/s group, the estimated systolic PAP (SPAP) was significantly elevated (52.08±12.45 mmHg vs. 30.24±5.25mmHg, <0.01). Linear analysis showed that SPAP was correlated with forced expiratory volume in 1 s (FEV ), diffusing capacity of the lungs for carbon monoxide, alveolar arterial oxygen gradient (P O ), and 6 min walking distance ( = −0.392, −0.351, 0.450, and −0.591, respectively; <0.05), in which P O was a risk factor for SPAP elevation ( = 0.064, OR= 1.066, <0.05). Moreover, in 10 patients who received sirolimus therapy, SPAP decreased from 57.0±12.6 mmHg to 35.2±11.1 mmHg. The study showed that LAM patients with PH exhibit poor pulmonary function and hypoxemia and may benefit from sirolimus treatment.

关键词： lymphangioleiomyomatosis     pulmonary hypertension     pulmonary function     hypoxemia     sirolimus    

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Heterogeneity of chronic obstructive pulmonary disease: from phenotype to genotype

null

《医学前沿（英文）》 2013年 第7卷 第4期   页码 425-432 doi: 10.1007/s11684-013-0295-x

摘要：

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality throughout the world and is mainly characterized by persistent airflow limitation. Given that multiple systems other than the lung can be impaired in COPD patients, the traditional FEV1/FVC ratio shows many limitations in COPD diagnosis and assessment. Certain heterogeneities are found in terms of clinical manifestations, physiology, imaging findings, and inflammatory reactions in COPD patients; thus, phenotyping can provide effective information for the prognosis and treatment. However, phenotypes are often based on symptoms or pathophysiological impairments in late-stage COPD, and the role of phenotypes in COPD prevention and early diagnosis remains unclear. This shortcoming may be overcome by the potential genotypes defined by the heterogeneities in certain genes. This review briefly describes the heterogeneity of COPD, with focus on recent advances in the correlations between genotypes and phenotypes. The potential roles of these genotypes and phenotypes in the molecular mechanisms and management of COPD are also elucidated.

关键词： chronic obstructive pulmonary disease     heterogeneity     phenotype     genotype     prediction    

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Survey on deep learning for pulmonary medical imaging

Jiechao Ma, Yang Song, Xi Tian, Yiting Hua, Rongguo Zhang, Jianlin Wu

《医学前沿（英文）》 2020年 第14卷 第4期   页码 450-469 doi: 10.1007/s11684-019-0726-4

摘要： As a promising method in artificial intelligence, deep learning has been proven successful in several domains ranging from acoustics and images to natural language processing. With medical imaging becoming an important part of disease screening and diagnosis, deep learning-based approaches have emerged as powerful techniques in medical image areas. In this process, feature representations are learned directly and automatically from data, leading to remarkable breakthroughs in the medical field. Deep learning has been widely applied in medical imaging for improved image analysis. This paper reviews the major deep learning techniques in this time of rapid evolution and summarizes some of its key contributions and state-of-the-art outcomes. The topics include classification, detection, and segmentation tasks on medical image analysis with respect to pulmonary medical images, datasets, and benchmarks. A comprehensive overview of these methods implemented on various lung diseases consisting of pulmonary nodule diseases, pulmonary embolism, pneumonia, and interstitial lung disease is also provided. Lastly, the application of deep learning techniques to the medical image and an analysis of their future challenges and potential directions are discussed.

关键词： deep learning     neural networks     pulmonary medical image     survey    

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Protein microspheres for pulmonary drug delivery

Yongda SUN,

《化学科学与工程前沿（英文）》 2010年 第4卷 第1期   页码 82-86 doi: 10.1007/s11705-009-0307-1

摘要： A new supercritical fluid (SCF) technique was developed for the preparation of microspheres for pulmonary drug delivery (PDD). This technique, based on the anti-solvent process, has incorporated advanced engineering design features to enable improved control of the particle formation process. Human recombinant insulin (HRI) was used as a model compound to evaluate the efficiency of this SCF process. An aqueous solution of HRI with a co-solvent was sprayed into high pressure carbon dioxide that extracted the solvent and water, leading to a dry fine powder with good particle size distribution and near ideal morphology for pulmonary drug delivery.

关键词： advanced engineering     improved     pressure     aqueous     technique    

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Treatment outcomes of pulmonary tuberculosis in the past decade in the mainland of China: a meta-analysis

null

《医学前沿（英文）》 2013年 第7卷 第3期   页码 354-366 doi: 10.1007/s11684-013-0257-3

摘要：

Due to the implementation of directly observed treatment strategy (DOTS), China has made a significant achievement in tackling the tuberculosis (TB) epidemic in the 1990s. However, only half of regions in China met or exceeded the 85% rate of treatment success target. The aim of the present study is to summarize the treatment outcomes of smear-positive pulmonary TB in the mainland of China in the past decade using meta-analysis based on systematic review of published observational studies. A total of 50 eligible articles (58 studies) were identified and included in this study. The summarized treatment success rates were 93.9% (95% CI, 92.8%–94.7%) for new cases and 85.4% (95% CI, 83.0%–87.6%) for previously treated cases, and the summarized cured rate were 92.2% (95% CI, 90.9%–93.3%) and 81.2% (95% CI, 79.1%–83.1%), respectively. A remarkable increase of rates for treatment success and cure was observed in the 1990s. After 2000, the summarized treatment outcomes were tending towards stability. In addition, geographic areas, type of the data and administrative level of the hospital were also found to influence the estimates of the treatment outcomes. Results of the present study clearly show, in general, that the pulmonary TB treatment achieved significant success in the past decade in the mainland of China. However, it needs to be further strengthened in the central and west areas.

关键词： tuberculosis     treatment     outcome     China     meta-analysis    

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Perioperative management for parturients with pulmonary hypertension: experience with 30 consecutive

null

《医学前沿（英文）》 2013年 第7卷 第3期   页码 395-395 doi: 10.1007/s11684-013-0289-8

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Clinical characteristics of pulmonary hypertension in bronchiectasis

null

《医学前沿（英文）》 2016年 第10卷 第3期   页码 336-344 doi: 10.1007/s11684-016-0461-z

摘要：

Pulmonary hypertension (PH), as a complication of bronchiectasis, is associated with increased mortality. However, hemodynamic characteristics and the efficacy of pulmonary arterial hypertension (PAH) therapies in patients with bronchiectasis and PH remain unknown. Patients with bilateral bronchiectasis and concurrent PH were included in the study. Patient characteristics at baseline and during follow-up, as well as survival, were analyzed. This observational study was conducted in 36 patients with a mean age of 51.5 years (range, 17?74 years). The 6 min walking distance was 300.8±93.3 m. The mean pulmonary arterial pressure (PAP) was 41.5±11.7 mmHg, cardiac output was 5.2±1.4 L/min, and pulmonary vascular resistance was 561.5±281.5 dyn·s·cm−5. The mean PAP was>35 mmHg in 75% of the cases. Mean PAP was inversely correlated with arterial oxygen saturation values (r = −0.45, P = 0.02). In 24 patients who received oral PAH therapy, systolic PAP was reduced from 82.4±27.0 mmHg to 65.5±20.9 mmHg (P = 0.025) on echocardiography after a median of 6 months of follow-up. The overall probability of survival was 97.1% at 1 year, 83.4% at 3 years, and 64.5% at 5 years. Given the results, we conclude that PH with severe hemodynamic impairment can occur in patients with bilateral bronchiectasis, and PAH therapy might improve hemodynamics in such patients. Prospective clinical trials focusing on this patient population are warranted.

关键词： bronchiectasis     hemodynamics     pulmonary hypertension    

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Effect of Feixian Recipe on laminin, collagen I and III in rats with pulmonary fibrosis induced by bleomycin

ZHANG Xiaomei, JIANG Liangduo, ZHANG Wei, WU Jianjun, LU Xiangfeng

《医学前沿（英文）》 2008年 第2卷 第3期   页码 314-316 doi: 10.1007/s11684-008-0060-8

摘要： The aim of this paper is to observe the effect of the Feixian Recipe on pulmonary fibrosis in rats. A rat model with pulmonary fibrosis was established by intratracheal injection of bleomycin. On days 14, 28 and 45, the contents of laminin, collagen I and collagen III in lung tissue homogenate in the model group, the sham operated group, the Feixian group and the prednisone group were measured. The contents of laminin and collagen I and III were decreased significantly by the Feixian Recipe. Feixian Recipe has a significant therapeutic effect on bleomycin-induced pulmonary fibrosis in rats.

关键词： bleomycin     intratracheal injection     prednisone     collagen     bleomycin-induced pulmonary    

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mycelium inhibits epithelial-mesenchymal transition by inactivating the midkine pathway in pulmonary

Li Lu, Haiyan Zhu, Hailin Wang, Huaping Liang, Yayi Hou, Huan Dou

《医学前沿（英文）》 2021年 第15卷 第2期   页码 313-329 doi: 10.1007/s11684-020-0737-1

摘要： The medical fungus has been used as a Chinese folk health supplement because of its immunomodulatory properties. Our previous studies established the antifibrotic action of mycelium (HSM) in the lung. The epithelial–mesenchymal transition (EMT) is involved in the pathogenesis of idiopathic pulmonary fibrosis. The present study investigates the role of HSM in mediating EMT during the development of pulmonary fibrosis. HSM significantly inhibits bleomycin (BLM)-induced pulmonary fibrosis by blocking the EMT. In addition, the expression levels of midkine are increased in the lungs of the BLM-induced group. Further analysis of the results indicates that the mRNA level of midkine correlated positively with EMT. HSM markedly abrogates the transforming growth factor β-induced EMT-like phenotype and behavior . The activation of midkine related signaling pathway is ameliorated following HSM treatment, whereas this extract also caused an effective attenuation of the induction of EMT (caused by midkine overexpression) . Results further confirm that oral medication of HSM disrupted the midkine pathway . Overall, findings suggest that the midkine pathway and the regulation of the EMT may be considered novel candidate therapeutic targets for the antifibrotic effects caused by HSM.

关键词： epithelial−mesenchymal transition     H. sinensis mycelium     midkine     pulmonary fibrosis    

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Stevens–Johnson syndrome and toxic epidermal necrolysis in China: evaluation of risk models and new predictor of pulmonary

Yanhong Shou, Lu Yang, Yongsheng Yang, Xiaohua Zhu, Feng Li, Bo Yin, Yingyan Zheng, Jinhua Xu

《医学前沿（英文）》 2021年 第15卷 第4期   页码 585-593 doi: 10.1007/s11684-020-0817-2

摘要： Stevens--Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but severe diseases. This study aimed to validate the predictive ability of risk models in patients with SJS/TEN and propose possible refinement in China. Patients in the Department of Dermatology of Huashan Hospital from January 2008 to January 2019 were included. Results showed that the severity-of-illness score for TEN (SCORTEN) had a good discrimination (area under the receiver operating characteristic curve (AUC), 0.78), and it was superior to auxiliary score (AS) and ABCD-10, which indicates age, bicarbonate level, cancer, dialysis, and 10% involved body surface area (AUC, 0.69 and 0.68, respectively). The calibration of SCORTEN (Hosmer–Lemeshow goodness-of-fit test, = 0.69) was also better than that of AS ( = 0.25) and ABCD-10 ( = 0.55). SCORTEN and ABCD-10 were similar (Brier score (BS), 0.04 and 0.04) in terms of accuracy of predictions. In addition, the imaging appearance of pulmonary consolidation on computed tomography was associated with high mortality. Refined models were formed using the variables and this imaging appearance. The refined AS and ABCD-10 models were similar in discrimination compared with the original SCORTEN (0.74 vs. 0.78, = 0.23; 0.74 vs. 0.78, = 0.30, respectively). Therefore, SCORTEN showed good discrimination performance, calibration, and accuracy, and refined AS or ABCD-10 model may be an option when SCORTEN variables are not available.

关键词： Stevens–Johnson syndrome     toxic epidermal necrolysis     auxiliary score     ABCD-10     pulmonary consolidation    

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comprehensive therapy based on traditional Chinese medicine patterns on older patients with chronic obstructive pulmonary

null

《医学前沿（英文）》 2014年 第8卷 第3期   页码 368-375 doi: 10.1007/s11684-014-0360-0

摘要：

This study aimed to evaluate the efficacy of comprehensive therapy based on traditional Chinese medicine (TCM) patterns on older patients with chronic obstructive pulmonary disease (COPD) through a four-center, open-label, randomized controlled trial. Patients were divided into the trial group treated using conventional western medicine and Bu-Fei Jian-Pi granules, Bu-Fei Yi-Shen granules, and Yi-Qi Zi-Shen granules based on TCM patterns respectively; and the control group treated using conventional western medicine. A total of 136 patients≥65 years completed the study, with 63 patients comprising the trial group and 73 comprising the control group. After the six-month treatment and the 12-month follow-up period, significant differences were observed between the trial and control groups in the following aspects: frequency of acute exacerbation (P≤0.040), duration of acute exacerbation (P = 0.034), symptoms (P≤0.034), 6-min walking distance (6MWD) (P≤0.039), dyspnea scale (P≤0.036); physical domain (P≤0.019), psychological domain (P≤0.033), social domain (P≤0.020), and environmental domain (P≤0.044) of the WHOQOL-BREF questionnaire; and daily living ability domain (P≤0.007), social activity domain (P≤0.018), depression symptoms domain (P≤0.025), and anxiety symptoms domain (P≤0.037) of the COPD-QOL. No differences were observed between the trial and control groups with regard to FVC, FEV1, and FEV1%.

关键词： chronic obstructive pulmonary disease     older adult     clinical trial     Bu-Fei Jian-Pi granules     Bu-Fei Yi-Shen granules     Yi-Qi Zi-Shen granules    

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Applications of the crystallization process in the pharmaceutical industry

Sohrab ROHANI

《化学科学与工程前沿（英文）》 2010年 第4卷 第1期   页码 2-9 doi: 10.1007/s11705-009-0297-z

摘要： The applications of the crystallization technique in the pharmaceutical industry as a purification and separation process for the isolation and synthesis of pure active pharmaceutical ingredients (API), co-crystals, controlled release pulmonary drug delivery, and separation of chiral isomers are briefly discussed using a few case studies. The effect of process variables and solvent on the polymorphism and morphology of stavudine is discussed. The implementation of external control in the form of feedback and real-time optimal control using cooling and antisolvent crystallization of paracetamol in water-isopropyl alcohol is introduced. Two methods to prepare micron-sized drug particles, namely, micro-crystallization and polymer-coated API-loaded magnetic nanoparticles for pulmonary drug delivery, are discussed. The significance of co-crystals in drug administration is highlighted using the theophylline-nicotinamide co-crystal system. Resolution of chloromandelic acid derivatives, a racemic compound, is achieved using direct crystallization and diastereomeric salts crystallization. The crystal structures of diastereomeric salts of chloromandelic acid and phenylethylamine are determined. The structure comparison between the less soluble and more soluble salts shows that weak interactions such as CH/π interactions and van der Waals forces contribute to chiral recognition when the hydrogen bonding patterns are similar.

关键词： feedback     morphology     pulmonary     paracetamol     recognition    

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Pulmonary alveolar microlithiasis: an interesting case report with systematic review of Indian literature

null

《医学前沿（英文）》 2015年 第9卷 第2期   页码 229-238 doi: 10.1007/s11684-015-0394-y

摘要：

Pulmonary alveolar microlithiasis is a rare disease characterized by intra-alveolar presence of microliths. This study reports an interesting case of pulmonary alveolar microlithiasis and provides a systematic review of cases reported from India. A 23-year-old female presented with a history of cough, wheeze, chest pain, and episodic wheeze for five months. Pulmonary function tests demonstrated an obstructive pattern, and chest X-ray showed fine micronodular opacities predominantly involving the middle and lower zones of both lungs. Transbronchial lung biopsy revealed the diagnosis. She responded well to inhaled steroid therapy. A systematic review of literature was performed and identified 73 cases of pulmonary alveolar microlithiasis reported from India. The mean (SD) age of the patients was 28.8 (14.9) years, with an almost equal male:female ratio. Many patients were asymptomatic at presentation. Breathlessness and cough were the most common symptoms, and the disease progressed into respiratory failure associated with cor pulmonale. About one-third of the cases were initially misdiagnosed and treated as pulmonary tuberculosis. Extra-pulmonary manifestations and co-morbidities were also evident in our series. This systematic review helps to determine epidemiological and clinical characteristics of pulmonary alveolar microlithiasis. Further research is needed to elucidate the etiopathogenesis, diagnosis, and therapeutic options, which are beneficial in developing and identifying cost-effective treatment for pulmonary alveolar microlithiasis.

关键词： pulmonary alveolar microlithiasis     alveolar microlithiasis     microliths     rare diseases    

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Learning curve of totally thoracoscopic pulmonary segmentectomy

Weibing Wu, Jing Xu, Wei Wen, Yue Yu, Xinfeng Xu, Quan Zhu, Liang Chen

《医学前沿（英文）》 2018年 第12卷 第5期   页码 586-592 doi: 10.1007/s11684-017-0566-z

摘要：

Totally thoracoscopic pulmonary segmentectomy (TTPS) is a feasible and safe technique that requires advanced thoracoscopic skills and knowledge of pulmonary anatomy. However, data describing the learning curve of TTPS have yet to be obtained. In this study, 128 patients who underwent TTPS between September 2010 and December 2013 were retrospectively analyzed to evaluate the learning curve and were divided chronologically into three phases, namely, ascending phase (A), plateau phase (B), and descending phase (C), through cumulative summation (CUSUM) for operative time (OT). Phases A, B, and C comprised 39, 33, and 56 cases, respectively. OT and blood loss decreased significantly from phases A to C (P <0.01), and the frequency of intraoperative bronchoscopy for target bronchus identification decreased gradually (A, 8/39; B, 4/33; C, 3/56; P = 0.06). No significant differences were observed in demographic factors, conversion, complications, hospital stay, and retrieved lymph nodes among the three phases. Surgical outcomes and techniques improved with experience and volume. CUSUMOT indicated that the learning curve of TTPS should be more than 72 cases.

关键词： thoracoscopic     segmentectomy     learning curve     CUSUM    

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High risk factors for pulmonary fungous infection in intensive care units of neurosurgery

ZHU Wenyu, TAN Liping, CHEN Xiangfeng, HUANG Qiang, LAN Qing

《医学前沿（英文）》 2007年 第1卷 第3期   页码 299-303 doi: 10.1007/s11684-007-0057-8

摘要： By analyzing the high risk factors for pulmonary fungous infection in intensive care units of neurosurgery, the strategy of early diagnosis and treatment was explored. According to the domestic diagnostic standard on pulmonary fungous infection, clinical data on 58 patients with the infection in our department were analyzed. One hundred and seventeen strains of fungi were separated from the 58 cases. Candidiasis was the most frequent type, accounting for 92.3% of the cases. Conditions such as the severity of primary diseases, long-time coma, long-term use of broad-spectrum antibiotic, abuse of glucocorticoid, the open airway, and some invasive intubations, may be regarded as high risk factors for pulmonary fungous infection. Fluconazole showed good clinical effects on the treatment of fungous infection. To eliminate these high risk factors, early diagnosis and the use of prophylactic antifungal agents can help reduce the incidence of pulmonary fungous infection.

关键词： seventeen     incidence     glucocorticoid     broad-spectrum antibiotic     Candidiasis    

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标题 作者 时间 类型 操作

Clinical characteristics in lymphangioleiomyomatosis-related pulmonary hypertension: an observation on

Xiuxiu Wu, Wenshuai Xu, Jun Wang, Xinlun Tian, Zhuang Tian, Kaifeng Xu

期刊论文

Heterogeneity of chronic obstructive pulmonary disease: from phenotype to genotype

null

期刊论文

Survey on deep learning for pulmonary medical imaging

Jiechao Ma, Yang Song, Xi Tian, Yiting Hua, Rongguo Zhang, Jianlin Wu

期刊论文

Protein microspheres for pulmonary drug delivery

Yongda SUN,

期刊论文

Treatment outcomes of pulmonary tuberculosis in the past decade in the mainland of China: a meta-analysis

null

期刊论文

Perioperative management for parturients with pulmonary hypertension: experience with 30 consecutive

null

期刊论文

Clinical characteristics of pulmonary hypertension in bronchiectasis

null

期刊论文

Effect of Feixian Recipe on laminin, collagen I and III in rats with pulmonary fibrosis induced by bleomycin

ZHANG Xiaomei, JIANG Liangduo, ZHANG Wei, WU Jianjun, LU Xiangfeng

期刊论文

mycelium inhibits epithelial-mesenchymal transition by inactivating the midkine pathway in pulmonary

Li Lu, Haiyan Zhu, Hailin Wang, Huaping Liang, Yayi Hou, Huan Dou

期刊论文

Stevens–Johnson syndrome and toxic epidermal necrolysis in China: evaluation of risk models and new predictor of pulmonary

Yanhong Shou, Lu Yang, Yongsheng Yang, Xiaohua Zhu, Feng Li, Bo Yin, Yingyan Zheng, Jinhua Xu

期刊论文

comprehensive therapy based on traditional Chinese medicine patterns on older patients with chronic obstructive pulmonary

null

期刊论文

Applications of the crystallization process in the pharmaceutical industry

Sohrab ROHANI

期刊论文

Pulmonary alveolar microlithiasis: an interesting case report with systematic review of Indian literature

null

期刊论文

Learning curve of totally thoracoscopic pulmonary segmentectomy

Weibing Wu, Jing Xu, Wei Wen, Yue Yu, Xinfeng Xu, Quan Zhu, Liang Chen

期刊论文

High risk factors for pulmonary fungous infection in intensive care units of neurosurgery

ZHU Wenyu, TAN Liping, CHEN Xiangfeng, HUANG Qiang, LAN Qing

期刊论文