Canadian respiratory journal最新文献

{"title":"Efficacy of High-Flow Nasal Cannula versus Conventional Oxygen Therapy in Obese Patients during the Perioperative Period: A Systematic Review and Meta-Analysis.","authors":"Rong Zhou, Hao-Tian Wang, Wei Gu","doi":"10.1155/2022/4415313","DOIUrl":"10.1155/2022/4415313","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a risk factor for severe airway obstruction and hypoxemia. High-flow nasal cannula (HFNC) is considered as a novel method for oxygen therapy, but the efficacy of HFNC for obese patients is controversial. This meta-analysis aimed to assess the efficacy of HFNC compared with conventional oxygen therapy (COT) in obese patients during the perioperative period.</p><p><strong>Methods: </strong>We searched the PubMed, Embase, Web of Science, the Cochrane Library, and Google scholar databases for randomized controlled trials (RCTs) that compared the efficacy of HFNC with COT in obese patients during the perioperative period. The primary outcome was the incidence of hypoxemia, while the secondary outcomes included the lowest SpO₂, the need for additional respiratory support, and the hospital length of stay (LOS).</p><p><strong>Results: </strong>Twelve trials with 798 obese patients during the perioperative period were included. Compared with COT, HFNC reduced the incidence of hypoxemia (RR, 0.60; 95% CI, 0.43 to 0.83; <i>P</i>=0.002; <i>I</i> ² = 24%; 8 RCTs; <i>n</i> = 458), increased the lowest SpO₂ (MD, 2.88; 95% CI, 1.53 to 4.22; <i>P</i> < 0.0001; <i>I</i> ² = 32%; 5 RCTs; <i>n</i> = 264), decreased the need for additional respiratory support (RR, 0.43; 95% CI, 0.21 to 0.88; <i>P</i>=0.02; <i>I</i> ^<i>2</i>  = 0%; 3 RCTs; <i>n</i> = 305), and shortened the hospital LOS (MD, -0.31; 95% CI, -0.57 to -0.04; <i>P</i>=0.02; <i>I</i> ² = 0%; 3 RCTs; <i>n</i> = 214).</p><p><strong>Conclusions: </strong>This meta-analysis showed that compared with COT, the use of HFNC was able to reduce the incidence of hypoxemia, increase the lowest SpO₂, decrease the need for additional respiratory support, and shorten the hospital LOS in obese patients during the perioperative period. Well-organized trials with large sample size should be conducted to support our findings.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":"4415313"},"PeriodicalIF":2.1,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33515957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Value of Adenosine Deaminase 2 in the Detection of Tuberculous Pleural Effusion: A Meta-Analysis and Systematic Review.","authors":"Tingting Zeng, Bing Ling, Xueru Hu, Shuyan Wang, Wenliang Qiao, Lijuan Gao, Yongchun Shen, Dajiang Li","doi":"10.1155/2022/7078652","DOIUrl":"10.1155/2022/7078652","url":null,"abstract":"<p><p>Adenosine deaminase 2 (ADA₂) is reported as a novel diagnostic biomarker for tuberculous pleural effusion (TPE) in many studies. This meta-analysis was conducted to systematically evaluate the general diagnostic performance of pleural ADA₂ in TPE. After searching for relevant studies that investigated the diagnostic performance of pleural ADA₂ in TPE in several databases, we assessed and selected eligible studies to calculate pooled parameters by STATA 16.0 software. A final set of thirteen studies entirely met the inclusion standards and were used to calculate pooled parameters in our meta-analysis. Among them, there were nine English studies and four Chinese studies. The pooled parameters of pleural ADA₂ in diagnosing TPE were summarized as follows: sensitivity, 0.91 (95% CI: 0.86-0.95); specificity, 0.93 (95% CI: 0.92-0.95); positive likelihood ratio, 13.9 (95% CI: 10.6-18.3); negative likelihood ratio, 0.09 (95% CI:0.06-0.16); diagnostic odds ratio, 147 (95% CI: 76-284); and the area under the curve, 0.95 (95% CI: 0.93-0.97). Pleural ADA₂ is a reliable indicator with excellent accuracy in TPE diagnosis. However, we need to combine pleural ADA₂ with diverse examinations to diagnose TPE in clinical practice.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2022 ","pages":"7078652"},"PeriodicalIF":2.1,"publicationDate":"2022-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9482525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10326352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidance for Administering Biologics for Severe Asthma and Allergic Conditions.","authors":"Delbert R Dorscheid,&nbsp;Jason K Lee,&nbsp;Warren Ramesh,&nbsp;Mark Greenwald,&nbsp;Jaime Del Carpio","doi":"10.1155/2022/9355606","DOIUrl":"https://doi.org/10.1155/2022/9355606","url":null,"abstract":"<p><p>Asthma is a common respiratory disorder in Canada for which biologics may be prescribed for poorly controlled illness. Treatment with biologics, however, is sometimes inappropriately discontinued due to misconceptions regarding their potential immunologic effects, and concerns surrounding their continued use in severe asthma during the COVID-19 pandemic continue to propagate. Biologics can still be administered in a majority of health and treatment conditions. With regard to cardiac-related issues such as hypertension or cardiovascular disease (CVD), there is no solid evidence that suggests biologics should be withheld, as the benefits of treatment outweigh the risks. Asthmatic patients on biologic treatment should also continue treatment if they have, or are currently being treated for, a respiratory infection, including COVID-19. Evidence also indicates the importance of maintaining asthma control to reduce the risk of severe COVID-19 infection. Biologic treatment can be administered in severe asthmatic patients with bronchiectasis, though further evidence is needed to better understand the benefits. Biologic treatment should be continued postsurgery to reduce postoperative respiratory complications, as well as throughout the course of pregnancy. Regarding concerns over vaccine administration, nearly all vaccines can be given without interruption of biologic treatment in patients with severe asthma or allergic conditions. Appropriate screening for respiratory illnesses, such as COVID-19, continues to be warranted in clinical practices to reduce the risk of transmission. As recommendations from public health and regulatory agencies have been lacking, this guidance document addresses the administration of biologics in different health circumstances and respiratory illness screening during the COVID-19 pandemic.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":"9355606"},"PeriodicalIF":2.2,"publicationDate":"2022-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9482537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40371573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Exhaled Nitric Oxide as an Indicator for Postoperative Pneumonia in Surgical Lung Cancer Patients: A Prospective Cohort Study Based on 183 Cases.","authors":"Gui-Xian Liu,&nbsp;Yue Yang,&nbsp;Lei Chen,&nbsp;Mi-Qi Gu,&nbsp;Jin-Tao He,&nbsp;Xin Wang","doi":"10.1155/2022/9149385","DOIUrl":"https://doi.org/10.1155/2022/9149385","url":null,"abstract":"<p><strong>Introduction: </strong>This study is conducted to investigate the correlation between perioperative fractional exhaled nitric oxide and postoperative pneumonia (POP) and the feasibility of perioperative FeNO for predicting POP in surgical lung cancer patients.</p><p><strong>Methods: </strong>Patients who were diagnosed with non-small-cell lung cancer (NSCLC) were prospectively analyzed, and the relationship between perioperative FeNO and POP was evaluated based on patients' basic characteristics and clinical data in the hospital.</p><p><strong>Results: </strong>There were 218 patients enrolled in this study. Finally, 183 patients were involved in the study, with 19 of them in the POP group and 164 in the non-POP group. The POP group had significantly higher postoperative FeNO (median: 30.0 vs. 19.0 ppb, <i>P</i> < 0.001) as well as change in FeNO (median: 10.0 vs. 0.0 ppb, <i>P</i> < 0.001) before and after the surgery. For predicting POP based on the receiver operating characteristic (ROC) curve, a cutoff value of 25 ppb for postoperative FeNO (Youden's index: 0.515, sensitivity: 78.9%, and specificity: 72.6%) and 4 ppb for change in FeNO (Youden's index: 0.610, sensitivity: 84.2%, specificity: 76.8%) were selected. Furthermore, according to the bivariate regression analysis, FEV1/FVC (OR = 0.948, 95% CI: 0.899-0.999, <i>P</i>=0.048), POD1 FeNO (OR = 1.048, 95% CI: 1.019-1.077, <i>P</i>=0.001), and change in FeNO (OR = 1.087, 95% CI: 1.044-1.132, <i>P</i> < 0.001) were significantly associated with occurrence of POP.</p><p><strong>Conclusions: </strong>This prospective study revealed that a high postoperative FeNO (>25 ppb), as well as an increased change in FeNO (>4 ppb), may have the potential in detecting the occurrence of POP in surgical lung cancer patients.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":"9149385"},"PeriodicalIF":2.2,"publicationDate":"2022-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9464969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40359378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noninvasive Ventilation in Treatment of Respiratory Failure-Related COVID-19 Infection: Review of the Literature.","authors":"Bushra Mina,&nbsp;Alexander Newton,&nbsp;Vijay Hadda","doi":"10.1155/2022/9914081","DOIUrl":"https://doi.org/10.1155/2022/9914081","url":null,"abstract":"<p><p>The recently diagnosed coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in December 2019 commonly affects the respiratory system. The incidence of acute hypoxic respiratory failure varied among epidemiological studies with high percentage of patients requiring mechanical ventilation with a high mortality. Noninvasive ventilation is an alternative tool for ventilatory support instead of invasive mechanical ventilation, especially with scarce resources and intensive care beds. Initially, there were concerns by the national societies regarding utilization of noninvasive ventilation in acute respiratory failure. Recent publications reflect the gained experience with the safe utilization of noninvasive mechanical ventilation. Noninvasive ventilation has beneficiary role in treatment of acute hypoxic respiratory failure with proper indications, setting, monitoring, and timely escalation of therapy. Patients should be monitored frequently for signs of improvement or deterioration in the clinical status. Awareness of indications, contraindications, and parameters reflecting either success or failure of noninvasive ventilation in the management of acute respiratory failure secondary to COVID-19 is essential for improvement of outcomes.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":"9914081"},"PeriodicalIF":2.2,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9453089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33460607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ADAM33 Silencing Inhibits Vascular Smooth Muscle Cell Migration and Regulates Cytokine Secretion in Airway Vascular Remodeling via the PI3K/AKT/mTOR Pathway.","authors":"Fang Yan,&nbsp;Xin Hu,&nbsp;Long He,&nbsp;Kegang Jiao,&nbsp;Yanyan Hao,&nbsp;Jing Wang","doi":"10.1155/2022/8437348","DOIUrl":"https://doi.org/10.1155/2022/8437348","url":null,"abstract":"<p><strong>Introduction: </strong>Vascular smooth muscle cells (VSMCs) are highly involved in airway vascular remodeling in asthma.</p><p><strong>Objectives: </strong>This study aimed to investigate the mechanisms underlying the effects of a disintegrin and metalloproteinase-33 (ADAM33) gene on the migration capacity and inflammatory cytokine secretion of VSMCs.</p><p><strong>Methods: </strong>Human aortic smooth muscle cells (HASMCs) were transfected with lentiviral vectors carrying short hairpin RNA (shRNA) targeting ADAM33 or negative control vectors. The migration capacity of HASMCs was evaluated by a transwell assay. The levels of secreted inflammatory cytokines were measured using enzyme-linked immunosorbent assay (ELISA) kits. Reverse transcription-quantitative polymerase chain reaction and Western blot assays were performed to detect mRNA and protein expression levels.</p><p><strong>Results: </strong>Silencing of ADAM33 significantly inhibited the migration of HASMCs. The expression of tumor necrosis factor alpha (TNF-<i>α</i>) in the supernatant of HASMCs was decreased, while that of interferon gamma (IFN-<i>γ</i>) was increased after the transfection of shRNA targeting ADAM33. Insufficient ADAM33 expression also suppressed the expression levels of phosphatidylinositol 3-kinase (PI3K), phospho-protein kinase B (AKT), phospho-mammalian target of rapamycin (mTOR), Rho-associated protein kinases, phospho-forkhead box protein O1 (FOXO1), and cyclin D1, but it did not affect the levels of AKT, mTOR, or Rho.</p><p><strong>Conclusion: </strong>Silencing of the ADAM33 gene inhibited HASMC migration and regulated inflammatory cytokine secretion via targeting the PI3K/AKT/mTOR pathway and its downstream signaling. These data contribute to a better understanding of the regulatory mechanisms of airway vascular remodeling in asthma.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":"8437348"},"PeriodicalIF":2.2,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9453083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33460605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Viral RNA Load in Symptomatic and Asymptomatic COVID-19 Omicron Variant-Positive Patients.","authors":"Qian Wu,&nbsp;Lixia Shi,&nbsp;Haomin Li,&nbsp;Shuping Huang,&nbsp;Hongwei Li,&nbsp;Li Li,&nbsp;Jin Han,&nbsp;Qi Wu,&nbsp;Zhengcun Pei","doi":"10.1155/2022/5460400","DOIUrl":"https://doi.org/10.1155/2022/5460400","url":null,"abstract":"<p><strong>Objectives: </strong>Viral load is important when evaluating viral transmission potential, involving the use of a polymerase chain reaction (PCR) cycle threshold (Ct) value. We aimed to analyze the PCR Ct values of respiratory tract samples taken from patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant strains to evaluate these strains' viral dynamics.</p><p><strong>Methods: </strong>This study comprised 361 patients. The Ct values of SARS-CoV-2-related respiratory samples were compared between symptomatic and asymptomatic patients.</p><p><strong>Results: </strong>The median (25^th percentile and 75^th percentile) nasopharynx and oropharynx SARS-CoV-2 Ct values were 30.5 (24.5-35.0) and 34.5 (30.0-37.0) in the symptomatic group, respectively, and 27.8 (23.4-34.5) and 33.5 (26.0-35.0) in the asymptomatic group, respectively, without significance. In the symptomatic group, subgroup analyses according to age showed the mean nasal Ct value for patients aged >18 years was 29.0 (23.5-34.5), which was significantly lower than that of patients aged 0-4 years and 5-13 years (36.0 (30.5-38.0) and 34.5 (31.0-39.0), respectively). The nasal Ct value for asymptomatic patients aged >18 years was 25.5 (20.9-28.4), which was significantly lower than of patients aged 5-13 years (34.5 (25.6-36.4)).</p><p><strong>Conclusion: </strong>Our findings suggest that the viral loads of asymptomatic and symptomatic patients did not differ significantly. However, adults infected with SARS-CoV-2 had higher nasal viral loads that those of young children.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":"5460400"},"PeriodicalIF":2.2,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9444452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33448945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Signal Pathways and Hub Genes of Pulmonary Arterial Hypertension by Bioinformatic Analysis.","authors":"Rui-Qi Wei,&nbsp;Wen-Mei Zhang,&nbsp;Zhe Liang,&nbsp;Chunmei Piao,&nbsp;Guangfa Zhu","doi":"10.1155/2022/1394088","DOIUrl":"https://doi.org/10.1155/2022/1394088","url":null,"abstract":"<p><p>Pulmonary arterial hypertension (PAH) is a progressive and complex pulmonary vascular disease with poor prognosis. The aim of this study was to provide a new understanding of the pathogenesis of disease and potential treatment targets for patients with PAH based on multiple-microarray analysis.Two microarray datasets (GSE53408 and GSE113439) downloaded from the Gene Expression Omnibus (GEO) database were analysed. All the raw data were processed by R, and differentially expressed genes (DEGs) were screened out by the \"limma\" package. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed and visualized by R and Cytoscape software. Protein-protein interactions (PPI) of DEGs were analysed based on the NetworkAnalyst online tool. A total of 442 upregulated DEGs and 84 downregulated DEGs were identified. GO enrichment analysis showed that these DEGs were mainly enriched in mitotic nuclear division, organelle fission, chromosome segregation, nuclear division, and sister chromatid segregation. Significant KEGG pathway enrichment included ribosome biogenesis in eukaryotes, RNA transport, proteoglycans in cancer, dilated cardiomyopathy, rheumatoid arthritis, vascular smooth muscle contraction, focal adhesion, regulation of the actin cytoskeleton, and hypertrophic cardiomyopathy. The PPI network identified 10 hub genes including HSP90AA1, CDC5L, MDM2, LRRK2, CFTR, IQGAP1, CAND1, TOP2A, DDX21, and HIF1A. We elucidated potential biomarkers and therapeutic targets for PAH by bioinformatic analysis, which provides a theoretical basis for future study.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":"1394088"},"PeriodicalIF":2.2,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9444450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33448944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy and Cost-Effectiveness of Umeclidinium/Vilanterol versus Tiotropium in Symptomatic Patients with Chronic Obstructive Pulmonary Disease.","authors":"Yinhua Gong,&nbsp;Chen Lin,&nbsp;Yifeng Jin,&nbsp;Rong Chen","doi":"10.1155/2022/2878648","DOIUrl":"https://doi.org/10.1155/2022/2878648","url":null,"abstract":"<p><strong>Background: </strong>Both long-acting muscarinic antagonists (LAMAs) and long-acting <i>β</i>2-agonists (LABAs) are widely used in the treatment of chronic obstructive pulmonary disease (COPD). A novel LAMA/LABA combination of umeclidinium/vilanterol (UMEC/VI; 62.5 <i>μ</i>g/25 <i>μ</i>g) is approved for chronic obstructive pulmonary disease (COPD) treatment.</p><p><strong>Objective: </strong>This study aimed to assess the efficacy and cost-effectiveness of UMEC/VI versus tiotropium (TIO) 18 <i>μ</i>g in symptomatic patients with COPD from the perspective of the Chinese National Healthcare System.</p><p><strong>Methods: </strong>A simple analysis included three studies in the meta-analysis that compared UMEC/VI with TIO. A Markov model was developed to estimate the cost-effectiveness of UMEC/VI compared with TIO treatment in symptomatic patients with COPD. First, utilities, clinical efficacy, and adverse events obtained from the literature were utilized as model inputs. Costs were from Chinese average data, including local data. Costs were expressed in dollars based on 2020 prices. Then, the model outputs including drug costs, other medical costs, and total costs, and quality-adjusted life years (QALYs) were estimated. Costs and outcomes were discounted at a 5% annual rate. Furthermore, incremental cost-effective ratios (ICERs) were analyzed. Finally, the influences of changing parameters on the uncertainty of the results were assessed by means of one-way and probabilistic sensitivity analyses.</p><p><strong>Results: </strong>This study revealed that UMEC/VI treatment had a higher rate of clinical efficacy in comparison with TIO, and the differences in the rate of adverse events between the two treatments were not significant. The results indicated that UMEC/VI was superior to TIO, which provided an increase in QALYs (0.002) and a total cost savings of $765.67 per patient over 3 years. In the base case, the ICER of UMEC/VI is -$397468.04/QALY compared with TIO, suggesting that UMEC/VI may be considered a dominant option over TIO. According to the Chinese medical system, the probability of UMEC/VI being cost-effective was 61.6% at a willingness-to-pay (WTP) of $31554/QALY. Sensitivity analyses confirmed that the results were robust.</p><p><strong>Conclusion: </strong>UMEC/VI could be considered a cost-effective treatment compared with TIO in symptomatic COPD patients from the Chinese National Healthcare System perspective. These results may help decision-makers in China when making judgements on which treatments to administer.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":"2878648"},"PeriodicalIF":2.2,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9436597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40350124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small Airway Dysfunction in Chronic Bronchitis with Preserved Pulmonary Function.","authors":"Qi Ding,&nbsp;Bai-Bing Mi,&nbsp;Xia Wei,&nbsp;Jie Li,&nbsp;Jiu-Yun Mi,&nbsp;Jing-Ting Ren,&nbsp;Rui-Li Li","doi":"10.1155/2022/4201786","DOIUrl":"https://doi.org/10.1155/2022/4201786","url":null,"abstract":"<p><p>Impairment of pulmonary function was evaluated in chronic bronchitis patients with preserved ratio impaired spirometry (PRISm). We retrospectively collected clinical data from 157 chronic bronchitis (CB) and 186 chronic obstructive pulmonary disease (COPD) patients between October 2014 and September 2017. These patients were assigned to three groups: control (normal pulmonary function), PRISm (forced expiratory volume in 1 second [FEV1]/forced vital capacity [FVC] ≥ 0.7, FEV1 < 80% of predicted value), and COPD (FEV1/FVC <0.7) groups. Because small airway function was the main focus, in the COPD group, only patients in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 1 and 2 were included. Evaluation of pulmonary function (including impulse oscillometry) was performed and compared among these groups. Compared with the control group, the PRISm and COPD groups showed statistically significant differences in the predicted FEV1% (<i>p</i> < 0.001), maximal expiratory flow (MEF) 25% (<i>p</i> < 0.001), MEF50% (<i>p</i> < 0.001), maximal midexpiratory flow (MMEF) 25-75% (<i>p</i> < 0.001), residual volume (RV)/total lung capacity (TLC; <i>p</i> < 0.001), FVC% (<i>p</i> < 0.001), total respiratory resistance and proximal respiratory resistance (R5-R20; <i>p</i> < 0.001), respiratory system reactance at 5 Hz (X5; <i>p</i> < 0.001), resonant frequency (Fres; <i>p</i> < 0.001), and area of reactance (Ax; <i>p</i> < 0.001). However, the predicted FEV1% and RV/TLC were similar between the PRISm and COPD groups (<i>p</i>=0.992 and 0.122, respectively). PRISm is a nonspecific pattern of pulmonary function that indicates small airway dysfunction and may increase the risk of transformation to obstructive ventilation dysfunction. This trial is registered with ChiCTR-OCH-14004904.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":"4201786"},"PeriodicalIF":2.2,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9433251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40350125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}