Objective To compare the differences of flow and volume responses in patients with mild to very severe chronic obstructive pulmonary disease（COPD） in bronchodilatation test. Methods The different changes of FEV1 and FVC in 217 patients with mild to very severe COPD（GOLD stage Ⅱ-Ⅳ） after inhaling salbutamol were analyzed retrospectively. Results FEV1 and FVC of the patients with COPD at stage Ⅱ-Ⅳ increased remarkably after inhaling β2 agonist，while there were significant differences between the changes of FEV1 and FVC. Increment of FEV1 and FVC (ΔFEV1 and ΔFVC)，representing flow and volume responses respectively，showed a normal distribution. The majority of patients fell in the range of ΔFEV1 from 0.00 to 0.04，0.05 to 0.09 and 0.10 to 0.14 liter，and ΔFVC from 0.00 to 0.09，0.10 to 0.19 and 0.20 to 0.29 liter. There was significant difference of ΔFEV1 among stage Ⅱ-Ⅳ patients with COPD （Plt;0.01），namely more severe the disease less ΔFEV1 got.In the other hand ΔFVC increased along with the progression of COPD，although no significant difference of ΔFVC among stage Ⅱ-Ⅳ patients with COPD was found. Though different changes of ΔFEV1 and ΔFVC were revealed，there was a positive correlation between ΔFEV1 and ΔFVC in patients at each GOLD stage and the correlation became more insignificant with the progression of COPD. Conclusions There are significant differences between post-bronchodilator flow and volume responses in patients with COPD.Flow response decreases remarkably along with the progression of COPD，whereas volume response increases along with the progression of COPD.
ObjectivesTo systematically review the efficacy of Qiliqiangxin capsule on cardiac function in patients with heart failure with preserved ejection fraction (HFpEF).MethodsCNKI, VIP, WanFang Data, CBM, EMbase, PubMed and The Cochrane Library databases were electronically searched to collect randomized controlled trials (RCTs) of Qiliqiangxin capsule for HFpEF from inception to August 1st, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was performed by RevMan5.3 software.ResultsA total of 24 RCTs involving 2 021 patients were included. The results of meta-analysis showed that Qiliqiangxin capsule combined with conventional western medicine could improve E/A wave ratio (MD=0.17, 95%CI 0.13 to 0.21, P<0.000 01), reduce E/e' wave ratio (MD=−2.16, 95%CI −3.23 to −1.08, P<0.000 1), BNP (MD=−240.43, 95%CI −357.66 to −123.20, P<0.000 1), and NT-proBNP (MD=−200.64, 95%CI −290.02 to −111.27, P<0.000 1). However, there were no statistically significant differences between two groups in re-hospitalization rate (RR=0.57, 95%CI 0.27 to 1.19, P=0.13), mortality (RR=0.33, 95%CI 0.04 to 3.05, P=0.33), and incidence of adverse events (RR=0.59, 95%CI 0.26 to 1.34, P=0.20).ConclusionsThe present evidence shows that Qiliqiangxin capsule combined with conventional western medicine can improve neuroendocrine disorders and cardiac structure in patients with HFpEF, and further improve cardiac diastolic function. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
ObjectivesTo analyze the application value of 6-minute walking test (6MWT) in the clinical evaluation of chronic heart failure (CHF).MethodsPubMed, EMbase, The Cochrane Library, CBM, VIP, WanFang Data and CNKI databases were searched online to collect randomized controlled trials (RCTs) of 6-minute walking distance (6MWD) as the CHF evaluation index. Two reviewers independently screened literature, extracted data, and then analyzed data by using SPSS 17.0 statistical software. The 6MWD with symptom, quality of life, exercise tolerance (ETT), left ventricular ejection fraction (LVEF), peak oxygen consumption (pVO2) were analyzed by Kappa consistency test, and the possible influencing factors of 6MWD were analyzed by logistic regression.ResultsA total of 158 RCTs involving 17 853 patients were included. The results of statistical analysis showed that: 6MWD was consistent with the improvement of symptoms, quality of life, ETT, LVEF and pVO2 (Kappa>0.4). Baseline 6MWD (OR=2.91, 95%CI 1.278 to 6.634,P=0.011) and NYHA Ⅲ-Ⅳ ratio (OR=2.59, 95%CI 1.091 to 6.138, P=0.031) were the independent influencing factors for 6MWD improvement separately.ConclusionsThe 6MWT is an objective and reliable indicator of CHF evaluation.
ObjectiveTo compare the efficacy and safety in the treatment of malignant gastric outlet obstruction between gastrojejunostomy (GJ) and self-expandable metallic stent (SEMS) placement.MethodsThe relevant literatures of efficacy and safety of GJ and SEMS placement in the treatment of malignant gastric outlet obstruction were searched in the PubMed, Embase, Cochrane Library, Web of Science, Clinical Trial, VIP, CNKI, Wanfang Data databases. The data were extracted and evaluated by the RevMan 5.3 software.ResultsA total of 12 articles with 1 505 patients were included, of which 620 underwent the GJ (GJ group) and 885 underwent the SEMS placement (SEMS group); 3 RCTs, 9 non-RCTs. The meta-analysis results showed: the length of hospital stay [MD=5.83, 95%CI (4.24, 7.42), P<0.000 01] and time of postoperative recovery diet [MD=3.41, 95%CI (1.79, 5.03), P<0.000 1] of the SEMS group were significantly shorter than those of the GJ group; Although the incidence of complications of the GJ group was significantly higher than that of the SEMS group [OR=1.85, 95%CI (1.27, 2.70), P=0.001], the technical success rate [OR=2.72, 95%CI (1.13, 6.53), P=0.03] and clinical success rate [OR=1.86, 95%CI (1.35, 2.57), P=0.000 2] were higher and the survival time was longer [MD=38.31, 95%CI (28.98, 47.64), P<0.000 01] of the GJ group as compared with the SEMS group.ConclusionsSEMS placement is more effective in recovering dietary capacity, length of hospital stay, and incidence of complications, while GJ is more effective in survival time, technical success rate, and clinical success rate. In clinical practice, we could choose different surgical method according to patient situation.