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Influence of the Pre-shock State on the Prognosis of Medical Patients with Sepsis: A Retrospective Cohort Study

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Biomedical and Environmental Sciences 2023年第12期36卷 1152-1161页

作者： ZHANG Lei GAI Xiao Yan LI Xin LIANG Ying WANG Meng ZHAO Fei Fan ZHOU Qing Tao sun yong chang Department of Respiratory and Critical Care Medicine Peking University Third HospitalBeijing 100191China Respiratory Intensive Care Unit Zhengzhou Central HospitalZhengzhou 450007HenanChina

Objective To investigate the effects of the pre-shock state on the mortality of patients with sepsis.Methods We enrolled patients with sepsis admitted to the medical intensive care unit of a tertiary care university hospital. These patients were then classified into three groups: sepsis, pre-shock state,and septic shock. The primary outcome was the 28-day mortality rate. The secondary outcomes were the 90-day, 180-day, and 1-year mortality rates.Results A total of 303 patients(groups: sepsis 135 [44.6%]), pre-shock state(93 [30.7%]), and septic shock(75 [24.8%]) completed the 1-year follow-up. The mortality rates at 28 days, 90 days, and 180days and 1 year were significantly higher in the pre-shock state group than those of the sepsis group,but significantly lower than those in the septic shock group, especially among older patients. When compared with the pre-shock state group, the sepsis group had significantly lower mortality risks at 28days, 90 days, and 180 days and 1 year, whereas the sepsis shock group had higher mortality risks at these time points.Conclusion The mortality rates of patients in the pre-shock state were notably different from those of patients with sepsis or septic shock. The introduction of a modified sepsis severity classification, which includes sepsis, pre-shock state, and septic shock, could offer valuable additional prognostic information.

关键词： Critical care Mortality Pre-shock state Sepsis Septic shock

Chronic obstructive pulmonary disease in China： a tale of two people

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Chinese Medical Journal 2010年第12期123卷 1491-1493页

作者： sun yong-chang Department of Respiratory Medicine Beijing Tongren Hospital Capital Medical University Beijing 100730 China

The term chronic obstructive pulmonary disease （COPD） has been well known and the diseaseextensively studied for more than a decade in China, but only recently has great progress been made in the epidemiology and management of this highly prevalent disease in this country. Historically, beginning in the early 1960s, long before the definition of COPD was widely accepted, a great number of studies that included traditional Chinese medicine had been performed on chronic bronchitis, emphysema, and related respiratory failure and cor pulmonale.

关键词： ACUTE EXACERBATION PERSPECTIVE

Taking ACTion for better control of asthma

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Chinese Medical Journal 2007年第12期120卷 1035-1036页

作者： sun yong-chang Department of Respiratory Medicine Peking University Third Hospital Beijing 100083 China

The global prevalence of asthma ranges from 1% to 18% of the population in different countries. In China, while national data of asthma prevalence are still lacking, an epidemiological study in Beijing showed that the prevalence of asthma in occupational populations was 1.25%. Based on epidemiological data reported in different regions, it is estimated that 15-20 million people suffer from asthma in the mainland of China,^4 and its prevalence continues to rise. A national epidemiological study of childhood asthma in the year of 2000 showed that the prevalence of asthma in urban children under the age of 14 years was 0.12%-3.34% in different regions,

关键词： asthma asthma disease management

A dangerous combination： tuberculosis and chronic obstructive pulmonary disease

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Chinese Medical Journal 2013年第12期126卷 2203-2204页

作者： sun yong-chang Department of Respiratory Medicine Beijing Tongren Hospital Capital Medical University Beijing 100730 China

oth chronic obstructive pulmonary disease （COPD） and pulmonary tuberculosis are leading causes of morbidity and mortality, and theretbre the most important challenges to public health in China. A large, populationbased survey showed that the prevalence of COPD was 8.2% （men, 12.4%; women, 5.1%） in adults 40 years of age or older,1 and even higher in Chinese rural areas where biomass fuels are the main sources of energy for cooking,

关键词： tuberculosis chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease in primary healthcare institutions in China: Challenges and solutions

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Chronic Diseases and Translational Medicine 2020年第4期6卷 219-223页

作者： sun yong-chang Department of Respiratory and Critical Care Medicine Peking University Third HospitalBeijing 100191China

Chronic obstructive pulmonary disease(COPD)is a preventable and treatable condition characterized by persistent respiratory symptoms and airflow limitation.It usually results from airway and/or alveolar abnormalities caused by exposure to noxious particles or gases.1 The burden of respiratory diseases,most commonly COPD,ranks third among all systemic diseases in China.2 In the latest epidemiological survey,the prevalence rate of COPD in rural areas was significantly higher than that in urban areas(9.6%vs.7.4%).3 Furthermore,most patients with COPD first visit primary healthcare institutions.However,the overall prevention and treatment standard for COPD at the primary level in China is not promising.4,5,6 This study aimed to introduce and present challenges in the prevention and treatment of COPD based on the relevant literature to improve the knowledge of and attention on healthcare-related treatment and prevention for COPD.

关键词： Chronic obstructive pulmonary disease Primary healthcare Primary guidelines China

Untreated Prior Pulmonary Tuberculosis Adversely Affects Pregnancy Outcomes in Infertile Women Undergoing in vitro Fertilization and Embryo Transfer: A Large Retrospective Cohort Study

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Biomedical and Environmental Sciences 2021年第2期34卷 130-138页

作者： GAI Xiao Yan CHI Hong Bin ZENG Lin CAO Wen Li CHEN Li Xue ZHANG Chen LU Ming NING Lan Ding chang Chun ZHANG Wei Xia LIU Ping LI Rong sun yong chang QIAO Jie Department of Respiratory and Critical Care Medicine Peking University Third HospitalBeijing 100191China Center for Reproductive Medicine Department of Obstetrics and GynecologyPeking University Third HospitalBeijing 100191China National Clinical Research Center for Obstetrics and Gynecology Beijing 100191China Research Center of Clinical Epidemiology Peking University Third HospitalBeijing 100191China Tuberculosis Department Beijing Geriatric HospitalBeijing 102699China Information Center Peking University Third HospitalBeijing 100191China

Objective Prior pulmonary tuberculosis(PTB) on chest X-ray(CXR) was commonly found in infertile patients receiving examinations before in vitro fertilization and embryo transfer(IVF-ET). It was unclear whether untreated PTB would affect pregnancy outcomes after IVF-ET.Method We conducted a retrospective cohort study of 14,254 infertile patients who had received IVFET at Peking University Third Hospital in 2017. Prior PTB was defined as the presence of signs suggestive of old or inactive PTB on CXR, with or without a clinical TB history. Patients who had prior PTB on CXR but had not received a clinical diagnosis and anti-TB therapy were included for analysis. Live birth,clinical pregnancy, and miscarriage rates were compared between the untreated PTB and non-PTB groups.Results The untreated PTB group had significantly lower clinical pregnancy(31.7% vs. 38.1%) and live birth(23.8% vs. 30.6%) rates than the non-PTB group(both P < 0.001). Multivariate analysis revealed that untreated PTB was a risk factor for decreased live birth rate [odds ratio(OR), 0.80;95% confidence interval(CI), 0.66–0.98;P = 0.028] in all patients and for increased miscarriage(OR, 4.19;95% CI,1.69–10.39;P = 0.002) and decreased live birth(OR, 0.45;95% CI, 0.24–0.83;P = 0.011) rates in patients with unexplained infertility.Conclusions Untreated PTB was associated with adverse pregnancy outcomes after IVF-ET, especially in patients with unexplained infertility, highlighting the clinical significance of PTB in this specific patient population.

关键词： Tuberculosis Embryo transfer In vitro fertilization Infertility Pregnancy outcome

Imbalance of osteoprotegerin/receptor activator of nuclear factor-κB ligand and oxidative stress in patients with obstructive sleep apnea-hypopnea syndrome

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Chinese Medical Journal 2019年第1期132卷 25-29页

作者： Xiao-Rong Ma yong Wang yong-chang sun Department of Respiratory Medicine Beijing Shijitan HospitalCapital Medical UniversityBeijing 100038China Department of Respiratory Medicine Beijing Tongren HospitalCapital Medical UniversityBeijing 100730China

Background:Obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with a higher prevalence of osteoporosis.However,the underlying mechanisms linking OSAHS with bone loss are still unclear.The aim of this study was to investigate the changes of receptor activator of nuclear factor-κB ligand (RANKL,an osteoclastogenesis-promoting factor) and osteoprotegerin (OPG,the decoy receptor for RANKL),oxidative stress and bone metabolism markers in OSAHS,in order to understand the potential mechanisms underlying bone loss in OSAHS patients.Methods:Forty-eight male patients with OSAHS,confirmed by polysomnography (PSG) study,were enrolled.Twenty male subjects who were confirmed as not having OSAHS served as the controls.The subjects’bone mineral density (BMD) was assessed in lumbar spine and femoral neck using dual-energy X-ray absorptiometry (DXA).Blood samples were collected from all subjects for measurement of RANKL,OPG,the bone formation marker bone-specific alkaline phosphatase (BAP),the bone resorption marker tartrate-resistant acid phosphatase 5b (TRAP-5b),and total antioxidant capacity (TAOC).Results:The BMD and the T-score of the femoral neck and the lumbar spine were significantly lower in OSAHS patients as compared to the control group (P 0.05).The serum level of OPG and the OPG/RANKL ratio were lower in the OSAHS group compared to the control group (bothP< 0.05).TAOC level was also decreased significantly in the OSAHS group (P< 0.05).Correlation analysis showed that the TAOC level was positively correlated with BAP in the OSAHS group (r= 0.248,P= 0.04),but there were no correlations between TAOC and the BMD or the T-scores.The correlations between the level of OPG (or the OPG/RANKL ratio) and BMD or TAOC did not reach significance.Conclusion:In OSAHS patients,lo

关键词： Obstructive sleep apnea-hypopnea syndrome Osteoporosis Receptor activator of nuclear factor-κB ligand Oxidative stress

Bronchiectasis as a Comorbidity of Chronic Obstructive Pulmonary Disease： Implications and Future Research

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Chinese Medical Journal 2016年第17期129卷 2017-2019页

作者： Ya-Hong Chen yong-chang sun Department of Respiratory and Critical Care Medicine Peking University Third Hospital Beijing 100191 China

Chronic obstructive pulmonary disease （COPD） is a heterogeneous disease with high morbidity and mortality. With increasing use of computed tomography in the assessment of patients with COPD, the presence of previously unrecognized radiological bronchiectasis is being identified. Accumulating evidence shows that bronchiectasis has an important impact on the natural history of COPD. Moderate-severe COPD with eomorbid bronchiectasis has more severe symptoms, higher frequency of exacerbations, and increased mortality Given the prognostic implications of bronchiectasis in COPD, its detection could serve as a guide to better management and eventually improved survival. Therefore, bronchiectasis was proposed as a comorbidity of COPD by Global Initiative for Chronic Obstructive Lung Disease （GOLD） updated 2014.

关键词： Bronchiectasis Chronic Obstructive Pulmonary Disease Comorbidity Computed Tomography

Allergy and Chronic Obstructive Pulmonary Disease

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Chinese Medical Journal 2017年第17期130卷 2017-2020页

作者： Jian-Min Jin yong-chang sun Department of Respiratory and Critical Care Medicine Beijing Tongren Hospital Capital Medical University Beijing 100730 China Department of Respiratory and Critical Care Medicine Peking University Third Hospital Beijing 100191 China

Allergy,airway hyperreactivity （AHR）,and allergic asthma are risk factors of chronic obstructive pulmonary disease （COPD）,a heterogeneous disease presenting with various phenotypes.An allergic phenotype of COPD,characterized by more severe respiratory symptoms and higher risk of acute exacerbations,was described recently.[1] Further investigations into the role of allergy in the pathogenesis and/or expressions of COPD may lead to new modalities targeting the allergic component,a potentially treatable feature of a progressive disease like COPD.

关键词： Allergy Chronic Obstructive Pulmonary Disease Phenotype