A high prevalence of bronchiectasis was found by chest computed tomography (CT) in patients with moderate–severe chronic obstructive pulmonary disease (COPD), and it was shown to be associated with more severe symptoms, higher frequency of exacerbations and mortality. The risk factors for bronchiectasis in COPD are not yet clarified.High-resolution computed tomography (HRCT) of chest was performed in patients with moderate–severe COPD, and the presence and the extent of bronchiectasis were evaluated by two radiologists. Demographic data, respiratory symptoms, lung function, previous pulmonary tuberculosis, serum inflammatory markers, serum total immunoglobulin E (T-IgE), and sputum culture of Pseudomonas aeruginosa were compared between those with and without bronchiectasis. Multivariate logistic regression analysis was used to determine the independent factors associated with bronchiectasis.We enrolled 190 patients with stable COPD, of which 87 (87/190, 45.8%) had bronchiectasis on HRCT. Compared with those without bronchiectasis, COPD patients with bronchiectasis were more likely to be males (P = 0.021), had a lower body mass index (BMI) (P = 0.019), a higher prevalence of previous tuberculosis (P = 0.005), longer history of dyspnea (P < 0.001), more severe dyspnea (P = 0.041), higher frequency of acute exacerbation (P = 0.002), higher serum concentrations of C-reactive protein (CRP) (P = 0.017), fibrinogen (P = 0.016), and T-IgE [P = 0.004; for log10(T-IgE), P <0.001]. COPD patients with bronchiectasis also showed poorer lung function (for FEV1/FVC, P = 0.013; for FEV1%predicted, P = 0.012; for global initiative for chronic obstructive lung disease (GOLD) grades, P = 0.035), and a higher positive rate of sputum P aeruginosa (P = 0.020). Logistic regression analysis demonstrated that male gender (P = 0.021), previous tuberculosis (P = 0.021), and increased level of serum T-IgE [for log10(T-IgE), P < 0.001] were risk factors for coexistent bronchiectasis. More notably, the level of serum T-IgE [log10(T-IgE)] was positively correlated with the extent of bronchiectasis in COPD patients (r = 0.208, P = 0.05).Higher serum T-IgE, male gender, and previous tuberculosis are independent risk factors for coexistent bronchiectasis in COPD. The association of T-IgE with the extent of bronchiectasis also suggests that further investigations are needed to explore the potential role of IgE in the pathogenesis of bronchiectasis in COPD.

Hydrogel-based biomaterials have been widely used for tissue engineering applications because of their high water content, swellability, and permeability, which facilitate transport and diffusion of essential nutrients, oxygen, and waste across the scaffold. These characteristics make hydrogels suitable for encapsulating cells and creating a cell supportive environment that promotes tissue regeneration when implanted in vivo. This is particularly important in the context of tissues whose intrinsic regenerative capacity is limited, such as cartilage. However, the clinical translation of hydrogels has been limited by their poor mechanical performance, low adhesive strength, uncontrolled degradation rates, and their susceptibility to bacterial colonization. Here, we introduce an elastic, antimicrobial, and adhesive hydrogel comprised of methacrylated hyaluronic acid (MeHA) and an elastin-like polypeptide (ELP), which can be rapidly photo-cross-linked in situ for the regeneration and repair of different tissues. Hybrid hydrogels with a wide range of physical properties were engineered by varying the concentrations of MeHA and ELP. In addition, standard adhesion tests demonstrated that the MeHA/ELP hydrogels exhibited higher adhesive strength to the tissue than commercially available tissue adhesives. MeHA/ELP hydrogels were then rendered antimicrobial through the incorporation of zinc oxide (ZnO) nanoparticles, and were shown to significantly inhibit the growth of methicillin-resistant Staphylococcus aureus (MRSA), as compared to controls. Furthermore, the composite adhesive hydrogels supported in vitro mammalian cellular growth, spreading, and proliferation. In addition, in vivo subcutaneous implantation demonstrated that MeHA/ELP hydrogels did not elicit any significant inflammatory response, and could be efficiently biodegraded while promoting the integration of new autologous tissue. In summary, we demonstrated for the first time that MeHA/ELP-ZnO hydrogel can be used as an adhesive and antimicrobial biomaterial for tissue engineering applications, because of its highly tunable physical characteristics, as well as remarkable adhesive and antimicrobial properties.

Preoperative combination of MRI and CT provides a better option to accurately predict the SNIP originating site, and thus may facilitate accurate and complete excision of the SNIP.