[Meta-analysis of efficacy and safety of Suhuang Zhike Capsules in treatment of chronic obstructive pulmonary disease].

This study aims to evaluate the effectiveness and safety of Suhuang Zhike Capsules in treating chronic obstructive pulmonary disease. The Chinese and English databases were searched(from the establishment to July 2021) for randomized controlled trials(RCTs) on the treatment of chronic obstructive pulmonary disease with Suhuang Zhike Capsules, yielding 130 articles and finally 12 eligible RCTs. The 12 RCTs enrolled a total of 1 159 patients(579 in experimental group, 580 in control group), with 728 males(62.8%) and 431 females(37.2%). Meta-analysis showed that the conventional western medicine combined with Suhuang Zhike Capsules increased clinical efficacy(OR=4.31, 95%CI[2.88, 6.46], Z=7.08, P<0.000 01), forced expiratory volume in one second(FEV1)(SMD=0.88, 95%CI[0.60, 1.16], Z=6.24, P<0.000 01), forced vital capacity(FVC)(SMD=0.96, 95%CI[0.38, 1.55], Z=3.22, P=0.001), forced vital capacity rate of one second(FEV1/FVC%)(SMD=0.85, 95%CI[0.51, 1.19], Z=4.92, P<0.000 01), and maximum voluntary ventilation(MVV)(SMD=0.61, 95%CI[0.39, 0.83], Z=5.40, P<0.000 01) compared with the conventional western medicine alone. The differences in residual volume/total lung capacity(RV/TLC)(SMD=-0.93, 95%CI[-3.38, 1.53], Z=0.74, P=0.46) and adverse reactions(OR=1.39, 95%CI[0.76, 2.56], Z=1.07, P=0.28) are insignificant. The study showed that the conventional western medicine combined with Suhuang Zhike Capsules could improve clinical efficacy and lung functions in the treatment of chronic obstructive pulmonary disease. In addition, the combination had been verified to be safe. However, in view of the uneven method quality, small sample size, and inconsistent outcome indicators of the included studies, higher-quality, multi-center, and large-sample RCTs are needed for further verification.

Puzzling onsets of pneumonia sequentially after each session of bronchial thermoplasty: a case report.

BACKGROUND: Bronchial thermoplasty (BT) is a novel bronchoscopic intervention for severe persistent asthma. An increase in transient respiratory adverse events associated with BT were noted over the treatment periods, however, these events appear sporadic and should not always recur in a single individual and BT-related pneumonia has rarely been reported. CASE PRESENTATION: We present a case of uncontrolled severe asthma who developed puzzling pneumonia sequentially after each session of BT procedures. After each operation of three sequential BT procedures, she developed cough and purulent expectoration when her chest radiology showed new infiltrates right in the treatment regions. After empirical use of antibacterial agents plus physiotherapy and postural sputum drainage, her symptoms vanished and chest imaging resumed normal. CONCLUSION: The originality of our case report is related to the recurrence of pneumonia after three sequential BT procedures. To date, similar report has not been available in the literature. We hope to prompt alerts for post-BT respiratory infections, although most of them, along with other adverse events, are mild and tractable.

The neuroprotective effect of apigenin against OGD/R injury in rat hippocampal neurons.

To investigate the effects of apigenin on the injury caused by oxygen and glucose deprivation in neurons and the underlying mechanisms, primary cultured rat hippocampal neurons were incubated with apigenin for 90 min before a 2-h oxygen and glucose deprivation followed by a 24-h reperfusion (OGD/R). Subsequently, cell viability, lactate dehydrogenase (LDH) leakage rate, apoptotic rate of neurons and activity of the sodium pump were assessed. In addition, activity of the sodium pump was also examined in the hippocampus of SD rats injected intraperitoneally with apigenin 90 min before a 10-min global cerebral ischemia/24-h reperfusion. The results showed that cell viability and activity of the sodium pump markedly decreased but LDH leakage rate and apoptotic rate significantly increased in OGD/R-treated neurons. However, pretreatment with apigenin (20-50µmol/L) reversed the changes dose-dependently. Compared to sham controls, activity of the sodium pump was significantly suppressed in global ischemia/reperfusion rats; application of apigenin (200mg/kg) restored the activity of the sodium pump. Furthermore, the neuroprotective effect of apigenin was blocked partly by the sodium pump inhibitor ouabain. Our findings provide the evidence that apigenin has a neuroprotective effect against OGD/R injury and the protective effect may be associated with its ability to improve sodium pump activity.

Formoterol as reliever medication in asthma: a post-hoc analysis of the subgroup of the RELIEF study in East Asia.

BACKGROUND: As-needed formoterol can effectively relieve asthma symptoms. Since budesonide/formoterol is available as maintenance and reliever therapy in Asia, formoterol is now being used as-needed, but always with concomitant inhaled corticosteroids. The objective of this analysis was to assess the safety and efficacy of formoterol therapy in patients in East Asia (China, Indonesia, Korea, the Philippines and Singapore) with asthma. METHODS: Post-hoc analyses of data from the East Asian population of the RELIEF (REal LIfe EFfectiveness of Oxis® Turbuhaler® as-needed in asthmatic patients; study identification code: SD-037-0699) study were performed. RESULTS: This sub-group comprised 2834 randomised patients (formoterol n = 1418; salbutamol n = 1416) with mean age 35 years; 50.7% were male. 2678 patients completed the study. There was no significant difference in the total number of adverse events (AEs) reported in the formoterol and salbutamol groups (21.3% vs 20.9% of patients; p = 0.813), nor in the total number of serious AEs and/or discontinuations due to AEs (4.6% vs 5.5%, respectively; p = 0.323). Compared with salbutamol, formoterol was associated with a significantly longer time to first exacerbation (hazard ratio 0.86; p = 0.023) and a 14% reduction in the risk of any exacerbation (p < 0.05). Relative to salbutamol, mean adjusted reliever medication use throughout the study was significantly lower in the formoterol group (p = 0.017) and the risk of increased asthma medication use was 20% lower with formoterol (p = 0.005). CONCLUSIONS: Among patients with asthma in East Asia, as-needed formoterol and salbutamol had similar safety profiles but, compared with salbutamol, formoterol reduced the risk of exacerbations, increased the time to first exacerbation and reduced the need for reliever medication.

[Comparison of the Effectiveness of Different Supraglottic Ventilation Methods during Bronchial Thermoplasty].

OBJECTIVE: To compare the effectiveness of high-frequency jet ventilation via Wei jet nasal airway and controlled ventilation with improved laryngeal mask airway during bronchial thermoplasty. METHODS: Twenty-eight patients undergoing bronchial thermoplasty were equally divided into two groups: group A (high-frequency jet ventilation through Wei jet nasal airway) and group B (controlled ventilation with improved laryngeal mask airway). Pulse oxygenation,heart rate,and mean arterial blood pressure were recorded after entering the operating room (T0), 1 minute after administration/induction (T1), bronchoscope inserting (T2), 15 minutes (T3)/30 minutes (T4)/45 minutes (T5) after ventilation,at the end of the operation (T6), and at the recovery of patients' consciousness (T7). The pH,arterial oxygen partial pressure,and arterial carbon dioxide partial pressure were recorded at T0, T4, and T6. The endoscope indwelling duration,operative time,patients' awakening time,adverse events during anesthesia,satisfactions of patients and operators, anesthesic effectiveness were also recorded. RESULTS: The arterial carbon dioxide partial pressur in group A at T4 and T6 were significantly higher than in group B (P<0.05). The pH in group A at T4 and T6 was significantly lower than in group B (P<0.05). The endoscope indwelling duration and the operative time in group B were significantly shorter than in group A (P<0.05) while the recovery of consciousness in group B was significantly longer than in group A (P<0.05). The satisfaction for operators and the efficacy of anesthesia in group B were better than in group A (P<0.05). The number of adverse events in group B was significantly smaller than in group A (P<0.05). CONCLUSION: The improved laryngeal mask airway with controlled ventilation is more suitable for bronchial thermoplasty.

[Survey on the prevalence rate of bronchial asthma in Beijing area among the residents aged over 14 years from 2010 to 2011].

OBJECTIVE: To survey the prevalence rate of bronchial asthma in Beijing area among residents aged over 14 years. METHODS: In accordance with stratified cluster random sampling, epidemiological questionnaires were performed in Beijing residents aged over 14 years during household visits from February 2010 to August 2011. Asthma was diagnosed on the basis of case history, clinical signs and lung function test. The statistical software SAS 9.2 was employed to analyze the epidemiological status of asthma. RESULTS: In a sampling population of 61 107, 57 647 questionnaires were effective. Among 687 asthmatics, there were 296 males and 391 females. The overall prevalence rate of asthma was 1.19% (687/57 647). The asthma prevalence rates were 1.09% (418/38 468) and 1.40% (269/19 179) in urban and suburb Beijing respectively and the prevalence rate of asthma in suburb area was significantly higher than that of urban area (χ(2) = 10.850, P = 0.001). The prevalence rates of males and females were 1.06% (296/27 947) and 1.32% (391/29 700) respectively and the prevalence rate of asthma in females was much higher than that of males (χ(2) = 8.098,P = 0.004). Significant differences existed among different age groups (χ(2) = 404.874, P = 0.000) and residents aged at or over 71 years had the highest prevalence rate. The prevalence rates in urban and suburb Beijing area increased by 1.12 and 2.26 folds respectively than that of 2002. And 198 asthmatics were first diagnosed in this survey and accounted for 28.8% (198/687) in all asthma diagnosed asthmatics. CONCLUSIONS: The prevalence rate of asthma in Beijing area among residents aged over 14 years increased greatly from 2010 to 2011. And the epidemiological data may reflect the current distribution status of asthma in Beijing area.

[A survey of knowledge on common cold in outpatient clinics].

OBJECTIVE: To investigate outpatients' cognition towards common cold and their habituated medication so as to provide evidence for future public healthcare education. METHODS: Patients who attended hospital for diagnosis and treatment of common cold at least within past three months were asked to fill a questionnaire independently so as to learn their cognition towards common cold and medication habit. RESULTS: Among the patients underwent survey, 52.21% had incorrect knowledge about common cold; 12.99% didn't know about the hazards of common cold; 34.80% couldn't distinguish common cold from influenza; 30.07% considered common cold couldn't get relief without treatment; 68.24% didn't know about the proper effects of influenza vaccination; 61.14% often took oral medicine even intravenous injection when they caught a common cold; 59.77% often took medication from drugstore without prescription by doctor, and a few asked doctors to prescribe medicine on their request; 19.42% didn't know about the side effects of drug for cold treatment; and 19.72% didn't know about the active ingredients of drug for cold treatment. There were significant differences in the common cold cognition among population of different ages and education background. The older or the higher education status patients had a better cognition (P < 0.01). CONCLUSION: There exist a certain degree of wrong cognition towards common cold among patients of different literacy degree and different age. Public health education on common cold need to be further strengthened.

[A survey of knowledge on common cold and its treatment situation among physicians from various levels of hospitals in mainland China].

OBJECTIVE: To investigate the cognition of the common cold and current situation of the treatment among physicians from various levels of hospitals in Chinese mainland, so as to provide evidence for future continuing medical education and rational medication. METHODS: A questionnaire designed for this survey was used to learn about the general information, cognitive degree of the common cold and prescription habits of physician who prescribed for cold within last three months, from various levels hospitals. RESULTS: A total of 1001 physicians were interviewed. Among them, 749 physicians chose right options that the cold was the common cold and the influenza with 79.84% in resident physicians and 56.76% in chief physicians. A total of 745 physicians chose options that the course of common cold will be lasting 4 to 7 days; 895 physicians chose options that old people are the most susceptible for complication; 669 physicians thought the common cold was the most common infection in winter; 841 physicians used clinical methods to diagnose the common cold; 736 physicians thought although the cold was a kind of self-limited disease and symptomatic treatment could alleviate symptoms and improve life quality, patients should see doctor in time if it turns to severer; and 745 physicians held the opinion that treatment of the common cold should focus on relieving symptoms first. In addition, 61.60% physicians had made prescription based on clinical symptoms; 505 (54.24%) of them thought compound drugs were priority in treating the common cold. However, there were still 43 physicians prescribed antibiotics for common cold. CONCLUSIONS: There is misunderstanding and discrepancy in cognition towards common cold and treatment among physicians from various levels of hospitals in mainland China. Physicians should standardize diagnosis and treatment for the common cold according to the domestic and foreign guidelines.

[Normal values and influencing factors of fractional exhaled nitric oxide for Chinese healthy adults].

OBJECTIVE: To evaluate the normal values of fractional exhaled nitric oxide (FENO) for Chinese adults. METHODS: A total of 200 non-smoking and healthy Chinese adults were recruited according to the inclusion and exclusion criteria. They received lung function and allergen skin prick tests at the Outpatient Department of China-Japan Friendship Hospital from February to August 2011. There were 100 males and 100 females. FENO test was performed according to the standard procedures of American Thoracic Society/European Respiratory Society (ATS/ERS) recommendation. The FENO levels of healthy non-smokers were tested by the NIOXMINO analyzer. All variables, such as age, gender, height, weight, forced expiratory volume at 1 second (FEV(1))% predicted and FEV(1)/FVC, were included for multiple regression analyses. RESULTS: The FENO level of healthy non-smokers was (14.2 ± 5.6)×10(-9) mol/L with the 95% normal range of (3.2 - 25.2)×10(-9) mol/L. The value of FENO was significantly higher in males than females ((15.6 ± 5.5) vs (12.9 ± 5.4)×10(-9) mol/L, t = 3.48, P = 0.001). The FENO level of the subjects aged 60 - 80 years was (15.7 ± 5.4)×10(-9) mol/L and it was higher than those aged 18 - 60 years ((13.8 ± 5.6)×10(-9) mol/L, t = 2.04, P = 0.040). Multiple regression analysis showed that gender was an independent influencing factor of FENO level. CONCLUSIONS: The FENO level of non-smoking and healthy Chinese adults is similar with that of the westerners. Gender is an independent influencing factor of FENO level.

[Mechanism of p38 mitogen-activated protein kinase inhibitor SB203580 to glucocorticoid sensitivity].

OBJECTIVE: To establish a model of cigarette smoke exposure to asthmatic rats and glucocorticoid resistance induced by nicotine in alveolar epithelioid cells A549 and study the mechanism for the change of glucocorticoid sensitivity induced by p38 mitogen-activated protein kinase (p38 MAPK) inhibitor SB203580. METHODS: Sixty Wistar rats were randomly divided into 4 groups: normal group, asthmatic group, cigarette smoke exposure to asthmatic group and SB203580 group. The mRNA expressions of glucocorticoid receptor (GR), heat shock protein 90 (HSP90) and p38 MAPK were detected by real time-polymerase chain reaction (RT-PCR) while their protein expressions detected by Western blot in vivo. A549 cells were divided averagely into 4 groups: group A: normal; group B: 1 µmol/L dexamethasone (DEX); group C: 1 µmol/L DEX +1 µmol/L nicotine; group D: 1 µmol/L DEX +1 µmol/L nicotine+1 µmol/L SB203580. Immunofluorescence staining was used to study the in vitro colocalization of glucocorticoid receptor (GR) in A549 cells. RESULTS: The mRNA expression of GR was 0.671 ± 0.002 in cigarette smoke exposure to asthmatic group and 0.595 ± 0.061 in SB203580 group (P = 0.065). The protein expression of GR was 0.700 ± 0.033 in cigarette smoke exposure to asthmatic group and 0.628 ± 0.091 in SB203580 group (P = 0.148). The mRNA expression of HSP90 was 0.558 ± 0.009 in cigarette smoke exposure to asthmatic group and 0.377 ± 0.046 in SB203580 group (P = 0.000). The protein expression of HSP90 was 0.507 ± 0.030 in cigarette smoke exposure to asthmatic group and 0.402 ± 0.050 in SB203580 group (P = 0.005). The mRNA expression of p38 MAPK was 0.971 ± 0.012 in cigarette smoke exposure to asthmatic group and 0.278 ± 0.049 in SB203580 group (P = 0.000). The protein expression of p38 MAPK was 0.982 ± 0.038 in cigarette smoke exposure to asthmatic group and 0.338 ± 0.042 in SB203580 group (P = 0.000). The ratio of GR amount within A549 nucleus versus that in cytoplasm was 0.077 ± 0.047 in group C and 0.592 ± 0.249 in group D (P = 0.000). CONCLUSION: The mechanism of SB203580 enhancing the corticosteroid sensitivity may be improving nuclear translocation of GR to elevate corticosteroid sensitivity.

[A study on the correlation between exercise-induced bronchoconstriction and atopy].

OBJECTIVE: To investigate the correlation between exercise-induced bronchoconstriction and atopy. METHODS: Exercise-induced bronchoconstriction (EIB) was defined by free running asthma screening test. Atopy was defined by serum total IgE level and skin allergen test. Airway hyperreactivity was determined by bronchial provocation test. For a matched pair study, all EIB and some non-EIB students received serum total IgE measurements, skin allergen test and bronchial provocation test. All data were calculated by correlation analysis to investigate the correlation between EIB and atopy. RESULTS: Totally 773 students participated in the free running screening test, and 89 students (11.5%) were diagnosed as having EIB. The serum total IgE level exceeded the normal range in 16 among the 89 EIB students, but in 10 among the 70 non-EIB students. Statistical analysis (χ(2) test) did not support the correlation between atopy and EIB. Fifty EIB students received bronchial provocation test, but only 1 showed airway hyperreactivity. CONCLUSION: There was no correlation between atopy and EIB, and airway hyperreactivity was absent in most of the EIB students.

[Values of fractional exhaled nitric oxide in the diagnosis of chronic cough].

OBJECTIVE: To evaluate the diagnostic value of fractional exhaled nitric oxide (FeNO) in the diagnosis of chronic cough. METHODS: A total of 106 subjects with chronic cough and normal chest radiographs were recruited from October 2009 to September 2010. Based on the management guidelines of the Chinese Respiratory Society for cough, the golden standard methods were used to make the definite diagnosis of chronic cough, including sputum cell counts, pulmonary function tests, bronchial hyperresponsiveness, 24-h esophageal pH monitoring, skin pricking test and serum immunoglobulin E. All subjects received a FeNO test by a NIOXMINO analyzer. The values of FeNO to diagnose cough variant asthma (CVA) from chronic cough and EB from non-asthma cough were respectively assessed by the receiver operating characteristic (ROC) curves. RESULTS: Among them, the definite diagnoses were cough variant asthma (CVA, n = 39), eosinophilic bronchitis (EB, n = 30) and other causes (n = 37). The FeNO levels in CVA [(54 ± 21) ppb)] (1 ppb = 1 × 10(9) mol/L) were significantly higher than those in EB [(34 ± 17) ppb, P < 0.01] and other causes [(21 ± 10) ppb, P < 0.01]. And the FeNO levels in EB were higher than those in other causes (P < 0.01). To diagnose CVA from chronic cough, the optimal FeNO cutoff value was 40 ppb with a sensitivity of 75%, a specificity of 86%, a positive predictive value of 77%, a negative predictive value of 86% and an accuracy of 81%. To diagnose EB from non-asthma chronic cough, the optimal FeNO cutoff value was 31 ppb with a sensitivity of 63%, a specificity of 92%, a positive predictive value of 88%, a negative predictive value of 92% and an accuracy of 72% respectively. CONCLUSION: There are significant differences between the FeNO levels of different causes of chronic cough. A marked elevation of FeNO level helps to make a final diagnosis of CVA or EB. FeNO test is useful for making the diagnosis and differential diagnosis of chronic cough in clinic practices.

[The values of fractional exhaled nitric oxide in the diagnosis and treatment of chronic cough].

OBJECTIVE: To evaluate the values of fractional exhaled nitric oxide (FENO) in the diagnosis and treatment of chronic cough. METHODS: Based on the protocol from The Chinese Respiratory Society guidelines for management of cough, 75 consecutive subjects with chronic cough and normal chest radiographs were recruited from the outpatient clinic of the Department of Respiratory Diseases in China-Japan Friendship Hospital from January to June 2010. All the patients accepted FENO tests, sputum cell counts, pulmonary function tests, bronchial hyperresponsiveness (BHR), serum IgE, cough symptom scores and Leicester cough Questionnaire (LCQ) before and after treatment of 4 weeks. RESULTS: The final diagnosis of the subjects included 29 with cough variant asthma (CVA), 19 with eosinophilic bronchitis (EB) and 27 with other causes (Others). FENO levels in CVA (58 ± 26) ppb were significantly higher than those in EB (36 ± 18) ppb and Others (20 ± 7) ppb, and the FENO levels in EB were higher than Others (F = 28.2, P < 0.01). FENO levels showed significant correlations with sputum eosinophils, BHR, cough symptom scores, non-specific IgE, and LCQ scores. The mean baseline FENO level of the subjects whose coughs were relieved after inhaled corticosteroid therapy was (63 ± 42) ppb, higher than those of the non-responders (28 ± 13) ppb (t = 3.91, P < 0.01). There were significant correlations between the percentage of FENO decrease and the percentage of sputum eosinophil decrease or the cough symptom score decrease. CONCLUSION: FENO could be used as a inflammation marker of chronic cough because of its good correlation with sputum eosinophils, AHR, atopy, and cough symptoms. FENO also has a potential to predict the response of anti-inflammatory therapy because FENO decrease is correlated with the decrease of eosinophilic inflammation and improvement of cough symptoms.

Impact of Preoperative Short-Term Parenteral Nutrition Support on the Clinical Outcome of Gastric Cancer Patients: A Propensity Score Matching Analysis.

OBJECTIVES: Nutrition status is of great significance to the clinical outcome after major abdominal surgery. However, the effect of preoperative short-term parenteral nutrition (PN) support among gastric cancer (GC) patients remains unknown and was evaluated in the current study. METHODS: We retrospectively analyzed 455 nutritionally at-risk GC patients after radical resection from 2010 to 2016. We matched patients with 3-7 days of PN support to those without PN support. χ2 And Mann-Whitney U tests were used to compare differences between the PN and control groups. RESULTS: The propensity-matched sample included 368 GC patients (PN group, n = 184; control group, n = 184). The PN and control groups did not differ regarding postoperative complications (P = .528). The incidence of anastomotic leakage in the PN group was lower than in the control group (P = .011), whereas other complications were not found to differ between the groups. The hospitalization cost of the PN group was significantly higher than that of the control group (P < .001), whereas other outcome indicators were similar. Subgroup analysis showed that short-term PN support may have an improved benefit for patients with serum albumin level <35 g/L, but not at the level of statistical significance (P = .17). CONCLUSION: Short-term PN support did not significantly improve the short-term clinical outcomes of nutritionally at-risk GC patients, with the exception of a lower incidence of anastomotic leakage. Considering that short-term PN support increases economic burden, PN should not be the preferred method among these patients.

A comparison of tiotropium/olodaterol vs tiotropium alone in terms of treatment effect for chronic obstructive pulmonary disease: A meta-analysis.

BACKGROUND: Combinations of long-acting bronchodilators with different mechanisms of action are recommended to improve prognosis and reduce risk of adverse events of chronic obstructive pulmonary disease (COPD). It is unclear whether the new combination therapy with long-acting muscarinic antagonist (LAMA) tiotropium (TIO) and long acting beta-agonists (LABA) olodaterol (OLO) was superior to tiotropium alone. METHODS: We measured the efficacy of the TIO/OLO combination vsTIO alone for COPD patients based on electronic databases up to February 2019. After rigorous quality review, data was extracted from eligible trials. All the main outcomes were pooled analysis using RevMan software. RESULTS: A total of 6 randomized controlled trials (RCTs) were identified. The pooled results of our meta-analysis demonstrated that FEV1 [MD = 0.03, 95% CI (-0.01,0.07), P = .18], FVC [MD = -0.03, 95%CI (-0.06,0.00), P = .09] and FEV1%pred [MD = 0.35, 95%CI (-0.30, 0.99), P = .29] all showed no significant difference between the 2 groups. The overall incidence of adverse effects (AEs) [OR = 1.01,95%CI (0.93,1.09), P = .87] and serious AEs [OR = 1.04,95% CI (0.82, 1.32), P = .72] in the combination group was similar to that of the TIO alone group, without statistical significance. CONCLUSION: These studies reported that the TIO/OLO combination did not show superior effects than tiotropium alone for COPD. Additionally, both therapies were well tolerated.

[T-bet gene modified dendritic cells abrogate and reverse the airway inflammation in allergic asthma: experiment with mice].

OBJECTIVE: To explore the feasibility of the therapeutic strategy to use T-bet gene modified dendritic cells (DCs) to reverse the course of asthma. METHODS: (1) Mature DCs were derived from mononuclear cells obtained from femur of BALB/c mouse and divided into 3 groups, T-bet group transfected with recombinant adenovirus Ad-T-bet containing T-bet gene, LacZ group transfected with recombinant adenovirus Ad-LacZ containing LacZ gene, and control group. Seven days later ELISA was used to detect the interferon (IFN)-gamma level in the culture fluid. (2) Airway inflammation abrogating trial. Twenty-four BALB/c mice were sensitized with intraperitoneal injection of ovalbumin (OVA) (on day 1 and 15) to establish asthma models, and then randomly divided into 3 equal groups: T-bet group injected intravenously with T-bet-modified DCs on day 27, LacZ group injected with LacZ-modified DCs, and model control group without intravenous injection. Two days later the model mice began to undergo challenge by inhalation of OVA twice (on day 29 - 31). Eight mice were used as control group treated with PBS. On day 37 all mice were killed, ELISA was used to detect the blood interleukin (IL)-4 and IFN-gamma levels, and microscopy was conducted to observe the airway inflammation. (3) Airway inflammation reversing trial. Another 24 model mice were divided into 3 equal groups as well: re-challenged T-bet group injected intravenously with T-bet-modified DCs on day 27 and 42, re-challenged LacZ group injected intravenously with LacZ-modified DCs on day 27 and 42, and model control group. Since the day 45 OVA inhalation was given once a day for successive 3 days. On day 49 these mice were all killed to undergo the tests as mentioned above. RESULTS: The IFN-gamma level in the culture fluid of the T-bet gene modified DCs was (15.24 +/- 4.75) ng/ml, significantly higher than that of the LacZ gene modified DCs and control DCs [(3.08 +/- 0.61) and (2.35 +/- 0.41) ng/ml respectively, both P < 0.01]. The IFN-gamma in mice blood plasma of T-bet groups in abrogating and reversing trial were (130.2 +/- 10.5) and (145.7 +/- 16.7) pg/ml respectively, both significantly higher than those of the abrogating and reversing trial normal control groups [(25.0 +/- 6.5) and (24.6 +/- 5.9) pg/ml respectively], asthmatic model control groups [(20.7 +/- 4.5) and (16.5 +/- 7.0) pg/ml respectively] and LacZ groups [(17.6 +/- 7.0) and (24.2 +/- 9.0) pg/ml respectively] (all P < 0.01). However, the IL-4 levels in mice blood plasma of T-bet groups were both significantly lower than those of asthmatic model control groups and LacZ groups (all P < 0.01). The airway inflammation of T-bet groups were remarkable milder than those of the model control groups and LacZ groups. CONCLUSION: The asthma management strategy based on T-bet gene modified DCs is feasible with the plausible mechanism that the T-bet gene modified DCs regulate the T cells differentiation and polarization on the antigen presenting level.

[Survey of asthma control and perception in asthmatic outpatients of Beijing urban district].

OBJECTIVE: To evaluate the status of asthma control and asthma perception in asthmatic outpatients of Beijing urban district. METHODS: A questionnaire survey in a face-to-face setting was conducted among 360 asthmatic out-patients, 144 males and 316 females, aged (48 +/- 15), from June 2007 to December 2007 in 3 class 3 first level general hospitals in 3 Beijing urban districts. RESULTS: Among 360 asthmatic patients, 325 (90.3%) enjoyed various kinds of social insurance. During the past year, 12.2% (44/360) of them were in hospital because of asthma exacerbation, 25.6% (92/360) of them had visited emergency department because of asthma exacerbation; the percentage of adults with lost workdays caused by asthma was 29.6% (65/220), and the percentage of children with lost school days was 26.9% (7/26); 87.8% (316/360) of the respondents had undergone a lung-function test, 29.2% (105/360) had ever used peak flow meter; 68.6% (247/360) of these patients had been used inhaled corticosteroids regularly for a long time, and 30.6% (110/360) of them achieved asthma control. CONCLUSIONS: The levels of asthma control and asthma perception among the asthma patients in Beijing have been improved a lot. The asthma perception of the patients influences the control level greatly.

[The spectrum and clinical features of causes for chronic cough].

OBJECTIVE: To explore the spectrum and clinical features of causes for chronic cough. METHODS: A total of 103 patients with at least 8 weeks of chronic cough and normal chest radiographs were recruited from the outpatient clinic of China-Japan Friendship Hospital Department of Respiratory Diseases between Oct 2005 to Feb 2009. The causes were investigated using a well established protocol according to The Chinese Respiratory Society guidelines for management of cough. The diagnostic protocol included history inquiring and physical examination, pulmonary function tests, induced sputum cell differentials, 24 h esophageal pH monitoring, CT of the paranasal sinuses or chest, fiberoptic rhinoscopy or bronchoscopy. The final diagnosis was made based on clinical manifestations, examination findings and a positive response to therapy. The results were compared with those reported in Guangzhou before. RESULTS: The cause of chronic cough was defined in 95.1% of the patients, of which 83 patients (83.5%) with a single cause, 32 (13.6%) with 2 causes, and 3 (2.9%) with 3 causes. The most important causes of cough were: cough variant asthma (CVA) (n = 41, 33.3%), rhinitis and/or sinusitis (n = 30, 24.4%), gastroesophageal reflux (GERC) (n = 25, 20.3%), medicine related (n = 7, 5.7%), eosinophilic bronchitis (EB) (n = 6, 4.9%), atopic (n = 4, 3.3%), and idiopathic (n = 6, 4.9%). Other causes included pulmonary interstitial fibrosis (n = 2, 1.6%), left heart insufficiency (n = 1, 0.8%) and bronchiectasis (n = 1, 0.8%). There was more nocturnal cough in CVA (80.9%, 36/41) than in other causes (chi2 = 19.81, P<0.01). In CVA, 63.4% (26/41) was complicated with atopic rhinitis, 68.3% (28/41) showed seasonal variations, and 67.8% (19/28) aggravated in the autumn. GERC manifested more day coughs, with 56.0% (14/25) cough associated with taking food and 68.0% (17/25) with reflux symptoms. There was more productive cough in rhinitis and/or sinusitis (73.3% (22/30) ,chi2 = 24.99, P<0.01). The percentages of CVA and GERC were significantly higher than those reported in Guangzhou (chi2 value were 9.52 and 4.56 respectively, P<0.01), but those of EB and atopic cough were significantly lower (p values were 17.61 and 7.86 respectively, P<0.01). CONCLUSIONS: The most common causes of chronic cough in our study were CVA, rhinitis and/or sinusitis, GERC, medicine related cough, EB and atopic cough, which were different from previous reports in other cities such as Guangzhou. The spectrum and clinical features of causes for chronic cough are important in the diagnostic procedure of chronic cough.

[Impact of "three-in-one" asthma education and management model on asthma control in adult patients].

OBJECTIVE: To evaluate the impact of the asthma education and management model developed by Peking University People's Hospital on the level of asthma control. METHODS: Trained respiratory physicians from 6 large teaching hospitals in the urban districts of Beijing conducted a successive questionnaire survey in the form of face-to-face interviews with adult asthma patients attending their respective clinics. The results were used to compare the levels of asthma control between patients who were administered "three-in-one" asthma education and management (education group) and those who were not (control group). RESULTS: Among the 100 patients in the education group, 85% showed asthma control test (ACT) values > or = 20 points. This was significantly higher than that in the 427 control group patients (37%, chi2 = 74.345, P < 0.01). During the past 1 year, the rate of hospitalization due to exacerbation of asthma, number of emergency treatments, and missed working days were significantly lower in the education group than in the control group (4%, 18%, 20% vs 23%, 32%, 55%, respectively; chi(2) = 19.431, 7.515 and 17.853 respectively; and P < 0.01 for all). CONCLUSION: The "three-in-one" asthma education and management model can significantly improve asthma control.