Ambient Temperature and Outpatient Visits for Acute Exacerbation of Chronic Bronchitis in Shanghai: A Time Series Analysis

The association between ambient temperature and acute exacerbation of chronic bronchitis （AECB） was still unknown. Therefore, we performed an epidemiological study in a large hospital of Shanghai to explore the relationship about temperature and outpatient visit for AECB. We adopted a quasi-Poisson generalized additive models and distributed lag nonlinear models to estimate the accumulative effects of temperature on AECB across multiple days. We found significant non-linear effects of cold temperature on hospital visits for AECB, and the potential effect of cold temperature might last more than 2 weeks. The relative risks of extreme cold （first percentiles of temperature throughout the study period） and cold （10th percentile of temperature） temperature over lags 0-14 d were 2.98 [95% confidence intervals （CI）： 1.77, 5.04] and 1.63 （95% Ch 1.21, 2.19）, compared with the 25th percentile of temperature. However, we found no positive association between hospital visits and hot weather. This study showed that exposure to both extreme cold and cold temperatures were associated with increased outpatient visits for AECB in a large hospital of Shanghai.

The susceptibility of T5-TG12 of theCFTR gene in chronic bronchitis occurrence in a Chinese population in Jiangsu province,China

Mutations in the cystic fibrosis transmembrane conductance regulator （CFTR） gene have been implicated in the onset of cystic fibrosis and other clinical respiratory disorders. In the present study, we investigated the role of CFTR variations, poly-T, TG-repeats, and M470V in susceptibility to bronchial asthma and chronic bronchitis in a Chinese population in Jiangsu province, China. A total of 72 bronchial asthma patients, 68 chronic bronchitis pa- tients, and 117 healthy subjects were included in this study. The Tn-TGm haplotype was sequenced and the CFTR variant M470V was detected using restriction fragment length polymorphism （RFLP）. We found that the fre- quency of TS-TG12-V470 in chronic bronchitis patients was 0.07%, which was notably higher than that in healthy subjects （0.01%） and bronchial asthma patients （0.04%）. Thus, the presence of the TS-TG12 haplotype of the CFTR gene is likely to play a role in the development and progression of respiratory conditions, such as chronic bronchitis.

Systematic review of Shufeng Jiedu capsules for acute attack of chronic bronchitis

Objective:To systematically evaluate the efficacy and safety of Shufeng Jiedu Capsules in the treatment of acute attacks of chronic bronchitis.Methods:CNKI,VIP,CBM,WanFang,PubMed,EMbase,Cochrane Library and ChiCTR were searched by computer,and randomized controlled trials of Shufeng Jiedu capsules in the treatment of AECB were integrated.The retrieval time was from the date of establishing the database to December 31,2020.Meta-analysis of outcome indicators[including effective rate,C-reactive protein(CRP),lung function[FEV1%and/or FEV1/FVC],interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)]were carried out by RevMan 5.3 software,and the effective rate was tested by sequential analysis(TSA),and the quality of evidence was evaluated according to GRADE standards.Results:A total of 680 cases in 8 articles were included.Shufeng Jiedu Capsules improved the effective rate of clinicaltreatment[RR=1.20,95%CI(1.13,1.28)],improved lung function[FEV1:MD=0.33,95%CI(0.22,0.45),FEV1/FVC:MD=10.17,95%CI(8.15,12.19)],reduced CRP[MD=-7.32,95%CI(-8.42,-6.22)],IL-8[MD=-63.39,95%CI(-73.49,-53.29)],TNF-α[MD=-7.44,95%CI(-8.35,-6.53)]levels.The above differences were statistically significant(P<0.05),and no serious adverse reactions were reported in all studies.The results of TSA analysis showed that the experimental group had definite evidence for improving the efficiency.According to the GRADE evaluation system,the efficiency,TNF-αwere medium-quality evidences,FEV1 was low-quality evidence,and FEV1/FVC,CRP,and IL-8 were extremely low-quality evidence.Conclusions:The curative effect of Shufeng Jiedu capsule combined with western medicine in the treatment of AECB was better than that of single western medicine.Nevertheless,considering the limited sample size and the quality of included articles,higher quality RCTs are still needed to further confirm its effectiveness and safety.

TCM aerosol inhalation treatment in acute exacerbations of chronic bronchitis： a meta-analysis

Objectives： To determine whether traditional Chinese medicine （TCM） aerosol inhalation treatment is effective inthe treatment of acute exacerbation of chronic bronchitis. Methods： Search double-blind randomised clinical trials（RCT） about the use of TCM aerosol inhalation in patient with acute exacerbation of chronic bronchitis via database including Chinese biomedicine literature database, Wanfang Data, CNKI, Pubmed, EMBASE and CochraneLibrary from the beginning to October 2016. Quality evaluation, data extraction and data analysis of these RCT wascarried out with reference to the Cochrane systematic review. Results： 16 studies with 738 patients in TCM aerosolinhalation group and 675 in control group were included. The results of meta-analysis showed, （1） TCM aerosolinhalation group could improve the total cure rate. （2） TCM aerosol inhalation could increase the expression of IL-2while decrease the expression of IL-8 and MDA in sputum and blood. （3） TCM aerosol inhalation could improvethe symptoms of cough, cough with sputum, cough with dyspnea and lung wet rales. It also improve the symptomsof cough, expectorate and lung wet rales. （4） Shorten the time of cough and lung rale. （5） The adverse reactionswere light only with 1 occurrence of nausea and vomiting. Conclusions： The use of TCM aerosol inhalation in thetreatment of acute exacerbation of chronic bronchitis was effective. However, the inclusion researches quality werenot very high, which only provided limited evidence for clinical application. Higher-quality randomized controlledtrials were needed for further study.

TREATMENT OF CHRONIC BRONCHITIS WITH FIFTY-YING-ACUPUNCTURE THERAPY

Objective: To observe the clinical effect of Fifty ying acupuncture therapy for treatment of chronic bronchitis, and to explore its underlying mechanisms. Methods: A total of 36 out and in patients with chronic bronchitis including 10 cases of asthma were subjected into this study. Among them, 20 cases were qi deficiency type and 16 qi yin deficiency with phlegm damp type. The changes of symptoms, T lymphocyte subgroups of CD 3 +, CD 4 +, CD 8 +, CD 4 +/CD 8 +, soluble interleuki 2 receptor (SIL 2 R), interleukin 6(IL 6), IgG, IgA and IgM before and after treatment were observed and detected using monoclonal indirect fluorescence method, enzyme linked immunosorbent assay (ELISA) and nephelometry respectively. Results: (1)The effective rate of qi dificiency type was 100% and that of qi yin deficiency with phlegm damp type 87.5%. (2) After acupuncture treatment, in qi deficiency type patients, serum IgG, IgA and IgM contents increased significantly (P<0.001) in comparison with pre treatment and in qi yin deficiency with phlegm damp type patients, IgG level lowered obviously. Serum SIL 2R and CD 4 +/CD 8 + decreased obviously (P<0.01, 0.001), CD 3 +, CD 4 + and CD 8 + increased evidently (P<0.01). Conclusion: The Fifty ying acupuncture therapy can better clinical symptoms of chronic bronchitis patients through its resultant up regulation of the immune system function.

Progress in the treatment of chronic bronchitis with Chinese and western medicine

Chronic bronchitis is a clinical common disease,which is a chronic nonspecific inflammation of the tracheal and bronchial mucosa and its surrounding tissues caused by a variety of factors.It is clinically characterized by symptoms such as cough,excessive phlegm,shortness of breath,and a recurrent chronic process.Chronic bronchitis has a high incidence and severe symptoms in winter.In severe cases,there are long-term clinical symptoms that impact the patient’s spirit and life.At the same time,the disease causes numerous diseases such as emphysema and pulmonary heart disease.Therefore,patients have an essential need for the treatment of chronic bronchitis.This article tells the etiology,treatment methods,process,prevention,and nursing of the disease from the perspective of western medicine and traditional Chinese medicine,respectively.

STUDY ON INFLAMMATORY CELLS IN BALF OF SMOKE-INDUCED CHRONIC BRONCHITIS RAT MODEL

Objective To establish a smoke-induced chronic bronchitis rat model and evaluate the patho-logical change semi-quantitatively, and study the characteristics of the inflammatory cells in the bronchoalveolar lav-age fluid (BALF) in various stages. Methods Chronic bronchitis sequential rat model was established by passively inhaling smoke mixture. Experiments were performed in 30 young male Sprague-Dawley rats, which comprised 5 groups in random, i.e.,4 chronic bronchitis model groups and 1 control group. After stained with hematoxylin and eosin, the specimens were studied by semi-quantitative method to evaluate the morphologic changes in various stages. Meanwhile, the inflammatory cells of the BALF and the activity of myeloperoxidase (MPO) of lung tissue were analysed. Results During the process of the chronic bronchitis, the pathologic score was increasing as time went on, and the typical morphologic changes of chronic bronchitis emerged in the group 7 weeks. The total number of inflammatory cells in BALF was increasing as time went on, correlated with the pathologic scores (P <0.01). And the percentage of lymphocyte increased as well as positively correlated with pathologic scores (P < 0. 05) , whereas that of macrophage decreased and negatively correlated with pathologic scores (P <0. 05). The MPO lever of lung tissue was correlated with the pathologic scores (P < 0. 01). But the percentage of the neutrophil in the BALF was just in a high level during the first week, then it maintained relatively lower. Conclusion Smoke-induced chronic bronchitis is a slowly progressive inflammation process. The model we established is convenient and simple for the longitudinal study on the inflammatory process of chronic bronchitis and the therapy in the early stage. The semi-quantitative evaluation for the pathological change is with much more value. During the inflammatory sequential process of early stage of chronic bronchitis, the cellular characteristics are similar to that of the common chronic inflammation.

Whether chronic bronchitis is an independent risk factor for cerebral infarction in the elderly 1:1 case paired study

BACKGROUND： The inflammatory reaction already becomes an important risk factor of causing acute cerebral infarction; however, the correlation between chronic bronchitis and senile cerebral infarction is still unclear. OBJECTIVE： To study whether the chronic bronchitis is the risk factor for senile cerebral infarction. DESIGN： 1 ： 1 pair, case contrast, and risk factor study. SETTINGS： Department of Respiratory Medicine, Third Hospital of Tangshan; Department of Neurology, Affiliated Hospital of North China Coal Medical College. PARTICIPANTS： A total of 147 patients with acute cerebral infarction who were regarded as case group were selected from Department of Neurology, the Third Hospital of Tangshan from January 2004 to December 2006. All patients met the diagnostic criteria of the Fourth National Cerebrovascular Diseases Meeting. There were 87 males and 60 females, and their ages ranged from 65 to 83 years. Based on 1 ： 1 pair study, another 147 subjects without cerebrovascular disease were regarded as control group. Except the diseases about infection, there were 73 males and 74 females, and their ages ranged from 62 to 81 years. All subjects provided the confirm consent and agreed with the coordinate experiment. METHODS： ①Questionnaire of risk factor of cerebral infarction was designed to measure the following items： chronic bronchitis, hypertension, diabetes mellitus, hyperlipemia, coronary heart disease, primary cerebral infarction/transient ischemic attack and history of smoking. ②Cerebral infarction was regarded as the dependent variance, while chronic bronchitis, hypertension, diabetes mellitus, hypedipemia, primary cerebral infarction/transient ischemic attack, coronary heart disease and smoking were regarded as the independent variance for multiple regression analysis, MAIN OUTCOME MEASURES： Risk factors of senile cerebral infarction. RESULTS： All 147 patients with acute cerebral infarction and 147 subjects without cerebrovascular diseases were involved in the final analysis. ①Risk factor analysis of senile cerebral infarction： There were no significant differences in age, hyperlipemia and history of smoking between the two groups （P 〉 0.05）. But, chronic bronchitis, diabetes mellitus, hypertension, cerebral infarction/transient ischemic attack and history of coronary heart disease were higher in the case group than those in the control group （33.6% vs. 19.0%, 38.8% vs. 23.3%, 54.3% vs. 36.2%, 29.3% vs. 17.2%, 44.0% vs. 29.3%, P 〈 0.05- 0.01）. ②Multiple Logistic regression analysis of risk factor of senile cerebral infarction Hyperlipemia, smoking and coronary heart disease were not correlated with cerebral infarction （P 〉0.05）, but chronic bronchitis, hypertension, diabetes mellitus and cerebral infarction/transient ischemic attack were risk factors for senile cerebral infarction （OR =2.47, 2.28, 2.18, 2.01, P 〈 0.05 - 0.01）. CONCLUSION： The chronic bronchitis mac become an independent risk factor senile cerebral infarction.

Clinical Observation in 31 Cases of Chronic Bronchitis at Remission Stage Treated with Bufei Keli

To observe the therapeutic effects of a Chinese drug Bufei Keli (补肺颗粒 granules for invigorating the lung) in the treatment of chronic bronchitis at remission stage, 62 cases were randomly divided into a treatment group (treated with Bufei Keli) and a control group (treated with Yupingfeng Keli 玉屏风颗粒). The results turned out to be that the short-term clinically controlled and markedly effective rate was 77.42% and the long-term relapse-resisting markedly effective rate was 74.2% in the treatment group, which were obviously higher than 45.16% and 38.71% respectively in the control group (P<0.05). And the increase in contents of SOD and CD_3 and the decrease in LPO content in the treatment group were also bigger than that in the control group (P<0.01). It is therefore concluded that Bufei Keli can improve qi deficiency syndrome and raise the immunity of patients with chronic bronchitis, hence its effect of resisting relapse of chronic bronchitis.

Effect of smoking cessation on airway inflammation of rats with chronic bronchitis

Background Smoking is the major cause of airway inflammation in chronic obstructive pulmonary disease （COPD）, and smoking cessation is regarded as one of the important strategies for prevention and treatment of the inflammation. The inflammation of the chronic airway may be present and deteriorated even if the COPD patients stop smoking. Whether and how early smoking cessation affects the progress of inflammation is still obscure. This study was conducted to find the appropriate time for smoking cessation to terminate the airway inflammation in rats with smoke-induced chronic bronchitis. Methods A rat model of COPD was established by passively inhaling smoke mixture. Fifty-four young male Sprague-Dawley rats were randomly divided into 9 groups with different periods of smoke exposure and different time points of cessation. The inflammation markers to be detected included inflammatory cells in the bronchoalveolar lavage fluid （BALF）, the myeloperoxidose （MPO） activity, the morphologic changes and the expression of ICAM-1 on the airway epithelium. Results When smoking was terminated at early stage, the inflammatory markers and related indexes were different from those of the typical chronic bronchitis group （group M7） （P〈0.01）. The pathologic score of group SC7 （2 weeks of smoking cessation after occurrence of typical chronic bronchitis ） was not different from that of group M7, and the level of ICAM-1 was still up-regulated （compared to group M7, P〉0.05）. Meanwhile, most of inflammatory cells in BALF were neutrophils compared to other groups （P〈0.01）.When smoking was terminated, the MPO activity was significantly lower than that of group M7 （P〈0.01）. Conclusions Smoking cessation at early stage can effectively inhibit the inflammatory reaction of COPD. Once chronic bronchitis occurs, little could be improved by smoking cessation.

Synchronous Dynamic Research on Respiratory and Intestinal Microflora of Chronic Bronchitis Rat Model

Objective： To investigate the mechanism of the Chinese medicine theory that Fei（Lung） and Dachang（Large Intestine） are exteriorly and interiorly related via synchronous observation on the dynamic changes of the respiratory and intestinal microflora. Methods： Forty specific pathogen free Sprague-Dawley rats were selected and randomly divided into blank（10 rats） and chronic bronchitis model groups（30 rats）. The blank group rats were put into the smoke-free environment and the model group rats were put into the smoke environment in order to establish pulmonary disease（chronic bronchitis） model. Then the corresponding changes of the respiratory and intestinal microflora of the model on 20th, 50th and 70th days were synchronously observed. Results： The respiratory tract microflora showed an increase in the total aerobic and Staphylococcus aureus and reduced anaerobic amount significantly on 20th day in the respiratory tract microflora（P〈0.05 or 0.01）. On 50th day, total aerobic, total anaerobic amount and bifidobacterium significantly increased（P〈0.05）. On 70th day, Staphylococcus aureus reduced and lactobacillus increased significantly（P〈0.01）. The intestinal microflora showed an increase in the total aerobic, Clostridium perfringens, enterobacter and enterococcus significantly increased on 20th day（P〈0.05 or 0.01）. Staphylococcus aureus on 50th day increased significantly（P〈0.05）. Total aerobic and enterococcus increased, total anaerobic and Clostridium perfringens reduced significantly on 70th day（P〈0.05 or 0.01）. Conclusions： The microecosystem of respiratory tract and intestine of rat model during the pathological process showed a dynamic disorder, indicating an interaction between the lung and large intestine which may be one of the connotations as they exteriorly and interiorly related.

Heat shock proteins mRNA expressions by peripheral blood mononuclear cells in asthma and chronic bronchitis

Objective To investigate the manifestations that heat shock proteins(HSPs) possess in the pathogenesis of asthma and chronic bronchitis.Methods Using reverse transcription DNA polymerase chain reaction(RT PCR), we investigated the expression levels of HSP70, HSP90α and HSP90β genes in peripheral blood mononuclear cells(PBMC) at natural state and after heat shock in 14 healthy volunteers, 21 patients with asthma and 18 patients with chronic bronchitis.Results No HSP70 gene but HSP90α and HSP90β expressions were found in non heat shocked PBMC of normal control; HSP90α and HSP90β genes may be expressed in PBMC of patients no matter whether they were in acute episode or not. Expression of HSP70 was found in PBMC of patients in acute episodes and of three symptoms free patients with Aas 3, step 2 No expression of HSP70 gene was found in PBMC of patients in convalescent period but in PBMC of patients in acute episode. HSP90α and HSP90β genes were expressed in PBMC of the two patients groups; After heat shock, expressions of the three genes increased in amount significantly in PBMC of all normal controls and patients. Conclusion Expression of HSP70 gene in PBMC of asthmatic patients and chronic bronchitis was different, indicating that HSPs, especially HSP70 might be involved in the pathogenesis of asthma.

Protective effect of a bacterial extract against acute exacerbation in patients with chronic bronchitis accompanied by chronic obstructive pulmonary disease

Background Immunostimulating agents made from bacterial extracts represent a class of medications that contains antigens derived from several bacterial strains and their potential ability to prevent bacterial infections results from the stimulation of the nonspecific component of the immune system. The present study investigated the effect of the oral immunostimulant Broncho-Vaxom,which includes material from eight different species of bacteria that are frequently present in the lower respiratory tract,on the frequency and severity of acute exacerbation in patients with chronic bronchitis accompanied by chronic obstructive pulmonary disease (COPD). Methods Ninety patients with chronic bronchitis complicated with COPD were randomly divided into groups A and B. Forty-nine subjects in group A received oral capsules containing 7mg Broncho-Vaxom,while 41 patients in group B received similar placebo capsules. Both groups took one capsule daily for the first 10 days of each month for 3 consecutive months. The frequency of acute exacerbation,symptom scores,and lung function were recorded for the following one year period.Results There was a significant decrease in the incidence,duration,and severity of acute exacerbation,as well as a reduction in the course of antibiotics administered and in the dosage of bronchodilator and mucolytic agent in group A,as compared to group B ( P <0.05,respectively). Symptom scores for cough,sputum,dyspnea,as well as symptoms observed upon auscultation of the chest also improved significantly in group A as compared to group B ( P <0.05,respectively). The bacterial clearance rate in sputum cultures from patients who received no antibiotics for the first 3 months was also significantly higher in group A compared to group B ( P <0.01).Conclusions Orally administered Broncho-Vaxom is associated with a decrease in the incidence of acute exacerbation and a decrease in the need for antibiotics and symptomatic relief medications in patients with chronic bronchitis accompanied by COPD. Broncho-Vaxom is also associated with a decrease in symptom scores. Without causing any apparent adverse effects,this drug may also help to eradicate pathogenic bacteria in the airways.

Efficacy comparison of different forms of dog-days acupoint application for prevention and treatment of chronic bronchitis

Objective: To analyze the clinical effect of traditionaldog-days acupoint application and Magic Acupuncture Patch (Manji) in the prevention and treatment of chronic bronchitis (CB) in remission stage in the past five years, and explore the principle of action and effective stimulation, to provide the evidence for treating CB by acupoint application. Methods: A retrospective study was conducted on 405 patients with CB who met the inclusion criteria. All patients were treated with dog-days acupoint application or Magic Acupuncture Patch between 2013 and 2017. The clinical data of 405 patients were statistically analyzed to compare the prevention and treatment effects of dog-days acupoint application and Magic Acupuncture Patch, and different degrees of stimulation of dog-days acupoint application. Results: Among the dog-days acupoint application groups, the total effective rate was 63.6% in the light stimulation group, 93.1% in the moderate stimulation group, and 94.8% in the strong stimulation group. The differences in the total effective rate between the light stimulation group and the moderate stimulation group, as well as the strong stimulation group, were statistically significant (both P<0.05). There was no significant difference in the total effective rate between the moderate stimulation group and the strong stimulation group (P>0.05). The total effective rate was 83.9% in the dog-days acupoint application group, versus 45.4% in the Magic Acupuncture Patch group, and there was a statistically significant difference between the two groups (P<0.05). Conclusion: The efficacy of dog-days acupoint application in the prevention and treatment of CB is better than that of Magic Acupuncture Patch;the degree of stimulation is the basis for the effect of dog-days acupoint application on prevention and treatment of CB, and the moderate and strong stimulations are more appropriate.

慢性支气管炎急性加重期嗜酸细胞阳离子蛋白与糖皮质激素疗效关系探讨

目的探讨慢性支气管炎急性加重期血清嗜酸细胞阳离子蛋白(ECP)与糖皮质激素疗效关系。方法采用荧光酶标法Pharmacia CAP检测系统测定慢性支气管炎急性加重期血清ECP及1 s用力呼气容积(FEV1)。结果血清ECP值慢性喘息型支气管炎显著高于慢性单纯型支气管炎,治疗后ECP显著下降,肺功能显著改善。结论血清ECP可作为临床使用糖皮质激素的指征,指导临床使用糖皮质激素。

Melanoma Identification Through X-ray Modality Using Inception-v3 Based Convolutional Neural Network

Melanoma,also called malignant melanoma,is a form of skin cancer triggered by an abnormal proliferation of the pigment-producing cells,which give the skin its color.Melanoma is one of the skin diseases,which is exceptionally and globally dangerous,Skin lesions are considered to be a serious disease.Dermoscopy-based early recognition and detection procedure is fundamental for melanoma treatment.Early detection of melanoma using dermoscopy images improves survival rates significantly.At the same time,well-experienced dermatologists dominate the precision of diagnosis.However,precise melanoma recognition is incredibly hard due to several factors:low contrast between lesions and surrounding skin,visual similarity between melanoma and non-melanoma lesions,and so on.Thus,reliable automatic detection of skin tumors is critical for pathologists’effectiveness and precision.To take care of this issue,numerous research centers around the world are creating autonomous image processing-oriented frameworks.We suggested deep learning methods in this article to address significant tasks that have emerged in the field of skin lesion image processing:we provided a Convolutional Neural Network(CNN)based framework using an Inception-v3(INCP-v3)melanoma detection scheme and accomplished very high precision(98.96%)against melanoma detection.The classification framework of CNN is created utilizing TensorFlow and Keras in the backend(in Python).It likewise utilizes Transfer-Learning(TL)approach.It is prepared on the data gathered from the“International Skin Imaging Collaboration(ISIC)”repositories.The experiments show that the suggested technique outperforms state-of-the-art methods in terms of predictive performance.

Management of AE-CB/COPD: a Survey of Respiratory Physicians in Some Regions of China

Objective To investigate the bacteria spectrum isolated from AE-CB/COPD and the manner of management of AE-CB/COPD in respiratory or internal medicine department in some regions of China. Methods Respiratory physicians received questionnaire at randomization just after they managed a patient presenting to outpatient department with AE-CB/COPD, on general conditions and symptoms of patients, type of examinations, diagnosis, type of antibiotics used and mode of administration. Results of sputum bacteria culture were followed up. Results Among the 1583 AE-CB/COPD, 63.04% were male and 35.19% were female. 54.6% of them were older than 60 years. 81.87% of the patients produced sputum. Sputum bacteria culture, chest X-ray and chest CT were carried out to 21.3%, 66.3% and 11.1% patients, respectively. 355 strains were isolated from patients whose sputum bacteria culture was positive. Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis were the three most isolates. 84.7% of the 1583 AE-CB/COPD received 1692 times of antibiotic prescribing. The most frequently prescribed antibiotic were B-lactams (51.36% of all antibiotic prescribing), macrolides (14.01%) and quinolones (31.03%). Much more macrolides were prescribed in the area where more patients pay the medicines at his own expense than those in the area where more patients share public health service. Conclusion In China, respiratory physicians can reasonably select antibiotics to manage acute exacerbation of chronic bronchitis/ chronic obstructive pulmonary disease in pulmonary outpatient department. Sputum culture is done in part of the patients, but susceptibility tests are missing. One issue revealed by the survey is that the list of prescribing medications laid down by government have great influence on antibiotic use.

影响慢性支气管炎患者黄苔的相关因素分析

目的对影响慢性支气管炎患者黄苔的相关因素进行分析,以深入探讨慢性支气管炎患者出现黄苔的原因。方法观察慢性支气管炎患者舌象,记录患者相关情况,对患者出现黄苔的影响因素进行logistic分析。结果对于慢性支气管炎患者的黄苔有影响的因素(P<0·05)包括:发热,外周血白细胞升高,外周血淋巴细胞升高,抗生素的使用情况。结论慢性支气管炎患者出现黄苔受到多种因素的影响,中医舌诊在慢性支气管炎中的应用具有一定的潜力。

MANAGEMENT OF AE-CB/COPD: A SURVEY OF RESPIRATORY PHYSICIANS IN SOME REGIONS OF CHINA

Objective To investigate the bacteria spectrum isolated from AE-CB/ COPD and the manner of management of AE-CB/COPD in respiratory or internal medicine department in some regions of China. Methods Respiratory physicians received questionnaire at randomization just after they managed a patient presenting to outpatient department with AE-CB/ COPD, on general conditions and symptoms of patients, type of examinations, diagnosis, type of antibiotics used and mode of administration. Results of sputum bacteria culture were followed up. Results Amang the1583 AE-CB/COPD, 63. 04% were male and 35.19% were female. 54.6% of them were older than 60 years. 81.87% of the patients produced sputum. Sputum bacteria culture, chest X-ray and chest CT were carried out to 21.3%, 66. 3% and 11. 1% patients, respectively. 355 strains were isolated from patients whose sputum bacteria culture was positive. Streptococcus pneumoniae, Haemophilus influenzae and Moraxella ca- tarrhalis were the three most isolates. 84. 7% of the 1583 AE-CB/COPD received 1692 times of antibiotic prescribing. The most frequently prescribed antibiotic were B-lactams （51.36% of all antibiotic prescribing）, macrolides （14. 01% ） and quinolones （31.03%）. Much more macrolides were prescribed in the area where mare patients pay the medicines at his own expense than those in the area where more patients share public health service. Conclusion In China, respiratory physicians can reasonably select antibiotics to manage acute exacerbation of chronic bronchitis/ chronic obstructive pulmonary disease in pulmonary outpatient department. Sputum culture is done in part of the patients, but susceptibility tests are missing. One issue revealed by the survey is that the list of prescribing medications laid down by government have great influence on antibiotic use.