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.

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.

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.

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.

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。

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.

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.

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。

Asymptomatic patients of chronic obstructive pulmonary disease in China

Background Chronic obstructive pulmonary disease （COPD） has a variable natural history and not all individuals follow the same course. This study aimed to identify the prevalence and characteristics of asymptomatic COPD patients from a population-based survey in China.Methods A multistage cluster sampling strategy was used in a population from seven different provinces/cities. All residents （over 40 years old） were interviewed with a standardized questionnaire and spirometry.Post-bronchodilator forced expiratory volume in 1 second （FEV1）/forced vital capacity （FVC） of less than 70% was defined as the diagnostic criterion of COPD. All COPD patients screened were divided into symptomatic group and asymptomatic group according to the presence or absence of chronic respiratory symptoms. Socio-demographic,personal and exposure variables were collected and analyzed.Results Among the 1668 patients who were diagnosed with COPD from the 25 627 sampling subjects, 589 （35.3%）were asymptomatic. The age, sex, body mass index （BMI）,rural and urban distributions, smoking habit and education levels were similar in the two groups. A total of 64.7% of the asymptomatic patients had no comorbidities. Cardiovascular diseases and lung cancer were more common among symptomatic COPD patients than asymptomatic group.Asymptomatic COPD group were less likely to present with poor ventilation in the kitchen, a family history of respiratory disease and recurrent childhood cough. Asymptomatic COPD patients had significantly higher FEV1 （73.1% vs. 61.0%）, FVC （91.9% vs. 82.0%）, and a higher ratio of FEV1/FVC （62.9% vs.58.7%） （all P 〈0.001） than symptomatic group. More asymptomatic patients were underdiagnosed （91.9% vs.54.3%, P〈0.001） than symptomatic patients.Conclusions This large population-based survey confirmed a high prevalence of asymptomatic COPD patients in China. More use of spirometry screening test may be important to the early detection of COPD.

Influence of urban air pollution on the population in the Klang Valley,Malaysia:a spatial approach

Background:Urban air pollution resulting from economic growth as well as urbanization impacts the health of inhabitants.This study aims to examine the spatial distribution of particulate matter(PM_(10))and the risk of exposure for the population in the Klang Valley,an urban conglomeration centred in Kuala Lumpur,Malaysia.Methods:The inverse distance weighted(IDW)interpolation technique in the ArcGIS platform was used to map the air quality from five air monitoring stations.Spatial statistics of the Global Moran’s I Spatial Autocorrelation and Optimized Hot Spot Analysis were used to estimate the spatial clustering of PM_(10).The population-weighted exposure level(PWEL)technique was used to calculate the population density susceptible to PM_(10)and the AirQ+model was applied to estimate the proportion of the adult population at risk of chronic bronchitis due to long-term exposure to PM_(10)concentrations in the Klang Valley.Results:The highest annual mean PM_(10)concentrations at the Klang station ranged between 80 and 100μg/m^(3)from 2000 to 2009 and exceeded the New Malaysia Ambient Air Quality Standard(NMAAQS)and the World Health Organi-zation Air Quality Guidelines(WHOAQG)levels of 40 and 20μg/m^(3),respectively.The Moran’s I results indicated that the statistically significant clusters of high PM_(10)in Klang present a health risk to the local community.The PWEL results showed that levels of PM_(10)in Petaling Jaya exceeded the WHOAQG limits,potentially posing a health risk to the high-density population.The AirQ+model found Klang to be a significantly high-risk area for chronic bronchitis among the adult population with 804,240 people(with a relative risk of 1.85)in 2009.Conclusion:These high-risk values are due to rapid urbanization and high motor vehicle usage in the Klang Valley and therefore the impact of PM_(10)on the population needs to be reduced.This situation should be taken seriously by the Department of Environment and Kuala Lumpur City Hall in addressing air pollution issues through stricter rules on emissions and implementing low-carbon policies to improve the well-being of residents.