Effect of Digested Sewage Sludge on the Ventilation and Coughing Rates of Two Fresh Water Fish

Addition of digested sewage sludge at concentrations of 2% and 10% (v/v) to the water increased coughing rate in big head and tilapia (P<0.05). Ventilation rate was significantly decreased (P<0.05) in big head and tilapia at sludge concentrations of 6% and 2% (v/v)respectively. Copper (Cu), cadmium (Cd) and zinc (Zn) are trace metals which are commonly found in sludge. Cu caused a significant increase (P<0.05) in coughing rate in both tilapia and big head at concentrations of 0.3 and 0.2 μg/ml respectively. Zn caused significant increase (P<0.05) in coughing rate only in big head at 2 μg/ml. Neither fish responded to Cd of up to 2μg/ml in the water. However, when the levels of these trace metals in the digested sludge were measured, they were below that which can cause significant changes in the respiratory movements. Therefore, the changes in ventilation and coughing rates after addition of sludge may be due to the presence of substances other than these metals. The results of this experiment provides a guideline to control the level of sludge that can be used in rearing these fresh water fish in ponds

Neural Mechanisms Underlying the Coughing Reflex

Breathing is an intrinsic natural behavior and physiological process that maintains life.The rhythmic exchange of gases regulates the delicate balance of chemical constituents within an organism throughout its lifespan.However,chronic airway diseases,including asthma and chronic obstructive pulmonary disease,affect millions of people worldwide.Pathological airway conditions can disrupt respiration,causing asphyxia,cardiac arrest,and potential death.The innervation of the respiratory tract and the action of the immune system confer robust airway surveillance and protection against environmental irritants and pathogens.However,aberrant activation of the immune system or sensitization of the nervous system can contribute to the development of autoimmune airway disorders.Transient receptor potential ion channels and voltage-gated Na+channels play critical roles in sensing noxious stimuli within the respiratory tract and interacting with the immune system to generate neurogenic inflammation and airway hypersensitivity.Although recent studies have revealed the involvement of nociceptor neurons in airway diseases,the further neural circuitry underlying airway protection remains elusive.Unraveling the mechanism underpinning neural circuit regulation in the airway may provide precise therapeutic strategies and valuable insights into the management of airway diseases.

SRC:Superior Robustness of COVID-19 Detection from Noisy Cough Data Using GFCC

This research is focused on a highly effective and untapped feature called gammatone frequency cepstral coefficients(GFCC)for the detection of COVID-19 by using the nature-inspired meta-heuristic algorithm of deer hunting optimization and artificial neural network(DHO-ANN).The noisy crowdsourced cough datasets were collected from the public domain.This research work claimed that the GFCC yielded better results in terms of COVID-19 detection as compared to the widely used Mel-frequency cepstral coefficient in noisy crowdsourced speech corpora.The proposed algorithm's performance for detecting COVID-19 disease is rigorously validated using statistical measures,F1 score,confusion matrix,specificity,and sensitivity parameters.Besides,it is found that the proposed algorithm using GFCC performs well in terms of detecting the COVID-19 disease from the noisy crowdsourced cough dataset,COUGHVID.Moreover,the proposed algorithm and undertaken feature parameters have improved the detection of COVID-19 by 5%compared to the existing methods.

A systemaic review and meta-analysis of traditional Chinese medicine in the treatment of chronic cough

Objective: To systematically evaluate the safety and efficacy of traditional Chinese medicine (TCM) in the treatment of chronic cough. Methods: Databases CNKI, WanFang Data, VIP, CBM, PubMed, Web of Science, Cochrane Library from inception to February 2021 were electronically searched by two researchers, to collect randomized controlled trials (RCTs) of traditional Chinese medicine in the treatment of chronic cough, UACS/PNDS, CVA, EB, AC, GERD and other types of cough. Revman 5.3 software was used to analyze and summarize the collected literature, and the methodological quality of the included studies was evaluated by the bias risk assessment scale of Cochrance Collaboration Network. Results: A total of 26 articles involving 2 820 patients, with 1 420 in the experimental group and 1 400 in the control group were included. The results of meta-analysis showed that compared to the control group which was treated with western medicine alone, TCM significantly improved the clinical effective rate [RR=1.20, 95% CI(1.16,1.25), P<0.000 01], alleviated cough syndrome score [SMD=-0.83, 95% CI(-1.21,-0.44)], and enhenced the score of quality of life [MD=-2.18, 95%CI(1.63,2.74), P<0.000 01];at the same time, the experimental group was better than the control group in improving lung function and reducing the time of cough relief. In terms of safety, a total of 24 patients in 5 literatures had adverse reactions, but the symptoms were mild and could be relieved quickly. In addition, there was no significant difference in adverse reactions between the control group and the experimental group, showing good safety. Conclusion: TCM treatment can significantly improve the cure rate of cough, reduce cough score, improve systemic symptoms, relieve psychological anxiety, improve lung function, and improve cough symptoms rapidly, with good safety.

Efficacy ofβ2-adrenergic receptor agonist combined with corticosteroid in the treatment of children with cough variant asthma

BACKGROUND Cough variant asthma(CVA)is one of the most common respiratory diseases in children,which has a serious impact on the quality of life and daily activities of children.For severe CVA,immunomodulatory drugs are needed.AIM To evaluate the efficacy of salmeterol combined with budesonide in the treatment of pediatric CVA.METHODS 130 children with CVA from January 2020 to December 2022 were prospectively selected and randomly divided into an observation group(salmeterol combined with budesonide)and a control group(budesonide combined with a placebo).Compare the clinical efficacy of two groups before and after intervention.The evaluation parameters include cough frequency score,nocturnal cough arousal,and lung function indicators.Serum inflammatory markers,immune function markers and airway anatomical indicators were also measured.RESULTS After the intervention,the total effective rate of the observation group was significantly higher than that of the control group,and the cough frequency score and the night cough wake rate of the observation group were lower than that of the control group,with a statistically significant difference.In addition,the changes of lung function indicators,serum markers and immune function markers in the observation group were better than those in the control group.CONCLUSION The clinical efficacy of salmeterol combined with Budesonide in the treatment of CVA is better than that of Budesonide alone.

Superior laryngeal nerve block for treatment of throat pain and cough following laryngeal herpes zoster:A case report

BACKGROUND Herpes zoster is caused by reactivation of latent varicella-zoster virus infection within the sensory nerve ganglion of the spinal or cranial nerves.Laryngeal herpes zoster is rare and involves superior laryngeal nerve,which leads to several complications such as throat pain,and cough.CASE SUMMARY Patient concerns:A 52-year old woman presented with a 70 d history of throat pain and a 67 d history of non-productive cough.Three days after onset of pain,she was diagnosed with laryngeal herpes zoster.Flexible nasolaryngoscopy revealed multiple white ulcerated lesions on the left hemi epiglottis and the left supraglottic area.She was prescribed with 750 mg famciclovir a day for 7 d,and 150 mg pregabalin,100 mg tramadol and 10 mg nortriptyline a day for 67 d.However,despite of these medications,she complained of pain and persistent cough.Therefore,superior laryngeal nerve block under ultrasound guidance was performed.Three days after the intervention,the throat pain and cough disappeared.The patient remained symptom-free at 3 mo follow-up.CONCLUSION A superior laryngeal nerve block can be an effective option for treatment of pain and cough following laryngeal herpes zoster.

Experimental study on the regulation effect of Qiaoqin Qingfei agent on cough variant asthma based on airway neurogenic inflammation

Objective:To investigate the mechanism of regulation of airway neurogenic inflammation by Qiaoqin Qingfei agent in rats with cough variant asthma(CVA).Methods:48 SD rats were randomly divided into blank group,model group,montelukast sodium group(1.05 mg/kg)and high,medium and low dose groups(26,13,6.5 g/kg),with 8 rats in each group.The rat CVA model was established by the method of ovalbumin(OVA)combined with aluminum hydroxide(Al(OH)3)sensitization and repeated stimulation.From the second day of sensitization,the rat CVA model was given by gavage for 28 days.The pathological changes of lung tissue were observed under microscope by HE staining.The content changes of nerve growth factor(NGF)and substance P(SP)in alveolar lavage fluid(BALF)were determined by double-antibody sandwich ABC-ELISA,and the protein expression levels of NGF and SP in lung tissue were detected by immunohistochemistry.Results:Pathological findings showed significant inflammatory manifestations in the model group,and the inflammatory infiltration in the high-dose,medium-dose and low-dose groups of Qiaoqin Qingfei agent and montelukast sodium groups were alleviated to varying degrees.Compared with blank group,the protein expression levels of NGF and SP in lung tissue of model group were significantly increased(P<0.01).Compared with model group,the protein expression levels of NGF and SP in lung tissue and the contents of NGF and SP in alveolar lavage fluid in high-dose,medium-dose and low-dose groups and montelukast sodium group were significantly decreased(P<0.05).Conclusion:Qiaoqin Qingfei agent may reduce airway inflammation and relieve cough variant asthma by regulating the protein expression levels of NGF and SP in airway neurogenic inflammation.

Effect of glycyrrhetinic acid on Th1/Th2 balance in cough variant asthma mice

Objective:To evaluate the therapeutic effect of Glycyrrhetinic Acid on cough variant asthma(CVA)mice and to investigate the possible mechanism in reducing lung inflammation.Methods:48 young female Balb/c mice were divided into Control,CVA,Prednisone Acetate,Glycyrrhetinic Acid high-dose,Glycyrrhetinic Acid middle-dose and Glycyrrhetinic Acid lowdose groups randomly,with 8 mice in each group.The CVA mice model was established by ovalbumin(OVA)sensitization and OVA challenge,the animal asthma behavior was observed after drug administration,and the index of the lung of mice were recorded.The level of OVAsIgE in the bronchoalveolar lavage fluid(BALF)was tested by ELISA.The pathological changes of the lung tissue were observed by Hematoxylin and Eosin(H&E)staining.The protein expressions of T-bet,IFN-γ,Gata3,IL-4 and IL-13 in the lung tissue were determined by Western blot.Results:Compared with the CVA group,the index of lung of mice,the OVA-sIgE level in BALF and expression levels of Th2-related factor in the lung tissue of mice in Prednisone Acetate and Glycyrrhetinic Acid groups were significantly decreased(P<0.05 or P<0.01),the infiltration of inflammatory cells in the lung tissue was reduced,while expressions of Th1-related factor in the lung tissue was significantly increased(P<0.05 or P<0.01).Conclusion:Glycyrrhetinic acid has therapeutic effect on CVA mice,the underlying mechanism of Glycyrrhetinic acid alleviating lung impairment and airway inflammation may be associated with mediating the Th1/Th2 imbalance in the lung tissue.

Life-threatening delayed mediastinal and subcutaneous emphysema after general anesthesia in a rheumatoid arthritis patient: a case report

Background:Delayed mediastinal emphysema with subcutaneous emphysema after extubation is rarely reported in current literature.Symptomatic treatment is considered effective for management.Case presentation:We report a case of a 56-year-old female with longstanding rheumatoid arthritis under corticosteroid therapy who developed mediastinal emphysema with subcutaneous emphysema 2 days after recovering from general anesthesia for orthopedic surgery treating a femoral neck fracture.The patient received aggressive subcutaneous decompression and symptomatic management.Results:The patient’s condition improved after treatment.Based on computed tomography scan results,we hypothesize that the longstanding rheumatoid arthritis may have resulted in fragile lung tissue.Violent postoperative coughing likely caused rupture of small airways,leading to mediastinal emphysema.Conclusions:It is crucial to preoperatively assess the risk of airway injury in high-risk patients with longstanding rheumatoid arthritis.Delayed postoperative mediastinal emphysema should be carefully evaluated and managed aggressively to avoid exacerbation or life-threatening scenarios.Further research is warranted to elucidate the pathology and guide perioperative management in these patients.

孟鲁司特钠对咳嗽变异性哮喘患者FeNO及炎症因子水平的影响

目的探讨孟鲁司特钠对咳嗽变异性哮喘(cough variant asthma,CVA)患者呼出气一氧化氮(Fractional exhaled nitric oxide,Fe NO)、肿瘤坏死因子(tumor necrosis factor,TNF-α)、白介素-5(interleukin-5,IL-5)、(Serum amyloid A,SAA)及肺功能的影响。方法 55例CVA患者随机分为对照组29例,观察组26例,两组患者均给予氨溴索片、茶碱缓释片及酮替芬口服;观察组加服孟鲁司特钠片10mg,每晚一次。观察治疗8周后2组患者Fe NO、TNF-α、IL-5、SAA、肺功能(FEV1、PEF、FEV1/FVC)变化。结果治疗8周后,观察组患者Fe NO、TNF-α、IL-5、SAA比对照组均明显下降(P<0.05),观察组FEV1、PEF、FEV1/FVC比对照组明显升高(P<0.05)。结论孟鲁司特钠治疗咳嗽变异性哮喘,炎症因子水平明显降低,肺功能及临床症状显著改善。

儿童上气道咳嗽综合征与腺样体肥大的相关性

腺样体位于鼻咽顶后壁中线处,为咽淋巴环内环的组成部分,6～7岁发育至最大,青春期后逐渐萎缩。本病多见于儿童[1]。肥大腺样体可以影响患儿呼吸,引起睡眠障碍;压迫咽鼓管可导致分泌性中耳炎;影响鼻腔通畅,反复鼻及鼻窦炎,从而引起鼻后滴漏,导致慢性咳嗽。对儿童的生长发育及生活产生多方面的影响。

鼻后滴漏综合征综合治疗分析

鼻后滴漏综合征（postnasal drip syndrome,PNDs）是指因变应性或非变应性鼻腔、鼻窦炎性分泌物倒流入咽,引起的慢性咳嗽、咽异物感等一系列症状。PNDs并非独立性疾病,其病因多样,是引起慢性咳嗽的重要原因之一[1],若不能明确诊断,针对病因和症状治疗,则效果不佳。我科2013年6月~2014年3月采用个体化综合治疗方案治疗鼻后滴漏综合征120例,取得良好效果,现报道如下。

咳嗽性晕厥1例临床分析并文献复习

咳嗽性晕厥综合征（ cough syncope syndrome, CSS）是因咳嗽诱发的短暂性意识丧失,现报告我院老年科收治的咳嗽性晕厥1例。

地佐辛对全麻诱导插管时呛咳反应的影响

芬太尼诱发的呛咳反应（fentanyl-induced cough，FIC）是其作为麻醉诱导用药的一大缺陷，可引起胸膜腔内压明显升高，影响静脉回流，同时脑脊液压力升高，甚至导致严重的并发症。临床上预防FIC的方法很多，均有一定的改善作用，但远未取得理想的效果。我院自2011年4月采用地佐辛作为麻醉诱导药插管时几无呛咳反应，现报道如下。

阻塞性睡眠呼吸暂停低通气综合征与慢性咳嗽的研究进展

不明原因的慢性咳嗽是呼吸内科门诊病人最常见的症状。目前对咳嗽患者的初始评估治疗着重于引起咳嗽的最常见病因：咳嗽变异性哮喘（ cough va-riant asthma,CVA）、胃食管反流性疾病（ gastroesoph-ageal reflux disease,GERD）、和上气道咳嗽综合征（ upper airway cough syndrome UACS）。然而有相当一部分患者在经过充分的检查和治疗后仍不能明确咳嗽的病因。近年来有研究者[1-3]发现阻塞性睡眠呼吸暂停低通气综合征（ obstructive sleep apnea hy-popnea syndrome,OSAHS）在不明原因慢性咳嗽患者中有很高的发生率,且经过持续气道正压通气（ con-tinuous positive airway pressure,CPAP）治疗后咳嗽症状明显好转,提示OSAHS很可能是慢性咳嗽的一个重要病因[4]。本文就OSAHS与慢性咳嗽的相关研究进展做一综述。

I COUGH综合气道管理在肝癌患者围术期中的应用

目的:探讨I COUGH综合气道管理对肝癌手术患者呼吸道并发症的临床作用。方法:选取2015年1月至2016年6月本院外科行开放手术的肝癌患者113例进行研究,分为实验组53例与对照组60例,实验组围术期应用I COUGH综合气道管理,对照组围术期应用常规气道管理,对比分析两组间的术后呼吸系统并发症发生率和术后平均住院日。结果:实验组的肺不张发生率显著低于对照组(χ2=4.875,P=0.027),但其他呼吸系统并发症发生率并无显著差异(χ2=0.841,P>0.05)。实验组的术后平均住院日显著短于对照组(t=2.557,P=0.012),且实验组肺不张患者术后平均住院日显著短于对照组肺不张患者(t=2.099,P=0.044)。结论:I COUGH综合气道管理能够有效预防肝癌开放手术术后肺不张的发生,并且能够缩短此类并发症相关的术后平均住院日,从而减轻患者的经济负担。