The application of traditional Chinese medicines(TCMs)has a history of more than 2000 years,which have the characteristics of multi-component,multi-target,and high safety.Post-infectious cough(PIC)is a respiratory dis...The application of traditional Chinese medicines(TCMs)has a history of more than 2000 years,which have the characteristics of multi-component,multi-target,and high safety.Post-infectious cough(PIC)is a respiratory disease with high incidence.It belongs to subacute cough and accounts for as much as40%–50%.Cough is the main clinical manifestation of PIC.PIC seriously affects people’s life quality because of complex etiology,long-term course of disease,treatment difficulties and other characteristics.Western medicines are based on the principle of symptomatic treatment,so they are often difficult to control PIC fundamentally.These factors could due to that PIC is prolonged and unable to heal repeatedly.TCMs have obvious advantages in treating PIC,with accurate curative effects,less side effects and adverse reactions and are effective in improving PIC-related symptoms and indicators,enhancing patients’life quality and reducing pain.TCMs,guided by holistic concept and syndrome differentiation,advocate determine treatment on the basis of pattern types,and have remarkable clinical treatment effects.As for TCMs etiology,pathogenesis and syndrome types of PIC,TCM scholars have not yet reached a unified standard.However,most of them think that wind pathogen can cause PIC alone,or it can be combined with other evils,which might be the main mechanism of PIC.This paper discusses the advantages and limitations of TCMs in PIC treatment from etiology,pathogenesis,distribution of syndrome types and treatment of TCMs.This article focuses on the treatment methods and pharmacodynamic material basis of wind pathogen,providing ideas in treating PIC of TCMs clinically and innovative drug development.展开更多
Irritable bowel syndrome(IBS)is a commonly encountered chronic functional gastrointestinal(GI)disorder.Approximately 10%of IBS patients can trace the onset of their symptoms to a previous a bout of infectious dysenter...Irritable bowel syndrome(IBS)is a commonly encountered chronic functional gastrointestinal(GI)disorder.Approximately 10%of IBS patients can trace the onset of their symptoms to a previous a bout of infectious dysentery.The appearance of new IBS symptoms following an infectious event is defined as post-infectiousIBS.Indeed,with the World Health Organization estimating between 2 and 4 billion cases annually,infectious diarrheal disease represents an incredible international healthcare burden.Additionally,compounding evidence suggests many commonly encountered enteropathogens as unique triggers behind IBS symptom generation and underlying pathophysiological features.A growing body of work provides evidence supporting a role for pathogen-mediated modifications in the resident intestinal microbiota,epithelial barrier integrity,effector cell functions,and innate and adaptive immune features,all proposed physiological manifestations that can underlie GI abnormalities in IBS.Enteric pathogens must employ a vast array of machinery to evade host protective immune mechanisms,and illicit successful infections.Consequently,the impact of infectious events on host physiology can be multidimensional in terms of anatomical location,functional scope,and duration.This review offers a unique discussion of the mechanisms employed by many commonly encountered enteric pathogens that cause acute disease,but may also lead to the establishment of chronic GI dysfunction compatible with IBS.展开更多
AIM:To investigate the interstitial cells of Cajal(ICC) number using a new rat model.METHODS:Sprague-Dawley rats were assigned to two groups.The first group received gavage with Campylobacter jejuni(C.jejuni) 81-176.T...AIM:To investigate the interstitial cells of Cajal(ICC) number using a new rat model.METHODS:Sprague-Dawley rats were assigned to two groups.The first group received gavage with Campylobacter jejuni(C.jejuni) 81-176.The second group was gavaged with placebo.Three months after clearance of Campylobacter from the stool,precise segments of duodenum,jejunum,and ileum were ligated in self-contained loops of bowel that were preserved in anaerobic bags.Deep muscular plexus ICC(DMP-ICC) were quantified by two blinded readers assessing the tissue in a random,coded order.The number of ICC per villus was compared among controls,Campylobacter recovered rats without small intestinal bacterial overgrowth(SIBO),and Campylobacter recovered rats with SIBO.RESULTS:Three months after recovery,27% of rats gavaged with C.jejuni had SIBO.The rats with SIBO had a lower number of DMP-ICC than controls in the jejunum and ileum.Additionally there appeared to be a density threshold of 0.12 DMP-ICC/villus that was associated with SIBO.If ileal density of DMP-ICC was < 0.12 ICC/villus,54% of rats had SIBO compared to 9% among ileal sections with > 0.12(P<0.05).If the density of ICC was < 0.12 DMP-ICC/villus in more than one location of the bowel,88% of these had SIBO compared to 6% in those who did not(P<0.001).CONCLUSION:In this post-infectious rat model,the development of SIBO appears to be associated with a reduction in DMP-ICC.Further study of this rat model might help understand the pathophysiology of postinfectious irritable bowel syndrome.展开更多
BACKGROUND Post-infectious irritable bowel syndrome(PI-IBS)is generally regarded as a functional disease.Several recent studies have reported the involvement of lowgrade inflammation and immunological dysfunction in P...BACKGROUND Post-infectious irritable bowel syndrome(PI-IBS)is generally regarded as a functional disease.Several recent studies have reported the involvement of lowgrade inflammation and immunological dysfunction in PI-IBS.T helper 17(Th17)polarization occurs in IBS.Adenosine and its receptors participate in intestinal inflammation and immune regulation.AIM To investigate the role of Th17 polarization of CD4+T cells regulated by adenosine 2A receptor(A2AR)in PI-IBS.METHODS A PI-IBS model was established by infecting mice with Trichinella spiralis.The intestinal A2AR and CD4+T lymphocytes were detected by immunohistochemistry,and the inflammatory cytokines were detected by enzyme-linked immunoassay.CD4+T lymphocytes present in the animal’s spleen were separated and cultured with or without A2AR agonist and antagonist.Western blotting and real-time quantitative polymerase chain reaction were performed to determine the effect of A2AR on the cells and intestinal tissue.Cytokine production was determined.The protein and mRNA levels of A2AR associated signaling pathway molecules were also evaluated.Furthermore,A2AR agonist and antagonist were injected into the mouse model and the clinical features were observed.RESULTS The PI-IBS mouse model showed increased expression of ATP and A2AR(P<0.05),and inhibition of A2AR improved the clinical features in PI-IBS,including the abdominal withdrawal reflex and colon transportation test(P<0.05).The number of intestinal CD4+T cells and interleukin-17(IL-17)protein levels increased during PI-IBS,which was reversed by administration of the A2AR antagonist(P<0.05).CD4+T cells expressed A2AR and produced IL-17 in vitro,which was regulated by the A2AR agonist and antagonist.The A2AR antagonist increased the production of IL-17 by CD4+T cells via the Janus kinase-signal transducer and activator of transcriptionreceptor-related orphan receptorγsignaling pathway.CONCLUSION The results of the present study suggested that the upregulation of A2AR increases PI-IBS by promoting the Th17 polarization of CD4+T cells.展开更多
One-hundred years have passed since the original description of the commonly described phenomenon of persistent abdominal symptoms being triggered by an acute enteric infection. This first account was generated out of...One-hundred years have passed since the original description of the commonly described phenomenon of persistent abdominal symptoms being triggered by an acute enteric infection. This first account was generated out of astute observations by Sir Arthur Hurst in World War I. Additional descriptions followed from military and non-military practitioners adding the evidence which has transitioned this recognized condition from association to causation. While mechanistic understanding is an area of active pursuit, this historical accounting of a centuries progress highlights important advances and contributions of military medicine and scientists to advances benefiting global populations.展开更多
Lianhua Qingke tablets,a patented traditional Chinese medicine that has validated clinical efficacy for treating cough caused by severe acute respiratory syndrome coronavirus 2 infection,lack rigorous evidence-based r...Lianhua Qingke tablets,a patented traditional Chinese medicine that has validated clinical efficacy for treating cough caused by severe acute respiratory syndrome coronavirus 2 infection,lack rigorous evidence-based research evaluating their effect on long coronavirus disease(COVID)cough.A randomized,double-blind,placebo-controlled,multicenter clinical study was conducted among patients with long COVID cough from 19 hospitals and 23 community health centers in China.Patients were randomized 1:1 to receive either Lianhua Qingke tablets or placebo orally for 14 days(four tablets,1.84 g,three times a day).The primary endpoint indicator was the disappearance of cough,with the remission of cough also considered.Among 482 randomized patients,480(full analysis set 480;per-protocol set 470;safety set 480)were included in the primary analysis.According to the full analysis,the time until cough disappearance was significantly shorter in the trial group than in the control group,with a significant increase in the 14-day cough disappearance rate.Accordingly,the time to cough remission was significantly shorter in the trial group than in the control group.The change in the total symptom score was significantly greater in the trial group than in the control group on days 7 and 14,consistent with the results indicated by the visual analog scale(VAS)and cough evaluation test(CET)scores.No serious adverse events were recorded during the study.Lianhua Qingke tablets significantly improved the clinical symptoms of patients with long COVID cough.展开更多
Objective:To explore the presence of inflammatory memory in the lung tissue of mice with cough variant asthma(CVA)and the mechanism of Wuhu decoction in preventing and treating CVA.Methods:Among the 90 SPF-grade femal...Objective:To explore the presence of inflammatory memory in the lung tissue of mice with cough variant asthma(CVA)and the mechanism of Wuhu decoction in preventing and treating CVA.Methods:Among the 90 SPF-grade female BALB/c mice,20 were randomly selected as the blank group,while the remaining 70 were sensitized by intraperitoneal injection of ovalbumin(OVA)combined with aluminum hydroxide and then exposed to OVA by nebulization to establish the CVA mouse model.From the conctrol group and the model group,10 mice were randomly selected to detect airway responsiveness using an animal ventilator.Successfully modeled mice were then randomly divided into 7 groups:a CVA model group,a CVA re-challenge group,low-,medium-,and high-dose Wuhu decoction groups,and a positive control(dexamethasone)group,with 10 mice in each group.After 30 days of rest,except for the conctrol group and the model group,mice in the other groups underwent a second OVA nebulization challenge and received corresponding drug interventions once a day for 10 consecutive days before further analysis.Pathological changes in lung tissue were observed using periodic acid-schiff(PAS)and Masson staining methods.Serum levels of tumor necrosis factor-α(TNF-α),interleukin-4(IL-4),interferon-γ(IFN-γ),and interleukin-10(IL-10)were detected using enzyme-linked immunosorbent assay(ELISA).The expression of T-bet mRNA and GATA-3 mRNA in lung tissue was determined by real-time quantitative polymerase chain reaction(Real-time PCR).Results:The results of airway responsiveness indicated successful establishment of the model.Compared with the control group,the model group exhibited severalkey pathological changes including inflammatory cellinfiltration around the lung tissue,epithelialmetaplasia,airway collagen deposition,increased airway mucus accumulation index and airway collagen deposition index(P<0.05),elevated serum TNF-αand IL-4 expression(P<0.05),decreased IFN-γand IL-10 levels(P<0.05),decreased T-bet mRNA levels(P<0.05),increased GATA-3 mRNA levels(P<0.05),and a reduced T-bet mRNA/GATA-3 mRNA ratio(P<0.05)in lung tissue.When compared to the CVA re-challenge group,the Wuhu decoction groups and the dexamethasone group effectively alleviated pathological changes in lung tissue,reduced the airway mucus accumulation index and airway collagen deposition index(P<0.05),decreased serum TNF-αand IL-4 expression(P<0.05),increased serum IFN-γand IL-10 levels(P<0.05),upregulated T-bet mRNA levels(P<0.05),downregulated GATA-3 mRNA levels(P<0.05),and increased the T-bet mRNA/GATA-3 mRNA ratio(P<0.05)in lung tissue.Conclusion:The lung tissue of mice with cough variant asthma exhibits inflammatory memory,and Wuhu decoction may intervene in this inflammatory memory by restoring the balance between T-bet and GATA-3,thereby correcting the imbalance in Th1/Th2 immunity and exerting a preventive and therapeutic effect on cough variant asthma.展开更多
目的介绍一种有助于诊断急性阑尾炎的新体征。方法回顾性分析110例经病理证实的急性阑尾炎病人的“咳嗽征”、“呼吸疼痛征”以及“结肠充气试验”的阳性率,采用2χ检验统计比较。结果“Cough S ign”获得了96.4%的较高的阳性率,阳性率...目的介绍一种有助于诊断急性阑尾炎的新体征。方法回顾性分析110例经病理证实的急性阑尾炎病人的“咳嗽征”、“呼吸疼痛征”以及“结肠充气试验”的阳性率,采用2χ检验统计比较。结果“Cough S ign”获得了96.4%的较高的阳性率,阳性率与其它两种试验比较有显著性差异(P<0.05)。结论该方法诊断急性阑尾炎简单、实用,有较高的阳性诊断率,有助于诊断急性阑尾炎。展开更多
AIM:To evaluate the efficacy and safety of baclofen for treatment of refractory gastroesophageal reflux-induced chronic cough (GERC) unresponsive to standard anti-reflux therapy. METHODS:Sixteen patients with refracto...AIM:To evaluate the efficacy and safety of baclofen for treatment of refractory gastroesophageal reflux-induced chronic cough (GERC) unresponsive to standard anti-reflux therapy. METHODS:Sixteen patients with refractory GERC were given an 8-wk course of baclofen 20 mg three times a day as an add-on therapy to omeprazole. Changes in the cough symptom score, cough threshold to capsaicin, reflux symptom score and possible adverse effects were determined after treatment. The variables of multi-channel intraluminal impedance combined with pH monitoring were compared between responders and non-responders to baclofen. RESULTS:Twelve of 16 patients completed treatment. Cough disappeared or improved in 56.3% (9/16)of patients, including 6 patients with acid refluxinduced cough (66.7%) and 3 patients with non-acid reflux-induced cough (33.3%). With baclofen treatment, the cough symptom score began to decrease at week 2, was clearly decreased at week 6 and reached a minimum at week 8. At the end of therapy, the lowest concentration of capsaicin required for induction of ≥ 2 and ≥ 5 coughs increased from 0.98 (1.46) to 1.95 (6.82) μmol/L (Z = -2.281, P = 0.024) and from 1.95 (7.31) to 7.8 (13.65) μmol/L (Z = -2.433, P = 0.014), respectively, and the reflux symptom score decreased from 8.0 ± 1.6 to 6.8 ± 0.8 (t = 2.454, P = 0.023). The number of acid reflux episodes was significantly lower in responders than in non-responders. The main adverse effects were somnolence, dizziness and fatigue. CONCLUSION:Baclofen is a useful, but suboptimal treatment option for refractory GERC.展开更多
AIM: To compare two different daily doses of lansoprazole given for 12 weeks and to assess the role of gastrointestinal (GI) investigations as criteria for selecting patients. METHODS: Out of 45 patients referred ...AIM: To compare two different daily doses of lansoprazole given for 12 weeks and to assess the role of gastrointestinal (GI) investigations as criteria for selecting patients. METHODS: Out of 45 patients referred for unexplained chronic persistent cough, 36 had at least one of the GI investigations (endoscopy, 24-h esophageal pH- metry and a 4-week trial of proton pump inhibitor (PPI) therapy) positive and were randomly assigned to receive either 30 mg lansoprazole o.d. or 30 mg lansoprazole b.i.d, for 12 weeks. Symptoms were evaluated at baseline (visit 1) after the PPI test (visit 2) and after the 12-week lansoprazole treatment period (visit 3). RESULTS: Thirty-five patients completed the study protocol. Twenty-one patients (60.0%) reported complete relief from their cough with no difference between the two treatment groups (58.8% and 61.1% had no cough in 30 mg lansoprazole and 60 mg lansoprazole groups, respectively). More than 80% of the patients who had complete relief from their cough at the end of the treatment showed a positive response to the PPI test. CONCLUSION: Twelve weeks of lansoprazole treatment even at a standard daily dose, is effective in patients with chronic persistent cough. A positive response to an initial PPI test seems to be the best criterion for selecting patients who respond to therapy.展开更多
Refractory chronic cough due to gastroesophageal reflux is a trouble some condition unresponsive to thestandard medical anti-reflux therapy. Its underlying mechanisms may include incomplete acid suppression, non-acid ...Refractory chronic cough due to gastroesophageal reflux is a trouble some condition unresponsive to thestandard medical anti-reflux therapy. Its underlying mechanisms may include incomplete acid suppression, non-acid reflux, transient lower esophageal sphincter relaxations and esophageal hypersensitivity. The diagnosis of this disorder depends on both the findings of multi-channel intraluminal impedance-pH monitoring and the subsequent intensified anti-reflux therapy. The strategies of pharmacological treatment for refractory chronic cough due to reflux include the optimization of proton pump inhibitors and add-on therapies with histamine H2 receptor antagonists, baclofen and gabapentin. However, the further study is needed to satisfy its management.展开更多
AIM:To evaluate the association between genetic polymorphisms and angiotensin converting enzyme in-hibitor (ACEI)-related cough,and the race-or ethnicity-related difference in the prevalence of cough attributed to ACE...AIM:To evaluate the association between genetic polymorphisms and angiotensin converting enzyme in-hibitor (ACEI)-related cough,and the race-or ethnicity-related difference in the prevalence of cough attributed to ACEI therapy.METHODS:We conducted a search in PubMed,EM-BASE,Cinahl,and the Cochrane Database without language limitation.A database of 11 studies on ACEI-related cough,with detailed information regarding ACE I/D or bradykinin B 2 receptor polymorphisms,was created.Eligible studies were synthesized using meta-analysis methods,including cumulative meta-analysis.A subgroup analysis was also performed using ethnicity.RESULTS:Six studies were included on ACE I/D poly-morphism (398 Caucasians,723 East Asians),and three studies were included on bradykinin B 2 receptor poly-morphism (300 East Asians).The distribution of ACE genotypes showed significant differences in the entire population (P=0.004) and in East Asians (P=0.005)but not in Caucasians (P=0.23).Allelic frequencies of ACE showed significant differences in East Asians [odds ratio (OR)=1.49 (1.11-2.02)].The meta-analysis with a random effects model showed a significant associa-tion between ACE allele I/D and ACEI-related cough [random effects (RE) OR=1.49 (1.11-2.02),P=0.009] in East Asians,but not in Caucasians [RE OR=0.90 (0.60-1.35)].The allelic frequencies of the bradykinin B 2 receptor gene were significantly different [OR=2.25 (1.42-3.57)].The distributions of the T/C genotypes of the bradykinin B 2 receptor gene were significantly dif-ferent (χ 2=8.366,P=0.015).The meta-analyses re-vealed that there was a significant association between the bradykinin B 2 receptor allele and ACEI-related cough in East Asians [RE OR=2.29 (1.42-3.69),P=0.001].CONCLUSION:ACE I/D and Bradykinin B 2 receptor polymorphisms contributed to the risk of ACEI-related cough in East Asians,but a negative association be-tween ACE I/D polymorphism and ACEI-related cough was observed in Caucasians.展开更多
Objective:With today’s modern imaging modalities,patients diagnosed with renal cell carcinoma(RCC)rarely present symptomatically.In some cases,however,they can develop paraneoplastic syndromes with associated symptom...Objective:With today’s modern imaging modalities,patients diagnosed with renal cell carcinoma(RCC)rarely present symptomatically.In some cases,however,they can develop paraneoplastic syndromes with associated symptoms.To date,only three cases of RCC presenting with chronic dry cough have been reported.We describe six patients who presented with cough that improved following radical nephrectomy.Methods:A retrospective review of patients undergoing partial or radical nephrectomy for renal masses between January 2015 and March 2016 was performed,and patients presenting with a cough were examined.Results:Six patients presented with chronic cough and were discovered to have a large renal mass.Postoperative spontaneous resolution of cough was noted in all but one patient,in whom coughing was reduced and limited to the mornings.Cough duration ranged from 3 months to just over a year.All patients were treated with radical nephrectomy,which was cytoreductive in four patients.Average tumor size was 10.9 cm(SD=2.2 cm).Five of the tumors had clear cell pathology,and every tumor was Fuhrman grade IV,unifocal,and demonstrated necrosis.Sarcomatoid features were reported in four of the tumors.Conclusion:Our study presents the largest series of patients with RCC who presented with a chronic cough that was significantly improved following radical nephrectomy.We believe the cause of cough is multifactorial and further investigation is needed to clearly elucidate the etiology.展开更多
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 a...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.展开更多
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 lar...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.展开更多
Cough is a common respiratory complaint driving patients to seek medical advice.Besides being a fundamental respiratory sign,it is also a crucial neurological sign.There are three main types of coughs:Reflex cough(typ...Cough is a common respiratory complaint driving patients to seek medical advice.Besides being a fundamental respiratory sign,it is also a crucial neurological sign.There are three main types of coughs:Reflex cough(typeⅠ),voluntary cough(typeⅡ),and evoked cough(typeⅢ).Cough is a reflex predominantly mediated by control centers in the respiratory areas of the brainstem,modulated by the cerebral cortex.Cough reflex sensitivity could be increased in many neurological disorders such as brainstem space-occupying lesions,medullary lesions secondary to Chiari typeⅠmalformations,tics disorders such as Tourette's syndrome,somatic cough,cerebellar neurodegenerative diseases,and chronic vagal neuropathy due to allergic and non-allergic conditions.Meanwhile,cough sensitivity decreases in multiple sclerosis,brain hypoxia,cerebral hemispheric stroke with a brainstem shock,Parkinson's disease,dementia due to Lewy body disease,amyotrophic lateral sclerosis,and peripheral neuropathy as diabetic neuropathy,hereditary sensory and autonomic neuropathy typeⅣ,vitamin B12,and folate deficiency.Arnold's nerve ear-cough reflex,syncopal cough,cough headache,opioids-associated cough,and cough-anal reflex are signs that could help diagnose underlying neurological conditions.Cough reflex testing is a quick,easy,and cheap test performed during the cranial nerve examination.In this article,we reviewed the role of cough in various neurological disorders that increase or decrease cough sensitivity.展开更多
Objective:This study mainly explores the clinical effect of dispelling wind,eliminating lung and relieving cough combined with western medicine in the treatment of cough variant asthma.Methods:80 children with cough v...Objective:This study mainly explores the clinical effect of dispelling wind,eliminating lung and relieving cough combined with western medicine in the treatment of cough variant asthma.Methods:80 children with cough variant asthma accepted by our hospital from January 2018 to December 2020 were randomly selected for the study and divided into two groups.One group was the reference group(40 cases)treated with procaterol hydrochloride tablets and montelukast sodium,and the other group was the research group(40 cases)・The method of eliminating wind,eliminating lung and relieving cough was combined with procaterol hydrochloride tablets and montelukast sodium to observe and compare the curative effects of the two groups.Results:There was no significant difference in TCM symptom score and eosinophil(EOS)count between the two groups before treatment(P>0.05);After treatment,the TCM symptom scores of coughs,pharyngeal itching,expectoration,nasal congestion and nasal itching in the research group were lower than those in the reference group,and the EOS count was lower than that in the reference group(P<0.05);The effective rate of research group was higher than that of reference group(P<0.05).Conclusions:For children with cough variant asthma,Qufeng Sufei cough relieving method combined with procaterol hydrochloride and montelukast sodium can improve children's symptoms and reduce eosinophil count.展开更多
Twenty-eight cases of intractable cough were treated with moving cupping method. Theresults showed that 17 cases were cured, 7 cases markedly effective and 4 cases ineffective. The totaleffective rate was 85.7%.
基金financially supported by National Natural Science Foundation of China(Grant No.U1903122,81872768,82003630)Liaoning Revitalization Talents Program(XLYC1807118)+4 种基金Liaoning BaiQianWanShenyang Young Scientific and Technological Innovators Program(RC200408)Doctoral Scientific Research Foundation of Liaoning Province(2020-BS-129)Postdoctoral Scienceof China(2020M671384)Special Fund of Research Institute of Drug Regulatory Science Research Shenyang Pharmaceutical University(2021jgkx010)。
文摘The application of traditional Chinese medicines(TCMs)has a history of more than 2000 years,which have the characteristics of multi-component,multi-target,and high safety.Post-infectious cough(PIC)is a respiratory disease with high incidence.It belongs to subacute cough and accounts for as much as40%–50%.Cough is the main clinical manifestation of PIC.PIC seriously affects people’s life quality because of complex etiology,long-term course of disease,treatment difficulties and other characteristics.Western medicines are based on the principle of symptomatic treatment,so they are often difficult to control PIC fundamentally.These factors could due to that PIC is prolonged and unable to heal repeatedly.TCMs have obvious advantages in treating PIC,with accurate curative effects,less side effects and adverse reactions and are effective in improving PIC-related symptoms and indicators,enhancing patients’life quality and reducing pain.TCMs,guided by holistic concept and syndrome differentiation,advocate determine treatment on the basis of pattern types,and have remarkable clinical treatment effects.As for TCMs etiology,pathogenesis and syndrome types of PIC,TCM scholars have not yet reached a unified standard.However,most of them think that wind pathogen can cause PIC alone,or it can be combined with other evils,which might be the main mechanism of PIC.This paper discusses the advantages and limitations of TCMs in PIC treatment from etiology,pathogenesis,distribution of syndrome types and treatment of TCMs.This article focuses on the treatment methods and pharmacodynamic material basis of wind pathogen,providing ideas in treating PIC of TCMs clinically and innovative drug development.
基金Supported by Natural Sciences and Engineering Research Council of Canada(individual operating and CREATE)
文摘Irritable bowel syndrome(IBS)is a commonly encountered chronic functional gastrointestinal(GI)disorder.Approximately 10%of IBS patients can trace the onset of their symptoms to a previous a bout of infectious dysentery.The appearance of new IBS symptoms following an infectious event is defined as post-infectiousIBS.Indeed,with the World Health Organization estimating between 2 and 4 billion cases annually,infectious diarrheal disease represents an incredible international healthcare burden.Additionally,compounding evidence suggests many commonly encountered enteropathogens as unique triggers behind IBS symptom generation and underlying pathophysiological features.A growing body of work provides evidence supporting a role for pathogen-mediated modifications in the resident intestinal microbiota,epithelial barrier integrity,effector cell functions,and innate and adaptive immune features,all proposed physiological manifestations that can underlie GI abnormalities in IBS.Enteric pathogens must employ a vast array of machinery to evade host protective immune mechanisms,and illicit successful infections.Consequently,the impact of infectious events on host physiology can be multidimensional in terms of anatomical location,functional scope,and duration.This review offers a unique discussion of the mechanisms employed by many commonly encountered enteric pathogens that cause acute disease,but may also lead to the establishment of chronic GI dysfunction compatible with IBS.
基金Supported by A grant from Beatrice and Samuel A Seaver Foundation as well as the Shoolman Foundation
文摘AIM:To investigate the interstitial cells of Cajal(ICC) number using a new rat model.METHODS:Sprague-Dawley rats were assigned to two groups.The first group received gavage with Campylobacter jejuni(C.jejuni) 81-176.The second group was gavaged with placebo.Three months after clearance of Campylobacter from the stool,precise segments of duodenum,jejunum,and ileum were ligated in self-contained loops of bowel that were preserved in anaerobic bags.Deep muscular plexus ICC(DMP-ICC) were quantified by two blinded readers assessing the tissue in a random,coded order.The number of ICC per villus was compared among controls,Campylobacter recovered rats without small intestinal bacterial overgrowth(SIBO),and Campylobacter recovered rats with SIBO.RESULTS:Three months after recovery,27% of rats gavaged with C.jejuni had SIBO.The rats with SIBO had a lower number of DMP-ICC than controls in the jejunum and ileum.Additionally there appeared to be a density threshold of 0.12 DMP-ICC/villus that was associated with SIBO.If ileal density of DMP-ICC was < 0.12 ICC/villus,54% of rats had SIBO compared to 9% among ileal sections with > 0.12(P<0.05).If the density of ICC was < 0.12 DMP-ICC/villus in more than one location of the bowel,88% of these had SIBO compared to 6% in those who did not(P<0.001).CONCLUSION:In this post-infectious rat model,the development of SIBO appears to be associated with a reduction in DMP-ICC.Further study of this rat model might help understand the pathophysiology of postinfectious irritable bowel syndrome.
基金Supported by National Natural Science Foundation of China,No.81160057,No.81860102,and No.82060102.
文摘BACKGROUND Post-infectious irritable bowel syndrome(PI-IBS)is generally regarded as a functional disease.Several recent studies have reported the involvement of lowgrade inflammation and immunological dysfunction in PI-IBS.T helper 17(Th17)polarization occurs in IBS.Adenosine and its receptors participate in intestinal inflammation and immune regulation.AIM To investigate the role of Th17 polarization of CD4+T cells regulated by adenosine 2A receptor(A2AR)in PI-IBS.METHODS A PI-IBS model was established by infecting mice with Trichinella spiralis.The intestinal A2AR and CD4+T lymphocytes were detected by immunohistochemistry,and the inflammatory cytokines were detected by enzyme-linked immunoassay.CD4+T lymphocytes present in the animal’s spleen were separated and cultured with or without A2AR agonist and antagonist.Western blotting and real-time quantitative polymerase chain reaction were performed to determine the effect of A2AR on the cells and intestinal tissue.Cytokine production was determined.The protein and mRNA levels of A2AR associated signaling pathway molecules were also evaluated.Furthermore,A2AR agonist and antagonist were injected into the mouse model and the clinical features were observed.RESULTS The PI-IBS mouse model showed increased expression of ATP and A2AR(P<0.05),and inhibition of A2AR improved the clinical features in PI-IBS,including the abdominal withdrawal reflex and colon transportation test(P<0.05).The number of intestinal CD4+T cells and interleukin-17(IL-17)protein levels increased during PI-IBS,which was reversed by administration of the A2AR antagonist(P<0.05).CD4+T cells expressed A2AR and produced IL-17 in vitro,which was regulated by the A2AR agonist and antagonist.The A2AR antagonist increased the production of IL-17 by CD4+T cells via the Janus kinase-signal transducer and activator of transcriptionreceptor-related orphan receptorγsignaling pathway.CONCLUSION The results of the present study suggested that the upregulation of A2AR increases PI-IBS by promoting the Th17 polarization of CD4+T cells.
文摘One-hundred years have passed since the original description of the commonly described phenomenon of persistent abdominal symptoms being triggered by an acute enteric infection. This first account was generated out of astute observations by Sir Arthur Hurst in World War I. Additional descriptions followed from military and non-military practitioners adding the evidence which has transitioned this recognized condition from association to causation. While mechanistic understanding is an area of active pursuit, this historical accounting of a centuries progress highlights important advances and contributions of military medicine and scientists to advances benefiting global populations.
基金supported by National Multidisciplinary Innovation Team Project of Traditional Chinese Medicine(ZYYCXTD-D-202201)Beijing Key Specialized Department for Major Epidemic Prevention and Control(Construction ProjectJingweiyi[2019]161).
文摘Lianhua Qingke tablets,a patented traditional Chinese medicine that has validated clinical efficacy for treating cough caused by severe acute respiratory syndrome coronavirus 2 infection,lack rigorous evidence-based research evaluating their effect on long coronavirus disease(COVID)cough.A randomized,double-blind,placebo-controlled,multicenter clinical study was conducted among patients with long COVID cough from 19 hospitals and 23 community health centers in China.Patients were randomized 1:1 to receive either Lianhua Qingke tablets or placebo orally for 14 days(four tablets,1.84 g,three times a day).The primary endpoint indicator was the disappearance of cough,with the remission of cough also considered.Among 482 randomized patients,480(full analysis set 480;per-protocol set 470;safety set 480)were included in the primary analysis.According to the full analysis,the time until cough disappearance was significantly shorter in the trial group than in the control group,with a significant increase in the 14-day cough disappearance rate.Accordingly,the time to cough remission was significantly shorter in the trial group than in the control group.The change in the total symptom score was significantly greater in the trial group than in the control group on days 7 and 14,consistent with the results indicated by the visual analog scale(VAS)and cough evaluation test(CET)scores.No serious adverse events were recorded during the study.Lianhua Qingke tablets significantly improved the clinical symptoms of patients with long COVID cough.
文摘Objective:To explore the presence of inflammatory memory in the lung tissue of mice with cough variant asthma(CVA)and the mechanism of Wuhu decoction in preventing and treating CVA.Methods:Among the 90 SPF-grade female BALB/c mice,20 were randomly selected as the blank group,while the remaining 70 were sensitized by intraperitoneal injection of ovalbumin(OVA)combined with aluminum hydroxide and then exposed to OVA by nebulization to establish the CVA mouse model.From the conctrol group and the model group,10 mice were randomly selected to detect airway responsiveness using an animal ventilator.Successfully modeled mice were then randomly divided into 7 groups:a CVA model group,a CVA re-challenge group,low-,medium-,and high-dose Wuhu decoction groups,and a positive control(dexamethasone)group,with 10 mice in each group.After 30 days of rest,except for the conctrol group and the model group,mice in the other groups underwent a second OVA nebulization challenge and received corresponding drug interventions once a day for 10 consecutive days before further analysis.Pathological changes in lung tissue were observed using periodic acid-schiff(PAS)and Masson staining methods.Serum levels of tumor necrosis factor-α(TNF-α),interleukin-4(IL-4),interferon-γ(IFN-γ),and interleukin-10(IL-10)were detected using enzyme-linked immunosorbent assay(ELISA).The expression of T-bet mRNA and GATA-3 mRNA in lung tissue was determined by real-time quantitative polymerase chain reaction(Real-time PCR).Results:The results of airway responsiveness indicated successful establishment of the model.Compared with the control group,the model group exhibited severalkey pathological changes including inflammatory cellinfiltration around the lung tissue,epithelialmetaplasia,airway collagen deposition,increased airway mucus accumulation index and airway collagen deposition index(P<0.05),elevated serum TNF-αand IL-4 expression(P<0.05),decreased IFN-γand IL-10 levels(P<0.05),decreased T-bet mRNA levels(P<0.05),increased GATA-3 mRNA levels(P<0.05),and a reduced T-bet mRNA/GATA-3 mRNA ratio(P<0.05)in lung tissue.When compared to the CVA re-challenge group,the Wuhu decoction groups and the dexamethasone group effectively alleviated pathological changes in lung tissue,reduced the airway mucus accumulation index and airway collagen deposition index(P<0.05),decreased serum TNF-αand IL-4 expression(P<0.05),increased serum IFN-γand IL-10 levels(P<0.05),upregulated T-bet mRNA levels(P<0.05),downregulated GATA-3 mRNA levels(P<0.05),and increased the T-bet mRNA/GATA-3 mRNA ratio(P<0.05)in lung tissue.Conclusion:The lung tissue of mice with cough variant asthma exhibits inflammatory memory,and Wuhu decoction may intervene in this inflammatory memory by restoring the balance between T-bet and GATA-3,thereby correcting the imbalance in Th1/Th2 immunity and exerting a preventive and therapeutic effect on cough variant asthma.
文摘目的介绍一种有助于诊断急性阑尾炎的新体征。方法回顾性分析110例经病理证实的急性阑尾炎病人的“咳嗽征”、“呼吸疼痛征”以及“结肠充气试验”的阳性率,采用2χ检验统计比较。结果“Cough S ign”获得了96.4%的较高的阳性率,阳性率与其它两种试验比较有显著性差异(P<0.05)。结论该方法诊断急性阑尾炎简单、实用,有较高的阳性诊断率,有助于诊断急性阑尾炎。
基金Supported by National Natural Science Foundation of China, No. 81170079Shanghai Shenkang Hospital Development Center Project, No. SHDC12012211
文摘AIM:To evaluate the efficacy and safety of baclofen for treatment of refractory gastroesophageal reflux-induced chronic cough (GERC) unresponsive to standard anti-reflux therapy. METHODS:Sixteen patients with refractory GERC were given an 8-wk course of baclofen 20 mg three times a day as an add-on therapy to omeprazole. Changes in the cough symptom score, cough threshold to capsaicin, reflux symptom score and possible adverse effects were determined after treatment. The variables of multi-channel intraluminal impedance combined with pH monitoring were compared between responders and non-responders to baclofen. RESULTS:Twelve of 16 patients completed treatment. Cough disappeared or improved in 56.3% (9/16)of patients, including 6 patients with acid refluxinduced cough (66.7%) and 3 patients with non-acid reflux-induced cough (33.3%). With baclofen treatment, the cough symptom score began to decrease at week 2, was clearly decreased at week 6 and reached a minimum at week 8. At the end of therapy, the lowest concentration of capsaicin required for induction of ≥ 2 and ≥ 5 coughs increased from 0.98 (1.46) to 1.95 (6.82) μmol/L (Z = -2.281, P = 0.024) and from 1.95 (7.31) to 7.8 (13.65) μmol/L (Z = -2.433, P = 0.014), respectively, and the reflux symptom score decreased from 8.0 ± 1.6 to 6.8 ± 0.8 (t = 2.454, P = 0.023). The number of acid reflux episodes was significantly lower in responders than in non-responders. The main adverse effects were somnolence, dizziness and fatigue. CONCLUSION:Baclofen is a useful, but suboptimal treatment option for refractory GERC.
文摘AIM: To compare two different daily doses of lansoprazole given for 12 weeks and to assess the role of gastrointestinal (GI) investigations as criteria for selecting patients. METHODS: Out of 45 patients referred for unexplained chronic persistent cough, 36 had at least one of the GI investigations (endoscopy, 24-h esophageal pH- metry and a 4-week trial of proton pump inhibitor (PPI) therapy) positive and were randomly assigned to receive either 30 mg lansoprazole o.d. or 30 mg lansoprazole b.i.d, for 12 weeks. Symptoms were evaluated at baseline (visit 1) after the PPI test (visit 2) and after the 12-week lansoprazole treatment period (visit 3). RESULTS: Thirty-five patients completed the study protocol. Twenty-one patients (60.0%) reported complete relief from their cough with no difference between the two treatment groups (58.8% and 61.1% had no cough in 30 mg lansoprazole and 60 mg lansoprazole groups, respectively). More than 80% of the patients who had complete relief from their cough at the end of the treatment showed a positive response to the PPI test. CONCLUSION: Twelve weeks of lansoprazole treatment even at a standard daily dose, is effective in patients with chronic persistent cough. A positive response to an initial PPI test seems to be the best criterion for selecting patients who respond to therapy.
基金Supported by The National Natural Science Foundation of China,Nos.81170079 and 81470276Shanghai Shenkang Hospital Development Center,No.SHDC12012211
文摘Refractory chronic cough due to gastroesophageal reflux is a trouble some condition unresponsive to thestandard medical anti-reflux therapy. Its underlying mechanisms may include incomplete acid suppression, non-acid reflux, transient lower esophageal sphincter relaxations and esophageal hypersensitivity. The diagnosis of this disorder depends on both the findings of multi-channel intraluminal impedance-pH monitoring and the subsequent intensified anti-reflux therapy. The strategies of pharmacological treatment for refractory chronic cough due to reflux include the optimization of proton pump inhibitors and add-on therapies with histamine H2 receptor antagonists, baclofen and gabapentin. However, the further study is needed to satisfy its management.
文摘AIM:To evaluate the association between genetic polymorphisms and angiotensin converting enzyme in-hibitor (ACEI)-related cough,and the race-or ethnicity-related difference in the prevalence of cough attributed to ACEI therapy.METHODS:We conducted a search in PubMed,EM-BASE,Cinahl,and the Cochrane Database without language limitation.A database of 11 studies on ACEI-related cough,with detailed information regarding ACE I/D or bradykinin B 2 receptor polymorphisms,was created.Eligible studies were synthesized using meta-analysis methods,including cumulative meta-analysis.A subgroup analysis was also performed using ethnicity.RESULTS:Six studies were included on ACE I/D poly-morphism (398 Caucasians,723 East Asians),and three studies were included on bradykinin B 2 receptor poly-morphism (300 East Asians).The distribution of ACE genotypes showed significant differences in the entire population (P=0.004) and in East Asians (P=0.005)but not in Caucasians (P=0.23).Allelic frequencies of ACE showed significant differences in East Asians [odds ratio (OR)=1.49 (1.11-2.02)].The meta-analysis with a random effects model showed a significant associa-tion between ACE allele I/D and ACEI-related cough [random effects (RE) OR=1.49 (1.11-2.02),P=0.009] in East Asians,but not in Caucasians [RE OR=0.90 (0.60-1.35)].The allelic frequencies of the bradykinin B 2 receptor gene were significantly different [OR=2.25 (1.42-3.57)].The distributions of the T/C genotypes of the bradykinin B 2 receptor gene were significantly dif-ferent (χ 2=8.366,P=0.015).The meta-analyses re-vealed that there was a significant association between the bradykinin B 2 receptor allele and ACEI-related cough in East Asians [RE OR=2.29 (1.42-3.69),P=0.001].CONCLUSION:ACE I/D and Bradykinin B 2 receptor polymorphisms contributed to the risk of ACEI-related cough in East Asians,but a negative association be-tween ACE I/D polymorphism and ACEI-related cough was observed in Caucasians.
文摘Objective:With today’s modern imaging modalities,patients diagnosed with renal cell carcinoma(RCC)rarely present symptomatically.In some cases,however,they can develop paraneoplastic syndromes with associated symptoms.To date,only three cases of RCC presenting with chronic dry cough have been reported.We describe six patients who presented with cough that improved following radical nephrectomy.Methods:A retrospective review of patients undergoing partial or radical nephrectomy for renal masses between January 2015 and March 2016 was performed,and patients presenting with a cough were examined.Results:Six patients presented with chronic cough and were discovered to have a large renal mass.Postoperative spontaneous resolution of cough was noted in all but one patient,in whom coughing was reduced and limited to the mornings.Cough duration ranged from 3 months to just over a year.All patients were treated with radical nephrectomy,which was cytoreductive in four patients.Average tumor size was 10.9 cm(SD=2.2 cm).Five of the tumors had clear cell pathology,and every tumor was Fuhrman grade IV,unifocal,and demonstrated necrosis.Sarcomatoid features were reported in four of the tumors.Conclusion:Our study presents the largest series of patients with RCC who presented with a chronic cough that was significantly improved following radical nephrectomy.We believe the cause of cough is multifactorial and further investigation is needed to clearly elucidate the etiology.
文摘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.
文摘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.
文摘Cough is a common respiratory complaint driving patients to seek medical advice.Besides being a fundamental respiratory sign,it is also a crucial neurological sign.There are three main types of coughs:Reflex cough(typeⅠ),voluntary cough(typeⅡ),and evoked cough(typeⅢ).Cough is a reflex predominantly mediated by control centers in the respiratory areas of the brainstem,modulated by the cerebral cortex.Cough reflex sensitivity could be increased in many neurological disorders such as brainstem space-occupying lesions,medullary lesions secondary to Chiari typeⅠmalformations,tics disorders such as Tourette's syndrome,somatic cough,cerebellar neurodegenerative diseases,and chronic vagal neuropathy due to allergic and non-allergic conditions.Meanwhile,cough sensitivity decreases in multiple sclerosis,brain hypoxia,cerebral hemispheric stroke with a brainstem shock,Parkinson's disease,dementia due to Lewy body disease,amyotrophic lateral sclerosis,and peripheral neuropathy as diabetic neuropathy,hereditary sensory and autonomic neuropathy typeⅣ,vitamin B12,and folate deficiency.Arnold's nerve ear-cough reflex,syncopal cough,cough headache,opioids-associated cough,and cough-anal reflex are signs that could help diagnose underlying neurological conditions.Cough reflex testing is a quick,easy,and cheap test performed during the cranial nerve examination.In this article,we reviewed the role of cough in various neurological disorders that increase or decrease cough sensitivity.
文摘Objective:This study mainly explores the clinical effect of dispelling wind,eliminating lung and relieving cough combined with western medicine in the treatment of cough variant asthma.Methods:80 children with cough variant asthma accepted by our hospital from January 2018 to December 2020 were randomly selected for the study and divided into two groups.One group was the reference group(40 cases)treated with procaterol hydrochloride tablets and montelukast sodium,and the other group was the research group(40 cases)・The method of eliminating wind,eliminating lung and relieving cough was combined with procaterol hydrochloride tablets and montelukast sodium to observe and compare the curative effects of the two groups.Results:There was no significant difference in TCM symptom score and eosinophil(EOS)count between the two groups before treatment(P>0.05);After treatment,the TCM symptom scores of coughs,pharyngeal itching,expectoration,nasal congestion and nasal itching in the research group were lower than those in the reference group,and the EOS count was lower than that in the reference group(P<0.05);The effective rate of research group was higher than that of reference group(P<0.05).Conclusions:For children with cough variant asthma,Qufeng Sufei cough relieving method combined with procaterol hydrochloride and montelukast sodium can improve children's symptoms and reduce eosinophil count.
文摘Twenty-eight cases of intractable cough were treated with moving cupping method. Theresults showed that 17 cases were cured, 7 cases markedly effective and 4 cases ineffective. The totaleffective rate was 85.7%.