Objective To explore the diagnostic significance of differential cell count in induced sputum to chronic cough and assessment of airway inflammation.Methods The sputum of 335 chronic cough patients were induced.Differential cell counts were measured in these samples.The side effects were observed during the induced procedure.The final diagnosis was made based on clinical manifestation and examination findings including pulmonary function tests,provocation test,induced sputum cell differentials, etc.Results The cause of chronic cough was defined in 322 patients.The six most important causes of cough were typical asthma(TA,n=84),eosinophilic bronchitis (EB,n=62),atopic cough (AC,n= 42),cough variant asthma (CVA,n=40),gastroesophageal reflux cough(GERC,n=37),rhinitis and/ or paranasal sinusitis (PNDs,n=32),and others and indefinite cause (n=25,13).Percentage of eosinophils were significantly increased in the induced sputum of AC,EB,CVA,and GERC patients (0.005,0.052,0.059,0.234) compared with those in other causes and the healthy controls (0) (P

Adult ; Aged ; Endotoxemia ; Endotoxins ; blood ; Female ; Humans ; Inflammation Mediators ; blood ; Liver Diseases ; blood ; therapy ; Liver, Artificial ; Male ; Middle Aged ; Plasma Exchange ; Serum ; chemistry ; Young Adult

OBJECTIVETo study the prevalence of cough and its risk factors in young college students in Guangzhou.

METHODSUsing a questionnaire with uniform scheme, a cluster-randomized sampling survey was conducted among young college students in Guangzhou. Fluoroscopy of chest was performed in subjects with persisted cough longer than 8 weeks.

RESULTSThere were 1087 cases with complete data from 1091 people including 648 males, 439 females with an average age of 21.16 years old. The total prevalence of cough was 10.9%. Difference in prevalence of cough between males and females showed no significance (10.3% vs. 11.9%, P > 0.05). There were also no significant differences between male and female in prevalence rates of acute cough (6.9% vs. 8.7%, P > 0.05) and chronic cough (3.4% vs. 3.2%, P > 0.05). Under chronic cough condition, cough was more likely to be the only or major symptom than under acute cough condition (77.8% vs. 44.6%, chi(2) = 11.166, P < 0.01). Nasal disease was an important risk factor to the development of chronic cough, which was found in 33.3% of the patients with chronic cough and when having chronic nasal diseases.

CONCLUSIONCough seemed a common disorder in young college student in Guangzhou and there was no significant difference in prevalence between males and females. Nasal disease was an important risk factor to chronic cough.

China ; epidemiology ; Chronic Disease ; Cough ; epidemiology ; etiology ; Female ; Fluoroscopy ; Humans ; Male ; Nose Diseases ; complications ; Prevalence ; Risk Factors ; Sampling Studies ; Students ; statistics & numerical data ; Surveys and Questionnaires ; Universities ; Young Adult

OBJECTIVETo study the histopathologic features, differential diagnosis and pathogenesis of diabetic cardiomyopathy.

METHODSThe clinicopathologic features of 40 autopsy cases of diabetes mellitus were studied. The hearts from another 40 cases of non-diabetic elderly deceased were used for comparison.

RESULTSIn the 40 cases of diabetes studied, 36 cases (90.0%) showed microscopic myocardial cell death. Focal interstitial fibrosis was observed in 37 cases (92.5%). On the other hand, similar myocardial cell death and patchy interstitial fibrosis was seen in 8 cases (20.0%) and 9 cases (22.5%) of non-diabetic hearts, respectively. The difference between the two groups was statistically significant (P < 0.01). The mural thickness of intramyocardial blood vessels was significantly increased in diabetic group (20.6 microm +/- 4.2 microm) than in non-diabetic group (7.2 microm +/- 5.2 microm), P < 0.01.The myocardial changes in diabetic group however were similar to those in non-diabetic group with systemic hypertension.

CONCLUSIONSPathologic diagnosis of diabetic cardiomyopathy relies on detailed histologic examination of heart tissue and clinical correlation of a long history of diabetes mellitus. Exclusion of other possible etiologies is also essential. The myocardial cell death observed may be due to the ischemic effect induced by diabetic microangiopathy in cardiac muscle.

Aged ; Aged, 80 and over ; Autopsy ; Cardiomyopathies ; complications ; diagnosis ; Cell Death ; Coronary Vessels ; cytology ; pathology ; Diabetes Complications ; pathology ; Diagnosis, Differential ; Female ; Fibrosis ; diagnosis ; pathology ; Humans ; Male ; Myocardium ; cytology ; pathology

OBJECTIVETo retrospectively analyze the medical treatment of 332 patients with lower leg fracture in Wenchuan earthquake admitted in West China Hospital.

METHODSFrom May 12, 2008 to June 15, 2008, 332 patients with lower leg fracture injured in Wenchuan earthquake were treated in our hospital. The data on trauma condition and clinical treatment were collected and analyzed.

RESULTSAmong the 332 cases of lower leg fracture, there were 179 cases of open fracture, accounting for 53.9%, in which 91% belonged to Gustilo II or III injury with serious pollution. Many patients had posttraumatic complications, vascular and nerve injury, wound infection or osteofascial compartment syndrome. After medical treatment, blood vessels were reconnected, wound surface was repaired and wound infection was under control.

CONCLUSIONFor the patients with lower leg fracture in earthquake, we followed the principle of "complete debridement - restoring the continuity of bone bracket-timely recovering blood supply of limbs and repairing nerve damage - repair the wound surface at stage I or II " so as to reduce the incidence of amputation and infection.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; China ; Compartment Syndromes ; etiology ; Earthquakes ; Female ; Fracture Healing ; Fractures, Bone ; surgery ; Humans ; Leg ; blood supply ; innervation ; Leg Injuries ; surgery ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVESTo observe the clinical and coronary features of patients with systemic lupus erythematosus (SLE) and coronary artery disease (CAD).

METHODSAmong 2877 SLE inpatients (age ≥ 18 years, male 363, female 2514) admitted in the Peking Union Medical College Hospital between January 1999 to October 2009, 33 patients [mean age (50.7 ± 12.8) years] were diagnosed with CAD and coronary angiogram was available in 20 out of these 33 patients. Clinical and coronary features of these patients were retrospectively reviewed.

RESULTSThe incidence of CAD was significantly higher in male SLE patients than in female patients [2.48% (9/363) vs. 0.95% (24/2514), P = 0.022]. Patients with secondary antiphospholipid syndrome were more likely to suffer from CAD [5.76% (8/139) vs. 0.91% (25/2738), P < 0.001]. Myocardial infarction was the major form of CAD (24/33). Coronary artery angiographic changes included coronary stenosis and occlusions, coronary aneurysms and acute thrombosis and multi-vessel lesions was found in 75.0% (15/20) patients with SLE and CAD.

CONCLUSIONSMale SLE patients and patients with secondary antiphospholipid syndrome are at higher risk for CAD. Myocardial infarction and multi-vessel lesions are common in SLE patients with CAD.

Adolescent ; Adult ; Aged ; Antiphospholipid Syndrome ; complications ; Coronary Angiography ; Coronary Artery Disease ; complications ; pathology ; Female ; Humans ; Lupus Erythematosus, Systemic ; complications ; pathology ; Male ; Middle Aged ; Risk Factors ; Young Adult

OBJECTIVETo observe the effect of repeated esophageal acid infusion on specific airway resistance (sRaw) and airway reactivity in the guinea pigs and explore the mechanism.

METHODSsRaw and airway reactivity were measured by double-chamber plethysmography in normal control group (group N), saline control group (group NS), and repeated acid irrigation group (group H). The initial measurement was used as the baseline sRaw and airway reactivity (1d1), and 2 h after the initial measurement, sRaw and airway reactivity were measured again (1d2). Similarly, such measurements were repeated on the 15th day for all the guinea pigs (15d1, 15d2) with a 2-h interval. The content of Substance P (SP) and vasoactive intestinal peptide (VIP) in lung tissue, trachea, BALF and ganglion were detected by ELISA.

RESULTSThe percent change of sRaw, (15d2-1d1)/1d1 in group H was significantly higher than that in group N. The differences in the airway reactivity of the group N, group NS, and group H were not statistically significant. The SP content in the lung, trachea, ganglion and bronchoalveolar lavage fluid (BALF) in group H was significantly higher than those in group N. The SP content in ganglion showed a significant positive correlation to that in the trachea. No significant differences were found in the VIP content in the lung, trachea, ganglion or BALF between the groups.

CONCLUSIONRepeated esophageal acid infusion increases the airway resistance, but not the airway reactivity in normal guinea pigs. SP may be involved in development of high sRaw through the esophageal-tracheobronchial reflex.

Airway Resistance ; Animals ; Bronchoalveolar Lavage Fluid ; chemistry ; Esophagus ; Gastroesophageal Reflux ; metabolism ; physiopathology ; Guinea Pigs ; Lung ; metabolism ; Male ; Respiratory System ; Substance P ; metabolism ; Trachea ; metabolism ; Vasoactive Intestinal Peptide ; metabolism

OBJECTIVETo establish a method for measurement of airway resistance (sRaw) and reactivity in guinea pigs.

METHODSMethacholine spray at gradient concentrations was given to guinea pigs. PC100 was defined as the concentration of methacholine when the sRaw doubled in the guinea pigs using a double-chamber plethysmograph. The time for the recovery of PC100 resistance to baseline levels was measured. The sRaw and PC100 were measured twice on days 1 and 15 (4 time points) in the guinea pigs before and after OVA challenge.

RESULTSPC100 in a normal guinea pig airway was shown to recover the baseline level within 1 h. Double-chamber plethysmographical measurement of the sRaw and PC100 in normal guinea pigs did not show significant differences between the time points [sRaw: 3.25-/+0.67, 3.33-/+0.58, 3.30-/+0.56, and 3.32-/+0.75 cm H2O.s; log2PC100: 8.48-/+0.94, 8.64-/+1.04, 8.56-/+0.67, and 8.64-/+0.60, respectively, P>0.05]. The sRaw and airway reactivity were significantly increased in guinea pigs challenged with OVA [sRaw: 7.08-/+1.82 vs 2.87-/+0.53 cmH2O.s, P<0.01; log2PC100: 6.64-/+1.26 vs 8.48-/+1.17, P<0.01].

CONCLUSIONA double-chamber plethysmography for measurement of sRaw and airway reactivity in guinea pig is established successfully.

Airway Resistance ; Animals ; Asthma ; chemically induced ; physiopathology ; Bronchial Hyperreactivity ; etiology ; physiopathology ; Guinea Pigs ; Male ; Methacholine Chloride ; Plethysmography ; instrumentation ; methods ; Random Allocation

OBJECTIVETo compare the epidemiological and clinical features of lower respiratory tract infection (LRTI) caused by influenza virus A (IVA) and influenza virus B (IVB) in children.

METHODSThe clinical data of 366 children with LRTI caused by influenza virus (IV), who were hospitalized in Yuying Children′s Hospital of Wenzhou Medical University between 2010 and 2014, were analyzed retrospectively, and there were 272 cases caused by IVA and 94 cases caused by IVB.

RESULTSIV was mainly prevalent from December to March of the next year, with the predominance of IVA. There were small peaks of IVA prevalence in July or September every other year, and IVB was prevalent from December to March of the next year every other year. The children with LRTI caused by IVA alone had a significantly higher white blood cell (WBC) count and significantly higher percentages of children with increased WBC, abnormal serum sodium, and abnormal serum potassium than those caused by IVB alone (P<0.05). However, there were no significant differences in age, sex, underlying diseases, clinical manifestations, and co-infection rate with bacteria or atypical pathogens between the two groups (P>0.05). The rate of co-infection with respiratory syncytial virus (RSV) was significantly higher in the IVB group than in the IVA group (P<0.01).

CONCLUSIONSIVA is prevalent in winter and spring every year and has small peaks in summer every other year, while IVB is prevalent in winter and spring every other year. Compared with IVB, IVA causes more cases of increased WBC and electrolyte disturbance. The children infected with IVB are more likely to be co-infected with RSV. The children with LRTI caused by IVA and IVB have similar clinical manifestations.

Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Infant, Newborn ; Influenza A virus ; genetics ; isolation & purification ; physiology ; Influenza B virus ; genetics ; isolation & purification ; physiology ; Influenza, Human ; diagnosis ; epidemiology ; virology ; Male ; Respiratory Tract Infections ; diagnosis ; epidemiology ; virology ; Retrospective Studies ; Seasons

OBJECTIVETo establish the method of cytological examination and the normal reference values for hypertonic saline solution-induced sputum of healthy children (age range from 5 to 15 years) with physical examination in Guangzhou.

METHODA total of 352 children, 5 to 15 years old, were enrolled from primary school and middle school in Guangzhou from January to December, 2010. All subjects completed a standardized questionnaire on the presence of respiratory, allergic symptoms and family history, the medical history and the physical examination was performed by doctors, lung function (forced expiratory volume at 1 s in predicted normal, FEV(1)%) was determined. There were 266 healthy children (137 males, 129 females) who were selected and undergone hypertonic saline solution induction of sputum, and cytological examination was performed. Hypertonic saline (5%) was nebulized and inhaled for 15 - 30 min. No expectoration within 30 min was defined as failure, and the procedure was terminated. The part of opaque and higher density sputum samples was detected by cytology. The proportion of neutrophils, lymphocytes, eosinophils, macrophages and monocytes was calculated. This study was approved by the institutional Ethics Review Committee of First Affiliated Hospital of Guangzhou Medical College. Informed consent was obtained from the legal guardians of all participants following a detailed description of the purpose and potential benefits of the study.

RESULTThere were 175 subjects' induced sputum specimens (175/266, 65.8%), non-qualified sputum samples were obtained from 16 of the subjects. The proportions of median (IQR) of lymphocytes were 0.012 (0.020), 95%CI were ranged from 0.015 to 0.022; neutrophils 0.207 (0.330), 95%CI 0.266 - 0.356 macrophages 0.761 (0.327), 95%CI 0.607 - 0.699; eosinophils 0.004 (0.019), 95%CI 0.013 - 0.022. There were no significant differences in proportions of cytological findings of female or male, different age groups and second-hand smoking or not (all P > 0.05). The incidence of adverse event was 4.40% (7/159).

CONCLUSIONThe method and the preliminary data may be used for research, diagnosis and treatment of patients with chronic cough and airway inflammation.

Adolescent ; Child ; Child, Preschool ; China ; Cough ; diagnosis ; physiopathology ; Eosinophils ; cytology ; Female ; Forced Expiratory Volume ; Humans ; Leukocyte Count ; Lymphocyte Count ; Lymphocytes ; cytology ; Male ; Monocytes ; cytology ; Neutrophils ; cytology ; Reference Values ; Saline Solution, Hypertonic ; chemistry ; Sputum ; cytology ; metabolism