OBJECTIVETo compare the conventional pulmonary function test results of children with asthma or cough variant asthma (CVA).

METHODSA total of 140 children, who were diagnosed with asthma or CVA from May 2010 to May 2011, were divided into acute asthma attack (n=50), asthma remission (n=50) and CVA groups (n=40); 30 healthy children were included as a control group. The forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), forced expiratory flow after 25% of vital capacity has been expelled (FEF25), forced expiratory flow after 50% of vital capacity has been expelled (FEF50), forced expiratory flow after 75% of vital capacity has been expelled (FEF75) and maximal midexpiratory flow (MMEF75/25) were measured.

RESULTSThe mean percent predicted values of all the above indices were lower than 80% in the acute asthma attack group, with FEF50, FEF75 and MMEF75/25 declining markedly; the mean percent predicted values of FEF75 and MMEF75/25 were lower than 80% in the CVA group. All the pulmonary function indices in the acute asthma attack group were lower than those in the control group. The mean percent predicted values of FVC, FEV1, FEF25 and MMEF75/25 in the asthma remission and CVA groups were lower than in the control group. All the pulmonary function indices in the acute asthma attack group were lower than in the asthma remission and CVA groups, but there were no significant differences between the asthma remission and CVA groups.

CONCLUSIONSThere is small and large airway dysfunction, particularly small airway dysfunction, in children with acute asthma attack. Children with CVA present mainly with mild small airway dysfunction, as do those with asthma in remission.

Asthma ; physiopathology ; Child ; Cough ; physiopathology ; Female ; Forced Expiratory Volume ; Humans ; Lung ; physiopathology ; Male ; Vital Capacity

Cough ; diagnosis ; physiopathology ; Dyspnea ; diagnosis ; physiopathology ; Female ; Humans ; Hyperparathyroidism, Primary ; diagnosis ; physiopathology ; Middle Aged

Unilateral vocal cord paralysis(UVCP) is defined as affected side vocal cord emerges immobility or motion weakening and abnormal tension due to unilateral intrinsic laryngeal muscles suffering from disorder about motor nerve. The patients usually present with hoarse voice, disability of high pitch, cough, aspiration, or a combination of these symptoms. There are increasing therapeutics researches and case analyses regarding UVCP in recent years. Thus this review summarized the progression about its causes and treatment methods.
Cough ; Hoarseness ; Humans ; Laryngeal Muscles ; physiopathology ; Vocal Cord Paralysis ; diagnosis ; therapy ; Vocal Cords ; physiopathology

Adult ; Bronchial Hyperreactivity ; physiopathology ; Bronchial Provocation Tests ; Chronic Disease ; Cough ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Respiratory Function Tests

OBJECTIVETo observe the effects of cross electro-nape-acupuncture on reflex remodeling of airway protective reflex cough in patients with tracheotomy after cerebral hemorrhage.

METHODSWith the method of completely random design, according to treatment order, 60 patients who received tracheotomy after cerebral hemorrhage accompanied with cough reflex difficulty were randomly divided into a cross electro-nape-acupuncture group and an acupuncture group, 30 cases in each group. Both groups were treated with basic treatment, including anti-inflammation, eliminating phlegm, improving cerebral metabolism and so on. The acupuncture group was treated with acupuncture at Yifeng (TE 17), Fengchi (GB 20), Lianquan (CV 23), Baihui (GV 20), Touwei (ST 8), Dicang (ST 4) through Jiache (ST 6), Hegu (LI 4), Quchi (LI 11), and motor area on the affected side, and the needles were retained for 30 min. Based on the treatment of acupuncture group, the cross electro-nape-acupuncture group was additionally treated with cross electro-nape-acupuncture (continuous wave) for 30 min per treatment. The treatment was both given twice a day from Monday to Friday and once a day on Saturday and Sun day for 4 weeks. Tracheostomy cough reflex grading score (TCRGS) and clinical pulmonary infection score (CPIS) were observed before and after treatment in the two groups, and the clinical efficacy of two groups was evaluated.

RESULTSCompared before the treatment, TCRGS and CPIS were both reduced in two groups (both P < 0.01); after treatment, there were significant differences of TCRGS and CPIS between two groups (both P < 0.01), indicating cross electro-nape-acupuncture group was superior to acupuncture group. Regarding the effects of cough reflex remodeling, the cured and markedly effective rate was 96.7% (29/30) in the cross electro-nape-acupuncture group, which was significantly different from 55.2% (16/29) in the acupuncture group (P < 0.01).

CONCLUSIONCross electro-nape-acupuncture could effectively improve the remodeling of cough reflex and promote the recovery of lung infection in patients with tracheotomy after cerebral hemorrhage, leading to an increased quality of life.

Acupuncture Points ; Aged ; Cerebral Hemorrhage ; physiopathology ; surgery ; therapy ; Cough ; physiopathology ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Reflex ; Tracheotomy

PURPOSE: The purpose of this study is to investigate how respiratory muscle strength correlates to cough capacity in patients with respiratory muscle weakness. MATERIALS AND METHODS: Forty-five patients with amyotrophic lateral sclerosis (ALS), 43 with cervical spinal cord injury (SCI), and 42 with Duchenne muscular dystrophy (DMD) were recruited. Pulmonary function tests including forced vital capacity (FVC) and respiratory muscle strength (maximal expiratory pressure, MEP; maximal inspiratory pressure, MIP) were performed. The correlation between respiratory muscle strength and cough capacity was analyzed. RESULTS: In the SCI group, FVC in a supine position (2,597 +/- 648 mL) was significantly higher than FVC in a sitting position (2,304 +/- 564 mL, p < 0.01). Conversely, in the ALS group, FVC sitting (1,370 +/- 604 mL) was significantly higher than in supine (1,168 +/- 599 mL, p < 0.01). In the DMD group, there was no statistically significant difference between FVC while sitting (1,342 +/- 506 mL) and FVC while supine (1,304 +/- 500 mL). In addition, the MEP and MIP of all three groups showed a significant correlation with peak cough flow (PCF) (p < 0.01, Pearson's correlation analysis). In the SCI group, MIP was more closely correlated with PCF, while in the ALS and DMD groups, MEP was more closely correlated with PCF (p < 0.01, multiple regression analysis). CONCLUSION: To generate cough flow, inspiratory muscle strength is significantly more important for SCI patients, while expiratory muscle function is significantly more important for ALS and DMD patients.
Adult ; Amyotrophic Lateral Sclerosis/*physiopathology ; Cough/*physiopathology ; Female ; Humans ; Inspiratory Capacity ; Male ; Middle Aged ; Muscle Strength/*physiology ; Muscle Weakness/pathology/*physiopathology ; Muscular Dystrophy, Duchenne/*physiopathology ; Respiratory Muscles/pathology/*physiopathology ; Spinal Cord Injuries/*physiopathology

OBJECTIVE: To systematically summarize the clinical features of coronavirus disease 2019 (COVID-19) in children. METHODS: PubMed, Embase, Web of Science, The Cochrane Library, CNKI, Weipu Database, and Wanfang Database were searched for clinical studies on COVID-19 in children published up to May 21, 2020. Two reviewers independently screened the articles, extracted data, and assessed the risk of bias of the studies included. A descriptive analysis was then performed for the studies. Related indices between children with COVID-19 and severe acute respiratory syndromes (SARS) or Middle East respiratory syndrome (MERS) were compared. RESULTS: A total of 75 studies were included, with a total of 806 children with COVID-19. The research results showed that the age of the children ranged from 36 hours after birth to 18 years, with a male-female ratio of 1.21 : 1. Similar to SARS and MERS, COVID-19 often occurred with familial aggregation, and such cases accounted for 74.6% (601/806). The children with COVID-19, SARS, and MERS had similar clinical symptoms, mainly fever and cough. Some children had gastrointestinal symptoms. The children with asymptomatic infection accounted for 17.9% (144/806) of COVID-19 cases, 2.5% (2/81) of SARS cases, and 57.1% (12/21) of MERS cases. The children with COVID-19 and MERS mainly had bilateral lesions on chest imaging examination, with a positive rate of lesions of 63.4% (421/664) and 26.3% (5/19) respectively, which were lower than the corresponding positive rates of viral nucleic acid detection, which were 99.8% and 100% respectively. The chest radiological examination of the children with SARS mainly showed unilateral lesion, with a positive rate of imaging of 88.9% (72/81), which was higher than the corresponding positive rate of viral nucleic acid detection (29.2%). Viral nucleic acid was detected in the feces of children with COVID-19 or SARS, with positive rates of 60.2% (56/93) and 71.4% (5/7) respectively. The children with COVID-19 had a rate of severe disease of 4.6% (31/686) and a mortality rate of 0.1% (1/806), the children with SARS had a rate of severe disease of 1.5% (1/68) and a mortality rate of 0%, and those with MERS had a rate of severe disease of 14.3% (3/21) and a mortality rate of 9.5% (2/21). CONCLUSIONS Children with COVID-19 have similar symptoms to those with SARS or MERS, mainly fever and cough. Asymptomatic infection is observed in all three diseases. Children with COVID-19 or SARS have milder disease conditions than those with MERS. COVID-19 in children often occurs with familial aggregation. Epidemiological contact history, imaging examination findings, and viral nucleic acid testing results are important bases for the diagnosis of COVID-19.
Betacoronavirus ; Child ; Coronavirus Infections ; physiopathology ; Cough ; virology ; Female ; Fever ; virology ; Humans ; Male ; Middle East Respiratory Syndrome Coronavirus ; Pandemics ; Pneumonia, Viral ; physiopathology ; Severe Acute Respiratory Syndrome ; physiopathology ; virology

OBJECTIVETo study the roles of allergen testing in vitro and impulse oscillometry for lung function measurements in preschool children with cough variant asthma (CVA).

METHODSethodsForty-four preschool children with acute asthma, 41 with chronic asthma, 46 with CVA, and 35 healthy preschool children as control were recruited in the study. Inhaled allergen, food allergen, and mite-specific IgE were determined by Pharmacia UniCAP System. Serum eosinophil cationic protein (ECP) and total IgE levels were measured. Lung function was assessed by impulse oscillometry.

RESULTSThe positive rates of inhaled allergen and food allergen, and total IgE levels in the CVA, acute asthma and chronic asthma groups were higher than those in the control group (P<0.01). However, no significant differences were found among the three case groups. The serum ECP levels in the CVA group were lower than those in the acute asthma group (P<0.01), but did not show differences when compared with the chronic asthma group. The impulse oscillometry demonstrated that the respiratory total impedance (Zrs), airway resistance at 5 Hz (R5), airway resistance at 20 Hz (R20), subtracting R5 from R20 (R5-R20) and resonant frequency (Fres) in the CVA, acute asthma and chronic asthma groups were higher than those in the control group (P<0.01). Zrs, R5, R20, R5-R20, and Fres in the CVA and chronic asthma groups were lower than those in the acute asthma group (P<0.01). Serum ECP levels were positively correlated with Zrs, R5, R5-R20 and Fres (P<0.05) in the CVA and chronic asthma groups.

CONCLUSIONSThe measurements of allergens, serum ECP and impulse oscillometry for lung function are helpful for the evaluation of airway inflammation and airway obstruction in preschool children with CVA.

Allergens ; immunology ; Asthma ; immunology ; physiopathology ; Child ; Child, Preschool ; Cough ; immunology ; physiopathology ; Eosinophil Cationic Protein ; blood ; Humans ; Immunoglobulin E ; blood ; Lung ; physiopathology ; Oscillometry ; methods

The endpoint detection of cough signal in continuous speech has been researched in order to improve the efficiency and veracity of manual recognition or computer-based automatic recognition. First, using the short time zero crossing ratio(ZCR) for identifying the suspicious coughs and getting the threshold of short time energy based on acoustic characteristics of cough. Then, the short time energy is combined with short time ZCR in order to implement the endpoint detection of cough in continuous speech. To evaluate the effect of the method, first, the virtual number of coughs in each recording was identified by two experienced doctors using the graphical user interface (GUI). Second, the recordings were analyzed by automatic endpoint detection program under Matlab7.0. Finally, the comparison between these two results showed: The error rate of undetected cough is 2.18%, and 98.13% of noise, silence and speech were removed. The way of setting short time energy threshold is robust. The endpoint detection program can remove most speech and noise, thus maintaining a lower rate of error.
Algorithms ; Artificial Intelligence ; Cough ; physiopathology ; Endpoint Determination ; Humans ; Pattern Recognition, Automated ; methods ; Signal Processing, Computer-Assisted ; Sound

The cough sound is a very important symptom of well over 100 kinds of diseases. Cough sound analysis can provide much information which is useful for diagnosing. Detecting the frequencies and intensity of cough can evaluate the efficiency of therapy quantitatively. In this paper, we put forward an algorithm for cough sound recognition. We first decompose signals with wavelet transform and calculate the normalized energy at each time-frequency point. Then we obtain the normalized energy distribution statistically. After that, we pick out the time-frequency points maximizing a certain discriminant measure of normalized energy distribution between cough sound and non-cough sound, and then we use the normalized energy belonging to these time-frequency points as the inputs of Linear discriminant analysis/Generalized singular value decomposition (LDA/GSVD) classifier. The experimental results show that the classification accuracies achieved by using the algorithm is about 85%, and the computation complexity is low.
Algorithms ; Cough ; physiopathology ; Data Interpretation, Statistical ; Discriminant Analysis ; Humans ; Markov Chains ; Monitoring, Physiologic ; methods ; Pattern Recognition, Automated ; methods ; Sound