The new revision of 《Guideline on Diagnosis and Management of Cough(2009)》 is published in China in 2009 following the first revision of 《Guideline on Diagnosis and Management of Cough (draft)》in 2005.The new revision hold prvious stucture basically,more focuses on diagnosis and management of chronic ough,adds new sections including subacute cough,empiric treatment,phlegm-removing drugs,and assessement of cough severity as an appendix.A few news terms have been intrduced to replace older terms,such as upper airway cough syndrome for post nasal drip symdrome,and postinfection cough for cough post influenza.

An experimental model of asthma was established with ovalbumin sensitization in guinea-pigs and then the preventive effects of ketotifen on the terbutaline-induced down regulation of beta-adrenoceptors in lymphocytes were investigated with radioligand binding assay.It was found that terbutaline significantly reduced the density of beta-adrenoceptors in lymphocytes,ketotifen administered simultaneously with terbutaline prevented the density of beta-adrenoceptors in lymphocytes from reducing.and neither ketotifen nor terbutaline changed the Kd values in either group.These findings suggest that ketotifen is of value to provent asthmatic patients from the adverse effects of tschyphylactic therapy of beta-adrenoceptor stimulants.

Objective To investigate the severity of cough in patients with different etiology of chronic cough and its related factors. Methods One hundred and fifty patients with chronic cough were recruited. The diagnosis of the patients was as follows: 24 cases with post nasal drip syndrome (PNDs), 26 cough variant asthma (CVA), 20 gastroesophageal reflux-induced cough (GERC), 31 eosinophilic bronchitis (EB), 30 atopic cough (AC) and 19 cough post infection (CPI). The severity of cough at daytime and night-time were scored by the doctor and the patient at the first visit. The correlation between cough score and age, gender and course duration of patients was analyzed. Results There was no significantly difference of cough score at daytime among different groups. Cough score at night in CVA group was significantly higher than that of other five groups (all P <0.01). Regression analysis showed that cough score at daytime was significantly correlated with age of patients (P < 0.05), while cough score at night was correlated significantly with gender (P < 0.01). Conclusion Cough severity at daytime in different etiology of chronic cough is similar, while that at night in patient with CVA is higher than that with other etiology.

AIM: The expression of the Fas Antigen and induction of apoptosis by anti-Fas antibody in esoinophils in vitro were investigated. METHODS: Purified eosinophils from health donors were cultured for 72 h in the presence of human IL-5 and with or without anti-Fas monclonal antibody (MoAb) at various concentrations (1-1000 ?g/L). The expression of the Fas antigen on eosinophils was determined by immunocytochemistry. The changes of eosinophils viability and apoptosis were also studied. RESULTS: The Fas antigen was expressed on freshly isolated eosinophils, which had no significant changes after culture in the presence or absence of IL-5. The anti-Fas MoAb at different concentration suppressed significantly the IL-5-mediated eosinophils survival (78%?9%). When eosinophils were cultured in the presence of IL-5 (1?10 4 U/L) with anti-Fas MoAb (1 000 ?g/L), the percentage of alive cell decreased to 30%?12%( P

Objective:To find related polypeptides which could bind interleukin (IL) 5 with high affinity.Methods:The recombinant human IL 5 was biotinylated with NSH LC Biotin,then biotinylated IL 5 was used to react with random peptide library displaying 7 amino acids fused on protein III of M13 Phage for three rounds biopanning.The selected clones were assayed by sandwich enzyme linked immunosorbent assay(ELISA)and competition ELISA.The positive clones with high affinity were used for automated sequencing with dye labeled dideoxynucleotides,and the amino acid sequence of polypeptide displayed on phage was deduced.Results:The enrichment was shown by ELISA after 3 rounds of biopanning.9 positive clones could bind to IL 5 with high affinity.Sequencing of the genes encoding these peptides on 9 positive clones showed some conserved epitope information such as SX 1 2 AS,ALAS.Conclusion:Potential polypeptides binding IL 5 with high affinity could be selected from phage display peptide library,SX 1 2 AS may be the motifs recognized by IL 5.

Objectiev To explore the use of different nebulizer to establish mice model that have airway eosinophilic inflam -mation without airway hyperresponsiveness .Methods Female BALB/c mice were obtained and divided randomly into 3 groups:eo-sinophilic airway inflammation group ( experimental group ) , asthma group, and control group .Mice were immunized with ovalbumin ( OVA) .The experiment group and asthma group were challenged with an aerosol of 1% w/v OVA using a PARI TIA and PARI LC STAR nebulizer on day 28, 29, 30, respectively.The control mice were received saline sensitization and challenge .Airway respon-siveness was measured .Cell different counts in bronchial alveolus lavage fluid ( BALF) were performed and a pathologist performed histopathological evaluation of the trachea and lung .Results Airway responsiveness in the experimental group was not significantly different compared with the normal saline ( NS) group but was significantly different compared with the asthma group .Eosinophils in BALF were increased significantly in experimental group compared with the NS group , and significant difference was observed between experimental group and asthma group .The intensity of airway inflammation in experimental group was milder than that in the asthma model .Conclusions We established an eosinophilic bronchitis mice model without hyperresponsiveness successfully .Our model es-tablished a foundation for the further research in airway hyperresponsiveness .

AIM: To explore the pathological features of airway inflammation in patients with eosinophilic bronchitis(EB) and compared to those with cough variant asthma(CVA).METHODS: Flexible fibre optic bronchoscopy was performed in 11 patients with EB,10 with CVA,14 with bronchial asthma and 10 normal controls.The mean thickness of the basement membrane was measured by light microscopy.Using immunohistochemical and special staining,the localization and density of inflammatory cells(eosinophils,mast cells,T lymphocytes) were detected in bronchial submucosa in EB and CVA patients.RESULTS: The mean thickness of the basement membrane was significantly increased in the subjects with EB [2.92 ?m(2.10-6.50 ?m)],CVA [5.64 ?m(3.23-8.48 ?m)] and bronchial asthma [9.08 ?m(6.61-11.99 ?m)] rather than that in the normal controls [2.08 ?m(1.62-3.40 ?m)].There were also significant differences among the three groups.The number of mast cells and eosinophils in the bronchial submucosal from subjects with EB [75 cells/mm~2(35-112 cells/mm~2),7 cells/mm~2(0-31(cells/mm~2))] was substantially decreased than those in subjects with CVA [148 cells/mm~2(34-200 cells/mm~2),114 cells/mm~2((1-768 cells/mm~2));P

Cough is one of the most common symptoms of many respiratory diseases; the characteristics of intensity and frequency of cough sound offer important clinical messages. When using these messages, we have need to differentiate the cough sound from the other sounds such as speech voice, throat clearing sound and nose clearing sound. In this paper, based on Empirical Mode Decomposition (EMD) and Hidden Markov Model (HMM), we proposed a novel method to analyze and detect cough sound. Employing the property of adaptive dyadic filter banks of EMD, we gained the mean energy distribution in the frequency domain of the signals in order to analyze the statistical characteristics of cough sound and of other sounds not accompanied by cough, and then we found the optimal characteristics for the recognition using HMM. The experiments on clinical date showed that this optimal characteristic method effectively improved the detective rate of cough sound.
Cough ; diagnosis ; physiopathology ; Diagnosis, Computer-Assisted ; methods ; Humans ; Markov Chains ; Monitoring, Physiologic ; methods ; Pattern Recognition, Automated ; methods ; Sound ; Sound Spectrography ; methods

PURPOSE: Extensive data support the influence of the upper airway on lower airway inflammation and pathophysiology in allergic disease. However, few studies have focused on allergic inflammation in the nose after an isolated lower airway allergen challenge, a situation that can exist clinically when human subjects breathe primarily through the mouth, as occurs when nasally congested. This study used a mouse model to investigate whether upper airway inflammation and hyperresponsiveness were induced by an isolated lower airway allergen challenge. METHODS: BALB/c mice were sensitized by systemic intraperitoneal injection of ovalbumin/saline and challenged with intratracheal ovalbumin/saline. Inflammation in the nose and lungs was assessed by cytology and histology of nasal tissues and bronchoalveolar lavage fluid (BALF), while nasal airway resistance and response were measured over 3 days post-challenge. RESULTS: Intratracheal application of an allergen in anaesthetized mice resulted in exclusive deposition in the lower airway. Compared to control animals, ovalbumin-sensitized mice after challenge showed bronchial hyperreactivity and increased IL-5 in the serum BALF, as well as eosinophil infiltration in the lungs. However, nasal histology of the ovalbumin-sensitized mice showed no increase in eosinophil infiltration. The nasal lavage fluid revealed no increase in eosinophils or IL-5, and the nasal airway resistance did not increase after challenge either. CONCLUSIONS: In a mouse allergy model, exclusive allergen challenge of the lower airway can elicit a pulmonary and systemic allergic response, but does not induce upper airway inflammatory or physiological responses.
Airway Resistance ; Animals ; Asthma* ; Bronchial Hyperreactivity ; Bronchoalveolar Lavage Fluid ; Eosinophils ; Estrogens, Conjugated (USP) ; Humans ; Hypersensitivity ; Inflammation* ; Injections, Intraperitoneal ; Interleukin-5 ; Lung ; Mice ; Mouth ; Nasal Lavage Fluid ; Nose* ; Rhinitis

Objective To evaluate the role of transthoracic echocardiography ( T T E ) and transesophageal echocardiography( T EE) in the process of transapical mitral valve repair using a novel edge‐to‐edge device( ValveClamp) and this device′s efficacy and safety in a preliminary clinical trial . Methods Six patients with moderate to severe or severe degenerative mitral regurgitation ( DM R) confirmed by T T E and T EE were enrolled . T T E was performed pre and post procedure as well as 30 days post procedures . Related cardiac structure and hemodynamic parameters ,including mitral regurgitation area ( MRA‐max ) , vena contracta width ( VCW ) ,mitral valve effective orifice area ( M VEOA ) ,left ventricular end diastolic diameter ( LVEDD ) , left ventricular end systolic diameter ( LVESD ) , left ventricular ejection fraction ( LVEF) ,max and mean mitral valve pressure gradient ( M VPG‐max and M VPG‐mean) were recorded and evaluated in a central core laboratory . Results All the procedures were successfully performed .M RA‐max , VCW and M VEOA decreased significantly post procedures ( all P ＜ 0 .000 ) , and they remained no significant changes within 30 days post procedures ( all P ＞ 0 .05 ) . M eanwhile ,M VPG‐max and M VPG‐mean slightly increased ( all P ＜0 .01 ) and left atrial anterior‐posterior dimension attenuated 30 days post procedures( P ＜0 .05) ,but all M VPG‐mean were lower than 5 mm Hg ( 1 mm Hg＝0 .133 kPa) . T here were no significant changes in other hemodynamic parameters ( all P ＞ 0 .05) . Conclusions T ransapical mitral valve repair using ValveClamp can be performed safely and a significant reduction in mitral regurgitation can be achieved in patients with DM R . T EE and T T E facilitate the patient selection for ValveClamp procedures as well as perioperative navigation and assessment .