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.

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.

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.

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

Objective To evaluate the effect of casting back the whole life cycle of medication orders on the nurse work .Methods Sixty-two nurses were surveyed by the self-designed questionnaire .The standard of casting back medication orders was carried out through the design of the module for casting back medication orders based on the information of nurse workstation and the check of Itouch bar code .The time of carrying out the medication orders and the medication safety were compared before and after the implementation . Results After the implementation , the time of carrying out the doctor ’ s advice for every bed on daily decreased from (4.36 ±1.28)min to (0.97 ±0.34)min, and the difference was statistically significant (t=20.181,P<0.01).The error rate of carrying out the doctor ’ s advice for every thousand beds on daily decreased from 0.74‰to 0.15‰, and the error rate of medication decreased from 1.33‰ to 0.35‰, and leakage rate of medication decreased from 1.24‰to 0.06‰, and the differences were statistically significant (χ2 =13.548, 19.073, 36.347, respectively; P<0.05).Conclusions Implementation of the management of casting back the whole life cycle of medication orders can improve the work efficiency , and decrease the occurrence of nursing defects, and ensure the safety of patients .

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

The clinical presentation,chest image and electrocardiogram of 4 cases of premature complex-induced chronic cough admitted in the First Affiliated Hospital of Guangzhou Medical University from March 2008 to February 2009,were retrospectively analyzed.And other 6 cases of premature complex-induced chronic cough were retrieved for literature review.In total 10 patients,there were 3 males and 7 females aged 58(36-74) years,with a disease duration of 10.5 (3.0,264.0) months.The main clinical presentations were chronic dry cough with post-sternal thump and premature beats as shown by auscultation and 24 h-electrocardiogram examination.Cough was relieved after the premature beats were controlled with the treatment of arrhythmia drugs or radiofrequency ablation.Premature complex-induced cough is rare but it should be considered when the chief complaint of patients with premature beat is chronic cough.

PURPOSE: An older female predominance has been reported among chronic cough patients in Western countries, which is considered to be associated with a higher cough sensitivity in females. However, the characteristics of Chinese chronic cough patients remain unclear. This study aimed to explore the age and sex distribution as well as their relationship with cough reflex sensitivity to capsaicin in Chinese chronic cough patients. METHODS: We analyzed the demographic features of 1,882 consecutive chronic cough patients who attended our cough clinic in Guangzhou, China. Cough sensitivity to capsaicin, which was defined as the lowest concentration of capsaicin causing 5 coughs or more (C5), was measured in 539 of the 1,882 patients and 68 healthy volunteers. RESULTS: The mean age of the patients was 43.0 ± 13.7 years and patients aged <50 years accounted for more than two-thirds of the study population. Around 87% of the patients were never-smokers. The proportion of females (51.5%) was almost equal to that of males (48.5%). The pattern of the age and sex distribution was consistently reflected within most common causes of chronic cough, while a female predominance was shown in patients with cough-variant asthma and patients aged ≥50 years. Female patients had higher cough sensitivity to capsaicin than male patients (log C5: 1.58 ± 0.84 vs. 2.04 ± 0.84 μmol/L, P = 0.001), and patients aged ≥50 years had higher cough sensitivity to capsaicin than patients aged <50 years. CONCLUSIONS: In China, patients with chronic cough have a roughly equal sex distribution and a middle-aged predominance, irrespective of a higher cough sensitivity to capsaicin in females and older patients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02591550
Age Distribution ; Asian Continental Ancestry Group ; Asthma ; Capsaicin ; China ; Cough ; Female ; Healthy Volunteers ; Humans ; Male ; Reflex ; Sex Distribution