Yuebi Plus Banxia Decoction is derived from the Synopsis of the Golden Chamber(Jin Gui Yao Lue) by ZHANG Zhong-jing. With the effects of ventilating lung, discharging heat, descending adverse Qi, and relieving cough and asthma, this prescription is mainly used to treat pulmonary distension caused by phlegm heat obstructing the lungs. Currently, it is commonly used in clinical practice for the treatment of acute exacerbation of chronic obstructive pulmonary disease, acute bronchitis, pneumonia, bronchial asthma, pulmonary heart disease, and pertussis. In the original text, lung distension refers to the inability of lung Qi to descend, including symptoms such as barrel chest, chest tightness, shortness of breath, coughing, and phlegm accumulation, and it is often seen in acute exacerbation of chronic obstructive pulmonary disease. The description of "the patient is panting and their eyes are likely to dislodge" indicates that Yuebi Plus Banxia Decoction is used to treat severe cases of pathogenic heat obstructing the lungs. The description of "the eyes are likely to dislodge" does not refer to hyperthyroidism with sunken orbits, but to the enlarged eye opening caused by severe coughing and asthma as well as chemosis caused by type Ⅱ respiratory failure. The disease indications of this prescription include acute exacerbation of chronic obstructive pulmonary disease, chronic obstructive pulmonary disease combined with type Ⅱ respiratory failure, severe pulmonary infection, pulmonary heart disease combined with infection, interstitial pneumonia, and bronchial asthma. The symptom and sign indications of this prescription include chest tightness, wheezing, cough, expectoration, yellow and sticky phlegm, difficult cough, dry mouth/thirst, desire for cold drinks, irritability, enlarged open of eyes, chemosis, dry stool, yellow urine, red tongue, thin white or yellow tongue coating, dry tongue coating, and floating and slippery powerful pulse. In terms of the disease nature, the indications of this prescription are mainly excess syndromes and rarely include deficiency syndromes. In terms of treatment course, one or two bags of Yuebi Plus Banxia Decoction can demonstrate effects of relieving dyspnea and coughing. In terms of prescription identification, Yuebi Plus Banxia Decoction needs to be distinguished from Yuebi Decoction and Yuebi Plus Atractylodes Macrocephala Decoction. In terms of pharmacological effects, Yuebi Plus Banxia Decoction demonstrates anti-inflammatory and antioxidant effects and can alleviate congestion and edema in the bronchial wall and surrounding interstitium.
Pulmonary Disease, Chronic Obstructive/physiopathology* ; Humans ; Drugs, Chinese Herbal/administration & dosage* ; Respiratory Insufficiency/etiology* ; Respiratory Tract Infections/physiopathology* ; Male

INTRODUCTION: Respiratory virus (RV) infections have been implicated in acute exacerbation cardiopulmunary conditions. This study aimed to determine the prevalence of RV infections in patients admitted to the cardiology unit with acute decompensated heart failure (ADHF) in a tertiary hospitals in Singapore. MATERIALS AND METHODS: This was a single-centre, prospective observational study. A total of 194 adults (aged >21) admitted to the Singapore General Hospital with ADHF were recruited. A nasopharyngeal swab was taken for multiplex polymerase chain reaction (PCR) detection of influenza virus, rhinovirus, parainfluenza virus (HPIV), human coronavirus (HcoV), adenoviurs, human bocavirus (HboV), human metapneumovirus (hMPV), and respiratory syncytial virus (RSV). RESULTS: Twenty-five (13%) had RVs detected by RV multiplex PCR. There comprised 9 rhinoviruses (36%), 4 influenza A viruses (16%), 3 HPIV (12%), 3 HCoV (12%), 2 adenoviruses (8%), 1 human HBoV (4%), 1 hMPV (4%), and 1 RSV (4%). Symptoms-wise, cough was significantly more common in the PCR-positive group (48% vs 24%, = 0.02). There were no statistically significant differences in laboratory investigations (haemoglobin, leukocytes, platelets, creatine kinase, creatine kinase-muscle/brain, troponin T), and radiology findings between RV PCR-positive and -negative groups. The PCR-positive group did not have increased mortality or length of hospital stay. CONCLUSION This study identified a considerable burden of RVs in our ADHF cohort, and highlights the need for prevention of RVs in this group of patients. We also recognised the difficulty with clinical diagnosis of RVs in ADHF patients.
Adult ; Comorbidity ; Diagnosis, Differential ; Female ; Heart Failure ; epidemiology ; physiopathology ; therapy ; Humans ; Length of Stay ; statistics & numerical data ; Male ; Nasopharynx ; virology ; Outcome Assessment (Health Care) ; Prospective Studies ; Respiratory Tract Infections ; epidemiology ; therapy ; virology ; Singapore ; epidemiology ; Survival Analysis ; Symptom Flare Up ; Viruses ; classification ; isolation & purification ; pathogenicity

Anti-Infective Agents ; administration & dosage ; therapeutic use ; Biomarkers ; blood ; Child, Preschool ; Dermatomyositis ; complications ; diagnosis ; therapy ; Edema ; etiology ; therapy ; Electromyography ; Extremities ; pathology ; physiopathology ; Hormones ; administration & dosage ; therapeutic use ; Humans ; Male ; Muscle, Skeletal ; pathology ; physiopathology ; Respiratory Tract Infections ; etiology ; therapy ; Tomography, X-Ray Computed

OBJECTIVE: To investigate hypoxia tolerance of children with recurrent respiratory papillomatosis with the spread of trachea in surgical procedures without ventilation via endotracheal tube intermittently under general anesthesia. METHOD: Forty children with recurrent respiratory papillomatosis were enrolled in the observation. The duration of SpO2 from 100% to the points of 99%, 95%, 90%, 85%, the heart rate in each time point above. PaO2, PaCO2, pH valve when SpO2 was 85%, the duration of SpO2 back to 100% were recorded respectively. RESULT: Duration of SpO2 from 100% down to 99%, 95%, 90%, 85% was (168.4 +/- 58.3)s, (204.6 +/- 56.4)s, (224.8 +/- 58.9)s, (239.9 +/- 60.6)s, respectively. Heart rate was (121.6 +/- 14. 6)bpm, (123.3 +/- 15.1) bpm, (124.1 +/- 14.8)bpm, (125.0 +/- 15.1)bpm, respectively. When SpO2 was 85%, pH value was 7.22 +/- 0.05, PCO2 was (69 +/- 8.7)mmHg, PO2 was (52 +/- 7.9)mmHg. Duration of SpO2 up to 100% was (28.6 +/- 2.5)s; When SpO2 back to 100%, pH value was 7.40 +/- 0.02, PCO2 was (40.5 +/- 2.0)mmHg, PO2 was (358 +/- 104.3)mmHg. CONCLUSION Intermittent apnea during the surgical procedures in RRP children with distal spread of papillomas was safe, hypercapnia and hypoxia caused by the apnea can be corrected soon after the re-ventilation. Duration of apnea should be controlled within 3--5 minutes in each apnea-reoxygenation cycle.
Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Hypoxia ; physiopathology ; Male ; Monitoring, Intraoperative ; Papillomavirus Infections ; pathology ; surgery ; Respiratory Tract Infections ; pathology ; surgery ; Respiratory Tract Neoplasms ; pathology ; surgery

OBJECTIVEWU polyomavirus (WUPyV), a new member of the genus Polyomavirus in the family Polyomaviridae, has been found to be associated with respiratory tract infections recently. But the role of the WUPyV as agents of human disease remains uncertain. We sought to describe the detection and clinical characterization of WUPyV in acute respiratory tract infection in children.

METHODFrom July 2008 through June 2009, nasopharyngeal aspirates were collected from 771 children who were hospitalized with acute respiratory tract infection in Second Affiliated Hospital of Shantou University Medical College, and from 82 asymptomatic children who visited the health checkup clinic. WUPyV was detected by using PCR technology and was identified by using DNA sequencing. All WUPyV-positive specimens were screened for 9 common viruses [influenza A and B, respiratory syncytial virus (RSV), parainfluenza virus (PIV) 1 and 3, human metapneumovirus, human bocavirus, adenovirus and rhinovirus] by using PCR or RT-PCR. The clinical data of WUPyV infection were collected and analyzed.

RESULTIn this study, fifteen of the 771 tested specimens with acute respiratory tract infection were positive for WUPyV, the positive rate was 1.95% and all of the asymptomatic children who visited the health checkup clinic were negative. Of the 15 cases who were positive for the virus, the age range was 2 to 48 (mean 18.8) months, 9 (60%) were male and 6 (40%) were female. WUPyV was the sole virus detected in 9 specimens (60%) from patients with acute respiratory tract infection. WUPyV was associated with the co-infection with another respiratory virus in 6 of 15 (40%) cases, most frequently with RSV (n = 4), followed by adenovirus (n = 1) and rhinovirus (n = 1). The most common clinical findings in the patients with WUPyV were cough, fever and wheezing. The most frequent diagnoses were pneumonia (n = 8), bronchiolitis (n = 4), upper respiratory tract infections (n = 2) and bronchitis (n = 1). A severe case was complicated with viral encephalitis.

CONCLUSIONWUPyV may be a respiratory pathogen because it was the sole virus detected in 9 specimens from patients with respiratory illness and all of the asymptomatic controls were negative. The most common clinical findings are cough and wheezing. Young children may be susceptible to infection with this virus and occasionally the infection with this virus may cause severe disease. More comprehensive and in-depth studies are required to prove the pathogenicity of these viruses.

Child ; Child, Preschool ; Female ; Genes, Viral ; Humans ; Infant ; Infant, Newborn ; Male ; Polymerase Chain Reaction ; Polyomavirus ; genetics ; isolation & purification ; Polyomavirus Infections ; physiopathology ; virology ; Respiratory Tract Infections ; virology

OBJECTIVEThe impact of human bocavirus (HBoV), a newly identified human parvovirus, on childhood persistent wheezing has not been identified. In this study, the clinical features of infantile persistent wheezing induced by HBoV was analyzed.

METHODSTracheal aspirates were collected by bronchofibroscope or nasopharyngeal (NP) aspirates from April, 2006 to January, 2007. HBoV DNA in the tracheal aspirates of 33 children with persistent wheezing and in NP aspirates of 6 children with persistent wheezing, who had at least or more than four weeks wheezing. RSV was identified by virus isolation in Hep-2 cells and antigen detetion by direct immunofluorescence assay (DIFA) which was also used for diagnosis of adenovirus, influenza A and B, parainfluenza 1, 2, 3 infection.

RESULTSOf the 39 children with persistent wheezing, 12 cases (31%) were positive for HBoV DNA. Age of HBoV-positive patients ranged from 2 month to 1 year. The results of sequencing of PCR products proved that sequences of HBoV DNA from these 12 samples were exactly identical to the those of HBoV stored in GeneBank (accession numbers DQ000495 and DQ000496). Two cases with HBoV infection were found to be co-infected with RSV. Ten of the 12 HBoV-positive samples were collected during the period from winter to spring (1 in November, 4 in December, 2 in January and 3 in April), the other two HBoV-positive samples were collected during the period from summer to autumn (1 in May and the other in July). Seven of the 12 HBoV DNA-positive patients had fever, 5 of them had high fever. Significantly more patients with HBoV infection had fever as compared to patients with RSV infection. All the HBoV positive patients showed abnormal findings on chest X ray such as interstitial infiltrates, lung infiltration and hyperinflation. Abnormal findings on chest X ray were found in higher proportion of HBoV positive patients as compared with RSV positive patients. And other manifestations such as wheezing, cough and respiratory distress had no significant difference between HBoV and RSV infected patients.

CONCLUSIONSThis study further demonstrated that HBoV probably is a common pathogen of lower respiratory infection in children and might particularly be associated with persistent wheezing.

Child, Preschool ; Cough ; etiology ; Female ; Fever ; etiology ; Human bocavirus ; pathogenicity ; Humans ; Infant ; Male ; Nasopharynx ; pathology ; Paramyxoviridae Infections ; physiopathology ; Parvoviridae Infections ; physiopathology ; Respiratory Sounds ; etiology ; Respiratory Syncytial Virus Infections ; classification ; physiopathology ; Respiratory Tract Infections ; diagnosis ; physiopathology ; virology

Child ; China ; Humans ; Paramyxoviridae Infections ; physiopathology ; Respiratory Tract Infections ; physiopathology ; virology