Objective To study the relationship between bronchial asthma and smoking status in Chinese people.Methods Asthma epidemiological survey and stratified-cluster-random method survey were performed in residents over 14 years in 8 provinces (cities) of China from February 2010 to August 2012.Asthma was diagnosed based upon case history,clinical signs and lung function test.Smoking status was investigated by questionnaire.Results Sampling population was 180 099 and 164 215 were valid.A total of 2 034 subjects were diagnosed as asthma including 79 692 men and 84 523 women.The overall prevalence rate of asthma was 1.24％ (2 034/164 215).Smokers were 23.8％ (39 137/164 215) in the whole population.Smokers were 34.5％ (702/2 034) in asthmatic patients,compared with 23.7％ (38 435/ 162 181) in no-asthmatic population.The incidence of asthma was 1.79％ and 1.06％ in smokers and nonsmokers respectively (P ＜0.001),suggesting that OR of smoking was 1.70 (95％ CI 1.55-1.86,P ＜ 0.001).According to asthma control test (ACT) score,the level of asthma control in non smoking group was higher than that in smoking group(43.2％ vs 35.3％).The times of hospitalization due to acute exacerbations (0.51 vs 0.41 events/person/year),total hospitalization rate (27.35 ％ vs 20.12％),annual emergency room visits (0.80 vs 0.60 events/person/year) and emergency room visit rate (31.77％ vs 24.47％) were all much higher in smoking asthmatic patients than those in non smoking asthmatic patients,indicating that the level of asthma control in smoking patients was significantly worse than in non smoking patients.Conclusions The smoking rate in Chinese people over 14 years is still high.The prevalence rate of asthma in smokers is significantly higher than that of non-smokers.The level of asthma control in smokers is significantly worse than that in non smokers.

BACKGROUNDLittle is known about asthma control and perception of asthma among asthmatic patients in China. This study marked the first survey conducted on a national scale that aimed at obtaining baseline information on asthma control and patients' perception of asthma and providing a point of reference for future studies.

METHODSThis face-to-face, questionnaire-based survey was conducted from April 2007 to March 2008 with 3 069 asthmatic patients from the respiratory outpatient clinics of 36 general hospitals located in 10 geographically dispersed cities.

RESULTSConsistent with the Global Initiative for Asthma (GINA) guidelines, 28.7% and 45.0% of our patients achieved control and partial control, respectively. Of the patients in the study, only 21.8% had used a peak flow meter (PFM), and 6.6% of these patients used it daily. Inhaled corticosteroids (ICS) plus a long-acting β2 agonist (LABA) and ICS were the two most common medication regimens and were used in 45.6% and 30.4% of patients, respectively. Asthma had a significant effect on the patients' life and work. A considerable number of hospitalizations, emergency department visits, and sick days were observed.

CONCLUSIONDespite improvements in asthma control and ICS and PFM compliance compared with past literature, the current level of asthma control countrywide continues to fall short of the goals set in the GINA.

Adolescent ; Adrenal Cortex Hormones ; therapeutic use ; Adrenergic beta-Agonists ; therapeutic use ; Adult ; Aged ; Aged, 80 and over ; Anti-Asthmatic Agents ; therapeutic use ; Asthma ; drug therapy ; epidemiology ; China ; epidemiology ; Data Collection ; Female ; Humans ; Male ; Middle Aged ; Surveys and Questionnaires ; Young Adult

Objective To study the diagnostic value of fractional exhaled nitric oxide(FeNO)in non-typical bronchial asthma.Methods Ninety-five patients with unknown-cause respiratory symptoms including wheezing,cough and breathlessness were enrolled.FeNO was measured by nitric oxide analyzer.The clinical symptoms and bronchial bronchodilator test were defined as golden standard for asthma diagnosis.The diagnostic value of FeNO was assessed and the optimal operating point of FeNO test was determined by means of the receiver operating characteristic(ROC)curve.Results Among 95 patients,44 cases were diagnosed as asthma,51 cases were diagnosed as non-asthma.The level of FeNO of asthma patients were higher than that of non-asthma patients[(55.2±14.0)nmol/L vs.(18.9±5.2)nmol/L,P＜0.01].A non-linear correlation of FeNO with FEV1％ was revealed in the cases with asthma(r=-0.162,P＞0.05).Area under ROC curve was 0.858.The optimal diagnostic cut off point was 36 nmol/L which was capable of differentiating asthma and non-asthma with sensitivity of 80.2％,specificity of 79.5％,positive predictive value of 85.4％,negative predictive value of 83.3％ and accuracy of 85.9％.Conclusions FeNO test may be helpful in the diagnosis of non-typical asthma with high sensitivity and specificity,which can also improve the diagnostic effectiveness and avoid misdiagnosis,missed diagnosis when combined with lung function test.

Objective To investigate outpatients' cognition towards common cold and their habituated medication so as to provide evidence for future public healthcare education.Methods Patients who attended hospital for diagnosis and treatment of common cold at least within past three months were asked to fill a questionnaire independently so as to learn their cognition towards common cold and medication habit.Results Among the patients underwent survey,52.2 ％ had incorrect knowledge about common cold; 2.99％ didn't know about the hazards of common cold; 34.80％ couldn't distinguish common cold from influenza; 30.07％ considered common cold couldn't get relief without treatment; 68.24％ didn't know about the proper effects of influenza vaccination; 6.4％ often took oral medicine even intravenous injection when they caught a common cold; 59.77％ often took medication from drugstore without prescription by doctor,and a few asked doctors to prescribe medicine on their request; 9.42％ didn't know about the side effects of drug for cold treatment; and 9.72％ didn't know about the active ingredients of drug for cold treatment.There were significant differences in the common cold cognition among population of different ages and education background.The older or the higher education status patients had a better cognition ( P ＜0.0 ).Conclusion There exist a certain degree of wrong cognition towards common cold among patients of different literacy degree and different age. Public health education on common cold need to be further strengthened.

Objective To investigate the cognition of the common cold and current situation of the treatment among physicians from various levels of hospitals in Chinese mainland,so as to provide evidence for future continuing medical education and rational medication.Methods A questionnaire designed for this survey was used to learn about the general information,cognitive degree of the common cold and prescription habits of physician who prescribed for cold within last three months,from various levels hospitals.Results A total of 1001 physicians were interviewed.Among them,749 physicians chose right options that the cold was the common cold and the influenza with 79.84％ in resident physicians and 56.76％ in chief physicians.A total of 745 physicians chose options that the course of common cold will be lasting 4 to 7 days; 895 physicians chose options that old people are the most susceptible for complication; 669 physicians thought the common cold was the most common infection in winter; 841 physicians used clinical methods to diagnose the common cold; 736 physicians thought although the cold was a kind of self-limited disease and symptomatic treatment could alleviate symptoms and improve life quality,patients should see doctor in time if it turns to severer; and 745 physicians held the opinion that treatment of the common cold should focus on relieving symptoms first. In addition, 61.60％ physicians had made prescription based on clinical symptoms; 505(54.24％ ) of them thought compound drugs were priority in treating the common cold.However,there were still 43 physicians prescribed antibiotics for common cold.Conclusions There is misunderstanding and discrepancy in cognition towards common cold and treatment among physicians from various levels of hospticals in mainland China.Physicians should standardize diagnosis and treatment for the common cold according to the domestic and foreign guidelines.

Objective To identify the imbalance of T cell-specific transcription factors T-bet/GATA-3,and to explore the modulation with dexamethasone and imiquimod in CD4+T cells from ovalbumin (OVA)sensitized mice.Methods CD4+T cells were obtained fromsingled-cell suspension of spleen(after lysis of RBC).ELISA assay was used to detect the concentrations of IL-4,IL-5 and IFN-γin superna tants and cell pellets,and the expression of T-bet and GATA-3 was detected by Western blot.Resuits In the control group,tIle low levels of IFN-γ were detected in the supernatants during 24 h.In OVA treatment group,the concentrations of IL-4,IL-5 were increased significantly,and the concentrations of IFN-γ were always low in the supernatants.In the dexamethasone treatment group,the concentrations of IFN-γ,IL-4 and IL-5 were all low in the supernatants during 24 h.In the imiquimod treatment group,the concentrations of IFN-γ were increased significantly,and the concentrations of IL-4 and IL-5 were decreased in the super natants.It worked at 6 h,and achieved the peak at 12 h,lasted over 24 h.In the control group,the expres sions of T-bet and GATA-3 were detected in CD4+T cells during 24 h.In OVA treatment group,the expressions of T-bet were decreased,and that of GATA-3 were increased rapidly in CD4+T cells.In dexam ethasone treatment group,the expressions of T-bet were always low in CD4+T cells,and that ofGATA-3 were no change during 24 h.In imiquimod treatment group,the expressions of T-bet were increased,andthat of GATA-3 were decreased in CD4+T cells.The protein expressions worked at 6 h.and achieved the peak at 12 h,lasted over 24 h.Conclusion The imbalance T cell-specific transcription factors T-bet/GA-TA-3 contributes to both high expression of GATA-3 and low expression of T-bet in CD4+T cells from OVA sensitized mice.Dexamethasone treatment inhibits the expression of T-bet in CD4+T cells and has no func tion in GATA-3.Imiquimod treatment modulates key master switches GATA-3 and T-bet that results in com mitting T helper cell to a TH 1 phenotype and imiquimod may play a key role in the regulation of TH2 cytokine responses in asthma.

BACKGROUND: Inhaled glucocorticoids(IGC) are powerful anti_inflammatory agents used in the treatment of asthma. But it is still uncertain whether long-term use of the IGC affects bone metabolism in asthmatic patients, especially women.OBJECTIVE: To investigate if the prolonged treatment with IGC to Chinese asthmatic woman has a detrimental effect on bone mass and metabolism.DESIGN: A matched controlled study based on the patients SETTING:Clinical Laboratory and the Department of Respiratory Medicine, First Affiliated Hospital, Nanjing Medical University.PARTICIPANTS: From February 1998 to February 2002, forty female Chinese patients with bronchial asthma, regularly followed up at our outpatient clinic, all in the Nanjing area, none of them having a history of chronic systemic GC use, agreed to take part in the study, were selected and divided into two groups: therapeutic group (IGC group): 20 asthmatic women, aged 18-63 years, 5 menopausals, received IGC therapy regularly for at least 5 months; Control group: 20 asthmatic women, aged 18-60 years, 5 menopausals, never received IGC received conventional bronchodilators . They were matched individually for sex, age and menopausal status.METHODS: Bone mineral density (BMD) at the lumbar spine (2-4),femoral neck, trochanter, ward's triangle and total body of femur were measured by dual energy X-ray absorptiometry, BMD were expressed as a absolute value and a T score considered as a SD from peak bone mass respectively. Meanwhile, BMD was also expressed as a percentage (%), which was defined by comparing the BMD absolute value of subjects and BMD normal value of isosexual age cohorts. Osteocalcin and some other markers of bone metabolism were measured by radio immunoassay in two groups.daily dose and accumulative total dose of IGC and BMD in the IGC group.RESULTS: There were no significant difference between two groups in BMD and T score (including the lumbar spine (2-4), femoral neck,trochanter, ward' s triangle and total body of femur) (P ＞ 0.05). There were also no significant correlation between daily dose of IGC and BMD of above 5 parts in the IGC group (r=-0.325 to -0.1102, P ＞ 0.05). But,there were significantly negative correlation between the accumulative total dose of IGC and BMD at lumbar spine2-4,femoral neck and ward's triangle(r=-0.495 ,-0.517,-0.531 ,P ＜ 0.05).There were no significant correlation between the accumulative total dose of IGC and T score of above 5 parts in the IGC group (r=0.443to 0.295 ,P ＞ 0.05). There was negative correlation between the age and the BMD at ward's triangle in the IGC group(r=-0.506,P ＜ 0.05). However ,BMD at 5 locus were not correlated with the age in control group (r=-0.079 to 0.326, P ＞ 0.05).Osteocalcin and some other markers of bone metabolism were no significant difference between two groups (P ＞ 0.05).CONCLUSION: The data suggests that there is no significant influence of IGC on bone mineral density and bone metabolism in asthmatic women,but if continuing exposures to high doses over many years,there may be a detrimental effect on bone mass and metabolism in women, especially elder or postmenopausal asthmatic women treated with IGC who may be more susceptible to any bone mineral loss caused by IGC.

OBJECTIVE:Inhaled glucocorticoids(GC) are the first-line medicine for bronchial asthma during relieve phase, thereby this study was designed to explore if patient tends to suffer osteoporosis due to long term inhalation of glucocorticoids. DATA SOURCES:Literatures about GC and osteoporosis were computer-searched in Medline and Embase from January 1980 to December 2003, with the key word of " asthma, bone density, bone metabolism and inhaled glucocorticoids" and language limited to English.Meanwhile it was also computer-searched in CBM, CBM disc and manually searched in Chinese Journal of Clinical Rehabilitation between January 1990 and April 2004 with language limited to Chinese. DATA SELECTION: Literatures about the comparison of bone density and bone metabolic change between inhaled GC group and control group were consorted deleting randomized controlled trial(RCT) so as to look up the whole content of healthy controls;While patients in the treatment group received GC inhalation.Exclusive standards:obvious non-RCT. Quality assessment is mainly focused on the reality of data,the strictness of design and implementation,and the rationality of statistical management. DATA EXTRACTION:Totally 30 randomized and nonrandomized studies about the influence of inhaled GC on the bone density and bone metabolism of patients with asthma were referred to amongst which 18 studies were admitted with the other 12 excluded for similarity in content in 8 and Meta-analysis in 4. DATA SYNTHESIS:A total of 1 153 asthmatic patients in 18 studies were divided into GC inhalation group and non-inhalation control group for comparing the difference of bone density and/or bone metabolism between them. CONCLUSION:Although the results of studies on the influence of long-term inhaled GC on bone quantity were different, but there was still not enough evidence to demonstrate that osteoporosis was due to long-term GC inhalation.

0.05);the bacterial sensitive rates of amoxicillin/(sulbactam),(amoxicillin)/clavulanate,amoxicillin,ampicillin/sulbactam and cefotaxime were 88.42%,86.78%,57.02%,(86.78%) and 85.95%,respectively;the antibacterial potency of amoxicillin/sulbactam was higher than(amoxicillin)/clavulanate that of from the results of MIC_(90).CONCLUSIONS Amoxicillin/sulbactam has good (bacteriological) efficacy.

OBJECTIVESTo characterize the prethrombotic state (PTS) in elderly Chinese patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and the effect of nasal continuous positive airway pressure (nCPAP) ventilation on their PTS.

METHODSForty-one elderly patients with moderate and severe OSAHS were enrolled into the OSAHS group and underwent nCPAP treatment. Their blood samples were drawn at 6:00 am and 4:00 pm before and during nCPAP treatment, respectively, to test hemocrit, platelet aggregation (PAG), whole blood viscosity (WBV), plasma fibrinogen (fng), prothrombin time (PT) and activated partial thromboplastin time (APTT). All blood factors were also tested in a control group consisting of 32 healthy elderly Chinese with neither OSAHS nor cerebrocardiac vascular disease.

RESULTSIn the OSAHS group there was a significantly higher hemocrit, WBV, fng, and a significantly shorter PT and APTT at 6:00 am compared to 4:00 pm before nCPAP treatment, while there was no significant difference among all blood test factors between 6:00 am and 4:00 pm on day 30 of the nCPAP treatment. In the OSAHS group, the hemocrit, WBV, PAG and plasma fng were significantly lower and the PT and APTT were significantly longer at 6:00 am on day 30 of the nCPAP treatment compared to 6:00 am before the nCPAP treatment. A significantly lower hemocrit, but a much longer PT and APTT were observed at 4:00 pm on day 30 of the treatment, compared with 4:00 pm before the treatment. No significant difference among the blood test factors was found between 6:00 am and 4:00 pm blood in the control group or between the control and OSAHS groups after 30 days of nCPAP treatment.

CONCLUSIONIn elderly Chinese OSAHS patients, PTS could be effectively eliminated by nCPAP treatment.

Aged ; Cerebrovascular Disorders ; prevention & control ; China ; Continuous Positive Airway Pressure ; Female ; Humans ; Male ; Middle Aged ; Sleep Apnea, Obstructive ; blood ; therapy