High fractional exhaled nitric oxide may predict response to inhaled corticosteroid therapy in patients with subacute cough / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate fractional exhaled nitric oxide (FENO) level in patients with subacute cough and its value in predicting the patients' response to inhaled corticosteroids (ICS) treatment.</p><p><b>METHODS</b>A total of 100 patients with persistent cough lasting more than 3 weeks were enrolled, including 52 patients with subacute cough and 48 with chronic cough. FENO, spirometry, and responses to ICS therapy of the patients were evaluated.</p><p><b>RESULTS</b>The recruited patients had a median (inter-quartile ranges) FENO level of 19 ppb (12-30 ppb). Patients with chronic cough had a significantly higher median FENO level than those with subacute cough (20.5 vs 16 ppb; Z=-2.245, P=0.025). A FENO level ≥25 ppb was recorded in 15 (28.8%) patients with subacute cough, as compared with 20 (41.6%) in patients with chronic cough (χ(2)=1.801, P=0.179). With a FENO ≥25 ppb as the critical value to justify ICS treatment, 15 patients with subacute cough received ICS and 14 (93.3%) of them showed obvious relief of cough after 2 weeks of therapy, a response rate similar to that of 85.0% (17/20) in patients with chronic cough receiving the treatment (χ(2)=0.588, P=0.443). In patients with subacute cough, those with cough variant asthma (CVA) or eosinophilic bronchitis (EB) had a significantly higher median FENO level than those with postinfectious cough [(16 (11-31) ppb vs 11 (8-19) ppb, P<0.01]. In the etiological analysis, CVA or EB was identified in 23 (44.2%) of the patients with subacute cough, as compared 21 (43.8%) in patients with chronic cough (χ(2)=0.002, P=0.961).</p><p><b>CONCLUSION</b>FENO may be an important indicator for etiological diagnosis of subacute cough and for predicting the response to ICS treatment.</p>

Investigation of the level of perceived control of asthma and the factors affecting such perception in South China / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the level of the patients perceived control of asthma (PCA) in South China and analyze the risk factors contributing to inadequate PCA.</p><p><b>METHODS</b>A total of 150 asthmatic out-patients consisting of 86 males and 64 females aged 19-65 (38.6∓11.7) years were enrolled in this investigation. The patients were asked to complete questionnaires of the demographic data, perceived control of asthma (PCAQ-6) scales, asthma control test (ACT) scales and Standard asthma-specific quality of life [AQLQ(S)] scale. The data of spirometric measurements, blood cell count and induced sputum cell count were also collected.</p><p><b>RESULTS</b>All the 150 asthmatic out-patients recruited completed the questionnaires and examinations. The PCAQ-6 scores ranged from 10 to 26 (18.75∓3.42) in these patients (18.6∓3.28 in male and 18.95∓3.6 in female patients), significantly lower than those reported in other countries (P<1). PCA was positively correlated to the level of asthma control (r(p)=0.377, P=0.000) and AQLQ(S) scores (r(p)=0.675, P=0.000). Multiple linear regression showed that PCA was positively correlated to FEV1% and blood neutrophil counts, and inversely to asthma duration.</p><p><b>CONCLUSION</b>The level of the PCA appears inadequate in South China. The PCA can affect the level of asthma control and asthma-specific quality of life. The factors contributing to inadequate PCA include primarily asthma duration, lung function and blood neutrophil counts.</p>

Application of flexirigid thoracoscopy in the diagnosis of pleural disease with unknown etiology / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the diagnostic accuracy of flexirigid thoracoscopy for pleural diseases and the patients' compliance.</p><p><b>METHODS</b>Forty-seven patients with pleural effusion and thickening of unknown etiology underwent examinations with flexirigid thoracoscopy with subsequent pathological examination, and the diagnostic accuracy and the patients' compliance were observed.</p><p><b>RESULTS</b>Thoracoscopy identified lesions in the pleural and/or diaphragm in 42 patients and no lesions in 5 patients. Malignancy was confirmed in 21 (44.7%), tuberculosis in 17 (36.2%), idiopathic hypereosinophilic syndrome in 1 (2.1%), nocardiasis in 1 (2.1%), constrictive pericarditis in 1 (2.1%), chronic empyema in 2 (4.3%), splenic artery embolization in 1 (2.1%), and negative result in 3 (6.4%) of the cases. The diagnostic accuracy rate of flexirigid thoracoscopy reached 93.6%, and no serious complications in relation to the examination was found.</p><p><b>CONCLUSION</b>Flexirigid thoracoscopy is efficient and relatively safe for diagnosis of pleural diseases with or without hydrothorax.</p>

Peripheral natural killer cell counting and its clinical significance blood in patients with bronchial asthma / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the changes in natural killer (NK) cell count in the peripheral blood of asthmatic patients.</p><p><b>METHODS</b>The number of NK cells in the peripheral blood was determined with flow cytometry in 63 asthmatic patients with acute episodes, 65 patients with stable asthma and 62 healthy nonatopic subjects.</p><p><b>RESULTS</b>A significant decrease in NK cell number was noted in asthmatic patients during acute exacerbation [(13.9-/+9.4) %] in comparison with patients with stable asthma [(22.5-/+12.3) %] and healthy subjects [(19.6-/+10.1)%] (P<0.05), and the NK cell number showed no significant difference between the latter two groups (P>0.05).</p><p><b>CONCLUSION</b>NK cell number is reduced in acute exacerbation of asthma, suggesting its important role in the asthmatic process.</p>