[Meta-analysis of efficacy and safety of Suhuang Zhike Capsules in treatment of chronic obstructive pulmonary disease].

This study aims to evaluate the effectiveness and safety of Suhuang Zhike Capsules in treating chronic obstructive pulmonary disease. The Chinese and English databases were searched(from the establishment to July 2021) for randomized controlled trials(RCTs) on the treatment of chronic obstructive pulmonary disease with Suhuang Zhike Capsules, yielding 130 articles and finally 12 eligible RCTs. The 12 RCTs enrolled a total of 1 159 patients(579 in experimental group, 580 in control group), with 728 males(62.8%) and 431 females(37.2%). Meta-analysis showed that the conventional western medicine combined with Suhuang Zhike Capsules increased clinical efficacy(OR=4.31, 95%CI[2.88, 6.46], Z=7.08, P<0.000 01), forced expiratory volume in one second(FEV1)(SMD=0.88, 95%CI[0.60, 1.16], Z=6.24, P<0.000 01), forced vital capacity(FVC)(SMD=0.96, 95%CI[0.38, 1.55], Z=3.22, P=0.001), forced vital capacity rate of one second(FEV1/FVC%)(SMD=0.85, 95%CI[0.51, 1.19], Z=4.92, P<0.000 01), and maximum voluntary ventilation(MVV)(SMD=0.61, 95%CI[0.39, 0.83], Z=5.40, P<0.000 01) compared with the conventional western medicine alone. The differences in residual volume/total lung capacity(RV/TLC)(SMD=-0.93, 95%CI[-3.38, 1.53], Z=0.74, P=0.46) and adverse reactions(OR=1.39, 95%CI[0.76, 2.56], Z=1.07, P=0.28) are insignificant. The study showed that the conventional western medicine combined with Suhuang Zhike Capsules could improve clinical efficacy and lung functions in the treatment of chronic obstructive pulmonary disease. In addition, the combination had been verified to be safe. However, in view of the uneven method quality, small sample size, and inconsistent outcome indicators of the included studies, higher-quality, multi-center, and large-sample RCTs are needed for further verification.

Impact of Preoperative Short-Term Parenteral Nutrition Support on the Clinical Outcome of Gastric Cancer Patients: A Propensity Score Matching Analysis.

OBJECTIVES: Nutrition status is of great significance to the clinical outcome after major abdominal surgery. However, the effect of preoperative short-term parenteral nutrition (PN) support among gastric cancer (GC) patients remains unknown and was evaluated in the current study. METHODS: We retrospectively analyzed 455 nutritionally at-risk GC patients after radical resection from 2010 to 2016. We matched patients with 3-7 days of PN support to those without PN support. χ2 And Mann-Whitney U tests were used to compare differences between the PN and control groups. RESULTS: The propensity-matched sample included 368 GC patients (PN group, n = 184; control group, n = 184). The PN and control groups did not differ regarding postoperative complications (P = .528). The incidence of anastomotic leakage in the PN group was lower than in the control group (P = .011), whereas other complications were not found to differ between the groups. The hospitalization cost of the PN group was significantly higher than that of the control group (P < .001), whereas other outcome indicators were similar. Subgroup analysis showed that short-term PN support may have an improved benefit for patients with serum albumin level <35 g/L, but not at the level of statistical significance (P = .17). CONCLUSION: Short-term PN support did not significantly improve the short-term clinical outcomes of nutritionally at-risk GC patients, with the exception of a lower incidence of anastomotic leakage. Considering that short-term PN support increases economic burden, PN should not be the preferred method among these patients.

Puzzling onsets of pneumonia sequentially after each session of bronchial thermoplasty: a case report.

BACKGROUND: Bronchial thermoplasty (BT) is a novel bronchoscopic intervention for severe persistent asthma. An increase in transient respiratory adverse events associated with BT were noted over the treatment periods, however, these events appear sporadic and should not always recur in a single individual and BT-related pneumonia has rarely been reported. CASE PRESENTATION: We present a case of uncontrolled severe asthma who developed puzzling pneumonia sequentially after each session of BT procedures. After each operation of three sequential BT procedures, she developed cough and purulent expectoration when her chest radiology showed new infiltrates right in the treatment regions. After empirical use of antibacterial agents plus physiotherapy and postural sputum drainage, her symptoms vanished and chest imaging resumed normal. CONCLUSION: The originality of our case report is related to the recurrence of pneumonia after three sequential BT procedures. To date, similar report has not been available in the literature. We hope to prompt alerts for post-BT respiratory infections, although most of them, along with other adverse events, are mild and tractable.

A comparison of tiotropium/olodaterol vs tiotropium alone in terms of treatment effect for chronic obstructive pulmonary disease: A meta-analysis.

BACKGROUND: Combinations of long-acting bronchodilators with different mechanisms of action are recommended to improve prognosis and reduce risk of adverse events of chronic obstructive pulmonary disease (COPD). It is unclear whether the new combination therapy with long-acting muscarinic antagonist (LAMA) tiotropium (TIO) and long acting beta-agonists (LABA) olodaterol (OLO) was superior to tiotropium alone. METHODS: We measured the efficacy of the TIO/OLO combination vsTIO alone for COPD patients based on electronic databases up to February 2019. After rigorous quality review, data was extracted from eligible trials. All the main outcomes were pooled analysis using RevMan software. RESULTS: A total of 6 randomized controlled trials (RCTs) were identified. The pooled results of our meta-analysis demonstrated that FEV1 [MD = 0.03, 95% CI (-0.01,0.07), P = .18], FVC [MD = -0.03, 95%CI (-0.06,0.00), P = .09] and FEV1%pred [MD = 0.35, 95%CI (-0.30, 0.99), P = .29] all showed no significant difference between the 2 groups. The overall incidence of adverse effects (AEs) [OR = 1.01,95%CI (0.93,1.09), P = .87] and serious AEs [OR = 1.04,95% CI (0.82, 1.32), P = .72] in the combination group was similar to that of the TIO alone group, without statistical significance. CONCLUSION: These studies reported that the TIO/OLO combination did not show superior effects than tiotropium alone for COPD. Additionally, both therapies were well tolerated.

The neuroprotective effect of apigenin against OGD/R injury in rat hippocampal neurons.

To investigate the effects of apigenin on the injury caused by oxygen and glucose deprivation in neurons and the underlying mechanisms, primary cultured rat hippocampal neurons were incubated with apigenin for 90 min before a 2-h oxygen and glucose deprivation followed by a 24-h reperfusion (OGD/R). Subsequently, cell viability, lactate dehydrogenase (LDH) leakage rate, apoptotic rate of neurons and activity of the sodium pump were assessed. In addition, activity of the sodium pump was also examined in the hippocampus of SD rats injected intraperitoneally with apigenin 90 min before a 10-min global cerebral ischemia/24-h reperfusion. The results showed that cell viability and activity of the sodium pump markedly decreased but LDH leakage rate and apoptotic rate significantly increased in OGD/R-treated neurons. However, pretreatment with apigenin (20-50µmol/L) reversed the changes dose-dependently. Compared to sham controls, activity of the sodium pump was significantly suppressed in global ischemia/reperfusion rats; application of apigenin (200mg/kg) restored the activity of the sodium pump. Furthermore, the neuroprotective effect of apigenin was blocked partly by the sodium pump inhibitor ouabain. Our findings provide the evidence that apigenin has a neuroprotective effect against OGD/R injury and the protective effect may be associated with its ability to improve sodium pump activity.

[Comparison of the Effectiveness of Different Supraglottic Ventilation Methods during Bronchial Thermoplasty].

OBJECTIVE: To compare the effectiveness of high-frequency jet ventilation via Wei jet nasal airway and controlled ventilation with improved laryngeal mask airway during bronchial thermoplasty. METHODS: Twenty-eight patients undergoing bronchial thermoplasty were equally divided into two groups: group A (high-frequency jet ventilation through Wei jet nasal airway) and group B (controlled ventilation with improved laryngeal mask airway). Pulse oxygenation,heart rate,and mean arterial blood pressure were recorded after entering the operating room (T0), 1 minute after administration/induction (T1), bronchoscope inserting (T2), 15 minutes (T3)/30 minutes (T4)/45 minutes (T5) after ventilation,at the end of the operation (T6), and at the recovery of patients' consciousness (T7). The pH,arterial oxygen partial pressure,and arterial carbon dioxide partial pressure were recorded at T0, T4, and T6. The endoscope indwelling duration,operative time,patients' awakening time,adverse events during anesthesia,satisfactions of patients and operators, anesthesic effectiveness were also recorded. RESULTS: The arterial carbon dioxide partial pressur in group A at T4 and T6 were significantly higher than in group B (P<0.05). The pH in group A at T4 and T6 was significantly lower than in group B (P<0.05). The endoscope indwelling duration and the operative time in group B were significantly shorter than in group A (P<0.05) while the recovery of consciousness in group B was significantly longer than in group A (P<0.05). The satisfaction for operators and the efficacy of anesthesia in group B were better than in group A (P<0.05). The number of adverse events in group B was significantly smaller than in group A (P<0.05). CONCLUSION: The improved laryngeal mask airway with controlled ventilation is more suitable for bronchial thermoplasty.

Formoterol as reliever medication in asthma: a post-hoc analysis of the subgroup of the RELIEF study in East Asia.

BACKGROUND: As-needed formoterol can effectively relieve asthma symptoms. Since budesonide/formoterol is available as maintenance and reliever therapy in Asia, formoterol is now being used as-needed, but always with concomitant inhaled corticosteroids. The objective of this analysis was to assess the safety and efficacy of formoterol therapy in patients in East Asia (China, Indonesia, Korea, the Philippines and Singapore) with asthma. METHODS: Post-hoc analyses of data from the East Asian population of the RELIEF (REal LIfe EFfectiveness of Oxis® Turbuhaler® as-needed in asthmatic patients; study identification code: SD-037-0699) study were performed. RESULTS: This sub-group comprised 2834 randomised patients (formoterol n = 1418; salbutamol n = 1416) with mean age 35 years; 50.7% were male. 2678 patients completed the study. There was no significant difference in the total number of adverse events (AEs) reported in the formoterol and salbutamol groups (21.3% vs 20.9% of patients; p = 0.813), nor in the total number of serious AEs and/or discontinuations due to AEs (4.6% vs 5.5%, respectively; p = 0.323). Compared with salbutamol, formoterol was associated with a significantly longer time to first exacerbation (hazard ratio 0.86; p = 0.023) and a 14% reduction in the risk of any exacerbation (p < 0.05). Relative to salbutamol, mean adjusted reliever medication use throughout the study was significantly lower in the formoterol group (p = 0.017) and the risk of increased asthma medication use was 20% lower with formoterol (p = 0.005). CONCLUSIONS: Among patients with asthma in East Asia, as-needed formoterol and salbutamol had similar safety profiles but, compared with salbutamol, formoterol reduced the risk of exacerbations, increased the time to first exacerbation and reduced the need for reliever medication.

Energy intake, oxidative stress and antioxidant in mice during lactation.

Reproduction is the highest energy demand period for small mammals, during which both energy intake and expenditure are increased to cope with elevated energy requirements of offspring growth and somatic protection. Oxidative stress life history theory proposed that reactive oxygen species (ROS) were produced in direct proportion to metabolic rate, resulting in oxidative stress and damage to macromolecules. In the present study, several markers of oxidative stress and antioxidants activities were examined in brain, liver, kidneys, skeletal muscle and small intestine in non-lactating (Non-Lac) and lactating (Lac) KM mice. Uncoupling protein (ucps) gene expression was examined in brain, liver and muscle. During peak lactation, gross energy intake was 254% higher in Lac mice than in Non-Lac mice. Levels of H2O2 of Lac mice were 17.7% higher in brain (P<0.05), but 21.1% (P<0.01) and 14.5% (P<0.05) lower in liver and small intestine than that of Non-Lac mice. Malonadialdehyde (MDA) levels of Lac mice were significantly higher in brain, but lower in liver, kidneys, muscle and small intestine than that of Non-Lac mice. Activity of glutathione peroxidase (GSH-PX) was significantly decreased in brain and liver in the Lac group compared with that in the Non-Lac group. Total antioxidant capacity (T-AOC) activity of Lac mice was significantly higher in muscle, but lower in kidneys than Non-Lac mice. Ucp4 and ucp5 gene expression of brain was 394% and 577% higher in Lac mice than in Non-Lac mice. These findings suggest that KM mice show tissue-dependent changes in both oxidative stress and antioxidants. Activities of antioxidants may be regulated physiologically in response to the elevated ROS production in several tissues during peak lactation. Regulations of brain ucp4 and ucp5 gene expression may be involved in the prevention of oxidative damage to the tissue.

[Survey on the prevalence rate of bronchial asthma in Beijing area among the residents aged over 14 years from 2010 to 2011].

OBJECTIVE: To survey the prevalence rate of bronchial asthma in Beijing area among residents aged over 14 years. METHODS: In accordance with stratified cluster random sampling, epidemiological questionnaires were performed in Beijing residents aged over 14 years during household visits from February 2010 to August 2011. Asthma was diagnosed on the basis of case history, clinical signs and lung function test. The statistical software SAS 9.2 was employed to analyze the epidemiological status of asthma. RESULTS: In a sampling population of 61 107, 57 647 questionnaires were effective. Among 687 asthmatics, there were 296 males and 391 females. The overall prevalence rate of asthma was 1.19% (687/57 647). The asthma prevalence rates were 1.09% (418/38 468) and 1.40% (269/19 179) in urban and suburb Beijing respectively and the prevalence rate of asthma in suburb area was significantly higher than that of urban area (χ(2) = 10.850, P = 0.001). The prevalence rates of males and females were 1.06% (296/27 947) and 1.32% (391/29 700) respectively and the prevalence rate of asthma in females was much higher than that of males (χ(2) = 8.098,P = 0.004). Significant differences existed among different age groups (χ(2) = 404.874, P = 0.000) and residents aged at or over 71 years had the highest prevalence rate. The prevalence rates in urban and suburb Beijing area increased by 1.12 and 2.26 folds respectively than that of 2002. And 198 asthmatics were first diagnosed in this survey and accounted for 28.8% (198/687) in all asthma diagnosed asthmatics. CONCLUSIONS: The prevalence rate of asthma in Beijing area among residents aged over 14 years increased greatly from 2010 to 2011. And the epidemiological data may reflect the current distribution status of asthma in Beijing area.

[Mechanism of p38 mitogen-activated protein kinase inhibitor SB203580 to glucocorticoid sensitivity].

OBJECTIVE: To establish a model of cigarette smoke exposure to asthmatic rats and glucocorticoid resistance induced by nicotine in alveolar epithelioid cells A549 and study the mechanism for the change of glucocorticoid sensitivity induced by p38 mitogen-activated protein kinase (p38 MAPK) inhibitor SB203580. METHODS: Sixty Wistar rats were randomly divided into 4 groups: normal group, asthmatic group, cigarette smoke exposure to asthmatic group and SB203580 group. The mRNA expressions of glucocorticoid receptor (GR), heat shock protein 90 (HSP90) and p38 MAPK were detected by real time-polymerase chain reaction (RT-PCR) while their protein expressions detected by Western blot in vivo. A549 cells were divided averagely into 4 groups: group A: normal; group B: 1 µmol/L dexamethasone (DEX); group C: 1 µmol/L DEX +1 µmol/L nicotine; group D: 1 µmol/L DEX +1 µmol/L nicotine+1 µmol/L SB203580. Immunofluorescence staining was used to study the in vitro colocalization of glucocorticoid receptor (GR) in A549 cells. RESULTS: The mRNA expression of GR was 0.671 ± 0.002 in cigarette smoke exposure to asthmatic group and 0.595 ± 0.061 in SB203580 group (P = 0.065). The protein expression of GR was 0.700 ± 0.033 in cigarette smoke exposure to asthmatic group and 0.628 ± 0.091 in SB203580 group (P = 0.148). The mRNA expression of HSP90 was 0.558 ± 0.009 in cigarette smoke exposure to asthmatic group and 0.377 ± 0.046 in SB203580 group (P = 0.000). The protein expression of HSP90 was 0.507 ± 0.030 in cigarette smoke exposure to asthmatic group and 0.402 ± 0.050 in SB203580 group (P = 0.005). The mRNA expression of p38 MAPK was 0.971 ± 0.012 in cigarette smoke exposure to asthmatic group and 0.278 ± 0.049 in SB203580 group (P = 0.000). The protein expression of p38 MAPK was 0.982 ± 0.038 in cigarette smoke exposure to asthmatic group and 0.338 ± 0.042 in SB203580 group (P = 0.000). The ratio of GR amount within A549 nucleus versus that in cytoplasm was 0.077 ± 0.047 in group C and 0.592 ± 0.249 in group D (P = 0.000). CONCLUSION: The mechanism of SB203580 enhancing the corticosteroid sensitivity may be improving nuclear translocation of GR to elevate corticosteroid sensitivity.

[Normal values and influencing factors of fractional exhaled nitric oxide for Chinese healthy adults].

OBJECTIVE: To evaluate the normal values of fractional exhaled nitric oxide (FENO) for Chinese adults. METHODS: A total of 200 non-smoking and healthy Chinese adults were recruited according to the inclusion and exclusion criteria. They received lung function and allergen skin prick tests at the Outpatient Department of China-Japan Friendship Hospital from February to August 2011. There were 100 males and 100 females. FENO test was performed according to the standard procedures of American Thoracic Society/European Respiratory Society (ATS/ERS) recommendation. The FENO levels of healthy non-smokers were tested by the NIOXMINO analyzer. All variables, such as age, gender, height, weight, forced expiratory volume at 1 second (FEV(1))% predicted and FEV(1)/FVC, were included for multiple regression analyses. RESULTS: The FENO level of healthy non-smokers was (14.2 ± 5.6)×10(-9) mol/L with the 95% normal range of (3.2 - 25.2)×10(-9) mol/L. The value of FENO was significantly higher in males than females ((15.6 ± 5.5) vs (12.9 ± 5.4)×10(-9) mol/L, t = 3.48, P = 0.001). The FENO level of the subjects aged 60 - 80 years was (15.7 ± 5.4)×10(-9) mol/L and it was higher than those aged 18 - 60 years ((13.8 ± 5.6)×10(-9) mol/L, t = 2.04, P = 0.040). Multiple regression analysis showed that gender was an independent influencing factor of FENO level. CONCLUSIONS: The FENO level of non-smoking and healthy Chinese adults is similar with that of the westerners. Gender is an independent influencing factor of FENO level.

Budesonide/formoterol maintenance and reliever therapy in Chinese patients with asthma.

BACKGROUND: Many studies have shown the superior efficacy of budesonide (BUD)/formoterol (FORM) maintenance and reliever therapy, but still lack evidence of its efficacy in Chinese asthma patients in a relative large patient-group. We finished this research to compare BUD/FORM maintenance and reliever therapy and high-dose salmeterol (SALM)/fluticasone (FP) maintenance plus an as-needed short-acting ß(2)-agonist in Chinese patients with persistent uncontrolled asthma. This was a post hoc analysis based on a 6-month, multicenter, randomized, double-blind study (NCT00242775). METHODS: A total of 222 eligible asthma patients from nine centers in China were randomized to either BUD/FORM+as-needed BUD/FORM (160/4.5 µg/inhalation) (640/18 µg/d; n = 111), or SALM/FP+as-needed terbutaline (0.4 mg/inhalation) (100/1000 µg/d; n = 111). The primary endpoint was time to first severe exacerbation while secondary endpoints included various measures of pulmonary function, symptom control and quality-of-life. RESULTS: Time to first severe exacerbation over six months was lower with the BUD/FORM than with the SALM/FP treatment (risk ratio = 0.52, 95%CI 0.22 - 1.22), but the difference did not achieve statistical significance (P = 0.13). The cumulative number of severe exacerbations in the BUD/FORM group was lower than in the SALM/FP group (7.2% vs. 13.5%; risk ratio = 0.45, P = 0.028). BUD/FORM produced significantly better improvements in reliever use, cumulative mild exacerbations, symptom-free days (%), and morning/evening peak expiratory flow (PEF) than SALM/FP (P < 0.05 in all cases). The two groups achieved similar improvements in their time to first mild exacerbation, forced expiratory volume in one second (FEV(1)), asthma control questionnaire and asthma symptom scores, and percentage of nights with awakening(s). Both treatments were well tolerated. CONCLUSIONS: In Chinese patients with persistent asthma, BUD/FORM decreased severe and mild exacerbations, decreased reliever use, increased symptom-free days, and improved morning/evening PEF compared with SALM/FP. There were no significant differences in time to first severe exacerbation or other assessments regarding daily asthma control between BUD/FORM and SALM/FP. BUD/FORM was more effective in this Chinese sub-group than in the total cohort involved in the original study.

[A study on the correlation between exercise-induced bronchoconstriction and atopy].

OBJECTIVE: To investigate the correlation between exercise-induced bronchoconstriction and atopy. METHODS: Exercise-induced bronchoconstriction (EIB) was defined by free running asthma screening test. Atopy was defined by serum total IgE level and skin allergen test. Airway hyperreactivity was determined by bronchial provocation test. For a matched pair study, all EIB and some non-EIB students received serum total IgE measurements, skin allergen test and bronchial provocation test. All data were calculated by correlation analysis to investigate the correlation between EIB and atopy. RESULTS: Totally 773 students participated in the free running screening test, and 89 students (11.5%) were diagnosed as having EIB. The serum total IgE level exceeded the normal range in 16 among the 89 EIB students, but in 10 among the 70 non-EIB students. Statistical analysis (χ(2) test) did not support the correlation between atopy and EIB. Fifty EIB students received bronchial provocation test, but only 1 showed airway hyperreactivity. CONCLUSION: There was no correlation between atopy and EIB, and airway hyperreactivity was absent in most of the EIB students.

[A survey of knowledge on common cold in outpatient clinics].

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, 52.21% had incorrect knowledge about common cold; 12.99% 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; 61.14% 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; 19.42% didn't know about the side effects of drug for cold treatment; and 19.72% 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 < 0.01). 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.

[A survey of knowledge on common cold and its treatment situation among physicians from various levels of hospitals in mainland China].

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 hospitals in mainland China. Physicians should standardize diagnosis and treatment for the common cold according to the domestic and foreign guidelines.

Nicotine inhibits histone deacetylase 6 activity and chaperone-dependent activation of the glucocorticoid receptor in A549 cells.

BACKGROUND: Nicotine, a major component of tobacco, is the main cause of smoking addiction. It was found that asthmatic patients who smoke were insensitive to glucocorticoid treatment. In this paper, we investigated whether nicotine could inhibit histone deacetylase 6 activity (HDAC6) and chaperone-dependent activation of the glucocorticoid receptor (GR) in A549 cells. Furthermore, the expression level of heat shock protein 90 (HSP90) was determined. METHODS: Quantitative real-time polymerase chain reaction was used to detect the levels of RNA transcription, and Western blotting was applied to analyze the levels of protein expression of HDAC6, GR, and HSP90 in A549 cells. Moreover, the effects of dexamethasone and trichostatin A were observed in A549 cells. RESULTS: A549 cell proliferation was inhibited in the presence of nicotine, and the level of RNA and protein expression of HDAC6 and GR were down-regulated. CONCLUSIONS: Nicotine could inhibit HDAC6 activity and chaperone-dependent activation of GR. This might be the main reason why asthmatic patients who smoke show insensitivity to the glucocorticoid treatment.

[The values of fractional exhaled nitric oxide in the diagnosis and treatment of chronic cough].

OBJECTIVE: To evaluate the values of fractional exhaled nitric oxide (FENO) in the diagnosis and treatment of chronic cough. METHODS: Based on the protocol from The Chinese Respiratory Society guidelines for management of cough, 75 consecutive subjects with chronic cough and normal chest radiographs were recruited from the outpatient clinic of the Department of Respiratory Diseases in China-Japan Friendship Hospital from January to June 2010. All the patients accepted FENO tests, sputum cell counts, pulmonary function tests, bronchial hyperresponsiveness (BHR), serum IgE, cough symptom scores and Leicester cough Questionnaire (LCQ) before and after treatment of 4 weeks. RESULTS: The final diagnosis of the subjects included 29 with cough variant asthma (CVA), 19 with eosinophilic bronchitis (EB) and 27 with other causes (Others). FENO levels in CVA (58 ± 26) ppb were significantly higher than those in EB (36 ± 18) ppb and Others (20 ± 7) ppb, and the FENO levels in EB were higher than Others (F = 28.2, P < 0.01). FENO levels showed significant correlations with sputum eosinophils, BHR, cough symptom scores, non-specific IgE, and LCQ scores. The mean baseline FENO level of the subjects whose coughs were relieved after inhaled corticosteroid therapy was (63 ± 42) ppb, higher than those of the non-responders (28 ± 13) ppb (t = 3.91, P < 0.01). There were significant correlations between the percentage of FENO decrease and the percentage of sputum eosinophil decrease or the cough symptom score decrease. CONCLUSION: FENO could be used as a inflammation marker of chronic cough because of its good correlation with sputum eosinophils, AHR, atopy, and cough symptoms. FENO also has a potential to predict the response of anti-inflammatory therapy because FENO decrease is correlated with the decrease of eosinophilic inflammation and improvement of cough symptoms.