A multicenter survey on the current status of chronic cough and its impact on quality of life in Guangdong, China.

Background: Chronic cough is a troublesome clinical problem with long-term impacts at the patient level. However, the burden of chronic cough in China is largely unknown. Thus, we performed a multicenter cross-sectional survey on the current status of chronic cough and its impact on quality of life in Guangdong, south China. Methods: Using a standardized questionnaire, we extracted and analyzed the relevant data on demographics, number of visits to a doctor, previous diagnosis, previous medications used and initial diagnosis. Cough-specific quality of life was measured by the Mandarin Chinese version of the Leicester Cough Questionnaire (LCQ-MC). Results: Of 933 patients from 13 tertiary medical centers in Guangdong, 52.2% were female, the median age was 40.0 [interquartile range (IQR), 31.0-52.0] years, and the median duration of chronic cough was 6.0 (IQR, 3.0-24.0) months. Over half (n=452, 54.0%) of the patients had visited physicians ≥3 times for cough. In terms of previous diagnosis, bronchitis (n=432, 46.5%) had been most frequently diagnosed, followed by pharyngitis (n=246, 26.5%) and asthmatic cough (n=98, 10.5%). A majority of patients with chronic cough had used antitussive agents (n=539, 58.5%), antibiotics (n=374, 40.6%) and traditional Chinese medicine (TCM) (n=294, 31.9%). Among the three subscales of the LCQ-MC, we observed lower scores in the mental health domain than in the physical and social domains (both P<0.001). Additionally, lower LCQ-MC scores were found in females and patients who saw the doctor >3 times for both the total and three subscale scores (all P<0.05). Conclusions: Misdiagnosis and inappropriate treatment are prevalent in patients with chronic cough and lead to considerable antibiotic abuse. Chronic cough markedly affects suffers' quality of life, especially for women.

Clinical characteristics of patients with chronic cough in Guangdong, China: a multicenter descriptive study.

BACKGROUND: The clinical characteristics of patients with chronic cough are reported only in single-center survey in China, being significantly different from that in western countries. Here, we performed a multicenter study to describe the clinical characteristics of chronic cough patients. METHODS: A cross-sectional observational survey was conducted in thirteen tertiary hospitals of Guangdong, South China. Relevant data were recorded using a standardized questionnaire and analyzed, including demographics, educational attainment, cough features, and concomitant symptoms. RESULTS: Of 933 patients in this study, the median age was 40.0 (IQR 31.0-52.0) years with a peaked age of 30-39 years. The proportion of females (487, 52.2 %) was comparable to that of males (446, 47.8 %). Up to 81.9 % of the patients were non-smokers. More than two-thirds of the subjects with chronic cough had a low educational level. The median cough duration was 6.0 (IQR 3.0-24.0) months, and 73.0 % of chronic cough patients presented with dry cough. Laryngeal paresthesia was the most common concomitant symptom (704, 75.5 %), followed by rhinitis/sinusitis-related (350, 37.5 %) and respiratory symptoms (322, 34.5 %). Rhinitis/sinusitis-related symptoms more frequently occurred in patients with productive cough than in those with dry cough (49.0 % vs. 33.0 %, P < 0.001). Moreover, female patients displayed an older age and a higher prevalence of nocturnal cough compared to male patients (both P < 0.05). CONCLUSIONS: Our results show an equal gender, young profile and laryngeal paresthesia in patients with chronic cough, and different clinical features between females and males.

[The effects and mechanisms of interleukin-22 and interferon-γ on epithelial-mesenchymal transition of pleural mesothelial cells].

OBJECTIVE: To investigate the effects of interleukin (IL)-22 and interferon (IFN)-γ on epithelial-mesenchymal transition (EMT) of pleural mesothelial cells, and to explore the relevant signal transduction pathways, in tuberculous pleural effusion. METHODS: Twenty-two patients (12 males and 10 females, age range 22-64 years, mean 38.4 years) with tuberculous pleurisy hospitalized in department of respiratory medicine of the First People's Hospital of Foshan were recruited from July 2013 to June 2014. Diagnosis was confirmed by pathology. Freshly isolated pleural mesothelial cells (PMCs) from tuberculous pleural effusion were cultured either in medium alone as control, or stimulated with IL-22 and/or IFN-γ, and the phosphorylated signal transducers and activators of transcription (STAT) signalings in PMCs were determined by flowcytometry. In some experiments, STAT inhibitors were added into coculture with IL-22 and/or IFN-γ, and then morphological changes of PMCs were observed, and the expressions of epithelial markers such as cytokeratin-8 and E-cadherin as well as mesenchymal markers such as vimentin and α-Smooth muscle actin (SMA) were also determined by flow cytometry. RESULTS: As compared with the control group, IFN-γ induced epithelial-mesenchymal transition of PMCs via a STAT1 pathway as evidenced by down-regulation of cytokeratin-8 [(43.8 ± 2.8)% vs (14.3 ± 1.5)%,t=8.1, P<0.05] and E-cadherin [(43.8 ± 1.9)% vs (13.4 ± 1.2)%, t=9.7, P<0.05], and by up-regulation of vimentin [(41.2 ± 2.4)% vs (70.6 ± 3.6)%,t=8.5, P<0.05] and α-SMA [(55.8 ± 2.0)% vs (80.6 ± 2.9)%,t=7.2, P<0.05]. IL-22 not only maintained the epithelial property of PMCs, but also reverted IFN-γ-induced EMT [cytokeratin-8 (62.4 ± 3.1)%, E-cadherin (46.5 ± 3.6)%, vimentin (36.7 ± 2.8)%, and α-SMA (35.2 ± 2.5)% in 'IFN-γ + IL-22' group, all P<0.05 as compared with those of IFN-γ group]. Whereas addition of STAT3 inhibitor significantly abrogated such anti-EMT effect of IL-22 on PMCs [cytokeratin-8 (16.7 ± 0.7)%, E-cadherin (14.4 ± 0.9)%, vimentin (67.9 ± 2.5)%, and α-SMA (79.2 ± 5.7)% in 'IFN-γ + IL-22 + STAT3 inhibitor' group, all P<0.05 as compared with those of 'IFN-γ + IL-22' group]. CONCLUSION: The IL-22-STAT3 signal pathway could revert IFN-γ-induced EMT of PMCs, and might play a protective role in anti-pleural fibrosis in tuberculous pleurisy.