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International Journal of Chronic... 2020Chronic cough and phlegm are frequently reported chronic obstructive pulmonary disease (COPD) symptoms. Prior research classified chronic mucus hypersecretion (CMH)...
BACKGROUND
Chronic cough and phlegm are frequently reported chronic obstructive pulmonary disease (COPD) symptoms. Prior research classified chronic mucus hypersecretion (CMH) based on the presence of these symptoms for ≥3 months, called chronic bronchitis (CB) if respiratory infection symptoms were present for 1-2 years (Medical Research Council [MRC] definition). We explored whether the COPD Assessment Test (CAT), a simple measure developed for routine clinical use, captures CMH populations and outcomes similarly to MRC and St. George's Respiratory Questionnaire (SGRQ) definitions.
METHODS
We identified CMH in the SPIROMICS COPD cohort using (a) MRC definitions, (b) SGRQ questions for cough and phlegm (both as most/several days a week), and (c) CAT cough and phlegm questions. We determined optimal cut-points for CAT items and described exacerbation frequencies for different CMH definitions. Moderate exacerbations required a new prescription for antibiotics/oral corticosteroids or emergency department visit; severe exacerbations required hospitalization. Results were stratified by smoking status.
RESULTS
In a population of 1431 participants (57% male; mean FEV% predicted 61%), 47% and 49% of evaluable participants had SGRQ- or CAT-defined CMH, respectively. A cut-point of ≥2 for cough and phlegm items defined CMH in CAT. Among SGRQ-CMH+ participants, 80% were also defined as CMH+ by the CAT. CMH+ participants were more likely to be current smokers. A higher exacerbation frequency was observed for presence of CMH+ versus CMH- in the year prior to baseline for all CMH definitions; this trend continued across 3 years of follow-up, regardless of smoking status.
CONCLUSION
Items from the CAT identified SGRQ-defined CMH, a frequent COPD trait that correlated with exacerbation frequency. The CAT is a short, simple questionnaire and a potentially valuable tool for telemedicine or real-world trials. CAT-based CMH is a novel approach for identifying clinically important characteristics in COPD that can be ascertained in these settings.
Topics: Bronchitis, Chronic; Female; Humans; Male; Mucus; Pulmonary Disease, Chronic Obstructive; Quality of Life; Respiratory Function Tests; Surveys and Questionnaires
PubMed: 33116463
DOI: 10.2147/COPD.S267002 -
Frontiers in Cellular and Infection... 2022Obesity is conventionally considered a risk factor for multiple metabolic diseases, such as dyslipidemia, type 2 diabetes, hypertension, and cardiovascular disease...
BACKGROUND
Obesity is conventionally considered a risk factor for multiple metabolic diseases, such as dyslipidemia, type 2 diabetes, hypertension, and cardiovascular disease (CVD). However, not every obese patient will progress to metabolic disease. Phlegm-dampness constitution (PDC), one of the nine TCM constitutions, is considered a high-risk factor for obesity and its complications. Alterations in the gut microbiota have been shown to drive the development and progression of obesity and metabolic disease, however, key microbial changes in obese patients with PDC have a higher risk for metabolic disorders remain elusive.
METHODS
We carried out fecal 16S rRNA gene sequencing in the present study, including 30 obese subjects with PDC (PDC), 30 individuals without PDC (non-PDC), and 30 healthy controls with balanced constitution (BC). Metagenomic functional prediction of bacterial taxa was achieved using PICRUSt.
RESULTS
Obese individuals with PDC had higher BMI, waist circumference, hip circumference, and altered composition of their gut microbiota compared to non-PDC obese individuals. At the phylum level, the gut microbiota was characterized by increased abundance of and decreased levels of and ratio. At the genus level, , producing short-chain fatty acid, achieving anti-inflammatory effects and strengthening intestinal barrier functions, was depleted in the PDC group, instead, was enriched. Most PDC-associated bacteria had a stronger correlation with clinical indicators of metabolic disorders rather than more severe obesity. The PICRUSt analysis demonstrated 70 significantly different microbiome community functions between the two groups, which were mainly involved in carbohydrate and amino acid metabolism, such as promoting Arachidonic acid metabolism, mineral absorption, and Lipopolysaccharide biosynthesis, reducing Arginine and proline metabolism, flavone and flavonol biosynthesis, Glycolysis/Gluconeogenesis, and primary bile acid biosynthesis. Furthermore, a disease classifier based on microbiota was constructed to accurately discriminate PDC individuals from all obese people.
CONCLUSION
Our study shows that obese individuals with PDC can be distinguished from non-PDC obese individuals based on gut microbial characteristics. The composition of the gut microbiome altered in obese with PDC may be responsible for their high risk of metabolic diseases.
Topics: Bacteria; Diabetes Mellitus, Type 2; Feces; Gastrointestinal Microbiome; Humans; Obesity; RNA, Ribosomal, 16S
PubMed: 35719350
DOI: 10.3389/fcimb.2022.859708 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Jun 2018At present, laryngeal cancer is more common in otolaryngology and head and neck surgery malignancies. Patients such as hoarseness, difficulty swallowing, ear pain, cough... (Review)
Review
At present, laryngeal cancer is more common in otolaryngology and head and neck surgery malignancies. Patients such as hoarseness, difficulty swallowing, ear pain, cough or cough, phlegm, dyspnea and other symptoms. which brings severe physical and psychological trauma to the patients and brings a heavy burden to the families and families of patients.Laryngeal cancer patients often take surgery, radiotherapy and other treatment methods, but these methods often cause patients with speech and speech disorders,patients with adverse psychological effects.With the continuous improvement of clinical diagnosis and treatment, patient survival gradually extended, the quality of their lives are increasingly valued.This basic indicator is the normal function of the throat recovery,preoperative and postoperative mood and cognitive status are also important aspects of quality of life (QOL).This article reviews the progress of preoperative and postoperative mood and cognitive changes in patients with laryngeal cancer..
Topics: Cognition; Deglutition Disorders; Emotions; Humans; Laryngeal Neoplasms; Quality of Life; Surveys and Questionnaires
PubMed: 29921065
DOI: 10.13201/j.issn.1001-1781.2018.11.021 -
PloS One 2022Growing evidence has indicated that the characteristics of gut microbiota are associated with acute ischemic stroke (AIS). Phlegm-heat syndrome (PHS), a specific...
Growing evidence has indicated that the characteristics of gut microbiota are associated with acute ischemic stroke (AIS). Phlegm-heat syndrome (PHS), a specific pathological state of the AIS, is one of the common traditional Chinese syndromes of stroke. The long duration of PHS in patients with AIS could lead to poor clinical outcomes. Gut microbiota characteristics in patients with both AIS and PHS, and their relationship remains unknown. This study was designed to investigate the alterations in gut microbiota in patients with AIS and PHS through a cross-sectional study. Fecal samples were collected from 10 patients with AIS and non-PHS (ntAIS), 7 patients with AIS and PHS (tAIS), and 10 healthy controls (HC). Samples were profiled via Illumina sequencing of the 16S rRNA V3-V4. Stroke severity was assessed at admission by the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS); their correlation with gut microbiota was investigated. The alpha-diversity of the bacterial communities was significantly higher in the fecal samples of patients with tAIS than in patients with ntAIS (Shannon index, P = 0.037). In addition, the combined tAIS and ntAIS group (tntAIS) exhibited higher microbiotic diversity when compared with HC (chao1, P = 0.019). The structure of intestinal microbiota was effectively distinguished between the tAIS and ntAIS group (ANOSIM, r = 0.337, P = 0.007). Additionally, the gut microbiota structure was significantly different between the tntAIS and HC groups (ANOSIM, r = 0.217, P = 0.005). The genera, Ruminococcaceae_ UCG_002 and Christensenellaceae_R-7_group, were implicated in the discrimination of PHS from non-PHS. The order Lactobacillales and family Lachnospiraceae were significantly negatively correlated with NIHSS and mRS at admission (P < 0.05). By contrast, the order Desulfovibrionales, families Christensenellaceae and Desulfovibrionaceae, and genera Ruminococcaceae UCG-014 and Ruminococcaceae UCG-002 were significantly positively correlated with NIHSS and mRS at admission (P < 0.05). This study is the first to profile the characteristics of gut microbiota in patients with AIS and PHS, compared with those with non-PHS. The genera, Ruminococcaceae_ UCG_002 and Christensenellaceae_R-7_group, may be objective indicators of this traditional Chinese medicine (TCM) syndrome in AIS. Furthermore, it provides a microbe-inspired biological basis for TCM syndrome differentiation.
Topics: Humans; Gastrointestinal Microbiome; RNA, Ribosomal, 16S; Ischemic Stroke; Hot Temperature; Cross-Sectional Studies; Stroke; Syndrome; Clostridiales
PubMed: 36327217
DOI: 10.1371/journal.pone.0276598 -
Experimental and Therapeutic Medicine Jan 2018Mitochondrial factor and cell cytokines play important roles in the incidence of vascular dementia (VD), but their correlations with inflammatory and mitochondrial...
Mitochondrial factor and cell cytokines play important roles in the incidence of vascular dementia (VD), but their correlations with inflammatory and mitochondrial factors and the role of both in the kidney essence deficiency pattern and phlegm turbidity blocking orifice pattern are not clear. This study was aimed at studying the correlations between the serum mitochondrial factor and cell cytokines with TCM Syndrome Scale in vascular dementia. According to the inclusion criteria we collected 108 vascular dementia patients which were divided into the kidney essence deficiency pattern and phlegm turbidity blocking orifice pattern based on the TCM Syndrome Scale. We measured serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-18 (IL-18) concentration using an enzyme-linked immunosorbent assay (ELISA) and serum malondialdelyde (MDA) and superoxide dismutase (SOD) was quantified according to instructions of kits from the 108 patients (45 in kidney essence deficiency pattern, 63 in phlegm turbidity blocking orifice pattern). The scale scores were assessed using TCM Syndrome Scale, MMSE, Hachinski, Barthel, BBS, CDR. There was a significant difference on the scores of CDR and the factors of the memory, judgment, social affairs, personal care, family and hobbies among the two groups, The means of kidney essence deficiency group was higher than that of phlegm turbidity blocking orifice pattern group. IL-18 and SOD in the phlegm turbidity blocking orifice group was higher than those in the kidney essence deficiency pattern; IL-6 in phlegm turbidity blocking orifice pattern group was lower than that in the kidney essence deficiency pattern. By logistic regression analysis, we demonstrated that high concentration of IL-6, TNF-α, and MDA were associated with increased TCM syndrome scores in two groups, while IL-6, IL-18, TNF-α, SOD were associated with decreased MMSE, Barthel. Our study support the notion that IL-6 plays a more important role in the integral of kidney essence deficiency pattern, IL-18 is a more important factor in phlegm turbidity blocking orifice pattern. The results can be used as the theoretical basis of traditional Chinese Medicine prescription and pharmacological research in future, through decrease in IL-6 lever and increase in SOD in integral kidney essence deficiency pattern, and IL-18 as the main anti inflammation index in phlegm turbidity blocking orifice pattern.
PubMed: 29375680
DOI: 10.3892/etm.2017.5387 -
Nan Fang Yi Ke Da Xue Xue Bao = Journal... Oct 2021To investigate the effect of dissipating phlegm and blood stasis simultaneously for protecting cardiac microvascular endothelial cells (CMECs) against high...
OBJECTIVE
To investigate the effect of dissipating phlegm and blood stasis simultaneously for protecting cardiac microvascular endothelial cells (CMECs) against high glucose-induced injury and the role of AGEs/RAGE axis in the underlying mechanism.
METHODS
The primary CMECs were isolated from rat heart by enzymatic digestion and identified by immunofluorescence assay. The CMECs exposed to 33 mmol/L glucose for 48 h were divided into model group (MC), resolving phlegm (RP) group, dissipating blood stasis (DBS) group, dissipating phlegm and blood stasis (RPDBS) group and ALT-711 group. After treatment with 10% drug-containing serum and ALT-711 for 48 h, the content of AGEs in the cells were measured with ELISA. The expressions of RAGE mRNA and protein were measured with real-time quantitative PCR, immunofluorescence assay and Western blotting; The activity of NADPH oxidase and ROS level were measured by cytochrome c reduction and fluorescent probe DHE.
RESULTS
High glucose exposure significantly increased the content of AGEs, RAGE expressions at the protein and mRNA levels, NADPH oxidase activity and ROS level in the CMECs ( < 0.01). These changes were significantly mitigated by treatments with RP, DBS, RPDBS and ALT-711 ( < 0.01), among which RPDBS caused the most significant decrements in AGEs content, RAGE expression and NADPH oxidase activity ( < 0.01, < 0.05). The reduction of ROS level in the RPDBS group was significantly greater than that in RP group ( < 0.01), but similar to that in DBS group ( > 0.05).
CONCLUSION
Dissipating phlegm and blood stasis simultaneously can be helpful for prevention and treatment of diabetic myocardial microangiopathy by suppressing the excessive activation of AGEs-RAGE signal axis and oxidative stress, thus protecting CMECs against high glucose-induced damage. Dissipating phlegm and blood stasis simultaneously is better than either of the therapy alone.
Topics: Animals; Diabetes Mellitus; Diabetic Angiopathies; Endothelial Cells; Glucose; Glycation End Products, Advanced; Myocardium; Oxidative Stress; Rats; Receptor for Advanced Glycation End Products
PubMed: 34755668
DOI: 10.12122/j.issn.1673-4254.2021.10.11 -
Zhongguo Zhong Yao Za Zhi = Zhongguo... Sep 2023A cross-sectional study method combined with two types of traditional Chinese medicine(TCM) syndrome differentiation methods was adopted to investigate the clinical...
A cross-sectional study method combined with two types of traditional Chinese medicine(TCM) syndrome differentiation methods was adopted to investigate the clinical symptoms and distribution characteristics of TCM syndromes in patients with pulmonary nodules from the perspectives of number, size, nature, and stability of pulmonary nodules by using the χ~2 test, systematic clustering and Apriori algorithm correlation analysis. The common clinical symptoms of pulmonary nodules were fatigue(77.35%) and irritability(75.40%), and 40 symptoms were clustered into 3 groups(digestive system symptoms, respiratory system symptoms, and emotional and systemic symptoms) and 8 major symptom categories. The proportion of cold and heat in complexity syndrome(63.43%) was higher based on cold-heat syndrome differentiation. The top two syndromes were Qi deficiency syndrome(88.03%) and Qi depression syndrome(83.17%) based on disease syndrome differentiation. Yang deficiency syndrome(60.52%) was more than Yin deficiency syndrome(50.16%). There were higher proportions of phlegm syndrome(78.67%) and Yang deficiency syndrome(69.33%) of so-litary pulmonary nodules in terms of the number of pulmonary nodules. In terms of size, the proportion of phlegm syndrome decreased as the mean diameter of pulmonary nodules increased, while the proportions of Yang deficiency syndrome and blood stasis syndrome increased. The distribution of Qi depression syndrome was more in those with mean diameter<10 mm(85.02%, P=0.044) and cold syndrome was more in those with mean diameter ≥10 mm(16.67%, P=0.024). In terms of the nature of pulmonary nodules, the proportions of Qi depression syndrome and heat syndrome decreased with the increase in solid components of pulmonary nodules, while the proportions of Yin deficiency syndrome and cold and heat in complexity syndrome increased. The blood stasis syndrome accounted for a higher proportion of pulmonary nodules with solid components. In terms of the stability of pulmonary nodules, dampness syndrome(72.97%), blood stasis syndrome(37.84%), and cold and heat in complexity syndrome(70.27%) accounted for higher proportions. In addition, patients with new nodules presented higher proportions in Qi inversion syndrome(52.00%, P=0.007) and cold and heat in complexity syndrome(66.00%, P=0.008). Meanwhile, 11 syndromes were associated and 4 common compound syndromes were obtained(Qi deficiency and depression syndrome, Qi depression and phlegm coagulation syndrome, Qi deficiency and phlegm coagulation syndrome, and Qi deficiency and dampness obstruction syndrome). Qi deficiency syndrome and Qi depression syndrome could be associated with other syndromes. The results show that the main clinical symptoms of pulmonary nodules are fatigue and irritability. The main TCM syndromes of pulmonary nodules are Qi deficiency syndrome, Qi depression syndrome, Yang deficiency syndrome, and cold and heat in complexity syndrome. The distribution of TCM syndromes is significantly correlated with the size of pulmonary nodules and the presence or absence of new nodules. The common compound syndromes are Qi deficiency and depression syndrome, Qi depression and phlegm coagulation syndrome, Qi deficiency and phlegm coagulation syndrome, and Qi deficiency and dampness obstruction syndrome.
Topics: Humans; Medicine, Chinese Traditional; Yin Deficiency; Yang Deficiency; Cross-Sectional Studies; Syndrome
PubMed: 37802817
DOI: 10.19540/j.cnki.cjcmm.20230606.501 -
Evidence-based Complementary and... 2022To investigate the correlation between Chinese medicine syndrome and cognitive dysfunction in patients with mild cognitive impairment (MCI).
OBJECTIVE
To investigate the correlation between Chinese medicine syndrome and cognitive dysfunction in patients with mild cognitive impairment (MCI).
METHODS
121 MCI patients were included for syndrome differentiation and syndrome scoring according to the Chinese medicine syndrome classification standard of senile dementia. The cognitive function and cognitive subitems (including visual space and executive function, naming, attention, language, abstraction, delayed recall, and orientation) of patients with different Chinese medicine syndromes were scored with the Montreal Cognitive Assessment (MoCA). Correlation analysis was made on Chinese medicine syndromes and cognitive domain damage.
RESULTS
Chinese medicine syndromes from most to least were kidney deficiency and marrow reduction syndrome, turbid phlegm obstructing orifices syndrome, deficiency of heart and spleen syndrome, stagnation and blood stasis syndrome, and deficiency of heart and liver syndrome. There were no significant differences in MoCA scores among different Chinese medicine syndromes ( > 0.05).In the kidney deficiency and marrow reduction syndrome, the delayed recall score was 1.74 ± 1.23 and the difference was statistically significant when compared with deficiency of heart and spleen syndrome or the deficiency of heart and liver syndrome ( < 0.05). In the turbid phlegm obstructing orifices syndrome, the delayed recall score was 1.81 ± 1.33 and the difference was statistically significant when compared with the deficiency of heart and liver syndrome ( < 0.05). There was a significant negative correlation between the kidney deficiency and marrow reduction syndrome's Chinese medicine syndrome scores and MoCA scores ( < 0.01), and there was a negative correlation between the turbid phlegm obstructing orifices syndrome's Chinese medicine syndrome scores and MoCA scores ( < 0.05). Correlation analysis showed that the kidney deficiency and marrow reduction syndrome was significantly negatively correlated with delayed recall scores ( < 0.01), and it was also negatively correlated with visual space and executive function scores ( < 0.05). The turbid phlegm obstructing orifices syndrome was significantly negatively correlated with delayed recall scores ( < 0.01).
CONCLUSION
The kidney deficiency and marrow reduction syndrome and the turbid phlegm obstructing orifices syndrome were the most common syndromes in MCI. Patients with kidney deficiency and marrow reduction syndrome might have obvious damage in delayed recall function and have damage in visual space and executive function. Patients with turbid phlegm obstructing orifices syndrome might have obvious damage in delayed recall function.
PubMed: 35783529
DOI: 10.1155/2022/7117704 -
Journal of Traditional Chinese Medicine... Oct 2017To use the theory of Traditional Chinese Medicine to identify the major symptom patterns of Parkinson's disease.
OBJECTIVE
To use the theory of Traditional Chinese Medicine to identify the major symptom patterns of Parkinson's disease.
METHODS
Journal databases were searched for relevant articles in the last 30 years. Articles were reviewed for symptom patterns of Parkinson's disease and analyzed using frequency analysis, cluster analysis, and other methods of data extraction.
RESULTS
The analyses indicated that the most frequent symptom patterns of Parkinson's disease are Yin deficiency of kidney and liver, deficiency of Qi and blood, phlegm heat and wind stirring, blood stasis and wind stirring, and deficiency of Yin and Yang.
CONCLUSION
Taken together, the analyses identified the primary symptom patterns of Parkinson's disease as Yin deficiency of kidney and liver, deficiency of Qi and blood, phlegm heat and wind stirring, and blood stasis and wind stirring.
PubMed: 32188231
DOI: No ID Found -
International Journal of Surgery Case... Feb 2022Patients with hemorrhagic pleural effusion who live in tuberculosis endemic areas are recommended to perform adenosine deaminase (ADA) test.
BACKGROUND
Patients with hemorrhagic pleural effusion who live in tuberculosis endemic areas are recommended to perform adenosine deaminase (ADA) test.
CASE PRESENTATION
A Javanese 22-year-old male complained of shortness of breath and cough with phlegm for 1 week, and worsened 3 days before being admitted to the hospital. The X-ray results showed pleural effusion, and hemorrhagic pleural effusion examination showed an increase in lymphocytes (60.2%), lactate dehydrogenase/LDH (2624 U/L), and cell count (4584 cells/mm), and the ADA test obtained 49 IU/L. The water-sealed drainage (WSD) was installed and first-line anti-tuberculosis drug (ATD) was given for 1 month. After showing improvement in the first month, the first-line ATD was continued until 6 months.
DISCUSSION
Patients with hemorrhage pleural effusion who live in tuberculosis endemic areas are recommended to perform differential diagnosis of hemorrhage pleural effusion and pulmonary tuberculosis. The use of the first-line ATD in hemorrhagic pleural effusion and pulmonary tuberculosis needs to be evaluated in the first month to detect improvement, otherwise, the medication is stopped and other investigations are carried out.
CONCLUSION
Successful management of hemorrhagic pleural effusion and pulmonary tuberculosis depends on early diagnosis.
PubMed: 35101716
DOI: 10.1016/j.ijscr.2022.106800