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Ear, Nose, & Throat Journal Oct 2023To summarize the characteristics of laryngopharyngeal reflux in patients with chronic cough induced by gastroesophageal reflux disease (GERD). The clinical data of...
To summarize the characteristics of laryngopharyngeal reflux in patients with chronic cough induced by gastroesophageal reflux disease (GERD). The clinical data of patients with chronic cough induced by GERD treated at our hospital were retrospectively analyzed, including their reflux symptom index (RSI), reflux finding scores (RFS), and results of oropharyngeal pH monitoring. There were 44 patients in total, including 21 males and 23 females. The average history of chronic cough was 29.60 (29.60 ± 37.60) months. In addition to coughing, all patients had at least 2 symptoms of laryngopharyngeal reflux disease (LPRD), and their RSI averaged 15.66 (15.66 ± 6.33). The most frequent symptoms were cough, throat clearing, excessive phlegm, or postnasal drip. All patients had LPRD signs, with an average RFS of 10.89 (10.89 ± 2.81). The most frequent signs were erythema or hyperemia/vocal cord edema, posterior commissure hypertrophy, and diffuse laryngeal edema. There were 42 patients (42/44, 95.45%) whose RSI and/or RFS were abnormal. Oropharyngeal pH monitoring identified 10 patients (10/44, 22.72%) with abnormal Ryan scores. All patients with chronic cough induced by GERD had symptoms and signs of LPRD, and most of them had an abnormal RSI and/or RFS and could be diagnosed with suspect LPRD. A part of the patients had LPR episodes according to Dx-pH monitoring, most of which occurred in the upright position. These results indicated that most patients with chronic cough induced by GERD may have suspected LPRD simultaneously and that cough was one of their LPRD symptoms.
PubMed: 37830343
DOI: 10.1177/01455613231205393 -
Journal of Traditional Chinese Medicine... Feb 2024To evaluate the extent of vascular endothelial dysfunction and preliminary identify serum protein biomarkers associated with obese individuals at risk for cardiovascular...
OBJECTIVE
To evaluate the extent of vascular endothelial dysfunction and preliminary identify serum protein biomarkers associated with obese individuals at risk for cardiovascular disease (CVD).
METHODS
Fifteen obese volunteers with the phlegm-dampness constitution or balanced constitution were recruited for this study respectively. The clinical baseline data was collected, and the vascular endothelial function was evaluated using the EndoPAT. Blood samples were collected for the serum proteome analysis. The differences in the serum protein expression levels between the two groups were detected and the protein interaction network analysis, correlation analysis, receiver operating characteristic (ROC) curve analysis, and random forest model investigation were conducted.
RESULTS
There were no statistical differences found in the baseline data. For vascular endothelial function, the reactive hyperemia index (RHI) of the phlegm-dampness constitution obese group was significantly lower than that of the balanced constitution obese group (1.46 ± 0.30 2.82 ± 0.78, < 0.0001), indicating vascular endothelial dysfunction. There are 66 differentially expressed serum proteins between the two groups. apolipoprotein A2 (ApoA2), angiotensin-converting enzyme 2 (ACE-2), interleukin-33 (IL-33), and forkhead box P3 (FoxP3) showed significant differences and area under curve values of their ROC curves were greater than 0.7 and correlated significantly with RHI.
CONCLUSION
Vascular endothelial dysfunction was present in the phlegm-dampness constitution obese group. Thus, alterations in the expression levels of key serum proteins, including ApoA2, ACE-2, IL-33, and FoxP3 could serve as potential biomarkers in the obese population at risk of CVD.
Topics: Humans; Medicine, Chinese Traditional; Proteome; Interleukin-33; Obesity; Cardiovascular Diseases; Biomarkers; Blood Proteins; Forkhead Transcription Factors
PubMed: 38213254
DOI: 10.19852/j.cnki.jtcm.20231110.005 -
Frontiers in Pharmacology 2024Laryngopharyngeal reflux disease (LPRD) is an extraesophageal syndromic manifestation of gastroesophageal reflux disease (GERD). Despite the increasing incidence of and...
Tonghua Liyan granules in the treatment of Laryngopharyngeal reflux disease with stagnation of phlegm and qi syndrome: a randomized, double-blind, placebo-controlled study.
Laryngopharyngeal reflux disease (LPRD) is an extraesophageal syndromic manifestation of gastroesophageal reflux disease (GERD). Despite the increasing incidence of and concern about LPRD, treatment with proton pump inhibitors (PPIs) is unsatisfactory. Here, LPRD was treated with Tonghua Liyan (THLY) granules in combination with PPIs to evaluate treatment efficacy and possible adverse reactions. Seventy-six LPRD patients with stagnation of phlegm and qi syndrome (SPQS) were randomly divided into an experimental group and a control group. The experimental group received THLY granules combined with rabeprazole capsules. The control group received THLY granule placebo combined with rabeprazole capsules. A parallel, randomized, double-blind, placebo-controlled clinical trial was conducted with these two groups. The treatment cycle was 8 weeks. The reflux symptom index (RSI), clinical symptom score, salivary pepsin content, reflux finding score (RFS) and gastroesophageal reflux disease questionnaire (GerdQ) were used to evaluate clinical efficacy. The final efficacy rate was evaluated according to the RSI and clinical symptom score. Compared with those at baseline, all the indicators in the experimental group and control group significantly improved ( < 0.01). In terms of the RSI, clinical symptom score, and RFS, the experimental group had a higher degree of improvement ( < 0.05), and the overall efficacy rate was higher ( < 0.05). In terms of the salivary pepsin concentration and GerdQ, there was no significant difference between the test group and the control group ( > 0.05). Both groups of safety indicators showed no abnormalities and did not cause any allergic reactions in the body. Compared with PPIs alone, THLY granules combined with PPIs are more effective in the treatment of LPRD patients with SPQS in terms of symptoms and signs. This combination treatment, because of its higher clinical efficacy and lack of obvious adverse reactions, is worthy of clinical promotion and further in-depth study. www.chictr.org.cn, identifier ChiCTR2100046614.
PubMed: 38464723
DOI: 10.3389/fphar.2024.1275740 -
Journal of Ethnopharmacology Jun 2024Bronchitis is a respiratory disease characterized by a productive cough. Polygala tenuifolia Willd., commonly known as Yuan zhi, is a traditional Chinese herbal medicine...
Phytochemical determination and mechanistic investigation of Polygala tenuifolia root (Yuanzhi) extract for bronchitis: UPLC-MS/MS analysis, network pharmacology and in vitro/in vivo evaluation.
ETHNOPHARMACOLOGICAL RELEVANCE
Bronchitis is a respiratory disease characterized by a productive cough. Polygala tenuifolia Willd., commonly known as Yuan zhi, is a traditional Chinese herbal medicine used for relieving cough and removing phlegm. Despite its historical use, studies are lacking on the effectiveness of P. tenuifolia in treating bronchitis. Furthermore, the molecular mechanisms underlying the action of its bioactive compounds remain unknown.
AIM OF THE STUDY
This study aims to identify the main bioactive compounds responsible for the effects of P. tenuifolia liquid extract (PLE) in treating bronchitis and to elucidate the associated molecular mechanisms.
MATERIALS AND METHODS
The main chemical compounds in PLE were identified and determined using ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). The antitussive, expectorant and anti-inflammatory activities of PLE were evaluated in an ammonia-induced mouse cough model, a tracheal phenol red excretion mouse model, and a xylene-induced ear swelling mouse model, respectively. A network pharmacology analysis was conducted to investigate the associated gene targets, gene ontology, and KEGG pathways related to the main bioactives in PLE targeting bronchitis. PLE and its five bioactive compounds were assessed for their potential anti-inflammatory activities in lipopolysaccharide (LPS)-stimulated RAW264.7 cells. Western blot analysis was conducted to elucidate the associated molecular mechanisms.
RESULTS
Thirty-seven compounds in PLE were identified, and twelve main compounds were further quantified in PLE using UPLC-MS/MS. PLE oral gavage administrations (0.6 and 0.12 mg/kg) for 7 days markedly reduced cough frequency, prolonged latency period of cough, reduced phlegm and inflammation in mice. The network pharmacology analysis identified 57 gene targets of PLE against bronchitis. The PI3K/AKT and MAPK signalling pathways were the top two modulated pathways. In RAW264.7 cells, PLE (12.5-50 μg/mL) significantly reduced cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α. PLE downregulated LPS-elevated protein targets in both PI3K/AKT and MAPK signaling pathways. In PLE, tenuifolin, polygalaxanthone ⅠⅠⅠ, polygalasaponin ⅩⅩⅤⅢ, tenuifoliside B, and 3,6'-Disinapoyl sucrose, were identified as the top five core components responsible for treating bronchitis. These compounds were also found to modulate the protein targets in the PI3K/AKT and MAPK signalling pathways.
CONCLUSIONS
This study demonstrated the potential therapeutic effects of PLE on bronchitis by reducing cough, phlegm and inflammation. The anti-inflammatory action and molecular mechanisms of the 5 main bioactive compounds in PLE were partly validated through the in vitro assays. The findings provide valuable insights into the mechanisms underlying the traditional use of PLE for bronchitis.
PubMed: 38838926
DOI: 10.1016/j.jep.2024.118418 -
Frontiers in Pharmacology 2024(Swingle) C. Jeffrey (), a perennial indigenous liana from the Cucurbitaceae family, has historically played a significant role in southern China's traditional remedies... (Review)
Review
(Swingle) C. Jeffrey (), a perennial indigenous liana from the Cucurbitaceae family, has historically played a significant role in southern China's traditional remedies for various ailments. Its dual classification by the Chinese Ministry of Health for both medicinal and food utility underscores its has the potential of versatile applications. Recent research has shed light on the chemical composition, pharmacological effects, and toxicity of . Its active ingredients include triterpenoids, flavonoids, amino acids, volatile oils, polysaccharides, minerals, vitamins, and other microconstituents. Apart from being a natural sweetener, has been found to have numerous pharmacological effects, including alleviating cough and phlegm, preventing dental caries, exerting anti-inflammatory and anti-allergic effects, anti-aging and anti-oxidative, hypoglycemic, lipid-lowering, anti-depression, anti-fatigue, anti-schizophrenic, anti-Parkinson, anti-fibrotic, and anti-tumor activities. Despite its versatile potential, there is still a lack of systematic research on to date. This paper aims to address this gap by providing an overview of the main active components, pharmacological efficacy, toxicity, current status of development and application, development dilemmas, and strategies for intensive exploitation and utilization of . This paper aims to serve as a guide for researchers and practitioners committed to exploiting the biological resources of and further exploring its interdisciplinary potential.
PubMed: 38638866
DOI: 10.3389/fphar.2024.1388747 -
Frontiers in Cardiovascular Medicine 2024The concepts of "individualization" and "preventive treatment" should be incorporated into the precise diagnosis and treatment of coronary heart disease (CHD). Both...
BACKGROUND
The concepts of "individualization" and "preventive treatment" should be incorporated into the precise diagnosis and treatment of coronary heart disease (CHD). Both hemodynamics and Chinese medicine constitution studies align with these two concepts.
METHODS
This study utilized data from 81 patients with CHD, including 12 patients with balanced constitution (BC), 20 patients with blood stasis constitution (BSC), 17 patients with phlegm-dampness constitution (PDC), 15 patients with qi-deficiency constitution (QDC), and 17 patients with other constitutions. Clinical data provided information on the patients' blood property, heart function, degree of coronary stenosis, coronary hemodynamics, and so on. These parameters were compared between patients with balanced constitution vs. biased constitutions as well as between those with blood stasis constitution, phlegm-dampness constitution, and qi-deficiency constitution.
RESULTS
Compared to biased constitution (BC), patients with balanced constitution exhibited lower total cholesterol (TC) levels and low-density lipoprotein (LDL) levels. Additionally, they had lighter stenosis degrees in the Left anterior descending branch (LAD) and Left circumflex branch (LCX) branches. The hemodynamic condition of the LAD and LCX was better for those with balanced constitution; however there was no difference in heart function. Among the groups categorized by blood stasis, phlegm dampness or qi deficiency constituions, patients classified under phlegm dampness had higher levels of LDL compared to those classified under blood stasis or qi deficiency, while patients classified under qi deficiency had higher levels of blood glucose compared to those classified under blood stasis or phlegm dampness. Hemodynamic environments also differed among the LAD and LCX for each group but there were no significant differences observed in heart function or degree of coronary stenosis among these three groups.
CONCLUSION
The balanced constitution demonstrates superior blood property, degree of coronary artery stenosis, and coronary hemodynamics compared to the biased constitution. Furthermore, among the three constitutions with CHD, variations in blood property and certain hemodynamic parameters are observed. These findings emphasize the significant clinical value of incorporating physical factors into the diagnosis and treatment of patients with CHD.
PubMed: 38529331
DOI: 10.3389/fcvm.2024.1383082 -
Mikrobiyoloji Bulteni Oct 2023Pasteurella species are gram-negative bacilli found in healthy pets' oropharynx and gastrointestinal tract flora. In humans, skin and soft tissue infections develop most...
Pasteurella species are gram-negative bacilli found in healthy pets' oropharynx and gastrointestinal tract flora. In humans, skin and soft tissue infections develop most frequently with the bite or scratching of animals such as cats or dogs. At the same time, they cause infections in the respiratory tract, mainly in patients with chronic lung disease or immunosuppressive patients. In this case report, a rare case of pneumonia caused by P.multocida bacteria in a patient with bronchiectasis was presented. A young male patient was admitted to the emergency department of our hospital with complaints of hemoptysis, cough with phlegm, and weight loss. The patient's blood pressure was 140/82 mmHg and SO2= 94%. Rales and rhonchi were detected in the lower left lung during the examination. Standard thorax tomography revealed prominent cystic structures and pneumonic infiltrates in the left lower lobe. Laboratory findings were normal. The Coronavirus disease-2019 (COVID-19) quantitative real-time polymerase chain reaction (qRt-PCR) test was found to be negative in the nasopharyngeal swab sample taken from the patient. Fiberoptic bronchoscopy was performed on the patient to investigate the presence of endobronchial lesion or foreign body aspiration. Culture and cytological evaluation was requested from the bronchial lavage taken. Gram-negative coccobacilli were seen among dense polymorphonuclear leukocytes in the Gram stain of the sample. Acid-fast bacilli were not detected with Ehrlich Ziehl Neelsen stain. In the lavage culture evaluated after 24 hours, colonies growing in blood and chocolate media were stained and gramnegative coccobacilli were observed. The isolate was identified as 96.0% P.canis with the automated Vitek 2 (Biomerieux, France) system. It was determined that the isolate was susceptible to levofloxacin, trimethoprim-sulfamethoxazole, amoxicillin-clavulanic acid, penicillin, ciprofloxacin and cefotaxime in the antibiogram performed by disc diffusion test according to EUCAST v13.0 guideline criteria. Sequence analysis of the isolate obtained from the culture was performed on the ABI Prism 310 Genetic Analyzer (Applied Biosystems, USA). Sequence analysis of the isolate revealed 99.85% homology with P.multocida (GenBank accession no: NG_115137.1). Although Pasteurella multocida pneumonia is not commonly observed, the presence of underlying bronchiectasis in this patient facilitated the establishment of the bacteria. In order not to miss the diagnosis of pneumonia due to P.multocida, microbiological evaluation and molecular typing should be performed in the samples taken from the respiratory tract in patients with chronic respiratory diseases such as bronchiectasis.
Topics: Humans; Male; Bronchiectasis; Hemoptysis; Pasteurella Infections; Pasteurella multocida; Pneumonia
PubMed: 37885394
DOI: 10.5578/mb.20239954 -
Medicine Mar 2024Botrychium ternatum ((Thunb.) Sw.), a traditional Chinese medicine, is known for its therapeutic properties in clearing heat, detoxifying, cough suppression, and phlegm... (Review)
Review
RATIONALE
Botrychium ternatum ((Thunb.) Sw.), a traditional Chinese medicine, is known for its therapeutic properties in clearing heat, detoxifying, cough suppression, and phlegm elimination. It has been extensively used in clinics for the treatment of many inflammation-related diseases. Currently, there are no documented cases of rhabdomyolysis resulting from Botrychium ternatum intoxication.
PATIENT CONCERNS
A 57-year-old male presented with a complaint of low back discomfort accompanied by tea-colored urine lasting for 4 days. The patient also exhibited markedly increased creatine phosphate kinase and myoglobin levels. Prior to the onset of symptoms, the patient consumed 50 g of Botrychium ternatum to alleviate pharyngodynia.
DIAGNOSES
The patient was diagnosed with rhabdomyolysis due to Botrychium ternatum intoxication.
INTERVENTIONS
The patient underwent a substantial volume of fluid resuscitation, diuresis, and alkalization of urine, as well as correction of the acid-base balance and electrolyte disruption.
OUTCOMES
Following a 10-day treatment plan involving massive fluid resuscitation, diuresis, and alkalization of urine, the patient showed notable improvement in his lower back pain and reported the absence of any discomfort. Following reexamination, the levels of creatine phosphate kinase and myoglobin were restored to within the normal ranges. Additionally, no abnormalities were detected in liver or renal function. As a result, the patient was considered eligible for discharge and was monitored.
CONCLUSIONS
Botrychium ternatum intoxication was associated with the development of rhabdomyolysis. To manage this condition, it is recommended that patients provide massive fluid resuscitation, diuresis, alkalization of urine, and other appropriate therapeutic interventions.
LESSON
Currently, there are no known cases of rhabdomyolysis resulting from Botrychium ternatum intoxication. However, it is important to consider the potential occurrence of rhabdomyolysis resulting from Botrychium ternatum intoxication when there is a correlation between the administration of Botrychium ternatum and the presence of muscular discomfort in the waist or throughout the body, along with tea-colored urine. Considering the levels of creatine phosphate kinase and myoglobin, the diagnosis or exclusion of rhabdomyolysis caused by Botrychium ternatum intoxication should be made, and suitable treatment should be administered accordingly.
Topics: Male; Humans; Middle Aged; Myoglobin; Phosphocreatine; Rhabdomyolysis; Fluid Therapy; Creatine Kinase; Tea
PubMed: 38428852
DOI: 10.1097/MD.0000000000037304 -
BMJ Open Nov 2023Cough as a symptom of renal cell carcinoma (RCC) was first described by Creevy in 1935, and despite one (unpublished) study suggesting it may affect 31% of these...
Protocol for a mixed-method study to assess chronic cough in patients with renal cell carcinoma: the prevalence, impact on quality of life, trigger and potential clinical application of chronic cough as an early screening tool in patients with kidney cancer.
INTRODUCTION
Cough as a symptom of renal cell carcinoma (RCC) was first described by Creevy in 1935, and despite one (unpublished) study suggesting it may affect 31% of these patients, as well as cough being discussed in forums for patients with kidney cancer, few clinicians are aware of this association. The cough has been described as unusual in nature, resolving rapidly after treatment with nephrectomy/embolisation but returning if the tumour recurs.
METHODS AND ANALYSIS
A prospective study using a questionnaire will identify the prevalence of cough in patients with suspected or confirmed RCC attending the Specialist Centre for Kidney Cancer (London, UK). A longitudinal study in a representative sample of these patients, using EQ-5D-5L and Leicester Cough Questionnaires, together with the use of semi-structured interviews with patients, will identify the impact of cough in addition to having a diagnosis of suspected or confirmed RCC on quality of life. To investigate cough mechanisms, a pilot study using cough hypersensitivity testing will be performed on patients with RCC, with and without a cough. Clinical samples (urine, blood, phlegm and breath condensate) from patients with RCC, with and without a cough, will be collected and analysed for the presence of substances known to trigger or enhance cough and compared with the results obtained from healthy volunteers.
ETHICS AND DISSEMINATION
Ethical approval has been granted (UK HR REC 22/PR/0791 dated 25/08/2022). Study outputs will be presented and published nationally and internationally at relevant conferences. This study will establish the prevalence of cough in patients with suspected or confirmed kidney cancer and support the education of clinicians to consider this diagnosis in patients with chronic cough (eg, recommending protocols to include both kidneys when investigating respiratory symptoms with chest CT scans). If substances known to trigger or enhance cough are identified and elevated in clinical samples, this research could offer potential targets for treatment for this distressing symptom.
TRIAL REGISTRATION NUMBER
NIHR CRN portfolio CPMS ID:53 372.
Topics: Humans; Carcinoma, Renal Cell; Cough; Longitudinal Studies; Prospective Studies; Quality of Life; Prevalence; Pilot Projects; Early Detection of Cancer; Kidney Neoplasms
PubMed: 37949629
DOI: 10.1136/bmjopen-2023-074077 -
Journal of Traditional Chinese Medicine... Jun 2024To analyze the distribution of Traditional Chinese medicine (TCM) syndromes in patients with diabetic kidney disease (DKD) and its related factors.
OBJECTIVE
To analyze the distribution of Traditional Chinese medicine (TCM) syndromes in patients with diabetic kidney disease (DKD) and its related factors.
METHODS
We enrolled 435 patients with DKD, who were not undergoing dialysis, admitted to the Department of Nephrology, First Medical Center, Chinese PLA General Hospital from April 2020 to August 2021. Analysis of their TCM syndromes and related factors was carried out.
RESULTS
The 435 patients included 109, 117, 86, and 123 chronic kidney disease (CKD) 1-2, CKD3, CKD4, and CKD5 cases, respectively. With the progression of CKD1-5, the proportion of deficiency and dry heat syndrome, and that of and deficiency syndrome showed a downward trend, whereas the proportion of spleen-kidney deficiency, blood deficiency, blood stasis, water stagnation, and phlegm turbidity syndromes showed an upward trend; the differences were statistically significant ( < 0.05). Multivariate logistic regression analysis showed that deficiency and dry heat syndrome was positively correlated with hemoglobin [odds ratio () = 1.022, = 0.005], albumin ( = 1.058, 0.006), and estimated glomerular filtration rate (eGFR) ( = 1.020, 0.001) but negatively correlated with male sex ( = 0.277, 0.004). and deficiency syndrome was positively correlated with albumin ( = 1.056, < 0.001) and eGFR ( = 1.008, = 0.022) but negatively correlated with age ( = 0.977, = 0.023). Liver-kidney deficiency syndrome was positively correlated with age ( = 1.028, 0.021) and glycosylated hemoglobin ( = 1.223, 0.007) but negatively correlated with total cholesterol ( = 0.792, = 0.006). Spleen-kidney deficiency syndrome was negatively correlated with hemoglobin ( = 0.977, < 0.001), albumin ( = 0.891, < 0.001), and eGFR ( = 0.978, < 0.001) but positively correlated with high density lipoprotein ( = 3.376, = 0.001).
CONCLUSION
With CKD1-5 progression, TCM syndromes changed from deficiency and dry heat syndrome to syndrome of deficiency of both and , liver-kidney , and spleen-kidney deficiency syndromes. TCM syndromes were correlated with laboratory test results.
Topics: Humans; Male; Female; Middle Aged; Medicine, Chinese Traditional; Aged; Diabetic Nephropathies; Yin Deficiency; Adult; Renal Insufficiency, Chronic; Glomerular Filtration Rate; Yang Deficiency; Aged, 80 and over
PubMed: 38767642
DOI: 10.19852/j.cnki.jtcm.20230802.007