Links between allergic rhinitis and asthma.
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Antibodies, Anti-Idiotypic↗
Biomedical subjects
Nan-shan Zhong
Publications and source records attributed to Nan-shan Zhong.
[Time trends in the prevalence of asthma and allergic diseases over 7 years among adolescents in Guangzhou city].
OBJECTIVE: To assess time trends in the prevalence of asthma, allergic rhinitis and eczema in Guangzhou urban adolescents. METHODS: A cross-sectional study using the International Study of Asthma and Allergies in Childhood (ISAAC) Phase III protocol was conducted in 2001. Cluster randomized samples of 3516 schoolchildren aged 13 - 14 from 10 secondary schools of four central districts were recruited for the study in Guangzhou city. The results were compared with those obtained in ISAAC Phase I Study (1994 - 1995), which used the identical and validated core questionnaires. Each subject was given an ISAAC Phase III written questionnaire to complete, followed by the video questionnaire about asthma at the same session in school. RESULTS: The prevalence rate of physicians' diagnosis of asthma in Phase III was 4.6%, which was similar to that of 3.9% in Phase I (P > 0.05). But the prevalence rates of wheeze and exercise-induced wheeze in the past 12 months by written questionnaire have increased from 3.4% and 17.4% in Phase I to 4.8% and 23.4% in Phase III respectively (all P < 0.01). By the video questionnaire, the 12-months prevalence rates of wheeze at rest and exercise-induced wheeze were also significantly higher in Phase III (3.8% and 11.3%) compared with those in Phase I (2.0% and 6.9%) (P < 0.01). The 12-months prevalence rates of nasal symptoms without common cold, both related to rhinitis and rhinoconjunctivitis had also increased from 39.5% and 8.7% in Phase I to 45.5% and 11.1% in Phase III, respectively (both P < 0.01). Meanwhile, the prevalence rates of physicians' diagnosis of hayfever and allergic rhinitis in Phase III were 4.1% and 22.7%, which were significantly higher than that of 2.9% and 17.4% in Phase I (both P < 0.05). The 12-months prevalence rate of flexural eczema symptoms had increased from 1.3% in Phase I to 2.2% in Phase III (P < 0.01). However, the prevalence rates of physicians' diagnosis of eczema were similar in both surveys (P > 0.05). The absolute percentage changes in 12-months prevalence rate related to symptoms and physicians' diagnosis for asthma, allergic rhinitis and eczema were more in males than those in females. CONCLUSION: There is a general tendency towards an increase in the prevalence of asthma, allergic rhinitis and eczema over 7 years among adolescents in Guangzhou city, remarkably more so among males than females.
Adolescent↗
DNA vaccine encoding Der p2 allergen down-regulates STAT6 expression in mouse model of allergen-induced allergic airway inflammation.
BACKGROUND: Activation of signal transducer and activator of transcription 6 (STAT6) plays a critical role in the late phase of Th2-dependent allergy induction. STAT6 is essential to Th2 cell differentiation, recruitment, and effector function. Our previous study confirmed that DNA vaccination inhibited STAT6 expression of spleen cells induced by allergen. In the present study, we determined whether DNA vaccine encoding Dermatophagoides pteronyssinus group 2 (Der p2) could down-regulate the expression and activation of STAT6 in lung tissue from asthmatic mice. METHODS: After DNA vaccine immunization, BALB/c mice were sensitized by intraperitoneal injection and challenged by intranasal instillation of rDer p2. The levels of the cytokines IL-4 and IL-13 in BAL fluid were measured by enzyme-linked immunosorbent assay. The lung tissue was assessed by immunohistochemical staining with anti-STAT6. The protein expression of STAT6 was determined by Western blot. The activation of STAT6 binding ability was analyzed with electrophoretic mobility shift assay. RESULTS: DNA vaccine encoding Der p2 allergen effectively decreased the levels of IL-4 and IL-13 in the asthmatic mice. Histological evidence and Western blot showed that the expression of STAT6 in the DNA treated mice was markedly attenuated. STAT6 binding to specific DNA motif in lung tissue from the gene vaccinated mice was inhibited. CONCLUSION: DNA vaccine encoding Der p2 prevents allergic pulmonary inflammation probably by inhibiting the STAT6 signaling pathway in mice with Der p2 allergen-induced allergic airway inflammation.
Animals↗
[Expression and significance of severe acute respiratory syndrome associated coronavirus (SARS-CoV)-X4 protein in lungs of SARS patients].
OBJECTIVE: To investigate the significance of severe acute respiratory syndrome associated coronavirus (SARS-CoV)-X4 protein expression in lungs of patients with SARS. METHODS: Pathological features of the lungs from 4 SARS patients were examined and the expression of SARS-CoV-X4 protein in the lungs was evaluated with immunohistochemical staining using specific antibodies against protein X4. RESULTS: Microscopically, all lungs from 4 cases showed edema, erythrocyte and fibrin exudates in the alveoli, hyperplasia of alveolar epithelium, necrosis, hyaline membrane formation and fibroblast foci. Immunohistochemical stains showed a strong positivity of X4 protein in denudation cells, vascular endothelial cells and also erythrocytes and neutrophils in the alveoli of the lung tissues from the 4 cases. CONCLUSIONS: Expression of SARS-CoV-X4 protein in the lungs may be involved in the pathogenesis and progression of SARS.
Adult↗
[The epidemiology and management of influenza].
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Communicable Disease Control↗
[Etiology and a diagnostic protocol for patients with chronic cough].
OBJECTIVE: The spectrum and frequency of causes and the diagnostic protocol for chronic cough were explored. METHODS: A total of 194 patients with at least 3 weeks of chronic cough and normal chest radiographs were recruited from the outpatient clinic of Guangzhou Institute of Respiratory Diseases between July 2003 to June 2004. The causes were investigated using a well-established protocol. The diagnostic protocol included history inquiring and physical examination, pulmonary function tests, induced sputum cell differentials, 24 h esophageal pH monitoring, CT of the paranasal sinuses or chest, fiberoptic rhinoscopy or bronchoscopy. The final diagnosis was made based on clinical manifestation, examination findings and a positive response to therapy. RESULTS: The cause of chronic cough was defined in 95.4% of the patients, with a single cause found in 153 patients (82.7%), and multiple causes in 32 patients (17.3%). The five most important causes of cough were: eosinophilic bronchitis (n = 51, 22.4%), rhinitis and/or paranasal sinusitis (PNDs, n = 39, 17.1%), cough-variant asthma (n = 31, 13.6%), atopic cough (n = 28, 12.3%), and gastroesophageal reflux (n = 27, 11.8%). CONCLUSIONS: The spectrum and frequency of causes of chronic cough in our study is different from the previous reports in western countries. Eosinophilic bronchitis and atopic cough are important causes of chronic cough. A modified diagnostic protocol was established accordingly.
Adolescent↗
[The relationship between mouth pressure or tracheal pressure and esophagus pressure and diaphragmatic pressure].
OBJECTIVE: To investigate the relationship between mouth pressure (Pmo) or tracheal pressure (Ptr) and esophagus pressure (Pes) or transdiaphragmatic pressure. METHODS: Seventeen patients were involved in the study. Maximal inspiratory pressure (MIP), maximal transdiaphragmatic pressure (Pdi(max)), maximal esophagus pressure (Pes(max)), twitch mouth pressure (TwPmo), twitch transdiaphragmatic pressure (TwPdi) and twitch esophagus pressure (TwPes) were measured before narcotization as a normal procedure for the abdominal operation and twitch tracheal pressure (TwPtr(nar)), twitch esophagus pressure (TwPes(nar)) and twitch transdiaphragmatic pressure (TwPdi(nar)) were dynamically monitored during narcotization. RESULTS: (1) The correlation coefficient (r) values between Pdi(max) and MIP, TwPdi and TwPmo, TwPdi(nar) and TwPtr(nar), Pes(max) and MIP, TwPes and TwPmo, TwPes(nar) and TwPtr(nar) were 0.976 +/- 0.030, 0.816 +/- 0.155, 0.923 +/- 0.446, 0.981 +/- 0.185, 0.829 +/- 0.168 and 0.955 +/- 0.292, respectively. (2) The coefficient variation (CV) of MIP, Pes(max), Pdi(max), TwPmo, TwPes and TwPdi were (14.2 +/- 4.7)%, (15.2 +/- 4.3)%, (15.5 +/- 4.1)%, (30.4 +/- 15.9)%, (10.8 +/- 5.1)% and (9.9 +/- 4.0)%, respectively. The CV of TwPmo was the highest (compare with others, all P < 0.05) and that of TwPes and TwPdi was the lowest (compare with others, all P < 0.05). There was no significant difference among MIP, Pes(max) and Pdi(max) (P > 0.05). (3) The r value between the changing values of TwPtr(nar) and TwPdi(nar) or TwPes(nar) during narcotization were 0.839 or 0.894 (P = 0.000, respectively). CONCLUSION: The measurement of MIP and TwPmo should be repeated and the highest value should be chosen in order to reduce the possibility of underestimating the function of diaphragm, which could be dynamically monitored by TwPtr(nar).
Abdomen↗
[Investigation of proximal femoral marrow with magnetic resonance imaging in recovered patients with severe acute respiratory syndrome].
OBJECTIVE: To determine the effect of corticosteroid treatment and severe acute respiratory syndrome (SARS) infection itself on the marrow conversion in the proximal femoral marrow in the recovered patients of health care workers with SARS. METHODS: The distribution of proximal femoral marrow on MR imaging of 148 health care workers with recovered SARS including 106 cases treated with varied dosage of steroids and 42 cases without steroid, and 97 age and sex matched health adults as controls were observed. The index of marrow conversion (signal intensity of the femoral neck and intertrochanteric area divided by signal intensity of the greater trochanter multiplied by 100%) was quantitatively measured and compared between SARS patients treated with steroid and without steroid and the normal control group. RESULTS: In 106 cases treated with steroid of the 148 health care workers, femoral head osteonecrosis was found in 4 cases, bilateral femoral marrow edema in 2 cases, femoral marrow infarction in 1 case. The index of marrow conversion in the normal controls, in SARS patients treated without and with steroids was (79.4 +/- 6.8)%, (86.9 +/- 7.4)%, (88.6 +/- 5.9)%, respectively. There was significantly statistical difference between groups (P < 0.05). CONCLUSION: In addition to fat conversion in the proximal femoral marrow due to steroid treatment, the infection of SARS itself may promote an excessively conversion of the red marrow to yellow marrow of the femoral neck in SARS patients.
Adolescent↗
[An epidemiologic study of cough in young college students in Guangzhou].
OBJECTIVE: To study the prevalence of cough and its risk factors in young college students in Guangzhou. METHODS: Using a questionnaire with uniform scheme, a cluster-randomized sampling survey was conducted among young college students in Guangzhou. Fluoroscopy of chest was performed in subjects with persisted cough longer than 8 weeks. RESULTS: There were 1087 cases with complete data from 1091 people including 648 males, 439 females with an average age of 21.16 years old. The total prevalence of cough was 10.9%. Difference in prevalence of cough between males and females showed no significance (10.3% vs. 11.9%, P > 0.05). There were also no significant differences between male and female in prevalence rates of acute cough (6.9% vs. 8.7%, P > 0.05) and chronic cough (3.4% vs. 3.2%, P > 0.05). Under chronic cough condition, cough was more likely to be the only or major symptom than under acute cough condition (77.8% vs. 44.6%, chi(2) = 11.166, P < 0.01). Nasal disease was an important risk factor to the development of chronic cough, which was found in 33.3% of the patients with chronic cough and when having chronic nasal diseases. CONCLUSION: Cough seemed a common disorder in young college student in Guangzhou and there was no significant difference in prevalence between males and females. Nasal disease was an important risk factor to chronic cough.
China↗
[Expiratory flow limitation detected by negative expiratory pressure in patients with chronic obstructive pulmonary disease].
OBJECTIVE: To evaluate the relationship between expiratory flow limitation (EFL) and chronic dyspnea and the effect of bronchodilator on EFL in patients with chronic obstructive pulmonary disease (COPD). METHODS: Thirty-three ambulatory patients with COPD (46 - 78 yrs; male 31, female 2) were included in this study. The severity of chronic dyspnea was rated according to the dyspnea scale proposed by the Medical Research Council (MRC). EFL was measured by applying negative pressure at the mouth during tidal expiration before and after bronchodilation test (inhalation of 400 microg salbutamol). RESULTS: EFL was detected in 12 (36%) of the 33 COPD patients in both seated and supine positions and in 11 (33%) only in supine position. There was a significant difference in the percent predicted forced expired volume in one second (FEV(1%)pred) between subgroups of the patients with or without EFL (t = 7.601, P < 0.01). The mean values of FEV(1%)pred in non-EFL group and EFL group was (66 +/- 16)% and (31 +/- 10)%, respectively, and the value was lowest in patients who showed EFL both in seated and supine positions [(24 +/- 7)%]. Both three-point EFL and five-point EFL were significantly correlated with FEV(1) (r = -0.836 and -0.818, respectively, all P < 0.01). There was a significant correlation between MRC dyspnea scale and three-point EFL and five-point EFL (r = 0.903 and 0.912, respectively, all P < 0.01). In the multiple regression analysis, five-point EFL was a better predictor of dyspnea than FEV(1) (regression coefficient was 0.679 and -0.265, respectively, P < 0.01 and 0.029, respectively). EFL persisted after salbutamol in all of the 23 patients with EFL under baseline conditions. CONCLUSIONS: EFL as measured by negative expiratory pressure (NEP) technique may be more useful in the evaluation of dyspnea in COPD patients than routine lung function measurements. The EFL in COPD patients is irreversible after bronchodilator administration.
Aged↗
[Deep fungal infections: new challenges and prospective].
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Humans↗
[The management of the contralateral lungs in four cases with single allograft lung transplantation].
OBJECTIVE: To report the management of the contralateral lungs in 4 cases with single allograft lung transplantation. METHODS: Four cases receiving lung transplantation were analyzed respectively. One presented with bilateral multiple lung cysts and three with chronic obstructive pulmonary disease (COPD) with bilateral bullae. In the case with bilateral multiple cysts, the contralateral lung remained untreated after operation. For the contralateral lungs in the three cases with COPD, one remained untreated, one received lung volume reduction surgery (LVRS) immediately after lung transplantation, and one received LVRS 47 days after lung transplantation. RESULTS: Three patients recovered after operation, and 2 of them survived more than 18 months. One patient with delayed contralateral LVRS died 74 days after lung transplantation. CONCLUSIONS: For advanced stage COPD with bilateral bullae, contralateral LVRS may be performed immediately after single lung transplantation. In patient with bilateral cysts only, the resection of the contralateral cysts may be avoided if there is no severe infection.
Humans↗
[Retrospective discriminant analysis of the clinical diagnostic criteria for serious contagious severe acute respiratory syndrome].
OBJECTIVE: To analyze the clinical diagnostic criteria for serious severe acute respiratory syndrome (SARS) in Guangdong retrospectively discriminant with SARS database, and to screen out the sensitive warning factors in predicting the outcome. METHODS: Four hundred and two SARS patients were selected based on the diagnostic criteria for SARS from Ministry of Health, China. Of them, 358 SARS patients were selected as their clinical manifestations conformed to the diagnostic criteria of serious SARS. The study subjects were divided into two groups. One group consisted of the patients with serious SARS (358 patients), and they either underwent invasive or non-invasive mechanical ventilation or died of the disease. The remaining 44 SARS patients constituted the non-serious SARS group. Taking the lowest value of oxygen index (OI) as the main index, the OI was categorized into 3 classes, namely< or =200 mm Hg (1 mm Hg=0.133 kPa) as 1,200-300 mm Hg as 2, and >300 mm Hg as 3. According to this index, the seriousness and the prognosis were analyzed. RESULTS: OI less than 300 mm Hg were identified as the unequivocal serious SARS patients, and the mistake judgement rate was 6.800%. Furthermore mortality and complications were compared with Logistic regression, and questionable SARS patients were excluded. The results showed that the patients identified with OI less than 300 mm Hg had worse outcome than the original ones diagnosed with criteria of Ministry of Health. CONCLUSION: OI less than 300 mm Hg in patients with ALI meet the diagnostic criteria of serious SARS better, and it can be taken as a prognostic criterion in clinic.
China↗
[Comparison of tiotropium inhalation capsules and ipratropium metered dose inhaler in a randomized, double-blind, double-dummy, efficacy and safety study in patients with chronic obstructive pulmonary disease].
OBJECTIVE: To compare the efficacy and safety between tiotropium capsule and ipratropium MDI in a 4 week treatment in patients with chronic obstructive pulmonary disease (COPD). METHODS: A multi-center, randomized, double blind, double dummy and parallel comparison clinical trial was conducted in 221 stable moderate to severe patients with COPD. They were randomized into tiotropium 18 microg once per day arm or ipratropium 2 puffs qid. arm for four weeks. The spirometry was conducted at 5 minutes pre-medication; and 30, 60, 120, and 180 minutes post-medication before; 2 weeks and 4 weeks after treatment. RESULTS: The forced expiratory volume in one second (FEV(1)) trough response, the primary endpoint, was significantly higher in the tiotropium arm than that of the ipratropium with (0.063 +/- 0.024) L (95% CI 0.016 - 0.111 L, t = 2.63, P = 0.009) after 4 weeks of treatment. Meanwhile the clinical evidences indicated the continuous improvement of bronchodilation in the tiotropium arm. Forced vital capacity (FVC) trough response was also significantly higher in the tiotropium arm 4 weeks after treatment with (0.133 +/- 0.047) L (t = 2.83, P = 0.005). By comparison with baseline, no significant differences were found between these two arms in the average change of FEV(1) as well as FVC 0 - 3 hours after inhalation (all P > 0.05). There was no significant difference in rescue medication consumptions (t = 0.60, P = 0.548). Adverse events occurred in 12 (10.9%) patients in the tiotropium arm and 18 (16.2%) in the ipratropium arm, without statistical difference (chi(2) = 1.326, P = 0.249). The major adverse event in the tiotropium group was dry mouth (5, 4.5%). No cardiac disorder or abnormal electrocardiogram was reported. CONCLUSION: The results indicated that tiotropium 18 microg once per day is more potent than ipratropium qid. in bronchodilation to COPD patients with the similar tolerance of ipratropium.
Aerosols↗
[The clinical application of cough provocation tests].
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Bronchial Provocation Tests↗
[Prediction of the possible tertiary structure alterations of p53 protein following point mutation in p53 gene condon 282 in lung cancer cells].
This study was carried out to predict the possible tertiary structure alterations of p53 protein after point mutation of p53 gene condon 282 in lung cancer cells based on the latest 3D structure analysis platform series of Phyre software. It was found that the p53 gene condon 282 mutation (Arg/Leu) may destabilize the H2 helix and DNA binding in the major groove by compromising the contacts of p53 protein with the beta-hairpin of DNA binding surface.
Amino Acid Sequence↗
[Theophylline in the treatment of chronic obstructive pulmonary disease: a randomized, double-blind, placebo-controlled study].
OBJECTIVE: To observe the benefits and safety of low-dose, slow-release oral theophylline for long-term treatment of stable chronic obstructive pulmonary disease (COPD). METHODS: This was a randomized, parallel-group, double-blind, placebo-controlled trial. Slow-release theophylline (200 mg/d) twice daily or placebo (matching theophylline) was randomly given to 110 patients with stable COPD in the rural area of Shaoguan, Guangdong Province, for one year. Efficacy measures were spirometry and exacerbations, quality of life, dyspnea scores, satisfaction with treatments and adverse effects. Comparison of benefits was performed using superiority test. RESULTS: Of 110 patients, 85 (42 subjects in theophylline group and 43 subjects in placebo group) completed the study. An analysis for intention-to-treat (ITT) individuals showed that individuals with the treatment of theophylline experienced statistically fewer numbers [(0.8 +/- 1.2) times/year, (1.7 +/- 2.6) times/year, Z = -1.674, P = 0.047] and days of exacerbations [(4.6 +/- 7.9) d, (12.5 +/- 22.8) d, Z = -1.699, P = 0.045] in comparison to subjects receiving placebo, that patients receiving theophylline were less likely than the placebo group to experience moderate exacerbations [(0.4 +/- 1.0) times/year, (1.0 +/- 1.8) times/year, Z = -2.136, P = 0.017], and that more individuals satisfied with treatments in the theophylline group than the placebo group (n = 16, 3, Z = -2.198, P = 0.014), and that statistically greater improvement in pre-bronchodilators FEV(1) [(0.006 +/- 0.180) L, (-0.053 +/- 0.169) L, t = 1.789, P = 0.038] were found in the theophylline group in comparison to the placebo group. The similar results were observed in an analysis for per-protocol (PP) subjects. Statistical improvement on quality of life was observed in the PP subjects of theophylline group than in placebo group (-28 +/- 20, -20 +/- 23, F = 2.893, P = 0.047). Time to the first exacerbation in patients receiving theophylline was also delayed in comparison to placebo (365 d, 276 d, chi(2) = 3.880, P = 0.049). But no statistical difference was found between the two groups in post-bronchodilators FEV(1) in both ITT and PP subjects (t = -0.012, P = 0.495 and t = 0.040, P = 0.484 respectively). Drug-related adverse events (8.8%) such as insomnia, palpitation, stomach discomforts or stomachache, and headache were observed in the theophylline group. CONCLUSION: Slow-released oral theophylline (200 mg/d) may be beneficial and safe in long-term treatment of stable COPD in rural area.
Aged↗
[The possible mechanism of lung injury induced by severe acute respiratory syndrome coronavirus spike glycoprotein].
OBJECTIVE: To investigate the role of severe acute respiratory syndrome coronavirus (SARS-CoV) in the induction of acute lung injury by promoting the synthesis of chemokine/cytokines in human endothelial cells. METHODS: Twenty-three SARS patients were enrolled in this study, comprising 15 male and 8 female, aged 27 - 55 years, mean (36 +/- 6) years. They were treated at Guangzhou Institute of Respiratory Disease from February to May in 2003. Chemokines/cytokines in the blood of patients with SARS were dynamically screened by liquid chip system. The lung was studied histopathologically using immunohistochemical technique. Spike glycoprotein of SARS-CoV was recombined by using insect-baculovirus expression system and Nickel affinity Magnet Beads, and then used to stimulate cultured human umbilical vein endothelial cells (HUVEC). Morphological changes of HUVEC were observed by microscope. Levels of chemokines/cytokines involved in immunoreaction in response to virus infection were detected in the supernatants of those cells cultured with the Spike glycoprotein by liquid chip system. RESULTS: Interferon-gamma inducible protein 10 (IP-10) was markedly elevated in the blood during the early stage of SARS [(7,600 +/- 2,400) ng/L, P < 0.01], and remained at a high level in the progressive stage [(8,100 +/- 2,300) ng/L, P < 0.01] and the end stage [(8,000 +/- 2,800) ng/L, P < 0.01] until convalescence [(1,250 +/- 450) ng/L, P > 0.05]. Moreover, IP-10 was highly expressed in the lung. Vacuoles appeared in part of HUVEC after Spike glycoprotein stimulation. As time going on, the HUVEC turned to be round in shape and even disrupted. Under normal condition, no detectable IP-10 was found in HUVEC. A high level of IP-10 [(179 +/- 34), (889 +/- 212), (1,676 +/- 199) ng/L, all P < 0.05] was detected in the HUVEC 12 h after Spike glycoprotein (5, 20, 40 mg/L) stimulation respectively, and presented with a significant dose-dependent response. CONCLUSIONS: (1) A significant increase of IP-10 activity in the blood was found in patients with SARS-CoV infection, and remained at a high level until the stage of convalescence. A strong IP-10 protein expression was also found in SARS-CoV infected lung in autopsy. (2) The Spike glycoprotein of SARS-CoV induced a high level of IP-10 in endothelial cells, which in turn damaged endothelial cells. (3) The Spike glycoprotein of SARS-CoV induced IP-10 production by a way independent of IFN-gamma.
Adult↗