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Prevalence of asthma symptoms in Golestan schoolchildren aged 6–7 and 13–14 years in Northeast Iran

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《医学前沿（英文）》 2016年 第10卷 第3期   页码 345-350 doi: 10.1007/s11684-016-0462-y

摘要：

Asthma is the most common chronic disease among children, and its incidences are often imminent among elementary schoolchildren. This study aimed to examine the prevalence of asthma symptoms in Golestan schoolchildren aged 6–7 and 13–14 years in Northeast Iran. The prevalence rate was compared according to age group (aged 6–7 years vs. aged 13–14 years) and gender (male vs. female). In this cross-sectional study, 1706 Iranian schoolchildren aged 6–7 and 13–14 years in Golestan Province were enrolled. Participants completed questionnaires between February and July 2014. Asthma symptoms were assessed using the questionnaire of the International Study of Asthma and Allergies in Childhood protocol in Persian. The logistic regression model was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of the asthma symptoms for each of the gender and age groups. The prevalence rates of “current asthma” symptoms and “asthma ever” in all the children were estimated as 9.5% and 7.5%, respectively. The prevalence of asthma (“asthma ever” and “wheezing in the past 12 months”) in junior high schoolchildren (aged 13–14 years) is higher than that in elementary schoolchildren (aged 6–7 years) (P <0.05). The prevalence of the severity of wheezing in girls is lower than that in boys (OR= 1.7, 95%CI= 1.06–2.96, P = 0.02). Asthma is still a major public health problem. This study shows that the prevalence of the asthma symptoms in boys is lower than that in girls in both age groups, and the severity of asthma in girls is higher than that in boys aged 13–14 years.

关键词： asthma     asthma symptoms     epidemiology     childhood     chronic disease    

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Lung function and air pollution exposure in adults with asthma in Beijing: a 2-year longitudinal panel

《医学前沿（英文）》 2022年 第16卷 第4期   页码 574-583 doi: 10.1007/s11684-021-0882-1

摘要： The effect of air pollution on the lung function of adults with asthma remains unclear to date. This study followed 112 patients with asthma at 3-month intervals for 2 years. The pollutant exposure of the participants was estimated using the inverse distance weight method. The participants were divided into three groups according to their lung function level at every visit. A linear mixed-effect model was applied to predict the change in lung function with each unit change in pollution concentration. Exposure to carbon monoxide (CO) and particles less than 2.5 micrometers in diameter (PM2.5) was negatively associated with large airway function in participants. In the severe group, exposure to chronic sulfur dioxide (SO2) was negatively associated with post-bronchodilator forced expiratory flow at 50%, between 25% and 75% of vital capacity % predicted (change of 95% CI per unit: −0.34 (−0.55, −0.12), −0.24 (−0.44, −0.03), respectively). In the mild group, the effect of SO2 on the small airways was similar to that in the severe group, and it was negatively associated with large airway function. Exposure to CO and PM2.5 was negatively associated with the large airway function of adults with asthma. The negative effects of SO2 were more evident and widely observed in adults with severe and mild asthma than in adults with moderate asthma. Patients with asthma react differently to air pollutants as evidenced by their lung function levels.

关键词： lung function     asthma     air pollution     adult    

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Not asthma, but GERD: case report

WANG Zhonggao

《医学前沿（英文）》 2007年 第1卷 第1期   页码 115-119 doi: 10.1007/s11684-007-0022-6

摘要： Asthma is a disorder of the lungs characterized by increased responsiveness of the airways, as manifested by episodes of wheezing and increased resistance to expiratory airflow because of varying degrees of smooth muscle contraction, edema of the mucosa, and mucus in the lumen of the bronchi and bronchioles. The stimuli vary widely and include antigens, infection, air pollutants, respiratory tract irritants, exercise, and emotional factors. This condition is completely different from distress breathing because of laryngotracheal spasm. One of its causes is the gastric content reflux through the pharynx to the larynx because of gastroesophageal reflux disease (GERD), in addition to the typical human avian flu that may cause immediate suffocation by laryngospasm owing to acute larygotrachitis. A patient suffered from GERD without esophageal symptoms, which was diagnosed and treated as bronchial asthma during his five emergency admissions. The admissions were because of episodic attacks of severe air hunger owing to an extreme throat tightening. The patient was being treated for as long as two years. After the correct diagnosis was made and treatment of laporascopic fundaplication was performed, the longstanding bronchial asthma , after all, completely disappeared. The concept of not asthma, but GERD seems undervalued, unappreciated, even misunderstood among patients with intractable asthma. Therefore, such a case is reported in detail, similar cases are mentioned briefly as well, and a mechanism responsible for GERD-originated larryngo- or laryngotracho-spasm is proposed.

关键词： resistance     mechanism responsible     unappreciated     responsiveness     different    

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Efficacy and safety of benralizumab in patients with eosinophilic asthma: a meta-analysis of randomized

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《医学前沿（英文）》 2018年 第12卷 第3期   页码 340-349 doi: 10.1007/s11684-017-0565-0

摘要：

Benralizumab is a monoclonal antibody that targets interleukin-5 receptor α to deplete blood eosinophils and improve the clinical outcomes of allergic asthma. We conducted a meta-analysis to evaluate the safety and efficacy of different doses of benralizumab in patients with eosinophilic asthma. All randomized controlled trials involving benralizumab treatment for patients with eosinophilic asthma, which were searched in PubMed, Embase, and the Cochrane Library published until January 2017, as well as the rate of asthmatic exacerbation, pulmonary functionality, asthma control, quality of life scores, and adverse events were included. Randomized-effect models were used in the meta-analysis to calculate the pooled mean difference, relative risks, and 95% confidence intervals. Five studies involving 1951 patients were identified. Compared with the placebo, benralizumab treatment demonstrated significant improvements in the forced expiratory volume in 1?s (FEV1), Asthma Quality of Life Questionnaire scores, decreased asthmatic exacerbation and Asthma Control Questionnaire-6 (ACQ-6) scores. Benralizumab treatment was also not associated with increased adverse events. These findings indicated that benralizumab can be safely used to improve FEV1, enhance patient symptom control and quality of life, and reduce the risk of exacerbations and ACQ-6 scores in patients with eosinophilic asthma. Furthermore, our meta-analysis showed that benralizumab with 30 mg (every eight weeks) dosage can improve the health-related quality of life and appear to be more effective than 30 mg (every four weeks) dosage. Overall, data indicated that the optimal dosing regimen for benralizumab was possibly 30 mg (every eight weeks).

关键词： benralizumab     anti-interleukin-5     monoclonal antibody     eosinophilic asthma     meta-analysis    

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A belated revelation: from gastroesophageal reflux derived asthma to laryngotracheal irritation even

WANG Zhonggao

《医学前沿（英文）》 2008年 第2卷 第2期   页码 127-129 doi: 10.1007/s11684-008-0023-0

摘要： The author has been inspired by the Global Evidence-Based Consensus for gastroesophageal reflux (GER), which put forward four extra-esophageal syndromes: reflux cough syndrome, reflux laryngitis syndrome, reflux dental erosion syndrome and the reflux asthma syndrome. The author himself happened to receive five emergency rescue treatments following apparent “bronchial asthma”, which was to be diagnosed as GER at his own insistence. PPI resulted in some relief. After being rescued again from suffocation, he had a fundaplication, which was performed at the Englewood Hospital & Medical Center, Englewood, USA in March 2006. The procedure immediately cleared up his “asthma”. A month later he brought forth a Center for GER in an army hospital in Beijing, China. Up to now, 601 patients with mainly respiratory distress (84%) were treated by Stretta Radiofrequency, 58 by surgery and more by PPI. The GER Center is now complete with a ward. GER patients with respiratory distresses turned out to fare better than those with acid regurgitation. A nozzle-shaped pharynx was found in patients with the reflux. Animal study revealed that the refluxate entered into trachea and even lungs. Gradually a hypothesis of a gastro-oesophago-laryngo-tracheal reflux took shape.Our modest effort to treat GER-derived respiratory distresses has got off to an encouraging start amid relative shortage of experience and facilities. We would like to share two thoughts with scholars and experts at home and abroad:1. The GER-derived asthma is not asthma, but GER pure and simple;2. The pathogenesis of “asthma” is not asthma, but laryngotracheal irritation/spasm and its sequence.

关键词： laryngotracheal irritation/spasm     gastro-oesophago-laryngo-tracheal     sequence     fundaplication     encouraging    

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Cerebral regional and network characteristics in asthma patients: a resting-state fMRI study

Siyi Li, Peilin Lv, Min He, Wenjing Zhang, Jieke Liu, Yao Gong, Ting Wang, Qiyong Gong, Yulin Ji, Su Lui

《医学前沿（英文）》 2020年 第14卷 第6期   页码 792-801 doi: 10.1007/s11684-020-0745-1

摘要： Asthma is a serious health problem that involves not only the respiratory system but also the central nervous system. Previous studies identified either regional or network alterations in patients with asthma, but inconsistent results were obtained. A key question remains unclear: are the regional and neural network deficits related or are they two independent characteristics in asthma? Answering this question is the aim of this study. By collecting resting-state functional magnetic resonance imaging from 39 patients with asthma and 40 matched health controls, brain functional measures including regional activity (amplitude of low-frequency fluctuations) and neural network function (degree centrality (DC) and functional connectivity) were calculated to systematically characterize the functional alterations. Patients exhibited regional abnormities in the left angular gyrus, right precuneus, and inferior temporal gyrus within the default mode network. Network abnormalities involved both the sensorimotor network and visual network with key regions including the superior frontal gyrus and occipital lobes. Altered DC in the lingual gyrus was correlated with the degree of airway obstruction. This study elucidated different patterns of regional and network changes, thereby suggesting that the two parameters reflect different brain characteristics of asthma. These findings provide evidence for further understanding the potential cerebral alterations in the pathophysiology of asthma.

关键词： asthma     brain     regional activation     functional connectivity     resting-state fMRI    

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Outcome of Stretta radiofrequency and fundoplication for GERD-related severe asthmatic symptoms

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《医学前沿（英文）》 2015年 第9卷 第4期   页码 437-443 doi: 10.1007/s11684-015-0422-y

摘要：

This study aimed to investigate the outcome of treatment with Stretta radiofrequency (SRF) or laparoscopic Nissen fundoplication (LNF). A total of 137 gastroesophageal reflux disease (GERD) patients with severe asthmatic symptoms who responded inadequately to medical treatment for asthma were investigated. The patients were followed up 1 year and 5 years after SRF (n = 82) or LNF (n = 55) treatment. A questionnaire covering 29 related symptoms and medication use was employed. Digestive, respiratory, and ear-nose-throat (ENT) symptom scores significantly decreased after antireflux treatment. Symptom scores respectively changed from 17.2±10.1, 31.9±6.6, and 21.1±11.8 to 5.0±6.2, 11.5±10.2, and 6.3±6.8 at 1 year and to 5.6±6.5, 13.1±10.1, and 7.8±7.2 at 5 years (P <0.001). The outcome of LNF was significantly better than that of SRF in terms of digestive (P <0.001, P = 0.001), respiratory (P = 0.006, P = 0.001), and ENT symptoms (P = 0.006, P = 0.003) at both 1 year and 5 years. SRF and LNF were both effective against the digestive symptoms of GERD as well as GERD-related severe asthmatic and ENT symptoms, with better outcomes exhibited by the LNF group. Severe asthmatic symptoms and GERD were closely associated, and this finding warrants further study.

关键词： asthma     gastroesophageal reflux     Stretta radiofrequency     laparoscopic Nissen fundoplication    

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Tim-3 mRNA expression in peripheral blood lymphocytes from asthmatic patients

Xiaoxia LU, Weikun HU, Shengdao XIONG, Guopeng XU, Fen LAN

《医学前沿（英文）》 2009年 第3卷 第2期   页码 187-190 doi: 10.1007/s11684-009-0033-6

摘要： The study aimed to detect the expression of the Th1-specific cell surface protein T cell Ig and mucin domain-containing molecule-3 (Tim-3) mRNA in peripheral blood lymphocytes isolated from asthmatic patients and to examine the correlation among Tim-3 mRNA, interleukin-4 (IL-4), interferon-γ (IFN-γ) level, and FEV1/FVC (force expiratory volume in one second/forced vital capacity) to explore the role of Tim-3 in the development and progression of asthmatic inflammation. Tim-3 mRNA expression was detected by reverse transcription polymerase chain reaction (RT-PCR). The IL-4 and IFN-γ levels were determined by using enzyme-linked immunosorbent assay (ELISA). The correlation among Tim-3 mRNA, IL-4, IFN-γ level, and pulmonary ventilatory capacity was analyzed. The expression of Tim-3 mRNA in patients with acute asthma exacerbation was 0.39±0.06, significantly higher than that in patients at the remission stage and controls (0.18±0.05 and 0.07±0.03, <0.05). The level of IL-4 in patients with acute asthma exacerbation was 68.42±10.54, significantly higher than that in the patients at the remission stage and controls (41.83±9.37 and 32.75±8.16, <0.05). The level of IL-4 in patients in remission was significantly higher than that in controls ( <0.05). The level of IFN-γ in patients with acute asthma exacerbation was 65.74±7.85, significantly lower than that in patients in remission and the control group (120.84±11.62 and 139.65±13.47, <0.05). The level of IFN-γ in patients in asthma remission was significantly lower than that in controls ( <0.05). Tim-3 mRNA expression was positively correlated with the level of IL-4 ( =0.68, <0.05) and negatively with the level of IFN-γ and pulmonary ventilatory capacity ( =-0.85, =-0.76, both <0.01). The increased expression of Tim-3 mRNA in peripheral blood lymphocytes might be involved in the development and progression of asthmatic inflammation.

关键词： asthma     airway inflammation     peripheral blood lymphocyte     Tim-3    

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Insult of gastroesophageal reflux on airway: clinical significance of pharyngeal nozzle

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《医学前沿（英文）》 2015年 第9卷 第1期   页码 117-122 doi: 10.1007/s11684-014-0343-1

摘要：

At the very time of global paying the highest attention to the worst insults of smoking as well as haze on the airway, everybody knows both are exogenous and noticeable. However, people mostly, including many medical personnel, do not know how badly the gastroesophageal reflux (GER) insults on our own airway. Symptoms of GER are commonly seen as heartburn and regurgitation, which can be mostly tolerated. However, when the up going gastric content reversely passes the esophagus and then the distal pharynx, where it appears a beak like stricture, serving as a nozzle, so as to produce numerous micro-particles and reach the oro-nasal cavity and also the airway causing allergic rhinitis and asthmatic attacks, even pulmonary parenchyma lesions. It will reduce life quality or even jeopardize life. The point that the endogenous insult appears in the respiratory system, but originates from the digestive tract is not well known and often undiagnosed and not correctly treated. The GER induced airway challenge is a treatable and preventive entity, as soon as a diagnosis is made, a good relief could be expected by means of life style adjustment, medicine, or fixation of the patulous cardia through radiofrequency or fundoplication. The author Dr. Zhonggao Wang had suffered it for long and symptoms disappeared for 8 years after anti-reflux surgery. Here is a presentation of Dr. Zhonggao Wang and his team’s work and would call attention to the public so as to recognize this relatively unknown entity — a treatable condition occurring from human itself, but not from outside surroundings as smoking or haze does.

关键词： gastroesophageal reflux     airway     pharyngeal nozzle     micro-aspiration     asthma    

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标题 作者 时间 类型 操作

Prevalence of asthma symptoms in Golestan schoolchildren aged 6–7 and 13–14 years in Northeast Iran

null

期刊论文

Lung function and air pollution exposure in adults with asthma in Beijing: a 2-year longitudinal panel

期刊论文

Not asthma, but GERD: case report

WANG Zhonggao

期刊论文

Efficacy and safety of benralizumab in patients with eosinophilic asthma: a meta-analysis of randomized

null

期刊论文

A belated revelation: from gastroesophageal reflux derived asthma to laryngotracheal irritation even

WANG Zhonggao

期刊论文

Cerebral regional and network characteristics in asthma patients: a resting-state fMRI study

Siyi Li, Peilin Lv, Min He, Wenjing Zhang, Jieke Liu, Yao Gong, Ting Wang, Qiyong Gong, Yulin Ji, Su Lui

期刊论文

Outcome of Stretta radiofrequency and fundoplication for GERD-related severe asthmatic symptoms

null

期刊论文

Tim-3 mRNA expression in peripheral blood lymphocytes from asthmatic patients

Xiaoxia LU, Weikun HU, Shengdao XIONG, Guopeng XU, Fen LAN

期刊论文

Insult of gastroesophageal reflux on airway: clinical significance of pharyngeal nozzle

null

期刊论文