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Objective To evaluate the consistency between Kyoto classification scoring of gastritis and modified Kyoto classification scoring of gastritis in directly determining Helicobacter pylori (Hp) infection under white light endoscopy by endoscopists with 13C- urea breath test, and to clarify the clinical application value of the modified Kyoto classification scoring of gastritis. Methods Digestive endoscopists in a county hospital in Chongqing received special training on the Kyoto classification of gastritis. Patients who underwent both the upper gastrointestinal endoscopy and 13C- urea breath test within one week were screened. At the same time, the Kyoto classification scoring of gastritis and the modified Kyoto classification scoring of gastritis were used to score the endoscopic gastrie mucosa characteristics of the target population. The total score was calculated and compared with the 13C- urea breath test. Results A total of 1 342 patients were included in the study. The sensitivity of the Kyoto classification scoring of gastritis and the modified Kyoto classification scoring of gastritis for the diagnosis of Hp infection under white light endoscopy were 74.03% and 90.70%, the specificity was 95.85% and 95.39%, and the positive predictive values were 80.93% and 82.39%, the negative predictive values were 93.94% and 97.73%, respectively. The sensitivity, negative predictive value and AUC of the modified Kyoto classification scoring of gastritis in the diagnosis of Hp infection under white light endoscopy had statistical significance compared with the Kyoto classification scoring of gastritis (all P < 0.01).Conclusion For endoscopists receiving special training for Kyoto classification of gastritis, the modified Kyoto classification scoring of gastritis yields high diagnostic consistency in directly determining Hp infection under white light endoscopy. [ABSTRACT FROM AUTHOR]

Ventilator associated pneumonia (VAP) is an infectious disease in clinic with high incidence rate (about 5%-40%) and mortality (about 10%), which is mainly caused by bacteria. At present, the clinical diagnosis of VAP depends on the microbial pathogen diagnosis of sputum samples from the lower respiratory tract. The whole process takes more than 24 hours, which is easy to cause antibiotic misuse and initial treatment failure. In recent years, breath test has received widespread attention due to its non-invasive and convenient characteristics, which attempt to screen and diagnose VAP through analysis of volatile organic compounds (VOCs) in exhalation. Therefore, the research on characterization of VOCs released by VAP pathogens has certain guiding significance for the related breath tests. In this study, the main VAP pathogenic bacteria, including P. aeruginosa, S. aureus, E. coli, E. cloacae, K. pneumoniae, A. baumannii, S. maltophilia, and S. epidermidis, were cultured in tryptic soy broth (TSB) culture medium in vitro, and their headspace samples were obtained after 10 hours of shaking culture. Then, non-targeted detection of VOCs in the headspace was performed by using solid phase microextraction coupled to gas chromatography-mass spectrometry (SPME-GC-MS). It was found that a total of 44 differential amounts of VOCs were released by the 8 strains. Subsequently, these bacterial VOCs were classified and discussed according to ketones, aldehydes, ethers, alcohols, acids, esters, alkanes, benzenes, amides, and (nitrogen-containing) heterocycles. These results showed that there was some consistency in the types of VOCs released by the 8 VAP pathogens, such as the production of dimethyl ether and methyl mercaptan. However, there were some differences in the released VOCs among the different pathogens. For example, only S. aureus released 2-butanone and 3-hydroxy-2-butanone, only E. coli produced acetic acid, only E. coli, S. maltophilia, and S. aureus produced N-nenenebc methylformamide. In addition, K. pneumoniae and P. aeruginosa released dimethyl disulfide (DMDS), and S. maltophilia released dimethyl trisulfide (DMTS). This study systematically reports the similarities and differences in the types of VOCs released by VAP pathogens, providing a reference and foundament for VAP related breath research. In the future, it is expected to achieve rapid and non-invasive screening of VAP through exhalation. However, this study did not detect clinically isolated strains or samples, and it was not possible to verify whether there were any differences in results between standard strains and clinical strains. In future work, it is necessary to consider the characteristic spectra of clinically isolated strains and the landmark VOCs in the exhalation of clinical patients. [ABSTRACT FROM AUTHOR]

Background Spirometry is the most common and extensively used pulmonary function test method, whose quality control is the cornerstone for its promotion and application. The report format is a key factor associated with the quality control of spirometry, but it is generally various in China, which is not conducive to the popularization and application of spirometry. Objective To assess the current status of report formats for spirometry in Chinese mainland. Methods The reports of spirometry were collected from some hospitals in China between April 2016 and December 2018, which are composed of four parts, including the general demographic information, test indicators, graphs, and results evaluation. The key and/or essential information for each part is as follows: (1) the general demographicinformation part: sex, height, BMI, age and the reference source; (2) test indicators part: forced vital capacity (FVC) , forced expiratory volume in 1 second (FEV1) , the ratio of FEV1/FVC or FEV1/VCmax, maximal mid-expiratory flow〔FEF25%-75%, forced expiratory flow at 50% (FEF50%) , forced expiratory flow at 75% (FEF75%) 〕, peak inspiratory flow (PIF) and forced expiratory time (FET) ; (3) graphs part: flow-volume curve (F-V curve) and volume-time curve (V-T curve) ; (4) results evaluation part: subjects cooperation, test quality control level, and physician interpretation. The differences in the report format of spirometry were compared by region and hospital level in this study. Results In total, 1 562 spirometry reports from 1 562 hospitals (one from each hospital) across China were enrolled, but only 0.4% provided all key indicators. (1) For the general demographic information part, only 27.7% reports provided complete key indicators, which differed significantly by regions and the level of hospitals (P

Objective: To explore the clinical research of compound glutamine combined with quadruple therapy in the treatment of peptic ulcer. Methods: A total of 80 patients with peptic ulcer treated in our hospital from March 2019 to March 2022 were selected as the research objects. The patients were divided into conventional group and combined group, 40 cases in each group. The routine group was treated with quadruple therapy, and the combination group was treated with compound glutamine on the basis of the control group. The clinical efficacy and clinical indicators, carbon-13 breath test, changes in inflammatory factor levels, quality of life and recurrence rate were compared between the two groups of patients. Results: In this study, 80 patients underwent carbon-13 breath test, and there was no difference in the positive rate of Hp between the two groups (P>0.05). <0.05); after treatment, the total effective rate of the combined group was 95%, and the total effective rate of the conventional group was 75%, which was better than that of the conventional group (P<0.05); before treatment, there was no difference in the levels of inflammatory factors between the two groups ( P>0.05), after treatment, the levels of hs-CRP, IL-6, and TNF-α in the two groups decreased, and the combination group was better than the routine group (P<0.05); before treatment, the quality of life in the two groups was different There was no significant difference in the dimension scores (P>0.05). After treatment, the scores of each dimension in the two groups were improved, and the combination group was higher than that in the routine group (P<0.05). After the treatment, the patients in the two groups were followed up. The recurrence rate was 5%, and the ulcer recurrence rate in the conventional group was 25%, which was lower in the combined group than in the conventional group (P<0.05). Conclusion: In clinical treatment, compound glutamine combined with quadruple therapy can reduce the positive rate of Hp in patients, effectively reduce the inflammatory response of the body, improve the quality of life of patients, the clinical effect is obvious, and the recurrence rate is low. [ABSTRACT FROM AUTHOR]

Pleural mesothelioma (PMe) was associated with asbestos exposure.The Diagnosis of PMe is difficult due to the lack of specificity of clinical signs and symptoms, although there are many tools available for early diagnosis of mesothelioma. Most PMe patients are diagnosed at an advanced stage. This article reviews advances in strategies for early diagnosis of mesothelioma, focusing on breath analysis, early diagnosis of pleural effusion cytology in patients with mesothelioma, serum biomarkers and miRNA.

Objectives: To explore the diagnostic efficacy of serum 14-3-3β protein combined with fractional exhaled nitric oxide (FeNO) and conventional ventilatory lung function parameters in diagnosing bronchial asthma (referred to as "asthma") in children., Methods: A prospective study included 136 children initially diagnosed with asthma during an acute episode as the asthma group, and 85 healthy children undergoing routine health checks as the control group. The study compared the differences in serum 14-3-3β protein concentrations between the two groups, analyzed the correlation of serum 14-3-3β protein with clinical indices, and evaluated the diagnostic efficacy of combining 14-3-3β protein, FeNO, and conventional ventilatory lung function parameters for asthma in children., Results: The concentration of serum 14-3-3β protein was higher in the asthma group than in the control group ( P <0.001). Serum 14-3-3β protein showed a positive correlation with the percentage of neutrophils and total serum immunoglobulin E, and a negative correlation with conventional ventilatory lung function parameters ( P <0.05). Cross-validation of combined indices showed that the combination of 14-3-3β protein, FeNO, and the percentage of predicted value of forced expiratory flow at 75% of lung volume had an area under the curve of 0.948 for predicting asthma, with a sensitivity and specificity of 88.9% and 93.7%, respectively, demonstrating good diagnostic efficacy ( P <0.001). The model had the best extrapolation., Conclusions: The combination of serum 14-3-3β protein, FeNO, and the percentage of predicted value of forced expiratory flow at 75% of lung volume can significantly improve the diagnostic efficacy for asthma in children. Citation:Chinese Journal of Contemporary Pediatrics, 2024, 26(7): 723-729 .

Copyright of Journal of Modern Laboratory Medicine is the property of Journal of Modern Laboratory Medicine Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To investigate the expression of cyclinD1 and matrix metalloproteinase-9 (MMP-9) in helicobacter pylori (HP) infected gastric carcinoma and its clinical significance. Methods: 80 patients with gastric cancer who were treated in Lanzhou University First Hospital from December 2016 to June 2018 were selected and their pathological tissues were collected. C-14 breath test and modified Giemsa staining were used to detect the status of HP infection. Immunohistochemistry was used to detect the expression of cyclinD1 and MMP-9 in gastric cancer tissues. The relationship between HP infection and cyclinD1, MMP-9 expression and clinicopathological features of patients with gastric cancer was analyzed. The correlation between HP infection and cyclinD1, MMP-9 expression in patients with gastric cancer was analyzed. Results: In 80 patients with gastric cancer, 56 cases were positive for HP infection (70.00%) and 24 cases were negative (30.00%). The positive rate of HP infection in gastric cancer patients with lymph node metastasis and depth of invasion with T3+T4 was higher than that in gastric cancer patients without lymph node metastasis and depth of invasion with T1+T2 (P<0.05). In 80 patients with gastric cancer, 45 cases were positive for cyclinD1 expression (56.25%), 35 cases were negative expression (43.75%), 65 cases were positive for MMP-9 expression (81.25%), 15 cases were negative expression (18.75%). The positive expression rates of cyclinD1 and MMP-9 in gastric cance patients with TNM stage for III+IV stage, low differentiation, lymph node metastasis and depth of invasion with T3+T4 were significantly higher than that of TNMstage for I+II stage, moderately high differentiation, no lymph node metastasis and depth of invasion with T1+T2 (P<0.05). The positive rate of cyclinD1 and MMP-9 in HP positive group was significantly higher than that in HP negative group (P<0.05). Pearson correlation analysis showed that HP infection was positively correlated with cyclinD1 and MMP-9 expression in patients with gastric cancer (P<0.05). Conclusion: HP infection in patients with gastric cancer is related to lymph node metastasis and depth of invasion. The expression of cyclinD1 and MMP-9 is related to TNMclinical stage, differentiation, lymph node metastasis and depth of invasion.Moreover, HP infection is positively correlated with cyclinD1 and MMP-9 expression in gastric cancer patients. [ABSTRACT FROM AUTHOR]

Objective: To investigate the correlation between Helicobacter pylori(Hp) infection and serum levels of interleukin-32(IL-32), interleukin-1β(IL-1β) and tumor necrosis factor-α(TNF-α) in patients with gastric cancer. Methods: 151 patients with gastric cancer(gastric cancer group) and 100 healthy people(control group) were selected as the subjects of study. Hp infection was detected by14 C urea breath test, and Hp-infected U value was recorded. According to the results of detection, gastric cancer was divided into Hp positive group(119 cases) and Hp negative group(32 cases). Fasting venous blood was collected and serum levels of IL-32, IL-1β and TNF-α were measured by enzyme-linked immunosorbent assay. The differences of serum IL-32, IL-1β TNF-α levels and Hp-infected U value between gastric cancer group and control group, and Hp negative group and Hp positive group were compared. Pearson correlation analysis was used to analyze the correlation between serum levels of IL-32, IL-1β, TNF-α and Hp-infected U value in patients with gastric cancer. Results: The levels of serum IL-32, IL-1β, TNF-α and Hp-infected U value in gastric cancer group were higher than those in control group(P<0.05). The levels of serum IL-32, IL-1β, TNF-α and Hp-infected U value in Hp positive group were higher than those in Hp negative group(P<0.05). The levels of serum IL-32, IL-1β and TNF-α were positively correlated with the Hp-infected U value(r=0.585,0.428, 0.406, P <0.05). Conclusion: Hp infection in patients with gastric cancer can increase the levels of serum IL-32, IL-1β and TNF-α. Hp infection, IL-32, IL-1 beta and TNF-alpha may promote the occurrence and progression of gastric cancer through combined action. [ABSTRACT FROM AUTHOR]

Objective: To analyze the risk factors of colorectal adenoma and its correlation with helicobacter pylori(Hp) infection.Methods: 180 patients with colorectal adenoma who were treated from June 2018 to December 2018 and 152 patients who received colonoscopy without abnormality in our hospital were selected as the study group and control group. The general data of the two groups were collected and compared. The Hc infection was detected by 14 C urinary nitrogen breath test. The risk factors of colon adenoma were analyzed by multivariate logistic regression. Results: Male, age, body mass index of 24 kg/m~2, abdominal obesity, drinking, smoking, like eating red meat, like eating fruits and vegetables, hyperlipidemia, diabetes, fecal occult blood positive, a positive family history of cancer and Hp were influencing factors for colorectal adenoma, like eating fruits and vegetables was the protective factors. The HP positive rate group had >1 cm adenoma, multiple adenomas, and the left colon rate was higher than the HP negative group(P<0.05). There was no statistically significant difference in the pathological types of adenoma pedicle type and adenoma in patients with intestinal adenoma between the Hp positive group and the Hp negative group(P>0.05). Conclusion: Colorectal adenoma is related to a variety of risk factors,Hp infection may increase the risk of developing colorectal adenoma. In order to reduce the potential risk of colon cancer, this high-risk group should be the focus of screening for colorectal adenoma. [ABSTRACT FROM AUTHOR]

Background: The promising effects of smoking cessation for coronary artery disease (CAD) patients include decreased risks of subsequent clinical events and mortality. However, most CAD patients continue to smoke after being hospitalized for a cardiac event. Purpose: To explore the factors that are associated with successful smoking cessation in CAD male patients at 3 months after hospital discharge. Method: A correlational design was applied. A convenience sample (N = 165) was recruited from the cardiac wards of two medical centers in northern Taiwan and 154 of these completed the 3-month follow up. The medical charts of the participants were reviewed to obtain their disease-related factors. All of the participants finished one questionnaire during their hospital stay. This questionnaire collected data on participant demographics, smoking and quitting history, and nicotine addiction as well as the causal attribution of heart disease to smoking, importance of smoking outcomes, self-efficacy for quitting, and post-discharge intention to quit. Information on post-discharge smoking status was collected via phone calls to the participants at three-months after hospital discharge and, for participants who claimed to have not smoked since discharge, was further confirmed by measuring their expired CO (carbon monoxide) level. Multiple logistic regression analysis was used to examine the identified predictors of successful smoking cessation. Results: The 3-month self-reported rate of abstinence was 37.01% (n = 57), while the rate of abstinence as confirmed by expired CO was 31.17% (n = 48). Those with acute coronary syndrome, longer hospital stays, and higher postdischarge intention to quit were more likely to quit smoking. Conclusions / Implications for Practice: The abstinence rate as confirmed by expired CO for hospitalized male patients with CAD is more accurate than the rate obtained by self-reporting. Healthcare providers should stress the importance of smoking cessation, especially for those who have been diagnosed with angina, are hospitalized for shorter periods of time, and indicate a lower post-discharge intention to abstinence. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Modern Laboratory Medicine is the property of Journal of Modern Laboratory Medicine Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In order to find a simple and convenient physical strength evaluation method, various physical strength evaluation methods presented at home and abroad are analyzed, and relatively integrated heart rate is put forward as evaluation index for physical strength evaluation. Laboratory equipment is optimized. Treadwheel and polar heart rate monitor watch are selected as experimental equipment and the design of experiment is completed. Common physical strength evaluation methods include breath analysis test, energy metabolism, and heart rate. The first two are used for the job since they can't be performed by continuous dynamic measurement; also have complex experiment process which affects the normal activities of the operator. Besides, some operators can not adapt to the measurements. Experiment confirms the linear relationship between physical strength and relatively integrated heart rate. Furthermore, relatively comprehensive rate considers the physiological differences between individual operators, so, it is more scientific and reliable. Moreover, the experiment process is quite simple. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the effects of Helicobacter pylori ( H. pylori) infection and eradication therapy on small intestinal bacterial overgrowth (SIBO). Methods: From September to December 2021, patients with abdominal symptoms who received 13 C urea breath test at the Department of Gastroenterology in Peking University First Hospital were enrolled. 13 C urea breath test was used to detect H. pylori infection and patients were divided into H. pylori positive and negative groups accordingly. Lactulose hydrogen methane breath test was performed to determine SIBO. H. pylori positive patients were treated with quadruple therapy including amoxicillin, metronidazole, rabeprazole and bismuth potassium citrate. 13 C urea breath test and lactulose hydrogen methane breath test were reexamined 6 weeks after the treatment. Results: A total of 102 patients (49 males and 53 females) were enrolled, with a mean age of (42.1±9.9) years. Among them, 49 patients were H. pylori negative and 53 were H. pylori positive. Moreover, 47 patients were SIBO positive and 55 were SIBO negative. There was no significant difference in age, sex, body mass index, abdominal symptoms and the diagnosis of chronic atrophic gastritis between H. pylori positive and negative patients at the enrollment (all P >0.05). The detection rate of SIBO in H. pylori infected patients was higher than that in uninfected patients, and the difference was statistically significant (60.4% vs 30.6%, P =0.003). Patients with SIBO had significantly more frequent abdominal distension (36.2% vs 10.9%, P =0.002) and constipation (27.7% vs 1.8%, P <0.001) than patients without SIBO. The rate of SIBO after H. pylori eradication treatment was significantly lower than that before treatment (20.8% vs 60.4%, P <0.001). The remission rate of SIBO after eradication therapy was 66.7% (20/30). Besides, patients had obvious improvement of constipation (6.0% vs 18.9%, P =0.008), and the incidence of other abdominal symptoms decreased to various degrees including diarrhea, abdominal pain, abdominal distention and poor appetite. Conclusion: H. pylori infection increases the risk of SIBO, and the quadruple regimen containing amoxicillin and metronidazole has a therapeutic effect for patients with H.pylori infection and concomitant SIBO.

Objectives: To study the association of fractional exhaled nitric oxide (FeNO) and nasal nitric oxide (nNO) with asthma control and their value in the diagnosis of allergic rhinitis in children., Methods: A total of 186 children aged 5-12 years, who attended the outpatient service of the Department of Respiration, Shanghai Children's Hospital due to bronchial asthma and/or allergic rhinitis or who underwent physical examination, were enrolled as subjects, with 52 children in the asthma group, 60 children in the asthma+allergic rhinitis group, 36 children in the allergic rhinitis group, and 38 children in the control group. FeNO, nNO, and pulmonary function were compared between groups., Results: The asthma+allergic rhinitis, asthma, and allergic rhinitis groups had a significantly higher level of FeNO than the control group ( P <0.05). The asthma+allergic rhinitis and allergic rhinitis groups had a significantly higher level of nNO than the asthma and control groups ( P <0.05). The uncontrolled asthma and partially controlled asthma groups had significantly higher levels of FeNO and nNO than the completely controlled asthma group ( P <0.05). The receiver operating characteristic (ROC) curve analysis showed that nNO had an area under the ROC curve of 0.91, with a sensitivity of 80.0% and a specificity of 89.5% in the diagnosis of allergic rhinitis in children with asthma ( P <0.05)., Conclusions: The combined measurement of nNO and FeNO can be used to evaluate the control of asthma, and the measurement of nNO can help with the diagnosis of allergic rhinitis in children with bronchial asthma.

Lung cancer is a leading cause of cancer-related morbidity and mortality globally, which is the biggest menace to the health and life of the population. Screening and early detection of lung cancer are effective in reducing its mortality, and the measurement of volatile organic compounds (VOCs) has become a promising clinical means for early detection, course detection and prognosis management of lung cancer, with advantages of rapid speed, non-invasiveness and convenience. Now, a variety of VOCs collection ways and analysis methods have emerged at home and abroad. This report summarized three aspects, including VOCs collection, multiple methods of analysis and progress in the diagnosis and treatment of lung cancer. At last, we discussed the limitations and prospects of VOCs analysis.
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Objectives: To study the association between milk consumption and lactose malabsorption in Indonesian children aged 3-12 years., Methods: This cross sectional study was conducted in randomly selected presumed healthy children with good nutritional status aged 3-12 years in Central Jakarta, Indonesia ( n =174), including 72 children aged 3-5 years and 102 children aged 6-12 years., Results: The prevalence of lactose malabsorption in children aged 3-5 years and children aged 6-12 years was 20.8% (15/72) and 35.3% (36/102), respectively. There was no association between milk or milk product consumption and lactose malabsorption ( P >0.05). In the 51 children with lactose malabsorption, the predominant clinical symptoms were diarrhea (62%), abdominal pain (52%), and nausea (5%) during the hydrogen breath test., Conclusions: There is no association between milk consumption and lactose malabsorption in Indonesian children aged 3-12 years, suggesting that genetic predisposition may be more important than adaptive mechanisms to lactose consumption.

Objective: To measure the normal value of nasal nitric oxide（nNO） concentration of 50 healthy adults in Dalian. By investigating the changing trend of nitric oxide accumulation concentration in the nasal cavity when changing the duration of nasal non-ventilation under quiet state, to provide ideas for the noninvasive detection of the concentration of nitric oxide in the sinus and the patency of the sinus ostium. Methods: ①The left and right nNO concentrations（LnNO, RnNO） of 50 healthy subjects in Dalian were measured by Sunvou-CA2122（Wuxi）, and the LnNO₁₀, LnNO₂₀, and LnNO₃₀ were measured through the left nasal cavity when the the time of nasal non ventilation was set for 10 s, 20 s, 30 s respectively. Ten subjects with good cooperation extended the time of nasal non ventilation to 50 s, and the measured nNO value was denoted as LnNO₅₀. ②Statistical analysis was performed by SPSS 19.0, and differences between two sides of nNO were analyzed by t -test, and the trend of changes in concentration of NO accumulation in the nasal cavity when changing the duration of nasal nonventilation was investigated by One-way repeated measures ANOVA. Results: ①The mean LnNO concentration in 50 healthy subjects was （383.32±126.35） ×10⁻⁹, the mean RnNO concentration was （395.26±124.32） ×10⁻⁹, and there was no significant difference between the two side（ P >0.05）, and the mean nNO was （389.29±124.85） ×10⁻⁹. ②The mean nNO concentration measured at 10, 20, and 30 seconds nasal nonventilation were （984.54±477.69） ×10⁻⁹ for LnNO₁₀, （1527.32±717.25） ×10⁻⁹ for LnNO₂₀, （2183.26±946.21） ×10⁻⁹ for LnNO₃₀, and（3083.00±1905.62） ×10⁻⁹ for LnNO₅₀ measured at prolonging nasal nonventilation time to 50 seconds for ten of these subjects; The difference in the presence of increased nNO concentrations measured after prolonged nasal nonventilation was statistically significant（ P <0.01）. Conclusion: ①The values of nNO of 50 healthy individuals in Dalian were（389.29±124.85） ×10⁻⁹. ②In healthy individuals, nNO can be measured unilaterally instead of bilaterally. ③In quiet condition, the duration of nasal nonventilation was prolonged for a certain period of time, and the nNO concentration showed a gradually increasing trend. It is expected to provide ideas for noninvasive detection of NO concentration in nasal sinuses and patency of nasal sinuses., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To investigate the value of fractional exhaled nitric oxide (FeNO) in the diagnosis of occupational asthma (OA) , and analyze the correlation between FeNO and pulmonary function in patients with OA. Methods: In October 2019, clinical datas, including pulmonary function, FeNO and blood routine test of 64 workers who applied for the diagnosis of OA in January 2012 to October 2018 in our hospital were collected. The diagnostic value of FeNO in OA was evaluated, FeNO and pulmonary function in different degrees of OA were compared, and the correlations were analyzed. Results: The FeNO value of OA patients [ (58.4±13.1) ppb] was higher than non-OA patients[ (30.1±13.7) ppb] ( P <0.05) . The FeNO value of patients with moderate OA [ (68.9±13.8) ppb] was higher than that of patients with mild OA[ (54.2±10.3) ppb] ( P <0.05) . The area under the receiver operating characteristic (ROC) curve of FeNO in the diagnosis of OA was 0.9453 (95% CI : 0.8928-0.9978, P <0.05) , the optimal cut-off point is 47.5 ppb, and the sensitivity and specificity are 88.6% and 89.7% respectively. There was negative correlation between FeNO and FEV1% pred ( r =-0.454, P <0.01) . Conclusion: FeNO has a clinical application value in the diagnosis of OA. It should be combined with pulmonary function index in practical work.

Objective: To evaluate the diagnostic value of hydrogen sulfide breath test(SBT) for small intestinal bacterial overgrowth (SIBO). Methods: College students were enrolled to complete gastrointestinal symptom scale, food frequency questionnaire, lactulose hydrogen- methane breath test (LHMBT) and SBT. Based on the correlation between hydrogen sulfide(H 2 S) and hydrogen or methane gas,the receiver operating characteristic (ROC) curve of H 2 S was drawn and diagnostic criteria of SBT was defined. Results: A total of 300 subjects including 84 males and 216 females with age 17-32 (21.6±2.4) years were enrolled from April 2019 to December 2019 and divided into two groups.Two hundred and three patients reported SIBO discomforts with 99 (48.8%) LHMBT positive, while 38 (39.2%) were LHMBT positive in 97 health controls. Rise of H 2 S at 90 min was positively related with that of hydrogen ( r =0.516, P <0.01), and H 2 S levels at 90 min were positively correlated with methane ( r =0.632, P <0.01). A rise in H 2 S of ≥25.0 ppb or H 2 S levels ≥62.5 ppb at 90 min during lactulose breath test was considered positive for SIBO, that sensitivity, specificity and accuracy were 66.4%,79.1% and 73.3% respectively. H 2 S levels were significantly related to the amount of Vitamin B 12 intake ( P =0.011). H 2 S-positive subjects exhibited a constipation-predominant pattern. Conclusion: SBT is consistent with LHMBT, especially in constipation-predominant patients, which may provide a reference to the diagnosis of SIBO.

Objective: In this study, the level of nasal nitric oxide（nNO）, exhaled nitric oxide（eNO）, and exhaled carbon monoxide（eCO） in patients with allergic rhinitis（AR） were tested, to explore the correlation between nNO, eNO, eCO and AR. Method: A total of 60 AR patientswere enrolled as the allergy group and then divided into mild, medium and severe subgroups according to symptom scores. 30 healthy volunteers were recruited as control group. The levels of nNO, eNO and eCO were detected in AR group, AR subgroups and control group. Result: The levels of nNO, eNO and eCO in AR group were higher than those in control group（ P <0.05）. nNO, eNO and eCO levels were positively correlated with symptom scores（ P <0.05）.Pairwise comparison was used between mild, moderate and severe subgroups. The difference of both nNO and eNO levels between mild, moderate and severe AR subgroups was statistically significant, severe>and moderate>were mild（ P <0.05）, but there was no significant difference in eNO levels between the mild AR subgroup and the control group（ P >0.05）. Level of eCO in severe AR subgroup was higher than those in moderate and mild AR subgroups（ P <0.05）, but there was no significant difference between mild, moderate AR subgroups and control group（ P >0.05）. nNO, eNO and eCO levels were used as indicators to evaluate the severity of AR, and the receiver operating characteristic（ROC） curves were plotted. The area under curve（AUC） was 0.978, 0.786 and 0.577, respectively. Taking eCO level as the indicator for disease assessment of severe AR, the AUC was 0.728. It showed that nNO had a high accuracy in evaluating the severity of AR, eNO had a certain accuracy in evaluating the severity of AR, and eCO had a certain accuracy in the assessment of severe AR. Conclusion: The detection of nNO, eNO and eCO levels can be used as an objective assessment method of the severity of AR., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: Long-term proton pump inhibitor(PPI) therapy may increase the risk of small intestinal bacterial overgrowth(SIBO). Few studies on the effect of on-demand and continuous PPI therapy are available in elderly. To investigate the prevalence of SIBO and the effect of on-demand and continuous PPI therapy on SIBO in elderly. Methods: A total of 200 elderly outpatients admitted to Department of Gastroenterology at the Second Medical Center of PLA General Hospital were enrolled and divided into 3 groups: continuous PPI group, on-demand PPI group and control group. SIBO was diagnosed according to methane and hydrogen lactulose breath test (LBT).The prevalence of SIBO in the 3 groups was analyzed. Results: The prevalence of SIBO was 71.5% in 200 elderly. PPI therapy and diabetes mellitus (DM) were independent risk factors for SIBO. The prevalence of SIBO was 77.1% (108/140) in elderly who underwent long-term PPI therapy and 58.3% (35/60) in those without PPI therapy ( P< 0.01).The prevalence of SIBO was significantly higher in continuous PPI therapy group than that in on-demand PPI group and control group(88.6% vs. 65.7% and 58.3%, all P< 0.01).However, no significant difference was found in the prevalence of SIBO between on-demand PPI group and control group ( P> 0.05). In elderly who underwent long-term PPI therapy, the prevalence of SIBO increased significantly if administration time was longer than 61 months. Conclusions: SIBO usually occurs in elderly patients who receive continuous PPI rather than on-demand use. If elderly require long-term PPI therapy, on demand administration is suggested as long as primary diseases are properly treated.

Objective: To determine the acute effects of exposure to fine particulate matter(PM&#95;(2. 5))on children&apos;s respiratory inflammation and oxidative stress., Methods: This study was a cross-sectional study. A total of 115 9-12 year-old children in boarding schools were selected as the research objects. The PM&#95;(2. 5) exposure concentration was continuously monitored for 5 days, and the individual exposure level was estimated by using the time activity mode and the PM&#95;(2. 5) microenvironment concentration. Exhaled breath condensate(EBC) and urine samples were collected on the 5 th day. Fractional exhaled nitric oxide(FeNO) was detected by a FeNO detector, EBC pH was measured by microelectrode potential analysis method, urine 8-hydroxydeoxyguanosine(8-OHdG) was detected by ELISA kit, and the effect of PM&#95;(2. 5) on three effect indicators was analyzed by a linear model., Results: The highest individual exposure concentration was 102 μg/m~3 4 days before the physical examination, and the lowest individual exposure concentration was 9. 19 μg/m~3 2 days before the physical examination. The FeNO of boys was higher than that of girls, and the difference was significant(P&lt;0. 05). There were no significant differences between gender in other indicators. Correlation analysis found that there was a significant correlation between the exposure concentration of PM&#95;(2. 5) and FeNO, and the strongest correlation was 0 to 2 days before the physical examination with each 10 μg/m~3 increase in PM&#95;(2. 5) caused a 29. 7% increase in FeNO, other indicators did not change significantly. Gender subgroup analysis found that PM&#95;(2. 5) had a significant effect on boys&apos; FeNO, every 10 μg/m~3 increase in PM&#95;(2. 5) during the study period can cause an increase in boys&apos; FeNO of 3. 47%-50. 97%, but had no significant effect on all three indicators of girls., Conclusion: PM&#95;(2. 5) had significant effects on FeNO in healthy children with immediate and delayed effects, especially on boys.

Objective: To study the correlation between fractional exhaled nitric oxide (FeNO) and airway reversibility in children with IgE-mediated asthma., Methods: A total of 86 children, aged 6-14 years, who were initially diagnosed with acute attack of asthma from September 2016 to August 2018 were enrolled as subjects. According to the results of serum specific IgE, they were divided into IgE mediated group with 61 children and non-IgE mediated group with 25 children. According to the results of allergen detection, the IgE mediated group was further divided into four groups with one, two, three, and four or more positive allergens. FeNO and the parameters of pulmonary ventilation function before and after dilation test were measured. Pearson correlation analysis was used to evaluate the correlation of FeNO with each parameter of pulmonary function., Results: The IgE mediated group had significantly higher FeNO than the non-IgE mediated group (P<0.05). FeNO increased with the increase in the number of positive serum specific allergens (P<0.05). In the IgE mediated group, FeNO level was positively correlated with the change in forced expiratory volume in the first second (FEV1) and the improvement in percentage of predicted FEV1 after medication in bronchial dilation test (r=0.655 and 0.473 respectively, P<0.05). The FeNO level was not correlated with FEV1, percentage of predicted FEV1, peak expiratory flow (PEF), change in PEF after medication, percentage of predicted PEF (PEF%pred), and improvement in PEF%pred after medication (P>0.05). In the non-IgE mediated group, FeNO level was not correlated with the above indicators (P>0.05)., Conclusions: FeNO level is associated with the degree of allergies. For children with IgE-mediated asthma, FeNO is positively correlated with airway reversibility, which has a certain value in the diagnosis of asthma, disease evaluation, and understanding of airway reversibility. For children with non-IgE-mediated asthma, FeNO cannot be used to evaluate airway reversibility. These two types of asthma should be treated differently.

Objective: To explore the predictive significance of exhaled breath temperature (EBT) for airway inflammation changes in children with asthma., Methods: A total of 60 children with asthma who met the inclusion criteria at the first visit were chosen as the asthma group, and 60 healthy children were selected as the control group. The EBT level was measured by the latest third-generation product (X-halo). The Childhood Asthma Control Test (C-ACT) score was recorded. EBT level and C-ACT score were compared between the asthma and control groups. At the subsequent visit one month later, the children were divided into well-controlled, partially-controlled, and uncontrolled groups according to their C-ACT scores. The EBT level and the FeNO level of the three groups were measured. EBT level and C-ACT score were compared among the three groups. The correlation between EBT and FeNO was analyzed. The data of initial diagnosis were reviewed, the EBT level and C-ACT score at the first visit were compared among the three groups, and the differences in EBT level and C-ACT score among the three groups at the second and first visits were evaluated., Results: At the first visit, the asthma group had a significantly higher EBT and a significantly lower C-ACT score compared with the control group (P<0.05). At the time of the subsequent visit, there was a significant difference in EBT level between the three groups, i.e., uncontrolled group > partially-controlled group > well-controlled group (P<0.05), and there was also a significant difference in C-ACT score between the three groups, i.e., well-controlled group > partially-controlled group > uncontrolled group (P<0.05). There were no significant differences in EBT level and C-ACT score at the first visit between the three groups. From the first visit to the subsequent visit, EBT level was significantly decreased in the well-controlled group (P<0.05), but significantly increased in both partially-controlled group uncontrolled groups (P<0.05); C-ACT score was significantly increased in the well-controlled and partially-controlled groups (P<0.05), but significantly decreased in the uncontrolled group (P<0.05). EBT and FeNO levels at the subsequent visit were positively correlated with each other in the uncontrolled group (P<0.05)., Conclusions: EBT has predictive significance for the changes in airway inflammation in children with asthma.

Objective: To study the clinical value of combined measurement of fractional exhaled nitric oxide (FeNO) and nasal fractional exhaled nitric oxide (FnNO) and its correlation with the level of asthma control., Methods: A total of 120 children who were diagnosed with asthma from January to June, 2018 and were in the chronic persistent stage were enrolled as subjects. The childhood asthma control test (C-ACT) was performed for all the 120 children. According to the C-ACT score, these children were divided into 4 groups: complete control group with a C-ACT score of >23, partial control group with a C-ACT score of 20-23, and uncontrolled group with a C-ACT score of ≤19 (n=40 each). According to the presence or absence of allergic rhinitis, they were divided into 2 groups: non-rhinitis group with 55 children and rhinitis group with 65 children. A total of 40 children who underwent physical examination during the same period of time were enrolled as the control group. FeNO and FnNO levels were measured for all the 120 children., Results: The uncontrolled group had the highest level of FeNO, followed by the partial control group and the complete control group (P<0.05). The uncontrolled and partial control groups had a significantly higher level of FeNO than the control group (P<0.05). The uncontrolled and partial control groups had a significantly higher level of FnNO than the complete control and control groups (P<0.05). The rhinitis group had significantly higher FeNO and FnNO levels than the non-rhinitis group (P<0.05)., Conclusions: FeNO can be used to assess the level of asthma control in children, and its combination with FnNO may be useful for the evaluation of the degree of inflammation in the upper and lower airways and provide a basis for the combined treatment of the upper and lower airways.

Objective: This work aimed to identify the risk factors of Helicobacter pylori (H. pylori) infection in preschool children and provide effective measures for the prevention and reduction of the incidence of H. pylori infections., Methods: A total of 204 children from two kindergartens in Suzhou city were recruited through a questionnaire survey. Risk factors were selected through the single factor paired data χ² test and multiple factor Logistic regression analysis. Oral and gastric H. pylori infections were detected by using H. pylori saliva detection (HPS) and ¹³C-urea breath test (¹³C-UBT). Special toothpaste for H. pylori control was selected for oral cleaning. Oral H. pylori infection rates at 2 months after special toothpaste treatment were examined by using HPS., Results: The high-risk factors of H. pylori infections among preschool children included poor personal hygiene habits, such as the nibbling of fingers and the avoidance of hand-washing before meals, diet, and parent's history of stomach disease. Among the 204 subjects enrolled in this study, 158 (77.45%), 37 (18.14%), and 28 (13.73%) were HPS positive, ¹³C-UBT positive, and HPS and ¹³C-UBT positive, respectively. The incidence of oral H. pylori infections was significantly higher than that of gastric H. pylori infections (P<0.01). The positive rate of infections significantly decreased after special toothpaste treatment (P<0.01). This result indicates that the intervention was effective., Conclusions: Children must receive education on good eating habits. Individualized dining habits or the use of public chopsticks must be implemented. H. pylori infections must be detected as early as possible. Specific toothpaste for oral cleaning must be selected. These approaches could drastically prevent or reduce the incidence of H. pylori infections among preschool children.

Objective: To study effects of ketotifen on fractional exhaled nitric oxide in patients with combined allergic rhinitis and asthma syndrome. Method: One hundred and twelve patients with asthma were selected from department of respiration, Affiliated Hospital of North China University of science and technology from January 2016 to 2017 in March. Eighty-four patients with allergic rhinitis were selected as the subjects, Randomly divided into two groups,including observed group(n=42) and control group(n=42).The control group was treated with antitussive,expectorant and inhaled corticosteroids, while the observed group in the control group combined with ketotifen 1 mg 2/ day oral treatment,the changes of FeNO and IL-17 in the two groups were compared after one month treament. Result: Before treatment, two groups of patients in general IL-17 and fractional exhaled nitric oxide ware no significant difference( P > 0.05).After treatment, compared to the control group, the observed group was significantly more effective,the difference was statistically significant( P <0.05);fractional exhaled nitric oxide in treatment group were lower than those in control group, the difference was statistically significant( P &lt;0.05, P < 0.01).And the observed group was lower than the control group, and the differences were statistically significant,t( P <0.05). Conclusion: Ketotifen significantly reduce the FeNO of allergic rhinitis and asthma syndrome, reduce airway inflammation., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To study the effect of monrustet on fractional exhaled nitric oxide and inflammatory cytokines in the elderly with bronchial asthma combined obstructive sleep apnea hypopnea syndrome. Method: 150 cases diagnosed as asthma were enrolled in this study. The patients were divided into bronchial asthma combined with OSAHS (n=72)and bronchial asthma (n=78). According to the different treatment methods , patients were divided into observation group and control group. Two groups were given common treatment with inhaled corticosteroids, and the observation group was taken orally montrast 10mg/night additionally. The fractional exhaled nitric oxide was detected before and after treatment. Serum were collected for detection of tumor necrosis factor alpha (TNR-α), Creactive protein (CRP) and interleukin 6 (IL-6), according to the sleep monitoring results, the sleep apnea low ventilation index (AHI) was calculated, and the changes of FeNO level,CRP,TNR-α,IL-6 and AHI were analyzed in the two groups. Result: Before treatment, the gender, age, degree of disease, FeNO level,TNR-α, CRP,IL-6 and AHI differences were not statistically significant in the two groups ( P >0.05).After treatment, both groups of FeNO, TNR-α,CRP,IL-6 and AHI decreased before treatment ( P < 0.05).The observation group was lower than the control group, and the difference was statistically significant (FeNO level, AHI P < 0.01,TNR-α, CRP,IL-6 P < 0.05). Conclusion: :Montelukast can reduce the FeNO level, the expression of TNR-α, CRP, and IL-6 of patients of bronchial asthma combined with OSAHS. Further improvement of the patient's condition, and provide reference value for the clinical medicine of patients with asthma., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To investigate the clinical value of combined determination of in vitro allergens and fractional exhaled nitric oxide (FeNO) in indentifying children at a high risk of asthma among those with recurrent wheezing., Methods: A total of 148 children with recurrent wheezing (0.5-6 years old) were enrolled as study subjects, and 80 healthy children who underwent physical examination were enrolled as the control group. Pharmacia UniCAP immunoassay analyzer was used to measure specific immunoglobulin E (sIgE). Nano Coulomb Nitric Oxide Analyzer was used to measure FeNO. The asthma predictive index (API) was evaluated., Results: The recurrent wheezing group had a significantly higher proportion of children with positive sIgE than the control group [68.9% (102/148) vs 11.3% (9/80); P<0.05]. The recurrent wheezing group also had significantly higher levels and positive rate of FeNO than the control group (P<0.05). The overall positive rate of API in children with wheezing was 32.4%, and the API-positive children had a significantly higher FeNO value than the API-negative children (51±6 ppb vs 13±5 ppb; P<0.05). The detection rate of API was 40.2% (41/102) in positive-sIgE children and 50.1% (38/73) in FeNO-positive children, and there was no significant difference between these two groups. The children with positive sIgE and FeNO had a significantly higher detection rate of API (81.4%) than those with positive sIgE or FeNO (P<0.05)., Conclusions: Combined determination of FeNO and in vitro allergens is more sensitive in detecting children at a high risk of asthma than FeNO or in vitro allergens determination alone and provides a good method for early identification, diagnosis, and intervention of asthma in children.

Objective: To evaluate the clinical value of fractional exhaled nitric oxide (FeNO) and impulse oscillometry (IOS) in screening out cough variant asthma (CVA) from patients with subacute cough. Methods: Patients with subacute cough were included from the outpatient department of Respiratory Medicine of Zhujiang Hospital of Southern Medical University from May to October in 2016. Based on "the guidelines for the diagnosis and treatment of cough (2015 edition)" , patients were classified into CVA group, and non CVP group with other causes of subacute cough. Lung function, bronchial provocation test, FeNO and IOS were measured. The diagnostic efficiency and optimal cut-off points of FeNO and IOS indicators to diagnose CVA from subacute cough were respectively assessed by the receiver operating characteristic (ROC) curves. Results: A total of 85 patients with subacute cough were included. Among them, 35 patients were diagnosed with CVA (CVA group), the others are classified as non CVP group ( n =50). In CVA group, the levels of FeNO and total respiratory impedance (Zrs) were significantly higher, while maximal mid expiratory flow (MMEF)%pred, and mid expiratory flow (MEF)75/50/25%pred, reactance at 5 Hz (X5) levels were significantly lower than those in non CVP group (all P <0.05). Furthermore, the FeNO had a positive correlation with Zrs and Fres (ρ=0.312, P =0.003 and ρ=0.318, P =0.003, respectively), had a negative correlation with X5 (ρ=-0.288, P =0.007). A ROC analysis indicated that the area under ROC curve (AUC) of FeNO in diagnosis of CVA was 0.786 (95% CI: 0.684-0.889), the best cut-off point of FeNO volume ratio was 24.5×10(-9). When FeNO volume ratio=24.5×10(-9,) the sensitivity of in diagnosing CVA was 77.8%, specificity was 70.0%. The AUC for Zrs and X5 were 0.679 and 0.687, respectively. The combination of FeNO and X5 had a greater AUC than other indicators (AUC: 0.817, 95% CI : 0.726-0.908), the sensitivity and specificity were 80.6% and 66.0%, respectively. Conclusion: Both FeNO level and IOS index can be used to screen CVA in patients with subacute cough, and the combination of both have better value in diagnosing CVA.

Background: The promising effects of smoking cessation for coronary artery disease (CAD) patients include decreased risks of subsequent clinical events and mortality. However, most CAD patients continue to smoke after being hospitalized for a cardiac event., Purpose: To explore the factors that are associated with successful smoking cessation in CAD male patients at 3 months after hospital discharge., Methods: A correlational design was applied. A convenience sample (N = 165) was recruited from the cardiac wards of two medical centers in northern Taiwan and 154 of these completed the 3-month follow up. The medical charts of the participants were reviewed to obtain their disease-related factors. All of the participants finished one questionnaire during their hospital stay. This questionnaire collected data on participant demographics, smoking and quitting history, and nicotine addiction as well as the causal attribution of heart disease to smoking, importance of smoking outcomes, self-efficacy for quitting, and post-discharge intention to quit. Information on post-discharge smoking status was collected via phone calls to the participants at three-months after hospital discharge and, for participants who claimed to have not smoked since discharge, was further confirmed by measuring their expired CO (carbon monoxide) level. Multiple logistic regression analysis was used to examine the identified predictors of successful smoking cessation., Results: The 3-month self-reported rate of abstinence was 37.01% (n = 57), while the rate of abstinence as confirmed by expired CO was 31.17% (n = 48). Those with acute coronary syndrome, longer hospital stays, and higher post-discharge intention to quit were more likely to quit smoking., Conclusions / Implications for Practice: The abstinence rate as confirmed by expired CO for hospitalized male patients with CAD is more accurate than the rate obtained by self-reporting. Healthcare providers should stress the importance of smoking cessation, especially for those who have been diagnosed with angina, are hospitalized for shorter periods of time, and indicate a lower post-discharge intention to abstinence.

Objective: To investigate the changes of pulmonary function and fractional exhaled nitric oxide (FeNO) in the standardized treatment of bronchial asthma in children., Methods: A total of 254 children who were newly diagnosed with acute exacerbation of bronchial asthma were selected as asthma group, and they were divided into two subgroups: asthma with concurrent rhinitis and asthma without concurrent rhinitis. All patients received the standardized management and treatment for one year. The pulmonary function parameters included forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), maximal mid-expiratory flow (MMEF), and mid-expiratory flow at 25%, 50%, and 75% of vital capacity (MEF25, MEF50, and MEF75). The FeNO levels were measured before treatment and at 3, 6, 9, and 12 months after treatment. Another 62 healthy children were selected as the control group, and the pulmonary function and FeNO levels were measured only once., Results: During one year of standardized treatment, FEV1, PEF, MMEF, MEF25, MEF50, and MEF75 gradually increased, and FeNO levels gradually decreased (P<0.05). Indicators of large airway function, such as FEV1 and PEF, almost returned to normal after 6 months of treatment; indicators of small airway function, such as MMEF, MEF25, MEF50, and MEF75 almost returned to normal after 9 months of treatment; there were no significant differences in the above indices between the asthma group and the control group after one year of treatment (P>0.05). However, the asthma group had a significantly higher FeNO levels than the control group after one year of treatment (P<0.05). The asthmatic patients with concurrent rhinitis had significantly higher FeNO levels than those without concurrent rhinitis before treatment and 3 months after treatment (P<0.05). Before treatment, there was a significant negative correlation between FeNO levels and pulmonary function parameters (P<0.05)., Conclusions: With the standardized treatment of bronchial asthma in children, pulmonary function parameters gradually increase and FeNO levels gradually decrease. The recovery of large airway function occurs earlier than the recovery of small airway function. Furthermore, the effect of rhinitis on airway responsiveness should be noted.

Objective: To analyse the changes and clinical implication of biomarkers in exhaled breath condensates (EBC) of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) before and after treatment. Methods: 20 patients with AECOPD were enrolled, including 15 males and 5 females. The average age was 71±10, ranging from 50-85. The concentrations of Leukotriene B4 (LTB4) and Interleukin 6 (IL-6) from EBC were assayed by ELISA kit before and after treatment. Serum inflammatory indexes, pulmonary function test and quality of life (CAT) were observed at the same time, the relationship between EBC biomarkers and clinical markers were investigated. Results: The concentration of LTB4 and IL-6 of AECOPD patients with treated [(20.79±2.27)ng/L, (0.39±0.18)ng/L, respectively], were significantly lower compared with that before treatment [(22.64±3.01)ng/L, (0.60±0.36)ng/L, P <0.05, respectively]. The percentage of neutrophils, CRP were decreased after treatment. But no correlation was found between LTB4, IL-6 and serum inflammatory indexes, pulmonary function or CAT( P >0.05). Conclusion: The concentration of biomarkers (LTB4, IL-6) in EBC of AECOPD patients can dynamically monitor the inflammation in respiratory tract and evaluate the therapeutic effect.

Objective: To compare the value of sinonasal CT scan with other clinical parameters in the pre-diagnosis of eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP). Methods: From January to May of 2016, One hundred and fifty consecutive CRSwNP patients (90 eCRSwNP and 60 non-eosinophilic CRSwNP) undergoing endoscopic functional sinus surgery in Beijing Tongren Hospital were recruited in this study. Preoperative CT scan, skin prick test (SPT) and oral fractional exhaled nitric oxide (FeNO) measurements were performed in each patient and full blood count with differential analysis was performed within 1 week before surgery. t test and X2 test were used to compare the age, gender, history of surgery, onset of asthma, history of allergy, CT scores' ratio for the ethmoid sinus and maxillary sinus (E/M ratio) and presence of osteoneogenesis of two groups. Mann-Whitney analysis was used to compare the total Lund-Mackay scores, FeNO and blood eosinophil counts of two groups. Logistic regression analysis and receiver operating characteristic (ROC) curve were used to assess the predictive value of clinical parameters. Results: E/M ratio, FeNO, blood eosinophil percentage of eCRSwNP group was significantly higher than those of non-eosinophilic CRSwNP group [3.56±0.37 vs 1.80±0.10, (34.4±18.1) μg/L vs (22.1±11.7) μg/L, 8.19%±1.50% vs 4.55%±5.60%; χ(2) value was 0.900; t value was 0.994 and 0.900, respectively; all P <0.05]. E/M ratio had the highest predictive value, with area under curve (AUC) value of 0.938. The cut-off point of 2.59 for E/M ratio demonstrated a sensitivity of 94.3% and a specificity of 89.6% for eCRSwNP. Conclusion: The E/M ratio is a more useful predictor in the diagnosis of eCRSwNP compared to other clinical parameters.

Considering the importance of the human respiratory signal detection and based on the Cole-Cole bio-impedance model,we developed a wearable device for detecting human respiratory signal.The device can be used to analyze the impedance characteristics of human body at different frequencies based on the bio-impedance theory.The device is also based on the method of proportion measurement to design a high signal to noise ratio(SNR)circuit to get human respiratory signal.In order to obtain the waveform of the respiratory signal and the value of the respiration rate,we used the techniques of discrete Fourier transform(DFT)and dynamic difference threshold peak detection.Experiments showed that this system was valid,and we could see that it could accurately detect the waveform of respiration and the detection accuracy rate of respiratory wave peak point detection results was over 98%.So it can meet the needs of the actual breath test.

Objective: To explore the efficacy of Jinhuaweikang capsules plus furazolidone-based triple or quadruple therapy as the rescue treatment for Helicobacter pylori ( H . pylori ) infection. Methods: This is a prospective randomized controlled multicenter clinical trial. Patients with chronic gastritis from H . pylori infection in whom eradication treatment failed were recruited from 6 hospitals. All patients were divided into 4 groups using stratified randomization: group A1 (PAFJ), receiving pantoprazole 40 mg+ amoxicillin 1 000 mg+ furazolidone 100 mg+ Jinghuaweikang 3 capsules, twice a day for 10 d (d1-10); group A2, PAFJ therapy as in group A1, followed by Jinghuaweikang 3 capsules twice a day for 18 d (d11-28); group B1 (PAFB), receiving pantoprazole 40 mg+ amoxicillin 1 000 mg+ furazolidone 100 mg+ bismuth potassium citrate 220 mg, twice a day for 10 d (d1-10); group B2, PAFB therapy as in group B1, followed by Jinghuaweikang 3 capsules twice a day for 18 d (d11-28). At least 28 days after the end of treatment, all patients underwent 13 C urea breath test for assessment of H . pylori eradication. Results: A total of 357 patients, 145 males and 212 females, were recruited, including 90 in group A1, 88 in group A2, 89 in group B1, and 90 in group B2. The eradication rates of H . pylori in groups A1 and A2 were 76.1%(67/88)and 79.6%(70/88) in per-protocol (PP) analysis, 74.4%(67/90) and 79.6%(70/88)in intention-to-treat (ITT) analysis; the rates in groups B1 and B2 were as 85.9%(73/85) and 92.1%(81/88) in PP analysis, 82.0%(73/89) and 90.0%(81/90)in ITT analysis. There were statistically significant differences in PP eradication rates among the 4 groups ( P =0.020); there was statistically significant difference between groups A1 and B2, and also between groups A2 and B2 ( P =0.003, 0.020), but not between groups A1/A2 and B1 ( P >0.05), nor between groups B1 and B2 ( P >0.05). No statistically significant differences in ITT eradication rates were found among the 4 groups ( P >0.05). The improvement of belching and poor appetite for patients in groups A2 and B2 was better than those in groups A1 and B1. Conclusions: The efficacy of Jinghuaweikang capsules plus furazolidone-based quadruple therapy is superior to combination with furazolidone-based triple therapy as the rescue treatment of H . pylori, and superior to bismuth-containing quadruple therapy. Extending administration of Jinghuaweikang capsules to 28 days may better improve symptoms of indigestion.

Bronchial asthma is a heterogeneous disease that is characterized by airway hyperresponsiveness and chronic inflammation. It is often accompanied by reversible airflow obstruction. Current laboratory testing methods for the diagnosis of asthma in children mainly include lung ventilation function test. Due to the non-cooperation of children, it is very challenging to conduct lung ventilation function test for preschoolers. Lung function testing is an instantaneous indicator, which is influenced by the children's understanding ability and mental factors. In addition, it could not assess the severity of airway inflammation. Fractional exhaled nitric oxide (FeNO) is a noninvasive, simple, and objective indicator of airway inflammation and has gradually gained increased use in children in recent years. This review article introduces the source of FeNO, the reference value of FeNO in laboratory testing, and the progress in the application of FeNO in the diagnosis, prediction, and treatment of asthma in children of various ages.

Objective: To study the infection rate and current infection rate of Helicobacter pylori (Hp) among children aged 7 to 18 years old in Minhang district of Shanghai., Method: A school-based cross-sectional study in three elementary and middle schools (with students aged 7 to 18 years old) in Minhang district of Shanghai was conducted. A total of 1 988 students were investigated by questionnaire and non-invasive tests. The positive rate of serum Hp-IgG or (13)C urea breath test was the basis for calculation for Hp infection rate. The positive rate of (13)C urea breath test was the basis for current infection rate. The relationship between infection rate and age was studied through Spearman rank correlation analysis. The consistency of the two diagnostic methods was determined using kappa value analysis., Result: A total of 1 988 subjects were included in the analysis: 944 males and 944 females. The Hp infection rate was 36.3%(721/1 988). Current infection rate was 32.1%(625/1 949). Hp infection rates of primary (7-12 years old), junior (13-15 years old), high school group (16-18 years old) were 27.4% (223/813), 33.6% (93/277), 45.1% (405/898) respectively. Hp infection was associated with age, with a correlation coefficient of 0.167 (P<0.001). The kappa value of the serum Hp-IgG and (13)C Urea breath test was 0.67., Conclusion: Hp infection rate among children aged 7 to 18 years old in Minhang district of Shanghai is 36.3%, with the infection rate increasing with age. Serum Hp-IgG and the (13)C urea breath test are two detection methods each of which has advantages and disadvantages.

Objective: To evaluate fractional exhaled nitric oxide (FENO) level in patients with subacute cough and its value in predicting the patients' response to inhaled corticosteroids (ICS) treatment., Methods: A total of 100 patients with persistent cough lasting more than 3 weeks were enrolled, including 52 patients with subacute cough and 48 with chronic cough. FENO, spirometry, and responses to ICS therapy of the patients were evaluated., Results: The recruited patients had a median (inter-quartile ranges) FENO level of 19 ppb (12-30 ppb). Patients with chronic cough had a significantly higher median FENO level than those with subacute cough (20.5 vs 16 ppb; Z=-2.245, P=0.025). A FENO level ≥25 ppb was recorded in 15 (28.8%) patients with subacute cough, as compared with 20 (41.6%) in patients with chronic cough (χ(2)=1.801, P=0.179). With a FENO ≥25 ppb as the critical value to justify ICS treatment, 15 patients with subacute cough received ICS and 14 (93.3%) of them showed obvious relief of cough after 2 weeks of therapy, a response rate similar to that of 85.0% (17/20) in patients with chronic cough receiving the treatment (χ(2)=0.588, P=0.443). In patients with subacute cough, those with cough variant asthma (CVA) or eosinophilic bronchitis (EB) had a significantly higher median FENO level than those with postinfectious cough [(16 (11-31) ppb vs 11 (8-19) ppb, P<0.01]. In the etiological analysis, CVA or EB was identified in 23 (44.2%) of the patients with subacute cough, as compared 21 (43.8%) in patients with chronic cough (χ(2)=0.002, P=0.961)., Conclusion: FENO may be an important indicator for etiological diagnosis of subacute cough and for predicting the response to ICS treatment.

Objective: To study the effects and significance of methacholine (Mch) bronchial provocation tests and salbutamol bronchial dilation test on measurements of fractional exhaled nitric oxide (FeNO) in patients with asthma., Methods: This was a prospective study conducted between November 2014 and August 2015. A total of 135 patients with asthma visiting the respiratory clinic of Zhujiang Hospital were enrolled. The patients received either Mch bronchial provocation test or salbutamol bronchial dilation test based on their FEV1/FVC values and cooperative degree. Mch bronchial provocation test was performed by using Astograph Jupiter-21 (Astograh group) or APS-Pro airway reaction testing apparatus (APS group), and salbutamol bronchial dilation test was performed by using Jaeger spirometer (Dilation group). We compared the differences between FeNO values measured before examinations (Pre-FeNO) and 5 min after completion of these examinations (Post-FeNO)., Results: The geometric mean of Pre-FeNO and Post-FeNO was 28.07 ppb and 24.08 ppb respectively in the Astograh group, with a significant decrease of the FeNO value after the examination (Z=-3.093, P=0.002). A significant difference between Pre-FeNO and Post-FeNO was found in patients who had positive provocation results in the Astograh group (Z=-2.787, P=0.005), but not in the patients with negative results (Z=-1.355, P=0.176). The geometric mean of FeNO in the APS group decreased significantly from 27.95 ppb to 23.15 ppb after the examination was completed (Z=-5.170, P=0.000); both in patients with positive saline or Mch provocation results and in patients with negative provocation results, the differences between Pre-FeNO and Post-FeNO in the APS group being significant (Z=-2.705, -3.709, -2.371, P=0.002, 0.000, 0.018). No difference of FeNO change(ΔFeNO) was observed between the 2 Mch bronchial provocation test groups (U<918.000, P=0.117). The geometric mean of Pre-FeNO was 36.74 ppb and that of Post-FeNO was 34.79 ppb in the Dilation group; the difference being not significant (Z=-1.281, P=0.200)., Conclusions: Our results confirm that salbutamol bronchial dilation test has minor effect on the measurement of FeNO, but Mch bronchial provocation tests can significantly decrease measured FeNO value in patients with asthma, and therefore Post-FeNO values should be interpreted with caution.

Objective: To observe the effects and safety of quadruple regimens including domestically manufactured rabeprazole used as first line/initial therapy for Helicobacter pylori(H.pylori) eradication in gastritis and duodenal ulcer patients, and to investigate the effects of extended use of bismuth after the quadruple therapy on eradication of H. pylori., Methods: From January to August 2013, 430 patients with chronic gastritis or duodenal ulcer who were confirmed as H. pylori positive in gastroscopy for upper gastrointestinal symptoms were enrolled from 12 centers in China for initial treatment using quadruple regimens for H. pylori eradication. The study was a prospective, multicenter, randomized double-blinded double-dummy parallel-controlled clinical trial. The 310 chronic gastritis patients were divided into 2 groups: group A1 was given quadruple regime (rabeprazole+ amoxicillin+ clarithromycin+ bismuth potassium citrate) for 10 days followed by bismuth-placebo for 21 days; group A2 was given the quadruple regimen for 10 days and then bismuth potassium citrate for 21 days. The duodenal ulcer patients were given the quadruple for 10 days, then rabeprazole for 14 days. All the patients took (13)C urea breath test to detect H. pylori 28 days after medicine withdrawal., Results: Altogether 428 cases were enrolled and 404 completed the trial. The total eradication rate in the chronic gastritis patients was 85.1% (262/308, intention-to-treat (ITT)analysis), which was 81.7% (125/153, ITT) in the A1 group and 88.4% (137/155, ITT) in the A2 group; the eradication rate in the duodenal ulcer patients was 85.8% (103/120, ITT). No severe adverse effects were reported. The symptoms (pain, burning sensation, reflux, belching, nausea, and vomiting) improvement status was similar among A1 and A2 groups., Conclusions: The quadruple regimen using rabeprazole manufactured in China and administered for 10 days as first line/initial therapy in chronic gastritis and duodenal ulcer patients could achieve good H. pylori eradication rate. The extended use of bismuth after 10-day quadruple regimen might further improve the eradication rate. The regimens containing proton-pump inhibitor and bismuth may be well tolerated and safe in clinical application.

Objective: To evaluate the accuracy and effectiveness of Helicobacter pylori(H.pylori)antibody detection kit (immunoblot) in typing H. pylori strains, and to investigate the relationship between characteristics of H. pylori strains and clinical outcomes., Methods: A total of 378 patients with upper gastrointestinal symptoms who had received gastroscopy and had pathological results within the period from March to August 2012 were collected from 6 centers in China.In all the patients, H. pylori antibody detection kit was used to detect and type serum H. pylori antibodies.The sensitivity, specificity, and accuracy of immunoblot in diagnosing H. pylori infection were evaluation in comparison to (13)C urea breath test (UBT) as the"gold standard". The results were also compared with those colloidal gold method.The relationship between H. pylori typing and clinical conditions was analyzed., Results: Totally 378 patients were enrolled, in which 257 had H. pylori-positive (13)C UBT results, and 121 were negative.With (13)C UBT as the"gold standard", the sensitivity, specificity, positive predictive value, negative predictive value, and concordance rate of H. pylori antibodies detection kit(immunoblot)were 97.7%, 86.8%, 94.0%, 94.6%, and 94.2%, respectively; the sensitivity, specificity, positive predictive value, negative predictive value, and concordance rate of colloidal gold method were 84.4%, 92.6%, 96.0%, 73.7%, and 87.0%, respectively.In patients diagnosed as H. pylori-positive by (13)C UBT and immunoblot, 93.0%(53/57) in H. pylori eradication failure patients and 93.8%(182/194)in untreated patients were infected with type Ⅰ H. pylori as detected by immunoblot, with no statistically significant difference (P=0.764). The type Ⅰ strains positive rate was 94.2%(65/69), 89.9%(62/69)and 98.2% (55/56) in non-atrophy gastritis, atrophy gastritis, and duodenal ulcer untreated patients, respectively, the positive rate of type Ⅰ strains higher in duodenal ulcer cases than in gastritis ones, but with no statistically significant difference(P=0.185)., Conclusions: Compared with the"gold standard"(13)C UBT, the accuracy of H. pylori antibody detection kit (immunoblot) and that of colloidal gold method are both fairly high.Different H. pylori strains may have significantly different potential in causing diseases, as typeⅠtrain appeared to be more virulent than type Ⅱ strain, especially in causing peptic ulcer.There was no obvious difference between eradication failure and untreated patients in terms of positive rate of type Ⅰ H. pylori strains, hence further study is needed to explore the relationship between type Ⅰ H. pylori and eradication rates.

Objective: To observe the effect of Yiqi Huoxue Qingre Huashi Recipe (YHQHR, a recipe capable of supplementing qi, activating blood, clearing heat, and dissipating dampness) on ulcer healing and Helicobacter pylori (Hp) eradication rate in Hp positive peptic ulcer patients, and to explore coccoid Hp occurrence in the eradication., Methods: Totally 80 Hp positive peptic ulcer patients were assigned to the treatment group and the control groups by random digit table, 40 in each group. All patients received standard triple therapy of Western medicine for 2 successive weeks. Those in the control group additionally took omeprazole enteric coated tablet, 20 mg each time, once per day for 4 successive weeks. Those in the treatment group additionally took YHQHR, twice per day for 6 successive weeks. The ulcer healing was observed and recorded by gastroscope after discontinued medication of 14 days. The effective rate of ulcer healing under endoscope was statistically calculated. Rapid urease test (RUT) was performed in one small piece of tissue from corpora ventriculi and sinuses ventriculi using 14C breathe test (UBT). Gastric juice was collected from the stomach. Hp urease gene amplification test (urea A-PCR) was performed in living tissue from gastric antrum. Results obtained from the above three test methods were recorded and assessed to decide the final eradiation rate. Gastric mucosa tissue was observed under electron microscope,attempting to find non-eradicated Hp, which was further observed., Results: The total curative effect under gastroscope was 97.5% (39/40 cases) in the treatment group, obviously higher than that in the control group (80.0%, 32/40 cases) (P < 0.05). The eradication rate of Hp was 75.0% (30/40 cases), obviously better than that of the control group (52.5%, 21/40 cases) (P < 0.05). The total positive Hp numbers after treatment was 14C UBT (12), RUT (8), and urea A-PCR (27), respectively. The Hp positive rate detected by 14C UBT and RUT was lower than the Hp positive rate detected by urea A-PCR (P < 0.05). Rod-like and coccoid Hp bacteria could be observed under electron microscope., Conclusion: YHQHR combined standard triple therapy was more effective than standard triple therapy alone in promoting ulcer healing and elevating the eradication rate of Hp.

Objective: To study the diagnostic values of fractional exhaled nitric oxide (FeNO) for typical bronchial asthma and cough variant asthma in children, and to explore whether FeNO can be applied to differentiate typical bronchial asthma from cough variant asthma in children., Methods: A total of 150 children who were newly diagnosed with typical bronchial asthma between June 2012 and June 2014, as well as 120 children who were newly diagnosed with cough variant asthma during the same period, were selected as subjects. FeNO measurement, spirometry, and methacholine provocation test were performed for both groups. Meanwhile, 150 healthy children were selected as the control group, and their FeNO was measured. The diagnostic values of FeNO for typical bronchial asthma and cough variant asthma were analyzed using the receiver operating characteristic curve., Results: The FeNO values in the typical bronchial asthma and cough variant asthma groups were significantly higher than in the control group (P<0.01), and the FeNO value in the typical bronchial asthma group was significantly higher than in the cough variant asthma group (P<0.01). FEV1/FVC%, FEV1%pred, and PD20 were significantly lower in the typical bronchial asthma group than in the cough variant asthma group (P<0.01). The optimal cut-off value of FeNO was 19.5 ppb for the diagnosis of typical bronchial asthma, with a sensitivity of 83.3% and a specificity of 86.7%; the optimal cut-off value of FeNO was 15.5 ppb for the diagnosis of cough variant asthma, with a sensitivity of 67.5% and a specificity of 78.0%; the optimal cut-off value of FeNO was 28.5 ppb for the differentiation between typical bronchial asthma and cough variant asthma, with a sensitivity of 60.7% and a specificity of 82.5%., Conclusions: Measurenment of FeNO may be useful in the diagnosis and differential diagnosis of typical bronchial asthma and cough variant asthma.