BACKGROUND Boerhaave syndrome,or spontaneous esophageal rupture,is a rare and lifethreatening emergency,typically caused by a sudden increase in esophageal pressure due to violent coughing or vomiting.Early diagnosis ...BACKGROUND Boerhaave syndrome,or spontaneous esophageal rupture,is a rare and lifethreatening emergency,typically caused by a sudden increase in esophageal pressure due to violent coughing or vomiting.Early diagnosis is challenging as its symptoms often resemble those of other diseases.Understanding its pathological features and treatment strategies is therefore critical for clinical practice.CASE SUMMARY This report describes a case of spontaneous esophageal rupture triggered by violent coughing in a 55-year-old male with a history of smoking and hypertension.Following severe coughing,the patient developed chest pain,vomiting,and respiratory distress.Initial clinical evaluation was inconclusive,with a suspected diagnosis of cardiovascular or gastrointestinal conditions.After further examination,the diagnosis of spontaneous esophageal rupture was confirmed.Chest X-ray,computed tomography,and endoscopy revealed a rupture in the lower esophagus,along with mediastinal abscess and pleural effusion.Laboratory tests showed mild infection markers.The patient underwent surgical repair of the esophageal rupture(approximately 3 cm in length)with mediastinal drainage.Postoperatively,the patient’s temperature normalized within 3 days,respiratory function improved,and pleural effusion significantly decreased.After two weeks of treatment,the patient was discharged without complications and had a favorable prognosis.The study suggests that while violent coughing is a rare trigger,it can lead to severe damage,and imaging techniques play a crucial role in diagnosis.CONCLUSION Spontaneous esophageal rupture presents significant diagnostic and therapeutic challenges.Early recognition and timely intervention are crucial for improving prognosis.This case highlights the importance of imaging and surgical treatment,offering new insights for managing similar cases and providing valuable clinical guidance.展开更多
Addition of digested sewage sludge at concentrations of 2% and 10% (v/v) to the water increased coughing rate in big head and tilapia (P<0.05). Ventilation rate was significantly decreased (P<0.05) in big head a...Addition of digested sewage sludge at concentrations of 2% and 10% (v/v) to the water increased coughing rate in big head and tilapia (P<0.05). Ventilation rate was significantly decreased (P<0.05) in big head and tilapia at sludge concentrations of 6% and 2% (v/v)respectively. Copper (Cu), cadmium (Cd) and zinc (Zn) are trace metals which are commonly found in sludge. Cu caused a significant increase (P<0.05) in coughing rate in both tilapia and big head at concentrations of 0.3 and 0.2 μg/ml respectively. Zn caused significant increase (P<0.05) in coughing rate only in big head at 2 μg/ml. Neither fish responded to Cd of up to 2μg/ml in the water. However, when the levels of these trace metals in the digested sludge were measured, they were below that which can cause significant changes in the respiratory movements. Therefore, the changes in ventilation and coughing rates after addition of sludge may be due to the presence of substances other than these metals. The results of this experiment provides a guideline to control the level of sludge that can be used in rearing these fresh water fish in ponds展开更多
Breathing is an intrinsic natural behavior and physiological process that maintains life.The rhythmic exchange of gases regulates the delicate balance of chemical constituents within an organism throughout its lifespa...Breathing is an intrinsic natural behavior and physiological process that maintains life.The rhythmic exchange of gases regulates the delicate balance of chemical constituents within an organism throughout its lifespan.However,chronic airway diseases,including asthma and chronic obstructive pulmonary disease,affect millions of people worldwide.Pathological airway conditions can disrupt respiration,causing asphyxia,cardiac arrest,and potential death.The innervation of the respiratory tract and the action of the immune system confer robust airway surveillance and protection against environmental irritants and pathogens.However,aberrant activation of the immune system or sensitization of the nervous system can contribute to the development of autoimmune airway disorders.Transient receptor potential ion channels and voltage-gated Na+channels play critical roles in sensing noxious stimuli within the respiratory tract and interacting with the immune system to generate neurogenic inflammation and airway hypersensitivity.Although recent studies have revealed the involvement of nociceptor neurons in airway diseases,the further neural circuitry underlying airway protection remains elusive.Unraveling the mechanism underpinning neural circuit regulation in the airway may provide precise therapeutic strategies and valuable insights into the management of airway diseases.展开更多
Objective:To investigate the suppressive effect of dexmedetomidine on the cough reflex during tracheal extubation in pediatric patients undergoing general anesthesia and its impact on vital signs.Methods:A total of 60...Objective:To investigate the suppressive effect of dexmedetomidine on the cough reflex during tracheal extubation in pediatric patients undergoing general anesthesia and its impact on vital signs.Methods:A total of 60 pediatric patients undergoing elective surgery admitted to our hospital from January to August 2025 were selected and randomly divided into an observation group and a control group,with 30 cases in each group,using a random number table method.The control group received an intravenous infusion of 0.9% sodium chloride injection 30 minutes before the end of surgery,while the observation group received an intravenous pump infusion of dexmedetomidine(1μg/kg,diluted to 4μg/ml with normal saline).The severity of cough(graded from 0 to 3)and vital signs,including heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),and pulse oxygen saturation(SpO₂),were recorded 5 minutes before extubation,at the time of extubation,and 5 minutes after extubation in both groups.Results:The severity of cough in the observation group was significantly milder than that in the control group(P<0.05),with a significantly higher proportion of grade 0 cough in the observation group(23.33%vs 3.33%).At extubation and five minutes post-extubation,the observation group exhibited significantly lower HR,SBP,and DBP than the control group(P<0.05).In contrast,SpO_(2)levels remained comparable between the groups(P>0.05).Conclusion:Dexmedetomidine can effectively suppress the cough reflex during tracheal extubation in pediatric patients undergoing general anesthesia,reduce the severity of cough,stabilize hemodynamic parameters,and has no significant impact on respiratory function,demonstrating good clinical safety.展开更多
Objective:To investigate the predictive value of diaphragm thickening fraction(DTF)combined with cough peak expiratory flow(CPEF)on the success rate of weaning from mechanical ventilation.Methods:The clinical data of ...Objective:To investigate the predictive value of diaphragm thickening fraction(DTF)combined with cough peak expiratory flow(CPEF)on the success rate of weaning from mechanical ventilation.Methods:The clinical data of patients undergoing invasive mechanical ventilation via oral endotracheal intubation in the ICU of our hospital from January 2022 to December 2023 were studied.All patients underwent a 30-minute spontaneous breathing trial(SBT)using low-level pressure support ventilation(PSV)after meeting the clinical weaning screening criteria.Among them,150 patients who met the clinical weaning criteria were weaned from the ventilator.They were divided into a successful weaning group(n=100)and a failed weaning group(n=50)based on the weaning outcome.Clinical data,including age,gender,APACHE II score,duration of mechanical ventilation,DTF,and CPEF,were collected from 150 patients.The differences in clinical data between the two groups were compared,and the correlation between DTF,CPEF,and the success rate of weaning was analyzed.Results:There were no significant differences between the two groups in gender ratio(χ^(2)=0.884,P=0.347>0.05),age(t=0.350,P=0.727>0.05),and APACHE II score(t=1.295,P=0.197>0.05),but there was a significant difference in the duration of mechanical ventilation(t=3.766,P<0.001).The DTF and CPEF values in the successful weaning group were significantly higher than those in the failed weaning group(P<0.05).ROC curves were drawn to predict the weaning results using DTF,CPEF,and the combination of DTF and CPEF.The results showed that the specificity of the combination of DTF and CPEF was comparable to that of either metric alone,but the sensitivity and AUC were significantly higher than those of either metric alone.Conclusion:The combination of DTF and CPEF can be used as an effective indicator to evaluate the weaning efficacy of mechanically ventilated patients,which has important clinical significance for guiding clinical weaning treatment,improving the success rate of weaning,reducing the incidence of ventilator-associated pneumonia,and shortening the length of hospital stay.展开更多
Objective:To investigate the clinical efficacy of Xiaochaihu Decoction combined with Xiaoxianxiong Decoction in the treatment of post-stroke pneumonia.Methods:To complete the sample grouping comparison,all patients wi...Objective:To investigate the clinical efficacy of Xiaochaihu Decoction combined with Xiaoxianxiong Decoction in the treatment of post-stroke pneumonia.Methods:To complete the sample grouping comparison,all patients with post-stroke pneumonia were investigated,and the number of cases was 60.These patients’diseases were consistent with the dialectical standards of traditional Chinese medicine(phlegm-heat obstructing lungs).The patients were randomly divided into a control group(30 cases,treated with antibiotics and symptomatic methods)and a treatment group(30 cases,treated with Xiaochaihu Decoction and Xiaoxianxiong Decoction on the basis of the control group).Various indicators were compared.Results:The total clinical effective rates were 93%and 80%in the treatment group and the control group,respectively,with statistical significance(P<0.05).The improvement of various clinical symptoms was compared,and the values in the treatment group were reduced,showing significance(P<0.05).Analysis of serum factor indicators showed that the overall trend of the treatment group was reduced,and the comparison between groups was below 0.05.Conclusion:Xiaochaihu Decoction combined with Xiaoxianxiong Decoction has a significant clinical effect in the treatment of post-stroke pneumonia(phlegm-heat obstructing lungs syndrome),which can reduce inflammatory reactions and has few adverse reactions,worthy of clinical application.展开更多
Objective To observe the clinical efficacy of Wentong needling method in the treatment of long-term cough cases after common cold. Methods Wentong needling method was used in the treatment of 30 cases with long-term c...Objective To observe the clinical efficacy of Wentong needling method in the treatment of long-term cough cases after common cold. Methods Wentong needling method was used in the treatment of 30 cases with long-term cough after common cold. Acupoints including Quchi （曲池 LI 11, left side）, Hegu （合谷, LI 4, left side）, Lieque （列缺, LU 7, right side）, Fenglong （丰隆＇, ST 40, right side）, Chize （尺泽, LU 5, right side）, Zusanli （足三里, ST 36, right side）, Zhaohai （照海, KI 6, left side）, Taichong （太冲h, LR 3, both sides）, and Waiqiu （外丘, GB 36, left side） were selected. The treatment was given every other day. After one treatment course, the relation between the long-term cough cases after common cold and Wentong needling method clinical efficacy was observed from aspects of different ages, disease duration and disease degree. Results There were 18 cured cases （60.0%）, 8 markedly effective cases （26.7%）, 4 effective cases （13.33%）, and 0 invalid case （0.0%）. The total effective rate was 200%. The treatment efficacy of cough patients after common cold of less than 24 months was better than that of more than 24 months. Along with the increasing of age, the cured and markedly effective rate was of certain downward tendency. Along with the increasing of treatment times, the cured and markedly effective rate increased. Conclusion The clinical efficacy of Wentong needling method is obvious in the treatment of long-term cough cases after common cold.展开更多
基金Supported by Guangzhou Municipal Science and Technology Bureau,No.SL2024AD3JD0112.
文摘BACKGROUND Boerhaave syndrome,or spontaneous esophageal rupture,is a rare and lifethreatening emergency,typically caused by a sudden increase in esophageal pressure due to violent coughing or vomiting.Early diagnosis is challenging as its symptoms often resemble those of other diseases.Understanding its pathological features and treatment strategies is therefore critical for clinical practice.CASE SUMMARY This report describes a case of spontaneous esophageal rupture triggered by violent coughing in a 55-year-old male with a history of smoking and hypertension.Following severe coughing,the patient developed chest pain,vomiting,and respiratory distress.Initial clinical evaluation was inconclusive,with a suspected diagnosis of cardiovascular or gastrointestinal conditions.After further examination,the diagnosis of spontaneous esophageal rupture was confirmed.Chest X-ray,computed tomography,and endoscopy revealed a rupture in the lower esophagus,along with mediastinal abscess and pleural effusion.Laboratory tests showed mild infection markers.The patient underwent surgical repair of the esophageal rupture(approximately 3 cm in length)with mediastinal drainage.Postoperatively,the patient’s temperature normalized within 3 days,respiratory function improved,and pleural effusion significantly decreased.After two weeks of treatment,the patient was discharged without complications and had a favorable prognosis.The study suggests that while violent coughing is a rare trigger,it can lead to severe damage,and imaging techniques play a crucial role in diagnosis.CONCLUSION Spontaneous esophageal rupture presents significant diagnostic and therapeutic challenges.Early recognition and timely intervention are crucial for improving prognosis.This case highlights the importance of imaging and surgical treatment,offering new insights for managing similar cases and providing valuable clinical guidance.
文摘Addition of digested sewage sludge at concentrations of 2% and 10% (v/v) to the water increased coughing rate in big head and tilapia (P<0.05). Ventilation rate was significantly decreased (P<0.05) in big head and tilapia at sludge concentrations of 6% and 2% (v/v)respectively. Copper (Cu), cadmium (Cd) and zinc (Zn) are trace metals which are commonly found in sludge. Cu caused a significant increase (P<0.05) in coughing rate in both tilapia and big head at concentrations of 0.3 and 0.2 μg/ml respectively. Zn caused significant increase (P<0.05) in coughing rate only in big head at 2 μg/ml. Neither fish responded to Cd of up to 2μg/ml in the water. However, when the levels of these trace metals in the digested sludge were measured, they were below that which can cause significant changes in the respiratory movements. Therefore, the changes in ventilation and coughing rates after addition of sludge may be due to the presence of substances other than these metals. The results of this experiment provides a guideline to control the level of sludge that can be used in rearing these fresh water fish in ponds
文摘Breathing is an intrinsic natural behavior and physiological process that maintains life.The rhythmic exchange of gases regulates the delicate balance of chemical constituents within an organism throughout its lifespan.However,chronic airway diseases,including asthma and chronic obstructive pulmonary disease,affect millions of people worldwide.Pathological airway conditions can disrupt respiration,causing asphyxia,cardiac arrest,and potential death.The innervation of the respiratory tract and the action of the immune system confer robust airway surveillance and protection against environmental irritants and pathogens.However,aberrant activation of the immune system or sensitization of the nervous system can contribute to the development of autoimmune airway disorders.Transient receptor potential ion channels and voltage-gated Na+channels play critical roles in sensing noxious stimuli within the respiratory tract and interacting with the immune system to generate neurogenic inflammation and airway hypersensitivity.Although recent studies have revealed the involvement of nociceptor neurons in airway diseases,the further neural circuitry underlying airway protection remains elusive.Unraveling the mechanism underpinning neural circuit regulation in the airway may provide precise therapeutic strategies and valuable insights into the management of airway diseases.
文摘Objective:To investigate the suppressive effect of dexmedetomidine on the cough reflex during tracheal extubation in pediatric patients undergoing general anesthesia and its impact on vital signs.Methods:A total of 60 pediatric patients undergoing elective surgery admitted to our hospital from January to August 2025 were selected and randomly divided into an observation group and a control group,with 30 cases in each group,using a random number table method.The control group received an intravenous infusion of 0.9% sodium chloride injection 30 minutes before the end of surgery,while the observation group received an intravenous pump infusion of dexmedetomidine(1μg/kg,diluted to 4μg/ml with normal saline).The severity of cough(graded from 0 to 3)and vital signs,including heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),and pulse oxygen saturation(SpO₂),were recorded 5 minutes before extubation,at the time of extubation,and 5 minutes after extubation in both groups.Results:The severity of cough in the observation group was significantly milder than that in the control group(P<0.05),with a significantly higher proportion of grade 0 cough in the observation group(23.33%vs 3.33%).At extubation and five minutes post-extubation,the observation group exhibited significantly lower HR,SBP,and DBP than the control group(P<0.05).In contrast,SpO_(2)levels remained comparable between the groups(P>0.05).Conclusion:Dexmedetomidine can effectively suppress the cough reflex during tracheal extubation in pediatric patients undergoing general anesthesia,reduce the severity of cough,stabilize hemodynamic parameters,and has no significant impact on respiratory function,demonstrating good clinical safety.
文摘Objective:To investigate the predictive value of diaphragm thickening fraction(DTF)combined with cough peak expiratory flow(CPEF)on the success rate of weaning from mechanical ventilation.Methods:The clinical data of patients undergoing invasive mechanical ventilation via oral endotracheal intubation in the ICU of our hospital from January 2022 to December 2023 were studied.All patients underwent a 30-minute spontaneous breathing trial(SBT)using low-level pressure support ventilation(PSV)after meeting the clinical weaning screening criteria.Among them,150 patients who met the clinical weaning criteria were weaned from the ventilator.They were divided into a successful weaning group(n=100)and a failed weaning group(n=50)based on the weaning outcome.Clinical data,including age,gender,APACHE II score,duration of mechanical ventilation,DTF,and CPEF,were collected from 150 patients.The differences in clinical data between the two groups were compared,and the correlation between DTF,CPEF,and the success rate of weaning was analyzed.Results:There were no significant differences between the two groups in gender ratio(χ^(2)=0.884,P=0.347>0.05),age(t=0.350,P=0.727>0.05),and APACHE II score(t=1.295,P=0.197>0.05),but there was a significant difference in the duration of mechanical ventilation(t=3.766,P<0.001).The DTF and CPEF values in the successful weaning group were significantly higher than those in the failed weaning group(P<0.05).ROC curves were drawn to predict the weaning results using DTF,CPEF,and the combination of DTF and CPEF.The results showed that the specificity of the combination of DTF and CPEF was comparable to that of either metric alone,but the sensitivity and AUC were significantly higher than those of either metric alone.Conclusion:The combination of DTF and CPEF can be used as an effective indicator to evaluate the weaning efficacy of mechanically ventilated patients,which has important clinical significance for guiding clinical weaning treatment,improving the success rate of weaning,reducing the incidence of ventilator-associated pneumonia,and shortening the length of hospital stay.
文摘Objective:To investigate the clinical efficacy of Xiaochaihu Decoction combined with Xiaoxianxiong Decoction in the treatment of post-stroke pneumonia.Methods:To complete the sample grouping comparison,all patients with post-stroke pneumonia were investigated,and the number of cases was 60.These patients’diseases were consistent with the dialectical standards of traditional Chinese medicine(phlegm-heat obstructing lungs).The patients were randomly divided into a control group(30 cases,treated with antibiotics and symptomatic methods)and a treatment group(30 cases,treated with Xiaochaihu Decoction and Xiaoxianxiong Decoction on the basis of the control group).Various indicators were compared.Results:The total clinical effective rates were 93%and 80%in the treatment group and the control group,respectively,with statistical significance(P<0.05).The improvement of various clinical symptoms was compared,and the values in the treatment group were reduced,showing significance(P<0.05).Analysis of serum factor indicators showed that the overall trend of the treatment group was reduced,and the comparison between groups was below 0.05.Conclusion:Xiaochaihu Decoction combined with Xiaoxianxiong Decoction has a significant clinical effect in the treatment of post-stroke pneumonia(phlegm-heat obstructing lungs syndrome),which can reduce inflammatory reactions and has few adverse reactions,worthy of clinical application.
文摘Objective To observe the clinical efficacy of Wentong needling method in the treatment of long-term cough cases after common cold. Methods Wentong needling method was used in the treatment of 30 cases with long-term cough after common cold. Acupoints including Quchi （曲池 LI 11, left side）, Hegu （合谷, LI 4, left side）, Lieque （列缺, LU 7, right side）, Fenglong （丰隆＇, ST 40, right side）, Chize （尺泽, LU 5, right side）, Zusanli （足三里, ST 36, right side）, Zhaohai （照海, KI 6, left side）, Taichong （太冲h, LR 3, both sides）, and Waiqiu （外丘, GB 36, left side） were selected. The treatment was given every other day. After one treatment course, the relation between the long-term cough cases after common cold and Wentong needling method clinical efficacy was observed from aspects of different ages, disease duration and disease degree. Results There were 18 cured cases （60.0%）, 8 markedly effective cases （26.7%）, 4 effective cases （13.33%）, and 0 invalid case （0.0%）. The total effective rate was 200%. The treatment efficacy of cough patients after common cold of less than 24 months was better than that of more than 24 months. Along with the increasing of age, the cured and markedly effective rate was of certain downward tendency. Along with the increasing of treatment times, the cured and markedly effective rate increased. Conclusion The clinical efficacy of Wentong needling method is obvious in the treatment of long-term cough cases after common cold.
