Cough recognition provides important clinical information for the treatment of many respiratory diseases. A new Mel frequency cepstrum coefficient (MFCC) extracting method has been proposed on the basis of the distributional characteristics of cough spectrum. The whole frequency band was divided into several sub-bands, and the energy coefficient for each band was obtained by method of principle component analysis. Then non-uniform filter-bank in Mel frequency is designed to improve the extracting process of MFCC by distributing filters according to the spectrum energy coefficients. Cough recognition experiment using hidden Markov model was carried out, and the results showed that the proposed method could effectively improve the performance of cough recognition.
ObjectiveTo evaluates the values of fractional exhaled nitric oxide (FENO) in the treatment of chronic cough prospectively.MethodsSubjects with chronic cough were recruited from the outpatient clinic of China-Japan Friendship Hospital. All the patients accepted FENO tests, sputum cell counts, pulmonary function tests, bronchial provocation tests, serum IgE, cough symptom scores and Leicester Cough Questionnaire before and after treatment of 4 weeks.ResultsThere were 29 patients with cough variant asthma (CVA), 19 patients with eosinophilic bronchitis (EB) and 39 patients with other causes. The baseline FENO level of the subjects whose coughs were relieved after inhaled corticosteroids (ICS) therapy of 4 weeks was (63±42) ppb, significantly higher than those with bad-response [(28±13) ppb, P<0.01]. The proportion of FENO decrease after ICS therapy was not only significantly related to the proportion of eosinophilic decrease (r=0.54, P<0.01), but also significantly related to the proportion of decrease of cough symptom scores (r=0.48, P<0.01). To distinguish the good responders from bad responders, the optimal baseline FENO cutoff value was 36 ppb, with sensitivity of 82%, specificity of 93%, positive predictive value of 94%, negative predictive value of 87%, accuracy of 83%.ConclusionsThere is a good relationship between the FENO decreasing levels after ICS therapy and the reliefs of cough symptoms in the CVA and EB patients. Chronic cough patients with FENO value more than 36 ppb are indicated to respond to ICS therapy.
ObjectiveTo systematically evaluate the risk factors for persistent cough after lung resection, providing a theoretical basis for preventing persistent postoperative cough. MethodsThe Cochrane Library, Web of Science, EMbase, PubMed, Chinese Biomedical Literature Database, Wanfang, CNKI, and VIP databases were searched for studies related to risk factors for persistent cough after lung resection. The search period was from database inception to March 30, 2023. Two researchers independently screened the literature, extracted data, and performed quality assessment. RevMan 5.3 software was used for meta-analysis. ResultsA total of 17 articles with 3 698 patients were included. Meta-analysis results showed that females [OR=3.10, 95%CI (1.99, 4.81), P<0.001], age [OR=1.72, 95%CI (1.33, 2.21), P<0.001], right-sided lung surgery [OR=2.36, 95%CI (1.80, 3.10), P<0.001], lobectomy [OR=3.40, 95%CI (2.47, 4.68), P<0.001], upper lobectomy [OR=8.19, 95%CI (3.87, 17.36), P<0.001], lymph node dissection [OR=3.59, 95%CI (2.72, 4.72), P<0.001], bronchial stump closure method [OR=5.19, 95%CI (1.79, 16.07), P=0.002], and postoperative gastric acid reflux [OR=6.24, 95%CI (3.27, 11.91), P<0.001] were risk factors for persistent cough after lung resection, while smoking history was a protective factor against postoperative cough [OR=0.59, 95%CI (0.45, 0.77), P<0.001]. In addition, the quality of life score of patients with postoperative cough decreased compared with that before surgery [MD=1.50, 95%CI (0.14, 2.86), P=0.03]. ConclusionCurrent evidence suggests that females, age, right-sided lung surgery, lobectomy, upper lobectomy, lymph node dissection, bronchial stump closure method (stapler closure), and postoperative gastric acid reflux are independent risk factors for persistent postoperative cough in lung resection patients, while smoking history may be a protective factor against postoperative cough. This provides evidence-based information for clinical medical staff on how to prevent and reduce persistent postoperative cough in patients and improve their quality of life in the future.
Automatic classification of different types of cough plays an important role in clinical. In the previous research of cough classification or cough recognition, traditional Mel frequency cepstrum coefficients (MFCC) which extracts feature mainly from low frequency band is usually used as feature expression. In this paper, by analyzing the distributions of spectral energy of dry/wet cough, it is found that spectral difference of two types of cough exits mainly in middle frequency band and high frequency band. To better reflect the spectral difference of dry cough and wet cough, an improved method of extracting reverse MFCC is proposed. In this method, reverse Mel filter-bank in which filters are allocated in reverse Mel scale is adopted and is improved by placing filters only in the frequency band with high spectral energy. As a result, features are mainly extracted from the frequency band where two types of cough show both high spectral energy and distinguished difference. Detailed process of accessing improved reverse MFCC was introduced and hidden Markov models trained by 60 dry cough and 60 wet cough were used as cough classification model. Classification experiment results for 120 dry cough and 85 wet cough showed that, compared to traditional MFCC, better classification performance was achieved by the proposed method and the total classification accuracy was raised from 89.76% to 93.66%.
ObjectiveTo explore the spectrum and frequency of respiratory symptoms in outpatients clinics.MethodsPatients were enrolled from outpatient clinic of Guangzhou Institute of Respiratory Disease. Information about respiratory symptoms especially cough was obtained from the survey questionnaire from July 2013 to August 2013 .ResultsA total of 900 were eligible out of 939 questionnaires. The mean age of the patients was (48.9±18.3) years, 453 (50.3%) were males, 447 (49.7%) were females. The cases of cough, wheeze, polypnea, chest distress, pharyngalgia, catarrh, chest pain, throat itching, fever, hemoptysis and other symptom was 687 (76.3%), 310 (34.4%), 307 (34.1%), 173 (19.2%), 107 (11.9%), 101 (11.2%), 82 (9.1%), 59 (6.6%), 36 (4.0%), 10 (1.1%) and 129 (14.3%) out of the patients, respectively. In patients with cough, 69.5% of them considered cough as their predominant symptom, and 22.1% of them reported that cough was the only symptom. 56.3% of cases were chronic cough, while acute and subacute cough accounted for 29.7% and 14.0%, separately. The proportion of female in acute cough was significantly higher than that of males (60.3%vs. 39.7%, P<0.01).ConclusionsCough, especially the chronic cough is the most common reason for patients who seeking health care in outpatient clinic of respirologist. There are more females suffered from acute cough than males.
Objective To investigate the etiological diagnosis of chronic cough with pharyngitis-like manifestations. Methods Patients with chronic cough and pharyngitis-like manifestations were recruited from Outpatient Department of Guangzhou Institute of Respiratory Diseases between December 2002 to March 2010. The causes of chronic cough were investigated using a well-established diagnostic protocol, including history taking and physical examination, pulmonary function tests, induced sputum cytology, 24-h esophageal pH monitoring, etc. The final diagnosis depended on clinical manifestations, examination findings, and a successful response to therapy. Results 326 patients with chronic cough and pharyngitislike manifestations were included in the study with amedian duration of 24 ( 2 ～480) months, amean age of 41 ±13 years. The causes of chronic cough were identified as follows: post nasal drip syndrome or upper airway cough syndrome in 73 cases ( 23. 31% ) , cough variant asthma in 61 cases( 18. 71% ) , eosinophilic bronchitis in 70 cases( 22. 47% ) , gastroesophageal reflux-induced cough in 54 cases ( 16. 56% ) , atopiccough in 48 cases ( 14. 72% ) , and others in 40 cases ( 12. 27% ) . There is no significant difference in percentage of common causes of chronic cough ( P gt; 0. 05) . Conclusion The proportions of upper airway syndrome and other common causes are similar in chronic cough with pharyngitis-like manifestatioins, whichsuggest pharyngitis-like manifestations are not specific for diagnosis of upper airway cough syndrome.
ObjectiveTo systematically review the efficacy and safety of Yangyinqingfei decoction for chronic cough and chronic obstructive pulmonary disease (COPD) patients.MethodsWe electronically searched databases including PubMed, Web of Science, CBM, CNKI, VIP and WanFang Data for randomized controlled trials (RCTs) of Yangyinqingfei decoction for chronic cough and COPD patients from inception to August 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, RevMan 5.3 software was used for meta-analysis.ResultsTwenty-four RCTs involving 2 268 patients with COPD and chronic cough were included. The results of meta-analysis showed that compared with the control group, Yangyinqingfei decoction combined with the conventional medicine could significantly improve clinical effective rate (RR=1.21, 95%CI 1.16 to 1.27, P<0.000 01) and lung function (SMD=0.76, 95%CI 0.59 to 0.94, P<0.000 01) in patients with COPD. Yangyinqingfei decoction combined with the conventional medicine group was superior to the control group (RR=1.41, 95%CI 1.22 to 1.64, P<0.000 01) in clinical efficacy for adults patients with chronic cough. In terms of safety, seven cases occurred adverse reactions in the Yangyinqingfei decoction group, while 13 were found in the control group, the types and degree of adverse reactions in both groups were almost the same.ConclusionThe combination of Yangyinqingfei plus conventional medicine may significantly improve the clinical efficacy for chronic cough and COPD with reliable safety. However, due to the limited quality and quantity of included studies, the above conclusions are needed to verify by more high quality studies.
Detection of the fraction of exhaled nitric oxide (FeNO) is a safe, simple and easy method to assess airway inflammation noninvasively. Thus, FeNO detection has been paid more attention to diagnosis and guide treatment of pulmonary diseases. The common feature of pneumonia, asthma, chronic obstructive pulmonary disease and chronic cough is the existence of varying degrees of airway inflammation. In this review, FeNO production and its potential pathologic and physiologic role in various pulmonary diseases were discussed.
In recent years, the number of lung surgeries has increased year by year, and the number of patients with postoperative cough has also increased gradually. Chronic cough after lung surgery seriously affects patients' quality of life and surgical outcome, and has become one of the clinical problems that clinicians need to solve. However, there is currently no guideline or consensus for the treatment of chronic cough after lung surgery in China, and there is no standardized treatment method. Therefore, we searched databases such as PubMed, Web of Science, CNKI, and Wanfang databases ect. from 2000 to 2023 to collected relevant literatures and research data, and produced the first expert consensus on chronic cough after lung surgery in China by Delphi method. We gave 11 recommendations from five perspectives including timing of chronic cough treatment, risk factors (surgical method, lymph node dissection method, anesthesia method), prevention methods (preoperative, intraoperative, postoperative), and treatment methods (etiological treatment, cough suppressive drug treatment, traditional Chinese medicine treatment, and postoperative physical therapy). We hope that this consensus can improve the standardization and effectiveness of chronic cough treatment after lung surgery, provide reference for clinical doctors, and ultimately improve the quality of life of patients with chronic cough after lung surgery.
ObjectiveTo investigate the diagnostic value of bronchial provocation test in patients with chronic cough.
MethodsA total of 550 chronic cough patients were selected in the 452nd Military Hospital from March 2011 to February 2012. These patients all underwent the basic lung function test and the bronchial provocation test (BPT) to acetylcholine so as to assess the bronchial hyper-reactivity by inhaling methacholine. The diagnostic value of BPT was then evaluated.
ResultsAll included patients had normal lung function. There were 267 patients (48.5%) who showed positive results in BPT, of whom, 236 BPT-positive patients were finally diagnosed as cough variant asthma. After regular treatment, the cough symptoms were well controlled.
ConclusionCough variant asthma is one of the main causes of chronic cough. The BPT is an important method of aiding the diagnosis of cough variant asthma which helps early diagnosis of it.
