Excessive Phlegm Research Articles

"Understanding and treating baras (vitiligo) in unani medicine: historical perspectives, pathophysiology, and therapeutic approaches".

Vitiligo, also known as baras in Unani medicine, causes patches of depigmented skin due to the loss of melanocytes. According to ancient Unani scholars, factors like excessive phlegm in the blood and weakened color-controlling power were believed to be the cause. This study dives into the historical insights of luminaries like Majūsī and Hakim Akbar Arzānī, alongside modern medical understanding. It explores the pathophysiology, epidemiology, and clinical features of vitiligo, while also addressing confusing definitions, dietary influences, and demographic patterns. We take a close look at the classification, prognosis, and investigative methods. The aim of this research is to bring together traditional and modern perspectives to fully understand vitiligo, covering its cultural, historical, and scientific aspects. By incorporating epidemiological data, dietary considerations, and insights into the underlying mechanisms, we enhance diagnostic and treatment approaches. In conclusion, this study establishes a cohesive connection between the historical wisdom of Unani medicine and the current scientific discourse on vitiligo. By merging these perspectives, we gain a comprehensive understanding of the condition, enabling a more holistic approach to diagnosis and management. As dermatological research continues to evolve, the integration of traditional and modern insights becomes crucial in effectively addressing complex skin disorders like vitiligo.

Molecular authentication of commercial "Qian-hu" through the integration of nrDNA internal transcribed spacer 2 and nucleotide signature.

Peucedani Radix, also known as "Qian-hu" is a traditional Chinese medicine derived from Peucedanum praeruptorum Dunn. It is widely utilized for treating wind-heat colds and coughs accompanied by excessive phlegm. However, due to morphological similarities, limited resources, and heightened market demand, numerous substitutes and adulterants of Peucedani Radix have emerged within the herbal medicine market. Moreover, Peucedani Radix is typically dried and sliced for sale, rendering traditional identification methods challenging. We initially examined and compared 104 commercial "Qian-hu" samples from various Chinese medicinal markets and 44 species representing genuine, adulterants or substitutes, utilizing the mini barcode ITS2 region to elucidate the botanical origins of the commercial "Qian-hu". The nucleotide signature specific to Peucedani Radix was subsequently developed by analyzing the polymorphic sites within the aligned ITS2 sequences. The results demonstrated a success rate of 100% and 93.3% for DNA extraction and PCR amplification, respectively. Forty-five samples were authentic "Qian-hu", while the remaining samples were all adulterants, originating from nine distinct species. Peucedani Radix, its substitutes, and adulterants were successfully identified based on the neighbor-joining tree. The 24-bp nucleotide signature (5'-ATTGTCGTACGAATCCTCGTCGTC-3') revealed distinct differences between Peucedani Radix and its common substitutes and adulterants. The newly designed specific primers (PR-F/PR-R) can amplify the nucleotide signature region from commercial samples and processed materials with severe DNA degradation. We advocate for the utilization of ITS2 and nucleotide signature for the rapid and precise identification of herbal medicines and their adulterants to regulate the Chinese herbal medicine industry.

Selection and evaluation of quality markers for the regulation of PXR-CYP3A4/FXR-LXRα by Exocarpium Citri Grandis for the treatment of hyperlipidaemia with dispelling blood stasis and removing phlegm

Hyperlipidaemia is described as "excessive phlegm" and "blood stasis" in the classic theory of traditional Chinese medicine. Exocarpium Citri Grandis has the effect of dispelling blood stasis and removing phlegm, which can better meet the treatment needs of this disease. However, there is still a lack of focus and depth in the study of the chemical composition of this medicine, and the correlation between the study of relevant medicinal substances and the efficacy of dispelling stasis and removing phlegm is insufficient. To address this issue, this study was carried out to validate the overall efficacy and identify and determine the chemical composition of Exocarpium Citri Grandis. The regulatory mechanism of the PXR-CYP3A4/FXR-LXRα pathway and its active ingredients were screened, and a pharmacokinetic study of active ingredients was performed. The obtained multidimensional data were statistically analysed and comprehensively evaluated. The quality marker of Exocarpium Citri Grandis in the treatment of hyperlipidaemia based on the PXR-CYP3A4/FXR-LXRα mechanism to exert the efficacy of dispelling blood stasis and removing phlegm was finally determined. Based on the above experiments, we identified 27 compounds from the ethanol extract of Exocarpium Citri Grandis. Among them, naringenin, meranzin hydrate, apigenin, caffeic acid phenethyl ester, anacardiin, hesperidin and naringin can significantly regulate all or part of the targets in the PXR-CYP3A4/FXR-LXRα pathway. It also has suitable content and pharmacokinetic characteristics in vivo. In conclusion, this study established quality markers to characterize the efficacy of Exocarpium Citri Grandis in dispelling blood stasis and removing phlegm, which provides a scientific basis for the targeted evaluation of the hypolipidaemic activity of this medicinal plant.

Identification of potentially suitable areas for nucleosides of Pinellia Ternata (Thunb.) Breit using ecological niche modeling.

Pinellia ternata, a traditional Chinese medicine, is well-renowned for its effectiveness in treating sickness such as coughs with excessive phlegm, vomiting, and nausea. The nucleoside components of P. ternata have been shown to have antitumor activity. Identifying potential growth areas of high-quality P. ternata based on the content of five nucleoside components and the identification of climatic features suitable for the growth of P. ternata will help to conserve P. ternata resources with targeted bioactive compounds. Using high-performance liquid chromatography (HPLC), we determined five nucleoside components, uridine, guanosine, adenosine, inosine, and thymidine, at 27 sampling points of P. ternata collected from 21 municipalities of 11 provinces in China. We used ecological niche modeling to identify the major environmental factors associated with the high metabolite content of P. ternata, including precipitation of the warmest quarter, annual mean temperature, annual precipitation, and isothermality. Areas with high suitability for the five nucleosides were found in Hebei, Shandong, Shanxi, Gansu, Sichuan, Guizhou, and Hubei Provinces. Under the RCP 2.6, RCP 4.5, and RCP 8.5 scenarios, the areas with a suitable distribution decreased and some areas with high suitability became areas with low suitability. Overall, our findings advance our knowledge of the ecological impacts of climate change and provide a valuable reference for conserving and sustainably developing high-quality P. ternata resources in the future.

Characteristics of Laryngopharyngeal Reflux in Patients with Chronic Cough Induced by Gastroesophageal Reflux Disease.

Objective: To summarize the characteristics of laryngopharyngeal reflux in patients with chronic cough induced by gastroesophageal reflux disease (GERD). Materials and Methods: The clinical data of patients with chronic cough induced by GERD treated at our hospital were retrospectively analyzed, including their reflux symptom index (RSI), reflux finding scores (RFS), and results of oropharyngeal pH monitoring. Results: There were 44 patients in total, including 21 males and 23 females. The average history of chronic cough was 29.60 (29.60 ± 37.60) months. In addition to coughing, all patients had at least 2 symptoms of laryngopharyngeal reflux disease (LPRD), and their RSI averaged 15.66 (15.66 ± 6.33). The most frequent symptoms were cough, throat clearing, excessive phlegm, or postnasal drip. All patients had LPRD signs, with an average RFS of 10.89 (10.89 ± 2.81). The most frequent signs were erythema or hyperemia/vocal cord edema, posterior commissure hypertrophy, and diffuse laryngeal edema. There were 42 patients (42/44, 95.45%) whose RSI and/or RFS were abnormal. Oropharyngeal pH monitoring identified 10 patients (10/44, 22.72%) with abnormal Ryan scores. Conclusions: All patients with chronic cough induced by GERD had symptoms and signs of LPRD, and most of them had an abnormal RSI and/or RFS and could be diagnosed with suspect LPRD. A part of the patients had LPR episodes according to Dx-pH monitoring, most of which occurred in the upright position. These results indicated that most patients with chronic cough induced by GERD may have suspected LPRD simultaneously and that cough was one of their LPRD symptoms.

Integrated transcriptomic and metabolomic analysis reveals the molecular basis of tissue-specific accumulation of bioactive steroidal alkaloids in Fritillaria unibracteata

Fritillaria unibracteata is an endangered medicinal plant whose bulb has been used as a Chinese herb to suppress cough, asthma and excessive phlegm for centuries. Steroidal alkaloids, which are synthesized via the steroid synthesis pathways, are their significant bioactive constituents. However, few studies on genes involved in steroidal alkaloid biosynthesis in F. unibracteata have been reported, mainly due to the lack of the F. unibracteata genome. In this paper, comparative transcriptomic and metabolomic analyses of four different tissues of F. unibracteata (leaves, flowers, stems, and bulbs) were performed. Imperialine, peiminine, and peimisine were among the significant bioactive compounds that were considerably abundant in bulb tissue, according to the metabolomic findings. Then, 83.60 Gb transcriptome sequencing of four different tissues was performed, of which one gene encoding phosphomevalonate kinase was directly functionally characterized to verify the accuracy of sequences obtained from the transcriptome. A total of 9217 differentially expressed unigenes (DEGs) were identified in four different tissues of F. unibracteata. GO and KEGG enrichments revealed that phenylpropanoid biosynthesis, MVA-mediated terpenoid backbone biosynthesis, and steroid biosynthesis were enriched in bulb tissue, whereas enrichment of MEP-mediated terpenoid backbone biosynthesis, photosynthesis, photosynthesis-antenna protein and carotenoid biosynthesis was observed in aerial tissues. Moreover, clustering analysis indicated that the downstream steroid biosynthesis pathway was more important in steroidal alkaloid biosynthesis compared to the upstream terpenoid backbone biosynthesis pathway. Hence, MVA-mediated biosynthesis of steroidal alkaloids was proposed, in which 15 bulb-clustered DEGs were positively correlated with a high accumulation of bioactive steroid alkaloids, further validating our proposal. In addition, 36 CYP450s showing a positive correlation with bioactive steroidal alkaloids provided candidate enzymes to catalyze the subsequent steps of steroidal alkaloid biosynthesis. In addition, the transcription factors and ABC transporters clustered in bulb tissue might be responsible for the regulation and transportation of steroidal alkaloid biosynthesis. Protein-protein interaction analysis implied a highly complex steroid alkaloid biosynthesis network in which delta (24)-sterol reductase might be one of the central catalysts. Based on the integrated transcriptome and metabolome, this current study is a first step in understanding the tissue-specific biosynthesis of steroidal alkaloids in F. unibracteata. Furthermore, key genes and regulators identified herein could facilitate metabolic engineering to improve steroidal alkaloids in F. unibracteata.

Insect tea originated from ethnic minority regions in Southwest China: A review on the types, traditional uses, nutrients, chemistry and pharmacological activities.

Insect tea is a special non-Camellia tea produced from the feces of insects in ethnic minority regions in Southwest China. Insect tea was recorded to have the traditional functions to treat summer heat, dampness, digestive disturbance, excessive phlegm, shortness of breath and otitis, etc. AIM OF THIS STUDY: This review provides an updated and comprehensive review of insect tea on the tea types, host plants, tea-producing insects, producing process, traditional uses, nutritional values, chemistry, pharmacological activities, biological safety and toxicity. Moreover, the general challenges and the possible suggestions on insect tea in future were also discussed. The relevant literature on insect tea was obtained from scientific database, including Elsevier, PubMed, Springer, Wiley, Web of Science, Google Scholar, SciFinder, China National Knowledge Infrastructure (CNKI), Baidu Scholar, Wanfang Database, etc. In addition, pertinent information available in Ph.D theses, MSc. dissertations, books, records, and some classical Chinese herbal literature were also included. The references cited in this review were up to September 2022. Insect tea has been traditionally used as popular beverage with various medicinal functions in the ethnic minority regions in Southwest China for centuries. At present, ten types of insect teas are recorded in different regions. Ten species tea-producing insect and fifteen species host plants are used to in the production of the tea. Insect teas were rich in various nutrients including proteins, carbohydrates, fat, minerals, dietary fiber and Vitamins. A total of 71 compounds have been isolated from insect teas, mainly including flavonoids, ellagitannins, chlorogenic acids and other phenolic compounds as well as the alkaloids. Modern studies demonstrated that insect tea had a variety of pharmacological activities in vitro and in vivo, such as anti-diabetic, lipid-lowing and anti-hypertensive, hepato-protective, gastro-intestinal promoting, anti-cancer, anti-mutagenic, antioxidant, and anti-aging activity, etc. Moreover, existing experimental results showed that insect teas are non-toxicity and biological safety. Insect tea is a unique and niche product originated in the ethnic minority regions of Southwest China with various health-promoting benefits. Phenolics including flavonoids, ellagitannins, chlorogenic acids were reported as the main chemical constituents identified from insect tea. Multiple pharmacological activities of insect tea have been reported, which indicated that it had great potential for further development and application as drugs and health-promoting products. However, more studies on the tea-producing insects, host plants, chemistry and pharmacological activity of insect tea, as well as the toxicology should be further investigated.

Effect of Smoking on Serum Vitamin D Levels and the Influence on COPD Symptoms Using NHANES 2007 – 2014 Datasets Among Women of Different Ethnic Backgrounds

Smoking is one of the major causes of chronic obstructive pulmonary disease (COPD). The number of women who smoke is increasing and they are at enhanced risk of developing fatal COPD. Symptoms of COPD include frequent coughing, wheezing, whistling, excess phlegm and shortness of breath. According to National Health Interview Survey (NHIS) data during 1999 to 2011, the prevalence of COPD among non-Hispanic whites was generally higher contrasted with non-Hispanic blacks and Hispanics. Among women the annual age-adjusted prevalence was higher than in men, especially among young women. It is likely that nutritional status of COPD patients may impact the outcome of the disease. Deficient levels of vitamin D is common among COPD patients. The goal of this study is to further investigate a potential correlation between smoking and serum vitamin D levels as it influences COPD. The National Health and Nutrition Examination Survey (NHANES) 2007-2014 datasets were utilized for this study. A 10 ng/mL decrease in vitamin D₃ level was associated with an increased number of wheezing and whistling attacks (relative risk (RR) 1.33 (95% CI (1.03, 1.07), <I>P</I>=0.02). There was no evidence of an association between vitamin D₂ with the number of wheezing and whistling attacks. Although there was no evidence of an association between vitamin D₃ (either lower or higher levels) with bringing up phlegm and coughing, there was marginal evidence <I>P</I><0.1 of an association between vitamin D₂ with bringing up phlegm and coughing. Conclusion: This data confirmed the previous conclusion from an NHANES 2001-2006 investigation that smoking may still influence vitamin D₃ levels among women. Further research is necessary to better understand whether vitamin D₃ has a positive impact on respiratory health in women because they are more likely to be burdened by the symptoms of COPD.

Vitamin A deficiency in peafowl with secondary visceral urate deposition

Clinical History: In a flock of approximately 180 peafowl, several were showing signs of a possible upper respiratory infection and had mouth gaping per the owner. They were also reported to be lethargic, to have excessive phlegm or mucus in the mouths, had trouble swallowing, and were losing weight. They were being treated with Baytril and Metronidazole with no improvement. Approximately eight had died. Five peafowl were submitted for necropsy and diagnostic work-up, including three peahens and two peacocks. Gross Findings: In all five peafowl, the oral cavity contained excess mucus. The oral, crop, and esophageal mucosa had disseminated, smooth, raised, round nodules with a central pore. The proximal esophagus was the most severely affected site. The nodules measured on average ~2 mm in diameter. Upon squeezing some of these nodules, pale tan, caseous material could be expressed. In all five peafowl, the heart was diffusely coated by abundant white, chalky, urate material. Similar though lesser amounts of urates partially coated the surface of the liver and other coelomic membranes. In one peahen, the ureters were multifocally distended and contained consolidated accumulations of tan to pale yellow, caseous material. The kidneys in this bird were pale.

Epidemiology &amp; Management of Cough in Smaller Settings-An Indian Case Study

Nearly every person experiences at least one episode of cough every year in their lifetime. Most, people seek care outside home only after trying known home remedies, especially when cough disturbs their sleep due to postnasal drip. Available data suggest that an average Indian adult has 3 episodes of cough per year, while an average child has 7-10 such episodes every year. The COVID-19 pandemic has increased the magnitude of cough across the world since early 2020. The most annoying part about a cough is “phlegm or mucus.” Mucus forms a protective lining in certain parts of our body, protects our body from foreign invaders by trapping the irritants and expel them in a cough. Excessive Phlegm or mucus is produced as a response to an irritant from the environment like allergies, smoke, smoking, dust, and infections. Excess phlegm or difficulty to expel phlegm can be tackled as per its cause or origin. No doctor or a health care worker, in his/her clinical practice has a day without seeing a patient with cough. The diagnostic tests are either not available, or unaffordable, if available and used take a long time for definitive diagnosis. Another problem is of self-medication with innumerable number of over-the-counter cough syrups. Most practitioners know about the types of coughs, their symptomatic treatment and over the counter cough syrups and mucolytics, but very few know, the Ideal rationale of managing cough. Having analysed six varieties of coughs namely i) Cough due to postnasal drip in an elderly person ii &amp; iii) Cough of Community acquired Pneumonia in a child and an adult by antibiotics iv) Cough in an elderly person managed by traditional approach of using roasted Guava fruit v) A case of Cough variant Asthma vi) Cough among Covid 19 cases and vii) Cough in COPD case in an elderly, the author is recommending a simple symptoms based logarithmic approach for differentiating various conditions causing cough and managing them empirically. This article highlights the need for a rational approach for small settings or individual practitioners. Materials &amp; Methodology: This review is based on the review of literature on the ideal rationale of managing cough, own learning from personal practice and practices observed among colleagues, in public sector teaching institutes and private sector hospitals. The article addresses the general practitioner’s dilemma of diagnosis and management by simple symptoms based logarithmic approach and managing empirically.

Potential application of herbal medicine treatment based on pattern identification for canine cognitive dysfunctional syndrome: a comparative analysis of Korea medicine therapy for patients with dementia

Canine cognitive dysfunction syndrome (CDS) is a neurodegenerative disease that causes cognitive and behavioral disorders and reduces the quality of life in dogs and their guardians. This study reviewed the complementary and alternative medicine (CAM) for CDS and compared the diagnosis and therapy of CAM between CDS in canines and dementia in humans. The evaluation tools for the diagnosis of CDS and dementia were similar in the neurological and neuropsychiatric examinations, daily life activity, cognitive tests, and neuroimaging, but the evaluation for dementia was further subdivided. In CAM, pattern identification is a diagnostic method for accurate, personalized treatment, such as herbal medicine. For herbal medicine treatment of cognitive impairment in canines and humans, a similar pattern identification classified as deficiency (Qi, blood, and Yin) and Excess (phlegm, Qi stagnation, and blood stasis) is being used. However, the veterinary clinical basis for verifying the efficacy and safety of CAM therapies for CDS is limited. Therefore, based on CAM evidence in dementia, it is necessary to establish CDS-targeted CAM diagnostic methods and therapeutic techniques considering the anatomical, physiological, and pathological characteristics of dogs.

Correlation and Influencing Factors Between Laryngopharyngeal Reflux Disease and Sleep Status in Patients.

ObjectiveTo observe the correlation between laryngopharyngeal reflux disease (LPRD) and patients' sleep status, and to explore the related factors of LPRD.MethodsFour hundred and sixteen patients who visited the otorhinolaryngology clinic in our hospital from June 2019 to June 2021 were selected as the research subjects. According to the scale of reflux symptom index, the subjects were divided into a patients group (120 patients) with an the reflux symptom index (RSI) > 13 and a control group (296 patients) with an RSI ≤ 13 according to the RSI scale score. General patient information was collected. The sleep state and emotional state of patients in the two groups were evaluated, and the related influencing factors for LPRD were also evaluated. The correlation between sleep state and depression in LPRD patients was analyzed.ResultsFour hundred and sixteen patients were divided into patients group and control group according to RSI score, the ratio of the two groups was 1:2.47. In the patients group, the common symptoms of RSI score and the top three of the total score were as follows: Foreign body sensation in throat in 112 patients, 438 points; Keep voice clear in 108 patients, 381 points; Excessive phlegm or nasal discharge reflux in 101 patients, 348 points. The PSQI and HADS scores in the patients group were higher than those in the control group (t = 19.990, 13.007, 14.690, P all <0.001). Logistic regression analysis showed that high-fat diet and high PSQI score were the risk factors for the development of LPRD (P = 0.012, P = 0.007). According to the PSQI score, the patients in the patients group were divided into 35 patients with abnormal PSQI score, 85 patients with normal PSQI score, and the HADS scores of those with abnormal PSQI score were all lower than those with normal PSQI score (P > 0.05). The PSQI score of the patients in the patients group was positively correlated with the HADS score (r = 0.714, P = 0.013).ConclusionSleep disorder may lead to the occurrence or aggravation of anxiety and depression in patients with LPRD, and it is an independent risk factor for the development of LPRD. Clinical attention to the treatment of sleep disorders in patients with LPRD may be conducive to improving the efficacy of LPRD.

Establishment and Development of a Quality Evaluation Method for Sangbaipi Decoction.

Sangbaipi decoction (SD), a traditional Chinese "Ancient Classical Prescription" consisting of eight medicinal materials, is usually used to treat asthma due to excess lung Qi and phlegm fire. To establish a comprehensive quality evaluation method for SD. HPLC fingerprint analysis, hierarchical cluster analysis (HCA), and principal component analysis (PCA) were applied for the quality control of SD prepared from different batches of medicinal materials. A total of 10 batches of SD samples were prepared and analyzed. A total of 24 common peaks and six active components (gardenoside, rutin, berberine, palmatine, baicalein, and wogonin) were identified in the HPLC fingerprint of SD. The ten batches of SD samples were divided into four groups via HCA and PCA. The HPLC fingerprint similarities of the 10 batch samples were 0.934 or higher. The precision, stability, repeatability, and other methodological indexes suggested that the developed method met the requirements for qualitative fingerprint research. The results indicated that HPLC fingerprints combined with PCA and multicomponent determination can be successfully applied to SD quality control. This study also provides a basis for a more comprehensive quality evaluation method for SD. The fingerprint of SD, a TCM famous classical formula, was established by HPLC in this paper. Moreover, contents of six pharmacodynamic related components in SD were determined simultaneously in order to establish a comprehensive quality evaluation method of SD. This study can also provide a basis for raw material selection, quality evaluation, extraction process, preparation development and pharmacodynamic material basis research of SD.

PENERAPAN TEKNIK FISIOTERAPI DADA TERHADAP KETIDAKEFEKTIFAN BERSIHAN JALAN NAFAS PADA ANAK DENGAN PENYAKIT SISTEM PERNAFASAN

Respiratory disease is a condition where there is a problem in respiratory system. Some of disease include in respiratory disease are pneumonia, asthma, and bronchitis. Child who experience respiratory tract disorders often occur an increase in the production of excessive phlegm in the lungs of phlegm which thicknes and accumulates so that it is difficult to remove, therefore to help speed healing assisted by chest physiotherapy. The aim is to know the effect of chest physiotherapy on ineffective of clearance airway on a child with respiratory disorders. This research use literature review as method to know the effect of chest physiotherapy. The result of research After performing chest physiotherapy, airway clearance of child effectively with the criteria for respiratory frequency within normal limits, being able to remove sputum, no additional breath sounds, and coughing decreased. Chest physiotherapy are significantly effective to overcome ineffective airway clearance.&#x0D;

User-Perceived Negative Respiratory Symptoms Associated with Electronic Cigarette Use.

IntroductionElectronic cigarettes (ECIGs) expose users to an aerosol containing chemicals, which could affect the respiratory system negatively. This study examined negative respiratory symptoms associated with ECIG use.MethodsIn 2019, adult current ECIG users from 24 US states who reported experiencing negative respiratory symptoms from ECIG use (n = 49; 44.9% women; mean age = 35.2, SD = 11.5) completed an online survey and brainstormed statements that completed the prompt: “A specific negative effect or symptom related to my breathing, nose, mouth, throat, or lungs that I have experienced from vaping/using my e-cigarette is...” Participants sorted the final list of 56 statements into groups of similar content and rated statements on how true they were for them. Multidimensional scaling analysis identified thematic clusters.ResultsEight ECIG use respiratory symptom clusters identified in analysis included Mucus and Congestion, Fatigue, Throat Symptoms, Breathing Problems, Mouth Symptoms, Chest Symptoms, Illness Symptoms, and Nose and Sinus Symptoms. Highly rated (ie, most common) symptoms included dry throat or mouth, fatigue during physical activity, coughing, shortness of breath, excessive phlegm, and bad taste in mouth. Mean cluster ratings did not differ based on lifetime cigarette smoking status (100 lifetime cigarettes smoked), but current cigarette smokers (ie, dual users) rated the Fatigue, Breathing Problems, Mucus and Congestion, and Nose and Sinus Symptoms clusters higher than noncurrent cigarette smokers.ConclusionsParticipant-identified respiratory symptoms perceived to be ECIG related, many similar to cigarette smoking symptoms. Future research should assess if these symptoms are associated with other negative health outcomes.ImplicationsECIG use exposes users to chemicals that may have negative health impacts on the respiratory system. Limited research has examined the broad range of negative respiratory symptoms associated with e-cigarette use. This study identified that ECIG–cigarette users perceive their ECIG use to be associated with negative respiratory symptoms. Many e-cigarette user-reported negative respiratory symptoms are similar to those associated with cigarette smoking, though some appear unique to e-cigarette use. Future research should continue to monitor respiratory symptoms reported by ECIG users and whether these are associated with health outcomes over time.

Analysis of classical prescription Jinshui Liujun Jian based on ancient literature

To provide the ancient literary evidence support for the clinical application and development of classical prescription based on systematical collection and analysis of the ancient Chinese medical literature containing Jinshui Liujun Jian, including its origin and development. Bibliometric analysis was used and information of Jinshui Liujun Jian in ancient Chinese medical literature was then collected for statistical analysis of formula compositions, main indications, dosage, preparation methods, etc. A total of 151 valid items of data were obtained from 48 ancient Chinese medicine books. Jinshui Liujun Jian was first recorded in Jingyue Quanshu written by ZHANG Jiebin. This prescription consisted of Rehmanniae Radix Praeparata, Angelicae Sinensis Radix, Pinelliae Rhizome, Citri Reticulatae Pericarpium, Poria and Glycyrrhizae Radix et Rhizome Praeparata cum Melle, and it was mainly used to treat the deficiency of lung and kidney, edema and excess production of phlegm, or Yin deficiency in the old, insufficient blood-qi, wind-cold evil, cough and disgusting, asthma and excessive phlegm. Doctors in later dynasties mostly followed the prescription compositions, dosages and indications in Jingyue Quanshu, and extended the clinical application of this prescription.

Chemical Constituents from Physalis Calyx seu Fructus and Their Inhibitory Effects against Oxidative Stress and Inflammatory Response.

Physalis Calyx seu Fructus, a traditional Chinese medicine consisting of the calyxes and fruits of Physalis alkekengi var. franchetii, has been used as therapy for inflammation-related respiratory diseases such as excessive phlegm, cough, sore throat, and pharyngitis for a long history in China. The aim of the present study was to investigate the chemical constituents of Physalis Calyx seu Fructus and identify the bioactive constituents responsible for its traditional application as therapy for inflammation-related diseases. In the present study, one new phenylpropanoid (1: ), two new steroids (17: and 18: ), together with 55 known constituents have been purified from the EtOH extract of Physalis Calyx seu Fructus. Among them, seven and twelve known constituents were isolated for the first time from Physalis Calyx seu Fructus and the genus Physalis, respectively. Fourteen constituents, including steroids [physalins (5: - 9, 12: - 14: , and 15: ) and ergostane (21: )], a sesquiterpenoid (35: ), alkaloids (36: and 37: ), and a flavonoid (44: ), showed inhibitory effects against oxidative stress. Ten constituents, including steroids (5, 6, 8, 13: , and 15: ), sesquiterpenoids (34: and 35: ), alkaloids (37: and 41: ), and a flavonoid (43: ), were found be potential anti-inflammatory constituents of this medicinal plant. The inhibition of oxidative stress and inflammatory response may be related to the regulation of Nrf2 and nuclear factor-κB pathways. The ethnomedical use of Physalis Calyx seu Fructus as a treatment for respiratory diseases might be attributed to the combined inhibitory effects of steroids, alkaloids, sesquiterpenoids, and flavonoids against oxidative stress and inflammatory response.

Anti-colitic effects of Physalin B on dextran sodium sulfate-induced BALB/c mice by suppressing multiple inflammatory signaling pathways

Ethnopharmacological relevancePhysalin B is one of the main active withanolide existed in Physalis alkekengi L. var. franchetii (Mast.) Makino, a famous traditional Chinese food and herbal medicine, which has been widely used as heat-clearing and toxin-resolving medicine for the treatment of various inflammatory disease, such as cough, excessive phlegm, pharyngitis, sore throat, pemphigus, eczema, and jaundice. Aim of the studyWe aimed to confirm the therapeutic effects of Physalin B on ulcerative colitis (UC) and enrich the further application of its traditional anti-inflammatory effect. Materials and methodsThe anti-UC effects of Physalin B were evaluated in Balb/c mice with dextran sulfate sodium (DSS) induction. The body weight, colon length, disease activity index (DAI) and pathological changes of colon tissue were measured. Cytokine levels were detected by ELISA. NF-κB pathway and protein levels of related pathways, such as signal transducer and activator of transcription 3 (STAT3), β-arrestin1 and NOD-like receptor pyrin domain-containing protein 3 (NLRP3) inflammasome were detected by western blot. ResultsThe dose of Physalin B that is not cytotoxic could dramatically reduce the levels of TNF-α, IL-6 and IL-1β on LPS-stimulated RAW 264.7 cells. Meanwhile, Physalin B dramatically improved clinical signs and symptoms, alleviated body weight loss and colon length shortening in DSS-induced UC mice. Meanwhile, Physalin B also dramatically relieved the pathological damage, reduced in the activity of myeloperoxidase (MPO) and reestablished the balance of pro-inflammatory cytokines. Physalin B could suppress DSS-induced activation of NF-κB. Moreover, Physalin B also markedly suppressed the activation of STAT3, β-arrestin1 and NLRP3 inflammasome. ConclusionThis study preliminary confirmed the therapeutic effect of Physalin B on experimental acute UC mice and provided robust evidence support for the anti-inflammatory effect of Physalin B, suggesting that Physalin B might be a potential agent for the therapeutic efficacy on UC.

Bioactive platycodins from Platycodonis Radix: Phytochemistry, pharmacological activities, toxicology and pharmacokinetics

Platycodonis Radix, the root of Platycodon grandiflorum (Jacq.) A. DC., is a well-known edible herbal medicine. It is a common vegetable used for the preparation of side dish, kimchi, dessert, and tea. Besides, it has been used to treat respiratory disease including cough, excessive phlegm, and sore throat for a long history. In the past decades, the bioactive components and the pharmacological activities of Platycodonis Radix have been widely investigated. Thereinto, platycodins, the oleanane-type triterpenoid saponins were demonstrated to be the main bioactive components in Platycodonis Radix, and more than 70 platycodins have been identified up to date. This paper mainly reviewed the phytochemistry, pharmacological activities (apophlegmatic, anti-tussive, anti-inflammatory, anti-cancer, anti-obesity, anti-diabetic, immunomodulatory, cardiovascular protective, and hepatoprotective activities, etc.), toxicology and pharmacokinetics of platycodins isolated from Platycodonis Radix, aiming to promote further investigation on therapeutic potential of these platycodins.

Active Cycle Breathing Exercise on Post Tuberculosis Bronchiectasis

Introduction: Tuberculosis (TB) has remained as a major global health issue in Indonesia. Bronchiectasisfrequently occurs in healing process, followed by excessive phlegm and low physical activity.Methods: A case presentation of 49 years old female diagnosed as bronchiectasis post tuberculosis,difficulty to clear the phlegm, and inactive. Patient has undergone pulmonary rehabilitation by activecycle breathing exercise, 5 days a week, 30 minute/session, for 2 weeks.Results: There was no dyspnea, patient easily remove phlegm, and can be more active, after cyclebreathing exercise program.Conclusion: Active cycle breathing exercise effective to relieve dyspnea, improving patient ability toclearance the phlegm, and increase physical activity.Keywords: Bronchiectasis, active cycle breathing exercise, phlegm clearance, physical activity