The common cold is the most common acute respiratory infectious disease, with a high incidence and widespread susceptibility. Most common colds are self-limited but can lead to serious social and economic burdens. In recent years, the symptoms of common cold patients have been complex and diverse, and some patients can develop serious complications, even threatening their lives. The Anti-infection Committee, Emergency Doctor Branch of Chinese Medical Doctor Association has developed the Practice Guidelines for the Diagnosis and Management of Common Cold in Adults, 2023, which explored 15 important issues related to clinical practice. This article provides a detailed and comprehensive interpretation of the guideline, in order to better understand the diagnosis and treatment of adult common cold and serve clinical practice.
ObjectiveTo systematically review the association between the level of plasma YKL-40 and obstructive sleep apnea hypopnea syndrome (OSAHS).MethodsWe searched PubMed, EMbase, MEDLINE, CNKI, WanFang Data, VIP database and supplemented by Google academic retrieval to collect case-control studies about the association between the level of plasma YKL-40 and OSAHS from inception to April 2017. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies. And then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 5 case-control studies were included, involving 755 OSAHS patients and control population. The results of meta-analysis showed that the level of plasma YKL-40 in OSAHS patients was higher than that in control group (SMD=1.20, 95%CI 0.33 to 2.06, P=0.007). The subgroup analysis showed that the level of plasma YKL-40 in OSAHS patients from Asia was significantly higher than that in control group (SMD=1.79, 95%CI 0.83 to 2.75, P=0.000 2). The comparison between different severity of OSAHS showed that the wild-medium group had lower plasma level of YKL-40 than the severe group (SMD=–0.83, 95%CI –1.46 to –0.19, P=0.01).ConclusionYKL-40 may play an important role in the pathogenesis of OSAHS. Due to limited quantity and quality of the included studies, more high quality studies are needed to verify above conclusions.
Objective To evaluate the prognostic values of CURB-65 score and inflammatory factors in hospitalized patients with community-acquired pneumonia (CAP). Methods A retrospective study was conducted in hospitalized adult CAP patients in West China Hospital between January 1st, and December 31th, 2013. Data of CURB-65 score and serum levels of inflammatory factors (WBC, ESR, PCT, CRP, IL-6 and ALB) on admission and clinical outcomes were collected. The associations between CURB-65 score, inflammatory factors and clinical outcomes were examined. Logistic regression analysis was performed to develop combined models to predict in-hospital death of CAP patients, and ROC analysis was conducted to measure and compare the prognostic values of CURB-65 score, inflammatory factors or combined models. Results A total of 505 hospitalized CAP patients were included. 81 patients died during the hospitalization and the in-hospital mortality rate was 16.0%. Possible risk factors of in-hospital death included old age, male sex, hypertension, cardiovascular or cerebrovascular diseases, multi-lobular pneumonic infiltration, high risk scores, ICU admission, mechanical ventilation and severe pneumonia (all P values<0.05). Logistic regression analysis showed that CURB-65 score, ALB and IL-6 were the independent factors in predicting in-hospital death of CAP patients and the area under curve (AUC) of them while predicting in-hospital death were 0.75 (95%CI 0.69 to 0.81), 0.75 (95%CI 0.69 to 0.81) and 0.75 (95%CI 0.69 to 0.80), respectively. ROC analysis found that ALB and IL-6 could improve the AUC of CURB-65 score significantly while predicting the in-hospital death (P<0.05). When ALB and IL-6 were added to the CURB-65 score simultaneously, the AUC was improved to 0.84 (95%CI 0.80 to 0.87). When IL-6 or ALB was added to the CURB-65 score to form a new scale, the AUC of the new scale was significantly higher than that of the CURB-65 score in predicting in-hospital death (P<0.001). Conclusion The prognostic values of CURB-65 score and inflammatory factors may be not ideal when they are used alone in hospitalized CAP patients. IL-6 and ALB may significantly improve the prognostic value of CURB-65 score in predicting in-hospital death.
ObjectivesTo systematically review the efficacy of lidocaine injected prior to tracheal extubation in preventing hemodynamic responses to tracheal extubation in general anesthesia.MethodsPubMed, Ovid, Web of Science, EMbase, The Cochrane Library, CBM, CNKI, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of lidocaine administrated prior to extubation in preventing hemodynamic responses to tracheal extubation in patients undergoing general anesthesia from inception to October, 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 and Stata 13.0 software.ResultsA total of 10 RCTs involving 525 patients were included. The results of meta-analysis showed that: compared with control group, lidocaine could reduce mean arterial pressure in 5 min after extubation (MD=–5.10, 95%CI –9.41 to –0.79, P=0.02), weaken the increase in systolic blood pressure caused by extubation from the moment before extubation to 5 minutes after extubation (before extubation: MD=–7.22, 95%CI –10.34 to –4.11, P<0.000 01; at extubation: MD=–14.02, 95%CI –19.42 to –8.62, P<0.000 01; 1 minutes after extubation: MD=–15.82, 95%CI –22.20 to –9.45, P<0.000 01; 3 minutes after extubation: MD=–12.55, 95%CI –20.36 to –4.74, P=0.002; and 5 minutes after extubation: MD=–12.05, 95%CI –20.35 to –3.74, P=0.004), and weakened extubation-induced increase in diastolic blood pressure at extubation (MD=–9.71, 95%CI –16.57 to –2.86, P=0.005). In addition, lidocaine inhibited heart rate in all time points except the moment of before and at 10 minutes after extubation.ConclusionsCurrent evidence shows that lidocaine can inhibit the increase in blood pressure and heart rate caused by extubation at certain times. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusions.