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Assessment of human airway lumen opening is important in diagnosing and understanding the mechanisms of airway dysfunctions such as the excessive airway narrowing in asthma and chronic obstructive pulmonary disease (COPD). Although there are indirect methods to evaluate the airway calibre, direct in vivo measurement of the airway calibre has not been commonly available. With recent advent of the flexible fiber optical nasopharyngoscope with video recording it has become possible to directly visualize the passages of upper and lower airways. However, quantitative analysis of the recorded video images has been technically challenging. Here, we describe an automatic image processing and analysis method that allows for batch analysis of the images recorded during the endoscopic procedure, thus facilitates image-based quantification of the airway opening. Video images of the airway lumen of volunteer subject were acquired using a fiber optical nasopharyngoscope, and subsequently processed using Gaussian smoothing filter, threshold segmentation, differentiation, and Canny image edge detection, respectively. Thus the area of the open airway lumen was identified and computed using a predetermined converter of the image scale to true dimension of the imaged object. With this method we measured the opening/narrowing of the glottis during tidal breathing with or without making "Hee" sound or cough. We also used this method to measure the opening/narrowing of the primary bronchus of either healthy or asthmatic subjects in response to histamine and/or albuterol treatment, which also provided an indicator of the airway contractility. Our results demonstrate that the image-based method accurately quantified the area change waveform of either the glottis or the bronchus as observed by using the optical nasopharygoscope. Importantly, the opening/narrowing of the airway lumen generally correlated with the airflow and resistance of the airways, and could differentiate the level of airway contractility between the healthy and asthmatic subjects. Thus, this quantitative assessment of airway opening may provide a useful tool to assist clinical diagnosis of airway dysfunctions and understanding the mechanisms of associated pathophysiologies.

Objective: This study aims to systematically evaluate the efficacy and safety of catgut implantation at acupoints (CIA) treating asthma, extracting data from the published clinical trials.

Methods: The Cochrane Library, PubMed, Chinese Biomedical Database (CBM), CNKI, WANFANG and VIP databases were searched up to February 2017. Randomized controlled trials (RCTs) involving CIA or CIA plus conventional medicine treatment (CMT) were selected with CMT as control. We assessed the methodological quality of RCTs using the Cochrane Handbook for Systematic Review of Interventions. The outcome data of trials were analyzed using RevMan5.3.

Results: A total of 12 studies ($n=861$) were included. Most of the included studies were assessed to have high risk of bias with low quality of methodology. CIA application significantly improved the overall therapeutic efficacy ($p<0.001$) and pulmonary function (forced expiratory volume in 1s (FEV1) and FEV1%, $p<0.05$ and $p<0.001$) and reduced the overall scores of TCM symptoms ($p<0.05$). Further, it significantly relieved several TCM symptoms including shortness of breath, chest distress and cough ($p<0.05$). However, CIA only exerted a protective tendency for expectoration and wheezing without significant difference and had no effects on recurrence rate (all $p>0.05$).

Conclusions: CIA treatment could improve the overall efficacy and pulmonary function and relief several symptoms. However, the evidence remains weak. Rigorous and larger trials will be the basis of the effectiveness and long-term effects of CIA therapies.

Objective: The anti-asthma herbal medicine Bu–Shen–Yi–Qi Decoction (BSYQ Decoction), a combination of three traditional Chinese medicine herbs developed in our lab, has shown demonstrated efficacy in Ovalbumin (OVA)-induced acute bronchial asthma. However, the obscure substances, multiple potential targets and the unclear molecular mechanisms are obstacles to control drug quality, stability and standardization. Multi-component formulae with a clear pharmacodynamic material and specific mechanism are an innovation worth exploring. They may also partly reserve a potential synergistic and additive effect compared with single components extracted from traditional Chinese herbs. This study was designed to select three standard multi-component formulae of the combination of effective components preliminarily based on four effective components [total flavonoids of Herba Epimedii ($A)$; Astragalus polysaccharide ($B)$; Astragaloside ($C)$; and Catalpol ($D)$] in BSYQ Decoction.

Methods: OVA-induced asthmatic murine models were established. A uniform design was applied to select 10 proportions from four target components, and 3 formulae which showed best effect aimed at IFN-$\gamma$, IL-4 and IgE in the serum respectively were screened based on stepwise regression analysis.

Results: According to the regression analysis, Formula I ($A$:$B$:$D=5$:6:29), Formula II ($A$:$C$:$D=250$:8:2) and Formula III ($A$:$B$:$C$:$D=250$:50:8:2) are the three potential proper ratios for the new multi-component formula aimed at serum IFN-$\gamma$, IL-4 and IgE in OVA-induced asthma mice, respectively.

Conclusion: Three multi-component formulae derived from BSYQ Decoction could exert anti-inflammatory effect against OVA-induced asthma, which might provide evidences and lay foundations for further study of standard modern Chinese drug for treating asthma based on BSYQ Decoction.

This paper discusses the understanding of traditional Chinese medicine, Uyghur medicine, Tibetan medicine and Mongolian medicine on bronchial asthma, and discusses the causes and pathogenesis, syndrome differentiation, treatment principles and treatment drugs, respectively. It compares the similarities and differences of different ethnic groups’ traditional medicines on bronchial asthma treatment, so as to help each ethnic group learn from each other and further improve their understanding of asthma.

Nonsteroidal anti-inflammatory drugs (NSAIDs) can induce hypersensitivity reactions with various clinical manifestations including acute/delayed reactions and three common phenotypes, NSAID/aspirin-exacerbated respiratory disease (NERD or AERD) with/without chronic rhinosinusitis (CRS) and nasal polyps, NSAID-exacerbated cutaneous disease (NECD). NSAID-induced urticaria/angioedema (NIUA). NIAU is commonly combined with anaphylaxis and named as NIUAA. The major pathogenic mechanism is the inhibition of cyclooxygenase-1 with a reduction in prostaglandin E2 levels, leading to the overproduction of cysteinyl leukotrienes and activation of inflammatory cells, including eosinophils and mast cells.

To confirm the diagnosis, provocation testing via the oral route or inhalation remains the gold standard; in vitro diagnostic methods are still not available. Essential managements are: (1) avoidance of cross-reacting NSAIDs along with the use of alternative analgesics; (2) pharmacologic treatment should follow standard guidelines in patients with underlying asthma/rhinitis (NERD, CRS), and urticaria (NECD). Aspirin desensitization and biologic treatment can be done when indicated.

Delayed reactions, including fixed drug eruptions, maculopapular eruptions, and severe cutaneous adverse reactions, are rare and mediated by T-cell responses. Symptomatic treatment with avoidance is essential. NSAID is a cofactor of food-dependent exercise-induced anaphylaxis. In this talk, we will update various clinical phenotypes and discuss practical issues faced in real clinical practice.