Prevalence and burden of chronic cough in China: results from a population-based survey

BACKGROUND

Chronic cough is associated with reduced mental and physical health and increased health care resource use. The lack of nationwide data on chronic cough hinders our understanding of the prevalence, demographics, and impacts of chronic cough in China. The aim of this study was to estimate the lifetime and annual prevalence of chronic cough in mainland China and to describe the sociodemographic and health-related characteristics of adults with chronic cough.

METHODS

This was a cross-sectional study using self-reported information from a nationally representative sample of 20,051 adults. Respondents with chronic cough (daily cough for ≥ 8 weeks) during the prior 12 months were matched to respondents without chronic cough.

RESULTS

We estimated a lifetime prevalence of 7.0% and an annual prevalence of 4.1% for chronic cough among adult residents of mainland China. Affected individuals had a mean age of 43.5 years, and there were no significant differences in prevalence between men and women. Compared to matched controls, the chronic cough group had more comorbidities and included a higher proportion of individuals who had been diagnosed with respiratory and sleep-related conditions. Chronic cough was also associated with significantly worse depression and anxiety symptom severity and health-related quality of life, as well as increased impairment of work and other daily activities and higher rates of all-cause health care resource use.

CONCLUSIONS

Chinese adults with chronic cough show a middle age, equal gender distribution. Chronic cough affects an estimated 46.4 million adults in mainland China during their lifetime and is associated with significant individual and health care system burden.

TAKE HOME MESSAGE

Chronic cough affects approximately 4.1% (27.2 million) of adults per year in mainland China and is associated with worse health and health-related quality of life, impairment of work productivity and other daily activities, and increased all-cause health care resource use.

Sustainable Development Performance for Small and Medium Enterprises Using a Fuzzy Synthetic Method-DEMATEL

Small and medium enterprises (SMEs) are forced to adhere to sustainable development (SD) regulations and standards. However, SMEs encounter difficulty in assessing their performance due to the lack of an efficient and effective approach to deal with the uncertainties in hierarchical relationships and interrelationships. Moreover, interrelations exist among the proposed attributes that increase the difficulty of the assessment. To overcome these issues, exploratory factor analysis is used to screen out the less important attributes and build a hierarchal structure. The fuzzy synthetic method addresses the hierarchical structure and decision-making, and a trial evaluation laboratory assesses the interrelationships among the attributes by providing a visual interrelationship map. The results indicate that strategic and financial management are the major problems for SMEs. SD relies on enhancing sustainable supply chain performance, sustainable human resources and environmental management. This study contributes by not only filling the information gap for SD for SMEs but also providing a guideline for improvement. The theoretical and managerial implications are discussed.

Melatonin Attenuates Chronic Cough Mediated by Oxidative Stress via Transient Receptor Potential Melastatin-2 in Guinea Pigs Exposed to Particulate Matter 2.5

The aim of this study was to investigate the effects of melatonin on oxidative stress, the expression of transient receptor potential melastatin-2 (TRPM2) in guinea pig brains, and the influence of melatonin on oxidative stress in lungs and airway inflammation induced by particulate matter 2.5 (PM2.5). A particle suspension (0.1 g/ml) was nasally administered to the guinea pigs to prepare a PM2.5 exposure model. Cough frequency and cough incubation period were determined through RM6240B biological signal collection and disposal system. Oxidative stress markers, including malondialdehyde (MDA), total antioxidant capacity (T-AOC), total superoxide dismutase (T-SOD), and glutathione peroxidase (GSH-Px), in the medulla oblongata were examined through spectrophotometer. Reactive oxygen species (ROS) were detected in the hypoglossal nucleus, cuneate nucleus, Botzinger complex, dorsal vagal complex, and airway through dihydroethidium fluorescence. Hematoxylin-eosin (HE) staining and substance P expression via immunohistochemistry revealed the inflammatory levels in the airway. TRPM2 was observed in the medulla oblongata through immunofluorescence and Western blot. The ultrastructure of the blood-brain barrier and neuronal mitochondria was determined by using a transmission electron microscope. Our study suggests that melatonin treatment decreased PM2.5-induced oxidative stress level in the brains and lungs and relieved airway inflammation and chronic cough. TRPM2 might participate in oxidative stress in the cough center by regulating cough.