Inhalation Research Articles

Blood Lead Level and Toxicity in Opium Smokers; a Comparison between inhalation and Ingestion of Opium

Objectives: During the recent years, risk of lead poisoning has increased in Iranian’s opium users. A few researches showed that the most common route were ingestion of lead contaminated opium in these patients. However, some use of inhaler opium and data on lead poisoning through this route is scarce. The aim of the current study was to determine lead poisoning in opium users who consume it inhalational. Methods: In this case-control study, blood lead level (BLL) and clinical Lead poisoning assessed and compared between pure inhalational and pure ingestionally chronic opium users and healthy controls. Results: There were totally 90 cases, 30 patients in each group (pure inhaler opium users, pure oral opium users, and control group). In chronic opium users (case group), mean age of the patients was 48.91±13.14 yeas (range; 22 to 79 years). Eighty-four (85%) patients were male (Male to Female ratio; 5.6/1). Mean BLL was 10.6 ±4.2, 126.1 ±52µg/dl, in inhalational opium users and ingestional users, respectively (P=0.001). The mean of BLL in healthy control group was and 4.78 µg/dl ± 1.83. Conclusions: In contrast to chronic ingestion of opium, the probability of absorption of lead via lungs is low when opium used by smoking and inhalation route. So, lead toxicity is not common in acute or chronic inhalational users of lead-contaminated opium.

Abuse liability of electronic cigarettes in men who are experienced electronic cigarette users.

Most electronic cigarettes (e-cigs) aerosolize a nicotine-containing liquid that users inhale. Few experimental studies have examined e-cig abuse liability (the extent to which use of these products may lead to persistent and/or problematic use). In this study, 24 experienced male e-cig users completed 4 sessions that differed byproduct used: own e-cig (OWN), an eGo e-cig filled with participants' own brand/flavor liquid in 0 mg/mL nicotine (e-cig0), an eGo e-cig filled with the highest nicotine concentration available in participants' own brand/flavor (e-cighighest), and a U.S. Food and Drug Administration-approved nicotine inhaler (IN). Outcome measures included crossover point on the multiple-choice procedure, plasma nicotine delivery, and subjective effect profile. After 10 puffs, a significantly higher mean crossover point was observed for OWN at $1.35 (SD = 0.90) compared to e-cighighest at $0.88 (SD = 0.89), e-cig0 at $0.83 (SD = 0.79), and IN at $0.72 (SD = 0.84). Significant increases in mean plasma nicotine concentration were observed for OWN at 7.94 ng/mL (SD = 6.19) and e-cighighest at 7.51 ng/mL (SD = 5.39). Significant reductions in abstinence symptom suppression and higher ratings of satisfaction were observed for OWN and e-cighighest, with significantly less suppression and lower ratings of satisfaction for e-cig0 and IN. These findings suggest that human laboratory methods can be used to assess e-cig abuse liability and that nicotine-containing e-cigs have greater abuse liability than nicotine-free e-cigs and the IN. Potential regulations intended to limit e-cig abuse liability should be tested using these or similar procedures. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The clinical research on Bairui grain combined with ambroxol atomization inhalation treating acute attack patients of chronic bronchitis

Objective To observe the clinical effect of Bairui grain combined with ambroxol atomization inhalation treating acute attack of chronic bronchitis (wind heat attact the lung symptom). Methods A total of 150 patients with acute attack of chronic bronchitis who were admitted in our hospital from July 2015 to July 2018 were randomly divided into control and intervention groups (75 each group) by the random number table method. The control group received ambroxol atomization inhalatio based on the regular western medicine treatment; the intervention group took Bairui grain orally based on control group. Both of the two groups were treated for 2 weeks. Before and after the treatment, to score the clinical symptoms and wind-heat attact the lung symptom. Use pulmonary function meter to detect the ratio of FEV1 to estimated value (FEV1%) and FEV1/FVC; use ELISA to detect serum and sputum levels of TNF-α and IL-6. Record the extinction time of the symptoms (cough, wheezing, sputum, lung rumble) and evaluate the clinical efficacy. Results The total efficacy rate of intervention group was 98.6% (72/73), which was significantly higher than control group 88.9% (64/73) (χ2=4.354, P=0.037). The symptoms (cough, wheezing, sputum, lung rumble) extinction time of intervention group were significantly less than those of the control group (t values 5.331, 5.590, 5.841, 6.305, respectively, all Ps<0.01). After the treatment, scores of clinical symptoms (cough, wheeze, cough, cough) and symptoms of wind-heat attacking lung (cough, wheezing, fever, dry mouth, stuffy nose, runny nose) of intervention group were significantly lower than those of the control group (t values 4.990, 4.431, 5.221, 5.004, 5.652, 5.190, 5.311, 5.793, 5.643, respectively, all Ps<0.01). After treatment, the FEV1% (52.51% ± 5.63% vs. 47.30% ± 5.21%, t=8.931) and FEV1/FVC (61.57 ± 6.44 vs. 56.87 ±5.82, t=8.251) were significantly higher than the control group (P<0.01). The serum level of TNF-α, IL-6 (t values 5.331, 4.908) and the level of TNF-α, IL-6 (t values 6.001, 4.803) in sputum were significantly lower than those of the control group (P<0.01). Conclusions The Bairui grain combined with ambroxol atomization inhalation can decrease the inflammotory cytokine levels of the acute attack patients with chronic bronchitis (syndrome of wind-heat attacking lung symptome), improve clinical symptoms and enhance efficacy. Key words: Bronchitis, chronic; Bairui grain; Ambroxol; Nebulization inhalation therapy; Integrated Chinese traditional and western medicine therapy

FIRST STUDY OF INHALED ASPIRIN VERSUS CHEWED ASPIRIN: PHARMACOKINETIC AND PHARMACODYNAMIC EFFECTS

Aspirin (ASA) inhalation may speed platelet inhibition versus chewing. The PK and PD of inhaled ASA [(I-ASA), Otitopic, Inc.], versus chewed and swallowed ASA (C-ASA) are unknown. The PD, PK, and safety of 50mg (n=6) and 100 mg I-ASA (n=5) and 162mg C-ASA (n=6) in healthy adults were determined.

Effect of sivelestat sodium on early inflammatory reaction and pulmonary edema in rats with smoke inhalation induced lung injury

Objective To investigate the effects of sivelestat sodium on early inflammatory response and pulmonary edema in rats with smoke inhalation-induced lung injury. Methods Seventy-five Sprague-Dawley rats were randomly divided into control group, model group, low-dose group, middle-dose group and high-dose group. The smoke inhalation model was continued except for the control group. The rats were given intraperitoneal injection of normal saline, cevicell sodium 10 mg/kg, 20 mg/kg and 30 mg/kg. The general condition and lung tissue were observed after 24 hours. Results Compared with the control group, rats in each group had a certain degree of lung injury, alveolar wall thickening, alveolar interstitial hyperemia, etc. The alveolar septal thickness, lung tissue wet-dry (W/D) level, the incidence of edema and the levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), neutrophil elastase (NE) and myeloperoxidase (MPO) in the model group were significantly higher than those of the other 4 groups. The lung function recovery was highest in the low dose group and the alveolar septal thickness was the highest among the dose group. The alveolar wall thickening incidence of W/D level and pulmonary edema in lung tissue in the low dose group were (6.76±0.40)μm, (5.18±0.13) and 40.00%, respectively, and the levels of TNF-α, IL-6, NE and MPO were (19.62±0.83)pg/L, (9.41±0.25)pg/L, (6.23±0.18)μg/L and (30.64±0.87)pg/L, significantly better than the middle dose group and high dose group (P<0.05). Conclusions Sivelestat sodium can significantly affect the smoke inhalation lung injury, and improve the recovery of liver function, which can significantly reduce the incidence of inflammation and pulmonary ede-ma in the lung, but its therapeutic effect and drug delivery. There was a significant association between doses and therapeutic effect, in the case of rats, a dose of 10 mg/kg was the best for treatment. Key words: Lung injury; Smoke inhalation injury; Sivelestat sodium; Inflammation; Pulmonary edema; Rats

Effects of holistic nursing management model in aerosol inhalation for children with mycoplasma pneumonia

Objective To explore the effects of holistic nursing management model in aerosol inhalation for children with mycoplasma pneumonia. Methods From June 2018 to April 2019, this study selected 150 mycoplasma pneumonia children with aerosol inhalation in the Affiliated Hospital of Jining Medical University as subjects by convenience sampling. All of children were divided into observation group and control group with the method of random number table, 75 cases in each group. Control group carried out routine nursing, while observation group implemented nursing care with the holistic nursing management model. This study compared the compliance of aerosol inhalation among children between two groups. Perceived society support of children parents and quality of life of children between two groups were evaluated with the Perceived Social Support Scale (PSSS) and the Pediatric Quality of Life Inventory Measurement Models (PedsQL 4.0) respectively before and after intervention. Results The compliance rates of aerosol inhalation among children were 94.67% (71/75) in observation group and 82.67% (62/75) in control group with a statistical difference (P<0.05) . A total of 5 days after intervention, the scores of PSSS of children parents in observation group and control group were (73.25±10.08) and (66.36±9.96) respectively with a statistical difference (P<0.05) . There were also statistical differences in the scores of PedsQL 4.0 between observation group (74.14±10.77) and control group (65.64±9.55) 5 days after intervention (P<0.05) . Conclusions The holistic nursing management model is conducive to improving the aerosol inhalation compliance and quality of life among children with pneumonia as well as social support among children parents which has high application effects. Key words: Mycoplasma pneumohia; Child pneumonia; Aerosol inhalation; Holistic nursing management model

The effects of occupational exposure to manganese fume on neurobehavioral and neurocognitive functions: An analytical cross-sectional study among welders.

This study aimed to measure concentrations of manganese fume in breathing zone (BZ) and blood among welders to assess neurocognitive and neurobehavioral functions among them. In this study 38 welders and 27 administrative employees participated. Q16 questionnaire was used to evaluate neurobehavioral symptoms. The computerized Stroop test and Continuous Performance Test (CPT) were used to assess neurocognitive functions. Sampling and analysis of manganese fumes in the BZ and blood samples were performed according to NIOSH-7300 and NIOSH-8005 methods, respectively. Average concentration of manganese in the welders' BZ and blood was 0.81 ± 0.21 mg/m3 and 18.33 ± 5.84 µg/l. Frequency of neurobehavioral symptoms was significantly higher in welders compared with control group. Spearman correlation test showed a moderate correlation between Mn concentrations in the BZ and blood Mn levels (rs = 0.352). There were statistical moderate and strong correlations between the frequency of neurobehavioral symptoms and manganese concentrations in the BZ (r=0.504) and blood Mn levels (r=0.643).The Pearson correlation coefficient (r=0.433-0.690) obtained on the psychological tests showed a moderate to strong correlation between manganese concentrations in the welders' BZ and blood and some indices of the Stroop test and CPT. The results of this study can confirm the effect of manganese inhalation on creating neurobehavioral and neurocognitive impairments in welders.

Controller Inhalers: Overview of Devices, Instructions for Use, Errors, and Interventions to Improve Technique

Inadequate inhaler technique in persistent asthma is frequently reported. However, there is little consensus on inhaler checklists, and critical elements of technique are not uniformly described. In addition, inhaler error rates and risk factors for poor technique are variable across studies. This Clinical Commentary Review summarizes the literature on inhaler design, use, and interventions to improve technique. Our aim is to help clinicians identify patients with poor inhaler technique, recognize the most important errors, and correct technique using evidence-based interventions.

Characteristics and practice management of intensive care for patients with Coronavirus Disease 2019

Objective To explore and analyze the characteristics and causes of intensive nursing needs of patients with Coronavirus Disease 2019. Methods This was a cross-sectional study. Severe or critical patients’ treatment and care information were extracted through the HIS system in a designated hospital of critical patients with Coronavirus Disease 2019. We used statistical descriptions to analyze patient general information, nursing degree, therapeutic intensive care needs. The chi-square test or Fisher's exact test was used to analyze the differences between characteristics of patients and nursing degree. Results A total of 1849 cases of severe and critical patients were collected, including special grade nursing care 697 (37.70%), grade I nursing care (62.30%) . There were 893 (48.30%) patients aged ≥65 years, and 853 (46.13%) patients with one or more complications. All patients required the nursing routine of infection department, and the therapeutic intensive care followed was vein blood collection (99.62%), oxygen inhalation (98.92%), oral medication (98.65%), finger pulse oxygen monitoring (77.07%) and pharyngeal swab collection (71.93%).The nursing degree of patients with different gender, age, admission mode, body position and complications were statistically significant (P<0.05). Conclusions The intensive care needs of patients with Coronavirus Disease 2019 are complex, which are special in treatment, life and psychology, and the tasks of nursing are heavy, difficult and professional. Special attention should be paid to elderly patients and patients with complications. Our hospital has established the temporary nursing department in the period of COVID-19 outbreak, unified the coordination of nursing manpower and quality of nursing management, and set up a nursing expert consultation team to further enhance the quality of care for critical patients with Coronavirus Disease 2019. Key words: Coronavirus Disease 2019 (COVID-19); Intensive care; Nursing degree; Nursing workload

Effectiveness of strengthening management in bronchial asthma control among community patients

Objective To evaluate the effectiveness of strengthening management in the bronchial asthma control among community patients. Methods One hundred and eighteen community patients with bronchial asthma were recruited from January 2017 to January 2018. The patients were divided into community strengthening management group (n=60) and control group (n=58), the annual times of acute attack, time to first exacerbation and annual medical expenses were compared between the two groups. The proportion of inhaled corticosteroid (ICS) administration was documented; the Asthma Control Test (ACT), the Mini Asthma Quality of Life Questionnaire (MiniAQLQ), Leicester Cough Questionnaire (LCQ), Fractional exhaled nitric oxide(FeNO) and pulmonary function were evaluated in two groups. Results The management group had greater improvements in the proportion of ICS administration [45(75.0%) vs.36(62.1%), χ2=4.143], ACT [(20.7±3.9) vs.(18.1±4.1), t=3.213], LCQ [(13.5±5.3) vs.(10.8±3.0), t=2.603], FeNO [(29.8±12.8) vs. (37.1±11.1), t=2.018] than the control group after six months of management (all P 0.05) between two groups. The LCQ score [(16.5±4.2) vs. (13.5±5.3), t=3.186] and the MiniAQLQ score [(83.2±11.1) vs. (69.1±14.3), t=5.603] of the management group were significantly improved after 1 year of management than those after 6 months. There was significant improvement in time to first exacerbation [182(92, 284) vs. 92(58, 176), Z=4.384] and the annual exacerbation was significantly reduced [0(0, 1)vs. 2(1, 3), Z=-3.187], annual medical costs of management group were significantly lower than those of control group [(10 523.0±550.5)Yuan vs. (15 787.1±1 421.2)Yuan, t=2.653]. Conclusion The strengthening management can effectively improve the control rate of bronchial asthma, reduce acute exacerbation, improve clinical symptoms and improve the quality of life in community patients with bronchial asthma. Key words: Asthma; Community health services; Quality of life

Clinical characteristics of COVID-19 in pregnancy: analysis of nine cases

Objective To evaluate the clinical characteristics and pregnant outcomes of gravidae with COVID-19. Methods This study involved nine gravidae with COVID-19 admitted to the Renmin Hospital of Wuhan University from January 22 to February 1, 2020. Their clinical data, including epidemiological history, clinical symptoms, laboratory examinations, chest CT, treatment, delivery mode, and pregnancy outcomes, were analyzed retrospectively. Specimens of maternal vaginal swab were collected in six pregnant women, and the specimens of amniotic fluid, cord blood, neonatal throat swab and breast milk samples were collected in four pregnant women who had a delivery during our study. All samples were tested for the existence of COVID-19. Descriptive analysis was applied in this study. Results (1) Among the nine cases, five were admitted in the third trimester and four in the second trimester. The median incubation period of COVID-19 was 8 (1-14) d. Fever was presented in all cases on admission, and the other commonly seen symptoms were cough (seven cases) and diarrhea (five cases). Other signs and symptoms were also reported, including shortness of breath, myalgia and fatigue (four cases in each), nasal obstruction, pharyngalgia, chest pain, and headache/dizziness (three cases in each), rash (two cases), and chills and expectoration (one case in each). The most common laboratory abnormalities were a decreased number of lymphocytes (seven cases) and elevated C-reactive protein (six cases). Chest CT scans were performed in seven women, and all showed patchy areas or ground-glass opacity in both lungs. Oligohydramnios was detected in only one case at 37+5 weeks, which was 7 d after the diagnosis of COVID-19. (2) All nine cases received empiric antibiotic and antiviral therapy with Chinese medicine as adjuvant treatment. Eight patients required oxygen inhalation, and eight were treated with glucocorticoid. Six cases received immunotherapy. (3) Four of the nine cases had delivered, including three cesarean sections and one spontaneous vaginal preterm birth after premature rupture of membranes, and the mother was transferred to the intensive care unit 2 d after delivery due to acute respiratory distress syndrome. One case was terminated at 26 gestational weeks. Of the four neonates, there were two term and two premature babies, and one preterm baby was small-for-gestational-age. No neonatal asphyxia was observed. Serial real-time quantitative reverse transcription-polymerase chain reaction showed negative results in the detection of 2019-novel coronavirus in all samples obtained from amniotic fluid, umbilical cord blood, neonatal nasopharynx, breast milk, and vagina. Maternal conditions were all stable in all cases, including the four continuing pregnancy, and the terminated ones, except the case mentioned above. Conclusions There is no distinguishable clinical feature between pregnant and non-pregnant COVID-19 patients. So far, there is no evidence for vertical transmission or worsening perinatal outcome in mothers and babies. Key words: Coronavirus infections; COVID-19; Pneumonia, viral; Pregnancy, vertical transmission

The predictive value of serum EOS% and FeNO in stable phase of COPD for the therapeutic effect of glucocorticoids

Objective To investigate the predictive value of peripheral blood eosinophil percentage (EOS%) and exhaled nitric oxide (FeNO) on the efficacy of inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD) at stable stage. Methods A total of 78 patients with stable COPD during the outpatient clinic from January 2017 to December 2018 were enrolled. EOS%, FeNO, and pulmonary function indicators [forced vital capacity(FVC), forced expiratory volume in 1 sec (FEV1), peak expiratory flow (PEF)] were measured after ICS-free elution. The questionnaire was used to assess the severity of the symptoms. The above indicators were reviewed after 4 weeks of ICS treatment. According to the improvement of pulmonary function and chronic obstructive pulmonary disease assessment (CAT) improvement , the patients were divided into effective and ineffective groups. Pearson correlation analysis and receiver operating characteristic (ROC) curve were used to analyze the predictive value of EOS% and FeNO for ICS. Results After ICS treatment, EOS% and FeNO were lower, FVC, FEV1, and PEF were higher than before, and CAT score was lower than before (P 0.05). The FeNO level in the effective group was higher than that in the ineffective group before and after ICS treatment, with statistically significant difference (P 0.05); the area under the ROC curve for EOS% prediction of ICS efficacy before treatment was 0.531 (P>0.05), with critical value 3.13%, the sensitivity 57.1% and specificity 52.4%, respectively. The area under the ROC curve of FeNO for ICS treatment before treatment was 0.628 (P<0.05), with critical value 30.00%, sensitivity and specificity (64.6% and 91.0%) respectively. Conclusions For patients with stable COPD, EOS% and FeNO levels are positively correlated with the improvement of FEV1 after ICS treatment. Both of them can predict the efficacy of ICS to a certain extent, and FeNO has higher predictive value than EOS%, which can be applied to clinical practice. Key words: Pulmonary disease, chronic obstructive; Eosinophils; Fractional exhaled nitric oxide; Inhaled glucocorticoid

Early antiviral therapy of abidol combined with lopinavir/ritonavir and recombinant interferon α-2b for patients with COVID-19 in Zhejiang: A multicenter prospective study

Objective To compare the efficacy of the combination of abidol, lopinavir/ritonavir plus recombinant interferon α-2b (rIFNα-2b) and the combination of lopinavir/ritonavir plus rIFNα-2b for patients with COVID-19 in Zhejiang province. Methods A multicenter prospective study was carried out to compare the efficacy of triple combination antiviral therapy and dual combination antiviral therapy in 15 medical institutions of Zhejiang province during January 22 to February 16, 2020. All patients were treated with rIFNα-2b (5 million U, 2 times/d) aerosol inhalation, in addition 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir/ritonavir (2 tablets, 1 time/12 h) (triple combination group) and 41 patients were treated with lopinavir/ritonavir (2 tablets, 1 time/12 h) (dual combination group). The patients who received triple combination antiviral therapy were further divided into three subgroups: 5 d according the time from the symptom onset to medication starting. The therapeutic efficacy was compared between triple combination group and dual combination group, and compared among 3 subgroups of patients receiving triple combination antiviral therapy. SPSS 17.0 software was used to analyze the data. Results The virus nucleic acid-negative conversion time in respiratory tract specimens was (12.2±4.7) d in the triple combination group, which was shorter than that in the dual combination group [(15.0±5.0) d] (t=6.159, P 5 d, respectively (Z=32.983, P<0.01), while the time from antiviral therapy to viral negative conversion was (11.8±3.9), (13.5±5.1) and (11.2±4.3) d, respectively(Z=6.722, P<0.05). Conclusions The triple combination antiviral therapy of abidol, lopinavir/litonavir and rIFNα-2b shows shorter viral shedding time and shorter hospitalization time, compared with the dual combination antiviral therapy; and the earlier starting triple combination antiviral therapy will result in better antiviral efficacy. Key words: COVID-19; Antiviral therapy; Abidol; Lopinavir/ritonavir; Recombinant interferon α-2b

Application of extracorporeal membrane oxygenation in the treatment of neonatal respiratory failure

Extracorporeal membrane oxygenation is an important treatment for neonatal cardiopulmonary failure, which is often unresponsive to conventional treatments such as high-frequency ventilation, surfactant replacement, and inhaled nitric oxide.The basic principle is to drain blood from the patient′s body, pump it into a membrane oxygenation(artificial lung), where carbon dioxide is removed and oxygen is added, and then flow back to the patient.A large number of domestic and foreign neonatal clinical trials have confirmed the effectiveness and the good long-term outcomes of extracorporeal membrane oxygenation in the treatment of severe respiratory failure, but its application in China is still in the initial stage.This paper reviews the development of extracorporeal membrane oxygenation technology, indications and contraindications, management, complications, inter-hospital transport, and long-term quality of life assessment of the survived children. Key words: Extracorporeal membrane oxygenation; Respiratory failure; Newborn infant

Hyperbaric oxygen improves the effectiveness of wet healing in the treatment of refractory skin ulcers

Objective To explore the effect of combining hyperbaric oxygen inhalation with wet healing in the treatment of chronic refractory ulcers of the skin. Methods Sixty male Sprague-Dawley rats were randomly formed into a general treatment group (group A), a wet healing group (group B), and a hyperbaric oxygen + wet healing group (group C), each of 20. Chronic and refractory skin ulcers were induced on all of the rats after one week of routine feeding and 6 hours of fasting. Six courses (once daily for 10 days/course)of the three treatments were then administered. After 2, 4 and 6 courses of treatment the wound healing rate and recovery were analyzed using histopathological methods. Results After 2, 4 and 6 courses of treatment, the average wound healing rates of groups B and C were significantly higher than group A′s average, and that of group C was significantly better than that of group B. After 6 courses of treatment, group C′s average histopathology score was significantly higher than that of group B, and those of groups B and C were both significantly higher than group A′s average. Conclusion Single wet healing is better than common treatment for chronic skin ulcers, but hyperbaric oxygen inhalation can further improve its effectiveness. Key words: Hyperbaric oxygen; Wet healing; Skin ulcers

Effect of neurokinin 1 receptor antagonist on airway inflammation and hyperresponsiveness in asthmatic mice

Objective To investigate the effects of neurokinin-1 receptor antagonist WIN 62, 577 on airway inflammation and airway hyperresponsiveness in asthmatic mice. Methods Thirty-two BALB/c mice(Specific-pathogen-free grade) were randomly divided into 4 groups: control group, asthmatic group, WIN 62, 577 intervention group and dexamethasone group.The asthmatic group, the WIN 62, 577 intervention group, and the dexamethasone group were given intraperitoneal injection of 0.2 ml of OVA sensitization solution at 0 d, 7 d, and 14 d, respectively.Then the asthmatic group, WIN 62, 577 group and dexamethasone group were given OVA challenge solution(4% OVA solution) by inhalation once a day for 30 min from 21 d to 28 d for 7 consecutive days.The WIN 62, 577 intervention group was given WIN 62, 577 300 μg intraperitoneal injection 1 h before each challenge; the dexamethasone group was given intraperitoneal injection of dexamethasone 2 mg/kg 1 h before each challenge.The airway responsiveness of each group of mice was detected by non-invasive pulmonary function test.The bronchoalveolar lavage fluid(BALF) was obtained for inflammatory count.The HE staining of lung tissue was used to observe airway inflammation in mice. Results Compared with the asthmatic group, the mice in the WIN 62, 577 intervention group showed less restlessness, standing upright, crouching back, scratching the ears and scratching the cheeks, shortness of breath and cyanosis of the lips.After inhaling different concentrations of acetylcholine, the Penh value of mice in the WIN 62, 577 intervention group and the dexamethasone group was significantly lower than that in the asthmatic group(P<0.05). Compared with the asthmatic group, the number of WBC and EOS in BALF decreased significantly in the WIN 62, 577 intervention group and the dexamethasone group(P<0.01). HE staining showed that the inflammatory changes in the lung tissue of mice in the WIN 62, 577 intervention group were significantly reduced, the bronchial epithelium did not fall off significantly, the mucosal edema was not obvious, the smooth muscle proliferation was reduced, and the inflammatory cell infiltration was reduced, similar to the airway changes in the dexamethasone group. Conclusion Neurokinin-1 receptor antagonist WIN 62, 577 can reduce airway inflammation and airway hyperresponsiveness in asthmatic mice. Key words: Asthma; Inflammation; Hyperresponsiveness; Substance P; Neurokinin-1 receptor

How do oral and inhaled antibiotics compare for people with bronchiectasis?

How do oral and inhaled antibiotics compare for people with bronchiectasis?

A clinical study of ultrasound-guided internal branch of superior laryngeal nerve block to treat postoperative sore throat after extubation under general anesthesia

Objective To investigate the efficacy of ultrasound-guided internal branch of superior laryngeal nerve (ibSLN) block to treat postoperative sore throat (POST) after extubation under general anesthesia. Methods Sixty patients, aged from 18 to 45 years old, American Society of Anesthesiologist (ASA) Ⅰ or Ⅱ who suffered from moderate to severe postoperative sore throat after extubation under general anesthesia were selected. They were divided into two groups according to the random number table method (n= 30): a lidocaine combined with budesonide aerosol inhalation group (group L) and an iBSLN block group (group S). The Visual Analogue Scale (VAS) scores and the significant analgesic efficiency rate of POST were recorded in two groups immediately before treatment (T0), 10 min after treatment (T1), 30 min after treatment (T2), 1 h after treatment (T3), 2 h after treatment (T4), 4 h after treatment (T5), 8 h after treatment (T6), and 24 h after treatment (T7). The mean arterial pressure (MAP), heart rate, and pulse oxygen saturation (SpO2) were also recorded from T0 to T7. Adverse reactions such as chocking on water, regurgitation and aspiration, hoarseness and dyspnea were observed in the two groups, while the score of patient satisfaction towards treatment was evaluated. Results The VAS score of POST in group S was lower than that in group L from T0 to T6 (P<0.05). The significant analgesic efficiency rate of POST in group S was significantly higher than that in group L from T1 to T6 (P<0.05). Compared with group L, heart rate in group S reduced from T1 to T4 (P<0.05), while MAP decreased from T1 to T3 (P<0.05). The satisfaction score of group S was higher than that of group L (P< 0.05). No chocking on water, regurgitation and aspiration, hoarseness, and dyspnea was found in the two groups. Conclusions Ultrasound-guided ibSLN block can effectively treat POST after extubation under general anesthesia, with remarkably improved analgesic effects in comparison with traditional methods where hormone combined with local anesthetic aerosol are inhaled. It provides a good approach to treat POST after extubation under general anesthesia. Key words: Ultrasound-guided; Superior laryngeal nerve; Nerve blocking anesthesia; Postoperative sore throat; Anesthesia, general

Value analysis of Danqing SanjiaSan in the treatment of chronic hypertrophic laryngitis during the implementation of auxiliary atomization inhalation nursing

Objective To analyze the value of Danqing SanjiaSan in the treatment of chronic hypertrophic laryngitis during the implementation of auxiliary atomization inhalation nursing. Methods A total of 57 cases of patients with chronic hypertrophic laryngitis treated with Danqing SanjiaSan, who were admitted to the hospital from April 2016 to April 2018, were selected as the study subjects, and were divided into the observation group with 28 cases and the control group with 29 cases according to simple random sampling.The control group was treated with oxygen-driven budesonide nursing intervention, and the observation group was treated with laryngning atomizer spray throat on the basis of routine intervention.Blood oxygen saturation, clinical efficiency, TCM syndrome score, voice acoustic time and hospital stay were compared between the two groups. Results There was no significant difference between the two groups of patients in blood oxygen saturation before assisted atomization nursing(P>0.05). After nursing intervention, the blood oxygen saturation of patients in both groups was improved, but the value of blood oxygen saturation in the observation group was higher than that in the control group, and the difference between the two groups was statistically significant(P 0.05). After intervention, the sound time of the two groups was prolonged, but the sound of the observation group was longer than that of the control group, the difference was statistically significant(P<0.05). Conclusions Budesonide combined with lanning atomizing agent can optimize the clinical rehabilitation effect of patients with chronic hypertrophic laryngitis treated with conventional therapy combined with Danqing SanjiaSan. Key words: Danqing SanjiaSan; Chronic hypertrophic laryngitis; Atomization inhalation; Budesonide; Aerosol inhalation of larynx

Survey on the rationality and standardization of clinical oxygen therapy in a general hospital in Shanghai

Objective To survey the current status of oxygen therapy in a comprehensive hospital in Shanghai and to assess its rationality and standardization. Methods Cluster sampling method was adopted in selecting in-patients who received oxygen therapy from various departments in Changhai Hospital from March 2018 to June 2018. General information such as gender, age, and department were recorded. The self-developed Oxygen Therapy Form for Inpatients was used to collect clinical data such as admission diagnosis, oxygen therapy indications, oxygen therapy orders, and related parameters. BTS guideline for Oxygen use in adults in Health care and Emergency Settings was used to assess the rationality and standardization of oxygen therapy. Results In this survey, 464 patients were assessed for their oxygen treatment orders. According to the guidelines, the overall reasonable rate of oxygen therapy was 92.2% (428/464); the standardization rate of oxygen therapy was 22.4% (104/464). Among them, the reasonable rate of oxygen therapy in internal medicine ward (64.7%, 46/71) was lower than that in surgery ward (98.3%, 304/309) and in wards of other specialties (92.8%, 78/84) (χ2=91.09, P<0.01); while the reasonable rate of general ward (90.9%, 362/398) was lower than that of ICU (100.0%, 66/66) (χ2=6.47, P<0.05). In the standardization assessment, the wards of other specialties (54.8%, 46/84) were better than the internal medicine ward (26.8%, 19/71) and the surgery ward (12.6%, 39/309) (χ2=68.35, P<0.01); while the ICU (65.2%, 43/66) was superior to the general ward (15.3%, 61/398) (χ2=80.81, P<0.01). Conclusions The rationality of oxygen therapy in the general hospital is acceptable, but the standardization needs to be improved. There are some differences in the rationality and standardization of oxygen therapy orders among different departments and different levels of wards. Key words: Oxygen inhalation therapy; Cross-sectional studies; Clinical audit