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Objective:To observe the clinical efficacy of Xiaosheng Powder ultrasonic nebulization combined with meibomian gland massage in treating liver depression and Yin deficiency pattern of meibomian gland dysfunction dry eye.Methods:Randomized controlled trial. From March 2021 to September 2021, a total of 50 patients (100 eyes) diagnosed with meibomian gland dysfunction dry eye of the liver depression and Yin deficiency pattern at the Ophthalmology Hospital of China Academy of Chinese Medical Sciences were selected. They were randomly divided into two groups using a random number table, with 25 patients (50 eyes) in each group. The control group received 0.1% sodium hyaluronate eye drops combined with meibomian gland massage, while the treatment group received Xiaosheng Powder nebulization combined with meibomian gland massage. Both groups were treated for 4 weeks. Before and after treatment, the tear film break-up time (BUT), Schirmer I test (SIT), corneal fluorescein staining (FL) scores, TCM symptom scores, and meibomian gland function scores were observed and evaluated. Adverse reactions were recorded.Results:After treatment, the treatment group exhibited statistically significant improvements compared to the control group in the following aspects: BUT was significantly longer in the treatment group (t=8.76, P<0.01); SIT values were significantly higher in the treatment group ( t=6.18, P<0.01); FL scores, TCM symptom scores and meibomian gland function scores were significantly lower than in the treatment group ( t values were 2.19, 5.36 and 12.09, P<0.01). The total effective rate in the treatment group was 96.0% (24/25), while in the control group, it was 68.0% (17/25), and the difference between the two groups was statistically significant ( χ2=4.88, P=0.027). Conclusion:The combination of Xiaosheng Powder ultrasonic nebulization and meibomian gland massage is effective in improving the clinical symptoms of patients with meibomian gland dysfunction dry eye of the liver depression and Yin deficiency pattern. Furthermore, this approach is considered safe and efficient.
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Objective:To investigate the clinical efficacy and safety of non-invasive bilevel positive airway pressure (BiPAP) ventilator combined with oxygen atomization in the treatment of chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure.Methods:A total of 80 patients with COPD complicated with type Ⅱ respiratory failure admitted to Haiyan County People′s Hospital from June 2019 to July 2021 were selected, and they were divided into the observation group and the control group by the random number table method, with 40 cases in each group. Patients in both groups received conventional treatment, while patients in the control group were connected with BiPAP non-invasive ventilator and received non-invasive mechanical ventilation in S/T mode; the observation group was given aerosol inhalation drugs during ventilation, and both groups were treated for 7 d. Blood gas indicators and vital signs were collected before treatment and 7 d after treatment. Clinical symptoms were investigated by COPD patient Caring Assessment Tool (CAT) and Dyspnea Scale (DECAF). Serum levels of interleukin (IL)-10, tumor necrosis factor (TNF-α) and CD 4+/CD 8+ were determined, and treatment outcomes and adverse reactions were compared between the two groups. Results:After treatment, the partial pressure of oxygen (PaO 2) and the oxygen saturation (SaO 2) in the observation group were higher than those in the control group: (73.41 ± 5.26) mmHg(1 mmHg = 0.133 kPa) vs. (65.11 ± 4.33) mmHg, 0.921 ± 0.052 vs. 0.884 ± 0.039; the arterial partial pressure of carbon dioxide (PaCO 2), heart rate (HR), respiratory rate (RR) were lower than those in the control group: (45.20 ± 5.33) mmHg vs. (50.52 ± 5.96) mmHg, (90.12 ± 8.56) times/min vs. (98.52 ± 9.63) times/min, (17.41 ± 2.26) times/min vs. (22.10 ± 3.05) times/min, there were statistical differences ( P<0.05). After treatment, CAT scores and DECAF scores in the observation group were lower than those in the control group: (8.45 ± 1.63) scores vs. (12.77 ± 2.36) scores, (0.89 ± 0.15) scores vs. (1.15 ± 0.19) scores, there were statistical differences ( P<0.05). After treatment, the levels of IL-10 and CD 4+/CD 8+ in the observation group were higher than those in the control group: (15.28 ± 3.12) ng/L vs. (13.41 ± 2.96) ng/L, 1.71 ± 0.38 vs. 1.54 ± 0.30; while the level of TNF-α was lower than that in the control group: (215.27 ± 33.96) ng/L vs. (251.11 ± 50.95) ng/L, there were statistical differences ( P<0.05). The hospitalization time in the observation group was shorter than that in the control group: (13.52 ± 3.96) d vs. (15.22 ± 2.74) d, there was statistical difference ( P<0.05). The rates of tracheal intubation and the incidence of adverse reactions between the two groups had no significant differences ( P>0.05). Conclusions:Non-invasive BiPAP ventilator combined with oxygen atomization can improve blood gas index, vital signs and clinical symptoms of COPD patients complicated with type Ⅱ respiratory failure and reduce inflammatory response.
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Objective To explore the clinical efficacy and cost-effectiveness of honey,low-temperature oxygen ato-mization and conventional mouthwash on chemotherapy-induced oral mucositis(CIOM)in patients with acute lym-phoblastic leukemia(ALL).Methods 129 ALL patients who were hospitalized in the hematology department of a tertiary first-class hospital in Yinchuan City of Ningxia from February to May 2023 and met the inclusion and exclu-sion criteria were selected,they were randomly divided into honey group,low-temperature oxygen atomization group,and conventional mouthwash group,with 43 cases in each group.During chemotherapy period,the honey group applied honey to oral mucosa surface,the low-temperature oxygen atomization group inhaled granulocyte stimulating factors through low-temperature oxygen atomization,the conventional mouthwash group gargled with prescribed mouthwash.Results There were 7(16.28％),9(20.93％),and 20(46.51％)patients with CIOM in honey group,low-temperature oxygen atomization group,and conventional mouthwash group,respectively.The in-cidence and severity of CIOM among three groups of patients were statistically different(H=11.598,P=0.003).Honey and low-temperature oxygen atomization were superior to conventional mouthwash in the prevention and treatment efficacy on CIOM in ALL patients(both P＜0.05),but the efficacy was no statistically different between honey and low-temperature oxygen atomization(P＞0.05).The cost of honey group was lower than low-tempera-ture oxygen atomization group and conventional mouthwash group(both P＜0.05),although the low-temperature oxygen atomization group has certain therapeutic effect,its cost was much higher than that of the honey group and the conventional mouthwash group(both P＜0.05).Conclusion Honey has a better prevention and treatment effect on CIOM in ALL patients,and can also reduce the hospitalization cost of patients.
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Objective:To investigate the efficacy and safety of nasal continuous positive airway pressure (NCPAP) combined with inhalation of pulmonary surfactant (PS) using vibrating mesh nebulizers in the treatment of neonatal respiratory distress syndrome (RDS).Methods:A prospective study was performed on premature infants with RDS admitted to the First Affiliated Hospital of Bengbu Medical College between December 2020 and June 2021. They were randomly assigned into vibrating mesh atomization technology group and intubation-surfactant-extubation (INSURE) technology group. The two groups were treated with NCPAP combined with PS. PS in the vibrating mesh atomization technology group was inhaled into the lungs by the new vibrating mesh atomization technology, while PS in the INSURE group was injected into the lungs by endotracheal tube. The pH value, arterial partial pressure of carbon dioxide (PaCO 2), oxygenation index (PaO 2/FiO 2), mechanical ventilation via endotracheal tube (MVET) demand rate, duration of respiratory support, secondary use of PS, complications, and hospital mortality were compared between the two groups. The occurrences of adverse events in the two groups were recorded. Results:A total of 42 preterm infants were finally enrolled, including 20 cases in the vibrating mesh atomization technology group and 22 cases in the INSURE technology group. There were no significant differences in blood gas analysis and PaO 2/FiO 2 before PS administration between the two groups. One hour after PS administration, blood gas analysis and PaO 2/FiO 2 were significantly improved in both groups. Compared with the INSURE technology group, the improvement of PaO 2/FiO 2 was more obvious in the vibrating mesh atomization technology group [mmHg (1 mmHg≈0.133 kPa): 198±34 vs. 173±39, P < 0.05], but no significant difference in pH value or PaCO 2 was found between the two groups. The duration of respiratory support in the vibrating mesh atomization technology group was significantly shorter than that in the INSURE technology group (hours: 96±13 vs. 120±18, P < 0.01), but there was no statistical difference in MVET demand rate [5.0% (1/20) vs. 13.6% (3/22), P > 0.05]. The incidence of periventricular-intraventricular hemorrhage (PVH-IVH) in the vibrating mesh atomization technology group was less than that in the INSURE technology group [0% (0/20) vs. 18.2% (4/22)], but no statistical difference was found ( P > 0.05). No significant differences in the secondary use rate of PS and incidence of bronchopulmonary dysplasia (BPD) or other complications were found between the vibrating mesh atomization technology group and the INSURE technology group [5.0% (1/20) vs. 9.1% (2/22), 5.0% (1/20) vs. 4.5% (1/22), both P > 0.05]. There were no deaths or serious adverse events such as pneumothorax, pulmonary hemorrhage, periventricular leukomalacia (PVL), retinopathy of prematurity (ROP), and necrotizing enterocolitis (NEC) in both groups. Conclusion:Compared with the INSURE technique, NCPAP combined with vibrating mesh atomization technology was also effective and safe in the treatment of RDS, which could significantly improve PaO 2/FiO 2 and shorten the duration of respiratory support. Thus, it was worthy of clinical popularization and application.
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Objective:To investigate of optimal flow oxygen-driven aerosol inhalation of budesonide in patients with acute exacerbation of chronic obstructive pulmonary disease, to provides a reference for improving the atomization effect.Methods:Totally, ninety-six patients with acute exacerbation of chronic obstructive pulmonary disease in Guangzhou Red Cross Hospital from June 2019 to December 2020 were collected and assigned to the low flow group, middle flow group and high flow group according to the random number table method, with 32 cases in each group. All patients received oxygen-driven aerosol inhalation of budesonide therapy, the oxygen flow were 4 L/min, 6 L/min and 8 L/min in the three groups, respectively. Before and after 7 days of treatment, the indices including respiratory dynamics, pulmonary function and blood gas analysis were compared among the three groups.Results:There was no significant difference in the indices including respiratory dynamics, pulmonary function and blood gas analysis before treatment among the three groups( P>0.05). After 7 days of treatment, the peak airway pressure, plateau airway pressure, inspiratory resistance were (22.53 ± 3.83) cmH 2O(1 cmH 2O=0.098 kPa), (15.97 ± 3.01) cmH 2O, (23.25 ± 2.92) cmH 2O·L -1·s -1 in the middle flow group, lower than those in the low flow group (26.09 ± 3.04) cmH 2O, (18.13 ± 2.54) cmH 2O, (26.31 ± 3.65) cmH 2O·L -1·s -1 and high flow group (26.13 ± 3.28) cmH 2O, (17.44 ± 2.02) cmH 2O, (25.06 ± 3.56) cmH 2O·L -1·s -1, the pulmonary dynamic compliance was (33.16 ± 4.43) ml/cmH 2O in the middle flow group, higher than that in the low flow group and high flow group (29.84 ± 3.73), (30.47 ± 3.53) ml/cmH 2O, the differences were statistically significant ( F values were 5.96-11.82, all P<0.05). The FEV 1, FEV 1/FVC, ratio of FEV 1 to estimated vital capacity were (1.36 ± 0.26) L, (49.91 ± 5.94)%, (44.81 ± 5.53)% in the middle flow group, higher than those in the low flow group and high flow group (1.23 ± 0.19) L, (45.22 ± 6.56)%, (40.88 ± 5.97)% and (1.20 ± 0.18) L, (46.41 ± 5.30)%, (41.78 ± 6.32)%, the differences were statistically significant ( F=4.91, 5.36, 3.84, all P<0.05). The PaO 2, oxygenation index were (73.06 ± 7.24), (176.18 ± 17.62) mmHg(1 mmHg=0.133 kPa) in the middle flow group, higher than those in the low flow group and high flow group (67.16 ± 5.10), (164.54 ± 12.34) mmHg and (69.44 ± 7.10), (167.07 ± 16.24) mmHg, PaCO 2 was (52.75 ± 6.22) mmHg in the middle flow group, lower than that in the low flow group and high flow group(57.97 ± 6.75), (56.31 ± 6.45) mmHg, the differences were statistically significant ( F=6.61, 4.96, 5.42, all P<0.05). Conclusions:Oxygen-driven aerosol inhalation of budesonide for acute exacerbation of chronic obstructive pulmonary disease patients, oxygen flow are 6 L/min can effectively improve the indices of respiratory dynamics and blood gas analysis as well as improve pulmonary function.
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Objective Based on computational fluid dynamics (CFD) method, the air and aerosol transport in a single alveolus were simulated to study the characteristics of airflow and aerosol transport in deep alveolus. Methods A long straight duct with a hemispherical wall at one end which had periodic expansion/contraction were regarded as simplified approximation of a single alveolus. Based on this, a two-dimensional (2D) mathematical model was established.The Euler-Euler method was used to solve the transport equations of airflow and aerosol particles in the alveolus considering air diffusion along the hemisphere boundary. Results The composition ratio of the air in the duct changed in a stable periodic way during the whole breathing process.The aerosol transport in the duct mainly depended on the particle diffusion coefficient. The advection transport had only a small effect on it. The diffusion velocity and depth of aerosol increased when the particle size decreased, especially when the particle size was smaller than 4 μm. The increase of respiratory frequency and amplitude could significantly improved the transport capacity of aerosol particles. Conclusions In atomization treatment, aerosol particles with smaller particle size have better transportation and curative efficacy. Deep breathing should be encouraged to improve particle transport.
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OBJECTIVE：To evaluate the efficacy and safety of atomization inhalation of polymyxin combined in the adjunctive treatment for ventilator-associated pneumonia ，and to provide evidence-based reference for clinical treatment. METHODS ： Retrieved from Cochrane Library ，Embase，PubMed，Web of Science ，CNKI，CBM，VIP and Wanfang database （from their inception to March 2021），randomized controlled trials （RCTs）about efficacy and safety of atomization inhalation of polymyxin combined with conventional treatment （trial group ） versus conventional treatment （control group ） for ventilator- associated pneumonia were collected. After data extraction and quality evaluation of included literatures met inclusion and exclusion criteria ， Meta-analysis was performed by using Rev Man 5.4 software. RESULTS ：A total of 13 clinical studies were included ，involving 2 RCTs and 11 cohort studies with a total of 1 066 patients. The results of Meta-analysis showed that clinical response rate [OR ＝ 1.53，95％CI（1.17，2.00），P＝0.002]，microbial clearance rate [OR ＝1.46，95％CI（1.11，1.91），P＝0.007] of trial group were significantly higher than those of control group ，with statistical significance. There was no statistical significance in the mortality rate [OR ＝0.88，95％CI（0.68，1.14），P＝0.32] and the incidence of renal impairment [OR ＝1.04，95％CI（0.72，1.49），P＝0.85] between 2 groups. CONCLUSIONS ：Based on current evidence ，atomization inhalation of polymyxin combined with conventional treatment can significantly improve clinical response rate and microbial clearance rate of patients with ventilator- associated pneumonia. However ， more strictly-designed ， long-term follow-up and large-scale RCTs are needed.
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【Objective】 To observe the effect of hydrogen peroxide atomization sterilizer using low concentration hydrogen peroxide disinfectant on the environment and object surface of physical examination area (hereinafter referred to as " physical examination area" ) in blood centers, so as to provide a simple method which is safe, efficient, easy to operate, harmless to human body and has no corrosive effect on equipment. 【Methods】 The physical examination area was disinfected with atomized hydrogen peroxide sterilizer, and the difference of colony number between air and surface before and after disinfection was compared to evaluate the disinfection effect. 【Results】 After disinfection, the hydrogen peroxide residue was detected for 25 times at 5 points, and the results were (0.7~1)ppm, with no statistical difference (P>0.05). 25 tests were carried out at 5 points, and the quartile of the test results was (0~2)CFU/ dish, and the qualified rate was 100%. The test results of bacteria before and after disinfection were statistically significant (P<0.05), which met the requirements of Class Ⅱ environment in Hygienic Standard for Hospital Disinfection(GB15982-2012). After disinfection, the quartile of surface colony detection results of workbench, blood donor seat, screen and door handle were (0~24.1)CFU/cm2, (1.6~55.4)CFU/cm2, (0~7.2)CFU/cm2 and (0~4.8)CFU/cm2, with the qualified rate at 80%, 48%, 100% and 100%, respectively, which were in accordance with the requirements of Class Ⅲenvironment in GB15982-2012. The number of colonies after disinfection at the above detection sites decreased significantly compared with that before disinfection (P<0.05). The surface contact plate pressing method and cotton swab smearing method were used to detect the number of colonies on the surface of sterilized work tables and blood donor seats, and the detection rate of the former was higher than that of the latter, with statistical significance (P<0.05). 【Conclusion】 After disinfection by hydrogen peroxide atomization sterilizer, the hydrogen peroxide residue met the requirements specified in the manual. The terminal disinfection effect of air in the physical examination area environment can meet the Class Ⅱ environmental requirements of GB15982-2012. However, the number of microorganisms on object surface after terminal disinfection was significantly lower than that before disinfection.
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OBJECTIVE：To compare the protective effect of atomization inhalation and intraperitoneal injection of edaravone on acute lung injury in smoke inhalation lung injury model rats. METHODS ：Thirty male SD rats were divided into normal control group（group A ），injury group （group B ），intraperitoneal injection group （group C ），low-dose aerosol inhalation group （group D），high-dose aerosol inhalation group （group E ）according to random numble table ，with 6 rats in each group. Group B-E were placed in smoke generator containing pine sawdust to induce smoke inhalation lung injury model. In group A ，the operation was the same as above except that the pine sawdust was not placed. Thirty minutes after modeling ，group C were injected intraperitoneally with edaravone 18 mg/kg（every 70 min，4 times in total ）. Group D and E inhaled edaravone 9，1.8 mg/kg（every 60 min，lasting for 10 min each time ，4 times in total ）. The rats were treated by no means in group A and group B. Six hours after last medication，arterial blood gas analysis was performed ，and the lung wet to dry ratio （W/D）and water content of lung tissue were calculated. The levels of TNF-α，IL-6 and IL- 10 in serum were detected by double antibody ELISA. The contents of MDA ，MPO， SOD and Caspase- 3 in lung tissue were determined by ELISA and other methods. HE staining was used to observe the pathological changes of lung tissue. The apoptotic rate of cells in lung tissue were determined by TUNEL assay. RESULTS ：No abnormality was found in lung tissue of group A ；in group B ，hemorrhage and edema were found in lung tissue ，alveolar structure was difficult to identify，and inflammatory cells and red blood cell infiltration were seen. Above symptoms of rats in group C-E were improved to different extent. Compared with group A ，PaO2/FiO2 and SOD content of lung tissue were decreased significantly in other groups （P＜0.05）；water content of lung tissue ，W/D，serum contents of TNF-α，IL-6 and IL- 10，the contents of MDA ，MPO and Caspase-3 in lung tissue ，apoptotic rate were increased significantly （P＜0.05）. Compared with group B ，PaO2/FiO2 and serum contents of IL- 10 were increased significantly in administration groups （P＜0.05）；water content of lung tissue ，W/D，serum contents of TNF-α and IL-6，the contents of MDA ，MPO and Caspase- 3 in lung tissue ，apoptotic rate were significantly decreased，in dose-dependent manner （P＜0.05）. CONCLUSIONS ：Edaravone has a certain protective effect on smoke inhalation lung injury model rat. It can reduce the production and release of inflammatory mediators and/or cytokines ，reduce the peroxide damage and inhibit cell apoptosis in a dose-dependent manner. The effect of atomization inhalation is more obvious than that of intraperitoneal injection.
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@#AIM:To investigate the clinical effect of ultrasonic atomization of Shenmai Runmu formula on dry eyes related to meibomian gland dysfunction(MGD). <p>METHODS: Totally 120 cases of MGD related dry eye patients in our hospital patients were randomly divided into two groups: treatment group(ultrasonic atomization of Shenmai Runmu group)and control group(OPT intense pulse phototherapy), 60 cases each, both groups were combined with meibomian gland massage. The ocular surface comprehensive analyzer was used to detect various indicators: average non-invasive tear break-up time(NITBUTav), lower tear meniscus height(LTMH), meibomian gland score, <i>etc</i>. Subjective symptoms of patients' eyes were scored by questionnaire survey, and the clinical data were statistically processed. <p>RESULTS: There was no statistical difference between the treatment group and the control group in terms of gender, age, course of disease before treatment, and the indicators in the period from treatment start to 6mo after the treatment end(<i>P</i>>0.05); The total effective rate was about 94.9% in the treatment group and 96.6% in the control group(<i>P</i>>0.05). <p>CONCLUSION: Ultrasonic atomization combined with meibomian gland massage can improve the subjective symptoms and objective indexes of MGD related dry eyes. Compared with the modern medical treatment, the therapeutic effect of this method is basically the same, safe and effective, but it is more convenient and economic, which is worth popularizing in clinical application.
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Objective To observe and analyze the clinical effect of noninvasive sputum aspiration combined with atomization inhalation in the treatment of pediatric bronchiolitis. Methods Totally 79 children with bronchiolitis diagnosed from January 2016 to December 2017 were selected. The children were divided into observation group (40 cases) and control group (39 cases) by double blind method of stratified random sampling. The observation group were treated with atomization inhalation after noninvasive sputum aspiration;and the control group were treated with the traditional inhalation of sputum according to the condition of the disease.The improvement effect of the symptoms before and after the treatment of the two groups was compared. Results After treatment, the improvement of symptoms in the two groups included cough, fever, wheezing, shortness of breath, lung rales, daily sputum aspiration and hospital stay were (5.34±1.06) d, (1.82±0.35) d, (2.66±0.85) d, (1.76±0.39) d, (4.37±1.29) d, (6.38± 1.39) times, (6.31 ± 0.82) d in the observation group, (6.25 ± 0.98) d, (2.34 ± 0.41) d, (3.08 ± 0.94) d, (2.56 ± 0.41) d, (5.39 ± 1.33) d, (8.31 ± 1.52) times, (8.25 ± 1.09) d in the control group, the difference was statistically significant( t=2.084-8.954, P<0.05). Respiratory function improvement including arterial oxygen saturation,heart rate,respiratory rate was 0.96±0.03, (110.85±4.16) times/min, (29.49±1.87) times/min in the observation group, 0.92±0.03, (119.34±4.22) times/min, (35.14±1.95) times/min in the control group,the difference was statistically significant(t=5.925, 9.005, 13.146, P<0.05). The effective rate of the observation group was 97.50％ (39/40), which was significantly higher than that of the control group 79.49％(31/39), the difference was statistically significant (χ2=4.688, P<0.05).The satisfaction rate of the family members of the observation group of the nebulization and sputum suction service was 100.00％(40/40), which was significantly higher than that of the control group (87.18％, 34/39), the difference was statistically significant (χ2=13.698, P<0.05). Conclusions Noninvasive sputum aspiration combined with atomization inhalation is effective in the treatment of pediatric bronchiolitis. It can relieve airway obstruction, improve asthma symptoms, shorten the time of hospitalization, and the operation is convenient and safe.
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@#AIM: To observe the effect of ultrasonic atomization of Shufeng Mingmu Decoction on tear film stability and index of tear fluid in patients with allergic conjunctivitis.<p>METHODS: Totally 140 patients with allergic conjunctivitis were randomly divided into 2 groups. 70 patients in the control group were treated with olopatadine hydrochloride eye drops combined with normal saline atomization therapy, while the 70 patients in the observation group were treated with ultrasonic atomization of Shufeng Mingmu Decoction combined with oldpatadine hydrochloride eye drops. After 14d of continuous treatment, the single symptoms(lacrimation, itching, photophobia, foreign body sensation), the stability of tear film(BUT, FL), and the index of tear fluid(ECP, HA, IgE)of the two groups were compared and analyzed. The clinical effects of the two groups were compared. <p>RESULTS: The total effective rate of the observation group was significantly higher than that of the control group(90.7% <i>vs </i>74.3%, <i>P</i><0.05). After treatment, the scores of single symptoms in both groups were lower than those before treatment, and those in the observation group were lower than those in the control group(<i>P</i><0.05). After treatment, the index of BUT in both groups were significantly higher than before treatment(<i>P</i><0.05), while the index of FL was significantly lower than before treatment, and the improvement degree of which in the observation group was better than that of control group(<i>P</i><0.05). After treatment, the levels of HA, ECP and IgE in the two groups were significantly lower than before treatment, and the improvement degree of which in the observation group was better than that in the control group(<i>P</i><0.05).<p>CONCLUSION: Ultrasonic atomization treatment of Shufeng Mingmu Decoction can improve the index of tear fluid of allergic conjunctivitis patients and the stability of tear film, which help relieve local allergy and improve clinical symptoms of patients.
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Objective To investigate the clinical value of atomization inhalation combined with montelukast in the treatment of infantile cough after infection.Methods From September 2015 to August 2017,300 children with post-infection cough in Taizhou Tumor Hospital were randomly divided into two groups,with 150 cases in each group.The control group was treated with montelukast,and the observation group was given atomization inhalation combined with montelukast.The clinical effect,symptom improvement time,adverse events and parents' satisfaction were observed.Results The total effective rate of the observation group was 97.33％,which was higher than 86.67％ in the control group(P ＜0.05).The improvement time of cough and expectoration of the observation group [(3.02 ± 0.45)d,(2.11 ± 0.71)d] was better than those of the control group(all P ＜ 0.05).The incidence rate of adverse events in the observation group(3.33％) was lower than that in the control group(P ＜0.05).The total satisfactory rate of parents in the observation group was 96.00％,which was obviously higher than that in the control group(P ＜ 0.05).Conclusion The effect of atomization inhalation combined with montelukast on children's cough after infection is good,it can effectively control the condition and relieve the symptoms such as cough,and the safety is higher.The risk of adverse reactions is low.
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Objective To investigate the effect of atomization inhalation of budesonide and terbutaline sulfate on serum levels of cyclcoxygenase 2 (COX-2) and chemokine like factor-1 (CKLF-1) in children with bronchial asthma.Methods A total of 78 children with bronchial asthma in Hangzhou Children's Hospital from April 2016 to August 2017 were selected and divided into the control group(n =39) and the study group(n =39).The control group was treated with routine treatment,and the study group was treated with budesonide and terbutaline sulfate on the basis of the control group.The treatment was continued for 7 d.After t treatment,the clinical effects,clinical symptoms improvement,hospitalization time,the serum levels of COX-2 and CKLF-1 before and after treatment,and the incidence of adverse reaction of two groups were observed.Results The total effective rate of the study group(94.87％) was higher than that of the control group (74.36％)(x2 =6.303,P ＜ 0.05).The improvement time of chest tightness,wheezing,cough and hospitalization time of the study group were shorter than those of the control group (t1 =13.054,t2 =7.365,t3 =4.944,t4 =8.342,all P ＜ 0.05).After treatment,the levels of serum COX-2 and CKLF-1 in the two groups were lower than those before treatment,which of the study group were lower than those in the control group(t1 =4.934,t2 =4.660,all P ＜0.05).There was statistically significant difference in the incidence rate of adverse reactions between the study group(12.82％) and the control group(7.69％) (x2 =0.139,P ＞ 0.05).Conclusion Atomization inhalation of budesonide and terbutaline sulfate in the treatment of children with bronchial asthma can effectively alleviate the clinical symptoms,reduce serum levels of COX-2 and CKLF-1,improve therapeutic effect,promote children's recovery and shorten the hospitalization time.Besides,the incidence rate of adverse reactions is low,and it is safe.
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OBJECTIVE: To study the local irritative response and cytotoxicity of glycerol in vivo and in vitro, and evaluate the safety of glycerol as an excipient in inhaled preparations preliminarily. METHODS: Local irritation test: rats were divided into two groups, the glycerol group received 20% glycerol by intratracheal atomization once a day, followed by 5 d, the control group was given the equal volume of 0.9% sodium chloride solutions in the same way. After administration, the throat, trachea and lung were taken for histopathological examination, and bronchoalveolar lavage was performed in each group, total protein (TP) content (BCA method) and alkaline phosphatase (ALP), lactate dehydrogenase (LDH) activity in the lavage fluid were detected (biochemical instrument). Cytotoxicity test: the toxic effects of glycerol on adenocarcinoma human alveolar epithelial-like cells (A549), human bronchial epithelial cells (16HBE) and rat tracheal epithelial cells (RTE) were studied by MTT assay. RESULTS: Local irritation test:the control group showed mild infiltration of inflammatory cells in the alveolar (1/8), glycerol group showed perivascular inflammation (2/8) and moderate mild to mild infiltration of inflammatory cells in the alveolar (6/8); bronchoalveolar lavage fluid test showed that, compared with the control group, the level of ALP in the glycerol group was elevated significantly (P<0.05). There was a dose-effect relationship between the cytotoxicity on A549, 16HBE and RTE cells with varying volume fraction of glycerol content in the range of 0.25%-10%, r2 values were 0.989, 0.981, 0.964, and IC50 were 4.28%, 4.40%, 4.31% respectively. CONCLUSION: The 20% glycerol has slight irritation to the lung in vivo, and in vitro glycerol has obvious toxic effect on A549 and 16HBE cells when the volume fraction reached 2.0%, when it reached 4.0%, it has significant toxic effect on RTE cells, suggesting that large dose of glycerol may cause mild irritation and toxicity to the lungs.
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Objective To study the clinical efficacy of respiratory allergic diseases in children treated by nasal atomization of budesonide combined with 3% hypertonic saline. Methods Children diagnosed as upper air-way cough syndrome or mild to moderate asthma without being controlled by anti-asthma treatment were included in the study.They contracted with complications of nasal congestion and/or running noseand other symptoms,and na-sal CT confirmed the nasal lesions.Thirty children undergoing conventional treatment(conventional drug therapy+keeping away from allergen)were defined as the control group. 89 children treated with nasal spray therapy(con-ventional drug therapy + keeping away from allergen + nasal spray treatment)were defined as the therapy group. The treatment group was subdivided into IgE-mediated group and non-IgE-mediated group according to IgE level. The treatment course was 7 days.The clinical symptoms score,nasal symptom visual scale(VAS),peak expirato-ry flow(PEF)index were observed and analyzed. Results The clinical symptom score and nasal VAS showed a decreasing trend and the percentage of PEF showed an increasing trend in the two groups within 1 week after treat-ment.The clinical symptom score and nasal VAS score of the treatment group were significantly lower than those of the control group,while the PEF%value was significantly higher.The difference in treatment method was interact-ed with the treatment time(P<0.05).The percentage of PEF in the non-IgE-mediated group was significantly high-er than that of IgE-mediated group 1 week after treatment(P < 0.05). Conclusion The nasal atomization of budesonide combined with hypertonic saline in the treatment of children with respiratory allergic diseases is effec-tive and of a good clinical value.
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Objective To evaluate the efficacy of early controlled cold atomization inhalation of budesonide in the treatment of post-operative sore throat (POST) after double-lumen endotracheal intubation. Methods A total of 105 ASAⅠ~Ⅲpatients having POST after thoracic surgery with double-lumen endotracheal intubation were randomly divided into three groups(n = 35 each). The patients in the control group were treated with atomization inhalation of 12 mL 20℃saline(Group C)and those in the observation groups were treated with 10 mL 20℃saline plus 2 mL(1 mg)budesonide(Group R)or 10 mL 0℃saline plus 2 mL(1 mg)budesonide (Group L)for 15 minutes immediately after extubation. The 4-score scale was used to evaluate sore throat,dry throat,hoarseness and swallowing difficulty 1,2,6 and 24 h after the extubation and QoR-40 scale to assess post-operative recovery at 24 h. Results The scores of sore throat and dry throat were significant lower in group L than those in group C(P < 0.05)at 1,2 and 24 h and the score of swallowing difficulty(dysphagia)was also signifi-cant relieved at 1,6 and 24 h after the extubation in group L. Furthermore,the score of sore throat was significant lower in group L than that in group R(P<0.05)at 1 h. There were no significant differences of hoarseness in three groups(P > 0.05). The total score of QoR-40 scale was the significantly highest in group L than that in group C and group R(P<0.05)24 h postoperatively. Conclusion Cold atomization inhalation of budesonide immediately after the extubation of double-lumen endotracheal can alleviate POST and bring more benefits to patients which help to enhance the recovery after throracic surgery.
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Objective To investigate the effects of aerosol inhalation on respiratory mechanical parameters under different ventilation patterns and ventilator parameters in patients on mechanical ventilation and simulated model of aqualung in vitro. Methods ① Clinical research: the patients needed sedative undergoing mechanical ventilation admitted to intensive care unit (ICU) of Qingdao Municipal Hospital from January 2016 to January 2018 were enrolled. They were randomly divided into volume controlled ventilation (VCV) group and pressure controlled ventilation (PCV) group according to random number table. Main parameters setting of respirator: the predetermined tidal volume (VT) was set at 500 mL in the VCV group; the preset pressure was regulated, so that when the atomizer was connected to the atomization device, the VT was nearly equal to or slightly larger than 500 mL in the PCV group. Respiratory mechanical indices [peak airway pressure (Ppeak), inspiratory tidal volume (VTi), exhaled tidal volume (VTe)] were recorded before atomization (atomized oxygen flow was 0) and 10 minutes after the beginning of atomization under the condition of 7 L/min and 9 L/min of atomized oxygen flow respectively. ② Simulated scuba test in vitro: the ventilator was connected to the simulated scuba, and an external mechanical ventilation model was constructed. They were divided into VCV group and PCV group according to ventilation mode. Main parameters setting of respirator: VCV group was given 450, 550, 650 mL preset VT, and PCV group was given 12, 16, 20 cmH2O (1 cmH2O = 0.098 kPa) preset suction pressure. The changes in respiratory mechanical indexes were observed under different ventilation patterns and ventilator parameters of 0 (only connected with atomizing device), 5, 7, 9 L/min atomizing oxygen flow. Results ① Clinical research results: all 77 patients were enrolled in the final analysis, including 20 patients with 7 L/min of atomized oxygen flow under VCV mode, 18 patients with 9 L/min of atomized oxygen flow, and 21 patients with 7 L/min of atomized oxygen flow under PCV mode and 18 patients with 9 L/min of atomized oxygen flow. Under VCV mode, the levels of Ppeak and VTe were increased with the increase in atomized oxygen flow, and there was significant difference at 9 L/min as compared with those before atomization [Ppeak (cmH2O): 29.44±4.58 vs. 24.39±4.64, VTe (mL): 896.26±24.91 vs. 497.61±8.67, both P < 0.05]. There was no significant change in VTi, and no significant difference at 9 L/min of atomized oxygen flow as compared with that before atomization (mL: 494.67±3.07 vs. 492.61±6.05, P > 0.05). Under PCV mode, with the increase in oxygen atomization flow, VTi was decreased gradually, and VTe was increased gradually, with significant difference as compared with those before atomization when the atomized oxygen flow was 9 L/min [VTi (mL): 322.78±17.75 vs. 518.17±8.97, VTe (mL): 730.89±31.20 vs. 519.00±9.06, both P < 0.05]. There was no significant change in Ppeak, and no significant difference at 9 L/min of atomized oxygen flow as compared with that before atomization (cmH2O: 21.44±2.23 vs. 21.39±2.55, P > 0.05). ② Simulated scuba results in vitro: under VCV mode, VTe monitored by respirator and VT showed by simulated scuba in different preset VT groups were continuously increased with the increase in oxygen atomization flow, while VTi monitored by ventilator was not significantly changed. At 10 minutes after the beginning of atomization, the VTi monitored by ventilator in different preset VT groups was significantly lower than VT showed by simulated water lung (mL: 649.67±5.03 vs. 840.00±10.00 at 650 mL of preset VT and 9 L/min of atomized oxygen flow, P < 0.05), and VTe was significantly higher than VT showed by simulated water lung (mL: 1 270.33±11.06 vs. 840.00±10.00 at 650 mL of preset VT and 9 L/min of atomized oxygen flow, P < 0.05). Under PCV mode, with the increase in atomized oxygen flow, VTi monitored by ventilator in different preset suction pressure groups was decreased gradually, and VTe was increased gradually, but Ppeak monitored by ventilator did not changed significantly. At 10 minutes after the beginning of atomization, the VTi monitored by ventilator in different preset suction pressure groups was significantly lower than VT showed by simulated water lung (mL: 917.33±4.51 vs. 1 103.33±5.77 at 20 cmH2O of preset suction pressure and 9 L/min of atomized oxygen flow, P < 0.05), and VTe was significantly higher than VT showed by simulated water lung (mL: 1 433.33±4.73 vs. 1 103.33±5.77 at 20 cmH2O of preset suction pressure and 9 L/min of atomized oxygen flow, P < 0.05). Conclusions Under the VCV mode, the oxygen flow outside the atomization could lead to the increase in VT of the patient side, while under the PCV mode, the VT and Ppeak in the patient side had no significant change. Both VTi and VTe monitored by ventilator could not reflect the patient's VT under either VCV or PCV mode.
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OBJECTIVE:To investigate the optimal administration route of ambroxol in the treatment of pediatric respiratory disease. METHODS:Totally 120 children with respiratory disease in pediatric department of our hospital during Jun. 2014-Jun. 2016 were divided into intravenous dripping group and atomization inhalation group according to even and odd-numbered admission order,with 60 cases in each group. Intravenous drip group was given Ambroxol hydrochloride injection 7.5 mg dissolved in 5%glucose solution 50 mL,ivgtt,bid;aerosol inhalation group was given aerosol inhalation of Ambroxol hydrochloride injection 7.5 mg,for 15 min each time,bid. The two groups were treated with 7 d. Clinical efficacies,p(O2)and p(CO2)level,the times of sputum absorption,clinical indexes and the occurrence of ADR were compared between 2 groups. RESULTS:Total response rate of atomization inhalation group(96.67%)was significantly higher than intravenous dripping group(78.33%);p(O2)level was sig-nificantly higher than intravenous dripping group,while the times of sputum absorption,fever disappearance time,asthma disap-pearance time,oxygen therapy time,pulmonary rales disappearance time,cough disappearance time and average hospitalization time were significantly less or shorter intravenous dripping group,with statistical significance (P0.05). CONCLUSIONS:Ambroxol is effective in the treatment of pediatric respiratory disease,and clinical efficacy of atomization inhalation is better than intravenous drop.
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Objective To study the clinical effects of inhalation of albuterol and the treatment of chronic obstructive pulmonary disease in the treatment of chronic obstructive pulmonary disease.Methods Choose 88 cases of patients treated in our hospital, it can be divided into two groups, separately carries on the routine therapy, salbutamol aerosol inhalation therapy, and routine health education and psychological intervention.The clinical outcomes and anxiety were analyzed in the two groups.Results The curative effect of observation group, anxiety, improve the situation, obviously better than the control group, all the data through a detailed comparison between groups, the difference was statistically significant(P<0.05).Conclusion Chronic obstructive pulmonary disease, the use of albuterol atomization inhalation and combined psychological intervention, the treatment effect is good.