集束化护理对肺炎患儿雾化吸入治疗的效果研究

目的探讨集束化护理在肺炎患儿雾化吸入中的辅助效果。方法将120例肺炎需要雾化吸入的患儿随机分为观察组和对照组各60例,对照组采用常规护理,观察组采用集束化管理,比较2组雾化吸入治疗过程中血流动力学指标的变化、治疗效果以及治疗耐受情况。结果观察组治疗过程中、治疗后p(CO2)低于对照组,治疗过程中和治疗后的p(CO2)、Sa O2高于对照组(P0.05);观察组中断治疗的比例少于对照组,雾化吸入耐受时间长于对照组(P0.05);观察组的发热消失、肺啰音消失、咳嗽消失、住院时间少于对照组(P0.05)。结论集束化护理策略有利于增加肺炎患儿雾化吸入的耐受性,提高治疗效果,缩短疗程。     

Ultrasonic atomization and subsequent desolvation for monoclonal antibody (mAb) to the glycoprotein (GP) IIIa receptor into drug eluting stent

An eluting-stent system with mAb dispersed in the PLLA (poly (L-lactic acid)) was validated in vitro. Specifically designed spray equipment based on the principle of ultrasonic atomization was used to produce a thin continuous PLLA (poly (L-lactic acid)) polymer coating incorporating monoclonal antibody (mAb). This PLLA coating was observed in light microscopy (LM) and scanning electron microscopy (SEM). The concentration of the monoclonal antibody (mAb) to the platelet glycoprotein (GP) IIIa receptor and the eluting rate were then measured by a radioisotope technique with ¹²⁵I-labelled GP IIIa mAb. An in vitro perfusion circuit was designed to evaluate the release rates at different velocities (10 or 20 ml min^?1). The PLLA coating was thin and transparent, uniformly distributed on the surface of the stent. Three factors influenced its thickness: PLLA concentration, duration and gas pressure. The concentration of mAb was influenced by the duration of absorption and the concentration of the mAb solution; the maximum was 1662.23 ± 38.83 ng. The eluting rate was fast for the first 2 h, then decreased slowly and attained 80% after 2 weeks. This ultrasonic atomization spray equipment and technological process to prepare protein eluting-stents were proved to be effective and reliable.     

Comparison of bronchodilator administration with vibrating mesh nebulizer and standard jet nebulizer in the emergency department

Introduction

Projects comparing bronchodilator response by aerosol devices in the ED are limited. Evidence suggests that the vibrating mesh nebulizer (VMN) provides 5-fold greater aerosol delivery to the lung as compared to a jet nebulizer (JN). The aim of this project was to evaluate a new nebulizer deployed in an Emergency Department.

双水平气道正压通气联合雾化吸入治疗AECOPD临床研究

目的探讨双水平气道正压通气(BiPAP)呼吸机加雾化吸入复方异丙托溴铵溶液治疗慢性阻塞性肺疾病急性加重(AECOPD)的临床疗效。方法 96例AECOPD患者随机分为治疗组和对照组。两组患者均根据痰培养及药敏结果选用敏感抗生素,纠正酸碱失衡及水、电解质紊乱,给予解痉平喘、止咳祛痰及营养支持等常规治疗,并使用BiPAP呼吸机治疗。治疗组在此基础上加用复方异丙托溴铵溶液2 ml(含异丙托溴铵4 mg,沙丁胺醇2 mg)加生理盐水3 ml雾化吸入15~20 min,2次/d。结果 1治疗组总有效率为91.7%(44/48),对照组总有效率为81.3%(39/48),两组比较差异有统计学意义(P0.05);2治疗组死亡1例,对照组死亡3例,两组对比差异无统计学意义(P0.05)。3治疗后两组动脉血二氧化碳分压逐渐下降,治疗组下降更明显,两组比较差异均有统计学意义(P0.01)。治疗后两组动脉血氧分压、pH、动脉血氧饱和度逐渐升高,治疗组升高更明显,两组比较差异均有统计学意义(P0.05或P0.01)。4治疗后两组心率、呼吸频率逐渐下降,治疗组下降更明显,两组比较差异均有统计学意义(P0.05或P0.01)。5治疗组与对照组通气时间、住院天数比较差异有统计学意义(P0.01),治疗组通气时间、住院天数均比对照组缩短。结论 BiPAP联合雾化吸入复方异丙托溴铵溶液治疗AECOPD具有疗效显著、操作简单、安全方便等优点,值得在临床推广应用。     

Workshop report: Nucleic acid delivery devices for HIV vaccines: Workshop proceedings,National Institute of Allergy and Infectious Diseases,Bethesda, Maryland,USA, May 21, 2015

On May 21st, 2015, the U.S. National Institute of Allergy and Infectious Diseases (NIAID) convened a workshop on delivery devices for nucleic acid (NA) as vaccines in order to review the landscape of past and future technologies for administering NA (e.g., DNA, RNA, etc.) as antigen into target tissues of animal models and humans. Its focus was on current and future applications for preventing and treating human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) disease, among other infectious-disease priorities. Meeting participants presented the results and experience of representative clinical trials of NA vaccines using a variety of alternative delivery devices, as well as a broader group of methods studied in animal models and at bench top, to improve upon the performance and/or avoid the drawbacks of conventional needle-syringe (N–S) delivery. The subjects described and discussed included (1) delivery targeted into oral, cutaneous/intradermal, nasal, upper and lower respiratory, and intramuscular tissues; (2) devices and techniques for jet injection, solid, hollow, and dissolving microneedles, patches for topical passive diffusion or iontophoresis, electroporation, thermal microporation, nasal sprayers, aerosol upper-respiratory and pulmonary inhalation, stratum-corneum ablation by ultrasound, chemicals, and mechanical abrasion, and kinetic/ballistic delivery; (3) antigens, adjuvants, and carriers such as DNA, messenger RNA, synthesized plasmids, chemokines, wet and dry aerosols, and pollen-grain and microparticle vectors; and (4) the clinical experience and humoral, cellular, and cytokine immune responses observed for many of these target tissues, technologies, constructs, and carriers. This report summarizes the presentations and discussions from the workshop (https://web.archive.org/web/20160228112310/https://www.blsmeetings.net/NucleicAcidDeliveryDevices/), which was webcast live in its entirety and archived online (http://videocast.nih.gov/summary.asp?live=16059).     

低温氧气雾化在放射性口腔黏膜炎患者的应用

目的 探讨低温氧气雾化吸入在鼻咽癌患者放射性口腔黏膜炎中的防治效果。方法 将101例接受放疗的鼻咽癌患者按照整群随机法分为对照组(54例)和干预组(47例)。放疗期间,两组均以生理盐水和粒细胞刺激因子150 μg为雾化液,每日进行2次雾化,每次持续吸入20 min。对照组接受常温超声雾化吸入,干预组接受低温氧气雾化吸入。结果 干预组放射性口腔黏膜炎的严重程度以及持续时间显著轻于或短于对照组,而出现时间、唾液流量长于或高于对照组（均P＜0.05）。但两组放射性口腔黏膜炎的发生率及在放射剂量达33 Gy时的口腔pH值比较,差异无统计学意义（均P＞0.05)。结论 低温氧气雾化可减轻鼻咽癌放疗患者放射性口腔黏膜炎的严重程度,延缓放射性口腔黏膜炎的出现并缩短病程,同时在保护口腔唾液腺、维持口腔内环境方面也有一定的效果。     

氧气驱动雾化治疗小儿中重度哮喘急性发作的效果观察

目的：探讨氧气驱动雾化治疗小儿中重度哮喘急性发作的临床效果。方法选取本院2012年1月~2014年1月收治的中重度哮喘急性发作期患儿60例,按入院先后顺序分为观察组和对照组各30例,对照组给予常规吸氧、抗炎治疗,观察组在对照组治疗的基础上加用氧气驱动雾化治疗,比较两组的临床疗效。结果观察组治疗总有效率为93.3%,高于对照组的70.0%,差异有统计学意义（P＜0.05）;观察组咳嗽、喘憋和肺部哮鸣音消失时间明显短于对照组（P＜0.05）,肺功能指标FEV1%和最大呼气峰值流速（PEF）的改善情况明显优于对照组（P＜0.05）;两组均未见严重不良事件。结论氧气驱动雾化治疗在小儿中重度哮喘急性发作期中的应用可快速改善患儿的临床症状,改善肺功能,提高疗效。