The physiological rationale of heat and moisture exchangers in post-laryngectomy pulmonary rehabilitation: a review

Total laryngectomy results in a permanent disconnection of the upper and lower airways and inevitably leads to chronic pulmonary complaints like frequent involuntary coughing, increased sputum production and repeated daily forced expectoration to clean the airway. Heat and moisture exchangers (HMEs), applied in an attempt to compensate for the lost functions of the upper respiratory tract, have been found to diminish these symptoms and improve the quality of life significantly. An HME has three physical properties that might be responsible for these improvements. First, its heat and moisture exchanging capacity improves intra-airway preservation of heat and water. Since the condensation and evaporation of moisture are accompanied by the release and uptake of thermal energy, these parameters are inseparable. Secondly, the HMEs resistance may reduce dynamic airway compression, thereby improving ventilation. Thirdly, to some extent, an HME might filter out particles, thereby cleaning inspiratory breathing air. This article summarizes our present knowledge of changes in respiratory physiology after total laryngectomy and the influence of the HME by reviewing the physiological impact of these three physical properties separately for in vitro and in vivo data.     

氧气湿化瓶消毒保存方法的改进

目的　探讨氧气湿化瓶最有效的消毒、保存方法 ,减少湿化瓶的污染。方法　设常规组、观察组氧气湿化瓶各 10 3件 ,常规组用 0 .1%消毒灵 (含有效氯 4 0 0mg/L)浸泡 30min ,取出用无菌蒸馏水均匀冲洗晾干后安装在氧气瓶上备用。观察组用 0 .1%消毒灵浸泡 30min ,再用 95 %的酒精干燥处理后安装在氧气瓶上备用。二组均在消毒处理后 1,3,5 ,7d分别采样培养 ,比较污染程度。结果　随着保存时间延长常规组污染率明显增加 ,观察组污染率明显低于常规组。常规组、观察组保存 7d的污染率分别是 5 2 .2 8%和 9.71% ,两组比较 ,有高度显著性差异(P <0 .0 1)。结论　氧气湿化瓶在常规消毒处理后加用 95 %的酒精进行干燥处理 ,能提高消毒效果 ,延长保存时间。     

水分对壳聚糖包膜尿素养分释放特性的影响

探讨了土壤中水分对壳聚糖包膜尿素（CCU）养分释放特性的影响。结果表明：CCU具有很好的缓释效果，养分释放率与包膜内水蒸气压差呈线性关系；介质离子浓度对养分释放有很大的影响，在盐类饱和溶液中，最大释放率达不到100％。CCU的养分释放是单个颗粒在不同时间内释放养分的累积行为，单个颗粒不能提供满足要求的持续的养分释放。CCU养分释放速率随着土壤水分的增加而增大，土壤水分含量对CCU养分释放的影响是非常复杂的，养分释放不能简单地用饱和水分条件下的模型来预测。CCU在干旱的土壤中表现出优于聚合物包膜肥料的养分释放特性。     

白果饮片质量标准修订研究

目的 建立并完善白果饮片的质量标准。方法 参照《中国药典》（2015年版）第一增补本相关方法对29批白果仁饮片及12批炒白果仁饮片进行性状鉴别,并测定水分含量。结果 不同批次的白果仁饮片及炒白果仁饮片性状较一致;白果仁饮片水分含量为8.8%～12.2%,平均为10.5%;炒白果仁饮片水分含量为5.4%～12.3%,平均为8.9%。鉴于白果饮片存储较久,易虫蛀发霉,规定白果饮片水分含量不超过10.0%。结论 与《中国药典》（2015年版）第一增补本相比,增加了白果仁及炒白果仁饮片的性状鉴别,完善了白果饮片的质量标准;白果仁及炒白果仁饮片水分含量需严格控制,不超过10.0%,以防止饮片发霉及虫蛀。     

一次性气管切开集痰保湿防护罩在气管切开术后患者气道湿化中的应用效果

目的 评价一次性气管切开集痰保湿防护罩在气管切开术后非机械通气患者气道湿化中的应用效果。方法 选取气管切开术后非机械通气患者48例,随机将其分入传统组(n=16)、实验组(n=16)和对照组(n=16)。传统组采用2层湿纱布覆盖气管切开导管口进行湿化,实验组使用防护罩湿化,对照组使用人工鼻湿化。比较3组患者呼吸功能、气道温度和湿度、Ⅲ度黏痰以及湿化不足并发症的发生情况。结果 3组患者血氧饱和度、动脉血氧分压和动脉血二氧化碳分压在时间效应、组间效应及交互效应上比较,差异均无统计学意义(P＞0.05)。干预7 d后,实验组吸气温度高于对照组(P＜0.05),吸气湿度低于对照组(P＜0.05),且均高于传统组(P＜0.05);3组呼气温度比较,差异无统计学意义(P＞0.05),实验组与对照组呼气湿度差异无统计学意义(P＞0.05),但2组均高于传统组(P＜0.001);3组的痰液黏稠度比较,差异有统计学意义(χ²=6.400,P=0.041),3组气道出血及肺部感染发生率比较,差异无统计学意义(χ²=3.091,P=0.230;χ²=1.948,P=0.763)。结论 一次性气管切开集痰保湿防护罩能提升气管切开术后患者气道温度和湿度,有效湿化气道。     

Effect of denture adhesives on oral moisture: A multicenter randomized controlled trial

PurposeThe purpose of this study was to investigate the effect of denture adhesives on oral moisture in a 10-center parallel randomized clinical trial.MethodsTwo hundred edentulous subjects wearing complete dentures were allocated into three groups: cream-type adhesive, powder-type adhesive and control groups. The adhesives (and saline solution in the control group) were applied to the mucosal surface of the dentures for 4 days, and baseline data and data after the intervention for eight meals over 4 days were obtained. For the main outcome, oral moisture was measured with a moisture checking device. Secondary outcomes were denture satisfaction, masticatory performance, denture retention, and occlusal force. In addition to between-group and within-group comparisons of oral moisture, investigations for secondary outcomes were undertaken in subgroups classified according to the degree of oral moisture at baseline (normal subgroup and dry mouth subgroup). Intention-to-treat analysis was also performed.ResultsBetween-group and within-group comparisons of oral moisture showed no significant differences. The cream-type and powder-type denture adhesives were significantly effective in the dry mouth group for denture satisfaction ratings of ability to masticate, stability, retention, and comfort of mandibular dentures (p < 0.05). The masticatory performance and retentive force of the dry mouth denture adhesive using groups were significantly improved after intervention (p < 0.05).ConclusionsThe oral moisture of complete denture wearers was not influenced by the use of denture adhesives. Our findings showed that denture adhesives improved subjective denture satisfaction, masticatory performance, and retention for complete denture patients with oral dryness.     

近红外光谱技术快速测定麦门冬药材中水分的含量

[目的]利用近红外漫反射光谱法结合化学计量法建立一种快速测定麦门冬药材中水分含量的方法。[方法]以烘干法测定90批麦门冬的水分含量作为参考值,利用近红外光谱仪采集麦门冬漫反射光谱结合偏最小二乘法(PLS)建立麦门冬药材中水分定量校正模型。[结果]运用SNV+First Derivative+Norris平滑光谱预处理方法,筛选最佳建模波段在5 000~9 000 cm-1,主因子数为8,建立的定量模型内部交叉验证相关系数R为0.981 1,交叉验证误差均方差RMSECV为0.131,12批验证集样品的参考值与预测值经统计学t检验,P=0.950.05,表明2组数据无统计学意义。[结论]运用近红外光谱技术建立麦门冬水分定量模型可快速预测其水分值,该方法快速、简便,结果准确,为中药材质量的实时监测提供数据支持。     

天津市城市生活垃圾热值测定分析

采用自动量热仪对天津市中心城区、环城四区、滨海新区3个区域14个来源地168个样品的生活垃圾热值进行测定,并对热值变化的规律进行了分析。     

近红外光谱法快速测定逍遥丸(浓缩丸)中水分含量

目的: 应用近红外光谱法建立一种逍遥丸(浓缩丸)中水分含量的快速测定方法。方法: 利用烘干法测定样品中水分含量,并以其作为参考值,运用偏最小二乘法(PLS)建立水分含量与近红外光谱之间的多元校正模型,对未知样品进行含量预测。结果: 所建水分定量分析模型的相关系数(R²),校正均方差(RMSEC),预测均方差(RMSEP)分别为0.953 52,0.132,0.177。结论: 方法操作简便,无污染,结果准确可靠,可用于逍遥丸(浓缩丸)中水分含量的快速测定。