Computer assisted recognition and quantitation of the effects of airborne chemicals acting at different areas of the respiratory tract in mice

The pattern and timing of a normal breath in unanesthetized mice was analyzed from measurement of inspiratory and expiratory airflows (V^.I and V^.E). Airflow was measured via a differential pressure transducer, attached to a pneumotachograph, which itself was attached to a body plethysmograph into which a mouse was placed. The analog voltage from the differential pressure transducer was digitized and stored for analysis on a microcomputer. Criteria were developed to classify each breath as normal (N) or belonging into one of seven abnormal categories. The abnormal categories were arrived at by computer analysis, recognizing specific modifications of the normal pattern into patterns of: sensory irritation of the upper respiratory tract (S), airflow limitation within the conducting airways of the lungs (A) or pulmonary irritation at the alveolar level (P). Combinations of these effects, i.e., S+A, P+A, P+S and P+S+A were also recognized. Computer analysis of each breath also permitted quantitative evaluation of the degree of S, A or P abnormalities. To induce each type of effect we used inhalation exposures to 2-chlorobenzylchloride, carbamylcholine or propranolol. We propose that this approach will permit rapid evaluation of the possible effects of airborne chemicals at three levels of the respiratory tract, with the classification of the type of effect easily obtained in an objective way using well defined criteria, followed by quantitation of the degree of each effect. Received: 16 December 1993 / Accepted: 11 April 1994     

机械通气治疗123例COPD合并呼吸衰竭的临床分析

目的探讨呼吸机治疗慢性阻塞性肺病的效果,减少慢性阻塞性肺病的死亡率。方法将1998年12月～2006年12月收治的165例慢性肺疾病合并呼吸衰竭患者,随机分为两组,123例用呼吸机治疗,42例未用呼吸机治疗,并比较分析。结果123例用呼吸机组患者缓解出院率为72%,死亡率为28%;42例未用呼吸机组缓解出院率为36%,死亡率为64%(P<0.01)。结论呼吸机治疗慢性阻塞性肺病能改善通气,治疗呼吸衰竭、降低死亡率。     

An attempt to define a just detectable effect for airborne chemicals on the respiratory tract in mice

 We have attempted to define a just detectable effect (JDE) for three different types of reactions along the respiratory tract: (a) sensory irritation of the upper airways (S), (b) airflow limitation along the conducting airways (A), and (c) pulmonary irritation at the alveolar level (P1 or P). Each type of reaction, S, A, P1 or P, was recognized by analyzing the breathing pattern of unanesthetized mice held in body plethysmographs. A rule-based computer program analyzed each breath during a period of 3.75 h and classified each breath as normal (N) or falling in any of the above categories (i.e., S, A, P1 or P). Eight groups of four mice were used for sham exposures: exposed to water vapor. These data sets were used, as sham exposure data, to define the variation which can occur with time in order to define an expected range of normal variation. Once this range was established, we defined JDE values for each type of effect and used such values to evaluate the results obtained in exposed animals. Eight groups of four mice were exposed to a mixture of airborne chemicals, machining fluid G (MFG), at concentrations from 0.17 to 55 mg/m³. Data sets for individual animals and for each group of animals exposed to MFG were analyzed to determine if and when a particular effect occurred. It was possible to recognize the effects of low exposure concentrations on groups of exposed animals or individual animals within each group. This procedure will be valuable when investigating the effect of airborne chemicals and when it is impossible to generate high exposure concentrations to define concentration-response relationships. Received: 4 October 1995/Accepted: 20 December 1995     

Computer-based bioassay for evaluation of sensory irritation of airborne chemicals and its limit of detection

We expanded a previously described rule-based computerized method to recognize the sensory irritating effect of airborne chemicals. Using 2-chlorobenzylchloride (CBC) as a sensory irritant, characteristic modifications of the normal breathing pattern of exposed mice were evaluated by measuring the duration of braking (TB) after inspiration and the resulting decrease in breathing frequency. From the measurement of TB, each breath was then classified as normal (N) or sensory irritation (S). Using increasing exposure concentrations, the classification S increased from ≤2% (equivalent to sham-exposure) to 100% within a narrow exposure concentration range. The potency of CBC was then evaluated by calculating the concentration necessary to produce 50% of the breaths classified as S, i.e., S₅₀. This approach is easier to use than obtaining RD₅₀ (decrease in respiratory frequency by 50%) when high exposure concentrations are difficult to achieve. Detection limits were also established for this bioassay and experiments were conducted to obtain a level of response just around these limits, in order to delineate the practicality of using this bioassay at low exposure concentrations. Using this approach, sensory irritation was the only effect induced by CBC at low exposure concentrations. However, bronchoconstriction and pulmonary irritation were superimposed on this effect at higher exposure concentrations. Received: 9 December 1997 / Accepted: 6 January 1997     

老年人呼吸道感染恢复期的社区护理研究

目的探讨对老年呼吸道感染恢复期患者实施社区护理干预的临床效果。方法对80例老年呼吸道感染恢复期患者实施社区护理干预,社区护理干预模式包括注意观察体征变化、改善通气功能、注意预防继发感染、加强饮食护理、锻炼方式及运动量的指导、合理用药等社区护理干预措施。随访2年,比较干预前后患者的临床症状改善情况,患者每人平均住院次数和平均住院天数。结果咳嗽、咯痰症状好转64例(80%),气促、胸闷症状改善60例(75%)。平均住院次数、住院天数比较在干预前后均存在统计学差异(P<0.05)。结论社区护理干预可改善老年呼吸道感染恢复期患者的临床症状及提高其生活质量。     

澳特斯小儿止咳露治疗小儿呼吸道感染咳嗽疗效观察

目的：评估澳特斯小儿止咳露化痰、祛痰、止咳等临床疗效。方法：采用随机、对照方法，将100例急性呼吸道感染患儿随机分为治疗组和对照组各50例，疗程均为3d，采用Χ^2检验比较两组总有效率。结果：澳特斯组至疗程第3d总有效率优于百咳静糖浆组，治疗组与对照组总有效率分别为82．0％与54．0％（P〈0．01），且药物接受程度高（P〈0．05）。结论：澳特斯小儿止咳露是一种适用于各年龄期小儿的安全有效的化痰止咳药。     

澳特斯小儿止咳露治疗小儿呼吸道感染咳嗽疗效观察

目的:评估澳特斯~小儿止咳露化痰、祛痰、止咳等临床疗效。方法:采用随机、对照方法,将100例急性呼吸道感染患儿随机分为治疗组和对照组各50例,疗程均为3 d,采用χ2检验比较两组总有效率。结果:澳特斯~组至疗程第3 d总有效率优于百咳静糖浆组,治疗组与对照组总有效率分别为82.0%与54.0%(P<0.01),且药物接受程度高(P<0.05)。结论:澳特斯~小儿止咳露是一种适用于各年龄期小儿的安全有效的化痰止咳药。     

国产注射用头孢呋辛钠治疗呼吸道感染的临床疗效观察

目的 比较国产注射用头孢呋辛钠与进口注射用头孢呋辛钠（对照组）治疗下呼吸道感染的疗效和安全性。方法 在3家医院进行前瞻性多中心随机比较,共治疗120例患者,头孢呋辛钠组和对照组均静脉滴注,3g/d,疗程7－14d,一般资料相似（P＞0．05）。结果 两组临床疗效无显著性差异（P＞0．05）,痊愈率分别为91．7％和95．0％,细菌阳性率为79．2％（95／120）,细菌清除率分别为95．2％和100．0％,两组在统计学上无显著性差异（P＞0．05）。两组不良反应发生率分别为1．77％（1／60）和5．00％（3／60）,无显著性差异。结论 在治疗下呼吸道感染中,国产注射用头孢呋辛钠和进口注射用头孢呋辛钠都是安全有效的。     

注射用阿奇霉素治疗呼吸道感染的临床疗效

目的：评价注射用阿奇霉素治疗呼吸道感染的疗效与安全性。方法：利用随机对照研究方法，将71例轻中度呼吸道感染病人随机分为两组。试验组用阿奇霉素治疗，首次500mg，每天1次，以后用250mg，每天1次静脉滴注，疗程共5d。对照组用红霉素治疗，每天1000－1250mg，每天1次，静脉滴注，疗程7－10d。结果：两药的临床疗效和细菌学疗效相似，但试验药不良反应发生率低，试验组不良反应发生率为8．57％，对照组27．78％。结论：注射用阿奇霉素治疗急性呼吸道感染有效且不良反应更低。     

Chronic exposure of mice to environmental endocrine-disrupting chemicals disturbs their energy metabolism

We evaluated the effects of a 20-week chronic exposure of mice to a low dose of cypermethrin (CYP), atrazine (ATZ) and 17α-ethynyestradiol (EE2) on energy metabolism. Here, male mice were exposed to 50 μg/kg BW/day CYP, 100 μg/kg BW/day ATZ or 1 μg/kg BW/day EE2 supplied in their drinking water for 20 weeks. During the exposure, mice were fed a high energy diet (HD). The bodyweights were not significantly affected by chronic exposure to EDCs, while the serum-free fatty acids (FFA) levels, hepatic lipid accumulation and triacylglycerol (TG) contents increased significantly in the ATZ- and CYP-HD groups. To determine the mechanism involved, we determined the expression levels of the genes in the glucose and fat metabolism pathways in the liver and adipose tissue. The results showed that chronic exposure to ATZ and CYP increased the mRNA levels of a number of key genes involved in both the de novo FFA synthesis pathway and the transport of FFA from blood. The increased amount of FFA was partially consumed as energy through β-oxidation in the mitochondria. Some of the FFA was used to synthesize TG in the liver by up-regulating primary genes, which resulted in increased TG levels and lipid accumulation. The results indicate that chronic exposure to EDCs has the potential to cause energy metabolic dysregulation and hepatotoxicity in mice.     

儿童急性呼吸道感染抗生素应用调查分析

目的：通过对本院门诊患儿静脉注射抗生素的调查,了解目前我院抗生素应用现状。方法：随机抽取急性呼吸道感染静脉注射抗生素患儿584例,对急性上呼吸道感染、急性支气管炎、肺炎患儿使用青霉素类、头孢茵素类、大环内酯类抗生素的情况进行分析。结果：急性上呼吸道感染组、急性支气管炎组抗生素使用以单用为主,肺炎组以抗生素联用为主;随着病变部位的深入,病情加重,单用抗生素比例逐渐减小,而级别较高的抗生素使用比例增加;在联合使用抗生素中,随着病情加重,抗生素联合种类也逐渐升级。结论：我院门诊患儿抗生素使用正趋于合理化、规范化。     

蓝芩口服液治疗病毒性上呼吸道感染发热疗效观察

目的观察蓝芩口服液治疗病毒性上呼吸道感染发热的治疗效果。方法130例病毒性上呼吸道感染发热患者,其中包括甲型H1N1流感确诊病例20例,疑似病例8例,临床诊断病例41例,予蓝芩口服液治疗3d,随访1d,观察退热效果和退热时间。结果治疗后,4h内退热39例（30．0％）,72h退热118例（90．8％）,平均退热时间为（23．7±14．9）h。结论蓝芩口服液治疗病毒性上呼吸道感染发热疗效确切。     

头孢匹罗头孢吡肟头孢曲松治疗下呼吸道感染的疗效比较

目的比较头孢匹罗、头孢吡肟、头孢曲松治疗下呼吸道轻中度感染的疗效和安全性。方法在139例患者中进行多中心、前瞻性、随机比较。头孢匹罗组（Ⅰ组）46例,头孢吡肟组（Ⅱ组）48例,头孢曲松组（Ⅲ组）45例。各组所用药物均为2g／a,静脉注射,疗程7d。结果3组临床疗效分别为82％、79％、60％;细菌阳性率48％（67／139）,细菌清除率分别为80％、78％、56％,3组比较Ⅰ、Ⅱ组间差异无显著性（P〉0．05）。Ⅰ、Ⅱ组与Ⅲ组间差异均有显著性（P〈0．05）。治疗过程中3组患者无1例出现皮疹及其他不良反应。结论头孢匹罗、头孢吡肟、头孢曲松各用2g／d治疗轻中度下呼吸道感染安全有效,且1周疗程足够。但在治疗这些疾病时,可先选用头孢曲松、当头孢曲松治疗无效时,再选用头孢匹罗或头孢吡肟。     

小儿呼吸道异物200例临床研究

目的提高临床医生对呼吸道异物的认识。方法对200例呼吸道异物患儿的临床资料进行回顾性研究。结果根据患儿入院时情况,尽早在全身麻醉下行支气管镜检异物取出术,痊愈197例,死亡3例。结论呼吸道异物一经确诊,需急诊在全身麻醉下行支气管镜检异物取出术。根据异物的性质及种类选择不同的手术方法。     

老年呼吸道感染患者肺炎支原体抗体检测的调查分析

目的了解老年呼吸道感染患者肺炎支原体（Mycoplasmapneumoniae,MP）感染情况。方法选取广州市红十字会医院2010年1月至2012年9月≥65岁的呼吸道感染患者3765例,男2136例,女1629例,年龄在65～110岁以内,采用间接免疫荧光法（indirectimmunofluorescenceassay,IFA）对其血清中的肺炎支原体抗体（MP—IgM）进行检测。结果3765例老年呼吸道感染患者血清标本中,检出阳性的标本为834例,阳性率为22．15％,其中男性阳性率为21．11％,而女性阳性率为23、51％,不同性别间比较差异无统计学意义（X2=3．080,P〉0．05）。肺炎支原体抗体（MP—IgM）各年龄组问阳性率比较差异无统计学意义（X2=0．090,P〉0．05）。老年呼吸道感染患者肺炎支原体感染阳性率存在季节差异（X2=11．040,P〈o．05）,春季、夏季和冬季的老年呼吸道感染患者MP感染率之间比较差异无统计学意义（P〉0．05）,而春季、夏季和冬季的老年呼吸道感染患者MP感染率分别与秋季比较差异有统计学意义（P〈0．05）。结论老年呼吸道感染患者有一定的MP感染率,不同性别间差异无统计学意义,感染存在季节的差异性,因老年呼吸道感染患者感染MP合并有基础性疾病时可能会引起严重的损害,故临床应重视老年呼吸道感染患者MP的感染和防治,早发现早治疗;     

下呼吸道不动杆菌感染72例临床分析

目的探讨不动杆菌致下呼吸道感染的临床特点、危险因素和对抗生素的敏感性。方法对72例不动杆菌致下呼吸道感染患者的临床资料、痰细菌培养及药敏结果进行回顾性分析。结果72例中53例（73．6％）为60岁以上患者,69例（95．8％）患有基础疾病,59例（81．9％）为医院感染患者;感染的危险因素是患有各种基础疾病、免疫功能低下、各种侵入性操作、雾化吸人、不合理使用抗生素等;药物敏感试验显示,敏感率大于50％者有亚胺培南、左氧氟沙星、头孢哌酮／舒巴坦及丁胺卡那霉素;治愈38例,好转21例,死亡13例,病死率为18．1％。结论下呼吸道不动杆菌感染,多发生于老年、合并有基础疾病患者,多为医院感染,其耐药率高,预后差;对亚胺培南、左氧氟沙星、头孢哌酮／舒巴坦、丁胺卡那霉素等较为敏感。     

呼吸道真菌感染48例临床分析

目的:探讨肺部真菌感染的危险因素、诊断及治疗.方法:回顾性分析48例呼吸道真菌感染的临床资料.结果:呼吸道真菌感染的危险因素为长期使用广谱抗生素、糖皮质激素,以慢性阻塞性肺疾病,支气管扩张、矽肺多见.结论:合理使用抗生素及糖皮质激素,早期诊断和及时抗真菌治疗是降低呼吸道真菌感染和降低病死率的重要措施.     

法罗培南治疗细菌性呼吸道感染的临床研究

目的评价国产法罗培南治疗细菌性呼吸道感染的疗效和安全性。方法将64例细菌性呼吸道感染患者随机分为试验组和对照组各32例。试验组予以法罗培南钠口服治疗,对照组予以头孢呋辛酯口服治疗,疗程均为6～14d。比较2组临床疗效、细菌学疗效及不良反应发生率。结果试验组和对照组痊愈率分别为78.1%和81.3%,总有效率分别为96.9%和93.7%;细菌清除率分别为92.8%和88.9%;不良反应发生率分别为6.3%和6.3%,差异均无统计学意义(P>0.05)。结论国产法罗培南治疗细菌性呼吸道感染安全、有效,与头孢呋辛酯相仿。     

呼吸道感染铜绿假单胞菌耐药特点分析

目的分析呼吸道感染铜绿假单胞菌的耐药性,为临床用药提供参考。方法收集北京通州区2002年10月～2004年10月住院病人的各种呼吸道标本分离的铜绿假单胞菌136株,使用微量稀释法进行药敏试验,并对结果进行分析。结果136株铜绿假单胞菌敏感性最高的抗菌药物是哌拉西林/他唑巴坦(94.1%),其次分别为哌拉西林(89.7%)、亚胺硫霉素(85.3%)、头孢他啶(79.4%)、环丙沙星(77.9%)。同时耐氨苄青霉素、头孢噻肟、头孢唑啉和头孢西丁四种药的铜绿假单胞菌最多。结论铜绿假单胞菌是临床常见致病菌,耐药性严重。治疗中应根据分离株耐药特点选择合理用药方案,避免MDRP的出现。     

Modifications of breathing pattern induced by inhaled sulphur mustard in mice

A head-only exposure assembly was used for exposing mice to vapours of sulphur mustard (SM). The respiration was monitored using an on-line computer program, capable of recognizing the breathing pattern as sensory irritation, airflow limitation and pulmonary irritation. SM was dissolved in acetone and vapourized using a compressed air nebulizer. Mice were exposed to the vapours (8.5, 16.9, 21.3, 26.8, 42.3 and 84.7 mg/m³) for 1h in a body plethysmograph fitted with a 20-gauge needle and a microphone for sensing the respiratory flow signals. The signals were amplified, digitized and integrated to give tidal volume, and stored in a computer for further analysis. The respiration of the mice was followed for modifications in the breathing pattern until 7 days post-exposure. SM induced sensory irritation during exposure, and there was a concentration dependent decrease in the respiratory frequency and an increase in tidal volume. Lower concentrations showed recovery after stopping the exposure. RD₅₀, the concentration that depresses 50% of the respiration was estimated to be 27.4 mg/m³. Following exposure to higher concentrations the animals started dying after 6␣days. The LC₅₀ was estimated to be 42.5 mg/m³ (14␣days observation period). The respiratory frequency decreased on subsequent days of exposure depending upon the exposure concentration, and the breathing pattern was characteristic of airflow limitation. The ratio of flow/tidal volume was decreased following exposure to concentrations of 26.8 and 42.3 mg/m³. The ratio of flow/tidal volume may be a better measurement than the measurements based on flow alone for the assessment of airflow limitation. Pulmonary irritation was not observed showing that the lungs were not affected. The body weight of the animals decreased progressively. The present methodology will be useful for identifying the effects of SM on the respiratory system, one of the end-points considered when establishing occupational exposure limits. Received: 12 April 1996 / Accepted: 21 August 1996