刷牙冲洗法对ICU经口气管插管患者口腔护理的效果研究

目的 探讨刷牙冲洗法对ICU经口气管插管患者口腔护理的临床效果.方法 将150例ICU经口气管插管患者随机分为实验组（n=75）和对照组（n=75）,实验组采用儿童软毛牙刷蘸牙膏刷牙,然后用生理盐水冲洗的方法进行口腔护理,对照组采用传统口腔护理方法进行口腔护理,对两组患者口腔护理的效果进行比较.结果 实验组患者口腔护理效果明显优于对照组患者,与对照组比较,实验组患者口臭发生率为6.67％、口腔溃疡发生率为1.33％、疱疹发生率为4.00％及呼吸机相关性肺炎发生率均明显降低,经统计学分析,差异均有统计学意义（P＜0.05）.结论 刷牙冲洗法应用于ICU经口气管插管患者口腔护理,能促进患者舒适,降低气管插管后并发症的发生.     

新型气管插管固定器在临床急诊中的应用效果分析

目的:探索新型气管插管固定器在临床急诊中的应用效果。方法:选择2016年6月至2017年6月至我院急诊科就诊需行气管插管患者97例作为研究对象,观察组(n=50)采用新型气管插管固定器固定气管插管,对照组(n=47)采用传统方式固定气管插管,记录和对比分析两组患者固定效果、操作时间、病人的耐受程度以及意外事件发生情况。结果:观察组患者固定效果明显优于对照组患者,二者比较具有显著统计学意义(P0.05);观察组患者的操作时间(2.5±0.9)min,显著低于对照组患者(6.7±2.2)min(P0.05);观察组患者的耐受率也明显优于对照组患者,二者比较具有统计学意义(P0.05)。观察组与对照组患者意外事件发生率分别为2.00%与14.89%,观察组显著低于对照组患者,二者比较具有统计学差异(P0.05)。结论:新型气管插管固定器在临床急诊中的应用能够显著增强固定效果,缩短操作时间,提高病人的耐受程度,且具有更低的意外事件发生率,是一种行之有效的方法,值得在临床中推广使用。     

Transplantation of multiciliated airway cells derived from human iPS cells using an artificial tracheal patch into rat trachea

Tracheal resection is often performed for malignant tumours, congenital anomalies, inflammatory lesions, and traumatic injuries. There is no consensus on the best approach for the restoration of tracheal functionality in patients with tracheal defects. Artificial grafts made of polypropylene and collagen sponge have been clinically used by our group. However, 2 months are required to achieve adequate epithelialization of the grafts in humans. This study aimed to investigate the feasibility of transplantation therapy using an artificial trachea with human‐induced pluripotent stem cell (hiPSC)‐derived multiciliated airway cells (hiPSC‐MCACs). Collagen vitrigel membrane, a biocompatible and absorbable material, was used as a scaffold to cover the artificial trachea with hiPSC‐MCACs. Analyses of hiPSC‐MCACs on collagen vitrigel membrane were performed by immunocytochemistry and electron microscopy and by assessing ciliary beat frequency. Along with the artificial trachea, hiPSC‐MCACs were transplanted into surgically created tracheal defects of immunodeficient rats. The survival of transplanted cells was histologically evaluated at 1 and 2 weeks after the transplantation. The hiPSC‐MCACs exhibited motile cilia on collagen vitrigel membrane. The surviving hiPSC‐MCACs were observed in the endotracheal epithelium of the tracheal defect at 1 and 2 weeks after transplantation. These results suggest that hiPSC‐MCAC is a useful candidate for tracheal reconstruction.     

激素抵抗型哮喘小鼠动物模型的实验性研究

目的探索建立激素抵抗型支气管哮喘小鼠动物模型的有效方法。方法普通级BALB/C雌性小鼠30只,随机均分为5组。正常对照（NC）组直接处死,非治疗哮喘（NTA）、激素治疗敏感哮喘（SSA）、气管重塑（AR）、激素抵抗型哮喘（SRA）组均采用卵清白蛋白（OVA）致敏、激发造模,SSA、SRA组予地塞米松（DEX）干预,AR、SRA组连续雾化9周。行肺泡灌洗液（BALF）细胞计数、肺组织切片细胞分类计数、气管壁及平滑肌厚度图像分析。结果SRA组在实验末期出现持续性喘息,DEX干预后喘息不缓解。NTA、AR、SRA组肺内炎症细胞浸润程度、气管壁程度较NC组严重,SRA组肺内嗜酸性粒细胞、淋巴细胞浸润及AR程度较SSA组严重（P<0.05）,AR组BALF细胞计数及AR程度较NTA组严重（P<0.05）,SRA组与AR组比较,仅肺内嗜酸性粒细胞数明显升高（P<0.01）。结论本研究建立SRA小鼠动物模型的方法切实可行。     

Antispasmodic and bronchorelaxant activities of Salsola imbricata are mediated through dual Ca+2 antagonistic and β-adrenergic agonistic effects

Context: Salsola imbricata Forssk. (Chenopodiaceae) has folkloric repute for the treatment of various gastrointestinal and respiratory ailments.

Objective: The present study investigates spasmolytic and bronchorelaxant effects of S. imbricata.

Materials and methods: The crude aqueous-ethanol extract of the aerial parts of S. imbricata and its fractions, in cumulative concentrations (0.01–10?mg/mL), were tested on contractions of isolated rabbit jejunum and tracheal preparations. Furthermore, concentration response curves (CRCs) of Ca⁺² and carbachol were constructed in the absence and presence of the extract. Standard organ bath methods were used.

Results: The crude extract relaxed spontaneous, K^+?(80?mM) and carbachol (1?μM)-induced contractions in jejunum preparations with respective EC₅₀ values of 0.40 (0.35–0.46), 0.69 (0.60–0.79) and 0.66 (0.57–0.75) mg/mL. It shifted Ca⁺² CRCs rightward in nonparallel manner. In isolated tracheal preparations, the crude extract caused relaxation of K^+?(80?mM) and carbachol (1?μM)-induced contractions with EC₅₀ values of 0.86 (0.75–0.98) and 0.74 (0.66–0.84) mg/mL, respectively. It displaced carbachol CRCs rightward with suppression of maximal response. In both tissues, pretreatment with propranolol (1?μM) caused rightward shift in inhibitory CRCs of the extract against carbachol-induced contractions. The ethyl acetate fraction was found more potent in relaxing smooth muscle contractions than the parent extract and its aqueous fraction.

Discussion and conclusion: The results suggest that the spasmolytic and bronchorelaxant activities of S. imbricata are related to Ca⁺² antagonistic and β-adrenergic agonistic effects, thus justifying some of the traditional uses of the plant.     

小儿肺热咳喘颗粒治疗小儿急性咽气管炎(感冒风热夹痰证)的多中心临床试验研究

目的评价小儿肺热咳喘颗粒治疗小儿急性咽-气管炎(感冒风热夹痰证)的有效性与安全性。方法采用分层区组随机、阳性药(急支糖浆)平行对照、双盲双模拟、非劣效检验、多中心临床研究的方法。结果共收集病例210例,两组各105例。试验组、对照组疾病疗效总有效率分别为96.04%、96.08%(PPS),中医证候疗效总有效率分别为97.03%、98.04%(PPS),经非劣效性检验,试验组疾病疗效及证候疗效均不劣于对照组。两组咽红肿或痛症状消失率分别为57.43%、43.14%(PPS),试验组优于对照组,差异有统计学意义(P0.05),其他单项症状消失率及并发症发生率比较,差异不显著。两组均无不良反应发生。结论小儿肺热咳喘颗粒的总体治疗效果不劣于急支糖浆,对于咽红肿或痛的治疗消失率高于急支糖浆,且临床应用安全性良好。     

九味麦冬方对Iso致太阴急性心肌缺血太阴小鼠模型气管夹闭心电消失时间、Ⅱ导联心电图ST-T波影响随机平行对照研究

[目的]观察九味麦冬方对Iso致急性心肌缺血太阴小鼠模型气管夹闭心电消失时间、Ⅱ导联心电图ST-T波影响。[方法]使用随机平行对照方法,1气管夹闭心电消失时间影响,将48只昆明种小鼠,编号按随机数字表分为四组:空白组,模型组,九味麦冬方组,丹参组,12只/组。2Ⅱ导联心电图ST-T波影响,将40只昆明种小鼠,编号按随机数字表分为四组:空白组,模型组,九味麦冬方组,丹参组,10只/组。灌胃干预:九味麦冬方组(25.6g生药/kg),丹参组(13.0g生药/kg),模型组(等量蒸馏水);1次/d,连续21d。末次给药45min后,除空白组外,各组均皮下注射0.015g/kg Iso制备小鼠急性心肌缺血模型。观测指标:气管夹闭心电消失时间、Ⅱ导联心电图ST-T波。[结果]气管夹闭心电消失时间九味麦冬方组明显高于丹参组、模型组(P0.01)。Ⅱ导联心电图ST-T波变化率九味麦冬方组优于丹参组。[结论]九味麦冬方具有良好的抗心肌缺血损伤能力。     

多层螺旋CT低剂量扫描对气管异物的诊断价值

目的探讨多层螺旋CT低剂量扫描在气管、支气管异物中的诊断价值。方法选取35例气管和支气管异物患者行胸部低剂量扫描,与支气管镜对比。结果多层螺旋CT低剂量扫描诊断气管异物9例,支气管异物26例,支气管镜取出异物34例,1例为黏液栓,多层螺旋CT低剂量扫描显示结果与支气管镜诊断结果在气管、支气管异物病例中的符合率为97%,多层螺旋CT后处理技术对于气管支气管异物的精确定位准确。结论多层螺旋CT低剂量扫描在明显降低辐射剂量的前提下,对诊断气管异物具有很高的诊断价值。     

毛冬青素L7抗小鼠缺氧作用

目的:研究毛冬青素L7抗小鼠缺氧作用。方法:通过常压耐缺氧、亚硝酸钠中毒、氰化钾中毒、利多卡因中毒、夹闭气管小鼠心电消失时间、断头小鼠张口动作持续时间等实验观察其抗小鼠缺氧作用。结果:毛冬青素L7可明显延长小鼠在常压缺氧条件下的存活时间;延长亚硝酸钠、氰化钾、利多卡因中毒后的小鼠存活时间;延长夹闭气管小鼠心电消失时间及断头小鼠的喘气时间。结论:毛冬青素L7对缺氧有保护作用。     

重型颅脑损伤的护理体会

目的探讨重型颅脑损伤患者的护理。方法选取42例重型颅脑损伤患者,重点加强病情观察、呼吸道护理、基础护理、气管切开护理等。结果经过护理42例重型颅脑损伤患者治愈26例,中残7例,重残3例,死亡6例。结论对重症颅脑损伤患者,除做好原发病的护理外,也应做好合并伤及并发症的护理,护理人员在病情的不同阶段应抓住重点做好护理