桑杏汤合三口十汤治疗上气道咳嗽综合征43例临床疗效观察

目的：观察桑杏汤合三叶汤对上气道咳嗽综合征的治疗效果。方法：将43例上气道咳嗽综合征病例随机分为治疗组22例和对照组21例。治疗组采用桑杏汤合三叶汤随症加减治疗,对照组采用桑杏汤随症加减治疗。观察两组咳嗽症状改善及整体疗效情况,并作比较。结果：治疗组上气道咳嗽症状改善及整体疗效情况都明显优于对照组。结论：桑杏汤合三叶汤对上气道咳嗽综合征具有明显的治疗作用。     

喉罩通气在成人中耳显微手术中的应用

目的评价喉罩通气在全身麻醉中耳显微手术中的安全性和有效性。方法 100例美国麻醉医师协会（ASA）Ⅰ-Ⅱ级择期行中耳显微手术的成年中耳炎患者,随机分为喉罩组（LMA组,n=50）和气管插管组（ETT组,n=50）。记录患者进入手术室至手术开始的时间,各时间点的心率和血压变化：麻醉前（T0）、插管/罩前即刻（T1）、插管/罩后即刻（T2）、拔管/罩前即刻（T3）、拔管/罩后即刻（T4）。记录2组患者插管/罩时体动或呛咳和拔管/罩时的呛咳反应。记录手术结束至拔除管/罩的时间和麻醉恢复室停留时间。结果喉罩组患者进入手术室至手术开始时间低于气管插管组（P〈0.05）;喉罩组和气管插管组T1时平均动脉压（MAP）、心率显著低于T0时（P〈0.05）;气管插管组T2和T4时MAP和心率较T0时显著升高（P〈0.05）;组间比较T2和T4时气管插管组MAP和心率均显著高于喉罩组（P〈0.05）。置入管/罩及拔管/罩时气管插管组呛咳发生率分别为25%和84%,明显高于喉罩组的0和4%（P〈0.05）。气管插管组手术结束至拔除通气装置的时间高于喉罩组（P〈0.05）。结论喉罩通气用于成人中耳显微手术气道管理,易于维持血流动力学稳定,有效避免了拔管时呛咳。     

经鼻持续气道正压通气对肺表面活性物质治疗新生儿呼吸窘迫综合征效果的影响

目的 探讨不同时间点应用经鼻持续气道正压通气(nCPAP)对肺表面活性物质(PS)治疗新生儿呼吸窘迫综合征(RDS)效果的影响.方法 对湖北科技学院附属第一医院于2013年1月-2016年6月收治的RDS 100例的临床资料进行回顾性分析.根据应用nCPAP时间分为≤2h组38例、2～4h组41例、≥4 h组21例.观察3组治疗前后动脉血气变化、治疗3、7d的机械通气率及并发症发生情况.结果 3组给药24 h后吸入氧浓度(FiO2)和二氧化碳分压(PaCO2)低于给药前,pH和氧分压(PaO2)高于给药前,且2～4h组改善情况优于≤2h组和≥4h组;给药2h后,2～4h组FiO2低于≤2h组和≥4 h组,≥4h组PaO2均高于≤2h组和2～4h组(P＜0.05);治疗3d2～4h组需机械通气率低于≤2h组和≥4 h组(P＜0.05);支气管肺发育不良发病率≤2h组高于2～4h组和≥4h组(P＜0.05).结论 早期给予nCPAP对PS治疗RDS效果明显,可改善预后,在发病2～4h应用效果最佳.     

双管喉罩在COPD呼吸衰竭患者无创通气中的应用效果

目的：探讨双管喉罩用于COPD呼吸衰竭无创通气中的应用效果。方法选取本院2012年1月~2014年6月收治的60例COPD合并Ⅱ型吸吸衰竭患者作为研究对象,随机分为两组,各30例。观察组给予双管喉罩,对照组给予普通口鼻面罩,比较两组的SpO2上升时间、动脉血气改善时间、通气失败率、脱机时间、并发症发生率。结果观察组的SpO2上升时间、脱机时间显著短于对照组,差异有统计学意义(P<0.01)。观察组的反流误吸率、通气失败率显著低于对照组,差异有统计学意义(P<0.05)。观察组治疗后8、48 h的pH、PaCO2水平显著高于对照组,观察组的PaCO2水平显著低于对照组,差异有统计学意义(P<0.01)。结论双管喉罩可以更好地改善COPD合并Ⅱ型呼吸衰竭患者的预后,能够替代口鼻面罩用于该类患者的无创通气治疗。     

痰湿证睡眠呼吸暂停患者CPAP压力水平研究

目的:对痰湿证睡眠呼吸暂停(OSA)患者运用持续正压通气(CPAP)治疗,探讨呼吸机压力水平和BMI、颈围、最低血氧、AHI、鼾声指数的关系,推导相关压力值计算公式,方便临床应用。方法:对54例痰湿证OSA患者行呼吸机压力滴定,分析呼吸机压力水平和BMI、颈围、最低血氧、AHI、鼾声指数的相关性,得出平均压力的多元线性回归方程,用于临床参考。结果:(1)CPAP治疗前后AHI指数和鼾声指数有显著差异(P0.01),CPAP治疗疗效显著。(2)BMI、颈围、最低血氧、AHI、鼾声指数均和平均压力直线相关(P0.01)。(3)根据多元线性逐步回归,得出平均压力=0.220×颈围+0.036×AHI+0.001×鼾声指数-3.746。结论:OSA患者BMI、颈围、最低血氧、AHI、鼾声指数均与CPAP平均压力显著相关,通过回归方程计算得出相关压力水平。     

CpG寡脱氧核苷酸对慢性哮喘小鼠模型气道炎症的预防作用

目的研究含非甲基化的胞嘧啶-磷酸-鸟嘌呤（CpG）寡脱氧核苷酸（CpG-oligodeoxynueleotides,CpG- ODN）能否预防或减轻慢性哮喘小鼠气道炎症的发生。方法40只雌性C57BL／6小鼠随机均分为4组,A组（慢性哮喘组）、B组（CpG-ODN干预组）和C组（GpC-ODN对照组）分别腹腔注射卵蛋白致敏,然后用卵蛋白雾化吸入激发以制作慢性哮喘模型,D组（生理盐水对照组）用生理盐水进行致敏和激发。B组在致敏同时（d1, d14）和激发阶段（每2周1次）分别给予60μg／mLCpG-ODN腹腔注射,共6次。C组将CpG替换为鸟嘌呤-磷酸-胞嘧啶（GpC）作为对照。在末次激发24 h后,取血测嗜酸粒细胞（eosinophil,EOS）数,血清IgE、IgG1和IgG2α;收集支气管肺泡灌洗液（bronehoalveolar lavage fluid,BALF）作细胞分类计数;测定肺组织中白介素-4 （interleukin-4,IL-4）、白介素-13（interleukin-13,IL-13）和γ-干扰素的mRNA（interferon-γ,IFN-γ）表达量;以及肺组织病理学检查。结果A组外周血EOS数[（89±10）×10^4／mL]、血清IgE值[（279±53）ng／mL）、IgG1（A值2．151±0．628）、IgG2α（A值0．772±0．245）、BALF中EPS（6．3±1．3）]×10^5／mL）及百分比[（18．1±3．0）％]较D组明显增高（P〈0．01）;且肺组织中IL-4、IL-13和IFN-γ等细胞因子mRNA表达量[（分别为（5．72±3．89）×10^-2、（9．45±5．91）×10^-2和（3．23±1．69）×10^-2）]也明显高于D组（P〈0．05）。用CpG-ODN干预后（B组）,除IgG2α（A值1．186±0．414）和IFNγmRNA表达量[（18．91±9．85）×10^-2]增高外（P〈0．05）,其余指标均低于A组（P〈0．05）。C组的上述各指标与A组相比差异均无显著性（P〉0．05）。结论CpG- ODN对小剂量OVA反复激发所致的慢性气道炎症有一定的预防作用。     

The impact of continuous positive airway pressure on cardiac mechanics: Findings from a meta‐analysis of echocardiographic studies

Current evidence on the effects of continuous positive airway pressure (CPAP) on cardiac mechanics in patients with obstructive sleep apnea (OSA) is based on a few single studies. The authors investigated this topic through a meta‐analysis of speckle tracking echocardiography (STE) studies that provided data on left ventricular (LV) and right ventricular (RV) mechanics as assessed by global longitudinal strain (GLS). The PubMed, OVID‐MEDLINE, and Cochrane library databases were systematically analyzed to search English‐language review papers published from inception to January 31, 2022. Studies were identified by crossing the following terms: “obstructive sleep apnea”, “sleep quality”, “sleep disordered breathing”, “continuous positive airway pressure therapy”, “noninvasive ventilation”, “left ventricular hypertrophy”, “systolic dysfunction”, “global longitudinal strain”, “left ventricular mechanics”, “right ventricular mechanics”, “echocardiography” and “STE echocardiography”. The meta‐analysis, including a total of 337 patients with OSA from nine studies (follow‐up 2–24 months) showed a significant GLS improvement in both LV and RV after CPAP, standard mean difference (SMD) being 0.51±0.08, CI:0.36–0.66, p = .0001 and 0.28±0.07, CI:0.15–0.42, p = .0001), respectively. Corresponding SMD values for LV ejection fraction (LVEF) and tricuspid annular plane systolic excursion (TAPSE) were 0.20±0.06, CI:0.08–0.33, p = .001 and 0.08±0.06, CI: ‐0.04/0.20, p = .21. Our meta‐analysis suggests that: I) CPAP treatment exerts beneficial effects on biventricular function in patients with OSA; II) the assessment of cardiac mechanics by STE should be routinely recommended for monitoring cardiac function in this setting, due to limitations of conventional echocardiography in evaluating biventricular performance.     

A comparative study of the efficacy and safety of high-flow nasal cannula and nasal continuous positive airway pressure in neonatal respiratory distress syndrome: A protocol for systematic review and meta-analysis

Background:When it comes to preterm newborns, respiratory distress syndrome (RDS) is the most frequent respiratory condition. Despite the fact that it is well acknowledged that preterm delivery plays a significant role, the causes of lung damage are still not completely understood. In newborns with extremely low birth weight and neonatal RDS, nasal continuous positive airway pressure has been suggested as the first respiratory assistance for spontaneous breathing. In the current research, we aim to carry out a meta-analysis to assess the effectiveness and safety of high-flow nasal cannula (HFNC) and non-invasive continuous positive airway pressure (nCPAP) in patients with neonatal respiratory distress syndrome (NRDS).Methods:We intend to search the following databases: PubMed, EMBASE, Cochrane Library, Wanfang database, China National Knowledge Infrastructure (CNKI), and Google Scholar, starting from their initial publication until February 2022, to identify randomized controlled trials comparing HFNC to nCPAP in patients with NRDS. The suitable papers will be chosen by 2 writers who will work independently of one another. Using the Cochrane updated technique for risk of bias, each included article will be subjected to an independent data extraction process by the 2 writers who will then independently evaluate the risk of bias. Consequently, a third author will be asked to address any discrepancies that may arise between the writers. It will be necessary to pool the data and do a meta-analysis with the help of the RevMan 5.3 software.Results:In this study, the effectiveness and safety of HFNC will be compared with those of nCPAP in patients with NRDS.Conclusion:If the results of this research are confirmed, they may serve as a summary of the most recent data for non-invasive respiratory assistance in NRDS.Ethics and dissemination:The study will require ethical approval.Registration number:DOI 10.17605/OSF.IO/BKSQ5     

辛伐他汀对大鼠气道黏液高分泌的影响和机制研究

目的了解辛伐他汀对丙烯醛引起的气道黏液高分泌的作用及其可能的机制。方法大鼠雾化吸人丙烯醛,建立气道黏液高分泌模型。将42只雄性SD大鼠按随机数字表法分为7组：对照组（A组）、辛伐他汀自身对照组（B组）、模型组（C组）、低剂量辛伐他汀组（D组）、中剂量辛伐他汀组（E组）、高剂量辛伐他汀组（F组）和甲羟戊酸组（G组）,每组6只。分别用阿辛蓝-过碘酸雪夫（AB—PAS）和免疫组化染色检测气道黏蛋白和黏蛋白5ac（mucinSac,MUC5ac）的表达。RT—PCR检测MUC5acmRNA的表达。结果丙烯醛刺激可以使大鼠气道黏蛋白、MUC5ac蛋白和mRNA表达增高,使支气管肺泡灌洗液中巨噬细胞数增多。结论辛伐他汀可以抑制丙烯醛所致的气道黏液高分泌,甲羟戊酸可以部分逆转辛伐他汀的作用,其机制可能是通过甲羟戊酸途径减少巨噬细胞在肺中的浸润。     

医用外科口罩和防护口罩生物气溶胶过滤效率的评价

目的:对医用外科口罩和防护口罩的颗粒过滤效率(particle filtration efficiency,PFE)、细菌过滤效率(bacte-rial filtration efficiency,BFE)及病毒过滤效率(viral filtration efficiency,VFE)进行评价.方法:参照YY 0469...