细节管理在老年留置普通硅胶胃管患者鼻饲饮食中的应用

目的 研究细节管理减少老年留置普通硅胶胃管患者鼻饲饮食后并发症、减少感染及死亡率的作用.方法 选取80例老年留置普通硅胶胃管患者,随机分为对照组40例与干预组40例,对照组患者鼻饲饮食实施常规管理,干预组患者鼻饲饮食实施管理,比较两组干预效果.结果 干预组发生胃肠道并发症6例,无堵管现象,肺部感染2例;对照组发生胃肠道...     

Innate and Adaptive Immune Responses in the Upper Respiratory Tract and the Infectivity of SARS-CoV-2

Increasing evidence shows the nasal epithelium to be the initial site of SARS-CoV-2 infection, and that early and effective immune responses in the upper respiratory tract (URT) limit and eliminate the infection in the URT, thereby preventing infection of the lower respiratory tract and the development of severe COVID-19. SARS-CoV-2 interferes with innate immunity signaling and evolves mutants that can reduce antibody-mediated immunity in the URT. Recent genetic and immunological advances in understanding innate immunity to SARS-CoV-2 in the URT, and the ability of prior infections as well as currently available injectable and potential intranasal COVID-19 vaccines to generate anamnestic adaptive immunity in the URT, are reviewed. It is suggested that the more detailed investigation of URT immune responses to all types of COVID-19 vaccines, and the development of safe and effective COVID-19 vaccines for intranasal administration, are important needs.     

高效液相色谱法测定复方环麻喷鼻剂中主要成分的含量

目的:探讨用高效液相色谱法(HPLC法)测定复方环麻喷鼻剂中主要成分含量的方法.方法:采用Hypersil-0DS C18色谱柱(250 mm×4.6 mm,5μm),以0.02 mol/L磷酸二氢钾溶液-甲醇-10 mmol/L四丁基溴化铵溶液(60:40:5,用磷酸调节pH值至3.2)为流动相,检测波长为258 nm.结果:线性范围环丙沙星为4.8～24 μg/mL,盐酸麻黄碱为16～μg/mL;环丙沙星的平均回收率为99.4%,RSD为1.4%;盐酸麻黄碱平均回收率为101.3%,RSD为0.9%;精密度的RSD环丙沙星为0.9%,盐酸麻黄碱为1.1%.结论:HPLC法灵敏、准确,可用于复方环麻喷鼻剂的含量测定.     

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     

甘辛喷雾剂的鼻黏膜纤毛毒性评价

目的:确定适宜的药物浓度,评价甘辛喷雾剂及处方各组分对鼻黏膜纤毛功能的影响.方法:用光学显微镜观察离体蛙口腔上腭纤毛在药物溶液作用下持续摆动时间,以此作为指标考查不同药物浓度和组分对蛙口腔黏膜纤毛功能的影响.结果:4%甘辛喷雾剂对纤毛运动影响最小,与对照组药物相比,4%甘辛喷雾剂和处方中各组分对蛙口腔黏膜纤毛的影响弱于滴通鼻炎水(P＜0.01).结论:甘辛喷雾剂对鼻黏膜纤毛的功能无明显损伤作用.     

品管圈在降低长期卧床老年鼻饲患者误吸中的应用效果分析

目的 探讨品管圈活动在降低长期卧床老年鼻饲患者误吸中的效果.方法 成立品管圈小组、确定活动主题为降低长期卧床老年鼻饲患者误吸的发生率,通过现状调查与原因分析,按照80/20定律选定真因,通过头脑风暴法找出对策:自制并应用床头角度测量仪;辅导员做留置胃管置入长度相关护理新进展培训;圈长做鼻饲注食量、注食速度标准化讲座;提高床头抬高角度的精确性;提高护士置入胃管长度的正确性;提高护士宣教能力及患者家属(护工)的依从性.结果 根据误吸判断指标比较活动前后误吸的发生率,长期卧床老年鼻饲患者误吸的发生率由活动前77.0％降至21.1％.结论 品管圈活动不仅降低了长期卧床老年鼻饲患者误吸的发生率,还提高了圈员的工作积极性、团队意识、解决问题能力.     

Nasal delivery of insulin using chitosan microspheres

Nasal delivery of insulin is an alternative route for administration of this drug. The objective of this study was preparation of chitosan microspheres for insulin nasal delivery. After preparation of insulin chitosan microspheres by emulsification-cross linking process, the effect of chitosan quantity (200–400?mg), cross-linker type (ascorbic acid or ascorbyl palmitate) and amount (70–140?mg) were studied on the morphology, particle size, loading efficiency, flow and release of insulin from the microspheres by a factorial design. Optimized formulation was administered nasally in four groups of diabetic rats and their serum insulin levels were analysed by the insulin enzyme immunoassay kit and the serum glucose by the glucose oxidase kits. Insulin loading in microspheres was between 4.7–6.4% w/w, preparation efficiency more than 65% and mean particle size was 20–45?µm. In most cases, drug released followed a Higuchi model. Ascorbic acid caused an increase in stability, particle size and T_50% while decreased the loading efficiency and production efficiency. Increasing the chitosan content, increased particle size, flow and insulin release rate form the microspheres. The increase of cross-linking percentage decreased the flow and size of the microspheres while increase of cross-linking percentage promoted the stability and decreased DE₈% of insulin. Microspheres containing 400?mg of chitosan and 70?mg ascorbyl palmitate caused a 67% reduction of blood glucose compared to i.v. route and absolute bioavaliability of insulin was 44%. The results showed that chitosan microspheres of insulin are absorbable from nasal route.     

鼻腔扩容术的临床疗效观察

目的评价鼻腔扩容术治疗OSAHS患者主客观症状的改善情况。方法观察30例行鼻腔扩容术的成年OSAHS患者,所有患者于术前进行多道睡眠图（PSG）描记,鼻声反射和鼻阻力测试等鼻功能检查,填写白天嗜睡主观评分Epworth嗜睡量表（Epworth sleepiness score,ESS）、鼻塞主观视觉模拟量表（visual analogue scale,VAS）评分、鼾声评分量表,以上主客观检查于鼻腔手术后3个月重复记录。所有患者接受鼻腔扩容术（鼻中隔三线减张成形术、双侧下鼻甲外移、双侧中鼻甲内移和双侧中鼻道鼻窦对称性开放）。结果鼻腔扩容术后患者鼻腔总阻力显著降低[（0.89±0.23）kPa·s/L vs（0.29±0.12）kPa·s/L,P〈0.01],鼻塞VAS评分显著降低[8.2±1.1 vs 2.1±0.73,P〈0.01],白天嗜睡ESS评分显著降低（12.7±1.2 vs 8.6±2.9,P〈0.01）,打鼾程度减轻（62.2±25.6 vs 45.6±18.6,P〈0.01）。轻度OSAHS患者呼吸暂停低通气指数（apnea and hypopnea index,AHI）较术前显著下降（P〈0.05）,觉醒指数较术前显著下降（P〈0.01）,最低动脉血氧饱和度（lowest SaO2,LSaO2）较术前显著升高（P〈0.01）。中度和重度OSAHS患者的AHI指数、觉醒指数、LSaO2均较术前无显著改变（P〉0.05）。LSaO2、睡眠结构各阶段的比例、快动眼睡眠阶段的长度在所有OSAHS患者均没有显著变化（P〉0.05）。30例OSAHS患者鼻腔扩容术的总体有效率为26.7%。结论鼻腔扩容手术可以改善OSAHS患者鼻塞及白天嗜睡、睡眠打鼾等相关睡眠主观症状,并在一定程度上改善OSAHS患者的阻塞性睡眠呼吸暂停的严重程度,应适当选择其手术适应证。     

下鼻甲肥大对功能性溢泪影响的分析

目的探讨下鼻甲肥大与功能性溢泪的关系及临床治疗价值。方法 11例下鼻甲肥大伴溢泪患者中,7例同时伴鼻中隔偏曲,术前完善检查,并利用CT泪囊造影术和三维重建,排除溢泪的眼部疾病,行下鼻甲减容术伴或不伴鼻中隔偏曲矫正术,观察疗效。术后随访12个月。结果 11例患者中8例(72.7%)溢泪症状消失,3例(27.3%)溢泪症状好转。7例患者术后鼻中隔均居中,下鼻甲明显缩小。其中鼻塞痊愈10例(90.9%),好转1例(9.1%)。结论下鼻甲肥大为功能性溢泪的一个重要的原因,对其进行治疗可治愈或改善功能性溢泪。