Inhaled fentanyl as a method of analgesia

A study was undertaken to investigate the use of fentanyl by aerosol for postoperative analgesia. Seven patients had placebo, six received fentanyl 100 micrograms and seven were given fentanyl 300 micrograms. A significant improvement in postoperative pain, as assessed by linear visual analogue scale, was achieved in the higher dose group, and in both fentanyl groups the time to alternative analgesia was significantly longer than in the control group. Serum fentanyl levels after inhalation of 100 micrograms reached a plateau around 0.04 ng/ml and after 300 micrograms at around 0.1 ng/ml after 15 minutes. Inhaled fentanyl may have a useful analgesic effect despite these low serum levels; this supports the hypothesis that the mode of analgesia from inhaled opioids may be different from that after other routes of administration. There were no adverse effects such as respiratory depression, bronchospasm, nausea or drowsiness.     

盛夏时节成都市区空气飘尘浓度及分散度测试分析

利用光散射法对盛夏时节成都市区空气中的风尘浓度及分散度进行了测试，并就风尘的粒径分布及分散度的统计模式、气象参数时飘尘浓度的影响，以及飘尘浓度和分散度的日变化进行了分析。结果表明：成都市区空气中飘尘的大多数粒径分布的统计模式为Ｊｕｎｇｅ分布，峰值浓度出现在中午１２：００前后，相对湿度对空气中飘尘浓度影响显著，降雨对风尘有明显的清除作用。测试结果对评价城市环境卫生条件和分析人类活动对环境的干扰情况有参考价值。     

Moisture transport into chlorofluorocarbon-free metered dose inhalers

Moisture is known to affect the stability of some metered dose inhalers (MDIs). Hydrofluoroalkanes such as tetrafluoroethane (134a) and heptafluoropropane (227) are known to have higher affinity for moisture than the currently used chlorofluorocarbon propellents. An initial study was conducted to determine the water vapor transmission rates of various elastomers that may be used as gaskets in MDIs. A further study was conducted to measure the moisture ingress rates of various chlorofluorocarbon-free MDIs. The data indicate that moisture transport into chlorofluorocarbon-free MDIs is influenced by the elastomeric nature of the gaskets used and the type of hydrofluoroalkane formulation and storage conditions used.     

Efficacy of Preprocedural Mouth Rinsing in Reducing Aerosol Contamination Produced by Ultrasonic Scaler: A Pilot Study

Background: The aerosol generated by an ultrasonic scaler contains microorganisms that can penetrate into the body through the respiratory system of dental surgeons and patients. The aim of this pilot study is to evaluate and compare the efficacy of commercially available preprocedural mouthrinses containing 0.2% chlorhexidine gluconate, an herbal mouthwash, and water in reducing the levels of viable bacteria in aerosols. Methods: This single‐center, double‐masked, placebo‐controlled, randomized, three‐group parallel design was conducted over a period of 45 days. Twenty‐four patients with chronic periodontitis were divided randomly into three groups (A, B, and C) of eight patients each to receive 0.2% chlorhexidine gluconate, herbal mouthwash, and water, respectively, as a preprocedural rinse. The aerosol produced by the ultrasonic unit was collected at patient's chest area, doctor's chest area, and assistant's chest area on blood agar plates in all three groups. The blood agar plates were incubated at 37°C for 48 hours, and the total number of colony‐forming units (CFUs) was counted and statistically analyzed. Results: The results showed that CFUs in groups A and B were significantly reduced compared with group C, P <0.001 (analysis of variance). Also, CFUs in group A were significantly reduced compared with group B, P <0.05 (independent t‐test). The numbers of CFUs were highest at the patient's chest area and lowest at the assistant's chest area. Conclusion: This study suggests that a routine preprocedural mouthrinse could eliminate the majority of bacterial aerosols generated by the use of an ultrasonic unit, and that 0.2% chlorhexidine gluconate is more effective than herbal mouthwash.     

Comparison of 1 mg and 5 mg sodium cromoglycate metered dose inhalers in the treatment of asthma: A 12-week double-blind,parallel group trial

Summary

A double-blind, parallel group trial of a 1?mg sodium cromoglycate metered dose inhaler, a 5?mg formulation and a placebo aerosol was undertaken in 139 asthmatic patients with extrinsic allergic asthma. None of the patients had previously been treated with sodium cromoglycate and few (15%)were familiar with the use of a pressurized aerosol device. Each test treatment was taken at a dose of 2 ‘puffs’ 4-times per day for a period of 12 weeks. Response to treatment was assessed by analysis of symptom scores, medication usage and 3-times daily home measurements of PEFR recorded on diary cards, and by assessment of asthma severity and lung function in the clinic at the beginning and end of a 2-week baseline period and at intervals of 3 weeks throughout the trial. Analysis of patient-generated data (symptom scores and PEFR)demonstrated statistically significant differences in favour of each active treatment compared with placebo treatment. Clinic assessments of asthma severity and the investigator's opinion of treatment also showed the superiority of each sodium cromoglycate treatment regimen over placebo. These differences were statistically significant after 9 weeks (high dose)and 12 weeks (both doses). No statistically significant differences were demonstrated between the two active treatment groups in the clinic assessments of asthma severity, or in the home or clinic measurements of PEFR. There was, however; a consistent trend in favour of the higher dose formulation with respect to diary card symptom scores. In general, improvement in the low-dose sodium cromoglycate treatment group was slower than in the high-dose group suggesting an advantage for the 5?mg sodium cromoglycate inhaler in terms of onset of therapeutic response. The results indicate that sodium cromoglycate administered by pressurized aerosol at a dose of 2×1?mg or 2×5?mg 4-times daily is effective in the treatment of asthma and suggest that the higher dose formulation may provide more rapid control of symptoms.     

川芎茶调气雾剂处方的选择

采用显微镜－较正因子法测定了不同工艺制备的川芎茶调气雾剂粒度，为优选本制剂最佳处方提供了科学依据。     

Acute inhalation studies with irritant aerosols: technical issues and relevance for risk characterization

Current testing conventions for inhalation toxicity studies require that solid and non-volatile liquid compounds are converted to respirable aerosol, which is often achieved by laboratory-specific technical methodologies. So far, internationally harmonized approaches are lacking that would allow comparison of results from inhalation studies with contrived test aerosols taking into account the actual particle size of the product as it might be encountered in normal handling and use. The focus of this paper is to consider aerosols of irritant substances eliciting their mode of action on sites of initial deposition within the respiratory tract of rats. Assessment is based on conventional endpoints, such as mortality (LC₅₀), and sublethal endpoints that include an analysis for the concentration–effect relationship of protein in bronchoalveolar lavage fluid (BAL-protein) as a sensitive, early marker of lung edema. This retrospective analysis also addresses whether common denominators can be found for different aerosol sizes of direct and indirect irritants, such as monomeric and polymeric diphenylmethane-4,4-diisocyanate (mMDI and pMDI), naphthylene diisocyanate (NDI), dicyclohexylmethane-4,4-diisocyanate (HMDI), 2,4-triisopropyl-benzene-diisocyanate (TRIDI) and substances (e.g., chlorofluoroalkyl side-chain fungicides) known to decompose to irritant intermediates in the lining fluids of the airways. Collectively, this analysis shows that for irritant aerosols both the concentration and the particle size are equally important for the outcome of the test, independent of whether the endpoint chosen is lethality or BAL protein. The scientific value of 1-h exposures to high aerosol concentrations, as required by some regulations, could be challenged because high concentrations and high respirability of aerosol appear to be mutually exclusive, as shown for mMDI and NDI (LC₅₀ >2000 mg/m³). Thus, for a meaningful risk characterization, test results from inhalation studies with contrived properties due to the specific techniques employed need to be compared with the real properties of substances as marketed, handled and used.     

喜炎平雾化吸入治疗急性脑卒中患者肺部感染的临床研究

目的：探讨喜炎平雾化吸入治疗急性脑卒中患者肺部感染的疗效。方法收集2011年2月－2013年3月急性脑卒中患者肺部感染者63例,按病历尾号将患者随机分为2组,对照组31例在常规治疗基础上配合抗感染、化痰药物治疗;治疗组32例在对照组治疗基础上,配合雾化吸入喜炎平治疗。2组均治疗7d为1个疗程,共治疗2个疗程。比较患者症状、体征消失时间和炎性指标改化情况。结果治疗组总有效率为93.75%（30/32）,对照组为74.19%（23/31）,2组比较差异有统计学意义（χ2＝4.510,P＝0.034）。治疗组咳嗽痰多[(5.94±1.25)d 比(6.73±1.48)d;t＝2.292,P＝0.025]、发热[(2.72±0.11)d 比(3.25±0.18)d;t＝12.046,P＝0.001]、肺部啰音[(5.22±1.15)d比(7.21±1.21)d;t＝6.693,P＝0.001]、呼吸困难[(1.17±0.49)d 比(2.82±0.61)d;t＝11.855,P＝0.001]等症状、体征的消失时间均短于对照组。治疗组治疗后白细胞计数[(2.55±1.02)×109/L 比(3.91±1.25)×109/L;t＝4.738,P＜0.01]、中性粒细胞比例[(4.92±1.32)%比(6.25±1.16)%;t＝4.738,P＜0.01]、淋巴细胞比例[(58.62±6.15)%比(65.94±6.17)%;t＝4.716,P＜0.01]均较对照组降低（P均＜0.01）。结论喜炎平雾化吸入可缩短急性脑卒中后肺部感染患者症状、体征时间,提高疗效。