Objective To compare three approaches of lipopolysaccharides ( LPS) administration for inducing acute lung injury ( ALI) in mice. Methods LPS ( 5 mg/kg) was intratracheally aerosol administered ( ITA group) , intratracheally instilled ( ITI group) , or intraperitoneally injected ( IPI group) to induce ALI in BLAB/ c mice. Evans Blue instead of LPS was intratracheally administered to observe the liquid distribution in the lungs. Two hours after LPS administration, the mice were sacrificed and the lungs were removed to determine wet-to-dry lung weight ratio ( W/D) , and the histological changes were evaluated by HE staining. Phosphorylation level of IκB-αand NF-κB p65 in lung tissue were investigated by Western blot. Transcription intensity of TNF-α and IL-1β mRNA in lung tissue were detected by real-time quantitative PCR. Results Evans Blue distributed more uniformly in the ITA group than the ITI group. The lung W/D ratio and histological changes score in three LPS administration groups were all significantly higher than the normal control group ( P lt;0. 01) , with the ITA group being the highest. The phosphorylation levels of IκB-αand NF-κB p65 were significantly higher in the ITA group than the ITI group ( P lt;0. 05) , and were significantly higher in the ITI group than the IPI group ( P lt; 0. 05) . Transcription intensity of TNF-αand IL-1βmRNA was significantly higher in the ITA group than the ITI group ( P lt;0. 05) , and were significantly higher in the ITI group than the IPI group ( P lt;0. 05) . Conclusion Being non-invasive and convenient,intratracheal LPS aerosol inhalation is an optimal method to induce ALI in mice because it induces more extensive and uniformly distributed injuries in lung.
【摘要】目的探討喉癌手術后患者對兩種不同霧化方式的耐受性,為選擇最佳霧化方式提供參考。方法將49例喉癌手術后患者隨機分為觀察組(25例)和對照組(24例),觀察組采用氧氣霧化吸入,對照組采用空氣壓縮泵霧化吸入。分別記錄兩組患者霧化吸入前及吸入15 min時脈搏血氧飽和度(SpO2)及心率;霧化過程中患者有無心慌、氣緊等不適以及霧化后痰液的性質及量。采用SPSS 13.0軟件進行統計分析。結果兩組患者霧化吸入15 min時的SpO2差異有統計學意義(Plt;001),觀察組高于對照組;而兩組患者霧化吸入前SpO2、心率、不適主訴及霧化后痰液的性質差異均無統計學意義(Pgt;005)。結論氧氣霧化吸入可以提高喉癌手術后患者霧化過程中的SpO2,使患者感覺更加舒適。【Abstract】Objective To investigate postoperative patients with laryngeal carcinoma atomization of two different forms of tolerance, in order to choose the best means of atomization. Methods Fifty postoperative patients with laryngeal carcinoma were divided into observation group using oxygen inhalation and control group using the air compression pump inhalation. Two groups of patients were recorded the value of SpO2 and heart rate before 15 minutes after the inhalation,as well as the discomforts such as flustered,gas tight during the atomization process and the nature and olume of sputum. Results The results of two groups of patients at the time of 15 minutes inhalation SpO2 statistically significant difference (Plt;001), the observation group than in the control group average SpO2 high; and two groups of patients with preinhalation SpO2 average, average heart rate, Discomfort chief complaint and the nature of sputum after aerosol compared no significant difference (Pgt;005). Conclusion Oxygen inhalation in patients with laryngeal cancer can improve the atomization process SpO2 value, so that patients feel more comfortable.
Objective To compare the application effects of two kinds of oxygen and nebulizer inhalation devices applied to patients undergoing partial hepatectomy, with a view to providing reference for clinical selection oxygen and nebulizer inhalation modality. Methods A prospective case-control study was used to select 228 patients who required oxygen inhalation and nebulization after hepatectomy under general anesthesia in the Department of Liver Surgery of West China Hospital of Sichuan University from January to December 2022 as study subjects, and were randomly divided into two groups: grouping group (n=77) and integrating group (n=151). The traditional oxygen inhalation device and atomization device (grouping oxygen inhalation atomization device) commonly used in clinic were used in the grouping group, and the humidifying bottle and humidifying water were replaced every 24 hours. The integrating group adopts a new device (integrated oxygen atomization inhalation device) which integrates oxygen inhalation and atomization functions. The integrating group was divided into integrating group 1 (n=77) and integrating group 2 (n=74) according to the different time of changing the humidifying bottle and humidifying water. The time for replacing the humidifying bottle and humidifying water in the integrating 1 was the same as that in the grouping group. The time for replacing the humidifying bottle and humidifying water in the integrating group 2 was 48 h after used, and replace again it after 72 hours of used. Samples from different parts of the grouping group and the integrating group 1 were collected at 24 h, 48 h, 72 h, 96 h and 120 h after oxygen inhalation, respectively, for colony culture. In the integrating group 2, samples were taken for colony culture when the device was changed twice (48 h and 120 h). At the same time, the nurses’ fogging operation time and the fogging noise of the two groups were measured. The self-made patients’ satisfaction questionnaire and nurses’ questionnaire were used to investigate the satisfaction of two groups of patients and 30 medical staff respectively. Results There were no statistically significant difference in the number of bacterial colonies between the grouping group and the integrating group 1 at different time periods and between the two groups at the same time (P＞0.05). In terms of atomization performance, atomization noise in the integrating group was lower than that of the grouping group (P＜0.05), and the atomization preparation and disposal time in the integrating group were shorter than that of the grouping group (P＜0.05). The patients and nurses were more satisfied with the integrating group (P＜0.05). Conclusions There is no difference in pollution risk between the integrated oxygen atomization bottle and the grouped oxygen atomization bottle. The atomization performance and humidification performance of the integrated oxygen atomization bottle are better than that of the grouped oxygen atomization bottle. The noise generated during operation is small, the comfort of patients is high, and the operation time of nurses can be shortened and the work efficiency can be improved, which has high clinical application value.
Objective To systematically review the effectiveness and model building process of heparin treatment for animal model with smoke inhalation injury. Methods Databases including PubMed, EMbase, CBM, CNKI, VIP and WanFang Data were searched to collect animal experiments about the treatment of heparin for animal model with smoke inhalation injury from inception to November 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was conducted by RevMan 5.3 software. Results A total of nine studies involving 11 animal experiments were included. The results showed that building animal model with smoke inhalation injury were through burning of cotton towels or pine sawdust by sheep or rats below 40℃. The results of meta-analysis showed that there was no significant difference in mortality rate between two groups (heparin group vs. control group: RR=0.38, 95%CI 0.14 to 1.05, P=0.06; heparin plus DMSO group vs. DMSO group: RR=0.10, 95%CI 0.01 to 1.51, P=0.10). In addition, the pulmonary artery pressure (MD=–3.31, 95%CI –4.51 to –2.11, P<0.000 01), wet to dry weight ratio (MD=–0.90, 95%CI –1.19 to –0.61, P<0.000 01), and lung water content (MD=–1.18, 95%CI –1.67 to –0.70, P<0.000 01) of the experimental group were lower than those in the control group. PaO2/FiO2 after 12 hours (MD=131.00, 95%CI 59.54 to 202.46, P=0.000 3), PaO2/FiO2 after 24 hours (MD=114.00, 95%CI 60.56 to 167.44, P<0.000 1), PaO2/FiO2 after 48 hours (MD=46.00, 95%CI 20.62 to 71.38, P=0.000 4) were higher than those in the control group. However, there was no significant difference in coagulation function between both groups. Conclusion The current evidence shows that the establishment of animal model of smoke inhalation injury is still lack of standard method. Heparin can decrease pulmonary artery pressure and lung water content in animal models with smoke inhalation injury. Due to the limited quality and quantity of included studies, the above conclusions are still needed to be verified by more high quality studies.
ObjectiveTo determine whether there was a clinical relevant association between anesthetic regimen (propofol or inhalational anesthetics) and the occurrence of postoperative delirium (POD) in patients undergoing cardiac surgery.MethodsThis retrospective study was conducted on patients with elective cardiac surgery under cardiopulmonary bypass (CPB) at West China Hospital of Sichuan University between October 2018 and March 2019. The patients were divided into a propofol group or an inhalational anesthetics group according to anesthetic regimen (including CPB). The primary outcome was the occurrence of POD during first 3 days after surgery. Logistic regression analysis was used to determine the relationship between anesthetic regimen and the occurrence of POD.ResultsA total of 197 patients who met the inclusion criteria were included, with an average age of 53 years, and 51.8% (102/197) were females. POD occurred in 21.3% (42/197) patients. The incidence of POD was 21.4% in the propofol group and 21.2% in the inhalational anesthetics group; there was no significant difference between the two groups (RR=1.01, 95%CI 0.51-2.00, P=0.970). Logistic regression analysis did not find that anesthetic regimen was a risk factor for delirium after cardiac surgery after adjusting risk factors (OR=1.05, 95%CI 0.48-2.32, P=0.900).ConclusionAnesthetic regimen (propofol or inhalational anesthetics) is not associated with an increased risk for POD in adult patients undergoing elective cardiac surgery under CPB.
摘要:目的:定量測定50 %小兒在喉罩表面涂抹丁卡因膠漿的情況下平穩拔除喉罩時呼氣末七氟烷濃度。方法:25例擇期行四肢及體表手術的患兒,高流量吸入七氟烷誘導并以七氟烷和氧化亞氮維持麻醉,不使用肌肉松弛劑及靜脈麻醉藥物,手術結束后停止吸入氧化亞氮,并維持設定的七氟烷濃度10min后拔除喉罩。根據Dixon序貫法確定喉罩拔除時的七氟烷濃度,每0.1 Vol%七氟烷為1個增減單位。患兒未出現咳嗽、牙關緊閉、體動、屏氣及喉痙攣則認為拔除喉罩平穩。結果:50 %小兒平穩拔除喉罩時呼氣末七氟烷濃度(EC50)為1.22 Vol%(95 %的置信區間分別為0.99 Vol%～1.49 Vol%)。結論:在喉罩表面涂抹丁卡因膠漿的情況下,3～8歲患兒喉罩滿意拔除時呼氣末七氟烷EC50值為1.22 Vol%。Abstract: Objective: To determine the concentration of sevoflurane where 50%( EC50 ) of the attempts to remove the laryngeal mask airway (LMA ) with the Teracainum Gel would be successful in children. Methods: Twentyfive nonpremedicated children, aged 38 years old, ASA physical status I, scheduled for extremities or peripherical surgery were enrolled in this study. General anesthesia was induced with sevoflurane and maintained with sevoflurane and nitrous oxide in oxygen. After the surgery, the target concentration was maintained for at least 10 min, and then the LMA was removed. Each target concentration was predetermined by the Dixon’s upanddown method (with 0.1 Vol% as a step size), starting at 1.20 Vol% concentration of sevoflurane. A removal accomplished without coughing, teeth clenching, gross purposeful movement, breath holding or laryngospasm, during or within 1 min after removal was considered to be successful. Results:The concentration of sevoflurane to achieve successful LMA removal in 50% of children was 1.22 Vol% (95%CL, 0.99 Vol%1.49 Vol%). Conclusion: The EC50 value of sevoflurane for LMA smooth extubation in children aged 38 years old with teracainum gel was 1.22 Vol%.
Objective To compare the clinical efficacy of intravenous polymyxin B alone and intravenous drip combined with nebulized inhaled polymyxin B in treatment of patients with carbapenem-resistant organism (CRO) pneumonia. Methods The clinical data of 85 patients with CRO pneumonia admitted to the Intensive Care Unit of Nanjing Drum Tower Hospital from September 2020 to June 2023 were collected using a retrospective study. According to the different ways of administration of polymyxin B, the patients receiving polymyxin B intravenous drip therapy alone were included in group A, and the patients receiving polymyxin B intravenous drip therapy combined with nebulized inhalation therapy were included in group B. The therapeutic effective rate, bacterial clearance rate, 30-day all-cause mortality and the level of infection indexes before and after the use of medication were compared between the two groups. The occurrence of acute kidney injury during the use of drugs in the two groups was observed and recorded. Results The pathogenicity culture results showed that there was no statistically significant difference between the two groups (P=0.144). Serum procalcitonin and C-reactive protein were significantly lower in the two groups after drug administration compared with those before drug administration (both P<0.05). The therapeutic efficiency and bacterial clearance rate in group B were higher than those in group A (both P<0.05). There was no statistically significant difference in 30-day all-cause mortality between the two groups (P=0.664). And there was no statistically significant difference in the incidence of adverse reactions between the two groups (P=0.650). Conclusion When polymyxin B is used to treat patients with CRO pneumonia, the intravenous drip combined with nebulized inhalation regimen is superior to intravenous drip therapy alone and does not increase the risk of developing nephrotoxicity.
Objective To study the pathology and possible mechanism of experimental hydrochloric acid（HCl） inhalation-indued pulmonary fibrosis in rats.Methods 120 male SD rats were randomly divided into a nomal control group，a bleomycin group，a high dose HCl group，a middle dose HCl group and a low dose HCl group.The bleomycin group was intratracheally injected with bleomycin once to induce pulmonary fibrosis.The three HCl groups were intratracheally injected with HCl once per week.The control group was given saline by the same way.Six rats of each group were randomly sacrificed on day 7，14，28 and 42 respectively.The histological changes of lung tissue were studied by HE and Masson’s trichrome staining.Hydroxyproline level in lung tissue was measured by digestion method.Protein and mRNA expression of transforming growth factor-β1（TGF-β1） were assayed by immunohistochemistry and RT-PCR respectively.Results Alveolitis in three HCl groups was significantl compared to control group，most severe at the second week，then remained at a high level which was equivalent to or exceeded the level of the bleomysin group after 28 days.Pulmonary fibrosis in three HCl groups was also significantly more severe than that in the control group，but milder than that in the bleomysin group.The high-dose and middle-dose HCl groups were not significantly different from the bleomysin group on day 42.There was no difference between three HCl groups in the earlier period，but the high-dose HCl group has a significantly difference from low-dose group on day 42.The content of hydroxyproline in high-dose and middle-dose HCl groups was also significantly higher than that in the control group.On day 42 hydroxyproline content in high-dose HCl dose rather middle –or low dose group was similiar with the level of bleomysin group.Content of TGF-β1 mRNA in three HCl groups was comparable to the level of bleomysin group on day 28 and exceeded on day 42.The expression of TGF-β1 in three HCl groups was not significantly different from the bleomysin group on day 42.Conclusion Experimental acid aspiration might contribute to pulmonary fibrosis in rats.Acid induced alveolar epithelial cell damage，abnormal proliferation and repair and fibrosis could be involved..
Objective To observe the systemic inhalation anesthetic effects of preterm children with different gestational ages under ocular fundus examination, and to assess its safety. Methods Fifty-one preterm children with retinopathy of prematurity (ROP) were included in the study. These kids were divided into 2 groups, group Ⅰ included 24 kids with a corrected gestational age of 33 to ＜44 weeks, and group Ⅱ included 27 kids with a corrected gestational age of 44 to 64 weeks. The preterm months were same (t=-1.3.P＞0.05), but the body weights were different (t=-10.5.P＜0.05) between these two groups. Anesthesia was induced by inhalation of 6% sevoflurane, and the period from the beginning of inhalation to disappearance of body movement was the induction time. 6% sevoflurane was inhaled continuously for another period of the induction time, and then the concentration of sevoflurane was adjusted to a maintenance concentration. The initial maintenance concentration was 3%, and was adjusted by 0.5% each time. Sequential method was used to determine the subsequent maintenance concentration. If the preceding patient had not moved during the maintenance period, the sevoflurane concentration was decreased by 0.5% for the next patient. If the preceding patient had moved during the maintenance period, the sevoflurane concentration was increased by 0.5% for the next patient. Respiratory depression and cough during the induction and maintenance period, duration of anesthesia and recovery time were recorded. Choking and vomiting during drinking or milk-feeding in one hour after the ocular fundus examination were also recorded. Results The effective inhale concentration in 50% patient of sevoflurane was 2.5% in group Ⅰ, 2.9% in group Ⅱ. The average maintenance concentration was (2.5plusmn;0.5)% in group Ⅰ, (3.0plusmn;0.5)% in group Ⅱ. The difference was statistically significant (t=-3.3.P＜0.05). The average duration of anesthesia and the average awake time were the same (t=0.04 and -1.0 respectively.P＞0.05) between these two groups. The average induction time was significantly shorter in group Ⅰ than in group Ⅱ, the difference was statistically significant (t=-4.9.P＜0.05). All patients were successfully completed the ocular examination. No respiratory depression or cough occurred during and after the examination. No choking and vomiting during drinking or milkfeeding in one hour after the ocular fundus examination. Conclusion Anesthesia with inhaled sevoflurane by a face mask is safe for preterm outpatients undergoing fundus examination.
ObjectiveTo assess the effect of prolonged oxygen inhalation after total hip arthroplasty (THA) on early postoperative rehabilitation in elderly patients.MethodsPatients who underwent primary unilateral THA from June to December 2018 were divided into a conventional oxygen inhalation group (control group) and a prolonged oxygen inhalation group (trial group) according to a random number table. The control group received oxygen inhalation via a single nasal catheter from their return to the ward after surgery until 08:00 a.m. on the first day postoperatively. In addition to routine oxygen inhalation, the trial group received oxygen inhalation during the rehabilitation exercise in bed and before half an hour of floor activities on the first and second day after operation. Oxygen saturation, heart rate, respiratory rate, blood pressure, pain, fatigue score, hip mobility and Pittsburgh Sleep Quality Index (PSQI) scores were recorded and analyzed at 24 and 48 hours after surgery.ResultsA total of 60 patients were included finally, 30 patients in each group. At 24 and 48 h after surgery, the differences were statistically significant in the respiratory rate [(20.30±1.20) vs. (21.40±1.04) breaths per minute, (18.87±1.14) vs. (22.03±0.85) breaths per minute], oxygen saturation [(94.70±2.34)% vs. (90.60±0.73)%, (96.40±1.81)% vs. (91.20±0.85)%］, abduction angles of hip joint [(33.50±5.44) vs. (29.31±5.30)°, (38.67±2.60) vs. (33.00±4.84)°], pain scores (3.03±1.27 vs. 5.07±1.14, 1.43±0.97 vs. 3.60±1.13) and fatigue scores (4.17±1.34 vs. 8.20±0.61, 3.23±1.38 vs. 7.43±1.19) between the trial group and control group (P<0.05). PSQI scores (2.20±0.76 vs. 3.97±0.76) on the first day after surgery, and hip flexion [(105.17±4.82) vs. (99.50±2.40)°] , heart rate [(72.86± 6.38) vs. (79.40±3.97) beats per minute], diastolic blood pressure [(71.43±10.24）vs. (77.57±4.59) mm Hg (1 mm Hg=0.133 kPa)] at 48 h after surgery in the trial group were better than the those in control group (P<0.05).ConclusionCompared with conventional oxygen inhalation, prolonged oxygen inhalation after THA in elderly patients can improve postoperative pain, fatigue, sleep and hip function.