Objective To observe the effect of fresh orange peel flavor inhalation on the improvement of gastrointestinal reactions such as nausea and vomiting in tumor patients during chemotherapy. Methods Ninety-one inpatients undergoing chemotherapy with PF and TP regimens between May 2012 and September 2013 were included in this study. The patients were randomly divided into orange group (n=45) and control group (n=46). Patients in the control group received conventional care, while those in the orange group were treated with fresh orange peel flavor inhalation during chemotherapy. We observed the effect of orange peel flavor inhalation on such gastrointestinal reactions as nausea and vomiting in tumor patients during chemotherapy. Results All the patients completed each cycle of chemotherapy. At the fifth day during chemotherapy, compared with the control group, the incidence rates of grade Ⅲ-Ⅳ gastrointestinal reactions (nausea and vomiting) in the orange group were significantly lower (P=0.023). At the fourth day, when gastrointestinal reactions were the most significant, the food intake of patients in the orange group was significantly higher than that in the control group (P=0.012). During chemotherapy, the addition rate of antiemetic drugs in the orange group was significantly lower than that in the control group (P=0.038). In the orange group, 80.0% of the patients had good self-feeling after orange peel flavor inhalation. Conclusions The study results have shown that fresh orange peel flavor inhalation can effectively improve the gastrointestinal reactions (such as nausea and vomiting), appetite, and degree of comfort in tumor patients during chemotherapy, and reduce the use of antiemetic drugs. This study is of great significance to guide the future research on how to reduce the discomfort of on-chemotherapy patients and provide more comfortable care.
Objective The purpose of this study was to explore the correlation between peripheral blood eosinophil (EOS) count and smoking history, some inflammatory indicators, lung function, efficacy of ICS, risk of respiratory failure and chronic pulmonary heart disease, risk of acute exacerbation within 1 year, readmission rate and mortality in patients with acute exacerbation of COPD. Methods Retrospective analysis of the baseline clinical data of 816 patients with acute exacerbation of chronic obstructive pulmonary disease in the Department of Respiratory and Critical Care Medicine of the First Affiliated Hospital of Shihezi University from January 1,2019 to December 31,2021. The patients were divided into EOS ≥ 200 cells / μL (High Eosinophi, HE) group and EOS<200 cells / μL (low Eosinophi, LE) group according to whether the peripheral blood EOS was greater than 200 cells / μL at admission. Peripheral venous blood data (including blood eosinophil count, white blood cell count, lymphocyte percentage, neutrophil percentage), blood gas analysis value, lung function index and medication regimen of all patients were collected, and the efficacy of ICS was recorded. The patients were followed up for 1 year to observe the acute exacerbation and readmission rate, and the mortality rate was followed up for 1 year and 2 years. Results Neutrophil count, lymphocyte count and peak expiratory flow (PEF) in HE group were positively correlated with EOS value (P<0.05), and smoking was more likely to increase EOS value. HE group was more sensitive to ICS. The risk of acute exacerbation in HEA group was higher than that in LE group. ICS could reduce the rate of acute exacerbation in HE group. EOS value in LE group was inversely proportional to FEV1 / FVC and MMEF values (P<0.05). The risk of chronic pulmonary heart disease in LE group was higher than that in HE group. The 2-year mortality rate in HE group was higher than that in LE group. Conclusions Peripheral blood EOS count is correlated with some inflammatory indicators, acute exacerbation risk, and lung function. ICS can improve the clinical symptoms and prognosis of patients with higher EOS count.
Objective To evaluate the effects of inhalation combined intravenous antibiotics for the treatment of ventilator-associated pneumonia. Methods A computerized search was performed through Cochrane library, Joanna Briggs Institute Library, PubMed, MEDLINE, CINAHL, CBM, CNKI and Wangfang medical network about inhalation combined intravenous antibiotics therapy in ventilator-associated pneumonia in the literatures. The data extracting and quality assessment were performed by three researchers. The meta-analysis was performed by RevMan 5.3 software. Results Thirteen studies was included for analysis. The results showed that the cure rate was higher in the experimental group compared with the control group with significant difference (RR=1.16, 95%CI 1.07 to 1.56,P=0.000 5). There were no significant differences in the mortality (RR=1.04, 95%CI 0.82 to 1.32,P=0.74) or the incidence of kidney damage (RR=0.79, 95%CI 0.51 to 1.22,P=0.29). The difference in pathogenic bacteria removal was statistically significant (RR=1.38, 95%CI 1.09 to 1.74,P=0.007). The negative conversion rate of respiratory secretions was higher in the experimental group. Conclusion Inhalation combined intravenous antibiotics can improve the cure rate of patients with ventilator-associated pneumonia, clear pathogenic bacteria effectively, and is worthy of recommendation for clinical use.
Objective To evaluate the effects of midazolam intravenous drip combined with lidocaine via nebulization on patients during mechanical ventilation in intensive care unit ( ICU) . Methods 60 thoracic patients required postoperative mechanical ventilation in ICUwere randomized into 2 groups. The patients in therapeutic group received lidocaine 1 mg/kg via nebulization and midazolam intravenous drip 0. 1 mg·kg- 1·h- 1 . The patients in control group received 0. 9% NaCl 1 mg/kg via nebulization andmidazolam0. 1 mg·kg- 1 ·h- 1 . According to the scale of Ramsay, the additional midazolam and fentanyl were injected to maintain sedation and inhibit cough in both groups. During ventilation, calm score, the number and the severity of cough, the mean arterial pressure ( MAP) , heart rate ( HR) , and the consumption of midazolam and fentanyl were record. Results The number and severity of cough, the scale of MAP and HR in the therapeutic group were all significant lower than those in the control group ( P lt; 0. 05) . Theconsumption of midazolam and fentanyl in the therapeutic group were also significantly lower than that in the control group ( P lt; 0. 05) .Conclusion Midazolam intravenous drip combined with lidocaine via nebulization can reduce the side effects and requirement of sedative and opioids drug in ICU patients undergoing mechanical ventilation.
Objective To explore the influencing factors of inhalation medication compliance in Chinese asthma patients, and to provide evidence for improving the compliance of patients with inhalation therapy. Methods PubMed, China National Knowledge Infrastructure, Wanfang, Chongqing VIP, and SinoMed were searched for literature on factors influencing inhalation medication compliance in Chinese asthma patients from the establishment of databases to December 2021. Meta-analysis was performed using RevMan 5.2 software. Results A total of 16 studies were included, with a sample size of 2 600 cases, 1 084 cases of good compliance with inhalation administration, 1 516 cases of poor compliance with inhalation administration, and good compliance with inhalation administration accounted for 41.69%. The literature quality evaluation scores were all ≥4 points, all of which were of medium quality and above. Meta-analysis showed that the factors affecting inhalation compliance of asthma patients included age [odds ratio (OR)=0.54, 95% confidence interval (CI) (0.32, 0.91), P=0.02], educational level [OR=0.57, 95%CI (0.36, 0.90), P=0.02], doctor-patient relationship [OR=0.42, 95%CI (0.19, 0.93), P=0.03], disease severity [OR=0.25, 95%CI (0.11, 0.58), P=0.001], degree of mastery of asthma knowledge [OR=2.51, 95%CI (1.11, 5.65), P=0.03], degree of mastery of inhalation technique [OR=8.66, 95%CI (3.20, 23.40), P<0.0001], adverse drug reaction [OR=0.23, 95%CI (0.13, 0.41), P<0.00001]. Conclusion The compliance of inhaled dosing in Chinese asthma patients needs to be improved urgently. Age, education level, doctor-patient relationship, disease severity, mastery of asthma knowledge, mastery of inhalation technology, and adverse drug reactions are the important influencing factors of inhaled medication compliance.
ObjectiveTo observe repairing process of trachea epithelium cells in chlorine-induced airway epithelial injury.MethodsTwelve mice were exposed to chlorine gas and prepared the mice model of airway damage. Three mice were executed respectively on 2nd, 4th, 7th, 10th day after exposure to chlorine gas, and tracheal tissues were collected. In addition 3 normal mice served as control. Airway repair and cell proliferation were detected by EdU labeling method. The basal cell markers keratin 5 (K5), keratin 14 (K14) were adopted as the tracheal epithelial markers for locating the position of the proliferation of repairing cells. Morphological analysis was adopted to measure the proliferation rate as well as the recovery of the false stratified epithelium.ResultsIn the control group, cell proliferation rate was very low, all basal cells expressed K5, and most basal cells did not express K14. Most of epithelial cells shed from the trachea epithelium after exposure to chlorine gas. 2-4 days after chlorine exposure, K5 and K14 expression basal cells increased, K14 expression cells increased greatly. In the peak period of cell proliferation, only a small number of ciliated cells appeared in the repairing trachea area. Epithelial cells repaired fast and widely at the bottom of the trachea.ConclusionThe trachea residual basal cells play roles of progenitor cells and repair the airway epithelium after chlorine damage in mice.
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.
目的:探讨烧伤合并吸入性损伤患者行预防性气管切开的时机和可行性, 以提高治疗中、重度吸入性损伤的疗效。方法:对80例烧伤合并气道吸入性损伤患者的临床资料进行回顾性研究,按气管切开手术不同时机分为预防性气管切开组70例与紧急气管切开组10例。70例在烧伤后(5.2±2.1)h行气管切开术,和10例在烧伤后(23.24±2.36) h行气管切开术。比较两组患者相关生命体征、血氧分压、氧饱和度、呼吸频率及预后情况。结果: 预防性气管切开组气管切开术70例患者,解除上呼吸道梗阻、改善缺氧状况69例,死亡1例。紧急气管切开组10例,死亡6例。预防性气管切开组与紧急气管切开组比较死亡率有明显降低(Plt;0.01)。结论:烧伤合并中、重度吸入性损伤应及早进行预防性气管切开术,防止呼吸道梗阻,减少并发症,降低死亡率,手术时机选择在伤后5小时内为宜。