Introduction The efficacy of inhaled budesonide for managing moderate-to-severe acute exacerbations in children is not clear.Therefore,this study aimed to evaluate hospital admission rates,need for use of systemic cor...Introduction The efficacy of inhaled budesonide for managing moderate-to-severe acute exacerbations in children is not clear.Therefore,this study aimed to evaluate hospital admission rates,need for use of systemic corticosteroids,length of hospital stay and adverse events when inhaled budesonide is added to standard pediatric emergency department management of moderate-to-severe acute exacerbations of asthma.Methods A systematic search was conducted in PubMed,Scopus,CENTRAL(Cochrane Central Register of Controlled Trials)and Google scholar databases.Randomized controlled trials that evaluated the effect of nebulized budesonide in moderate-to-severe acute exacerbations of asthma in pediatric patients were included for this meta-analysis.Statistical analysis was done using STATA version 13.0.Results A total of 16 RCTs were included.Children receiving nebulized budesonide had 43%lower risk of being hospital-ized(RR 0.57;95%CI,0.39;0.85)and 66%lower risk of requiring systemic corticosteroids(RR 0.34;95%CI,0.21;0.55)compared with those receiving placebo.There were no differences in the length of hospital stay(Hedges's g standardized mean difference-1.53;95%CI,-3.64;0.58)and risk of adverse events(RR 0.87,95%CI;0.65;1.17)between the two groups.There was no evidence of publication bias for any of the outcomes considered.Conclusion The findings of this meta-analysis support the use of inhaled budesonide in reducing risk of hospitalization and the need for systemic corticosteroids among children with acute moderate-to-severe asthma exacerbation.展开更多
BACKGROUND： Few studies have reported the effects of early tracheotomy in acute severe asthmatic patients. We report two patients with acute severe asthma who were successfully treated with early tracheotomy. METHOD...BACKGROUND： Few studies have reported the effects of early tracheotomy in acute severe asthmatic patients. We report two patients with acute severe asthma who were successfully treated with early tracheotomy. METHODS：The two patients with acute severe asthma were retrospectively reviewed. They had been treated at the Department of Emergency and Critical Care, Renji Hospital, Shanghai Jiaotong University School of Medicine. RESULTS： They developed progressively hypercapnia and severe acidosis, and were not improved after conventional therapies. Early tracheotomy after mechanical ventilation decreased airway resistance and work of breathing, and corrected hypercapnia and acidosis. Adequate gas exchange was maintained after tracheotomy. The two patients were subsequently weaned from mechanical ventilation and discharged. CONCLUSION：Early tracheotomy could be a valuable approach in certain patients with severe asthma.展开更多
Objective:To explore the therapeutic effect of Dingchuan Decoction combined with omazumab on acute attack of bronchial asthma.Methods:From January 2020 to November 2021,90 patients with acute asthma were treated in ou...Objective:To explore the therapeutic effect of Dingchuan Decoction combined with omazumab on acute attack of bronchial asthma.Methods:From January 2020 to November 2021,90 patients with acute asthma were treated in our hospital,which belonged to heat asthma syndrome according to TCM syndrome differentiation in our hospital.They were divided into control group and observation group with 45 cases in each group.The control group was treated with omazumab,while the observation group was treated with omazumab combined with Dingchuan Decoction.The changes of lung function,exhaled nitric oxide(FeNO),blood gas indexes and hematological indexes were observed before and after treatment,and the adverse reactions and asthma recurrence within 3 months were observed.At the same time,animal experiments were carried out to verify the curative effect of Dingchuan.Results:After treatment,the total effective rate,FeNO,pulmonary function,partial pressure of blood oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2)),interleukin-6(IL-6),interleukin-5(IL-5),immunoglobulin E(IgE)and asthma recurrence in 3 months in the observation group were better than those in the control group;There was no significant difference in pulse oxygen saturation(SaO_(2))and the incidence of adverse reactions between the two groups.Animal experiments show that Dingchuan Decoction can effectively improve lung inflammation.Conclusion:The combination of Dingchua Decoction and omazumab has a good curative effect in the treatment of acute attack of bronchial asthma,which can effectively improve the lung function and blood gas index of patients,reduce the levels of inflammatory factors and IgE,and has no obvious increase in adverse reactions,and effectively control the recurrence of asthma within 3 months.It can be used as an auxiliary maintenance treatment for patients with mild and moderate acute attack and clinical remission of asthma,thus reducing the utilization rate of hormones and having high application value.展开更多
Objective: to apply the combined therapy of shegan mahuang decoction and acupoint application in the treatment of acute exacerbation of bronchial asthma in children. Methods: the children with acute exacerbation of br...Objective: to apply the combined therapy of shegan mahuang decoction and acupoint application in the treatment of acute exacerbation of bronchial asthma in children. Methods: the children with acute exacerbation of bronchial asthma who were treated in our hospital from January 2021 to January 2022 were selected as the research subjects, and the effects of different treatments were compared, including shegan mahuang decoction and acupoint application + shegan mahuang decoction. Results: after the effective treatment plan was implemented, the condition improved, especially the children treated with acupoint application + shegan mahuang decoction had a higher total effective rate, a lower incidence of adverse reactions, a good trend in FVC and other levels, and symptoms and signs. The scores were lower, and the children who received acupoint application treatment were relatively poor, and the difference was significant (P<0.05). Conclusion: in the treatment of acute exacerbation of bronchial asthma in children, shegan mahuang decoction combined with acupoint application has obvious application value and high safety, and plays a positive role in further shortening the course of the disease in children.展开更多
Objective: to study the possible problems and risks in nursing management of patients with acute attack of bronchial asthma complicated with acute upper respiratory tract infection. Methods: 80 patients with acute att...Objective: to study the possible problems and risks in nursing management of patients with acute attack of bronchial asthma complicated with acute upper respiratory tract infection. Methods: 80 patients with acute attack of bronchial asthma complicated with acute upper respiratory tract infection treated in our hospital from February 2020 to February 2021 were randomly divided into study group (nursing risk management) and control group (routine nursing), with 40 cases in each group. After nursing, the nursing effects were compared. Results: the incidence of nursing adverse events in the control group was significantly higher than that in the study group (P < 0.05), and its treatment compliance, nursing satisfaction and nursing quality were significantly lower than those in the control group (P < 0.05). Conclusion: in the actual clinical treatment of patients with acute attack of bronchial asthma complicated with acute upper respiratory tract infection, in order to better improve the nursing effect and reduce the incidence of nursing adverse events, the majority of medical institutions need to take nursing risk management as the starting point, strengthen nursing risk management, eliminate the occurrence of nursing adverse events, and fundamentally promote the improvement of clinical nursing quality.展开更多
Objective Air pollution is a leading public health issue.This study investigated the effect of air quality and pollutants on pulmonary function and inflammation in patients with asthma in Shanghai.Methods The study mo...Objective Air pollution is a leading public health issue.This study investigated the effect of air quality and pollutants on pulmonary function and inflammation in patients with asthma in Shanghai.Methods The study monitored 27 asthma outpatients for a year,collecting data on weather,patient self-management[daily asthma diary,peak expiratory flow(PEF)monitoring,medication usage],spirometry and serum markers.To explore the potential mechanisms of any effects,asthmatic mice induced by ovalbumin(OVA)were exposed to PM_(2.5).Results Statistical and correlational analyses revealed that air pollutants have both acute and chronic effects on asthma.Acute exposure showed a correlation between PEF and levels of ozone(O_(3))and nitrogen dioxide(NO_(2)).Chronic exposure indicated that interleukin-5(IL-5)and interleukin-13(IL-13)levels correlated with PM_(2.5)and PM_(10)concentrations.In asthmatic mouse models,exposure to PM_(2.5)increased cytokine levels and worsened lung function.Additionally,PM_(2.5)exposure inhibited cell proliferation by blocking the NF-κB and ERK phosphorylation pathways.Conclusion Ambient air pollutants exacerbate asthma by worsening lung function and enhancing Th2-mediated inflammation.Specifically,PM_(2.5)significantly contributes to these adverse effects.Further research is needed to elucidate the mechanisms by which PM_(2.5)impacts asthma.展开更多
文摘Introduction The efficacy of inhaled budesonide for managing moderate-to-severe acute exacerbations in children is not clear.Therefore,this study aimed to evaluate hospital admission rates,need for use of systemic corticosteroids,length of hospital stay and adverse events when inhaled budesonide is added to standard pediatric emergency department management of moderate-to-severe acute exacerbations of asthma.Methods A systematic search was conducted in PubMed,Scopus,CENTRAL(Cochrane Central Register of Controlled Trials)and Google scholar databases.Randomized controlled trials that evaluated the effect of nebulized budesonide in moderate-to-severe acute exacerbations of asthma in pediatric patients were included for this meta-analysis.Statistical analysis was done using STATA version 13.0.Results A total of 16 RCTs were included.Children receiving nebulized budesonide had 43%lower risk of being hospital-ized(RR 0.57;95%CI,0.39;0.85)and 66%lower risk of requiring systemic corticosteroids(RR 0.34;95%CI,0.21;0.55)compared with those receiving placebo.There were no differences in the length of hospital stay(Hedges's g standardized mean difference-1.53;95%CI,-3.64;0.58)and risk of adverse events(RR 0.87,95%CI;0.65;1.17)between the two groups.There was no evidence of publication bias for any of the outcomes considered.Conclusion The findings of this meta-analysis support the use of inhaled budesonide in reducing risk of hospitalization and the need for systemic corticosteroids among children with acute moderate-to-severe asthma exacerbation.
文摘BACKGROUND： Few studies have reported the effects of early tracheotomy in acute severe asthmatic patients. We report two patients with acute severe asthma who were successfully treated with early tracheotomy. METHODS：The two patients with acute severe asthma were retrospectively reviewed. They had been treated at the Department of Emergency and Critical Care, Renji Hospital, Shanghai Jiaotong University School of Medicine. RESULTS： They developed progressively hypercapnia and severe acidosis, and were not improved after conventional therapies. Early tracheotomy after mechanical ventilation decreased airway resistance and work of breathing, and corrected hypercapnia and acidosis. Adequate gas exchange was maintained after tracheotomy. The two patients were subsequently weaned from mechanical ventilation and discharged. CONCLUSION：Early tracheotomy could be a valuable approach in certain patients with severe asthma.
文摘Objective:To explore the therapeutic effect of Dingchuan Decoction combined with omazumab on acute attack of bronchial asthma.Methods:From January 2020 to November 2021,90 patients with acute asthma were treated in our hospital,which belonged to heat asthma syndrome according to TCM syndrome differentiation in our hospital.They were divided into control group and observation group with 45 cases in each group.The control group was treated with omazumab,while the observation group was treated with omazumab combined with Dingchuan Decoction.The changes of lung function,exhaled nitric oxide(FeNO),blood gas indexes and hematological indexes were observed before and after treatment,and the adverse reactions and asthma recurrence within 3 months were observed.At the same time,animal experiments were carried out to verify the curative effect of Dingchuan.Results:After treatment,the total effective rate,FeNO,pulmonary function,partial pressure of blood oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2)),interleukin-6(IL-6),interleukin-5(IL-5),immunoglobulin E(IgE)and asthma recurrence in 3 months in the observation group were better than those in the control group;There was no significant difference in pulse oxygen saturation(SaO_(2))and the incidence of adverse reactions between the two groups.Animal experiments show that Dingchuan Decoction can effectively improve lung inflammation.Conclusion:The combination of Dingchua Decoction and omazumab has a good curative effect in the treatment of acute attack of bronchial asthma,which can effectively improve the lung function and blood gas index of patients,reduce the levels of inflammatory factors and IgE,and has no obvious increase in adverse reactions,and effectively control the recurrence of asthma within 3 months.It can be used as an auxiliary maintenance treatment for patients with mild and moderate acute attack and clinical remission of asthma,thus reducing the utilization rate of hormones and having high application value.
文摘Objective: to apply the combined therapy of shegan mahuang decoction and acupoint application in the treatment of acute exacerbation of bronchial asthma in children. Methods: the children with acute exacerbation of bronchial asthma who were treated in our hospital from January 2021 to January 2022 were selected as the research subjects, and the effects of different treatments were compared, including shegan mahuang decoction and acupoint application + shegan mahuang decoction. Results: after the effective treatment plan was implemented, the condition improved, especially the children treated with acupoint application + shegan mahuang decoction had a higher total effective rate, a lower incidence of adverse reactions, a good trend in FVC and other levels, and symptoms and signs. The scores were lower, and the children who received acupoint application treatment were relatively poor, and the difference was significant (P<0.05). Conclusion: in the treatment of acute exacerbation of bronchial asthma in children, shegan mahuang decoction combined with acupoint application has obvious application value and high safety, and plays a positive role in further shortening the course of the disease in children.
文摘Objective: to study the possible problems and risks in nursing management of patients with acute attack of bronchial asthma complicated with acute upper respiratory tract infection. Methods: 80 patients with acute attack of bronchial asthma complicated with acute upper respiratory tract infection treated in our hospital from February 2020 to February 2021 were randomly divided into study group (nursing risk management) and control group (routine nursing), with 40 cases in each group. After nursing, the nursing effects were compared. Results: the incidence of nursing adverse events in the control group was significantly higher than that in the study group (P < 0.05), and its treatment compliance, nursing satisfaction and nursing quality were significantly lower than those in the control group (P < 0.05). Conclusion: in the actual clinical treatment of patients with acute attack of bronchial asthma complicated with acute upper respiratory tract infection, in order to better improve the nursing effect and reduce the incidence of nursing adverse events, the majority of medical institutions need to take nursing risk management as the starting point, strengthen nursing risk management, eliminate the occurrence of nursing adverse events, and fundamentally promote the improvement of clinical nursing quality.
基金supported by Shanghai Science and Technology Commission with Project(No.14411951100,No.21s31900400)。
文摘Objective Air pollution is a leading public health issue.This study investigated the effect of air quality and pollutants on pulmonary function and inflammation in patients with asthma in Shanghai.Methods The study monitored 27 asthma outpatients for a year,collecting data on weather,patient self-management[daily asthma diary,peak expiratory flow(PEF)monitoring,medication usage],spirometry and serum markers.To explore the potential mechanisms of any effects,asthmatic mice induced by ovalbumin(OVA)were exposed to PM_(2.5).Results Statistical and correlational analyses revealed that air pollutants have both acute and chronic effects on asthma.Acute exposure showed a correlation between PEF and levels of ozone(O_(3))and nitrogen dioxide(NO_(2)).Chronic exposure indicated that interleukin-5(IL-5)and interleukin-13(IL-13)levels correlated with PM_(2.5)and PM_(10)concentrations.In asthmatic mouse models,exposure to PM_(2.5)increased cytokine levels and worsened lung function.Additionally,PM_(2.5)exposure inhibited cell proliferation by blocking the NF-κB and ERK phosphorylation pathways.Conclusion Ambient air pollutants exacerbate asthma by worsening lung function and enhancing Th2-mediated inflammation.Specifically,PM_(2.5)significantly contributes to these adverse effects.Further research is needed to elucidate the mechanisms by which PM_(2.5)impacts asthma.
