Purpose:The aim was to synthesize quantitative and qualitative research that identified the most effective educational strategies for nurse-led inhaler technique(IT)education in Chronic Obstructive Pulmonary Disease(C...Purpose:The aim was to synthesize quantitative and qualitative research that identified the most effective educational strategies for nurse-led inhaler technique(IT)education in Chronic Obstructive Pulmonary Disease(COPD)patients,as perceived by patients,healthcare providers,and nurses.Methods:A systematic literature search in Embase,PubMed,Cochrane Library,Web of Science,and CINAHL from 2018 to 30 June 2024 was conducted.In total,327 articles were identified.The results of 14 studies that met the inclusion criteria were synthesized.Data were analyzed with des-criptive and semi-quantitative methods to yield summarizing findings on the effectiveness of different educational strate-gies.All investigations had assessed patient adherence to IT.Results:Data indicated that nurse-led IT teaching strategies are effective in promoting IT adherence and correctness in COPD patients utilizing the personalized Teach-Back method.However,studies in disease control and comparison of patient IT satisfaction and self-efficacy need further investigation.Conclusion:The results of this study may contribute to the understanding of the most effective educational strategies in nurse-led IT education for COPD patients.The synthesized findings can be used for the development of new educational interventions and assessment instruments for IT adherence.展开更多
Ciclesonide is a new corticosteroid currently in clinical development for the treatment of asthma by oral inhalation. The objectives of the present study were to develop ciclesonide dry powder inhalers （DPIs, 80 μg...Ciclesonide is a new corticosteroid currently in clinical development for the treatment of asthma by oral inhalation. The objectives of the present study were to develop ciclesonide dry powder inhalers （DPIs, 80 μg） and investigate the anti-asthmatic effect in animals. For preparing a ciclesonide capsule-type DPI, sphere-shaped lactose was used as a diluent carrier, mixed with micronized ciclesonide, and filled into a capsule, and then put into a dry powder inhaler for oral inhalation. The asthmatic model was established with guinea pigs, and the therapeutic efficacy of ciclesonide was performed on the asthmatic guinea pig model. Results showed that the pulmonary deposition ratio of ciclesonide DPIs was approximately 26% and their content uniformity met the requirements of China Pharmacopoeia. The established pathological model exhibited the typical features of asthma with a widened pulmonary alveolar interval, narrowed alveolar space and detached bronchial mucosal epithelium with topical necrosis, goblet cell hyperplasia, and inflammatory cell infiltration. After treating with ciclesonide, the impaired indicators in asthmatic guinea pigs were significantly recovered or alleviated, exhibiting decreased total cells, decreased eosinophils and a decreased IL-5 level while there was an increased IFN-γ level in the bronchoalveolar lavage fluid （BALF）. This study develops a new pulmonary ciclesonide delivery system for treating asthma, and proves the therapeutic efficacy in asthmatic guinea pigs.展开更多
Dry powder inhalers are often formulated by attaching micronized drug particles onto carrier particles, which are generally lactose. In this study, commercially available lactose was air jet milled to produce unique s...Dry powder inhalers are often formulated by attaching micronized drug particles onto carrier particles, which are generally lactose. In this study, commercially available lactose was air jet milled to produce unique slab-like coarse carrier particles, which have larger and rougher surfaces compared to other commercially available lactose. Two key processing factors, i.e.,classifier speed and jet milling pressure, were systematically investigated. The largest fraction of slab-like particles in the resulting powder was obtained at a classifier speed of 3000 rpm.The slab-like coarse carrier particles are expected to exhibit superior performance than commercial lactose due to their unique surface properties.展开更多
Objective: Dual bronchodilation with long-acting muscarinic antagonist and long-acting β2-agonist combinations are available worldwide in COPD patients. However, the choice of agents remains under debate. We hypothes...Objective: Dual bronchodilation with long-acting muscarinic antagonist and long-acting β2-agonist combinations are available worldwide in COPD patients. However, the choice of agents remains under debate. We hypothesized that switching devices between dry powder and soft mist inhalers without a wash-out period to mimic clinical practice would improve clinical symptoms and lung function. The aim of this study was to examine the effects of switching between once-daily glycopyrronium/indacaterol (GLY/IND) or umeclidinium/vilanterol (UMEC/VI), dry powder inhalers, and tiotropium/olodaterol (TIO/OLO), a soft mist inhaler, in COPD patients. Methods: This was a prospective, open-label, 8-week, observational study with follow-up. Subjects included 57 COPD patients, who attended outpatient clinics at Shizuoka General Hospital for routine check-ups between February and December 2015, receiving GLY/IND (50/110 μg) or UMEC/VI (62.5/25 μg). After an 8-week run-in period, medications were switched to TIO/OLO (5/5 μg). Study outcomes included patient’s global rating (PGR), modified MRC (mMRC), COPD assessment test (CAT), and spirometric and forced oscillatory parameters after 8 weeks. PGR used in this study was a 7-point scale ranging from 1 to 7, with 4 in the middle. Patients who consented to switch from TIO/OLO to GLY/IND or UMEC/VI were followed-up thereafter. Results: In total, 53 patients completed the study (mean age, 75 years;48 males and 5 females;GOLD 1/2/3/4 = 19/27/6/1;mMRC 0/1/2/3/4 = 14/22/12/4/1;UMEC/VI 26, GLY/IND 27). PGR, mMRC, and CAT improved in 20 (38%), 9 (17%), and 15 patients (28%), respectively. Respiratory system resistance at 5 Hz (R5), 20 Hz (R20), and the difference between R5 and R20 (R5 - R20) significantly improved. In a follow-up of 16 patients after switching from TIO/OLO to UMEC/VI (9) or GLY/IND (7), PGR, mMRC, and CAT improved in 5 (31%), 3 (12%), and 4 patients (25%), respectively, and R20 significantly improved (p = 0.011). Conclusions: Switching dual bronchodilators between dry powder and soft mist inhalers improves symptoms and airway narrowing in some COPD patients.展开更多
The issue of microplastic(MPs)pollution has received increased attention in recent years.Studies have indicated that inhalation of microplastics may result in the cardiovascular harm.However,the specific mechanism rem...The issue of microplastic(MPs)pollution has received increased attention in recent years.Studies have indicated that inhalation of microplastics may result in the cardiovascular harm.However,the specific mechanism remains to be elucidated.In this study,5μm polystyrene microplastics(PS-MPs)were employed to construct in vivo and in vitro exposure models to investigate the potential mechanisms of microplastic-induced cardiac fibrosis.In vivo model of respiratory exposure to MPs,echocardiography observed a decrease in systolic-diastolic function of the mouse heart,and myocardial tissue showed significant mitochondrial morphological abnormalities and myocardial fibrosis.In vitro models also revealed upregulation of fibrosis indicators in human cardiomyocytes AC16 cells.Transcriptome and RT-qPCR assay exposed that ferroptosis-related pathways were significantly gath-ered in the MPs group,with decreased expression of ferroptosis related genes SLC7A11 and GPX4.Liproxstatin-1(Lip-1),a ferroptosis inhibitor,significantly ameliorated MPs-induced cardiomyocyte fibrosis and ferroptosis.We further demonstrated that inhibition of hypoxia-inducible factor𝛼(HIF-𝛼)and oxidative stress ameliorated PS-MPs-induced cardiomyocyte ferroptosis,and thus upregulation of the HIF pathway and oxidative stress may be the upstream mechanism of MPs-induced ferroptosis in myocardial fibrosis.Above all,our study demonstrated that MPs exposure resulted in cardiac fibrosis via the HIF-ROS-SLC7A11/GPX4 signaling pathway.展开更多
For patients with lung disease,dry powder inhalers(DPI)are profoundly beneficial.The current study introduces and develops a series of dry powder inhalers(DPIs).A capsule-based(size 0)active DPI was considered.The stu...For patients with lung disease,dry powder inhalers(DPI)are profoundly beneficial.The current study introduces and develops a series of dry powder inhalers(DPIs).A capsule-based(size 0)active DPI was considered.The study aims to investigate whether swirling flow and outlet capillary diameter(dc_out)affect the percentage of emitted doses(ED)released from the capsule.Spiral vanes were added to the capillary inlet to produce a swirling flow.Computational fluid dynamics(CFD)was applied to simulate the problem.The results were compared with previous in vitro and numerical studies to validate the results.Based on the derived results,the small swirl parameter(SP)enhances the secondary flow and recirculation zone.It increases the central jet flow,which increases the ED value by about 5–20%compared to no-swirl flow.However,as the airflow rate increases,the recirculation zone enlarges,vorticities become dominant,and asymmetrical flow patterns emerge.Consequently,ED%drops significantly(more than 50%).As d_(c_out)decreases,the vorticities around the outlet capillary become more potent,which is undesirable.Indeed,the emptying of the capsule does not happen ideally.The research provides a perspective on the device's design and DPI performance.展开更多
Asthma, one of the most prevalent chronic inflammatory diseases, remains challenging to manage effectively. Current therapies commonly alleviate symptoms through broad immunosuppression and bronchodilation but fail to...Asthma, one of the most prevalent chronic inflammatory diseases, remains challenging to manage effectively. Current therapies commonly alleviate symptoms through broad immunosuppression and bronchodilation but fail to target disease-specific molecular pathways. Genetic intervention using small interfering RNA(siRNA) has emerged as a promising strategy for asthma therapy. However, its success is largely hindered by the lack of an efficient delivery approach targeting airway epithelial cells(AECs). Here, we developed a novel inhalable siRNA delivery system based on artificially prepared nanovesicles through designed extrusion processes of mesenchymal stem cells. To enable an effective inhalation delivery of siRNA via nanovesicles, various parameters, including extrusion cycles,membrane pore sizes, and centrifugal forces were examined through orthogonal testing.Results revealed that the artificially prepared nanovesicles demonstrated remarkable capability to deliver thymic stromal lymphopoietin-targeted siRNA into AECs and substantially suppressed the inflammatory pathways and goblet cell hyperplasia, and eventually achieved a significant inhibition of asthma symptoms in ovalbumin-induced asthma models. Thus, the present study provides a novel nebulized nanovesicle-based carrier for effective delivery of siRNA through local inhalation, offering a promising therapeutic delivery platform for asthma and potentially other respiratory diseases.展开更多
Lung cancer is the leading cause of cancer-related deaths. Traditional chemotherapy causes serious toxicity due to the wide bodily distribution of these drugs. Curcumin is a potential anticancer agent but its low wate...Lung cancer is the leading cause of cancer-related deaths. Traditional chemotherapy causes serious toxicity due to the wide bodily distribution of these drugs. Curcumin is a potential anticancer agent but its low water solubility, poor bioavailability and rapid metabolism significantly limits clinical applications. Here we developed a liposomal curcumin dry powder inhaler(LCD) for inhalation treatment of primary lung cancer. LCDs were obtained from curcumin liposomes after freeze-drying. The LCDs had a mass mean aerodynamic diameter of 5.81 μm and a fine particle fraction of 46.71%, suitable for pulmonary delivery. The uptake of curcumin liposomes by human lung cancer A549 cells was markedly greater and faster than that of free curcumin. The high cytotoxicity on A549 cells and the low cytotoxicity of curcumin liposomes on normal human bronchial BEAS-2B epithelial cells yielded a high selection index partly due to increased cell apoptosis. Curcumin powders, LCDs and gemcitabine were directly sprayed into the lungs of rats with lung cancer through the trachea. LCDs showed higher anticancer effects than the other two medications with regard to pathology and the expression of many cancer-related markers including VEGF, malondialdehyde, TNF-α, caspase-3 and BCL-2. LCDs are a promising medication for inhalation treatment of lung cancer with high therapeutic efficiency.展开更多
Dry powder inhalers(DPIs) offer distinct advantages as a means of pulmonary drug delivery and have attracted much attention in the field of pharmaceutical science. DPIs commonly contain micronized drug particles which...Dry powder inhalers(DPIs) offer distinct advantages as a means of pulmonary drug delivery and have attracted much attention in the field of pharmaceutical science. DPIs commonly contain micronized drug particles which, because of their cohesiveness and strong propensity to aggregate, have poor aerosolization performance. Thus carriers with a larger particle size are added to address this problem. However, the performance of DPIs is profoundly influenced by the physical properties of the carrier, particularly their particle size, morphology/shape and surface roughness. Because these factors are interdependent, it is difficult to completely understand how they individually influence DPI performance.The purpose of this review is to summarize and illuminate how these factors affect drug–carrier interaction and influence the performance of DPIs.展开更多
Air flow and particle-particle/wall impacts are considered as two primary dispersion mechanisms for dry powder inhalers(DPIs).Hence,an understanding of these mechanisms is critical for the development of DPIs.In this ...Air flow and particle-particle/wall impacts are considered as two primary dispersion mechanisms for dry powder inhalers(DPIs).Hence,an understanding of these mechanisms is critical for the development of DPIs.In this study,a coupled DEM-CFD(discrete element method-computational fluid dynamics)is employed to investigate the influence of air flow on the dispersion performance of the carrier-based DPI formulations.A carrier-based agglomerate is initially formed and then dispersed in a uniformed air flow.It is found that air flow can drag API particles away from the carrier and those in the downstream air flow regions are prone to be dispersed.Furthermore,the influence of the air velocity and work of adhesion are also examined.It is shown that the dispersion number(i.e.,the number of API particles detached from the carrier)increases with increasing air velocity,and decreases with increasing the work of adhesion,indicating that the DPI performance is controlled by the balance of the removal and adhesive forces.It is also shown that the cumulative Weibull distribution function can be used to describe the DPI performance,which is governed by the ratio of the fluid drag force to the pull-off force.展开更多
Objective:To evaluate the efficacy of Sanhua essential oil inhalation as aromatherapy in patients with breast cancer-related depression.Methods:In total,144 patients with breast cancer-related depression who underwent...Objective:To evaluate the efficacy of Sanhua essential oil inhalation as aromatherapy in patients with breast cancer-related depression.Methods:In total,144 patients with breast cancer-related depression who underwent postoperative chemotherapy were recruited.The participants in the control group(n=52)were offered a placebo(sunflower oil)daily,whereas those in the essential oil group(n=52)were administered Sanhua essential oil.This study evaluated depression improvement,Hamilton Depression Scale score,scores of symptoms in traditional Chinese medicine(TCM),Pittsburgh Sleepiness Quotient Index score,incidence of nausea and vomiting,and signal changes on functional magnetic resonance imaging.Results:Depression improved by 48.1%and 21.2%in the essential oil and control groups,respectively(P=.010).The Hamilton Depression Scale score(P=.017),scores for symptoms in TCM(P=.002),and the incidence of nausea and vomiting in the acute and delayed phases were lower in the essential oil group than in the control group(nausea in the acute phase,P=.017;nausea in the delayed phase,P=.039;vomiting in the acute phase,P=.008;vomiting in the delayed phase,P=.081).The Pittsburgh Sleepiness Quotient Index score was lower in the essential oil group than in the control group(P=.005).Significant differences existed between the two groups in the left superior parietal gyrus,right precuneus,left dorsolateral superior frontal gyrus,and right precentral gyrus according to functional connectivity on functional magnetic resonance imaging.Conclusion:Inhalation of Sanhua essential oil alleviated depression in patients undergoing chemotherapy for breast cancer,improved sleep quality,relieved TCM symptoms,reduced nausea and vomiting,and regulated activities in the brain regions.展开更多
Herein,porous poly(lactic-co-glycolic acid)(PLGA)microspheres were prepared to load icariin andmiR-23b for the treatment of metastatic lung cancer.The microspheres exhibited desirable aerodynamic diameter,high drug lo...Herein,porous poly(lactic-co-glycolic acid)(PLGA)microspheres were prepared to load icariin andmiR-23b for the treatment of metastatic lung cancer.The microspheres exhibited desirable aerodynamic diameter,high drug loading and encapsulation efficiency,as well as a favorable drug release profile,which was beneficial for the deposition and exposure of drugs in the lung tissues.The release solution from microspheres exhibited a favorable anti-proliferative effect by inducting cell apoptosis and arresting the cell cycle at G1 phase,and meanwhile inhibited the migration and invasion of cancer cells.More importantly,the microspheres could be effectively inhaled and accumulated in the lung tissues to trigger the in situ apoptosis of tumor cells and suppress metastasis,using mice bearing melanoma-metastatic lung cancer as a model.Furthermore,inhalation of themicrospheres showed favorable biocompatibility,barely causing tissue damage.Overall,porous PLGA microspheres provide a promising platform for the inhalable co-delivery of drugs and genes to obtain ideal therapeutic efficacy in lung cancer and other pulmonary diseases.展开更多
In recent years,the rising prevalence of respiratory diseases,coupled with advancements in biotechnology and pharmacology,has positioned inhalable formulations as a preferred method of drug administration.This approac...In recent years,the rising prevalence of respiratory diseases,coupled with advancements in biotechnology and pharmacology,has positioned inhalable formulations as a preferred method of drug administration.This approach enables direct and rapid delivery of medication to the lungs,maximizing therapeutic effects while minimizing dosage and potential side effects.In this review,we meticulously examined current literature and clinical trial databases to present a comprehensive overview of three key areas:(1)inhalation devices currently utilized in clinical settings;(2)the clinical applications of approved inhalable formulations;and(3)preclinical research on inhalable treatments targeting various lung conditions,including pulmonary infections,tuberculosis,lung cancer,pulmonary fibrosis,as well as systemic diseases like Parkinson’s disease.The objective was to delve into both foundational research and the clinical use of inhalable formulations within the pharmaceutical field,with the aim of fostering their broader adoption and guiding the development of inhalable therapies for a more comprehensive range of diseases.展开更多
Background:Pulmonary fibrosis(PF)is a refractory disease with limited treatment options.This study investigates the potential anti-PF effects of the herbal formula Yiqi Huatan Sanjie(YQHTSJ)administered via nebulized ...Background:Pulmonary fibrosis(PF)is a refractory disease with limited treatment options.This study investigates the potential anti-PF effects of the herbal formula Yiqi Huatan Sanjie(YQHTSJ)administered via nebulized inhalation,exploring its underlying mechanisms.Methods:The anti-fibrotic properties of nebulized YQHTSJ were assessed using a bleomycin(BLM)-induced PF mouse model.RNA sequencing identified differentially expressed genes(DEGs),and subsequent gene enrichment analysis,along with transcription factor(TF)prediction,revealed YQHTSJ-regulated DEGs.Active components and targets of YQHTSJ were retrieved from the HERB database,leading to the identification of key TFs interacting with DEGs.Quercetin,a constituent of YQHTSJ,was evaluated for its effects on transforming growth factor-β1-induced myofibroblast activation and BLM-induced PF.The direct binding interaction between quercetin and the key TF Jun proto-oncogene(JUN)was confirmed through molecular docking studies and the cellular thermal shift assay(CETSA)experiments.Results:Nebulized YQHTSJ was found to significantly inhibit PF and inflammation in the mouse model.RNA sequencing identified 135 DEGs regulated by YQHTSJ,and 27 key TFs associated with these DEGs were predicted.Among YQHTSJ’s potential targets,41 were identified as TFs,with six-JUN,Fos proto-oncogene,MYC proto-oncogene,RELA proto-oncogene,nuclear factor kappa B subunit 1,and peroxisome proliferator activated receptor alpha-recognized as key TFs targeted by YQHTSJ.Molecular docking and CETSA experiments confirmed that quercetin directly targets JUN protein and inhibits its phosphorylation,thereby contributing to the suppression of myofibroblast activation and PF.Conclusion:The potential mechanisms of YQHTSJ and its component quercetin in combating PF may involve the regulation of critical TFs like JUN and the suppression of pathogenic gene expression.展开更多
Background:Inhalation exposure is the gold standard when assessing pulmonary tox-icity.However,it typically requires substantial amounts of test material.Intratracheal instillation is an alternative administration tec...Background:Inhalation exposure is the gold standard when assessing pulmonary tox-icity.However,it typically requires substantial amounts of test material.Intratracheal instillation is an alternative administration technique,where the test substance is suspended in a liquid vehicle and deposited into the lung via the trachea.Instillation requires minimal test material,delivers an exact dose deep into the lung,and is less labor-intensive than inhalation exposures.However,one shortcoming is that the pro-cedure may induce short-term inflammation.To minimize this,we tested different modifications of the technique to identify the potential for refinement.Methods:First,we tested whether previous findings of increased inflammation could be confirmed.Next,we tested whether instillation with a disposable 1 mL syringe with ball-tipped steel-needle(Disposable-syringe/steel-needle)induced less inflammation than the use of our standard set-up,a 250μL reusable glass syringe with a disposable plastic catheter(Glass-syringe/plastic-catheter).Finally,we tested if access to pelleted and liquid feed prior to instillation affected inflammation.We evaluated inflammation by neutrophil numbers in bronchoalveolar fluid 24 h post-exposure.Results:Vehicle-instilled mice showed a small increase in neutrophil numbers com-pared to untreated mice.Neutrophil numbers were slightly elevated in the groups in-stilled with Disposable-syringe/steel-needle;an interaction with feed type indicated that the increase in neutrophils was more pronounced in combination with feed pel-lets compared to liquid feed.We found no difference between the feed types when using the Glass-syringe/plastic-catheter combination.Conclusion:The Glass-syringe/plastic-catheter combination induced the least exposure-related inflammation,confirming this as a preferred instillation procedure.展开更多
This study explores the clinical efficacy of budesonide combined with ambroxol inhalation therapy for neonatal pneumonia.A total of 68 neonatal pneumonia patients treated at Li County Hospital from January 2023 to Dec...This study explores the clinical efficacy of budesonide combined with ambroxol inhalation therapy for neonatal pneumonia.A total of 68 neonatal pneumonia patients treated at Li County Hospital from January 2023 to December 2024 were randomly divided into a monotherapy group and a combination group,with 34 patients in each.The monotherapy group received ambroxol inhalation therapy,while the combination group received budesonide inhalation therapy in addition to ambroxol.The recovery progress,blood gas analysis indicators,inflammatory response improvement,and overall clinical efficacy were compared between the two groups.Results showed that the combination group experienced a significantly shorter time for body temperature normalization(3.36±0.58 days vs.4.59±0.45 days),oxygen inhalation duration(4.89±0.57min vs.6.96±0.79min),disappearance of shortness of breath and cough(4.56±0.29 days vs.6.63±0.75 days),and resolution of lung wet rales(5.62±1.46 days vs.7.92±1.28 days)compared to the monotherapy group(P<0.05).Additionally,the total effective rate was significantly higher in the combination group(97.06%)than in the monotherapy group(73.52%)(P<0.05).Post-treatment,the combination group exhibited significantly better blood gas analysis and inflammatory response indicators(P<0.05).These findings suggest that budesonide combined with ambroxol inhalation therapy can effectively improve blood oxygen saturation,reduce inflammation,promote faster recovery,and enhance overall clinical efficacy,making it a reliable treatment option for neonatal pneumonia.展开更多
BACKGROUND Postpartum pulmonary arterial hypertension(PAH)complicated with hereditary hemorrhagic telangiectasia(HHT)is a rare condition.Diagnosing and treating PAH in patients with HHT can be challenging.To the best ...BACKGROUND Postpartum pulmonary arterial hypertension(PAH)complicated with hereditary hemorrhagic telangiectasia(HHT)is a rare condition.Diagnosing and treating PAH in patients with HHT can be challenging.To the best of our knowledge,no previous reports have investigated the efficacy of pulmonary vasodilators in improving hemodynamics in postpartum patients with this disease.CASE SUMMARY In this paper,we report a postpartum case of HHT combined with PAH,pre-senting with worsening dyspnea.Genetic testing revealed that the patient carried a heterozygous variant of activin receptor-like kinase 1.The patient received various treatments,including diuretics,anticoagulants,sildenafil,macitentan,inhalation of nitric oxide,and iloprost.Changes in PaO2/FiO2,pulmonary artery systolic pressure as assessed by echocardiography,and N-terminus pro-brain natriuretic peptide levels suggested that,except for iloprost inhalation,the other treatments appeared to have limited efficacy.CONCLUSION To our knowledge,this is the first report on efficacy of pulmonary vasodilators in postpartum patients with HHT and PAH.展开更多
Phencyclidine(PCP,known as angel dust) is a nonbarbiturate,non-narcotic intravenous(IV) anesthetic with potent analgesic effects.However,its medical use was discontinued because of postoperative agitation,disorientati...Phencyclidine(PCP,known as angel dust) is a nonbarbiturate,non-narcotic intravenous(IV) anesthetic with potent analgesic effects.However,its medical use was discontinued because of postoperative agitation,disorientation,psychosis,cardiotoxicity,and hallucinogenic effects.Consequently,the PCP began to be illicitly distributed.The use methods include snorting,inhalation,IV,and subcutaneous(SC) injection.[1-5] The characteristic toxidrome of PCP includes altered mental status,tachycardia,and nystagmus.At higher doses,patients may become comatose and develop sympathomimetic effects such as tachycardia,hypertension,hypersalivation,urinary retention,and bronchospasm.In cases of intoxication,the pupillary light reflex remains intact,although the pupil size may vary.[1,3-6] PCP has a direct cardiotoxic effect and may induce arrhythmias.[2] Hyperreflexia,muscle rigidity,choreiform movements and muscle fasciculations may occur.[2,4,6] PCP-induced acute respiratory distress syndrome(ARDS) and alveolar hemorrhage(AH) are rare but potentially life-threatening complications.The main causes of non-traumatic death in patients with PCP intoxication include cardiopulmonary arrest,intracranial hemorrhage and rhabdomyolysis.[2,3,5] This case report aims to emphasize the management and potential benefits of inhaled N-acetylcysteine(NAC) and tranexamic acid(TXA)for PCP-induced ARDS and AH.展开更多
This clinical study aimed to explore the therapeutic effect of recombinant human interferonα2b nebulization inhalation in the treatment of hand,foot,and mouth disease in children.Sixty-six patients were selected as t...This clinical study aimed to explore the therapeutic effect of recombinant human interferonα2b nebulization inhalation in the treatment of hand,foot,and mouth disease in children.Sixty-six patients were selected as the research subjects by the random sampling method and divided into a control group and an observation group.The patients in the control group were treated with ribavirin injection and oral lysine-inositol-vitamin B12 solution,while the patients in the observation group received the treatment of the control group combined with recombinant human interferonα2b nebulization inhalation.The clinical effects of the two groups were compared to determine the clinical efficacy of the two treatment plans.The total effective rates of treatment were 78.79%in the control group and 90.91%in the observation group.The research confirmed that the clinical effect of recombinant human interferonα2b nebulization inhalation in the treatment of hand,foot,and mouth disease in children is remarkable.It can significantly improve the symptoms of children with hand,foot,and mouth disease and is suitable for clinical application and promotion.展开更多
The effect of inhaled nano-TiO2 on lung histology and serum biochemical indexes is evaluated in healthy and adult Kunming mice（eight in each group）after exposure to TiO2 aerosols（1 500 mg/m3）in a sealed chamber.An...The effect of inhaled nano-TiO2 on lung histology and serum biochemical indexes is evaluated in healthy and adult Kunming mice（eight in each group）after exposure to TiO2 aerosols（1 500 mg/m3）in a sealed chamber.Another eight mice are exposed to indoor air to be served as a control group.Lung tissue and blood are collected after euthanizing the animals.The results show that lactate dehydrogenase（LDH）activity increases in all experimental groups.Alanine aminotransferase（ALT）activity and blood urea nitrogen（BUN）levels are increased in the group exposed to TiO2 aerosols for 28 d,and creatinine（Cr）levels are increased in 14 d and 28 d samples（P0.05）.No obvious changes are observed in other serum indexes.Lungs of mice exposed to 28 d exposure show significant but moderate increase in pulmonary inflammation,and many TiO2 particles are found in the interstitium of pulmonary alveoli.展开更多
文摘Purpose:The aim was to synthesize quantitative and qualitative research that identified the most effective educational strategies for nurse-led inhaler technique(IT)education in Chronic Obstructive Pulmonary Disease(COPD)patients,as perceived by patients,healthcare providers,and nurses.Methods:A systematic literature search in Embase,PubMed,Cochrane Library,Web of Science,and CINAHL from 2018 to 30 June 2024 was conducted.In total,327 articles were identified.The results of 14 studies that met the inclusion criteria were synthesized.Data were analyzed with des-criptive and semi-quantitative methods to yield summarizing findings on the effectiveness of different educational strate-gies.All investigations had assessed patient adherence to IT.Results:Data indicated that nurse-led IT teaching strategies are effective in promoting IT adherence and correctness in COPD patients utilizing the personalized Teach-Back method.However,studies in disease control and comparison of patient IT satisfaction and self-efficacy need further investigation.Conclusion:The results of this study may contribute to the understanding of the most effective educational strategies in nurse-led IT education for COPD patients.The synthesized findings can be used for the development of new educational interventions and assessment instruments for IT adherence.
基金Tianjin Pharmaceuticals Research Organization Co.,Ltd,and in part by the Key Grant of Beijing Natural Science Foundation(Grant No.7091005)
文摘Ciclesonide is a new corticosteroid currently in clinical development for the treatment of asthma by oral inhalation. The objectives of the present study were to develop ciclesonide dry powder inhalers （DPIs, 80 μg） and investigate the anti-asthmatic effect in animals. For preparing a ciclesonide capsule-type DPI, sphere-shaped lactose was used as a diluent carrier, mixed with micronized ciclesonide, and filled into a capsule, and then put into a dry powder inhaler for oral inhalation. The asthmatic model was established with guinea pigs, and the therapeutic efficacy of ciclesonide was performed on the asthmatic guinea pig model. Results showed that the pulmonary deposition ratio of ciclesonide DPIs was approximately 26% and their content uniformity met the requirements of China Pharmacopoeia. The established pathological model exhibited the typical features of asthma with a widened pulmonary alveolar interval, narrowed alveolar space and detached bronchial mucosal epithelium with topical necrosis, goblet cell hyperplasia, and inflammatory cell infiltration. After treating with ciclesonide, the impaired indicators in asthmatic guinea pigs were significantly recovered or alleviated, exhibiting decreased total cells, decreased eosinophils and a decreased IL-5 level while there was an increased IFN-γ level in the bronchoalveolar lavage fluid （BALF）. This study develops a new pulmonary ciclesonide delivery system for treating asthma, and proves the therapeutic efficacy in asthmatic guinea pigs.
基金the funding support for this study from GEA-NUS PPRL (N-148-000-008-001)SERC Grant No. 102 169 0049 (R-148-000-157-305)partial support from the NSF through the NNIN program
文摘Dry powder inhalers are often formulated by attaching micronized drug particles onto carrier particles, which are generally lactose. In this study, commercially available lactose was air jet milled to produce unique slab-like coarse carrier particles, which have larger and rougher surfaces compared to other commercially available lactose. Two key processing factors, i.e.,classifier speed and jet milling pressure, were systematically investigated. The largest fraction of slab-like particles in the resulting powder was obtained at a classifier speed of 3000 rpm.The slab-like coarse carrier particles are expected to exhibit superior performance than commercial lactose due to their unique surface properties.
文摘Objective: Dual bronchodilation with long-acting muscarinic antagonist and long-acting β2-agonist combinations are available worldwide in COPD patients. However, the choice of agents remains under debate. We hypothesized that switching devices between dry powder and soft mist inhalers without a wash-out period to mimic clinical practice would improve clinical symptoms and lung function. The aim of this study was to examine the effects of switching between once-daily glycopyrronium/indacaterol (GLY/IND) or umeclidinium/vilanterol (UMEC/VI), dry powder inhalers, and tiotropium/olodaterol (TIO/OLO), a soft mist inhaler, in COPD patients. Methods: This was a prospective, open-label, 8-week, observational study with follow-up. Subjects included 57 COPD patients, who attended outpatient clinics at Shizuoka General Hospital for routine check-ups between February and December 2015, receiving GLY/IND (50/110 μg) or UMEC/VI (62.5/25 μg). After an 8-week run-in period, medications were switched to TIO/OLO (5/5 μg). Study outcomes included patient’s global rating (PGR), modified MRC (mMRC), COPD assessment test (CAT), and spirometric and forced oscillatory parameters after 8 weeks. PGR used in this study was a 7-point scale ranging from 1 to 7, with 4 in the middle. Patients who consented to switch from TIO/OLO to GLY/IND or UMEC/VI were followed-up thereafter. Results: In total, 53 patients completed the study (mean age, 75 years;48 males and 5 females;GOLD 1/2/3/4 = 19/27/6/1;mMRC 0/1/2/3/4 = 14/22/12/4/1;UMEC/VI 26, GLY/IND 27). PGR, mMRC, and CAT improved in 20 (38%), 9 (17%), and 15 patients (28%), respectively. Respiratory system resistance at 5 Hz (R5), 20 Hz (R20), and the difference between R5 and R20 (R5 - R20) significantly improved. In a follow-up of 16 patients after switching from TIO/OLO to UMEC/VI (9) or GLY/IND (7), PGR, mMRC, and CAT improved in 5 (31%), 3 (12%), and 4 patients (25%), respectively, and R20 significantly improved (p = 0.011). Conclusions: Switching dual bronchodilators between dry powder and soft mist inhalers improves symptoms and airway narrowing in some COPD patients.
基金supported by the National Natural Science Foundation of China(No.82073520).
文摘The issue of microplastic(MPs)pollution has received increased attention in recent years.Studies have indicated that inhalation of microplastics may result in the cardiovascular harm.However,the specific mechanism remains to be elucidated.In this study,5μm polystyrene microplastics(PS-MPs)were employed to construct in vivo and in vitro exposure models to investigate the potential mechanisms of microplastic-induced cardiac fibrosis.In vivo model of respiratory exposure to MPs,echocardiography observed a decrease in systolic-diastolic function of the mouse heart,and myocardial tissue showed significant mitochondrial morphological abnormalities and myocardial fibrosis.In vitro models also revealed upregulation of fibrosis indicators in human cardiomyocytes AC16 cells.Transcriptome and RT-qPCR assay exposed that ferroptosis-related pathways were significantly gath-ered in the MPs group,with decreased expression of ferroptosis related genes SLC7A11 and GPX4.Liproxstatin-1(Lip-1),a ferroptosis inhibitor,significantly ameliorated MPs-induced cardiomyocyte fibrosis and ferroptosis.We further demonstrated that inhibition of hypoxia-inducible factor𝛼(HIF-𝛼)and oxidative stress ameliorated PS-MPs-induced cardiomyocyte ferroptosis,and thus upregulation of the HIF pathway and oxidative stress may be the upstream mechanism of MPs-induced ferroptosis in myocardial fibrosis.Above all,our study demonstrated that MPs exposure resulted in cardiac fibrosis via the HIF-ROS-SLC7A11/GPX4 signaling pathway.
基金This work was supported the National Natural Science Foundation of China(grant No.12172146).
文摘For patients with lung disease,dry powder inhalers(DPI)are profoundly beneficial.The current study introduces and develops a series of dry powder inhalers(DPIs).A capsule-based(size 0)active DPI was considered.The study aims to investigate whether swirling flow and outlet capillary diameter(dc_out)affect the percentage of emitted doses(ED)released from the capsule.Spiral vanes were added to the capillary inlet to produce a swirling flow.Computational fluid dynamics(CFD)was applied to simulate the problem.The results were compared with previous in vitro and numerical studies to validate the results.Based on the derived results,the small swirl parameter(SP)enhances the secondary flow and recirculation zone.It increases the central jet flow,which increases the ED value by about 5–20%compared to no-swirl flow.However,as the airflow rate increases,the recirculation zone enlarges,vorticities become dominant,and asymmetrical flow patterns emerge.Consequently,ED%drops significantly(more than 50%).As d_(c_out)decreases,the vorticities around the outlet capillary become more potent,which is undesirable.Indeed,the emptying of the capsule does not happen ideally.The research provides a perspective on the device's design and DPI performance.
基金supported by National Natural Science Foundation of China (U22A20383)Natural Science Foundation of Zhejiang Province (LY24H300001)+2 种基金Fundamental Research Funds for the Central Universities (226-2022-00125)Zhejiang Province Postdoctoral Research Excellence Funding Project (ZJ2023151)Pharmacy 80 Basic Research Funding in College of Pharmaceutical Sciences, Zhejiang University Education Foundation。
文摘Asthma, one of the most prevalent chronic inflammatory diseases, remains challenging to manage effectively. Current therapies commonly alleviate symptoms through broad immunosuppression and bronchodilation but fail to target disease-specific molecular pathways. Genetic intervention using small interfering RNA(siRNA) has emerged as a promising strategy for asthma therapy. However, its success is largely hindered by the lack of an efficient delivery approach targeting airway epithelial cells(AECs). Here, we developed a novel inhalable siRNA delivery system based on artificially prepared nanovesicles through designed extrusion processes of mesenchymal stem cells. To enable an effective inhalation delivery of siRNA via nanovesicles, various parameters, including extrusion cycles,membrane pore sizes, and centrifugal forces were examined through orthogonal testing.Results revealed that the artificially prepared nanovesicles demonstrated remarkable capability to deliver thymic stromal lymphopoietin-targeted siRNA into AECs and substantially suppressed the inflammatory pathways and goblet cell hyperplasia, and eventually achieved a significant inhibition of asthma symptoms in ovalbumin-induced asthma models. Thus, the present study provides a novel nebulized nanovesicle-based carrier for effective delivery of siRNA through local inhalation, offering a promising therapeutic delivery platform for asthma and potentially other respiratory diseases.
文摘Lung cancer is the leading cause of cancer-related deaths. Traditional chemotherapy causes serious toxicity due to the wide bodily distribution of these drugs. Curcumin is a potential anticancer agent but its low water solubility, poor bioavailability and rapid metabolism significantly limits clinical applications. Here we developed a liposomal curcumin dry powder inhaler(LCD) for inhalation treatment of primary lung cancer. LCDs were obtained from curcumin liposomes after freeze-drying. The LCDs had a mass mean aerodynamic diameter of 5.81 μm and a fine particle fraction of 46.71%, suitable for pulmonary delivery. The uptake of curcumin liposomes by human lung cancer A549 cells was markedly greater and faster than that of free curcumin. The high cytotoxicity on A549 cells and the low cytotoxicity of curcumin liposomes on normal human bronchial BEAS-2B epithelial cells yielded a high selection index partly due to increased cell apoptosis. Curcumin powders, LCDs and gemcitabine were directly sprayed into the lungs of rats with lung cancer through the trachea. LCDs showed higher anticancer effects than the other two medications with regard to pathology and the expression of many cancer-related markers including VEGF, malondialdehyde, TNF-α, caspase-3 and BCL-2. LCDs are a promising medication for inhalation treatment of lung cancer with high therapeutic efficiency.
基金supported by Pearl River S&T Nova Program of Guangzhou(2014J2200082)
文摘Dry powder inhalers(DPIs) offer distinct advantages as a means of pulmonary drug delivery and have attracted much attention in the field of pharmaceutical science. DPIs commonly contain micronized drug particles which, because of their cohesiveness and strong propensity to aggregate, have poor aerosolization performance. Thus carriers with a larger particle size are added to address this problem. However, the performance of DPIs is profoundly influenced by the physical properties of the carrier, particularly their particle size, morphology/shape and surface roughness. Because these factors are interdependent, it is difficult to completely understand how they individually influence DPI performance.The purpose of this review is to summarize and illuminate how these factors affect drug–carrier interaction and influence the performance of DPIs.
基金The financial support from the Chinese Scholarship Council(CSC)the School of Chemical Engineering at the University of Birmingham through the Li Siguang Scholarship Scheme is gratefully acknowledged by the first author.
文摘Air flow and particle-particle/wall impacts are considered as two primary dispersion mechanisms for dry powder inhalers(DPIs).Hence,an understanding of these mechanisms is critical for the development of DPIs.In this study,a coupled DEM-CFD(discrete element method-computational fluid dynamics)is employed to investigate the influence of air flow on the dispersion performance of the carrier-based DPI formulations.A carrier-based agglomerate is initially formed and then dispersed in a uniformed air flow.It is found that air flow can drag API particles away from the carrier and those in the downstream air flow regions are prone to be dispersed.Furthermore,the influence of the air velocity and work of adhesion are also examined.It is shown that the dispersion number(i.e.,the number of API particles detached from the carrier)increases with increasing air velocity,and decreases with increasing the work of adhesion,indicating that the DPI performance is controlled by the balance of the removal and adhesive forces.It is also shown that the cumulative Weibull distribution function can be used to describe the DPI performance,which is governed by the ratio of the fluid drag force to the pull-off force.
基金supported by grants from the National Natural Science Foundation of China Youth Project(82104952)Shanghai Science and Technology Commission Medical Innovation Research Special Fund(21Y11923600,23Y11921600)+2 种基金Shanghai Municipal Health Commission Clinical Research Special Fund(202140172)Yueyang Hospital Translational Medicine Research Institute Level Fund(2024yyzh05)Yueyang Hospital Young Talent Training Project(RY411.07.02.04).
文摘Objective:To evaluate the efficacy of Sanhua essential oil inhalation as aromatherapy in patients with breast cancer-related depression.Methods:In total,144 patients with breast cancer-related depression who underwent postoperative chemotherapy were recruited.The participants in the control group(n=52)were offered a placebo(sunflower oil)daily,whereas those in the essential oil group(n=52)were administered Sanhua essential oil.This study evaluated depression improvement,Hamilton Depression Scale score,scores of symptoms in traditional Chinese medicine(TCM),Pittsburgh Sleepiness Quotient Index score,incidence of nausea and vomiting,and signal changes on functional magnetic resonance imaging.Results:Depression improved by 48.1%and 21.2%in the essential oil and control groups,respectively(P=.010).The Hamilton Depression Scale score(P=.017),scores for symptoms in TCM(P=.002),and the incidence of nausea and vomiting in the acute and delayed phases were lower in the essential oil group than in the control group(nausea in the acute phase,P=.017;nausea in the delayed phase,P=.039;vomiting in the acute phase,P=.008;vomiting in the delayed phase,P=.081).The Pittsburgh Sleepiness Quotient Index score was lower in the essential oil group than in the control group(P=.005).Significant differences existed between the two groups in the left superior parietal gyrus,right precuneus,left dorsolateral superior frontal gyrus,and right precentral gyrus according to functional connectivity on functional magnetic resonance imaging.Conclusion:Inhalation of Sanhua essential oil alleviated depression in patients undergoing chemotherapy for breast cancer,improved sleep quality,relieved TCM symptoms,reduced nausea and vomiting,and regulated activities in the brain regions.
基金the National Natural Science Foundation of China(32271319 and 32071267)the Science and Technology Department of Jilin Province(YDZJ202301ZYTS537 and 20240402035GH)+1 种基金the Development and Reform Commission of Jilin Province(2023C015)the“Medicine+X”cross-innovation team of Bethune Medical Department of Jilin University“Leading the Charge with Open Competition”construction project(2022JBGS04).
文摘Herein,porous poly(lactic-co-glycolic acid)(PLGA)microspheres were prepared to load icariin andmiR-23b for the treatment of metastatic lung cancer.The microspheres exhibited desirable aerodynamic diameter,high drug loading and encapsulation efficiency,as well as a favorable drug release profile,which was beneficial for the deposition and exposure of drugs in the lung tissues.The release solution from microspheres exhibited a favorable anti-proliferative effect by inducting cell apoptosis and arresting the cell cycle at G1 phase,and meanwhile inhibited the migration and invasion of cancer cells.More importantly,the microspheres could be effectively inhaled and accumulated in the lung tissues to trigger the in situ apoptosis of tumor cells and suppress metastasis,using mice bearing melanoma-metastatic lung cancer as a model.Furthermore,inhalation of themicrospheres showed favorable biocompatibility,barely causing tissue damage.Overall,porous PLGA microspheres provide a promising platform for the inhalable co-delivery of drugs and genes to obtain ideal therapeutic efficacy in lung cancer and other pulmonary diseases.
文摘In recent years,the rising prevalence of respiratory diseases,coupled with advancements in biotechnology and pharmacology,has positioned inhalable formulations as a preferred method of drug administration.This approach enables direct and rapid delivery of medication to the lungs,maximizing therapeutic effects while minimizing dosage and potential side effects.In this review,we meticulously examined current literature and clinical trial databases to present a comprehensive overview of three key areas:(1)inhalation devices currently utilized in clinical settings;(2)the clinical applications of approved inhalable formulations;and(3)preclinical research on inhalable treatments targeting various lung conditions,including pulmonary infections,tuberculosis,lung cancer,pulmonary fibrosis,as well as systemic diseases like Parkinson’s disease.The objective was to delve into both foundational research and the clinical use of inhalable formulations within the pharmaceutical field,with the aim of fostering their broader adoption and guiding the development of inhalable therapies for a more comprehensive range of diseases.
基金supported by the Guangdong Basic and Applied Basic Research Foundation under Grant(2023A1515011243)National Natural Science Foundation of China under Grant(82004141)+2 种基金Bao’an Traditional Chinese Medicine Development Foundation under Grant(2022KJCX-ZJZL-11)Science,Technology,and Innovation Commission of Shenzhen Municipality under Grant(JCYJ20190808160407500)Shenzhen Bao’an Traditional Chinese Medicine Hospital Research Program under Grant(BAZYY20220701).
文摘Background:Pulmonary fibrosis(PF)is a refractory disease with limited treatment options.This study investigates the potential anti-PF effects of the herbal formula Yiqi Huatan Sanjie(YQHTSJ)administered via nebulized inhalation,exploring its underlying mechanisms.Methods:The anti-fibrotic properties of nebulized YQHTSJ were assessed using a bleomycin(BLM)-induced PF mouse model.RNA sequencing identified differentially expressed genes(DEGs),and subsequent gene enrichment analysis,along with transcription factor(TF)prediction,revealed YQHTSJ-regulated DEGs.Active components and targets of YQHTSJ were retrieved from the HERB database,leading to the identification of key TFs interacting with DEGs.Quercetin,a constituent of YQHTSJ,was evaluated for its effects on transforming growth factor-β1-induced myofibroblast activation and BLM-induced PF.The direct binding interaction between quercetin and the key TF Jun proto-oncogene(JUN)was confirmed through molecular docking studies and the cellular thermal shift assay(CETSA)experiments.Results:Nebulized YQHTSJ was found to significantly inhibit PF and inflammation in the mouse model.RNA sequencing identified 135 DEGs regulated by YQHTSJ,and 27 key TFs associated with these DEGs were predicted.Among YQHTSJ’s potential targets,41 were identified as TFs,with six-JUN,Fos proto-oncogene,MYC proto-oncogene,RELA proto-oncogene,nuclear factor kappa B subunit 1,and peroxisome proliferator activated receptor alpha-recognized as key TFs targeted by YQHTSJ.Molecular docking and CETSA experiments confirmed that quercetin directly targets JUN protein and inhibits its phosphorylation,thereby contributing to the suppression of myofibroblast activation and PF.Conclusion:The potential mechanisms of YQHTSJ and its component quercetin in combating PF may involve the regulation of critical TFs like JUN and the suppression of pathogenic gene expression.
基金This work was supported by the Focused Research Effort on Chemicals in the Working Environment(FFIKA)from the Danish Government.
文摘Background:Inhalation exposure is the gold standard when assessing pulmonary tox-icity.However,it typically requires substantial amounts of test material.Intratracheal instillation is an alternative administration technique,where the test substance is suspended in a liquid vehicle and deposited into the lung via the trachea.Instillation requires minimal test material,delivers an exact dose deep into the lung,and is less labor-intensive than inhalation exposures.However,one shortcoming is that the pro-cedure may induce short-term inflammation.To minimize this,we tested different modifications of the technique to identify the potential for refinement.Methods:First,we tested whether previous findings of increased inflammation could be confirmed.Next,we tested whether instillation with a disposable 1 mL syringe with ball-tipped steel-needle(Disposable-syringe/steel-needle)induced less inflammation than the use of our standard set-up,a 250μL reusable glass syringe with a disposable plastic catheter(Glass-syringe/plastic-catheter).Finally,we tested if access to pelleted and liquid feed prior to instillation affected inflammation.We evaluated inflammation by neutrophil numbers in bronchoalveolar fluid 24 h post-exposure.Results:Vehicle-instilled mice showed a small increase in neutrophil numbers com-pared to untreated mice.Neutrophil numbers were slightly elevated in the groups in-stilled with Disposable-syringe/steel-needle;an interaction with feed type indicated that the increase in neutrophils was more pronounced in combination with feed pel-lets compared to liquid feed.We found no difference between the feed types when using the Glass-syringe/plastic-catheter combination.Conclusion:The Glass-syringe/plastic-catheter combination induced the least exposure-related inflammation,confirming this as a preferred instillation procedure.
文摘This study explores the clinical efficacy of budesonide combined with ambroxol inhalation therapy for neonatal pneumonia.A total of 68 neonatal pneumonia patients treated at Li County Hospital from January 2023 to December 2024 were randomly divided into a monotherapy group and a combination group,with 34 patients in each.The monotherapy group received ambroxol inhalation therapy,while the combination group received budesonide inhalation therapy in addition to ambroxol.The recovery progress,blood gas analysis indicators,inflammatory response improvement,and overall clinical efficacy were compared between the two groups.Results showed that the combination group experienced a significantly shorter time for body temperature normalization(3.36±0.58 days vs.4.59±0.45 days),oxygen inhalation duration(4.89±0.57min vs.6.96±0.79min),disappearance of shortness of breath and cough(4.56±0.29 days vs.6.63±0.75 days),and resolution of lung wet rales(5.62±1.46 days vs.7.92±1.28 days)compared to the monotherapy group(P<0.05).Additionally,the total effective rate was significantly higher in the combination group(97.06%)than in the monotherapy group(73.52%)(P<0.05).Post-treatment,the combination group exhibited significantly better blood gas analysis and inflammatory response indicators(P<0.05).These findings suggest that budesonide combined with ambroxol inhalation therapy can effectively improve blood oxygen saturation,reduce inflammation,promote faster recovery,and enhance overall clinical efficacy,making it a reliable treatment option for neonatal pneumonia.
基金Supported by the Shanghai Sailing Program,No.21YF1440300 and No.22YF1407700and the National Natural Science Foundation of China,No.82200061.
文摘BACKGROUND Postpartum pulmonary arterial hypertension(PAH)complicated with hereditary hemorrhagic telangiectasia(HHT)is a rare condition.Diagnosing and treating PAH in patients with HHT can be challenging.To the best of our knowledge,no previous reports have investigated the efficacy of pulmonary vasodilators in improving hemodynamics in postpartum patients with this disease.CASE SUMMARY In this paper,we report a postpartum case of HHT combined with PAH,pre-senting with worsening dyspnea.Genetic testing revealed that the patient carried a heterozygous variant of activin receptor-like kinase 1.The patient received various treatments,including diuretics,anticoagulants,sildenafil,macitentan,inhalation of nitric oxide,and iloprost.Changes in PaO2/FiO2,pulmonary artery systolic pressure as assessed by echocardiography,and N-terminus pro-brain natriuretic peptide levels suggested that,except for iloprost inhalation,the other treatments appeared to have limited efficacy.CONCLUSION To our knowledge,this is the first report on efficacy of pulmonary vasodilators in postpartum patients with HHT and PAH.
文摘Phencyclidine(PCP,known as angel dust) is a nonbarbiturate,non-narcotic intravenous(IV) anesthetic with potent analgesic effects.However,its medical use was discontinued because of postoperative agitation,disorientation,psychosis,cardiotoxicity,and hallucinogenic effects.Consequently,the PCP began to be illicitly distributed.The use methods include snorting,inhalation,IV,and subcutaneous(SC) injection.[1-5] The characteristic toxidrome of PCP includes altered mental status,tachycardia,and nystagmus.At higher doses,patients may become comatose and develop sympathomimetic effects such as tachycardia,hypertension,hypersalivation,urinary retention,and bronchospasm.In cases of intoxication,the pupillary light reflex remains intact,although the pupil size may vary.[1,3-6] PCP has a direct cardiotoxic effect and may induce arrhythmias.[2] Hyperreflexia,muscle rigidity,choreiform movements and muscle fasciculations may occur.[2,4,6] PCP-induced acute respiratory distress syndrome(ARDS) and alveolar hemorrhage(AH) are rare but potentially life-threatening complications.The main causes of non-traumatic death in patients with PCP intoxication include cardiopulmonary arrest,intracranial hemorrhage and rhabdomyolysis.[2,3,5] This case report aims to emphasize the management and potential benefits of inhaled N-acetylcysteine(NAC) and tranexamic acid(TXA)for PCP-induced ARDS and AH.
文摘This clinical study aimed to explore the therapeutic effect of recombinant human interferonα2b nebulization inhalation in the treatment of hand,foot,and mouth disease in children.Sixty-six patients were selected as the research subjects by the random sampling method and divided into a control group and an observation group.The patients in the control group were treated with ribavirin injection and oral lysine-inositol-vitamin B12 solution,while the patients in the observation group received the treatment of the control group combined with recombinant human interferonα2b nebulization inhalation.The clinical effects of the two groups were compared to determine the clinical efficacy of the two treatment plans.The total effective rates of treatment were 78.79%in the control group and 90.91%in the observation group.The research confirmed that the clinical effect of recombinant human interferonα2b nebulization inhalation in the treatment of hand,foot,and mouth disease in children is remarkable.It can significantly improve the symptoms of children with hand,foot,and mouth disease and is suitable for clinical application and promotion.
文摘The effect of inhaled nano-TiO2 on lung histology and serum biochemical indexes is evaluated in healthy and adult Kunming mice（eight in each group）after exposure to TiO2 aerosols（1 500 mg/m3）in a sealed chamber.Another eight mice are exposed to indoor air to be served as a control group.Lung tissue and blood are collected after euthanizing the animals.The results show that lactate dehydrogenase（LDH）activity increases in all experimental groups.Alanine aminotransferase（ALT）activity and blood urea nitrogen（BUN）levels are increased in the group exposed to TiO2 aerosols for 28 d,and creatinine（Cr）levels are increased in 14 d and 28 d samples（P0.05）.No obvious changes are observed in other serum indexes.Lungs of mice exposed to 28 d exposure show significant but moderate increase in pulmonary inflammation,and many TiO2 particles are found in the interstitium of pulmonary alveoli.
