Inhalation Bioaccessibility of Potentially Toxic Metals in Tobacco Snuff and Related Exposure Risks

This study determined the concentrations and inhalation bioaccessibility of cadmium, chromium, nickel and zinc in some foreign and locally available tobacco snuff and leaves. For the determination of the heavy metals concentration, the samples were ashed and washed with hydrochloric acid according to standard method. The bioaccessibility test employed the Stimulated Epithelial Lung Fluid (SELF). The total concentration of heavy metals in the four samples investigated ranged between 9.7 - 14.9 μg/g, 24.1 - 37.0 μg/g, 41 - 69 μg/g and 153 - 183 μg/g for cadmium, chromium, nickel and zinc respectively. The percentage inhalation bioaccessibility fraction of the four samples investigated ranged between 20.8% - 59.8%, 3.3% - 8.1%, 21.7% - 48.8% and 7.6% - 12.5% for cadmium, chromium, nickel, and zinc respectively. Statistical analyses using SPSS 21, revealed significant differences in the total concentration of heavy metals in the samples investigated except for Zinc. Risk assessment based on daily consumption of 10 g of the tobacco snuff employing total concentration of the heavy metals suggests that excluding nickel, all other metals investigated indicated daily intake values above WHO permissible levels. However, with the bioaccessible fractions, only cadmium, a known carcinogen indicated levels above WHO limits. From the results of this study, it can be deduced that consumption of tobacco snuff may induce negative health effects such as cancer and its attendant complications, the risk analysis based on bioaccessible concentration suggests lower health risk than analysis based on total heavy metal concentration;hence the assumption that snuff is a safe alternative to tobacco smoking may be erroneous.

Topical Application of Ascorbic Acid Solution as an Adjunctive Method of Periodontal Therapy among Wet Snuff Users after Prosthodontics Therapy

Background: During several years, ascorbic acid (vitamin C) played a significant role in the health of periodontal tissues. The goals of prosthodontics management are to restore the missing teeth, provide the loss of teeth functions, and establish acceptable dental esthetics, and there are some evidences revealing the passive effects of snuff on the results of prosthodontics and periodontal treatment, so the present study is performed to evaluate the outcomes of topical application of ascorbic acid solution as an adjunctive method of periodontal therapy among wet sniff users after prosthodontics therapy. Methods: The clinical situation was evaluated in 150 moderate periodontitis patients after conventional periodontal and prosthodontics therapy. They were selected from outpatient clinics, college of dentistry, King Khalid University, and from some hospitals Ministry of Health in Tabuk, Jazan and Aseer regions. The study was conducted from September 2020 to December 2020. The time of post-treatment assessment was one year. The study was included 50 patients who don’t use wet snuff as a group I (GI) (control group), 50 patients wet snuff users as group II (GII), and 50 patients wet snuff users were treated with topical application of ascorbic acid solution as group III (GIII). The participants were aged over 20 years, with a mean age of 35 years. The duration of using wet snuff was at least one year. Plaque index (PLI), gingival index (GI), clinical attachment loss (CAL) were recorded at baseline (first visit), then after 4 weeks (second visit) and after 6 weeks (third visit) of conventional periodontal therapy and topical application of ascorbic acid solution. Statistical analysis was done using ANOVA test and paired t-test. Results: According to statistical analysis, there was the inclination of decrease in the mean and standard deviation of plaque index (PLI) from 2.8 ± 1.4 to 2.5 ± 0.51, and 2.7 ± 0.33 in group II, and decrease from 2.7 ± 0.34 to 2.5 ± 0.23 and 2.6 ± 0.65 in group III. Similarly in the gingival index (GI), there was a decrease in the mean and standard deviation from 2.8 ± 0.52 to 2.3 ± 0.62 and 2.5 ± 0.51 in group II and a decrease from 2.5 ± 0.8 to 2.3 ± 0.58 and 2.4 ± 0.47 in group III. Moreover, there was a decrease in the mean and standard deviation of clinical attachment loss (CAL) from 4.5 ± 0.26 to 3.9 ± 0.83 and 4.2 ± 0.83 in group II and from 4.2 ± 0.31 to 3.8 ± 0.46 and 3.8 ± 0.31 in group III;less than group I without significance differences (p > 0. 05) in all study groups at baseline and after 4 weeks, and 6 weeks of follow up except CAL. Conclusion: The results of our study displayed that periodontal parameters vary among wet snuff users after topical application of ascorbic acid solution as an adjunctive method of periodontal therapy

Snuff Bottles—An East-Meets-West Art

THE snuft bottle came toChina from Italy,but once itwas in China, it was turnedinto an exquisite object of art.The Italians say that long,longago a tobacconist stocked a greatdeal of tobacco,but one day hediscovered it has all gone rotten andwas exuding a special smell。

经远端桡动脉路径行脑血管造影的安全性和有效性:系统评价和Meta分析

目的通过系统评价和Meta分析评估经远端桡动脉路径(distal radial access,DRA)行脑血管造影的安全性和有效性。很多研究已经表明,经DRA行冠脉造影(coronary angiography,CAG)和经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)是安全有效的。经DRA行脑血管造影的安全性和有效性尚不清楚。方法检索PubMed、Embase、Cochrane、万方、中国知网、维普数据库建库以来至2023年5月1日有关经DRA行脑血管造影的文献,通过文献筛选、数据提取和文献质量评价,采用随机效应模型进行Meta分析。结果检索到239项研究,最终纳入12项研究进行分析(共858例患者)。路径成功率为0.96(95%CI:0.94~0.98),异质性明显(I^(2)=64.4%)。路径相关并发症发生率为0.03(95%CI:0.01~0.05),异质性较低(I^(2)=35.4%)。部分研究的循证医学证据等级较低。结论DRA完全可以作为脑血管造影的可选路径,经DRA行脑血管造影是安全有效的。

经鼻烟壶桡动脉与常规桡动脉行冠脉介入治疗术在临床疗效中的对比研究

目的探讨经鼻烟壶桡动脉与常规桡动脉行冠脉介入治疗术在临床疗效中的对比研究。方法选取2022年6月—2023年10月平坝区人民医院心内科收治的58例行冠脉介入治疗术的患者作为研究对象,用随机数表法分为对照组和研究组,各29例,对照组在常规桡动脉行经皮冠脉介入治疗(Percutaneous Coronary Intervention,PCI),研究组在鼻烟壶桡动脉处介入PCI术治疗。对比两组临床疗效。结果两组患者造影剂所需量和手术耗时对比,差异无统计学意义(P均>0.05)。研究组住院时间和术后压迫时间短于对照组,差异有统计学意义(P均<0.05)。研究组穿刺耗时、X线曝光时段短于对照组,穿刺次数少于对照组,差异有统计学意义(P均<0.05)。研究组并发症发生率(10.34%)低于对照组(27.59%),差异有统计学意义(χ^(2)=9.681,P<0.05)。结论经鼻烟壶桡动脉行冠脉介入治疗术相较于常规桡动脉临床疗效更加显著,不仅降低了患者的并发症发生率,还缩短了患者住院时间和术后压迫时间,改善了患者穿刺情况,安全可靠。

Snuff Bottle

Chinese snuff bottles are artistic curiosities enjoyed by connoisseurs and collectors alike. In the 17th century, artisans of the Chinese imperial court made several different kinds of snuff bottles with a superior aesthetic. Nowadays, China

Tiny Gems of Chinese Handicraft:Snuff Bottles

THE snuff bottle, a kind of handicraft introduced to China from abroad along with the habit of sniffing powdered tobacco, has a history of more than 200 years. Despite the fact that the practice of taking snuff has long since disappeared, Chinese snuff bottles have become precious collector’s items because of their exquisite artistry. The snuff bottle was especially popular in the reign of Emperor Yongzheng (1723-1735) during the

皮下注射硝酸甘油应用于经鼻烟壶区桡动脉置管的随机对照研究

目的探究皮下注射硝酸甘油在经鼻烟壶区桡动脉穿刺置管操作中的临床价值。方法选取2021年7月至2023年2月广东省中医院珠海医院拟行经皮冠脉造影术的患者205例,采用数字奇偶法随机将其分为对照组(102例)和研究组(103例)。对照组穿刺处皮下注射利多卡因与盐水混合液,研究组穿刺处皮下注射利多卡因与硝酸甘油混合液,比较两组动脉管腔长、短径,首针穿刺成功比例、穿刺针数、置管成功时间、置管成功率、血管痉挛发生率、鞘管型号比例、血肿发生率、术后24 h桡动脉闭塞发生率。结果两组给药后平均动脉压差、心率差比较,差异无统计学意义(P>0.05);研究组血管痉挛发生率低于对照组,置管成功率高于对照组,差异有统计学意义(P<0.05);局麻后,研究组鼻烟壶区桡动脉管腔长、短径长于局麻前血管痉挛发生率低于对照组,差异有统计学意义(P<0.05),对照组局麻前后比较,差异无统计学意义(P>0.05);局麻后,研究组鼻烟壶区桡动脉管腔长、短径长于对照组,差异有统计学意义(P<0.05);研究组鞘管型号比例、首针穿刺成功比例、穿刺针数、置管成功时间、术中肝素用量及压迫止血时间比较,差异无统计学意义(P>0.05);两组术后血管痉挛发生率、术口血肿、前臂血肿、近桡闭塞、远桡闭塞、夹层、超声管腔直径比较,差异无统计学意义(P>0.05)。结论经鼻烟壶区桡动脉穿刺置管术前皮下注射硝酸甘油能扩张动脉,减少置管前桡动脉痉挛发生,提高置管成功率,具有良好的安全性,值得临床推广使用。

经远端桡动脉路径行冠脉造影和经皮冠状动脉介入治疗的安全性和有效性Meta分析

目的通过Meta分析评估经远端桡动脉路径(distal radial access,DRA)行冠脉造影(coronary angiography,CAG)和经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)的安全性和有效性。DRA是一个新的手术路径,已发表的一些随机对照试验结果不完全一致,其安全性和有效性仍存在争议。方法检索2017年1月1日至2022年9月1日发表在PubMed、Embase、Cochrane、万方、中国知网、维普数据库的文献,筛选出符合要求的随机对照试验,提取数据后进行Meta分析。结果检索到537项研究,最终纳入18项随机对照试验进行分析(共7143例患者)。DRA与桡动脉路径(transradial artery access,TRA)相比,桡动脉闭塞(radial artery occlusion,RAO)发生率更低(RR:0.27,95%CI:0.18~0.39,P<0.001,I2=10.4%),穿刺部位血肿发生率无统计学差异(RR:0.89,95%CI:0.67~1.18,P=0.417,I2=12.9%),桡动脉痉挛发生率无统计学差异(RR:0.89,95%CI:0.50~1.58,P=0.680,I2=72.5%),路径成功率更低(RR:0.93,95%CI:0.89~0.98,P<0.05,I2=93.6%)。部分随机对照试验质量不高为本研究的局限性。结论与TRA相比,经DRA行CAG和PCI是安全有效的,但是DRA的路径成功率可能更低。

经远端桡动脉行冠状动脉介入诊疗围术期穿刺部位管理的证据总结

目的:对经远端桡动脉行冠状动脉介入诊疗围术期穿刺部位管理的证据进行检索、提取、评价并进行整合,为临床护理工作提供循证支持。方法:基于“6S”证据金字塔模型进行文献检索,检索时限为建库至2023年4月30日。采用文献质量评价工具评估各类文献,在高质量文献中提取证据并进行分级判定。结果:共纳入11篇文献,其中指南2篇,专家共识6篇,随机对照试验研究、类试验研究、队列研究各1篇。最终总结了17条经远端桡动脉行冠状动脉介入诊疗围术期穿刺部位管理的最佳证据,涉及术前准备、术中配合及转运、加压止血与观察、并发症处理4个主题。结论:本研究为经远端桡动脉行冠状动脉介入诊疗围术期穿刺部位管理提供了最佳证据,经远端桡动脉入径路径适用人群广泛、并发症发生率低,在证据转化时应结合各科室术者穿刺特点及止血方式选择最佳证据,以改善围术期穿刺部位的管理质量,准确选择冠状动脉介入术式,降低穿刺部位并发症,并提高病人的舒适度和安全性。

经鼻烟窝远端桡动脉穿刺行冠脉介入治疗患者的临床效果分析

目的分析经鼻烟窝远端桡动脉穿刺行冠脉介入治疗患者的临床效果。方法随机选取2021年1月—2023年6月在邳州市中医院行冠脉介入治疗的70例患者为研究对象,按照随机数表法分为对照组(经桡动脉入径行冠脉介入治疗)和观察组(经鼻烟窝远端桡动脉穿刺行冠脉介入治疗),各35例。比较两组穿刺情况、手术情况、术后动脉压迫及住院时间、疼痛情况及并发症发生率。结果观察组穿刺次数少于对照组,差异有统计学意义(P<0.05);两组穿刺时间、手术时间、X线曝光时间及造影剂使用量对比,差异无统计学意义(P>0.05);观察组术后动脉压迫时间、住院时间均较对照组更短,差异有统计学意义(P<0.05);观察组疼痛评分为(1.49±0.31)分低于对照组,差异有统计学意义(t=5.728,P<0.05);观察组并发症发生率为2.86%,低于对照组,差异有统计学意义(χ^(2)=4.590,P<0.05)。结论经鼻烟窝远端桡动脉穿刺行冠脉介入治疗,可以减少穿刺次数,缩短患者动脉压迫及住院时间,疼痛较轻且并发症少。

经鼻烟壶区远端桡动脉入路在冠状动脉造影中的应用效果

目的探讨经鼻烟壶区远端桡动脉入路在冠状动脉造影中的应用效果。方法选取2020年6月至2022年12月赣州市立医院超声科收治的60例接受冠状动脉造影的患者作为研究对象,按照计算机随机分组方法分为观察组(n=30)和对照组(n=30),观察组采用经鼻烟壶区远端桡动脉入路方法,对照组采用传统桡动脉入路方法。比较两组的桡动脉与远端桡动脉内径、并发症以及患者满意度。结果两组右侧、左侧的远端桡动脉内径均小于同侧桡动脉内径,差异有统计学意义(P<0.05);观察组患者的并发症发生率低于对照组,差异有统计学意义(P<0.05);观察组患者的满意程度高于对照组,差异有统计学意义(P<0.05)。结论在冠状动脉造影中,选择应用经鼻烟壶区远端桡动脉入路较为可行,有效降低血管并发症的发生,提高患者满意度,有临床应用推广的价值。

远端桡动脉入路在下肢动脉疾病腔内治疗中的应用

目的 探讨经解剖鼻烟壶区远端桡动脉入路在下肢动脉疾病腔内治疗中的疗效。方法 回顾性分析我院因下肢动脉疾病行腔内治疗的11例患者的临床资料,统计患者穿刺及手术相关指标。结果 所有患者均成功穿刺远端桡动脉,穿刺成功时间(2.8±1.5)min,穿刺次数(1.6±0.6)次,仅1例穿刺点周围淤青,无穿刺部位相关的严重并发症发生;患者手术均成功进行,手术成功率100%,其中机械吸栓3例,球囊扩张3例,球囊扩张+支架置入4例,股动脉假性动脉瘤硬化治疗1例;干预血管总数16根,平均(1.45±0.52)根,手术时间(114.3±58.4)min,X射线照射时间(45.3±23.6)min,造影剂用量(147.3±54.6)mL,围术期未发生重大并发症。结论 远端桡动脉入路是一种安全可行的下肢动脉疾病腔内治疗的手术入路,有较高的穿刺成功率和较低的并发症并发生率。但由于导管长度限制,远端桡动脉入路在处理膝下动脉病变时有一定局限性。

3例经“鼻烟壶”左侧远端桡动脉入路行肝动脉灌注化疗术患者的报道及护理体会

总结3例原发性肝癌患者经“鼻烟壶”左侧远端桡动脉入路(dTRA)行肝动脉灌注化疗术(HAIC)的护理体会。护理要点包括术前及术后的基础护理、用药护理、穿刺部位护理、健康宣教、个体化营养支持等。通过上述护理措施,降低了患者并发症的发生风险,缩短了住院时间,改善了患者的生存质量,最终提高患者的临床预后。

无烟气烟草制品的发展现状和趋势

综述了国外无烟气烟草制品的发展历史、产品类型、生产工艺、主要生产厂商和品牌以及相关监管法规等内容,旨在为国内无烟气烟草制品的研制和监管提供参考。

经鼻烟壶区远端桡动脉入路在冠状动脉造影和经皮冠状动脉介入治疗中的效果和安全性分析

目的:分析经鼻烟壶区远端桡动脉入路(d TRA)在冠状动脉造影和经皮冠状动脉介入治疗(PCI)中的效果和安全性。方法:纳入2020年1月至6月在石河子市人民医院经鼻烟壶区dTRA行冠状动脉造影和PCI的患者120例。观察患者术后出血相关并发症。患者在术前、术后3 d和1个月时应用血管超声观察桡动脉和远端桡动脉的闭塞发生率、血管管腔直径以及横截面积的变化。结果:120例患者中,5例穿刺失败,远端桡动脉穿刺成功率为95.8%;另有7例导丝上行困难,更改为桡动脉穿刺,置管成功率为90.0%(108/120);40例(37.0%,40/108)行PCI,术后仅1例穿刺部位少量出血,无皮下血肿发生。血管超声检查结果表明,与桡动脉管腔直径比较,远端桡动脉管腔直径术前[(2.50±0.39)mm vs.(2.88±0.45)mm]、术后1个月[(2.38±0.45)mm vs.(2.77±0.46)mm]均较小,远端桡动脉管腔面积术前[(5.05±1.61)mm^(2)vs.(6.78±2.52)mm^(2)]、术后1个月[(4.58±2.24)mm^(2)vs.(6.29±2.08)mm^(2)]均小于桡动脉管腔面积,差异均有统计学意义(P均<0.05);术后1个月,1例(1.6%)患者血管超声发现桡动脉闭塞。所有患者均无远端桡动脉闭塞。结论:远端桡动脉穿刺具有较高的成功率,行冠状动脉造影及PCI安全、有效,术后出血相关并发症发生率低,桡动脉闭塞发生率低。

口含烟发展现状及原料研究进展

在世界控烟越来越严峻的形势下,各国烟草生产者把口含型烟草制品或卷烟替代品的研究和开发作为发展的重要目标和竞争点。我国的口含型烟草制品研发领域尚处于初级阶段。为了解口含烟的发展状况及原料需求,对口含型烟草制品的主要种类、发展历程及现状、销售状况及原料的需求种类和特点进行综述,展望了口含型烟草制品的未来发展方向及前景。

以桡动脉鼻烟窝段为蒂岛状皮瓣的应用解剖

目的：为桡动脉鼻烟窝段为蒂的岛状皮瓣提供解剖基础。方法：在４３例成人手标本上，观察了桡动脉鼻烟窝段的形态及其发出的筋膜皮支。结果：桡动脉鼻烟窝段的长度为２．５±０．１ｃｍ，其近侧端和远侧端外径分别为２．６±０．１ｍｍ和２．２±０．１ｍｍ；发自该段桡动脉的筋膜皮支有５．４（２～１１）支，外径为０．５～１．０ｍｍ；皮瓣的面积为４ｃｍ×６ｃｍ左右。结论：可设计以桡动脉鼻烟窝段为蒂的岛状筋膜皮瓣，修复手部软组织缺损，对手部的血供无明显影响。

18例改良鼻烟窝皮瓣治疗腕手部桡侧皮肤软组织缺损的临床应用

目的探讨应用改良鼻烟窝皮瓣治疗腕手部桡侧皮肤软组织缺损的手术方法。方法用红色乳胶灌注20侧成人上肢标本,观察桡动脉在鼻烟窝段的分支外径、长度、行径及伴行静脉与神经的关系,并以此为基础,以桡骨茎突为旋转点设计改良鼻烟窝皮瓣,临床应用治疗腕手部桡侧皮肤软组织缺损18例,术后随访1-6个月,平均4个月。结果皮瓣全部成活,1例出现远端部分表皮坏死,经换药后愈合,皮瓣质地柔软,血运良好。结论应用改良鼻烟窝皮瓣治疗腕手部桡侧皮肤软组织缺损具有操作简便、安全、质地薄、无需再次整形等优点,较传统的鼻烟窝皮瓣扩大了修复的面积,是一种较好的修复方法。

以鼻烟窝区血管作动静脉内瘘血液透析的应用解剖

在30侧上肢标本上,按动静脉内瘘术的设计求要,解剖观测了鼻烟窝区有关血管.鼻烟窝段桡动脉长2.4(1.9～2.8)cm,外径2.8(1.8～3.8)mm;头静脉外径2.9(1.8～5.2)mm。对在鼻烟窝区进行动静脉内瘘术用于血液透析的解剖要点和优缺点进行了讨论.