Inhaling muscle spray: A rising trend of abuse

Ethyl chloride was popular as an inhalant recreational drug in the 1980s.It is easily available in pharmacies as well as sold online as a topical anesthetic spray for pain relief.In recent times,its use is gaining popularity again among the youth as an inhalant drug due to its neuro-stimulatory effects.To avoid the risks associated with use of illegal drugs,and ease of availability of ethyl chloride without restrictions,there is a rising trend to use it as a“substitute”drug of abuse.In this paper,we try to highlight to the critical care and emergency physicians that majority of these cases present with predominant neurological symptoms,with occasional involvement of the cardiovascular system.The diagnosis of ethyl chloride poisoning is primarily clinical and supportive care is the mainstay of treatment,along with subsequent counseling.Ethyl chloride abuse should be considered as a differential diagnosis in young patients presenting with predominant neurological symptoms.Alongside raising public awareness,the manufacturers and retail distributors of these products have an important role to play in reducing the risk of abuse.

Threshold friction velocity influenced by soil particle size within the Columbia Plateau, northwestern United States

Wind erosion is a geomorphic process in arid and semi-arid areas and has substantial implications for regional climate and desertification.In the Columbia Plateau of northwestern United States,the emissions from fine particles of loessial soils often contribute to the exceedance of inhalable particulate matter(PM)with an aerodynamic diameter of 10μm or less(PM10)according to the air quality standards.However,little is known about the threshold friction velocity(TFV)for particles of different sizes that comprise these soils.In this study,soil samples of two representative soil types(Warden sandy loam and Ritzville silt loam)collected from the Columbia Plateau were sieved to seven particle size fractions,and an experiment was then conducted to determine the relationship between TFV and particle size fraction.The results revealed that soil particle size significantly affected the initiation of soil movement and TFV;TFV ranged 0.304-0.844 and 0.249-0.739 m/s for different particle size fractions of Ritzville silt loam and Warden sandy loam,respectively.PM10 and total suspended particulates(TSP)emissions from a bed of 63-90μm soil particles were markedly higher for Warden sandy loam than for Ritzville silt loam.Together with the lower TFV of Warden sandy loam,dust emissions from fine particles(<100μm in diameter)of Warden sandy loam thus may be a main contributor to dust in the region's atmosphere,since the PM10 emissions from the soil erosion surfaces and its ensuing suspension within the atmosphere constitute an essential process of soil erosion in the Columbia Plateau.Developing and implementing strategic land management practices on sandy loam soils is therefore necessary to control dust emissions in the Columbia Plateau.

Factors influencing agitation during anesthesia recovery after laparoscopic hernia repair under total inhalation combined with caudal block anesthesia

BACKGROUND Laparoscopic hernia repair is a minimally invasive surgery,but patients may experience emergence agitation(EA)during the post-anesthesia recovery period,which can increase pain and lead to complications such as wound reopening and bleeding.There is limited research on the risk factors for this agitation,and few effective tools exist to predict it.Therefore,by integrating clinical data,we have developed nomograms and random forest predictive models to help clinicians predict and potentially prevent EA.AIM To establish a risk nomogram prediction model for EA in patients undergoing laparoscopic hernia surgery under total inhalation combined with sacral block anesthesia.METHODS Based on the clinical information of 300 patients who underwent laparoscopic hernia surgery in the Nanning Tenth People’s Hospital,Guangxi,from January 2020 to June 2023,the patients were divided into two groups according to their sedation-agitation scale score,i.e.,the EA group(≥5 points)and the non-EA group(≤4 points),during anesthesia recovery.Least absolute shrinkage and selection operator regression was used to select the key features that predict EA,and incorporating them into logistic regression analysis to obtain potential pre-dictive factors and establish EA nomogram and random forest risk prediction models through R software.RESULTS Out of the 300 patients,72 had agitation during anesthesia recovery,with an incidence of 24.0%.American Society of Anesthesiologists classification,preoperative anxiety,solid food fasting time,clear liquid fasting time,indwelling catheter,and pain level upon awakening are key predictors of EA in patients undergoing laparoscopic hernia surgery with total intravenous anesthesia and caudal block anesthesia.The nomogram predicts EA with an area under the receiver operating characteristic curve(AUC)of 0.947,a sensi-tivity of 0.917,and a specificity of 0.877,whereas the random forest model has an AUC of 0.923,a sensitivity of 0.912,and a specificity of 0.877.Delong’s test shows no significant difference in AUC between the two models.Clinical decision curve analysis indicates that both models have good net benefits in predicting EA,with the nomogram effective within the threshold of 0.02 to 0.96 and the random forest model within 0.03 to 0.90.In the external model validation of 50 cases of laparoscopic hernia surgery,both models predicted EA.The nomogram model had a sensitivity of 83.33%,specificity of 86.84%,and accuracy of 86.00%,while the random forest model had a sensitivity of 75.00%,specificity of 78.95%,and accuracy of 78.00%,suggesting that the nomogram model performs better in predicting EA.CONCLUSION Independent predictors of EA in patients undergoing laparoscopic hernia repair with total intravenous anesthesia combined with caudal block include American Society of Anesthesiologists classification,preoperative anxiety,duration of solid food fasting,duration of clear liquid fasting,presence of an indwelling catheter,and pain level upon waking.The nomogram and random forest models based on these factors can help tailor clinical decisions in the future.

Efficacy of budesonide/formoterol inhalation powder in treating viral pneumonia in children

BACKGROUND Respiratory viruses are increasingly detected in children with communityacquired pneumonia.Further strategies to limit antibiotic use in children with viral pneumonia are warranted.AIM To explore clinical efficacy of budesonide/formoterol inhalation powder for viral pneumonia in children and its impact on cellular immunity and inflammatory factor production.METHODS A total of 60 children with viral pneumonia were recruited:30 receiving budesonide/formoterol inhalation powder and 30 conventional symptomatic treatment.Outcome measures included peripheral blood levels of inflammatory cytokines,CD4^(+),CD8^(+),Th1,Th2,Th17 and Treg,clinical efficacy,and incidence of adverse reactions.RESULTS Compared with the control group,the observation group showed a significant reduction in interleukin-6 and high-sensitivity C-reactive protein levels after treatment.Compared with the control group,the observation group showed a significant increase in CD4^(+)/CD8^(+)and Th1/Th2 levels,and a decrease in Th17/Treg levels after treatment.The total effective rates in the observation group and the control group were 93.75%and 85.00%,respectively,which was a significant difference(P=0.003).CONCLUSION Budesonide/formoterol inhalation powder significantly improved therapeutic efficacy for viral pneumonia in children.The mechanism of action may be related to downregulation of the inflammatory response and improved cellular immune function.

Inhaling β_2-agonist with heliox-driven in bronchial asthma

Objective To evaluate the effectiveness of a helium oxygen mixture (79%He 21%O 2) as an aerosolizing compressed gas for β 2 agonist therapy in patients with an asthma exacerbation Methods Twenty four patients in the outpatient department with a mild to moderate exacerbation of asthma were enrolled The patients were randomly divided into an experimental group (13 cases) and a control group (11 cases) The experimental group inhaled Berotec with heliox driven, and the control group inhaled Berotec with compressed air driven Eight hospitalized patients in the respiratory department with severe exacerbation of asthma were enrolled The patients inhaled Berotec with heliox driven or compressed air driven in a random order Results The results of spirometric parameters and arterial blood gas analysis were measured In the mild to moderate asthma patients, no statistical differences between the two groups for forced vital capacity (FVC), forced expired volume in one second (FEV 1), and expiratory flow in 50% forced vital capacity (FEF 50 ) were presented But the severe patients showed significant differences between heliox driven and compressed air driven for FVC, FEV 1, FEF 50 and partial pressure of oxygen (PaO 2) Conclusions Compared with the traditional inhalation of β 2 agonist therapy using compressed air driven, the method of inhaling β 2 agonist with heliox driven has more obvious benefits for those suffering from severe asthma This is likely due to the cooperative effects between inhaling heliox on its physical gas properties and improving delivery of β 2 agonist in the treatment of exacerbation of severe asthma

Clinical Efficacy Analysis of Tiotropium Bromide Combined with Budesonide and Formoterol Inhalation in Treating COPD

Objective:To analyze the clinical efficacy of tiotropium bromide(TB)combined with budesonide formoterol(BUD/FM)inhalation in treating chronic obstructive pulmonary disease(COPD).Methods:62 COPD patients admitted to the hospital between June 2020 and December 2022 were selected as samples for this study.The patients were divided into a combination group and a conventional group using the random number table method,with 31 cases in each group.The patients in the combination group were treated with TB combined with BUD/FM inhalation,whereas the patients in the conventional group were treated with BUD/FM inhalation only.The treatment efficacy and changes in lung function indicators of both groups were compared.Results:The total efficacy of treatment in the combined group was higher than that in the conventional group,and the difference was statistically significant(P<0.05).Before treatment,there was no difference in pulmonary function indicators between the two groups(P>0.05).After three months of treatment,all lung function indicators of the combined group were higher than those of the conventional group,and the difference was statistically significant(P<0.05).Conclusion:Combining TB with BUD/FM inhalation therapy increases the efficacy of treatment for patients with COPD.Besides,it also improves lung function and leads to a better prognosis.

Home-Nebulized Inhaled Glucocorticoid Therapy in Pediatric Respiratory Diseases

Objective:To evaluate the therapeutic effect of home-nebulized inhaled glucocorticoid therapy in pediatric respiratory diseases.Methods:60 cases of children with respiratory diseases admitted between October 2022 and October 2023 were selected as study subjects and randomly divided into the control group and the observation group,30 cases each.The control group was provided with conventional treatment only,while the observation group was provided with home-nebulized inhalation glucocorticosteroid treatment,and the treatment effects,clinical symptom relief time,disease recurrence rate,and treatment satisfaction of the children’s families were recorded and compared between the two groups.Results:A comparison of the two groups in terms of gender and age showed that the differences were not statistically significant(P>0.05).In terms of clinical efficacy,the total effective rate of the observation group was 90.00%,which was significantly higher than that of the control group of 66.67%(P<0.05).Compared with the control group,the disappearance time of the clinical symptoms of the observed group was significantly shortened(P<0.05).In addition,the satisfaction scores of the families of the children in the observation group were significantly higher than those of the control group(P<0.05).Conclusion:Home-nebulized inhalation glucocorticoid therapy shows significant clinical efficacy in pediatric respiratory diseases,significantly reduces the time of disappearance of clinical symptoms,and improves the satisfaction of patients’families,which provides an effective treatment option for children.

Effect of moxa smoke produced during combustion of Aiye(Folium Artemisiae Argyi) on behavioral changes in mice inhaling the smoke

OBJECTIVE: To evaluate the effects that inhalation of the combustion products of the traditional Chinese herb Aiye(Folium Artemisiae Argyi) has on the central nervous system.METHODS: Forty Kunming mice(half male) were randomly assigned(n = 10/group) to a control group(C) or one of three moxa smoke concentration groups(% opacity): low(L1; 0.4%), medium(M1; 2%), and high(H1; 15%). Mice in the latter three groups were exposed to moxa smoke in a dynamic gas exposure cabinet for 20 min per day for7 days. Mice in control group were placed in the same cabinet without any intervention. For the sleep experiments, another 50 mice were divided into five groups of 10 mice each: a saline-injected control group, L1 + pentobarbital sodium(PS)-injected group, M1+PS group, H1(15%)+PS group,and a positive control group(10 mg/kg, chlorpromazine, p.o.). The weight, general activities, locomotor activities, rotarod performance, sleep duration,and sleeping rate induced by a subthreshold dose of pentobarbital sodium were recorded in the mice,and the composition of moxa smoke was analyzed using headspace gas chromatography(GC-HS).RESULTS: A low concentration of smoke significantly decreased the frequency of locomotor activities and the time for which the mice remaining on the rotarod; however, a high smoke concentration significantly prolonged the pentobarbital-induced sleeping time and sleeping rate.CONCLUSION: The concentration-dependent relaxing effects of moxa smoke on the Central Nervous System(CNS) were confirmed. Moreover, GC-HS analysis showed that the component present in the highest concentration in moxa smoke was eucalyp-tol, an essential oil well recognized for its soothing effects on the CNS. This may therefore be accountable for the sedative effects of moxa smoke.

Recent progress of respiratory inhalation drug delivery systems

With the influence of many factors such as the aging of the population,the younger smokers,and the serious air pollution,the incidence of chronic respiratory diseases is increasing year by year.In the treatment of respiratory diseases,clinical intervention is still mainly based on drug control of pulmonary symptoms.However,systemic drugs have disadvantages such as many adverse reactions and severe systemic side effects.In recent years,the research and development of local drug delivery systems for the respiratory tract has brought new changes to the treatment of respiratory diseases.Locally delivered drugs can directly act on the airways and have the characteristics of fast onset,good curative effect and small side effects.It is a simple,efficient and safe treatment method,which has a very significant effect,and has become a hot topic of current research and promotion.This paper briefly reviews the development track and latest research progress of respiratory local drug delivery systems at home and abroad,in order to provide reference for clinical workers in drug selection and application.

Effectiveness of one-to-one feedback methods of teaching with proper metered-dose inhaler technique and correcting errors in chronic obstructive lung disease patients

Objective:To determine the most common mistakes made during the use of a metered-dose inhaler(MDI),and the effect of the repeated trainings performed with demonstration method by providing one-to-one feedback on these mistakes.Methods:This is a quasi-experimental study with a control group.A total of 100 chronic obstructive pulmonary disease(COPD)patients(50 in the control group and 50 in the experimental group)were included in the research.“Patient Information Form(PIF)”(to determine the descriptive characteristics of patients)through the face-to-face interview method,using“MDI Skill Assessment Form”(MDISAF)(it is composed of 10 skill steps about the use of MDI)through observation method was used.Patients in both the groups were asked to use MDI and their abilities regarding use of MDI were assessed.Then in the intervention group,usage of MDI was explained by a nurse via demonstration and placebo MDI.Trainings were repeated on days 1,3,and 5 as from hospitalization of the patient.In the intervention group,three methods were used in this study:“face-to-face training,”“one-to-one,”and“with feedbacks and repeated.”Routine training regarding use of MDI was given by the nurses in the clinic to patients in the control group.The use of an MDI was assessed using MDISAF before training and after the training on the first,third and fifth days of hospitalization.On the seventh day,the last measurement was performed.Percentage,chi square,and mean were used to assess the data.Results:After repetitive training with one-to-one feedback,several differences between the groups in favor of the experimental group were found in 7 of the 10 skill levels of the MDI.There was a significant difference after“training”between the groups in the third,fourth,fifth,sixth,seventh,eighth and ninth MDI steps in posttest measurement(P<0.05).Evaluating the skills of the groups to use MDI from pretest to posttest,it was determined that while the intervention group made less mistakes in steps in which mistakes were made mostly,the control group continued to make mistakes.Conclusions:Inhaler technique intervention with repeated,face to face,and one-to-one feedback trainings can significantly enhance the MDI techniques in COPD patients.The patients in the intervention group made less mistakes during MDI application and their application skills improved.It may be asser ted that the training provided to the intervention group was effective for using the device correctly,while the training provided in the clinic for the control group was inadequate.

Human Health Risks from Exposure to Heavy Metals of Suspended Particulate Matter around the Tongon Gold Mine, Côte d’Ivoire

The Tongon mine, the largest gold mine in C?te d’Ivoire, has been in operation since April 2010. However, to our knowledge to date, no study has been conducted on metallic contamination in suspended particulate matter (PM10 and PM2.5) where there is a lack of information on the carcinogenic and non-carcinogenic risk to human health associated with the exposure of populations in the Tongon area to these pollutants. The general objective of this study is to evaluate the level of contamination of PM10;PM2.5 by heavy metals and their impact on the health of populations exposed to these pollutants in the Tongon gold mine area. The sampling and measurement of suspended particulate matter (PM10 and PM2.5) were done using a MiniVol TAS passive air sampler. Heavy metal concentrations were determined by inductively coupled plasma mass spectroscopy (Nex ION 2000 ICP-MS, USA). The results indicate that the average concentrations of suspended particles (PM2.5 and PM10) obtained are all above the recommended exposure limits. In addition, among the heavy metals contained in the suspended particles, the concentrations of arsenic and nickel are high and all above the standard limit values. The assessment of the health risks related to the inhalation of PM10 particles reveals that their inhalation over a long period could cause a carcinogenic risk.

Inhalation therapy for pulmonary fibrosis:chemical medicines and herbal medicines

Pulmonary fibrosis(PF)is a chronic,progressive,and irreversible pulmonary interstitial disease with unclear pathogenesis.Currently,there are few treatment options for managing PF.Inhalation therapy,as a routine treatment for respiratory diseases,is being used to study the treatment of PF.Some herbal medicines and their active ingredients have been reported to have anti-PF effects.This review aims to provide an overview of the latest developments in inhalation therapy,focusing on the utilization of chemical medicines and herbal medicines for the treatment of PF in both clinical practice and basic research.The inhalation of chemical drugs such as pirfenidone,nintedanib,N-acetylcysteine,and interferon-γhas been shown to demonstrate anti-PF effects.Additionally,the inhalation of various natural products derived from herbal medicines,encompassing polyphenols,alkaloids,flavonoids,saponins,terpenoids,and herbal extracts,contributes to the therapeutic management of PF through diverse mechanisms.The inhalation of both chemical and herbal medicines presents promising advantages in the treatment of PF.Further clinical trials are required to investigate the effectiveness,safety,and mechanism of action of inhalation therapy utilizing natural products derived from herbal medicines.

Toxicity of Radon-222 in Groundwater across Keana in Nasarawa,Nigeria

The most common supply of freshwater for drinking,irrigation,and other domestic uses is groundwater;however,because of increased radon concentrations brought on by mining activities,its quality is still a severe concern.Using a liquid scintillation detector,this study investigated the radon content,its related toxicity,and its risk to human health in the groundwater of the Keana in Nasarawa,Nigeria.Ten(10)borehole samples and five(5)well samples totaling fif­teen(15)groundwater samples were taken.The results showed that the average radon concentration in water samples from Keana was 2.25 Bq/L.The mean annual effective dosage(ingestion)for adults and children in Keana was 0.016 mSv/y and 0.027 mSv/y,respectively.In Keana,the additional lifetime cancer risk per adult was 5.65×10^(-5),and per child,it was 8.79×10^(-5).The study’s radon concentration was lower than the benchmark of 11.1 Bq/L established in 1991 by the Nigerian Standard Organization and the US Environmental Protection Agency.The results of this study indicate that the level of radon is safe;as a result,people can continue farming and other activities.To reduce the risk of cancer,however,more research could be done in the area.Further research should be done by looking at additional sources in the study area in order to cover the entire zone.Further investigation should be carried out both during the dry and wet seasons because radon concentrations in groundwater alter over time due to dilution by recharge from rainfall.

The Effect of Nebulized Budesonide Inhalation in Treating Children with Asthma and its Influence on Immune Indexes

Objective:To explore and analyze the effect of nebulized budesonide inhalation on children with asthma and its influence on immune indexes.Methods:300 children who were with asthma admitted to the Pediatric Respiratory Department of our hospital from January 2021 to January 2023 were selected as the research subjects.The patients were divided into a nebulization group(n=150)and a reference group(n=150)by drawing lots.The nebulization group received routine treatment along with budesonide nebulization inhalation therapy,while the reference group only received routine treatment.The treatment effect,the immune indicators,the time taken for the disappearance of symptoms,and the pulmonary function indicators of both groups were compared.Results:The total efficacy of treatment received in the nebulization group was significantly higher than that in the reference group(P<0.05).Before treatment,there was no statistically significant difference in the CD4^(+),CD8^(+),CD4^(+)/CD8^(+),between the two groups(P>0.05);after treatment,the nebulization group’s CD4^(+),CD8^(+),CD4^(+)/CD8^(+)and other immune indicators were significantly better than the reference group(P<0.05).The time taken for the disappearance of symptoms like wheezing,coughing,crackles,shortness of breath,and other symptoms in the nebulization group was significantly shorter than in the reference group(P<0.05).Before treatment,there was no statistically significant difference in the pulmonary function indexes such as FEV1,PEF,and FVC between the two groups(P>0.05);after treatment,the pulmonary function indexes of the patients in the nebulization group were significantly better than those in the reference group(P<0.05).Conclusion:Nebulized budesonide inhalation therapy has shown significant efficacy in the treatment of pediatric asthma,with notable improvements in immune indicators.Therefore,it is worthy of recommendation and further promotion.

EFFECT OF INHALED NANO-TiO_2 ON LUNG AND SERUM BIOCHEMICAL INDEXES OF MICE

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.

吸入用N-乙酰半胱氨酸雾化治疗在急性鼻窦炎中的疗效和炎症指标的临床观察

目的 观察吸入用N-乙酰半胱氨酸雾化在急性鼻窦炎患者中的疗效,分析其对鼻呼出气一氧化氮(nasal nitric oxide,nNO)和炎症指标的影响。方法 选取就诊于绵阳市中心医院耳鼻咽喉科急性鼻窦炎患者164例,采用随机对照和自身对照方法,观察两组治疗效果,并比较两组治疗前、后各症状视觉模拟评分法(VAS)评分、鼻内镜检查Lund-Kennedy评分、nNO含量、炎症因子(TNF-α、IL-6、IL-8、IL-10)水平、血清C反应蛋白(C-reactive protein,CRP)和降钙素原(procalcitonin,PCT)水平。结果 实验组疗效明显优于对照组(P<0.05);两组患者治疗后VAS和Lund-Kennedy评分显著降低(P<0.05)、炎症因子(TNF-α、IL-6、IL-8、IL-10)和两项感染指标水平均显著下降(P<0.05),但上述指标比较实验组改变较为显著(P<0.05)。结论 吸入用N-乙酰半胱氨酸能促进急性鼻窦炎患者nNO释放、降低炎症因子和全身感染指标,提高治疗效果。

吸入用布地奈德混悬液联合水溶性全吸收多糖纤维素在鼻-鼻窦炎术后运用

慢性鼻-鼻窦炎是耳鼻咽喉科的常见病及多发病,特别是伴发鼻息肉的慢性鼻-鼻窦炎的发病率仍很高。如何减少复发是困扰很多临床医师的难题。我科将吸入用布地奈德混悬液联合水溶性全吸收多糖纤维素应用于鼻-鼻窦炎术后填塞,局部用药,安全有效。1.1一般资料。慢性鼻-鼻窦炎鼻息肉伴变应性鼻炎患者80例,男56例,女24例,年龄28-60岁,平均年龄46.4岁,病程2-10年,符合慢性鼻-鼻窦炎诊断标准,

慢性阻塞性肺疾病(COPD)患者应用皮质类固醇激素后出现骨折或骨质疏松的风险分析

慢性阻塞性肺疾病（COPD）的治疗通常包括长期应用皮质类固醇激素。这些药物经口服应用后,会增加骨质疏松和骨折的风险。但是吸入性应用皮质类固醇激素是否会增加类似的风险,是我们研究的主要目的。通过对658例COPD患者历经3年的跟踪研究，我们认为：应用吸人性皮质类固醇药物或者不应用该药，对COPD患者骨密度的影响的差异不明显。

耳内镜联合七氟醚吸入麻醉用于儿童耵聍取出术

研究回顾性分析门诊耵聍栓塞患儿在硬性耳内镜联合七氟醚吸入麻醉下,应用耳科显微手术器械进行耵聍取出术。

Experimental study and numerical simulation of gas/particle flow in tunneling of mine

Respiration particles can be collected into a dust catcher by an inside inhalingand outside pressing particle collector. The work environment of the grab operator in tunneling mining was improved when a dust catcher is placed before the working face of thegrab operator. The particle movement was affected by the gas flow. The flow field insideand outside the dust collector was simulated. The effect of the operating parameter wasanalyzed. The numerical results show a good approach to predict the gas flow and particledistribution in the inside and outside of the particle collector.