红光理疗对改善鼻中隔成形术后黏膜缺血的疗效观察

目的：观察红光理疗对改善鼻中隔成形术后鼻中隔黏膜局部缺血状态的疗效。方法：对30例行鼻中隔成形术,术后发现鼻中隔黏膜局部缺血的患者,将其随机分成两组,一组为红光理疗组即实验组,另一组为常规治疗组即对照组。实验组每日先行鼻部红光理疗15分钟,然后以浸有重组人表皮生长因子及金霉素软骨的明胶海绵贴敷于鼻中隔缺血处黏膜;对照组...     

鼻内窥镜下YAG激光治疗鼻中隔棘突弯曲

目的：探讨鼻内镜下YAG激光治疗鼻中隔棘突状弯曲的方法及疗效。方法：我们选择鼻中隔弯曲的患者29例,均为单侧鼻中隔呈棘状突起者,在鼻内镜下利用YAG激光行鼻中隔矫正术。结果：经过6至36个月的随访,所有患者鼻塞和头痛等症状消失,无并发症出现。结论：在鼻内镜下利用YAG激光矫正鼻中隔棘突的方法,视野清晰,操作简单,出血少...     

Carriage of Staphylococcus aureus in the nose of patients on regular dialysis treatment using hemodialysis catheters

In the hemodialysis population, the incidence of Staphylococcus aureus colonization has been documented to be as high as 80%; effective prophylaxis of vascular access infection and bacteremia is a worthwhile goal in the management of hemodialysis population. Surveillance of 50 hemodialysis patients for S. aureus‐positive nasal cultures was performed by monthly nasal swabs over a 12‐month period. All patients were performing dialysis using hemodialysis catheters thrice weekly. All positive cultures were treated with a prophylactic antibiotic regimen. Thirty‐one patients (62%) had one or more positive cultures. The surveillance period was longer in the S. aureus nasal carriers (p < 0.01). The frequency of positive cultures correlated with the duration of surveillance (p < 0.05). The incidence of S. aureus bacteremia was greater in patients with three or more positive cultures (p < 0.05). This study suggests that continuous surveillance for S. aureus nasal colonization is essential to properly identify all hemodialysis patients using catheters at risk of developing S. aureus bacteremias.     

Development of thiolated poly(acrylic acid) microparticles for the nasal administration of exenatide

The purpose of this study was to develop a microparticulate formulation for nasal delivery of exenatide utilizing a thiolated polymer. Poly(acrylic acid)-cysteine (PAA-cys) and unmodified PAA microparticles loaded with exenatide were prepared via coprecipitation of the drug and the polymer followed by micronization. Particle size, drug load and release of incorporated exenatide were evaluated. Permeation enhancing properties of the formulations were investigated on excised porcine respiratory mucosa. The viability of the mucosa was investigated by histological studies. Furthermore, ciliary beat frequency (CBF) studies were performed. Microparticles displayed a mean size of 70–80?µm. Drug encapsulation was ～80% for both thiolated and non-thiolated microparticles. Exenatide was released from both thiolated and non-thiolated particles in comparison to exenatide in buffer only within 40?min. As compared to exenatide dissolved in buffer only, non-thiolated and thiolated microparticles resulted in a 2.6- and 4.7-fold uptake, respectively. Histological studies performed before and after permeation studies showed that the mucosa is not damaged during permeation studies. CBF studies showed that the formulations were cilio-friendly. Based on these results, poly(acrylic acid)-cysteine-based microparticles seem to be a promising approach starting point for the nasal delivery of exenatide.     

Evaluating the Protective Properties of a Xyloglucan-Based Nasal Spray in a Mouse Model of Allergic Rhinitis

A breached nasal epithelial barrier plays an important role in driving allergic rhinitis (AR). Corticosteroids remain the standard of care (SoC) but come with side effects, thus alternative safe and effective treatments able to avoid inflammation and restore barrier integrity are needed. The aim of the present study is to evaluate the barrier-forming capacity of a xyloglucan-based nasal spray (XG) and compare its efficacy to several SoC treatments (corticosteroid spray, oral mast-cell stabilizer and oral antihistamine) in reducing allergic responses in addition to its effect when concomitantly administered with an antihistamine. An ovalbumin (OVA)-induced mouse AR model was used. XG shows a significant efficacy in reducing histological damage in AR mice; improves nasal rubbing and histamine-induced hyper-responsiveness. Total and OVA-specific IgE as well as pro-inflammatory cytokines are significantly reduced compared to OVA challenged-mice, with im-proved efficacy when used as an add-on treatment. However, XG reduces mucous secreting cells (PAS-positive) and mucin mRNA expression similar to the corticosteroid-treated mice. XG-spray maintains tight junction protein expression (ZO-1) and conversely decreases HDAC1 significantly; the latter being highly expressed in AR patients. Moreover, the concomitant treatment showed in all of the endpoints a similar efficacy to the corticosteroids. This innovative approach may represent a novel therapeutic strategy for nasal respiratory diseases like AR, reducing undesirable side effects and improving the quality of life in patients.     

New Fast Acting Glucagon for Recovery from Hypoglycemia,a Life-Threatening Situation: Nasal Powder and Injected Stable Solutions

The goal of diabetes care is to achieve and maintain good glycemic control over time, so as to prevent or delay the development of micro- and macrovascular complications in type 1 (T1D) and type 2 diabetes (T2D). However, numerous barriers hinder the achievement of this goal, first of all the frequent episodes of hypoglycemia typical in patients treated with insulin as T1D patients, or sulphonylureas as T2D patients. The prevention strategy and treatment of hypoglycemia are important for the well-being of patients with diabetes. Hypoglycemia is strongly associated with an increased risk of cardiovascular disease in diabetic patients, due probably to the release of inflammatory markers and prothrombotic effects triggered by hypoglycemia. Treatment of hypoglycemia is traditionally based on administration of carbohydrates or of glucagon via intramuscular (IM) or subcutaneous injection (SC). The injection of traditional glucagon is cumbersome, such that glucagon is an under-utilized drug. In 1983, it was shown for the first time that intranasal (IN) glucagon increases blood glucose levels in healthy volunteers, and in 1989–1992 that IN glucagon is similar to IM glucagon in resolving hypoglycemia in normal volunteers and in patients with diabetes, both adults and children. IN glucagon was developed in 2010 and continued in 2015; in 2019 IN glucagon obtained approval in the US, Canada, and Europe for severe hypoglycemia in children and adults. In the 2010s, two ready-to-use injectable formulations, a stable non-aqueous glucagon solution and the glucagon analog dasiglucagon, were developed, showing an efficacy similar to traditional glucagon, and approved in the US in 2020 and in 2021, respectively, for severe hypoglycemia in adults and in children. Fast-acting glucagon (nasal administration and injected solutions) appears to represent a major breakthrough in the treatment of severe hypoglycemia in insulin-treated patients with diabetes, both adults and children. It is anticipated that the availability of fast-acting glucagon will expand the use of glucagon, improve overall metabolic control, and prevent hypoglycemia-related complications, in particular cardiovascular complications and cognitive impairment.     

Nd:YAG激光治疗鼻息肉的体会

目的:本文报导应用Nd:YAG激光治疗鼻息肉患者98例。方法:98例鼻息肉患者在1%丁卡因液鼻腔粘膜表面麻醉下应用连续输出功率为20~25W的Nd:YAG激光光纤先气化鼻息肉表面,然后再插进鼻息肉深部进行气化凝固。结果:98例中治愈68例(占69.4%),好转30例(占30.6%)。结论:Nd:YAG激光适用于治疗单个鼻腔息肉及中鼻甲息肉样变组织,术时出血少或不出血,由于Nd:YAG激光穿透组织较深,易引起鼻部周围组织肿胀反应。鼻息肉经激光治疗后,息肉消失,可保持鼻腔通畅,激光治疗优点是手术简便,病人痛苦少。     

Automated actuation of nasal spray products: determination and comparison of adult and pediatric settings

Objective: To determine and compare patient-relevant settings for automated nasal spray actuation stations from adult and pediatric hand data. Methods: Twenty adults and 20 pediatric participants were asked to spray Flonase® Nasal Spray six times in a Hand Actuation Monitor, which records force and displacement data in 5-ms increments. Settings for force- and velocity-controlled actuation stations were determined from the data using a predefined set of calculations. Results: For force-controlled settings, hand spraying by children resulted in lower actuation forces, and longer force rise, hold and fall times. Pediatric velocity-controlled actuator settings were lower for travel, compression velocity, and release velocity compared with adults. The pediatric spray weight recorded during hand spraying was significantly lower than the spray weight generated by adult participants. Adult participants were able to generate full sprays with each attempt, whereas 11 out of 120 actuations performed by pediatric participants resulted in partial and ‘no spray’ events. No differences in spray weight were detected in participants who chose to actuate the nasal spray using both hands. Conclusions: A predefined set of calculations was used to determine patient-relevant settings from force and displacement hand data for force- and velocity-controlled automated actuation stations. This study determined and quantified, for the first time, the differences in hand spraying between adults and children.     

Mucoadhesive Polymeric Hydrogels for Nasal Delivery of Acyclovir

The study evaluated different mucoadhesive polymeric hydrogels for nasal delivery of acyclovir. Gels containing poly-N-vinyl-2-pyrrolidone (PVP) were prepared with crosslinking achieved by irradiation with a radiation dose of 15 kGy being as efficient as 20 kGy. Gels containing chitosan and carbopol were also evaluated. The mucoadhesive properties of gels were measured by a modification of a classical tensile experiment, employing a tensile tester and using freshly excised sheep nasal mucosa. Considering the mucoadhesive force, chitosan gel and gel prepared with 3% PVP in presence of polyethylene glycol (PEG) 600 were the most efficient. The in vitro drug release depended on the gel composition. Higher release rates were obtained from PVP gels compared to chitosan or carbopol gels. The release rate of drug from PVP gels was increased further in presence of PEG or glycerol. Histopathological investigations proved that the PVP was a safe hydrogel to be used for mucosal delivery. The PEG in gel formulations caused less damages to the nasal mucosal compared to formulation containing glycerol.     

Polymers for Mucoadhesive Drug Delivery System: A Current Status

To overcome the relatively short gastrointestinal (GI) time and improve localization for oral controlled or sustained release drug delivery systems, bioadhesive polymers that adhere to the mucin/epithelial surface are effective and lead to significant improvement in oral drug delivery. Improvements are also expected for other mucus-covered sites of drug administration. Bioadhesive polymers find application in the eye, nose, and vaginal cavity as well as in the GI tract, including the buccal cavity and rectum. This article lays emphasis mainly on mucoadhesive polymers, their properties, and their applications in buccal, ocular, nasal, and vaginal drug delivery systems with its evaluation methods.