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1.
Nat Commun ; 11(1): 5752, 2020 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-33188207

RESUMO

Efficacious interventions are urgently needed for the treatment of COVID-19. Here, we report a monoclonal antibody (mAb), MW05, with SARS-CoV-2 neutralizing activity by disrupting the interaction of receptor binding domain (RBD) with angiotensin-converting enzyme 2 (ACE2) receptor. Crosslinking of Fc with FcγRIIB mediates antibody-dependent enhancement (ADE) activity by MW05. This activity is eliminated by introducing the LALA mutation to the Fc region (MW05/LALA). Potent prophylactic and therapeutic effects against SARS-CoV-2 are observed in rhesus monkeys. A single dose of MW05/LALA blocks infection of SARS-CoV-2 in prophylactic treatment and clears SARS-CoV-2 in three days in a therapeutic treatment setting. These results pave the way for the development of MW05/LALA as an antiviral strategy for COVID-19.


Assuntos
Anticorpos Monoclonais/imunologia , Anticorpos Neutralizantes/imunologia , Antivirais/farmacologia , Betacoronavirus/imunologia , Infecções por Coronavirus/terapia , Pneumonia Viral/terapia , Glicoproteína da Espícula de Coronavírus/imunologia , Animais , Anticorpos Antivirais/imunologia , Linhagem Celular , Chlorocebus aethiops , Infecções por Coronavirus/prevenção & controle , Feminino , Células HEK293 , Humanos , Macaca mulatta , Masculino , Pandemias/prevenção & controle , Peptidil Dipeptidase A/metabolismo , Pneumonia Viral/prevenção & controle , Receptores de IgG/genética , Receptores de IgG/imunologia , Receptores Virais/metabolismo , Células Vero , Ligação Viral
2.
ACS Nano ; 2020 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-33236885

RESUMO

Hypoxia can increase the resistance of tumor cells to radiotherapy and chemotherapy. However, the dense extracellular matrix, high interstitial fluid pressure, and irregular blood supply often serve as physical barriers to inhibit penetration of drugs or nanodrugs across tumor blood microvessels into hypoxic regions. Therefore, it is of great significance and highly desirable to improve the efficiency of hypoxia-targeted therapy. In this work, living photosynthetic bacteria (PSB) are utilized as hypoxia-targeted carriers for hypoxic tumor therapy due to their near-infrared (NIR) chemotaxis and their physiological characteristics as facultative aerobes. More interestingly, we discovered that PSB can serve as a kind of photothermal agent to generate heat through nonradiative relaxation pathways due to their strong photoabsorption in the NIR region. Therefore, PSB integrate the properties of hypoxia targeting and photothermal therapeutic agents in an "all-in-one" manner, and no postmodification is needed to achieve hypoxia-targeted cancer therapy. Moreover, as natural bacteria, noncytotoxic PSB were found to enhance immune response that induced the infiltration of cytotoxicity T lymphocyte. Our results indicate PSB specifically accumulate in hypoxic tumor regions, and they show a high efficiency in the elimination of cancer cells. This proof of concept may provide a smart therapeutic system in the field of hypoxia-targeted photothermal therapeutic platforms.

3.
Nat Nanotechnol ; 15(12): 1053-1064, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33106640

RESUMO

Cancer vaccines hold great promise for improved cancer treatment. However, endosomal trapping and low immunogenicity of tumour antigens usually limit the efficiency of vaccination strategies. Here, we present a proton-driven nanotransformer-based vaccine, comprising a polymer-peptide conjugate-based nanotransformer and loaded antigenic peptide. The nanotransformer-based vaccine induces a strong immune response without substantial systemic toxicity. In the acidic endosomal environment, the nanotransformer-based vaccine undergoes a dramatic morphological change from nanospheres (about 100 nanometres in diameter) into nanosheets (several micrometres in length or width), which mechanically disrupts the endosomal membrane and directly delivers the antigenic peptide into the cytoplasm. The re-assembled nanosheets also boost tumour immunity via activation of specific inflammation pathways. The nanotransformer-based vaccine effectively inhibits tumour growth in the B16F10-OVA and human papilloma virus-E6/E7 tumour models in mice. Moreover, combining the nanotransformer-based vaccine with anti-PD-L1 antibodies results in over 83 days of survival and in about half of the mice produces complete tumour regression in the B16F10 model. This proton-driven transformable nanovaccine offers a robust and safe strategy for cancer immunotherapy.

4.
J Tradit Chin Med ; 40(4): 509-517, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32744019

RESUMO

OBJECTIVE: To evaluate the effectiveness of Chinese herbal medicine for primary Raynaud's phenomenon (PRP). METHODS: The Cochrane Central Register of Controlled Trials, PubMed, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang Database were searched up to February 13, 2018. Randomized controlled trials (RCTs) on treatment of PRP with Chinese herbal medicine compared with placebo, blank control, lifestyle changes, or calcium antagonists were identified and reviewed. The quality of included trials was assessed using a risk of bias tool. RESULTS: Eight RCTs involving 674 participants were included. The methodological quality of the included trials was generally poor. Meta-analysis of two trials showed that Buyang Huanwu Tang plus Danggui Sini Tang produced greater improvement in global symptoms than nifedipine. One trial showed that Danggui Sini Tang and a self-composed Chinese herbal medicine decoction, respectively, produced greater improvement in global symptoms than nifedipine alone. In one trial, modified Danggui Sini Tang showed greater improvement in global symptoms and arterial peak systolic velocity compared with nifedipine. One trial showed that Jiejing Tongmi Tang produced greater improvement in global symptoms, plasma endothelin, and plasma nitric oxide than cinepazide maleate injection. However, Jiejing Tongmi Tang did not produce a significant difference in skin temperature and peripheral artery blood stream drawing after cold pressor testing compared with cinepazide maleate injection. None of the trials reported frequency of attacks, duration of attacks, participant preference scores, or adverse events. CONCLUSION: Chinese herbal medicine may have a positive effective on PRP. However, owing to weak methodology, the benefits of Chinese herbal medicine for PRP are inconclusive. More rigorously designed studies are needed to confirm these findings.

5.
J Struct Biol ; 212(1): 107593, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32736072

RESUMO

Akkermansia muciniphila is a beneficial microorganism colonized in the human gut that can reverse many intestinal metabolic-related diseases. Amuc_1100 is an outer-membrane protein of A. muciniphila. Oral administration of Amuc_1100 can reduce fat mass development, insulin resistance, and dyslipidemia in mice and activated the toll-like receptor 2 (TLR2) to regulate the immune response of the host, but the molecular mechanism remains unclear. Here we report the crystal structure of the extramembranous domain of Amuc_1100, which consists of a four-stranded antiparallel ß-sheet and four α-helices. Two C-terminal helices and the four-stranded antiparallel ß-sheet formed two "αßß" motifs and constituted the core domain, which shared a similar fold with type IV pili and type II Secretion system protein. Although the full-length of the extramembranous domain of Amuc_1100 existed as a monomer in solution, they formed trimer in the crystal. Elimination of the N-terminal coiled-coil helix α1 led to dimerization of Amuc_1100 both in solution and in crystal, indicating that the oligomeric state of Amuc_1100 was variable and could be influenced by α1. In addition, we identified that Amuc_1100 could directly bind human TLR2 (hTRL2) in vitro, suggesting that Amuc_1100 may serve as a new ligand for hTLR2. Dimerization of Amuc_1100 improved its hTLR2-binding affinity, suggesting that the α1-truncated Amuc_1100 could be a beneficial candidate for the development of A. muciniphila related drugs.

6.
ACS Appl Mater Interfaces ; 12(31): 34667-34677, 2020 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-32610896

RESUMO

Efficient drug delivery into tumor cells while bypassing many biological barriers is still a challenge for cancer therapy. By taking advantage of the palladium (Pd)-mediated in situ activation of a prodrug and the glucose oxidase (GOD)-based ß-d-glucose oxidation reaction, we developed a multisynergistic cancer therapeutic platform that combined doxorubicin (DOX)-induced chemotherapy with GOD-mediated cancer-orchestrated oxidation therapy and cancer starvation therapy. In the present work, we first synthesized DOX prodrugs (pDOXs) and temporarily assembled them with ß-cyclodextrins to reduce their toxic side effects. Then, a nanoreactor was constructed by synthesizing Pd0 nanoparticles in situ within the pores of mesoporous silica nanoparticles for the conversion of pDOX into the active anticancer drug. Furthermore, GOD was introduced to decrease the pH of the tumor microenvironment and induce cancer-orchestrated oxidation/starvation therapy by catalyzing ß-d-glucose oxidation to form hydrogen peroxide (H2O2) and gluconic acid. Our study provides a new strategy that employs a cascade chemical reaction to achieve combined orchestrated oxidation/starvation/chemotherapy for the synergistic killing of cancer cells and the suppression of tumor growth.

7.
Theranostics ; 10(13): 5649-5670, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32483410

RESUMO

The unique features of noble-metal nanostructures (NMNs) are leading to unprecedented expansion of research and exploration of their application in therapeutics, diagnostics and bioimaging fields. With the ever-growing applications of NMNs, both therapeutic and environmental NMNs are likely to be exposed to tissues and organs, requiring careful studies towards their biological effects in vitro and in vivo. Upon NMNs exposure, tissues and cells may undergo a series of adaptive changes both in morphology and function. At the cellular level, the accumulation of NMNs in various subcellular organelles including lysosomes, endoplasmic reticulum, Golgi apparatus, mitochondria, and nucleus may interfere with their functions, causing changes in a variety of cellular functions, such as digestion, protein synthesis and secretion, energy metabolism, mitochondrial respiration, and proliferation. In animals, retention of NMNs in metabolic-, respiratory-, immune-related, and other organs can trigger significant physiological and pathological changes to these organs and influence their functions. Exploring how NMNs interact with tissues and cells and the underlying mechanisms are of vital importance for their future applications. Here, we illustrate the characteristics of NMNs-induced adaptive changes both in vitro and in vivo. Potential strategies in the design of NMNs are also discussed to take advantage of beneficial adaptive changes and avoid unfavorable changes for the proper implementation of these nanoplatforms.

8.
ACS Appl Mater Interfaces ; 12(24): 26832-26841, 2020 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-32449617

RESUMO

Although considerable clinical attempts on various kinds of cancers have been made, photodynamic therapy (PDT) still suffers from attenuated therapeutic effects because of the developed resistance of cancer cells. As a novel antiapoptosis protein, survivin has been demonstrated to be selectively overexpressed in a great number of human malignancies and plays a significant part in cancer progression and therapeutic resistance. Herein, we present an upconversion nanoplatform for enhanced PDT by DNAzyme-mediated gene silencing of survivin. In our system, a long single-stranded DNA (ssDNA) with a repetitive aptamer (AS1411) and survivin-targeted DNAzyme was fabricated by rolling circle amplification (RCA) and adsorbed on the upconversion nanoparticles (UCNPs) by electrostatic attraction. The multivalence of the ssDNA endows the upconversion nanoplatform with high recognition and loading capacity of photosensitizers and DNAzymes. When the nanoplatform is targeted internalized into cancer cells, PDT can be triggered by near-infrared (NIR) light to generate reactive oxygen species (ROS) for killing the cancer cells. Moreover, the encoded DNAzyme can efficiently inhibit the gene expression of survivin, providing the potential to enhance the efficiency of PDT. This study thus highlights the promise of an upconversion photodynamic nanoplatform for admirable combination therapy in cancer.

9.
Bioconjug Chem ; 31(5): 1247-1258, 2020 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-32319762

RESUMO

As a classical nanocatalyst-based therapeutic modality, chemodynamic therapy (CDT) has received more and more attention. To improve the therapeutic efficacy of CDT, various metal-based nanocatalysts have been designed and constructed to catalyze the Fenton or Fenton-like reaction in the past few years. However, the therapeutic efficacy of certain CDT is still restricted by the tumor microenvironment, such as limited concentration of intracellular H2O2, inappropriate pH condition, as well as overexpressed glutathione (GSH). Therefore, many other therapeutic modalities, such as photodynamic therapy (PDT), photothermal therapy (PTT), starvation therapy, chemotherapy, and gas therapy, have been utilized to combine with CDT for increasing the tumor treatment performance. In this review, we summarized the development of combinatory therapeutic modalities based on CDT in recent years.

10.
Theranostics ; 10(11): 4944-4957, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32308760

RESUMO

Due to their lower systemic toxicity, faster kidney clearance and higher tumor accumulation, ultrasmall gold nanoparticles (less than 10 nm in diameter) have been proved to be promising in biomedical applications. However, their potential applications in cancer imaging and treatment have not been reviewed yet. This review summarizes the efforts to develop systems based on ultrasmall gold nanoparticles for use in cancer diagnosis and therapy. First, we describe the methods for controlling the size and surface functionalization of ultrasmall gold nanoparticles. Second, we review the research on ultrasmall gold nanoparticles in cancer imaging and treatment. Specifically, we focus on the applications of ultrasmall gold nanoparticles in tumor visualization and bioimaging in different fields such as magnetic resonance imaging, photoacoustic imaging, fluorescence imaging, and X-ray scatter imaging. We also highlight the applications of ultrasmall gold nanoparticles in tumor chemotherapy, radiotherapy, photodynamic therapy and gene therapy.

11.
J Mater Chem B ; 8(18): 3985-4001, 2020 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-32239013

RESUMO

Cancer stem cells (CSCs) exhibit high resistance to conventional therapy and are responsible for cancer metastasis and tumor relapse. Therefore, it is of significance to develop effective novel strategies to target CSCs for cancer therapies. The challenges associated with developing novel strategies include specific CSC targeting and overcoming their therapeutic resistance. In the present review, we summarize the various strategies for CSC-targeted cancer thermotherapy and combinational therapy, and the potential challenges and prospects for future work in this emerging field.

12.
Sci China Life Sci ; 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32239367

RESUMO

Excessive reactive oxygen species (ROS) would attack living cells and cause a series of oxidative stress related diseases, such as liver damage. Hydroxyl radicals (·OH) are currently known as one of the most toxic and harmful free radicals to organisms. Therefore, studies involving hydroxyl radicals have become important research topics in the fields of biology, biochemistry, and biomedicine. In addition, imaging of analytes using upconversion nanoparticles (UCNPs) possesses significant advantages over that using general fluorescent dyes or nanoparticles due to its high spatial resolution, reduced photodamage, and deep tissue penetration properties. Herein, we designed a highly selective and sensitive hydroxyl radical nanoprobe based on the luminescence resonance energy transfer between upconversion nanoparticles and methylene blue (MB). The concentration of ·OH could be determined by the fluorescence recovery of the UCNPs due to the oxidative damage of MB. Using this nanoprobe, the ·OH in living cells or in liver tissues could be monitored with high sensitivity and selectivity.

15.
J Inorg Biochem ; 202: 110857, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31669695

RESUMO

Thirteen novel palladium(II) complexes of the general formula [Pd(bipy)(O,O'-dkt)](PF6), (where bipy is 2,2'-bipyridine and O,O'-dkt is ß-diketonate ligand hispolon or its derivative) have been prepared through a metal-ligand coordination method that involves spontaneous formation of the corresponding diketonate scaffold. The obtained palladium(II) complexes have been characterized by NMR spectroscopy, ESI-mass spectrometry as well as elemental analysis. The cytotoxicity analysis indicates that most of the obtained palladium(II) complexes show promising growth inhibition in three human cancer cell lines. Flow cytometry analysis shows complex 3e could promote intracellular reactive oxygen species (ROS) accumulation and lead cancer cell death. And the suppression of ROS accumulation and the rescue of cell viability in HeLa cells by N-acetyl-L-cysteine (NAC) suggest the possible link between the increase in ROS generation and cytotoxicity of complex 3e. Flow cytometry analysis also reveal that complex 3e cause cell cycle arrest in the G2/M phase and collapse of the mitochondrial membrane potential, promote the generation of ROS and lead to tumor cell apoptosis. The interactions of complex 3e with calf thymus DNA (CT-DNA) have been evaluated by UV-Vis spectroscopy, fluorescence quenching experiments and viscosity measurements, which reveal that the complex interact with CT-DNA through minor groove binding and/or electrostatic interactions. Further, the results of fluorescence titration and site marker competitive experiment on bovine serum albumin (BSA) suggest that complex 3e can quench the fluorescence of BSA via a static quenching process and bind to BSA in Sudlow's site II.


Assuntos
Antineoplásicos , Apoptose/efeitos dos fármacos , Catecóis , Complexos de Coordenação , DNA/química , Paládio , Soroalbumina Bovina/química , Antineoplásicos/síntese química , Antineoplásicos/química , Antineoplásicos/farmacologia , Catecóis/química , Catecóis/farmacologia , Complexos de Coordenação/síntese química , Complexos de Coordenação/química , Complexos de Coordenação/farmacologia , Pontos de Checagem da Fase G2 do Ciclo Celular/efeitos dos fármacos , Células HeLa , Humanos , Pontos de Checagem da Fase M do Ciclo Celular/efeitos dos fármacos , Paládio/química , Paládio/farmacologia
16.
Trials ; 20(1): 674, 2019 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-31801593

RESUMO

BACKGROUND: Psoriasis is a chronic, immune-mediated disorder with chronic plaque psoriasis being the primary manifestation during the remission stage. Patients often have a slow course and long history of the disease. The refractory type of psoriasis is a stubborn rash that does not subside easily. We designed this randomized controlled trial to compare the effectiveness and relapse rates of plaque psoriasis in patients treated with either acupuncture, moxibustion or calcipotriol ointment. The ultimate aim of the study is to select an effective traditional Chinese medicine therapy for patients with plaque psoriasis. METHODS: The study will be a multicenter, prospective, randomized controlled trial that compares the effectiveness of fire needle therapy, moxibustion and calcipotriol ointment. In total, 160 patients with plaque psoriasis who meet the inclusion criteria will be recruited from three hospitals in Beijing and then randomly assigned to receive either fire needle therapy (group A1), moxibustion (group A2) or calcipotriol ointment (group B). All participants will receive an 8-week treatment and will then be followed up for another 24 weeks, with time points at weeks 12 and 24 after treatment completion. The primary outcomes to be measured are relapse rates and psoriasis area and severity index score of the target lesions. In addition, the target lesion onset time, dermatology life quality index, traditional Chinese medicine syndrome score, and the relapse interval of the target lesion will be measured. Adverse events will be recorded for safety assessment. DISCUSSION: The aim of this study is to determine whether fire needle therapy or moxibustion could improve the clinical effectiveness for psoriasis lesions and reduce the relapse rate. Once completed, it will provide information regarding therapeutic evaluation on fire needle therapy or moxibustion for plaque psoriasis, which will assist clinicians in selecting the most effective treatment options for patients. TRIAL REGISTRATION: International Clinical Trials Registry Platform (ICTRP), ChiCTR1800019588. Registered on 19 November 2018.

17.
Nano Lett ; 19(12): 8476-8487, 2019 12 11.
Artigo em Inglês | MEDLINE | ID: mdl-31711283

RESUMO

In contrast to the booming production and application of nanomaterials, research on the toxicological impacts and possible hazards of nanoparticles to tissues and organs is still in its infancy. Golgi apparatus is one of the most important organelles in cells and plays a key role in intracellular protein processing. The structural integrity of Golgi is vital for its normal function, and Golgi disturbance could result in a wide range of diseases and disorders. In this study, for the first time we found gold nanoparticles (Au NPs) induced size-dependent cytoplasmic calcium increase and Golgi fragmentation, which hampers normal Golgi functions, leads to abnormal protein processing, and causes cellular adhesion decrease, while cell viability was not significantly compromised. Additionally, early renal pathological changes were induced in vivo. This work is significant to nanoparticle research because it illustrates the important role of size on Au NP-induced changes in Golgi morphology and their consequences in vitro and in vivo, which has important implications for the biological applications of nanomaterials.

18.
Commun Biol ; 2: 392, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31667366

RESUMO

Programmed cell death 1 (PD-1) is inhibitory receptor and immune checkpoint protein. Blocking the interaction of PD-1 and its ligands PD-L1/ L2 is able to active T-cell-mediated antitumor response. Monoclonal antibody-based drugs targeting PD-1 pathway have exhibited great promise in cancer therapy. Here we show that MW11-h317, an anti-PD-1 monoclonal antibody, displays high affinity for PD-1 and blocks PD-1 interactions with PD-L1/L2. MW11-h317 can effectively induce T-cell-mediated immune response and inhibit tumor growth in mouse model. Crystal structure of PD-1/MW11-h317 Fab complex reveals that both the loops and glycosylation of PD-1 are involved in recognition and binding, in which Asn58 glycosylation plays a critical role. The unique glycan epitope in PD-1 to MW11-h317 is different from the first two approved clinical PD-1 antibodies, nivolumab and pembrolizumab. These results suggest MW11-h317 as a therapeutic monoclonal antibody of PD-1 glycosylation-targeting which may become efficient alternative for cancer therapy.


Assuntos
Anticorpos Monoclonais/farmacologia , Antineoplásicos Imunológicos/farmacologia , Receptor de Morte Celular Programada 1/antagonistas & inibidores , Animais , Anticorpos Monoclonais/química , Anticorpos Monoclonais Humanizados/química , Afinidade de Anticorpos , Complexo Antígeno-Anticorpo/química , Antineoplásicos Imunológicos/química , Asparagina/metabolismo , Antígeno B7-H1/metabolismo , Ligação Competitiva , Cristalografia por Raios X , Epitopos/química , Feminino , Glicosilação , Humanos , Camundongos , Camundongos Endogâmicos C57BL , Modelos Moleculares , Neoplasias/tratamento farmacológico , Nivolumabe/química , Proteína 2 Ligante de Morte Celular Programada 1/metabolismo , Receptor de Morte Celular Programada 1/imunologia , Receptor de Morte Celular Programada 1/metabolismo , Domínios e Motivos de Interação entre Proteínas
19.
Bioconjug Chem ; 30(11): 2828-2843, 2019 11 20.
Artigo em Inglês | MEDLINE | ID: mdl-31592652

RESUMO

A smart theranostic prodrug IMC-FDU-TZBC-NO2, releasing active drug on-demand based on hypoxia-activated and indomethacin-mediated, for solid tumor imaging and efficient therapy was designed. This prodrug was constructed by conjugating chemotherapy drug 5-fluoro-2-deoxyuridine (FDU), targeting moiety indomethacin (IMC), and the hypoxic trigger 4-nitrobenzyl group to a fluorescent dye precursor, which was mediated by IMC and activated by NTR under hypoxic conditions. The fluorescent dye IMC-TZBCM was generated and FDU was released at the same time in tumor cells. The rates and amounts of FDU release and IMC-TZBCM generation were regulated by hypoxia status, and increased with increasing degree of hypoxia. Nevertheless, it is "locked" in normal cells. It combined the advantages of tumor targeting, diagnosis, and chemotherapy functions, showed excellent targeting ability to cancer cells, excellent stability in physiological conditions, high cellular uptake efficiency, and on-demand drug release behavior. The in vitro and in vivo assays demonstrated that IMC-FDU-TZBC-NO2 exhibits enhanced anticancer potency and low side effects. The novel targeted theranostic prodrug activated by hypoxia shows a great potential in cancer therapy.

20.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 31(8): 1039-1042, 2019 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-31537236

RESUMO

OBJECTIVE: To apply the concept of evidence-based nursing in the practice of inhalation therapy for patients with chronic obstructive pulmonary disease (COPD) complicated respiratory failure, introduce the application method of self-made anti-carbon dioxide retention atomizer, and to observe the application effect. METHODS: Patients with COPD combine respiratory failure admitted to the respiratory department of Harrison International Peace Hospital Affiliated to Hebei Medical University from May 2018 to April 2019 were enrolled. All patients received atomization inhalation therapy in addition to anti-infection and spasmolysis. By using self-made carbon dioxide retention atomizer time node, 40 patients in the prospective study using home-made carbon dioxide retention atomizer inhalation therapy from November 2018 to April 2019 were enrolled as observation group. Through evidence-based nursing strategy, the related literature at home and abroad was retrieved, to find the clinical evidence, formulation and implementation of care plan. Forty patients who received inhalation therapy with normal mask atomizer from May to October in 2018 were enrolled as the control group in the retrospective analysis. The peripheral arterial blood gas analysis indexes [pH value, arterial oxygen partial pressure (PaO2), arterial carbon dioxide partial pressure (PaCO2)], the disappearance of pulmonary asthma at 5 minutes before atomization inhalation and 20 minutes after atomization inhalation, and the patient's cooperation in treatment were compared between the two groups. RESULTS: All patients were included in the final analysis. There was no significant difference in blood gas analysis indexes between the two groups. After 20 minutes of atomization inhalation, the pH value, PaO2 and PaCO2 of the two groups were improved, and the improvement was more obvious in the observation group [pH value: 7.32±0.35 vs. 7.25±1.25, PaO2 (mmHg, 1 mmHg = 0.133 kPa) : 61.50±1.55 vs. 59.50±1.05, PaCO2 (mmHg) : 43.25±1.65 vs. 49.05±1.75, all P < 0.05]. The lung asthma in the two groups was significantly improved with 20 minutes of atomization inhalation as compared with that before atomization, and the improvement of lung asthma in the observation group was significantly better than that in the control group (asthma score: 0.91±0.29 vs. 1.65±0.35, P < 0.05). The good coordination rate of the observation group was significantly higher than that of the control group [90% (36/40) vs. 70% (28/40), χ2 = 3.828, P = 0.048]. CONCLUSIONS: Compared with the inhalation treatment with ordinary mask nebulizer, inhalation treatment with self-made anti-carbon dioxide retention atomizer for COPD patients with respiratory failure can reduce carbon dioxide retention, significantly improve respiratory failure symptoms and improve compliance.


Assuntos
Nebulizadores e Vaporizadores , Doença Pulmonar Obstrutiva Crônica , Insuficiência Respiratória , Dióxido de Carbono , Humanos , Estudos Prospectivos , Estudos Retrospectivos
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