SEVERE tracheal stenosis can not only cause criti- cal medical problems such as severe shortness of breath, hypoxia, and even orthopnea, but also impose overwhelming challenges on thephysicians, particularly the anest...SEVERE tracheal stenosis can not only cause criti- cal medical problems such as severe shortness of breath, hypoxia, and even orthopnea, but also impose overwhelming challenges on thephysicians, particularly the anesthesiologist. Life-threa- tening airway obstruction can make the patient＇s gas ex- change extremely difficult. Though several options could be offered regarding the treatment of tracheal stenosis, normally, tracheal resection and following reconstruction is the first choice for severe airway stenosis.1 Successful surgical intervention relies on the close communication and cooperation between surgeons and anesthesiologists.展开更多
Canopy air curtain （CAC） technology has been developed by the National Institute for Occupational Safety and Health （NIOSH） for use on continuous miners and subsequently roof bolting machines in underground coal m...Canopy air curtain （CAC） technology has been developed by the National Institute for Occupational Safety and Health （NIOSH） for use on continuous miners and subsequently roof bolting machines in underground coal mines to protect operators of these machines from overexposure to respirable coal mine dust. The next logical progression is to develop a CAC for shuttle cars to protect operators from the same overexposures. NIOSH awarded a contract to Marshall University and J.H. Fletcher to develop the shuttle car CAC. NIOSH conducted laboratory testing to determine the dust control efficiency of the shuttle car CAC. Testing was conducted on two different cab configurations： a center drive similar to that on a Joy 10SC32AA cab model and an end drive similar to that on a Joy 10SC32AB cab model. Three different ventilation velocities were tested-0.61, 2.0, 4.3 rrds （120, 400, and 850 fpm）. The lowest, 0.61 m/s （120 fpm）, represented the ventilation velocity encountered during loading by the continuous miner, while the 4.3 m/s （850 fpm） velocity represented ventilation velocity airflow over the shuttle car while tramming against ventilation airflow. Test results showed an average of the dust control efficiencies ranging from 74 to 83% for 0.61 m/s （120 fpm）, 39%-43% for 2.0 m/s （400 fpm）, and 6%-16% for 4.3 m/s （850 fpm）. Incorporating an airflow spoiler to the shuttle car CAC design and placing the CAC so that it is located 22.86 cm （9 in.） forward of the operator improved the dust control efficiency to 51%-55% for 4.3 m/s （850 fpm） with minimal impact on dust control efficiencies for lower ventilation velocities. These laboratory tests demonstrate that the newly developed shuttle car CAC has the potential to successfully protect shuttle car operators from coal mine respirable dust overexposures.展开更多
Asthma and allergies are considered by many physicians as being triggered by different substances in the air that people breathe. The lung is the most common site of injury by airborne pollutants. Acute effects, howev...Asthma and allergies are considered by many physicians as being triggered by different substances in the air that people breathe. The lung is the most common site of injury by airborne pollutants. Acute effects, however, may also include non-respiratory signs and symptoms, which may depend upon toxicological characteristics of the substances and host-related factors. The studying of indoor air quality can provide a method for appropriate remedial action. Research suggests that SHD （Settled House Dust） may be a significant source for indoor exposure to different substances. This research study consisted of sampling dust from homes in different area codes. The dust samples were collected from August 2006 thru March 2007 and analyzed using GC/MS （Gas Chromatography/Mass Spectrometry）. The purpose of this research study will display how sampling household dust is a powerful tool for identifying chemicals that contribute to poor indoor air quality.展开更多
OBJECTIVE: To compare the influence of cardiac-pulmonary function on clinical acute respiratory failure patients using Proportional assist ventilation (PAV), Pressure support ventilation (PSV) and intermittent positiv...OBJECTIVE: To compare the influence of cardiac-pulmonary function on clinical acute respiratory failure patients using Proportional assist ventilation (PAV), Pressure support ventilation (PSV) and intermittent positive pressure ventilation (IPPV). Here, we also describe some our experience with the clinical use of PAV. METHODS: Using the IPPV mode in ten acute respiratory failure patients, calculate Elastance (Ers) and Resistance (Rrs), then change to PSV, set inspiratory positive airway pressure (IPAP) according to IPPV, so that tidal volume (V(T)) is the same as that of IPPV. We then changed the mode into PAV and set the assist ratio according to PSV, so that V(T) and Ppeak were the same as that of PSV. Then we observed the changes of respiratory mechanics, blood gas levels and hemodynamics during ventilation. RESULTS: Compared with PSV and IPPV, peak pressure (Ppeak) of PAV was markedly lower while V(T) was similar; work of breathing of patient (WOBp), and work of breathing of ventilation (WOBv) were also lower; center vein pressure (CVP) and pulmonary capillary wedge pressure (PCWP) of PAV were markedly lower than that of IPPV while V(T) were similar. Compared with PSV, V(T), mean blood pressure (mBP) and cardiac output (CO) of PAV were higher. Mean pulmonary artery pressure (mPAP) and WOBp of PAV were lower while Ppeak was similar; the differences in WOBp were notable. CONCLUSIONS: For clinical acute respiratory failure patients, compared with PSV and IPPV, PAV has lower airway pressure, less WOBp and less influence on hemodynamics.展开更多
Patients who are diagnosed with acute lung injury/acute respiratory distress syndrome （ALI/ARDS） usually have ventilation-perfusion mismatch, severe decrease in lung capacity, and gas exchange abnormalities. Health ...Patients who are diagnosed with acute lung injury/acute respiratory distress syndrome （ALI/ARDS） usually have ventilation-perfusion mismatch, severe decrease in lung capacity, and gas exchange abnormalities. Health care workers have implemented various strategies in an attempt to compensate for these pathological alterations. By rotating patients with ALI/ARDS between the supine and prone position, it is possible to achieve a significant improvement in PaO2/FiO2, decrease shunting and therefore improve oxygenation without use of expensive, invasive and exprimental procedures. Prone positioning is a safe and effective way to improve ventilation when conventional strategies fail to initiate a patient response. Because a specific cure for ARDS is not available, the goat is to support the patients with therapies that cause the least amount of injury while the lungs have an opportunity to heat. Based on current data, a trial of prone positioning ventilation should be offeted to the patients who have ALI/ARDS in the early course of the disease. Published studies exhibit substantial heterogeneity in clinical results, suggesting that an adequately sized study optimizing the duration of pronmg ventilation strategy is warranted to enable definitive conclusions to be drawn.展开更多
Objective:To observe the therapeutic efficacy of acupoint application at different groups of acupoints in treating bronchial asthma in remission stage.Methods:A total of 120 patients with bronchial asthma in remission...Objective:To observe the therapeutic efficacy of acupoint application at different groups of acupoints in treating bronchial asthma in remission stage.Methods:A total of 120 patients with bronchial asthma in remission stage were recruited and divided by the random number table method into acupoint application group 1,acupoint application group 2 and acupoint application group 3,with 40 cases in each group.In all the three groups,Tiantu(CV 22),Dazhui(GV 14)and Feishu(BL 13)were selected,with Dingchuan(EX-B 1)added in acupoint application group 1,Shenshu(BL 23)added in acupoint application group 2,and Gaohuang(BL 43)added in acupoint application group 3.Before intervention,one month and 3 months after intervention,clinical symptoms,peak expiratory flow(PEF)and forced expiratory volume in 1 second percentage of predicted value(FEV1%)of the three groups were observed,and their clinical efficacies were evaluated.Results:Comparing the therapeutic efficacy regarding traditional Chinese medicine symptoms and signs,after 1-month treatment,the total effective rate was 87.5%in acupoint application group 1,versus 62.5%in acupoint application group 2 and 55.0%in acupoint application group 3,and the between-group differences were statistically significant.After 3-month treatment,the total effective rate was 95.0%in acupoint application group 1,versus 70.0%in acupoint application group 2 and 65.0%in acupoint application group 3,and the between-group differences were statistically significant.After intervention,the three groups all showed significant improvements in pulmonary function with statistical significance;among the three groups,the improvement in acupoint application group 1 was more significant than that in the other two groups.Conclusion:Tiantu(CV 22),Dazhui(GV 14)and Feishu(BL 13)as basic prescription plus Dingchuan(EX-B 1)can improve symptoms of bronchial asthma in remission stage,and it works better in improving pulmonary function than the basic prescription plus Shenshu(BL 23)or Gaohuang(BL 43).展开更多
Asthma is a common disease with recurrent onset which severely affects patients＇ quality of life. Acupuncture can improve pulmonary functions in asthma patients and thus treat this disorder. To summarize the status o...Asthma is a common disease with recurrent onset which severely affects patients＇ quality of life. Acupuncture can improve pulmonary functions in asthma patients and thus treat this disorder. To summarize the status of acupuncture treatment for asthma, we have collected clinical literatures published in the recent 20 years and analyzed the influence of acupuncture on pulmonary functions in asthma patients from the aspects of frequently used points, needling techniques, manipulation and mechanisms to provide references for treating asthma with acupuncture.展开更多
文摘SEVERE tracheal stenosis can not only cause criti- cal medical problems such as severe shortness of breath, hypoxia, and even orthopnea, but also impose overwhelming challenges on thephysicians, particularly the anesthesiologist. Life-threa- tening airway obstruction can make the patient＇s gas ex- change extremely difficult. Though several options could be offered regarding the treatment of tracheal stenosis, normally, tracheal resection and following reconstruction is the first choice for severe airway stenosis.1 Successful surgical intervention relies on the close communication and cooperation between surgeons and anesthesiologists.
文摘Canopy air curtain （CAC） technology has been developed by the National Institute for Occupational Safety and Health （NIOSH） for use on continuous miners and subsequently roof bolting machines in underground coal mines to protect operators of these machines from overexposure to respirable coal mine dust. The next logical progression is to develop a CAC for shuttle cars to protect operators from the same overexposures. NIOSH awarded a contract to Marshall University and J.H. Fletcher to develop the shuttle car CAC. NIOSH conducted laboratory testing to determine the dust control efficiency of the shuttle car CAC. Testing was conducted on two different cab configurations： a center drive similar to that on a Joy 10SC32AA cab model and an end drive similar to that on a Joy 10SC32AB cab model. Three different ventilation velocities were tested-0.61, 2.0, 4.3 rrds （120, 400, and 850 fpm）. The lowest, 0.61 m/s （120 fpm）, represented the ventilation velocity encountered during loading by the continuous miner, while the 4.3 m/s （850 fpm） velocity represented ventilation velocity airflow over the shuttle car while tramming against ventilation airflow. Test results showed an average of the dust control efficiencies ranging from 74 to 83% for 0.61 m/s （120 fpm）, 39%-43% for 2.0 m/s （400 fpm）, and 6%-16% for 4.3 m/s （850 fpm）. Incorporating an airflow spoiler to the shuttle car CAC design and placing the CAC so that it is located 22.86 cm （9 in.） forward of the operator improved the dust control efficiency to 51%-55% for 4.3 m/s （850 fpm） with minimal impact on dust control efficiencies for lower ventilation velocities. These laboratory tests demonstrate that the newly developed shuttle car CAC has the potential to successfully protect shuttle car operators from coal mine respirable dust overexposures.
文摘Asthma and allergies are considered by many physicians as being triggered by different substances in the air that people breathe. The lung is the most common site of injury by airborne pollutants. Acute effects, however, may also include non-respiratory signs and symptoms, which may depend upon toxicological characteristics of the substances and host-related factors. The studying of indoor air quality can provide a method for appropriate remedial action. Research suggests that SHD （Settled House Dust） may be a significant source for indoor exposure to different substances. This research study consisted of sampling dust from homes in different area codes. The dust samples were collected from August 2006 thru March 2007 and analyzed using GC/MS （Gas Chromatography/Mass Spectrometry）. The purpose of this research study will display how sampling household dust is a powerful tool for identifying chemicals that contribute to poor indoor air quality.
文摘OBJECTIVE: To compare the influence of cardiac-pulmonary function on clinical acute respiratory failure patients using Proportional assist ventilation (PAV), Pressure support ventilation (PSV) and intermittent positive pressure ventilation (IPPV). Here, we also describe some our experience with the clinical use of PAV. METHODS: Using the IPPV mode in ten acute respiratory failure patients, calculate Elastance (Ers) and Resistance (Rrs), then change to PSV, set inspiratory positive airway pressure (IPAP) according to IPPV, so that tidal volume (V(T)) is the same as that of IPPV. We then changed the mode into PAV and set the assist ratio according to PSV, so that V(T) and Ppeak were the same as that of PSV. Then we observed the changes of respiratory mechanics, blood gas levels and hemodynamics during ventilation. RESULTS: Compared with PSV and IPPV, peak pressure (Ppeak) of PAV was markedly lower while V(T) was similar; work of breathing of patient (WOBp), and work of breathing of ventilation (WOBv) were also lower; center vein pressure (CVP) and pulmonary capillary wedge pressure (PCWP) of PAV were markedly lower than that of IPPV while V(T) were similar. Compared with PSV, V(T), mean blood pressure (mBP) and cardiac output (CO) of PAV were higher. Mean pulmonary artery pressure (mPAP) and WOBp of PAV were lower while Ppeak was similar; the differences in WOBp were notable. CONCLUSIONS: For clinical acute respiratory failure patients, compared with PSV and IPPV, PAV has lower airway pressure, less WOBp and less influence on hemodynamics.
文摘Patients who are diagnosed with acute lung injury/acute respiratory distress syndrome （ALI/ARDS） usually have ventilation-perfusion mismatch, severe decrease in lung capacity, and gas exchange abnormalities. Health care workers have implemented various strategies in an attempt to compensate for these pathological alterations. By rotating patients with ALI/ARDS between the supine and prone position, it is possible to achieve a significant improvement in PaO2/FiO2, decrease shunting and therefore improve oxygenation without use of expensive, invasive and exprimental procedures. Prone positioning is a safe and effective way to improve ventilation when conventional strategies fail to initiate a patient response. Because a specific cure for ARDS is not available, the goat is to support the patients with therapies that cause the least amount of injury while the lungs have an opportunity to heat. Based on current data, a trial of prone positioning ventilation should be offeted to the patients who have ALI/ARDS in the early course of the disease. Published studies exhibit substantial heterogeneity in clinical results, suggesting that an adequately sized study optimizing the duration of pronmg ventilation strategy is warranted to enable definitive conclusions to be drawn.
文摘Objective:To observe the therapeutic efficacy of acupoint application at different groups of acupoints in treating bronchial asthma in remission stage.Methods:A total of 120 patients with bronchial asthma in remission stage were recruited and divided by the random number table method into acupoint application group 1,acupoint application group 2 and acupoint application group 3,with 40 cases in each group.In all the three groups,Tiantu(CV 22),Dazhui(GV 14)and Feishu(BL 13)were selected,with Dingchuan(EX-B 1)added in acupoint application group 1,Shenshu(BL 23)added in acupoint application group 2,and Gaohuang(BL 43)added in acupoint application group 3.Before intervention,one month and 3 months after intervention,clinical symptoms,peak expiratory flow(PEF)and forced expiratory volume in 1 second percentage of predicted value(FEV1%)of the three groups were observed,and their clinical efficacies were evaluated.Results:Comparing the therapeutic efficacy regarding traditional Chinese medicine symptoms and signs,after 1-month treatment,the total effective rate was 87.5%in acupoint application group 1,versus 62.5%in acupoint application group 2 and 55.0%in acupoint application group 3,and the between-group differences were statistically significant.After 3-month treatment,the total effective rate was 95.0%in acupoint application group 1,versus 70.0%in acupoint application group 2 and 65.0%in acupoint application group 3,and the between-group differences were statistically significant.After intervention,the three groups all showed significant improvements in pulmonary function with statistical significance;among the three groups,the improvement in acupoint application group 1 was more significant than that in the other two groups.Conclusion:Tiantu(CV 22),Dazhui(GV 14)and Feishu(BL 13)as basic prescription plus Dingchuan(EX-B 1)can improve symptoms of bronchial asthma in remission stage,and it works better in improving pulmonary function than the basic prescription plus Shenshu(BL 23)or Gaohuang(BL 43).
文摘Asthma is a common disease with recurrent onset which severely affects patients＇ quality of life. Acupuncture can improve pulmonary functions in asthma patients and thus treat this disorder. To summarize the status of acupuncture treatment for asthma, we have collected clinical literatures published in the recent 20 years and analyzed the influence of acupuncture on pulmonary functions in asthma patients from the aspects of frequently used points, needling techniques, manipulation and mechanisms to provide references for treating asthma with acupuncture.
