Observation on the Effect of Non-Invasive Ventilator Combined with Conventional Therapy in the Treatment of Chronic Obstructive Pulmonary Disease Complicated with Respiratory Failure

Objective:To explore the clinical effect of a non-invasive ventilator combined with conventional therapy in the treatment of patients with chronic obstructive pulmonary disease(COPD)combined with respiratory failure.Methods:68 patients with COPD combined with respiratory failure treated in our hospital from September 2021 to October 2023 were selected as the research subjects.Using the random number table method,they were divided into a control group and an experimental group of 34 cases each.The control group received conventional symptomatic treatment,and the experimental group received non-invasive ventilator treatment based on the control group.The clinical effects,blood gas indicators(partial pressure of carbon dioxide(PaCO_(2)),partial pressure of oxygen(PaO_(2)),arterial oxygen saturation(SaO_(2))),lung function(forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),6 min walking distance),complications,and inflammatory factor levels(c-reactive protein(CRP),interleukin-6(IL-6),neutrophil-to-lymphocyte ratio(NLR))of the two groups of patients were observed.Results:(1)The clinical efficacy of the patients in the experimental group(33/97.06%)was more significant as compared with the control group(25/73.53%)(P<0.05);(2)After treatment,the clinical efficacy of the two groups of patients in terms of FEV1,FEV1/FVC,6-minute walking distance,PaO_(2)and SaO_(2)all increased in the experimental group as compared to that of the control group(P<0.05);(3)After treatment,the PaCO_(2),CRP,IL-6,and NLR of the two groups of patients decreased,and the decrease in the experimental group was higher than that of the control group(P<0.05);(4)The patients’complication rate in the experimental group(2/5.88%)was lower as compared to that of the control group(9/26.46%)(P<0.05).Conclusion:Non-invasive ventilators combined with conventional therapy achieved good clinical results in treating patients with COPD and respiratory failure.

Effect of Digested Sewage Sludge on the Ventilation and Coughing Rates of Two Fresh Water Fish

Addition of digested sewage sludge at concentrations of 2% and 10% (v/v) to the water increased coughing rate in big head and tilapia (P<0.05). Ventilation rate was significantly decreased (P<0.05) in big head and tilapia at sludge concentrations of 6% and 2% (v/v)respectively. Copper (Cu), cadmium (Cd) and zinc (Zn) are trace metals which are commonly found in sludge. Cu caused a significant increase (P<0.05) in coughing rate in both tilapia and big head at concentrations of 0.3 and 0.2 μg/ml respectively. Zn caused significant increase (P<0.05) in coughing rate only in big head at 2 μg/ml. Neither fish responded to Cd of up to 2μg/ml in the water. However, when the levels of these trace metals in the digested sludge were measured, they were below that which can cause significant changes in the respiratory movements. Therefore, the changes in ventilation and coughing rates after addition of sludge may be due to the presence of substances other than these metals. The results of this experiment provides a guideline to control the level of sludge that can be used in rearing these fresh water fish in ponds

Application of fiberoptic bronchscopy in patients with acute exacerbations of chronic obstructive pulmonary disease during sequential weaning of invasive-noninvasive mechanical ventilation

BACKGROUND:Early withdrawal of invasive mechanical ventilation(IMV) followed by noninvasive MV(NIMV) is a new strategy for changing modes of treatment in patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD) with acute respiratory failure(ARF).Using pulmonary infection control window(PIC window) as the switch point for transferring from invasive to noninvasive MV,the time for early extubation can be more accurately judged,and therapy efficacy can be improved.This study aimed to prospectively investigate the clinical effectiveness of fiberoptic bronchscopy(FOB) in patients with AECOPD during sequential weaning of invasive-noninvasive MV.METHODS:Since July 2006 to January 2011,106 AECOPD patients with ARF were treated with comprehensive medication and IMV after hospitalization.Patients were randomly divided into two groups according to whether fiberoptic bronchoscope is used(group A,n=54) or not(group B,n=52) during sequential weaning from invasive to noninvasive MV.In group A,for sputum suction and bronchoalveolar lavage(BAL),a fiberoptic bronchoscope was put into the airway from the outside of an endotracheal tube,which was accompanied with uninterrupted use of a ventilator.After achieving PIC window,patients of both groups changed to NIMV mode,and weaned from ventilation.The following listed indices were used to compare between the groups after treatment:1) the occurrence time of PIC,the duration of MV,the length of ICU stay,the success rate of weaning from MV for the first time,the rate of reventilatJon and the occurrence rate of ventilator-associated pneumonia(VAP);2) the convenience and safety of FOB manipulation.The results were compared using Student's f test and the Chi-square test.RESULTS:The occurrence time of PIC was(5.01 ±1.49) d,(5.87±1.87) d in groups A and B,respectively(P<0.05);the duration of MV was(6.98±1.84) d,(8.69±2.41) d in groups A and B,respectively(P<0.01);the length of ICU stay was(9.25±1.84) d,(11.10±2.63) d in groups A and B,respectively(P<0.01);the success rate of weaning for the first time was 96.30%,76.92%in groups A and B,respectively(P<0.01);the rate of reventilation was 5.56%,19.23%in groups A and B,respectively(P<0.05);and the occurrence rate of VAP was 3.70%,23.07%in groups A and B,respectively(P<0.01).Moreover,it was easy and safe to manipulate FOB,and no side effect was observed.CONCLUSIONS:The application of FOB in patients with AECOPD during sequential weaning of invasive-noninvasive MV is effective in ICU.It can decrease the duration of MV and the length of ICU stay,increase the success rate from weaning MV for the first time,reduce the rate of reventilation and the occurrence rate of VAP.In addition,such a method is convenient and safe in patients of this kind.

Use of Ventilation-Index in the Development of Exposure Model for Indoor Air Pollution—A Review

In indoor environment, emission factor of the cooking fuel plays a vital role in determining correlation between exposure assessment and health effects. Both indoor and outdoor air pollution exposures are widely influenced by the ventilation status. An optimum control of the air change rate has also significant impact on the exposure pattern. A number of studies revealed that the indoor particulates and gaseous exposures, resulting from the combustion of various cooking fuels, are associated with significant adverse health effects on pregnant mothers and new born babies. The impacts of ventilation status on air pollution exposure in households’ kitchens or living rooms have not been explored enough. Except a few studies with concrete rooms, especially in industries, no other studies have been established on the correlation between the ventilation index and air pollution exposure. The intent of this review is to discuss reported findings focused on the ventilation and exposure to air pollution. This will obviously help better understanding to modulate exposure profile in household condition using simple tool of ventilation measurement.

Clinical Study on Respiratory Medicine Treatment of Chronic Obstructive Pulmonary Disease Combined with Respiratory Failure

Objective:To explore the respiratory medicine treatment methods for treating chronic obstructive pulmonary disease(COPD)combined with respiratory failure.Methods:70 cases of COPD patients with combined respiratory failure admitted to our hospital from January 2021 to January 2023 were selected as the study subjects,and randomly divided into the control group and the experimental group,each with 35 cases.The control group received only conventional treatment,and the experimental group received non-invasive positive pressure ventilation,and the treatment effects and changes in the levels of IL-18,hs-CRP,and CES2 inflammatory factors were observed and evaluated in the two groups.Results:There was no significant difference between the general data of the two groups(P>0.05);after treatment,the total effective rate of clinical efficacy of the observation group(91.43%)was significantly higher than that of the control group(71.43%),and the difference showed a significant correlation(P<0.05);after treatment,the level of inflammatory factor of the observation group was significantly reduced compared with that of the control group,and the difference showed a highly significant correlation(P<0.001).Conclusion:The non-invasive positive pressure ventilation treatment program significantly improves the therapeutic effect,effectively controls the level of inflammatory factors,and improves the health status of patients when dealing with patients with chronic obstructive pulmonary disease accompanied by respiratory failure,showing a good clinical application prospect.

卷烟纸材料对卷烟通风率影响效应研究

卷烟通风率是卷烟品质评价中不可或缺的关键指标。为了验证不同卷烟材料对于卷烟纸通风率的影响,采用均匀设计实验方法,建立起不同卷烟材料要素对卷烟通风率二次多项逐步回归模型,并对模型的边际效应和因素效应进行了分析。结果表明,不同卷烟材料组合的卷烟通风率变异系数为41.7%,说明卷烟通风率受到卷烟材料组合的影响较大,而单一因素对于卷烟通风率的作用不是很大。

有创-无创序贯机械通气治疗慢性阻塞性肺疾病合并呼吸衰竭患者的效果

目的:探讨有创-无创序贯机械通气治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者的效果。方法:回顾性分析2022年6月至2023年6月该院收治的66例COPD合并呼吸衰竭患者的临床资料,按照机械通气方法的不同将其分为观察组和对照组各33例。对照组采取有创机械通气治疗,观察组采取有创-无创序贯机械通气治疗。比较两组总机械通气时间、有创机械通气时间、住院时间,治疗前后动脉血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、pH值]、心功能损伤指标[肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)]水平,治疗2周内脱机成功率及并发症发生率。结果:治疗后,观察组总机械通气时间、有创机械通气时间和住院时间均短于对照组,差异有统计学意义(P<0.05);治疗后,观察组PaO_(2)水平、pH值均高于对照组,PaCO_(2)水平低于对照组,差异有统计学意义(P<0.05);观察组脱机成功率为96.97%(32/33),高于对照组的75.76%(25/33),并发症发生率为6.06%(2/33),低于对照组的24.24%(8/33),差异均有统计学意义(P<0.05)。结论:有创-无创序贯机械通气用于COPD合并呼吸衰竭患者中能够缩短机械通气时间和住院时间,改善患者血气指标和心功能,提高脱机成功率,并降低并发症发生率,效果优于常规有创机械通气治疗。

几种卷烟纸材料对卷烟通风率的效应研究

为了评估不同组合卷烟材料对卷烟通风率产生的影响,卷烟通风率的二次多项逐步回归模型采用均匀设计实验方法,构建了多种类卷烟材料要素对卷烟通风率的二次多项逐步,且分析上述模型边际效应、单因素效应、因素主效应。根据研究结果表面,不同材料组合卷烟通风率最高数据为84.59%,除滤嘴末端丝束特性参数升高、卷烟通风率降低外,滤嘴末端丝束特性参数升高。

煤矿局部通风技术的优化与效果比较

为进一步提升煤矿工作面的通风效率,通风机的运行效率等,为保障工作面安全生产奠定扎实基础,在对矿井基本情况包括有煤尘、瓦斯涌出量、二氧化碳涌出量等分析的基础上;根据局部通风技术优化原则和依据优选通风方案,并完成局部通风机的选型和配套风筒的选型;最后,对局部通风技术的优化效果进行比对。

工作面局部通风技术的优化及效果分析

为解决随着工作面断面面积增大、巷道延长所导致的工作面通风能力无法满足实际需风量的问题,在对某煤矿通风现状进行分析的基础上,结合其现场情况拟提出两种优化方案并对方案进行对比得出最佳方案完成了通风机和井筒的重新选型;最后,通过现场测定对通风技术的优化效果进行评估,并取得理想结果。

纵向通风下障碍物对隧道火灾燃烧速率的影响研究

采用模型隧道实验的方法,研究不同纵向通风速度和障碍物距离下池火燃烧速率的变化规律。结果表明,在纵向通风的条件下,障碍物的距离为5 cm时池火的燃烧速率最高。在障碍物距离一定时,池火的燃烧速率随纵向通风速度增加而增加。障碍物距离在一定范围内,池火的燃烧速率高于无障碍物的情况,而障碍物距离超出一定范围时,池火燃烧速率与无障碍物的情况相差不大。障碍物的存在对池火燃烧速率的影响主要归因于侧壁辐射效应和气流场的变化。纵向通风对池火燃烧的影响更为明显。当障碍物距离改变时,气流场会改变火焰的倾斜方向,进而改变侧壁辐射效应。这些发现对于深入理解隧道火灾特性、优化消防安全设计以及制定有效的火灾防控措施具有一定的指导意义。

几种不同情况下的自然通风量的计算

自然通风是建筑物主要的通风形式,是改善环境的最简单、最直接的手段,其风量和风向时刻随着室内外温度、室外风速、风向及建筑物孔口位置的变化而变化。孔口有效面积和室内外压差,直接决定了自然通风量的大小。为了合理利用自然通风技术消除室内余热余湿,提高能源利用效率,基于建筑物围护结构孔口形式的多样性,提出了在风压和热压作用下的不同形式的孔口有效面积的计算方法,继而得到自然通风量的计算方法。

从通风保障效果全面认识房间通风量概念

通常采用名义通风量指标描述房间整体的通风情况,然而实际室内环境多为非均匀环境,仅用名义通风量很难有效评价房间真实的通风效果。从实际通风效果的角度出发,定义名义通风量、有效通风量和局部通风量3类新风量指标,并通过算例说明3类指标的区别。建议采用有效风量代替名义风量用于评价房间的整体通风效果;而在评价局部区域通风效果时,采用局部纯净风量和局部通风量指标。

基于故障统计模型的可修通风系统可靠性指标体系研究

以可靠性工程理论为指导,针对矿井通风系统自身的属性———强耦合性、参数时变性和非线性等特点,通过对影响系统可靠性运行因素剖析,从通风网络和矿井主要通风机两个方面进行了矿井通风系统可靠性评价,推导出了各项评价指标的求解公式,从而从故障统计角度提出并构建起了矿井通风系统可靠性评价模型,并结合实例进行了验证.

开展品管圈活动 降低呼吸机故障

目的:观察开展品管圈降低呼吸机故障率的效果,加强科室对呼吸机的维护管理。方法:通过自发组建品管圈,开展相关活动,实施相关措施,观察降低呼吸机故障率的效果。结果:通过开展品管圈活动,使科室呼吸机故障率从6.31%降至1.63%,呼吸机月平均维修费从3531元降至1450元。结论:开展品管圈活动降低了科室呼吸机的故障率,增强了呼吸机的使用安全性,节约了科室呼吸机的维修费。

室内废气污染的计算与分析

通过对吸油烟机抽吸风场有效强度矢量图的测量 ,给出了吸油烟机质量技术检验方法和油烟废气、燃气废气污染泄漏量的计算方法 ;对油烟、燃气废气在厨房的扩散与循环作了详细分析 ,并对国标提出几点建议。

大跨径悬索桥施工猫道气动力系数数值分析

为了探讨用数值方法研究大跨径悬索桥猫道的气动力系数,并且考虑雷诺数效应的影响,以某大跨径悬索桥为背景,分别利用计算流体力学软件Fluent中的标准k-ε模型、RNG k-ε模型和SST模型,且采用一定的猫道透风率进行二维数值模拟,对猫道的气动力系数在不同风速、不同攻角和不同雷诺数情况下进行CFD识别,并与相应风洞试验的结果进行对比分析.结果表明:雷诺数的变化对阻力系数影响较小,但对升力系数影响较大,因此在进行猫道的数值模拟时,选择合适的雷诺数很有必要;SST湍流模型是猫道断面CFD识别中较合理的模型;模拟的猫道透风率是可行的.

肺泡表面活性物质结合高频振荡通气治疗新生儿呼吸窘迫综合征

目的探究肺泡表面活性物质结合高频振荡通气治疗新生儿呼吸窘迫综合征的疗效及安全性。方法研究纳入116例呼吸窘迫综合征新生儿,用随机数字表法分为观察组与对照组,对照组(58例)给予常频通气治疗联合肺泡表面活性物质治疗,观.察组(58例)给予肺泡表面活性物质联合高频振荡通气治疗,比较2组新生儿的存活率、临床疗效、并发症发生率、治疗前及治疗24 h后的血气指标变化、治疗前后氧化应激指标变化、铁蛋白(SF)及Clara细胞分泌蛋白(CC16)、骨形态发生蛋白-7(BMP-7)等指标变化以及患儿用机时间及住院时间。结果观察组新生儿存活率(100.00%)高于对照组(98.28%),P>0.05;观察组新生儿临床有效率(100.00%)高于对照组(93.10%),P<0.05;观察组新生儿并发症发生率(3.45%)低于对照组(13.79%),P<0.05;治疗前,2组新生儿pH值、动脉血氧分压(PaO_(2))及动脉二氧化碳分压(PaCO_(2))水平比较差异无统计学意义,治疗24 h后2组新生儿pH值及PaO_(2)、PaCO_(2)指标均改善,观察组新生儿治疗24 h后pH值及PaO_(2)、PaCO_(2)指标优于对照组,P<0.05;治疗前,2组新生儿丙二醛(MDA)、谷胱甘肽过氧化酶(GSH-Px)、超氧化物歧化酶(SOD).SF、CC16及BMP-7指标比较,差异无统计学意义(P>0.05),治疗后2组患儿MDA.GSH-Px.SOD、SF、CC16及BMP-7等指标均改善,且观察组均优于对照组,P<0.05;观察组新生儿用机时间及住院时间均短于对照组,P<0.05。结论肺泡表面活性物质结合高频振荡通气治疗新生儿呼吸窘迫综合征临床疗效显著,患儿存活率高,并发症发生率低,安全性高,疗效好,恢复快。

通风的有效性与室内空气品质

指出了通风有效性对改善室内空气品质的重要性 ,比较了不同送风方式的换气与通风效率 ,分析了通风效率与室内污染度的关系 ,最后提出了关于如何提高通风效率的建议。

基于FMEA与PDCA循环的呼吸机管理探讨

目的探讨失效模式与效应分析(Failure Mode and Effects Analysis,FMEA)方法和PDCA循环管理方法对提高我院呼吸机可靠性的应用价值。方法通过FMEA方法分析我院2016年12月至2018年11月及2019年3月至2021年2月共2年的呼吸机故障数据风险顺序数(Risk Priority Number,RPN),并选取RPN最高的4种故障类型,运用PDCA循环管理的目标设定、鱼骨图、柏拉图、六何分析法(5W1H)等方法进行目标设定、原因查找、真因分析并拟定对策。结果管理方案实施后,影响呼吸机可靠性的关键性4类故障的指标达到设定的目标值;故障发生频率较实施前明显降低,且差异有统计学意义(P<0.05)。结论通过FMEA方法和PDCA循环管理方法的实施和执行,能够有效提高我院呼吸机可靠性。