Exploring occupational hazards and protective strategies in power generation enterprises / 中国职业医学

Currently, power generation in China is dominated by thermal power, wind power, nuclear power, and hydropower enterprises. The power source mainly comes from thermal power generation. The occupational hazards in thermal power station are noise, high temperature, power frequency electric fields, dust, and chemical toxins and so on, with noise and dust (silica and coal dust) being the primary factors. The occupational hazards in wind power station are noise, power frequency electric fields, high temperature, low temperature, and chemical toxins (sulfur hexafluoride, toluene, styrene, etc.), with noise and power frequency electric fields being the major concerns. The occupational radiation hazards in nuclear power station are gamma rays, beta rays, X-rays, neutrons, alpha rays, and radioactive aerosols. There is special attention in radiation protection but not enough protection in non-radioactive hazards such as noise, high temperature, and ammonia. The occupational hazards in hydropower station are noise, power frequency electric fields, vibration, radon and its de-composites, and chemical toxins, with noise and power frequency electric fields being the primary hazards. Different categories of power generation enterprises should identify key hazards and work site for occupational disease prevention and control based on the features of occupational hazards. Improving occupational health management and protection levels are essential measures.

Advances in pancreatic β-cell protective strategies / 中国药科大学学报

@#Pancreatic β cells, the only cells in the body that can synthesize and secrete insulin, can be damaged by a variety of pathological factors. Increasing attention has been paid to the studies of protecting pancreatic β cells in the treatment of diabetes. In this review, we highlight the studies that focus on enhancement of islet β cell function, reduction of islet β cell apoptosis, increase of islet β cell number and induction of islet β cell differentiation, providing novel targets and therapeutic strategies for the treatment of diabetes.

Lung protective strategy in acute respiratory distress syndrome:current status and new understanding / 中华实用儿科临床杂志

For the last 20 years,lung protective strategy which comprises of low tidal volume,higher positive end expiratory pressure,and limited plateau pressure has become a standard care for acute respiratory distress syndrome (ARDS),but still do not know the best way to ventilate patients with ARDS.This article reviews clinical trials related to lung protective strategy published in recent years and give some suggestions in optimal mechanical ventilation.In addition,the article also introduces some concept of ventilator related lung injury and new understanding in lung protective strategy using stress and strain theory.

Effect of lung protection strategy on stroke volume variation in patients undergoing open-chest operation / 第二军医大学学报

Objective To investigate the effect of lung-protective ventilation mode on stroke volume variation (SVV) in patients receiving selected thoracotomy. Methods Twenty patients of the American Society of Anesthesiology (ASA) class I or class II were selected for this study, with no drugs administrated before operation. In addition to standard hemodynamic monitoring, SVV and cardiac index (CI) were recorded at the following eight time points: spontaneous breathing when awake and at supine position (T1), spontaneous breathing when awake and at lateral position (T2), general anesthesia with two-lung ventilation and at supine position (T3), general anesthesia with one-lung ventilation under lung-protective strategy and at supine position (T4), general anesthesia with two-lung ventilation and at lateral position (T5), general anesthesia with one-lung ventilation under lung-protective strategy and at lateral position (T6), combined anesthesia with one-lung ventilation under lung-protective strategy when skin incision (T7), and combined anesthesia with one-lung ventilation under lung-protective strategy when pleural dissection (T8). The changes of heart rate (HR), mean arterial pressure (MAP), SVV, and CI were observed at the above eight time points; and the relation of SVV with HR, MAP and CI was discussed. Homogenity test of variances was used to analyze the data of the four indices; the use of further statistical scheme was judged by the result of homoscedasticity. A Pearson correlation analysis was used for SVV with HR, MAP, and CI. Results Homogenity of variance test showed that the changes of SVV and HR at T1 -T8 had no significant difference (P>0.05), while the changes of MAP and CI had significant difference (P<0.05). LSD multiple comparison indicated significant differences for the followings (P<0.05): SVV between T2 and T5, CI among T1 and T3-8, CI among T2 and T4,6,7,8, MAP among T1 and T3,4,6,7,8, MAP among T2 and T3,4,6,7,8, and MAP between T4 and T5. We also found that SVV had negative correlation with CI (r=-0.267, P=0.018). Conclusion The change of body position (from supine to lateral position) in patients without hypovolemia before operation has no significant impact on SVV and HR; one-lung ventilation under lung-protective strategy has no noticeable effects on SVV, HR, MAP or CI. Anesthetic factor can cause the drop of MAP and CI, and the action of passive position change under anesthesia can result in the rise of MAP and CI. Alteration of SVV has negative correlation with CI, but the correlation is weak.

Continuous intra-tracheal gas insufflation during mechanical ventilation in juvenile piglets with acute lung injury induced by endotoxin / 中华急诊医学杂志

Objective To evaluate the effects of continuous intra-tracheal gas insufflation (TGI) during mechanical ventilation for protecting the juvenile piglets with acute lung injury (ALI) induced by endotoxin. Method Twelve healthy juvenile piglets were anesthetized and mechanically ventilated at 2 cmH2O PEEP with 10 cmH2O peak inspiration pressure. The piglets were challenged with lipopolysaccharide (LPS) and randomly (random number) assigned to two groups (n = 6 each): (1) piglets treated with mechanical ventilation alone (group MV) and (2) piglets treated with TGI by continuous airway flow of 2 L/min (group TGI). FiO2 was set at 0.4 to avoid oxygen toxicity, and the piglets were continuously monitored with an oxygen analyzer. Results Tidal volume, ventilation efficacy index and mean airway pressure were significantly improved in piglets of TGI group (P < 0.01 or P < 0.05). Four hours after ALI, pH decreased to below 7.20 in piglets of MV group, and was higher in piglets of TGI group (P < 0.01). Similarly, PaCO2 was stable and was significantly lower in piglets of TGI group than that in piglets of MV group (P < 0.01). PaO2 and PaO2/FiO2 increased in piglets of TGI group (P < 0.05). There were no significant differences in heart rate, respiraaatory rate, mean arterial pressure, central venous pressure, dynamic lung compliance and mean resistance of airway between two groups. Lung histopathological changes showed severe inflammation,and intra-alveolar hemorrhage and interstitial patchy hemorrhage were ameliorated and the lungs were more homogenously expanded in piglets of TGI group. Conclusions Continuous TGI during MV can significantly improve gas exchange and ventilation efficacy, and may provide a better treatment for acute lung injury.