Investigation and analysis of superficial fungal infection and drug use among naval trainees / 药学实践杂志

Objective To investigate the pathogenesis of superficial mycosis among naval trainees, and observe the efficacy of a novel antifungal drug. Methods A questionnaire survey was conducted on the onset, medication and recurrence of superficial fungal infection among the trainees from January, 2020 to July, 2020. At the same time, the new antifungal drug sulconazole nitrate spray was provided for treatment and the drug efficacy was observed. Results The participants generally lacked understanding and attention to superficial fungal infections. The incidence rate of superficial fungal infection was 52%, of which 76.2% of patients had recurrence of superficial fungal infection. The sulconazole nitrate spray showed great effect against these infections. Conclusion The trainees should understand the causes of superficial fungal infection through health education and seek medical treatment and medication in time. The cure rate of superficial fungal infections could only be improved through the collaborative management of the school, hospital, and trainees to reduce the impact of these infections on naval trainees’ work and life.

Metformin inhibits airway inflammation, remodeling and neovascularization in asthma mice / 中国病理生理杂志

AIM: To investigate the effects of metformin on airway inflammation, remodeling and neovascularization in a mouse model of chronic asthma and its possible mechanisms.METHODS: BALB/c mice were randomly divided into saline group, ovalbumin (OVA) group and OVA+metformin group, with 8 in each.At the end of OVA exposure, blood and bronchoalveolar lavage fluid (BALF) were collected for the measurement of OVA specific IgE and leukocyte counts.Lung tissue sections were stained with hematoxylin-eosin, periodic acid-Schiff and Masson's trichrome to detect inflammatory cell infiltration, goblet cell hyperplasia, and collagen deposition around the airway, respectively.Immunohistochemistry was used to evaluate the number and percentage area of new blood vessels (CD31+), and the protein level of phosphorylated AMP-activated protein kinase (p-AMPK) in the airway.RESULTS: Compared with saline group, the eosinophil percentage and OVA specific IgE in serum in OVA group were all increased obviously (P<0.01).Metformin inhibited the above increases (P<0.05).Compared with control group, a marked increase in inflammation infiltration, PAS+ cells and collage deposition in the airway mucosa in OVA group were observed.Metformin partially relieved the above changes.CD31+ vessels in the wall of bronchi showed the abundance of blood vessels observed in OVA group compared with control group, which was suppressed by the treatment with metformin (P<0.05).The protein level of p-AMPK was reduced in the lung tissue challenged with OVA as compared with control group (P<0.05), while metformin increased the protein level of p-AMPK (P<0.01).CONCLUSION: The protein level of p-AMPK in the airway in OVA group is attenuated.Metformin effectively inhibits airway inflammation, remodeling and neovascularization possibly via activating AMPK signaling pathway.

The relationship between smoking status and epidermiology of asthma in people aged over 14 years in China / 中华内科杂志

Objective To study the relationship between bronchial asthma and smoking status in Chinese people.Methods Asthma epidemiological survey and stratified-cluster-random method survey were performed in residents over 14 years in 8 provinces (cities) of China from February 2010 to August 2012.Asthma was diagnosed based upon case history,clinical signs and lung function test.Smoking status was investigated by questionnaire.Results Sampling population was 180 099 and 164 215 were valid.A total of 2 034 subjects were diagnosed as asthma including 79 692 men and 84 523 women.The overall prevalence rate of asthma was 1.24％ (2 034/164 215).Smokers were 23.8％ (39 137/164 215) in the whole population.Smokers were 34.5％ (702/2 034) in asthmatic patients,compared with 23.7％ (38 435/ 162 181) in no-asthmatic population.The incidence of asthma was 1.79％ and 1.06％ in smokers and nonsmokers respectively (P ＜0.001),suggesting that OR of smoking was 1.70 (95％ CI 1.55-1.86,P ＜ 0.001).According to asthma control test (ACT) score,the level of asthma control in non smoking group was higher than that in smoking group(43.2％ vs 35.3％).The times of hospitalization due to acute exacerbations (0.51 vs 0.41 events/person/year),total hospitalization rate (27.35 ％ vs 20.12％),annual emergency room visits (0.80 vs 0.60 events/person/year) and emergency room visit rate (31.77％ vs 24.47％) were all much higher in smoking asthmatic patients than those in non smoking asthmatic patients,indicating that the level of asthma control in smoking patients was significantly worse than in non smoking patients.Conclusions The smoking rate in Chinese people over 14 years is still high.The prevalence rate of asthma in smokers is significantly higher than that of non-smokers.The level of asthma control in smokers is significantly worse than that in non smokers.

Clinical Study of Bencycloquidium Bromide Nasal Spray in the Treatment of Rhinitis after Cold / 中国药房

OBJECTIVE:To evaluate the effects and safety of Bencycloquidium bromide nasal spray in the treatment of acute rhinitis after a cold. METHODS:A multicenter,dose parallel controlled,randomized,double-blind,placebo-controlled clinical tri-al was conducted. Two hundred and thirty-eight patients with acute rhinitis after a cold were selected and divided into group A(24 cases),B(24 cases),C(24 cases),D(24 cases),E(23 cases),F(24 cases),G(23 cases),H(24 cases),I(24 cases),J (24 cases). Group A-C were given Bencycloquidium bromide nasal spray 22.5μg,45μg,90μg,respectively,bid,spraying it once for each nostril. Group D-F were given Bencycloquidium bromide nasal spray 22.5 μg,45 μg,90 μg,respectively,tid,spraying it once for each nostril. Group G-I were given Bencycloquidium bromide nasal spray 22.5 μg,45 μg,90 μg,respectively,qid,spray-ing it once for each nostril. Group J was given placebo. All groups were treated for(4±1)d. Rhinorrhea score and continuous rhi-norrhea duration were compared among 10 groups,and the safety was evaluated. RESULTS:The rhinorrhea score and continuous rhinorrhea duration of 10 groups were improved significantly,with statistical significance (P0.05). There was no statistical significance in the incidence of ADR among 10 groups(P>0.05). CONCLUSIONS:Bencycloquidium bromide nasal spray with 90 μg,qid times significantly improves rhinorrhea score and continuous rhinorrhea duration with good safety.

Chinese expert consensus for non-antiinfective effects and clinical use of macrolides / 中华内科杂志

Important/potential value of macrolides has been proved in the management of chronic respiratory diseases by increasing basic and clinical trials.Through three face-to-face discussions,10 experts examined important data and drafted this consensus related to macrolides:(1) mechanism of nonantiinfective effects;(2) clinical use in chronic respiratory diseases;(3) cautions of long-term use.The mechanism out of non-antiinfective effects includes anti-inflammatory effect,modifying airway secretion,immune-regulation related to antibacterial effect,corticoid saving effect and anti-viral effect.The efficacy of long-term use of low-dose macrolides is definitely confirmed in diffuse panbronchiolitis,chronic rhinosinusitis.It is considerably used in bronchiectasia,cystic fibrosis,severe asthma and chronic obstructive pulmonary disease.Further studies should be conducted in cryptogenic organizing pneumonia and respiratory viral infection.It should be paid attention to its possible adverse effects (including drug interactions,cardiac toxicity,ototoxicity and disturbance of intestinal flora) and drug resistance in long-term use.A Chinese consensus for non-antiinfective effects and clinical use of macrolides is developed for the first time,which aims to expand their rational use and the further research.

Evaluation of asthma control: a questionnaire-based survey in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Little is known about asthma control and perception of asthma among asthmatic patients in China. This study marked the first survey conducted on a national scale that aimed at obtaining baseline information on asthma control and patients' perception of asthma and providing a point of reference for future studies.</p><p><b>METHODS</b>This face-to-face, questionnaire-based survey was conducted from April 2007 to March 2008 with 3 069 asthmatic patients from the respiratory outpatient clinics of 36 general hospitals located in 10 geographically dispersed cities.</p><p><b>RESULTS</b>Consistent with the Global Initiative for Asthma (GINA) guidelines, 28.7% and 45.0% of our patients achieved control and partial control, respectively. Of the patients in the study, only 21.8% had used a peak flow meter (PFM), and 6.6% of these patients used it daily. Inhaled corticosteroids (ICS) plus a long-acting β2 agonist (LABA) and ICS were the two most common medication regimens and were used in 45.6% and 30.4% of patients, respectively. Asthma had a significant effect on the patients' life and work. A considerable number of hospitalizations, emergency department visits, and sick days were observed.</p><p><b>CONCLUSION</b>Despite improvements in asthma control and ICS and PFM compliance compared with past literature, the current level of asthma control countrywide continues to fall short of the goals set in the GINA.</p>

A Three-Month Non-Interventional Study of Asthma Treatment with Budesonide/Formoterol / 中国呼吸与危重监护杂志

Objective To evaluate the efficacy of Budesonide/formoterol to control asthma under real-life conditions.Methods A muhi-center, open label, non-interventional study was conducted.Asthma control after 12 week therapy with Budesonide/formoterol was assessed by Asthma Control Questionnaire (ACQ) and modified Asthma Control Questionnaire (ACQ5).Results A total of 360 asthma patients were recruited,including 228 adult patients and 132 child patients.After 12 weeks' therapy,all the patients' medium value of ACQ was decreased significantly from 2.03 (adults 2.20, children 1.74) at baseline to 0.60 (adults 0.78, children 0.29) (P < 0.0001), and the medium value of ACQ5 was also decreased significantly from 2.4 (adults 2.24, children 1.76) at baseline to 0.47 (adults 0.62, children 0.20) (P < 0.0001).Conclusion Budesonide/formoterol is effective in asthma treatment, by which most asthma patients obtain and maintain clineal control.

Survey on Control Status and Knowledge Level about Disease in Asthmatic Patients in Region Level Cities of Shaanxi Province / 中国呼吸与危重监护杂志

Objective To evaluate the control status and knowledge level about disease in asthmatic patients in region level cities of Shaanxi province for effect appraisal of patient education.Methods Eight hospitals were selected from six region level cities, where questionnaire survey was completed in out-patients with asthma (≥ 14 years old).Results A total of 523 patients completed the questionnaire with a ratio of male to female of 1: 1.14,and an average age of (44.3±15.5) years old.The percentage of controlled, partly controlled and uncontrolled by self-evaluation was respectively 26.4%, 52.4% and 11.1%.48% insisted on using inhaled corticosteroids (ICS).The average score was 17.88±4.43 by asthma control test (ACT).The first three medicines used daily were ICS (26.6%), sustained-release theophyline (25.2%) and combination ICS/long-acting β2-agonists (21.8%).12.6% had no medicine and 5.2% used non-orthodox medicines.68.6% patients had omen before exacerbation, and those were sneezing, chest distress and cough.73.6% knew asthma is a disease of airway inilammatian,and 33.3% selected ICS as the leader medicine.Only 32.1% attended the lecture about asthma in hospitals and 85.0% longed for such education.Conclusions The control status and knowledge level about disease in asthmatic patients in cities still need to be improved in Shaanxi province, and too much work need to be done in order to realize the total control in all patients.

Recombinant human granulocyte-macrophage colony stimulating factor in the treatment of drug induced skin ulcer / 中国组织工程研究

BACKGROUND: Recombinant human granulocyte-macrophage colony stimulating factor (rhGM-CSF) could stimulate the proliferation of fibroblasts, keratinocyte and skin mucosae cells to different degrees.OBJECTIVE: To observe the effect of rhGM-CSF on the healing of drug exosmose induced skin ulcers.DESIGN: A randomized and controlled animal experiment.SETTING: Department of Respiratory Medicine, Xijing Hospital, Fourth Military Medical University of Chinese PLA.MATERIALS: This experiment was carried out at the Department of Respiratory Medicine, Xijing Hospital, Fourth Military Medical University of Chinese PLA from June to November 2004. Totally 20 male Kunming white mice, with body mass of 18 to 24 g, were chosen.METHODS: Prepared skin ulcers animal models were randomly divided into control group and treated group with 10 white mice in each group.Mice in the control group were given 1mg phentolamine ,20 mg lidocaine and 1mg dexamethasone diluted by normal saline to 0.5 mL ,then sealed up , once a day for 7 days; 25 μg rhGM-CSF was diluted by normal saline to 0.5 mL , then the solution was injected into the periphery of ulcers of mice in treated group , once every other day, for 7 days. Healing time and histological change of skin tissue at ulcer were observed.MAIN OUTCOME MEASURES: To observe the effect of rhGM-CSF on the healing time of drug exosmose induced skin ulcer and anabrosis and histological changeRESULTS: Totally 20 mice entered the stage of result analysis. ①Healing time: the healing time of ulcer and erosion was significantly longer in control group than in treated group [(20-24,8-12)d,t=2.264,P=0.01];②Histological observation: hyperplasia of granulation tissue was not obviously on 7 days after treatment in control group; Hyperplasia of granulation tissue appeared and the newly born blood vessel was abundant on 7 days after treatment in the treated group.CONCLUSION: rhGM-CSF can promote the wound healing of drug induced anabrosis and ulcer.

Inhibitory effect of Yichuanping capsule (易喘平胶囊) on the airway mucus overproduction in asthmatic mice / 中国中西医结合急救杂志

Objective: To evaluate the inhibitory effect of Yichuanping capsule (易喘平胶囊) on the airway mucus overproduction in asthmatic mice and its mechanism. Methods: Thirty-two male BALB/c mice were randomly divided into normal control group, asthma group, dexamethasone group and Yichuanping capsule (YC) group (n=8 in each group). Asthmatic mouse model was established by intraperitoneal injection of ovalbumin. The number of goblet cells and secretion of mucus were detected with periodic acid-Schiff (PAS) staining, and mucus protein MUC5AC mRNA was detected with reverse transcription-polymerase chain reaction (RTCD*2PCR). Number of total cells and eosinophil in bronchoalveolar lavage fluid (BALF) were counted with special staining. The contents of interleukinCD*24 (ILCD*24) and ?CD*2interferon (IFNCD*2?) in lung tissue were assessed by enzyme-linked immunoadsorbent assay (ELISA). Results: Compared with asthma group, the number of goblet cells, MUC5AC mRNA levels and secretion of mucus in airway were reduced in dexamethasone group and YC group(all P

Effect of dihydroartemisinin on proliferation of human lung adenocarcinoma cell line A549 / 中国肺癌杂志

<p><b>BACKGROUND</b>Recent researches discovered that artemisinin and its derivatives had anti-tumor activity. Dihydroartemisinin is one of the derivatives with higher activity. This study is to explore the effect of dihydroartemisinin on the proliferation of human lung adenocarcinoma cell line A549, so as to provide experimental base for treatment of lung cancer.</p><p><b>METHODS</b>Inhibition of proliferation in vitro was measured by MTT assay. The cell growth curve was drawn according to cell counts. The population doubling time was counted in logarithmic growth phase, DNA contents were measured by flow cytometry. Cell cycles were observed at the same time after the treatment. And the nude mice bearing A549 cancer cells were applied to detect the effect of dihydroartemisinin in vivo.</p><p><b>RESULTS</b>Dihydroartemisinin inhibited A549 cell proliferation in a concentration-dependent manner, after 96h of treatment, the IC50 for dihydroartemisinin inhibition of cell number was 0.23μmol/l. The population doubling time for human lung adenocarcinma in the control group was 21.3h and that in the dihydroartemisinin group was 38.5h . An highly significant difference was observed between the two groups (P < 0.01). Cells in G0 plus G1 were increased after the dihydroartemisinin treatment. The tumor inhibiting rate of dihydroartemisinin was 54.3% in vivo.</p><p><b>CONCLUSIONS</b>Dihydroartemisinin has marked anticancer activity on human lung adenocarcinoma cell line A549 both in vitro and in vivo. The inhibition in vitro is related to blockade of G0 and G1 phases.</p>

Therapeutic efficacy of chemotherapy with VIP for small cell lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>To evaluate the effect of combination chemotherapy with etoposide plus ifosfamide and cisplatin (VIP) for small cell lung cancer (SCLC).</p><p><b>METHODS</b>One-hundred and twenty patients with localized SCLC who never received chemotherapy were randomly divided into VIP regimen group and EP regimen group. The response and toxicity were evaluated after 3 cycle chemotherapy with VIP or EP respectively. In addition, salvage chemotherapy by VIP was given to 25 patients, who had progression or recurrence of the cancer after treatment with EP regimen, and the response was assessed after 3 cycles of the treatment.</p><p><b>RESULTS</b>In 118 evaluable patients, response rate was 89.6% for VIP regimen group and 78.3% for EP regimen group. There was no remarkable difference of response rates between the two groups. Toxicity of the two regimens was similar. However, complete response rate for VIP regimen group (43.1%) was significantly higher than that for EP regimen group (25.0%) (P < 0.05). In 23 patients who were progressive or relapsed after treatment with EP regimen, the complete response, partial response, progression and total response were 13.0%, 39.1%, 47.8% and 52.2% respectively.</p><p><b>CONCLUSIONS</b>VIP regimen may be used as the first-line chemotherapy for localized SCLC, its efficacy is superior to that of EP regimen. VIP can also be used as salvage chemotherapy regimen for patients with SCLC who failed to EP regimen chemotherapy.</p>

The Effect of Theophylline on Eosinophil Apoptosis / 中国医师杂志

Objective To vie the effect of theophylline on eosinophil (Eos) apoptosis. Methods EDTA-anticoagulated venous blood was obtained from 15 healthy volunteers and pre-incubated with saline or theophylline (10 -4 M) or dexamethasone and rhIL-5(10 -8 M),respectively.The mRNA of bcl-2 and bax were determined by reverse transcriptase polymerase chain reaction(RT-PCR),and their cytoplasm proteins were determined by flo cytometry. Results Analysis revealed that the bax protein express intracellular without any stimulator,but not bcl-2 in protein and mRNA levels.And culturing Eos in the presence of 10 -8 M IL-5 for 24 hours up-regulating bcl-2 mRNA ( P

The use of a self-made airway occluder in bronchoscopic lung volume reduction / 解放军医学杂志

Objective To explore the therapeutic efficacy of a self-made occluder used for bronchoscopic lung volume reduction(BLVR).Methods Two patients with severe chronic obstructive pulmonary disease(COPD)in stable phase were selected for the present study.One or two nitinol occluders were placed,guided by brochoscopy,into the target bronchi of the two patients.Examination of pulmonary functions,chest computed tomography,complications,blood gas analysis,and evaluation of life quality with St George's respiratory questionnaire(SGRQ)were carried out before and 7 months after the bronchoscopic lung volume reduction.Results No dislodging or shifting of all the inserted occluders occurred.Only slight proliferation of granulation tissue was found in mucous membrane around the occluder,and atelectasis was observed at the target sites of lung.Before and 7 months after BLVR,ventilatory capacity(VC)of case 1 rose from 3.08L to 3.57L,and that of case 2 was elevated from 2.19L to 2.58L.Forced vital capacity(FVC)of case 1 was elevated from 2.87L to 3.57L,and that of case 2 from 2.60L to 2.58L.SGRQ showed a remarkable improvement of patients' dyspnea with a decrease of scores from 62 to 26 in case 1 and from 48 to 23 in case 2.No evident changes were found on arterial oxygen blood partial pressure(PaO2)in both patients,and no severe complications such as obstructive pneumonia or pneumothorax occurred yet in either case 1 or case 2.Conclusion The present study has demonstrated that the self-made occluder is convenient for insertion with satisfactory stability and therapeutic efficacy.Application of such occluder is safe with few complications,and may serve the purpose of reducing lung volume and improving lung function.

Construction and identification of the recombinant BCG expressing Der p2 in form of secreting protein / 解放军医学杂志

Objective To construct and identify the recombinant BCG (bacille Calmette-Guerin) expressing exogenous antigen, namely Dermatophagoides pteronyssinus (house dust mite), major allergen (Der p2) in form of secreting protein. Methods The gene fragments containing ?-ss signal peptide gene were amplified by polymerase chain reaction (PCR) from the Mycobacteria tuberculosis H37Rv and cloned into the Der p2-rBCG, which can express Der p2 in intracellular pattern.Then the Der p2 gene was expressed by the rBCG in form of secreting protein, and it was identified by Western blotting. Results The sequence of signal peptide gene ?-ss was verified by sequencing identification. The constructed Der p2-rBCG could shuttle from E. coli to Mycobacteria to mediat the expression of antibiotic resistance gene and it served as a vector to express the Der p2 gene as a secreted protein. Conclusions The Der p2-rBCG, which can express exogenous antigen gene in form of secreting protein, has been constructed successfully.

Apoptosis inducing and anti-invasive effects of curcumin on A549 human lung adenocarcinoma cells and its mechanism / 解放军医学杂志

Objective To study the mechanism of apoptosis inducing and anti-invasive effects of curcumin on human lung adenocarcinoma cell (A549). Methods MTT colorimetry method, fluorescence mieroscopy, and FCM combining with PI and AnnexinV-FITC double pigmentation method were used to study the growth and apoptosis of A549 cells after being treated with curcumin, and Western blotting was used to identify apoptosis-inducing and anti-invasive effects. Results Under the effect of the curcumin, the nucleoli of A549 cells were found to be fragmented into different sized apoptosis bodies under fluorescence microscopy, and cell proliferation was obviously suppressed under the effect of curcumin in different concentrations, with the IC 50 value of 18?mol/L. When the curcumin concentration was increased from 5?mol/L to 40?mol/L, Annexin-FITC single positive cells (early apoptosis cell) were increased from 3.4% to 65.9%, and the proliferation of cells was blocked at G 2 phase. When curcumin concentration was increased from 10?mol/L to 20?mol/L curcumin effects 30 minutes, the expression of PARP in A549 cells was increased after 30 minutes. Curcumin could also down-regulate MMP-2 and up-regulate TIMP-2 expression. Conclusions Curcumin can interfere with cell growth cycle of A549 cells and suppress cell growth, which is concentration dependent. The anti- invasive effects of curcumin is probably the result of down-regulation of MMP-2 and up-regulation of TIMP-2 expression.

The expression of an alternative spliced variant of human interleukin-4 in patients with atopic asthma / 中国医师杂志

Objective To investigate the expressions and effects of interleukin-4(IL-4) and its alternative spliced variant(IL-4?2) in patients with atopic asthma.Methods The expressions of IL-4 and IL-4?2 were detected in 10 cases of patients with atopic asthma using a quantitative nested reverse-transcription polymerase chain reaction(RT-PCR) protocol.Result The expression level of IL-4 was higher in the patients with atopic asthma than that of the healthy controls.The median ratio of IL-4 to IL-4?2 was much higher in the patients with atopic asthma compared with that of the healthy controls.Conclusion The relative expression of IL-4 and IL-4?2 may play an important role in the mechanism of the pulmonary pathology in patients with atopic asthma,and may be one of the reason for the functional diversity of Th2 cells in different clinical conditions.

Responsiveness of the T-lymphocyte in peripheral blood from asthmatic patients to VIP / 中国病理生理杂志

0.05). VIP, however, could inhibit the Con A-induced proliferation of T-cells from control subjects more significantly than that from asthmatics (P0.05). The cAMP level in T-cells, however, increased more significantly in the control group than that in the asthmatic group after the treatment of VIP or NaF (P0.05). CONCLUSION: Inhibition effect of VIP on Con A-induced proliferation of T-cells was less in asthmatics than in control subjects, which may be related to insufficiency of Gs ? coupled VIP receptor on T-lymphocytes in asthmatics.

PAF promotes proliferation of smooth muscle cells of rat airway / 中国病理生理杂志

AIM: To study the effect of platelet-activating factor(PAF) on proliferation of cultured rat airway smooth muscle cells(ASMCs).METHODS: The cells were divided into control group and PAF group. The cells in PAF group were subdivided into four small groups by concentrations of PAF 10 -6 , 10 -7 , 10 -8 , 10 -9 mol?L -1 , MTT assay was used not only to investigate the effects of PAF on proliferation of ASMC but also to confirm the optimal concentration. Flow cytometry and immuneohistochemistry for proliferating cell nuclear antigen (PCNA) were also used to analyse its function on proliferation of ASMC.RESULTS: PAF (10 -6 -10 -9 mol?L -1 ) stimulated the cell proliferation and 10 -7 mol?L -1 PAF reached the maximal effect. The cell percentage of the ASMCs of 107 mol?L -1 PAF subgroup at G_ 0/1 phase (68.67%) was much lower than that of control group (85.57%, P

Medical Ethics Consideration of Ventilator / 中国医学伦理学

Ventilator aid respiration is important for patients with respiratory failure.But the negative emotional reaction of patient during connection and disconnection to ventilator will seriously influence the therapeutic effect,so a comprehensive underatanding about the emotional characteristic and dynamic emotion change of patient is of primary importance,because it will improve the diagnostic and therapeutic level,give patient personalized take care and make effective therapeutic plan,which will help keep a good emotion state for patient and accelerate recovery.This article will discuss how to use ventilator more effectively and economically.