Transtracheal puncture: a forgotten procedure

Transtracheal puncture has long been known as a safe, low-cost procedure. However, with the advent of bronchoscopy, it has largely been forgotten. Two researchers have suggested the use of α-amylase activity to diagnose salivary aspiration, but the normal values of this enzyme in tracheobronchial secretions are unknown. We aimed to define the normal values of α-amylase activity in tracheobronchial secretions and verify the rate of major complications of transtracheal puncture. From October 2009 to June 2011, we prospectively evaluated 118 patients without clinical or radiological signs of salivary aspiration who underwent transtracheal puncture before bronchoscopy. The patients were sedated with a solution of lidocaine and diazepam until they reached a Ramsay sedation score of 2 or 3. We then cleaned the cervical region and anesthetized the superficial planes with lidocaine. Next, we injected 10 mL of 2% lidocaine into the tracheobronchial tree. Finally, we injected 10 mL of normal saline into the tracheobronchial tree and immediately aspirated the saline with maximum vacuum pressure to collect samples for measurement of the α-amylase level. The α-amylase level mean ± SE, median, and range were 1914 ± 240, 1056, and 24-10,000 IU/L, respectively. No major complications (peripheral desaturation, subcutaneous emphysema, cardiac arrhythmia, or hemoptysis) occurred among 118 patients who underwent this procedure. Transtracheal aspiration is a safe, low-cost procedure. We herein define for the first time the normal α-amylase levels in the tracheobronchial secretions of humans.     

A Cybernetic Approach to Control of Speech

From the clinical impressions of Speech Pathologists and other professionals involved, emotional problems have been considered as either major causal factors, maintaining influences, prognostic indicators, predictable responses, or as totally irrelevant and insignificant in relation to communication disorders. It would be beneficial to examine these possible inter-relationships, to see if any trends do emerge, and to question whether we are sufficiently skilled in identifying and managing these problems, and secondly, competent to teach and demonstrate such skills to current Speech Pathology Students. It is hoped that this will lead to more objectively defined conclusions, improved service to those handicapped by communication disorders, and increased co-operation between allied professionals in research and clinical work.     

A perspective from Bolivia on the implications of the World Report on Disability for people with communication disabilities

Abstract

Implications of the World Report on Disability for people with communication disabilities (PWCD), as described by , include a drive for better demographic information, increased campaigning, and organizational change to improve speech-language pathology services. Qualitative data collected from PWCD and their families in Bolivia provide the baseline for this response. The benefits of collecting population survey information are recognized, but data reinforce the continued need to ensure a positive impact at caseload level. In a country where rhetoric is far removed from lived experience, the starting points for change are very different from those in Minority world countries. A supply and demand model is suggested as an equitable way of balancing efforts to overcome barriers to a better service. Knowledge and information are shown to be key in catalyzing the demand side for the service, while the importance of a solid evidence base for practice would help to improve supply. Although a warning against importing dominant Minority world models of service delivery is outlined by Wylie et al., findings from Bolivia support a more hybrid and nuanced approach that takes into account complex global influences of information flows, past and present.     

2005年重庆市燃煤污染型地方性氟中毒防治项目工作报告

目的：通过健康教育和改炉改灶，提高病区居民健康意识和改变不良卫生行为，预防控制燃煤污染型地方性氟中毒的流行。方法：对病区进行改炉改灶需求评估，包括基本情况、儿童氟斑牙和氟骨症病情、尿氟等指标的监测；利用宣传挂历、小册子、课程表、宣传单等形式进行健康教育宣传；运用改炉改灶技术降低燃煤污染型地方性氟中毒对居民的危害。结果：通过健康教育宣传．病区居民和学生的地氟病防治知识知晓率分别达86．87％和83．73％，完成改炉改灶70341户，其中改炉55734个，改灶60109个，炉灶合格率为97．53％，炉灶正确使用率为98．84％：测定19个乡镇28个村1336份学生尿氟，几何均数为0．72mg／L，平均数为0．93mg／L，范围为0．07—12．38mg／L之间。结论：坚持采取健康教育为先导，以改炉改灶为主的综合性防治措施．是防治燃煤污染型地方性氟中毒的有效措施。     

PACS实现方案及策略探讨

目的 探讨国内医院实现PACS的方案和策略。材料与方法 系统采用菲特公司最新的多服务器PACS软件－MiNet系列,全面支持DICOM 3．0标准,其中连接CT和MR设备、2台服务器、个光盘库、5个工作站、2个登记站,系统采用100M Internet网。结果 成功的实现了数字图像在放射科的PACS内传输、存储、管理和备份,而且可以方便地编辑、打印全中文报告。结论 在医院组建PACS系统是实用、可行的,但是同时要有策略的选择合作伙伴和有步骤的实施。     

趋化因子RANTES和SDF-1细胞内共表达抑制HIV-1感染的研究

目的　观察HIV 1辅受体CCR5和CXCR4的配体在细胞内共表达抑制HIV 1感染的作用。方法　应用磷酸钙沉淀法共转染HIV 1辅受体及其配体的质粒 ,制成辅受体表型剔除的靶细胞 ,与转染HIV 1膜蛋白质粒的细胞混合 ,观察合胞体形成并记数 ;脂质体介导法将含有报告基因CAT而缺失HIV包膜蛋白的质粒与HIV包膜蛋白质粒共转染 2 93细胞 ,包装成具有一次感染活性的假病毒 ,感染转化pCMV R K S K、pCMV R K、pCMV S K或pCMV的PM 1细胞 ,采用同位素薄层层析分析法检测CAT活性。结果　pCMV R K S K转染可以显著抑制M及T嗜性HIV膜蛋白诱导的合胞体形成 ;CAT检测发现与pCMV转染组相比 ,当两种嗜性重组病毒感染pCMV R K S K转染组PM 1细胞时 ,仅检测到背景水平的CAT活性。结论　HIV 1辅受体CCR5 CXCR4表型剔除可以明显抑制M和T嗜性HIV 1病毒进入靶细胞     

福建省有毒有害化学品专项整治效果报告

[目的]了解我省有毒有害化学品生产、销售和使用专项整治工作的效果。[方法]根据福建省专项整治工作方案，重点整治6类行业和4类企业，内容有危害项目申报、卫生培训、制度建立、警示标识、防护设施、场所检测和人员体检等14个项目。[结果]专项整治开展9个月后，用人单位危害项目申报率34．0％，用人单位负责人和劳动者的职业卫生知识培训率为32．4％和43．1％，场所检测率和合格率为69．6％和72．6％，职业健康体检率47．3％，7个类别企业的职业卫生管理也取得一定效果．行政处罚56起。[结论]本次专项整治首次摸清了全省的化学品用人单位的职业卫生基本情况，专项整治行动本身和体现防治效果的14项目调查，对化学品用人单位的职业病防治工作是一次有力的促进。     

传染性非典型肺炎分布特征及报告质量分析

目的 :分析传染性非典型肺炎 (SARS)分布特征 ,评价疫情报告质量 ,为今后制定对策提供依据。方法 :收集全国内地 SARS疫情及相关资料 ,采用统计学软件进行分析。结果 :医务人员发病率是其他人群的 5 6 .5 8倍 ;流行期间从事 SARS诊治的医务人员发病概率为 0 .5 36 /10 0人天 ,采取综合措施后下降至 0 .0 4 2 /10 0人天以下 ;6个流行强度较大的省市医务人员发病构成比明显高于其它省市 ;首发病例与北京有关省市的病死率明显高于与广东有关的省市 ;除北京外全国内地其它地区疑似病例漏报严重。结论 :医务人员的发病水平对当地 SARS流行强度影响较大 ;建议修订诊断标准和使用监测系统敏感性评价指标