Associations between occupational health behaviors and occupational dental erosion

OBJECTIVES: The aim of this study was to evaluate the associations between occupational health behaviors and occupational dental erosion. METHODS: Using data for 943 workers among 34 factories, selected by three-stage stratified cluster sampling from 888 factories using acids, two sets of modified case-control studies were performed. The cases were 242 workers with any dental erosion (G1-5) and 78 with severe dental erosion (G3-5); the controls were 701 workers with no erosion (GO) and 864 workers with no or mild erosion grades, GO-2, respectively. The main explanatory variables were behaviors such as wearing a respiratory mask and gargling at work. The results were adjusted for employment, age, sex, knowledge, and opinion about occupational health, attrition, and abrasion. Bivariate and multivariate logistic regression analyses were conducted. RESULTS: The odds of overall occupational dental erosion (G1-5) was 0.63 (95% CI = 0.42, 0.94) for respiratory mask wearers compared to nonwearers; the odds of severe occupational dental erosion (G3-5) was not significantly less in respiratory mask wearers (OR = 0.94; 95% CI = 0.53, 1.67). Gargling did not show a significant association with occupational dental erosion in this study. CONCLUSIONS: Among occupational health behaviors, wearing personal protective respiratory masks in work was significantly associated with less overall occupational dental erosion.     

以医用口罩为例探讨新型冠状病毒肺炎疫情中政府应急卫生资源保障对策

2019年12月,新型冠状病毒肺炎在武汉爆发,并蔓延至全国大部地区。在突如其来的疫情危机面前,民众面临着巨大恐慌,由此产生对某些疫情防护物品的需求猛增。文章以疫情发生后的医用口罩需求动态为观测点,搜集相关新闻、评论,发现该物资在疫情蔓延早期面临着价格暴涨、质量良莠不齐、保障不足与分配失衡等问题,而由此引发的民众脆弱性和政府信任危机给政府危机治理带来了巨大挑战。以医用口罩问题为依据进行分析,探讨其引发的政府危机治理和应对问题,并提出加强物品保障和协调,完善政府监管,加快推进信息公开和政务公开,加强健康宣教与规范信息科学传播等相应对策。     

Protection by Face Masks against Influenza A(H1N1)pdm09 Virus on Trans-Pacific Passenger Aircraft, 2009

In response to several influenza A(H1N1)pdm09 infections that developed in passengers after they traveled on the same 2 flights from New York, New York, USA, to Hong Kong, China, to Fuzhou, China, we assessed transmission of influenza A(H1N1)pdm09 virus on these flights. We defined a case of infection as onset of fever and respiratory symptoms and detection of virus by PCR in a passenger or crew member of either flight. Illness developed only in passengers who traveled on the New York to Hong Kong flight. We compared exposures of 9 case-passengers with those of 32 asymptomatic control-passengers. None of the 9 case-passengers, compared with 47% (15/32) of control-passengers, wore a face mask for the entire flight (odds ratio 0, 95% CI 0–0.71). The source case-passenger was not identified. Wearing a face mask was a protective factor against influenza infection. We recommend a more comprehensive intervention study to accurately estimate this effect.     

小剂量芬太尼对老龄女性喉罩置入丙泊酚半数有效浓度的影响

测定小剂量(50μg)芬太尼在老龄女性喉罩置入时丙泊酚半数有效浓度(EC.)的影响,探讨合理的诱导药物配伍.方法:择期行全麻下乳腺手术女性患者84例,根据年龄分为老年组(≥65岁)和中青年组(＜65岁),每组再随机分为芬太尼复合丙泊酚组及单纯丙泊酚组,应用Dixon序贯法预设丙泊酚效应部位靶控输注浓度,并计算各组EC5...     

七氟烷可替代丙泊酚用于成人麻醉诱导放置喉罩通气道

目的:比较七氟烷吸入诱导和丙泊酚静脉诱导用于插入喉罩通气道(LMA)的临床效能和安全性。方法:将80例ASAⅠ～Ⅱ级择期行下肢骨科手术患者随机分为2组。P组麻醉诱导采用静脉靶控输注丙泊酚,效应室浓度6mg/L;S组以肺活量法吸入七氟烷,目标呼气末浓度为4%。通过开口试验判断插入LMA适宜时机。观察麻醉诱导和放置LMA的过程,记录期间患者血流动力学的变化和不良反应的发生。结果:2种诱导方法都可以保证超过95%的患者一次顺利完成LMA的放置。S组患者意识消失时间较P组延长,但2组患者适宜LMA插入的麻醉诱导时间差异无统计学意义。P组患者诱导后平均动脉压(MAP)明显下降,S组患者试验期间血流动力学状态稳定,而且插入LMA后呼吸暂停的发生也明显低于P组(P<0.05)。结论:七氟烷吸入诱导可替代丙泊酚静脉诱导用于成年患者放置LMA。     

全身麻醉手术患者i-gel喉罩和SLIPA喉罩气道管理的效果

目的 比较全身麻醉手术患者i-gel喉罩和SLIPA喉罩气道管理的效果.方法 择期全身麻醉手术患者60例,ASA分级Ⅰ或Ⅱ级,采用随机数字表法分为i-gel喉罩组和SLIPA喉罩组,每组30例.麻醉诱导后置入喉罩,行机械通气.喉罩置入成功后行纤维支气管镜检查分级.记录最高气道压、平均气道压、喉罩置入成功情况、置入时间、喉罩拔除时间、苏醒时间、喉罩拔除时罩体带血和反流及术后1、24h咽喉部疼痛的发生情况.结果 两组麻醉时间、手术时间、喉罩拔除时间、苏醒时间、首次置入成功率、二次置入成功率、喉罩置入时间、最高气道压和平均气道压比较差异均无统计学意义(P＞0.05).i-gel喉罩组气道密封压高于SLIPA喉罩组[(29±6) cm H2O(1 cm H2O=0.098 kPa)比(23±4)cm H2O],差异有统计学意义(P＜0.05).i-gel喉罩组纤维支气管镜检查分级1级27例、2级3例,SLIPA喉罩组1级3例、2级4例、3级13例、4级10例,i-gel喉罩组明显优于SLIPA喉罩组,差异有统计学意义(P＜0.05).i-gel喉罩组罩体带血及术后1、24h咽喉部疼痛均为2例(6.7％),SLIPA喉罩组分别为5例(16.7％)、8例(26.7％)、7例(23.3％),i-gel喉罩组各发生率均低于SLIPA喉罩组,差异有统计学意义(P＜0.05).两组均未发生反流和误吸.结论 i-gel喉罩和SLIPA喉罩用于全身麻醉均可保证有效正压通气,但i-gel喉罩气道密封压高,不良反应少,气道管理效果更好.     

Proseal喉罩对乳腺癌改良根治术患者心钠素和皮质醇的影响

[目的]比较喉罩( PLMA)与气管插管(ET)复合全身麻醉对乳腺癌改良根治术患者心钠素(ANP)和皮质醇(COR)的影响.[方法]40 例ASAⅠ～Ⅱ患者随机分为两组,每组 20 例.A组为喉罩复合全身麻醉,B组为气管插管复合全身麻醉.观察记录麻醉插管或置入喉罩前后和拔管或拔除喉罩前后心率(HR) 、平均动脉压(MA...     

静脉全麻置入喉罩吸氧下行支气管镜肺泡灌洗治疗的可行性

【摘要】目的 评价静脉全麻下置入喉罩吸氧行纤维支气管镜肺泡灌洗治疗的可行性。方法 拟行肺泡灌洗治疗患者60例,年龄45~59岁,随机分为局麻组（LA组,n=20）、静脉麻醉下面罩吸氧组（GA-M组,n=20）及静脉麻醉下置入喉罩吸氧组（GA-L组,n=20）。吸入2%利多卡因表面麻醉后,GA-L组及GA-M组行静脉全身麻醉,意识消失后,GA-L组置入喉罩,GA-M组给予面罩吸氧。静脉全麻下行纤维支气管镜检查及肺泡灌洗治疗,记录完成及苏醒时间,观察患者反应性症状如体动、呛咳、屏气、呼吸困难等发生情况,询问患者是否有痛苦记忆,记录内镜医师因患者反应性症状而中断操作的次数及肺泡灌洗液回收率。结果 与LA组相比,GA-L组及GA-M患者体动,呛咳发生率减少（P<0.05）。与GA-M组比较,GA-L组呼吸困难发生率降低（P<0.05）。与LA组比较,GA-M组及GA-L组患者痛苦记忆发生率显著降低（P<0.05）。内镜医师中断操作次数GA-L组及GA-M组相比LA组明显减少（P<0.05）,GA-L组较GA-M组减少（P<0.05）。GA-L组及GA-M组肺泡灌洗液回收率较LA组提高（P<0.05）。结论　静脉全麻下置入喉罩吸氧可提高气管镜肺泡灌洗治疗效果及安全性,减少患者反应性症状,消除痛苦记忆。     

Effect of chest compressions on the time taken to insert airway devices in a manikin

BACKGROUND: Resuscitation guidelines recommend that chest compressions should continue throughout attempts to place airway devices. Few data support the use of the tracheal tube over supraglottic airway devices (SADs) during cardiopulmonary arrest. This study was designed to evaluate the speed with which different airway devices could be placed with and without interrupting chest compressions. METHODS: Forty volunteer doctors regularly involved in cardiopulmonary resuscitation (CPR) were timed inserting four different airway devices [tracheal tube (TT), LMA Classic (cLMA), LMA ProSeal (PLMA), and igel] into a manikin, with and without stopping chest compressions. RESULTS: Chest compressions delayed the placement of the TT only (3.3 s, P<0.0001). Comparison of the speed of insertion of the different airway devices during CPR enabled ranking of the devices: igel (fastest), PLMA (second), and TT and cLMA (joint slowest). The igel was inserted approximately 50% faster than the other devices. Doctors who had previously inserted more than 50 tracheal tubes were significantly faster at intubating the trachea, but no faster at inserting SADs. CONCLUSIONS: Our results show that continuing chest compressions has a minor effect on time for tracheal intubation and until clear human data are available the recommendation to intubate without interrupting CPR is therefore justified. The PLMA and igel (SADs with a gastric drain tube) were both faster to insert than the cLMA and offer additional benefits. They should be considered for use in CPR.