BACKGROUND Hypoxemia due to respiratory depression and airway obstruction during upper gastrointestinal endoscopy with sedation is a common concern.The Wei nasal jet tube(WNJT)is a new nasopharyngeal airway with the a...BACKGROUND Hypoxemia due to respiratory depression and airway obstruction during upper gastrointestinal endoscopy with sedation is a common concern.The Wei nasal jet tube(WNJT)is a new nasopharyngeal airway with the ability to provide supraglottic jet ventilation and oxygen insufflation via its built-in wall channel.The available evidence indicates that with a low oxygen flow,compared with nasal cannula,the WNJT does not decrease the occurrence of hypoxemia during upper gastrointestinal endoscopy with propofol sedation.To date,there has been no study assessing the performance of WNJT for supplemental oxygen during upper gastrointestinal endoscopy with sedation when a moderate oxygen flow is used.AIM To determine whether the WNJT performs better than the nasal prongs for the prevention of hypoxemia during gastroscopy with propofol mono-sedation when a moderate oxygen flow is provided in patients with a normal body mass index.METHODS This study was performed in 291 patients undergoing elective gastroscopy with propofol mono-sedation.Patients were randomized into one of two groups to receive either the WNJT(WNJT group,n=147)or the nasal cannula(nasal cannula group,n=144)for supplemental oxygen at a 5-L/min flow during gastroscopy.The lowest SpO2 during gastroscopy was recorded.The primary endpoint was the incidence of hypoxemia or severe hypoxemia during gastroscopy.RESULTS The total incidence of hypoxemia and severe hypoxemia during gastroscopy was significantly decreased in the WNJT group compared with the nasal cannula group(P=0.000).The lowest median SpO2 during gastroscopy was significantly higher(98%;interquartile range,97-99)in the WNJT group than in the nasal cannula group(96%;interquartile range,93-98).Epistaxis by device insertion in the WNJT group occurred in 7 patients but stopped naturally without any treatment.The two groups were comparable in terms of the satisfaction of physicians,anesthetists and patients.CONCLUSION With a moderate oxygen flow,the WNJT is more effective for the prevention of hypoxem展开更多
Background The global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease （COPD） guidelines classify patients into four groups according to the number of symptoms and the l...Background The global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease （COPD） guidelines classify patients into four groups according to the number of symptoms and the level of future risk of acute exacerbation COPD （AECOPD）. This study aimed to compare the results of different methods used in diagnosis of COPD and evaluate the accuracy of the assessment methods in guiding clinical practice. Methods A survey was conducted of 194 COPD outpatients between March and September 2012. Demographic characteristics, the number of exacerbations the patient has had within the previous 12 months, COPD assessment test （CAT）, Modified British Medical Research Council （mMRC） scale, and results of the lung function tests were recorded. Results Of the 194 patients assessed, 21 had a CAT score 〉10 and an mMRC grade ≤1, 13 had a CAT score 〈10 and an mMRC grade ≥2. A predicted forced expiratory volume in one second （FEV1%） of 〈50% with less than two acute exacerbations was observed in 39 patients, while a predicted FEV1% of 〉50% was noted in 20 patients with two or more acute exacerbations. The sensitivity of a predicted FEV1% 〈50% in predicting the risk of AECOPD in the future was 80.9%, while that in the real number of AECOPD events recorded was 62.8%, the difference being statistically significant （P=0.004）. The sensitivity of CAT in predicting the severity of symptoms was 90%, while that of mMRC was 83.8%, and the difference was not statistically significant. Conclusions The COPD assessment method recommended by the global initiative for chronic obstructive pulmonary disease （GOLD） 2011 is complicated and should be simplified. CAT is more comprehensive and accurate than mMRC. The lung function classification is a better tool for predicting the risk of AECOPD in the future, and the number of AECOPD can be referred to when required.展开更多
Using NCEP dataset we calculate the exchange of mass across the thermal tropopause by the Wei’s method from 1978 to 1997 over the Tibetan Plateau and its surroundings. We also calculate the annual variation of aeroso...Using NCEP dataset we calculate the exchange of mass across the thermal tropopause by the Wei’s method from 1978 to 1997 over the Tibetan Plateau and its surroundings. We also calculate the annual variation of aerosol and ozone of 100 hPa level with the monthly SAGE dataset from July 1988 to December 1993. Results indicate that (i) the mass from troposphere to stratosphere is magistral station in summer over the Tibetan Plateau and its surroundings. The air transport reaches the summit in midsummer with two large value centers, which lie in the north of Bengal Bay and southeastern Tibetan Plateau, respectively. A large value center, which lies over the Tibetan Plateau, is smaller than that aforementioned. In winter, the mass transport is from stratosphere to troposphere, and reaches the minimum in January. (ii) As far as the 19-year mean cross-tropopause mass exchange from June to September is concerned, the net mass transport is 14.84×l018 kg from troposphere to stratosphere. So the area from the展开更多
基金Supported by“Renfu”Research Fund by Chinese Society of Digestive Endoscopy,No.CSDE012017120006.
文摘BACKGROUND Hypoxemia due to respiratory depression and airway obstruction during upper gastrointestinal endoscopy with sedation is a common concern.The Wei nasal jet tube(WNJT)is a new nasopharyngeal airway with the ability to provide supraglottic jet ventilation and oxygen insufflation via its built-in wall channel.The available evidence indicates that with a low oxygen flow,compared with nasal cannula,the WNJT does not decrease the occurrence of hypoxemia during upper gastrointestinal endoscopy with propofol sedation.To date,there has been no study assessing the performance of WNJT for supplemental oxygen during upper gastrointestinal endoscopy with sedation when a moderate oxygen flow is used.AIM To determine whether the WNJT performs better than the nasal prongs for the prevention of hypoxemia during gastroscopy with propofol mono-sedation when a moderate oxygen flow is provided in patients with a normal body mass index.METHODS This study was performed in 291 patients undergoing elective gastroscopy with propofol mono-sedation.Patients were randomized into one of two groups to receive either the WNJT(WNJT group,n=147)or the nasal cannula(nasal cannula group,n=144)for supplemental oxygen at a 5-L/min flow during gastroscopy.The lowest SpO2 during gastroscopy was recorded.The primary endpoint was the incidence of hypoxemia or severe hypoxemia during gastroscopy.RESULTS The total incidence of hypoxemia and severe hypoxemia during gastroscopy was significantly decreased in the WNJT group compared with the nasal cannula group(P=0.000).The lowest median SpO2 during gastroscopy was significantly higher(98%;interquartile range,97-99)in the WNJT group than in the nasal cannula group(96%;interquartile range,93-98).Epistaxis by device insertion in the WNJT group occurred in 7 patients but stopped naturally without any treatment.The two groups were comparable in terms of the satisfaction of physicians,anesthetists and patients.CONCLUSION With a moderate oxygen flow,the WNJT is more effective for the prevention of hypoxem
文摘Background The global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease （COPD） guidelines classify patients into four groups according to the number of symptoms and the level of future risk of acute exacerbation COPD （AECOPD）. This study aimed to compare the results of different methods used in diagnosis of COPD and evaluate the accuracy of the assessment methods in guiding clinical practice. Methods A survey was conducted of 194 COPD outpatients between March and September 2012. Demographic characteristics, the number of exacerbations the patient has had within the previous 12 months, COPD assessment test （CAT）, Modified British Medical Research Council （mMRC） scale, and results of the lung function tests were recorded. Results Of the 194 patients assessed, 21 had a CAT score 〉10 and an mMRC grade ≤1, 13 had a CAT score 〈10 and an mMRC grade ≥2. A predicted forced expiratory volume in one second （FEV1%） of 〈50% with less than two acute exacerbations was observed in 39 patients, while a predicted FEV1% of 〉50% was noted in 20 patients with two or more acute exacerbations. The sensitivity of a predicted FEV1% 〈50% in predicting the risk of AECOPD in the future was 80.9%, while that in the real number of AECOPD events recorded was 62.8%, the difference being statistically significant （P=0.004）. The sensitivity of CAT in predicting the severity of symptoms was 90%, while that of mMRC was 83.8%, and the difference was not statistically significant. Conclusions The COPD assessment method recommended by the global initiative for chronic obstructive pulmonary disease （GOLD） 2011 is complicated and should be simplified. CAT is more comprehensive and accurate than mMRC. The lung function classification is a better tool for predicting the risk of AECOPD in the future, and the number of AECOPD can be referred to when required.
文摘Using NCEP dataset we calculate the exchange of mass across the thermal tropopause by the Wei’s method from 1978 to 1997 over the Tibetan Plateau and its surroundings. We also calculate the annual variation of aerosol and ozone of 100 hPa level with the monthly SAGE dataset from July 1988 to December 1993. Results indicate that (i) the mass from troposphere to stratosphere is magistral station in summer over the Tibetan Plateau and its surroundings. The air transport reaches the summit in midsummer with two large value centers, which lie in the north of Bengal Bay and southeastern Tibetan Plateau, respectively. A large value center, which lies over the Tibetan Plateau, is smaller than that aforementioned. In winter, the mass transport is from stratosphere to troposphere, and reaches the minimum in January. (ii) As far as the 19-year mean cross-tropopause mass exchange from June to September is concerned, the net mass transport is 14.84×l018 kg from troposphere to stratosphere. So the area from the
