Proseal与Slipa喉罩在腹腔镜胆囊切除术中的麻醉效果比较

目的:比较proseal与slipa喉罩在腹腔镜胆囊切除术中的麻醉效果。方法:收集我院收治的68例胆囊行腹腔镜胆囊切除术患者,随机分为A组和B组,每组各34例,A组患者应用slipa喉罩,B组患者应用proseal喉罩进行麻醉。观察并比较两组患者各时间点血压、心率水平,患者麻醉时间、苏醒时间、喉罩插入时间与拔除时间以及患者的不良反应发生率。结果:与喉罩置入前相比,两组患者手术中收缩压(SBP)以及舒张压(DBP)水平均下降,差异具有统计学意义(P0.05)。两组患者各时间点的血压以、心率、麻醉时间及苏醒时间比较差异均无统计学意义(P0.05)。与B组相比,A组患者的喉罩插入时间较长,喉罩沾血的发生率较高,差异具有统计学意义(P0.05)。结论:Pro seal与Slipa喉罩在腹腔镜胆囊切除术中的麻醉效果相当,但Slipa喉罩的插入时间以及喉罩沾血的发生率更高。     

Evaluation on masks with exhaust valves and with exhaust holes from physiological and subjective responses

The purpose of this study was to compare the effects of wearing different kinds of masks on the ear canal temperature, heart rate, clothing microclimate, and subjective perception of discomfort. Ten subjects performed intermittent exercise on a treadmill while wearing the protective masks in a climatic chamber controlled at an air temperature of 25 degrees C and a relative humidity of 70%. Two types of mask-mask A, with exhaust valves and mask B, with exhaust holes-were used in the study. The results of this study indicated: (1) The subjects had a tendency toward lower maximum heart rate when wearing mask A than when wearing mask B. (2) Temperatures and absolute humidities (the outer surface of mask, the microclimate inside the mask, the chest wall skin and microclimate) of mask A were significantly lower than those of mask B. (3) The ear canal temperature increased significantly in mask B as compared to that in mask A. (4) The ear canal temperature showed significant augmentation along with increased temperature and humidity inside the mask microclimate. The mask microclimate temperature also affected significantly the chest microclimate temperature. (5) Mask A was rated significantly lower for perception of humidity, heat, breath resistance, tightness, unfitness, odor, fatigue, and offered less overall discomfort than mask B. (6) Subjective preference for mask A was higher. (7) The ratings of subjective overall discomfort showed significant augmentation along with increased wetness and fatigue. We discuss how the ventilation properties of masks A and B induce significantly different temperature and humidity in the microclimates of the masks and the heat loss of the body, which have profound influences on heart rate, thermal stress, and subjective perception of discomfort.     

The mitigating effect of masks on the spread of Covid-19

We use US state-level data from early in the pandemic —March 15, 2020 to November 15, 2020— to estimate the effects of mask mandates and compliance with mandates on Covid-19 cases and deaths, conditional on mobility. A one-standard-deviation increase in mobility is associated with a 6 to 20 percent increase in the cases growth rate; a mask mandate can offset about one third of this increase with our most conservative estimates. Also, mask mandates are more effective in states with higher compliance. Given realized mobility, our estimates imply that total infections in the US on November 15, 2020 would have been 23.7 to 30.4 percent lower if a national mask mandate had been enacted on May 15, 2020. This reduction in cases translates to a 25 to 35 percent smaller decline in aggregate hours worked over the same period relative to a 2019 baseline.     

Alignment of Schlieren and Rayleigh opitcal systems in the ultracentrifuge. 3. Design, construction, and placement of Rayleigh mask

Problems in the optimal design on the double-slit mask used in the adaptation of the Rayleigh interferometer ultracentrifuge are discussed. Consideration is given to the orientation of the mask either symmetrically about a radius or offset with one slit along a radius from the center of rotation, to the placement of the mask above or below the rotor, to the use of a second pair of slits in the cell to mask imperfections in the cell windows, and to certain aberrations arising from variations in the refractive index across the width of the slit and from deviation of light perpendicular to the slits by a component of the radial refractive index gradients. Optimal mask dimensions for different experimental conditions for both symmetrical and offset masks are given. Equations based on the geometry of the cells and mask are derived, permitting calculations sufficient to align correctly a symmetrical mask with minimal labor.     

MC1R studies in dogs with melanistic mask or brindle patterns

Black mask is a characteristic pattern in which red, yellow, tan, fawn, or brindle dogs exhibit a melanistic muzzle which may extend up onto the ears. Melanistic mask is inherited in several breeds as an autosomal dominant trait, and appears to be a fixed trait in a few breeds of dogs. A MC1R nonsense mutation, R306ter, has been shown to cause a completely red or yellow coat color in certain breeds such as Irish setters, yellow Labrador retrievers, and golden retrievers. The amino acid sequence for the melanocortin receptor 1 gene (MC1R) was examined in 17 dogs with melanistic masks from seven breeds, 19 dogs without melanistic masks, and 7 dogs in which their coat color made the mask difficult to distinguish. We also examined nine brindle dogs of four breeds, including three dogs who also had a black mask. No consistent amino acid change was observed in the brindle dogs. All dogs with a melanistic mask had at least one copy of a valine substitution for methionine at amino acid 264 (M264V) and none were homozygous for the premature stop codon (R306ter). These results suggest that black mask, but not brindle, is caused by a specific MC1R allele.     

老年手术患者应用丙泊酚复合瑞芬太尼喉罩麻醉的临床效果观察

目的：探讨靶控输注丙泊酚复合瑞芬太尼喉罩麻醉在老年手术患者中的临床应用效果,为临床麻醉提供参考。方法：选取127例老年手术患者作为研究对象,随机分为A、B、C3组,A组43例（采用瑞芬太尼复合丙泊酚麻醉,喉罩通气）、B组42例（采用丙泊酚麻醉,喉罩通气）,C组42例（采用瑞芬太尼复合丙泊酚麻醉,面罩通气）,均采用靶控输注静脉麻醉法。观察麻醉诱导时间、术中反应、麻醉效果、镇静效果评分、苏醒时间、认知功能以及不良反应发生率等指标。结果：丙泊酚总用量：A组为（335．2±56．4）mg,B组为（466．5±64．8）mg,C组为（334．8±59．7）mg,经方差分析,差异有统计学意义,F=6．513,P〈0．05;Ramsay评分：A组6分的例数为37例（86．0％）,B组为30（71．4％）,C组为34（81．0％）,经卡方检验,差异有统计学意义,X^2=5．832,P〈0．05;不良反应发生率：A组为5例（11．6％）,B组为15例（35．7％）,C组为7例（16．7％）,经卡方检验,差异有统计学意义,X^2=7．546,P〈0．05。结论：老年手术患者应用丙泊酚复合瑞芬太尼喉罩麻醉效果显著,安全有效。     

Photoengraving of coverslips and slides to facilitate monitoring of micromanipulated cells or chromosome spreads

A simple photolithographic technique has been developed which can be used to produce microscopic grid patterns on glass coverslips. The grid pattern is first photo-reduced onto film, and the resulting photographic negative is then used as a mask. A glass slide or coverslip, coated with a layer of photoresist, is then exposed to tungsten light through the mask. After developing and etching, the grid pattern is transferred permanently onto glass. This simple and rapid procedure allows one to mass-produce very small, high resolution grids which are useful for monitoring individual microinjected cells or chromosomal spreads under the microscope.     

Backward masking is not required to elicit the central performance drop

In some circumstances, texture discrimination performance peaks in the parafovea rather than at the fovea. Kehrer (1987) referred to this phenomenon as the central performance drop (CPD). In most studies showing the CPD, task performance has been limited by a backward mask. Morikawa (2000) has argued that in these studies the backward mask was critical to the emergence of the CPD. In three studies we use textures comprising left and right oblique line segments and limit performance by manipulating the orientation variability within the foreground and background textures. Using this method we demonstrate that significant CPDs emerge whether or not there is a backward mask. We conclude that in past studies of the CPD the backward mask functioned primarily as a source of spatial noise and that its temporal relation to the texture display is not critical to the emergence of the CPD.     

Can a combination of vaccination and face mask wearing contain the COVID-19 pandemic?

The COVID-19 pandemic is going into its third year with Europe again being the focus of major epidemic activity. The present review tries to answer the question whether one can come to grip with the pandemic by a combination of vaccinations and non-pharmaceutical interventions (NPIs). Several COVID-19 vaccines are of remarkable efficacy and achieve high protection rates against symptomatic disease, especially severe disease, but mathematical models suggest that the current vaccination coverage in many countries is insufficient to achieve pandemic control. NPIs are needed as complementary measures because recent research has also revealed the limits of vaccination alone. Here, we review the evidence for efficacy of face mask wearing in various settings. Overall pooled analysis showed significant reduction in COVID-19 incidence with mask wearing, although heterogeneity between studies was substantial. Controlled trials of mask wearing are difficult to conduct, separating mask wearing effects in population studies from the impact of other NPIs is challenging and the efficacy of masks depend on mask material and mask fit. The combination of vaccination and mask wearing is potentially synergistic since vaccination protects so far well from disease development (the omicron variant is currently an unknown) but immunity from infection wanes over few months after vaccination. In comparison, masks interfere with the virus transmission process at a level of a physical barrier independent of coronavirus variant. Vaccination and masks are much less costly to apply than other NPI measures which are associated with high economic and social costs, but paradoxically both measures are the target of a vocal opposition by a sizable minority of the society. In parallel with biomedical research, we need more social science research into this opposition to guide political decisions on how to end the pandemic.     

Dual functions of a melanin-based ornament in the common yellowthroat

Melanin-based ornaments often function as signals in male-male competition, whereas carotenoid-based ornaments appear to be important in female mate choice. This difference in function is thought to occur because carotenoid pigments are more costly to produce than melanins and are thus more reliable indicators of male quality. We examined the role of melanin- and carotenoid-based ornaments in male-male competition and female choice in the common yellowthroat Geothlypis trichas, a sexually dichromatic passerine. Males display a black facial mask produced by melanin pigmentation and a bright yellow bib (throat, breast and belly) produced by carotenoid pigmentation. In controlled aviary experiments, mask size was the best predictor of both male-male competition and female mate choice, and, therefore, mask size may be regarded as an ornament of dual function. These dual functions may help to maintain the reliability of mask size as an indicator of male quality, despite the potentially low cost of production. The size of the bib was unrelated to male-male competition or female choice, but there was a tendency for females to prefer males with more colourful bibs. We propose that the black mask is important in competition for territories with other males and for attracting females. Our results highlight the need for more studies of the mechanisms of sexual selection in species with ornaments composed of different pigment types.     

喉罩与气管插管在呼吸衰竭患者院前和急诊急救中的应用效果比较

目的:探讨喉罩与气管插管在呼吸衰竭患者院前和急诊急救中的应用效果。方法:选择2016年1月至2018年5月由中国人民解放军第174医院急诊医学科出诊抢救的呼吸衰竭患者92例,所有患者根据通气方法的不同分为A组和B组。其中A组使用喉罩人工通气方法进行急救,共有47例,而B组则使用气管插管人工通气方法进行急救,共有45例,比较两组患者治疗前与治疗1 h后呼吸频率(RR)、心率(HR)以及血氧饱和度(SpO_2)等生命体征指标,对比喉罩与气管插管置入时间、一次性成功率、心肺复苏成功率情况,记录两组并发症发生情况。结果:两组患者治疗前HR、RR以及SpO_2比较差异无统计学意义(P0.05),两组患者治疗1 h后HR、RR均较治疗前降低,SpO_2较治疗前升高(P0.05),两组患者治疗1h后HR、RR以及SpO_2比较差异无统计学意义(P0.05)。A组的喉罩插管置入时间明显短于B组的气管插管置入时间,且A组插管一次性成功率明显高于B组,两组比较差异具有统计学意义(P0.05),而两组心肺复苏成功率比较差异无统计学意义(P0.05)。A组并发症发生率为2.13%(1/47),低于B组的并发症发生率13.33%(6/45),差异具有统计学意义(P0.05)。结论:喉罩通气与气管插管通气效果基本一致,但其操作更简单更安全,可缩短插管置入时间,提高一次性成功率,争取抢救时间。     

Masking the mask: An Israeli response to the threat of chemical warfare

This paper analyzes a form of visual euphemism which we call “masking the mask.” During the Gulf War, Iraq fired 40 missiles on Israel. Citizens were issued with gas mask kits and were ordered into sealed rooms in their homes during attacks. Thousands of Israelis of all ages decorated or covered their gas mask kits. Although no chemical warheads were fired on the country, Israelis were unusually fearful of gassing because of associations with the Holocaust. Masking the mask served important psychological and communicative functions. It provided a means to express one's fears, to attempt a modest form of mastery over a threatening environment, as well as to rebel against dehumanization and personalization, and to express solidarity with the group under threat, while reasserting one's individual identity.     

Micromachining in plastics using X-ray lithography for the fabrication of microelectrophoresis devices

Micromachining was performed in polymethylmethacrylate (PMMA) using X-ray lithography for the fabrication of miniaturized devices (microchips) for potential applications in chemical and genetic analyses. The devices were fabricated using two different techniques: transfer mask technology and a Kapton mask. For both processes, the channel topography was transferred (1:1) to the appropriate substrate via the use of an optical mask. In the case of the transfer mask technique, the PMMA substrate was coated with a positive photoresist and a thin Au/Cr plating base. Following UV exposure, the resist was developed and a thick overlayer (approximately 3 microns) of Au electroplated onto the PMMA substrate only where the resist was removed, which acted as an absorber of the X-rays. In the other technique, a Kapton film was used as the X-ray mask. In this case, the Kapton film was UV exposed using the optical mask to define the channel topography and following development of the resist, a thick Au overlayer (8 microns) was electrodeposited onto the Kapton sheet. The PMMA wafer during X-ray exposure was situated directly underneath the Kapton mask. In both cases, the PMMA wafer was exposed to soft X-rays and developed to remove the exposed PMMA. The resulting channels were found to be 20 microns in width (determined by optical mask) with channel depths of approximately 50 microns (determined by x-ray exposure time). In order to demonstrate the utility of this micromachining process, several components were fabricated in PMMA including capillary/chip connectors, injectors for fixed-volume sample introduction, separation channels for electrophoresis and integrated fiber optic fluorescence detectors. These components could be integrated into a single device to assemble a system appropriate for the rapid analysis of various targets.     

A mouthpiece face mask for the exercising dog

To develop a rebreathing method for lung volumes, cardiac output with acetylene, and CO diffusing capacity in awake exercising dogs, we have modified and adapted the low-dead-space mask of Montefusco et al. (Angiology 34: 340-354, 1983). We have simplified the fabrication procedure, allowing the physiologist to make the device from parts that can be prefabricated before each dog is custom fitted with the mouthpiece. This decreases the anesthesia time required to custom fit the mouthpiece to each dog. We have also reduced the weight of the mask, making it more tolerable during exercise. We have validated that the mask is leak-free by having the dog rebreathe an inert insoluble gas, He, until equilibration is achieved between the bag and lung. Preliminary measurements of lung volume, cardiac output with acetylene, and CO diffusing capacity have been made during exercise.     

Determinants of skin contact pressure formation during non-invasive ventilation

There is no published data about mask features that impact skin contact pressure during mask ventilation.To investigate the physical factors of skin contact pressure formation.We measured masks with original and reduced air cushion size and recorded contact pressure. We determined cushion contact and mask areas by planimetric measurements.Contact pressures necessary to prevent air leakage during inspiration exceed inspiratory pressure by 1.01±0.41 hPa independent of cushion size.Contact area, ventilator pressure and mask area during inspiration and expiration impact contact pressure. Mask contact pressures are higher during expiration. The contact pressure increases with increase in inspiratory pressures independent of the ventilator cycle. During expiration, the contact pressure will increase in proportion to the expiratory pressure reduction of the ventilator. The mask with reduced air cushion size developed higher contact pressures.Contact pressure can be reduced by selecting masks with a small mask area in combination with a large mask cushion.     

Helical Tomotherapy of the breast: Can thermoplastic immobilization improve the reproducibility of the treatment setup and the accuracy of the delivered dose?

PurposeTo evaluate the impact of thermoplastic mask immobilization in the setup reproducibility and delivered dose for Helical Tomotherapy (HT) of the breast/chest wall.Methods16 patients treated with Accuray Hi-Art HT for breast-cancer were considered. Patients were positioned supine with arms extended above the head using Civco Wing Board (WB) system. In 50% of patients an Orfit thermoplastic mask was added in order to improve immobilization.Before each treatment fraction a megavoltage CT (MVCT) scan was taken and registered to the planning CT by experienced medical staff. The impact of thermoplastic mask was investigated analysing MVCT shift-roll data and MVCT dose distribution using Planned Adaptive software.ResultsIn the analysed cases, the addition of thermoplastic mask had minor impact on the lateral, longitudinal and roll data distribution. Variance of vertical shifts was significantly reduced in the WB + Orfit group. Van Herk's margins were not affected by addition of thermoplastic immobilization.In both groups, target coverage (V95) and maximum dose (D1) were almost identical to planned values. D1 of organs at risk were not significantly different in the two groups.ConclusionsAnalysis of shift-roll data shows no improvement in the group of patients immobilized with the addition of thermoplastic mask. Van Herk's margin is quite large (7–10 mm) in both groups evidencing the need to perform daily setup correction. The adapted dose distribution complies well with the planned one, showing that if MVCT is used before each treatment fraction, a 3 mm margin (setup component) for CTVs expansion could be adequate.     

Feasibility of the laryngeal tube airway for artificial ventilation in pigs and comparison with the laryngeal mask airway

Airway management in anesthetized pigs is known to be technically demanding, and the 'gold standard' technique of endotracheal intubation is particularly difficult to master. The authors investigated the feasibility of the laryngeal tube as an alternative technique for airway management in German Landrace pigs (n = 5). They compared this method with the laryngeal mask, which is considered to be an effective yet relatively straightforward tool for porcine airway management. One after the other, investigators attempted to establish an airway in each anesthetized, artificially ventilated pig using each device. The laryngeal tube was too short to intubate the largest pig (weighing 45 kg), and it took investigators slightly longer to insert this device compared with the laryngeal mask. With the laryngeal mask, there were several incidents of gastric insufflation. Despite these complications, all investigators were able to establish a secure airway and maintain oxygenation with the laryngeal tube, and all subjectively rated both devices as easy to use.     

Determining the filtration efficiency of half-face medical protection mask (N99) against viral aerosol

Hospital-based outbreaks of severe acute respiratory syndrome (SARS) have once again highlighted the vulnerability of healthcare workers (HCWs). Use of personal respiratory protective equipment was the main method used by HCWs to avoid nosocomial transmission. This paper describes the technology used to evaluate the filtration efficiency of the half-face medical protection mask (N99), manufactured by Firmshield Biotechnology, against viral aerosol. Viral aerosol was generated and then sampled simultaneously with and without the test mask. This enables a percentage efficiency value to be calculated against test phage f2 aerosols (surrogates of viral pathogen aerosols). At the same time the mask filtration efficiency against NaCl particle aerosol was determined by use of TSI8130 equipment and face-fit factor was tested by use of TSI8020 equipment. The half-face medical protection mask (N99) evaluated by use of the viral aerosol had a filtration efficiency >99%. The mask filtration efficiency against NaCl particle aerosol was 99.634 ± 0.024% and it had a good face-fit factor. This half-face medical protection mask (N99) can protect the wearer from viral aerosol disease transmission. The test method can be used to assess filtration efficacy against viral aerosol of masks used for respiratory protection.