BACKGROUND & AIMS: :Steier, Joerg, Nic Cade, Ben Walker, John Moxham, and Caroline Jolley. Observational study of neural respiratory drive during sleep at high altitude. High Alt Med Biol. 18:242-248, 2017. AIMS:Ventilation at altitude changes due to altered levels of pO2, pCO2 and the effect on blood pH. Nocturnal ventilation is particularly exposed to these changes. We hypothesized that an increasing neural respiratory drive (NRD) is associated with the severity of sleep-disordered breathing at altitude. METHODS:Mountaineers were studied at sea level (London, United Kingdom), and at altitude at the Aconcagua (Andes, Argentina). NRD was measured as electromyogram of the diaphragm (EMGdi) overnight by a transesophageal multi-electrode catheter; results were reported for sea level, 3,380 m, 4,370 m, and 5,570 m. RESULTS:Four healthy subjects (3 men, age 31(3)years, body mass index 23.6(0.9)kg/m2, neck circumference 37.0(2.7)cm, forced expiratory volume in 1 second 111.8(5.1)%predicted, and forced vital capacity 115.5(6.3)%predicted) were studied. No subject had significant sleep abnormalities at sea level. Time to ascent to 3,380 m was 1 day, to 4,370 m was 5 days, and the total nights at altitude were 21 days. The oxygen desaturation index (4% oxygen desaturation index [ODI] 0.8(0.4), 22.0 (7.2), 61.4 (26.9), 144.9/hour, respectively) and the EMGdi (5.2 (1.9), 12.8 (5.1), 14.1 (3.4), 18.5%, respectively) increased with the development of periodic breathing at altitude, whereas the average SpO2 declined (97.5 (1.3), 84.8 (0.5), 81.0 (4.1), 68.5%, respectively). The average EMGdi correlated well with the 4%ODI (r = 0.968, p = 0.032). CONCLUSION:NRD sleep increases at altitude in relation to the severity of periodic breathing.

背景与目标： ：斯蒂尔，约尔格，尼克·凯德，本·沃克，约翰·莫克瑟姆和卡罗琳·乔利。高原睡眠中神经呼吸驱动的观察性研究。高Alt Med生物学。 18：242-248，2017。
目的：由于pO2，pCO2水平的改变以及对血液pH值的影响，海拔高度的通风情况发生变化。夜间通气尤其容易受到这些变化的影响。我们假设增加的神经呼吸驱动（NRD）与海拔高度的睡眠呼吸障碍的严重程度有关。
方法：在海平面（英国伦敦）和阿空加瓜的海拔高度（阿根廷安第斯山脉）对登山者进行了研究。通过经食管的多电极导管将NRD测量为隔夜肌膜（EMGdi）的肌电图；报告了海平面3380 m，4370 m和5570 m的结果。
结果：四名健康受试者（3名男性，年龄31（3）岁，体重指数23.6（0.9）kg / m2，颈围37.0（2.7）cm，1秒内被测出的呼气量为111.8（5.1）％，被测出肺活量115.5（6.3）％预计）。没有受试者在海平面上有明显的睡眠异常。上升到3,380 m的时间是1天，到达4,370 m的时间是5天，海拔高度的总夜晚数是21天。氧饱和度指数（4％氧饱和度指数[ODI] 0.8（0.4），22.0（7.2），61.4（26.9），144.9 /小时）和EMGdi（5.2（1.9），12.8（5.1），14.1（ 3.4），18.5％）随高海拔周期性呼吸的发展而增加，而平均SpO2下降（分别为97.5（1.3），84.8（0.5），81.0（4.1）和68.5％）。平均EMGdi与4％ODI密切相关（r = 0.968，p = 0.032）。
结论：与定期呼吸的严重程度相比，高海拔地区的NRD睡眠增加。

BACKGROUND & AIMS: INTRODUCTION:The aim of this study was to assess population-based changes in incidence, treatment, and in short- and long-term survival of patients with acute respiratory distress syndrome (ARDS) over 23 years. MATERIALS AND METHODS:Analysis of all patients in Iceland who fulfilled the consensus criteria for ARDS in 1988-2010. Demographic variables, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores and ventilation parameters were collected from hospital charts. RESULTS:The age-standardised incidence of ARDS during the study period was 7.2 cases per 100,000 person-years and was increased by 0.2 cases per year (P < 0.001). The most common causes of ARDS were pneumonia (29%) and sepsis (29%). The use of pressure-controlled ventilation became almost dominant from 1993. The peak inspiratory pressure (PIP) has significantly decreased (-0.5 cmH(2) O/year), but the peak end-expiratory pressure (PEEP) has increased (0.1 cmH(2) O/year) during the study period. The hospital mortality decreased by 1% per year (P = 0.03) during the study period, from 50% in 1988-1992 to 33% in 2006-2010. A multivariable logistic regression model revealed that higher age and APACHE II score increased the odds of hospital mortality, while a higher calendar year of diagnosis reduced the odds of mortality. This was unchanged when dominant respiratory treatment, PIP and PEEP were added to the model. The 10-year survival of ARDS survivors was 68% compared with 90% survival of a reference population (P < 0.001). CONCLUSION:The incidence of ARDS has almost doubled, but hospital mortality has decreased during the 23 years of observation. The 10-year survival of ARDS survivors is poor compared with the reference population.

背景与目标： 简介：本研究的目的是评估23年来急性呼吸窘迫综合征（ARDS）患者的发病率，治疗以及短期和长期生存的基于人群的变化。
材料与方法：分析冰岛所有在1988-2010年间符合ARDS共识标准的患者。人口统计学变量，急性生理和慢性健康评估II（APACHE II）得分和通气参数均从医院病历表中收集。
结果：研究期间ARDS的年龄标准化发病率为每100,000人年7.2例，并且每年增加0.2例（P <0.001）。 ARDS的最常见原因是肺炎（29％）和败血症（29％）。从1993年开始，几乎一直使用压力控制通气。最高吸气压力（PIP）明显降低了（-0.5 cmH（2）O /年），但是最高呼气末压力（PEEP）却增加了（0.1 cmH （2）O /年）。在研究期间，医院死亡率每年下降1％（P = 0.03），从1988-1992年的50％下降到2006-2010年的33％。多变量logistic回归模型显示，较高的年龄和APACHE II评分增加了医院死亡率的可能性，而较高的诊断日历年降低了死亡率的可能性。当将主要呼吸治疗，PIP和PEEP添加到模型中时，情况没有改变。 ARDS幸存者的10年生存率为68％，而参考人群的90％生存（P <0.001）。
结论：在23年的观察中，ARDS的发病率几乎翻了一番，但医院死亡率却下降了。与参考人群相比，ARDS幸存者的10年生存率很低。

BACKGROUND & AIMS: BACKGROUND:Abnormal respiratory rates are one of the first indicators of clinical deterioration in emergency department(ED) patients. Despite the importance of respiratory rate observations, this vital sign is often inaccurately recorded on ED observation charts, compromising patient safety. Concurrently, there is a paucity of research reporting why this phenomenon occurs. OBJECTIVE:To develop a substantive theory explaining ED registered nurses' reasoning when they miss or misreport respiratory rate observations. DESIGN:This research project employed a classic grounded theory analysis of qualitative data. PARTICIPANTS:Seventy-nine registered nurses currently working in EDs within Australia. Data collected included detailed responses from individual interviews and open-ended responses from an online questionnaire. METHODS:Classic grounded theory (CGT) research methods were utilised, therefore coding was central to the abstraction of data and its reintegration as theory. Constant comparison synonymous with CGT methods were employed to code data. This approach facilitated the identification of the main concern of the participants and aided in the generation of theory explaining how the participants processed this issue. RESULTS:The main concern identified is that ED registered nurses do not believe that collecting an accurate respiratory rate for ALL patients at EVERY round of observations is a requirement, and yet organizational requirements often dictate that a value for the respiratory rate be included each time vital signs are collected. The theory 'Rationalising Transgression', explains how participants continually resolve this problem. The study found that despite feeling professionally conflicted, nurses often erroneously record respiratory rate observations, and then rationalise this behaviour by employing strategies that adjust the significance of the organisational requirement. These strategies include; Compensating, when nurses believe they are compensating for errant behaviour by enhancing the patient's outcome; Minimalizing, when nurses believe that the patient's outcome would be no different if they recorded an accurate respiratory rate or not and; Trivialising, a strategy that sanctions negligent behaviour and occurs when nurses 'cut corners' to get the job done. Nurses' use these strategies to titrate the level ofemotional discomfort associated with erroneous behaviour, thereby rationalising transgression CONCLUSION: This research reveals that despite continuing education regarding gold standard guidelines for respiratory rate collection, suboptimal practice continues. Ideally, to combat this transgression, a culture shift must occur regarding nurses' understanding of acceptable practice methods. Nurses must receive education in a way that permeates their understanding of the relationship between the regular collection of accurate respiratory rate observations and optimal patient outcomes.

背景与目标： 背景：呼吸频率异常是急诊科（ED）患者临床恶化的首批指标之一。尽管进行呼吸频率观察很重要，但该生命体征常常不准确地记录在ED观察图上，从而危及患者的安全。同时，很少有研究报告这种现象发生的原因。
目的：建立一个实质性的理论来解释急诊室注册护士错过或误报呼吸频率观察值时的推理。
设计：该研究项目对定性数据进行了经典的扎根理论分析。
参与者：目前在澳大利亚的急诊室工作的九十九名注册护士。收集的数据包括个人访谈的详细回答和在线问卷的不限成员名额的回答。
方法：由于采用了经典的扎根理论（CGT）研究方法，因此编码对于数据的抽象及其作为理论的重新整合至关重要。与CGT方法同义的常量比较用于编码数据。这种方法有助于确定参与者的主要关注点，并有助于产生解释参与者如何处理此问题的理论。
结果：确定的主要关注点是，急诊注册护士并不认为需要在每一轮观察中为所有患者收集准确的呼吸频率，但是组织要求通常要求每次重要时都应包括呼吸频率值收集迹象。 “合理化违法行为”理论解释了参与者如何持续解决这一问题。该研究发现，尽管感到职业上有矛盾，但护士经常会错误地记录呼吸频率的观察结果，然后通过采用可调整组织要求重要性的策略来合理化这种行为。这些策略包括：补偿：当护士认为他们通过提高患者的治疗效果来补偿错误的行为时；当护士认为患者记录正确的呼吸频率与否时，结局没有什么不同，并且最小化；琐事化是一种惩罚过失行为的策略，当护士“偷工减料”完成工作时就会发生。护士使用这些策略来减轻与错误行为有关的情绪不适水平，从而使过犯合理化。结论：这项研究表明，尽管继续接受有关呼吸频率收集的金标准指南的教育，但最佳实践仍在继续。理想情况下，为了应对这种违法行为，必须在护士对可接受的练习方法的理解上发生文化转变。护士必须接受一定程度的教育，以使他们了解定期收集的准确呼吸频率观察值与患者最佳结局之间的关系。

BACKGROUND & AIMS: OBJECTIVE:To review the findings and discuss the implications of mechanical ventilator weaning protocols in children. DESIGN:A critical appraisal of Randolph et al. Effect of mechanical ventilator weaning protocols on respiratory outcomes in infants and children: A randomized controlled trial. JAMA 2002;288:2561-2568, and literature review. FINDINGS:There was no difference in ventilator weaning times between children randomized to a ventilator weaning protocol (pressure support, volume support, or no protocol). However, the study did show that increased sedative use during the first 24 hrs of weaning (the only time during which these data were collected) was an important predictor of weaning duration (p < .001) and weaning failure (p = .04). CONCLUSIONS:The majority of children are weaned from mechanical ventilation over a short period of time. Weaning protocols may not shorten this brief duration of weaning but may have other advantages such as improved collaboration between healthcare team members. Future research into the effects of sedation on weaning from mechanical ventilation is needed in children.

背景与目标： 目的：回顾研究结果并讨论机械呼吸机断奶方案对儿童的影响。
设计：Randolph等人的重要评估。机械呼吸机断奶方案对婴幼儿呼吸系统结局的影响：一项随机对照试验。 JAMA 2002； 288：2561-2568，以及文献综述。
结果：随机分配到呼吸机断奶方案（压力支持，容量支持或无协议）的儿童之间的呼吸机断奶时间没有差异。但是，该研究确实表明，在断奶的前24小时（收集这些数据的唯一时间）内镇静剂使用的增加是断奶持续时间（p <.001）和断奶失败（p = .04）的重要预测指标。 。
结论：大多数儿童在短时间内断奶了机械通气。断奶协议可能不会缩短这段短暂的断奶时间，但可能具有其他优势，例如改善医疗团队成员之间的协作。儿童需要镇静剂对机械通气对断奶的影响的未来研究。

BACKGROUND & AIMS: :This study examined the effects of human pregnancy and advancing gestation on the intensity of respiratory discomfort (dyspnea) during cycle exercise. Fourteen pregnant women (PG) performed a progressive cycle ergometer exercise test involving 20 W/min increases in work rate to symptom limitation and/or a heart rate of 170-175 beats/min at 19.7+/-1.2 weeks (ENTRY), 28.2+/-0.3 weeks (TM2) and 36.3+/-0.3 weeks (TM3) gestation. Eight, age-matched, sedentary non-pregnant women (CG) were also studied for comparison purposes. Measurements included dyspnea intensity (Borg scale), minute ventilation (VE), breathing pattern and other cardiorespiratory parameters. At peak exercise, neither pregnancy nor advancing gestation had an effect on dyspnea, VE, breathing pattern, oxygen uptake or work rate (p>0.05). VE was significantly greater (by 11 L/min at 100 W) in the PG at TM3 versus CG (p<0.05) at all submaximal work rates. VE also increased progressively from ENTRY to TM2 and TM3 during submaximal exercise. Dyspnea was not significantly different at any submaximal work rate in the PG at TM3 versus CG or with advancing gestation in the PG. In addition, dyspnea at a standardized exercise VE of 40 L/min was not different at TM3 versus ENTRY or in the PG at TM3 versus CG. Neither pregnancy nor advancing gestation were associated with increased respiratory discomfort during strenuous non-weight bearing cycle ergometer exercise, despite substantial increases in VE and progressive mechanical adaptations of the respiratory system to accommodate the increasing size of the gravid uterus.

背景与目标： ：这项研究检查了人的妊娠和提前妊娠对周期运动期间呼吸不适（呼吸困难）强度的影响。十四名孕妇（PG）进行了渐进式自行车测功机运动测试，涉及工作时间增加20 W / min以达到症状限制和/或在19.7 /-1.2周时心率为170-175次/ min（ENTRY），28.2 / -0.3周（TM2）和36.3 /-0.3周（TM3）妊娠。为了比较目的，还研究了八名年龄匹配的久坐不孕女性（CG）。测量包括呼吸困难强度（Borg评分），分钟通气量（VE），呼吸模式和其他心肺参数。在运动高峰期，妊娠和提前妊娠对呼吸困难，VE，呼吸方式，摄氧量或工作率均无影响（p> 0.05）。在所有次最大工作速率下，TM3的PG中的VE均明显大于CG（p <0.05）（100 W时为11 L / min）（p <0.05）。在最大程度的运动期间，VE也从ENTRY逐渐增加到TM2和TM3。无论在TM3时，PG的任何次最大工作速率下的呼吸困难与CG相比，或在PG中妊娠进展的情况下，呼吸困难均无显着差异。此外，标准运动VE为40 L / min时的呼吸困难在TM3与ENTRY或PG在TM3与CG时无差异。尽管剧烈增加VE和进行性呼吸系统机械适应，以适应妊娠增加的子宫大小，但剧烈的非负重循环测力计运动期间，怀孕或妊娠晚期均与呼吸不适增加无关。

BACKGROUND & AIMS: :A case of essential tremor since early adultness is presented, which has been treated successfully with the acetylcholine precursor 2-dimethylaminoethanol (deanol) for 10 years. Development of a marked dyskinesia syndrome affecting predominantly orofacial and respiratory musculature has been noticed with this medication. Partial remission after discontinuation and a favorable response to anticholinergics are suggestive of an adverse drug effect.

背景与目标： ：自从成年以来就出现了一种基本的震颤，该病已经用乙酰胆碱前体2-二甲基氨基乙醇（脱醇）成功治疗了十年。用这种药物已经注意到显着的运动障碍综合症的发展，这种综合症主要影响口面部和呼吸系统的肌肉组织。停药后部分缓解和对抗胆碱药的良好反应提示药物不良反应。

BACKGROUND & AIMS: OBJECTIVE(S):Obstructive sleep apnea syndrome (OSAS) is a respiratory disorder which affects from 1 to 3 % of people during development. OSAS treatment may be pharmacological, surgical or based on application of intraoral devices to increase nasal respiratory spaces. The purpose of this study was to determine the efficacy of the Rapid Maxillary Expander in OSAS young patients by measuring cardio-respiratory monitoring parameters (AHI, the average value of complete and incomplete obstructed respiration per hour of sleep, and SAO2, the percentage of oxygen saturation). STUDY DESIGN:The study was conducted on 11 OSAS young subjects (mean age 6.9±1.04 years), all treated with rapid maxillary expansion (RME). Cardio-respiratory monitoring (8-channel Polymesam) was performed at the beginning (diagnostic, T0) and after 12 months of treatment. RESULTS:The mean values of cardio-respiratory parameters at TO were: AHI=6.09±3.47; SAO2=93.09%±1.60. After 12 months of treatment, the mean values of the same polysomnographic parameters were: AHI=2.36 ± 2.24;SAO2=96.81% ±1.60. These changes were associated with an improvement in clinical symptoms, such as reduction of snoring and sleep apnea. CONCLUSION(S):This study confirms the therapeutic efficacy of RME in OSAS young patients. This orthopedic-orthodontic treatment may represent a good option in young patients affected by this syndrome.

背景与目标： 目的：阻塞性睡眠呼吸暂停综合症（OSAS）是一种呼吸系统疾病，在发育过程中会影响1-3％的人。 OSAS的治疗可以是药物治疗，外科手术或基于口腔内器械的应用以增加鼻腔呼吸空间。这项研究的目的是通过测量心脏呼吸监测参数（AHI，每小时完全和不完全阻塞性呼吸的平均值，每小时SAO2，氧气百分比）来确定快速上颌骨扩张器在OSAS年轻患者中的疗效。饱和）。
研究设计：该研究针对11名OSAS年轻受试者（平均年龄6.9±1.04岁）进行，所有受试者均接受快速上颌骨扩张（RME）治疗。在治疗开始（诊断为T0）和治疗12个月后进行心脏呼吸监测（8通道Polymesam）。
结果：在TO时，心脏呼吸参数的平均值为：AHI = 6.09±3.47； SAO 2 ＝ 93.09％±1.60。治疗12个月后，相同的多导睡眠图参数的平均值为：AHI = 2.36±2.24； SAO2 = 96.81％±1.60。这些变化与临床症状的改善有关，例如打呼and和睡眠呼吸暂停的减少。
结论：该研究证实了RME在OSAS年轻患者中的治疗功效。这种骨科正畸治疗可能是受此综合征影响的年轻患者的一个不错的选择。

BACKGROUND & AIMS: BACKGROUND:During hospitalization, stroke patients are bedridden due to neurologic impairment, leading to loss of muscle mass, weakness, and functional limitation. There have been few studies examining respiratory muscle strength (RMS) in the acute phase of stroke. OBJECTIVE:This study aimed to evaluate the RMS of patients with acute stroke compared with predicted values and to relate this to anthropometric variables, risk factors, and neurologic severity. METHODS:This is a cross-sectional study in the acute phase of stroke. After admission, RMS was evaluated by maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP); anthropometric data were collected; and neurologic severity was evaluated by the National Institutes of Health Stroke Scale. The analysis of MIP and MEP with predicted values was performed by chi-square test, and the relationship between anthropometric variables, risk factors, and neurologic severity was determined through multiple linear regression followed by residue analysis by the Shapiro-Wilk test; P < .05 was considered statistically significant. RESULTS:In the 32 patients studied, MIP and MEP were reduced when compared with the predicted values. MIP declined significantly by 4.39 points for each 1 kg/m2 increase in body mass index (BMI), and MEP declined significantly by an average of 3.89 points for each 1 kg/m2 increase in BMI. There was no statistically significant relationship between MIP or MEP and risk factors, and between MIP or MIP and neurologic severity in acute phase of stroke. CONCLUSION:There is a reduction of RMS in the acute phase of stroke, and RMS was lower in individuals with increased age and BMI.

背景与目标： 背景：住院期间，中风患者由于神经系统受损而卧床不起，导致肌肉量减少，无力和功能受限。很少有研究检查中风急性期的呼吸肌强度（RMS）。
目的：本研究旨在评估急性脑卒中患者的均方根值与预测值，并将其与人体测量学变量，危险因素和神经系统严重程度相关联。
方法：这是中风急性期的横断面研究。入院后，通过最大吸气压力（MIP）和最大呼气压力（MEP）评估RMS。收集人体测量数据；美国国立卫生研究院卒中量表对神经系统的严重程度进行了评估。通过卡方检验对具有预测值的MIP和MEP进行分析，并通过多元线性回归，然后通过Shapiro-Wilk检验进行残留分析，确定了人体测量学变量，危险因素和神经系统严重程度之间的关系。 P <.05被认为具有统计学意义。
结果：在32例患者中，与预期值相比，MIP和MEP降低。身体质量指数（BMI）每增加1 kg / m2，MIP显着下降4.39点，而体重指数每增加1 kg / m2，MIP平均显着下降3.89点。在卒中急性期，MIP或MEP与危险因素之间，MIP或MIP与神经系统严重程度之间无统计学意义的相关性。
结论：中风急性期RMS降低，而年龄和BMI增加的个体RMS更低。

BACKGROUND & AIMS: :Respiratory failure (RF) developed in 43 (40.2 percent) of 107 patients with acute organophosphate or carbamate poisoning; 22 (51.2 percent) died. The 64 patients who did not develop RF survived. All cases of RF developed within 96 hours after poisoning: within 24 hours in 35 patients (acute onset) and between 24 and 96 hours in eight patients (subacute onset). Severity of poisoning was the primary determinating factor for RF. Cardiovascular collapse and pneumonia were also associated with RF. In 19 patients with cardiovascular collapse, 17 had acute onset of RF and two had subacute onset. In 28 patients with pneumonia, 17 developed acute onset of RF and eight developed subacute onset. No organophosphorus compound caused RF more frequently than another. The duration of ventilator support for subacute RF was significantly longer than for acute RF (287 +/- 186 vs 115 +/- 103 hours, p = 0.02). The use of pralidoxime did not reduce the incidence of RF. We found that severity of poisoning, cardiovascular collapse, and pneumonia were the predisposing factors to RF. The golden time for treatment of acute organophosphate or carbamate poisoning was the initial 96 hours. No RF occurred after this time. Aggressive treatment and prevention of the above three factors will reduce the incidence of RF, or in other words, reduce the mortality.

背景与目标： ：107例急性有机磷酸酯或氨基甲酸酯中毒患者中，有43例（40.2％）出现呼吸衰竭（RF）； 22人（51.2％）死亡。 64例未发生RF的患者幸存。所有RF病例在中毒后96小时内发展：35例患者在24小时内（急性发作），而8例患者在24到96小时内（亚急性发作）。中毒的严重程度是影响RF的主要因素。心血管衰竭和肺炎也与射频有关。在19例心血管衰竭患者中，有17例急性RF发作，其中2例为亚急性发作。在28例肺炎患者中，有17例发展为RF急性发作，有8例为亚急性发作。没有一种有机磷化合物比另一种引起RF的频率更高。亚急性RF的呼吸机支持时间明显长于急性RF（287 /-186 vs 115 /-103小时，p = 0.02）。使用普利昔肟并不能降低RF的发生率。我们发现中毒的严重程度，心血管衰竭和肺炎是导致RF的诱因。治疗急性有机磷酸酯或氨基甲酸酯中毒的黄金时间是最初的96小时。在此时间之后没有RF发生。积极地治疗和预防以上三个因素将降低RF的发生率，换句话说，可以降低死亡率。

BACKGROUND & AIMS: OBJECTIVE:This study examined the associations between respiratory symptoms and patterns of pulmonary dysfunction of 115 male roofing cement workers compared with 134 unexposed subjects. METHODS:A cross-sectional study was conducted. Environmental samplings and spirometry measurements were also collected. RESULTS:The exposed workers had higher respiratory dust exposure levels (0.65 mg/m3) compared with the unexposed groups (0.32 mg/m3). The exposed group had significantly higher prevalence than the unexposed group for shortness of breath (OR=2.19). The exposed group also had higher but insignificant prevalence of chronic cough (OR=1.34), chest tightness (OR=1.64), and wheezing (OR=1.89). The ventilatory respiratory function values (FEV1 and FVC) were slightly lower for the exposed group. CONCLUSION:An association between higher cement dust levels and a decline in ventilatory function among roofing fiber cement workers suggests that the respiratory health of roofing cement workers should be protected through policies or work standards.

背景与目标： 目的：本研究调查了115名男性屋面水泥工人与134名未暴露受试者的呼吸系统症状与肺功能障碍类型之间的关系。
方法：进行横断面研究。还收集了环境采样和肺活量测定法。
结果：暴露工人的呼吸粉尘暴露水平（0.65 mg / m3）高于未暴露组（0.32 mg / m3）。暴露组的呼吸困难患病率明显高于未暴露组（OR = 2.19）。暴露组的慢性咳嗽（OR = 1.34），胸闷（OR = 1.64）和喘息（OR = 1.89）的患病率也较高，但微不足道。暴露组的通气呼吸功能值（FEV1和FVC）略低。
结论：屋面纤维水泥工人中较高的水泥粉尘含量与通风功能下降之间存在关联，这表明应通过政策或工作标准保护屋面水泥工人的呼吸健康。

BACKGROUND & AIMS: BACKGROUND AND OBJECTIVE:Allergic diseases of the respiratory tract are common atopic diseases in the population. Pollen of plants are one of their main causes. Pollen of trees, grasses, and weeds like mugwort are of particular importance in this context. The purpose of the present study was to determine the association between typical respiratory symptoms due to pollen allergens and the sensitization to pollen of ragweed and mugwort in adults. METHODS:1039 participants (18 to 66 years) from Southwest Germany were included in this cross-sectional study. Complains typically for aeroallergens were recorded by questionnaire. In-vitro existing sensitizations were determined for grasses/early bloomer (gx1), trees (tx6), mugwort (w6 and Art-v1) and ragweed (w1 and Amb-a1) by testing for specific IgE-antibodies. RESULTS:In a screening test with a mixed allergen sample (sx1) 36.0 % of the participants showed an aeroallergen sensitization. Consecutive investigations of these 374 positive samples revealed a sensitization to grasses/early bloomer, trees, ragweed (w1), mugwort (w6) and the major allergens ragweed (Amb-a1) and mugwort (Art-v1) in 61.8 %, 54.5 %, 29.9 %, 24.3 %, 1.9 %, and 12.3 %, respectively. This corresponds to 22.2 %, 19.6 %, 10.8 %, 8.7 %, 0.7 % and 4.4 %, respectively, in the whole study population. The participants tested positively stated significantly more disorders. On average, 51.1 % had known hay fever, 65.2 % sneezing without cold and 41.5 % sneezing due to contact with grasses or flowers. In contrast, participants tested negatively stated disorders in only 4.4 %, 32.5 %, and 3.9 %, respectively. CONCLUSION:In Southwest Germany, sensitizations to plant pollen mainly are still caused by grasses, trees, and weeds like mugwort. A sensitization to pollen of ragweed alone is rare until now. However, in case of continuous allergic disorders of the respiratory tract in late summer, a sensitization to ragweed can be important for differential diagnostics.

背景与目标： 背景与目的：呼吸道过敏性疾病是人群中常见的特应性疾病。植物的花粉是其主要原因之一。在这种情况下，树木，草和像艾蒿这样的杂草的花粉尤为重要。本研究的目的是确定成人花粉过敏原引起的典型呼吸道症状与豚草和艾蒿对花粉的敏感性之间的关系。
方法：来自德国西南部的1039名参与者（18至66岁）被纳入本横断面研究。通过问卷调查记录了典型的气源性过敏原投诉。通过测试特定的IgE抗体，确定了草/早bloom（gx1），树木（tx6），艾蒿（w6和Art-v1）和豚草（w1和Amb-a1）的体外现有致敏性。
结果：在混合过敏原样品（sx1）的筛查测试中，有36.0％的参与者表现出了空气过敏原致敏性。对这374个阳性样本的连续调查显示，对草/早熟花，树木，豚草（w1），艾蒿（w6）和豚草的主要过敏原（Amb-a1）和艾蒿（Art-v1）的致敏性分别为61.8％，54.5％。 ，29.9％，24.3％，1.9％和12.3％。在整个研究人群中，这分别对应于22.2％，19.6％，10.8％，8.7％，0.7％和4.4％。参与者进行了积极测试，表明明显更多的疾病。平均而言，有51.1％的人患有花粉症，有65.2％的人不接触感冒打喷嚏，以及41.5％的人因接触草或花而打喷嚏。相比之下，参与者仅以4.4％，32.5％和3.9％的比率对负面陈述的疾病进行了测试。
结论：在德国西南部，对植物花粉的致敏作用仍然主要是由草，树木和艾蒿等杂草引起的。迄今为止，仅对豚草的花粉进行敏化是罕见的。但是，在夏末持续出现呼吸道过敏性疾病的情况下，对豚草过敏可能对鉴别诊断很重要。

BACKGROUND & AIMS: :Aquatic birds are a reservoir of all known influenza A viruses. Avian influenza viruses have played a major role in the creation of pandemic influenza viruses in humans. In this study, we genetically characterized genes of nine isolates from waterfowl in Eulsukdo, a congregating place for migratory birds on the flyway of migration from Siberia, which is located in the southern part of South Korea. Phylogenic analysis showed that HA and NA genes of isolates belonged to Eurasian lineage, and lineage analysis showed that NS, PB1, PA, NP, and M genes of isolates clustered with Eurasian lineage, and PB2 genes of isolates belonged to North American or Eurasian lineage. Results suggest that the interregional transmission of genes of avian influenza viruses may occur in the migratory birds.

背景与目标： ：水禽是所有已知的A型流感病毒的储存库。禽流感病毒在人类大流行性流感病毒的产生中发挥了重要作用。在这项研究中，我们通过遗传学鉴定了Eulsukdo水禽的9个分离株的基因，Eulsukdo是位于韩国南部从西伯利亚迁徙的迁徙飞鸟的聚集地。系统发育分析表明，分离株的HA和NA基因属于欧亚谱系，谱系分析表明，分离株的NS，PB1，PA，NP和M基因与欧亚谱系聚在一起，而分离株的PB2基因属于北美或欧亚谱系。 。结果表明，禽流感病毒基因的区域间传播可能发生在候鸟中。

BACKGROUND & AIMS: :PRRSV (porcine reproductive and respiratory syndrome virus) nucleocapsid (N) protein is the most abundant structural protein of the virus. During infection, the N protein is specifically localized to the nucleus and nucleolus in addition to its normal cytoplasmic distribution. Previously, a nuclear localization signal (NLS, 41-PGKK(N/S)KKKN)-null mutant virus (41-PGGGNKKKN) showed reduced viremia and increased production of neutralizing antibodies in infected pigs. However, the mutagenized NLS underwent strong selection pressure in the pig that resulted in partial or complete reversion and reacquisition of NLS function, and thus the biological effect of the NLS-null mutation needed further investigation. In the present study, a total of 9 "reversion resistant" mutants were generated by amino acid deletions and substitutions using an infectious cDNA clone. Two mutant clones (PG--SKKKS and PG--S-KKS) that produced progeny viruses were genetically stable for at least 20 passages in cell culture. Infection of pigs with those mutants induced neutralizing antibodies to higher titers than with wild-type virus. Both mutant viruses induced viremia of lower titer and of shorter duration than wild-type virus. RT-PCR from tonsils showed that both mutants persisted at a reduced level. Virus transmission to contact pigs was also lower in the mutant virus infected groups. No reversion to functional NLS was detected in either mutant from any pig. These data demonstrate that N protein nuclear localization is indeed associated with viral pathogenesis and host response to PRRS.

背景与目标： ：PRRSV（猪生殖和呼吸综合征病毒）核衣壳（N）蛋白是该病毒中最丰富的结构蛋白。在感染过程中，N蛋白除了其正常的细胞质分布外，还特异地位于细胞核和核仁中。以前，核定位信号（NLS，41-PGKK（N / S）KKKN）-无效突变病毒（41-PGGGNKKKN）显示出降低的病毒血症，并增加了感染猪中和抗体的产生。但是，诱变的NLS在猪中受到强大的选择压力，导致NLS功能部分或完全回复和重新获得，因此NLS-null突变的生物学效应需要进一步研究。在本研究中，使用感染性cDNA克隆通过氨基酸缺失和置换产生了总共9个“抗逆转”突变体。产生后代病毒的两个突变体克隆（PG--SKKKS和PG--S-KKS）在细胞培养中至少20代具有遗传稳定性。用那些突变体感染猪所诱导的中和抗体的滴度要高于野生型病毒。与野生型病毒相比，两种突变病毒均能引起较低的滴度和持续时间较短的病毒血症。扁桃体的RT-PCR显示两个突变体均以降低的水平持续存在。在突变病毒感染组中，接触猪的病毒传播率也较低。在任何猪的任一突变体中均未检测到功能性NLS的逆转。这些数据表明，N蛋白核定位确实与病毒发病机制和宿主对PRRS的反应有关。

BACKGROUND & AIMS: :This article reports the occurrence of Guillain-Barre syndrome in a critically ill patient manifesting as a "difficult-to-wean" patient. This uncommon but possible etiology is worth noting by physicians in the intensive care unit.

背景与目标： ：本文报道了表现为“难以断奶”的重症患者发生格林巴利综合症。重症监护病房的医师值得注意这种罕见但可能的病因。

BACKGROUND & AIMS: :Low-frequency respiratory impedance (Zrs) was measured by applying a forcing signal, between 0.5 and 21 Hz at a transrespiratory pressure of 20 cm H(2)O, in a cross-sectional study of 37 normal infants. A model containing an airway resistance (Raw) and inertance (Iaw) and a tissue damping (G) and elastance (H) was fitted to the individual Zrs. Forced expiratory volume in 0.5 second (FEV(0.5)) was determined using the raised volume rapid thoracic compression technique. Multivariate regression analysis was used to analyze the relationships between the lung function parameters and length. Both airway and tissue parameters showed a decreasing quadratic relationship with increasing length. FEV(0.5) showed an increasing cubic relationship with length. A family history of asthma was found to have a negative effect on Raw, H, and FEV(0.5).

背景与目标： ：在37例正常婴儿的横断面研究中，通过在20 cm H（2）O的跨呼吸压力下施加0.5至21 Hz之间的强迫信号来测量低频呼吸阻抗（Zrs）。将包含气道阻力（Raw）和惯性（Iaw）以及组织阻尼（G）和弹性（H）的模型拟合到各个Zrs。使用增加体积的快速胸廓压缩技术确定0.5秒内的呼气量（FEV（0.5））。多元回归分析用于分析肺功能参数和长度之间的关系。气道和组织参数均显示出随着长度增加而减小的二次关系。 FEV（0.5）随长度增加呈立方关系。发现哮喘家族史对Raw，H和FEV有负面影响（0.5）。