Daytime driving simulation performance and sleepiness in obstructive sleep apnoea patients

BACKGROUND: Sleepiness related car accidents are common in obstructive sleep apnoea syndrome (OSAS) patients. The objective measurements of sleepiness used in clinical setting quantify the tendency to fall asleep in quiet situations that are completely different from driving. METHODS: We studied 30 OSAS patients with subjective (subjective sleepiness scales) and objective (multiple sleep latency test, MSLT) sleepiness measurements, associated with driving simulation test (DST), previously validated in young healthy subjects. The results of subjective and objective sleepiness tests were compared with simulated driving performance in order to evaluate the suitability of our DST for measuring alertness. RESULTS: Subjective and objective sleepiness measurements were significantly correlated with driving performance on the simulator. The most significant correlates of sleepiness were the measures of the primary vehicle control task on the simulator: lane position variability and crash data. The comparison of DST and MSLT results suggested our driving simulated approach could be used to evaluate daytime sleepiness in the clinical setting of OSAS patients. CONCLUSIONS: Our DST is a suitable objective tool to detect sleepiness in OSAS patients, and could be useful in the clinical setting of sleep medicine and research.     

双水平正压通气最优控制方案

睡眠呼吸机的人机同步性问题目前还没有彻底解决,文章通过Lab View搭建实验平台,在传统PID控制策略的基础上,加入压力提前释放模块,使呼吸机能够准确预测出吸气时间并提前释放压力。选择10名志愿者对实验平台的人机同步性进行测试,实验结果表明经过改进的PID控制算法可以有效提高呼吸机的人机同步性,降低使用中的不适或憋闷感。     

茶多酚对两种淀粉热力学特性及糊化特性影响的研究

利用差示扫描量热仪(DSC)及快速粘度仪(RVA)研究了茶多酚(TP)对糯玉米淀粉(WMS)及由糯玉米淀粉改性的辛烯基琥珀酸淀粉酯(OSA淀粉)的热特性及糊黏度的影响.结果表明,两种淀粉的糊化温度和焓值随TP添加量的增加而明显降低(p＜0.05);4℃下贮存7d,两种淀粉的回生焓值和重结晶随TP添加量增加而降低(p＜0.05),添加15％TP的糯玉米淀粉及添加10％和15％ TP的OSA淀粉没有出现重结晶及回生焓值;由RVA曲线知,随TP添加量增大,OSA淀粉糊黏度降低,其中添加15％ TP的OSA淀粉,其峰值黏度、谷值黏度及终粘度降低最大,而糯玉米淀粉并未呈现一定规律性.以上结果证明,TP能够降低两种淀粉的糊化温度及焓值,抑制淀粉老化,且在一定程度上具有降低淀粉糊黏度的作用.     

改良小儿腭咽成型术治疗小儿睡眠呼吸暂停综合征疗效观察

目的:探讨改良小儿腭咽成型术用于治疗小儿OSAS的效果。方法:将195例扁桃体切除术患者随机分为治疗组108例,对照组87例,两组病例均行常规的扁桃体切除术,术后治疗组病例将腭舌弓、腭咽弓及扁桃体窝组织一并缝合,修复创面,封闭创腔。对照组病例经压迫止血或双极电凝止血成功,术创未予缝合。对比研究治疗组与对照组术后症状缓解、出血并发症及患儿术后不适反映的情况。结果:术后症状缓解:治疗组有效率96.30%,对照组有效率85.06%。治疗组病例无1例发生术后原发性或继发性出血。对照组病例发生原发性出血1例,继发性出血3例,出血并发症的发生率为4.56%。术后观察患儿哭闹情况及进食情况,治疗组和对照组无明显差别。结论:改良小儿腭咽成型术对治疗小儿OSAS疗效可靠,安全性高,小儿舒适度好。     

Obstructive sleep apnoea among professional taxi drivers: A pilot study

Purpose

This study aimed to describe the distribution of risk factors for obstructive sleep apnoea syndrome (OSAS) among taxi drivers, and to investigate differences by ethnicity in OSAS symptoms among drivers.

Methods

A two-page postal questionnaire was completed by 241 professional taxi drivers from Wellington, New Zealand. Obstructive sleep apnoea syndrome was defined as having an estimated 15 or more respiratory disturbances, per hour of sleep (Respiratory Disturbance Index (RDI) ≥ 15) and self-reported daytime sleepiness.

Results

Pacific and Māori taxi drivers were more likely to have symptoms and risk factors for OSAS, compared to non-Māori non-Pacific drivers. In particular, Pacific drivers had a significantly increased pre-test probability of having moderate-severe OSA (RDI ≥ 15).

Conclusions

Some professional taxi drivers are at increased risk for moderate-severe OSAS, especially Pacific and Māori taxi drivers. Untreated OSAS increases motor vehicle crash risk, so these findings have implications for the health and safety of drivers and their passengers. They suggest a need for more comprehensive research to guide policy on medical examinations required for licensing professional drivers as fit to drive.     

鼻内窥镜下腺样体＋扁桃体切除术在儿童阻塞性睡眠呼吸暂停综合症中的应用

儿童阻塞性睡眠呼吸暂停综合症（OSAS），俗称鼾症。是由于上气道狭窄、阻塞引起的呼吸障碍，是危害儿童身心健康的一种严重疾病。腺样体、扁桃体肥大是该病最常见的发病原因，手术切除为其治疗首选。鼻内窥镜明视下应用鼻腔电动切割吸引器切除增性肥大的腺样体及扁桃体组织为其最佳手术方式，该方式安全性强、操作方便、创伤小、治愈率高、并发症少，值得推广。     

Patient-Specific Geometry Modeling and Mesh Generation for Simulating Obstructive Sleep Apnea Syndrome Cases by Maxillomandibular Advancement

The objective of this paper is the reconstruction of upper airway geometric models as hybrid meshes from clinically used Computed Tomography (CT) data sets in order to understand the dynamics and behaviors of the pre- and postoperative upper airway systems of Obstructive Sleep Apnea Syndrome (OSAS) patients by viscous Computational Fluid Dynamics (CFD) simulations. The selection criteria for OSAS cases studied are discussed because two reasonable pre- and postoperative upper airway models for CFD simulations may not be created for every case without a special protocol for CT scanning. The geometry extraction and manipulation methods are presented with technical barriers that must be overcome so that they can be used along with computational simulation software as a daily clinical evaluation tool. Eight cases are presented in this paper, and each case consists of pre- and postoperative configurations. The results of computational simulations of two cases are included in this paper as demonstration.     

辛烯基琥珀酸淀粉酯制备高含量β-胡萝卜素微胶囊

以辛烯基琥珀酸淀粉酯(OSAS)和β-环糊精为主要壁材,葵花籽油为溶解载体,硬脂酰乳酸钠(SSL)为乳化剂,并添加适量dl-α-生育作为的抗氧化剂,通过高温油熔和喷雾干燥方式研制高含量的β-胡萝卜素微胶囊产品。以微胶囊的包埋率为目标,利用单因素和混料实验设计优化β-胡萝卜素微胶囊的最佳工艺配方。结果表明:在微胶囊壁材含量占62%(β-环糊精和辛烯基琥珀酸淀粉酯分别占42%和20%)、葵花籽油21%、SSL 2%时可制得高含量的β-胡萝卜素微胶囊产品,产品包埋率、流动性及溶解性均能满足应用性要求。