Understanding and controlling airborne organic compounds in the indoor environment: mass transfer analysis and applications.

Mass transfer is key to understanding and controlling indoor airborne organic chemical contaminants (e.g., VVOCs, VOCs, and SVOCs). In this study, we first introduce the fundamentals of mass transfer and then present a series of representative works from the past two decades, focusing on the most recent years. These works cover: (i) predicting and controlling emissions from indoor sources, (ii) determining concentrations of indoor air pollutants, (iii) estimating dermal exposure for some indoor gas-phase SVOCs, and (iv) optimizing air-purifying approaches. The mass transfer analysis spans the micro-, meso-, and macroscales and includes normal mass transfer modeling, inverse problem solving, and dimensionless analysis. These representative works have reported some novel approaches to mass transfer. Additionally, new dimensionless parameters such as the Little number and the normalized volume of clean air being completely cleaned in a given time period were proposed to better describe the general process characteristics in emissions and control of airborne organic compounds in the indoor environment. Finally, important problems that need further study are presented, reflecting the authors' perspective on the research opportunities in this area.

[Diagnosis and treatment of adult capitellar fractures].

OBJECTIVE: To discuss the diagnosis, differential diagnosis, classification methods and treatment of the capitellar fractures of the distal humerus. METHODS: In the study, 28 adult patients with the capitellar fractures were treated in Beijing Jishuitan Hospital from Sep. 2008 to Jan. 2014. There were 10 females and 18 males with an average age of 34 years (range: 14-66 years). According to Dubberley classification: IA type in 6 cases, IB type in 2 cases, IIA type in 8 cases, IIB type in 4 cases, IIIA type in 4 cases, and IIIB type in 4 cases. Sixteen patients were treated with a single Kochr approach, 1 with a lateral approach combined with a medial approach, 2 combined with anterior elbow approach and 9 combined with posterior median approach. All of the fractures were fixed with Herbert screws, 7 cases with support plates, and 4 cases with the hinged elbow external fixator. All of the patients were followed up for clinical examination and radiograph check. They were evaluated with Broberg-Morrey score system. RESULTS: The average follow-up time was 28.5 months (range 12-72 months). The average bone union time was 8 weeks. The average ulnohumeral motion was 112°(60°-150°) and forearm rotation was 145°(100°-170°). The average Broberg-Morrey score was 92.5 points (range: 62-100 points). The excellent and good rate was 91.8%. The complications of traumatic arthritis was in 2 cases and elbow stiffness was in 2 cases. CONCLUSION: Attention should be paid to the diagnosis and differential diagnosis of capitellar fractures without missing the combined injury. According to Dubberley classification, appropriate surgical approach and the internal and external fixed methods could be chosen. Early postoperative, reasonable and effective exercise is helpful to the recovery of elbow joint function.

[Value of using gonadotropin-releasing hormone agonist pretreatment in adenomyosis patients before adenomyomectomy].

Objective: To investigate the value of using gonadotropin-releasing hormone agonist (GnRH-a) pretreatment in adenomyosis patients before adenomyomectomy. Methods: From May 2012 to September 2015, 87 patients with adenomyosis who were non-effective to conservative therapy in Renmin Hospital of Wuhan University were enrolled in this study. According to the principle of randomized control, 41 patients were in the treatment group who were treated with GnRH-a 2-3 cycles before adenomyomectomy, while 46 patients in the control group. The control group paients were operated without any pretreatments. The blood loss, the number of penetrating into uterine cavity, duration of operation, duation of peritoneal drainage and the amount of drainage fluid, the difference of hemoglobin value before and after operation, total white blood cell count, duration of hospitalization, the maximum diameter of uterus and other indicators between the two groups were compared. Results: In the treatment group, before and after treatment with GnRH-a, the uterus size, blood hemoglobinand CA125 value were statistically different (all P<0.05); between the treatment group of GnRH-a treated for 2 cycles and for 3 cycles, there were statistical differences of blood hemoglobin value [(108 ± 20) versus (118 ± 24) g/L], CA125 value [(26 ± 11) versus(19 ± 4) kU/L; all P< 0.05]. There were statistical differences of blood loss in operation [(113 ± 32) versus (194 ± 42) ml], ratio of penetrating into uterine cavity [12% (5/41) versus 12% (8/46)], duration of operation[(79±23) versus (91±25) minutes], duration of peritoneal drainage after operation [(2.1±0.9) versus (3.0±1.2) days] and the amount of drainage fluid [(152±43) versus (232±32) ml], the difference of hemoglobin value before and after surgery [(-15.6±2.9) versus (-23.7±3.5) g/L], white blood cell count after 2-3 days of operation [(11.4±4.2)×109/L versus (13.5 ± 3.2) × 109/L], ratio of peri-operative blood transfusion [5% (2/41) versus 20% (9/46)] and duration of hospitalization [(11.2±1.9) versus (13.6±3.1) days] between the treatment group and the control group (all P<0.05). Conclusion: The pretreatment of using GnRH-a before adenomyomectomy in adenomyosis patients has benefits for implementation of surgery and reducing peri-operative and postoperative complications.

A model of self-regulation for control of chronic disease.

Chronic disease poses increasing threat to individual and community health. The day-to-day manager of disease is the patient who undertakes actions with the guidance of a clinician. The ability of the patient to control the illness through an effective therapeutic plan is significantly influenced by social and behavioral factors. This article presents a model of patient management of chronic disease that accounts for intrapersonal and extemal influences on management and emphasizes the central role of self-regulatory processes in disease control. Asthma serves as a case for exploration of the model. Findings from a 5-year study of 637 children with asthma and their care-taking parents supported that the self-regulation elements of the model were reasonably stable over time and baseline values were predictive of important disease management outcomes.

[Therapeutic effect of blood activating polypeptide on the treatment of chronic severe viral hepatitis].

OBJECTIVE: To study the therapeutic effect of blood activating polypeptide on chronic severe viral hepatitis (CSH) and the method used. METHODS: The treated group included 50 CSH patients (male 82, female 8, age 39 +/- 9). Based on routine treatments, they were intravenously injected with 15 ml blood activating polypeptide dissolved in 250 ml of 10% glucose, qd x 4 wks. The control group contained 50 CSH patients (male 3, female 7, age 38+/-12). They were only treated with routine treatments for liver protection, jaundice regression, health maintenance, anti-infection and diuresis. RESULTS: The SB and ALT in treated patients decreased obviously (P < 0.01) after treatment, the prominent efficacy was 52%, the total efficacy was 86%, all were superior to the control group. CONCLUSIONS: Blood activating polypeptide is safe, reliable and effective in the treatment of CSH.

Impact of education for physicians on patient outcomes.

OBJECTIVES: This study was conducted to assess the impact of an interactive seminar based on self-regulation theory on 1) the treatment practices and communications and education behavior of physicians, 2) the health status and medical care utilization of their pediatric patients with asthma, and 3) the satisfaction with care of the subjects' parents. METHODS: A total of 74 general practice pediatricians were assigned to either a program or a control group in a randomized controlled study. Data were collected from physicians at baseline, and 69 (93%) provided follow-up data 5 months after the program. Data were also collected from 637 of their patients at baseline, and in a 22-month window after the intervention, 472 (74%) of this number provided follow-up data. RESULTS: After the seminar, physicians in the program group were more likely than were control group physicians to address patients' fears about medicines, review written instructions, provide a sequence of educational messages, write down how to adjust the medicines at home when symptoms change, and report that they spent less time with their patients. Parents of the children treated by program physicians were significantly more likely than were control group parents to report that the physician had been reassuring, described as a goal that the child be fully active, and gave information to relieve specific worries. After a visit with the physician, these parents were also more likely to report that they knew how to make management decisions at home. After the intervention compared to controls, patients of physicians in the program group were more likely to have received a prescription for inhaled antiinflammatory medicine and to have been asked by the physician to demonstrate how to use a metered-dose inhaler. After the intervention, children seen by program physicians made significantly fewer nonemergency office visits and visits for follow-up of an episode of symptoms; however, there were no differences in emergency department visits and hospitalizations. Among children who were placed on inhaled corticosteroids during this study, however, children treated by physicians who had received education had significantly fewer symptoms and fewer follow-up office visits, nonemergency physician office visits, emergency department visits, and hospitalizations. CONCLUSIONS: The interactive seminar based on theories of self-regulation led to patient-physician encounters that were of shorter duration, had significant impact on the prescribing and communications behavior of physicians, led to more favorable patient responses to physicians' actions, and led to reductions in health care utilization.

Long-term effects of asthma education for physicians on patient satisfaction and use of health services.

This randomized clinical trial evaluated the long-term impact of an interactive seminar for physicians based on principles of self-regulation on clinician behaviour, children's use of health services for asthma, and parent's views of physician performance. Seventy-four general practice paediatricians, and 637 of their asthma patients aged 1-12 yrs, were randomized to treatment or control. Children and parents were blind to physicians' participation. Data were collected at baseline and follow-up through self-administered surveys (paediatricians), telephone interviews (parents) and medical records. The seminar focused on development of communication and teaching skills and use of therapeutic medical regimens for asthma as outlined in the National Asthma Education and Prevention Program guidelines. Approximately 2 yrs postintervention, treatment group physicians were more likely than control physicians to: use protocols for delivering asthma education (odds ratio (OR) 4.9, p=0.2), write down for patients how to adjust medicines when symptoms change (OR 5.7, p=0.05), and provide more guidelines for modifying therapy (OR 3.8, p=0.06). Parents scored treatment group physicians higher than control physicians on five specific positive communication behaviours. Children seen by treatment group physicians had fewer hospitalizations (p=0.03) and those with higher levels of emergency department (ED) use at baseline had fewer subsequent ED visits (p=0.03). No differences regarding the number of office visits were noted. There were no significant differences found between treatment and control group physicians in the amount of time spent with patients during office visits (26 versus 29 min) or in the number of patients treated with anti-inflammatory medicine. It is concluded that interactive asthma seminars for paediatricians had significant long-term benefits for their asthma care.