The Difference of the Pulmonary-Artery Pressure of the Migrants from Difference Elevation at the 4636 - 4907 m Altitude

Study Objective： To compare and analyze the changes of the pulmonary-artery pressure of the migrants coming from different elevation in the hypoxic environment of 4636 - 4907 m extreme altitude. To explore the susceptibility to hypoxic pulmonary-artery hypertension （PH） in the subjects from different altitude and profession. Methods： By using Color Doppler Ultmsonography （CDU）, measuring the pulmonary-artery pressure of 207 healthy men, who had continuously being lived and worked at the extreme altitude for more than six months, and then were divided into three groups according to their profession and the altitude of original living place. Results： There was a significant difference in the outcomes of pulmonary-artery pressure from the 3 groups. Conclusions： Altitude of original living place, labor intensity are some of factors that impact the pulmonary-artery pressure of the people who exposure to a hypoxic environment. The pulmonary- artery pressure of person without strenuously physical work experience was more sensitive to hypoxic surroundings than that of labor workers. It was not always the fact at an extreme altitude that the moderate altitude mountaineers were superior to other migrants from a lower altitude or plain. The higher PH was found in the groups of the moderate altitude mountaineers and labor workers. It is unlikely certain that one with PH would surfer from HAPE.     

Study of Treating HAPE with HBO in Situ at the Altitude of 4636 m

Study Objective ： To evaluate the treatment effect of HAPE with HBO in situ at an extreme altitude of 4636 m. To investigate the relationship between pulmonary hypertension （PH） and HAPE. To emphasize the importance of the treatment in situ. Methods： The 32 patients from the plateau of 4636 - 5130 m （the barometric pressure： 57.41 - 53.28 kPa/431.6 - 400.6 mmHg（1 mmHg = 133.3224 Pa）, the partial pressure of oxygen： 12.0 - 11.6 kPa/90.0 - 87.0 mmHg） were treated in situ of 4636 m altitude with HBO. Before and after the treatment, the clinical symptoms / signs, radiographic evidence, SaO2, and MPAP were compared. Results： The clinical symptoms/signs, and all the targets of the patients were improved dramatically （p 〈 0.001）. Conclusions： Treating HAPE with HBO is the most effective method among various therapies in situ at an extreme altitude. The pulmonary -artery pressure was significantly decreased. All eases showed improved immediately. Among the subjects, 11 eases （34.3 %） were cured at once. The therapy made it possible for patients to get further treatment at a lower altitude area with prospective good results. We suggested that treating HAPE with HBO should be the first choice in situ. There must be PH in the patients of HAPE, but the reverse is not the true. The PH is a mechanism of normal compensation of the body exposing in the hypoxie environment. It is very necessary for us to explore the threshold of PH when a HAPE happens.     

Study on Occupational Hazards and Preventive Measures for the Constructors in Building Qinghai-Tibetan Railway

To analyze the hazard factors for the constructors through the geographic environment along the Qinghai-Tibetan railway. On the basis of the physical examination data of the constructors, we dynamically investigated the impact of the plateau environment on the constructors＇ health. We concluded the adaptation after the plain people entering into the plateau, and the application of the medical security measures and the effectiveness of the Plateau diseases preventing and controlling measures during the construction of the Qinghai- Tibetan railway. The results showed that there existed many occupational hazard factors because of the harsh environment in the Qinghai-Tibetan plateau, and they did a severe harm to the constructors. To take an effective prevention measure could apparently alleviate the occupational hazards, and ensure the safety and health of the constructors. The paper not only provided the valuable experiences for the medical support during the economic construction in the Qinghai-Tibetan plateau areas in the future, but also made a contribution for improving the development of the world plateau medicine.     

Design of Hygienic Support System ＆ Research of Correlative Technology during Qinghai-Tibet Railway Operation

TheQinghai Tibetrailwayishighestand longestofallplateaurailwaysintheworld.TherailwayfromGermutoLhasaisunder construction,totally1142km.Thesectionof above4000maltitudeis965km,accountingfor84%ofthewholeline.Thehighestaltitudein thissectionis5072m.Fromtheconstructionbeginningin2001,wepaygreatattentionto hygienicsupportsystemusedforQinghai Tibet railway.Staffsintheconstructionovercomethefouleffectoftheinclementnaturalenvironmenton humanhealthandworkingcapacity,suchaslow airpressure,hypoxia,lowt…     

Study on Occupational Health Surveillance System Used during Construction of Qinghai-Tibet Railway

Whencarryingouthealthsurveillancetocertain occupationalgroups,establishmentofobjectivediseaseandmonitoringindexsystemshouldbe mainlyaccordingtothecategoriesofharmfulfactorsandthedegreeofharmtohealthin constructionenvironment[1-2].From2001to2002,naturalenvironmentfactorsincludingairtemperature,airpressure,anddistributive pressureofoxygen,theharmfulproductivefactors,suchasCO,NO,NO2,dustandnoise,andthephysicallaborintensityof38typicalposts arealldetermined.Theresultshowsthatduring altitudeconst…     

Investigation of Prevalence Rate of Acute Severe Altitude Disease of Construction Groups at High Altitude

Objective： To know the prevalence rate of the acute severe altitude disease of the crowds who are working on the high altitude and the influential foctors upon the people. Method By epidemiology, a survey of 27606 persons who are working on the plateau has been made in the past three years, of which 229 persons had got the disease. 8175 persons who had received finer basic preventions in the group （Group A）, has been compared with 19430 persons who had a weak or no basic provention in the group （ Group B） ; the groups working on the plateau with 3 different elevations of above - 3600, - 4600 ＆ 5072 meters sea level have been compared. Resuts： The prevalence rate is 0.83 % in total groaps, of wich, high altitude pulmonary edema is 0.50%, high altitude cerebral edema is 0.28%, the patients who has got both the above diseases is 0.05%. The prevalance rates of the above in Group B and those of higher elevation are higher than those in Group A. 0.32% in Group A, and 1.04% in Group B. （x^2 = 36.95, p 〈 0.001） ;the prevalence rate on the 3 different high elevations are 0.00%, 0.68% and 1.34% in proper order. The prevalence rate of individuals groups in the highest 4.82% （the first year） and 2.26% （the next year ） and all the diseases came on the groups working on the highest elevation areas. Conclusion： The prevalence rate of acute severe plateau disease is very stem, the main influential factors are the height above the sea level, and the level of basic prvention for the crowds. Enhancing the protection of the labourers and medical safeguard, and social psychological adaption can cut down the prevalence rate, and this is the first important problem to solve for the plateau medicine and support from the society.