9.
THE FIRST PRIORITY IS PUBLIC HEALTH IN QINGHAI-TIBETAN RAILWAY. Liang
Bao-Zhu
1
, Zhao Ji-Zhu
1
. China Railway Construction Company, Beijing,
1
008
55
China
1
.
Construction of the Qinghai-Tibet railway is a symbolic project especially for the
development of the west in China. In light of the effects of harsh climate and environment on the
health and work capacity of the workers, the Ministry of Railways is upholding the idea of people
first, public-health security first. The Ministry has guided construction and policy-making
agencies, constantly improving various safeguard measures, overcoming all kinds of difficulties
caused by the harsh climate and environment of the Qinghai-Tibet Plateau. Since the project
began on 29th June, 2001, about 70,000 workers have worked above an altitude of 4000m, and no
deaths from high altitude disease were found. Utilizing domestic and foreign advanced high
altitude medicine research, modern scientific technologies and spot investigation, public-health
security measures have been developed, a three-level medical security organization has been
established, medical equipment and medications have been purchased and medical
rules/regulations have been established. People entering the plateau region should first receive
health education, physical examination and personal health records. The work itself should be
assigned selectively to those who are physically capable of performing each required task. Work
should proceed only during seasons of the year when weather and environmental conditions do
not pose significant health threats. There should be strict controls on the intensity of work that
each worker can be assigned. Workers should be provided necessary oxygen supplementation.
Workers should be given appropriate time for adaptation, considering the altitude from which
they originate. For those who do suffer high altitude diseases, a policy entitled "The Five Earlier"
has been established; early diagnosis, early reporting, early intervention, early treatment and early
evacuation to lower altitude.
10.
NEUROLOGICAL CONDITIONS AT ALTITUDE THAT FALL OUTSIDE THE GENERAL
DEFINITION OF ALTITUDE SICKNESS. Buddha Basnyat
1
. Nepal
1
.
Altitude sickness in its commonly recognized forms consists of acute mountain sickness and
the two life-threatening forms, high altitude cerebral and pulmonary edema. Less well known are
other conditions, chiefly neurological, which may arise completely outside the usual definition of
altitude sickness. These, often focal neurological conditions, are important to recognize so that
they do not become categorized as altitude sickness, as besides oxygen and descent, treatment
may be vastly different. Transient ischemic attacks, cerebral venous thrombosis, seizures,
syncope, double vision and scotomas are some of the well-documented neurological disturbances
at high altitude discussed in order to enhance their recognition and treatment.
11.
THE EFFECTS OF AMINOPHYLLINE ON OXYGEN METABOLISM DYNAMICS OF
YOUNG PIGS TAKEN QUICKLY TO HIGH ALTITUDE. Zheng Bi-Hai
1
, Li Su-Zhi
1
, Zhou
Xiao-Bao
1
. High Altitude Medical Research Center of PLA, Lhasa,
1
.
Purpose: To observe the effects of aminophylline on oxygen dynamics of young pigs which
are airlifted to the Qinghai-Tibet plateau. This situation is very similar to patients who suffer from
acute mountain sickness. Methods: Young male changbai pigs were airlifted from Chengdu
(elevation 400 meters) to Lhasa (elevation 3658 meters, PiO2 97 mmHg) and studied in one
week. A right cardiac catheter was used to inject venous aminophylline 25mg/kg and 5% glucose
fluid 20ml in the pigs by means of a float pipe in the right ventricle. Five minutes after the
injection, the changes in the oxygen dynamics of the pigs were observed. Results: After
aminophylline, the mean pulmonary arterial pressure, mean vascular resistance, and Qs/Qt of the
pigs were significantly reduced _P<0.01, P<0.05). Cardiac output and arterial oxygen saturation
were significantly improved. Oxygen uptake was not changed. Conclusion: Aminophylline can
decrease PVR of young pigs that are airlifted to high altitude and improve oxygen delivery and
arterial oxygen saturation.
