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Modified Glucose-insulin-potassium Therapy for Hemorrhage-induced Traumatic Cardiac Arrest in Rabbits

Current Medical Science 2023年第6期43卷 1238-1246页

作者： Lin ZHANG wen-qiong DU zhao-wen zong Xin ZHONG Yi-jun JIA Ren-qing JIANG zhao YE State Key Laboratory of Trauma Burn and Combined InjuryDepartment for Combat Casualty Care TrainingTraining Base for Army Health CareArmy Medical UniversityChongqing400038China Department of Orthopedics Xinqiao HospitalArmy Medical UniversityChongqing400037China

Objective Resuscitation with whole blood is known to be better than that with saline in attaining the return of spontaneous circulation(ROSC)and improving the short-term survival rate for hemorrhage-induced traumatic cardiac arrest(HiTCA).However,the resuscitation with whole blood alone fails to address the pathophysiological abnormalities,including hyperglycemia,hyperkalemia and coagulopathy,after *** present study aimed to determine whether the modified glucose-insulin-potassium(GIK)therapy can ameliorate the above-mentioned pathophysiological abnormalities,enhance the ROSC,improve the function of key organs,and reduce the mortality after *** HiTCA was induced in rabbits(n=36)by controlled *** arrest,the rabbits were randomly divided into three groups(n=12 each):group A(no resuscitation),group B(resuscitation with whole blood),and group C(resuscitation with whole blood plus GIK).The GIK therapy was administered based on the actual concentration of glucose and *** ROSC rate and survival rate were *** and biochemical changes were ***(TEG)was used to measure coagulation parameters,and enzyme-linked immunosorbent assay to detect parameters related to inflammation,coagulation and the function of *** All animals in groups B and C attained *** rabbits died 24–48 h after HiTCA in group B,while no rabbits died in group *** GIK therapy significantly reduced the levels of blood glucose,potassium,and biological markers for inflammatory reaction,and improved the heart,kidney,liver and brain function in group C when compared to group ***,the R values of TEG were significantly lower in group C than in group B,and the maximum amplitude of TEG was slightly lower in group B than in group C,with no significant difference *** Resuscitation with whole blood and modified GIK therapy combined can ameliorate the pathophysiological disorders,including hyperglycemi

关键词： hemorrhage-induced traumatic cardiac arrest return of spontaneous circulation glucose-insulin-potassium therapy resuscitation

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Chinese expert consensus on echelons treatment of pelvic fractures in modern war

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Military Medical Research 2018年第4期5卷 279-292页

作者： zhao-wen zong Si-Wu Chen Hao Qin Hua-Ping Liang Lei Yang Yu-Feng zhao State Key Laboratory of Trauma Burn and Combined Injury Department of War Wound Rescue Skills Training Base of Army Health Service Training Army Medical University First Department Research Institute of Surgery Daping Hospital Army Medical University Department of Trauma Surgery Daping Hospital Army Medical University

The characteristics and treatment of pelvic fractures vary between general conditions and modern war. An expert consensus has been reached based on pelvic injury epidemiology and the concepts of battlefield treatment combined with the existing levels of military medical care in modern warfare. According to this consensus, first aid, emergency treatment and early treatment of pelvic fractures are introduced in three separate levels. In Level Ⅰ facilities, simple triage and rapid treatment following the principles of advanced trauma life support are recommended to evaluate combat casualties during the first-aid stage. Re-evaluation, further immobilization and fixation, and hemostasis are recommended at Level Ⅱ facilities. At Level Ⅲ facilities, the main components of damage control surgery are recommended, including comprehensive hemostasis, a proper resuscitation strategy, the treatment of concurrent visceral and blood vessel damage, and battlefield intensive care. The grading standard for evidence evaluation and recommendation was used to reach this expert consensus.

关键词： Pelvic fractures Combat injuries Classification and treatment Expert consensus

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Chinese expert consensus on the treatment of modern combat-related spinal injuries

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Military Medical Research 2019年第2期6卷 93-104页

作者： zhao-wen zong Hao Qin Si-Xu Chen Jia-Zhi Yang Lei Yang Lin Zhang wen-Qiong Du Xin Zhong Ren-Jie Zhou Dan Tan Hao Wu State Key Laboratory of Trauma Burn and Combined InjuryDepartment of War Wound Rescue Skills TrainingBase of Army Health Service TrainingArmy Medical UniversityChongqing 400038China Department of Tactical Health Service NCO School of Army Medical UniversityShijiazhuang 050000China Xinqiao Hospital Army Medical UniversityChongqing 400037China

The battlefield treatments of spinal and spinal cord injury vary from civilian settings. However, there is no unified battlefield treatment guidelines for spine trauma in PLA. An expert consensus is reached, based on spine trauma epidemiology and the concepts of battlefield treatment combined with the existing levels of military medical care in modern warfare. Since the specialized treatment for spine trauma are no significant difference between civilian settings and modern war, the first aid, emergency treatment and early treatment of spine trauma are introduced separately in three levels in this consensus. In Level I facilities, the fast and accurate evaluation of spine trauma followed by fixation and stabilization are recommended during the first-aid stage. Re-evaluation, further treatment for possible hemorrhagic shock, dyspnea and infection are recommended at Level II facilities. At Level III facilities, it is recommended to strengthen the intensive care and the prevention of urinary system and lung infection for the wounded with severe spinal injury, however, spinal surgery is not recommended in a battlefield hospital. The grading standard for evidence evaluation and recommendation was used to reach this expert consensus.

关键词： Expert consensus Spinal injury Combat injuries Treatment Modern combat

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Establishment of a combat damage control surgery training platform for explosive combined thoraco-abdominal injuries

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Chinese Journal of Traumatology 2022年第4期25卷 193-200页

作者： wen-Qiong Du Ren-Qing Jiang zhao-wen zong Lin Zhang zhao Ye Xin Zhong Yi-Jun Jia State Key Laboratory of Trauma Burn and Combined InjuryDepartment for Combat Casualty Care TrainingTraining Base for Army Health CareArmy Medical UniversityChongqing400038China Department of Orthopedics Xinqiao HospitalArmy Medical UniversityChongqing400038China

Purpose:It is challenging to prepare military surgeons with the skills of combat damage control surgery(CDCS).The current study aimed to establish a damage control surgery(DCS)training platform for explosive combined thoraco-abdominal ***:The training platform established in this study consisted of 3 main components:(1)A 50 m×50 m square yard was constructed as the explosion *** was assessed through cameras.(2)Sixteen pigs were injured by an explosion of trinitrotoluene attached with steel balls and were randomly divided into the DCS group(accepted DCS)and the control group(have not accepted DCS).The mortality rate was observed.(3)The literature was reviewed to identify the key factors for assessing CDCS,and testing standards for CDCS were then *** questionnaires were employed to evaluate the scientificity and feasibility of the testing ***,a 5-day training course with incorporated tests was used to test the efficacy of the established *** total,30 teams attended the first training *** scores that the trainees received before and after the training were *** 11.0 was employed to analyze the ***:The high-speed video playback confirmed the safety of the explosion site as no explosion fragments projected beyond the *** pig died within 24 h when DCS was performed,while 7 pigs died in the control *** a literature review,assessment criteria for CDCS were established that had a total score of 100 points and had 4 major parts:leadership and team cooperation,resuscitation,surgical procedure,and final *** questionnaire results showed that the scientific score was 8.6±1.25,and the feasibility score was 8.74±*** compared with the basic level,the trainees’score improved significantly after training.

关键词： Damage control surgery Simulation training Warfare Explosions Test

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Animal model-based simulation training for three emergent and urgent operations of penetrating thoracic injuries

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Chinese Journal of Traumatology 2023年第1期26卷 41-47页

作者： wen-Qiong Du Xin Zhong Ren-Qing Jjiang zhao-wen zong Yi-Jun Jia zhao Ye Xiao-Lin Zhou State Key Laboratory of Trauma Burn and Combined InjuryDepartment for Combat Casualty Care TrainingTraining Base for Army Health CareArmy Medical UniversityChongqing400037China State Key Laboratory of Trauma Burn and Combined InjuryDepartment for Combat Casualty Care TrainingTraining Base for Army Health Care&Department of OrthopedicsXinqiao HospitalArmy Medical UniversityChongqing400037China

Purpose:To develop animal models of penetrating thoracic injuries and to observe the effects of the animal model-based training on improving the trainees’performance for emergent and urgent thoracic ***:With a homemade machine,animal models of lung injuries and penetrating heart injuries were produced in porcine and used for training of chest tube drainage,urgent sternotomy,and emergent *** of variation of abbreviated injury scale and blood loss was calculated to judge the reproducibility of animal *** operation teams from basic-level hospitals(group A)and five operation teams from level III hospitals(group B)were included to be trained and *** standards for the operations were established after thorough literature review,and expert questionnaires were employed to evaluate the scientificity and feasibility of the testing *** were carried out after the ***-and post-training performances were ***-training survey using 7-point Likert scale was taken to evaluate the feelings of the trainees to these training ***:Animal models of the three kinds of penetrating chest injuries were successfully established and the coefficient of variation of abbreviated injury scale and blood loss were all less than 25%.After literature review,testing standards were established,and expert questionnaire results showed that the scientific score was 7.30±1.49,and the feasibility score was 7.50±***-training performance was significantly higher in both group A and group B than pre-training ***-training survey showed that all the trainees felt confident in applying the operations and were generally agreed that the training procedure were very helpful in improving operation skills for thoracic penetrating ***:Animal model-based simulation training established in the current study could improve the trainees’performance for emergent and urgent thoracic surgeries,espec

关键词： Penetrating thoracic injuries Emergent operations Urgent operations Simulation training Animal model

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Expert consensus on the evaluation and diagnosis of combat injuries of the Chinese People's Liberation Army

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Military Medical Research 2018年第3期5卷 189-198页

作者： zhao-wen zong Lian-yang Zhang Hao Qin Si-xu Chen Lin Zhang Lei Yang Xiao-xue Li Quan-wei Bao Dao-cheng Liu Si-hao He Yue Shen Rong Zhang Yu-feng zhao Xiao-zheng Zhong representing the PLA Professional Committee and Youth Committee on Disaster Medicine State Key Laboratory of Trauma Burn and Combined InjuryDepartment of Trauma SurgeryDaping HospitalArmy Medical UniversityChongqingChina Special Slinic Department of Bethune Medical Profession Sergeant School ShijiazhuangChina Research Institute of Disaster Medicine General Hospital of Chinese People's Armed Police ForcesBeijingChina Military Medical Training Brigade of Chinese People's Liberation Army HutubiXinjiangUygur Autonomous RegionChina 不详

The accurate assessment and diagnosis of combat injuries are the basis for triage and treatment of combat casualties. A consensus on the assessment and diagnosis of combat injuries was made and discussed at the second annual meeting of the Professional Committee on Disaster Medicine of the Chinese People's Liberation Army(PLA). In this consensus agreement, the massive hemorrhage, airway, respiration, circulation and hypothermia(MARCH) algorithm, which is a simple triage and rapid treatment and field triage score, was recommended to assess combat casualties during the first-aid stage, whereas the abbreviated scoring method for combat casualty and the MARCH algorithm were recommended to assess combat casualties in level Ⅱ facilities. In level Ⅲ facilities, combined measures, including a history inquiry, thorough physical examination, laboratory examination, X-ray, and ultrasound examination, were recommended for the diagnosis of combat casualties. In addition, corresponding methods were recommended for the recognition of casualties needing massive transfusions, assessment of firearm wounds, evaluation of mangled extremities, and assessment of injury severity in this consensus.

关键词： Combat injuries Assessment Diagnosis Expert consensus

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Diagnosis and treatment of rare complications of pelvic fractures

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Chinese Journal of Traumatology 2016年第4期19卷 199-205页

作者： zhao-wen zong Quan-Wei Bao Hua-Yu Liu Yue Shen Yu-Feng zhao Xiang Hua Qing-Shan Guo Lian-Yang Zhang Hui Chen State Key Laboratory of Trauma Burns and Combined Injury. Department of Trauma Surgery Daping Hospital Third Military Medical University Chongqing. 400042 China

Purpose： To enhance the awareness of rare complications of pelvic fracture and describe the correct diagnosis and effective treatment. Methods： A total of 188 cases of pelvic fractures were retrospectively reviewed, and four patients who suffered from four types of rare pelvic fracture complications were described, namely ureteral obstruction caused by retroperitoneal hematoma-induced abdominal compartment syndrome （ACS）, bowel entrapment, external lilac artery injury, and open scrotal sac injury. Results： We demonstrated that combined measures should be employed to prevent the occurrence of ACS following major pelvic fractures. Ureteral catheter support may be a good option at an early stage when ACS occurred. Contrasted computed tomography examination and sufficient awareness are keys to a correct diagnosis of bowel entrapment following pelvic fractures. Recognition of risk factors, early diagnosis, and prompt treatment of suspected injury of the external iliac artery are keys to patient survival and to avoid limb loss. Scrotal and/or testicular injury complicated by pelvic fractures should be carefully treated to maintain normal gonad function. Additionally, establishment of a sophisticated trauma care system and multi-disciplinary coordination are important for correct diagnosis and treat- ment of rare complications in pelvic fractures. Conclusions： Rare complications of pelvic fractures are difficult to diagnose and negatively impact outcome. Recognition of risk factors and sufficient awareness are essential for correct diagnosis and prompt treatment.

关键词： Pelvis Fractures, bone Complications Diagnosis

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基于主动悬架控制轮边驱动电动车垂向振动研究

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振动与冲击 2017年第11期36卷 242-247页

作者：钟银辉李以农杨超徐广徽孟凡明重庆大学汽车工程学院重庆400030 重庆大学机械传动国家重点实验室重庆400030

针对轮边驱动电动车存在的轮毂电机振动问题,以开关磁阻电机(SRM)为例,分析了电机垂向激励对车辆性能的影响。探讨分析不同车速工况下路面和电机两种耦合激励对轮边驱动电动车垂向动力学特性的影响。研究表明,电机激励对车辆垂向性能的... 详细信息

针对轮边驱动电动车存在的轮毂电机振动问题,以开关磁阻电机(SRM)为例,分析了电机垂向激励对车辆性能的影响。探讨分析不同车速工况下路面和电机两种耦合激励对轮边驱动电动车垂向动力学特性的影响。研究表明,电机激励对车辆垂向性能的影响主要集中在低车速范围。此时,电机激励频率接近悬架系统固有频率,容易引发车辆共振。鉴于电机激励具有的周期性特点,提出了基于FxLMS算法的主动悬架控制方法,进而抑制电机垂向激励产生的车辆垂向振动负效应,仿真分析验证了算法的有效性。

关键词：轮边驱动开关磁阻电机垂向激励和响应 FxLMS算法

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基于自适应速度观测器的感应电机控制策略

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系统仿真学报 2009年第20期21卷 6581-6584,6588页

作者：任军李春文赵德宗清华大学自动化系北京1000841

给出了一种基于全阶模型参考自适应速度观测器的感应电机速度和磁通控制策略。该控制策略能确保转子速度和转子磁通幅值准确跟踪参考值,且对转子时间常数的漂移和负载转矩的变化具有强鲁棒性。控制器的结构由开环和闭环两部分组成,其中... 详细信息

给出了一种基于全阶模型参考自适应速度观测器的感应电机速度和磁通控制策略。该控制策略能确保转子速度和转子磁通幅值准确跟踪参考值,且对转子时间常数的漂移和负载转矩的变化具有强鲁棒性。控制器的结构由开环和闭环两部分组成,其中开环控制器确保控制信号能够准确跟踪期望值,闭环控制器由实现系统鲁棒镇定。所采用的速度观测器在低速条件下性能良好,观测结果明显优于传统速度观测器。仿真结果验证了该控制策略和速度观测器的有效性。

关键词：感应电机速度控制全阶观测器鲁棒性

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Evaluation of Teaching and Learning： A Basis for Improvement in Medical Education

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Chinese Medical Journal 2017年第10期130卷 1259-1260页

作者： Xue-Fei Yang Tomer Talmy Cong-Hui Zhu Peng-Fei Li Wei Wang Peng Zhang Hua-Wei Zhang Shir Bulis Ke-Xue Wang Xi Chen Yao-Li Wang Dong-Po Jiang zhao-wen zong Jian Zhou Intensive Care Unit Trauma Center Institute of Surgery Research Daping Hospital Third Military Medical University Chongqing 400042 China The Institute of Research in Military Medicine The Hebrew University of Jerusalem Hadassah Medical Center Jerusalem 91120 Israel Department of Surgery and Field Surgery Institute of Surgery Research Daping Hospital Third Military Medical University Chongqing 400042 China Intensive Care Unit The First People's Hospital of YLbin City Yibin Sichuan 644000 China

To the Editor： Individualized medical education is crucial for the quality improvement of physicians in hospitals. However, the capacity to acquire medical theory and clinical skills differs among different medical students, international medical students, residents, and training physiciansTheir skills are at very different levels. Differences in learners＇ characteristics can contribute to a mismatch with historical teaching strategies.

关键词：钙调蛋白结合蛋白质类教育医学磷蛋白磷酸酶类临床工作能力评价研究学生医科医师胰岛素

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