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Combat lifesaver-trained, first-responder application of junctional tourniquets: A prospective, randomized,crossover trial

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Military Medical research 2019年第2期6卷 105-110页

作者： Ismael Flecha Jason FNaylor Steven GSchauer Ryan ACurtis Cord WCunningham 21st Combat Support Hospital Fort HoodKilleen76544TXUSA Madigan army Medical Center JBLM Fort LewisLakewood98431USA San Antonio Military Medical Center JBSA Fort Sam HoustonSan Antonio78234TXUSA us army institute of surgical research JBSA Fort Sam HoustonSan Antonio78234TXUSA 59th MedicalWing JBSA LacklandSan Antonio78234TXUSA

Background:Junctional hemorrhage surpassed extremity hemorrhage as the leading cause of preventable death after the resurgence of limb tourniquets during the recent conflicts in Afghanistan and *** tourniquets(JTQs)were developed in response to this injury *** data for JTQ efficacy are limited and do not incorporate nonmedical,military first *** compared the time for effective placement and scores for device satisfaction between two different JTQs,stratified by combat lifesaver(CLS)and combat ***:We performed a prospective,randomized,crossover trial utilizing the SAM ’ Medical Junctional Tourniquet(SJT)and Junctional Emergency Treatment Tool(JETTTM).Investigators simple randomized CLS and combat medics to SJT or JETT for their first JTQ application on mannequins with penetrating inguinal ***,participants immediately placed the other JTQ on another casualty with the same *** primary outcome measured was time of successful applicatio *** was defined as proper JTQ placement and a pressu re reading of at least 180 *** compared outcomes between CLS and combat *** JTQ applications were excluded from the comparative ***:From June 2015 to August 2015,a total of 227 personnel(133 CLS and 94 combat medics)at Fort Hood,Texas,usA volunteered to participate in the ***-eight percent(38 of 133)of CLS and 40%(38 of 94)of combat medics placed both JTQs successfully,for a total of 152 applications(76 SJTs and 76 JETTs).We found a significant difference between applications of the JETT between the CLS and combat medics(92.0±37.7 s versus70.5±20.5 s,P=0.004).No other subg roup analyses,whether by device or user,demonstrated a sig nifica nt difference in application *** groups preferred the SJT over the *** disagreed with combat medics that the JETT could be easily applied by one person(median 3.0[2.0,4.0]versus median 4.0[3.0,5.0];P=0.006).Conclusions:Overall,succe

关键词： Junctional Tourniquet Hemorrhage Combat Battlefield

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Coordinate scheduling approach for EDS observation tasks and data transmission jobs

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Journal of Systems Engineering and Electronics 2016年第4期27卷 822-835页

作者： Hao Chen Jiangjiang Wu Wenyuan Shi Jun Li Zhinong Zhong School of Electronics Science and Engineering National University of Defense Technology First Engineers Scientific research institute of General Armaments Department People's Liberation Army

Electromagnetic detection satellite（EDS） is a type of Earth observation satellite（EOS）. Satellites observation and data down-link scheduling plays a significant role in improving the efficiency of satellite observation systems. However, the current works mainly focus on the scheduling of imaging satellites, little work focuses on the scheduling of EDSes for its specific *** current works mainly schedule satellite resources and data down-link resources separately, not considering them in a globally optimal perspective. The EDSes and data down-link resources are scheduled in an integrated process and the scheduling result is searched globally. Considering the specific constraints of EDS, a coordinate scheduling model for EDS observation tasks and data transmission jobs is established and an algorithm based on the genetic algorithm is proposed. Furthermore, the convergence of our algorithm is proved. To deal with some specific constraints, a solution repairing algorithm of polynomial computing time is designed. Finally, some experiments are conducted to validate the correctness and practicability of our scheduling algorithms.

关键词： electromagnetic detection satellites scheduling satellites and ground stations coordinate scheduling constraint handling solution repairing method genetic algorithm

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Bioelectrical impedance analysis-guided fluid management promotes primary fascial closure after open abdomen:a randomized controlled trial

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Military Medical research 2022年第2期9卷 193-204页

作者： Kai Wang Shi-Long Sun Xin-Yu Wang Cheng-Nan Chu Ze-Hua Duan Chao Yang Bao-Chen Liu Wei-Wei Ding Wei-Qin Li Jie-Shou Li Division of Trauma and surgical Intensive Care Unit Research Institute of General SurgeryJinling HospitalMedical School of Nanjing UniversityNo.305 East Zhongshan RoadNanjing 210002China Division of Trauma and surgical Intensive Care Unit Research Institute of General Surgerythe First School of Clinical MedicineSouthern Medical UniversityNanjing 210002China

Background:Fluid overload(FO)after resuscitation is frequent and contributes to adverse outcomes among postinjury open abdomen(OA)*** impedance analysis(BIA)is a promising tool for monitoring fluid status and ***,we sought to investigate the efficacy of BIA-directed fluid resuscitation among OA ***:A pragmatic,prospective,randomized,observer-blind,single-center trial was performed for all trauma patients requiring OA between January 2013 and December 2017 to a national referral center.A total of 140 postinjury OA patients were randomly assigned in a 1:1 ratio to receive either a BIA-directed fluid resuscitation(defined as BIA)protocol that included fluid administration with monitoring of hemodynamic parameters and different degrees of interventions to achieve a negative fluid balance targeting the hydration level(HL)measured by BIA or a traditional fluid resuscitation(TRD)in which clinicians determined the fluid resuscitation regimen according to traditional parameters during 30 d of intensive care unit(ICU)*** primary outcome was the 30-day primary fascial closure(PFC)*** secondary outcomes included the time to PFC,postoperative 7-day cumulative fluid balance(CFB)and adverse events within 30 d after *** Kaplan–Meier method and the log-rank test were utilized for PFC after OA.A generalized linear regression model for the time to PFC and CFB was ***:A total of 134 patients completed the trial(BIA,n=66;TRD,n=68).The BIA patients were significantly more likely to achieve PFC than the TRD patients(83.33%vs.55.88%,Puse of BIA-guided fluid resuscitation resulted in a higher PFC rate and fewer severe complicat

关键词： Trauma Open abdomen Fluid overload Fluid resuscitation Primary fascial closure Bioelectrical impedance analysis

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Value of neutrophil-lymphocyte ratio in evaluating response to percutaneous catheter drainage in patients with acute pancreatitis

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World Journal of Clinical Cases 2022年第1期10卷 91-103页

作者： Pankaj Gupta Gaurav Chayan Das Akash Bansal Jayanta Samanta Harshal S Mandavdhare Vishal Sharma Shano Naseem Vikas Gupta Thakur Deen Yadav usha Dutta Neelam Varma Manavjit Singh Sandhu Rakesh Kochhar Department of Radiodiagnosis Postgraduate Institute of Medical Education and ResearchChandigarh 160012India Department of Gastroenterology Postgraduate Institute of Medical Education and ResearchChandigarh 160012India Department of Hematology Postgraduate Institute of Medical Education and ResearchChandigarh 160012India Department of surgical Gastroenterology Postgraduate Institute of Medical Education and ResearchChandigarh 160012India

BACKGROUND Early prediction of response to percutaneous catheter drainage(PCD)of necrotic collections in acute pancreatitis(AP)using simple and objective tests is critical as it may determine patient *** role of white blood cell(WBC)count and neutrophil-lymphocyte ratio(NLR)has not been assessed as a tool of early prediction of PCD success and is the focus of this *** To assess the value of WBC and NLR in predicting response to PCD in *** This retrospective study comprised consecutive patients with AP who underwent PCD between June 2018 and December *** and fluid collections were classified according to the revised Atlanta classification and organ failure was defined according to the modified Marshall *** and NLR were monitored 24 h prior PCD(WBC-0/NLR-0)and 24 h(WBC-1/NLR-1),48 h(WBC-2/NLR-2)and 72 h(WBC-3/NLR-3)after *** was calculated by dividing the number of neutrophils by the number of *** association of success of PCD(defined as survival without the need for surgery)with WBC and NLR was *** trend of WBC and NLR was also assessed post *** One hundred fifty-five patients[median age 40±13.6(SD),64.5%males,53.5%severe AP]were included in the final *** was done for acute necrotic collection in 99(63.8%)patients and walled-off necrosis in 56(36.1%)*** pain to PCD interval was 24±69.89 *** was successful in 109 patients(group 1)and 46 patients(group 2)who failed to *** was no significant difference in the baseline characteristics between the two groups except the severity of AP and frequency of organ *** WBC and NLR showed an overall decreasing *** was a significant difference between WBC-0 and WBC-1(P=0.0001).WBC-1 and NLR-1 were significantly different between the two groups(P=0.048 and 0.003,respectively).The area under the curve of WBC-1 and NLR-1 for predicting the success of PCD was 0.602 and 0.682,*** a cut-off value of 9.87 fo

关键词： Acute pancreatitis Percutaneous catheter drainage White blood cell Neutrophil-lymphocyte ratio Necrotic collection

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Effect of Nano-coppers with Different Dimensions on Tribological Properties of Lithium Grease

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China Petroleum Processing & Petrochemical Technology 2020年第1期22卷 118-126页

作者： Wang Jing Guo Xiaochuan Mi Hongying Zhou Weigui Yang Xin institute of Military New Energy Technology Beijing 102300 Clean Energy research institute Shenzhen 518031 army Logistics University of PLA Chongqing 401311

As an excellent anti-wear and friction-reducing additive,nano-copper has attracted extensive researches and attention in tribology ***,the existing researches are still limited to zero-dimensional nano-copper,that is,the effect of copper nanoparticles on the tribological properties of *** this paper,the effects of nano-coppers with different dimensions(copper nanoparticles,copper nanowires and copper nanoplates)on the anti-wear ability and frictionreducing performance of lithium grease were systematically *** the mechanism of interaction between dimension and tribological properties was explained in *** is concluded that the tribological properties of lithium grease can be improved by the addition of nano-coppers due to the formation of the molten copper film and the CuO tribochemical reaction film on the worn *** the dimension of nano-copper has a great influence on its tribological *** copper nanoparticles can play the role of nano-bearing to change the friction form from sliding friction to rolling friction,which would decrease the wear loss of friction *** wear loss can be sharply decreased by addition of copper nanoplates with micron-scale diameter and lamellar structure which significantly prevents the direct contact of micro-protrusions on the surface of friction pairs and reduces the“welding”between micro-protrusions due to local high temperature caused by friction.

关键词： nano-copper dimension additive tribology

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Self-assembled metal-organic frameworks nanocrystals synthesis and application for plumbagin drug delivery in acute lung injury therapy

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Chinese Chemical Letters 2022年第1期33卷 324-327页

作者： Yang Wang Qing Li Mengsheng Deng Kuijun Chen Jianmin Wang State Key Laboratory of Trauma Burns and Combined InjuryDepartment of Surgical ResearchDaping HospitalArmy Medical UniversityChongqing 400042China School of Chemistry and Chemical Engineering Yangzhou UniversityYangzhou 225002China

Metal-organic frameworks(MOFs)have recently allured a variety of concern in the fields of ***,exploring their biomedical applications is still a relatively new *** this work,zeolite imidazole skeleton-8(ZIF-8)was reported for the first time as a drug carrier for the treatment of lung *** ZIF-8 nanoparticles encapsulating plumbagin(PLB)are achieved by a facile physical adsorption *** electron microscopy(SEM),powder X-ray diffraction(PXRD)and UV–vis absorption spectrum were conducted to investigate the physical properties of ZIF-8 and PLB@*** animal model,the collagen fibers deposition produced by severe lung injury is significantly *** secretion of inflammatory factor TGF-βand IL-6 were efficiently dropped by the combination of plumbagin and *** the same time,the expressions of collagen I,α-SMA and TNF-αwere also *** strategy puts forth a promising blueprint in the application of MOF materials,especially in biomedical fields.

关键词： ZIF-8 Plumbagin Drug delivery Lung injury

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Chinese expert consensus and practice guideline of totally implantable access port for digestive tract carcinomas

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World Journal of Gastroenterology 2020年第25期26卷 3517-3527页

作者： Ke-Cheng Zhang Lin Chen 无 Department of General Surgery&institute of General Surgery The First Medical CentreChinese People’s Liberation Army General HospitalBeijing 100853China Chinese research Hospital Association Digestive Tumor Committee Chinese Association of Upper Gastrointestinal Surgeons Chinese Gastric Cancer Association and Gastrointestinal surgical Group of Chinese surgical Society Affiliated to the Chinese Medical Association

Totally implantable access port is a fully implantable drug delivery system that is implanted subcutaneously and can be retained for a long *** of ports include a simple nursing process,low risk of infection and embolism,and high patient *** order to promote the standardized application of ports in the treatment of digestive tract tumors and reduce port-related complications,the Chinese research Hospital Association Digestive Tumor Committee,the Chinese Association of Upper Gastrointestinal Surgeons,the Chinese Gastric Cancer Association,and the Gastrointestinal surgical Group of Chinese surgical Society Affiliated to Chinese Medical Association have organized multidisciplinary expert discussions at the General Hospital of the People’s Liberation army and nationwide expert letter reviews and on-site seminars,and formulated an expert consensus of the operation guidelines.

关键词： Totally implantable access port Digestive tract tumor Consensus and guideline Venous port Peritoneal port Arterial port

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A history of low back pain affects pelvis and trunk coordination during a sustained manual materials handling task

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Journal of Sport and Health Science 2016年第1期5卷 52-60页

作者： Joseph F.Seay Shane G.Sauer Tejash Patel Tanja C.Roy Military Performance Division US. Army Research Institute of Environmental Medicine Natick MA 01760 USA Biophysics ancl Biomedical Modelling Division US. Army Research Institute of Environmental Medicine Natick MA O1760 USA

Purpose:The purpose of this study was to compare the coordination between the trunk and the pelvis during a sustained asymmetric repetitive lifting task between a group with a history of low back pain(LBP;HBP) and a group with no history of LBP(NBP).Methods:Volunteers lifted a 11-kg box from ankle height in front to a shelf 45° off-center at waist height,and lowered it to the start position at12 cycles/min for 10 *** side was alternated during the *** relative phase was used to calculate coordination between the pelvis and trunk rotation at the beginning(Min 1),middle(Min 5),and end of the bout(Min 9).Results:While there were no main effects for group,a significant interaction between time and group indicated that,in the frontal plane,the NBP group coordination was more anti-phase toward the end of the bout,with no such differences for the HBP *** of sagittal-axial(bend and twist) coordination revealed the HBP group coordination was more in-phase at the end of the bout over the entire cycle and for the lifting phase alone,with no such differences for the NBP ***:Differences between groups demonstrate residual consequences of LBP in an occupational scenario,even though the HBP group was pain-free for >6 months prior to data *** in-phase coordination in the HBP group may represent a coordination pattern analogous to'guarded gait' which has been observed in other studies,and may lend insight as to why these individuals are at increased risk for re-injury.

关键词： Lifting Lowering Occupational biomechanics Relative phase Relative phase variability

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Predictive factors for lymph node metastasis and defining a subgroup treatable for laparoscopic lymph node dissection after endoscopic submucosal dissection in poorly differentiated early gastric cancer

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World Journal of Gastrointestinal Oncology 2018年第10期10卷 360-366页

作者： Hua Li Zhi-Bin Huo Fan-Ting Kong Qing-Qiang He Yun-He Gao Wen-Quan Liang Deng-Xiang Liu De-partment of surgical Oncology Xing Tai People Hospital Department of General Surgery Chinese People’s Liberation Army General Hospital institute of Cancer Control Xing Tai People Hospital

AIM To investigate the predictive factors of lymph node metastasis(LNM)in poorly differentiated early gastric cancer(EGC);to guide the individual application of a combination of endoscopic submucosal dissection(ESD)and laparoscopic lymph node dissection(LLND)in a suitable subgroup of patients with poorly differentiated *** We retrospectively analyzed 138 patients with poorly differentiated EGC who underwent gastrectomy with lymphadenectomy between January 1990 and December *** association between the clinicopathological factors and the presence of LNM was retrospectively analyzed by univariate and multivariate logistic regression *** ratios(OR)with 95%confidence interval(95%CI)were *** further examined the relationship between the positive number of the significant predictive factors and the LNM *** The tumor diameter(OR=13.438,95%CI:1.773-25.673,P=0.029),lymphatic vessel involvement(LVI)(OR=38.521,95%CI:1.975-68.212,P=0.015)and depth of invasion(OR=14.981,95%CI:1.617-52.844,P=0.024)were found to be independent risk factors for LNM by multivariate *** the 138 patients diagnosed with poorly differentiated EGC,21(15.2%)had *** patients with one,two and three of the risk factors,the LNM rates were 7.7%,47.6%and 64.3%,*** was not found in 77 patients that did not have one or more of the three risk *** ESD might be sufficient treatment for intramucosal poorly differentiated EGC if the tumor is less than or equal to2 cm in size and when LVI is absent upon postoperative histological *** with LLND may lead to the elimination of unnecessary gastrectomy in poorly differentiated EGC.

关键词： Poorly differentiated cancer Laparoscopic lymph node dissection Lymph node metastasis Early gastric cancer Endoscopic submucosal dissection

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EACS: An Efficient Access Control Scheme for Electronic Publishing in Cloud Computing

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Chinese Journal of Electronics 2018年第1期27卷 60-69页

作者： WU Deming ZHANG Yu WANG Lina HOU Jian XIAO Lei CHEN Wei ZHOU Qing School of Computer Wuhan University Science and Technology on Information Assurance Laboratory army Aviation research institute Air Force Engineering University 95942 troops 24 squad

To guarantee that electronic publications are accessible only to the authorized users via cloud, we propose an Efficient access control scheme(EACS) based on Attribute-based encryption(ABE), which is suitable for fine-grained access control. Compared with existing stateof-the-art schemes, EACS is more practical by following functions. Considering the factor that the user membership may change frequently, EACS has the capability of coping with dynamic membership efficiently. Arbitrary-State is also supported to facilitate the system management and improve efficiency. Besides, we prove in the standard model that the security of EACS is based on the Decisional Bilinear Diffie-Hellman assumption. To evaluate the practicality of EACS, we provide a detailed theoretical performance analysis and a simulation comparison with existing schemes. Both the theoretical analysis and the experimental results show that our proposal is efficient and practical for electronic publishing under cloud environment.

关键词： Electronic publishing Attribute-based encryption Cloud computing Access control Dynamic membership Arbitrary-state

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