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Objective:To review the characteristics and coping strategies of the rescue and landing medical support mission of Shenzhou-14 manned spacecraft.Methods:The characteristics of rescue and landing medical support mission of Shenzhou-14 manned spacecraft was analyzed, and the coping strategies and experience were discussed.Results:(1) The characteristics of rescue and landing medical support mission of Shenzhou-14 manned spacecraft included: long time in space station and high-intensity space missions; high-density space medical support mission in short term; special environmental factors in severe cold night; complex terrain of landing site; and the young medical support team. (2) The main coping strategies of rescue and landing medical support mission of Shenzhou-14 manned spacecraft included: strengthened the organization and leadership and improved the training model; reinforcement learning the medical treatment plan and strengthened the medical rescue skills training; optimized the carrying equipment and added the heat preservation and lighting measures; improved the medical rescue process and perfected the emergency plan; emphasized on the scientific research as important as mission; and strengthened the physical exercise and cold resistance exercise.Conclusions:The characteristics and coping strategies of rescue and landing medical support mission of Shenzhou-14 manned spacecraft are summarized to provide the experience for space medical rescue and offer the support for China's manned space industry.
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Objective:To study the environmental characteristics of launch section during the space medical rescue mission of Shenzhou-13 spacecraft, evaluate the influence of special environment on peripheral veins, and investigate the coping strategies.Methods:Combined with the practice of launch section during space medical rescue mission of Shenzhou-13 spacecraft, the main factors of aerospace special environment, cold and faint light, were selected and the related literature was reviewed to explore the feasibility, advantages and disadvantages of peripheral venipuncture, central venous catheter and bone marrow puncture. The experience of the space medical rescue mission was summarized and the coping strategies were provided for follow-up task training.Results:The environmental characteristics of launch section during the space medical rescue mission of Shenzhou-13 spacecraft included cold, faint light, sand-wind and complex terrain. The vascular filling, vascular elasticity and visibility of peripheral vein decreased in different degrees under special environmental, the vascular visibility was most affected. The literature analysis showed that bone marrow puncture was a suitable method to establish infusion access in cold and faint light environment.Conclusions:The special environment of space launch mission has greater impact on peripheral veins. In order to assurance the successful implementation of manned space project, the training of basic operational skills should be consolidated, the training of ability in special environment should be enhanced and the advanced clinical auxiliary equipment should be equipped in follow-up space medical mission training.
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Objective:To summarize the nursing experience of medical rescue mission of Chinese manned spaceflight and space station astronauts returning to Dongfeng landing site, to analyze the characteristics of different mission stages of Shenzhou-12 manned spacecraft and Dongfeng landing site, and to take steps to implement effective medical rescue support of the space station missions.Methods:The relevant literature and reports at home and abroad were consulted, the nursing experience of previous medical rescue support tasks was summarized, and the corresponding clinical measures were put forward according to the orbit time of Shenzhou-12 and the complex terrain and climate of the main landing site.Results:Based on the existing experience, the rescue process had been further detailed, the emergency plan had been formulated, the clinical process in each plan had been refined, the clinical process in front of the cabin, in the carrier and in the evacuation process of nurses under different injury conditions had been formulated and improved, and the special training of nurses' own quality and nursing skills was carried out to improve the overall quality and combat ability of the nursing echelon.Conclusions:The improvement and refinement of clinical process in the medical rescue support task of the main landing site of Shenzhou-12 has provided a solid assurance for the successful completion of manned aerospace medical rescue support task.
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Objective:To discuss the medical support strategy by summarizing the experience of medical support in Dongfeng landing site.Methods:According to the current situation of medical support at Dongfeng landing site and the practice and experience of previous medical support, a retrospective summary study was conducted.Results:The main methods were summarized: (1) formulate a feasible plan; (2) strictly screen skilled personnel; (3) provide reasonable medicinal materials and equipments; (4) complete the modification of the rescue carrier; (5) attach importance to the training of first aid techniques; (6) strengthen political and ideological education; (7) carry out physical fitness training; (8) seriously participate in actual combat training. Three points of experience were put forward: (1) the importance of thinking and action is the premise of completing the task; (2) the cooperation between training and actual combat is the basis for completing the task; (3) equal emphasis on education and management is the bottom line for completing the task.Conclusions:The medical support experience of the Dongfeng landing site is summarized to provide support and experience for the long-term in-orbit operation of China's space station and on-site medical rescue after the landing of the manned spacecraft.
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Objective:This study aims to analyze the characteristics and basic principles of emergency surgery risks and anesthesia care of medical support at the landing site for China’s taikonauts of the Shenzhou-12, and to summarize China’s experience in medical support at the landing site for manned spaceflight, and ensure supports in special environments such as an emergency return of manned spaceflight.Methods:This study was carried out through literature research on relevant reports on the emergency surgery risks and aids of domestic and foreign astronauts at the landing sites, and summaries of the experience in medical support for taikonauts of spacecrafts from Shenzhou-5 to Shenzhou-11 at the landing sites. At the same time, according to the characteristics of Shenzhou-12 such as the long on-orbit time, the adjustment in the landing area, the optimization of the mission mode, and new search and rescue power, a series of organization, pre-arranged planning, equipment allocation, and effective anesthesia treatment plan were proposed and inspected in practice.Results:Based on the original anesthesia care plan of medical support, the first-aid carrier was adjusted and modified, the first-aid procedure was optimized, a new generation of supraglottic airway opening tool, video laryngoscope, portable ultrasound, and other devices were added, and the anesthesia care plan at the landing site for manned spaceflight was formulated to provide strong support for the medical care of taikonauts that had stayed in the outer space for a long time.Conclusions:Upon the targeted improvement and process optimization, the anesthesia care plan of medical support for taikonauts of Shenzhen-12 in the landing area fully meets the anesthesia requirement of medical support in special environments such as the emergency return of the taikonauts that have stayed in the outer space for a long time under the new orbital altitude.
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Objective:To review and summarize the main problems that have occurred in the history of manned spaceflight worldwide and the experience of the medical rescue support for astronauts at the main landing site since the first manned spaceflight mission of the Shenzhou-5 in China in 2003, focus on the technical status and return characteristics during the construction of the space station since the Shenzhou-12, and formulate a targeted injury treatment plan to ensure the safety of astronauts.Methods:This article summarized the lessons of accidental injuries of astronauts in foreign aerospace history, especially in the space station stage, combined with the experience of medical support of astronauts in manned spaceflight in China, and put forward a series of organizations, plans and treatments according to the mission characteristics of long-term orbits and adjustments of the main landing sites of space station mission spacecraft.Results:On the basis of the original pre-cabin emergency and helicopter ICU comprehensive rescue platform, the emergency procedures were further optimized, and the treatment plans under different complex terrains and the principles of rapid treatment and evacuation of astronauts were formulated.Conclusions:The effective treatment of astronauts returning from the space station in various situations could be ensured by the comprehensive rescue plan for the medical rescue of the space station mission and the construction and organization of the helicopter rescue platform.
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Objective:Summarize the experience of the medical rescue team at the main landing site of China's manned space mission, analyze the new characteristics of the Shenzhou 12 space station mission, and take corresponding countermeasures and measures to ensure the strong medical rescue guarantee for astronauts.Methods:Search the publications about astronaut medical aid domestic and abroad, summarize the rescue and medical aid experiences from Shenzhou 5 to Shenzhou 11. In consideration of prolonged on-orbit time, Location adjustment of the landing site and the new characteristics of the complex terrain, new targeted strategies were presented.Results:The astronauts flew in orbit for 90 days, and the main landing site and launch site are in the same area. The medical security includes three parts: launch section, running section and return section. Desert rescue model were added. Ten injuries were simulated and each injury first-aid procedure was standardized.Conclusion:After targeted improvement and optimization, the Shenzhou 12 astronauts medical rescue support program ensures the safety of the whole process, all-weather and all-terrain emergency and rear delivery of the astronauts in the new mission environment and complex terrain.
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Objective@#To investigate the clinical characteristics, diagnosis, treatment and prognosis of discordant lymphoma.@*Methods@#The clinical data of one patient with discordant lymphoma at the PLA Strategic Support Force Characteristic Medical Center were retrospectively analyzed, and the related literatures were reviewed.@*Results@#The patient was treated for thrombocytopenia and the examination showed splenomegaly. After hormone treatment, the platelet rebounded and thrombocytopenia occurred during hormone reduction. Splenectomy was performed. Postoperative pathological diagnosis of splenic marginal lymphoma was made and observed. Axillary lymph node enlargement occurred nine months later. Pathological diagnosis of diffuse large B-cell lymphoma was made by using lymph node biopsy, and the disease condition was alleviated after immunotherapy combined with chemotherapy.@*Conclusions@#Discordant lymphoma is rare and shows no special clinical manifestations. Its diagnosis should rely on pathological examination. Immunotherapy combined with chemotherapy may be more effective.
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Objective To summarize the medical security experience in first-aid and resuscitation for astronauts at the exit of capsule after the spacecraft returns to the main landing site in the process of human spaceflight in China,and thus to provide a powerful security measures for Chinese aerospace medicine.Methods The medical support experiences were summarized in human spaceflight from "Shenzhou V" to "Shenzhou X",relevant reports on emergency rescue and resuscitation were consulted in in-orbit process and after emergency return and landing for domestic and foreign astronauts,astronauts' physiological changes in cardiopulmonary resuscitation were analyzed during emergency return,and then,corresponding strategies were proposed and tested in practice (actual combat) by combining with the flight characteristics of the spacecraft "Shenzhou XI".Results On the basis of the original emergency treatment,the countermeasures for the cardiopulmonary resuscitation were proposed after the spacecraft returned to the main landing site in human spaceflight,the emergency equipment was adjusted,the emergency procedures were optimized,and anti-fog glidescopes were added,laryngeal masks were introduced to perform supraglottic ventilation as the quickest and most effective airway opening measure on site.In addition,ultrasound examination was applied in practice as an important treatment and assessment method for basic life support and advanced life support.All these could ensure the rescuing ability on cardiopulmonary resuscitation during their stay in space for the medium-term and after their return to the main landing site.Conclusions During the return of the astronauts of the spacecraft "Shenzhou XI" to the main landing site,the first aid and support program had been improved specifically and the process had been optimized to ensure the successful completion of medical security mission of China's human spaceflight.
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The rotary cell culture system(RCCS)was used to simulate the microgravity environment, and FRTL-5 cells were divided into simulated microgravity group(SMG)and normal gravity group(NG). FRTL-5 cells were harvested after treatment for 6, 12, 24, and 36 h, the cell viability was measured by MTT assay, and the cells cycles were detected by flow cytometry. The ultrastructure of FRTL-5 cells was observed under laser confocal microscope with FITC-labeled technique. The MTT assay showed that the proliferation of FRTL-5 cells was significantly inhibited after RCCS treatment for 6, 12, 24, and 36h compared with NG(P<0.05), in which the most obvious effect was observed at 24h. The flow cytometry showed that the proportion of FRTL-5 cells at G1 stage in RCCS group was increased significantly after 6, 12, 24, and 36h compared with NG(P<0.05), while the proportion of FRTL-5 cells at S stage was decreased significantly(P<0.05)except that cultured with RCCS for 6 h. The proportion of FRTL-5 cells at G2/M stage was decreased in early phase(6-12 hours)of RCCS culture, with the lowest at 12h and transient increase at 24h of RCCS culture. The laser confocal microscope revealed that there were local microfilament depolymerization, tension fibers decrease, structure disorder, cellular pseudopodia reduction, and irregular shape among FITC-labeled FRTL-5 cells cultured with RCCS for 36h. (Chin J Endocrinol Metab, 2018, 34: 598-601)
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Objective To investigate the effects of simulated microgravity by rotary cell culture system (RCCS) on expression profiles of miRNA in mouse fibroblasts L929 cell line.Methods L929 cells were cultured in vitro and divided into simulated microgravity (SMG) group and normal gravity (NG) group according to the simple random method.Samples of two groups were collected on 7th day of culture and the total RNAs were extracted,labeled,and hybridized in sequence.Feature Extraction Software was used to collect the array images and get raw data,which were analyzed by Genespring Software.Differentially expressed miRNAs were identified and then validated by qRT-PCR.Target genes of differentially expressed miRNAs were predicted by the databases of Targetscan and microRNAorg,and the intersections of databases were identified as potential regulatory target genes.Gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) analysis were applied to determine the roles of these target genes.Relevant biological functions and/or signaling pathways of the regulated genes especially related with wound healing process were categorized based on their enrichments.Then integration predictions of the miRNA and mRNA expression profiles had been proposed to refine the functional miRNA-mRNA relationships.The miRNA-mRNA functional network and miRNA-mRNA control network were constructed.Results Four miRNA genes were up-regulated significantly including mmumiR-669j,-122-5p,-30a-3p,-6516-3p,among which mmu-miR-669j was up-regulated at 52.84 folds with the greatest significance (P ＜ 0.05).Seventeen miRNA genes were down-regulated significantly including mmu-miR-21a-3p,-miR-28a-5p,-218-5p,-210-3p,-miR-19a-3p,-miR-31-3p,and-miR-19b-3p,among which mmu-miR-28a-5p was down-regulated at 15.47 folds with the greatest significance (P ＜ 0.05).The qRT-PCR showed a high concordance with the microarray results (P ＜ 0.05).Target gene prediction and functional enrichment analysis suggested that a variety of biological processes and signaling pathways involved in wound repair were significantly enriched (P ＜ 0.05).Function network and regulation network of miRNA-mRNA covered all the differentially expressed miRNAs,which suggested that miR-21 a-3p and predicted target gene Smad3 might play an important role in wound healing under microgravity.Conclusions Simulated microgravity by RCCS can significantly affect the expression of stress-related miRNAs in mouse fibroblasts L929.The miRNA target gene prediction and functional enrichment analysis based on gene chip technology may provide theoretical basis for illustrating the mechanism and management of weightlessness stress injury.
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Objective To ensure the medical security of the astronauts,new targeted strategies were adopted after summarizing the experience in Chinese astronauts rescue and medical aid at the main landing site,the specialty and characteristics of landing were analysied.Methods Search the publications about astronaut medical aid domestic and abroad,summarize the rescue and medical aid experiences from Shenzhou 5 to Shenzhou 10.In consideration of prolonged on-orbit time,the cold weather conditions at the landing zone of Shenzhou 11,new targeted strategies were presented.Results On the basis of the original helicopter emergency platform and first aid equipment,the emergency aid procedures were optimized,personal warm clothing,a heat preservation box,insulation blanket,self-heating pads and intraosseous rapid infusion system were used to ensure the medical security of astronauts in cold weather at the main landing site.Conclusions With the procedures optimized and the targeted strategies performed,the astronauts' s rescue and medical aid project was fully meet the cold and complex conditions at main landing site.
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<p><b>OBJECTIVE</b>To detect the number of cells and the level of IL-2, IL-4, IL-6, IL-10, TNF-alpha, IFN-γ and IL-17 cytokines in the peripheral blood of mice exposed to rocket kerosene by skin.</p><p><b>METHOD</b>ICR mice were randomly divided into the normal control group and RK experimental group (400 µl×1 group). RK undiluted fuel were applied directly to the dorsal skin of the mice. In control groups were treated with sesame oil (SO). the number of blood cells were detected by automatic blood cell counter and the level of IL-2, IL-4, IL-6, IL-10, TNF-alpha, IFN-γ and IL-17 cytokines in serum were detected by using flow cytometry and BD CBA Flex set kit.</p><p><b>RESULT</b>Compared with the normal group, WBC and LYM had a decreasing tendency 2 h and decreased significantly 6 h, 12 h and 1 d after RK exposure (P<0.05). They increased significantly 7 d after RK exposure (P<0.05). Compared with the normal group, the level of IL-6 increased significantly 2 h, 6 h, 12 h,1 d and 3 d (P<0.05). The level of TNF-α increased significantly 2h, 3d, 5d and 7d (P<0.05). The level of IL-10 increased significantly 2 h, 6 h, 3 d, 5 d and 7 d (P<0.05). The level of IFN-γ increased significantly 6 h and 3 d (P< 0.05). The level of IL-17 significantly increased 3 d, 5 d and 7d (P<0.05).</p><p><b>CONCLUSION</b>RK can change the number of immune cells, causing the immune cytokine changes in mice after RK cutaneous exposure.</p>
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Animals , Mice , Administration, Cutaneous , Blood Cell Count , Cytokines , Blood , Flow Cytometry , Kerosene , Toxicity , Mice, Inbred ICRABSTRACT
Objective To discuss the experience of medical treatment and rescue of the ‘SHENZHOU' astronauts in the landing place in the past 10 years,and to establish more effective mobile ICU in medical helicopters to ensure ‘SHENJIU' astronauts safety.Methods The data collected from foreign nations and our country was reviewed.Formerly experience in first-aid and rescue astronauts of our team was summerized.The important reasons of accidental injuries of astronaut during aerospace flight were listed.More effective and reasonable prophylactic measurements and clinical treatments of the accidental injuries of astronauts were brought forward.Results we established three effective mobile ICU that could ensure the safety of the astronauts.The carriers of the ICU were helicopters,and damage control surgery can be performed there.Fine armature made us more effective.Conclusions Reasonable and effective prophylactic measurements and clinical treatments were the important aspect of the successful manned aerospace flight.The first-aid system in helicopters could realize the destination of swift response and first-aid.
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Objective To identify the changes of mesenteric lymph fluid in cases of uncontrolled hemor-rhagic shock (UHS), which is most often occurred in modem trauma and battle injury. The lymph of gut plays an important role during shock and MODS. The objective of this experiment is to identify the change of mesenteric lymph fluid in UHS. Method Thirty-eight SD rats were canulated with PE 50 catheters separately into right carotid artery,left femoral artery and femoral vein. A serf-made steel catheter was inserted into main mesenteric lymph duct and the mesenteric lymph fluid was collected. The rots were divided into three groups: control group (n=10), controlled hemorrhagic shock (CHS) group (n=10) and UHS group (n=10). After the mean blood pressure was dropped to 40 mmHg by exsanguination, hemorrhage was made by amputation of 75% tail in length and let the stump keep open to bleed. The volume of mesenteric lymph fluid was recorded, and the protein and endotoxin in it were examined, too. Data were analyzed using ANOVA and Chi-square test. Results The mesenteric lymph fluid was decreasing remarkably during shock until it was below 1/4 of normal. After hemorrhage was controlled, the mesentefic lymph fluid increased slowly. However, it kept decreasing persistently in cases of UHS. So did the protein content. The eudotoxin in lymph fluid increased 2 hours after CHS and one hour after UHS. There was significant difference in endotoxin between CHS and UHS 2 hours after shock (P<0.05). Con-dusions The volume and protein content of mesenteric lymph fluid decreased mare significantly in UHS than that in CHS. And contrarily, the endotoxin in lymph fluid increased more significantly in UHS than that in CHS. The change of the mesenteric lymph fluid may be an important cause of MODS after UHS.
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Objective To study the early resuscitation with intravenous administration of liquor in uncontrolled hemorrhagic shock model by four-staged abdominal aorta injury in rats in order to settle the controversy over the issue of volume resuscitation.Method Forty Sprague-Dawley rats were canulated with catheters into the left ventricle,femoral artery and femoral vein,respectively.Animals were subjected to vaseular injury of infrarenal pierced with a 25G needle leading to uncontrolled hemorrhagic shock.After aorta injury,the models were processed into 4 stages:early injured stage,early rescue stage,delayed rescue stage and observation stage.The rescue with rapid infusion of 45 ml/kg lactated Ringer's solution in 15 minutes in the early stage and the followed rescue in the late stage;and(4)sham-rescued.The MAP,CVP,lactic acid and Hct were monitored.The volume of blood loss and the survival time of rats were recorded too.Results After aorta injury,The MAP dropped from 94.3 mmHg to 25.8 mmHg and rised quickly after early resuscitation with rapid infusion of liquor and then again fell soon,and CVP did likewise.Lactic acid was increased and reached 3-4 times of baseline at 4 h in all group except Sham-resuced group.The Hct levels decreased quickly after resuscitation with liquor in early rescue stage and delayed rescue stage.The blood loss in abdomen increased after rapid infusion of lactated Ringer's solution in early rescue stage(blood loss increased from 22.8 ml/kg to 27.7ml/kg,P＜0.05).There Was no significant difference in mortality between those groups.Conclusions Rapid volume resuscitation at early stage of abdominal aorta injured with uncontrolled hemorrhagic shock cannot increase the circulatory blood volume for maintaining stable blood pressure norminimize the elevation of blood lactic acid.On the contrary,resuscitation with rapid administration of liquor at early stage can enhance blood loss and decrease the level of Hct.The survival time and survival rate can't be increased by early rescue with rapid liquor infusion.
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Objective To study the pattern of cellular proliferation and apoptosis in different part of colorectal cancer and its relation to patients' prognosis. Methods The expression of PCNA and Fas protein were investigated by immunohistochemistry in cancer mucosa, cancer adjacent mucosa and cancer distant mucosa of 76 cases of colorectal cancer, and the patients prognosis were investigated too. Results The PCNA expression in cancer mucosa is significantly higher than that in cancer adjacent tissue(P
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OBJECTIVE: To elucidate the effects of lipopolysaccharide (LPS), phospholipase A(2) (PLA(2)) and oxygen free radical (OFR) on proton transmembrane translocation and H(+)-ATPase. METHODS: The normal rats were sacrificed for preparetion liver mitochondria and submitochondrial particles for experiments in vitro. Submitochondrial particles were incubated with LPS (100 &mgr;g/mL), PLA(2) (10 u/mL) and FeSO(4)/Vit C (30/90 &mgr;mol/L) at 30 degrees C for 30 min. The proton translocation of submitochondrial particles (SMPs) were assayed with the fluorescent probe ACMA (9-amino-6-chloro-2 methoxya cridine). The mitochondria were incubated with different concentration of LPS, PLA(2) and FeSO(4)/Vit C. The H(+)-ATPase, PLA(2) and malondialdehyde (MDA) were assayed. RESULTS: The fluorescent quenching of ACMA and H(+)-ATPase activity in high dose was significantly decreased after treatment with LPS, PLA(2), FeSO(4)/Vit C (P<0.05). The mitochondrial PLA(2) activity and MDA content were significantly increased after treatment with LPS (P<0.01). CONCLUSIONS: FeSO(4)/Vit C in low dose causes increases H(+)-ATPase activity. LPS, PLA(2), FeSO(4)/Vit C might be the important factors changing H(+)-ATPase and proton translocation across the membrane.
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Objective To establish an abdominal-trauma-induced uncontrolled hemorrhagic shock (UHS) model, and explore the effect of staged resuscitation. Methods Indwelling catheters were inserted into left ventricle, femoral artery and femoral vein of 50 Sprague-Dawley rats, and then laparotomy was performed. 42 out of the 50 animals were subjected to vascular injury to simulate UHS by infra-renal arterial puncture with 25G needles, and the model was successfully established in 32 rats, for which the animals were divided into 3 groups: control group (n=10), with no resuscitation; hospital-resuscitation group (n=11), resuscitated in early injured stage; and staged-resuscitation group (n=11), resuscitated pre-hospital and then in-hospital. 8 out of the 50 rats, which were not subjected to vascular injury, served as sham-operated group. The mean aortic pressure (MAP), central venous pressure (CVP), serum lactic acid, alanine aminotransferase (ALT) and creatinine (Cr) were determined, and the volume of blood loss and survival time were recorded. Results The MAP decreased from 94.7mmHg to 28.9mmHg 15min after aortic injury in control group and rose slowly after continuous transfusion in staged-resuscitation group. Similar change was found in CVP. Serum lactic acid, ALT and Cr were increased in control group and hospital-resuscitation group at early injured stage, but the increase was delayed in staged-resuscitation group. The mean survival time in control group, hospital-resuscitation group and staged-resuscitation group were 76, 846 and 2480 min, respectively. The 72 h mortalities of the three groups were 100%, 72.7% and 36.4%, respectively. Conclusion Staged resuscitation which is characterized by slowly continuous transfusion at early aid stage cannot increase the blood pressure and circulating blood volume to normal level in UHS, but can reduce the level of serum lactic acid, ALT and Cr, and dose not increase the blood loss. The survival rate and mean survival time can be increased by this method.