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Objective:To investigate the effect of chest compression synchronized ventilation on cerebral oxygenation in porcine cardiopulmonary resuscitation model.Methods:The porcine ventricular fibrillation model was constructed and randomly(random number)divided into two groups by envelope method. According to the different modes of ventilator during cardiopulmonary resuscitation, they were named intermittent positive pressure ventilation (IPPV) group and chest compression synchronized ventilation (CCSV) group. The arterial blood lactic acid value at 4 and 7 min after resuscitation and 30 min after spontaneous circulation recovery , carotid blood flow (CBF) within 1-8 min during resuscitation, cerebral oxygen saturation at 1 , 2 , 3, and 4 h after resuscitation were recorded. Neurological score was assessed 24 h after resuscitation.Results:The lactic acid value at 3 time points in the CCSV group was significantly lower than that in the IPPV group; during the resuscitation, the CBF of the pig carotid artery in the CCSV group was significantly higher than that in the IPPV group within 1-8 min during resuscitation; cerebral oxygen saturation was also significantly higher in the IPPV group at all time points after resuscitation. The neurological score of the CCSV group decreased significantly 24 h after resuscitation.Conclusions:The choice of CCSV ventilation mode in porcine ventricular fibrillation model can significantly improve cerebral perfusion during cardiac arrest and cerebral oxygenation after resuscitation.
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Objective To explore the feasibility and advantage of the drones in a county emergency medical service system.Methods The study was conducted in Changxing County,Zhejiang Province from January to September 2018.The Changxing County People's Hospital and the health centers within its radius of 25 km were included in the study.Three types of indicators were obtained by using commercial drones to transfer simulated first-aid medical supplies from health centers to county people's hospitals:(1)The flight time of the drone;(2) The road traffic time measured by Baidu map and Tencent map software of the above-mentioned route at midnight;(3) The road traffic time measured by Amap software of these routes at 0:00,8:00,10:00,12:00,14:00,16:00,18:00,20:00.The road traffic time at different time points measured by map softwares and drones flight time were compared.Wilcoxon symbolic rank test was used for statistical analysis,and P value of ＜ 0.05 was considered statistically significant.Results (1) A total of 10 health centers were involved in this study,the air straight-line distance between them and the county people's hospital was (10.97±3.59) km,and the road traffic distance was (13.61±4.95) km.(2) The flight time of drone was (16.35±5.15) min,less than road traffic time measured by Amap,Baidu and Tencent map software,which were (21.40±5.15) min,(22.50±6.11) min,(22.00±5.23) min,respectively (P＜ 0.01).(3)The road traffic time measured by Amap software was longer than that of drones from 0:00 to 20:00 (P＜ 0.01),with the maximum time of (27.80±6.12) min at 18:00,and the minimum time of (21.40±5.15) min at midnight.Drones could save up 14.07 min at most and 2.8 min at least,with an average save of (7.98±1.32) min.Conclusions Drone might be used to transfer first aid medical supplies between health centers in a county area,which is faster than road transportation.It has a better application prospect and is worth to further study.
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Objective To develop medical emergency support information system for large-scale social activities based on 5G communication technology to improve efficiency of emergency medical services.Methods The project was completed in Hangzhou,China,from March 2016 to September 2019.Based on the medical service of large social activities,five information terminals are constructed,including on-site mobile terminal,on-board first aid terminal,expert remote consultation terminal,hospital terminal,and command dispatch center.The system can realize the real-time communication of medical information,patient's vital signs,audio,picture and video information,and can also make intelligent scheduling decisions for patients.Results 5G Emergency Medical information System for Large-scale Social Activities has been completed,which consists of three parts:command and control platform,onsite rescue platform,and evacuation support platform.The command and monitoring platform displays the information of on-site medical teams,ambulances,hospitals and experts through web pages,and realizes multi-party video communication at any time,as well as text,voice and image information of patients' current condition,so as to realize command,dispatch and display statistical summary information.On-site rescue terminal includes patient information input,video signal acquisition and physiological information acquisition equipment.It realizes multiple methods of patient information input,vital signs and physiological information acquisition,multi-angle video acquisition and transmission to the command center.The evacuation support platform includes vehicle emergency terminal,remote expert consultation terminal,hospital terminal and UAV system.Vehicle terminal can scan and transfer with on-site ambulance team,record physiological information during transit,and also acquire and transmit monitor,electrocardiogram and ultrasound information.Hospital terminals can obtain patient information at the first time and prepare for first-aid in hospital.The remote expert terminal can be dispatched by the command center and the hospital terminal,and can join the remote consultation at any time.Unmanned aerial vehicle (UAV) system can transfer medical material between any locations.Conclusions This system can guarantee the patients to be transported from the scene to the ambulance and finally to the hospital during the large-scale social activities.In the whole process,the information transmission and dispatching decision-making are initially realized,and the statistical report forms can be made.However,to fully exert its advantages,it still needs the support of the complete 5G network and continuous optimization in real scenarios.
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Objective To explore a new platform for pre-hospital and in-hospital emergency medical services based on a new generation of 5G communication technology,providing a basis for further improving the level of emergency medical services.Methods This study was conducted at the Second Affiliated Hospital of Zhejiang University School of Medicine from October 2017 to April 2019.Based on the latest requirements of emergency medical services at home and abroad,the cross-enterprise and multi-disciplinary technical forces were organized to build platform.Firstly,to determine the process of pre-hospital and in-hospital emergency medical services,various modules and technical routes were constructed under 5G conditions and individual technologies were tested one by one.Then they were gradually integrated into two platforms of ambulance and hospital emergency.Finally,the simulation test is carried out under the support of the whole 5G network.Results The pre-hospital and in-hospital emergency medical service platform based on 5G technology comprises of 5G ambulance,5G panoramic VR real-time display system,5G remote ultrasonic examination system,medical drone system,and 5G emergency command platform.5G ambulance contains medical equipments such as multi-function monitor,ventilator,defibrillation monitor,portable B-ultrasound,high-definition remote video interactive system based on 5G network,VR immersive real-time panoramic experience system,and GPS positioning system.5G panoramic VR real-time display system includes VR panoramic camera and VR glasses.The wearer with VR glasses can view the real-time situation on the ambulance,which makes a preliminary judgment on the patient's condition and provides rescue guidance.5G remote ultrasonic examination system integrates robot technology,real-time remote control technology,and ultrasonic imaging technology.The specialist can control the movement of the ultrasonic probe set on the 5G ambulance by manipulating the mechanical arm.The patient's image and color super-picture can also be simultaneously returned to the specialist.The medical drone system enables the medical resources to be allocated in the shortest possible time through the 5G networked drones,so as to eliminate the delay caused by traffic congestion.5G emergency command platform can integrate,transmit,and display data from multiple sources and forms through web pages in assistance of AI and intemet of things.Conclusions The new platform for pre-hospital and in-hospital emergency medical services based on 5G technology can realize more fluent information exchange in pre-hospital and in-hospital,and realize the functions that are difficult to achieve under the previous network conditions.
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Objective@#To explore the feasibility and advantage of the drones in a county emergency medical service system.@*Methods@#The study was conducted in Changxing County, Zhejiang Province from January to September 2018. The Changxing County People's Hospital and the health centers within its radius of 25 km were included in the study. Three types of indicators were obtained by using commercial drones to transfer simulated first-aid medical supplies from health centers to county people's hospitals: (1)The flight time of the drone; (2) The road traffic time measured by Baidu map and Tencent map software of the above-mentioned route at midnight; (3) The road traffic time measured by Amap software of these routes at 0: 00, 8: 00, 10:00, 12:00, 14:00, 16:00, 18:00, 20:00. The road traffic time at different time points measured by map softwares and drones flight time were compared. Wilcoxon symbolic rank test was used for statistical analysis, and P value of < 0.05 was considered statistically significant.@*Results@#(1) A total of 10 health centers were involved in this study, the air straight-line distance between them and the county people's hospital was (10.97±3.59) km, and the road traffic distance was (13.61±4.95) km. (2) The flight time of drone was (16.35±5.15) min, less than road traffic time measured by Amap, Baidu and Tencent map software, which were (21.40±5.15) min, (22.50±6.11) min, (22.00±5.23) min, respectively (P< 0.01). (3)The road traffic time measured by Amap software was longer than that of drones from 0:00 to 20:00 (P< 0.01), with the maximum time of (27.80±6.12) min at 18:00, and the minimum time of (21.40±5.15) min at midnight. Drones could save up 14.07 min at most and 2.8 min at least, with an average save of (7.98±1.32) min.@*Conclusions@#Drone might be used to transfer first aid medical supplies between health centers in a county area, which is faster than road transportation. It has a better application prospect and is worth to further study.
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Objective@#To develop medical emergency support information system for large-scale social activities based on 5G communication technology to improve efficiency of emergency medical services.@*Methods@#The project was completed in Hangzhou, China, from March 2016 to September 2019. Based on the medical service of large social activities, five information terminals are constructed, including on-site mobile terminal, on-board first aid terminal, expert remote consultation terminal, hospital terminal, and command dispatch center. The system can realize the real-time communication of medical information, patient's vital signs, audio, picture and video information, and can also make intelligent scheduling decisions for patients.@*Results@#5G Emergency Medical information System for Large-scale Social Activities has been completed, which consists of three parts: command and control platform, on-site rescue platform, and evacuation support platform. The command and monitoring platform displays the information of on-site medical teams, ambulances, hospitals and experts through web pages, and realizes multi-party video communication at any time, as well as text, voice and image information of patients' current condition, so as to realize command, dispatch and display statistical summary information. On-site rescue terminal includes patient information input, video signal acquisition and physiological information acquisition equipment. It realizes multiple methods of patient information input, vital signs and physiological information acquisition, multi-angle video acquisition and transmission to the command center. The evacuation support platform includes vehicle emergency terminal, remote expert consultation terminal, hospital terminal and UAV system. Vehicle terminal can scan and transfer with on-site ambulance team, record physiological information during transit, and also acquire and transmit monitor, electrocardiogram and ultrasound information. Hospital terminals can obtain patient information at the first time and prepare for first-aid in hospital. The remote expert terminal can be dispatched by the command center and the hospital terminal, and can join the remote consultation at any time. Unmanned aerial vehicle (UAV) system can transfer medical material between any locations.@*Conclusions@#This system can guarantee the patients to be transported from the scene to the ambulance and finally to the hospital during the large-scale social activities. In the whole process, the information transmission and dispatching decision-making are initially realized, and the statistical report forms can be made. However, to fully exert its advantages, it still needs the support of the complete 5G network and continuous optimization in real scenarios.
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Objective@#To explore a new platform for pre-hospital and in-hospital emergency medical services based on a new generation of 5G communication technology, providing a basis for further improving the level of emergency medical services.@*Methods@#This study was conducted at the Second Affiliated Hospital of Zhejiang University School of Medicine from October 2017 to April 2019. Based on the latest requirements of emergency medical services at home and abroad, the cross-enterprise and multi-disciplinary technical forces were organized to build platform. Firstly, to determine the process of pre-hospital and in-hospital emergency medical services, various modules and technical routes were constructed under 5G conditions and individual technologies were tested one by one. Then they were gradually integrated into two platforms of ambulance and hospital emergency. Finally, the simulation test is carried out under the support of the whole 5G network.@*Results@#The pre-hospital and in-hospital emergency medical service platform based on 5G technology comprises of 5G ambulance, 5G panoramic VR real-time display system, 5G remote ultrasonic examination system, medical drone system, and 5G emergency command platform. 5G ambulance contains medical equipments such as multi-function monitor, ventilator, defibrillation monitor, portable B-ultrasound, high-definition remote video interactive system based on 5G network, VR immersive real-time panoramic experience system, and GPS positioning system. 5G panoramic VR real-time display system includes VR panoramic camera and VR glasses. The wearer with VR glasses can view the real-time situation on the ambulance, which makes a preliminary judgment on the patient's condition and provides rescue guidance. 5G remote ultrasonic examination system integrates robot technology, real-time remote control technology, and ultrasonic imaging technology. The specialist can control the movement of the ultrasonic probe set on the 5G ambulance by manipulating the mechanical arm. The patient's image and color super-picture can also be simultaneously returned to the specialist. The medical drone system enables the medical resources to be allocated in the shortest possible time through the 5G networked drones, so as to eliminate the delay caused by traffic congestion. 5G emergency command platform can integrate, transmit, and display data from multiple sources and forms through web pages in assistance of AI and internet of things.@*Conclusions@#The new platform for pre-hospital and in-hospital emergency medical services based on 5G technology can realize more fluent information exchange in pre-hospital and in-hospital, and realize the functions that are difficult to achieve under the previous network conditions.
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Objective To studythe cephalocaudal relationship ofabdominal aortic bifurcation relative toumbilicus and iliac crest vertex and their correlations with abdominal adipose tissue thickness and age. Methods The vertical distances,cephalocaudal relationship and other related anatomic parameters of aortic bifurcation relative to umbilicus and iliac crest vertex in 108 patientswere measured by consecutive abdominal CT scanning. The correlations of the acquired data with abdominal adipose tissue thickness and age were analyzed using Pearson correlation coefficient. Results Umbilicus was located at cephalad to aortic bifurcation in 67 patients(62.0%), caudal in 34(31.4%)andthe same level in 7(6.5%),with the vertical distance of(4.53 ± 17.51)mm to the aortic bifurcation. No statistically significant relationship was found between abdominal adipose tissue thickness(P>0.05) or age(P>0.05). Iliac crest vertex relative to aortic bifurcationwas located at cephalad,caudal and the same level in 31,71 and 6 patients,taking up 28.7%,65.7%and 5.6%,respectively. Its vertical distance to the bifurcation was(-6.34 ± 14.49)mm,nonrelated with abdominal adipose tissue thickness(P>0.05),but positively correlated with age(P<0.01). The difference in the cephalocaudal relationship of aortic bifurcation relative to umbilicus and iliac crest vertex was statistically significant(P<0.01). Conclusion Compared with iliac crest vertex,umbilicus is an important landmark of locating abdominal aortic terminal occlusion position in vitro because it mostly lies cephalad to aortic bifurcation in the front of the body,not easy to vary with abdominal adipose tissue thickness and age.
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To explore the effect of different concentrations of corticosterone (CORT) on primary cultured hippocampal neurons and their Ca2+/CaMK II expression and possible mechanism, the changes of hippocampal neurons were observed in terms of morphology, activity of cells, cell death, concentrations of cytosolic free calcium, and the expression of CaMK II by using MTT assay, flow cytometry, fluorescent labeling of Fura-2/AM and Western blotting after 10(-7), 10(-6) and 10(-5) mol/L of CORT was added to culture medium, The evident effect of 10(-6) and 10(-5) mol/L of CORT on the morphology of hippocampal neuron was found. Compared with control neurons, the activity of the cells was markedly decreased and [Ca2+]i increased in the neurons treated with 10(-6) and 10(-5) mol/L of CORT, but no change was observed in the neuron treated with 10(-7) mol/L of CORT. The death was either by way of apoptosis or necrosis in the cells treated with 10(-6) and 10(-5) mol/L of CORT respectively. The correlation analysis showed that a reverse correlation existed between [Ca2+]i and the expression of CaMK II. Either apoptosis or necrosis occurs in the hippocampal neurons treated with CORT. The increased hippocampal [Ca2+]i is both the result of CORT impairing the hippocampal neurons and the cause of the apoptosis of hippocampal neurons and the decreased CaMK II expression.