某部官兵战术战伤救治认知调查与思考

目的 了解部队官兵对战术战伤救治的认知现状,为指导部队官兵进行战伤救治训练提供依据.方法 2020年9月,通过便利抽样法选择某部官兵420名,采用自制调查问卷对其战术战伤救治认知现状进行调查.结果 420名官兵中,仅22名(5.24％)官兵接触过战术战伤救治,官兵知识测评平均得分(3.47±1.45)分,官兵自评了解程...     

陆军旅救护所战伤救治技术模拟评估概念模型的建立

为进行旅救护所战伤救治技术模拟评估,对我军旅救护所战伤救治的流程、伤员发生规律及旅救护所战伤救治范围和救治技术种类进行了描述,为卫勤人员和建模人员开发模拟评估系统提供参考。     

加强军队医院战伤救治相关学科建设的几点思考

随着军事斗争准备不断深入，军队医院不仅做到平时为军队服务，更要着眼于未来高科技战争。从作战需要角度研究战伤救治和野战救护等急需解决的问题，以提高部队卫勤保障能力，同时还要研究如何把平时医疗活动与战时战伤救治提高有机结合，加强战伤救治相关学科建设，提高医院卫勤保障能力，这是当前一个十分重要的问题。     

桌面推演在基地医院战伤救治原则制定中的应用

采用半结构式访谈收集资料,根据7步分析法对参加桌面推演队员的访谈资料进行分析,旨在明确基地医院的战伤救治范围、基地医院的战伤救治时机和基地医院战伤救治时程,以提高战救预案质量,确保战救预案实施.     

驻军三级乙等以上医院野战医疗队军医战伤救治水平的问卷调查

<正>野战医疗队是军队医院主要应急机动力量,以平时预编预任,战时抽组的形式存在[1],以提高战伤救治率,确保卫勤保障训练为安全目标[2],经常在紧急、突发、复杂情况下完成各项救治保障任务。这就要求医疗队军医必须有专业、精准、全面的战伤救治技术来救治伤病员,以提高伤员生存率,保障部队战斗力。笔者对中原地区同等规模的7家医院进行调研,了解到各医疗队军医战伤救治水平均存在薄弱环节,该文旨在分析就军医救治水平现状,并提出相关改进建议。     

“标准化伤员”在野战医疗队战伤救治训练中的作用

新时期军队医院担负着战时应战、平时应急的多样化卫勤保障任务,野战医疗队在应急保障中发挥着重要作用,然而大多医务人员缺乏卫勤实战经历,导致战伤救治能力不足、分级救治观念淡薄,甚至把战伤救治等同于平时的临床工作。针对卫勤训练中存在的脱离实战,缺乏实战经验,战救意识不强等问题,在野战医疗队战伤救治训练中使用"标准化伤员",旨在提升战伤救治能力尤其是批量急危重症伤病员的救治能力。     

现代神经战伤的特点及救治

随着现代化武器不断更新,神经战伤呈现高发生、高断裂、高缺损趋势,尤其在现代局部战争中大规模使用杀伤力较强的武器如钢珠弹、集束炸弹等,致使神经战伤发生比例大大提高.     

现代神经战伤的特点及救治

随着现代化武器不断更新,神经战伤呈现高发生、高断裂、高缺损趋势,尤其在现代局部战争中大规模使用杀伤力较强的武器如钢珠弹、集束炸弹等,致使神经战伤发生比例大大提高。为加强神经战伤的救治效果,减少致畸、致残率,我们对神经战伤特点及救治过程中需注意的问题进行了总结分析。     

护理团队交互训练体系在卫勤保障群众性战伤救治训练中的应用

<正>卫勤保障中的群众性战伤救治训练目的是提高单兵战(现)场急救技术的理论和实践操作水平,确保单兵在实战中发挥高水平的保障能力~([1])。目前世界上军事强国均已认识到提高军队官兵战伤救治水平的重要性,美军于2002年专门成立战术战伤救治委员会(CoTCCC)~([2,3])。在开展群众性战伤救治日常训练和集中训练过程中发现个别人思想认识不到位、训练时间不能保证、工训矛盾突出的问     

Potential strategies to combat the opioid crisis

Introduction: In the last few decades, the consumption of opioid analgesics in many countries, particularly the US, has dramatically increased. This rise has been paralleled by a proportional number of opioid-related deaths.

Areas covered: The development of opioid guidelines was a response to this health crisis with the intention of reducing the risk of harm related to opioid prescribing. These guidelines have received varying responses ranging from support to criticism. Pain physicians may often provide multidimensional management as the paradigm for responsible opioid treatment. Interventions should focus on preventing new cases of opioid addiction, identifying early cases of opioid addiction, and ensuring access to effective addiction treatment.

Expert opinion: Many activities have been suggested to face the opioid epidemic. Reducing supply is one of the most relevant aspects. Clinicians should find a fine balance that meets the patient’s need for pain relief while minimizing the chance for abuse.     

Antiviral strategies to combat cytomegalovirus infections in transplant recipients

Human cytomegalovirus remains an important pathogen for transplant recipients. To date, a limited number of drugs have been licensed for the treatment of HCMV infection and disease, all sharing the same target molecule, the viral DNA-polymerase. Although combating HCMV with DNA-polymerase inhibitors is effective and has been established for many years, there are several drawbacks associated with the use of these drugs including toxicity and emergence of drug resistance. In order to overcome these problems different treatment options and durations have been assessed and new and improved antiviral drugs with novel molecular targets have been discovered. However, not all of these novel drugs had the properties for success in clinical development, and alternative treatment options with known drugs have been evaluated in parallel. Today the need for an antiviral drug that is potent, safe and well tolerated remains.     

Vancomycin resistance: occurrence,mechanisms and strategies to combat it

Vancomycin has long been considered the antibiotic of last resort against serious and multi-drug-resistant infections caused by Gram-positive bacteria. However, vancomycin resistance has emerged, first in enterococci and, more recently, in Staphylococcus aureus. Here, the authors attempt to review the prevalence and the mechanisms of such resistance. Furthermore, they focus on strategies that have been developed or are under current investigation to overcome infections caused by vancomycin-resistant strains. Among these are glycopeptide derivatives with higher potency than vancomycin, small molecules that resensitise bacteria to the antibiotic and novel non-glycopeptide antibiotics. These agents are targeted to interfere with protein and/or peptidoglycan (PG) synthesis and integrity or with membrane permeability. Whilst most of these agents are still in clinical or preclinical development, some have entered the clinic and currently represent the only option for treating vancomycin-resistant enterococci (VRE).     

Vancomycin resistance: occurrence,mechanisms and strategies to combat it

Vancomycin has long been considered the antibiotic of last resort against serious and multi-drug-resistant infections caused by Gram-positive bacteria. However, vancomycin resistance has emerged, first in enterococci and, more recently, in Staphylococcus aureus. Here, the authors attempt to review the prevalence and the mechanisms of such resistance. Furthermore, they focus on strategies that have been developed or are under current investigation to overcome infections caused by vancomycin-resistant strains. Among these are glycopeptide derivatives with higher potency than vancomycin, small molecules that resensitise bacteria to the antibiotic and novel non-glycopeptide antibiotics. These agents are targeted to interfere with protein and/or peptidoglycan (PG) synthesis and integrity or with membrane permeability. Whilst most of these agents are still in clinical or preclinical development, some have entered the clinic and currently represent the only option for treating vancomycin-resistant enterococci (VRE).     

Medical imaging techniques in the evaluation of strategies for therapeutic angiogenesis

Recent advancements in our understanding of the basic biology of angiogenesis have prompted a focus on practical applications, both in cardiovascular disease and in oncology. The focus on practical applications has stimulated development of novel noninvasive tools that provide serial assessment of ongoing vessel growth in vivo. Nuclear imaging (SPECT, PET) and x-ray angiography have been used to assess changes in perfusion and anatomic appearance, respectively, after induced neovascular development. New MRI techniques provide the ability to identify early changes in vivo that are more sensitive to detection of the effects of new vessel growth than x-ray angiography or nuclear imaging. These new MRI techniques include measurement of blood delivery to the myocardium, development of intramyocardial vasculature, and incremental changes in regional myocardial contractile function. With the combination of methods now available, we expect to be able to track key steps of angiogenesis in vivo and to assess the efficacy of angiogenic therapies. These new imaging capabilities offer crucial information which we hope will hasten the identification and deployment of effective pharmaceutical therapies as an adjunct or alternative to invasive treatments of ischemic disease by targeted stimulation of angiogenesis, and of cancer, by targeted inhibition of angiogenesis.     

Educational strategies: Kaiser Permanente of Ohio shares its successful techniques

What strategies are effective for educating your medical staff about medications and medication-related issues? Kaiser Permanente of Ohio has developed an educational program for its medical staff that involves four key components: a custom-designed formulary handbook, drug fairs, traditional letter/newsletter communication pieces and educational meetings, and collaborative projects between its pharmacy and medical staffs. These educational techniques--many of which have been successfully adapted from the pharmaceutical industry--can be adopted for use at your institution.     

Tuberculosis pharmacotherapy: strategies to optimize patient care

Introduction: The treatment of tuberculosis (TB) is a mature discipline, with more than 60 years of clinical experience accrued across the globe. The requisite Multi-drug treatment of drug-susceptible TB, however, lasts 6 months and has never been optimized according to current standards. Multi-drug resistant TB and TB in individuals coinfected with HIV present additional treatment challenges. Objective: This article reviews the role that existing drugs and new compounds could have in shortening or improving treatment for TB. The key to treatment shortening seems to be sterilizing activity, or the ability of drugs to kill mycobacteria that persist after the initial days of multi-drug treatment. Results: Among existing anti-TB drugs, the rifamycins hold the greatest potential for shortening treatment and improving outcomes, in both HIV-infected and HIV-uninfected populations, without dramatic increases in toxicity. Clinical studies underway or being planned, are supported by in vitro , animal and human evidence of increased sterilizing activity - without significant increases in toxicity - at elevated daily doses. Fluoroquinolones also seem to have significant sterilizing activity. At present, at least two class members are being evaluated for treatment shortening with different combinations of first-line drugs. However, in light of apparent rapid selection for fluoroquinolone-resistant mutants, relative frequency of serious adverse events and a perceived need to ‘reserve’ fluoroquinolones for the treatment of drug-resistant TB, their exact role in TB treatment remains to be determined. Other possible improvements may come from inhaled delivery or split dosing (linezolid) of anti-TB drugs for which toxicity (ethionamide) or lack of absorption (aminoglycosides and polypeptides) precludes delivery of maximally effective, oral doses, once daily. New classes of drugs with novel mechanisms of action, nitroimidazopyrans and a diarylquinoline, among others, may soon provide opportunities for improving treatment of drug-resistant TB or shortening treatment of drug-susceptible TB. Conclusion: More potential options for improved TB treatment currently exist than at any other time in the last 30 years. The challenge in TB pharmacotherapy is to devise well-tolerated, efficacious, short-duration regimens that can be used successfully against drug-resistant and drug-resistant TB in a heterogeneous population of patients