"和谐使命-2010"医疗服务中神经外科临床工作分析

目的 分析"和谐使命-2010"医疗服务中神经外科工作,了解亚非5国的神经外科发病情况及治疗情况.方法 回顾性分析"和谐使命-2010"医疗服务中各服务点(吉布提的吉布提市、肯尼亚的蒙巴萨市、坦桑尼亚的达累斯萨拉姆市、塞舌尔的维多利亚和孟加拉国的吉大港)的门诊患者及开展手术的情况.结果 神经外科接诊门诊患者535例,专科手术6例.结论 当地神经外科技术及人才均很稀缺,神经外科工作在这5国医疗服务活动中均很重要.

Abstract：

Objective To analyze the neurosurgical work in the medical service of "Operation Harmony -2010" , and find out categories of neurosurgical diseases and treatment delivered to the countries during the Operation. Methods A retrospective analysis was made on the patients and neurosurgery delivered at various service points (Djibouti City in Djibouti, Mombasa in Kenya, Dallas Salam in Tanzania, Victoria in Seychelles and Chittagong in Bangladesh) , in the medical service during "Mission Harmony -2010". Results Five hundred and thirty-five cases of neurosurgical out - patients were treated and neurosurgical procedures were performed in 6 cases. Conclusions Neurosurgical techniques and neurosurgical specialists were badly short of in these cities, and neurosurgical operations delivered were considered to be very important in the medical service in the five countries.     

加强医院船对外医疗服务中门诊细节管理的实践与成效

ObjectiveTo provide experience and reference for similar medical service in future, this paper summarized and analyzed the detail management of overseas outpatient medical ser vice by “Mission Harmony 2013” hospital ship in Southeast Asia. MethodsProblems existed in overseas outpatient medical service in Southeast Asia were analyzed, and solutions were put forward by strengthening detail management. ResultsThe average daily service visits were obviously improved, registration and waiting time of patients were shortened. The medical order changed from the chaos into organized. ConclusionIn the overseas outpatient medical service on “Mission Harmony 2013” hospital ship in Southeast Asia, strengthening detail management was effective in improving service efficiency and quality.     

DISTRIBUTION OF SERO-TYPES, DRUG-SENSITIVENESS OF 1,470 STRAINS OF SERO-GROUP B OF BACILLUS SHIGELLA

An analysis of the distribution of serotypcs, drug sensitivity of 1,470 strains of sero-group B of Bacillus Shigella. and results of treatment of bacillary dysentery was reported.In 1962-1963, the predominant sero-type was 2a, while Ib, 4, 3a, y and 2b were less frequently isolated; other serotypes were either rare or not found. In 1979 -1980,1b was the prevalent type, with 2a, 2b, 4, 3a and la ranked spcond. All the serotypes which were isolated in 1979-1980 were relatively resistant to tetracyclines, chloramphenicol and furazolidone, but were more sensitive to newer drugs such as pipemidic acid, nalidixic acid, gentamycin and trimethoprim.     

飞行人员空晕病的诊治和医学鉴定

Objective To summarize the clinical features,diagnosis and treatment methods,prevention and control measures,and medical evaluation principles for airsickness in flying personnel. Methods Forty-nine cases of flying personnel with airsickness,who were hospitalized from September of 1976 to July of 2009,were retrospectively analyzed in respect of disease course,etiology or incentive,clinical diagnosis and medical evaluation of airsickness.The relationship between vestibular function status and medical evaluation was also statistically analyzed. Results ① Three of 49 picked cases were diagnosed as primary airsickness while the rest 46 were the secondary that were induced by different causes or incentives.Etiological treatment and vestibular habituation were the primarily treatments for such airsickness.② Among these cases,22 were normal in vestibular nystagmus electroretinogram (VNG) comparing to 27 abnormal cases.③ Sixteen and 33 cases were evaluated as normal and deficient Coriolis acceleration tolerance respectively.④ Eleven flying personnel Were finally qualified while 10 and 28 were temporarily and permanently grounded respectively.Flying personnel with abnormal VNG or with deficient Coriolis acceleration tolerance showed higher grounding rate than those with the normal (χ2=5.584,16.722,P<0.05). Conclusions Airsickness in active service flying personnel is mostly the secondary affection,which is caused by various primary disease or incentives.Such prevention and control measures as treating primary disease.eliminating incentives and implementing vestibular habituation are suggested.The effect of airsickness treatment and vestibular function should be emphasized in making medical evaluation.     

直升机应急医疗救治现状与发展

目的 综述国内外有关直升机应急医疗救护的发展情况. 资料来源与选择国内外该领域的相关文献. 资料引用引用国内外公开发表的文献资料36篇. 资料综合本文回顾了直升机医疗救护的历史及现状、直升机医疗救护的应用以及我国直升机医疗救护的发展情况,提出了对我国直升机医疗救护工作的发展建议. 结论 直升机应急医疗救护具有反应迅速、机动性强、受气候条件影响较小等优点而广泛应用于世界各国.直升机应急医疗救护为抢救人的生命尽可能地赢得时间,是适合现代医疗卫生的有效救治手段.中国在直升机应急医疗救护方面已取得长足进步,但与世界先进水平相比尚有很大距离,建立一支具有中国特色的直升机应急医疗救援体系十分必要. Abstract： Objective To review the domestic and abroad development of helicopter emergency medical service. Literature resource and selection Relevant articles published in China and abroad.Literature quotation Thirty-six published references were cited. Literature synthesis The paper reviewed the history and actuality of helicopter emergency medical service and its applications.The evolution in China was also reviewed and expected and the suggestions for future development were proposed. Conclusion Helicopter emergency medical service is being widely used in the world due to its advantages, such as rapid response, high flexibility, less weather influence, etc. It wins the furthest possibilities in saving people's life, and such effective rescue and cure concept is fitted to modern medication. China has made a remarkable progress in the development of helicopter emergency medical service but is still behind with the world's advanced stage. Building the system with Chinese characteristics would be the critical affair.     

飞行人员甲状腺疾病的特点、诊治及医学鉴定

Objective To summarize the experiences of diagnosis,treatment and medical evaluation of thyroid disease in flying personnel. Methods Sixty-seven cases of thyroid diseases,that were hospitalized from December 2000 to December 2009,were collected and analyzed.They were concluded such categories as:①asymptomatic benign thyroid nodules;②Hashimoto's disease;③diseases of abnormal thyroid functions (including hyperthyroidism and hypothyroidism);and ④thyroid cancer.Their characteristics and the relationship between different categories were analyzed correspondingly to the evaluations for flying. Results ①Among 36 cases of diagnosed asymptomatic benign thyroid nodules (53.73%),4 (3 were adenoma and 1 was nodular goiter) were surgically treated.31 Cases were evaluated as qualified for flying but should be with regular medical check-up while the other 5 were permanently grounded.②There were 5 cases of Hashimoto's disease with normal thyroid functions (7.46%).They were qualified for flying but should be with regular medical check-up.③Thyroid dysfunction took 20 cases (29.85%),among which 18 were hyperthyroidism and 2 were hypothyroidism.Drug treatment was applied.Six cases were finally qualified for flying while the other 3 and 11 were respectively assessed as temporary and permanent grounding.④Six cases were thyroid cancer (8.96%),included 4 papillary carcinoma cases and 2 follicular thyroid carcinoma cases.Only 1 case was finally qualified for flying while the others were permanently grounded.Statistical analysis showed that thyroid dysfunction diseases and thyroid cancer caused significant higher disqualification rate than benign thyroid nodules and Hashimoto's diseases (P<0.01 or P<0.05). Conclusions Benign thyroid nodules are the common thyroid diseases in flying personnel.But the diagnosis of thyroid dysfunction diseases and thyroid malignant tumors should be cared in order to win the chance of treatment and further to reduce the rate of flying disqualification.     

Preliminary safety evaluation of a cyclotron facility for positron emission tomography imaging

This work describes the design characteristics of a medical imaging centre which uses positron emission tomography, with a cyclotron for fluorine-18 and nitrogen-13 production, and which has provided experimental information on operational data recorded by area dosimetry since 1995. Doses to radiopharmacy and medical staff have been measured both in normal work and in some handling incidents. Data on radiation levels in the installation have also been obtained and related to design details and shielding. Area dosimetry was carried out using a five-stationary detector network, with a sampling rate of 2 min^–1, and by thermoluminescent dosimetry (TLD). Staff were also monitored by TLD, using extra chips for finger dosimetry and to duplicate individual whole-body dosimetry in order to measure doses in certain single operations. For normal work, average whole-body doses to radiopharmacy staff were between 0.03 and 0.28 mSv/month, wrist doses were between 0.42 and 2.67 mSv/month, and finger doses were between 1.4 and 7.7 mSv/day for the left hand and 0.8 and 2.4 mSv/day for the right hand; such variation reflects the differing expertise of staff and the role played by optimisation. Finger doses between 16 and 131 mSv were measured in handling incidents, and finger doses of 20.2 and 20.7 mSv for the left hand and 22.0 and 22.3 mSv for the right hand were measured during handling of a syringe without shielding, containing 3 GBq. For medical staff, contributions to the whole-body dose of 2.0 and 1.9 μSv/procedure were measured for injection and placing the patient on the examination couch, respectively. Dose measurement on the middle finger of the right hand gives an average of 70 μSv during the injection. The provisions regarding the shielding design have proved to be adequate and effective during a 3-year operational period. Operational doses to medical staff are comparatively low, while radiopharmacy staff are the most exposed. The finger doses in these professionals may exceed the annual limit, unless operational restrictions in daily practice are adopted. On-line area dosimetry records based on dose rate probes have proved to be effective both for monitoring radiation levels during the operation and for detecting changes in the behaviour of the facility in the irradiation process. Received 23 January and in revised form 12 April 1999     

我国首批女实习舰员长远航心理健康状况调查分析

目的 了解执行"和谐使命-2010"任务女实习舰员的心理健康状况及影响因素,为更好地维护女舰员心理健康及未来女舰员的选拔提供科学依据.方法 以参加此次任务的女实习舰员、女医务人员、男舰员为调查对象,以整群抽样和分层随机抽样相结合,采用症状自评量表(SCL-90)进行4次跟踪问卷调查,同时使用自制的一般资料问卷进行访谈.结果 女实习舰员长远航期间心理健康问题总体检出率为21.8%.长远航中期各因子分超出正常的人数明显增加,长远航后期各因子分超出正常的人数略有降低.女实习舰员长远航前、早期与中、后期比较,心理健康水平差异有统计学意义(P<0.05),躯体化、抑郁、恐怖、其他因子分均显著高于中国军人常模(P<0.05),人际敏感、焦虑、偏执因子分低于中国军人常模,但差异无统计学意义.女实习舰员在航行中、晚期较同期男舰员、女医务人员心理健康状况差(P<0.05).结论 长远航明显降低女实习舰员的心理健康水平,应及时对女实习舰员的心理健康进行必要的干预.

Abstract：

Objective To investigate the mental health status of the midshipwomen involved in Mission Harmony-2010 and its influencing factors, and also to provide scientific basis for the maintenance of mental health and selection of female ship crew.Methods With midshipwomen, female medical personnel, male shipcrew as study subjects, and with cluster sampling and stratified random sampling as study methods, questionnaires were conducted 4 times by using symptom checklist (SCL-90) and routine interviews were also made during our study.Results During the prolonged seagoing deployment, the rate of detection for mental health problems among the midshipwomen was 21.8%. Scores of various factors during the mid stage of deployment were obviously higher than those of the normal people. However, in the later stage, scores of various factors were slightly lower than those of the normal people. Statistical significance was shown in the mental health status of the midshipwomen, when a comparison was made between pre-deployment,early stage of deployment and the mid and later stages of deployment(P<0.05). Scores of somatization, depression, phobia and other factors were significantly higher than those of the norms of Chinese military personnel (P<0.05). Scores of interpersonal sensitivity, anxiety and paranoia were lower than those of the norms of Chinese military personnel, but without statistical significance. During the mid and later stage of the prolonged seagoing deployment, the mental health status of midshipwomen was worse than that of the male ship crew and female medical personnel(P<0.05).Conclusions Prolonged seagoing deployment could significantly worsen the mental health status of midshipwomen. It was necessary to give in-time psychological intervention so as to ensure the mental health of midshipwomen.     

南亚4国老视配镜情况调查分析

ObjectiveThe aim of our work was to evaluate presbyopia spectacles among mid age population in oceangoing medical service of South Asia Maldives, Pakistan, Bangladesh and Myanmar, and to provide reference for medical services in South Asia country in future prolonged sea mission. MethodsThe mid age population was grouped by age. Data were obtained from the Navy hospital ship (No866). ResultsThirty two—forty four years old people required the spectacles of +1.0—+2.5 DS , 45—54 years old people required the spectacles of +2.5—+3.5 DS. 52.1% of 818 peoples admitted the presence of presbyopia, 31.2% of them thought it was because of aging. ConclusionThe presbyopia could appear early in people of South Asia countries, which requires more attention and timely wearing of presbyopia spectacles.     

"和谐使命-2010"医疗工作满意度调查研究

目的 对"和谐使命-2010"任务医疗工作情况进行总体评价,总结经验做法,发现存在问题,研究相关对策,为我海军组织类似大型非战争军事行动提供参考.方法 对"和谐使命-2010"任务医疗相关专业人员进行调查,研究结果用统计软件进行定量、定性分析.结果 医疗活动的总体满意度为次优,最不满意的方面依次为组织计划工作、人员抽组工作和医疗管理工作等.结论 "和谐使命-2010"任务系海军首次成功举行的海外医疗救援活动,在服务对象、服务数量和质量、广度和深度等方面取得了质的飞跃,在全军非战争军事行动组织方面走在了前列."和谐使命-2010"任务借助医院船平台,将在今后很长一段历史时期内成为向全世界展示中国海军建设的主要载体之一,随着理论研究深入、实际经验积累,组织实施工作将会更上层次,更见成效.     

"和谐使命-2010"医疗服务中神经外科临床工作分析

目的 分析"和谐使命-2010"医疗服务中神经外科工作,了解亚非5国的神经外科发病情况及治疗情况.方法 回顾性分析"和谐使命-2010"医疗服务中各服务点(吉布提的吉布提市、肯尼亚的蒙巴萨市、坦桑尼亚的达累斯萨拉姆市、塞舌尔的维多利亚和孟加拉国的吉大港)的门诊患者及开展手术的情况.结果 神经外科接诊门诊患者535例,专科手术6例.结论 当地神经外科技术及人才均很稀缺,神经外科工作在这5国医疗服务活动中均很重要.     

Medical support of Russian Armed Forces: the results and perspectives

The results of work of the Russian Federation Armed Forces medical service obtained in 2007 were summarized and the main problems of its activities in the current year and the very near future were determined. So the work at defining medical support as a type of Army and Navy support was began. The most important task of medical service in 2008 is realization of the Armed Forces medical support conception and goal-oriented program "The improvement of Russian Federation Armed Forces medical support in 2008-2012", the formation of two-level system of personnel's medical support. During the task realization the medical units and institutions are reorganized into federal state institutions. The RF DM Main Military Medical Headquarters works at significant improvement of war and military service veterans' medical attendance. The departmental program "Development of material and technical basis of military medical institutions for 2001-2010" is successfully realized. The measures to optimize the assignment of graduates from military medical higher schools are carried out. The tasks to improve the research work were outlined. The new principles of organization of military medical service control and work will be based on centralization of planning and decentralization of decision implementation, the possibility of military medical units to carry it out taking into account the common intention, safe feedback in order to make the work of army and navy medical specialists more effective in any conditions.     

“和平方舟”号医院船参加“环太平洋－2016”联合军演实践与思考

中国海军“和平方舟”号医院船于2016年6月15日从浙江舟山启航,赴夏威夷参加“环太平洋－2016”联合军演。军演期间,参加了多场军事医学研讨会,主办了医务人员专场甲板招待会及传统中医展示,舰艇开放日组织静态展示以及观摩了人道主义救援演练等一系列活动。该文总结了此次演习的做法与经验,为我军后续组织大规模联合军演提供适当参考。     

“和谐使命-2015”任务医院船海外医疗服务的实践与思考

中国海军“和平方舟”号医院船于2015年9月7日从浙江舟山启航,执行“和谐使命-2015”任务。此次任务历时142 d,访问马来西亚并参加“和平友谊-2015”演习,访问澳大利亚、法属波利尼西亚、美国、墨西哥、巴巴多斯、格林纳达、秘鲁执行“和谐使命-2015”任务,并在后4个国家开展免费医疗与人道主义服务,医院船主平台共诊疗12589人次,派出29支医疗队前出诊疗4852人次,收治住院患者46人次,实施手术59例次,开展CT、DR等辅助检查7130人次,在各到访国还安排了学术交流、参观访问、文化联谊、动静态展示等系列活动。该文总结此次任务的做法与经验,为医院船建设及后续任务提供参考。     

医院船对外军事医学交流的经验与体会

医院船在执行“和平友谊-2015”中马军演及“和谐使命-2015”人道主义医疗服务任务的过程中,船上医务人员多次组织医学交流会、卫勤演练展示、现场医学展示、技能培训,并多次赴当地医学机构参观交流,内容涉及战创伤救治、海水浸泡伤、军事训练伤、常见病与多发病诊治、舰艇卫生、传染性疾病等多个专业,与到访国或地区军事医学专业人员进行了深入的探讨。该文详细介绍了此次出访期间对外军事医学交流的特点、具体做法,并归纳总结了这些机构中值得我方借鉴的经验与启示,为今后医院船出访中对外医学交流积累了宝贵的经验。     

"Tip of the spear" physical therapy during a 6-month deployment to the Persian Gulf: a preliminary report.

When a U.S. Navy aircraft carrier battle group deploys overseas, the ship's medical department is responsible for more than 10,000 personnel and their numerous musculoskeletal injuries. This paper reviews the effectiveness of having a U.S. Navy physical therapist and physical therapy technician onboard the USS Carl Vinson during its most recent deployment to the Persian Gulf. Physical therapy had 3,373 patient visits during the ship's 1998-1999 Western Pacific deployment. Having physical therapy personnel onboard resulted in fewer patient visits to sick call for musculoskeletal problems and fewer evacuations compared with other similar carrier deployments. Providing physical therapy at the "tip of the spear" is an effective, beneficial, and cost-saving landmark improvement in providing quality medical care to the fleet. The lessons learned from this experience will assist in clarifying the role of physical therapy in future military support operations and sustained deployments.     

医院船执行“和谐使命-2011”任务中存在的问题与对策

目的确保"和平方舟"号医院船在以后执行和谐使命任务中能够准备充分、流程顺畅,灵活开展各项医疗任务。方法针对"和谐使命-2011"任务中存在的问题,如派出的先遣组与医院的沟通不够,多头指挥协同不顺畅,医务人员配置不尽合理,工作计划下达不及时,便携式仪器准备不齐全,医疗服务时间短、任务重,使领馆的作用发挥不足,工作任务、目标及工作内容量化不清等提出对策,包括:①充分发挥先遣组的作用;②指挥机构的设置要简洁高效;③合理编配海上医院医务人员;④尽早确定工作内容和目标;⑤适情加强便携式医疗诊断器材的准备;⑥可适当延长在到访国家的停留时间;⑦充分调动和依托使领馆作用;⑧合理预算、准备医疗耗材和物资及匹配电源设备。结果与结论出色地完成了国外医疗服务任务,得到了军委、总部、海军首长的充分肯定和鼓励。总结"和谐使命-2011"任务中的经验对于今后完成此类任务具有重要意义。     

Nikolay Terentevich Potyomkin (on the occasion of 90th anniversary of the birth)

The article is confined to the 90th anniversary of the birth of famous organizer of medical arrangement of Russian Navy, participant of the Great Patriotic War, Honored Doctor of RSFSR, major-general of Medical Service Nikolay Terentyevich Potyomkin (1.05.1922-9.11.1994). He leaded Medical Service of Russian Navy almost 10 years, from January 1976 till November 1985, and made the contribution to development of organization of medical arrangement of oceanic nuclear missile Navy of our country. N. T. Potyomkin made the contribution to development of organization of medical arrangement of the ships and shore objects of Russian Navy. He paid attention to improvement of delivery of health care to complement, drawing active service in the seven seas.