"神舟十一号"飞船主着陆场医疗保障任务护理对策

我国载人航天事业已取得巨大成就,航天医学保障作为整个航天载人工程的重要一环,对每次任务的顺利实施起着至关重要的作用.在6次载人航天飞行中,解放军第306医院均承担主着陆场的医疗救护任务,负责航天员出舱后的伤情救治与转运,主着陆场医疗救护地位特殊,责任重大.     

加强航天员陆上应急医疗救护训练工作的几点思考

做好航天员陆上应急医疗救护是完成载人航天工程陆上应急搜救任务的重要环节。近年来,我区在承担载人航天工程陆上应急搜救备勤任务中,把航天员陆上应急医疗救护摆在突出位置,积极筹划、精心组织、加强训练,取得了明显成效。特别是2011年7月12日,总部组织了＂载人航天工程陆上应急搜救演练＂,军区某医疗救护队在近似实战的环境中,进行了航天员应急救治空地一体保障演练,积累了宝贵经验,受到了现场观摩的总部、军区首长的充分肯定。     

"和谐使命-2010"医院船医疗系统加改装的分析与探讨

866医院船的使命任务主要是担负战时三军海上伤病员医疗救护与后送、海上卫勤支援,可在除严重冰区以外的全球海区实施卫勤保障.和平时期医院船执行非战争军事行动增多,其使命任务拓展,执行医学科研试验、岛礁部队巡诊,以及参加国际维和、人道主义救助、海上应急救援和撤侨护侨行动等任务逐步常态化.因此,需要深入研究医院船平时执行各类医疗服务、医学救援等非战争军事行动的适用性,对医疗系统实施一定程度的加改装,提高平时卫勤保障能力.     

中国首飞航天员主着陆场的医疗救护保障

目的 探讨我国首飞航天员主着陆场的医疗卫勤保障的经验。方法 回顾国内外有关航天员意外伤害资料，结合我们多次医疗救护演练经验，提出并实施救治方案，进行经验总结。结果 针对我国首飞航天员可能发生的意外伤害，用医疗救护直升机及医疗救护车，把一个高质量的重症监护病房全天候前移至草原上和沙漠地区。使卫勤保障原则更趋于合理，抢救成功率更高，圆满完成了任务。结论 对返回着陆场区的航天员实施医疗保障及救护是保障航天员安全、圆满完成载人航天任务的一个重要环节。航天员主着陆场的医疗卫勤保障表明，我们的方案能够达到对着陆航天员实施”快速反应，立体救护”的目的。     

载人航天工程的后续目标与航天医学工程的研究方向

以载人航天为任务背景的航天医学工程学科在中国载人航天工程中发挥了重要的作用并得到了迅速发展.在此基础上,根据工程后续的3个目标1)突破航天员出舱活动技术,验证航天员的舱外作业能力;2)突破飞船与空间目标飞行器的交会对接技术;3)建立一定规模的空间实验室,著者提出了航天医学工程研究在航天员选拔训练,工程设计的医学、工效学要求与评价,航天员医监医保与航天医学研究,航天器环境控制与生命保障技术研究,出舱活动与交会对接的相关技术研究和训练与试验模拟技术研究等领域的研究方向和重点.     

北海舰队某水警区——陌生海域练救护

前不久,海军北海舰队某水警区组织"海上医疗救护队"队员,乘坐由民用船只改装成的医疗救护船,开赴黄海某陌生海域,在5级风浪中,进行了海上搜寻救捞伤员、用换乘舱海上换乘重伤员、海上对重伤员进行手术救治等战时海上救护课题演练,获得了圆满成功。     

一个轻便移动的生命支持保障和监测系统的创建

解放军第306医院载人航天主着陆场医疗救护队岳茂兴、邹德威、闵庆旺、张坚、刘志国等人在我国载人航天首飞航天员主着陆场的医疗保障及救护中，从设备配置、人员强化培训及组织等方面创新地将一个“轻便移动的生命支持保障和监测系统（transportable life support and monitoring unit）”贯穿于航天员医疗保障和救护的现场及整个后送过程中，将救命性的处理前移到致伤现场，达到“医疗与伤员同在”的目的。“轻便移动的生命支持保障和监测系统”事实上是一个更为轻便的、便携式的加强医疗病房（ICU），它的所有设备都可以放在一个担架上，根据任务需要，可以把一个高质量的轻便的ICU前移至草原上、沙漠里、马路上、医疗救护直升机内、医疗救护车内，在事故现场展开医疗救治工作。该系统包含了一整套通气装置、供氧、吸引、多功能心电监护除颤、血气分析、手术器械、液体药物输注装置、标准急救箱等。     

中国航天员选拔训练回顾与展望

航天员选拔与训练是载人航天工程不可或缺的重要组成部分,是确保飞行任务的圆满完成和飞行安全的一个至关重要的环节,在各国载人航天计划中一直受到高度重视.载人航天实践的经验表明,能否选拔训练出合格的航天员将直接影响到载人航天计划的顺利实施和飞行任务的成败.本文阐述了航天员选拔训练在载人航天工程中的地位和作用,回顾总结了我国航天员选拔与训练的发展历程以及发展各阶段在选拔训练体系的创建、首批航天员的选拔训练、两次载人飞行任务飞行乘组的选拔训练方面开展的工作及取得的成果;并根据我国载人航天工程后续任务的规划及选拔训练的发展趋势,明确提出了我国航天员选拔与训练体系未来建设的目标、发展方向与研究的重点.     

完善海上遇险人员航空救援体系的构想CSCD

“赢得时间,留住生命”是救援的核心.对海上遇险人员的成功救援,主要由几个要素构成,一是顺利找到,二是成功捞起,三是生命体征存在.也就是找到并成功捞起具有生命体征的遇险人员,才是实施海上医疗救护与后送的前提.随着远洋航行、洲际飞行等活动的日益频繁,海上遇险事件时有发生,既有个人又有群体.如2014年3月8日凌晨2时40分载有239人的马航370（波音777-200）失联事件,虽经多国联合搜救,至今仍无结果;又如2016年8月10日晚21时许,中国女游客不慎从邮轮四层甲板坠海,历经38 h才得以获救.此类事例,不胜枚举.为应对诸如此类的海难事故,很多国家都建有比较完善的、具有较强公益性的抢险救援打捞特性的沿海救捞网络体系,具备空中立体救援、水面快速反应、水下潜水打捞三位一体的综合功能,能有效应对和处置海上重大突发事件,完成海上人命救援、财产救援和环境救援任务.当前,海上遇险人员的救援,主要依托直升机、舰艇完成.     

人-人工智能系统在未来载人航天中的应用展望

目的为使载人航天工程更加安全高效并及早进行人-人工智能系统有关技术的预研准备,本文提出发展人-人工智能(AI)系统,以减少航天员的人数.方法对载人航天任务的需求发展和人-AI系统的有关技术进行系统分析.结果本文提出如下主要观点和技术研发路线1)航天员和AI在人-AI系统中的作用是相辅相成的;2)在航天人-AI系统中包括符号AI和连接式AI,舱内以专家系统和类似Soar的符号AI为主,舱外则以类似COG的机器人为主;3)航天-AI系统具有多层次结构,航天员位于系统的顶层;4)航天员与AI的信息接口是人-AI系统可靠运行的关键.结论鉴于人-AI系统在未来载人航天工程中的重要性和技术的复杂性,应及早作出研制规划.     

Soviet space flight: the human element

Building on past experience and knowledge, the Soviet manned space flight effort has become broad, comprehensive, and forward-looking. Their long-running space station program has provided the capabilities to investigate long-term effects of microgravity on human physiology and behavior, and test various countermeasures against microgravity-induced physiological deconditioning. Since the beginning of Soviet manned space flight, the biomedical training and preparation of cosmonauts has evolved from a process that increased human tolerance to space flight factors, to a system of interrelated measures to prepare cosmonauts physically and psychologically to live and work in space. Currently, the Soviet Union is constructing a multimodular space station, the Mir. With the emergence of dedicated laboratory modules, the Soviets have begun the transition from small-scale experimental research to large-scale production activities and specialized scientific work in space. In the future, additional laboratory modules will be added, including one dedicated to biomedical research, called the "Medilab." The longest manned space flight to date (326 d) has been completed by the Soviets. The biomedical effects of previous long-duration flights, and perhaps those of still greater length, may contribute important insight into the possibility of extended missions beyond Earth, such as a voyage to Mars.     

From the flight of Iu. A. Gagarin to the contemporary piloted space flights and exploration missions

The first human flight to space made by Yu. A. Gagarin on April 12, 1961 was a crucial event in the history of cosmonautics that had a tremendous effect on further progress of the human civilization. Gagarin's flight had been prefaced by long and purposeful biomedical researches with the use of diverse bio-objects flown aboard rockets and artificial satellites. Data of these researches drove to the conclusion on the possibility in principle for humans to fly to space. After a series of early flights and improvements in the medical support system space missions to the Salyut and Mir station gradually extended to record durations. The foundations of this extension were laid by systemic researches in the fields of space biomedicine and allied sciences. The current ISS system of crew medical care has been successful in maintaining health and performance of cosmonauts as well as in providing the conditions for implementation of flight duties and operations with a broad variety of payloads. The ISS abounds in opportunities of realistic trial of concepts and technologies in preparation for crewed exploration missions. At the same, ground-based simulation of a mission to Mars is a venue for realization of scientific and technological experiments in space biomedicine.     

International Space Station medical standards and certification for space flight participants

INTRODUCTION: The medical community of the International Space Station (ISS) has developed joint medical standards and evaluation requirements for Space Flight Participants ("space tourists") which are used by the ISS medical certification board to determine medical eligibility of individuals other than professional astronauts (cosmonauts) for short-duration space flight to the ISS. These individuals are generally fare-paying passengers without operational responsibilities. MATERIAL AND CONTEXT: By means of this publication, the medical standards and evaluation requirements for the ISS Space Flight Participants are offered to the aerospace medicine and commercial spaceflight communities for reference purposes. It is emphasized that the criteria applied to the ISS spaceflight participant candidates are substantially less stringent than those for professional astronauts and/or crewmembers of visiting and long-duration missions to the ISS. CONCLUSIONS: These medical standards are released by the government space agencies to facilitate the development of robust medical screening and medical risk assessment approaches in the context of the evolving commercial human spaceflight industry.     

A model of the expected occurrence of adverse pregnancy outcomes aboard U.S. Navy ships

The goal of this study was to model the incidence of ectopic pregnancy and spontaneous abortion if pregnant women in the first 20 weeks of gestation were to remain aboard ship while at sea during deployments. Ectopic pregnancies and other pregnancy complications at sea can be life-threatening events. Data sources included shipboard medical departments, an Enlisted Personnel Survey, and the Naval Health Research Center Hospitalized Pregnancy and Women Aboard Ship studies. The overall pregnancy rate was 19 per 100 woman-years (95% confidence interval, 18-20), based on the complement of women assigned to participating ships. If pregnant women routinely were to remain aboard ships at sea during deployments through their first 20 weeks of pregnancy, it is expected that approximately 9 ectopic pregnancies and 40 spontaneous abortions would occur aboard ships at sea.     

Biorhythmic selection of cosmonauts]

The paper describes some features of modern and future interplanetary space missions which may influence the stability of the circadian system of the human body. It presents requirements for biorhythmological selection of cosmonauts. The paper discusses the biorhythmological types of humans: biorhythmologically labile, biorhythmologically inert and intermediate. The time schedule specified by the flight program dictates the selection of the cosmonauts of a certain type for the given mission. The paper suggests methods for the biorhythmological selection of cosmonauts: 1) on the basis of adaptation to the concrete type of "space day" in the flight; 2) on the basis of the biorhythmological type; 3) on the basis of the length of the natural circadian period; 4) on the basis of typological features of the nervous system.     

基于肪搏波速度法的无创连续血压测量方法研究进展

连续血压作为载人航天关键的医学生理指标,在医学监护、疾病诊断、健康状态评价和医学研究等方面具有十分重要的应用价值.基于脉搏波速度法的无创连续血压测量方法不需要加压套袖即可方便舒适地完成血压的测量,具有广阔的应用前景.本文将脉搏波速度法分为正相关测量法、反相关测量法和多参数测量方法3类,并进行了详细综述,同时介绍了影响血...     

Medical care system for NASA-Mir spaceflights

A fundamental goal of space medicine is to maintain the health and fitness of spacecrews. Meeting this goal requires reliable, effective, up-to-date medical support systems for use in microgravity. This article describes some of the factors considered in the design and assembly of Russian and U.S. in-flight medical care systems. The successful mutual use of U.S. and Russian medications and medical equipment under the NASA-Mir program conclusively demonstrated the importance and advantages of cooperation among participating space agencies. Continued progress toward the integration of U.S. and Russian flight medical systems will further increase the effectiveness of the medical support of joint missions aboard the International Space Station.     

Results of medical research in the performance of the long-term manned flights of the Saliut-6 program

The major goal of biomedical investigations in prolonged (up to 6 months) manned missions was to obtain information about physiological reactions to long-term weightlessness and to carry out detailed clinical, physiological, immunological and anthropometric investigations before, during and after flight. The results obtained give evidence that man can adapt to the prolonged exposure and to maintain good health condition and high work capacity. The changes detected postflight were reversible and disappeared completely within a relatively short time period. The changes were not correlated with the flight duration. The good health condition and high performance inflight were maintained and postflight readaptation was facilitated due to a rational work-rest cycle and specific countermeasures which were modified with respect to the results of regular medical examinations. Salyut-6 medical data have demonstrated that the duration of forthcoming manned missions can be extended.     

Positive psychological outcomes of spaceflight: an empirical study

INTRODUCTION: Anecdotes from astronauts and cosmonauts suggest that spaceflight can be an enriching experience with enduring positive effects. These positive mental health effects may help protect flight crews from the psychological stress inherent in such high-risk missions. The goal of this study was to identify areas of personal growth likely to result from traveling in space and explore how they were patterned. METHODS: We developed a Positive Effects of Being in Space (PEBS) Questionnaire, which included a section adapted from the Post-Traumatic Growth Inventory (PTGI) as well as original items addressing experiences unique to spaceflight. We sent the anonymous questionnaire to 175 astronauts and cosmonauts who had flown on at least 1 mission; completed surveys were returned by 39 individuals. RESULTS: Every respondent had a positive reaction to being in space, the strongest of which related to the Earth's beauty and fragility. Respondents reported changes in both attitudes and behaviors. Respondents appeared to cluster into two groups based on the intensity of their reported changes. Response patterns did not vary by demographic group, number of missions flown, or total elapsed time in space. CONCLUSIONS: Overall, our findings support the idea that being in space is a meaningful experience that makes an enduring positive impression on astronauts and cosmonauts. An enhanced understanding of the salutogenic effects of space travel will contribute to the education, training, and support of future space crewmembers.     

Crewmember communication in space: a survey of astronauts and cosmonauts.

A total of 54 astronauts and cosmonauts returned questionnaires which addressed various aspects of crewmember communication in space. All respondents believed that crewmembers should be fluent in one shared common language, but American and Soviet space travelers were less tolerant of dialect differences than their international counterparts. Sensory activities (Watching and Listening) were rated as significantly increasing in space, whereas more complex communicative activities (Reading, Gesturing, and Writing) were judged to significantly decrease. Cosmonauts scored higher than astronauts in all verbal and nonverbal activities, possibly reflecting more responsiveness to the space environment. Several factors were rated as significantly helping intracrew communication: Shared Experience, Excitement of Space Flight, Close Quarters, and Isolation from Earth. Other factors were judged to significantly hinder communication: Facial Swelling, Spacecraft Ambient Noise, and Space Sickness. These findings have important operational and scientific implications involving future manned space missions.