Coronary artery disease and preventive cardiology in aviation medicine.

A review of 6,500 autopsied cases on record at the Armed Forces Institute of Pathology of deaths occurring in aircraft accidents or mishaps revealed that 816 cases (13%) had been diagnosed as heart disease other than traumatic (i.e., pre-existing at the time of the accident). Of these 816 cases (592 military and 135 civilian), 89.1% had atherosclerotic coronary artery disease (CAD). This autopsy series compared the severity of CAD, year of death, and crew position within the military 5-year age groups. CAD was found in 86.6% of the 20- to 34-year-old military group. Moderate and severe CAD was present in 17.1%. CAD in previous autopsy studies of U.S. military casualties in the Korean and Vietnam conflicts was reported as 77.3% and 45%, respectively. Study of severe and moderate CAD by year of death in the 20- to 34-year age group demonstrates 26.2% in 1965-1969 and 21.1% in 1970-74. These findings do not support the conclusion of the Vietnam autopsy study that CAD is decreasing. Preventive and predictive cardiology in aviation medicine should be instituted early and aggressively in the young aircrew population.     

The therapeutic problems of medicine in catastrophes

There are lack of principle differences between the problems of medical aid during the military and civil disasters, and therefore one can draw a conclusion concerning the validity and necessity of using the experience of military medics in disaster medicine during peace-time. The following aspects are discussed: organization of therapeutic caring of the victims during Chernobyl's AES disaster, earthquake in Armenia and accident in chemical enterprise "Nitrogen" in Jonava. Requirements to the teams for emergency medical service have been formulated with determination of Principles of putting them into practice; the further directions of therapeutic aid improvement are outlined.     

Injury prophylaxis in paragliding

OBJECTIVES: To show trends in paragliding injuries and derive recommendations for safety precautions for paraglider pilots on the basis of accident statistics, interviews, questionnaires, medical reports, and current stage of development of paragliding equipment. METHODS: All paragliding accidents in Germany have to be reported. Information on 409 accidents was collected and analysed for the period 1997-1999. RESULTS: There was a substantial decrease in reported accidents (166 in 1997; 127 in 1998; 116 in 1999). The number of accidents resulting in spinal injuries was 62 in 1997, 42 in 1998, and 38 in 1999. The most common cause of accident was deflation of the glider (32.5%), followed by oversteering (13.9%), collision with obstacles (12.0%), take off errors (10.3%), landing errors (13.7%), misjudgment of weather conditions (4.9%), unsatisfactory preflight checks (4.9%), mid-air collisions with other flyers (2.2%), accidents during winching (2.2%), and defective equipment (0.5%). Accidents predominantly occurred in mountain areas. Fewer than 100 flights had been logged for 40% of injured pilots. In a total of 39 accidents in which emergency parachutes were used, 10 pilots were seriously injured (26%) and an additional three were killed (8%). CONCLUSIONS: Injuries in paragliding caused by unpredictable situations can be minimised by (a) using safer gliders in the beginner or intermediate category, (b) improving protection systems, such as padded back protection, and (c) improving pilot skills through performance and safety training.     

军事医学顶层本体中语义类型框架的构建研究

目的：探索军事医学本体语义类型的构建方法,建立军事医学顶层本体语义类型框架,为军事医学本体的构建奠定基础,并进一步为军事医学信息资源的知识组织、知识揭示和知识服务提供支撑。方法通过文献计量法构建军事医学核心概念集,在复用一体化医学语言系统（ UMLS）顶层语义类型框架的基础上,采用语义分析法和专家咨询法,综合自底向上和自顶向下相结合的方式完成语义类型框架的构建。结果将军事医学同一类知识点归到一个语义类型,得出了军事医学顶层本体语义类型框架的树形层级结构。结论提出的军事医学本体语义类型的构建方法是有效实用的,构建的军事医学顶层本体语义类型框架能将军事医学知识进行重构,为军事医学顶层本体语义关系的建立提供基础架构。     

论军事医学系统的科学要素

军事医学的科学要素是指军事医学系统的科学子系统,该子系统又由军事医学科学的认识要素、知识要素和社会要素构成。军事医学科学要素的主要作用是揭示军事医学的特殊规律、引领军事医学的创新发展、指导平战时卫勤保障活动。军事医学科学要素的演化既受军事的影响,也受医学和科技的影响,更是军事医学科学要素自组织的结果。     

论军事医学系统的科学要素

军事医学的科学要素是指军事医学系统的科学子系统,该子系统又由军事医学科学的认识要素、知识要素和社会要素构成。军事医学科学要素的主要作用是揭示军事医学的特殊规律、引领军事医学的创新发展、指导平战时卫勤保障活动。军事医学科学要素的演化既受军事的影响,也受医学和科技的影响,更是军事医学科学要素自组织的结果。     

军事医学的政策制度建设

论文的研究目的是运用军事医学系统论的思想方法,指导军事医学政策制度的建立和完善。作者研究提出军事医学政策制度建设,是促进军事医学科学发展的根本保证;军事医学的战备制度建设,是实现军事医学目的功能的根本要求;军事医学的文化制度建设,是进行军事医学的思想建设和精神建设的重要基础;军事医学的科技管理创新制度建设,是促进军事医学创新发展的管理需要;军事医学的法规体系建设,是军事医学全面、持续、协调发展的法律保障。     

拓展军事医学研究的宏观思考

确保国家生物安全、巩固军队战斗力、保障军队履行＂两多＂职能是新世纪新阶段军事医学面临的战略性需求。转变军事医学模式、调整军事医学布局、强化军事医学功能是卫勤转型以及全面建设现代卫勤对军事医学的现实要求。适应战略需求与现实要求,军事医学研究领域应实施战略性拓展：三防专科救治向综合救治拓展;经典三防医学向＂亚＂三防医学拓展;大陆军军事医学向军兵种军事医学拓展;军事医学向灾害医学、认知医学拓展;军事医学向生命科学拓展。     

Underwater medicine: a neglected area in Accident and Emergency specialist training.

We have evaluated the available medical care to sports divers by a postal questionnaire sent to consultants and senior registrars in Accident and Emergency medicine in the UK, assessing their training in underwater medicine. Replies were received from 60 of 96 consultants (63%) and 32 of 58 (55%) senior registrars. Thirty-two per cent of consultants and 50% of senior registrars had previous personal experience in managing an underwater diving accident. Thirty per cent of consultants and only 19% of senior registrars had prior formal postgraduate training in underwater medicine. Twenty-seven per cent of consultants and 13% of senior registrars replying did not know the pattern of referral for specialist advice nor where the nearest recompression chamber was to be found. We believe that more formal postgraduate training in underwater medicine is needed by A and E medical staff. Furthermore, clear guidelines about emergency management and patterns of referral for diving accidents should be displayed prominently in all A and E departments.     

论军事医学系统的技术要素

军事医学技术要素是为保障部队战斗力而逐步形成的各类手段和方法。其作用主要包括：实施卫勤保障的主要手段、决定卫生勤务的组织形态、促进军事医学科学的发展3个方面;军事医学技术要素在演化形成过程中具有与军事需求的自适应、与医学技术相互促进、依赖科学技术发展的三个主要特点;本文还从军事医学技术创新工程和价值实现的角度对军事医学技术创新进行了初步的探讨。     

论军事医学系统的技术要素

军事医学技术要素是为保障部队战斗力而逐步形成的各类手段和方法。其作用主要包括:实施卫勤保障的主要手段、决定卫生勤务的组织形态、促进军事医学科学的发展3个方面;军事医学技术要素在演化形成过程中具有与军事需求的自适应、与医学技术相互促进、依赖科学技术发展的三个主要特点;本文还从军事医学技术创新工程和价值实现的角度对军事医学技术创新进行了初步的探讨。     

论军事医学的工程系统观

坚持军事医学的工程系统观,有利于从工程角度把握军事医学系统,能够突出军事医学系统的整体性,整合价值要素、科学要素、技术要素和管理要素,协调好4个要素之间的关系,真正优化军事医学系统的整体结构、发挥整体功能、适应军事环境、实现科学发展。     

论军事医学的工程系统观

坚持军事医学的工程系统观,有利于从工程角度把握军事医学系统,能够突出军事医学系统的整体性,整合价值要素、科学要素、技术要素和管理要素,协调好4个要素之间的关系,真正优化军事医学系统的整体结构、发挥整体功能、适应军事环境、实现科学发展。     

生成论视角下军事医学的创生与演进

军事医学是在军事与一般医学环境中生成的开放、复杂系统。军事医学的创生,是指随着系统环境的变化,一般医学中原本并不存在的军事医学特殊知识、专门技术、勤务管理的产生和出现,以及在新知识、新技术与新勤务基础上军事医学新学科、新体系、新体制的产生和出现。军事医学在整体层面的创生表现为军事医学系统的演进。     

论军事医学系统的功能

军事医学系统的功能主要是军事功能、医学功能和社会功能。军事功能体现在提高卫勤保障水平、促进武器装备发展和提升军人作业能力,服务军队战斗力建设;医学功能体现在提供创伤急救、疫病防治和健康促进的先进理论与技术,促进医学科技发展;社会功能体现在维护社会安全稳定、保障社会经济发展和促进社会经济文化发展。     

论军事医学系统的功能

军事医学系统的功能主要是军事功能、医学功能和社会功能。军事功能体现在提高卫勤保障水平、促进武器装备发展和提升军人作业能力,服务军队战斗力建设;医学功能体现在提供创伤急救、疫病防治和健康促进的先进理论与技术,促进医学科技发展;社会功能体现在维护社会安全稳定、保障社会经济发展和促进社会经济文化发展。     

Military graduate medical education in internal medicine: an outcomes study

Military graduate medical education has come under increasing scrutiny in recent years as the size of the military medical force declines. To document the outcomes of military graduate medical education in internal medicine, a cohort of Air Force internal medicine residency graduates from Wright-Patterson Medical Center were studied and their residency performance, staff performance, and active duty retention recorded. The study cohort had an outstanding residency performance, as measured by research experience and board certification rate. They also performed well as military staff physicians, receiving numerous individual military medals while holding important administrative and supervisory positions in the military. Finally, the study cohort had a higher than expected active duty retention rate. These findings support the notion that military graduate medical education in internal medicine produces outstanding military internists.     

军事医学顶层本体语义类型框架的初步评价

目的 分析军事医学顶层本体语义类型的使用情况,以期发现目前语义类型的问题,使之向更加科学和全面的方向发展.方法 基于数据驱动的方法,统计军事医学顶层本体语义类型在军事医学核心概念集中的使用频次.结果 通过对语义类型的使用频次列表排序,对使用频次较高、较低和未被使用的语义类型进行对比分析.结论 目前军事医学顶层本体的语义类型框架基本符合军事医学知识的表达,并可随着军事医学领域的发展不断更新和完善.     

Risk of accidents and occupational diseases among the Finnish Defence Forces

OBJECTIVES: Military activities are often considered more dangerous than civilian work, especially in crisis situations, but peacetime or even peacekeeping conditions have seldom been analyzed in this respect. According to the compensation statistics of the Finnish State Treasury, in 2001, 80% of injuries among military personnel were caused by accidents at work, 15% occurred during commuting to and from work, and 5% were attributable to occupational diseases. RESULTS: The compensated accident frequencies varied between 22 and 26 cases per 1 million work hours during the 1990s. During the past few years, the incidence rate has slightly declined. When accidents among military personnel were considered, most occurred during military exercises (57%), during other work (35%), or during work commuting (9%). One person died in an accident during a military exercise in 2001. On the basis of the data of this study, the hypothesis of a substantially higher risk during peacetime for military work, compared with civilian work, is not defensible. The accident rates in the calendar year 2000 were 25% higher for Finnish civilian work (32 cases per 1 million hours) than for the Finnish Defence Forces (22 cases per 1 million hours).     

军事医学的工程思维与工程系统管理

论文的研究目的是建立军事医学的工程思维方式与工程系统管理范式。作者运用系统论的思想方法,论述了军事医学工程思维的必要性、特点和应用;研究提出了军事医学工程系统管理的内涵、特点、应用和实施策略;探讨了军事医学的工程创新。