1.Military brain science factors of battle effectiveness under a new concept of operation strategies
Military Medical Sciences 2015;(11):863-867
Building a new concept of combat forces is an important initiative in the 12th Five-Year Plan of National Defense Strategies.In the era of biotechnology,global powers have been competing for brain control by means of accelerated development in brain science and the military theory of Innovation to Subdue.Based on elaboration on the concepts and developments of military applications of brain science as well as on analysis of impacts on the mechanism of winning,this paper proposes the operation concepts of pre-settingand bio-orientation,the combat modes of mechanized warfareand idiodynamic warfare,and weapon evolution into intellectualizationand brain-control orientation.This paper presents a practical system design of military applications of brain science:presetting—key technology—weapons′power source-mechanism of winning.The constitution and winning mechanism of the three-stage mode of battle effectiveness are summarized as improving the operation capability—war of super soldiers,changing the main force of operations—war of mechanized legions,altering the principles of operations—war of spiritual consciousness. This paper also suggests the upgradation from damage theoryto control theory,the shift from informatizationtointellectualization,and strategic breakthroughs from independent developmentto collaborative innovation.
2.Endovascular intervention for infrapopliteal arterial occlusion
Feng LU ; Hao ZHANG ; Wei LIANG ; Jiwei ZHANG ; Baigen ZHANG
Chinese Journal of General Surgery 2009;24(6):436-439
Objective To evaluate the results of endovascular intervention for infrapopliteal arterial occlusion in 40 patients. Methods There were 41 affected limbs in these 40 patients receiving 44 times of endovascular intervention for infrapopliteal arterial occlusion during Nov. 2006 and Dec. 2007. The average age was 76±6. The ABI(ankle brachial index)before intervention was 0.39±0.20 in anterior tibial artery and 0.39±0.23 in posterior tibial artery. CLI (critical limb ischemia) was 80.49% (33/41). Results The after intervention ABI increased by 0.43±0.22 (P<0.01) in anterior tibial artery and 0.43±0.25(P<0.01)in posterior tibial artery. 35 patients (36 limbs) were followed-up for (6±3) months. The limbs of Fontaine Ⅰ and Fontaine Ⅱ A were 28 (77.78%), CLI decreased to 19.44% (7/36) (P<0.01). At follow-up the ABI in anterior tibial artery was 0.63±0.22 and 0.56±0.22 in posterior tibial artery. The difference were all significant when compared with that before intervention and after intervention. The perioperative amputation rate was 0. The perioperative mortality rate was 2.5%. The total mortality rate was 15%. The limb salvage rate were 100%. Conclusion The effect of endovascular intervention for infrapopliteal arterial occlusion is satisfactory.
3.Clinical analysis of central venous stenosis In 5 hemodialysis patients without a previous history of catheterization
Yaxue SHI ; Meng YE ; Hao ZHANG ; Wei LIANG ; Jiwei ZHANG
Chinese Journal of Nephrology 2011;27(3):186-189
Objective To evaluate imaging findings and treatment experience in central venous stenosis without a history of previous catheterization in hemodialysis patients. Methods Clinical data of 5 haemodialysis cases of central vein stenosis without a previous catheterization history in our hospital from July 2006 to July 2008 were analyzed retrospectively. Results Patients were three women and two men aged 43 to 65 years with mean age(53±8)years and all had arm swelling as the main complaint.The vascular accesses were located at the wrist in all the patients.The mean duration of the vascular accesses from the time of creation was(33.6±35.4)months.Venography showed occlusion in 2 cases and stenosis in 3 cages of central vein including 1 case of stenosis in brachiocephalic vein.1 case of stenosis beth in branchiocephalic vein and subclavian vein,1 case of stenosis in two segments of subclavian vein.The stenosis of branchiocephalic vein was fixed anterior to the tracheal and CT showed the compression of the vein by the aorta.Symptoms were resolved by the treatment of PTA.subclavian vein-contralateral subclavian vein bypass and ligation of the access. Conclusions Central venous stenosis in haemodialysis patients without a history of catheterization may be due to the intimal hyperplasia of the compression site or valve which is accelerated by the high flow of vascular access.Venography is the first choice for the diagnosis and the current management of central venous stenosis is far from being effective for the long term.
4.Inferior vena cava filter is not always necessary during catheter directed thrombolysis for deep vein thrombosis
Hao ZHANG ; Guanhua XUE ; Wei LIANG ; Jiwei ZHANG ; Baigen ZHANG
Chinese Journal of General Surgery 2010;25(7):543-545
Objective To explore the necessity of inferior vena cava(IVC) filter implantation during catheter directed thrombolysis (CDT) for acute deep vein thrombosis (DVT). Method Ninety-three patients with acute DVT were reviewed from Nov. 2006 to Dec. 2008. There were 35 men and 58 women, age averaging at (60 ±29) year old, treated with CDT followed by percutaneous transluminal angioplasty ( PTA). The course of DVT was from 5 h ~ 15 d (6. 28 ±7.08) d with 80 left lower limbs and 13 right lower limbs involved. Results There were 30 patients with prior IVC filter implanted compared with 63 patients without filters (67. 7% ,63/93). Among the patients without filter, there were 93. 6% (59/63) left lower limbs. DSA was redone after thrombolysis. Seventy-seven iliacfemoral thrombosis was resolved completely and stenosis or occlusion of the iliac vein were found in 90. 9% (70/77) cases. Endovascular treatment was performed in 57 patients. There was no patients suffering from symptomatic pulmonary embolism (PE). PE was found in 3 cases with a filter and 1 case without filter was suspected of PE on pulmonary CTA after treatment. Conclusion It is not necessary to routinely place an IVC filter during CDT for treating DVT on left lower limb when the thrombosis is not involing the IVC.
5.Diagnosis and treatment of critical limb ischemia
Yaxue SHI ; Hao ZHANG ; Jiwei ZHANG ; Baigen ZHANG
Chinese Journal of General Surgery 2008;23(10):771-773
Objective To evaluate the clinical result of arterial reconstruction in critical limb isehemia. Methods Clinical data of 123 cases (137 lower extremities ) of critical limb ischemia ( Fontaine Ⅳ ), 79 males and 44 females, with a mean age of ( 74 ± 9 ) years, undergoing arterial reconstruction, were reviewed. Comorbidities included tobacco use (33. 33% ), coronary artery disease (43.09%), hypertension ( 50. 41% ), cerebral vascular disease ( 29. 27% ), and diabetes mellitus(52. 33% ). Result Perioperative mortality rate was 4. 88%, and 88. 89% cases were followed up with amean time of (18 ± 18) months and the mortality rate was 13.01%. The postoperative pateney rate of1 year, 2 years and 3 years was (81±4)% ,(68±6)% and (61±7)% respectively. Arterial occlusion occurred in 25 cases, 4 cases received reoperation and 9 cases received major amputation. Tissue healing rate was 78. 85% after half a year and 83. 65% after 1 year. The limb salvage rate was (81±4)% ,(71 ±5 )% and (65 ± 6)% after 1 year, 2 years and 3 years respectively. Conclusion Arterial reconstruction for the critical limb ischemia increases the limb salvage rate with satisfactory patency rate and improves the healing of ulcer.
6.Gemstone Spectral CT Imaging in Diagnosis of Gastric Stromal Tumor
Xuting ZHANG ; Qi LIU ; Yajing HAO ; Hongxing JIN ; Jiwei REN
Chinese Journal of Medical Imaging 2015;(4):264-267
Purpose To investigate the CT gemstone spectral imaging features of gastric stromal tumors (GST), so as to discuss the value of CT gemstone spectral imaging in the diagnosis and differential diagnosis of GST. Materials and Methods Thirty patients with GST proved pathologically were scanned by gemstone spectral imaging. Their GSI scanning image data and the related clinical data were retrospectively analyzed, and the quantitative analysis based on iodine content of the lesions in both arterial phase and portal phase was carried out. Results The GSI findings showed that the lesions were intra-luminal, extra-luminal or both intra-and extra-luminal soft tissue mass, the sizes were various, and they protruded either toward the inner side of stomach or the opposite or both. Among them, the diameter of 4 tumors in the low risk group ranged from 1 to 5 cm; in the intermediate risk group, 3 tumors had diameters from 1 to 5 cm, and 3 others were from 6 to 19 cm; in high-risk group, 18 tumors' diameter were between 6 to 9 cm, 2 were between 1 to 5 cm, and the rest 1 had multiple lesions in various sizes. Fifteen tumors occurred in gastric body, 10 occurred in gastric antrum, 4 were at the bottom of the stomach, and 1 had multifocal growth. Sixteen patients had internal and external growth of lesions, among whom 14 patients were at high risk; 10 patients' lesions were outside the cavity, including 6 patients at high risk and 1 patient at low risk; and 4 patients had lesions inside the cavity, including 3 patients at low risk. At the arterial phase the foci mildly strengthened, and they strengthened increasingly at the portal phase. The material value based water and iodine figure showed that material value based iodine of the lesions at both arterial phase and portal phase was higher than that in the normal gastric wall tissue, and the material value based iodine of the lesions at portal phase was higher than that at arterial phase (F=378.6 and 296.6, P<0.05). At arterial phase, the iodine content of the lesions in the mucosa was slightly higher than that in the submucosa and muscular layer (t= - 2.245, P<0.05). Conclusion CT gemstone spectral imaging can accurately show the external forms and internal changes of GST lesions and iodine content measurement can provide quantitative diagnostic information, therefore they can provide more effective information for clinical diagnosis.
7.The effect of re-operation on postoperative arterial bypass occlusion in lower limbs
Hao ZHANG ; Jiwei ZHANG ; Yaxue SHI ; Baigen ZHANG
Chinese Journal of General Surgery 1993;0(02):-
Objective To review the experiences of re-operational effect for occluded arterial bypass in lower limbs. Method We analyzed the re-operational effect of 19 patients (20 limbs) with occluded arterial bypass in lower limbs from May 1996 to Fab 2004. A total of 31 operations were performed in these patients. Results The patent rate of simple thrombectomy in 18 cases was only 27.7% (5/18) with a rate of re-obstruction of 72. 3%(13/18). The period of patent outflow of another 13 re-operations with rebuilt of in-flow or out-flow varied at 4 days to 11 months. The patent rate in this group was 61.5% (8/13). The rate of re-obstruction was 38. 5% (5/13). The overall patent rate of re-operation was 41.9% (13/31). The average patent period was 9. 1 months (3-29 m). The operative mortality rate in 19 patients was 5. 3% (1/19). The limb salvage rate of 19 limbs in 18 patients was 73. 7%(14/19). The amputation rate was 25%(5/20). Conclusion The main cause of late re-obstruction of bypass procedure was endothelial proliferation and development of lesions. The effect of rebuilt of in-flow or out-flow was better than thrombectomy only. Duplex follow-up helps to find restenoses and manage the proliferated lesions before a bypass becomes occluded.
8.Evaluation of the expression of CD35 on red blood cells and CD11b on neutrophils in patients with chronic venous insufficiency
Lan ZHANG ; Baigen ZHANG ; Jiwei ZHANG ; Hao ZHANG
Chinese Journal of General Surgery 1993;0(03):-
Objective To investigate the expression of CD35 on red blood cells (RBC) and CD11b on neutrophils in patients with chronic venous insufficiency (CVI). Methods Anticoagulated peripheral venous blood was assayed by flow cytometry for CD35 expression on RBC and CD116 on neutrophils from 42 CVI patients in different clinical picture,etiology,anatomic distribution, pathophysiology (CEAP) and clinical classes, results were compared with that of eight normal control subjects. Result Circulating neutrophils were more reactive to CDllb in CVI C5-C6 patients. Higher expression of CD35 on RBC were observed in C4 patients. Conclusion CD35 on RBC and CDllb on neutrophils may participate in the pathogenesis and to an extent reflect the severeness of CVI.
9.Acute injury to cerebral function produced by isoflurane anesthesia given at different time interval in neonatal rats
Jing YANG ; Mengmeng LI ; Jiwei HAO ; Xiaoyan FANG ; Qinghong ZHANG ; Jiaguang TANG ; Jianhua HAO
Chinese Critical Care Medicine 2016;28(3):267-271
Objective To investigate effects of isoflurane anesthesia of different time interval on acute injury of brain function in neonatal rats with consistent total time of isoflurane anesthesia. Methods Seven-day neonatal Sprague-Dawley (SD) rats were randomly divided into normal control group (breathe the air), continuous anesthesia group (a single 6-hour exposure to 1.5% isoflurane), and intermittent anesthesia 1 day and 3 days groups (three times of 2-hour exposure to anesthesia with an interval of 1 day or 3 days), 12 rats in each group. The ratio of male to female was 5:7. They underwent the test of learning and memory in the radial arm maze (RAM) 21 days after birth, twice a day for 4 days. The number of entry into wrong arms, number of repeated errors, number of total arm entries, and time for completing the task were recorded for evaluation of effect of neonatal isoflurane on cognitive behavior in rats. Results ① Compared with normal control group, the percentage of number of errors > 3 in anesthesia of 3-day interval group was significantly decreased (33.3% vs. 46.9%, P < 0.05), the percentages of repeated errors > 0 and total arm entries > 8 were significantly increased (33.3% vs. 18.8%, 27.1% vs. 13.5%, both P < 0.05), but there were no statistically significant difference in the percentage of mistake number > 3 between continuous anesthesia group, interval anesthesia 1-day group and the normal control group (44.8%, 44.8% vs. 46.9%), the percentages of number of repeated mistake > 0 and total arm entries > 8 in above three groups were slightly increased as compared with those of normal control group (27.1%, 22.9% vs. 18.8%, 20.8%, 21.9% vs. 13.5%, all P > 0.05). No statistical differences in completing the task among normal control group, continuous anesthesia group, interval anesthesia 1 day and 3 days groups were found (minutes: 1.32±0.91, 1.54±1.05, 1.46±0.86, 1.38±0.79, all P > 0.05). ② It was found by gender analysis that the percentages number of repeated errors > 0 and total arm entries > 8 were significantly lower in female rats than those in the male rats only in normal control group (5.0% vs. 28.6%, P < 0.01; 5.0% vs. 19.6%, P < 0.05). There was no obvious gender difference in exposed groups. ③ Compared between groups of female rats, the percentages of repeated mistake > 0 in continuous anesthesia group, interval anesthesia 1 day and 3 days groups (25.0%, 25.0%, 30.0% vs. 5.0%, P < 0.05 or P < 0.01) and the percentage of total arm entries > 8 in interval anesthesia 1 day and 3 days groups were significantly higher than that of normal control group (22.5%, 25.0% vs. 5.0%, both P < 0.05). No significant difference about the RAM task in male rats of all the four groups was found. Conclusions Different time interval of neonatal isoflurane exposure may develop certain degree of acute brain injury in rats, characterized by cognitive function. Prolongation of the interval time significantly enhanced long-term memory in rats. Multiple neonatal exposures to isoflurane were associated with greater cognitive impairment than a single exposure. In addition, isoflurane can significantly increase cognitional functional disorder in the female, not in the male rats.
10.Endovascular treatment of chronic total occlusions of the iliac vein
Meng YE ; Xiaozhong HUANG ; Guanhua XUE ; Hao ZHANG ; Yiping ZHAO ; Yaxue SHI ; Jiwei ZHANG
Chinese Journal of General Surgery 2011;26(3):195-198
Objective To present clinical results of endovascular treatment of total iliac vein occlusions and to discuss the technique details of this treatment. Methods From Feb 2006 to Aug 2010,15 patients with chronic total occlusive lesions of the iliac vein and adjacent vein segments underwent endovascular treatment. Average age was (62 ±7) years (range 35 to 81 years), the male/female ratio was 12: 3. Clinical score of CEAP was grade 3 in 33. 3%, grade 4 in 40%, grade 5 in 13. 3%, and grade 6 in 13.3%. Venography showed left iliac vein was occluded in all 15 patients, common femoral vein was occluded in 14 patients, and superior femoral vein was occluded in 9 patients, however profounder femoral vein was patent in these patients with superior femoral vein being occluded. Results No postoperative major morbidity or mortality was seen. The technique success rate was 93. 3%. Treatment failure was caused in one case for a wrong selection of the femoral vein approach site. The average length of stent was 18. 4 cm.In 12(80. 0% ) stents crossed the inguinal ligament. The average follow-up time was 11.6 ± 2. 4 months.The primary patency rates of the stents at 6 months were 92. 9%. 10 (66. 7% ) patients were asympotomatic, 3(20% )were improved, 1 (6. 7% ) was unchanged, and 1 (6.7%) was worse, compared to before intervention. Conclusions Endovscular recanalization and stent placement is a safe and effective treatment for chronic total occluded iliac veins, with good patency, significant symptom resolution, and minimal morbidity in the short term follow-up.