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Research on the application of 5G private network technology in medical emergencies

Xiaohua HU ; Ming LI ; Jia SHI ; Yafeng RONG ; Lijie ZHANG

Chinese journal of nautical medicine and hyperbaric medicine.2022;29(2):238-241. doi:10.3760/cma.j.cn311847-20210531-00174

In order to better serve the military and accelerate the digital transformation of medical treatment，we studied how to integrate and apply 5G private network technology in emergency information system，so as to improve the utilization rate of emergency resources，win more time for emergency patients，and establish an efficient and quality medical emergency service model，thus enhancing the health service capability of military hospitals. Based on the high bandwidth and low latency technologies of 5G private network，this study aimed to realize smooth real-time transmission and processing of medical data under multi-type service pattern of medical emergency，and to broaden the scope of medical emergency services of hospitals.

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Discussion on triage and treatment for surviving crew members after a submarine accident — taking NATO triage and treatment system as an example

Wenwu LIU ; Shuo YAN ; Jie CHEN ; Ci LI ; Jiajun XU ; Xuhua YU ; Shifeng WANG

Chinese journal of nautical medicine and hyperbaric medicine.2022;29(3):281-284. doi:10.3760/cma.j.cn311847-20210710-00201

At present，there is no triage and treatment system in China for the surviving crew members after a submarine accident. The North Atlantic Treaty Organization（NATO）provides a Triage and Treatment System for the management of diseases for the patients after a submarine accident. This system classifies diseases into four types，i.e.，T1，T2，T3，and T4，according to the severity of the specific disease. Furthermore，the diseases are classified into type C1 and C2 depending on whether the hyperbaric therapy is needed. The treatment zone is divided into 5 areas：triage area，grade 1 treatment area，grade 2 treatment area，grade 3 treatment area，and T4 treatment area. Based on our previous experience in teaching submarine rescue，we put forward some suggestions for improvement on the system，so as to provide a point of reference for the development of Chinese triage and treatment system after a submarine accident in future.

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Evaluation on thermal insulation performance of a new fast buoyant ascent escape suit in a specific low temperature environment

Shi ZHANG ; Jinghua GU ; Chumeng LIU ; Pingxiao LIU

Chinese journal of nautical medicine and hyperbaric medicine.2022;29(3):285-288. doi:10.3760/cma.j.cn311847-20211202-00325

Objective:To evaluate the thermal insulation performance of a new fast buoyant ascent escape suit in a specific low temperature environment，so as to provide a basis for the subsequent development of the suit and determining the stand-by time on the surface for rescue.Methods:Five subjects in new fast buoyant ascent escape suits were placed in a low temperature environment with water temperature（-1.0 ± 1.0）℃，air temperature（-2.0 ± 1.0）℃ and wind speed（9.0 ± 0.2）m/s . The changes of core body temperature，average body surface temperature，and heart rate were observed，and the participants’ subjective feelings and tolerance periods of time were recorded.Results:The core body temperature，average body surface temperature，and heart rate of the 5 subjects were within normal range. The tolerance periods of time were all more than 6 h，and the longest period of time reached 6.5 h.Conclusion:The thermal insulation performance of the new fast buoyant ascent escape suit can be maintained for more than 6 hours in a specific low-temperature environment，which meets the design requirements.

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CiteSpace-based visualization analysis of hotspots and frontiers of hyperbaric oxygen research

Ruihua FENG ; Qingli DOU ; Ya’nan GU

Chinese journal of nautical medicine and hyperbaric medicine.2022;29(3):294-299,303. doi:10.3760/cma.j.cn311847-20210416-00118

Objective:To analyze the hotspots and frontiers of hyperbaric oxygen（HBO）research in and out of China.Methods:HBO-related articles published on CNKI and Web of Science from January 1，2010 to December 31，2020 were analyzed by CiteSpace from the following aspects such as the country，institution，author，and high-frequency key words，etc.Results:The study included 9，911 Chinese and 5，193 English literature. The knowledge mapping analysis showed that the HBO departments in Chinese hospitals were currently the main institutions in contributing Chinese articles on HBO，with few close collaborations among them；there were three relatively large HBO research teams in China，and the co-authorship within each team was common，while the cooperation between teams was not so close. The US had the most HBO-related articles published in English，followed by China and Turkey，and the articles published in the US had the strongest centrality in the map. The authors of English articles mainly came from five research teams，with relatively close cooperation within and among the teams. Key words co-occurrence and cluster analyses of Chinese articles showed that the research hotspot was applied research on the therapeutic evaluation of HBO in the treatment of various diseases，such as CO poisoning，sudden deafness，cerebral infarction，severe craniocerebral injury，delayed encephalopathy，cerebral hemorrhage，diabetic foot，hypoxic-ischemic encephalopathy，brain edema，etc. Key words co-occurrence and cluster analyses of English articles showed that the hot topics included basic experimental research on HBO mechanism，such as oxidative stress，expression，and apoptosis，and research on clinical application of HBO therapy in radiation injuries from cancer treatment，cerebral ischemia，decompression sickness，CO poisoning，traumatic brain injury，stroke，and diabetic foot ulcer，etc.Conclusion:Research focuses of HBO in and out of China were not completely same. In China，researchers focus on clinical application of HBO，while out of China，basic experimental research on HBO receives more attention.

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Efficacy of hyperbaric oxygen combined with citalopram in depressed patients with traumatic brain injury

Shuangshuang WEN ; Zhijuan WANG ; Lin LIU

Chinese journal of nautical medicine and hyperbaric medicine.2022;29(3):300-303. doi:10.3760/cma.j.cn311847-20210125-00033

Objective:To study the clinical efficacy and action mechanism of hyperbaric oxygen combined with citalopram in treating depressed patients with traumatic brain injury（TBI）.Methods:A total of 114 patients with post-TBI depression treated in Yantaishan Hospital from January 2019 to December 2021 were selected and divided into control group and observation group by random number table method，with 57 patients in each group. The control group was treated with citalopram，and the observation group was treated with hyperbaric oxygen in addition to the treatment in the control group. Before treatment and at 2，4，and 6 weeks of treatment，Hamilton Depression Scale（HAMD）was used to score depression and calculate the treatment response rate. Serum 5-hydroxytryptamine（5-HT）and dopamine（DA）levels were detected by enzyme-linked immunosorbent assay.Results:After 6 weeks of treatment，the total effective rate of the observation group（94.74%）was significantly higher than that of the control group（80.70%），and the difference was statistically significant（ P<0.05）. The levels of Serum 5-HT and DA in both groups were significantly increased compared with those before treatment，and the levels of serum 5-HT and DA in the observation group were significantly higher than those in the control group at 4 and 6 weeks after treatment，and the differences were statistically significant（ P<0.05）. The HAMD scores in both groups were significantly lower than those before treatment，and the HAMD score in the observation group was lower than those in the control group at 4 and 6 weeks after treatment，and the differences were statistically significant（ P<0.05）. Conclusion:Hyperbaric oxygen combined with citalopram can improve the depressive symptoms of TBI patients，and its action mechanism is mainly achieved by increasing the serum levels of serum DA and 5-HT.

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Effects of hyperbaric oxygen combined with Adriamycin on HepG2 cell apoptosis and immunomodulatory factors in transplanted hepatocellular carcinoma of nude mice

Peng YAO ; Xiuli WANG ; Xiaozheng LI ; Haimin LI ; Jiayong NING ; Jiasui CHAI ; Jiejie DONG

Chinese journal of nautical medicine and hyperbaric medicine.2022;29(3):304-307,316. doi:10.3760/cma.j.cn311847-20210516-00155

Objective:To explore the effects of adriamycin（Adc）combined with hyperbaric oxygen（HBO）on the apoptosis of HepG2 cells and immunomodulatory factors in transplanted hepatocellular carcinoma（HCC）tissues in nude mice.Methods:The model of transplanted HCC was established in 20 nude mice，then the mice were divided into four groups：control group，HBO group，Adc group，and HBO + Adc group，with five mice in each group. The control group was reared normally. The HBO group was treated with HBO at 0.20 MPa for 1 h；the Adc group was treated with 10 mg/kg of Adc by gavage；the HBO + Adc group was treated with HBO at 0.20 MPa for 1 h and then given 10 mg/kg of Adc by gavage. All groups were treated once every other day for 21 days. After drug withdrawal，the tumors were dissected from the sacrificed mice，of which the tumor volume and weight were measured. The apoptosis of HepG2 cells was detected by TUNEL. The changes of apoptosis-related proteins in HepG2 cells were detected by western blotting. The changes of the contents of immunomodulatory factors in transplanted tumor tissues of nude mice were detected by ELISA.Results:After 21 days，the tumor volume and weight in the HBO + Adc group were lower than those in the other three groups（ P<0.05）. The proportion of apoptotic cells in the transplanted tumor tissues of nude mice of the HBO + Adc group was the highest. In the HBO + Adc group，the protein expression levels of Bax，caspase-3，and Cytochrome C were significantly increased；the protein expression of Bcl-2 was significantly reduced（ P<0.01）；and the IL-6 was significantly reduced；while the IL-18 and IFN-γ were significantly increased（ P<0.05）. Conclusion:The Adc combined with HBO can promote apoptosis of HepG2 cells in transplanted HCC tissues in nude mice，and effectively regulate the immunomodulatory factors to promote the recovery of the body’s immune function，suggesting obvious sensitizing and detoxifying effects.

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Study on hyperbaric oxygen enhancing the sensitivity of cervical cancer cells（Hela）to cisplatin

Liping WANG ; Yan LIANG ; Zhanying XU ; Jing ZHAO ; Xinli LI

Chinese journal of nautical medicine and hyperbaric medicine.2022;29(3):308-311. doi:10.3760/cma.j.cn311847-20210508-00144

Objective:To discuss whether hyperbaric oxygen（HBO）can enhance the drug sensitivity of Hela cells to cisplatin（DDP）and how does it work.Methods:After the Hela cells were cultured，they were divided into control group，DDP group，HBO group，and HBO+DDP group. The control group was not treated. The DDP group was treated with 20 μmol/L DDP for 24 h. The HBO group was treated with 0.2 MPa HBO for 3 h，and the HBO+DDP group was treated with 20 μmol/L DDP for 24 h after HBO pretreatment for 3 h. The proliferation of Hela cells was detected by CCK-8 assay，and the apoptosis of Hela cells was detected by flow cytometry. Transwell assay was used to detect the migration ability of Hela cells，and western blotting was used to detect the expression levels of proteins related to the apoptosis of Hela cells.Results:The Hela cells survival rate in the DDP group was significantly lower than those in the control group and the HBO group，and was higher than that in the HBO+DDP group（ P<0.05）. The migration rate of Hela cells in the HBO+DDP group［（19.61±1.53）%］was significantly lower than that in the DDP group［（48.19±2.47）%］，and the difference was statistically significant（ P<0.05）. The apoptosis rate of Hela cells in the HBO+DDP group［（58.68±3.69）%］was significantly higher than that in the DDP group［（35.74±3.57）%］，and the difference was statistically significant（ P<0.05）. The protein expression levels of Bad and caspase-3 in Hela cells in the HBO+DDP group were significantly increased and the protein expression of Bcl-2 was significantly decreased compared with those in the DDP group，and the differences were all statistically significant（ P<0.05 or P<0.01）. Conclusion:The combination of HBO and DDP can improve the sensitivity of Hela cells to cisplatin chemotherapy by enhancing the proliferation inhibition，apoptosis-inducing，and migration-blocking effects of DDP on Hela cells.

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Effect of external diaphragm pacing combined with hyperbaric oxygen therapy on ventilator-induced diaphragm dysfunction

Bing LI ; Wenhao CHEN ; Pei LIU ; Huiping LI ; Weihua TAO ; Hongxuan ZHANG

Chinese journal of nautical medicine and hyperbaric medicine.2022;29(2):177-183,220. doi:10.3760/cma.j.cn311847-20210722-00213

Objective:To investigate the protective effect of external diaphragm pacing（EDP）combined with hyperbaric oxygen（HBO）therapy on preventing ventilator-induced diaphragm dysfunction（VIDD）and its related mechanism.Methods:A total of 100 adult male rats were randomly divided into five groups：blank control（BC）group，VIDD group，EDP group，HBO therapy group，and the combination of EDP and HBO therapy（EDP+HBO）group，with 20 rats per group. After tracheotomy，the BC group received no treatment，while the rats in the other four groups were given controlled mechanical ventilation to establish the VIDD rat model. And after successful modeling，the VIDD group did not receive further intervention，and the other three groups were treated accordingly. After 10 days of consecutive treatment，the changes in diaphragm weight（DW）and DW/body weight（BW），contraction force of diaphragm in vitro，and transection area of muscle fibers of each group were measured. Gene and protein expressions of diaphragm-related factors were detected. Results:Compared with the BC group，the DW，DW/BW，the transection area of muscle fibers，and the fiber structure and the contraction force of diaphragm in vitro of the VIDD group were decreased significantly. The expression levels of MHC-1，Keap1，Drp1，atrogin-1，MuRF-l，caspase-3，and beclin1 in the VIDD group were significantly increased while the expression levels of MHC-2，p-Akt，Mfn2，Nrf2，SOD，and GSH-Px were significantly decreased after treatment（ P < 0.05）. Compared with the VIDD group，the EDP+HBO group had higher DW and DW/BW［（0.35 ± 0.02）g vs.（0.63 ± 0.06）g，0.78 ± 0.08 vs. 1.34 ± 0.06，both P<0.05］，stronger contraction force of diaphragm in vitro［（1.15 ± 0.42）N/cm 2vs.（2.19 ± 0.10）N/cm 2， P < 0.05］，declining expression levels of MHC-1，Keap1，Drp1，atrogin-1，MuRF-l，caspase-3，and beclin1，increased expression levels of MHC-2，p-Akt，Mfn2，Nrf2，SOD，and GSH-Px，and much better diaphragmatic function，and all the differences were statistically significant（ P<0.05）. Conclusion:External diaphragm pacing combined with HBO therapy can significantly mitigate and decelerate VIDD by increasing the contraction force of the diaphragm，and reducing the oxidative stress，diaphragmatic atrophy and structural injury.

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Analysis of the therapeutic outcome of consciousness disorders following brain injuries caused by different mechanisms

Xingming PAN ; Xiaolei ZHANG ; Xinjia TIAN ; Zhiqiang GAO

Chinese journal of nautical medicine and hyperbaric medicine.2022;29(2):184-187. doi:10.3760/cma.j.cn311847-20201118-00429

Objective:To explore the therapeutic outcome of consciousness disorders induced by different brain injury mechanisms.Methods:A total of 130 patients with impaired consciousness after brain injuries treated in Nanjing Zijin Hospital from January 2016 to May 2021 were taken as research subjects. According to the causes of injury，they were divided into cerebrovascular accident group（ n = 37），brain trauma group（ n=68），hypoxic-ischemic encephalopathy group（ n = 7），and cerebral aneurysm group（ n = 18）. The patients in the four groups were all given comprehensive treatment，including hyperbaric oxygen（HBO）therapy，electrical stimulation，acupuncture，passive training，and drug therapy. The Glasgow Coma Scale（GCS）scores and China Nanjing persistent vegetative state scale（CNPVSS）scores of the four groups before treatment and after three months of comprehensive treatment combined with HBO were compared，and the consciousness recovery rate and the overall curative effect of the four groups were also compared. Results:After three months of comprehensive treatment combined with HBO，the GCS scores and CNPVSS scores of the four groups were improved compared with those before treatment（all P < 0.05）；the most significant increase of GCS scores and CNPVSS scores was in the cerebral aneurysm group. The highest consciousness recovery rate was in the cerebrovascular accident group（64.86%，24/37），followed by cerebral aneurysm group（55.56%，10/18），and there were statistically significant differences in the consciousness recovery rate among the four groups（ P < 0.01）. The overall effective rate was in the descending order of cerebrovascular accident group［86.49%（32/37）］，cerebral aneurysm group［83.33%（15/18）］，brain trauma group［69.12%（47/68）］，and hypoxic-ischemic encephalopathy group［42.86%（3/7）］，with statistically significant differences（ P < 0.05）. The cerebrovascular accident group and the cerebral aneurysm group achieve higher consciousness recovery rates and greater improvement in consciousness disturbance compared with the other two groups after three months of comprehensive treatment combined with HBO. Conclusion:Different injury mechanisms affect the therapeutic outcomes of consciousness disorders induced by brain injuries.

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Effect of transcranial direct current stimulation combined with hyperbaric oxygen on motor function in stroke patients with hemiplegia

Jing SUN ; Junying WU ; Huiling LIU ; Cong WANG

Chinese journal of nautical medicine and hyperbaric medicine.2022;29(2):188-192. doi:10.3760/cma.j.cn311847-20210922-00257

Objective:To study the therapeutic effects of transcranial direct current stimulation（tDCS）combined with hyperbaric oxygen（HBO）in the treatment of dyskinesia in stroke patients with hemiplegia.Methods:A total of 90 stroke patients with hemiplegia admitted to the Department of Rehabilitation of the First Hospital of Shanxi Medical University between March 2019 and March 2021 were selected. They were divided into observation group and control group according to the random number table method，with 45 patients in each group. All patients underwent conventional rehabilitation treatment. The control group was treated with tDCS，and the observation group was treated with tDCS on the basis of HBO therapy. The lower limb motor ability，balance ability，activity of daily living，nerve defects and surface electromyography parameters were compared between the two groups.Results:After treatment，the Fugl-Meyer Assessment Scale（FMA-L）scores and Berg Balance Scale（BBS）scores of the two groups were significantly increased，and the observation group had significantly higher scores than the control group. The differences were statistically significant（ P < 0.05）. After treatment，the ellipse area of the center of gravity trajectory when eyes opened and closed was significantly reduced in the two groups，and the ellipse area of the observation group was significantly smaller than that of the control group. The differences were statistically significant（ P < 0.05）. After treatment，the National Institutes of Health Stroke Scale（NIHSS）scores of the two groups were significantly reduced，and the observation group had significantly lower scores than the control group. Barthel Index scores of the two groups were significantly increased，and the observation group had significantly higher scores than the control group. The differences were statistically significant（ P < 0.05）. After treatment，the integrated electromyogram（iEMG）was significantly increased in the two groups，and the observation group had significantly higher iEMG than the control group. The synergistic contraction rate（CR）was significantly reduced，and it was significantly lower in the observation group than in the control group. The differences were statistically significant（ P < 0.05）. Conclusion:The combined treatment of tDCS and HBO can effectively improve the motor ability of stroke patients with hemiplegia，restore their balance ability and muscle activity，and promote the nerve function recovery and quality of life.

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