Aeromedical evacuation, a crucial method for casualty transport, significantly enhances survival rates by providing exceptionally rapid transfer and thus gaining valuable treatment time. However, due to the contamination risks during the transport of radioactively contaminated casualties, aeromedical evacuation has not been widely adopted for this specific scenario. This paper reviews the current status of aeromedical evacuation for radioactively contaminated casualties and identifies several challenges. These include incomplete evacuation procedures and regulatory frameworks, difficulties in rapid triage and classification, inadequate evacuation and loading equipment, and the complexity of managing specific injuries during flight. We propose corresponding strategies to address these issues, aiming to provide a reference and guidance for the advancement of aeromedical evacuation for radioactively contaminated casualties.

Objective To compare the effects of two surgical methods(duodenal papillary reconstruction and small duodenal papillary incision+large balloon dilation)on Oddi's sphincter function in patients with common bile duct stones.Methods From January 2021 to December 2022,64 patients with large common bile duct stones underwent endoscopic retrograde cholangiopancreatography(ERCP)stone removal surgery,which were randomly divided into two groups using a lottery method(32 cases each).Group A underwent ECPP,while Group B underwent limited EST plus EPLBD.Before the procedure,immediately after procedure,and one month after procedure,duodenal pressure measurements(Oddi sphincter basal pressure,maximum systolic pressure,and systolic frequency)were conducted to observe changes in various measurement indicators,and to compare the incidence of short-term and long-term complications between the two groups.Results The basal pressure,maximum systolic pressure and systolic frequency of the Oddi sphincter in both groups immediately after the operation and one month after the operation showed a trend of first decreasing and then increasing,and were all lower than those before the operation,and the differences were statistically significant(P＜0.05).There were no statistically significant differences in the basic pressure,maximum systolic pressure and systolic frequency of the Oddi sphincter immediately after surgery between the two groups(P＞0.05).One month after the operation,the basal pressure,maximum systolic pressure and systolic frequency of the Oddi sphincter in group A were(21.12±4.08)mmHg,(113.60±12.07)mmHg and(6.10±0.96)times/minute,respectively.The values in group B were(16.28±1.64)mmHg,(104.19±19.25)mmHg,and(5.68±1.02)beats/minute,respectively.The values in group A were all higher than those in group B,and the differences were statistically significant(P＜0.05).The incidences of gas reflux in group A at 1 week,6 months and 12 months after surgery were 6.25％,3.13％and 0 respectively,while those in group B were 21.88％,15.63％and 12.50％respectively.The incidences of barium reflux in group A were 3.13％,0 and 0 respectively,and those in group B were 12.50％,9.38％ and 6.25％ respectively.There were statistically significant differences between the two groups(P＜0.05).The total incidence of short-term and long-term complications after surgery was close(34.38％and 31.25％),and there was no statistically significant difference between the two groups(P＞0.05).Conclusion Compared with limited EST plus EPLBD,ECPP is more helpful for the recovery of Oddi's sphincter function,and this surgical procedure is simple to operate without increasing the risk of postoperative complications.

Objective To compare the effects of two surgical methods(duodenal papillary reconstruction and small duodenal papillary incision+large balloon dilation)on Oddi's sphincter function in patients with common bile duct stones.Methods From January 2021 to December 2022,64 patients with large common bile duct stones underwent endoscopic retrograde cholangiopancreatography(ERCP)stone removal surgery,which were randomly divided into two groups using a lottery method(32 cases each).Group A underwent ECPP,while Group B underwent limited EST plus EPLBD.Before the procedure,immediately after procedure,and one month after procedure,duodenal pressure measurements(Oddi sphincter basal pressure,maximum systolic pressure,and systolic frequency)were conducted to observe changes in various measurement indicators,and to compare the incidence of short-term and long-term complications between the two groups.Results The basal pressure,maximum systolic pressure and systolic frequency of the Oddi sphincter in both groups immediately after the operation and one month after the operation showed a trend of first decreasing and then increasing,and were all lower than those before the operation,and the differences were statistically significant(P＜0.05).There were no statistically significant differences in the basic pressure,maximum systolic pressure and systolic frequency of the Oddi sphincter immediately after surgery between the two groups(P＞0.05).One month after the operation,the basal pressure,maximum systolic pressure and systolic frequency of the Oddi sphincter in group A were(21.12±4.08)mmHg,(113.60±12.07)mmHg and(6.10±0.96)times/minute,respectively.The values in group B were(16.28±1.64)mmHg,(104.19±19.25)mmHg,and(5.68±1.02)beats/minute,respectively.The values in group A were all higher than those in group B,and the differences were statistically significant(P＜0.05).The incidences of gas reflux in group A at 1 week,6 months and 12 months after surgery were 6.25％,3.13％and 0 respectively,while those in group B were 21.88％,15.63％and 12.50％respectively.The incidences of barium reflux in group A were 3.13％,0 and 0 respectively,and those in group B were 12.50％,9.38％ and 6.25％ respectively.There were statistically significant differences between the two groups(P＜0.05).The total incidence of short-term and long-term complications after surgery was close(34.38％and 31.25％),and there was no statistically significant difference between the two groups(P＞0.05).Conclusion Compared with limited EST plus EPLBD,ECPP is more helpful for the recovery of Oddi's sphincter function,and this surgical procedure is simple to operate without increasing the risk of postoperative complications.

Objective To compare the role of CTE and CE on the diagnosis of small bowel diseases and evaluate their advantages in patients with different indications.Methods Patients underwent both CTE and CE(interval time <2 weeks)at our institution in recent 3 years were enrolled.The positive detection rates,lesion properties and characteristics of CTE and CE were compared.The diagnostic accuracy of combined method was also analyzed.Results A total of 47 patients were enrolled and the indications included suspected or established Crohn′s disease (28 cases),unexplained abdominal pain (14 cases), obscure gastrointestinal bleeding(3 cases),insufficient small bowel obstruction(1 case)and protein losing enteropathy(1 case).Diagnostic yield of CTE and CE for whole small bowel disorders showed no significant difference(CE 83.0% VS CTE 78.7%,P =0.791).For suspected or established CD,CE had a higher diagnostic accuracy than CTE (78.6% VS 35.7%,P =0.002 ),especially in detecting lesions in the jejunum(CE 50.0% VS CTE 7.1%,P =0.002).The diagnostic accuracy reached 100.0% when two meth-ods were combined.For unexplained abdominal pain,no significant difference was found in the diagnostic ac-curacy of CE and CTE(CTE 42.8% VS CE 50.0%,P =1.000).Diagnostic accuracy of combining CTE and CE was 85.7%.Conclusion CTE and CE are both valuable in detecting small bowel lesions.For pa-tients with suspected or established CD,CE is better than CTE.For patients with unexplained abdominal pain,a combination of CTE and CE may be a better strategy than use CTE or CE alone.