Treating traumatic brain injury at sea:how to improve the skills and capabilities of the naval medical personnel

Dear Editor,Recent advances in military technology have led to the development of sophisticated and intelligent weapons, which increase mortality and morbidity. Since the advent of highexplosion weapons, "shock wave" has surpassed "shrapnel" and become the most important injurious component in conventional combat. Traumatic brain injury(TBI) is a leading cause of disability and death among military personnel and civilians during wartime[1]. Clinically, its symptoms and indications vary depending on the location and severity of the injury. The most frequently observed symptoms included altered consciousness and local dysfunction.

Red mud and fly ash-based ceramic foams using starch and manganese dioxide as foaming agent

Ceramic foams were prepared using red mud and fly ash as raw materials with sodium borate as sintering aid agent,starchand MnO2as foaming agent,respectively.The influence of the amount of starch or MnO2on the crystalline phase,pore morphologyand physical–chemical porosities was studied.The results showed that the main crystal phases of samples with starch addition andMnO2addition were sodalite phase Na6(AlSiO4)6and Na8(SiAlO4)6MnO4,respectively.The SEM images showed that the variation ofporous structure was mainly dominated by the addition of foaming agent.With the increase of foaming agent,the samples exhibitedbetter comprehensive properties:bulk density of0.59?0.96g/cm3,porosity of41.82%?63.51%,water absorption of3.16%?9.17%,compressive strength of4.22?8.38MPa,flexural strength of2.44?5.82MPa,acid resistance of95.59%?99.60%,alkali resistance of99.82%?99.99%.Based on these properties,the ceramic foams can be used in building field.

Medical rescue of naval combat: challenge and future

There has been no large-scale naval combat in the last 30 years. With the rapid development of battleships, weapons manufacturing and electronic technology, naval combat will present some new characteristics. Additionally, naval combat is facing unprecedented challenges. In this paper, we discuss the topic of medical rescue at sea: what challenges we face and what we could do. The contents discussed in this paper contain battlefield self-aid buddy care, clinical skills, organized health services, medical training and future medical research programs. We also discuss the characteristics of modern naval combat, medical rescue challenges, medical treatment highlights and future developments of medical rescue at sea.

Combination of dura turning-over and decompressive craniectomy： a new pattern of surgery for cerebral infarction caused by craniocerebral gunshot injury

Background:Craniocerebral gunshot injury refers to a wound caused by a bullet passing through or lodged in brain tissue,resulting in the loss of function of a certain area or other fatal damage to the human brain.Craniocerebral gunshot injury is usually life-threatening and is very common in modern warfare,accounting for the majority of battle casualties.Most of the patients suffer from acute cerebral infarction caused by vascular injury.Lack of early and solid battlefield emergency medical interference adds to the risk of death among the wounded.Case presentation:We present a 24-year-old man who was shot with a shotgun from a distance of 15m in an accidental injury.Forty-seven grape shots were found on his body surface by physical examination.A computed tomography(CT)scan demonstrated large areas of low-density shadows in his right parietal lobe and right temporal lobe with the midline shifting to the left side 2 days later.Afterwards,the patient was transferred to our emergency medical center at Changzheng Hospital in Shanghai.Cranial computed tomography angiography(CTA)showed a high-density shadow in the initial part of the right middle cerebral artery.The branches after the initial part were obliterated.Prompt medical attention and decompressive craniotomy(DC)surgery contributed to the final recovery from cerebral infarction of this patient.Conclusion:Bullets can penetrate or be lodged in the brain,causing intracranial hypertension.The bullets lodged in the brain can result in stenosis and embolism of a cerebral artery,causing acute cerebral infarction.Combining dura turning-over surgery with DC surgery can not only decrease intracranial pressure,which can increase the blood supply for hypertension-induced vessel stenosis,but also help vessels outside the dura mater grow into ischemic areas of the cerebral cortex.However,this new pattern of surgery needs further support from evidence-based medicine.

钢筋增强超高韧性水泥基复合材料梁的剪切性能试验研究（英文）

目的:揭示不同剪跨比和配箍率的钢筋增强超高韧性水泥基复合材料(RUHTCC)梁的抗剪性能,为超高韧性水泥基复合材料(UHTCC)用于结构关键抗剪部位提供参考。方法:基于抗剪试验结果,阐明剪跨比和配箍率对RUHTCC梁抗剪性能的影响,明确UHTCC与箍筋之间的复合抗剪效应,揭示RUHTCC梁的抗剪机理。方法:以剪跨比和配箍率为变量参数,通过RUHTCC梁在跨中集中荷载作用下的弯曲试验,研究RUHTCC梁的剪切裂缝形态、荷载-挠度行为、破坏模式、开裂剪切强度和极限剪切强度等抗剪性能,并结合试验结果,分析RUHTCC梁的剪力传递机理。结论:1.RUHTCC梁呈现出优良的剪切抗力以及稳态的斜裂缝扩展过程和多缝剪切开裂行为。2.配置少量的箍筋可将典型的剪切破坏转变为较为延性的弯剪破坏甚至弯曲破坏。然而,箍筋的配置并未显著提高RUHTCC梁的抗剪能力,同时耦合UHTCC与箍筋也没有表现出协同抗剪效应。3.拉杆-拱模型和桁架-拱模型可用以描述RUHTCC短梁和细长梁的抗剪机理。

Military Brain Science - How to influence future wars

Military Brain Science is a cutting-edge innovative science that uses potential military application as the guidance. It was preliminarily divided into 9 aspects by authors： understanding the brain, protecting the brain, monitoring the brain, injuring the brain, interfering with the brain, repairing the brain, enhancing the brain, simulating the brain and arming the brain. In this review, we attempt to propose the concept, content and meaning of the Military Brain Science, with the hope to provide some enlightenment and understandin~ of the research area.