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Experimental and numerical study on protective effect of RC blast wall against air shock wave
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作者 Xin-zhe Nian Quan-min Xie +2 位作者 Xin-li Kong Ying-kang Yao Kui Huang 《Defence Technology(防务技术)》 SCIE EI CAS CSCD 2024年第1期567-579,共13页
Prototype experiments were carried out on the explosion-proof performance of the RC blast wall.The mass of TNT detonated in the experiments is 5 kg and 20 kg respectively.The shock wave overpressure was tested in diff... Prototype experiments were carried out on the explosion-proof performance of the RC blast wall.The mass of TNT detonated in the experiments is 5 kg and 20 kg respectively.The shock wave overpressure was tested in different regions.The above experiments were numerically simulated,and the simulated shock wave overpressure waveforms were compared with that tested and given by CONWEP program.The results show that the numerically simulated waveform is slightly different from the test waveform,but similar to CONWEP waveform.Through dimensional analysis and numerical simulation under different working conditions,the equation for the attenuation rate of the diffraction overpressure behind the blast wall was obtained.According to the corresponding standards,the degree of casualties and the damage degree of the brick concrete building at a certain distance behind the wall can be determined when parameters are set.The above results can provide a reference for the design and construction of the reinforced concrete blast wall. 展开更多
关键词 Blast wall shock wave DIFFRACTION OVERPRESSURE Protection
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Evolution of molecular structure of TATB under shock loading from transient Raman spectroscopic technique
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作者 Hongliang Kang Xue Yang +5 位作者 Wenshuo Yuan Lei Yang Xinghan Li Fusheng Liu Zhengtang Liu Qijun Liu 《Defence Technology(防务技术)》 SCIE EI CAS CSCD 2024年第3期613-620,共8页
By combination of the transient Raman spectroscopic measurement and the density functional theoretical calculations,the structural evolution and stability of TATB under shock compression was investigated.Due to the im... By combination of the transient Raman spectroscopic measurement and the density functional theoretical calculations,the structural evolution and stability of TATB under shock compression was investigated.Due to the improvement in synchronization control between two-stage light gas gun and the transient Raman spectra acquisition,as well as the sample preparation,the Raman peak of the N-O mode of TATB was firstly observed under shock pressure up to 13.6 GPa,noticeably higher than the upper limit of 8.5 GPa reported in available literatures.By taking into account of the continuous shift of the main peak and other observed Raman peaks,we did not distinguish any structural transition or any new species.Moreover,both the present Raman spectra and the time-resolved radiation of TATB during shock loading showed that TATB exhibits higher chemical stability than previous declaration.To reveal the detailed structural response and evolution of TATB under compression,the density functional theoretical calculations were conducted,and it was found that the pressure make N-O bond lengths shorter,nitro bond angles larger,and intermolecular and intra-molecular hydrogen bond interactions enhanced.The observed red shift of Raman peak was ascribed to the abnormal enhancement of H-bound effect on the scissor vibration mode of the nitro group. 展开更多
关键词 TATB Raman spectra Structural evolution shock loading
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Propagation Properties of Shock Waves in Polyurethane Foam based on Atomistic Simulations
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作者 Zhiqiang Hu Jianli Shao +2 位作者 Shiyu Jia Weidong Song Cheng Wang 《Defence Technology(防务技术)》 SCIE EI CAS CSCD 2024年第1期117-129,共13页
Porous materials are widely used in the field of protection because of their excellent energy absorption characteristics.In this work,a series of polyurethane microscopic models are established and the effect of poros... Porous materials are widely used in the field of protection because of their excellent energy absorption characteristics.In this work,a series of polyurethane microscopic models are established and the effect of porosity on the shock waves is studied with classical molecular dynamics simulations.Firstly,shock Hugoniot relations for different porosities are obtained,which compare well with the experimental data.The pores collapse and form local stress wave,which results in the complex multi-wave structure of the shock wave.The microstructure analysis shows that the local stress increases and the local velocity decreases gradually during the process of pore collapse to complete compaction.Finally,it leads to stress relaxation and velocity homogenization.The shock stress peaks can be fitted with two exponential functions,and the amplitude of attenuation coefficient decreases with the increase of density.Besides,the pore collapse under shock or non-shock are discussed by the entropy increase rate of the system.The energy is dissipated mainly through the multiple interactions of the waves under shock.The energy is dissipated mainly by the friction between atoms under non-shock. 展开更多
关键词 Polyurethane foam shock wave ATTENUATION Atomistic simulation
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Effect of the interval between two shocks on ejecta formation from the grooved aluminum surface
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作者 Mingyang Xu Jianli Shao +1 位作者 Weidong Song Enling Tang 《Defence Technology(防务技术)》 SCIE EI CAS CSCD 2024年第3期147-159,共13页
This work focuses on the effect of the interval between two shocks on the ejecta formation from the grooved aluminum(Al_(1100))surface by using smoothed particle hydrodynamics numerical simulation.Two unsupported shoc... This work focuses on the effect of the interval between two shocks on the ejecta formation from the grooved aluminum(Al_(1100))surface by using smoothed particle hydrodynamics numerical simulation.Two unsupported shocks are obtained by the plate-impact between sample and two flyers at interval,with a peak pressure of approximately 30 GPa for each shock.When the shock interval varies from 2.11 to 7.67 times the groove depth,the bubble velocity reduces to a constant,and the micro jetting factor R_(J) from spike to bubble exhibits a non-monotonic change that decreases initially and then increases.At a shock interval of 3.6 times the groove depth,micro jetting factor R_(J) from spike to bubble reaches its minimum value of approximately 0.6.While,the micro jetting factor R_(F) from spike to free surface decreases linearly at first,and stabilizes around 0.25 once the shock interval surpasses 4.18 times the groove depth.When the shock interval is less than 4.18 times the groove depth,the unloading wave generated by the breakout of the first shock wave is superimpose with the unloading part of the second shock wave to form a large tensile area. 展开更多
关键词 EJECTA MICROJET Two shocks INTERVAL Smoothed particle hydrodynamics
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Study of relationship between motion of mechanisms in gas operated weapon and its shock absorber
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作者 Jiri Balla Roman Vitek +2 位作者 Dung Nguyen Van Zbynek Krist Hung Nguyen Van 《Defence Technology(防务技术)》 SCIE EI CAS CSCD 2024年第3期42-54,共13页
The article deals with the motion of the breech block carrier and the weapon casing of an automatic weapon mounted on a flexible carriage and the base of the weapon.Earlier works,which did not consider the dynamic pro... The article deals with the motion of the breech block carrier and the weapon casing of an automatic weapon mounted on a flexible carriage and the base of the weapon.Earlier works,which did not consider the dynamic properties of the base of the weapon,did not allow to reconcile the calculated and experimental results of the weapon casing displacement when shooting from firing rests.For the analysis of the motion of individual parts,the methods of mathematical modelling and firing experiments using a high-speed camera were chosen.Calculations show the best accord with experiment when modelling the system with 4 degrees of freedom.The oscillation of the system regarding the movement of the breech block carrier and the weapon casing was investigated under changed conditions of rate of fire,the use of a muzzle brake and different types of shock absorbers.The velocities and displacements of the weapon casing and the breech block carrier at different values of the impulse of the gases to the breech block carrier were determined. 展开更多
关键词 shock absorber Gas-operated weapon Force-impulse diagram Recoil system Breech block carrier
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Prognostic value of N -terminal pro B-type natriuretic peptide and troponin I in children with dengue shock syndrome
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作者 Truyen Phuoc Le Phung Nguyen The Nguyen 《Asian Pacific Journal of Tropical Medicine》 SCIE CAS 2024年第4期166-172,共7页
Objective:To investigate the contribution of N-terminal pro B-type natriuretic peptide(NT-pro BNP)and troponin I to mortality in children with dengue shock syndrome.Methods:A longitudinal study was conducted on childr... Objective:To investigate the contribution of N-terminal pro B-type natriuretic peptide(NT-pro BNP)and troponin I to mortality in children with dengue shock syndrome.Methods:A longitudinal study was conducted on children with dengue shock syndrome in a hospital in southern Vietnam.Detailed clinical histories,physical examinations,and laboratory parameters,including NT-pro BNP and troponin I,were recorded.A comparison between survival and non-survival was carried out to identify factors influencing mortality.Results:A total of 107 patients with a median age of 9 years were included in the study.Among them,63.6%(68/107)presented with compensated shock,36.4%(39/107)had hypotensive shock,23.4%(25/107)required mechanical ventilation,and 12.1%(13/107)died.The NT-pro BNP levels were 3.9 pmol/L(IQR:1.9,10.3)and 15.2 pmol/L(5.8,46.3),while the median high sensitivity troponin I levels were 20 pg/L(6,95)and 62 pg/L(12,325)at the first and second measurements,respectively.The mortality group exhibited higher rates of hypotensive shock,prolonged shock,lactate levels,liver damage,NT-pro BNP,and troponin I levels.Hypotensive shock(OR 12.96,95%CI 2.70-62.30,P=0.004),prolonged shock(OR 39.40,95%CI 6.68-232.70,P<0.001),AST>1000 IU/L(OR 9.50,95%CI 2.63-34.34,P=0.041),and NT-pro BNP>7 pmol/L(OR 44.40,95%CI 5.44-362.20,P=0.001)were identified as predictive factors for mortality in dengue shock syndrome.Conclusions:The NT-pro BNP level could serve as a potential biomarker for predicting mortality in children with dengue shock syndrome. 展开更多
关键词 Dengue shock syndrome Cardiac enzyme NT-pro BNP Troponin I
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Experimental investigation on weak shock wave mitigation characteristics of flexible polyurethane foam and polyurea
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作者 Shiyu Jia Cheng Wang +2 位作者 Wenlong Xu Dong Ma Fangfang Qi 《Defence Technology(防务技术)》 SCIE EI CAS CSCD 2024年第1期179-191,共13页
In recent years,explosion shock wave has been considered as a signature injury of the current military conflicts.Although strong shock wave is lethal to the human body,weak shock wave can cause many more lasting conse... In recent years,explosion shock wave has been considered as a signature injury of the current military conflicts.Although strong shock wave is lethal to the human body,weak shock wave can cause many more lasting consequences.To investigate the protection ability and characteristics of flexible materials and structures under weak shock wave loading,the blast wave produced by TNT explosive is loaded on the polyurethane foam with the density of 200.0 kg/m3(F-200)and 400.0 kg/m3(F-400),polyurea with the density of 1100.0 kg/m^(3)(P-1100)and structures composed of the two materials,which are intended for individual protection.Experimental results indicate that the shock wave is attenuated to weak pressure disturbance after interacting with the flexible materials which are not damaged.The shock wave protective capability of single-layer materials is dependent on their thickness,density and microscopic characteristics.The overpressure,maximum pressure rise rate and impulse of transmitted wave decrease exponentially with increase in sample thickness.For the same thickness,F-400 provides better protective capability than F-200 while P-1100 shows the best protective capability among the three materials.In this study,as the materials are not destroyed,F-200 with a thickness more than10.0 mm,F-400 with a thickness more than 4.0 mm,and P-1100 with a thickness more than 1.0 mm can attenuate the overpressure amplitude more than 90.0%.Further,multi-layer flexible composites are designed.Different layer layouts of designed structures and layer thickness of the single-layer materials can affect the protective performance.Within the research range,the structure in which polyurea is placed on the impact side shows the optimal shock wave protective performance,and the thicknesses of polyurea and polyurethane foam are 1.0 mm and 4.0 mm respectively.The overpressure attenuation rate reached maximum value of 93.3%and impulse attenuation capacity of this structure are better than those of single-layer polyurea and polyurethane foam with higher areal density. 展开更多
关键词 Free-field explosion Weak shock wave mitigation POLYUREA Polyurethane foam Multi-layered composites
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Shock-induced energy localization and reaction growth considering chemical-inclusions effects for crystalline explosives
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作者 Ruqin Liu Yanqing Wu +3 位作者 Xinjie Wang Fenglei Huang Xiaona Huang Yushi Wen 《Defence Technology(防务技术)》 SCIE EI CAS CSCD 2024年第3期278-294,共17页
Chemical inclusions significantly alter shock responses of crystalline explosives in macroscale gap experiments but their microscale dynamics origin remains unclear.Herein shock-induced energy localization,overall phy... Chemical inclusions significantly alter shock responses of crystalline explosives in macroscale gap experiments but their microscale dynamics origin remains unclear.Herein shock-induced energy localization,overall physical responses,and reactions in a-1,3,5-trinitro-1,3,5-triazinane(a-RDX)crystal entrained various chemical inclusions were investigated by the multi-scale shock technique implemented in the reactive molecular dynamics method.Results indicated that energy localization and shock reaction were affected by the intrinsic factors within chemical inclusions,i.e.,phase states,chemical compositions,and concentrations.The atomic origin of chemical-inclusions effects on energy localization is dependent on the dynamics mechanism of interfacial molecules with free space volume,which includes homogeneous intermolecular compression,interfacial impact and shear,and void collapse and jet.As introducing various chemical inclusions,the initiation of those dynamics mechanisms triggers diverse decay rates of bulk RDX molecules and hereby impacts on growth speeds of final reactions.Adding chemical inclusions can reduce the effectiveness of the void during the shock impacting.Under the shockwave velocity of 9 km/s,the parent RDX decay rate in RDX entrained amorphous carbon decreases the most and is about one fourth of that in RDX with a vacuum void,and solid HMX and TATB inclusions are more reactive than amorphous carbon but less reactive than dry air or acetone inclusions.The lessdense shocking system denotes the greater increases in local temperature and stress,the faster energy liberation,and the earlier final reaction into equilibrium,revealing more pronounced responses to the present intense shockwave.The quantitative models associated with the relative system density(RD_(sys))were proposed for indicating energy-localization mechanisms and evaluating initiation safety in the shocked crystalline explosive.RD_(sys)is defined by the density ratio of defective RDX to perfect crystal after dynamics relaxation and reveals the global density characteristic in shocked systems filled with chemical inclusions.When RD_(sys)is below 0.9,local hydrodynamic jet initiated by void collapse dominates upon energy localization instead of interfacial impact.This study sheds light on novel insights for understanding the shock chemistry and physical-based atomic origin in crystalline explosives considering chemical-inclusions effects. 展开更多
关键词 shock responses Energy localization Crystalline explosives Chemical inclusions Reactive molecular dynamics
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Numerical and experimental investigation into the evolution of the shock wave when a muzzle jet impacts a constrained moving body
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作者 Zijie Li Hao Wang +1 位作者 Changshun Chen Kun Jiang 《Defence Technology(防务技术)》 SCIE EI CAS CSCD 2024年第3期317-326,共10页
The gun-track launch system is a new special launch device that connects the track outside the muzzle.Because it is constrained by the track,the characteristics of development of the muzzle jet differ from those of th... The gun-track launch system is a new special launch device that connects the track outside the muzzle.Because it is constrained by the track,the characteristics of development of the muzzle jet differ from those of the traditional muzzle jet.Specifically,it changes from freely developing to doing so in a constrained manner,where this results in an asymmetric direction of flow as well as spatio-temporal coupling-induced interference between various shock waves and the formation of vortices.In this background,the authors of this article formulate and consider the development and characteristics of evolution of the muzzle jet as it impacts a constrained moving body.We designed simulations to test the gun-track launch system,and established a numerical model based on the dynamic grid method to explore the development and characteristics of propagation of disturbances when the muzzle jet impacted a constrained moving body.We also considered models without a constrained track for the sake of comparison.The results showed that the muzzle jet assumed a circumferential asymmetric shape,and tended to develop in the area above the muzzle.Because the test platform was close to the ground,the muzzle jet was subjected to reflections from it that enhanced the development and evolution of various forms of shock waves and vortices in the muzzle jet to exacerbate its rate of distortion and asymmetric characteristics.This in turn led to significant differences in the changes in pressure at symmetric points that would otherwise have been identical.The results of a comparative analysis showed that the constrained track could hinder the influence of reflections from the ground on the muzzle jet to some extent,and could reduce the velocity of the shock waves inducing the motion of the muzzle as well as the Mach number of the moving body.The work here provides a theoretical basis and the requisite technical support for applications of the gun-track launch system.It also sheds light on the technical bottlenecks that need to be considered to recover high-value warheads. 展开更多
关键词 shock wave/vortex interference Muzzle jet Constrained boundary Dynamic grid
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Knowledge,management,and complications of sepsis and septic shock:A significant therapeutic challenge in the intensive care unit
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作者 Jakub Mizera Adrian Bystroń +2 位作者 Karolina Matuszewska Justyna Pilch Ugo Giordano 《Journal of Acute Disease》 2024年第2期53-59,共7页
Sepsis and septic shock are life-threatening conditions that are globally responsible for almost 20%of mortality,especially in low and middle-income countries.This review was conducted on PubMed and Google Scholar dat... Sepsis and septic shock are life-threatening conditions that are globally responsible for almost 20%of mortality,especially in low and middle-income countries.This review was conducted on PubMed and Google Scholar databases with keywords sepsis,septic shock,sepsis management,and sepsis complications.Articles published up to July 2023 in English were included.Diagnosis and management should be carried out without unnecessary delay.Cooperation between various medical specialties including intensive care doctors,neurologists,hepatologists,cardiologists,and pediatric doctors is needed if a child is affected.New strategies have to be implemented in low and middle-income countries to decrease the sepsis incidence and reduce mortality in the population. 展开更多
关键词 SEPSIS Septic shock MANAGEMENT COMPLICATIONS Diagnosis Review
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Experimental study on the size effect on the equation of state of concretes under shock loading
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作者 Mei Li Jian Cui +2 位作者 Yanchao Shi Baijian Tang Xin Chen 《Defence Technology(防务技术)》 SCIE EI CAS CSCD 2024年第3期160-167,共8页
Adopting the classical theory of hydrocodes,the constitutive relations of concretes are separated into an equation of state(EoS)which describes the volumetric behavior of concrete material and a strength model which d... Adopting the classical theory of hydrocodes,the constitutive relations of concretes are separated into an equation of state(EoS)which describes the volumetric behavior of concrete material and a strength model which depicts the shear properties of concrete.The experiments on the EoS of concrete is always challenging due to the technical difficulties and equipment limitations,especially for the specimen size effect on the EoS.Although some researchers investigate the shock properties of concretes by fly-plate impact tests,the specimens used in their tests are usually in one size.In this paper,the fly-plate impact tests on concrete specimens with different sizes are performed to investigate the size effect on the shock properties of concrete materials.The mechanical background of the size effect on the shock properties are revealed,which is related to the lateral rarefaction effect and the deviatoric stress produced in the specimen.According to the tests results,the modified EoS considering the size effect on the shock properties of concrete are proposed,which the bulk modulus of concrete is unpredicted by up to 20% if size effects are not accounted for. 展开更多
关键词 CONCRETE Equation of state Size effect shock wave Fly-plate impact test
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Emergency rescue of a patient with hemorrhagic shock caused by superior mesenteric artery rupture:A case report
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作者 Xian-Ping Lin Xin-Li Guo +3 位作者 He-Feng Tian Zheng-Rong Wu Wei-Jie Yang Hong-Ying Pan 《World Journal of Clinical Cases》 SCIE 2024年第18期3567-3574,共8页
BACKGROUND Superior mesenteric artery(SMA)injuries rarely occur during blunt abdominal injuries,with an incidence of<1%.The clinical manifestations mainly include abdominal hemorrhage and peritoneal irritation,whic... BACKGROUND Superior mesenteric artery(SMA)injuries rarely occur during blunt abdominal injuries,with an incidence of<1%.The clinical manifestations mainly include abdominal hemorrhage and peritoneal irritation,which progress rapidly and are easily misdiagnosed.Quick and accurate diagnosis and timely effective treatment are greatly significant in managing emergent cases.This report describes emergency rescue by a multidisciplinary team of a patient with hemorrhagic shock caused by SMA rupture.CASE SUMMARY A 55-year-old man with hemorrhagic shock presented with SMA rupture.On admission,he showed extremely unstable vital signs and was unconscious with a laceration on his head,heart rate of 143 beats/min,shallow and fast breathing(frequency>35 beats/min),and blood pressure as low as 20/10 mmHg(1 mmHg=0.133 kPa).Computed tomography revealed abdominal and pelvic hematocele effusion,suggesting active bleeding.The patient was suspected of partial rupture of the distal SMA branch.The patient underwent emergency mesenteric artery ligation,scalp suture,and liver laceration closure.In view of conditions with acute onset,rapid progression,and high bleeding volume,key points of nursing were conducted,including activating emergency protocol,opening of the green channel,and arranging relevant examinations with various medical staff for quick diagnosis.The seamless collaboration of the multidisciplinary team helped shorten the preoperative preparation time.Emergency laparotomy exploration and mesenteric artery ligation were performed to mitigate hemorrhagic shock while establishing efficient venous accesses and closely monitoring the patient’s condition to ensure hemodynamic stability.Strict measures were taken to avoid intraoperative hypothermia and infection.CONCLUSION After 3.5 h of emergency rescue and medical care,bleeding was successfully controlled,and the patient’s condition was stabilized.Subsequently,the patient was transferred to the intensive care unit for continuous monitoring and treatment.On the sixth day,the patient was weaned off the ventilator,extubated,and relocated to a specialized ward.Through diligent medical intervention and attentive nursing,the patient made a full recovery and was discharged on day 22.The follow-up visit confirmed the patient’s successful recovery. 展开更多
关键词 Superior mesenteric artery Hemorrhagic shock Arterial ligation Emergency nursing Case report
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Recovering from prolonged cardiac arrest induced by electric shock:A case report
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作者 Jian Zhang Yan-Ru Qiao +2 位作者 Ya-Dong Yang Guo-Zheng Pan Chong-Qing Lv 《World Journal of Clinical Cases》 SCIE 2024年第13期2248-2253,共6页
BACKGROUND Cardiac arrest(CA)induced by electric shock is a rare occurrence,particularly in cases of prolonged CA.Currently,there is limited literature on similar incidents,and we present a relevant case report.CASE S... BACKGROUND Cardiac arrest(CA)induced by electric shock is a rare occurrence,particularly in cases of prolonged CA.Currently,there is limited literature on similar incidents,and we present a relevant case report.CASE SUMMARY A 27-year-old Asian male man,experiencing respiratory CA due to electric shock,was successfully restored to sinus rhythm after 50 min of cardiopulmonary resuscitation and 8 electrical defibrillation sessions.In the subsequent stages,the patient received multiple organ function protection measures,leading to a successful recovery and eventual discharge from the hospital.CONCLUSION Prolonging resuscitation time can enhance the chances of survival for patients,this study provide valuable insights into the management of electric shock-induced CA. 展开更多
关键词 Electric shock Cardiac arrest Prolonged cardiopulmonary resuscitation Cerebral resuscitation Case report
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Shock Initiation Experiments with Modeling on a DNAN Based MeltCast Insensitive Explosive
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作者 Feichao Miao Dandan Li +2 位作者 Yangfan Cheng Junjiong Meng Lin Zhou 《Defence Technology(防务技术)》 SCIE EI CAS CSCD 2024年第2期655-662,共8页
2,4-dinitroanisole(DNAN)is a good replacement for 2,4,6-trinitrotoluene(TNT)in melt-cast explosives due to its superior insensitivity.With the increasing use of DNAN-based melt-cast explosives,the prediction of reacti... 2,4-dinitroanisole(DNAN)is a good replacement for 2,4,6-trinitrotoluene(TNT)in melt-cast explosives due to its superior insensitivity.With the increasing use of DNAN-based melt-cast explosives,the prediction of reaction violence and hazard assessment of the explosives subjected to shock is of great significance.This study investigated the shock initiation characteristics for a DNAN-based melt-cast explosive,DHFA,using the one-dimensional Lagrangian apparatus.The embedded manganin gauges in the apparatus record the pressure histories at four Lagrangian positions and show that shock-todetonation transition in DHFA needs a high input shock pressure.The experimental data are analyzed to calibrate the Ignition and Growth model.The calibration is performed using an objective function based on both pressure history and the arrival time of shock.Good agreement between experimental and calculated pressure histories indicates the high accuracy of the calibrated parameters with the optimization method. 展开更多
关键词 2 4-Dinitroanisole(DNAN) shock initiation Insensitive explosives Ignition and growth model Equation of state(EOS)
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Systematic review with expert consensus on use of extracorporeal hemoadsorption in septic shock:An Indian perspective
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作者 Yatin Mehta Abdul Samad Ansari +8 位作者 Amit Kumar Mandal Dipanjan Chatterjee Gauri Shankar Sharma Prachee Sathe Purvesh V Umraniya Rajib Paul Sachin Gupta Vinod Singh Yogendra Pal Singh 《World Journal of Critical Care Medicine》 2024年第1期65-75,共11页
BACKGROUND Septic shock is a severe form of sepsis characterised by deterioration in circulatory and cellular-metabolic parameters.Despite standard therapy,the outcomes are poor.Newer adjuvant therapy,such as CytoSorb... BACKGROUND Septic shock is a severe form of sepsis characterised by deterioration in circulatory and cellular-metabolic parameters.Despite standard therapy,the outcomes are poor.Newer adjuvant therapy,such as CytoSorb®extracorporeal haemoadsorption device,has been investigated and shown promising outcome.However,there is a lack of some guidance to make clinical decisions on the use of CytoSorb®haemoadsorption as an adjuvant therapy in septic shock in Indian Setting.Therefore,this expert consensus was formulated.AIM To formulate/establish specific consensus statements on the use of CytoSorb®haemoadsorption treatment based on the best available evidence and contextualised to the Indian scenario.METHODS We performed a comprehensive literature on CytoSorb®haemoadsorption in sepsis,septic shock in PubMed selecting papers published between January 2011 and March 20232021 in English language.The statements for a consensus document were developed based on the summarised literature analysis and identification of knowledge gaps.Using a modified Delphi approach combining evidence appraisal and expert opinion,the following topics related to CytoSorb®in septic shock were addressed:need for adjuvant therapy,initiation timeline,need for Interleukin-6 levels,duration of therapy,change of adsorbers,safety,prerequisite condition,efficacy endpoints and management flowchart.Eleven expert members from critical care,emergency medicine,and the intensive care participated and voted on nine statements and one open-ended question.RESULTS Eleven expert members from critical care,emergency medicine,and the intensive care participated and voted on nine statements and one open-ended question.All 11 experts in the consensus group(100%)participated in the first,second and third round of voting.After three iterative voting rounds and adapting two statements,consensus was achieved on nine statements out of nine statements.The consensus expert panel also recognised the necessity to form an association or society that can keep a registry regarding the use of CytoSorb®for all indications in the open-ended question(Q10)focusing on“future recommendations for CytoSorb®therapy”.CONCLUSION This Indian perspective consensus statement supports and provides guidance on the use of CytoSorb®haemoadsorption as an adjuvant treatment in patients with septic shock to achieve optimal outcomes. 展开更多
关键词 CONSENSUS CytoSorb CYTOKINE Hemoadsorption REFRACTORY SEPSIS Septic shock
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Predictive value of thrombocytopenia for bloodstream infection in patients with sepsis and septic shock
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作者 Xia Li Sheng Wang +2 位作者 Jun Ma Su-Ge Bai Su-Zhen Fu 《World Journal of Critical Care Medicine》 2024年第1期49-57,共9页
BACKGROUND Thrombocytopenia is common in patients with sepsis and septic shock.AIM To analyse the decrease in the number of platelets for predicting bloodstream infection in patients with sepsis and septic shock in th... BACKGROUND Thrombocytopenia is common in patients with sepsis and septic shock.AIM To analyse the decrease in the number of platelets for predicting bloodstream infection in patients with sepsis and septic shock in the intensive care unit.METHODS A retrospective analysis of patients admitted with sepsis and septic shock in Xingtai People Hospital was revisited.Patient population characteristics and laboratory data were collected for analysis.RESULTS The study group consisted of 85(39%)inpatients with bloodstream infection,and the control group consisted of 133(61%)with negative results or contamination.The percentage decline in platelet counts(PPCs)in patients positive for pathogens[57.1(41.3-74.6)]was distinctly higher than that in the control group[18.2(5.1–43.1)](P<0.001),whereas the PPCs were not significantly different among those with gram-positive bacteraemia,gram-negative bacteraemia,and fungal infection.Using receiver operating characteristic curves,the area under the curve of the platelet drop rate was 0.839(95%CI:0.783-0.895).CONCLUSION The percentage decline in platelet counts is sensitive in predicting bloodstream infection in patients with sepsis and septic shock.However,it cannot identify gram-positive bacteraemia,gram-negative bacteraemia,and fungal infection. 展开更多
关键词 Platelet counts THROMBOCYTOPENIA Bloodstream infection SEPSIS shock
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Prognostic and immunological roles of heat shock protein A4 in lung adenocarcinoma
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作者 Xuan Wu Shen-Ying Yang +4 位作者 Yi-Hua Zhang Jin-Zhou Fang Shuai Wang Zhi-Wei Xu Xiao-Ju Zhang 《World Journal of Clinical Oncology》 2024年第1期45-61,共17页
BACKGROUND Heat shock protein A4(HSPA4)belongs to molecular chaperone protein family which plays important roles within variable cellular activities,including cancer initiation and progression.However,the prognostic a... BACKGROUND Heat shock protein A4(HSPA4)belongs to molecular chaperone protein family which plays important roles within variable cellular activities,including cancer initiation and progression.However,the prognostic and immunological significance of HSPA4 in lung adenocarcinoma(LUAD)has not been revealed yet.AIM To explore the prognostic and immunological roles of HSPA4 to identify a novel prognostic biomarker and therapeutic target for LUAD.METHODS We assessed the prognostic and immunological significance of HSPA4 in LUAD using data from The Cancer Genome Atlas database.The association between HSPA4 expression and clinical-pathological features was assessed through Kruskal-Wallis and Wilcoxon signed-rank test.Univariate/multivariate Cox regression analyses and Kaplan-Meier curves were employed to evaluate prognostic factors,including HSPA4,in LUAD.Gene set enrichment analysis(GSEA)was conducted to identify the key signaling pathways associated with HSPA4.The correlation between HSPA4 expression and cancer immune infiltration was evaluated using single-sample gene set enrichment analysis(ssGSEA).RESULTS Overexpressing HSPA4 was significantly related to advanced pathologic TNM stage,advanced pathologic stage,progression disease status of primary therapy outcome and female subgroups with LUAD.In addition,increased HSPA4 expression was found to be related to worse disease-specific survival and overall survival.GSEA analysis indicated a significant correlation between HSPA4 and cell cycle regulation and immune response,particularly through diminishing the function of cytotoxicity cells and CD8 T cells.The ssGSEA algorithm showed a positive correlation between HSPA4 expression and infiltrating levels of Th2 cells,while a negative correlation was observed with cytotoxic cell infiltration levels.CONCLUSION Our findings indicate HSPA4 is related to prognosis and immune cell infiltrates and may act as a novel prognostic biomarker and therapeutic target for LUAD. 展开更多
关键词 Heat shock protein A4 Lung adenocarcinoma Tumor-infiltration Prognosis T helper cells
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Efficacy and safety of ulinastatin in the treatment of septic shock:a systematic review and meta-analysis
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作者 Chao Tong Aheyeerke Halengbieke +6 位作者 Teng-Rui Cao Xin Huang Jia-Lu Luo Jia-Xin Li Xue-Tong Ni Feng Sun Xing-Hua Yang 《Medical Data Mining》 2024年第1期1-9,共9页
Background:Septic shock is a common systemic inflammatory response syndrome for critical patients in the intensive care unit.Ulinastatin is currently used for the treatment of septic shock.Our study sought to evaluate... Background:Septic shock is a common systemic inflammatory response syndrome for critical patients in the intensive care unit.Ulinastatin is currently used for the treatment of septic shock.Our study sought to evaluate the efficacy and safety of ulinastatin in the treatment of septic shock patients.Methods:Three English databases(Embase,Medline,and Cochrane Library)and four Chinese databases(China National Knowledge Infrastructure,Wanfang data,SinoMed,and VIP)were searched for published randomized controlled trials.Stata 16.0 software was used to conduct the meta-analysis.Results:A total of 48 articles were included(Chinese article 47,1 in English).The results show that the treatment of ulinastatin could reduce mortality(risk ratio=0.63,95%confidence interval(CI)(0.55,0.72)),multiple organ dysfunction syndrome(risk ratio=0.6,95%CI(0.53,0.68)),length of intensive care unit stay(mean difference(MD)=-3.92,95%CI(-4.65,-3.18)),length of hospital stay(MD=-4.39,95%CI(-6.63,-2.15))and decrease Acute Physiology and Chronic Health Evaluation II score(MD=-4.55,95%CI(-5.63,-3.47))and Sequential Organ Failure Assessment score(MD=-2.02,95%CI(-2.59,-1.44))with P<0.001.Moreover,it lowers TNF-α(standardized mean difference(SMD)=-1.78,95%CI(-2.24,-1.32)),Interleukin-6(SMD=-1.17,95%CI(-1.55,-0.8)),C reactive protein(SMD=-1.49,95%CI(-1.99,-0.99)),hypersensitive C-reactive protein(SMD=-1.9,95%CI(-2.87,-0.94))and procalcitonin(SMD=-0.89,95%CI(-1.12,-0.67))levels in the body.Conclusions:Available evidence shows that ulinastatin reduces case mortality rate,multiple organ dysfunction syndrome,length of intensive care unit stay,and length of hospital stay and decreases Acute Physiology and Chronic Health Evaluation II score and Sequential Organ Failure Assessment score.Moreover,it also lowers TNF-α,Interleukin-6,C reactive protein,hypersensitive C-reactive protein,and procalcitonin levels in the body. 展开更多
关键词 EFFECTIVENESS META-ANALYSIS randomized controlled trial septic shock ULINASTATIN
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Investigation of Supersonic Shock Wave Loading on Thin Metallic Sheets
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作者 Khushi Ram Kartikeya Kartikeya +1 位作者 Puneet Mahajan Naresh Bhatnagar 《Defence Technology(防务技术)》 SCIE EI CAS CSCD 2023年第11期10-14,共5页
Shock tube experiments were carried out to investigate dynamic behavior of Ultra-high hardness(UHH)steel and Aluminium(Al) sheets of 0.8 mm thickness at 0.55, 0.9 and 1.18 MPa peak-over pressure.Experimental results s... Shock tube experiments were carried out to investigate dynamic behavior of Ultra-high hardness(UHH)steel and Aluminium(Al) sheets of 0.8 mm thickness at 0.55, 0.9 and 1.18 MPa peak-over pressure.Experimental results showed that center point deflection increases with an increase in peak-over pressure for Al sheets. However, UHH steel sheets showed negligible deformation when loaded at low peak-over pressures and showed sudden brittle failure at high peak-over pressures. Similar results were obtained by quasi-static testing, UHH steel failed abruptly while Al showed ductile behavior. Results from literature indicate that to protect structures against shock loading it is necessary that they dissipate energy via plastic deformation. The Al sheets were shown to deform plastically both in quasi-static and shock loading. Thus, hardness along with ductility is required to dissipate supersonic shock waves. 展开更多
关键词 shock tube Peak-over pressure shock wave Blast mitigation Plastic deformation
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Configurations of Shock Regular Reflection by Straight Wedges
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作者 Qin Wang Junhe Zhou 《Communications on Applied Mathematics and Computation》 2023年第3期1256-1273,共18页
We are concerned with the shock regular reflection configurations of unsteady global solutions for a plane shock hitting a symmetric straight wedge.It has been known that patterns of the shock reflection are various a... We are concerned with the shock regular reflection configurations of unsteady global solutions for a plane shock hitting a symmetric straight wedge.It has been known that patterns of the shock reflection are various and complicated,including the regular and the Mach reflection.Most of the fundamental issues for the shock reflection have not been understood.Recently,there are great progress on the mathematical theory of the shock regular reflection problem,especially for the global existence,uniqueness,and structural stability of solutions.In this paper,we show that there are two more possible configurations of the shock regular reflection besides known four configurations.We also give a brief proof of the global existence of solutions. 展开更多
关键词 shock regular reflection Transonic shock Prandtl-Meyer reflection Degenerate elliptic equation Two-dimensional Euler equations
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