A meta-analysis of the success rates of heartbeat restoration within the platinum 10min among outpatients suffering from sudden cardiac arrest in China Background:The optimal time to save a person who has had a sudden cardiac arrest is within the first few minutes of the incident.Early compression and early defibrillation should be performed at this time.Timeliness is the key to successful CPR; as such,Prof.He proposed the "platinum 10 min" system to study early CPR issues.This paper systematically evaluates the success rates of heartbeat restoration within the "platinum 10min" among patients suffering from sudden cardiac arrest.Methods:The clinical data of outpatients suffering from a cardiac arrest were retrieved from the China Knowledge Network(January 1975-January 2015),the Chongqing VIP database(January 1989-January 2015),and the Wanfang database(January 1990-January 2015).The success of the cardiopulmonary resuscitation(CPR) performed at different times after the patients had cardiac arrests was analyzed.Two researchers screened the literature and extracted the data independently.A meta-analysis was conducted using Stata 12.0.A total of 57 papers met the inclusion criteria,including 29,269 patients.Of these patients,1,776 had their heartbeats successfully restored.The results showed high heterogeneity(χ~2=3428.85,P<0.01,I2=98.4%).The meta-analysis was conducted using a random-effects model.The combined effect size was 0.171(0.144-0.199).Results:1) The success rate of heartbeat restoration did not differ among the four emergency treatment methods that patients received:the methods described in the 2000 Guidelines for CPR and Emergency Cardiovascular Care,that described in the 2005 version,2010 version,and another CPR method.2) The patients were divided into five groups based on the time when CPR was performed:the ?1min group,the 1-5min group,the 5-10 min group,the 10-15 min group and the >15min group.The CPR success rates of these five groups were 0.247(0.15-0.344),0.353(0.250-0.456),0.136(0.109-0.163),0.058(0.041-0.075),and 0.011(0.004-0.019),respectively.The CPR success rates did not differ between the pa...Introduction to Military Medical Research <正>Military Medical Research is an integral part of the BioMed Central journals.By publishing your work it becomes a fully citable open-access article-freely and universally accessible online,permanently archived,with copyright resting with the authors.MMR is indexed by PubMed,PMC and DOAJ.
Adherence to acne treatment guidelines in the military environment-a descriptive,serial cross-sectional study Background:Acne vulgaris,a common skin disease,affects up to 80% of the population.Moderate to severe acne requires treatment with a combination of topical and oral drugs such as antibiotics,hormones and retinoids.Retinoids have many contraindications and adverse effects requiring close monitoring.The study’s objectives were to describe prescribing trends in acne medication over time in a military setting,and assess physician adherence to guidelines for acne treatment,including drug precautions,clinical monitoring,and treatment progression.Methods:We conducted a descriptive,serial cross-sectional study of acne drugs prescribed in the Israel Defense Forces(IDF) in the years 2002–2007,analyzing the classes of drugs prescribed and patient characteristics.In addition,the clinical quality of the medical encounter was assessed by examining physician adherence to IDF guidelines.Results:Between 2002 and 2007,64,281 patients were treated for acne.Treatment courses generally persisted for 1–2 months.Over 70% of female patients receiving oral retinoids were not concomitantly receiving oral contraceptives.Conclusions:This study provides a unique perspective of acne treatment in a military setting,overall displaying good adherence to general guidelines.The common prescription of oral retinoids to young females without concomitant contraception is alarming.
The possibility of a human-borne with bioagent terrorist at foreign Forward Operating Bases entry control point:the perceptions of U.S. military or security personnel,a preliminary report Background:The global war on terrorism has prompted an increase in the deployment of security personnel from multi-national forces on foreign lands,especially in places where known terrorist groups are based.The aim of this study was to obtain U.S.military and security personnel’s perceptions of the possibility of encountering a humanborne with bioagent(HBBA) terrorist at an entry control point(ECP).Methods:This study was a mixed-method,cross-sectional,survey-based,time-limited study.A validated,five-option Likert scale questionnaire with Cronbach’s alphas of 0.82 and 0.894 for Constructs 1 and 2 was distributed to over 113 respondents with combat experience.Results:The results indicated that 92.3% of the respondents thought it was possible for a terrorist to employ a biological agent to cause terror; 61.5% claimed it was either possible or very possible,and 26.9% claimed it was somewhat possible for a terrorist carrying a biological agent to successfully breach a combat Forward Operating Bases(FOB) ECP undetected.26.9% of the respondents agreed that "ECP soldiers are knowledgeable about bioagents(BA)",only 15.4% responded that ECP soldiers have effective devices for detecting a BA on a terrorist at an ECP.Conclusion:Despite some limitations,this pre-study tends to indicate that while many U.S.military or security personnel acknowledge the possibility of an HBBA terrorist breach and the vulnerability of U.S.combat post ECPs to a BA breach,the soldiers at the ECPs lack adequate knowledge or devices to effectively detect a BA on a terrorist at an ECP.
Investigation of the usefulness of zaleplon at two doses to induce afternoon-sleep under noise interference and its effects on psychomotor performance and vestibular function Background:Military operation personnel often suffer from sleep difficulty because of their work requirements.In this study,we investigated the efficacy of zaleplon at two doses to induce afternoon-sleep under noise interference and its effects on psychomotor performance and vestibular function; we subsequently established the optimal dosage regimen for military operation personnel.Methods:Twenty-two healthy young male volunteers were recruited for the study.Eight subjects took 10 mg or 15 mg of zaleplon and placebo alternately and then were exposed to noise.Changes in polysomnography(PSG) indices,including sleep latency(SL),sleep efficiency(SE) and sleep structure,were recorded after drug administration.After awakening,the volunteers’ subjective judgments of sleep quality and sleepiness were measured.Eight volunteers underwent 3 psychomotor performance tests at a one-week interval,and the psychomotor performance tests were conducted before and after taking zaleplon and placebo.Six volunteers participated in the vestibular function test session,and parameters,including optokinetic nystagmus(OKN),vestibular ocular reflex(VOR),visualvestibular ocular reflex(VVOR) and vestibular ocular reflex fixation suppression(VOR-Fix),were detected by the same experimental design as described above.The data of sleep observations were subjected to one-way variance analysis.Results:Compared with the placebo group,SL was shortened significantly,and the scores of subjective sleep quality and sleep depth were clearly increased in the zaleplon 10 mg group(P<0.05).Moreover,the SE and the percent of REM(rapid eye movement) sleep were increased remarkably in the zaleplon 15 mg group(P<0.01).Furthermore,the SE,percent of REM sleep and scores of subjective sleep depth in the zaleplon 15 mg group were significantly higher than in the zaleplon 10 mg group(P<0.05).The psychomotor performance did not change significantly after ingestion of 10 mg or 15 mg of zaleplon,whereas the OKN and VOR gai...Syncope as a health risk for soldiers-influence of medical history and clinical findings on the sensitivity of head-up tilt table testing Background:Syncope is a relevant health problem in military environments.Reliable diagnosis is challenging.Tilt table testing is an important tool for syncope diagnosis.The aim of this study was to determine whether signs such as prodromal symptoms,co-morbidity,frequency of syncopal events,body length,body mass index,and electrocardiography abnormalities can be used to predict the success of tilt table testing at diagnosing syncope.Methods:Data from 100 patients with histories of syncope or pre-syncope,who were diagnosed using head-up tilt table testing,were retrospectively analyzed in a cross-sectional analysis.The diagnostic procedure was based upon a modified version of the Westminster protocol without any pharmacological provocation.Results:Patients showing pathological reaction patterns during tilt table testing suffered from prodromal symptoms,such as dizziness and sweating,significantly more often.The patients reported more injuries resulting from syncopal events and more previous syncopal events,and the prevalence of co-morbidity was greater among patients presenting negative findings during tilt testing.An asthenic-leptosomal physique was not confirmed as a risk factor for syncopal events as is the case for idiopathic arterial hypotension.However,patients with pathological reaction patterns during tilt table testing were significantly taller.This finding was detected for both females and males.No significant predictors were found in the electrocardiogram patterns of patients showing syncope during tilt table testing.Conclusions:Frequency of prior syncope and prodromal symptoms,and increased body length with an otherwise good state of health influence the predictive value of tilt table testing for syncope diagnosis.In particular,if these factors are present,tilt table testing should be considered part of the diagnostic algorithm for soldiers with recurrent syncope.
An economic analysis of varicella immunization in the Singapore military Background:Varicella outbreaks occur frequently in closed environments such as those of militaries.This paper compares the economic outcomes of varicella vaccination in enlisted servicemen without prior reported varicella infection or vaccination.Methods:We analyzed the economic outcomes of a varicella vaccination program on all enlisted servicemen without prior reported varicella infection or vaccination in the Singapore Armed Forces(SAF) between December 11,2010–December 20,2013,compared with the previous program of varicella vaccination only for selected personnel between December 1,2007–December 10,2010.Results:In the at-risk population of all active SAF servicemen,the program of varicella vaccination for all servicemen without prior reported varicella infection or vaccination upon enlistment would save 72.0 work days per 1000(95% CI:61.2-82.9),valued at SG$6,544 per 1000(95% CI:6,524-6,564),i.e.,costing SG$91.5 per work day saved(95% CI:78.7-107.3).This also results in a reduction of 2.7 varicella cases per 1000 and 5.43 outbreaks per 10000,or a total savings of SG$1,695 per 1000(95% CI:–2,730-6,834),taking into account the cost of work days lost over a three-year period,compared with the previous regime of vaccinations only for selected individuals.Conclusion:The varicella vaccination strategy targeting all enlisted servicemen without prior reported varicella infection or vaccination is able to prevent varicella infections and outbreaks,thus reducing absenteeism and days lost.
Improvement in the signs and symptoms of dry eye disease with dobesilate eye drops Background:Dry eye is a multifactor disease of the tear film and ocular surface that substantially affects quality of life.Case presentation:Dobesilate administered as eye drops was well tolerated and effective in treating both the objective signs and subjective symptoms of dry eye disease in this 2-week study.Conclusion:To the best of our knowledge,this is the first clinical report of using dobesilate in eye drops.Dobesilate may provide a novel approach to treating drying diseases of the eye.
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主 编：戚中田 张绍祥 李云庆 姚开泰