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Objective On the fully automatic operation metro lines, there exists a gap between the platform screen door and the train, leading to the risk of clamping people and objects. In order to ensure train operation safety, a gap detection device must be installed. Method The current situation of the gap detection device application is briefly described, the working state of the laser gap detection device is mainly discussed, two interlocking modes of the laser gap detection device and the train operation are compared in order to access the safety loop of the train, and put forward some suggestions on the application of the anti-clamping safety device on the fully automatic operation metro lines. Result & Conclusion The signal system directly controls the start and shutdown of the gap detection device, and obtains the gap detecting state of the device. The laser gap detection device starts to work only after both the train door and the platform screen door are closed and locked, avoiding the extreme situation in which the platform screen door is closed but the train door still open. This mode provides a more favorable working environment for the gap detection device. When the device detects an obstacle or a false alarm, the signal system can automatically control the train door and the platform screen door to reopen and close, and restart the detection after the doors close, reducing impact on the metro operation. In addition, in fully automatic operation metro system, both the traditional clamping-proof device and the laser gap detection device are considered to be installed to prevent people from being clamped by the platform screen doors.

Objective To understand and evaluate the current situation of health emergency personnel capacity building in Chongqing, clarify the main factors that affect and restrict this capacity building, and propose countermeasures and suggestions. This will provide a reference for further improving the capacities of health emergency response in Chongqing. Methods Questionnaire surveys and expert interviews were used to analyze the current situation of health emergency personnel capacity building in 39 disease control and prevention centers and 10 medical institutions in Chongqing from four dimensions: general status, health status, training and drilling status, and health emergency capability. Spearman's rank correlation analysis was used to analyze the correlation between self-evaluation of health status and self-evaluation of sleep quality, and multiple linear regression was employed to analyze the main factors influencing emergency response capability. Results Among Chongqing's health emergency personnel, 34.85% had a BMI of overweight or above, only 37.92% regularly conducted health monitoring, and 9.19% experienced health problems during emergencies. The proportions of personnel who participated in two or more training sessions per year, two or more drills per year, and one or more physical fitness evaluations per year were 52.07%, 22.76%, and 31.12%, respectively. The average score of emergency response capability of Chongqing's health emergency personnel was 76.11, with the lowest score in the policy advice capability (48.59). Personnel with a medical background (β=1.025), longer years of emergency response work (β=1.774), better self-evaluated physical condition (β=3.664), better self-evaluated mental condition (β=4.362), and participation in drillings twice or more per year (β=2.696) had higher scores in terms of health emergency response capability (P<0.05). Conclusions There are still some weaknesses in the capacity building of Chongqing's health emergency response personnel. Future efforts should focus on optimizing the staffing structure of the health emergency response team, strengthening the physical training of emergency personnel in normal times and health monitoring and management under emergency conditions, continuously promoting the actual, contextual, and professional emergency training and drilling, and comprehensively improving the physical and mental quality, professional quality, and emergency response capacity of health emergency personnel through multiple approaches. [ABSTRACT FROM AUTHOR]

Under complex geological conditions of fault system, stratum and terrain, an accurate inversion of the in-situ stress field is a challenging and hot issue in the study on engineering geology. Focusing on the accurate inversion of fine in-situ stress field for deep-buried tunnel under complex geological conditions, and the influence of major geological factors on the stress state, we took the Jiangranshan tunnel of the express way from Shuangjiang to Cangyuan in southwest Yunnan as a case to perform the study. We first established the fine geological model of the Jiangranshan tunnel area by integrating the fine DEM data and the geological survey data. Then, taking the measured in-situ stress data in the tunnel site and the measured GPS data of velocity field as the integrated constraints, we carried out the inversion of fine in-situ stress field in the engineering region of Jiangranshan tunnel. On the basis of the inversion results, we analyzed the characteristics of fine in-situ stress field in the tunnel site and the influence of main geological conditions on the current in-situ stress field. Finally, we estimated the engineering geological stability of the surrounding rock mass of the Jiangranshan tunnel. The results show that the simulated displacement velocity field in the Jiangranshan tunnel area is basically consistent with the GPS observation results, revealing that the inversion model adopted in this study can well reflect the current tectonic stress environment of the engineering region. The simulation results show that the level of the in-situ stress field in the western part of the study area is relatively high, while it is low in the eastern part. The direction of the maximum principal stress shows partial deflection in the study area. The influence of the nearly E-W-striking Xiaoheijiang fault--the largest fault in the study area--on the in-situ stress is that it causes the slight deflection of the direction of the maximum principal stress; however, it does not cause abrupt change of the in-situ stress magnitude. The secondary faults and topography show little effect on the in-situ stress field, which is limited to very small area and does not cause notable disturbance of the in-situ stress field. The results reveal that the maximum, intermediate, and minimum principal stresses along the tunnel mainly distribute in 7.47--27.23 MPa, 1.59--15.12 MPa, and 0.01--6.71 MPa, respectively, and does not show obviously abnormal characteristics. The engineering geological stability of the surrounding rock mass of the Jiangranshan tunnel is estimated by the stress intensity index (i.e., the ratio of the maximum tangential stress to the uniaxial compress strength of rock). The estimation results, which are determined by integrating the stress field simulation results and the mechanical properties of the typical rocks obtained from the laboratory tests, show that the stress intensity indexes of the Jiangranshan tunnel mainly range between 0.20--0.48. It indicates that the surrounding rock masses of the Jiangranshan tunnel are mainly in a stable state or in a slight rockburst risk under the current in-situ stress conditions. The conclusion can be drawn from the case study that under the complex geological conditions, the fine geological model suitable for the scale of engineering area can be established by using the fine DEM and actual fault and strata data, which can effectively reveal the characteristics of the in-situ stress field in engineering area and the influence of the main geological conditions. This study provides not only the profound understanding of the in-situ stress field of the Jiangranshan tunnel area, but also the implications for the fine inversion of in-situ stress field under complex geological conditions in Yunnan and other similar areas. In addition, this study can directly support the stability evaluation of the surrounding rock of the deep-buried Jiangranshan tunnel. [ABSTRACT FROM AUTHOR]

Objective: To explore the feasibility and application value of the preservation of vegetative nervous functions in radical resection for right-sided colon cancer., Methods: Clinical data of 55 cases with right-sided colon cancer undergoing laparoscopic D3+ complete mesocolic excision (CME) radical resection from January 2016 to July 2017 at Department of Gastrointestinal Surgery of Guangdong Province Hospital of Traditional Chinese Medicine were retrospectively analyzed. Exclusion criteria included emergency surgery for various reasons, intestinal obstruction or perforation, distant metastasis or locally advanced cancer, previous history of abdominal surgery and preoperative neoadjuvant chemoradiotherapy. Twenty-nine cases underwent lymphadenectomy with intrathecal dissection of superior mesenteric artery (SMA) and part of superior mesenteric plexus was resected (nerve partial resection group, NPR group). Twenty-six cases received lymphadenectomy with the clearance of lymphatic adipose tissue on the right side of SMA by sharp or obtuse method outside the sheath; the sheath of superior mesenteric vein (SMV) was entered at the junction of SMA and SMV; the SMV was naked in the sheath; the third station lymph node dissection was completed with preservation of superior mesenteric plexus (nerve preserved group, NP group). Intra-operative and postoperative complications were compared between two groups., Results: The baseline data were not significantly different between two groups (all P>0.05). The operation time in NP group was significantly shorter than that in NPR group [(164.0±19.8) minutes vs. (176.0±19.7) minutes, t=2.249, P=0.029]. No significant differences in operative blood loss, operative vessel damage, postoperative time to flatus, postoperative hospital stay and abdominal pain were observed between two groups(all P>0.05). The number of harvested lymph node in two groups was 28.5±7.8 and 27.6±6.5 respectively without significant difference(P>0.05). As compared to NPR group, NP group had lower incidence of chylous leakage[3.8%(1/26) vs. 37.9%(11/29), χ²=9.337, P=0.002] and postoperative diarrhea [15.4%(4/26) vs. 41.4%(12/29), χ²=4.491, P=0.034]., Conclusion: Autonomic nerve-preserving D3+ CME radical resection for right-sided colon cancer is safe and feasible, and can prevent the postoperative gastrointestinal dysfunction caused by nerve injury and decrease the risk of chylous leakage.

Prevention of intraoperative incidental injuries during radical operation for rectal cancer and management of postoperative complication are associated with successful operation and prognosis of patients. This paper discusses how to prevent such intraoperative incidental injuries and how to manage postoperative complication. (1) Accurate clinical evaluation should be performed before operation and reasonable treatment decision should be made, including determination of the distance from transection to lower margin of the tumor, T and M staging evaluated by MRI, fascia invasion of mesorectum, metastasis of lateral lymph nodes, metastatic station of mesentery lymph node, association between levator ani muscle and anal sphincter, course and length of sigmoid observed by Barium enema, length assessment of pull-through bowel. Meanwhile individual factors of patients and tumors must be realized accurately. (2) Injury of pelvic visceral fascia should be avoided during operation. Negative low and circumference cutting edge must be ensured. Blood supply and adequate length of pull-down bowel must be also ensured. Urinary system injury, pelvic bleeding and intestinal damage should be avoided. Team cooperation and anesthesia procedure should be emphasized. Capacity of handling accident events should be cultivated for the team. (3) intraoperative incidental injuries during operation by instruments should be avoided, such as poor clarity of camera due to spray and smog, ineffective instruments resulted from repeated usage. (4) As to the prevention and management of postoperative complication of rectal cancer operation, prophylactic stoma should be regularly performed for rectal cancer patients undergoing anterior resection, while drainage tube placement does not decrease the morbidities of anastomosis and other complications. After sphincter-preserving surgery for rectal cancer, attentions must be paid to the occurrence of anastomotic bleeding, pelvic bleeding, anastomotic fistula, ileus, intestinal necrosis and anastomotic stenosis. After sphincter-preserving surgery for rectal cancer, if small amount of bleeding happens, titanium clamp or electric coagulation can be used; if delayed pelvic bleeding occurs obviously, embolism should be applied. Conservative treatment may be used for the non-carcinomatous ileus. When small anastomotic stenosis is found, local treatment is available (finger dilation, balloon expansion, transanal radiated cutting or resection), and for severe stenosis, transadominal operation is required.

Objective: To investigate the safety and feasibility of laparoscopic radical right hemicolectomy using caudal-to-cranial approach (yellow-white borderline between right mesostenium and retroperitoneal is firstly cut as the entry to dissect the fusion fascial space between the visceral and parietal peritoneum, which is called caudal-to-cranial approach for right hemicolectomy)., Methods: From January 2014 to May 2015, 76 consecutive patients with right side colon cancer underwent laparoscopic radical right hemicolectomy using caudal-to-cranial approach. The baseline characteristics, intraoperative and postoperative outcomes were prospective collected and reviewed retrospectively., Results: All the 76 patients completed operations successfully, and one patient (1.3%) was converted to open surgery because of intraoperative bleeding due to unexpected injury of ileocolic artery. The mean operative time was (152.8±42.1) min with a mean estimated blood loss of (70.4±43.5) ml. The mean time of first flatus was (49.3±22.9) h and mean liquid oral intake was (58.5±17.6) h. The postoperative complications appeared in 7 patients (9.2%), including one (1.3%) of pulmonary infection, one(1.3%) of urinary system infection, two (2.6%) of wound infection, two (2.6%) of inflammatory bowel obstruction and one (1.3%) of lymphatic fistula, and they were all cured with conservative treatments. The postoperative hospital stay was (7.8±5.4) d. The mean number of harvested lymph node was 34.2±10.9, among which 4.1±2.8 was positive., Conclusions: Laparoscopic radical right hemicolectomy using caudal-to-cranial approach is safe and feasible.

This article reports the successful experience of integration of burn treatment and rehabilitation for a child suffering from 91% TBSA flame burn injury (with 60% TBSA full-thickness injury, 30% TBSA deep partial-thickness injury, and 1% TBSA superficial partial-thickness injury), severe inhalation injury, severe burn shock, stress ulcer, gastrointestinal bleeding and atelectasis of the right upper lung. The patient was given effective fluid infusion against shock, treatment for gastrointestinal bleeding, and other effective supportive treatment for functions of various organs after being admitted to our burn ward. When vital signs became stable at 30 hours post injury, bedside rehabilitation was begun. On post injury day (PID) 4, escharectomy was performed for both lower limbs, followed by microskin grafting and allogeneic skin covering. On PID 10, invasive infection of multi-drug resistant bacteria was found with accompanied high fever, and at the same time allograft began to disintegrate, with dissolution of large area of eschar, leading to a raw surface reaching 86% TBSA. Following debridement, dressing, application of compound polymyxin B ointment, temporary covering of wounds with porcine acellular dermal matrix, adjustment of antibiotics, patient's condition was finally stabilized. From PID 28 on, split-thickness skin grafting was conducted 7 times, and the raw surface of 75% TBSA involving the upper and lower limbs and trunk was successfully covered. At the same time, our rehabilitation team launched comprehensive rehabilitation measures comprising active exercise, occupational therapy, prevention of scar formation, organ function training and psychological intervention. Finally, the patient was able to walk unaided and fed herself when the wounds were almost entirely healed in 3 months after injury. Oriented forwards functional rehabilitation, strong cooperation between team members, and synchronous effective implementation of burn treatment and rehabilitation in the whole process are the keys to achieve successful integration of burn treatment and rehabilitation of this child.