Difference between revisions of "Main Page"

From EECH Central
Jump to: navigation, search
m
m (Protected "Main Page" ([Edit=Allow only administrators] (indefinite) [Move=Allow only administrators] (indefinite)))
 
Line 1: Line 1:
5月31日,在华中科技大学同济医学院附属协和医院(以下简称 “武汉协和医院” )心脏大血管外科主任董念国教授带领的多学科团队齐心救治下,9个月大婴儿小涵涵心脏移植成功。这是一次牵动亿万人关注的手术,一颗鲜活的心脏从广西飞抵武汉,开启了一场跨越1千多公里的生命接力,董念国教授团队带给了小涵涵一场新生,迎来了她人生中第一个六一儿童节。目前,武汉协和医院已经建立起一整套适合国情的心脏移植技术体系。<br /><br />在中国的心血管病外科治疗领域,武汉协和医院董念国教授团队可以称得上“天团”,他们不仅可以开展心脏病外科治疗的所有术式,而且是国内极少有的把心脏移植年手术做到百台以上的团队,并且在多项关键技术的研发方面不断取得突破,为心脏移植事业的发展做出了卓越贡献。<br /><br /><br /><br />全球前三:他们已连续保持了7年<br /><br />心脏移植,是挽救终末期心脏病患者,特别是重度心衰患者生命的终极解决方案。在我国,心衰的患病率为0.9%,全国约有心衰患者400万人,其中重度心衰大约占心衰患者的7%~10%,董念国教授告诉我们,重度心衰的患者死亡率比较高,替代的办法也不多,从目前来讲心脏移植是最有效的治疗方法。<br /><br />“我做的第一例病人是在2008年9月26日,是一个20岁的小伙子,当时因为心肌病肝瘀血,送来时已经完全不能进食,腹痛得很厉害。”董念国教授至今还清楚地记得这个病人。在举全科之力为他成功进行了心脏移植后,这位患者又活了十多年。<br /><br />从2008年开展首例心脏移植手术以来,董念国教授团队不断深耕心脏移植技术,近7年心脏移植年手术均在100例左右,始终保持全球前三的水平,患者术后五年的存活率达到了84%,比国际心肺移植学会报告高11个百分点,十年的存活率是65%,比国际上高出7-8个百分点。<br /><br />董念国教授告诉我们,在提升心脏移植效果方面,他们主要取得了这样几个方面的突破:<br /><br />一是建立了武汉协和医院的供心保护策略。在心脏移植领域,由于供心短缺,很多情况下都要进行异地取心,这样如何延长供心的冷却时间,加强心肌保护就尤为重要。国际上一般的标准是4小时,武汉协和医院开发出了专用的转运箱,取得了3个国家专利,可以有效防止供体过冷过热,使得供心的冷却时间延长到了6~8小时,大大提高了供心的使用效率。<br /><br />二是攻克了一系列复杂心脏移植的技术难关,包括合并主动脉畸形的心脏移植、一站式杂交心脏移植、心脏联合多器官移植、右位心心移植等。<br /><br />三是在儿童心脏移植方面取得了重要突破。目前,在儿童心脏移植方面,武汉协和医院的手术量已经超过100例,位居全国首位,占全国的三分之一以上,同时还创造了多个儿童心脏移植方面的全国纪录。如去年完成的全国最小的两个心脏移植病例,一个是三个月4.3公斤的婴儿,另一个是66天,只有2点几公斤的婴儿。“其中一个小孩是个复杂的先天性心脏病合并心肌病,患者由于生理发育不全,左心室只有一到二个毫米,非常薄。还有一个小孩的心脏长在右位,怎么把供体放在右边,这些都是难度很大的技术。”董念国教授说。<br /><br /><br /><br />温血转运:让更多供心“用得上”<br /><br />温血转运,是供心转运中采用的一项新技术,目前还处于临床试验阶段。对于心脏移植而言,目前面临的最大挑战就是供心短缺。在这种情况下,在最短时间内将供心送到手术室,是心脏移植取得成功的关键因素。<br /><br />董念国教授告诉我们,在发达国家,心脏移植团队往往有自己的救护车辆,私人飞机和直升飞机,这样就可以保证取心效率的最大化。但在我国,目前还不具备这样的条件,主要还是要乘坐公共交通工具,加之我国国土面积辽阔,因此取心必须要预留更多的时间。<br /><br />目前在取心环节世界通用的还是冷缺血的保护方式。这种方式,是将心脏放在零上4度左右的冰水混合物中进行保存转运。但这个过程中,必然会对心脏造成一定程度的损伤。<br /><br />据介绍,很多供心在转运过程中,由于保存技术落后,在送达患者面前时已经失去了使用价值。在这种情况下,能否突破传统的供心转运瓶颈,成为提高心脏移植效率的核心。目前国外也正在开展常温灌注保存供心的研究,但尚未应用到临床。而武汉协和医院与苏州心擎医疗技术有限公司正在合作开发的温血转运设备,则有望大大延长这一保存时间。<br /><br />据武汉协和医院李平教授介绍,与以往供心转运的冷缺血保护不同,温血运转可以实现心脏在体外跳动的状态下,从一个地方转运到另一个地方。<br /><br />在温血转运系统里,通过加入患者的血液和一定的预充液,可以为供心建立起体外循环,使得供心在转运过程中始终保持工作状态,这样就可以最大限度地减轻心肌的损伤,从而让转运更加从容。<br /><br />董念国教授指出,除了能够延长转运时间,对于一些心脏功能不是特别好的供心,通过温血转运系统进行灌注,可以得到一定程度的修复,等状况好转再进行移植。“通过这一技术,可以把更多的供心作为有效的供心,来使用到中国心衰患者身上。“<br /><br />据李平教授介绍,温血转运系统从5年前开始进行研发,从前期的理念更新,到材料准备,机器设备的设计,团队成员一直在不断进行修正。目前,设备已经推出了第三代的产品,动物实验已经取得成功,近期将开展人体的实际应用试验。<br /><br /><br /><br /><br /><br /><br /><br />心室辅助装置:让更多患者“等得起”<br /><br />如果说温血转运是让更多供心“用得上”,新型心室辅助装置的作用就是让更多患者“等得起”。对于心脏移植患者而言,最大的风险就是他们的心脏等不到供心的到来。而桥接,则是指在患者等待供心的过程中,通过心脏(心室)辅助装置建立体外循环,对患者的生命进行维持。<br /><br />提到心脏辅助装置,让我们从体外膜肺氧合(ECMO)说起。去年新冠肺炎的大流行,让这个本来只有极少数医生了解的设备广为人知。其实,在心脏移植领域,很多终末期心衰患者在等待供体时心脏就已完全无法工作,甚至发生心源性休克,这时就需要为其进行循环维持,目前国内通常所使用的设备就是ECMO。<br /><br />体外膜肺氧合(ECMO)的核心部分是膜肺(人工肺)和血泵(人工心脏),它可以对重症心肺功能衰竭患者进行长时间心肺支持,为危重症的抢救赢得宝贵的时间。但对于很多重症心衰患者而言,他们的肺并没有原发性疾病,膜肺的使用反而会对凝血系统造成破坏,因此,独立的心室辅助装置已经成为近年来国际上开展心脏移植的一个新的选择。<br /><br />据介绍,董念国教授团队与苏州心擎医疗技术有限公司研发的体外中短期心室辅助装置(体外人工心脏)已经进入临床试验。<br /><br />心室辅助装置是一个机电一体化的离心泵装置,核心技术是通过流体力学和驱动机构的系统化集成设计,优化血液相容性,减少使用并发症。目前世界上前沿的产品尚未进入中国市场,用于体外循环的离心血泵仅有进口产品,且均使用上一代的技术。<br /><br />董念国教授告诉我们,这一心室辅助装置具有多个理念上的创新,首先是它去除了膜肺,对血液的保护特别好;其次,离心泵的设计,对整个凝血系统,以及患者的其他系统的影响都要小很多,在桥接阶段使用这一装置,管理简单,并发症少,用血量少,整体费用也更低。无论对患者、医生和护士,都是一个福音。<br /><br />据悉,该心室辅助装置还能用于开胸心脏手术后患者无法脱离体外循环的救治和恢复,以及如H1N1、严重车祸、溺水等急性疾病引起的爆发性心肌炎和心脏停止等危重急状况,能提高50%的存活率。<br /><br /><br /><br />团队:每个人都是专家也是多面手<br /><br />如果不亲身接触,我们无论如何也不会想到一个心脏移植团队会需要那么多人。据了解,目前董念国教授的心脏移植团队共有200多人,包括术前评估的队伍,体外循环队伍、手术队伍、麻醉队伍、ICU队伍、护理队伍、后勤保障队伍、行政队伍等多个学科的专家。<br /><br />“相对于其它专业,心脏移植是手术中难度和要求都非常高的一类,我们打造今天这样团队确实不容易。除了医学方面的人才,我们还要有专门联系买票的助手,还要有掌握法律法规的人员……”董念国教授表示,心脏移植是一个综合性学科,各个学科都要齐头并进,都要很强的队伍。<br /><br />陈澍教授是团队OPO(人体器官获取组织)工作的主要负责人,他告诉我们,目前我国采取的是公民脑死亡后自愿捐赠器官,他的工作就是要经常与省内外的同道联系,随时准备接收捐赠的心脏。<br /><br />“由于供心的质量是关系手术成败的是最重要因素,我们取心团队的成员不光要经常出差,而且要处于一个随时接到通知就要出发的状态。”陈澍教授说,从取心队伍出发开始,整个团队就要一环扣一环地开始准备工作。“取心团队一登机,医院的手术团队就要开始接病人,进行术前准备。心脏是个脆弱的器官,对冷缺血比较敏感,所以不管是转运还是移植,我们都要争分夺秒。”<br /><br />“可以说,每个人都是专家也是多面手。” 陈澍教授还告诉我们,虽然团队成员有不同的分工,但每个人几乎都是一专多能,在其他同事不能到位的情况下,就要及时顶上去。“做这样的工作,没有一个强有力的队伍, [https://www.magassist.com.cn/medicine/126.html 心擎微创介入式人工心脏] 。”他补充到。<br /><br />李平教授也认为,团队之所以能够在全国同行中脱颖而出,很大程度是由于董念国教授的理念很先进,而且艺高人胆大。同时,在开展手术和研究时又有非常严谨的科学态度。<br /><br /><br /><br />谈到取得成功的经验,董念国教授自己重点谈了这样几个方面:首先,武汉协和医院的前辈为心脏移植事业的发展奠定了较好的基础。早在1994年,老主任杨辰垣教授就在全国率先开展心脏移植手术,病人术后活了28天。老主任孙宗全教授曾经做了全国第二例的心脏移植手术,病人存活了一年多。<br /><br />其次, [https://www.magassist.com.cn/medicine/112.html 国内心脏移植] 。有媒体计算,协和医院心脏移植团队为了护送心脏,每年奔跑量程达20多万公里,相当于环绕赤道5圈。<br /><br />第三,是具有锲而不舍的精神。他说,团队一开始做心脏移植时也面临着很多的困难,2008年做了6例,2009年做了11例,2010年做了13例,11年做了12例,当时有四、五年都处于一个徘徊阶段,但在这个过程中也是一个积累,后来再到32例、48例、70多例,就慢慢地做起来了。<br /><br />“到现在,我们也不是一蹴而就的,也是有一个慢慢发展、慢慢的经验积累的过程。我们的口碑,也是建立在提高病人存活率的过程中。” 董念国教授说。<br /><br />
+
__notoc__
 +
{|
 +
[[Image:Eech central logo.png|287px|right|EECH Central Logo]]
 +
== Introduction ==
 +
 
 +
[[Image:Mi24 doors.jpg|thumb|left|Community-created Mi-24V cockpit]]
 +
 
 +
'''''Enemy Engaged – Comanche vs. Hokum ([[abbreviations|EECH]])''''' is a combined forces realtime battlefield helicopter simulation.
 +
 
 +
The player pilots an attack helicopter inside a dynamic campaign. Instead of being confined to separate pre-defined "missions" like in so many other simulation games, it is possible to see the battle unfold across the entire battlefield in real time, without "load times" during missions. Your tasks in the game range from attack missions on enemy bases, FARPs and vehicles, close air support or interdiction of enemy air defences, recon-missions to obtain photographic intelligence, down to simple transfer missions to replenish your forces.
 +
<br>
 +
<br>
 +
Effective air defence simulations necessitate NOE (Nap of the Earth) flying and the use of terrain as cover, as well as making best use of the stealth characteristics of the Comanche helicopter.
 +
A "Mission Commander" feature allows players to define their own missions and ultimately control the battle strategy from a powerful interactive game map that integrates seamlessly with the 3D action. The entire battlefield simulation is fully networked and supports multiple human pilots on either side of the simulated conflict.
 +
<br>
 +
<br>
 +
There are 9 helicopters modelled in the game that are flyable with their own cockpits, and seven of those have 3D cockpits. On the Blue side, these are the [[The Apache|AH-64A Apache]], [[The Apache|AH-64D Apache Longbow]], the [http://www.fas.org/man/dod-101/sys/ac/rah-66.htm RAH-66 Comanche], the [http://en.wikipedia.org/wiki/Bell_AH-1Z_Viper AH-1Z Viper], and the [http://www.army-technology.com/projects/kiowa/ OH-58D Kiowa]. On the Red side, these are the [http://www.fas.org/man/dod-101/sys/ac/row/ka-50.htm Ka-52 "Hokum B"], the [http://www.fas.org/man/dod-101/sys/ac/row/ka-50.htm Ka-50 "Black Shark"], the [http://www.fas.org/man/dod-101/sys/ac/row/mi-28.htm Mi-28N "Havoc"], and the [[Mi-24V_Section|Mi-24V Hind]]. All other helicopters in the game are flyable, but they use a 'default' cockpit from the Apache A.
 +
<br>
 +
<br>
 +
[[Image:Shot08.jpg|right|thumb]]
 +
The game tries to be as realistic as possible, having features like the [[Engine startup|realistic engine startup procedure]] and the [[priority fire zones]] for example, while retaining the ease-of-use factor that makes it popular with players who are more interested in action than avionics. Support for innovative input devices like TrackIR allow for an optimal level of immersion. Combined with the truly massive environments that retain a realistic sense of scale.
 +
<br>
 +
<br>
 +
Although the original game was released in 1999, the community has developed substantial graphics and gameplay-related enhancements, aside from stability and multiplayer improvements. The release of the game's [http://en.wikipedia.org/wiki/Sourcecode source code] ensured that an active fan community grew in size, turning EECH into it's current game.
 +
<br>
 +
<br>
 +
You can have a look at some [[Screenshots|screenshots]] of the game in the gallery.
 +
 
 +
|-
 +
 
 +
{| class="prettytable" width="100%"
 +
|-
 +
| colspan="3" align="center" |
 +
 
 +
== April 14th 2020 v1.16.1 released ==
 +
[[image:Folder.png]] [https://drive.google.com/open?id=1SvsRg6W9NmqOyor_gEZ0OaAuKV7Unf-d 1.16.1 allMods patch] (1.16.0 is required!)<br>
 +
([https://yadi.sk/d/Xfi1QAhj71mvcQ Mirror])<br>
 +
 
 +
[[image:Folder.png]] [https://drive.google.com/open?id=0B2tSjM_s_ROqRkhibzNtVXM2a3c 1.16.0 allMods installer]<br>
 +
([https://yadi.sk/d/XZ064nqG347cPT Mirror])<br>
 +
 
 +
[[Image:Review-icon.png|15px]] [https://simhq.com/forum/ubbthreads.php/topics/4516373/ Details]<br>
 +
[[Image:Review-icon.png|15px]] [[Installation guide]]<br>
 +
[[Image:Review-icon.png|15px]] [[Dual Install]]
 +
 
 +
== Guides & manuals ==
 +
 
 +
===[[Image:Review-icon.png|15px]] [[Special:AllPages|List of all pages]]===
 +
 
 +
|-
 +
| width="33%" style="background:#D8F3D5" valign="top" |
 +
=== Starters Guide ===
 +
To help you get started. Please, read the following:
 +
#[[Gameplay]]
 +
#[[Acquire EECH]]
 +
#'''[[Installation guide]]'''
 +
#[[Multiplayer|Multiplayer guide]]
 +
#[[Quick start]]
 +
 
 +
<font size="1">[[System requirements]] / [[FAQ]]</font>
 +
 
 +
| width="33%" style="background:#FFEDED" valign="top" |
 +
 
 +
=== Interesting Articles ===
 +
* about [[Enemy Engaged 2]]
 +
* [[eech.ini]]
 +
* [[Engine startup]]
 +
* [[Priority Fire Zones]]
 +
* [[Designated target list]]
 +
* [[Map list]]
 +
* [[Mi-24V Section]]
 +
* [[Clickable Cockpits]]
 +
* <font color="grey">[[ToC|more...]]<font>
 +
 
 +
| width="33%" style="background:#DFE7FF" valign="top" |
 +
 
 +
=== Strategy Guides ===
 +
*  [http://simhq.net/downloads/air_combat/eech/ApacheHavocManual.pdf Apache Havoc Manual]
 +
*  [http://simhq.net/downloads/air_combat/eech/apache_vs_havoc_guide.pdf Apache Havoc Strategy Guide]
 +
*  [http://simhq.net/downloads/air_combat/eech/EECHManual.pdf Comanche Hokum Manual]
 +
*  [http://simhq.net/downloads/air_combat/eech/comanche_vs_hokum_guide.pdf Comanche Hokum Strategy Guide]
 +
*  [https://app.box.com/s/2vota2riw3tev8giain2 EECH Keycard]
 +
*  Training missions:
 +
** [http://www.simhq.com/forum/ubbthreads.php/topics/1652467/1 1/4]
 +
** [http://www.simhq.com/forum/ubbthreads.php/topics/1652499/1 2/4]
 +
** [http://www.simhq.com/forum/ubbthreads.php/topics/1652510/1 3/4]
 +
** [http://www.simhq.com/forum/ubbthreads.php/topics/1652531/1 4/4]
 +
*  [[hints]]
 +
|-
 +
| colspan="3" width="100%" style="text-align:center;paddig:50px 10px;font-size: 150%;"|
 +
Categories
 +
|-
 +
| width="33%" style="background:#C8FEC5;text-align:center;paddig:50px 10px;font-weight:600;font-size:18px;" |
 +
[[:Category:Installation_and_setup|Installation and setup‏‎]]
 +
| width="33%" style="background:#C8FEC5;text-align:center;paddig:50px 10px;font-weight:600;font-size:18px;" |
 +
[[:Category:Eech.ini‏‎|Eech.ini‏‎‏‎]]
 +
| width="33%" style="background:#C8FEC5;text-align:center;paddig:50px 10px;font-weight:600;font-size:18px;" |
 +
[[:Category:Troubleshooting‏‎ |Troubleshooting‏‎ ‏‎]]
 +
|-
 +
| width="33%" style="background:#FFDDDD;text-align:center;paddig:50px 10px;font-weight:600;font-size:18px;" |
 +
[[:Category:Tutorials‏‎|Tutorials‏‎]]
 +
| width="33%" style="background:#FFDDDD;text-align:center;paddig:50px 10px;font-weight:600;font-size:18px;" |
 +
[[:Category:Gameplay‏‎|Gameplay‏‎‏‎‏‎]]
 +
| width="33%" style="background:#FFDDDD;text-align:center;paddig:50px 10px;font-weight:600;font-size:18px;" |
 +
[[:Category:Campaign|Campaign‏‎‏‎]]
 +
|-
 +
| colspan="3" width="100%" style="background:#CFD7FF;text-align:center;paddig:50px 10px;font-weight:600;font-size:18px;"|
 +
[[:Category:Developing‏‎|Developing‏‎]]
 +
 
 +
|}
 +
 
 +
[[category:installation and setup]] [[Category:eech.ini]] [[Category:tutorials]] [[Category:Developing]] [[category:Gameplay]] [[category:campaign]] [[Category:tutorials]]

Latest revision as of 17:22, 9 January 2024

EECH Central Logo

Introduction

Community-created Mi-24V cockpit

Enemy Engaged – Comanche vs. Hokum (EECH) is a combined forces realtime battlefield helicopter simulation.

The player pilots an attack helicopter inside a dynamic campaign. Instead of being confined to separate pre-defined "missions" like in so many other simulation games, it is possible to see the battle unfold across the entire battlefield in real time, without "load times" during missions. Your tasks in the game range from attack missions on enemy bases, FARPs and vehicles, close air support or interdiction of enemy air defences, recon-missions to obtain photographic intelligence, down to simple transfer missions to replenish your forces.

Effective air defence simulations necessitate NOE (Nap of the Earth) flying and the use of terrain as cover, as well as making best use of the stealth characteristics of the Comanche helicopter. A "Mission Commander" feature allows players to define their own missions and ultimately control the battle strategy from a powerful interactive game map that integrates seamlessly with the 3D action. The entire battlefield simulation is fully networked and supports multiple human pilots on either side of the simulated conflict.

There are 9 helicopters modelled in the game that are flyable with their own cockpits, and seven of those have 3D cockpits. On the Blue side, these are the AH-64A Apache, AH-64D Apache Longbow, the RAH-66 Comanche, the AH-1Z Viper, and the OH-58D Kiowa. On the Red side, these are the Ka-52 "Hokum B", the Ka-50 "Black Shark", the Mi-28N "Havoc", and the Mi-24V Hind. All other helicopters in the game are flyable, but they use a 'default' cockpit from the Apache A.

Shot08.jpg

The game tries to be as realistic as possible, having features like the realistic engine startup procedure and the priority fire zones for example, while retaining the ease-of-use factor that makes it popular with players who are more interested in action than avionics. Support for innovative input devices like TrackIR allow for an optimal level of immersion. Combined with the truly massive environments that retain a realistic sense of scale.

Although the original game was released in 1999, the community has developed substantial graphics and gameplay-related enhancements, aside from stability and multiplayer improvements. The release of the game's source code ensured that an active fan community grew in size, turning EECH into it's current game.

You can have a look at some screenshots of the game in the gallery.


April 14th 2020 v1.16.1 released

Folder.png 1.16.1 allMods patch (1.16.0 is required!)
(Mirror)

Folder.png 1.16.0 allMods installer
(Mirror)

Review-icon.png Details
Review-icon.png Installation guide
Review-icon.png Dual Install

Guides & manuals

Review-icon.png List of all pages

Starters Guide

To help you get started. Please, read the following:

  1. Gameplay
  2. Acquire EECH
  3. Installation guide
  4. Multiplayer guide
  5. Quick start

System requirements / FAQ

Interesting Articles

Strategy Guides

Categories

Installation and setup‏‎

Eech.ini‏‎‏‎

Troubleshooting‏‎ ‏‎

Tutorials‏‎

Gameplay‏‎‏‎‏‎

Campaign‏‎‏‎

Developing‏‎