Helmet liner evaluation to mitigate head response from primary blast exposure

Head injury resulting from blast loading, including mild traumatic brain injury, has been identified as an important blast-related injury in modern conflict zones. A study was undertaken to investigate potential protective ballistic helmet liner materials to mitigate primary blast injury using a detailed sagittal plane head finite element model, developed and validated against previous studies of head kinematics resulting from blast exposure. Five measures reflecting the potential for brain injury that were investigated included intracranial pressure, brain tissue strain, head acceleration (linear and rotational) and the head injury criterion. In simulations, these measures provided consistent predictions for typical blast loading scenarios. Considering mitigation, various characteristics of foam material response were investigated and a factor analysis was performed which showed that the four most significant were the interaction effects between modulus and hysteretic response, stress–strain response, damping factor and density. Candidate materials were then identified using the predicted optimal material values. Polymeric foam was found to meet the density and modulus requirements; however, for all significant parameters, higher strength foams, such as aluminum foam, were found to provide the highest reduction in the potential for injury when compared against the unprotected head.     

The epidemiology of blast lung injury during recent military conflicts: a retrospective database review of cases presenting to deployed military hospitals, 2003-2009

Blast injuries are becoming increasingly common in military conflicts as the nature of combat changes from conventional to asymmetrical warfare and counter-insurgency. This article describes a retrospective database review of cases from the UK joint theatre trauma registry from 2003 to 2009, containing details of over 3000 patients, mainly injured in Iraq and Afghanistan. During this period, 1678 patients were injured by explosion of whom 113 had evidence of blast lung injury. Of the 50 patients who survived to reach a medical facility, 80 per cent required ventilatory support. Injuries caused by explosion are increasing when compared with those caused by other mechanisms, and blast lung represents a significant clinical problem in a deployed military setting. Management of these patients should be optimized from point of wounding to definitive care.     

Blast injuries to the lung: epidemiology and management

Lung injury is frequently a component of the polytrauma sustained by military personnel surviving blast on the battlefield. This article describes a case series of the military casualties admitted to University Hospital Birmingham's critical care services (role 4 facility), during the period 1 July 2008 to 15 January 2010. Of the 135 casualties admitted, 107 (79.2%) were injured by explosive devices. Plain chest films taken soon after arrival in the role 4 facility were reviewed in 96 of the 107 patients. In 55 (57.3%) films a tracheal tube was present. One or more radiological abnormalities was present in 66 (68.75%) of the films. Five patients met the consensus criteria for the definition of adult respiratory distress syndrome (ARDS). The majority of casualties with blast-related lung injury were successfully managed with conventional ventilatory support employing a lung protective strategy; only a small minority received non-conventional support at any time in the form of high-frequency oscillatory ventilation. Of those casualties who survived to be received by the role 4 facility, none subsequently died as a consequence of lung injury.     

Blast injury research models

Blast injuries are an increasing problem in both military and civilian practice. Primary blast injury to the lungs (blast lung) is found in a clinically significant proportion of casualties from explosions even in an open environment, and in a high proportion of severely injured casualties following explosions in confined spaces. Blast casualties also commonly suffer secondary and tertiary blast injuries resulting in significant blood loss. The presence of hypoxaemia owing to blast lung complicates the process of fluid resuscitation. Consequently, prolonged hypotensive resuscitation was found to be incompatible with survival after combined blast lung and haemorrhage. This article describes studies addressing new forward resuscitation strategies involving a hybrid blood pressure profile (initially hypotensive followed later by normotensive resuscitation) and the use of supplemental oxygen to increase survival and reduce physiological deterioration during prolonged resuscitation. Surprisingly, hypertonic saline dextran was found to be inferior to normal saline after combined blast injury and haemorrhage. New strategies have therefore been developed to address the needs of blast-injured casualties and are likely to be particularly useful under circumstances of enforced delayed evacuation to surgical care.     

Prediction of globe rupture caused by primary blast: a finite element analysis

Although a human eye comprises less than 0.1% of the frontal body surface area, injuries to the eye are found to be disproportionally common in survivors of explosions. This study aimed to introduce a Lagrangian–Eulerian coupling model to predict globe rupture resulting from primary blast effect. A finite element model of a human eye was created using Lagrangian mesh. An explosive and its surrounding air domain were modelled using Eulerian mesh. Coupling the two models allowed simulating the blast wave generation, propagation and interaction with the eye. The results showed that the peak overpressures caused by blast wave on the corneal apex are 2080, 932.1 and 487.3 kPa for the victim distances of 0.75, 1.0 and 1.25 m, respectively. Higher stress occurred at the limbus, where the peaks for the three victim distances are 25.5, 14.1 and 6.4 MPa. The overpressure threshold of globe rupture was determined as 2000 kPa in a small-scale explosion. The findings would provide insights into the mechanism of primary blast-induced ocular injuries.     

原发冲击伤模拟实验概述

冲击波致伤动物模型是原发冲击伤模拟实验研究的前提和保障。目前绝大多数实验模拟冲击波是使用炸药产生冲击波和冲击波生成装置两种方法。早期建立冲击伤模型是使用烈性炸药产生冲击波致伤动物,随着技术的发展,冲击波生成装置取代烈性炸药应用到动物实验研究中。冲击波生成装置常见两种类型：生物激波管装置和激光冲击波发生装置。各种生物激波管装置已发展成熟并被广泛使用,激光冲击波发生装置也显示出独特的优势,大大促进了冲击伤模拟实验研究的开展。     

Molecular cloning and differential expression of an aldehyde dehydrogenase gene in rice leaves in response to infection by blast fungus

Aldehyde dehydrogenase (ALDH) superfamily is a group of enzymes metabolizing endogenous and exogenous aldehydes. Using differential display RT-PCR and cDNA library screening, a full-length aldehyde dehydrogenase cDNA (ALDH7B7) was isolated from rice leaves infected by incompatible race of blast fungus Magnaporthe grisea. The deduced amino acid sequence consists of 509 amino acid residues and shares 74∼81% identity with those of ALDH7Bs from other plants. ALDH7B7 expression was induced by blast fungus infection, ultraviolet, mechanical wound in rice leaves and was not detected in untreated rice organs. This gene has also been found to be inducible after exogenous phytohormones application, such as salicylic acid, methyl ester of jasmonic acid and abscisic acid. The function of ALDH7B7 in the interaction process between blast fungus and rice is discussed.     

Co-culture of primary pulmonary cells to model alveolar injury and translocation of proteins

Summary Primary rat alveolar type II cells and early passage rat lung fibroblasts were co-cultured on opposite sides of a collagen-coated polycarbonate filter. This is an approach to “model”, in part, an alveolar wall to study mechanisms of cytotoxicity and translocation of bioactive materials from the alveolar space to the lung interstitium. Type II cells were recovered from adult rat (Fischer 344) lungs by enzyme digestion and “panning”. Lung fibroblasts were separated from the same species, cultured initially in 10% fetal bovine serum and used in the co-culture system at early passage. The type II cells formed a monolayer of defferentiated epithelium which provided a barrier on the upper side of the collagen (human type IV)-coated filter. The fibroblasts on the bottom of the filter replicated logarithmically in the presence of serum, could be rendered quiescent in defined medium and then returned to rapid growth phase with the reintroduction of serum. The intact epithelial monolayer excluded trypan blue, albumin, platelet-derived growth factor, and alpha₂-macroglobulin from the lower compartment of the culture chamber. Altering the integrity of the monolayer by a variety of means allowed translocation of these materials through the collagen-coated filters. Particularly interesting was the effect of taurine chloramine which caused subtle changes in the alveolar epithelium and allowed subsequent translocation of albumin. In addition, we showed that rat alveolar macrophages remain viable with some spreading on the surface of the epithelial monolayer. This co-culture system will have future application in the study of how reactive oxygen species might affect the epithelial barrier, and whether macrophage-derived growth factors can influence fibroblast proliferation if the monolayer is intact or injured.     

硫化氢对大鼠内毒素性急性肺损伤肺泡表面活性物质的影响

目的：观察脂多糖（LPS）所致内毒素性急性肺损伤（ALI）大鼠肺泡表面活性物质（PS）的变化及硫化氢（H2S）对PS的影响,探讨H2S对肺脏的作用机制。方法：雄性SD大鼠共48只,随机分为6组（n=8）：空白对照组、LPS组、LPS＋NaHS低、中、高剂量组、LPS＋PPG组。空白对照组给予生理盐水,LPS组给予LPS,LPS＋NaHS低、中、高剂量组和LPS＋PPG组分别在给予LPS3h时腹腔注射低、中、高剂量氢硫化钠（NariS）或炔丙基甘氨酸（PPG）。各组均于给予生理盐水或LPS6h时电镜下观察肺泡Ⅱ型上皮细胞（AEC-Ⅱ）的形态改变,检测血浆中H2S含量、肺组织中胱硫醚-γ-裂解酶（CSE）活性、肺泡灌洗液（BALF）中总蛋白（1P）和总磷脂（TPL）含量、及肺组织中肺泡表面活性蛋白A、B、C（SP-A、B、C）mRNA表达的变化。结果：①与空白对照组比较,LPS组AEC-Ⅱ超微结构明显受损,血浆中H2S含量、肺组织中CSE活性、BALF中TPL的含量、及肺组织中SP-A、B、CmRNA表达均明显降低（P〈0．05,P〈0．01）,BALF中TP的含量明显增加（P〈0．01）;②与LPS组比较,LPS＋NaHS低、中、高剂量组,AEC-Ⅱ超微结构均有所恢复,血浆中H2S含量、肺组织中CSE海性、SP-AmRNA表达均明显升高（P〈0．05,P〈0．01）;LPS＋NaHS中、高剂量组BALF中吼含量明显增高,SP-BmRNA表达升高（P〈0．05）;LPS＋NaHS高剂量组BALF中,IP含量明显降低（P〈0．05）;LPS＋NaHS各剂量组SP-CznRNA表达无明显变化;③与LPS组比较,LPS＋PPG组AEC-Ⅱ超微结构仍损伤严重,血浆中H2S含量、肺组织中CSE活性、BALF中TPL的含量、及肺组织中SP-A、B、CmRNA表达均明显降低（P〈0．05）,BALF中TP的含量明显升高（P〈0．05）。结论：PS降低是内毒素性ALI的重要病理生理过程,H2S对LPS诱导的ALI有保护性作用,其机制可能与H2S对PS的调节有关。     

慢性粒细胞性白血病急变的分子机制

慢性粒细胞性白血病(chronic myelogenous leukemia,CML)是源于造血干细胞伴有t(9;22)(q34;q11)染色体易位的恶性骨髓增生性疾病,其急变期与急性白血病相似,具有较强致死性。本文对CML急变分子机制有关的最新研究成果进行了综述,旨在深入理解CML急变的分子机制,并试图发现新的研究思路。     

An approach to cloning of Pi-b rice blast resistance gene

A contig of clones from BAC rice genomic library encompassing blast resistance gene Pi-b was constructed. On an average eight clones (8 ± 2.6) were picked up by each marker, which was expected basing on the BAC library size (Nakamura et al. 1997). The 2.4 cM distance between flanking RFLP markers G 1234 and RZ 213 (Miyamoto et al. 1996) was spanned with 4 steps of contig including 25 clones. The physical distance of 370 kb between flanking markers corresponds to a small ratio of physical and genetical distances (155 kb/cM) due to a probable structure of the gene locus near the telomeric end of the chromosome. Markers cosegregating with blast resistance against Magnoporthe grisea were localized in a 2 kb restriction fragment. A new border marker was found on the telomeric side of the Pi-b gene, less than 10 kb from cosegregating markers. No clear marker for the centromeric side of the gene was found but the position of Pi-b rice blast resistant gene was narrowed to within at least 50 kb, which is to our knowledge the most precised estimation of the position of this gene.     

Lineage-specific function of Engrailed-2 in the progression of chronic myelogenous leukemia to T-cell blast crisis

In hematopoietic malignancies, oncogenic alterations interfere with cellular differentiation and lead to tumoral development. Identification of the proteins regulating differentiation is essential to understand how they are altered in malignancies. Chronic myelogenous leukemia (CML) is a biphasic disease initiated by an alteration taking place in hematopoietic stem cells. CML progresses to a blast crisis (BC) due to a secondary differentiation block in any of the hematopoietic lineages. However, the molecular mechanisms of CML evolution to T-cell BC remain unclear. Here, we have profiled the changes in DNA methylation patterns in human samples from BC-CML, in order to identify genes whose expression is epigenetically silenced during progression to T-cell lineage-specific BC. We have found that the CpG-island of the ENGRAILED-2 (EN2) gene becomes methylated in this progression. Afterwards, we demonstrate that En2 is expressed during T-cell development in mice and humans. Finally, we further show that genetic deletion of En2 in a CML transgenic mouse model induces a T-cell lineage BC that recapitulates human disease. These results identify En2 as a new regulator of T-cell differentiation whose disruption induces a malignant T-cell fate in CML progression, and validate the strategy used to identify new developmental regulators of hematopoiesis.     

硫酸锌对肠系膜上动脉闭塞性休克后肺损伤的治疗作用

目的：探讨硫酸锌对肠系膜上动脉闭塞性（SMAO）休克后肺损伤的治疗作用及其机制。方法：行腹部手术分离出肠系膜上动脉并夹闭,2h后松夹,复制家兔SMAO休克模型。检测给与硫酸锌后SMAO休克家兔血浆及红细胞膜丙二醛（MDA）、红细胞超氧化物歧化酶（SOD）、血浆黄嘌呤氧化酶（XOD）含量;同时检测肺组织MDA、SOD和肺表面活性物质（PS）的含量,并观察小肠和肺的病理改变。结果：硫酸锌可使MDA及XOD含量降低,且可防止SOD和PS减少,避免了SMAO休克后肺损伤的进行性加剧。结论：SMAO休克并发急性肺损伤与组织氧化过程代谢紊乱有关,硫酸锌通过其稳膜作用能减轻或在一定程度上防止休克后肺损伤的发生和发展。