Biomechanical Characterization of Internal Layer Subfailure in Blunt Arterial Injury

Blunt carotid artery injuries occur in 0.3% of blunt injured patients and may lead to devastating neurological consequences. However, arterial mechanics leading to internal layer subfailure have not been quantified. Twenty-two human carotid artery segments and 18 porcine thoracic aorta segments were opened to expose the intimal side and longitudinally distracted to failure. Porcine aortas were a geometrically accurate model of human carotid arteries. Internal layer subfailures were identified using videography and correlated with mechanical data. Ninety-three percent (93%) of vessels demonstrated subfailure prior to catastrophic failure. All subfailures occurred on the intimal surface. Initial subfailure occurred at 79% of the stress and 85% of the strain to catastrophic failure in younger porcine specimens, compared to 44% and 60%, respectively, in older human specimens. In most cases, multiple subfailures occurred prior to catastrophic failure. Due to limitations in human specimen quality (age, prior storage), young and fresh porcine aorta specimens are likely a more accurate model of clinical blunt carotid artery injuries. Present results indicate that vessels are acutely capable of maintaining physiologic function following initial subfailure. Delayed symptomatology commonly associated with blunt arterial injuries is explained by this mechanics-based and experimentally quantified onset of subcatastrophic failure.     

肾脏钝性撞击损伤影响因素的有限元方法研究

目的 采用有限元方法研究肾脏钝性撞击损伤的影响因素。方法 基于肾脏CT图像构建不同年龄人群肾脏有限元模型,重构肾脏钝性撞击实验,分析肾脏材料本构参数、肾脏组织结构、肾脏大小、撞击位置和撞击速度等参数对肾脏损伤的影响。结果 相同撞击工况下,肾皮质应力随肾脏质量的增加有所减少,随撞锤撞击速度的增加而增加;肾包膜具有一定的吸能效果,从而降低肾脏的应力;肾脏受到撞击时,侧面撞击的肾皮质应力明显高于正面撞击。结论 相比黏弹性本构模型,Mooney Rivlin材料本构模型更适合用于肾脏损伤的有限元评价;肾脏损伤随肾脏质量的增加有所减少;撞锤撞击速度的增加会加剧肾脏损伤;肾包膜会一定程度上减轻肾脏损伤,故在进行肾脏有限元建模时,必须考虑肾包膜结构的存在;相比正面和背面撞击,肾脏侧面受到撞击时损伤相对更严重。     

Lateral Impact Validation of a Geometrically Accurate Full Body Finite Element Model for Blunt Injury Prediction

This study presents four validation cases of a mid-sized male (M50) full human body finite element model—two lateral sled tests at 6.7 m/s, one sled test at 8.9 m/s, and a lateral drop test. Model results were compared to transient force curves, peak force, chest compression, and number of fractures from the studies. For one of the 6.7 m/s impacts (flat wall impact), the peak thoracic, abdominal and pelvic loads were 8.7, 3.1 and 14.9 kN for the model and 5.2 ± 1.1 kN, 3.1 ± 1.1 kN, and 6.3 ± 2.3 kN for the tests. For the same test setup in the 8.9 m/s case, they were 12.6, 6, and 21.9 kN for the model and 9.1 ± 1.5 kN, 4.9 ± 1.1 kN, and 17.4 ± 6.8 kN for the experiments. The combined torso load and the pelvis load simulated in a second rigid wall impact at 6.7 m/s were 11.4 and 15.6 kN, respectively, compared to 8.5 ± 0.2 kN and 8.3 ± 1.8 kN experimentally. The peak thorax load in the drop test was 6.7 kN for the model, within the range in the cadavers, 5.8–7.4 kN. When analyzing rib fractures, the model predicted Abbreviated Injury Scale scores within the reported range in three of four cases. Objective comparison methods were used to quantitatively compare the model results to the literature studies. The results show a good match in the thorax and abdomen regions while the pelvis results over predicted the reaction loads from the literature studies. These results are an important milestone in the development and validation of this globally developed average male FEA model in lateral impact.     

牛磺酸对大鼠心脏模拟缺血再灌注损伤的保护作用

在离体大鼠心脏模拟缺血再灌注(I/R)损伤的模型上观察了牛磺酸的心肌保护作用。实验结果发现预先给大鼠牛磺酸灌胃(300mg/kg)三日或再灌注同时给药(20mmol/L),对心肌均有保护作用,明显减少心肌细胞内的Mb、LDH的漏出,降低心肌MDA的生成,减轻细胞内钙的聚集,促进心肌ATP含量的恢复。在本实验条件下预防应用牛磺酸较再灌注的同时应用更为有效,表现为更大程度地减少LDH漏出,抑制心肌MDA生成和钙聚集。结果证明牛磺酸具有心肌保护作用,对于防治心肌I/R损伤可能具有临床应用价值。     

碱性成纤维细胞生长因子对缺血／再灌注大鼠心脏的保护作用

本实验在Ｌａｎｇｅｎｄｏｒｆ灌流装置上观察了碱性成纤维细胞生长因子（ｂＦＧＦ）对大鼠心肌缺血／再灌注（Ｉ／Ｒ）损伤的保护作用。结果表明：ｂＦＧＦ对心肌损伤有明显的保护作用。表现为：缓解冠脉流量的减少及冠脉流出液中蛋白、肌红蛋白和乳酸脱氢酶以及心肌组织丙二醛和钙含量的升高（Ｐ＜０．０５或（Ｐ＜０．０１），且缺血前给药的保护效果优于缺血后再灌时给药。     

Blunt cerebrovascular injuries

Over the past decade, the recognition and subsequent management of blunt cerebrovascular injuries has undergone a marked evolution. Originally thought to be a rare occurrence, blunt cerebrovascular injuries are now diagnosed in approximately 1% of blunt trauma patients. The recognition of a clinically silent period allows for angiographic screening for injuries based upon the mechanism of trauma and the patient's constellation of injuries. Comprehensive screening of patients has resulted in the early diagnosis of blunt cerebrovascular injuries during the asymptomatic phase, thus allowing treatment that could prevent neurologic sequelae. Although the ideal regimen of antithrombotic therapy is yet to be determined, treatment with either antiplatelet or anticoagulant agents has been shown to reduce the blunt cerebrovascular injuries related stroke rate. Blunt cerebrovascular injury is a rare but potentially devastating injury; appropriate angiographic screening in high-risk patients should be performed and prompt treatment initiated to prevent ischemic neurologic events.     

三氧化二砷预处理在离体心肌缺血-再灌注损伤中保护作用的初探

目的研究三氧化二砷（As2O3）预处理在心肌缺血-再灌注损伤中的保护作用,并初步探讨其机制。方法分别采用低中高三个剂量As2O3预处理大鼠,利用离体大鼠心脏Langendorff灌流模型,观察心功能、心肌梗死面积,SOD,MDA等指标的变化。结果As2O3预处理各组的左室舒张末压（LVDEP）、左室发展压（LVDP）、最大左室收缩速率（＋dP／dtmax）和最大左室舒张速率（-dP／dtmax）等各项心功能指标均得到明显改善,SOD活性显著升高,MDA含量大幅度下降。结论As2O3,预处理可对抗心肌缺血一再灌注性损伤,其作用可能与抗氧化应激有关。     

依达拉奉对离体大鼠心肌缺血再灌注损伤的保护作用

目的:探讨依达拉奉(ED)预先给药对大鼠离体心肌缺血再灌注(I/R)损伤的作用及其机制。方法:制作Langendorff主动脉逆行灌注心脏I/R模型。24只雄性大鼠随机分为三组(n均=8):对照组(C组)、I/R组、ED组。观察各组大鼠I/R后心功能指标:左室收缩峰压(LVSP)、左室压上升最大速率(+dp/dtmax)、左室压下降最大速率(-dp/dtmax)、冠脉流量(CF)、心肌细胞乳酸脱氢酶(LDH)及肌酸激酶同工酶(CK-MB)活性、心肌组织丙二醛(MDA)含量和超氧化物歧化酶(SOD)活性。结果:与基础值和C组比较,I/R组再灌注时各时点的CF、LVSP、+dp/dtmax、-dp/dtmax降低(P<0.05);与I/R组比较,ED组再灌各时点的CF、LVSP、+dp/dtmax、-dp/dtmax增高(P<0.05);ED组心肌SOD活性明显高于I/R组(P<0.05),LDH及CK-MB活性、MDA含量低于I/R组(P<0.05)。结论:ED对I/R心肌有保护作用,能促进心功能恢复。其机制与清除自由基和减轻氧化应激有关。     

降纤酶对离体大鼠工作心脏缺血再灌注损伤的作用

目的 :探讨降纤酶 ( Df)对心脏缺血再灌注损伤的作用。方法 :采用离体大鼠工作心脏缺血再灌注损伤模型 ,通过检测缺血再灌注损伤前后对照组、Df低剂量组及 Df高剂量组的心功能参数 ,观察Df的作用。结果 :Df可降低实验动物的室颤发生率 ,增强心肌收缩力 ( P<0 .0 5 ) ,防止冠脉流量下降 ( P<0 .0 5 )及左室内压下降 ( P<0 .0 1) ,促进压力最大上升速度的恢复 ( P<0 .0 5 )。结论 :Df对心脏缺血再灌注损伤具有显著的保护作用。