冲击波暴露后豚鼠耳蜗基底膜撕裂伤

目的 探讨爆炸冲击波和实验性冲击波负压引起耳蜗基底膜机械损伤的组织病理学特点.方法 将豚鼠暴露于爆炸冲击波和实验性冲击波负压后,分别应用火棉胶包埋组织切片技术和基底膜硬铺片技术,于光学显微镜下观察.结果 爆炸冲击波和实验性冲击波负压暴露后8～24 h即可见基底膜外毛细胞大部分缺失.当爆炸冲击波超压峰值达到121 kPa和实验性冲击波负压峰值达到-78.4 kPa时,分别发现穿透基底膜全层的位于第二转的横形及纵形机械性撕裂伤,横形撕裂伤穿透基底膜全层,从内毛细胞内侧直至第三排外毛细胞外侧;纵形撕裂形状不规则,长度相当于与其相邻的10个内毛细胞空间位置,宽度累及第二、三排外毛细胞区,一端累及内毛细胞区.结论 较大强度的爆炸冲击波和实验性冲击波负压均可导致豚鼠耳蜗基底膜的机械性撕裂性损伤.     

爆炸冲击波载荷下的人体胸部有限元模型数值模拟研究

目的探讨爆炸冲击波载荷下的人体胸部周围压力的分布、肺脏的应力分布规律,为冲击波致伤机制、损伤评估的研究提供帮助。方法对正常国人进行CT扫描,在Mimics中完成人体胸部三维表面模型的重建,通过Icem CFD软件进行网格划分,在Ls-Dyna中完成爆炸冲击波的加载与求解。结果构建了冲击波载荷下的人体胸部三维有限元模型。该模型由肌肉、肩胛骨、胸肋骨、心脏和肺脏五部分组成,单元类型为四节点四面体单元,单元总数为129543个,节点总数为32267个。当加载100kPa冲击波压力时,胸腔两侧冲击波峰压大小相近,为55～80kPa;胸腔前表面冲击波压力峰值最高,达到175kPa;胸腔后面是峰压为70kPa绕射冲击波;肺脏中产生应力最大的部位为肺部的边缘部位。结论构建的人体胸部有限元模型能够满足爆炸冲击波加载的要求;人体胸部有限元模型在爆炸冲击波载荷下的数值模拟研究可以模拟冲击波的加载过程和结果。     

颌面部破冲复合伤模型的建立与研究

目的 :建立颌面部破冲复合伤模型 ,并初步研究颌面部爆炸伤的特点 .方法 :采用雷管作爆炸源 ,滑膛枪发射钢珠模拟破片 ,同步测速及测压系统检测致伤参数 ,建立致伤模型 .整个致伤模型为一同步控制系统 ,由破片发射触发 .由破片对犬颌面部致伤 ,雷管悬于弹着点上方 ,爆距设计为 5 ,10 ,15ｃｍ .记录致伤参数 (撞击速度、能量吸收、体表压力 ) ,观察动物伤情 .结果 :该模型能稳定地模拟犬颌面部的爆炸伤 ,爆炸冲击波压力随爆距减少而急升高 .犬颌面部伤情严重 .损伤范围广 ,并有心、肺、脑等脏器的损伤 ,损伤程度随能量吸收与冲击波压力的升高…     

水下爆炸致水面泅渡战位比格犬脑和肺的损伤特点

目的 研究水下爆炸引起水面泅渡战位比格犬脑和肺的损伤情况.方法 20只健康比格犬随机分为4个实验组(距爆源5、8、11和15 m)和1个对照组(n=4).利用1 kg 2,4,6-三硝基甲苯(TNT)裸药在水下2 m实施爆炸对水中漂浮比格犬进行致伤,采用水下及颅内压力传感器和高速摄像机记录爆炸致伤的过程.爆炸后3 h内对存活的比格犬行头部和胸部CT检查及头部MRI检查.爆炸后24 h取脑和肺标本,观察颅脑和胸、肺大体损伤情况,并通过H-E染色和TUNEL染色观察脑和肺组织病理学变化及细胞凋亡情况.结果 压力传感器和高速摄像机观察到水下爆炸的致伤过程包括冲击波作用和气泡作用2个阶段.5 m、8 m、11 m和15 m组比格犬分别死亡4、3、1、0只.头部CT和MRI检查示实验组比格犬脑组织没有明显损伤,胸部CT检查示有肺内出血、气胸、血胸或胸腔积液等表现.H-E染色结果示实验组比格犬脑组织无明显变化,而肺组织肺泡破裂,肺泡腔内有大量红细胞,肺间质内有大量炎症细胞浸润.TUNEL染色仅见海马区少量细胞呈阳性表现,而肺组织肺泡上皮细胞和间质细胞呈现广泛的凋亡坏死趋势.结论 水下爆炸引起水面泅渡战位比格犬的损伤主要为肺爆震伤,脑组织损伤相对轻微.     

水下爆炸致急性脊髓损伤动物模型的构建

目的 构建水下爆炸致急性脊髓损伤(SCI)动物模型,为研究水下爆炸致急性SCI的治疗提供依据.方法 选取新西兰兔24只,随机分为A组(爆炸距离0.3m)、B组(爆炸距离0.8m)和C组(爆炸距离1.5m),每组8只.将实验兔固定在中国科学技术大学研制的水下实验装置中,分别在3种冲击波压力强度下致伤,选取T9～T10段脊髓,观察脊髓组织病理形态学、动物存活情况以及运动功能.结果 同样爆炸当量,A组、B组、C组测得的平均冲击波压力峰值分别为18、5、2 MPa,B组实验兔成活率高,致伤后双下肢运动功能障碍,病理学显示脊髓内见大量散在出血坏死灶,满足实验需要.B组实验兔爆炸前后、爆炸前与致伤后2h、爆炸前与致伤后24 h的改良Tarlov评分,差异有统计学意义(P＜0.05),致伤后2h与24h的改良Tarlov评分差异无统计学意义(P＞0.05);C组实验兔爆炸前后、爆炸前与致伤后2h、爆炸前与爆炸后24h的改良Tarlov评分差异有统计学意义(P＜0.05),致伤后2h与24 h的改良Tarlov评分差异无统计学意义(P＞0.05).结论 水下爆炸装置冲击波压力峰值5 MPa时能够建立急性SCI模型.     

冲击波负压所致大鼠肺损伤的病理学改变

用冲击波负压发生装置模拟单纯的冲击波负压致伤大白鼠。在不同强度冲击波负压作用下，动物可出现不同程度的肺损伤，伤情与冲击波超压所致基本相同。肺病变主要为出血水肿，光镜下可见肺泡扩张、破裂，肺小血管平滑肌离散，腔内气栓形成。电镜下见肺上皮细胞和毛血管内皮细胞的肿胀、缺失，以及血气屏障的水肿等。本文就肺病理意义进行了讨论。     

8 Hz和16 Hz次声对大鼠肺组织及肺氧合功能的影响

目的：观察次声对肺的损伤作用及对动脉血氧分压（PaO2)和动脉血氧饱和度（SaO2%)的影响。方法：SD大鼠300只随机分为正常对照组和次声作用1次,3次,7次,14次,21次6组,置本校研制的次声压力仓内致伤,次声作用组以8Hz和16Hz次声,声压分别为90,100,110,120,130dB的强度,每次作用2h,透射电镜下观察肺超微结构的改变,同时观察PaO2和SaO2%的改变。结果：8Hz,90-110dB单次作用对肺部的超微结构基本无影响,8Hz,120-130dB作用后则肺组织形态学发生改变,而PaO2和SaO2%无明显变化。16Hz,90dB的次声单次作用,即可引起肺组织的损伤,随着声压级的增大,肺组织的影响程度更为明显,8Hz,120dB,130dB和16Hz,90dB,130B的次声多次作用后,PaO2和SaO2％明显下降,与正常对照组相比有显差异（P＜0．01）,3次,7次组的形态学变化最为明显,随着作用次数的增加,其损伤并无继续加重,表现出适应性反应。结论：（1）肺损伤的最小阈值8Hz为120dB和16Hz为90dB,即在一定作用强度范围内,可较明显的反应其频率作用的特性。（2）次声损伤阈值的累积作用证明了细胞发生的变化性质和程度主要与次声作用的声压强度和时间（作用次数）有关。     

大威力弹头爆炸时破片复合冲击波对动物致伤的伤情特点分析

目的 研究大威力弹头爆炸时破片复合冲击波致伤动物的伤情。方法 以某大威力弹头为爆炸源，电引信引爆，动物围绕爆心呈扇形布放，于伤后０～７２ｈ内作大体解剖观察。结果：破片伤的发生率高达８６．７％；且是近爆心动物伤后即刻和早期死亡的主要原因。冲击伤的发生率为８２．２％。结论 破片和冲击波是大威力弹头爆炸时的主要致伤因素，且高速破片有加重冲击伤的作用。     

大威力弹头爆炸时破片复合冲击波对动物 致伤的伤情特点分析

目的：研究大威力弹头爆炸时破片复合冲击波致伤动物的伤情。方法：以某大威力弹头为爆炸源,电引信引爆,动物围绕爆心呈扇形布放,于伤后０～７２ ｈ 内作大体解剖观察。结果：破片伤的发生率高达８６．７％ ,且是近爆心动物伤后即刻和早期死亡的主要原因。冲击伤的发生率为８２．２％ 。结论：破片和冲击波是大威力弹头爆炸时的主要致伤因素,且高速破片有加重冲击伤的作用。     

冲击波对听器的致伤效应研究进展

近几十年来听器冲击一直是军事医学研究的重点之一 ,在冲击波对听器的致伤效应研究方面取得了很大进展 ,为进一步研究听器冲击伤的发生机制和防治 ,打下了良好基础。本文仅就二十多年有关冲击波对中耳和内耳 (主要是耳蜗部分 )的致伤效应研究进展做一综述。1　冲击波对中耳的致伤效应1 1　鼓膜和听骨损伤　鼓膜损伤的程度差异很大 ,可以从血管充血、上皮下出血、血肿、上皮损伤、小的裂隙状穿孔到多发性穿孔甚至完全穿孔 ,鼓膜穿孔严重者可伴有中耳粘膜的撕裂伤[1、2 ] 。超压峰值约 35ｋＰａ的冲击波 ,可使人的鼓膜破裂 ;66 2ｋＰａ(6 75…     

An experimental study of blast injury

This paper presents some aspects of the authors' experimental research on blast injury in the past two years. The main results are as follows: (1) A new designed 39 meter-long shock tube for biological test has been built in the laboratory. Its maximal overpressure values are 215 kPa (in open condition) and 505 kPa (in closed condition). It may meet the need for inflicting blast injuries with various degree of severity. (2) A study of the effect of simulating gun muzzle blast wave on sheep indicated that in the single explosion, the threshold overpressure values inflicting the injury of internal organs were: Lung-37.27 kPa, G-I tract-41.0 kPa; the upper respiratory tract-negative until 73 kPa, while in the multiple (20 times) explosions, they were 23.7, 23.7 and 41.4 kPa, respectively. (3) Using TEM, SEM and some other special techniques, such as morphometry, freeze-fracture technique, labelled lanthanum nitrate technique, etc, it was demonstrated that in the lung with blast injury there were significant pathological changes in pulmonary capillary endothelium, alveolar epithelium and their intercellular junctions with apparent increase of permeability. (4) It has been shown that parallel superficial stripelike hemorrhage typical for lung blast injury is "Intercostal marking" instead of "Rib marking". (5) A new type of material (foamy nickel) for protection against blast wave is presented. It was proved that the material can effectively weaken or eliminate the effect of blast wave on human body.     

短时激波作用下家兔胸腹内压力的变化

在短时激波作用下,机体胸腹腔之间存在着压力差,但缺乏实验证据。本实验通过引爆200g TNT炸药块致伤家兔,观察距爆心1.6m、1.8m和2.0m处爆炸激波作用下的家兔胸腹内压同步变化情况。动物致伤后立即解剖,观察动物伤情。实验结果显示,胸内正、负压峰值明显大于腹内正、负压峰值,而且压力的变化存在着时相上的差异,从胸腹内压峰值和时相变化上证实胸腹间存在着压力差,家兔胸腹腔之间的压力呈双向传导。实验结果提示家兔胸腹腔内器官组织冲击伤的发生可能与体腔扩张引起的负压增高有关,本文就肺冲击伤发生机理从压力差角度加以讨论。     

Blast Injury

The shock wave generated by an explosion (“blast wave”) may cause injury in any or all of the following: (1) direct impact on the tissues of variations in environmental pressure; (2) flying glass and other debris set in motion by it; (3) propulsion of the body. Injuries in the first category affect gas-containing organs (ears, lungs and intestines), and acute death is attributed to air forced into the coronary vessels via damaged pulmonary alveoli. It is estimated that overpressure sufficient to cause lung injury may occur up to five miles from a 20-megaton nuclear explosion. The greatest single hazard from blast is, however, flying glass, and serious wounding from this cause is possible up to 12 miles from an explosion of this magnitude.     

发泡镍对胸部冲击伤的防护效果

本文介绍了一种新型发泡金属材料——发泡镍对冲击波的防护效应。以狗、豚鼠、大鼠作为实验对象,模拟激波管作致伤源,TNT炸药电雷管引爆后致伤。根据致伤后大体解剖及光、电镜观察所见的形态学变化,充分肯定了该材料对冲击波的防护效果。     

Effects of Blast Wave-induced Biomechanical Changes on Lung Injury in Rats

Objective To observe the dynamic impacts of shock waves on the severity of lung injury in rats with different injury distances.Methods Simulate open-field shock waves; detect the biomechanical effects of explosion sources at distances of 40, 44, and 48 cm from rats; and examine the changes in the gross anatomy of the lungs,lung wet/dry weight ratio, hemoglobin concentration, blood gas analysis, and pathology.Results Biomechanical parameters such as the overpressure peak and impulse were gradually attenuated with an increase in the injury distance. The lung tissue hemorrhage, edema, oxygenation index, and pathology changed more significantly for the 40 cm group than for the 44 and 48 cm groups.The overpressure peak and impulse were significantly higher for the 40 cm group than for the 44 and 48 cm groups(P 0.05 or P 0.01). The animal mortality was significantly higher for the 40 cm group than for the other two groups(41.2% vs. 17.8% and 10.0%, P 0.05). The healing time of injured lung tissues for the 40 cm group was longer than those for the 44 and 48 cm groups.Conclusions The effects of simulated open-field shock waves on the severity of lung injuries in rats were correlated with the injury distances, the peak overpressure, and the overpressure impulse.     

Study on myocardial pathological changes after instant deathdue to blast overpressure in rats

ＳｔｕｄｙｏｎｍｙｏｃａｒｄｉａｌｐａｔｈｏｌｏｇｉｃａｌｃｈａｎｇｅｓａｆｔｅｒｉｎｓｔａｎｔｄｅａｔｈｄｕｅｔｏｂｌａｓｔｏｖｅｒｐｒｅｓｓｕｒｅｉｎｒａｔｓＬｉｎＹｕａｎ（林远）；ＣｈｅｎｇＴｉａｎｍｉｎ（程天民）；ＺｈｅｎｇＨｕａｉｅｎ（郑怀...     

Development of serial bio-shock tubes and their application.

ＤｅｖｅｌｏｐｍｅｎｔｏｆｓｅｒｉａｌｂｉｏｓｈｏｃｋｔｕｂｅｓａｎｄｔｈｅｉｒａｐｐｌｉｃａｔｉｏｎＷａｎｇＺｈｅｎｇｇｕｏ王正国，ＳｕｎＬｉｙｉｎｇ孙立英，ＹａｎｇＺｈｉｈｕａｎ杨志焕，ＬｅｎｇＨｕａｇｕａｎｇ冷华光ＪｉａｎｇＪｉａｎｘｉｎ蒋建...     

Development of serial bio-shock tubes and their application

OBJECTIVE: To design and produce serial shock tubes and further examine their application to experimental studies on blast injury. METHODS: Bio-medical engineering technique was used for the design and development of the serial shock tubes. One thousand four hundred and fifty nine animals (757 rats, 105 guinea pigs, 335 rabbits, 240 dogs and 22 sheep) were then used to test the wounding effects of the shock tubes. RESULTS: Three types of bio-shock tubes, that is, large-, medium- and small-scale shock tubes were made in our laboratory. The large-scale shock tube is 39 meters long; the inner diameter of the test section is 1 meter; and the maximum overpressure in the driving section is 10.3 MPa. A negative pressure could be formed by means of the reflected rarefactive wave produced by the end plate. The medium-scale shock tube is 34.5 meters long; the maximum overpressure in the driving section is 22 MPa; the test section is designed to be a knockdown, showing 5 basic types with inner diameter of 77 to 600 millimeters, which could be used for researches on overpressure, explosive decompression, underwater explosion, and so on. The small-scale shock tube is 0.5 meter long with the maximum endured overpressure of 68.6 MPa. Results from animal experiments showed that this set of shock tubes could induce various degrees of systemic or local blast injury in large or small animals. CONCLUSIONS: This set of bio-shock tubes can approximately simulate typical explosive wave produced by nuclear or charge explosion, and inflict various degrees of blast injury characterized by stability and reproducibility. Therefore, they can meet the needs of blast research on large and small animals.     

大面积瓦斯烧伤并吸入性损伤170例治疗分析

目的总结瓦斯爆炸烧伤并发吸入性损伤的治疗经验。方法分析170例瓦斯爆炸并发吸入性损伤、变化、以及伤情特点和治疗中的重点进行探讨。结果170例中爆炸复合伤142例(83．5％),出现呼吸功能不全108例(63．5％),并发肺部感染96例(56．4％),治愈124例(72．9％),死亡46例,死亡率27％。结论及时解除瓦斯爆炸致吸入性损伤的呼吸道梗阻,应用支纤镜清除呼吸道内吸入物,用呼吸机,维持有效气体交换,正确、及时复苏、治疗,连续血气监测、纠正低氧血症,可提高治愈率。     

Effects of ambient pressure on the severity of blast injury in rats

The effects of different ambient pressures of 53.99,61.33 and 96.60 kPa on theseverity of blast injury were observed in rats.It was found that when the incident shock wavewas 190.40 kPa in its peak pressure and 10 ms in its duration, both the mortality and the severityof lung injury were progressively increased along with the decrease of the ambient pressure.Themortality rate of the rats in the 6th hour after exposure was 0%,25% and 36.8% and the hem-orrhagic area on the lungs was 63.75+69.01,313.50+357.25 and 653.21+652.25 squaremilimeters when the ambient pressure was 96.60,61.33 and 53.99 kPa respectively.In addi-tion, the lung/body index was 0.93+0.21%,1.31+0.65% and 1.50+0.77% respectively.Itis believed that the decrease of the ambient pressure might decrease the tolerance of the rat to theimpact of blast waves to result in higher mortality and more extensive hemorrhage on the lungs.