Multi-detector computed tomography demonstrates smoke inhalation injury at early stage

A multitrauma victim was transported to our trauma centre. Smoke inhalation injury was suspected based on trauma history and clinical examination. The first trauma computer tomography (CT) obtained 2.8 h after the injury revealed subtle ground-glass opacifications with mainly peribronchial distribution and patchy peribronchial consolidations centrally in the left lung. A repeated scan showed a more distinctive demarcation of the peribronchial opacities, further substantiating the clinically verified smoke inhalation injury. The golden standard for diagnosing smoke inhalation injury still is fibroptic bronchoscopy examination. This paper shows that lesions typical to smoke inhalation injury appear much earlier than previously reported. Whether assessment of smoke inhalation injury severity using CT could clinically benefit patients is controversial and still requires further research. Multi-detector computed tomography is readily available in trauma centres and to simply neglect its potential as a diagnostic tool in some inhalation injury would be unwise.     

Doppler Ultrasound Evaluation of Facial Transverse and Infraorbital Arteries: Influence of Smoking and Aging Process

Background Plastic surgeons are always concerned about integrity of facial vascularization in smokers and elderly candidates for face-lifting. Using Doppler ultrasound, this study aimed to evaluate influence of chronic smoking and aging on facial transverse and infraorbital artery blood flow. Methods For this study, 40 healthy volunteer women were submitted to bilateral Doppler ultrasound of facial transverse and infraorbital arteries. Volunteers were divided into three groups: group 1 (13 nonsmoking women ages 18–33 years), group 2 (13 nonsmoking women ages 55–70 years), and group 3 (14 smoking women ages 55–70 years). Blood flow parameters measured were peak systolic velocity, end-diastolic velocity, resistivity index, and pulsatility index. Results Chronic smoking did not cause statistically significant alterations in peak systolic velocity in any of the arteries. However, there was a significant augmentation of end-diastolic velocity and a reduction in resistivity and pulsatility index in both arteries. Aging process did not significantly alter any of the parameters evaluated. Findings in both sides of the face were similar for both arteries. Conclusions Chronic smoking significantly altered end-diastolic velocity, resistivity, and pulsatility index in regional arterial circulation of the face. Aging process, however, did not significantly influence any of blood flow parameters studied.     

基于Toll样受体4/核因子κB通路观察香烟烟雾溶液刺激对人支气管上皮样细胞相关基因表达的影响

目的 观察Toll样受体4(TLR4)基因沉默或过表达后香烟烟雾溶液（CSE）对人支气管上皮样细胞（16HBE）相关基因表达的影响。方法 2020年8—12月,用常规培养的人支气管上皮样细胞16HBE作为空白对照组,实验设干扰小RNA(siRNA)TLR4-1组（hs-TLR4-si-1+16HBE）、siRNA TLR4-2组（hs-TLR4-si-2+16HBE）、siRNA TLR4-3组（hs-TLR4-si-3+16HBE）,另设阴性对照组（NC+16HBE）,实时荧光定量逆转录聚合酶链反应（qRT-PCR）筛选TLR4基因最佳沉默效果;自制CSE作用于16HBE,实验设常规培养的16HBE作为空白对照组、CSE组（CSE+16HBE）、siRNA TLR4组（CSE+hs-TLR4-si-2+16HBE）、siRNA TLR4-NC组（CSE+NC+16HBE）、Lv-TLR4组（CSE+Lv-TLR4+16HBE）、Lv-TLR4-NC组（CSE+Lv-TLR4-NC+16HBE）,qRT-PCR检测TLR4、核因子κB(NF-κB)以及黏蛋白MUC5AC、MUC7、MU...     

烟雾吸入性急性肺损伤药物治疗的研究进展

烟雾吸入性急性肺损伤是火灾中伤员死亡的独立危险因素及死亡的主要原因。烟雾中有毒、有害化学气体和微粒引起的吸入性肺损伤是火灾后住院患者伤残的重要原因。近十年来,烟雾吸入性急性肺损伤相关的急救药物有了显著进展。     

吸烟对室内空气污染的研究

目的了解吸烟对室内空气质量的影响及相关影响因素。方法对办公室内吸烟前以及吸烟后不同时间(5、10、15、30、60、90、120、150、180min)空气中CO、可吸入颗粒物(IP)、甲醛、总挥发性有机物(TVOC)浓度进行监测,并探讨通风状态以及吸烟人数对吸烟所致室内空气污染的影响。结果门窗关闭条件下,吸烟后5、10、15、30、60、90、120、150、180min,办公室内空气中CO、IP、甲醛、TVOC浓度均显著高于吸烟前(P<0.01)。CO未见超标。吸烟后120min,IP浓度降至标准限值。吸烟后180 min,甲醛、TVOC浓度仍然超标。门窗开启条件下,室内空气污染物浓度在吸烟后明显增加(P<0.01),但各指标均未超标,吸烟后30min基本恢复到吸烟前状态。门窗开启时,吸烟所致的室内空气污染物峰值浓度显著低于门窗关闭时(P<0.01)。吸烟人数与办公室污染物峰值浓度呈正相关(P<0.01)。结论吸烟导致严重的室内空气污染,污染程度随吸烟人数的增多而升高,通风可以有效降低污染程度。     

烟草烟雾对大鼠胸主动脉硫化氢/胱硫醚-γ-裂解酶体系的影响

目的探讨烟草烟雾对大鼠胸主动脉硫化氢(H2S)/胱硫醚-γ-裂解酶(CSE)体系的影响。方法以10周龄SD大鼠为研究对象,随机分为对照组、短期吸烟组、中期吸烟组和长期吸烟组。采用烟草烟雾熏吸方法建立被动吸烟大鼠模型,采用敏感硫电极法测定血清中H2S浓度,采用免疫组织化学染色和显微图像定量分析法观察胸主动脉平滑肌CSE的表达。结果短期吸烟组血清H2S浓度与对照组比较无统计学差异(P>0.05),长期吸烟组、中期吸烟组血清H2S浓度明显低于对照组和短期吸烟组(P<0.01),长期吸烟组血清H2S浓度明显低于中期吸烟组(P<0.05),H2S浓度随着烟草烟雾熏吸时间的延长而降低,并呈时间依赖性。短期吸烟组胸主动脉CSE面积密度和光密度与对照组比较无统计学差异(P>0.05),长期吸烟组、中期吸烟组胸主动脉CSE面积密度和光密度明显低于对照组和短期吸烟组(P<0.05),长期吸烟组胸主动脉CSE面积密度和光密度明显低于中期吸烟组(P<0.05),CSE的表达随着烟草烟雾熏吸时间的延长而降低,并呈时间依赖性。结论烟草烟雾可显著下调大鼠血清H2S的浓度及胸主动脉中CSE的表达。     

Suicide by self-inflicted burns – A persistent psychiatric problem

Self-inflicted burns are a relatively uncommon but profound attempt at suicide. Twenty years ago, we first reviewed our experience with self-inflicted burns. With this current study, we sought to determine whether there had been any change in the incidence or outcomes of self-inflicted burns. All burn patients admitted between January 1, 2012, and December 31, 2021, with self-inflicted burns were compared with all other admissions. The frequency of self-inflicted burns and confounding risk factors of patients with self-inflicted burns remained unchanged. A large proportion (87.4 %) of the patients had psychiatric disease. They also had larger burns and higher mortality than accidental burns. Unexpectedly, logistic regression analysis that controlled for age, total percent total body surface area (TBSA) burn, sex, and inhalation injury revealed that those patients with self-inflicted burns had 72 % lower odds of dying than the general population. In conclusion, there has been no improvement in the incidence of self-inflicted burns. They result in very severe injuries, but when age, burn size, gender, and inhalation injury are controlled for, they have at least as good a chance for survival as the general burn population.     

Dynamics of surgical smoke in the operating room during spinal surgery: Comparison of particulate matter 2.5-air concentration between the electric scalpel with and without a smoke evacuation pencil: A cross-sectional study

BackgroundSurgical smoke is a vaporous by-product generated during tissue incision and cauterization with an electric scalpel. This smoke contains tissue- and blood/vascular-derived substances, bacteria, viruses, and chemical substances. Among them, it contains many fine particles called particulate matter (PM) 2.5, which are harmful and hazardous to the human body. We aimed to investigate the occurrence of PM2.5 in surgical smoke produced during spinal surgery and to evaluate the efficacy of an electric scalpel with a smoke evacuation pencil.MethodsIn this retrospective observational study, 89 patients who underwent spinal surgery between June 2019 and May 2021 were included. A dust monitor was installed in the operating room to measure the PM2.5 air concentration during the surgery. During each surgery, the total amount of PM2.5, the maximum PM2.5 air concentration, the exposure time to PM2.5, and the average value of PM2.5 air concentration from the start to the end of the surgery were calculated.ResultsWe found that in 29 of the 89 cases (32.6%), the air concentration of PM2.5 increased to a level that could cause health damage during the surgery. Twelve cases (13.4%) reached the level that could cause serious health damage, and 8 cases (9%) reached an emergency warning level. The total amount and the maximum and average levels of PM2.5 were significantly suppressed in the surgery with a smoke evacuation pencil group than in the surgery without a smoke evacuation pencil group.ConclusionWe detected hazardous levels of PM2.5 in the air during spinal surgery, highlighting the importance of considering smoke control or reduction during spinal surgery. We recommend using an electric scalpel with a smoke evacuation pencil for regulating PM2.5 levels in the operating room.