Role of pyroptosis pathway related molecules in acute lung injury induced by gas explosion in rats / 中华劳动卫生职业病杂志

Objective: To explore the role and significance of pyroptosis in gas explosion-induced acute lung injury (ALI) in rats. Methods: In February 2018, 126 SPF male SD rats were selected and randomly divided into blank control group (18 rats) and experimental group (40 m, 80 m, 120 m, 160 m, 200 m and 240 m, 18 per group) . The experimental group carried out gas explosion in the roadway to build the ALI model, the control group did not carry out gas explosion, and other conditions were consistent with the experimental group. Respiratory function indexes such as respiratory frequency (f) , tidal volume (TV) , minute ventilation (MV) and airway stenosis index (Penh) were measured 24 hours after the explosion. 5 rats in each group were sacrificed after anesthesia, Hematoxylin-Eosin (HE) staining was used to observe the pathological morphology of lung tissue. Immunohistochemistry was used to detect the content of Caspase-1. Western blotting was used to detect the content of cell pyroptosis including nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) , Caspase-1, interleukin-1β (IL-1β) and interleukin-18 (IL-18) in lung tissue related protein expression. Results: The f and MV of rats in the experimental group were higher than those in the control group (P<0.05) . Except for the 40 m and 80 m groups, the TV of rats in the other experimental groups were higher than those in the control group (P<0.05) . Except for the 40 m group, the Penh of rats in the experimental groups were lower than those in the control group (P<0.05) . HE staining showed that the lung tissue of the experimental groups at different distance points showed obvious edema of the pulmonary interstitium and alveoli, a large number of red blood cells and inflammatory cells exuded in the alveolar space, thickening of the pulmonary interstitium, and increased lung injury score (P<0.05) . The results of immunohistochemistry showed that the positive expression of Caspase-1 in each experimental group was higher than that in the control group (P<0.05) . Western blotting results showed that the expression of pyroptosis-related proteins in each experimental group was higher than that in the control group (P<0.05) . Conclusion: Pyroptosis is involved in the pathophysiological process of gas explosion-induced ALI in rats.

Analysis on on-site rescue and traumatic features of victims involved in gas explosion accident in Hangzhou / 中华烧伤杂志

Objective@#To investigate the situations of on-site rescue and traumatic features of victims involved in gas explosion accident in Hangzhou, so as to provide more data support for emergency medical rescues of the similar incidents of massive casualty.@*Methods@#Two medical workers with a certain clinical experience were sent to Hangzhou 120 emergency medical centers to collect data of the on-site rescue on 21st July, 2017, including ambulance call-outs, on-site command and traffic conditions, and on-site triage and evacuation of the victims. They were then sent to the hospitals receiving the victims to investigate the situations of these victims including the general information (such as gender, age, admitted hospitals, and number of admission, discharge, and transferring in the first two weeks after the accident) and injury assessment [such as injury position and type, injury severity evaluation by New Injury Severity Scoring (NISS), and burn severity evaluation for victims with burns].@*Results@#(1) A total of 15 ambulances reached the accident site for rescue. The traffic and transportation were jammed and interrupted after this accident. On-site triage and distribution were disorderly conducted. (2) Clinical data of 53 victims were collected, including 24 males and 29 females, with the age of 8 to 70 (34±14) years old. They were sent into 6 hospitals in Hangzhou. Two victims died on the day of accident. Up to two weeks after this accident, 28 (52.8%) victims were discharged from the hospitals and received follow-up in outpatient department. Five victims with severe injuries were transferred to the other hospitals. (3) Based on the results of NISS, the injury severities were mild in 29 (54.7%) cases, moderate in 9 (17.0%) cases, serious in 3 (5.7%) cases, and severe in 12 (22.6%) cases. Those 2 dead victims were classified into the severe category due to the highest NISS score of 75. For all of the victims, skin and soft tissue defects were most common. Six (11.3%) victims were combined with burns. According to the classification of burn severity, there were one case of mild, one case of serious, and 4 cases of severe.@*Conclusions@#The gas explosion accident in Hangzhou caused massive casualties with complex injuries. The local emergency medical rescue responded quickly, but during the rescue process, lots of aspects should be further improved.

Pre-hospital scoring system for evaluation of coal mine gas explosion injury / 中华创伤杂志

ObjectiveTo explore and establish pre-hospital scoring system (respiration, pulse,motor and burn, RPMB) for evaluation of coal mine gas explosion injury. MethodsAfter analysis of characteristics of blast injury caused by coal mine gas explosion, a new pre-hospital scoring system,RPMB, for evaluation of blast injury was established on the basis of pre-hospital evaluation of coal mine injuries (respiration, pulse and motor, RPM). From January 2003 to December 2009, 251 patients with blast injury caused by coal mine gas explosion were collected in this study for a retrospective study. ISS≥16 points was set as the gold standard for severe wound. All the injuries were assessed by RPMB, RMP,pre-hospital index (PHI) and trauma triage rule (TTR). The consistency and detection rate of severe wounds were compared. The sensitivity and specificity were also calculated. ResultsOf 251 patients,41 patients were evaluated as severe, with high consistency rate between AIS-ISS and RPMB (kappa =0.985). The sensitivity of RPMB, RPM, PHI and TTR was 97.6％, 26.8％ , 22.0％ and 17.1％ respectively and the specificity of those was 88. 1 ％ , 97.6％ , 87.6％ and 95.7％ respectively. ConclusionRPMB is a simple and easy scoring method, with high detection rate of severe wound and potential of clinical applications.