Objective To explore the possibility for preventing the underwater blast injuries. Methods Fifty rabbits were divided into two groups: protection and control groups. The animals were placed at the rang of 5.0m to 17.5m far from the explosion point. 0.2kg of TNT Explosives was placed 3 meters under water. Physical parameters of blast wave were measured using pressure transducers. At 6 hours after injury, the mortality rate and morphological alternations were observed. Results The safe devices were shown to be effective against underwater blast injuries. Most of the animals had no or mild pulmonary and intestinal injuries. The whole injury severity was reduced by 2 to 3 degrees with our own made device. Conclusion Our safe device could be used to protect against underwater blast injueirs.

Objective To study the dose-effects relationship of underwater blast injury. Methods Sixty-one adult mongrel dogs were exposed to underwater explosion of 200g, 500g, and 1 000g of TNT, respectively. The physical parameters of blast wave were recorded by PCB pressure transducers (USA). Survival or death was observed 6 hours after injury. Correspondingly, the relationship between the physical parameters and injury severity was analyzed. Results Twenty-three among 61 dogs died after injury, the mortality rate was 37.70% (23/61). The main reasons of death were severe lung bleeding, lung edema, perforation of gastrointestinal tract, and rupture of liver and spleen. Half lethal (5/10) impulse of underwater blast wave was 337.7?14.3kPa?ms. The impulses resulting in mild, moderate, severe, and critical underwater blast injuries were 140.46?34.2, 199.2?25.2, 247.8?69.6, and 478.7?183.8kPa?ms, respectively. Conclusion The physical parameters were well related to the injury severity in underwater blast. The early main treatment consist of active and effective management of severe lung injuries, perforation of gastrointestinal tract, and rupture of liver and spleen.

Objective:This study was to explore "Internet + nursing service" mode, the tumor specialist nurses nursing service experience and feelings, in the process of mining "Internet + nursing service" model of current existing problems and future development direction, discussed under the background of constructing a new mode of medical and health services, how to expand the tumor specialized subject "Internet + nursing service" the breadth and depth to improve the quality of life of cancer patients and nursing service benefit.Methods:Through the review of the literature, the focus and direction of the research were determined. A semi-structured interview was conducted with 12 oncology nurses enrolled in "Internet + nursing service" by qualitative research. Colaizzi seven-step method was used to encode, classify and extract the data.Results:The experience of "Internet + nursing service" carried out by oncology nurses can be summarized into the following five themes: Be more willing; professional identity of specialist nurses is higher (self-identity, patient identity, social identity); Multiple psychological experience (stress experience: the limitation of specialized operation and the pressure of communication; Adaptive experience: "Specialist cooperation and two-person home visit mode" is well adapted). The time and economic cost of specialist services are higher. The matching degree of service item supply and market demand is insufficient.Conclusions:In order to further expand the depth and breadth of "Internet + nursing service" in oncology, and to benefit more cancer patients in the long-term treatment and rehabilitation process, it is necessary to improve the recognition degree of nurse specialty, so as to improve the willingness to work; increase nurse training to enhance nurses' comprehensive coping ability; improving policy and economic support based on the characteristics of tumor diseases; improve the oncology "Internet + nursing services" project.

Objective To develop a device for stretch-induced injury to cultured cells and measure the injury parameters.It makes possible to observe the changes of cell configuration and function directly after injury. Methods The device was developed based on aero-dynamical principle,and consisted of mini-type air compressor,electromagnetic valve,pressure transmitter,PGA amplifier,A/D converter and computer.The computer can accurately control the injury parameters.A new method and device were first introduced to measure the deformation rate and deformation degree of silastic membrance in the stretch induced cultured cell injury process.The device controlled by the computer was used to cause the astrocyte injury.The degree of cell injury was assessed qualitatively by electron microscopy,and quantitatively by lactate dehydrogenase(LDH) enzyme release and trypan blue staining.Results The experiment results showed that the injury of different levels could be reproduced by our device under the injury parameters we set.Conclusion The injury device and the measuring system meet the requirements of our design.The results suggested that the new device and the method were much better than those reported in foreign literature.It has the advantages of simple and convenient manipulation,high precision and real-time processing.It can be used for the cell-level experiment research.

Objective To study the mechanism and characteristic of traffic injury of front crash. Methods Thirty rabbits were divided randomly into 3 groups according to crash velocity. The initial velocity of GroupⅠ was 30 km/h, group Ⅱ 40 km/h, and group Ⅲ 50 km/h. The rabbits were fixed on the seats in a sitting position and the injury process were started by driving power system with the velocity and acceleration set primarily. The crashing velocity and deceleration were recorded by laser velocity measuring system and high speed camera system. The injury characteristics of rabbits were observed and then the AIS-ISS score was compared. Results During 1 hour after injury, all rabbits survived except one in group Ⅱ and three in group Ⅲ. No organ injury was found in group Ⅰ, but organ injuries in thorax and abdomen were found in group Ⅱ and Ⅲ. The score of AIS (MAIS) and ISS were (2.30?0.65), (14.50?2.10) in group Ⅱand (4.20?0.70), (36.40?4.58) in group Ⅲ respectively. Conclusion The velocity and deceleration of crash have impact on the injury character of animal, and the main injury organs are the thorax and abdomen in traffic injury of front crash in rabbits.

Objective　To observe the characteristics and rules of craniocerebral injury resulting from a high explosive shell to provide the bases for treating explosive injury. Methods　A total of 36 sheep were distributed at the distance 6 to 48 m away from the explosive center and the shell was exploded electrically at 7 m above the earth. At the same time, the velocity of fragments and shock wave pressure were determined. Gross and pathological observations were performed after injury. Results　Among all sheep with fragment injury, craniocerebral injury was 32%. Their immediate death rate was 75% and all died 6 h later. The incidence rates of penetrating wound and blind wound were 75% and 25% respectively. Pollution of wound track was heavy. The percentage of head lost was 50% in sheep and 50% of injured animal suffered from comminuted fracture of skull base. Bleeding was found extensively on the surface of the cerebrum, even medulla oblongata was involved. Hemorrhage, edema, rupture of small blood vessels and degeneration of neuron were found at the regions 4 cm away from the wound tract with light microscopy. Combined blast injury was found and occurred most often in the abdomen and limbs, both accounting for 62.5%, and combined thoracic injury was the third, up to 50%. All the animals of craniocerebral injury combined with lung blast injury. Conclusion　High explosive shells destroy cranium badly and extensively. Many skulls are lost and the cranial base is readily fractured. The wound track is heavily polluted. Combined injury is more often occurred.

Objective To explore the value of simple exercise provocation test ( 6?minute running test) combined with small airway function test in early diagnosis of cough variant asthma ( CVA ) in children.Methods Ninety?four children with chronic cough from September 2017 to September 2018 in the pediatric clinic of the Affiliated Hospital of Xuzhou Medical University were selected for routine pulmonary ventilation function examination,simple exercise stimulation test and questionnaire survey.The differences of pulmonary function,clinical manifestations and allergens between positive and negative children with simple exercise stimulation test were compared and analyzed.Results The forced expiratory volume in one second (FEV1) of 94 children with chronic cough were all more than 70% by routine pulmonary function test,and the exercise provocation test was successfully completed.Among them,32 (34.04%) were positive in simple exercise provocation test.Among the positive patients,30 cases ( 93.75%) were diagnosed as CVA after further examination,clinical treatment and follow?up.In CVA group, FEV1 ( 81.52 ± 14.22)%,forced vital capacity (FVC) (89.00 ± 14.31)%, peak expiratory flow ( PEF) ( 65.05 ± 15.10)%, one?second rate (FEV1／FVC) (92.18±13.59)%,and instantaneous flow at 50% forced expiratory flow were observed after exercise.The vital capacity ( FEF50 ) ( 57.57 ± 22.49 )%, forced expiratory flow at 75% vital capacity (FEF75) (41.15±18.28)%,maximum expiratory flow ( MMEF75／25) (53.14±22.53)% were significantly lower than those before exercise ((94.07±9.69)%,( 92.30± 13.60)%,(80.73± 17.85)%,(101.07± 13.79)%,(66.71±19.29)%,(51.32±18.38)%,(63.75±19.43)%),(t values were 8.592 ,2.617 , 10.246 ,5.428,3.590 ,3.646 ,3.687 ,respectively,all P＜0.05)) In routine examination of pulmonary ventilation function,FEF50 (66.71 ± 19.29)% and FEF75 ( 51.32 ± 18.38)% in the positive group were significantly lower than those in the negative group (( 79.75 ± 21.94)%、( 69.08 ± 29.28)%),( t values were －2.841,－3.123,all P＜0.01).The proportion of night cough,morning cough and severe dry cough in positive group was significantly higher than that in negative group,while the proportion of day cough and wet cough was significantly lower than that in negative group ( P＜0.01).The proportion of eczema history in positive group was significantly higher than that in negative group ( P＜0.01).Conclusion Patients with CVA have high airway responsiveness and small airway dysfunction.Combination of simple motor stimulation test and small airway function test has important clinical value in the early diagnosis of CVA.

Objective To explore pathological changes of the dog lungs after underwater blast injury. Methods Lungs from 37 adult dogs were taken after different underwater blast explosions, and observed with gross examination, light microscopy (LM) and electron microscopy (EM). Results Pulmonary hemorrhage and edema were the main morphological changes. Under LM the alveolus space was seen to be filled with edematous fluid and bloody components. Part of alveolus walls were ruptured and fused into bigger cavities while under EM the mitochondria of alveolar epithelium were vacuolated and some of the capillary predominant endothelium were broken. Hemorrhage was the pathological feature of intestinal tract. Conclusion Severe pulmonary hemorrhage and edema may be the main cause of early death of dogs with underwater blast injury.

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.

Objective: To evaluate activation of P38 mitogen-activatedprotein kinase (P38MAPK) in alveolar macrophage (AM), release of TNFα and NO from cells, and their relationship following lipopolysacchride (LPS) stimulation.Methods: AM was isolated from branch alveolar lavage fluid (BALF). The activation of P38MAPK was assayed by Westernblot. SB203580, a specific inhibitor of P38MAPK, was used with gradient concentration to evaluate the regulative effect of P38MAPK on the release of TNFα and NO from AM.Results: P38MAPK was activated by LPS (100 ng/ml) with peak activation at 30 minutes. The activation of P38MAPK was inhibited by SB203580. The secretion of TNFα and NO stimulated with LPS increased (P<0.01) and was inhibited by SB203580 significantly.Conclusions: The results indicate that P38MAPK is involved in the secreting process of TNFα and NO following LPS stimulation. P38MAPK may be an important site for controlling the secretion of both inflammatory mediators during lung inflammatory disorders.