| The blast injury, which induced by the shock wave energy, is very common in the wars of general and nuclear weapons. There were 70% blast injury wounded after two atomic bombs were dropped on Hiroshima and Nagasaki (August 1945), and 51% in 1,303 grievous bodily injuries induced by bombing in Bosnia and Herzegovina War. The increasing incidence of the blast injuries was due to the terrorism, antiterrorism and emergency blasting in military industrial factories, chemical plants, magazines, boilers and mines. The blast injury is not only an important task of the military medicine, but also an emergency of traumatic surgery.The high altitude is a region of height above sea level 3,000 meter and could induce biological effects on the organisms in the category of medical biology. There have scarce air, low barometric pressure and low partial oxygen pressure at high altitude. Comparing with the area of sea level, there are only 65% of the atmospheric density and 61% of the barometric pressure and partial oxygen pressure in the region of height above sea level 4,000 meter. There is still no well-defined report in the effects on the spreading rule and injuries induced by the shock wave at the high altitude of low atmospheric density and low barometric pressure. The high altitude is also one of the hot spots of local collisions in the future. So, there has the theoretical and practical importance to explore the characteristics and interventions of high altitude blast injury.The present study, for the first time, systemically observed the characteristics and interventions of high altitude blast injury from general level, cellular level and molecular level based on developing the experimental device of high altitude blast injury (HABIED). The main results of the present report are as following:1. The experimental device of high alitude blast injury was established for the first time. The HABIED could met the demands for studying blast injuries of stable characteristics and good repeatability at high altitude of height above sea level 3000~6000m with good stability and anti-decompression capability. It is an ideal equipmentto study the blast injury at high altitude.2. The characteristics of the blast injury at high altitude were exploring systemically. There had the characteristics of more severity, fast developing and high mortality of the blast injury at high altitude. The lung was still the main injured target organ. The results showed that more 20%~25% mortality, 1-2 degree higher pulmonary hemorrhage, 1-3 degree higher pulmonary edema and more severity pulmonary dysfunction induced by the shock wave at high altitude. And the severity of injuries was increased as rising of the altitude.3. The possible mechanism of the blast injury at high altitude was studied. The permeability of the pulmonary blood vessels was increased significantly. Meanwhile, Vascular endothelial growth factor (VEGF), Thromboxane B2 (TXB2) and 6-Keto-prostaglandin Fα (6-Keto-PGFα) were all increased, and the increasing of TXB2 was higher than that of 6-Keto-PGFα. The experimental results of pulmonary HIF-1αmRNA assayed by fixed quality and quantity in situ hybridization experiments indicated that the expression of HIF-1αmRNA at high altitude was much higher than that in plain. And the possible mechanism of pulmonary edema was related with VEGF, TXB2, 6-Keto-PGFa and HIF-1a.4. The factors of treatment and cure were studied to intervene the blast injury at high altitude. Hyperbaric oxygen, hydrochloric anisodamine and decacortin were used to treat the high altitude blast injured rats, respectively. The results showed that all hyperbaric oxygen, hydrochloric anisodamine and decacortin could improve the survival rate and relieve pulmonary dysfunction, and combining of these factors had better intervention effects.5. The characteristics of the shock wave spreading speed and wounded parameter in the locale experiments of the high altitude and plain were studied to provide data for the blast injury at high altitude.
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