Incidence, casualties and risk characteristics of civilian explosion blast injury in China: 2000-2017 data from the State Administration of Work Safety

Background: Civilian explosion blast injury is more frequent in developing countries, including China. However, the incidence, casualties, and characteristics of such incidents in China are unknown.Methods: This is a retrospective analysis of the State Administration of Work Safety database. Incidents during a period from January 1, 2000 to April 30, 2017 were included in the analysis. The explosions were classified based on the number of deaths into extraordinarily major, major, serious and ordinary type. Descriptive statistics was used to analyze the incidence and characteristics of the explosions. Correlation analysis was performed to examine the potential correlations among various variables.Results: Data base search identified a total of 2098 explosions from 2000 to 2017, with 29,579 casualties: 15,788 deaths(53.4%), 12,637 injured(42.7%) and 1154 missing(3.9%). Majority of the explosions were serious type(65.4%). The number of deaths(39.5%) was also highest with the serious type(P=0.006). The highest incidence was observed in the fourth quarter of the year(October to December), and at 9:00–11:00 am and 4:00–6:00 pm of the day. The explosions were most frequent in coal-producing provinces(Guizhou and Shanxi Province). Coal mine gas explosions resulted majority of the deaths(9620, 60.9%). The number of explosion accidents closely correlated with economic output(regional economy and national GDP growth rate)(r=–0.372, P=0.040;r=0.629, P=0.028).Conclusions: The incidence and civilian casualties due to explosions remain unacceptable in developing China. Measures that mitigate the risk factors are of urgently required.

Comprehensive epidemiological assessment of trauma incidents at a level I trauma center

BACKGROUND The continuous development of social and economic progress and ongoing enhancement of infrastructure construction has led to drastic changes in the occurrence of trauma.AIM To analyze the epidemiological characteristics of trauma in Lanzhou City to provide theoretical references for improving quality of trauma care.METHODS A retrospective analysis of clinical data from 16585 trauma patients treated at the First Hospital of Lanzhou University Trauma Center from November 1,2021 to October 31,2023 was conducted.Data including age,sex,time of trauma,cause of trauma,and major injured body parts were statistically analyzed.RESULTS A total of 18235 patients were admitted,with complete data for 16585 cases.Of these,9793 were male and 6792 were female(male-to-female ratio of 1.44:1).The peak times for trauma occurrence were 10 AM-12 PM and 6-10 PM,and the peak months were from May to October.The leading causes of trauma were falls(45.32%),other trauma(15.88%),road traffic accidents(15.15%),violence(10.82%),cutting/stabbing(9.41%),mechanical injuries(2.65%),winter sports injuries(0.36%),animal bites(0.22%),burns(0.09%),and electrical injuries(0.02%).The distribution of majorly injured body parts showed statistical significance,with limbs/skin being the most affected followed by the head/neck,chest/abdomen,and back.CONCLUSION Medical institutions and government agencies can implement preventive measures and policies based on the characteristics of trauma determined in this study to enhance the quality and level of trauma care.

Effect of Astragalus Polysaccharide on the Cell-mediated Immunity of Traumatic Stress Mice

To investigate the changes of immune functions and the effects of Astragalus polysaccharide (ASP) on the cell-mediated immunity of the traumatic stress model of mouse by amputation, 50 mice were randomly divided into 5 groups for study, in which the group A and B served as the normal control (by injecton of 0.5 ml of saline intra-peritoneally daily), and as the stress control (by intra-peritoneal injecton of 0.5 ml of normal saline into mice after amputation) respectively, to the group C, D and E of mice, 1000 mg/kg (high dose), 300 mg/kg (median dose) and 250 mg/kg (low dose). The CD4 + and CD8 + T cells as well as the expression of the c-fos protein were determined by immunohistochemical techniques, and the expressions of NF-κB mRNA and IL-10 mRNA were assayed by hybridization in situ . The experimental results showed that in comparison with the normal control group of mice (group A), the expression levels of NF-κB mRNA, IL-10 mRNA and the c-fos protein in the tissues of thymus and spleen in the stress controls were significantly elevated and the CD4 + T cells and CD4/CD8 ratio were decreased. However, in comparison with the stress control of mice (group B), the expressions of NF-κB mRNA and IL-10 mRNA were inhibited by ASP, and the CD4 + T cells and CD4/CD8 ratio were increased in groups C, D and E, but the level of c-fos protein was decreased. There was no significant difference in these parameters among group C, D and E. It is concluded that the functions of cell-mediated immunity of mice were disturbed under the stress condition of the traumatic injuries after amputation. And the immune functions can be effectively restored by the use of Astragalus polysaccharide.

Effects of Needle-knife Therapy on iNOS Activity and NO Content in Skeletal Muscles in the L_3 Transverse Process Syndrome Model Rat

Objective: To study on relationship of inducible nitric oxide synthase (iNOS) activity and nitric oxide (NO) content in the injured local soft tissue with injured degrees of the soft tissue in the third lumbar vertebrae (L3) transverse process syndrome model rat and to observe the effect of needle-knife therapy. Methods: One hundred and sixty male SD rats were randomly divided into normal group, model group, aminoguanidine (AG) group, needle-knife group, 40 rats in each group. The L3 transverse process syndrome rat model was established, and after treatment of needle-knife and AG, iNOS activities and NO contents and histomorpholocal changes in the soft tissues around L3 transverse process on 1, 3, 7 and 14 days were observed in the groups. Results: Compared with the normal group, iNOS activity and NO content in the model group were significantly increased (P<0.01); Compared with the model group, iNOS activities and NO contents were significantly decreased in both the needle-knife group and the AG group (both P<0.01); And both iNOS activities and NO contents were identical with both local inflammation response and injured degrees of the injured tissue in the groups. Conclusion: Needle-knife therapy can significantly inhibit generation of NO, alleviate inflammatory response and injured degree of the injured soft tissue, improve microcirculation, prevent formation of pathological scar tissue, and promote repair of the chronic soft tissue injury.

Outcome of severely injured trauma patients at a designated trauma centre in the Hong Kong Special Administrative Region

Background The Hong Kong Special Administrative Region （HKSAR） of the People＇s Republic of China （PRC） has seen significant changes in its trauma service over the last ten years including the implementation of a regional trauma system. The author＇s institution is one of the five trauma centres designated in 2003. This article reports our initial clinical experience. Methods A prospective single-centre trauma registry from January 2004 to December 2008 was reviewed. The primary clinical outcome measure was hospital mortality. The Trauma and Injury Severity Score （TRISS） methodology was used for bench-marking with the North America Major Trauma Outcome Study （MTOS） database. Results There were 1451 patients. The majority （83.9%） suffered from blunt injury. The overall mortality rate was 7.8%. Severe injury, defined as the Injury Severity Score 〉15, occurred in 22.5% of patients, and was associated with a mortality rate of 31.6%. A trend of progressive improvement was noted. The M-statistic was 0.99, indicating comparable case-mix with the MTOS. The Z- and W-statistics of each individual year revealed fewer, but not significantly so, number of survivors than expected. Conclusions Trauma centre designation was feasible in the HKSAR and was associated with a gradual improvement in patient care. Trauma system implementation may be considered in regions equipped with the necessary socio-economic and organizational set-up.