Chemical warfare agents, especially organophosphates, pose a serious threat when used in war. Despite the extensive experience gained over the 105 years since the fi rst use of medical protection against military poisoning, the system of medical protection requires further improvement and development. The enormous eff orts made by the Soviet Union in the pre-war period (1930s–1940s) prevented the intentions of the nazi Germany to use toxic substances during the Velikaya otechestvennaya voyna. The continuing danger of using chemical weapons in combat, as well as terrorist threats, necessitates maintaining a high level of preparedness to prevent and eliminate the medical consequences of exposure to toxic substances.

/pdf/asute-chemical-trauma-in-war-to-the-105th-anniversary-of-the-4zxcd1bkoi.pdf

Aсute chemical trauma in war (to the 105th anniversary of the use of medical protection against the damaging eff ects of toxic substances)

Publisher Summary The employment of chemicals in war fighting has a long history. As science and chemistry advanced in the 19th century, the possibilities of chemical warfare increased exponentially. Advancements were made in industrial applications of sulfur, cyanide, and chorine. In addition, the concept of chemicals in projectiles was introduced. During the Crimean War, the British refused to use cyanide-based artillery shells against the Russians on the grounds that it was a ‘‘bad mode of warfare.’’ This was an early example of the ethical questions surrounding chemical use in warfare that continued into the 20th century. World War I clearly demonstrated the deadly and destructive nature of chemicals in modern warfare. Both alliances in the war experimented with novel forms of warfare, to include chemical weapons, and followed the lead of their advisory. It is little wonder that this war is known as the ‘‘chemist's war.’’ The conceptualization of a protective mask dates back over 500 years to Leonardo da Vinci. By the mid-19th century, protective masks were proposed in the USA and Europe for both industrial and military use. The modern ‘‘gas mask’’ was developed by the Germans with sodium thiosulfate and bicarbonate soaked pads and used in World War I. In the lead up to World War II, the Germans forever changed chemical warfare with the discovery of the organophosphorus nerve agents.

Historical Perspective of Chemical Warfare Agents

Objective: Helper T cells 17 (Th17) and regulatory T cells (Treg), as CD4+T lymphocyte subsets, play an important role in the process of atherosclerosis. However, there are few studies on the regulation and efficacy of atorvastatin combined with amlodipine on Th17/Treg balance in hypertension combined with carotid atherosclerosis. Therefore, this study aims to verify the efficacy and immunomodulatory effects of atorvastatin combined with amlodipine in the treatment of hypertension combined with carotid atherosclerosis. Methods: A total of 260 patients with hypertension and carotid atherosclerosis were randomly divided into atorvastatin or combined treatment group. Inflammatory factors and Th17 and Treg levels were detected by enzyme-linked immunosorbent assay and flow cytometry. The messenger ribonucleic acid expression of retinoic acid receptor-related orphan receptor gamma and forkhead spiral transcription factor were detected by real-time quantitative polymerse chain reaction. Results: We found that the total effective rate in the treatment group was significantly higher than that in the control group. The levels of whole blood high shear viscosity, whole blood low shear viscosity, plasma specific viscosity and fibrin content in the 2 groups were significantly decreased after treatment, and the combined group was significantly lower than the control group (all P < .05). The improvement of endothelial function in the treatment group was also significantly higher than that in the control group (all P < .05). In addition, we found that there were statistically significant differences in Th17 percentage, Treg percentage and Treg/Th17 between the treatment group and the control group ( P < .05). The messenger ribonucleic acid levels of retinoic acid receptor-related orphan receptor gamma and forkhead spiral transcription factor showed the same trend. Further detection of Th17-related inflammatory factors showed that the expression of interleukin (IL)-17, IL-6, IL-23 and tumor necrosis factor- α in the treatment group was significantly decreased, which was better than that in the control group (all P < .05). Conclusion: These data indicate that amlodipine combined with atorvastatin can improve Th17/Treg imbalance, vascular endothelial function and efficacy in patients with hypertension and atherosclerosis. Abbreviations: Fh = fibrin content, Foxp3 = forkhead spiral transcription factor, H 2 S = hydrogen sulfide, IL = interleukin, LDL = low-density lipoprotein, mRNA = messenger ribonucleic acid, Nbh = whole blood high shear viscosity, Nbl = whole blood low shear viscosity, NO = nitric oxide, Np = plasma specific viscosity, PCR = polymerse chain reaction, ROR- γ t = retinoic acid receptor-related orphan receptor gamma, Th17 = helper T cells 17, TNF = tumor necrosis factor, Treg = regulatory T cells.

Medicine: Its Contribution to Civilization

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Medicine: Its Contribution to Civilization