After a concise review of the progress and achievements of burn works in the past 40 years the auther firmly pointed out that the currently most significant causes of death in burn injury are three,Inhalation injury,Infection and Internal organ injury, abbreviated as"Three I".The precent status and problems of"Three 1"are analyzed and the auther proprosed a model for planning burn research projects.In order to achieve an significant decrease of burn mortality,the auther also highlights that the crucial point is to protect the organism from damages to the body defense mechanism after burn injury.That is to say,in all dimensions and by all means,burn research projects should mainly focus on the early protection of the ability of the body defense mechanism.

The results of early resuscitation of 104 adult patients with BSA more than 50%were studied retrospectively. Although the mean amount of fluid replaced during 48h postburn was similar to the amount calculated with our formula, there existed significant individual differences. Therefore it seems not necessary to set up a rigid fluid replacement plan. To ensure adequate tissue perfusion, the fluid replacement formula might be modified as follows: 2 ml/kg/BSA%, with urinary output 30-40 ml/h, in the first 24h; and 1.5ml/kg/BSA%, with urinary output 40-50ml/h, in the second 24h. It should be emphasized that resuscitation should be started as early as possible,and adequate amount of fluid replacement is especially important during the first 2-3h postburn.There was no obvious relationship between the incidence of visceral complications and the total amount of fluid replaced during the resuscitation. Available data indicated that the amount of fluid calculated on the basis of our formula neither increased the incidence of early pulmonary edema nor influenced its development.As far as prevention of pulmonary edema was concerned, it did not seem justifiable to restrict the amount of resuscitation fluids. It was also noted that fluid therapy alone would not prevent entirely the development of postburn renal insufficiency.

A long course of systemic treatment with CsA in therapeutic dose to prolong skin allografts may produce severe toxic effects,therefore it is not acceptable for severe burn patients.Prior studies by one of us have reported that topical treatment with CsA will prolong the life of allografts.During the period of treatment,however,blood CsA levels were detected in high concentrations,similar to systemic use.The question occurs whether the immunosuppressive effect of topically applied CsA was due to local or systemic action.Two experiments were carried out.First,two skin grafts of ACI (RT1) ratswere transplanted on both sides of the back of same LEW (RT1) rat (n=56).The bandage was kept on for the first 5 postoperative days.One graft was treated topically daily with CsA 7.5mg/day in olive oil until rejection.At the same time,the other side was treated with olive oil alone as control.,The mean survival time (MST) was 12.38?0.70 and 9.14?0.33 d.,respectively,p

BACKGROUND:At present, spinal cord injury treatment is stil the worldwide difficult problem. Using the method of stem cells transplantation to treat the spinal cord injury is one of the hotspots of spinal cord injury repair research in recent years. OBJECTIVE:To summarize the progress and application prospects of stem celltransplantation in the treatment of spinal cord injury. METHODS:A computer-based search of PubMed and CNKI was retrieved for relevant articles concerning stem celltransplantation for treatment of spinal cord injury published after 2000. The keywords were“spinal cord injury, stem cell, celltherapy”in English and Chinese, respectively. Meta-analysis and secondary literature were excluded as wel as repetitive or old literature. Final y, 52 articles were included in result analysis. RESULTS AND CONCLUSION:This article summarizes types and biological characteristics of stem cells, basic mechanism, techniques and therapeutic efficacy of stem celltransplantation in the treatment of spinal cord injury, and proposes the issues and prospects concerning the stem cells transplantation for treatment of spinal cord injury.

0.05) on 15 day. There was a significant difference (P

The general data of 48.978 burn cases collected from 16 institutes and burn center in a period of 22 years (1958-1979) were analysed. It was found that the highest incidence of burns occurred in summer and before age of 30 (78.1%). particularly in the age group of 20-24 and under 5(22.97% and 22.95% respectively). Thermal burn was the commonest cause (89.57%). The ratio between female and male was 1:3. The ratio between cases with and without third degree burns was also 1:3. The burn extent was predominently under 30% TBSA (85.10%). cases with burn larger than 70% TBSA occupied less than 3% of the total. The exposed parts of the body. i.e. head, neck and limbs, were the prevalent areas affected. The mean hospitalization period was 26.9 days. The overall mortality rate was 4.93% and LA50 75.93%(Y = 7.5588-0.0337X). The incidences of shock and sepsis were 10.85% and 7.95% respectively. It was also found that the mortality rate (in terms of LA50). and incidences of both shock and sepsis have lowered remarkably (p

Objective:To determine a new management strategy, and create a win-win in the medical equipment maintenance outsourcing situation.Methods:Hospital with third-party manufacturers to adopt bidding game analysis, game theory is the study of the behavior of decision-making body when making a direct interaction and balance problems with this decision, its main emphasis on individual research model is rational, that is, at a given pursuit of utility maximization under constraints.Results: By studying this stage the hospital with third-party companies in game analysis equipment maintenance outsourcing, improve service quality and medical management standards, and achieve win-win cooperation between the two.Conclusion: Medical equipment maintenance outsourcing game analysis presented emphasis on service and reputation, win-win strategy to follow market rules.

Objective To investigate the effect of high-dose creatine phosphate (CP) on myocardial ischemia-reperfusion (I/R) injury in patients undergoing cardiac valve replacement. Methods Two hundred and forty-six ASA Ⅱ or Ⅲ patients aged 42-71 yr weighing 45-80 kg undergoing mitral-aortic valve replacement were randomly assigned into 2 groups: control group ( n = 122) and CP group ( n = 124). CP 10 g in 100 ml normal saline (NS) was infused over 60 min starting from the beginning of operation in group CP. In control group NS 100 ml was infused instead of CP. Blood samples were collected before anesthesia and on 1st and 5th postoperative day for determination of serum CK, CK-MB and LDH activity and cTnI concentration. The number of patients receiving dopamine and adrenaline at the time of return of spontaneous heart beat and 12, 24 and 48 h after operation was recorded. The incidence of arrhythmia (auricular fibrillation, ventricular arrhythmia), myocardial infarct and left ventricular ejection fraction (LVEF) were also compared between the 2 groups. Results Serum CK, CK-MB and LDH activity and cTnI concentration on 1st and 5th postoperative day, the doses of dopamine and adrenalin, the incidence of arrhythmia and myocardial infarct were significantly lower in group CP than in control group. The postoperative LVEF and the incidence of spontaneous recovery of spontaneous heart-beat were significantly higher in group CP than in control group. Conclusion Pretreatment with high dose CP can protect myocardium against I/R injury in patients undergoing cardiac valve replacement under CPB.

The serial changes in thromboxane (TXA2) prostacyclin(PGI2),circulatory platelet aggregate ratio (CPAR),platelet count,blood viscosity,myocardial enzyme spectrum,cortisol and epinephrine were determined in 42 severely burnt patients randomly divided into two groups.The findings demonstrated that in the control group,both TXA2 and TXA2/PGI2 ratio increased significantly during the early postburn stage.Myocardial enzyme spectrum,blood viscosity,cortisol and epinephrine also increased markedly.However,levels of the above parameters in the anisodamine-treated group were significantly lower than in the control following the infusion of anisodamine.On the contrary,CPAR and platelet count in the treated group increased and were significantly higher than those in the control.Moreover,TXA2 was closely correlated with CPAR,platelet count,blood viscosity and myocardial enzyme spectrum (P

The canine model to study inhalaton injury established in our lab was employed,and neutrophil NADPH oxidase activity,blood gas analysis,lung water volume,chest radiographs,and pulmonary histopathological changes were observed in the dogs after they were exposed to smoke inhalaton.It was found that carbon monoxide poisoning,hypoxemia,metabolic aci-dosisi respiratory alkalosis and lung damage developed rapidly and early after smoke inhalation;white blood cells disappeared from the circulation 5 minutes after injury onward;the activity of neutrophil NADPH oxidase increased gradually from the 30th minute to the 6th hour after injury,then decreased and approached to its preinjury level in the 12th hour after injury.It is postulated on the basis of the above findings that neutrophils would accumulate in the lungs after smoke inhalation and experince a "respiratory burst" characterized by the activation of NADPH oxidase and the production of large amounts of oxygen and other active oxygen radicals,which would play a significant role in the pathogenesis of acute lung damage in the early stage of smoke inhalation injury.