Objective　To evaluate the prophylactic-therapeutic role of escharectomy during early postburn stage on internal organ dysfunction. Methods　A total of 72 Wistar rats were randomized into 3 groups: burn without escharectomy group (A group), burn with escharectomy during early postburn stage (B group) and normal control. Vascular permeability were measured with 99Tc-labelled albumin. Furthermore, the effect of burn sera on permeability of monolayer of vascular endothelial cell (EC) was observed. Results　Vascular permeability in group B was significantly lower than in group A. When exposed to burn sera, EC monolayer permeability in group B is decreased when compared with group A. Conclusion　Escharectomy during early postburn stage could restore endothelial permeability

Objective To investigate the effects of NF-κB activation on paihogenesis of PMN aggregation in myocardium and early myocardial dysfunction induced by polymorphonuclear leukocyte (PMN) in burned rats. Method One hundred and seventy wistar rats were randomly divided into three groups, control group ( n = 20, with isotonic saline solution), bum group ( n = 90, with isotonic saline solution after bum), bum and pyrrolidine dithioncarbamate group ( PDTC group, n = 60, with isotonic saline solution and 250 mg/kg PDTC after bum). The rats in bum group and PDTC group underwent 35% TBSA full-thickness bums on the back. The acb'vaty of myocardial NF-κB was tested by electrophoretic mobility shift assay (EMSA) at 1, 3, 6, 12,24 postbum hours (PBH). Expressions of myocardial IL-8 and ICAM-1 mRNA were assessed by reverse transcription polymerase chain reaction (RT-PCR) at 3,6,12,24 PBH. Meanwhile, the avtivity of myocardial myeloperoxidse(MPO), the left ventricular systolic pressure(LVSP) and the left ventricular end diastolic pressure (LVEDP) as well as maximum positive and negative left ventricular pressure change (± dp/dtmax) were observed at 3,6,12,24 PBH. Results The activity of myocardial NF-κB in bum groups was markedly increased at 1 PBH [(20.27± 3.43) × 104 A] .which was obviously higher than that in control group [(2.18±0.38) × 104 A, P ＜ 0.01], and was still higher than that in control group at 24 PBH ( P ＜ 0.01). The expressions of myocardial IL-8 and ICAM-1 mRNA and avtivity of myocardial myeloperoxidse were obviously higher than that in control group at 3,6,12,24 PBH respectively (P ＜ 0.01), LVSP and ± dp/dtmax significantly were lower, but LVEDP was higher than that in control group during 3-24 PBH (P ＜ 0.01). Compared with that in bum group, these indices were ameliorated in PDTC group. Conclusions Severe bum might activate myocardial NF-κB, which ultimately lead to the production of cytokines, PMN aggregation in myocardium and deterioration of cardiac contractility and relaxation consequently.

AIM: To investigate the effects of burn sera on I?B? degradation, NF-?B activation in peripheral blood monocytes (PBMCs) in order to explore the role of burn sera on activation of monocytes. METHODS: PBMCs isolated from healthy volunteers were stimulated by sera from healthy volunteers and burn patients and by burn sera together with PDTC (pyrrolidine dithioncarbamate). Activation of monocytic NF-?B was tested by electrophoretic mobility shift assay (EMSA) and the degradation of monocytic I?B? was determined by Western blotting. RESULTS: When compared to that in control group, cytosolic I?B? degradation occurred within 30 min after PBMCs stimulated by burn sera, and peaked at 60 min. But I?B? gradually recovered in the cytoplasm after 2 h of stimulation. Meanwhile, activity of monocytic NF-?B was markedly increased, reached the peak at 30 min to 60 min after stimulation, and gradually decreased after 2 h of stimulation. PDTC (an antioxidants) effectively inhibited the monocytic I?B? degradation and activation of NF-?B induced by burn sera. CONCLUSION: Burn sera might induce the degradation of I?B?, then activate NF-?B, which ultimately lead to the secretion of cytokines from the monocytes. [

Objective To evaluate the effects of surgical and physical therapy on functional reconstruction post severe burn. Methods 21 patients with severe burn accepted comprehensive rehabilitation, while the other 18 cases accepted surgical therapy only. Modified Barthel Index and Vancouver Scar Scale were applied to assess their activities of daily living (ADL) and scar recovery 3 months, 1 year or 2 years post injury. Results Compared with the control group, the observation significantly improved in ADL and scar recovery with fewer operations (P<0.01). Conclusion The surgical and physical therapy facilitates to improve the functional recovery post severe burn.

To observe the effects of ursolic acid (UA) on insulin resistance and cell differentiation in 3T3-L1 adipocytes and to explore the mechanisms.

To explore the effects and mechanism of ursolic acid in improving hepatic insulin resistance in KKAy mice with spontaneous type 2 diabetes.

Objective To evaluate the effect of acupointhot compress with warming moxibustion bag on treating radiation proctitis caused by radiotherapy in cervical cancer. Methods 78 patients of cervical cancer with acute radioactive proctitis caused by radiotherapy were divided into two groups according to the length of hospital stays. The experiment group was given compress Tianshu acupoint with warm moxibustion bag every day, along with drug and retention enema, while the control group was treated with drug and retention enema only. Then observe and evaluate the effect of different treatment on each group. Results The total effective rate of treating radiation proctitis in experimental group was 94.44%(34/36) which was superior to 76.19% (32/42) of the control group (χ2=4.962, P<0.05). The influence of tumor radiotherapy in experimental group was also superior to the control group, nine patients were forced to suspend to radiotherapy by (6.11 ± 1.96) days in the control group, while five cases were suspended to radiotherapy by (2.20±1.09) days in the experiment group (t=4.066,P<0.05). Conclusions Acupoint hot compress with warming moxibustion bag combine with retention enema have an advantage over retention enema only on radiation proctitis caused by radiotherapy in cervical cancer.

OBJECTIVETo evaluate the therapeutic effects of VSD combined with irrigation of oxygen loaded fluid on the growth of granulation tissue and macrophage polarization in chronic venous leg ulcers.

METHODSThiry-four patients with chronic venous leg ulcers hospitalized in our department from December 2010 to July 2014 were divided into VSD group ( A, n = 11) , VSD + irrigation group ( B, n = 11) , and VSD + oxygen loaded fluid irrigation group ( C, n = 12) according to the random number table. After admissian, debridement was performed, and granulation tissue in the center of the wound was harvested during the operation. After dehridement, the patients in group A were treated with VSD only (negative pressure from -30 to -25 kPa, the same below) ; the patients in group B were treated with VSD combining irrigation of normal saline; the patients in group C were treated with VSD combining normal saline loaded with oxygen irrigation (flow of 1 L/min) . On post treatment day (PTD) 7, the VSD devices were removed. Cross observation was conducted before debridement and on PTD 7. On PTD 7, the granulation tissue in the center of the wound was harvested for histopathological observation with HE staining and Masson staining, following calculation of granulation tissue coverage rate. After debridement but before the negative pressure therapy (hereinafter referred to as before treatment) and on PTD 7, partial pressure of oxygen of the skin around the wound was measured by transcutaneous tissue oxygen tension survey meter. On PTD 7, expression of vascular endothelial growth factor (VECF) was determined with immunohistochemistry. Before treatment and on PTD 7, cells with double positive expressions of induced nitric oxide synthase plus CD68 ( type I macro- phage) and arginase 1 plus CD68 ( type II macrophage) were observed with immunofluorescence staining and quantified. Data were processed with Fisher's exact test, one-way analysis of variance, covariance analysis, paired test, and LSD test.

RESULTS(1) The gross observation showed that before debridement there was a certain amount of necrotic tissue and little granulation tissue in the wounds of patients in all the 3 groups. On PTD 7, new granulation tissue was found in the wounds of patients in all the 3 groups, and in group C its amount was the largest. (2) On PTD 7, the granulation tissue coverage rate of wounds in pa- tients of group C was higher than that of group A or B ( P <0.05 or P <0.01). (3) On PTD 7, HE staining showed that there appeared more abundant new born microvessels and fibroblasts in the wounds of patients in group C than those in groups A and B; Masson staining showed that there was more abundant fresh collagen distributed orderly in the wounds of patients in group C compared with group A or B. (4) On PTD 7, it was found that partial pressure of oxygen of the skin around the wounds in patients of group C [(40.7 +/- 4.1) mmHg, 1 mmHg = 0.133 kPa] was higher than that of group A [ (35.0 +/- 3.1) mmHg] or B [(35.4 +/- 2.7) mmHg, with P values below 0.01]; the partial pressure of oxygen of the skin around the wounds of patients in all the 3 groups was increased significantly compared with that before treatment (with values from 10.38 to 22.52, P values below 0.01). (5) On PTD 7, the expression of VECF in the wounds of patients in group C was higher than that in group A or B ( P <0.05 or P < 0.01). (6) On PTD 7, the number of type I macrophages in granulation tissue of patients was respectively 14.3 +/- 2.3, 11.5 +/- 3.0, and 10.7 +/- 2.3 per 400 times vision field in groups A , B, and C ( F = 25.14, P < 0.01), while the number in group C was less than that in group A or B ( P < 0.05 or P < 0.01). Compared with that before treatment, the number of type I macrophages was significantly decreased on PTD 7 in all the 3 groups (with values from 14.76 to 23. 73, P values below 0. 01). On PTD 7, the number of type II macrophages in granulation tissue of patients was respectively 32.7 +/- 3.2, 35.1 +/- 3.3 , and 41.3 +/- 3.2 per 400 times vision field in groups A, B, and C ( F = 81.10, P < 0.01), and the number in group C was lager than that in group A or B ( with P values below 0. 01). Compared with that before treatment, the number of type II macrophages in all the 3 groups was significantly increased (with t values from -69.34 to -47.95, P values below 0.01).

CONCLUSIONSVSD combined with irrigation of oxygen loaded fluid can raise the partial pressure of oxygen of the skin around the wounds effectively, promoting the transition of macrophages from type I to type II, thus it may promote the growth of granulation tissue, resulting in a better recipient for skin grafting or epithelization.

Debridement ; Drainage ; Granulation Tissue ; Humans ; Leg Ulcer ; etiology ; surgery ; Macrophages ; Microvessels ; Negative-Pressure Wound Therapy ; methods ; Nitric Oxide Synthase Type II ; Oxygen ; Skin ; Skin Transplantation ; Skin Ulcer ; Surgical Flaps ; Treatment Outcome ; Vacuum ; Vascular Endothelial Growth Factor A ; Veins ; Wound Healing

Objective To discuss how to identify the nerve and prevent the injury of the nonrecurrent laryngeal nerve during thyroid surgery. Methods The clinical data of 3078 patients undergoing thyroid resection were retrospectively analyzed. Results From January 1981 to December 2001,3078 thyroidectomy was performed at our department with the routine exploration of the recurrent laryngeal nerve.4241 recurrent laryngeal nerves were identified,among them there were 12 nonrecurrent laryngeal nerves(0.28%,12/4241),ofwhich all were right-sided.One patient was male and 11 female.Of these 12 cases,there were 2 of type Ⅰ(16.67%,2/12),6 of type Ⅱ(50%,6/12)and 4 of type Ⅲ (33.33%,4/12).One ofthe type Ⅰ patients suffered from intraoperative injury of his nonreurrent laryngeal nerve.Conclusions The careful intraoperative identification of the nonrecurrent laryngeal nerve helps prevent it from the inadvertent injury.

OBJECTIVETo analyze the clinical data of adult patients with total burn surface area (TBSA) greater than 50% in Guangzhou and explore the optimal fluid resuscitation protocols for these patients.

METHODSThe clinical data of 94 adult patients with a TBSA over 50% treated in our center during 1991-2010 were reviewed. and the former decade. Fluid resuscitation volume of various components in shock stage, urine volume, occurrence of visceral complications and mortality rate within 10 days after injury were compared between patients treated in 1991-1999 and those in 2000-2010.

RESULTSThe first 24-h crystalline colloidal fluid ratio, first 24-h infusion volume and the second 24-h crystalloid fluid coefficients were significantly greater in the patients treated in 2000-2010 than in those treated in 1991-1999. The visceral complications and mortality rate were significantly lower in the latter than in the former patients (7.69% vs 27.3% and 2.56% vs 18.18%, respectively, P<0.05).

CONCLUSIONFor patients with extensive burns, an individualized fluid resuscitation regimen, an adequately high colloid/crystal rehydration ratio, and a greater total infusion volume according to the local climate of Guangzhou can be beneficial to reduce the incidence of visceral complications and the mortality rate.

Adult ; Burns ; therapy ; Female ; Fluid Therapy ; methods ; Humans ; Male ; Resuscitation ; methods ; Retrospective Studies ; Treatment Outcome ; Young Adult