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.

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.

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

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 investigate the therapeutic effects of delayed lung lavage with exogenous pulmonary surfactant(PS)diluent on endogenous surfactant system dysfunction and acute respiratory failure caused by severe smoke inhalation in rats.Method Ninety Wistar rats were randomly separated into five groups:Group I,normal control(n=14);Group Ⅲ,smoke inhalation(n=27);GroupⅢ,smoke+PS lavage+mechanical ventilation(MV),n=21;Group IV,smoke+saline lavage+MV,n=10;Group V,smoke+MV,n=18.The lungs were lavaged with 30 ml/kg normal ssdine containing 100 mg/kg PS or same volume of saline via tra cheal catheter at 2 h after smoke inhalation,then the animals were placed on a ventilator for 4 h,and observed until 24 h after injury.The arterial blood gas level,lung water volume,static lung compliance(Cst),total protein and albumin contents in bronchoalveolar lavage fluid(BALF),surface tension properties of BALF,and fatality rate at 24 h were measured.Results Smoke inhalation caused a similar acute hypoxia and severe carbon monoxide poisoning immediately in all injured groups.The animals in group Ⅱ showed acute respiratory failure,serious hish permeability pulrnonary edema,and surfactant system dysfunction.The surface tension properties of BALF and Cst were significantly improved by delayed lung lavage treated with exogenous PS diluent in group m(P<0.05).However,the lung water volume,total protein and albumin contents in BALF and the oxygenation had not significant difference between group Ⅲ and group Ⅱ(P>0.05).Conclusions Delayed lung lavage with exogenous PS diluent,at a certain extemt,restored endogenous suffactant function inhibited by smoke inhalation and improved lung function.Nevertheless,the trent could not alleviate rash permeability pulmonary edema and respiratory failure drarnatically.The expected decrease of mortality at early stage after smoke inhalation injury was not showed yet.

Objective To study the safety of transcatheter arterial chemoembolization(TACE)via the intercostal artery(ICA)for hepatic carcinoma.Methods A total of 24 patients with hepatic carcinoma(HCC)fed by the ICA underwent TACE via the artery in our hospital.Among the cases,15 were mass type and 9 were nodular type.Plain and enhanced CT or MRI scan were performed before the operation.During the procedure,we carried out intercostal arteriography.Selected catheterization of the feeding branch and then TACE were done.The ICA angiographic features,tumor location,clinical observation,laboratory tests,and imageology were evaluated after the surgery.Results In our cases,the HCCs supplied by the ICA collaterals were located at segments six and/or seven.Angiography showed that all the ICA collaterals originated from the right side at the levels of T8(7.5%,3/40),T9(15.0%,6/40),T10(47.5%,19/40),or T11(30.0%,12/40).The procedure was completed in 22 of the patients.CT scan performed after the procedure showed that the tumor was completely filled with lipiodol in 87.5%(21/24)of the cases.The serum level of AFP decreased significantly in 82.6%(19/23)of the patients.Three patients complained of severe pain at the shoulder after the operation,1 patient had skin itching during TACE,and 5 developed skin erythema after the procedure.Conclusions HCC supplied with ICA collaterals are often detected in the patients who have the tumor at the right posterior segment(S6 and S7)and had received TACE for several times.TACE via the ICA is safe but may leads to skin injuries.

Objective This study was performed to investigate clinical characteristics of albuminuria in octagenarian or nanogenarian and provide primary study for chronic kidney disease in eldly patients.Methods The data of 218 patients with albumin-to-creatinine ratio (ACR)between 30 ~300 mg/g from first morning urine in hospital from June 2012 to December 2014 were analyzed retrospectively.Consec-utive hospitalized old patients were divided into 80 +group(aged from 80 to 89 years old)and 90 +group(age≥90 years old),who were al-so divided into albuminuria positive group(ACR 30 ~300 mg/g)and albuminuria negative group(ACR <30 mg/g)according to the ACR. Cohort study was performed to investigate albuminuria related characteristics.Results Of the 218 hospitalized old men,53.21% developed albuminuria with average Log ACR (1.78 ±0.85)mg/g.Albuminuria was positive in 45.16% of 80 +group compared to that of69.84% in 90 +group(P <0.05).For albuminuria positive old men average Log ACR (2.03 ±0.62)mg/g,while it was Log ACR(1.03 ±0.44)mg/g in al-buminuria negative old men.Positive rate of albuminuria in 80 + group vs.90 + group accompanied with either diabetes,hypertension or eGFR <60 mL·(min·1.73 m2 )-1 were 50% vs.77.5%(P <0.05),50.38% vs.58.82%(P >0.05),66.21% vs.75%(P >0.05), respectively.Of a few old men who were free from diabetes,hypertension or eGFR <60 mL·(min·1.73 m2 )-1 the corresponding rate of al-buminuria were 35.39% (21 /59),16.00%(4 /25)and 25.84% (23 /89),respectively.Conclusion Occurrence of albuminuria was seen in 53.21% of advanced aged hospitalized men,with tendency of higher occurrence rate in nanogenarian than those in the octogenarian.

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.