Objective To investigate the dynamic features of high-density lipoproteins(HDL) in burn patients and the relationship between the changes and infectious complications.Methods One hundred and twenty patients,aged from 18 to 59 years and admitted within 24 hours of with thermal injury,were involved in present study including mild-moderate,severe and extensive burns groups each of 40 cases.Empty stomach blood samples were drawn on admission and at day 1,2,3,5,7,14 and 21 after burn injury.Serum triglyceride(TG),total cholesterol(TC),high-density lipoproteins(HDL),low-density lipoproteins(LDL),apolipoprotein A1(apoA1) and apolipoprotein B(apoB) were measured in all patients and compared with those of 40 healthy volunteers(control group).The infectious complications and outcome were monitored.Results In 120 patients,a total of 51 identifiable nosocomial infection episodes occurred in 32 patients.Of 6 dead cases,5 were related to infections.The incidence of infection in mild-moderate,severe and extensive burn groups were 7.5%,20.0% and 52.5%,respectively,with statistically significant difference(P0.05) on admission and day 1;from day 2 to day 21,the concentrations of TC,HDL and apoA1 in infection patients were lower than those in non-infection patients(P

Objective To investigate the mechanism of mastoparan-1 (MP-1) antagonizing lipopolysaecharide (LPS) in vitro. Methods The affinity of MP-1 for lipid A was assayed by biosensor, and the neutralization of MP-1 on LPS (2 μg/L) was detected by kinetic turbidimetric limulus test. After exposing fluorescin isothiecyanate (FITC) labeled LPS (FITC-LPS) to MP-1 at different concentrations (5, 10, 20, 40 μmol/L), the binding of FITC-LPS to murine RAW264.7 cells was analyzed by laser scanning confocal microscopy. The influence of MP-1 on TLR4 expression in RAW264.7 cells stimulated by LPS (100 μg/L) was detected by immunoeytochemieal staining. The expressions of TLR4, TNF-α and IL-6 at the gene and protein level were detected by RT-PCR and ELISA after exposing LPS (100 μg/ L) stimulated RAW264.7 cells to MP-1 at different concentrations. The effect of MP-1 on the viability of RAW264.7 cells was detected by MTT assay. Results MP-1 had high affinity to lipid A and could neutralize LPS. MP-1 at 10 μmol/L significantly inhibited not only binding of FITC-LPS to RAW264.7 (P < 0.05), but also protein and gene expressions of TLR4, TNF-α and IL-6 in LPS stimulated RAW264.7 cells in a dose-dependent manner (P < 0.05). No toxic effect of MP-1 on the viability of RAW264.7 cells was found (P > 0.05). Conclusions MP-1 inhibits cell viability mediated by LPS, which may be related to its neutralization of LPS and inhibition of binding of LPS to RAW264.7 cell membrane receptors.

Objective To explore the effect of platelet-rich plasma (PRP) on flap graft survival.Methods Two random skin flaps were elevated on the back of the rabbits with spinal symmetry in fifteen healthy rabbits.We selected randomly one side as PRP side,another side as blank control side.And then the autologous PRP was daubed to the basement of the skin flap in PRP side,while the blank control side was treated with normal saline of the same volume.At 3 d,7 d,and 14 d after the surgical operation,the immunohistochemistry was conducted to detect the microvessel density by CD34,and the the flap graft survival rate was tested and the histological changes of the flaps were observed by HE staining.Results The survival rates of skin flap graft were that the PRP side in 3 d (74.4±4.7) ％,while the control side (65.8+6.8)％;the PRP side in 7 d (72.4±7.5)％,while the control side (58.5+7.0)％；the PRP side in 14 d (74.5±5.0)％,while the control side (65.0±5.4) ％.The inflammatory reaction became declining with the extension of time,while density of blood vessels was increasing.In 14 d inflammatory reaction was the lowest and blood vessels' density was the largest.In all the control sides inflammatory response was obvious than that of the PRP side.CD34 positive count in 3 d PRP side microvascular density (MD) was (13.9±2.0)/HP,controlled side (11.1±1.3)/HP;in 7 d PRP MD was (15.7±1.5)/HP,controlled side (12.1±1.2)/HP;in 14 d PRP MD was (19.6±1.2)/HP,controlled side (12.7±0.8)/HP.There were significant differences in the MD at 3 d,7 d,and 14 d (P＜0.05) between PRP side and control side.Conclusions Platelet-rich plasma is able to promote the survival of random rabbit flap.

OBJECTIVETo investigate the application of tourniquet in burn patients during tangential excision on the extremities.

METHODSSeventy - nine burn patients who were arranged to receive tangential excision and skin grafting on the extremities were randomly divided into A and B groups. The patients in A group (n = 41) underwent the operation with the tourniquet applied continuously throughout the operation, while those in B group (n = 38), only with tourniquet applied during tangential excision. The amounts of blood loss and blood transfusion, the operation time and the take rate of grafted skin and the incidence of complications were investigated and recorded.

RESULTSThe amounts of blood loss and blood transfusion during operation in A group were 42% and 50% less than those in B group, respectively (P < 0.001). Moreover, the operation time on the upper and lower extremities in A group was much shorter (for 41% and 37%, respectively) than those in B group (P < 0.001). In addition, there was no difference of the take rate of skin graft and the incidence of subcutaneous hematoma between the two groups (P > 0.05).

CONCLUSIONContinuous tourniquet application during tangential excision on the extremities in burn patients was proved to be effective in reducing operational blood loss, blood transfusion and in shortening operation time.

Adult ; Blood Loss, Surgical ; prevention & control ; Blood Transfusion ; Burns ; surgery ; Extremities ; surgery ; Humans ; Skin Transplantation ; Tourniquets