Blood samples were collected from 10 cases with Billroth Ⅰ gastrectomy(BI),15 cases with Billroth Ⅱ gstrectomy(BⅡ),and 15 cases with pyloroantral flap preserving gastrectomy(PAFPG)were examined to evaluate the changes of plasma insulin and serum gastrin.The blood samples of 8 normal subjects were examined likewise to serve as control.The blood samples were collected in intervals before and after the subject had taken hypertonic glucose solution.It was found that plasma insulin was significantly higher in BⅠ and BⅡ group than in PAFPG group,but it showed no significant difference between the PAFPG group and the control.Serum gastrin was signficantly higher in PAFPG group,BⅠ group,and the control than in BⅡ group.These findings suggest that the changes of insulin and gastrin secretion vary with the type of subtotal gastrectomy.

Objective　To study the effect of acute serious smoke inhalation injury to unilateral lung on contralateral lung and the therapeutic efficacy of massive bronchoscopic lavage with saline to the primary injured bronchoalveolus at early stage after smoke inhalation on mitigating the secondary damage of the other lung and so as to confirm the therapeutic validity of lung lavage to smoke inhalation injury. Methods　Fifteen mongrel dogs were insufflated with sawdust smoke into left lung and then randomized into 2 groups. The dogs in group A were maintained intravenous glucose saline transfusion and breathed air freely for 24 h after injury. Those in group B received a massive bronchoscopic lavage with 250 ml of saline to injured lung at 1 hour after injury and then were administrated similarly to those in group A. Gas exchange function of bilateral lungs in the process were observed and pathologic and phyiopathologic changes of the lung specimen were examined after the process. Results　While the total lavaging volume was kept to 250 ml, the liquid volume remained in left lung after each operating was from 90 ml to 140 ml. All animals had a significant decline in pulmonary function after smoke inhalation injury. PaO2 in group B decreased significantly soon after the lavage and then increased gradually to exceeding that in group A. The left lung showed serious edema similarly in two groups but in right lung the water content was less, dynamic and static compliance was more in group B than in group A. Conclusion　Bronchoalveolar massive lavage at early post-injury stage to injured lung after unilateral lung smoke inhalation injury can mitigate secondary damage of the non-injured lung. Lung lavage can decrease the intensity of secondary systemic inflammatory reaction and show a therapeutic validity to smoke inhalation injury.

Objective To understand the morbidity of schistosomiasis japonica and health status of the liver and spleen of residents in a village and to evaluate the application of ultrasound on schistosomiasis epidemiology. Methods A total of 454 residents aged 5-65 years were examined by methods of Kato-Katz and ultrasound as well as disease history inquiry. Results The positive rate was 9.38% by stool examination, with no significant difference between males and females. The intensity of the infection among population was 5.70 eggs per gram of stool (EPG), with significant difference between males and females. The stool positive rate and EPG in farmers and students were the highest. Among 10.66% of the males and 8.10% of the females, as well as in 23.81% of the stool positive and 8.31% of the stool negative, the parenchyma of the liver was abnormal(≥GradeⅡ),with significant difference between males and females and between the stool positive and the stool negative. The abnormal rate of liver parenchyma went up with the age. Conclusion Ultrasound can evaluate the health status of inhabitants with schistosomiasis japonica and improve the compliance rate of residents to praziquantel chemotherapy.

To establish kinetic assay method for the analysis of hemolysis and to investigate dynamic hemolytic process of polysorbate 80. The UV-VIS spectrum of heme changes when hemoglobin is released continuously during the hemolytic process. Therefore, dynamic hemolytic curve was determined as a new way to characterize the kinetic process of interaction between polysorbate 80 and red blood cells. The effect of polysorbate 80 on blood cells could be perfectly investigated by the hemolytic dynamics. Dynamic hemolytic parameters of polysorbate 80 were calculated according to the hemolytic curves. The constants of hemolytic rate and maximum hemolytic rate of polysorbate 80 had fine linear relationships at the range of 1-20 mg x mL(-1) and 5-20 mg x mL(-1), respectively. In comparison with the present official method such as macroscopic observation and static spectrophotometric methods, kinetic spectrophotometry has the advantages of real time, on-line determination, sensitive, objective, good reproducibility and 2-dimensional information acquired. Therefore, as a biological technique, kinetic spectrophotometry could be applied to evaluate the quality of polysorbate 80 and to screen other solubilizing excipients.

Objective　To explore the feasibility and safety of massive lung lavage to dogs in the early stage after acute serious smoke inhalation. Methods　A total of 16 dogs were inflicted with smoke inhaled injury and then divided into group A (n=5) without lung lavage, group B (n=6) in which left lung lavage was followed by lavage on the right 30 min later, and group C (n=5) in which the interval of the lavages on the left and right lung was 4 h. Massive lung lavage was carried out in 1 h after the injury under the guiding fiberoptic bronchoscopy and a special ventilation jet was served to supply enough oxygen to the dogs. The stability of pulmonary function and blood circulation were observed at different time points in every group. Results　The average operating time of unilateral lung lavage was about 15 minuted and the liquid volume left in every lung after operation was from 100 ml to 140 ml when the total lavaging volume was kept in 250 ml. The changes of hemodynamic parameters were identical in Group B and Group C. Inhalation injury had certain negative effect while lung lavage almost had no effect on the blood circulation of the animals in 2 lavage groups. No serious cardiac arrythemia was found in them during the lavaging. Pulmonary function in Group C was better than that in Group B but worse than that in Group A. In the 2 lavaging groups, PaO2 remained higher than 9.33 kPa（FiO2=0.4）during and after the lavaging. Conclusion The ventilation mode and the lavage method introduced here ensure the safety of massive lung lavage in dogs with acute smoke serious inhalation injury.

OBJECTIVETo investigate the effectiveness and the safety of clinical use of rhGH in the management of severe burn patients.

METHODSTwo hundred burn patients aged 20 - 25 yrs with TBSA from 20% to 50% and admitted within 5 postburn days (PBD) were enrolled in this study. The patients were divided into operation and non-operation groups. Furthermore, each group was randomly divided into control (N), treatment with rhGH in dosage 0.2 IU/Kg/d (A) and treatment with rhGH in dosage 0.4 IU/kg/d (B) groups. The general data, the metabolism of protein and glucose, the immune function, the urine biochemistry, the wound healing rate and hospital stay days recorded and compared among all groups.

RESULTSPlasma protein was increased, the immune function recovered early, the wound healing time was shortened obviously, the wound healing rate was increased evidently and the hospital stay days were decreased significantly in the treatment groups (A and B groups) compared with the N group. The body weight of burn patients remained unchanged in N group. Nevertheless, the plasma levels of glucose and insulin were increased and the urine output of potassium, sodium and chloride decreased in N group compared with those in A and B groups. Moreover, the levels of all these indices in B group were higher than those in A group, whereas side effects were more common in B group than in A group. In addition, the incidence of adverse reaction was higher in operation group than that in non-operation group.

CONCLUSIONrhGH could effectively promote protein synthesis, enhance systemic immune function, accelerate wound healing and shorten hospital stay days in severely burned patients. But attention should be paid to appropriate dosage and duration of use.

Adult ; Burns ; drug therapy ; immunology ; CD4-CD8 Ratio ; Dose-Response Relationship, Drug ; Growth Hormone ; therapeutic use ; Humans ; Middle Aged ; Wound Healing

OBJECTIVETo investigate relationship between apoptosis of the cardiac myocytes and myocardial dysfunction in severely scalded rats.

METHODSWistar rats inflicted by 40% TBSA III degree scalding were employed as the model. The myocardial tissue was obtained from the left ventricle at different postburn time points. Apoptosis was determined by the determination of myocardial tissue Caspase-3 activity and TUNEL staining (terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-biotin nick end labeling). The LVSP (left ventricular systolic pressure), LVEDP (left ventricular end-diastolic pressure) and +dp/dtmax (the rate of the rise of left ventricular pressure) and -dp/dtmax (the rate of the fall of left ventricular pressure) were all monitored by four-channel physiological recorder. In addition, myocardial activities of MPO and SOD were detected.

RESULTSThe TUNEL staining of rat myocardial cells was positive at 6 postburn hour (PBH) and reached top level at 12 PBH. The change in Caspase-3 activity was earlier than that of apoptotic morphology and reached peak values at 3 and 6 PBHs. The left ventricular function (systolic and diastolic function) was significantly impaired after the scalding and dropped to the lowest levels at 12 PBHs. The increase in myocardial tissue MPO activity was accompanied by the decrease in SOD activity.

CONCLUSIONMyocardial cellular apoptosis was one of the reasons of postburn myocardial injury in scalded rats. Caspase protease cascade pathway might be involved in the process of apoptosis, which suggested that the initiation of apoptosis was closely related to the infiltration of neutrophils and to the release of large amounts of oxygen free radicals in myocardial tissue.

Animals ; Apoptosis ; Burns ; pathology ; physiopathology ; Caspase 3 ; Caspases ; metabolism ; Female ; Male ; Myocytes, Cardiac ; pathology ; Peroxidase ; metabolism ; Rats ; Rats, Wistar ; Superoxide Dismutase ; metabolism ; Ventricular Function, Left

OBJECTIVETo explore the effects of direct current electric fields on directional migration and arrangement of dermal fibroblasts in neonatal BALB/c mice and the related mechanisms.

METHODSTwelve neonatal BALB/c mice were divided into 4 batches. The skin on the back of 3 neonatal mice in each batch was obtained to culture fibroblasts. Fibroblasts of the second passage were inoculated in 27 square cover slips with the concentration of 5 × 10(4) cells per mL. (1) Experiment 1. Six square cover slips inoculated with fibroblasts of the second passage were divided into electric field group (EF) and sham electric field group (SEF), with 3 cover slips in each group. The cover slips were put in live cell imaging workstation. The cells in group EF was treated with electric power with EF intensity of 200 mV/mm, while simulating process without actual power was given to SEF group (the same below) for 6 h. Cell proliferation rate was subsequently counted. (2) Experiment 2. Six cover slips were divided and underwent the same processes as in experiment 1. Cell movement locus within EF hour (EFH) 6, direction change of cell migration at EFH 0 (immediately), 1, 2, 3, 4, 5, and 6 which was denoted as cos(α), cell migration velocity within EFH 6, direction change of long axis of cell within EFH 6, and direction change of cell arrangement at EFH 0, 1, 2, 3, 4, 5, and 6 which was denoted as polarity value cos[2(θ-90)] were observed under live cell imaging workstation. After EFH 6, the morphological changes in microtubules and microfilaments were observed with immunofluorescent staining. (3) Experiment 3. Six cover slips were divided into cytochalasin D group (treated with 1 μmol/L cytochalasin D for 10 min) and colchicine group (treated with 5 μmol/L colchicine for 10 min), with 3 cover slips in each group. The morphological changes in microfilaments and microtubules were observed with the same method as in experiment 2. (4) Experiment 4. Nine cover slips were divided into control group (no reagent was added), cytochalasin D group and colchicine group (added with the same reagents as in experiment 3), with 3 cover slips in each group. Cells in the 3 groups were exposed to an EF of 200 mV/mm for 6 h. Cell movement locus within EFH 6, cell migration velocity within EFH 6, cell polarity values at EFH 0, 3, and 6, and morphological changes of cells at EFH 0 and 6 were observed. Data were processed with independent samples t-test, one-way analysis of variance, and LSD test.

RESULTS(1) There was no statistically significant difference in cell proliferation rate in group EF and group SEF (t=-0.24, P﹥0.05). (2) Within EFH 6, cells in group EF migrated towards the anode of EF, while cells in group SEF moved randomly. At EFH 0, the values of cos(α) of cells in the 2 groups were both 0. The absolute value of cos(α) of cells in group EF (-0.57 ± 0.06) was significantly higher than that in group SEF (0.13 ± 0.09, t=6.68, P<0.01) at EFH 1, and it was still higher than that in group SEF from EFH 2 to 6 (with t values from 5.33 to 6.83, P values below 0.01). Within EFH 6, migration velocity of cells in group EF was (0.308 ± 0.019) μm/min, which was significantly higher than that in group SEF [(0.228 ± 0.021) μm/min, t=-2.76, P<0.01]. Within EFH 6, long axis of cells in group EF was perpendicular to the direction of EF, while arrangement of cells in group SEF was irregular. Cell polarity values in group EF were significantly higher than that in group SEF from EFH 2 to 6 (with t values from -7.52 to -0.90, P values below 0.01). At EFH 6, the morphology of microfilaments and microtubules of cells in EF group was similar to that in SEF group. (3) The fluorescent intensity of microfilaments of cells in cytochalasin D group became weakened, and the filamentary structure became fuzzy. The microtubules of cells in colchicine group became fuzzy with low fluorescent intensity. (4) Within EFH 6, cells in control group migrated towards the anode of EF, while cells in cytochalasin D group and colchicine group moved randomly. Within EFH 6, there was statistically significant difference in migration velocity of cells in the 3 groups (F=6.36, P<0.01). Migration velocity of cells in cytochalasin D group and colchicine group was significantly slower than that in control group (P<0.05 or P<0.01). At EFH 0, 3, and 6, cell polarity values in the 3 groups were close (with F values from 0.99 to 1.51, P values above 0.05). At EFH 0, cells in control group were spindle; cells in cytochalasin D group were polygonal or in irregular shapes; cells in colchicine group were serrated circle or oval. At EFH 6, no morphological change was observed in cells in control group; cells in cytochalasin D group were spindle with split ends on both ends; cells in colchicine group were serrated oval.

CONCLUSIONSThe physiologic strength of exogenous direct current EF can induce directional migration and alignment of dermal fibroblasts in neonatal BALB/c mice. Microfilaments and microtubules are necessary skeleton structure for cell directional migration induced by EF, while they are not necessary for cell directional arrangement induced by EF.

Animals ; Cell Movement ; Cells, Cultured ; Electricity ; Fibroblasts ; cytology ; Mice ; Mice, Inbred BALB C ; Microtubules ; Skin ; cytology

Objective:To investigate the influencing factors and their predictive value of skin graft survival after Meek grafting in severe burn patients.Methods:A retrospective case-control study was conducted in 115 severe burn patients (95 males, 20 females, aged 1-74 years) who met the inclusion criteria and received Meek grafting in the First Affiliated Hospital of Army Medical University (the Third Military Medical University) from January 2013 to December 2019. The patients were divided into good skin graft survival group with skin graft survival rate≥70% (68 cases) and poor skin graft survival group with skin graft survival rate<70% (47 cases). The statistics of patients in the two groups were recorded during their first Meek grafting after admission including the gender, age, body mass index, full-thickness burn area, burn index, complication of inhalation injury, time from injury to operation, preoperative cystatin C level, preoperative albumin level, preoperative neutrophil, preoperative hemoglobin level, preoperative platelet count, and platelet count on the first, third, and fifth day after operation. The above indicators were statistically analyzed between the two groups with independent sample t test, Mann-Whitney U test, and chi-square test. A 1∶1 propensity score matching (PSM) of the gender, age, body mass index, full-thickness burn area, burn index, complication of inhalation injury, time from injury to operation of patients in the two groups were performed to eliminate the differences in baseline data, and then the above indicators of the remaining patients in the two groups were recorded and analyzed again. The indicators with statistically significant differences between the two groups after 1∶1 PSM were selected for multivariate logistic regression analysis to screen the independent risk factors affecting the skin graft survival after Meek grafting in severe burn patients. The receiver operating characteristic (ROC) curve of independent risk factors for predicting poor skin graft survival after Meek grafting in severe burn patients after 1∶1 PSM was drawn, and the area under the curve, the cut-off value, and the sensitivity and specificity under the cut-off value were calculated. The patients after 1∶1 PSM were divided into independent risk factor>the cut-off value group and independent risk factor≤the cut-off value group with the incidence of poor skin graft survival after Meek grafting compared using the chi-square test, and the relative risk of poor skin graft survival after Meek grafting was calculated. Results:Before 1∶1 PSM, there were no statistically significant differences in gender, age, body mass index, complication of inhalation injury, time from injury to operation, preoperative cystatin C level, preoperative albumin level, preoperative neutrophil, preoperative hemoglobin level of patients between the two groups ( P>0.05); the full-thickness burn area and burn index of patients in poor skin graft survival group were significantly higher than those in good skin graft survival group ( Z=-2.672, -2.882, P<0.01); the preoperative platelet count and the platelet count on the first, third, and fifth day after operation of patients in poor skin graft survival group were significantly lower than those in good skin graft survival group ( Z=-3.411, -3.050, -2.748, -2.686 , P<0.01). After 1∶1 PSM, 46 cases were remained in each group. There were no statistically significant differences in gender, age, body mass index, full-thickness burn area, burn index, complication of inhalation injury, time from injury to operation, preoperative cystatin C level, preoperative albumin level, preoperative neutrophil, preoperative hemoglobin level of remaining patients between the two groups ( P>0.05); the preoperative platelet count and the platelet count on the first, third, and fifth day after operation of patients in poor skin graft survival group were significantly lower than those in good skin graft survival group ( Z=-3.428, -2.940, t=-2.427, -2.316, P<0.05 or P<0.01). Multivariate logistic regression analysis showed that the preoperative platelet count was the only independent risk factor affecting the skin graft survival after Meek grafting in severe burn patients (odds ratio=0.994, 95% confidence interval=0.989-0.998, P<0.01). The area under the ROC curve of preoperative platelet count predicting poor skin graft survival after Meek grafting in 92 patients was 0.707 (95% confidence interval=0.603-0.798, P<0.01), and the cut-off value of preoperative platelet count was 98×10 9/L, with sensitivity of 54.3% and specificity of 78.3% under the cut-off value. The incidence of poor skin survival after Meek grafting of patients in preoperative platelet count≤98×10 9/L group was 71.4% (25/35), which was obviously higher than 36.8% (21/57) in preoperative platelet count>98×10 9/L group ( χ2=10.376, P<0.01). Compared with that in preoperative platelet count>98×10 9/L group, patients in preoperative platelet count≤98×10 9/L group had a relative risk of poor skin graft survival after Meek grafting of 2.211 (95% confidence interval=1.263-3.870). Conclusions:Preoperative platelet count is an independent risk factor affecting the skin graft survival after Meek grafting in severe burn patients and has a good predictive value. Meek grafting should be performed with caution when the preoperative platelet count of patients is≤98×10 9/L.

There is no national referral criteria for burns in China till now, which brings inconvenience and confusion. Based on the oversea experiences and the actual situation in China, many famous experts in burns discussed and developed this (2018 ). We hope these referral criteria will be helpful in clinical practice of burns and can be improved continuously through application.
Burn Units ; standards ; Burns ; therapy ; China ; Humans ; Practice Guidelines as Topic ; standards ; Referral and Consultation ; standards