Objective To investigate the effects of norepinephrine (NE) on vascular endothelial growth factor (VEGF) expression of brain tissues in severe burn rats. Methods The healthy male Wistar rats were made into 40%TBSAⅢ?burn models to observe the effect of NE on blood brain barrier. In the meantime, effect of NE was examined by means of immunocytochemistry and real time PCR. Results (1) Permeability of blood brain barrier was increased in burn and burn with NE stimulating rats, with significantly statistical difference compared with normal control group (P

Objective To investigate the effects of norepinephrine on brain edema of rats in 24 h after severe burn.Methods A total of 48 healthy Wistar rats were randomly divided into 8 groups: normal control group,1,2,5 mg/kg norepinephrine,burn group,burn with 1,2,5 mg/kg norepinephrine pretreatment groups(n=6 in each group).The rats in all burn groups were scalded into 40%TBSAⅢ degree burn.Pathological features were observed,and blood brain barrier,brain water(%) were examined in postburn 24 h.Results Pathological evidence of brain edema exhibited in the burn group and burn group with norepinephrine pretreatment,and increased permeability of blood brain barrier and brain water were observed.The burn with norepinephrine pretreatment groups were more significantly severe in comparison with simple burn groups and normal control group.Conclusion Norepinephrine may play an important role in brain edema in postburn 24 h,suggesting that stress of postburn may induce brain edema.

AIM: To investigate the changes of gene expression of vascular endothelial growth factor(VEGF) in norepinephrine/ burn serum-induced astrocytes.METHODS: Immunofluorescence staining was used to show the distribution of VEGF in astrocytes after 24 h using norepinephrine/burn serum stimulation.Western blotting was used to detect protein expression of VEGF.Real time PCR was used to investigate expression of VEGF mRNA.RESULTS: ① Green fluorescence of protein expression of VEGF in astrocytes was increased when treated with high dose norepinephrine(50 ?mol/L).Green fluorescence of protein expression of VEGF in astrocytes was increased distinctness after burn serum stimulation.Green fluorescence protein expression of VEGF in astrocytes was increased significantly when high dose norepinephrine combined with burn serum stimulation was added.② VEGF protein expression in burn serum stimulating group was increased,and VEGF protein expression was significantly increased when burn serum was added during moderate(20 ?mol/L),high dose norepinephrine stimulation.③ Expression of VEGF mRNA was increased in burn serumtreated astrocytes.Expression of VEGF mRNA was increased significantly when norepinephrine-stimulated astrocytes exposed to barn serum,and as norepinephrine dose increases gradually.CONCLUSION: Norepinephrine and burn serum play an important role in inducing VEGF protein expression in astrocytes,suggesting that stress reaction of postburn is an important cause in inducing brain edema by excreting VEGF in astrocytes.

AIM: To investigate the effect of norepinephrine (NE) on brain tissue VEGF protein expression in 24 h after severe burns. METHODS: (1) 40% total body surface area (TBSA) Ⅲ? burn model was made in Wistar males rats. Brain water (%) was examined at 24 h after burn. (2) NE levels in the rat brain tissue were determined by high performence liquid chromatography. (3) VEGF protein levels in the rat brain tissue were determined by Western blotting at 24 h of postburn. RESULTS: (1) Brain edema exhibited at the burns and burn with norepinephrine groups. (2) A increase in NE levels in the rat brain tissue was observed at the burns. NE levels increased significantly in burn with norepinephrine groups. (3) VEGF protein expression in the rat brain tissue was gradually increased with increasing in norepinephrine stimulating dose. VEGF protein expression in the burn rats brain tissue was significantly increased in burn with high dose of norepinephrine stimulation. CONCLUSION: Norepinephrine induced VEGF protein expression in rat brain tissue at 24 h after severe burn, suggesting that increases in norepinephrine level postburn induce brain edema.

To explore the hemodynamic characteristics during burn shock stage in dogs immigrated onto high altitude, dogs scalded with 40% TBSA of Ⅲ degree burn (n=8) were randomly divided into a high altitude treatment group (H group) and a flatlands treatment group (F group) . All subjects were infused with lactated Ringefs solution at 1 postburn hour according to the Parkland formula. The changes in hemodynamic parameters, organ water content, pulmonary microvascular permeability, serum activity of PLA2 and CK-MB were determined. The results showed that under simulated high altitude condition sustained hypoxemia and acidosis as well as hypoxic damage of myocardial function were present before scalding, and sustained increase of PAP, PCWP and RVWI, even pulmonary hypertension and lung edema were found at 24 postburn hour in H group. At 48 postburn hour, the organ water content of heart, lung, etc increased more remarkably but urine output decreased more obviously in H group than those in F group. Serum activity of PLA2 and CK-MB increased gradually after burn. It is suggested that tissue edema may easily supervene with infusion according to Parkland formula under plateau condition. Hypoxic damage of organs should be corrected by increase of colloid volume resuscitation and dehydration treatment. Administration of hypertonic solution is able to correct burn shock.

Objective　To study the effects of measures for preventing early postburn damage in improving survival rate of burn patients during the third stage. Methods　12 568 burn cases admitted to our institute were chronically divided into three groups (1958-1980;1981-1990;1991-2000). Total burn surface area (TBSA), survival rate, incidence of burn shock, systemic infection and organ damage as well as the main treatments adopted in the recent decade were retrospectively analyzed. Results　Incidence of burn shock, systemic infection and organ damage were significantly lower, and the total survival rate and the survival rate in patients with different TBSA were markedly higher in the third group as compared with those in the first and the second group. Incidence of organ damage in patients treated with delayed fast fluid infusion, early escharectomy en masse, early enteral feeding, early prevention of inhalation injury and gut bacterial translocation were also significantly lower than in the control. Conclusion Measures taken in the third group for preventing early postburn damage play an important role in improving the survival rate of burn patients.

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 observe the anaphylactoid reactions of Shuanghuanglian injection, determine the serum histamine level of sensitized animal, and to investigate its correlation with anaphylactoid reactions.Methods The guinea pigs were randomly selected to observe the anaphylactoid reactions using Shuanghuanglian injections in the different injection speed or different doses, and the serum histamine and the serum IgE of sensitized animals were determined by ELISA. Results The anaphylactoid reactions were induced by Shuanghuanglian injections in the different conditions of injection speed and doses in guinea pigs. There were no obvious difference about the serum IgE level between Shuanghuanglian group and saline group were injected in injection speed and doses. The serum histamine level was significantly increased in Shuanghuanglian group both different conditions of injection speed and doses, and it related to doses and speed. Conclusion Shuanghuanglian injection can cause anaphylactoid reactions in guinea pigs, and the changes of serum histamine level are related to injection speed and doses of Shuanghuanglian injection.

Objective To explore the changes of etiological factors,age of onset,misdiagnosis rates,length of stay and prognosis in central nervous system (CNS) infections between the near 2 decades.Methods A retrospective analysis was conducted between hospitalized patients with CNS infections in affiliated Yijishan Hospital of Wannan Medical College from January 1993 to December 2002 (group A,n =346) and from January 2003 to December 2012 (group B,n =412).The proportions of bacterial infections,Mycobacterium tuberculosis infections,Cryptococcus infections and viral infections between the 2 groups were comparable.Age,gender,underlying diseases and prehospitalization applications of immunosuppressant in two groups were analyzed.The data of prehospitalization misdiagnosis rates,length of stay and prognosis of the two groups were also compared.Measurement data were analyzed by variance analysis or t test,and enumeration data were analyzed by x2 test.Results The proportions of bacterial infections,Mycobacterium tuberculosis infections,Cryptococcus infections and viral infections in two groups were 24.3％ vs 20.1％,29.5 ％ vs 35.7 ％,6.6％ vs 11.4％ and 39.6％ vs 32.8％,respectively (x2 =10.61,P＜0.05).Compared with group A,patients in group B were older [(38.8±8.9) years vs (43.8±11.4) years,t=6.73,P＜0.05],with greater numbers of underlying diseases (1.21 ± 0.34 vs 1.72 ± 0.41,t=18.41,P＜ 0.05) and longer pre-use of immunosuppressants [(7.76 ± 3.58) d vs (12.43 ± 5.96) d,t =12.77,P＜ 0.05].There was no significant difference in sex distributions between the two groups (x2 =0.97,P＞0.05).In group A,the misdiagnosis rates for bacterial infections,Mycobacterium tuberculosis infections,Cryptococcus infections and viral infections were 9.5％,42.2％,69.6％ and 12.4％,respectively; average length of stay was (11.02±5.13) d,(19.18±8.34) d,(21.12±9.26) d and (8.24±3.17) d,respectively; and remission rates were 88.1％,60.8％,34.8％ and 80.3％,respectively.In group B,the misdiagnosis rates for bacterial infections,Mycobacterium tuberculosis infections,Cryptococcus infections and viral infections were 8.4％,29.3％,42.6％ and 11.1％,respectively; average length of staywas (10.13±4.25) d,(17.26±5.82) d,(23.05±7.97) d and (7.05±2.94) d,respectively; and remission rates were 90.4％,72.8％,61.7％ and 84.4％,respectively.The misdiagnosis rates and remission rates of Mycobacterium tuberculosis infections and Cryptococcus infections between group A and group B were of statistical significance (both P ＜ 0.05).Conclusions With the increase of underlying diseases and wide use of immunosuppressants,the causes of CNS infections are changing,among which Mycobacterium tuberculosis infections and Cryptococcus infections are increasing,with a tendency of misdiagnosis and poor prognosis.