Objective　To investigate the effects of escharectomy at different time points on myocardial damages in scalded rats during shock stage. Methods　A total of 42 rats were inflicted with 30% TBSA Ⅲ scalding on their backs and then randomly and equally divided into 7 groups: burned control group (C) and escharectomy groups at hour 1, 3, 6, 12, 24 and 36 postburn. Another 6 rats were employed as normal control (N). The serum levels of creatine kinase isoenzymes MB (CKMB), aspartate aminotransferase (AST) were determined and morphological changes in myocardial tissues were observed 72 hours after the burn. Results　The serum levels of CKMB and AST were higher in the C group than in other groups, and the levels in escharectomy groups were increased along with the prolongation of scar cutting. Pathologically, the myocardial tissues were severely damaged in C group, and the later the scars were cut, the severe the damages were in the escharectomy groups except the 2 groups with scars cut at hour 1 and 3. Conclusion　Escharectomy in shock stage can effectively prevent the damage of the myocardial tissues from postburn injury and the earlier it is performed, the better the result is.

Objective:To explore the mode,methods,and attentive problems of bilingual teaching of Burn Surgery for Seven-year medical program students.Methods:The bilingual teaching project of Burn Surgery was considered comprehensively from various angles,such as the teaching mode,methodology,teacher training,teaching material selection and teaching management in specialized course.Conclusion:It is very necessary to develop bilingual education for Seven-year program students.The course of bilingual teaching should be student-oriented to improve their integrated ability of English and to assure mastery of professional theory and knowledge.

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.

It has not been well agreed on transportation of severely burned patients for a long distance during shock stage due to having high risks. After meticulouss preparation and much effort, a group of severely burned patients during shock period were safely transferred by air far away from our hospital in Aug. 2000, and fluid resuscitation and hemodynamical stabilization were maintained on the plane. The process passed smoothly. All the patients survived finally after active and effective treatment in our burn center. The experience shows that transportation by air of burned patients for a long distance during shock stage is possible on condition that all relative measures are properly carried out during the journey.

Objective:To explore the mode,methods,and attentive problems of the network teaching carried out during the standardized training in residents.Methods:The project of carrying out network teaching during the standardized training in residents was considered comprehensively from various angles,such as teaching mode,teacher training,construction of the network teaching system and resources base,teaching management in specialized course.Conclusion:It is very necessary and helpful to develop network teaching during the standardized training in residents.The course of network teaching should be student-oriented,carried out to improve their self-educated ability and to assure mastery of professional theory and knowledge.

The construction of excellent courses is one important measure of carrying out the teaching quality project in university.To improve the quality of the construction of excellent courses,we must emphasize some basic operation strategies such as practical results,innovation,digital processing and integration.We should adopt workable measures to carry out the teaching quality project in university and strengthen the key position of teaching.

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.