BACKGROUND:Sheng-Huangmixture includingChinese medicine Shengmai Decoction and total flavonoids of stems and leaves of radix has been shown to resist inflammation, regulate immune function, and protect ischemic myocardial tissues. However, its effect on the apoptosis of cardiac muscle cels after ischemia/reperfusion injury remains unclear.
OBJECTIVE:To investigate the effects ofSheng-Huangmixture on cardiocyte apoptosis and bax and bcl-2 mRNA expression in rats with ischemia-reperfusion injury.
METHODS:Thirty-six Sprague-Dawley rats weredivided randomly into six groups: low-dose, moderate-dose and high-doseSheng-Huangmixture, positive control, blank and model groups (n=6). After 7 days of administration, models of myocardial ischemia-reperfusion injury were established. TUNEL was usedto detect myocardial apoptosis. RT-PCR was utilized to measure bax and bcl-2 mRNA expression in the ischemic and reperfusion region.
RESULTS AND CONCLUSION:(1) The bcl-2 mRNA expression was significantly higher in the Sheng-Huangmixture group than in the model group (P< 0.05), but bax mRNA expression was significantly lower (P< 0.05). Thus, bcl-2/bax ratio increased. In addition, apoptosis index was more significantly decreased in theSheng-Huangmixture group(P< 0.05). (2) Results demonstrated that Sheng-Huangmixture can protect rat myocardium against ischemia/reperfusion injury, and effectively increase the bcl-2/bax ratio andinhibit the apoptosis of cardiomyocytes, and the underlying mechanism is mediated by up-regulating bcl-2 mRNA expression and down-regulating bax mRNA expression.

Objective: To explore the effects of free anterolateral femoral or medial calf flaps in the repair of severe facial burns. Methods: From January 2014 to October 2017, 18 patients with severe facial burns were admitted to Zhengzhou First People′s Hospital, including 12 males and 6 females, aged 15-78 years. Autologous intermediate split-thickness skin grafts were transplanted to replace oral mucosa in 4 patients with perforating cheek defects, and 8 patients underwent early vacuum sealing drainage and autologous intermediate split-thickness skin grafting to reduce the wound area to 14 cm×6 cm-22 cm×14 cm before flap transplantation. The wounds of 15 patients were repaired with free anterolateral femoral flaps, and the wounds of the other 3 patients were repaired with free medial calf flaps. The area of flaps ranged from 16 cm×7 cm to 24 cm×17 cm. The facial artery or superficial temporal artery was anastomosed end-to-end with lateral femoral circumflex artery or posterior tibial artery under microscope routinely and manually, and the two accompanying veins were anastomosed end-to-end by Coupler microvascular anastomat. The donor site was sutured or transplanted with autologous intermediate split-thickness skin graft. The anastomosis time of veins was recorded. The patency rate of vascular was calculated. The survival status of flaps were observed. The recovery of recipient area was observed during follow-up. Results: The anastomosis time of two veins in this group was 6-10 minutes, with an average of 8.5 minutes. The patency rates of veins and arteries were 100%. There was no vascular crisis due to the anastomosis problem. The free flaps survived well in 16 patients; one patient had hemorrhage under the flap 6 hours after operation, and the blood circulation of flaps turned well after hemostasis by surgical exploration; the other patient had 3 cm necrosis at the distal end of flap after operation, and the wound was closed after dressing change and autologous intermediate split-thickness skin grafting. The patients were followed up for 2 to 24 months after discharge. Most of the five senses function recovered. The color and texture of the flaps were not consistent with those of the normal facial skin. Some flaps were slightly swollen. Oral integrity was restored in 4 patients with perforating cheek defect with mouth opening of 2.2-3.5 cm. Conclusions Free anterolateral thigh flaps or medial calf flaps can repair severe facial burn wounds. It takes less time to anastomose venous vessels by microvascular anastomat during operation and can ensure the quality of venous anastomosis.