BACKGROUND: Random flap as a primary means of wound healing, is widely used at present, its blood circulation to establish the situation is also researched a lot, but not yet the system of random skin flap perfusion were observed and measured. In addition, the timing of pedicle division of a pedicle flap random is also a hot topic, but not yet a mature clinical testing method has been discovered to determine the best timing.OBJECTIVE: By means of laser Doppler blood perfusion imaging, this study was designed to dynamically observe random flap microcirculation, to understand the changes on random flap blood flow, and to determine the best timing of pedicle division. METHODS: A total of 18 cases were divided into traditional pedicle division group and early pedicle division group. Pedicle flap blood perfusion values were statistically measured immediately after surgery, at 3, 7,11,15, and 19 days after surgery, before division, immediately after division, and at 24 hours after pedicle division, 8-9 phases in total.RESULTS AND CONCLUSION: Distal blood perfusion value was increased with the time prolongation in both groups; while, the blood perfusion in various time phases was significantly different from that after surgery (P < 0.05); but, the blood perfusion was decreased immediately after surgery, which was still significantly compared with traditional pedicle division group (P< 0.05). There was no significant different in blood perfusion between early pedicle division and immediate after surgery of pedicle division (P > 0.05), but there was significant difference between 24 hours after pedicle division and immediate after surgery of pedicle division (P< 0.05). Blood perfusion values were less changed in both groups (P> 0.05). The ratio of both groups peaked before pedicle division and then gradually decreased after pedicle division. The best timing of pedicle division was the ratio of 1.2.

OBJECTIVE:To explore the effects of early treatment with mouse nerve growth factor on the wound healing in aged patients with electric burn. METHODS:78 elderly patients with electric burn were divided into control group and observation group by random number table method,with 39 cases in each group. Control group was given routine method for electric burn, and observation group was additionally given Mouse nerve growth factor for injection 30 μg dissolved in 2 ml 0.9% Sodium chlo-ride injection within 24 h,im,qd,on the basis of control group. Treatment course of 2 groups lasted for 2 weeks. Clinical effica-cies of 2 groups were compared as well as VAS score before treatment,3,5,7 days after treatment. The survival rate of skin flaps and the rate of wound healing 3,5,7 days after treatment,the recovery of wound scar,the value of wound blood perfusion,the time of complete wound healing and the occurrence of ADR were also compared. RESULTS:The total effective rate of observation group(94.9%)was significantly higher than that of control group(66.7%),with statistical significance(P<0.05). 3,5,7 days after treatment,VAS score of observation group was significantly lower than that of control group,and the survival rate of skin flaps and the rate of wound healing were significantly higher than those of control group,with statistical significance(P<0.05). Af-ter treatment,VSS score of observation group was significantly lower than that of control group,while the value of wound blood perfusion was significantly higher than that of control group;the time of complete wound healing was significantly lower than that of control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Early treat-ment with mouse nerve growth factor for elderly patients with electric burns can effectively lower the VAS and VSS score,improve the survival rate of skin flaps and the rate of wound healing,increase the value of wound blood perfusion and shorten the time of complete wound healing with good clinical efficacy and safety.

Objective To know the establishment of the flap pedicle blood supply and the right moment of the cutting off of pedicle by means of laser Doppler blood perfusion imaging instrument on the random flap blood flow changes.Methods 20 adult healthy rabbits were divided in to four groups and each 5 have unilateral flaps.1,3,5,7,9,12,14,18 days after operation,the pedicle blood perfusion values (PU) measurement of the distal pedicle on the flap and midpoint of both ends of the pedicle were performed,and PU values were analyzed.Results Pedicle of the PU values at the different time points changed little (P＞0.05).The PU value in the distal flap reached the minimum 1 day after operation and then increased gradually [3 d (1.24±0.07),5 d (1.57±0.15),7 d (1.79±0.08),9 d(1.89±0.13),12 d(2.01±0.16),14 d(2.18±0.09) and 18 d(2.40±0.18),P＜0.05].When distal PU values/pedicle PU value≥1.2,the flap survival rate reached 99%.Conclusions The establishment of random skin flap blood circulation,as well as the ratio of PU values of distal to the pedicle flap pedicle can be used as the timing of an important indicators.

BACKGROUND: Pentoxifylline (PTX), as an effective drug to improve blood rheology, has been used as a vasodilator for the treatment of vascular diseases and peripheral vascular disease science 1960s. But the role of PTX on skin blood flow to improve flap survival remains still unclear. OBJECTIVE: Through the clinical application of PTX therapy, the dynamic observation of random flap to understand that the PTX can promote flap survival and improve blood circulation of flap. METHODS: A total of 39 patients (27 males and 12 females aging 7-54 years) with skin tissue defect undergoing random flap repairing were selected from Department of Burn and Plastic Surgery, First Hospital of Hebei Medical University. The 39 cases were randomly divided into control group and drug group. Patients in the drug group were given intravenous injection of 250 mL PTX at day 2 after random flap operation, once a day, until 14 days after flap repairing surgery. On the first day after flap pedicle surgery, 250 mL PTX sodium chloride injection was intravenously given, once a day, until 7 days after flap pedicle surgery. The control group was not given PTX treatment. The value of blood perfusion (PU) was measured using laser-Doppler blood reperfusion image after flap transplantation, before and after pedicle division. RESULTS AND CONCLUSION: All 39 patients were completely cured and discharged, with no interruption experiments. Before pedicle division, PU value at distal flap in both drug and control groups were increased obviously, and the PU value in the drug group was significantly higher than control group (P < 0.05); after pedicle division, the PU value in the two groups were decreased, and there was no significant difference between the two groups (P > 0.05). Prior to pedicle division, the PU value of pedicle was gradually decreased and then increased in the drug group, and that in the control group was gradually increased. On the seventh day, the PU value of pedicle was stable in the drug group, and there was no significant difference between the two groups (P> 0.05); after pedicle division immediately, the PU values of pedicle were decreased in the two groups, and then the increase in the drug group was remarkable compared to control group (P < 0.05). Two sets of random flaps all survived, and skin defects were successfully repaired after pedicle division. PTX can markedly increase blood perfusion after random flap transplantation, promote flap survival and pedicle division in an early stage, and effectively shorten the healing time.

Objective To investigate the therapeutic effect of hydrogen-rich saline on the rheological behavior of leukocytes in mesentery capillary of rats with high-voltage electrical burn .Methods 180 rats were randomly divided into four groups :burn injury plus normal saline group ,burn injury plus hydrogen-rich saline group ,sham plus normal saline group ,and burn injury plus papaver-ine group .The rats were received saline ,hydrogen-rich saline ,saline ,papaverine at different time points after scald respectively .The changes of rheological behavior of leukocytes in mesentery capillary of rats before and after the injury were investigated .Results The rheological behavior of leukocytes in mesentery capillary of the control group were observed no significant change (P>0 .05) . In experimental group the rolling white blood cell count ,the number of leukocyte adhesion ,the length of contact of leukocyte-endo-thelial cell at each phase after injury were higher than those at 15 min before injury (P<0 .05);leukocyte rolling speed after injury is lower than that before injury (P<0 .05) .In treatment group and positive control group ,the rolling white blood cell count ,the number of leukocyte adhesion ,the length of contact of leukocyte-endothelial cell at each phase after injury were higher than those at 15 min before injury (P<0 .05) ,but compared with the experimental group ,the increase range was lower (P<0 .05) .leukocyte rolling speed after injury is lower than that before injury (P<0 .05) ,and compared with the experimental group ,the reduction was lower (P<0 .05) .Conclusion The hydrogen-rich brine can effectively reduce the changes of rheological behavior of leukocytes in mesentery capillary of rats caused by high-voltage electrical burn ,and have a protective effect on rat mesenteric .

Objective: To investigate influences of high-voltage electrical burns on microcirculation perfusion on serosal surface of small intestine of rats and the interventional effects of pentoxifylline (PTX). Methods: Totally 180 SD rats were divided into sham injury group, simple electrical burn group, and treatment group according to the random number table, with 60 rats in each group. The electrical current was applied to the outside proximal part of left forelimb of rats and exited from the outside proximal part of right hind limb of rats. Rats in simple electrical burn group and treatment group were inflicted with high-voltage electrical burn wounds of 1cm×1cm at current entrances and exits, with the voltage regulator and experimental transformer. Rats in sham injury group were sham injured through connecting the same equipments without electricity. At 2 min post injury, rats in sham injury group and simple electrical burn group were intraperitoneally injected with 2 mL normal saline, and rats in treatment group were injected with 2 mL PTX injection (50 mg/mL). At 15 min before injury and 5 min, 1 h, 2 h, 4 h, and 8 h post injury, 10 rats in each group were selected to collect blood of heart respectively. Serum were separated from the blood to determine the level of soluble vascular cell adhesion molecule-1(sVCAM-1) with enzyme-linked immunosorbent assay method. The number of adhesional leukocyte in mesenteric venule of rats was determined with Bradford variable projection microscope system. The microcirculation perfusion on serosal surface of small intestine of rats was detected with laser Doppler perfusion imager. Data were processed with analysis of variance of factorial design and LSD test. Results: (1) At 5 min, 1 h, 2 h, 4 h, 8 h post injury, the serum content of sVCAM-1 in rats of simple electrical burn group were (8 502±1 158), (11 793±3 310), (9 960±2 146), (9 708±1 429), (7 292±1 386) ng/mL respectively, higher than that in sham injury group and treatment group [ (1 897±946), (1 882±940), (1 882±938), (1 888±946), (1 884±942) ng/mL, and (6 840±1 558), (6 742±2 465), (5 625±2 593), (2 373±1 463), (5 187±2 797) ng/mL, respectively, with P values below 0.001]. The serum content of sVCAM-1 in rats of sham injury group and treatment group at all time points post injury, except 4 h post injury of treatment group, was higher than that of the same group at 15 min before injury (with P values below 0.001). (2) At all time points post injury, the number of adhesional leukocyte in mesenteric venule of rats in simple electrical burn group was higher than that in sham injury group and treatment group (with P values below 0.001). The number of adhesional leukocyte in mesenteric venule of rats in simple electrical burn group and treatment group at all time points post injury was higher than that of the same group at 15 min before injury (with P values below 0.001). (3) At all time points post injury, the microcirculation perfusion on serosal surface of small intestine of rats in simple electrical burn group was lower than that in sham injury group and treatment group (with P values below 0.001). The microcirculation perfusion on serosal surface of small intestine of rats in simple electrical burn group and treatment group at all time points post injury was lower than that of the same group at 15 min before injury (with P values below 0.001). Conclusions High-voltage electrical burns can increase the serum content of sVCAM-1, the number of adhesional leukocyte in mesenteric venule, and reduce microcirculation perfusion on serosal surface of small intestine of rats. PTX can inhibit secretion of serum sVCAM-1, reduce the number of adhensional leukocyte in mesenteric venule to alleviate microcirculation disturbance caused by high-voltage electrical burns.

Objective: To explore the influence of high-voltage electrical burns on the number of platelet aggregation, β-thromboglobulin (β-TG) and platelet factor 4 (PF-4) and the interventional effects of ulinastatin in rats with high-voltage electrical burns. Methods: A total of 240 Sprague-Dawley rats were divided into sham injury (SI) group, simple electrical burn (SEB) group, normal saline (NS) group, and ulinastatin (UTI) group according to the random number table, with 60 rats in each group. The electrical current was applied to the outside proximal part of left forelimb of rats and exited from the outside proximal part of right hind limb of rats. Rats in groups SEB, NS, and UTI were inflicted with high-voltage electrical burn wounds of 1 cm×1 cm at current entrances and exits, with the voltage regulator and experimental transformer. Rats in group SI were sham injured through connecting the same equipments without electricity. At 2 min post injury, rats in group NS were intraperitoneally injected with 2 mL/kg NS, and rats in group UTI were intraperitoneally injected with 2×10⁴ U/kg UTI of 10 g/L. At 15 min before injury and 5 min, 1 h, 2 h, 4 h, 8 h post injury, 10 rats in each group were selected to collect 5-7 mL blood of heart respectively. Blood of 0.05 mL were collected to make fresh blood smear for observing the number of platelet aggregation, and serum were separated from the remaining blood to determine content of β-TG and PF-4 with enzyme-linked immunosorbent assay. Data were processed with analysis of factorial design of variance, student-Newman-Keuls test, Kruskal-Wallis H test, Wilcoxon rank sum test, and Bonferroni correction. Results: (1) At 15 min before injury, the numbers of platelet aggregation of rats were close among groups SI, SEB, NS and UTI (5.9±1.2, 5.8±1.2, 5.9±1.3, 5.9±1.1, respectively, with P values above 0.05). At 5 min, 1 h, 2 h, 4 h, 8 h post injury, the numbers of platelet aggregation of rats in group SEB were 57.2±16.3, 59.1±16.9, 60.8±20.6, 83.6±24.9, and 83.4±30.3, respectively, obviously more than those in group SI (6.0±1.3, 6.0±1.4, 5.9±1.4, 5.7±1.1, and 5.8±1.3, respectively, with P values below 0.001); the numbers of platelet aggregation of rats in group UTI were 29.6±7.4, 31.9±10.1, 35.0±14.2, 43.0±13.6, and 35.2±11.1, respectively, obviously more than those in group NS (58.3±16.1, 63.9±18.0, 60.8±17.7, 74.2±23.0, and 82.3±21.9, respectively, with P values below 0.001). There was no significantly statistical difference in the number of platelet aggregation of rats in group SI between each two time points within the same group (with P values above 0.05), but the number of platelet aggregation of rats in the other 3 groups at each time point post injury was significantly more than that of the same group at 15 min before injury (with P values below 0.001). (2) At 2, 4, and 8 h post injury, β-TG content of serum of rats in group SEB was significantly higher than that in group SI (with Z values from -3.780 to -3.477, P values below 0.05). At 5 min and 4 h post injury, β-TG content of serum of rats in group UTI was significantly lower than that in group NS (with Z values respectively -3.477 and -3.780, P values below 0.05). There was no significantly statistical difference in β-TG content of serum of rats in group SI at all time points of the same group (χ²=0.130, P >0.05). At 2, 4, and 8 h post injury, β-TG content of serum of rats in group SEB was significantly higher than that of the same group at 15 min before injury (with Z values from -3.780 to -3.553, P values below 0.05). At 5 min, 1 h, and 4 h post injury, β-TG content of serum of rats in group NS was significantly higher than that of the same group at 15 min before injury (with Z values from -3.780 to -3.477, P values below 0.05). At 1 and 4 h post injury, β-TG content of serum of rats in group UTI was significantly higher than that of the same group at 15 min before injury (with Z values respectively -3.250 and -3.780, P values below 0.05). (3) At 2 and 8 h post injury, PF-4 content of serum of rats in group SEB was significantly higher than that in group SI (with P values below 0.05). At 2 h post injury, PF-4 content of serum of rats in group UTI was significantly higher than that in group NS (P<0.05), and at 4 and 8 h post injury, PF-4 content of serum of rats in group UTI was significantly lower than that in group NS (with P values below 0.05). At all time points, PF-4 content of serum of rats in group SI was close (with P values above 0.05). At 2 and 8 h post injury, PF-4 content of serum of rats in group SEB was significantly higher than that of the same group at 15 min before injury (with P values below 0.05). At 1, 4, and 8 h post injury, PF-4 content of serum of rats in group NS was significantly higher than that of the same group at 15 min before injury (with P values below 0.05). There were significantly statistical differences in PF-4 content of serum of rats between all time points except for 5 min post injury and 15 min before injury (with P values below 0.05). Conclusions Increasing number of platelet aggregation and abnormal secretion of β-TG and PF-4 of rats with high-voltage electrical burns can lead to microcirculation disturbance. UTI can alleviate microcirculation disturbance caused by high-voltage electrical burns by reducing the number of platelet aggregation and inhibiting secretion of β-TG and PF-4.

Objective To investigate the protective effect of resveratrol (RSV) on improving cognitive function in severely burned rats and its possible mechanism. Methods 18 male SD rats aged 18-20 months were randomly divided into 3 groups: control group, model group and RSV group, with 6 rats in each group. After successful modeling, the rats in RSV group were gavaged once daily with RSV (20 mg/kg). Meanwhile, the rats in control group and model group were gavaged once daily with an equal volume of sodium chloride solution. After 4 weeks, the cognitive function of all rats was estimated by Step-down Test. The concentration of tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) protein in serum of rats were detected by ELISA. The expression of IL-6, TNF-α mRNA and protein were estimated by real-time PCR and Western blotting. The apoptosis of hippocampal neurons was tested by terminal deoxynuclectidyl transferase-mediated dUTP-biotin nick end labeling assay (TUNEL). The expression of nuclear transcription factor-κB (NF-κB)/c-Jun N-terminal kinase (JNK) pathway-related proteins in hippocampus were assessed by Western blotting. Results Compared with the rats in model group, rats in RSV group exhibited improved cognitive function. Consistently, the rats in RSV group had a reduced concentration of TNF-α and IL-6 in serum, decreased mRNA and protein expressions of TNF-α and IL-6 in hippocampus, and decreased apoptosis rate and relative expression of p-NF-κB p65/NF-κB p65 and p-JNK/JNK in hippocampal neurons. Conclusion RSV alleviates inflammatory response and hippocampal neuronal apoptosis by inhibiting NF-κB/JNK pathway, thereby improving cognitive function in severely burned rats.
Resveratrol/pharmacology* ; Male ; Animals ; Rats ; Rats, Sprague-Dawley ; Burns/drug therapy* ; Cognition/drug effects* ; Hippocampus/metabolism* ; MAP Kinase Signaling System ; NF-kappa B/metabolism* ; Tumor Necrosis Factor-alpha/blood* ; Interleukin-6/blood* ; Neurons/drug effects* ; Apoptosis

OBJECTIVE To study the nephrotoxicity of the extracts from different parts o f Miao medicine Wikstroemia indica in healthy rats ，and to provide reference for the study of its toxicity mechanism and clinical drug use. METHODS Using 70％ ethanol as solvent ，total ethanol extract of W. indica was extracted with diacolation method. After dispersing the above extract with water，the fractions of corresponding fractions were obtained with petroleum ether ，ethyl acetate and n-butanol，and the rest was the extract of water fraction. SD rats were randomly divided into total ethanol extract group ，petroleum ether fraction group ，ethyl acetate fraction group ，n-butanol fraction group ，water fraction group and blank group ，with 12 rats in each group （half male and half female ）. The rats in the administration groups were given the corresponding dose of drug solution intragastrically （total ethanol extract 317.520 mg/kg，petroleum ether fraction 7.875 mg/kg，ethyl acetate fraction 78.435 mg/kg，n-butanol fraction 53.865 mg/kg and water fraction 76.545 mg/kg），once a day ，for conse- cutive 2 weeks，and then stopped taking drug for 2 weeks； rats in the blank group were given equal volume of 1.0％ . sodium carboxymethyl cellulose solution intragastrically. Duringthe experiment ，the general conditions of rats were observed. The samples of urine （on the 14th and 28th day ），serum and bilateral renal tissues （on the 15th and 29th day ）were taken respectively，the renal index was calculated ，the levels of @qq.com renal function indexes in serum and urine were detected ，and the pathomorphological changes of renal tissues were observed. RESULTS During administration ，compared with blank group ，the rats in the total ethanol extract group and ethyl acetate fraction group showed poisoning behavior and activity characteristics such as mental depression ，decreased activity and diet ，thin stool and decreased body mass. The mental state of the rats in the petroleum ether fraction group ，n-butanol fraction group and water fraction group were slightly worse than that in blank group，and slightly decreased activity and diet as well as thin stool ，and slowly increased body mass were found ；however，there was no significant difference in anal temperature in each group. After 2 weeks of administration ，the renal index in total ethanol extract group ，the serum levels of N-acetylglucosaminidase（NAG），urea nitrogen （BUN）and creatinine （Cr）in total ethanol extract group and ethyl acetate fraction group ，serum level of NAG in n-butanol fraction group and serum level of Cr in water fraction group ，as while as NAG levels in urine of rats in total ethanol extract group and petroleum ether fraction group ，NAG and urinary protein levels in urine of rats in ethyl acetate fraction group were increased significantly （P＜0.05 or P＜0.01）. In the pathomorphological observation ，renal tubules showed different degrees of unclear structure ，cell swelling and a few cell necrosis in the total ethanol extract group ，petroleum ether fraction group and ethyl acetate fraction group ，accompanying by glomerular pyknosis，renal tubular sclerosis and inflammatory cell infiltration ，compared with blank group. After drug withdrawal ，the mental state of rats in the administration groups were significantly improved ，the amount of activity and diet increased ，and the stool tended to be normal. Two weeks after drug withdrawal and recovery ，the levels of above indexes in serum and urine of rats in administration groups returned to be close to that in blank group （P＞0.05）；the glomerular structure of rats in each administration group gradually recovered clearly ，and cell swelling and inflammatory cell infiltration were rare in total ethanol extract group ， petroleum ether fraction group and ethyl acetate fraction group. CONCLUSIONS The total ethanol extract ，petroleum ether fraction and ethyl acetate fraction of Miao medicine W. indica have certain nephrotoxicity and reversibility. The toxic component may