ObjectiveTo investigate the changes of arterial base deficits (BD) in the early stageof extensive burned patients. MethodsWe perform a retrospective review of 126 patients with a totalbody surface area (TBSA) over 30% whose resuscitations were initiated with the Ruijin formula to ob-serve the BD changes and analyze the relationship of BD and TBSA at different postburn time intervals insurvivors and deaths. ResultsWithin 48h after burn injury, the BD value improved gradually. Thedifference between survivors and nonsurvivors was significant at 4 to 8h interval after burn injury ( P <0.05). BD was correlated with TBSA strongly during 4 to 16h after burn injury ( P ≤0.05)in nonsur-vivors, but not in survivors. The incidence of the shock－ related complications in survivors was higherthan in nonsurvivors. ConclusionBD could be one of monitor index in the shock stage after severeburM injury.

OBJECTIVETo investigate the influence of hibernation drugs on postburn stress and inflammatory reaction in severely scalded rats.

METHODSSprague-Dawley rats inflicted with 30% TBSA deep partial thickness scalding were employed as the model. The rats were divided into A (scalding with immediate resuscitation), B (scalding with immediate resuscitation and lytic cocktail), C (scalding with delayed resuscitation), D (scalding with delayed resuscitation and lytic cocktail) and E (sham injury) groups. The rat plasma levels of NE (norepinephrine), E (epinephrine) and DA (dopamine) were determined by HPLC (high performance liquid chromatography) at 3, 6, 12, 24 and 48 postburn hours (PBHs), and the plasma IL-1alpha and PGE(2) levels were detected by ELISA (enzyme-linked immunosorbent assay) and RIA (radioimmunoassay) methods. The NF-kappaB activity in PBMCs (peripheral blood mononuclear cells) was determined by laser scanning confocal microscope.

RESULTSThe plasma NE and E levels reached summit at 6 PBH, while those in B group were lowest. But the plasma DA level was similar among all groups at all time points. The plasma IL-1alpha and PGE(2) levels increased continuously, however, the levels were were lower in B than A groups at the same time points, and also that of D were lower than C groups. At the same time points, the levels in B group were lower than those in D group. The NF-kappaB was located in the cytoplasma of PBMCs in E group and in the nucleus in A group at 6 PBH. Furthermore, the NF-kappaB was concentrated more in the cytoplasm than that in the nucleus in B group, while it was more concentrated in the nucleus in C and D groups.

CONCLUSIONThe secretion of stress hormones could be attenuated by hibernation drugs. The plasma cytokine levels and the nuclear translocation of NF-kappaB in PBMCs could also be modulated by the drugs.

Animals ; Dopamine ; blood ; Female ; Inflammation ; prevention & control ; Interleukin-1 ; blood ; Male ; NF-kappa B ; metabolism ; Norepinephrine ; blood ; Rats ; Rats, Sprague-Dawley ; Stress, Physiological ; prevention & control

Department of Burns and Plastic Surgery of Ruijin Hospital Affiliated to the Medical School of Shanghai Jiao Tong University is derived from the group of severe burn treatment in Surgical Department of Kuang-Ci Hospital in Shanghai in 1958. In three score years, they created and developed distinctive technologies in treatment of massive deep burns, including early eschar excision on deep burn wound by stages and batches, taking the scalp as a donor site, wound covering with the large sheet of allo- or xeno-skin graft with small holes covered by small pieces of autoskin, the Ruijin formula for fluid resuscitation in early stage post burn and the " hibernation remedy" , which achieved actual effects in clinic, and they summed up academically the experiences of their clinical practice and researches. These technologies with other creations by Chinese burn surgeons have been named as " Chinese method" of burn treatment.