Objective To design and prepare recombinant mutant human high mobility group box 1 protein (HMGB1s) that can combine with HMGB1 receptors but cannot produce inflammatory effect, and accordingly lead to the creation of a new potential agent for anti-inflammatory therapy. Methods This experiment was based on successful clone and expression of human HMGB1.Six mutant HMGB1 cDNA were designed and constructed by one step inverse PCR. They were cloned into prokaryotic expressive vector pQE80L and followed with production of mutant HMGB1s and identification by Western blotting. Results Six mutant proteins were designed and constructed into prokaryotic expressive vector pQE80L. The recombinant HMGB1 proteins were obtained and identified by Western blotting. Conclusion Human HMGB1 mutants have been successfully constructed and the expression and characterization of intent proteins are identified. It will lay a foundation for further study on biological functions of HMGB1.

Objective To evaluate the progress and experience in treatment of burn patients in the past 10 years (1993～2002) so as to bring forth ideas for further researches in burn surgery. Methods The general clinical data, complications, survival rate and causes of death in 5378 burn patients treated in our institute were collected and analyzed. The results were compared with those cases treated in our hospital during the years 1983～1992. Results in the past 10 years, there were no significant differences in the general clinical data including age, sex, causes, location, burn area and depth, incidence of combined injury and inhalation injury compared with those in the years 1983～1992. The survival rate of the cases in past 10 years was higher than that of the cases in the years 1983～1992. The main causes of death were organ dysfunction, inhalation injury and infection, among which the incidence of organ dysfunction stood foremost.Conclusions The results suggest that hypoxemia due to severe burn shock and inhalation injury, and endotoxin derived from burn wound still are the main causes of burn death. Protection of the body from early damage of postburn remains to be the most urgent problem in the burn research at present.

Objective To study the effects of early enteral feeding on the preservation of intestinal mucosal barrier in severely burned patients. Methods Twenty-two patients with severe burn were randomly divided into early enteral feeding group (EF) and delayed enteral feeding group (DF). The levels of serum endotoxin and TNF-? were dynamically detected in the patients of both groups, and two unmetabolized sugars (lactose and mannitol) were orally administered in these patients on 1d, 3d and 5d of postburn. The concentrations of lactose and mannitol in urinary and the L/M ratio were observed. Intestinal permeability was assessed by the L/M ratio. Results The levels of serum endotoxin and TNF-? in severely burned patients were significantly higher than in normal (P

Objective To establish a method for in vitro induction and amplification of immature dendritic cells(DCs) with maturation resistance from human peripheral blood. Methods Mononuclear cells separated from peripheral blood were cultured with rhGM-CSF and rhIL-4 for 9 days, and rhIL-10 was added into medium at the 7th day. The suspending cells were examined with scanning electronic microscope and flow cytometry, and their ability for stimulating non-sensitized T lymphocyte proliferation was observed by mixed lymphocyte reaction(MLR). Cultured cells were stimulated with LPS and TNF-? for additional 2 days, respectively, and MLR was performed again. Results rhGM-CSF+rhIL-4-induced and IL-10-treated peripheral blood mononuclear cells(PBMC) exhibited typical morphological characteristics and immunological phenotype of DCs with high expression of CD1a and no expression of CD 83 on the cellular surface. Costimulating molecules CD 40 and CD 86 expressions were down-regulated.The capability of cultured cells for stimulating the proliferation of non-sensitized T lymphocyte was weak, and the same result was observed in cultured cells stimulated with LPS or TNF-?. Conclusion Immature dendritic cells with maturation resistance were obtained by culturing with IL-10,which might be a useful in the induction of immune tolerance of allogenic skin grafting for the major burn patients with deep burn wounds.

Objective To observe the various influence of Imipenem/Cilastatin(IPM) and Cefoperazone(CPZ) on Gram-negative bacterial endotoxin release in severely burned patients.Methods Patients were divided into IPM group and CPZ group randomly. The bacterial cultures and microbial drug-sensitivities of burn wound swabs and subeschar tissues were performed on the 1st and 3rd day, At the same time, the levels of LPS in plasma were detected in seven burned patients administrated with IPM and six with CPZ at the time 0?2?4?12?24?48?72h of antibiotics administration.Results Patients were infected by Gram-negative bacterial. The counting of bacteria in subeschar tissues decreased 10~100 times after the administration of antibiotics 3 days; Plasma LPS levels elevated to the peak value at 2h after infusion of IPM or CPZ , and then showed significant decrease. The magnitude of increased LPS in CPZ group was higher than that in IPM group; The LPS levels of 72h were lower significantly than that of 0h.Conclusion IPM and CPZ could effectively control Gram-negative bacterial infection and induce the releases of LPS from bacteria, of which the former induced less LPS release than the latter; The levels of LPS came down with the decreasing of bacterial counting.

Infection is the most common complication and the most common cause of death in burn patients. It is very important to employ anti-infection measures reasonably and effectively for victims of major burns. However, a consensus of opinion of how to use systemic antibiotics in prophylaxis of infection in the early stage of burn is still lacking. The indications of the early systemic use of prophylactic antibiotics are discussed in this article.
Anti-Bacterial Agents ; therapeutic use ; Antibiotic Prophylaxis ; methods ; Burns ; complications ; drug therapy ; Humans ; Wound Infection ; chemically induced ; prevention & control

Objective To evaluate the interventional management in emergency splanchnic bleeding and the application value.Methods 27 patients with emergency splanchnic bleeding underwent the interventional management in our hospital from May of 2003 to January of 2006 were reviewed.The sites and causes of the splanchnic hemorrhage were verified through selective DSA,using different methods and materials for percutaneous transarterial embolization.Results No bleedings recurred in all 27 patients within 18 months after the treatment.3 patients of advanced hepatic carcinoma died in 6 months because of non-splanchnic bleeding etiology.Conclusions Selective angiography is a veracious way to detect the location and cause of emergency splanchnic hemorrhage.The choice of different selective arterial embolizations and embolic materials can effectively and promptly cease the bleeding with rescuing the patients.

Objective　To review the experience in the management of burned patients inflicted by inhalation injury in our institute in the past 42 years. Methods　Patients with inhalation injury were analyzed chronically in three different periods as 1958 to 1980, 1981 to 1990, and 1991 to 2000. Results　The mortality rates in general and in terms of different degrees decreased obviously with the elapse of time. In other words, the rates were 48.93%, 26.60% and 8.53 for the above three periods. Conclusion　The mortality of inhalation injury was decreased dramatically during the last decade in our institute. Five main measures consisting of inhalation of high concentration or pure oxygen, preventive tracheotomy, frequent tracheal lavage with small amount of lavage fluid at early stage of postburn, mechanical ventilation with PEEP and humidification as early as possible, and application of exogenous pulmonary surfactant contribute greatly to the decrement of death rate in the patients with inhalation injury.

OBJECTIVE:To determine the content of ceftazidime in renal dialysate effluent in burn patients.METHODS:HPLC was used.The sample was separated on Bondapak-C18 analysis column with a mobile phase of mixture of methanol-ammonium acetate(17∶83,V/V).The flow rate was 1.0ml/min.The UV detector wavelength was set at 254nm.RESULTS:A linearity was obtained from 0.5～100?g/ml with a good correlation(r=0.9 999).The RSDs of inter-day and intra-day precision were not more than 3.The average recovery was 100.30%.CONCLUSION:The method is simple,rapid and accurate.

Objective To investigate effect of Rho kinase combined with Sheng Mai injection on tumor necrosis factor alpha ( TNF-α) , interleukin-10 (IL-10), intercellular adhesion molecule-1 (ICAM-1) and adhesion molecule CD11/CD18 in patients withⅡ°superficial burn.Methods 48 cases patients withⅡ°superficial burn were collected and divided into experimental group and control group, according to different therapy, 24 cases in each group.The two groups were given symptomatic treatment such as anti-infectious, keep warm, anti-shock, pain-relieve and wound-healing treatment, the control group were given Rho kinase on the basis of symptomatic treatment, and experimental group were given Sheng Mai injection on the basis of control group, for a course of two weeks.The serum TNF-α, IL-10, ICAM-1 and CD11/CD18 levels were compared after treatment. ResuIts After treatment, the serum TNF-α, IL-10, ICAM-1 and CD11/CD18 levels after treatment were lower than those before treatment in two groups (P<0.05).Compared with control group, the levels of TNF-α, IL-10, ICAM-1 and CD11/CD18 were lower than those of experimental group (P<0.05).ConcIusion Rho kinase combined with Sheng Mai injection could significantly reduce the levels of TNF-α, IL-10, ICAM-1 and CD11/CD18 in patients with Ⅱ°superficial burn.