Nutrition Risk Screening 2002 (NRS 2002) was developed on the basis of 128 randomized controlled clinical studies by a group of experts led by Kondrup from the European Society for Parenteral and Enteral Nutrition (ESPEN).As the first evidence-based nutritional screening tool worldwide,NRS 2002 has been recommended for nutritional risk assessment of hospitalized patients in Europe for the addition of disease metabolism and its simplicity.In this article,we reviewed the increasing applications of NRS 2002 in China,pointed out the existing problems and made several suggestions on improvement for popularization and standardization of its clinical use.

Objective: To investigate the intention of breast reconstruction in breast cancer patients and explore the potentially-related impact factors. Methods: Breast reconstruction related questionnaires were distributed among 525 women breast cancer patients in multiple centers. Proportion constitution, univariate analysis and Logistic regression analysis were applied to the returned data. Results: 84 valid questionnaires were collected. There were 35.1%(170/484) patients who had the intention of breast reconstruction, and the patients with no intention of reconstruction accounted for 40.7%(197/484), while 24.2%(117/484) of the patients showed an unclear attitude to breast reconstruction. The average cognitive and attitude scores of reconstructive patients were significantly higher than those without reconstructive wishes (t=8.194, P<0.05; t=13.795, P<0.05). The higher rate of breast reconstruction willingness in breast cancer patients was associated with a lower age (χ²=13.466, P<0.05) and a better educational background (χ²=14.955, P<0.05). The rate in in-service personnel was higher than that in unemployed personnel (χ²=12.744, P<0.05). The rate of breast reconstruction willingness in the patients with various family income and medical insurance categories was significantly different (χ²=10.551, P<0.05; χ²=4.255, P<0.05). The marital status and the place of residence had no relation to the rate of reconstruction willingness (P>0.05). A further Logistic regression analysis showed that there was a significant correlation between the intention of breast reconstruction and the following factors: the age of patients, family income, medical expense category, the attitude of breast reconstruction (P<0.05). Conclusions Breast cancer patients have severe lack of knowledge of breast reconstruction. However, the young patients, with good economic condition and a positive attitude to reconstruction had a strong desire for breast reconstruction. Therefore, it is necessary to strengthen the communication with breast cancer patients in clinical environment and improve the cognitive level of patients and their families to increase the rate of breast reconstruction.

Objective: To explore the influence of collagen/fibroin scaffolds containing silver nanoparticles on dermal regeneration of full-thickness skin defect wound in rat. Methods: Eighty-one collagen/fibroin scaffolds containing silver nanoparticles (with the mass concentration of silver nanoparticles as 10 mg/L) and 81 collagen/fibroin scaffolds without silver nanoparticles were produced respectively with freeze-drying method and enrolled as silver nanoparticles scaffold group (SNS) and control scaffold group (CS). Nine scaffolds in each group were cultured with human fibroblasts. At post culture hour (PCH) 2, 12, and 24, the human fibroblasts adherent to the scaffolds (n=3) in two groups were counted. Four full-thickness skin defect wounds were reproduced on the back of each one of the 36 SD rats. The rats were divided into groups SNS (wounds were transplanted with collagen/fibroin scaffolds containing silver nanoparticles) and CS (wounds were transplanted with collagen/fibroin scaffolds without silver nanoparticles) according to the random number table, with 18 rats in each group. In post surgery week (PSW) 1, 2, and 4, 6 rats in each group were sacrificed respectively for general observation, observation of histological structure, inflammatory cell infiltration, and collagen deposition with HE staining, count of CD68 positive cells with immunohistochemical staining, and mRNA expressions of interleukin-6 (IL-6) and IL-10 with real-time fluorescent quantitative reverse transcription polymerase chain reaction. Data were processed with analysis of variance of factorial design, t test, and Bonferroni correction. Results: (1) At PCH 2, 12, and 24, the numbers of human fibroblasts adherent to the scaffolds in the two groups were close (with t values from 1.77 to 2.60, P values above 0.05). (2) In PSW 1, no obvious symptom of infection was observed in wound or wound edge of rats in group SNS with obvious vascularization of scaffolds, while obvious symptoms of infection were observed in wounds of rats in group CS with some scaffolds exfoliated. In PSW 2, the scaffolds were firmly attached to the wounds of rats in group SNS, while obvious contracture was observed in the wounds of rats in group CS with a lot of scaffolds exfoliated. In PSW 4, the scaffolds covered the wounds of rats in group SNS with obvious epithelization on the surface of the scaffolds, while all the scaffolds exfoliated, leaving obvious contracture of residual wounds of rats in group CS. (3) In PSW 1 and 2, compared with those in group CS, more collagen secretion and tissue regeneration and less inflammatory cell infiltration in the scaffolds were observed in the wounds of rats in group SNS. In PSW 4, obvious epithelization was observed in the wounds of rats in group SNS, while inflammatory cell infiltration was observed without obvious epithelization in the wounds of rats in group CS. (4) In PSW 1, the number of CD68 positive cells in the wounds of rats in group SNS [(54±10) /mm²] was similar to that in group CS [(78±7) /mm^2, t=1.52, P>0.05]. In PSW 2 and 4, the numbers of CD68 positive cells in the wounds of rats in group SNS [(154±10) and (77±7) /mm²] were significantly less than those in group CS [(268±16) and (136±13) /mm^2, with t values respectively 7.31 and 3.83, P values below 0.01] respectively. (5) Except for the expression in PSW 4 (t=1.23, P>0.05), the mRNA expressions of IL-6 in the wounds of rats in group SNS in PSW 1 and 2 were significantly lower than those in group CS (with t values respectively 13.12 and 4.65, P values below 0.01). Except for the expression in PSW 1 (t=3.08, P<0.05), the mRNA expressions of IL-10 in PSW 2 and 4 in the wounds of rats in the two groups were similar (with t values respectively 2.14 and 0.49, P values above 0.05). Conclusions Besides good biocompatibility, collagen/fibroin scaffolds containing silver nanoparticles have obvious effect in modulating inflammation, thus they can accelerate dermal regeneration induced by collagen/fibroin scaffolds for wound repair.

Objective: To explore the influences of hydrogen-rich saline on acute kidney injury in severely burned rats and to analyze the related mechanism. Methods: Fifty-six Sprague Dawley rats were divided into sham injury group (n=8), burn group (n=24), and hydrogen-rich saline group (n=24) according to the random number table. Rats in sham injury group were treated by 20 ℃ water bath on the back for 15 s to simulate injury, and rats in burn group and hydrogen-rich saline group were inflicted with 30% total body surface area (TBSA) full-thickness scald (hereinafter referred to as burns) by 100 ℃ water bath on the back for 15 s. Immediately after injury, hydrogen-rich saline at the dose of 10 mL/kg were intraperitoneally injected to the rats in hydrogen-rich saline group at one time, while normal saline with the same dose were intraperitoneally injected to the rats in sham injury group and burn group. At post injury hour (PIH) 6, rats in the 3 groups were intraperitoneally injected with 4 mL·kg^-1·%TBSA^-1 lactated Ringer′s solution for resuscitation. Eight rats from sham injury group at PIH 72 and eight rats from burn group and hydrogen-rich saline group at PIH 6, 24, and 72 were sacrificed respectively after their blood samples from abdominal aorta were collected. Then their kidney tissue was harvested for histopathological observation and renal tubular injury scoring by hematoxylin and eosin staining, serum creatinine and blood urea nitrogen were detected by the clinical blood biochemical analyzer, expression distribution and mRNA expressions of tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β), and IL-6 in renal tissue were evaluated by immunohistochemical staining and real time fluorescent quantitive reverse transcription polymerase chain reaction respectively, and protein expression of high mobility group protein 1 (HMGB1) was detected by Western blotting. Data were processed with Kruskal-Wallis H test, Dunn test, one-way analysis of variance, Bonferroni test. Results: (1) The renal tubular structure of rats in sham injury group at PIH 72 was complete with no inflammatory cell infiltration and no cellular degeneration or necrosis. Since PIH 6, the changes such as vacuolation and shape change of cells and aggregation of broken protein in renal tubules were observed in rats of burn group, and all these changes deteriorated with time. The renal injury of rats in hydrogen-rich saline group at different post injury time points were relieved compared with those of rats in burn group at the corresponding time points. The renal tubular injury scores of rats in burn group and hydrogen-rich saline group at PIH 6, 24, and 72 were significantly higher than the score in sham injury group at PIH 72 (P<0.05). The renal tubular injury scores of rats in hydrogen-rich saline group were significantly lower than those in burn group at PIH 6, 24, and 72 (P<0.05). (2) Except for those in hydrogen-rich saline group at PIH 6 and 72 (P>0.05), the levels of serum creatinine of rats in burn group at all the time points and hydrogen-rich saline group at the other time points were significantly higher than the level of serum creatinine of rats in sham injury group at PIH 72 (P<0.01). The levels of blood urea nitrogen of rats in burn group and hydrogen-rich saline group at PIH 6, 24, and 72 were significantly higher than the level of blood urea nitrogen of rats in sham injury group at PIH 72 (P<0.01). The levels of serum creatinine and blood urea nitrogen of rats in hydrogen-rich saline group at PIH 6, 24, and 72 were significantly lower than those in burn group at the corresponding time points (P<0.05). (3) There were certain degree of positive expressions of TNF-α, IL-1β, and IL-6 in renal tissue of rats in sham injury group at PIH 72, which were mainly observed in the cytoplasm of renal tubular epithelium cell. The expressions of above-mentioned inflammatory cytokines in renal tissue of rats in burn group at PIH 6, 24, and 72 were higher than those in sham injury group. The expressions of above-mentioned inflammatory cytokines in renal tissue of rats in hydrogen-rich saline group at all the time points were less than those in burn group at the corresponding time points. (4) Compared with those in sham injury group at PIH 72, the mRNA expression levels of TNF-α, IL-1β, and IL-6 of rats in burn group at PIH 6, 24, and 72 were significantly increased (P<0.01). The mRNA expression levels of TNF-α were significantly increased in hydrogen-rich saline group at PIH 6 and 24 (P<0.05 or P<0.01), and the mRNA expression level of IL-6 was significantly increased in hydrogen-rich saline group at PIH 6 (P<0.01). Compared with those at the corresponding time points in burn group, except for the mRNA expression level of TNF-α in hydrogen-rich saline group at PIH 6 showed no significant differences (P>0.05), and the mRNA expression levels of TNF-α, IL-1β, and IL-6 at the other time points in hydrogen-rich saline group were significantly decreased (P<0.05). (5) Compared with 0.39±0.03 in sham injury group at PIH 72, the protein expression of HMGB1 of rats in burn group at PIH 6, 24, and 72 (1.19±0.07, 1.00±0.06, 0.80±0.05) were significantly increased (P<0.05), while the protein expression of HMGB1 of rats in hydrogen-rich saline group at PIH 6, 24, and 72 (0.35±0.08, 0.47±0.06, 0.42±0.06) showed no significant differences (P>0.05). Compared with those in burn group, the protein expressions of HMGB1 of rats in hydrogen-rich saline group at PIH 6, 24, and 72 were significantly decreased (P<0.05). Conclusions Hydrogen-rich saline can alleviate the acute kidney injury in severely burned rats through regulating the release of inflammatory cytokines in renal tissue.

Objective:To explore the effect and mechanism of astaxanthin on acute kidney injury in rats with full-thickness burns.Methods:Forty-eight male Sprague Dawley rats of 8 to 10 weeks were divided into sham injury group, simple burn group, burn+ vehicle group, burn+ low-dose astaxanthin group, burn+ medium-dose astaxanthin group, and burn+ high-dose astaxanthin group according to the random number table, with 8 rats in each group. The back skin of rats in sham injury group were immersed in warm water of 20 ℃ for 15 s to simulate burn injury, and the back skin of rats in the other 5 groups were immersed in boiled water of 100 ℃ for 15 s to inflict full-thickness burn of 30% total body surface area. Fluid resuscitation was performed in rats in the 5 groups except of sham injury group immediately and 6 h after injury. At 30 min after injury, the rats in sham injury group and simple burn group were injected with 1 mL/kg normal saline via tail vein, rats in burn+ vehicle group were injected with 1 mL/kg astaxanthin solvent via tail vein, and rats in burn+ low-dose astaxanthin group, burn+ medium-dose astaxanthin group, and burn+ high-dose astaxanthin group were respectively injected with 5, 10, 20 mg/kg astaxanthin solution of 5, 10, 20 mg/mL via tail vein. The renal tissue was collected at post injury hour (PIH) 48, and hematoxylin eosin staining was used for histopathological observation and renal tubular injury score. At PIH 48, the venous blood was collected for detecting serum creatinine level through blood biochemical analyzer, and blood urea nitrogen (BUN) level was detected by enzyme-linked immunosorbent assay. The renal tissue was collected to detect the mRNA expressions of myeloperoxidase (MPO), interleukin-1β (IL-1β), and IL-6 by real-time fluorescent quantitative reverse transcription polymerase chain reaction method, and the protein expressions of Toll like receptor 4 (TLR4), phosphorylated nuclear factor kappa B (p-NF-кB) p65, and heme oxygenase 1 (HO-1) were detected by Western blotting. Besides, the expression of HO-1 in renal tissue was detected by immunofluorescence method. Data were statistically analyzed with Kruskal-Wallis H test, Dunn-Sidák correction, one-way analysis of variance, and Bonferroni method. Results:(1) At PIH 48, there were no inflammatory cell infiltrating and degeneration or necrosis of cells in renal tissue of rats in sham injury group, and the structure of renal tubules was intact. The renal tubules of burn rats in each group showed injury manifestation of separation between epithelial cell and basement membrane, and vacuole cells and lysate protein aggregation. The injury degree of renal tissue of rats in burn+ high-dose astaxanthin group was obviously decreased compared with that in simple burn group. (2) At PIH 48, compared with that of sham injury group, the renal tubular damage scores of rats in simple burn group, burn+ vehicle group, burn+ low-dose astaxanthin group, and burn+ medium-dose astaxanthin group were significantly increased ( P<0.05 or P<0.01). Compared with those of simple burn group and burn+ vehicle group, the renal tubular damage scores of rats in burn+ medium-dose astaxanthin group and burn+ high-dose astaxanthin group were significantly decreased ( P<0.05 or P<0.01). Compared with that of burn+ low-dose astaxanthin group, the renal tubular damage score of rats in burn+ high-dose astaxanthin group was significantly decreased ( P<0.01). (3) At PIH 48, the level of serum creatinine of rats in sham injury group was (2.42±0.06) mg/L, which was significantly lower than (6.11±0.11), (6.48±0.08), (5.79±0.09), (4.03±0.12) mg/L of simple burn group, burn+ vehicle group, burn+ low-dose astaxanthin group, and burn+ medium-dose astaxanthin group ( P<0.05 or P<0.01). The level of BUN of rats was (21.9±1.3) mmol/L in sham injury group, significantly lower than (32.1±7.4) mmol/L of simple burn group and (30.2±4.8) mmol/L of burn+ vehicle group ( P<0.05 or P<0.01). At PIH 48, compared with those of simple burn group and burn+ vehicle group, the levels of serum creatinine and BUN of (16.0±2.9) mmol/L in burn+ medium-dose astaxanthin group, serum creatinine of (3.02±0.08) mg/L and BUN of (14.5±2.9) mmol/L in burn+ high-dose astaxanthin group, and serum creatinine of (22.8±5.5) mmol/L of rats in burn+ low-dose astaxanthin group were significantly decreased ( P<0.05 or P<0.01). At PIH 48, compared with those of burn+ low-dose astaxanthin group, the levels of serum creatinine and BUN of burn+ high-dose astaxanthin group and serum creatinine of burn+ medium-dose group were obviously decreased ( P<0.05 or P< 0.01). (4) At PIH 48, compared with those of sham injury group, the mRNA expressions of MPO, IL-1β, and IL-6 in renal tissue of rats in simple burn group, burn+ vehicle group, burn+ low-dose astaxanthin group, and burn+ medium dose astaxanthin group, and the mRNA expressions of IL-1β and IL-6 in renal tissue of rats in burn+ high-dose astaxanthin group were obviously increased ( P<0.01). Compared with those of simple burn group and burn+ vehicle group, the mRNA expressions of MPO, IL-1β, and IL-6 in renal tissue of rats were significantly decreased in burn+ low-dose astaxanthin group, burn+ medium-dose astaxanthin group, and burn+ high-dose astaxanthin group ( P<0.01). Compared with those of burn+ low-dose astaxanthin group, the mRNA expressions of MPO, IL-1β, and IL-6 in renal tissue of rats were significantly decreased in burn+ medium-dose astaxanthin group and burn+ high-dose astaxanthin group ( P<0.01). The mRNA expressions of MPO, IL-1β, and IL-6 in renal tissue of rats in burn+ high-dose astaxanthin group were significantly decreased compared with those of burn+ medium-dose astaxanthin group ( P<0.01). (5) At PIH 48 h, compared with those of sham injury group, the protein expressions of TLR4 and p-NF-кB p65 in renal tissue of rats in simple burn group, burn+ vehicle group, burn+ low-dose astaxanthin group, and burn+ high-dose astaxanthin group were obviously increased ( P<0.01). Compared with those of simple burn group, the protein expressions of TLR4 and p-NF-кB p65 in renal tissue of rats in burn+ low-dose astaxanthin group, burn+ medium dose astaxanthin group, and burn+ high-dose astaxanthin group were significantly decreased ( P<0.01). (6) The results of Western blotting combined with immunofluorescence method showed that compared with that of sham injury group, the protein expression of HO-1 in renal tissue of rats in burn+ vehicle group, burn+ low-dose astaxanthin group, burn+ medium-dose astaxanthin group, and burn+ high-dose astaxanthin group were significantly increased at PIH 48 ( P<0.01), and the protein expression of HO-1 in renal tissue of rats in burn+ medium-dose astaxanthin group and burn+ high-dose astaxanthin group was significantly increased compared with that of simple burn group ( P<0.01). Conclusions:Astaxanthin can attenuate the structural damage and functional decline of renal tissue and regulate the release of injury-related inflammatory factors, thus to protect the rats from acute kidney injury after burn. The HO-1/TLR4/NF-кB signaling pathway is the main regulatory mechanism of astaxanthin to achieve anti-inflammation-based renoprotection.

There are many factors that may affect the microenvironment of acute and chronic wounds.This article reviews the relationship between temperature factor in the external microenvironment of wound surface and wound healing.The temperature changes in different types and stages of wounds are closely related to the wound healing status.Therefore,wound temperature monitoring provides timely,reliable,and non-invasive method in the evaluation of wound status.As low temperature affects the physiological state of wound,relieving the low temperature state and maintaining normal temperature of the microenvironment of wound can promote wound healing.Further research is needed on the wound repair related effector cell proliferation and the mechanism of regulatory function to determine the optimal constant temperature and heat treatment duration needed for wound healing.