Objective　To observe the effects and mechanism of TNFα and IL-1 on protein catabolism of skeletal muscles of mice in the early stage of severe burn. Methods　A BALB/c mice model was established with full thickness scalded of 18%～20% TBSA including the back and one hind limb. The catabolic rate of protein of soleus muscle was reflected with the net tyrosine releasing rate. The changes of the tyrosine releasing rates of the injured and uninjured limbs, the levels of TNFα and IL-1 of the plasma and soleus muscle, and the activities of lysosomal proteolytic enzymes were observed in 72 h after scald injury of the mice. Results　After injury, the levels of TNFα and IL-1 of plasma, injured and uninjured limbs were all increased, and reached the summit at the 48th h, but those of the injured limb were much higher than those of the uninjured one, then gradually the levels were decreased in 72 h. The protein catabolic rate of uninjured limb was higher than the normal at h 48, but it came to normal level at h 72. The rate of the injured limb was higher than that of normal and uninjured limbs significantly 72 h after the scalding. hrTNFα and hrIL-1 enhanced the protein catabolic rate and the activities of lysosomal protrolytic enzymes in the soleus muscle of normal mice in vivo and in vitro respectively. Conclusion　In the early stage of scald injury, TNFα and IL-1 could enhance the lysosomal protease activity, increase the protein catabolic rate in skeletal muscle and promote the negative nitrogen balance directly. These effects may not depend on the actions of emergent hormones.

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The effects of exogenous Na-DL-3-hydroxybutyate (3-HOBNa)and insulin(I) on skeletal muscle protein metabolism in rats inflicctcd with 37% TBSA full thickness scalding were studied It was found that the scrum acctoacctatc (AcAc) of the burned animals showed no significant difference from the control on the 4th day postburn,but the free fatty acid (FFA) decreased markedly and the urinary 3 - methylhistididne(3-MH) excretion and the protein de -gradation rate of the soleus muscle of the injured hind limb increased na kedly.Infusion of 3-HOBNa for 3 consecutive days following burns could lower the urinary 3-MH excretion and the protein,degradation rate of the soleus muscle with no significant influence on the skeletal muscle protein anabolism.Moreover,investigations revealed that there was no syncrgistic effect of insulin-kctone body combinalioan on the anti-catabolic capacity in burned rats.

One hind leg(7 %TBSA)of the rat was scalded and the changes of the reduction-oxidation state and protein degradation in the soleus muscle were observed 72 hours postinjury both in vitro and in vivo.It was found that the lactate/pyruvate (L/P) and malate/pyruvate(M/P)ratios of the soleus muscle were significantly lower and the protein degradation rate much higher in the scalded leg than in the unscalded legs and the control.After the addition of insulin to the medium significant elevation of L/P and M/P ratios and reduction of the protein degradation rate in the soleus muscle could be observed.There findings suggest that there is a good correlation between the changes of the reduction-oxidation state and the protein degradation rate in the cytosol of the soleus muscle after scalding in the rat.

Objective To evaluate the accuracy of monitoring the neuremuscular blockade intraoporatively by transcutaneous electrical stimulation at the P6 acupuncture point. Methods Thirty-five patients, ASA Ⅰ - Ⅲ, BMI≤35 kg/m2 scheduled for abdominal surgery were selected. Anesthesia was induced by sufentunil 0.2-0.3 μg/ kg iv, propofol 2,5-3.5 mg/kg iv. Neuromuscular monitoring was performed by TOF Watch SXR at the P6 acupuncture point on the left forearm and ulnar nerve on the right. The current intensity and gain were recorded frem all the patients;onset time, recovery time of TOF ratio 25% and TOF ratio 90% of atrucurium were also obtained by TOF stimulation on the P6 acupuncture point and the ulnar nerve in patients who were administered a single bolus of atracurium 0.5 mg/kg iv during operation. Controlled ventilation commenced after endotracheal intubation. Results There were no significant differences between the P6 acupuncture point and the ulnar nerve in stimulus intensity or gain ( P > 0.05 ). There were no significant differences between the P6 acupuncture point and the ulnar nerve in onset time, recovery time of TOF ratio 25% and TOF ratio 90% (P > 0.05).Conclusion Transcutaneous electrical stimulation at the P6 acupuncture point can be used to monitor neuromuscular blockade intraoperafively.

In order to study the role played by infection in the occurrence and mechanism of negative nitrogen balance of the skeletal muscles in the early stage of scalding,37% TBSA full thickness scalding was inflicted on the back and one hind leg of rats and the protein catabolic rate in the soleus muscle of both the scalded and healthy legs was determined and the effects of endotoxin on the catabolic rate were observed.It was found that the protein catabolic rate was markedly accelerated in the scalded soleus 3 days after iujusy;and showed no significant changes in the healthy one,in which the protein catabolic rate was near or similar to that of the normal control.After 2 mg/kg of endotoxin was administered intraperitoneally.the findings were as follows:(1)Endotoxin could also accelerate the protein catabolic rate in the skeletal muscles;(2)The protein catabolic rate in the scalded soleus was not further increased and no summation effect of scalding and endotoxin on protein catabolism occurred.

To elucidate the mechanism of negative nitrogen balance after burns, immuno precipitation deduction was used to observe the changes in the activity of 26S proteasome and 19S regulator in skeletal muscle of rats inflicted with 30%TBSAⅢ o burns. The protease activity, ATPase activity of 26S proteasome,as well as 19S regulator in skeletal muscle of rats were markedly enhanced on the second day after scald. It is suggested that burn injury could activate the 26S proteasome in skeletal muscle, in turn enhance the degradation of protein , which is associated with negative nitrogen balance following scald

Objectives:To compare the effect of defferent routes of nutritional support on the 26 S proteasome. Methods:The means of immuno precipitation deduction,ELISA and fluore photomction were used to test the change of activities,contents of the 26 S proteasome and the rate of protein degradation in skeletal muscle of scalding rats with the animal model of enteral feeding and parenteral nutrition. Results:Compared with parenteral nutrition,enteral feeding could markedly reduce the activity and content of the 26 S proteasome,and the release of tyrosine was also lowered. Conclusions:The early enteral feeding can distinctly inhibit the system of 26 S proteasome,and reduce the protein degradation in skeletal muscle in bruned rats.

To investigate the relationship among serum vascular endothelial cells(VE) -cadherin, advanced glycation end-products( AGE), and atherosclerotic lesion. 20 healthy subjects and 60 patients with diabetes mellitus,including 30 patients with carotid atherosclerosis (CI), were enrolled.Soluble VE-cadherin and AGE were determined using the enzyme-linked immunosorbent method (ELISA). The relationships among the concentration of soluble VE-cadherin, AGE, and the course of the disease, blood glucose, and blood lipid levels were analyzed with multivariant stepwise regression analysis. The levels of serum VE-cadherin and AGE in the patients with diabetes and CI were higher than those in control group( P＜0. 05 ). There was a significant difference in VE-cadherin between the diabetes group and the CI group( P＜0. 05 ). Serum VE-cadherin levels were positively correlated with serum AGE levels(r = 0. 69, P＜0. 01 ). AGE levels were positively correlated with the diabetes duration ( r = 0. 31, P =0. 02 ). The levels of serum VE-cadherin in diabetic patients are positively correlated with their serum AGE levels. The VE-cadherin seems to play an important role in the development of atherosclerosis caused by AGE.

Objective To study the mechanism of pulmonary injury and protective effect of modified ultrafiltration on lung function in infant open heart surgery.Methods According to the wishes of parents,40 cases of congenital heart disease were divided into without modified ultrafiltration control group (C) and modified ultrafiltration group (M),and parents signed informed consent.The cardiopulmonary bypass (CPB) was used without ultrafiltration in Group C,while with modified ultrafiltration in group M.The pneumodynamic parameters and C3a,C5a,TXA2,LT were measured at specific time points.Results The static pulmonary compliance (Cstat) and oxygen index (OI) were lower,and alveolar-arteria oxygen difference (AaDO2) was higher after CPB in the two groups(P ＜ 0.05).At T3,T4 and T5 time points,the Cstat and OI in Group M was higher than that in Group C; AaDO2 in Group M was lower than that in Group C (P ＜0.05).The levels of C3a and C5a were lower after CPB in the two groups; levels of TXA2,LT were higher after CPB in the C groups.At T2,T3,T4 and T5 time points,the TXA2 and LT in Group M were lower than that in Group C(P ＜0.05).Conclusions The pulmonary injury in pediatric open heart surgery may be concerned with the the alexin(C3a,C5a) activation and I/R.The level of C3a and C5a was considered earlier index of inflammatory reaction and pulmonary injury.Modified ultrafiltration improves pulmonary function due to elevating coloid osmotic pressure and degrading the plasma level of TXA2,LT.