Burns ; complications ; diagnosis ; prevention & control ; Humans ; Sepsis ; diagnosis ; etiology ; prevention & control

OBJECTIVETo investigate the expression of uncoupling protein (UCP)-2, 3 mRNA in skeletal muscle of the scalded rats after escharectomy at different post scalding stages.

METHODSOne hundred and twenty Wistar rats were employed in the study, in which 8 served as normal control (C) and 112 were subjected to 30% TBSA 3rd degree scalding and then again, divided into 4 groups. The rats in A group were sacrificed on 8th, 24th, 96th, 120th and 168th post scalding hours (PSHs) without escharectomy. The rats in B group underwent escharectomy at 8 PSH, and those in C group underwent escharectomy at 24 PSH. All the rats in both groups were sacrificed on 96, 120 and 168 PSHs after escharectomy, Escharectomy was performed at 96 PSH in rats of D group, and they were sacrificed on 120 and 168 PSHs after escharectomy. The serum levels of leptin and TNFalpha, and the expression level of UCP2 mRNA were determined at all time points in all groups of rats.

RESULTS(1) The serum levels of leptin in A group were obviously lower than that in C group (P < 0.01) during 24 approximately 168 PSHs, while those in B, C and D groups were much higher than those in A group (P < 0.01) during 24 approximately 168 PSH. (2) The serum TNFalpha levels in A group at all time points were higher than that in control group, while that in B group at all time points were lower than that in A group (P < 0.05 or 0.01), and that in C group at 168 PSH was lower than that in A group (P < 0.05). (3) The UCP2 mRNA expression in skeletal muscle in A group was increased evidently since 8 PSH (P < 0.01), peaking at 24 PSH and lowering thereafter, while that in B and C groups at 168PSH was significantly lower than that in A group at the same time points (0.32 and 0.35 vs 0.71, P < 0.05). The trend of the change in UCP3 mRNA expression in skeletal muscle was similar to that of UCP2.

CONCLUSIONThe postburn up-regulation of UCP mRNA expression might play important roles in the increase of metabolic rate. Escharectomy during shock stage could lower down the expression of UCP2 and UCP3 mRNA expression, and it could be beneficial by lowering metabolic rate.

Animals ; Burns ; metabolism ; surgery ; Cicatrix ; metabolism ; surgery ; Ion Channels ; metabolism ; Male ; Mitochondrial Proteins ; metabolism ; Muscle, Skeletal ; metabolism ; RNA, Messenger ; metabolism ; Rats ; Rats, Wistar ; Time Factors ; Uncoupling Protein 2 ; Uncoupling Protein 3

Most of the major advances in the prevention and treatment of burn sepsis and MODS have been made within the last 20 years. Improvements have been made in gaining a better understanding of the pathophysiology of burn sepsis and MODS, in revising the definition of sepsis and MODS, and in prevention and treatment of burn shock. Additionally, improvements have been made in fluid resuscitation in patients with burn shock and in early gastrointestinal feeding to prevent translocation of endotoxins from the gut. Other achievements have been made in using recombinant human growth hormone combined with intensive insulin therapy to control hyperglycemia, and potassium chloride to prevent hypokalemia in order to accelerate protein synthesis. Additional advances include early closure and coverage of the burn wound, rational use of antibiotics, immunological modulation to combat immunological dissonance. Also, advances have been made by using early anticoagulation treatment to prevent coagulopathy. In prevention and treatment of burn sepsis and MODS, comprehensive support for all organs during the course of treatment is emphasized. Although the advances in burn treatment have been extremely encouraging over the last 50 years, burn sepsis and MODS remain the most common cause of mortality in the critical ill. To cope with extreme environmental conditions, such as armed conflict and natural disasters, research is needed to optimize the oral resuscitation regime, and more efficacious treatment strategies that are based on an indepth understanding of the pathogenesis of sepsis.
Burns ; complications ; metabolism ; Humans ; Multiple Organ Failure ; etiology ; prevention & control ; Sepsis ; etiology ; prevention & control

Abdominal Neoplasms ; complications ; metabolism ; pathology ; surgery ; Adult ; Dendritic Cell Sarcoma, Follicular ; complications ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Female ; Humans ; Ki-1 Antigen ; metabolism ; Leukocytosis ; complications ; metabolism ; pathology ; surgery ; Receptors, Complement 3b ; metabolism ; Receptors, Complement 3d ; metabolism ; Young Adult

Prevention and treatment of infection in burn patients involve a wide range of issues. This present article is to introduce only briefly clinical experience focusing on this problem. Among them, satisfactory timely prevention and treatment of burn shock is imperative because it exerts tremendous impact on homeostasis, including especially deterioration of immune functions. Early gastro-intestinal feeding is known to help restore gastro-intestinal circulation after shock, and it is an important avenue to give important nutritional elements like glutamine. It is also very important to excise devitalized tissue, followed by total coverage of all open wounds as early as possible, so that nidus of infection is removed. Rational use of antibiotic, immunological modulation and other measured were also important contributory factors in successfully preventing and treating infection in patients with major burns.
Burns ; microbiology ; Humans ; Infection Control

OBJECTIVETo study the effect of extract of Ginkgo biloba (Egb761) on doxorubicin-associated cardiotoxicity in patients with breast cancer (BC).

METHODSSixty BC patients in stage IV were randomly assigned to two groups, the control group was treated with chemotherapy, using 4 cycles of PA protocol alone and the treated group with the same chemotherapy and Egb761. Changes in electrocardiogram (ECG), myocardial enzyme spectrum (MES) and ultrasono-cardiogram (USCG) before and after treatment were observed.

RESULTSAfter treatment, the incidence of abnormal ECG was lower in the treated group than in the control group (6.7% vs 30.0%); significant differences were found between the two groups in the parameters of MES (P< 0.05); USCG showed significant difference between the two groups in left ventricular diastolic diameter (LVDd), left ventricular systolic diameter (LVDs), ratio of early and late diastolic transmitral peak flow velocity (E/A) and fractional shortening (FS), while there was no significant difference in ejection fraction (EF).

CONCLUSIONEgb761 is an ideal drug for preventing and reducing the acute doxorbincin-induced cardiotoxicity; it could also be helpful for alleviating the chronic cardiotoxicity.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; drug therapy ; Carcinoma, Ductal, Breast ; drug therapy ; Cardiomyopathies ; chemically induced ; physiopathology ; prevention & control ; Doxorubicin ; administration & dosage ; adverse effects ; Female ; Ginkgo biloba ; chemistry ; Humans ; Middle Aged ; Phytotherapy ; Plant Extracts ; therapeutic use ; Treatment Outcome ; Ventricular Dysfunction, Left ; physiopathology ; prevention & control

Sepsis and septic shock as a result of an invasive infection are challenging problems in extensively burned patients, and frequently end in multiple organ dysfunction syndrome (MODS). It is of great significance to further elucidate the pathogenetic mechanisms, and to seek novel intervention strategies to prevent and treat sepsis/MODS secondary to severe burns. A more complete understanding of the pathogenetic mechanisms of postburn sepsis would certainly elicit a number of potential therapeutic strategies for it. It is our belief that comprehensive clinical measures for management of severe sepsis should include rapid, adequate fluid resuscitation for burn shock, early feeding, effective control of infection, early escharectomy, and reinforcement of organ support. Once burn wound sepsis occurs, prompt removal of infected necrotic tissue is the key procedure to ensure a successful result. Further study is necessary to determine the precise mechanisms of these protective effects and the clinical advantages for postburn sepsis using evidence-based methodology system.
Burns ; complications ; Humans ; Sepsis ; epidemiology ; etiology ; prevention & control

OBJECTIVETo study the resuscitative effect of hypertonic electrolyte glucose solution (HEGS) in enteral resuscitation of burn shock.

METHODSEighteen Beagle dogs with 35% TBSA full-thickness flame injury were used in this study. They were randomized to a control group (no-fluid resuscitation, N group), a HEGS resuscitation group (H group) or an isotonic electrolyte glucose solution (IEGS) resuscitation group (I group). The solution enterally was given for resuscitation from half an hour after burn. The volumes and rates of fluid infusion in the H group were basically in accordance with 2 ml/(kg x 1%TBSA), those in the I group were basically in accordance with parkland formula [4 ml/(kg x 1%TBSA)]. The haemodynamic parameters, global end-diastolic volume index, plasma volume, osmotic pressure of plasma, intestinal absorptive rates of water and Na(+), and intestine mucosa blood flow were continuously assessed.

RESULTSThe cardiac output index, global end-diastolic volume index, plasma volume and intestine blood mucosa flow reduced markedly after burn in the three groups, and then gradually returned from 2 h after burn in two resuscitation groups, which were higher than that in the N group (P < 0.05). The activities of diamine oxidase in plasma in the two resuscitation groups were higher than that in N group (P < 0.05). The intestinal absorption rates of water and Na(+) reduced markedly after burn in two resuscitation groups with the lowest levels, and then returned from 6 h after burn. The rates of water in H group were lower than that in I group (P < 0.05); the rates of Na(+) in H group were higher than in I group (P < 0.05).

CONCLUSIONThe results indicated that 35%TBSA III degrees burn-injury dogs be resuscitated effectively with 1.8% hypertonic electrolyte-glucose solution by enteral, which 1/2 volume of an isotonic electrolyte glucose solution.

Animals ; Burns ; therapy ; Disease Models, Animal ; Dogs ; Enteral Nutrition ; Fluid Therapy ; methods ; Glucose Solution, Hypertonic ; administration & dosage ; therapeutic use ; Random Allocation ; Resuscitation ; methods ; Saline Solution, Hypertonic ; administration & dosage ; therapeutic use

AIMTo study the expression and effect of TLR4 and NFkappaB protein in hippocampus neuron in rats exposed to chronic hypoxic hypercapnia.

METHODSThe disorder of learning-memory in pulmonary hypertension rat model was reproduced by chronic hypoxic hypercapnia. Thirty rats were randomly divided into three groups: normal control group, hypoxic hypercapnia 2-week and 4-week group. The number of apoptosis neurons in hippocampus CA1/3 was counted by TUNEL method. Activity of TLR4 and NFkappaB in hippocampus CA1/3 was detected by using SP immunocytochemical technique.

RESULTSThe expression of TLR4 protein in hippocampus CA1/3 in group 2HH( CA1: 0.1275 +/- 0.0242, CA3: 0.1156 +/- 0.0376) and 4HH (CA1: 0.1522 +/- 0.0187, CA3: 0.1427 +/- 0.0453) were significantly higher than those in the NC group (P < 0.05, P < 0.01). The positive expression of NFkappaB were showed in cell nucleus in group 2HH (CA1: 0.1326 +/- 0.0324, CA3: 0.1301 +/- 0.0112) and group 4HH (CA1: 0.1612 +/- 0.0428, CA3: 0.1578 +/- 0.0365), and significantly higher than those in the NC group (P < 0.05, P < 0.01). The apoptosis of neural cells in hippocampus CA1/3 gradually increased with the time of exposure, and reached peak at 4 weeks (P < 0.01 vs NC group).

CONCLUSIONThe activation of TLR4 and NFkappaB may play an important role in the apoptosis of hippocampus neural cells in rat exposed to chronic hypoxic hypercapnia.

Animals ; Apoptosis ; Hippocampus ; metabolism ; pathology ; physiopathology ; Hypercapnia ; metabolism ; physiopathology ; Hypertension, Pulmonary ; metabolism ; physiopathology ; Hypoxia ; metabolism ; physiopathology ; Male ; NF-kappa B ; metabolism ; Neurons ; metabolism ; physiology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Toll-Like Receptor 4 ; metabolism

AIMTo study the effect of antidigoxin antiserum on oxygen stress induced by myocardial ischemia/reperfusion (MI/R) injury in rats.

METHODSSprauge Dawley rats were submitted to ligate left anterior descending coronary artery 30 min followed by 45 min reperfusion. Experiment animals were randomly divided into seven groups including sham group, MI/R group, normal salina group, verapamil group and three antidigoxin antiserum groups from low to high dose. The left ventricular myocardial tissue sample of ischemia were processed and measured the level of endoxin and malondialdehyde (MDA), the activities of Na+, K(+) -ATPase and superoxin dismutase (SOD). The myocardia morphology was observed.

RESULTSThe levels of endoxin and MDA increased and the activities of Na+, K(+) -ATPase and MDA were inhibited significantly in MI/R and saline groups. Including verapamil group in comparison to MI/R and saline groups, MDA level decreased and SOD activities partly reserved, meanwhile, only in three antidigoxin antiserum groups, the myocardial endoxin level was remarkably decreased, Na+, K(+) -ATPase activities were drastically increased. The myocardial histological morphology was significantly improved.

CONCLUSIONAntidigoxin antiserum, an endoxin mutual clone antibody, had the effect of attenuating the damage of oxygen free radicals induced by MI/R via to antagonizing the inhibition effect of endoxin on myocardial membrane Na+, K(+) -ATPase activities.

Animals ; Cardenolides ; antagonists & inhibitors ; Digoxin ; pharmacology ; Immune Sera ; pharmacology ; Malondialdehyde ; analysis ; Myocardial Reperfusion ; Myocardial Reperfusion Injury ; physiopathology ; Rats ; Rats, Sprague-Dawley ; Saponins ; antagonists & inhibitors ; Sodium-Potassium-Exchanging ATPase ; metabolism ; Superoxide Dismutase ; metabolism