Cellular energy metabolism and intracellular pH of intact heart, kidney and liver of small animals were studied before and after burn with an effective technique of phosphorus-31 nuclear magnetic resonance (31P-NMR) spectroscopy. Advantages of this technique are that the measurement can be performed constantly without any complicated and destructive process, that it is possible to use this technique in clinical examination in the near future and that a lot of information can be obtained from only one spectrum.It was demonstrated that there were a short cellular energy source and a cellular acidosis in' heart, kidney and liver during burn shock. The high-energy phosphate compounds-lowered wavily but not straight, which could be divided into stress stage, compensation stage and decompensation stage. Intracellular pH decreased first in the heart, and then in the kidney and liver. In contrast to the results obtained by way of direct blood flow determination, the early and significant intracellular acidosis indicated the insufficiency of blood and oxygen supply in myocardium.

Although the research work on the permanent skin substitutes was started in our country later than in developed countries, the development has been promising in recent years. The results of this field of research would completely change the fact that deep burn wounds could only be repaired with autologous skin grafting. It is our expectation that with the advent of these permanent skin substitutes, the survival rate of severe trauma could be raised and the quality of wound repair could be improved. In a series of papers published in this issue, the development and the status quo of permanent skin substitutes will briefly be introduced.

Insulin resistance(IR) after severe burn may aggravate metabolic disturbance, delay wound healing and increase the probability of infection and MODS. The mechanism of IR may be the combined defects of insulin biological effects at pre-receptor, receptor and post-receptor levels. This article discusses the mechanism and intervention of postburn IR, aiming to improve treatment for extensive burn.

This study was aimed to improve the therapeutic results of composite skin substitutes. Human vascular endothelial cell growth factor (hVEGF 165 ) gene was constructed to an eukaryotic expression vector pcDNA3. Transfection of recombinant vector pcDNA3 hVEGF 165 into human dermal fibroblast cells was performed. VEGF protein level in the supernatant of transfected fibroblasts culture was determined. Its biological activities were tested by observing the growth rate of the human umbilical vein endothelial cells/HUVEC after being stimulated with the said supernatant, and by performing the Miles assay in guinea pigs. The results showed that these transgenic cells were able to secrete VEGF to certain extent, with biological activities to enhance the growth of HUVEC in vitro and improve vascular permeability. It indicated that transgenic fibroblasts could resurface the dermal substitute of a composite skin.

Pulse contour cardiac output (PiCCO) monitoring is a new type of invasive hemodynamic monitoring technology, which is more and more often applied in perioperative period and the patients suffering from multiple injuries, septic shock, and extensive burn. With PiCCO one is able to monitor patients' hemodynamic indexes safely, timely, accurately, and continuously to provide reference for judgment of patients' condition and proper quality and quantity of fluid administration. This technique has a good prospect in clinical application.
Cardiac Output ; physiology ; Fluid Therapy ; methods ; Hemodynamics ; Humans ; Monitoring, Physiologic ; instrumentation

Sepsis is one of the most common pathogenetic causes of acute lung injury (ALI), and at present there is still a lack of effective targeted techniques and methods for its prevention and treatment. Autophagy is a homeostatic mecha- nism common to all eukaryotic cells, including adaption to environment, defense against invasion of pathogens, and maintenance of cellular homeostasis. Autophagy is also involved in a variety of lung-related diseases. In septic lung injury, autophagy not only serves to dissipate dysfunctional organelles, but also inhibits the release of inflammatory cytokines. This review aims at eliciting the role of autophagy in sepsis-induced ALI and further exploring the potential targets of autophagy in inhibiting inflammation, in an effort to provide a new perspective for clinical treatment of sepsis-induced ALI.
Acute Lung Injury ; etiology ; metabolism ; Autophagy ; Cytokines ; metabolism ; Inflammation ; metabolism ; Lung ; metabolism ; Lung Injury ; Sepsis ; complications ; metabolism

Objectives: To study the alteration of total plasma antioxidant capacity(TAC), NO and IL 6 in severely burned rats, and evaluate the relationship between TAC and NO or IL 6 production. Methods: Full thickness scald burn covering 30%TBSA was produced on SD rats. At different time the blood were collected for isolating the plasma. The TAC and NO were measured according to the protocols of kits. The IL 6 was measured by radioimmunoassay. Results:TAC decreased significantly after burns, following by the increasing production of NO and IL 6. The lowest TAC level and highest production of NO and IL 6 appeared at 6 h after burns. The correlation analysis showed that TAC and NO or IL 6 had negative correlation( r=-0.839, r =-0.783). Conclusions: The low TAC level might be the cause of the high production of inflammatory mediate such as NO and IL 6. It hints that enhancing TAC level might inhibit the production of NO and inflammatory cytokines.

Objectives:To study the alterations of calcium ion and NF ?B activation in cultured PBMC after stimulation of post burn plasma, and to investigate the roles of signal transduction pathway in the mechanisms of SIRS after burn. Methods:PBMC were stimulated with post burn plasma in vitro . The calcium ion concentration were measured by fura 2. The NF ?B protein were measured by EMSA. Results:Lots of NF ?B proteins were sequester in nucleus in all burn plasma groups. Dantrium and Nimodipine could decrease the activity of NF ?B protein in nucleus, and have significant inhibitory effects on the production of interleukin 6 and NO. Conclusions:In signal transduction levels, calcium ion may modulate the activity of NF ?B which mediate the expression of most proinflammtory cytokines.

Objective To sum up the experiences in the prevention and treatment of systemic infection after burn injury. Methods 309 burn patients with systemic infection treated in our department from January 1990 to December 2003 were enrolled in this study. The patients were divided into two groups according to their hospitalized time: group 1(from 1990 to 1996) and group 2(from 1997 to 2003). The incidence and mortality of systemic infection were compared between the two groups, and the efficacy of different treatment strategies was analyzed. Results The morbidity of postburn systemic infection in the patients was 6.98%(309/4430). The incidence and mortality of systemic infection were 5.68% and 0.30% in the group 2, respectively, which were significantly lower than those in the group 1. Conclusion Rapid and adequate fluid resuscitation for burnshock, effective control of wound infection, early excision of crust and skin grafting for deep burnwounds, and reinforcement of organ support were key factors to decrease the incidence of systemic infection and increase the curative frequency. Once burn wound sepsis occurred, prompt removal of infectious necrotic tissues was a key means to ensure a good clinical outcome.

Objective: To prepare a collagen rnembrane and to investigate its feasibi1ity as a derma1 scaffold. Metbods:Pig hide collagen was dispersed in 0. 5 mol/L acetic acid, co-precipitated with chordroitin-6-sulfate and lyophilized for 48 h toproduce a highly porous membrane. Cross-linking was in 0. 25% glutaraldehyde for 24 h. The membrane was implanted be-neath the flaps on the dorsal sites of SD rats. After implantation, biopsies were obtained periodically to study the tissue com-patibility, vascularity and stability. Results: The average pore size of the spongiform collagen membrane was 100 pm. Sub-dermal implantation of it showed that the inflammation was minimal, with no evidence of an acute rejective reaction. Conclu-siou: The spongiform collagen membrane prepared is easy to secure and produce, it has satisfied tissue compatibility, abilityof vascularity and optimum dermal scaffold structure.