Burn is a common trauma,and debridement is an important step in the treatment of burn.Traditional surgical debridement is the standard of care,but it can lead to additional trauma,infection and other complications,with a low compliance.Enzymatic debridement,a new debridement strategy,can promote wound healing,reduce infection,inhibit scar formation,avoid secondary damage,greatly relieve pain,and shorten wound healing time.This paper comprehensively compares enzymatic debridement versus traditional surgical debridement in the management of burn injuries,and reviews the advantages and latest advancements of enzymatic debridement in burn management.

Objective To observe the effects of 3 neuroprotective measures on the expressions of apoptosis-related factors and their ligands (Fas and FasL) in brain tissue of neonatal rats with hypoxic ischemic brain injury. Methods One hundred and twenty Wistar rats 7 days old were selected as experimental subjects, the rats were divided into four groups: neural stem cell, erythropoietin (EPO), ω-3 unsaturated fatty acid treatment groups and hypoxic ischemic brain damage model group according to random number table method, with 30 rats in each group. Neural stem cell group, EPO group and ω-3 unsaturated fatty acid group were respectively injected with neural stem cells, EPO and ω-3 unsaturated fatty acid, each 5 mL via tail vein after modeling; the hypoxic ischemic brain damage model group was given equal volume of normal saline. At 6, 12, 24, 48 and 72 hours after administration of drug, 6 rats were sacrificed in each group, brain tissue was taken, the mRNA expression levels of Fas/FasL, protein expression levels of Toll-like receptor 4 (TLR4), nuclear transcription factor-κB (NF-κB), tumor necrosis factor-α (TNF-α), interleukin (IL-1β, IL-6) and cell apoptotic rate in hippocampus tissue were measured. Results ① mRNA expressions: the mRNA expressions of Fas and FasL of the 3 experimental groups were significantly lower than those of the hypoxic ischemic brain damage model group, the degrees of descent after administration for 24 hours were the most significant, neural stem cell treatment group < EPO treatment group < ω-3 unsaturated fatty acid treatment group < hypoxic ischemic brain damage model group [Fas mRNA expression (2-ΔΔCt): 140.5±2.9, 156.4±2.5, 165.2±2.7 vs. 173.7±2.8, FasL mRNA expression (2-ΔΔCt): 143.1±4.3, 154.6±1.5, 160.7±1.4 vs. 174.7±2.8], the differences were statistically significant (all P < 0.05). ② Protein expressions: the protein expressions of TLR4, NF-κB, TNF-α, IL-1β, IL-6 of the 3 experimental groups were significantly lower than those of the hypoxic ischemic brain damage model group (TLR4/GAPDH: 0.7±0.2, 0.6±0.1, 0.2±0.1 vs. 1.4±0.1; NF-κB/GAPDH: 6.7±0.4, 5.3±0.1, 1.1±0.2 vs. 11.2±0.3; TNF-α/GAPDH: 14.3±1.4, 11.2±1.2, 3.2±2.1 vs. 23.2±0.5; IL-1β/GAPDH: 9.4±0.2, 7.4±0.3, 2.2±0.3 vs. 13.4±0.1; IL-6/GAPDH: 36.2±4.4, 39.3±1.5, 26.2±2.1 vs. 51.4±1.4, all P < 0.05), the protein expression levels of above indexes in neural stem cell treatment group < those of EPO treatment group < those of ω-3 unsaturated fatty acid treatment group < those of hypoxic ischemic brain damage model group. ③ Apoptotic rates:after drug administration, the apoptotic rates of the ω-3 unsaturated fatty acid group, EPO treatment group, neural stem cell treatment group were obviously lower than the rate of model group [(3.7±0.3)%, (3.4±0.2)%, (2.5±0.1)% vs. (5.5±0.4)%, all P < 0.05]. Conclusion The mRNA expressions of Fas/FasL in the brain of neonatal rats with hypoxic-ischemic brain damage are high, and the treatment with each of the following agents; neural stem cells, EPO and ω-3 unsaturated fatty acid can reduce the mRNA expressions of Fas/FasL in such rats' brain tissues.

Objective To systematically evaluate the application efficacies of the peripherally inserted central catheter (PICC) and venous port access (VPA) during chemotherapy in the patients with malignant tumor.Methods The research data published in CNKI,WanFang Database and Pubmed Database were collected from October 2008 to December 2016.The related researches were screened according to the inclusion criteria.Then the meta analysis was performed by using the Revman Manager 5.3 software.Results Finally 63 articles were included for conducting the meta analysis,involving 11 296 patients.The one-time catheter placing success rate of VPA and PICC was investigated by 30 included articles,and the merged effect showed that the difference had no statistical significance (OR =0.96,95 ％ CI:0.75-1.23,P＞0.05).The analysis results of 16 articles showed that the proportion of the catheter indwelling time ≥ 1 year in the patients adopting VAP was higher than that in the patients adopting PICC (OR =27.17,95 ％ CI:18.08-40.83,P＜0.05).The incidence rate of complications in the patients adopting VPA was lower than that in the patients adopting PICC (OR =0.19,95 ％ CI:0.16-0.22,P＜0.01).The living quality of VPA and PICC was investigated by 11 included articles,which showed that the living quality in the VAP group was significantly higher than that in the PICC group (OR=8.53,95％CI:5.88-12.38,P＜0.05).Conclnsion The indwelling time of VPA during chemotherapy in the patients with malignant tumor is longer,the incidence rate of complications is lower and the patient's living quality is higher.

Objective: Select the appropriate disease assessment indicators, formulate the comprehensive evaluation group of pneumoconiosis patients, and explore the role of the comprehensive evaluation grouping in the clinical evaluation of pneumoconiosis, and provide the basis for the prognosis of pneumoconiosis. Methods: Combined with clinical symptoms, pulmonary function, pneumoconiosis stage, acute exacerbation and complications, a comprehensive assessment of pneumoconiosis patients was established.138 newly diagnosed pneumoconiosis patients were divided into low risk group, middle risk group and (very) high risk group. The patients were followed up by telephone to record their health status and quality of life within one year after discharge from hospital. Analysis of the relationship between the comprehensive assessment group of patients with pneumoconiosis and symptom score, pulmonary function, pneumoconiosis stage, acute exacerbation and complications. The relationship between the comprehensive assessment group of pneumoconiosis patients and the risk events (the number of visits, hospitalization, mechanical ventilation, death cases in one year) and CAT score were analyzed. Results: There were significant differences in clinical symptoms, pulmonary function injury, pneumoconiosis stage, acute exacerbation and complications among patients in low risk group, middle risk group and (very) high risk group (P<0.01) . With the increase of comprehensive assessment score, CAT score increased, the risk events increased, the difference was statistically significant (P<0.01) . Spearman correlation analysis showed that the comprehensive assessment group was significantly correlated with the number of visits, hospitalization, mechanical ventilation, deaths and CAT score in one year. Conclusion Combined with clinical symptom assessment, pulmonary function assessment, chest imaging assessment, acute exacerbation assessment, and complication assessment, the pneumoconiosis patients' comprehensive assessment group formulated can evaluate the severity of pneumoconiosis patients, and make a more accurate and comprehensive judgement of the disease.

To explore the dose-effect relationship between vitamin C and paraquat (PQ) poisoning rats.
 Methods: A total of 40 Sprague-Dawley (SD) rats were randomly divided into 4 groups: a control group, a PQ poisoning group, a vitamin C group 1 and a vitamin C group 2 (n=10 in each group). 150 mg/kg PQ was perfused into rat stomach to establish PQ poisoning rat model. In PQ poisoning group, 30 mg/kg methylprednisolone and 2.5 mg/kg cyclophosphamide were injected peritoneally on the basis of PQ poisoning rat model. In vitamin C1 and C2 group, vitamin C was injected at a dosage of 5 or 500 mg/kg, respectively. The control group only received normal saline (NS). The malondialdehyde (MDA), liver and kidney function as well as arterial blood gas in the blood were examined 36 h later. At the end, the rats were killed and took the liver tissues for pathological examination and weight ratio calculation. The glutathione peroxidase (GSH-PX), ctychrome C (Cyt C) in the liver tissues were detected by chromatometry, and the Bcl-2 was detected by Western blot.
 Results: Compared with the PQ poisoning group, the MDA and Cyt C were decreased, the GSH-PX was increased, and liver and kidney functions were improved in the vitamin C group 1 (all P<0.01); but in the vitamin C group 2, the MDA increased and liver/kidney functions were impaired (all P<0.01). The expression of Bcl-2 in the PQ poisoning group was lower than that in the control group; compared with the PQ poisoning group, it was increased in the vitamin C1 group, while it was decreased in the vitamin C group 2 (both P<0.01). There was no obvious difference in the lung function, wet/dry weight ratio and pathological changes between the poisoning group and experimental groups (all P>0.05).
 Conclusion: Vitamin C at the low dose shows a certain degree of protection for the liver and kidney in the PQ poisoning rats model through it antioxidative activity and anit-apoptosis activity, while vitamin C at the high does may promote oxidation. Meanwhile, vitamin C doesn't show protective effect on lung in the PQ poisoning rats.
Animals ; Apoptosis ; drug effects ; Ascorbic Acid ; administration & dosage ; pharmacology ; Cytochromes c ; drug effects ; metabolism ; Dose-Response Relationship, Drug ; Glutathione Peroxidase ; drug effects ; Kidney ; drug effects ; pathology ; physiopathology ; Lung ; drug effects ; pathology ; physiopathology ; Malondialdehyde ; metabolism ; Paraquat ; toxicity ; Protective Agents ; pharmacology ; Proto-Oncogene Proteins c-bcl-2 ; drug effects ; metabolism ; Rats ; Rats, Sprague-Dawley ; Vitamins

Objective To explore the effects of long-term Tai Ji exercise on risk factors of cardiovascular diseases and incidence of chronic diseases. Methods The elderly involved were divided into control group (n=62) and Tai Ji group (n=63). Both of them received 2-years health education. The Tai Ji group exercised with the frequency of 30~40 minutes each time, 3 times a week, while the control group didn't change their daily behavior. They were observed 2 and 6 years later. Results 2 years later, the blood pressure, weight and waistline decreased in Tai Ji group compared with the control group (P<0.05). After 6 years followed, 1 people died and 4 people occured cardiovascular diseases in Tai Ji group, while 2 people died and 12 people occured cardiovascular diseases in the control group. The incidence of chronic diseases was lower in Tai Ji group (9.52%) than in the control group (33.87%) (P<0.01). And the blood pressure, waistline, and hipline in Tai Ji group decreased significantly compared with the control group (P<0.001). Conclusion Long-term Tai Ji Exercise can ameliorate the risk factors of cardiovascular diseases and reduce the incidence of chronic diseases.