Objective:To study the effect of microglia depletion combined with bone marrow mesenchymal stem cells (BMSC) transplantation for spinal cord injury (SCI) repair.Methods:GFP-BMSCs were cultured, identified and detected for expression levels of growth factors. The effects of BMSCs ondorsal root ganglion (DRG) axon outgrowth were observed by the co-culture of BMSCs with DRGs. Mice were depleted of microglia by administrating the colony stimulating factor 1 receptor (CSF1R) inhibitor PLX3397. The spinal cords of these microglia-depleted mice were subjected to crush injury. BMSCs were transplanted into SCI area after microglia depletion. Mice were randomly divided into control group (SCI+BMSCs) and experimental group (PLX3397+SCI+BMSCs). Mice were sacrificed at corresponding time points after transplantation for observing the survival of transplanted BMSCs and the repair of spinal cord. BMS score was used for evaluation of motor function recovery.Results:BMSCs secreted a large number of neurotrophic factors and promoted the growth of DRG axons when co-cultured with DRGs. Depletion of microglia significantly improved the survival of transplanted BMSCs. Compared with BMSCs transplantation alone, the combined treatments slightly but non-significantly reduced the area of the lesion ( t=2.141, P=0.065). Immunofluorescence staining showed that both BMSC transplantation alone and the combined treatments did not cause the corticospinalaxons across the lesion and into distal spinal cord. BMS scores were (1.20±0.45), (3.20±0.45), (3.80±0.45), (4.20±0.45), and (4.60±0.55) points in control group at 1, 7, 14, 21 and 28 d after injury. The experimental groups were(0.60±0.55), (3.00±0.71), (3.80±0.84), (4.20±0.84), and (4.40±0.89) points, respectively. Conclusion:Depletion of microglia improves the survival of transplanted cells, depletion of microglia combined with BMSC transplantation did not result in a significant reduction in lesion area. At the same time, the damaged CST axons were notregenerated. Thus, combining cell transplantation with axon-promoting strategy may be necessary for SCI repair.

Objective:To explore the clinical effectiveness of arthroscopic treatment of tibial eminence avulsion fracture by four-point fixation with suture anchors.Methods:A retrospective analysis was performed of the 58 patients with tibial eminence avulsion fracture who had been treated by the same group of surgeons using four-point fixation technique with suture anchors under arthroscopy at Department of Sports Medicine, The Affiliated Hospital to Qingdao University from January 2015 to December 2018. They were 33 males and 25 females, with an average age of 18.4 years (from 14 to 32 years). By the modified Meyers-McKeever classification, 15 fractures were type Ⅱ, 19 type Ⅲ and 24 type Ⅳ. Recorded and compared were knee Lysholm scores, International Knee Documentation Committee (IKDC) scores and tibial eminence height between preoperation and one year postoperation; recorded at the last follow-up were range of knee motion and results of Lachman and pivot-shift tests.Results:The 58 patients were followed up for a mean of 20.7 months (from 12 to 33 months). Bony union was achieved in all patients within 12 weeks after operation. In this cohort, the Lysholm score (85.2±4.9) and IKDC score (86.2±4.3) at one year postoperation were significantly higher than the preoperative values (43.2±5.2 and 51.2±4.9), and the post-operative tibial eminence height [(9.1±1.2) mm] was significantly lower than the preoperative value [(12.6±1.2) mm] (all P<0.05). The correlation coefficients between the tibial eminence height and the Lysholm & IKDC scores at one year postoperation were -0.16 and -0.17, respectively. The last follow-up showed a 132°±5° range of knee motion for all patients, a positive result of pivot-shift test (grade Ⅱ) for 3 and a positive result of Lachman test (grade Ⅰ) for 2. Conclusion:Arthroscopic treatment of tibial eminence avulsion fracture by four-point fixation with suture anchors can lead to satisfactory effectiveness, showing advantages of minimal invasion, anatomic reduction, reliable fixation, and little impact on the epiphysis plate.

Objective:To investigate the expression and phosphorylation level change of adenosine monophosphate activated protein kinase (AMPK) in skeletal muscle of severely scald rats and its roles in skeletal muscle atrophy in severely scalded rats.Methods:The experimental research method was applied. Totally 100 6-week-old male Wistar rats were divided into sham injury group and scald group according to the random number table, with 50 rats in each group. After weighing the body weight, rats in scald group were inflicted with full-thickness scald of 30% total body surface area on the back, and rats in sham injury group were simulated with scald. At 6 h and on 1, 3, 5, and 7 d post injury, 10 rats in each group were taken to measure their body weights and weights of extensor digitorum longus and soleus muscle. At 6 h and on 1, 3, 5, and 7 d post injury, the tibialis anterior muscles were collected, the mRNA expressions of muscle atrophy F-box protein (MAFbx) and muscle-specific RING finger protein 1 (MuRF1) were detected by real-time fluorescent quantitative reverse transcription polymerase chain reaction; the content of adenosine monophosphate (AMP), adenosine diphosphate, and adenosine triphosphate (ATP) were detected by high performance liquid chromatography, and AMP/ATP ratio and energy charge were calculated; the protein expressions of AMPK-α and phosphorylated AMPK-α (p-AMPK-α) were detected by Western blotting, and the p-AMPK-α/AMPK-α ratio was calculated, with sample number of 4 in each time point of each group. Data were statistically analyzed with analysis of variance for factorial design and least significant difference test.Results:The body weights of rats in 2 groups before injury and at each time point post injury were close ( P>0.05). At 6 h post injury, the weight of extensor digitorum longus of rats in scald group was (0.107±0.007) g, which was significantly heavier than (0.086±0.0607) g of sham injury group ( P<0.01). On 3 d post injury, the weight of extensor digitorum longus of rats in scald group was (0.083±0.016) g, which was significantly lighter than (0.102±0.005) g of sham injury group ( P<0.01). The weight of soleus of rats in 2 groups were close at each time point post injury ( P>0.05). Compared with those of sham injury group, the mRNA expression of MAFbx in tibialis anterior muscle of rats in scald group was significantly up-regulated at 6 h post injury ( P<0.01), and the mRNA expressions of MuRF1 in tibial anterior muscle of rats in scald group were significantly up-regulated at 6 h and on 1 d post injury ( P<0.01). At 6 h and on 7 d post injury, compared with those of false injury group, the AMP/ATP ratios of the tibial anterior muscle of rats in scald group were significantly increased ( P<0.05 or P<0.01), and energy charges of the tibial anterior muscle of rats in scald group were significantly decreased ( P<0.01). At each time point post injury, the protein expressions of AMPK-α of the tibial anterior muscle of rats in 2 groups were close ( P>0.05). The p-AMPK-α/AMPK-α ratios of the tibial anterior muscle of rats in scald group at 6 h and on 7 d post injury were significantly higher than those in sham injury group ( P<0.05 or P<0.01). Conclusions:The decrease in energy charge and increase in AMP/ATP ratio of skeletal muscle of rats after severe scald activate AMPK. The activation of AMPK in the early stage of injury is consistent with the up-regulation of MAFbx and MuRF1 expressions and down-regulation of skeletal muscle weight. The above-mentioned changes may be one of the molecular mechanisms of skeletal muscle atrophy in rats with severe scald

Clinically, routine urinalysis includes more than 10 items, such as urine protein, urinary pH, urinary bilirubin and so on. The above items are usually analyzed by dry chemical methods. The principle is that after the urine infiltrates the reagent strips, the color changes can be observed in each strip. The color depth is related to the component concentration, and the darker the color, the greater the measured component concentration, and vice versa. In this paper, four color discrimination methods in urinary dry chemical analysis were introduced, i.e. the method based on integrating sphere photoelectric conversion, the method based on charge-coupled device (CCD) image sensor, the method based on color sensor, and the method based on the combination of color sensor and fiber bundle. Besides, the four methods were compared and analyzed. Finally, the recent research progress in urinalysis was reviewed.

In recent years, negative pressure wound therapy (NPWT) technique has been widely used in burn surgery, including wound repair, skin grafting, and cosmetic procedures, showing promising clinical results. Based on the literature and clinical experience, the mechanism of NPWT and its clinical application in burn surgery are briefly iterated herewith.
Burns ; surgery ; Humans ; Negative-Pressure Wound Therapy ; Skin ; Skin Transplantation ; Wound Healing

Objective:To evaluate the efficacy and safety of recombinant human acidic fibroblast growth factor( rh-aFGF)and re-combinant human basic fibroblast growth factor( rh-bFGF)in the treatment of deep second degree burn. Methods:A multicenter,pro-spective,randomized and double-blind clinical trial was conducted. Totally 216 cases of deep second degree burn were selected from five research centers and given appropriate antibiotics and nutritional supplement therapy. The wound of 108 cases in the observation group were rinsing with rh-aFGF(one bottle / 5cm2)according to the wound area at the time of admission followed by rh-aFGF daily spraying,3-4 press/cm2 ,6-8 times a day. The 108 patients in the control group were treated with rh-bFGF with the same regimen as the observation group. After the 30-day follow-up,the wound healing was evaluated in the two groups. Results:The complete healing time,debridement time,complete healing rate in 12 days and 15 days in the observation group were all better than those in the control group(P<0. 05). After the 7-day treatment,the level of leukocyte and seepage score of the observation group were both lower than those of the control group(P<0. 01). The moderate rate showed significant difference between the two groups(P<0. 05). Conclu-sion:rh-aFGF shows better clinical efficacy than rh-bFGF in the treatment of deep second degree burn with the similar safety.

Objective To study the resuscitative effect of hypertonic electrolyte glucose solution (HEGS) on the haemodynamics pa-rameters in enteral resuscitation of burn shock. Methods Eighteen beagle dogs with 35% TBSA third degree burned were used in this stud-y. They were random divided into no-resuscitation group (NR group), enteral resuscitation with HEGS group (EH group) and intravenous resuscitation with isotonic electrolyte glucose solution (lEGS) group (Ⅱ group). The fluid resuscitation was given from half an hour after TBSA). The haemodynamics parameters (cardiac index, mean arterial pressure, intrathoracic blood volume index, and systemic vascular re-sistance index) were continuously assessed by PICCO. Result The cardiac output index reduced markedly after bum in the three groups, and then returned after 2h in two resuscitation groups, which were higher than that in the NR group( P<0.05). The mean arterial pressure reduced in the three groups, which was higher in the two resuscitation groups than that in NR group(P < 0.05). The intrathoracic blood volume index was rapidly reduced in the three groups. It returned in EH group from 2 hours after burned, which was still higher than that in the other two groups (P < 0.05). Meanwhile the systemic vascular resistance index was increased quickly. It was reduced in EH group from 2 hours after burned, which was lower than that in the other two groups (P < 0.05). Conclusion The results show that it was feasible for 35% TBSAⅢ° burn-injury dogs to be resuscitated with 1.8% hypertonic electrolyte-glucose solution by enteral, which can markedly reduce liquid quantity needed.

This paper is to introduce our experiences in treating 2 batches of 13 burn victims transferred from remote areas on postburn days 3 and 4. Methods Thirteen burn victims of 2 mass casualties were transferred to our burns institute from remote areas on postburn days 3 and 4 on June 27, 2001 and June 2, 2002, respectively. There were 4 males and 9 females, age ranged from 20 to 43 years, with a mean age of 31.1±6.2 years. The mean total burn area was 74.3%±24.7% TBSA (range, 25% to 97%). Among them, 10 patients suffered from serious burn with mean total burn area involving 86.0%±11.5% TBSA (range, 60% to 97%), and mean full-thickness burn of 63.9%±26.3% TBSA. Four patients also manifested signs of severe inhalation injury, and 6 patients with moderate inhalation injury. In three patients with mean total burn area covering 35.5%±10.0% TBSA (range, 25% to 45%), with mean full-thickness burn of 15.3%±5.0%, were al having moderate inhalation injuries. Among these 13 patients, 3 were having high body temperature (39℃), while 3 manifested hypothermia. The heart rate was 140-160/min, and respiratory rate 26 to 32/min in 6 patients. Abdominal distension or loss of bowel sound were found in 4 patients. Low white cell and platelet count were found in some patients. In 13 cases, liver function, renal function, myocardiac enzyme, and coagulation function were abnormal. Results Among 13 burn victims, one patient died of myocarditis on postburn day 29, and another one died of hepatic failure (history of chronic hepatitis B) on postburn day 45 with only 2% TBSA of burn wound remained open. Conclusion Burns victims occurred in mass casualties who were transferred from remote areas to our Burns Institute were all in critical condition, usually with multiple complications, demanding most meticulous care. Our strategies in this regard consisted of dispatch of experienced surgeons and nurses to the referring hospitals and the airport to receive the patients to offer appropriate care to them during the journey,organization of the medical staff so that each of them was ordained specific function, thus conditions of the patients were evaluated immediately and appropriate treatment started expeditiously for those lethal complications on arrival. Timely and exact comprehensive treatments were prerequisite to save the patients’ life. Adequate metabolic support should be emphasized, and coagulant of anticoagulant treatment should be carried out when indicated.

OBJECTIVETo study the effects of glucocorticoid on skeletal muscle protein metabolism in burn sepsis and its possible mechanism.

METHODSThe rats were randomly divided into four groups with 15 rats in each group. Group B, 30% TBSA full-thickness burn was produced on the back and endotoxin (6 mg/kg bw) was given intraperitoneally after the injury to simulate burn sepsis. Groups C and D, glucocorticoid receptor antagonist RU38486 (10 mg/kg bw) was given by gavage 2 hours before or 2 hours after burn with endotoxin, respectively. Group A, the rats received only normal saline in same volume as endotoxin. Plasma levels of cortisol were determined with standard procedure. Extensor digitorium longus muscles (EDL) were procured from both legs 12 hours after the injury. After weighing, the proteolytic rate was determined in vitro in an incubation system with oxygen rich environment by high performance liquid chromatography. The gene expressions of ubiquitin, E(2)-14kDa and C2 in the muscles were determined by Northern blot analysis.

RESULTSThe weight of EDL was significantly lower in group B than in group A (t = 9.03, P < 0.01). Although the weight of EDL muscles was also lower in groups C and D than in group A, it was significantly higher than in group B (t = 2.26, 6.42, P < 0.05 or P < 0.01). The concentrations of plasma cortisol were markedly higher in groups B, C and D than in group A (t = 9.03 - 22.94, P < 0.01). A 58.8% (210/357) of the total and 335.5% (4.16/1.24) of myofibrillar proteolytic rate in group B was higher than in group A (t = 36.99 and t = 46.19, P < 0.01), respectively. The total and myofibrillar proteolytic rate in group D was 28.3% (161/567) and 49.6% (2.68/5.40) and in group C 18.9% (108/567) and 23.2% (1.25/5.40), which were lower than those in group B (t = 5.34 approximately 34.68, P < 0.01), respectively. Although the expressions of ubiquitin mRNA (2.4 kb), E(2)-14 kDa mRNA (1.2 kb) and C2 mRNA in groups C and D were significantly higher than in group A, all the values were lower than those in group B (t = 3.22, 11.32, P < 0.01), especially in group C.

CONCLUSIONSThe proteolytic rate of skeletal muscle, especially the myofibrillar proteolytic rate, was enhanced during burn with sepsis. Hypersecretion of glucocorticoid could upgrade the gene expression of ubiquitin system, resulting in hyperdegradation of skeletal muscle protein during burn with sepsis. Glucocorticoid receptor antagonist RU38486 could decrease the hyperdegradation of skeletal muscle during burn with sepsis.

Animals ; Burns ; metabolism ; Gene Expression Regulation ; Glucocorticoids ; physiology ; Hydrocortisone ; blood ; Male ; Mifepristone ; pharmacology ; Muscle Proteins ; metabolism ; Muscle, Skeletal ; metabolism ; Rats ; Rats, Wistar ; Sepsis ; metabolism ; Ubiquitin ; metabolism