Objective: To assess the current situation of early treatment of partial-thickness burn wounds by professional burn medical staff in China, and to further promote the standardized early clinical treatment of partial-thickness burn wounds. Methods: A cross-sectional investigation was conducted. From November 2020 to February 2021, the self-designed questionnaire for the early treatment of partial-thickness burn wounds was published through the "questionnaire star" website and shared through WeChat to conduct a convenient sampling survey of domestic medical staff engaged in burn specialty who met the inclusion criteria. The number, region, and grade of the affiliated hospital, the age, gender, occupation, and seniority of the respondents were recorded. The respondents were divided into physician group and nurse group, senior group and junior group, eastern region group and non-eastern region group, primary and secondary hospital group and tertiary hospital group. Then the seniority, grade of the affiliated hospital, region of the affiliated hospital of the respondents in physician group and nurse group, conventional treatment of partial-thickness burn blisters, reasons for retaining vesicular skin, reasons for removing vesicular skin, and the conventional selection and optimal solution recommendation of topical drugs or dressings for partial-thickness burn wounds in the early stage of respondents in each of all the groups were recorded. Data were statistically analyzed with chi-square test. Results: The survey covered 31 provinces, municipalities, and autonomous regions in China (except for Hong Kong, Macau, and Taiwan regions). A total of 979 questionnaires were recovered, which were all valid. The 979 respondents came from 449 hospitals across the country, including 203 hospitals in the eastern region, 116 hospitals in the western region, 99 hospitals in the central region, and 31 hospitals in the northeast region, 348 tertiary hospitals, 79 secondary hospitals, and 22 primary hospitals. The age of the respondents was (39±10) years. There were 543 males and 436 females, 656 physicians and 323 nurses, 473 juniors and 506 seniors, 460 in the eastern regions and 519 in the non-eastern regions, 818 in tertiary hospitals and 161 in primary and secondary hospitals. There were statistically significant differences in the composition of different seniority in the respondents between physician group and nurse group (χ²=44.32, P<0.01), while there were no statistically significant differences in grade or region of the affiliated hospital of the respondents between physician group and nurse group (P>0.05). There were no statistically significant differences in the conventional treatment of partial-thickness burn blisters among respondents between different occupational groups, seniority groups, and region of the affiliated hospital groups (P>0.05).The respondents in different grade of the affiliated hospital groups differed significantly in the conventional treatment of partial-thickness burn blisters (χ²=6.24, P<0.05). Compared with respondents in nurse group, larger percentage of respondents in physician group chose to retain vesicular skin for protecting the wounds and providing a moist environment, and alleviating the pain of dressing change (with χ² values of 21.22 and 19.96, respectively, P values below 0.01), and smaller percentage of respondents in physician group chose to retain vesicular skin for prevention of wound infection (χ²=23.55, P<0.01). The reasons for retaining vesicular skin of respondents between physician group and nurse group were similar in accelerating wound healing, alleviating pigmentation and scar hyperplasia post wound healing (P>0.05). Compared with respondents in junior group, larger percentage of respondents in senior group chose to retain vesicular skin for protecting the wounds and providing a moist environment and alleviating the pain of dressing change (with χ² values of 10.36 and 4.60, respectively, P<0.05 or P<0.01), and smaller percentage of respondents in senior group chose to retain vesicular skin for prevention of wound infection (χ²=8.20, P<0.01). The reasons for retaining vesicular skin of respondents in senior group and junior group were similar in accelerating wound healing, alleviating pigmentation and scar hyperplasia post wound healing (P>0.05). The 5 reasons for the respondents between eastern region group and non-eastern region group, primary and secondary hospital group and tertiary hospital group chose to retain vesicular skin were all similar (P>0.05). Compared with those in physician group, significantly higher percentage of respondents in nurse group were in favor of the following 6 reasons for removing the vesicular skin, including convenience for using more ideal dressings to protect the wounds, prevention of wound infection, facilitating the effect of topical drugs on the wounds, the likely rupture of blisters and wound contamination, accelerating wound healing, and alleviating pigmentation and scar hyperplasia post wound healing (with χ² values of 4.35, 25.59, 11.83, 16.76, 46.31, and 17.54, respectively, P<0.05 or P<0.01). Compared with respondents in senior group, larger percentage of respondents in junior group chose to remove vesicular skin for the reasons such as the likely blister rupture and wound contamination, preventing wound infection, accelerating wound healing, and alleviating pigmentation and scar hyperplasia post wound healing (with χ² values of 17.25, 18.63, 14.83, and 10.23, respectively, P values below 0.01). Compared with respondents in non-eastern region group, larger percentage of respondents in eastern region group chose to remove vesicular skin for preventing wound infection and the likely rupture of blisters and wound contamination (with χ² values of 9.30 and 8.65, respectively, P values below 0.01). The 6 reasons for the respondents between tertiary hospital group and primary and secondary hospital group choose to remove vesicular skin were similar (P>0.05). Compared with respondents in physician group, larger percentage of respondents in nurse group chose to use moisturizing materials for partial-thickness burn wounds in the early stage (χ²=6.18, P<0.05), and smaller percentage of respondents in nurse group chose other topical drugs or dressings (χ²=5.20, P<0.05). Compared with respondents in junior group, larger percentage of respondents in senior group chose to use moisturizing materials and other topical drugs or dressings for partial-thickness burn wounds in the early stage (with χ² values of 4.97 and 21.80, respectively, P<0.05 or P<0.01). Compared with respondents in non-eastern region group, larger percentage of respondents in eastern region group chose to use topical antimicrobial drugs for partial-thickness burn wounds in the early stage (χ²=4.09, P<0.05), and smaller percentage of respondents in eastern region group chose to use other topical drugs or dressings for the partial-thickness burn wounds in the early stage (χ²=5.63, P<0.05). Compared with respondents in primary and secondary hospital group, larger percentage of respondents in tertiary hospital group chose to use biological dressings for partial-thickness burn wounds in the early stage (χ²=9.38, P<0.01). The optimal solution recommendation of topical drugs or dressings for partial-thickness burn wounds in the early stage varied significantly among the respondents between different occupational groups and seniority groups (with χ² values of 39.58 and 19.93, respectively, P values below 0.01). There were no statistically significant differences between eastern and non-eastern region groups, tertiary hospital group and primary and secondary hospital groups in optimal solution recommendation of topical drugs or dressings for partial-thickness burn wounds in the early stage (P>0.05). Conclusions: The conventional treatment measures of partial-thickness burn blisters and reasons for preserving blister skin by professional burn medical staff in China are relatively consistent, but there are great differences in the selection of reasons for removing blister skin, the conventional selection and optimal solution recommendation of topical drugs or dressings for partial-thickness burn wounds in the early stage. Therefore, it is urgent to establish a clinical treatment standard for partial-thickness burn wounds.
Adult ; Blister ; Burns/drug therapy* ; Cicatrix/pathology* ; Cross-Sectional Studies ; Female ; Humans ; Hyperplasia ; Male ; Medical Staff ; Middle Aged ; Occupations ; Pain ; Soft Tissue Injuries ; Wound Infection

To systematically evaluate the clinical efficacy and safety of Cheezheng Pain Relieving Plaster in the treatment of soft tissue injury. Four Chinese databases(namely CNKI, WanFang, VIP, CBM) and 2 English databases(namely PubMed, Cochrane Library) were retrieved from the establishment of each database to March 2019. The randomized controlled trials of Cheezheng Pain Relieving Plaster compared with routine therapy in treatment of soft tissue injury were included. The quality of the included studies was assessed using the Cochrane Risk Assessment Tool. Five studies were included, and 367 patients were enrolled. None of the included studies reported randomized concealment, blinding, follow-up and dropping off. The results showed that Cheezheng Pain Relieving Plaster may have advantages in alleviating joint pain, swelling, tenderness and dysfunction and other symptoms, with no serious adverse reaction. Compared with routine therapy, Cheezheng Pain Relieving Plaster may have advantages in the treatment of soft tissue injury. However, due to the quality of the included RCTs, the conclusions of this study were limited. In addition, to produce high-quality evidences for the clinical application of Cheezheng Pain Relieving Plaster, the conclusions of this study shall be further verified with large-sample, scientifically designed and strictly implemented clinical trials.
Arthralgia/drug therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Edema/drug therapy* ; Humans ; Pain/drug therapy* ; Randomized Controlled Trials as Topic ; Soft Tissue Injuries/drug therapy* ; Treatment Outcome

OBJECTIVETo explore the influence of hydrogen sulfide on the intestinal biological barrier, by applying exogenous hydrogen sulfide and hydrogen sulfide synthase inhibitor for the treatment of rats with severe burn injury.

METHODSOne hundred and four SD rats were divided into sham injury (SI, n = 8), burn control (BC, n = 32), sodium hydrosulfide (SH, n = 32), and propargylglycine groups (PPG, n = 32) according to the random number table. Rats in group SI were sham injured without fluid resuscitation. Rats in the latter 3 groups were inflicted with 30% TBSA full-thickness scald (referred to as burn below) on the back and intraperitoneally injected with 40 mL/kg balanced salt solution immediately after injury. Rats in groups SH and PPG were respectively intraperitoneally injected with SH (56 µmol/kg) and PPG (45 mg/kg) within 1 hour post injury. From post injury day (PID) 2, SH (56 µmol/kg) and PPG (45 mg/kg) were respectively intraperitoneally injected once a day to rats in groups SH and PPG. Eight rats from groups BC, SH, and PPG were sacrificed on PID 2, 7, 14 and 21, and ceca samples were collected. Ceca samples were added to the appropriate culture medium after being homogenized and diluted, for the culture of Bifidobacterium, Lactobacillus, Enterococcus, Enterobacter, and Candida albicans. The content of bacteria was calculated after the bacteria number was counted. The same procedure was performed for rats in group SI. Data were processed with logarithmic function, one-way analysis of variance, analysis of variance of factorial design, and SNK-q test.

RESULTSOn each PID, the content of Bifidobacterium and Lactobacillus in the ceca of each group with burned rats was less than that of group SI (with q values from 4.12 to 20.74, P values below 0.05); while the content of Enterococcus, Enterobacter, and Candida albicans was more than that of group SI (with q values from 2.84 to 68.29, P values below 0.05). Compared with that of group BC, the content of Bifidobacterium and Lactobacillus in the ceca of rats in group SH were increased on each PID (with q values from 2.88 to 17.57, P values below 0.05). In group SH, the content of Bifidobacterium peaked as (6.54 ± 0.35) lg (CFU/g) on PID 7, the content of Lactobacillus peaked as (7.25 ± 0.71) lg (CFU/g) on PID 21. Compared with that of group BC, the content of Enterococcus, Enterobacter, and Candida albicans in the ceca of rats in group SH was reduced on each PID (with q values from 2.79 to 29.59, P values below 0.05). Compared with that of group BC, the content of Bifidobacterium and Lactobacillus in the ceca of rats in group PPG was decreased on each PID (with q values from 2.82 to 46.56, P values below 0.05); while the content of Enterococcus, Enterobacter, and Candida albicans was significantly increased on each PID (with q values from 2.93 to 41.42, P values below 0.05). In group PPG, the content of Enterococcus peaked as (9.41 ± 0.22) lg (CFU/g) on PID 21, the content of Enterobacter peaked as (9.96 ± 0.24) lg (CFU/g) on PID 14, and that of Candida albicans peaked as (3.94 ± 0.84) lg (CFU/g) on PID 14.

CONCLUSIONSExogenous hydrogen sulfide can subdue the growth of pathogenic bacteria while promote that of probiotics, thus helping maintain the integrity of intestinal biological barrier of rats with burn injury.

Animals ; Burns ; drug therapy ; pathology ; Hydrogen Sulfide ; pharmacology ; therapeutic use ; Intestines ; pathology ; Rats ; Rats, Sprague-Dawley ; Soft Tissue Injuries

OBJECTIVE: To observe the effect of curing-injury cataplasma on the expression of aquaporin protein 3 (AQP-3) in skeletal muscle of rat model with acute injury in soft tissues. METHODS: A total of 54 SD rats were randomly divided into 3 groups, and by using 10% sodium sulfide the depilating treatment was made in the thigh lateral of each left hind leg 1 day before modeling. The depilatory area in the control group was merely marked with striking range, not attacked for modeling. In the depilatory area of the modeling group, the blowing apparatus was used to attack the marked range to establish the model of soft tissue swelling with acute injury, to which none medication was given. In the drug treatment group, immediately after establishing the model of soft tissue swelling with acute injury, curing-injury cataplasma was scattered on the stricken area, and fixed with bandage. After the modeling, the rats were killed at 1 h, 6 h, 1 d, 3 d, 5 d, and 7 d, 3 rats in each group at each time point. In the marked area some tissue was taken, and the dry/wet proportion method was used to detect the water content in the skeletal muscle. Western blot and qPCR method were used for the AQP-3 protein and the level of gene expression. RESULTS: At the six time points, for the modeling and drug treatment groups, the water content of skeletal muscle was higher than that of the control group (P<0.05). At 3 d, 5 d and 7 d, the water content in the drug treatment group was lower than that of the modeling group (P<0.01); for the modeling and drug treatment groups, AQP-3 protein and the level of gene expression were higher than those of the control group. There was significant difference between the drug treatment group and the modeling group (P<0.01). CONCLUSION Curing-injury cataplasma can relieve soft tissue swelling with acute injury, and accelerate the repair process after the injury.
Animals ; Aquaporin 3 ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Hindlimb ; injuries ; Male ; Muscle, Skeletal ; metabolism ; Rats ; Rats, Sprague-Dawley ; Soft Tissue Injuries ; drug therapy ; metabolism

Transcatheter arterial chemoembolization (TACE) has been used widely to treat patients with unresectable hepatocellular carcinoma. However, this method can induce various adverse events caused by necrosis of the tumor itself or damage to nontumor tissues. In particular, neurologic side effects such as cerebral infarction and paraplegia, although rare, may cause severe sequelae and permanent disability. Detailed information regarding the treatment process and prognosis associated with this procedure is not yet available. We experienced a case of paraplegia that occurred after conducting TACE through the intercostal artery to treat hepatocellular carcinoma that had metastasized to the rib. In this case, TACE was attempted to relieve severe bone pain, which had persisted even after palliative radiotherapy. A sudden impairment of sensory and motor functions after TACE developed in the trunk below the level of the sternum and in both lower extremities. The patient subsequently received steroid pulse therapy along with supportive care and continuous rehabilitation. At the time of discharge the patient had recovered sufficiently to enable him to walk by himself, although some paresthesia and spasticity remained.
Antiviral Agents/therapeutic use ; Bone Neoplasms/radiography/secondary ; Carcinoma, Hepatocellular/diagnosis/pathology/*therapy ; Catheter Ablation ; Chemoembolization, Therapeutic/*adverse effects ; Hepatitis B/complications/drug therapy ; Humans ; Liver Cirrhosis/etiology ; Liver Neoplasms/diagnosis/pathology/*therapy ; Male ; Middle Aged ; Positron-Emission Tomography ; Soft Tissue Neoplasms/secondary ; Spinal Cord Injuries/*etiology ; Tomography, X-Ray Computed

OBJECTIVETo evaluate the early combination of Chinese and Western medicine for anti-inflammation and lateral superior genicular flap for the treatment of soft tissue defects around the knee joint.

METHODSFrom June 2004 to September 2008, 8 patients with soft tissue defects around the knee joint were treated with lateral superior genicular flap. Among the patients, 5 patients were male and 3 patients were female, ranging in age from 32 to 56 years, with an average of 35.2 years. The defected area ranged from 7.6 cm x 4.5 cm to 15.2 cm x 7.5 cm. The disease course ranged from 3 months to 3 years. Three patients had the defects at the posterior of the knee, 2 patients had the defects at the popliteal fossa, and 3 patients had the defects at the lateral side of the knee. At the early stage, all the patients were treated with Tuihuang Xiaozhong decoction and antibiotics for 3 to 5 days.

RESULTSAll the flaps survived, and the knee function recovered. One patient had epidermis necrosis at the distal end of the flap of lateral side of the knee.

CONCLUSIONThe early combination of Chinese and Western medicine for anti-inflammation is a simple, easy to promote, and no special microsurgical instruments are needed.

Adult ; Anti-Bacterial Agents ; administration & dosage ; Combined Modality Therapy ; Drug Administration Routes ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Knee Injuries ; drug therapy ; immunology ; surgery ; Knee Joint ; drug effects ; surgery ; Male ; Middle Aged ; Soft Tissue Injuries ; drug therapy ; immunology ; surgery ; Surgical Flaps ; Treatment Outcome

OBJECTIVEUsing the method of bleeding from the orbital vein and lancing to make the animal model of trauma, and to observe the influence of reinforcing Qi strength spleen in the expression of bFGF and EGF in the reparative process of raw surface, in order to explore the possible mechanism of reinforcing Qi strength spleen in promoting the rehabilitation of soft tissue.

METHODSForty healthly adult SD rats were made to be traumatic model using the method of bleeding from the orbital vein and lancing. After operation, there were 33 rats survival, which were divided into the reinforcing Qi strength spleen group, the activating blood circulation to dissipate blood stasis group and the model group randomly. The raw surface and ambient normal skin were taken at the 3rd, 7th and 14th days after operation to detect the expression of bFGF and EGF by immunohistochemical method.

RESULTSAt the 3rd, 7th and 14th days after operation, the expression of bFGF and EGF in the tissue of raw surface of the reinforcing Qi strength spleen group and the activating blood circulation to dissipate blood stasis group was obviously higher than that of the model group(P < 0.05). Compared with the activating blood circulation to dissipate blood stasis group, the expression of bFGF and EGF in the tissue of raw surface of the reinforcing Qi strength spleen group was higher (P < 0.05) in the 3rd and 7th day after operation. But in the 14th after operation, there was no significantly difference between reinforcing Qi strength spleen group and activating blood circulation to dissipate blood stasis group.

CONCLUSIONThe method of reinforcing Qi strength spleen can efficiently promote the expression of bFGF and EGF in raw surface of serious soft tissue injury.

Animals ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Epidermal Growth Factor ; genetics ; metabolism ; Female ; Fibroblast Growth Factor 2 ; genetics ; metabolism ; Gene Expression ; drug effects ; Humans ; Male ; Qi ; Rats ; Rats, Sprague-Dawley ; Soft Tissue Injuries ; drug therapy ; genetics ; metabolism ; physiopathology ; Spleen ; drug effects ; physiopathology

OBJECTIVETo probe the recovery mechanism of Zhenggu powder (ZGP) on acute soft tissue injury in cell levels.

METHODSForty rabbits which established animal model of acute soft tissue injury with hammer hitting,were divided randomly into normal group (A), model group (B), vaseline group (C)and ZGP group (D). Injured part was applied external drug daily after model was made. All animals were killed after using drug for 4 days. The local tissue of injured part was taken pathologic study, and was measured the content of IL-1beta, IL-6, TNFalpha by ELISA method and TXB2, 6-keto-PGF1alpha by RIA method.

RESULTSMuscular tissue of group A was normal. But that of group B and C was aberrant,such as swelling and broken of muscular fiber or infiltration of inflammatory cell. Such histological change of group D was lightly and hyperplasia of blood vessel was found. The contents of IL-1beta, TNFalpha, TXB2 and TXB2/6-keto-PGF1alpha in group D were lower than that of group B and group C. On the contrary, the contents of 6-keto-PGF1alpha in the group D were higher than that of group B and group C. The difference of content of IL-6 between groups was not obvious.

CONCLUSIONZGP could promote not only the dilution and the transportation of inflammatory cell factors,but also the repair and the regeneration of the injured tissue structures. The therapeutic effect of ZGP was not relative to IL-6.

Animals ; Cytokines ; immunology ; Drugs, Chinese Herbal ; pharmacology ; Female ; Humans ; Inflammation Mediators ; immunology ; Male ; Rabbits ; Random Allocation ; Soft Tissue Injuries ; drug therapy ; immunology ; pathology

OBJECTIVETo study the effects of Shibao Powder on the expression of b-FGF and TGF-beta 1 in granulation tissues of rabbit models with soft tissue injuries, so as to explore mechanism of external Chinese drugs for repairing of soft tissues in molecular levels.

METHODSThe rabbit models were established by classical method of full-thickness skin wounds. After 8% sodium sulfide was used and routine disinfection completed, intra-peritoneal anaesthesia was adopted. The skin was cut to expose gastrocnemius muscle, and imcomplete sharp dissection was made near the tendon insertion. The length of the incision was 0.8 cm and the width was 0.4 cm. The rabbits in the experimental group were treated with spread of Shibao Powder at the wound; the rabbits in clean group were treated with routine dressing changes and disinfection; and the rabbits in the control group were treated with dressing changes only. The granulation tissues in different stages were collected and observed with high power microscope. The expression of Transforming Growth Factor-beta 1 (TGF-beta 1) protein and b-FGF protein in wound tissues were detected using StreptA-ridin-Biotin-Complex (SABC) method.

RESULTSThe results showed that the expression of b-FGF protein had significant differences among 3 groups at the 6th day after trauma (P<0.05). The TGF-beta 1 protein expression also had significant differences among 3 groups at the 10th and 14th days after trauma (P<0.05). At the same time, the growth states of granulation tissues had difference among 3 groups at the same trauma stage, and within the same group among different trauma stages.

CONCLUSIONThis experimental study shows that Shibao Powder is effective to promote the repair of soft tissues after trauma by stimulating production of endogenous growth factor from cells in wound.

Animals ; Disease Models, Animal ; Fibroblast Growth Factors ; metabolism ; Gene Expression Regulation ; drug effects ; Granulation Tissue ; drug effects ; metabolism ; pathology ; Male ; Medicine, Chinese Traditional ; Powders ; Rabbits ; Soft Tissue Injuries ; drug therapy ; metabolism ; pathology ; Transforming Growth Factor beta1 ; metabolism ; Wound Healing ; drug effects

OBJECTIVETo explore in vivo effects of Qizheng-xiaotong plaster on soft tissue injury in rabbit ears at different periods and to offer theoretical bases for clinical application.

METHODSThe experimental models of soft tissue injury in ears were produced in 10 New Zealand white rabbits, and the ears were divided into three groups at the 1st, 2nd, 3rd week. The normal group and treatment group were given the Qizheng-xiaotong plaster extract, and the model group with normal saline. Microscopic analysis, digital collection system, infrared temperature tester and thickness tester were applied to determine the changes of soft tissue injury in local microcirculation and the temperature change after 0, 0.5, 3 and 5 hours, and swelling change at 1 to 5 days respectively.

RESULTSAt the 3rd hour, blood velocity speeded up in normal group and model group, and it lasted for two hours in model group. As compared with model group, it slowed down to original level in treatment group at the 5th hour and the soft tissue swelling decreased from the 3rd to the 5th day as well.

CONCLUSIONThe application of Qizheng-xiaotong plaster is effective in preventing further soft tissue oedema and haematoma. It can make the soft tissue swelling decreased at chronic stage compared with that at acute stage.

Animals ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Ear, External ; drug effects ; injuries ; physiopathology ; Humans ; Microcirculation ; drug effects ; Rabbits ; Soft Tissue Injuries ; drug therapy ; physiopathology