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 explore the healing effect on wound after transplanting sheep acellular dermal matrix (ADM) microparticle together with autoallergic skin microparticle.
 Methods: The rats were divided into three groups. Full-thickness skin wound at size about 4.0 cm×4.0 cm was generated on the back of every rat. Group A, the sheep ADM microparticle and autoallergic skin microparticle were mixed according to the ratio of 5:1, coating on wound of rat back. Group B, the sheep ADM microparticle and autoallergic skin microparticle were mixed according to the ratio of 2:1. Group C, autoallergic skin microparticle was only put on wound and be covered with heterograft. We observed the development of wound healing and compared the wound contraction rate among the three groups.
 Results: Three groups displayed same speed on extending of autoallergic skin microparticle and wound healing. The skin microparticles in Group A were wrapped up by around tissues and fused each other. A few renewal blood vessels were found in tissues, and ADM was replaced by around tissues and mixed with autoallergic skin microparticle. At the muscle surface, a few derma tissues distributed into point or patch, and the wound contraction rate was the lowest one among the 3 groups. The skin microparticles in Group B were mixed with more sheep ADMs than those in Group A. Some ADMs were wrapped by around tissues but could not been absorbed. Sheep ADM microparticles were free from around tissues, and the wound healing was delayed. The wound contraction rate in Group B was higher than that in Group A. The wound healing in Group C was faster than that in Group B, but there were few derma tissues under the skin. The wound contraction rate was the highest one.
 Conclusion: Mixing sheep ADM microparticle with autoallergic skin microparticle according to the ratio of 5:1 is good for regenerating derma tissues, and it can improve healing effect of wound.
Acellular Dermis ; Animals ; Cell-Derived Microparticles ; transplantation ; Contracture ; pathology ; Postoperative Complications ; pathology ; Rats ; Sheep ; Skin ; injuries ; Skin Transplantation ; methods ; Soft Tissue Injuries ; pathology ; surgery ; Wound Healing

OBJECTIVES: To analyze the characteristics and mechanisms of pelvic fractures in the cases of road traffic accident deaths. METHODS: Total 65 cases of road traffic accident deaths with pelvic fracture were collected, and the sites, characteristics and injury mechanisms of pelvic fracture were statistically analyzed. RESULTS: Among the 65 cases of pelvic fracture, 38 cases of dislocation of sacroiliac joint were found, and most combined with pubis symphysis separation or fracture of pubis. In the fractures of pubis, ischium and acetabulum, linear fractures were most common, while comminuted fractures were most common in sacrum and coccyx fractures. There were 54 cases combined with pelvic soft tissue injury, and 8 cases with pelvic organ injury and 44 cases with abdominal organ injury. In the types of pelvic ring injury, 32 cases were separation, 49.32%, followed by compression, 26.15% and only one case was verticality, 1.54%. CONCLUSIONS Detailed and comprehensive examination of the body and determination of the pelvic fracture type contribute to analyze the mechanisms of injury.
Accidents, Traffic ; Acetabulum/injuries* ; Death ; Forensic Pathology ; Fractures, Bone/diagnosis* ; Fractures, Comminuted/diagnosis* ; Humans ; Ischium/injuries* ; Pelvic Bones/injuries* ; Soft Tissue Injuries/diagnosis* ; Spinal Fractures/diagnosis*

OBJECTIVETo investigate the clinical effect of lateral superior genicular composite tissue flap for tissue defect.

METHODSThe axis line of flap is the lateral thigh vertical midline. The cutaneous branch is inserted 4 cm near the femoral lateral epicondylus. The anterior border is the elongation line along patellar lateral border. The posterior margin is the hinder margin of femoral biceps. The lower border is the horizontal line along the upper line of patella. The composite flaps were used in 18 cases with soft tissue defects in extremities, 11 cases with clacaneus tenden defects and 16 cases with bony nonunion. Results From Mar. 2002 to Sept. 2013, 45 cases were treated with the composite tissue flaps. The flaps size ranged from 6 cm x 3 cm to 17cm x 9 cm. All the flaps survived completely. Blood supply crisis happened in 2 cases, which was released by reanastomosis. The patients were followed up for 1 - 2. 5 years with satisfactory aesthetic and functional results. All the bone defect and nonunion were healed. Good healing was also achieved in donor sites. 8 months after operation, knee joint function is evaluated as good by hospital special surgery knee score (HSS).

CONCLUSIONLateral superior genicular compostie tissue flap can be used to reconstruct soft tissue defect, bone defect and tenden calcaneus defect in one stage.

Anatomic Landmarks ; anatomy & histology ; Follow-Up Studies ; Graft Survival ; Humans ; Knee ; anatomy & histology ; Muscle, Skeletal ; anatomy & histology ; Soft Tissue Injuries ; pathology ; surgery ; Surgical Flaps ; transplantation ; Thigh ; Time Factors ; Wound Healing

PURPOSE: Snakebite is an emergency which causes local symptoms such as pain and edema around the bite. Systemic symptoms may also develop, such as dizziness or renal failure, and may even cause death. The purpose of this research was to assess the validity and safety of snakebite protocol for surgery when treating snakebite patients. MATERIALS AND METHODS: Retrospective research was performed on patients who were admitted after being treated at the emergency center from January 2008 to December 2012. When necessary, debridement was also performed, and 46 of 111 patients (41.4%) underwent debridement. Those who had received debridement without antivenom administration due to a positive skin reaction test were classified as group A, and group B received antivenom and delayed debridement. We reviewed the emergency and admission charts of the patients in each group and recorded and compared their age, sex, bite site, severity of local and general symptoms, time to receive antivenin, and complications. RESULTS: Of the ten patients (21.7%) in group A, two (66.6%) developed cellulites, and one of them experienced skin necrosis, resulting in a skin graft. In group B, there were 36 patients (78.2%), 19 (52.7%) of whom developed cellulitis. Skin necrosis occurred in two patients, and one of these patients received a skin graft. Compartment syndrome was found in one patient, and fasciotomy and a skin graft were performed. CONCLUSION: The treatment protocol implemented to treat snakebite patients admitted to the emergency center during this research was safely and properly followed during surgical treatment.
Adult ; Aged ; Antivenins/administration & dosage ; Combined Modality Therapy ; Compartment Syndromes ; Debridement/*methods ; Disease Management ; Edema/etiology ; Female ; Humans ; Male ; Middle Aged ; Necrosis ; *Practice Guidelines as Topic ; Republic of Korea ; Retrospective Studies ; Severity of Illness Index ; Skin/pathology ; Skin Transplantation/*methods ; Snake Bites/complications/*diagnosis/pathology/*surgery ; Snake Venoms/adverse effects ; Soft Tissue Injuries/etiology/*pathology/surgery ; Treatment Outcome ; Wound Healing/physiology

OBJECTIVETo observe the changes in the expressions of microRNA-126 in myocardial tissue and cardiac troponin I (cTnI) in serum of rats in the early stage of severe burn injury with analysis of their relationship, and to validate the relationship between microRNA-126 and myocardial damage in cellular level.

METHODS(1) Forty-eight SD rats were divided into sham injury group (n=8, without fluid therapy after sham injury) and burn injury group (n=40, inflicted with 30% TBSA full-thickness scald on the back, hereinafter referred to as burn, and received intraperitoneally injection of lactic acid Ringer's solution) according to the random number table. Blood was collected from abdominal aorta of rats in sham injury group at post injury hour (PIH) 1, and then these 8 rats were sacrificed for obtaining left ventricular tissue. Blood was respectively collected from abdominal aorta of 8 rats in burn injury group at PIH 3, 6, 12, 24, and 48, and then they were sacrificed and the left ventricular tissue was obtained at each time point. The expression of microRNA-126 in myocardial tissue was assessed by real-time fluorescent quantitative RT-PCR. Serum level of cTnI was assessed by ELISA. (2) Rat myocardial cell line H9C2 was divided into normal control group (NC, routinely cultured), stimulation group (S), negative transfection+stimulation group (NT+S), and transfection+stimulation group (T+S) according to the random number table. Cells in S group were treated with hypoxia for 24 h after being cultured with DMEM containing 10% burn serum obtained from rats in burn injury group at PIH 6 in experiment (1). Cells in NT+S group and T+S group were respectively transfected with the negative control of microRNA mimics and microRNA-126 mimics for 24 h, and then were given the same treatment as that of S group. The expression of microRNA-126 in myocardial cells was determined by real-time fluorescent quantitative RT-PCR (with the sample number of 3). Cell counting kit 8 was used to examine the vitality of myocardial cell (with the sample number of 4, denoted as absorbance value). Apoptotic rate of myocardial cells was determined by flow cytometer (with the sample number of 3). Data were processed with one-way analysis of variance and LSD-t test. The relationship between microRNA-126 expression in myocardial tissue and serum level of cTnI of rats was assessed by linear correlation analysis.

RESULTS(1) Compared with that of sham injury group at PIH 1, the expression levels of microRNA-126 in myocardial tissue of rats in burn injury group at PIH 3, 6, 12, 24, and 48 were significantly decreased (with t values from 5.68 to 9.79, P values below 0.01), reaching its nadir at PIH 24 (0.40 ± 0.08). Compared with that of sham injury group at PIH 1, the serum levels of cTnI of rats in burn injury group at PIH 3, 6, 12, 24, and 48 were significantly increased (with t values from 6.68 to 12.79, P values below 0.01), peaking at PIH 12 [(1 035 ± 177) pg/mL]. A significant negative correlation between the expression level of microRNA-126 in myocardial tissue and serum level of cTnI was observed in rats of burn injury group at each time point (r=-0.797, P<0.001). (2) Compared with those of NC group, the microRNA-126 expression levels in myocardial cells of S group and T+S group were respectively decreased and increased (with t values respectively 4.57 and 5.73, P<0.05 or P<0.01), the cell vitality levels were obviously decreased (with t values respectively 14.88 and 6.48, P values below 0.01), and the apoptotic rates were significantly increased (with t values respectively 13.82 and 6.96, P values below 0.01). Compared with that in NT+S group, the microRNA-126 expression level in myocardial cells of T+S group was significantly increased (t=6.77, P<0.01), the cell vitality level was obviously increased (t=8.23, P<0.001), and the apoptotic rate was significantly decreased (t=6.14, P<0.001).

CONCLUSIONSExpression level of microRNA-126 in myocardial tissue of rat was decreased in the early stage of severe burn injury. It may participate in regulating myocardial damage and play a protective role.

Animals ; Burns ; metabolism ; pathology ; Cell Line ; Enzyme-Linked Immunosorbent Assay ; Hypoxia ; MicroRNAs ; genetics ; metabolism ; Myocardium ; metabolism ; pathology ; Myocytes, Cardiac ; metabolism ; pathology ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Reverse Transcriptase Polymerase Chain Reaction ; Serum ; Soft Tissue Injuries ; Transfection ; Troponin I ; metabolism

OBJECTIVETo explore selection and method of tissue flaps for the repair of severe defects of skin and soft tissue around the knee joints.

METHODSFifty-four patients with wounds around the knee joints, all accompanied by exposure or necrosis of tendon or bone and exposure of prosthesis, were hospitalized in our burn center from June 2008 to December 2014. Five of them were with knee joint injury. After thorough debridement or tumor resection, the wound area ranged from 5 cm × 5 cm to 46 cm × 22 cm. Three patients were repaired with free latissimus dorsi myocutaneous flaps, 7 were repaired with modified sartorius myocutaneous flaps, 8 were repaired with gastrocnemius myocutaneous flaps, one was repaired with gastrocnemius muscle flap, two were repaired with posterior leg flaps combined with gastrocnemius muscle flaps, one was repaired with femoral biceps muscle flap combined with gastrocnemius muscle flap, 13 were repaired with reverse anterolateral thigh island flaps, two were repaired with reverse anterolateral thigh island flap combined with gastrocnemius myocutaneous flaps, two were repaired with superior lateral genicular flaps, 4 were repaired with reverse posterior thigh island flaps, 11 were repaired with saphenous artery flaps. Patellar ligament was reconstructed in 4 patients. The tissue flap size ranged from 5 cm × 5 cm to 38 cm × 19 cm. Some donor sites were sutured directly, and the others were closed by split-thickness skin grafting obtained from ipsilateral or contralateral legs.

RESULTSAmong 59 tissue flaps of 54 patients, 55 tissue flaps of 50 patients survived, while necrosis of the distal part was observed in 4 tissue flaps, including one saphenous artery flap, two reverse anterolateral thigh island flaps, and one free latissimus dorsi myocutaneous flap. Among them, 3 flaps with necrosis at the distal part healed after debridement followed by skin grafting, one myocutaneous flap healed by transplanting gastrocnemius myocutaneous flap. During the follow-up period of 6 to 36 months, the tissue flaps were in good appearance and texture, and knee joint function was good in most cases. In 4 patients the knee joint function was satisfactory after patellar ligament reconstruction, while stiffness was observed in 4 out of 5 patients with knee joint injury.

CONCLUSIONSFree latissimus dorsi myocutaneous flaps are preferred to repair extensive defects around the knee joints. Reverse anterolateral thigh island flaps followed by saphenous artery flaps are preferred to repair wounds around the anterior knee. Wounds of the lateral knee are mainly repaired with reverse anterolateral thigh island flaps, and for small wounds the use of the superior lateral genicular flaps may be considered. Wounds of the medial knee can be repaired with modified sartorius myocutaneous flaps or saphenous artery flaps. Wounds of the posterior knee can be repaired with reverse posterior thigh island flaps or superior lateral genicular flaps. Wounds with severe infection or large space can be repaired with gastrocnemius myocutaneous flaps or muscle flaps or modified sartorius myocutaneous flaps. Anterolateral thigh flaps and gastrocnemius myocutaneous flaps are preferred in cases with indication of patellar ligament reconstruction.

Debridement ; Humans ; Knee Injuries ; surgery ; Knee Joint ; pathology ; Muscle, Skeletal ; Necrosis ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Treatment Outcome ; Wound Healing

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

OBJECTIVETo observe the effects of astragalus polysaccharide (AP) on the intestinal mucosal morphology, level of secretory IgA (s-IgA) in intestinal mucus, and distribution of T lymphocyte subsets in Peyer's patch in rats with severe scald injury.

METHODSOne hundred and thirty SD rats were divided into sham injury group (SI, sham injured, n = 10), scald group (S, n = 30), low dosage group (LD, n = 30), moderate dosage group (MD, n = 30), and high dosage group (HD, n = 30) according to the random number table. Rats in the latter 4 groups were inflicted with 30% TBSA full-thickness scald on the back. From post injury hour 2, rats in groups LD, MD, and HD were intraperitoneally injected with 0.5 mL AP solution with the dosage of 100, 200, and 300 mg/kg each day respectively, and rats in group S were injected with 0.5 mL normal saline instead. Ten rats from group SI immediately after injury and 10 rats from each of the latter 4 groups on post injury day (PID) 3, 7, 14 were sacrificed, and their intestines were harvested. The morphology of ileal mucosa was examined after HE staining; the level of s-IgA in ileal mucus was determined with double-antibody sandwich ELISA method; the proportions of CD3⁺, CD4⁺, CD8⁺ T lymphocytes in Peyer's patches of intestine were determined with flow cytometer, and the proportion of CD4⁺ to CD8⁺ was calculated. Data were processed with one-way analysis of variance, analysis of variance of factorial design, and SNK test.

RESULTS(1) Villi in normal form and intact villus epithelial cells were observed in rats of group SI immediately after injury, while edema of villi and necrosis and desquamation of an enormous amount of villi were observed in groups with scalded rats on PID 3, with significant infiltration of inflammatory cells. On PID 7, no obvious improvement in intestinal mucosal lesion was observed in groups with scalded rats. On PID 14, the pathology in intestinal mucosa of rats remained nearly the same in group S, and it was alleviated obviously in groups LD and MD, and the morphology of intestinal mucosa of rats in group HD was recovered to that of group SI. (2) On PID 3, 7, and 14, the level of s-IgA in intestinal mucus significantly decreased in groups S, LD, MD, and HD [(43 ± 5), (45 ± 5), (46 ± 5) µg/mL; (47 ± 5), (48 ± 5), (49 ± 6) µg/mL; (50 ± 6), (51 ± 5), (52 ± 5) µg/mL; (53 ± 6), (54 ± 5), (55 ± 5) µg/mL] as compared with that of rats in group SI immediately after injury [(69 ± 4) µg/mL, with P values below 0.05]. The level of s-IgA in intestinal mucus of rats in group MD was significantly higher than that in group S at each time point (with P values below 0.05), and that of group HD was significantly higher than that in groups S and LD at each time point (with P values below 0.05). (3) Compared with those of rats in group SI immediately after injury, the proportions of CD3⁺ T lymphocytes and CD4⁺ T lymphocytes significantly decreased in groups with scalded rats at each time point (with P values below 0.05), except for those in group HD on PID 14. The proportion of CD4⁺ T lymphocytes of rats in group LD was significantly higher than that in group S on PID 3 (P < 0.05). The proportions of CD3⁺ T lymphocytes and CD4⁺ T lymphocytes were significantly higher in groups MD and HD than in groups S and LD (except for the proportion of CD4⁺ T lymphocytes in group MD on PID 3 and 14) at each time point (with P values below 0.05). The proportion of CD3⁺ T lymphocytes on PID 7 and 14 and that of CD4⁺ T lymphocytes on PID 3 were significantly higher in group HD than in group MD (with P values below 0.05). Compared with that of rats in group SI immediately after injury, the proportion of CD8⁺ T lymphocytes significantly increased in the other 4 groups at each time point (with P values below 0.05). The proportion of CD8⁺ T lymphocytes was significantly lower in rats of group LD on PID 7 and 14 and groups MD and HD at each time point than in group S (with P values below 0.05). The proportion of CD8⁺ T lymphocytes was significantly lower in rats of group MD on PID 7 and 14 and group HD at each time point than in group LD (with P values below 0.05). The proportion of CD8⁺ T lymphocytes was significantly lower in rats of group HD on PID 7 and 14 than in group MD (with P values below 0.05). On PID 3, 7, and 14, the proportion of CD4⁺ to CD8⁺ was significantly lower in groups S, LD, MD, and HD (0.65 ± 0.11, 0.68 ± 0.13, 0.73 ± 0.22; 0.76 ± 0.15, 0.78 ± 0.14, 0.90 ± 0.10; 0.85 ± 0.21, 0.89 ± 0.18, 1.08 ± 0.19; 0.99 ± 0.20, 1.05 ± 0.21, 1.25 ± 0.23) as compared with that of rats in group SI immediately after injury (1.74 ± 0.20, with P values below 0.05). The proportion of CD4⁺ to CD8⁺ was significantly higher in rats of group HD than in group MD on PID 7 (P < 0.05), and the proportion was significantly higher in these two groups than in group S at each time point (with P values below 0.05). The proportion of CD4⁺ to CD8⁺ was significantly higher in rats of group MD on PID 14 and group HD at each time point than in group LD (with P values below 0.05). Compared within each group, the proportions of CD3⁺, CD4⁺, CD8⁺ T lymphocytes and the proportion of CD4⁺ to CD8⁺ of rats in groups LD, MD, and HD showed a trend of gradual elevation along with passage of time.

CONCLUSIONSAP can improve the injury to intestinal mucosa and modulate the balance of T lymphocyte subsets in Peyer's patch in a time- and dose-dependent manner, and it can promote s-IgA secretion of intestinal mucosa in a dose-dependent manner.

Animals ; Astragalus Plant ; adverse effects ; Burns ; immunology ; pathology ; physiopathology ; Dose-Response Relationship, Drug ; Immunity, Mucosal ; Immunoglobulin A ; metabolism ; Intestinal Mucosa ; metabolism ; physiology ; Intestine, Small ; metabolism ; Peyer's Patches ; immunology ; physiopathology ; Polysaccharides ; Rats ; Rats, Sprague-Dawley ; Soft Tissue Injuries ; T-Lymphocyte Subsets ; immunology

OBJECTIVETo observe the effects of docosahexaenoic acid (DHA) on the expressions of TNF-α, IL-6, and leukotriene B4 (LTB4) in serum and expression of NF-κB in pulmonary tissue of rats with severe scald injury.

METHODSOne hundred and sixty SD rats were divided into sham injury (A), sham injury+DHA (B), scald (C), and scald+DHA (D) groups according to the random number table, with 40 rats in each group. Rats in groups A and B were sham injured, while rats in groups C and D were inflicted with 30% TBSA full-thickness scald on the back. Rats in groups B and D were injected with 0.5 mg/mL DHA solution with the dosage of 1 mL/kg via tail vein 5 minutes post injury, while rats in groups A and C with normal saline solution 1 mL/kg. At post injury hour (PIH) 3, 6, 12, 24, and 48, pulmonary tissue and abdominal aorta blood were collected from 8 rats in each group. The serum levels of TNF-α, IL-6, and LTB4 were determined with ELISA, and the protein expression of NF-κB p65 in pulmonary tissue was determined with Western blotting. Data were processed with analysis of variance of factorial design and LSD-t test.

RESULTS(1) The serum levels of TNF-α and IL-6 of rats in group A were similar to those of group B at each time point (with tTNF-α values from 0.223 to 0.947, tIL-6 values from 0.767 to 2.084, P values above 0.05). Compared with those of group A, the serum levels of TNF-α and IL-6 of rats in groups C and D were significantly higher at each time point (with tTNF-α values from 11.800 to 40.357, tIL-6 values from 10.334 to 39.321, P values below 0.01). The serum levels of TNF-α and IL-6 of rats in group D were significantly lower than those of group C at each time point (with tTNF-α values from -17.643 to -8.331, tIL-6 values from -21.596 to -6.332, P values below 0.01). The serum levels of TNF-α and IL-6 in groups C and D both showed a trend of increase earlier and decrease later, and they peaked at PIH 12, respectively (360.4 ± 13.2), (306.8 ± 7.2) pg/mL and (265.4 ± 12.3), (230.5 ± 2.2) pg/mL. (2) The serum level of LTB4 in group A was similar to that of group B at each time point (with t values from 0.787 to 1.096, P values above 0.05). The serum level of LTB4 was significantly higher in groups C and D than in group A at each time point (with t values from 7.501 to 38.962, P values below 0.01). The serum level of LTB4 in group D was obviously lower than that of group C at each time point (with t values from -19.244 to -2.532, P values below 0.01). The serum level of LTB4 in groups C and D both showed a trend of increase earlier and decrease later, and it peaked at PIH 12, (4.59 ± 0.29) and (2.85 ± 0.32) ng/mL respectively. (3) The protein expression of NF-κB p65 in pulmonary tissue in group A was similar to that of group B at each time point (with t values from 0.847 to 1.256, P values above 0.05). The protein expression of NF-κB p65 was significantly higher in groups C and D than in group A at each time point (with t values from 15.167 to 98.074, P values below 0.01). The protein expression of NF-κB p65 in group D was obviously lower than that of group C at each time point (with t values from -37.190 to -14.415, P values below 0.01). The protein expression of NF-κB p65 in groups C and D both showed a trend of increase earlier and decrease later, and it peaked at PIH 12, respectively 4.46 ± 0.12 and 2.94 ± 0.21.

CONCLUSIONSParenteral supply of DHA to rats with severe scald injury can reduce the levels of TNF-α, IL-6, and LTB4 in serum and decrease the expression of NF-κB in pulmonary tissue, thus alleviating the inflammation response.

Animals ; Blotting, Western ; Burns ; Cytokines ; Docosahexaenoic Acids ; Enzyme-Linked Immunosorbent Assay ; Inflammation ; Interleukin-6 ; blood ; Leukotriene B4 ; blood ; Lung ; metabolism ; pathology ; NF-kappa B ; metabolism ; Rats ; Rats, Sprague-Dawley ; Serum ; Soft Tissue Injuries ; Tumor Necrosis Factor-alpha ; blood ; genetics ; Up-Regulation ; physiology