Research advances on the role of competing endogenous RNAs in wound healing / 中华烧伤杂志

Wound healing, as one of the important public health issues, has been a worldwide problem. Due to the unique biological wound environment, wound healing is a very complex process with current treatments requiring long cycles, being poorly effective, and bringing high economic burden to patients. An increasing number of studies have shown that non-coding RNAs (ncRNAs) play important roles in wound healing process. The competing endogenous RNAs (ceRNAs) hypothesis in recent years is a new proposal on the inter-regulation of RNAs, which suggests a "mode of communication" between different RNAs. ceRNA regulatory network (ceRNET) combines the functions of protein-coding mRNA with ncRNA (e.g., microRNA, long non-coding RNA, pseudogenes, and circular RNA). Recent studies have shown that ceRNAs play important roles in wound healing, which may provide new effective therapeutic targets for wound healing. This paper starting with ceRNET systematically reviewed the research progress on the effects of various ceRNAs in wound healing and the future research challenges, with the aim to deeply explore the molecular mechanisms and clinical significance of ceRNAs in the process of wound healing.

Reconstruction of upper lip defect / 中华整形外科杂志

<p><b>OBJECTIVE</b>To summarize the clinical experience for the reconstruction of upper lip defects in different degrees.</p><p><b>METHODS</b>Different treatment methods were selected to reconstruct the upper lip defects according to the subunit, size or location of defects on the upper lip. The therapeutic results were analyzed and compared.</p><p><b>RESULTS</b>From Jan. 1998 to Apr. 2012, 243 cases with upper lip defects were treated, including 85 cases of traumatic defects, 110 cases of defects secondary to lip cleft and 48 cases of defects after tumor resection. 48 cases were treated with direct closure, 69 cases with cross-lip flaps, 5 Cases with orbicularis oris muscle flaps, 53 cases with unilateral labial flaps, 42 cases with bilateral labial flaps, 22 cases with lower lip flaps, and 1 case with forehead flap, 1 case with forearm flap and 2 with nasolabial fold flaps. The patients were followed up for 3-18 months with satisfactory results.</p><p><b>CONCLUSIONS</b>Satisfactory results could be achieved for upper lip defects with appropriate treatment methods according to the defects degree and characters.</p>

Repair of wound on hand or foot due to electrical burn using free lateral upper arm perforator flap / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe the effect of free lateral upper arm perforator flap in repairing wound on hand or foot due to electrical burn.</p><p><b>METHODS</b>Six patients with full-thickness wounds on hand or foot resulting from electrical burn were hospitalized from June 2010 to June 2013. The wounds ranged from 6.0 cm ×4.0 cm to 8.5 cm×7.5 cm in area. Free lateral upper arm perforator flaps were used to repair these defects, with flap area ranging from 9 cm ×4 cm to 12 cm × 9 cm. The donor sites in five cases were closed by suturing; the other one donor site was closed by transplantation of full-thickness skin from abdomen.</p><p><b>RESULTS</b>One flap used to repair the wound in middle finger failed due to failure of venous return, and it was repaired with full-thickness skin harvested from abdomen after dressing change. The other five flaps survived resulting in good elasticity and matched appearance of the recipient area without obvious bulkiness. Patients were followed up for 6 to 24 months. The function of the injured hands or feet recovered well, and the results of function evaluation of five hands were excellent in 2 cases, good in 2 cases, and poor in 1 case. Little scar formation with no contraction or function impairment was observed on donor site, and the result was satisfactory.</p><p><b>CONCLUSIONS</b>Free lateral upper arm perforator flap, with long vessel and less adipose tissue, is suitable for repairing small but deep wound on hand or foot due to electrical burn.</p>

Anatomic basis of the accompanying pattern of the superficial temporal arterial branches and veins and its clinical application / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the course of branches of the superficial temporal artery (BSTA) and the accompanying pattern of their veins in order to provide anatomic basis for flap design.</p><p><b>METHODS</b>Head and facial part of ten adult corpses (19 sides) were dissected and photographed. The coordinate system was set up with external auditory foramen as the point of origin, aided by the graph analysis software Digimizer. The course of the frontal branch and parietal branch of the superficial temporal artery (STA), and the accompanying pattern between the BSTA and the veins were measured and analyzed. The STA and its branches were located by Ultrasonic Doppler, and the corresponding branches of the superficial temporal vein (BSTV) were disclosed by bowing patient's head with breath holding or cerclaging the basement of the patient's skull. And then 10 sides of transposition (fascia) flaps with axis at the angular bisector between BSTA and BSTV were devised to repair wounds of 9 patients that hospitalized from February 2008 to December 2009. Data were processed with test of variance homogeneity.</p><p><b>RESULTS</b>Frontal BSTV absence was found in 6 head sides, and the maximum distance between artery and vein was (2.1 ± 1.2) cm. Parietal BSTV absence was found in 3 head sides, and the maximum distance was (1.4 ± 0.7) cm. The distance between frontal BSTA and BSTV was larger than that between parietal BSTA and BSTV, and the dispersion degree of the former was higher than that of the latter (F = 0.0404, P = 0.0475). All the (fascia) flaps survived without congestion or necrosis.</p><p><b>CONCLUSIONS</b>When branch of the superficial temporal vessel was selected as the axial vessel of flap, the flap design shall depend on the accompanying pattern of BSTV to avoid the flap necrosis due to poor venous return after surgery. The superficial temporal vein and its branches can be well disclosed by bowing head or cerclaging skull. The approach is simple, useful, safe, and reliable.</p>

Repair of nose and adjacent tissue defect deformities after burn / 中华烧伤杂志

<p><b>OBJECTIVE</b>To look for the best method of repairing nose and adjacent tissue defect after burn and observe the effect.</p><p><b>METHODS</b>Twelve patients with post-burn nose and adjacent tissue defect deformities hospitalized from January 1999 to December 2008 were repaired with expanded forehead flap, pedicled upper-arm flap, axial post-auricular reversed flow island flap, and nasolabial groove flap. Among them, 4 cases with total nasal defect, 8 cases with partial nasal defect; and 3 cases were accompanied with scars on cheek, 5 cases accompanied with scars on forehead, 5 cases accompanied with upper lip ectropion and subtotal upper lip defect. The skin flap size ranged from 3.0 cm x 1.5 cm to 10.0 cm x 8.0 cm.</p><p><b>RESULTS</b>Five cases were repaired with expanded forehead flap, 3 cases with pedicled upper-arm flap, 1 case with axial post-auricular reversed flow island flap, and 3 cases with nasolabial groove flap respectively. All the 12 flaps survived. Patients were followed up for 1 to 7 years, and nasal function and appearance were obviously improved.</p><p><b>CONCLUSIONS</b>Optimal repairing method shall be chosen to repair nasal defect after burn according to its extent, and forehead flap is preferred. Pedicled upper-arm flap and reversed flow axial post-auricular island flap can be employed if local flap and ortho-position skin flap are unavailable when obvious scar is present on face as a result of severe burn.</p>

Application of latissimus dorsi flap in different forms in repair of skin and soft tissue defects in lower extremities / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore repair methods of skin and soft tissue defects in lower extremities with free latissimus dorsi flaps.</p><p><b>METHODS</b>Forty-two patients with wounds and soft tissue defects in lower extremities, including 4 cases on knee, 22 cases on leg, 15 cases on ankle and foot, 1 case with extensive avulsion from knee to dorsum of foot, were hospitalized in our unit from February 1996 to February 2008. Wounds or soft tissue defects were respectively repaired with latissimus dorsi musculocutaneous flaps, latissimus dorsi muscle flaps, latissimus dorsi perforator flaps with preserved vascular sleeves, 2 double-leaf segmental latissimus dorsi compound flaps after debridement. The flaps ranged from 18 cm x 8 cm to 40 cm x 18 cm in size. The donor sites were covered by skin grafting in 19 cases.</p><p><b>RESULTS</b>All wounds were healed primarily except vascular crisis occurred in 3 cases, partial necrosis of skin at donor site in 2 cases, and graft site (1 case). Follow-up for 3 to 24 months of 31 patients showed: six cases received two-stage plastic operation on account of bulkiness with trouble in wearing shoes, and mild contraction of muscular flap in 3 cases.</p><p><b>CONCLUSIONS</b>Latissimus dorsi flap in various forms can be satisfactory for repair of large skin and soft tissue defects in lower extremities.</p>

Proteomic change in lymphocytes of scalded rabbits caused by Staphylococcus aureus invasion / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the proteomic change in lymphocytes of rabbits with scald injury and Staphylococcus aureus (SA) invasion.</p><p><b>METHODS</b>Twenty-four rabbits were divided into four groups as follows: control group, scald group, scald with SA invasion 2 hs group, and scald with SA invasion 6 hs group, according to random number table, with 6 rabbits in each group. Except for rabbits in control group (sham scald at 37 degrees C), rabbits in the other 3 groups were subjected to 30% TBSA full-thickness scald. Rabbits in SA invasion 2 and 6 hs groups were injected with 2 mL (1.0 x 10(8) CFU/mL) SA suspension, which was in the log growth phase, via auricle vein 18 hs and 22 hs after injury. Whole blood samples were collected from carotid artery of rabbits in 4 groups 24 hs after scald. Lymphocytes were isolated and its extracted proteins were analyzed by two-dimensional gel electrophoresis coupled with mass spectroscopy.</p><p><b>RESULTS</b>About 1030 protein spots of lymphocytes were detected in each group. Compared with that of control group, 19 protein spots were found to be differentially expressed in the other 3 groups, and 11 spots (10 proteins) were identified. Expression levels of cofilin, cyclophilin A, ubiquitin, nucleoside diphosphate kinase, glutamate dehydrogenase and annexin 1 were down-regulated, but expression level of peroxiredoxin was up-regulated obviously.</p><p><b>CONCLUSIONS</b>There is obvious proteomic change in lymphocytes of scalded rabbits or of scalded rabbits invaded by SA, and it may relate to immune suppression and sepsis after injury.</p>

Repair of claw hand deformity after burn / 中华烧伤杂志

<p><b>OBJECTIVE</b>To summarize methods for repair of claw hand deformity after burn.</p><p><b>METHODS</b>Ninety-seven patients with 136 claw hands after burn hospitalized from May 1992 to May 2007 were repaired with skin grafting (104 hands) and transposition of skin flap (32 hands), among which 21 hands were minor-grade, 92 hands moderate, 23 hands severe. The metacarpophalangeal joint was repaired after scar release in dorsum of hand with manual extraction reduction, release of collateral ligament and joint capsula, separation of adhesion in joint, tendon lengthening for obvious contracture. Restitution of finger flexion deformity, lysis of adhesion and grafting among first web and finger webs, repair of central slip extensor tendon or phalangeal arthrodesis were performed according to the abnormal condition after lysis of dorsal scar of hand. The metacarpophalangeal joint from 31 patients were not repaired with above methods for severe finger flexion deformity, their palmar scar were loosened and transplanted firstly, then scar in dorsum of hand were loosened, metacarpophalangeal joint were repaired, flap or skin were transferred or transplanted. General rehabilitation were performed routinely after operation.</p><p><b>RESULTS</b>The ending of flaps (4 hands) due to the scar were necrosis after transposition and healed through dressing change, other skins or flaps all survived. Most articular deformities were corrected completely or basically. Functions including palmar opposition, grasp were also recovered with satisfactory results.</p><p><b>CONCLUSION</b>Skin transplantation and transferring of skin flap with overall planning and individual isatin are the key points for repair of claw hand after burn.</p>

Repair of large defects in upper extremities with pedicled combined flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the flap transposition for repairing large defects in upper extremities.</p><p><b>METHODS</b>12 cases with large defects in elbow, forearm, wrist or palm caused by high-voltage electricity, hot-pressure or crush, were treated. 4 cases were treated with latissimus dorsal myocutaneous flaps combined iliolumbar flaps. 2 cases were treated with latissimus dorsal myocutaneous flaps combined lateral thoracic flaps. 6 cases were treated with large combined thoracic-abdomen flaps.</p><p><b>RESULTS</b>All the flaps survived except for one flap with 2 cm distal necrosis and sub-flap infection. Satisfactory results were achieved.</p><p><b>CONCLUSIONS</b>Early debridement and reconstruction with pedicled combined flaps are feasible and reliable for large defects in the upper extremities.</p>

Expression of myeloid cell triggering receptor-1 in monocytes at early post-burn stage / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the expression of triggering receptor expressed on myeloid cells (TREM-1) in monocytes of burn patients at early post-burn stage, and its significance.</p><p><b>METHODS</b>The monocytes of 8 healthy volunteers (A group), 29 patients with mild and moderate burn (B group), and 9 patients with severe and very serious burns (C group) were isolated from the blood, and the THEM-1 mRNA and protein expression were determined by semi-quantitative RT-PCR and flow cytometry, respectively. The plasma levels of TNF-alpha, IL-1beta were determined by ELISA method.</p><p><b>RESULTS</b>The value of TREM-1 mRNA expression in A, B and C groups were 0.74 +/- 0.13, 1.24 +/- 0.09, and 1.46 +/-0.07, respectively, and the expression rates on cell surface in the 3 groups were (9 +/- 4)%, (51 +/- 6)%, and (71 +/- 7)%, respectively, and there were significant differences among the three groups (P = 0.000). the plasma levels of TNF-alpha and IL-1beta in B and C groups were obviously higher than that in A group (P = 0.000), and they were positively correlated to TREM-1 expression (rs = 0.68, 0.72, P = 0.000).</p><p><b>CONCLUSION</b>Increased expression of TREM-1 in monocytes of burn patients at early post-burn stage is correlated with the release of inflammatory factors, indicating that TREM-1 might contribute to the onset and development of acute inflammatory response after burns.</p>

Inhibitory effect of epidermal growth factor on apoptosis in HaCaT keratinocytes induced by TNF-alpha / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore the effect of epidermal growth factor (EGF) on apoptosis induced by TNF-alpha and the expression of PPARbeta in HaCaT keratinocytes.</p><p><b>METHODS</b>HaCaT keratinocytes were cultured and randomly divided into A (normal control), B (with treatment of 10 ng/ml TNF-alpha for 24 hours), C (with treatment of 20 ng/ml TNF-alpha for 24 hours), D (with treatment of 10 ng/ml TNF-alpha after 20 ng/ml EGF treatment for 4 hours), E (with treatment of 20 ng/ml TNF-alpha after 20 ng/ml EGF treatment for 4 hours) groups. The apoptosis of HaCaT keratinocytes was observed by flow cytometry. The proliferative activity of HaCaT keratinocytes was evaluated by MTT method. The activity of caspase-3 was analyzed with caspase colorimetric assay Kit. The changes in the mRNA and protein expression of PPARbeta in HaCaT keratinocytes were observed by RT-PCR and western-blotting after treatment with different concentrations (5, 10, 20, 40 ng/ml) of EGF for 4 or 24 hrs.</p><p><b>RESULTS</b>Compared with A and B groups [(32 +/- 6)%, (57 +/- 6)%], the apoptosis of HaCaT keratinocytes in D and E groups were significantly increased [(20 +/- 3)%, (28 +/- 4)%, respectively, P < 0.01], while the survival rate of HaCaT keratinocytes in D and E groups increased, and the caspase-3 activity were decreased (P < 0.01). The expression of PPARbeta mRNA and protein in HaCaT keratinocytes reached the peak with the treatment of 20 ng/ml EGF.</p><p><b>CONCLUSION</b>EGF can inhibit the apoptosis of HaCaT keratinocytes induced by TNF-alpha, and it can also increase the expression of PPARbeta.</p>

The influence of succinic acid on the apoptosis of polymorphonuclear neutrophil in peripheral blood / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the influence of succinic acid on the apoptosis of polymorphonuclear neutrophil (PMN) in human peripheral blood, and to explore its role in infection.</p><p><b>METHODS</b>PMNs were incubated in vitro, and its concentration was adjusted to 5 x 10(6)/mL. Then the cells were divided into normal control group and 5,10, 20, 30 mmol/L succinic acid groups according to different concentrations of succinic acid added into the medium. The supernatant of the cultures in each groups were collected to determine the superoxide content. 1 mL cell suspension was collected from 5, 20 mmol/L succinic acid groups before treatment and at 2, 4, 6, 8, 10 post-treatment hours (PTH) for the determination of caspase-3 activity and the apoptosis rate.</p><p><b>RESULTS</b>The content of superoxide in 5, 10, 20, 30 mmol/L succinic acid groups (0.437 +/- 0.056, 0.432 +/- 0.024, 0.395 +/- 0.049, 0.386 +/- 0.010) was significantly lower than that in control group (0.505 +/- 0.028, P < 0.05). The caspase-3 activity in each group increased along with the incubation time, but was in lower concentration in 5 mmol/L succinic acid group and in higher concentration in 20 mmol/L succinic acid group when compared with that in control group (P < 0.05). The apoptosis rate of PMN in control group was (6.1 +/- 1.1)% before incubation, and it reached (13.2 +/- 2.0)% at 2 PTH, and (27.7 +/- 3.7)% at 10 PTH. The apoptosis rate of PMN in 5 mmol/L succinic acid group was lower than that in control group except that at 4 PTH (P < 0.05). On the other hand, the apoptosis rate in 20 mmol/L succinic acid group (during 4-10 PTH) were obviously higher at each time points compared with the control group (P < 0.05).</p><p><b>CONCLUSION</b>Low concentration of succinic acid can suppress the apoptosis of PMN, while high concentration of succinic acid has an opposite effect. It is known that bacteria can produce succinic acid.</p>

Effect of dexamethasone on spontaneously apoptosis of polymorphonuclear neutrophils from postburn rabbits / 中国医学科学院学报

<p><b>OBJECTIVE</b>To study the effect of dexamethasone on spontaneously apoptosis, bcl-2, and neuclear facor kappa (NFkappaB) expressions of polymorphonuclear neutrophil (PMN) from postburn rabbits.</p><p><b>METHODS</b>PMN were isolated from 8 rabbits on 24 postburn hours and cultured with normal serum (NS), burn serum (BS), normal serum plus dexamethasone (ND), and burn serum plus dexamethasone (BD) for 24 hours, respectively. The quantification of apoptosis was analyzed by acridine orange + ethidium bromide fluorescent staining and flow cytometry , and the contents of bcl-2 and NFkappaB protein detected by immunohistochemical method.</p><p><b>RESULTS</b>In the BS group, the percentage of apoptotic PMN decreased (compared with NS group, 6.18 +/- 0.96 vs. 21.77 +/- 2.32, P<0.05), and the contents of bcl-2 and NFkappaB protein increased (compared with NS group, 83.27 +/- 5.45 vs. 49.95 +/- 2.67, P<0.05). When compared with BS group, the apoptotic percentage of BD group increased (12.67 +/- 0.71 vs. 6.18 +/- 0.96, P<0.05), and the content of NFkappaB protein reduced (0. 1031 +/- 0.0154 vs. 0.1802 +/- 0.0130, P<0.05), but no significant difference between ND and NS group was found.</p><p><b>CONCLUSION</b>Dexamethasone decreases the inhibition of PMN apoptosis by bumn serum, which may be associated with the down-regulation of NFKB expression.</p>

Effect of antisense oligonucleotide against Smac/DIABLO on inhibition of hydrogen peroxide induced myocardial apoptosis of neonatal rats / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the effects of antisense phosphorothioate oligonucleotides against Smac/DIABLO (asODN) on hydrogen peroxide (H2O2) induced myocardial apoptosis in neonatal rats.</p><p><b>METHODS</b>Primary myocardial cells from neonatal rats were cultured in vitro, and randomly divided into A (normal control, without transfection), B (with treatment of single liposome), C (with transfection of scrODN), D (with transfection of asODN), E (with H2O2, stimulation), F (with H2O2 stimulation after scrODN transfection), and G (with H2O2 stimulation after asODN transfection) groups. The expression of asODN mRNA and protein were determined with RT-PCR and Western blotting, respectively. The changes in cellular nuclear morphology were observed with 33258 fluorescent staining, and the percentage of nuclear apoptosis was calculated. DNA fragmentation was observed by agarose gel electrophoresis. Activation of caspase-3 and caspase-9 were evaluated by caspase colorimetric analysis kit.</p><p><b>RESULTS</b>The expression of Smac/DIABLO mRNA and protein was obviously inhibited by asODN, which was about 80% percent lower than the protein level in A,B and C groups, but there was no difference noted among A,B and C groups( P > 0.05). Not only the nuclear apoptotic percentage, but also the activity of caspase-3 and caspase-9 in A, C and D groups were in very low levels. But these indices in G group 24 hours after H2O2 stimulation were obviously lower than that in E and F groups [the nuclear apoptotic percentage were (19 +/- 5) %, (52 +/- 3) %, (55 +/- 5) %, respectively, P < 0.01)]. The DNA ladders in G group were also decreased markedly.</p><p><b>CONCLUSION</b>Myocardial apoptosis induced by H2O2 can be inhibited by asODN in rat.</p>

The use of composite sodium lactate and sorbitol composition in fluid resuscitation for shock in patients with major burn / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of the use of sodium lactate and sorbitol (CISS) in the fluid resuscitation for shock in patients with major burns.</p><p><b>METHODS</b>Fifty - three adult patients with major burns (hospitalized within 6 hours after burns) were randomly divided into A (n = 24, with i.v. infusion of 50 g/L CISS, 2 000 ml per day) and B (n = 29, with i. v. infusion of 50 g/L glucose, 2 000 ml per day) groups. The amount of electrolytes and colloid as the main resuscitation fluids was calculated according to the formula in both groups. Meanwhile, additional electrolytes and insulin were supplemented to the patients in the B group. The result of combating shock, energy supply, and side effects in the two groups were observed. The changes in hepatic and renal function, and the changes in electrolytes were monitored. The amount of fluid supplementation and urinary volume were recorded. The level of blood glucose of each patient was determined at the admission time and 24, 48, and 72 hours after injury.</p><p><b>RESULTS</b>No obvious difference was found in control of shock and energy supply between A and B group. There was no side effects or damage to hepatic and renal function related to infused fluids in A group. But the patients of the B group required supplementation of exra electrolytes and insulin during the fluid resuscitation period in order to maintain the normal levels of electrolytes and blood glucose, and this was not necessary in group A. The diuretic effect in group A was better than that in group B (average urinary volume in the first two 24 hours: group A: 1.9 +/- 0.6 and 3.3 +/- 0.8 L; group B:1.0 +/- 0.5 and 2.3 +/- 0.8 L).</p><p><b>CONCLUSION</b>The use of CISS during shock stage of the patients with major burns could be beneficial to the replenishment of blood volume, control of shock, promotion of diuresis and subsidence of edema. It could also provide electrolytes and energy, without the influence on the level of blood glucose.</p>

Long-term result of repair of deeply burned hands with large sheet of split-thickness autoskin grafting with the preservation of denatured dermis / 中华烧伤杂志

<p><b>OBJECTIVE</b>To evaluate the long-term results of repair of burn hands with large sheet of split-thickness autoskin grafting with the preservation of denatured dermis.</p><p><b>METHODS</b>One hundred and fifty-two hands in 86 burn patients with deep partial thickness and full thickness burn were enrolled in the study. The burned hands were treated by tangential excision and grafted with large sheet of split-thickness autoskin with the preservation of denatured dermis. The patients were followed-up from 3 months to 3 years. The skin color, elasticity, degree of contracture and the functional grading of the operated hands were observed.</p><p><b>RESULTS</b>Good function was found in one hundred and forty-one out of the 152 burn hands (92.8%). For the rest 11 hands, pigmentation was found in 4, poor appearance in 4, and 3 hands with both poor appearance and function.</p><p><b>CONCLUSION</b>Large sheet of split-thickness autoskin grafting with the preservation of denatured dermis could be an optimal choice for the management of hands with deep partial thickness burn, and it could restore the appearance and function of the hands satisfactorily.</p>

Repair of the penial injury in patients inflicted by high-voltage electrical injury / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore the repair and reconstruction of penial defect in patients inflicted by high-voltage electrical injury.</p><p><b>METHODS</b>Among one hundred and fifty three patients inflicted with high-voltage electrical injury, 6 suffered from penial injury (including 3 with necrosis of whole penis, 1 with partial necrosis of penis, 1 with partial necrosis of penial shin and 1 with necrosis of entire skin of penis) were enrolled in the study. The penis was repaired by direct suture of the residual skin following excision of necrotic skin in one case, by skin grafting in two case, by scrotum skin flap transplantation in 3 cases.</p><p><b>RESULTS</b>The appearance and function of the penis in three cases were satisfactory, and the result was also satisfactory in one patient who underwent reconstructive operation at late post injury stage. The penis was totally lost in 2 patients.</p><p><b>CONCLUSION</b>The skin necrosis of penis after high-voltage injury could be repaired with scrotum skin flap. Total necrosis of the penis could be reconstructed with abdominal skin flap.</p>

Experimental study on the induction of endothelial apoptosis by burn serum and subeschar tissue fluid / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore the molecular mechanism of apoptosis of the human umbilical vein endothelial cells (HUVECs) induced by burn serum and subeschar tissue fluid.</p><p><b>METHODS</b>In vitro cultured HUVECs were randomly divided into A (treated by normal serum, n = 6), B (treated by burn serum, n = 6) and C (treated by subeschar tissue fluid, n = 6) groups. The change in cellular nuclear morphology was determined by Hochst 33258 fluorescent staining, and the apoptotic rate was calculated at 24th and 36th post treatment hours (PTHs). The DNA ladder strips were observed with agarose electrophoresis at 12th and 24th PTH. The activity of caspase-3, 8, 9 was assayed by caspase colorimetric assay kit at 12 PTH.</p><p><b>RESULTS</b>It was found that nuclei appeared to be condensed and highly fluorescent granular in form in B and C groups. The nucleic apoptotic rate in B and C groups was (38.9 +/- 7.3)% and (49.5 +/- 6.5)%, respectively, which was evidently higher than that in A group (P < 0.01). The DNA ladder strips could be found by agarose electrophoresis in B and C groups. The activity of caspase-3, 8, 9 in B and C groups was significantly higher than that in A group after 12 PTHs (P < 0.01).</p><p><b>CONCLUSION</b>Burn serum and subeschar tissue fluid might induce apoptosis of HUVEC by means of the activation of death receptor and mitochondrial signal pathways simultaneously.</p>