Free Flow-through Anterolateral Thigh Flaps for Wrist High-tension Electrical Burns: A Retrospective Case Series / 生物医学与环境科学（英文）

Objective@#The objective of this report was to demonstrate the clinical application of free flow-through anterolateral thigh flaps for the treatment of high-tension electrical wrist burns.@*Methods@#We collected the data of 8 patients with high-tension electrical wrist burns admitted to Beijing Jishuitan Hospital from January 2014 to December 2018. The clinical and pathological data were extracted from electronic hospital medical records. We obtained follow-up information through clinic visits.@*Results@#The injury sites for all 8 patients were the wrists, specifically 5 right and 3 left wrists, all of which were on the flexor side. Five patients had ulnar artery embolism necrosis and patency, with injury to the radial artery. Two patients had ulnar and radial arterial embolization and necrosis. The last patient had ulnar arterial embolization and necrosis with a normal radial artery. After debridement, the wound area ranged from 12 cm × 9 cm to 25 cm × 16 cm. The diagnoses for the eight patients were type II to type III high-tension electrical wrist burns. Free flow-through anterolateral thigh flaps (combined with great saphenous vein transplantation if necessary) were used to repair the wounds. The prognosis for all patients was good after six months to one year of follow-up.@*Conclusion@#Treating wrist types II and III high-tension electrical burns is still challenging in clinical practice. The use of free flow-through anterolateral thigh flaps (combined with great saphenous vein transplantation if necessary) to repair the wound and to restore the blood supply for the hand at the same time is a good choice for treating severe wrist electrical burns.

Effect of Modified Shoutaiwan on Recurrent Abortion Due to Prethrombotic Status and Effect on Coagulation Factors / 中国实验方剂学杂志

Objective::To observe the efficacy of modified Shoutaiwan on recurrent abortion due to prethrombotic status with kidney deficiency and blood stasis and investigate its effect on coagulation factors. Method::The 100 cases were randomly divided into control group and observation group, 50 cases in each group. Bushen Yangxue capsule + enoxaparin sodium were given in control group, while modified Shoutaiwan + enoxaparin sodium were given in observation group, with a treatment course of 60 d in both groups. The serum clotting factor activated protein S (PS), activated protein C (PC), platelet aggregation function (PAF), platelet aggregation rate (PagT), antithrombin (AT), lupus anticoagulant material positive positive predictive value (LA), anti cardiolipin antibody positive rate of positive predictive value (ACA), plasminogen activator inhibitor-1(PAI-1), tissue factor (TF), fibrinogen (Fig), fibrinogen (FIB), fibrinogen alpha granule membrane glycoprotein-140 (GMP-140), fibrinogen fragment (F1+ 2), tissue fibrinogen activation factor (t-PA), D-dimer (D-D), activated partial thromboplastin time (APTT), prothrombin time (PT), and thrombin time (TT) were observed. Clinical efficacy, pregnancy rate, traditional Chinese medicine(TCM) syndromes and adverse reactions were compared between the two groups. Result::4 cases withdrew from the study. The total effective rate in observation group was 97.9% (48/49), higher than 85.1% (40/47) in control group (χ2=5.713, P<0.05). The pregnancy rate in observation group was 89.8% (44/49), higher than 70.2% (33/47) in control group (χ2=6.351, P<0.05). The score of traditional Chinese medicine syndromes in observation group was lower than that in control group. The indexes of PS, PC, AT, TF, Fig, FPA, APTT and TT in observation group were significantly higher than those in control group (P<0.05), while PAF, PagT, LA, ACA, PAI-1, PAP, TAT, FIB, GMP-140, F1+ 2, t-PA, D-D and PT were lower than those in control group (P<0.05). The incidence of adverse reactions in observation group was 10.2% (5/49), lower than 35.4% (17/48) in control group (P<0.05). Conclusion::Modified Shoutaiwan can effectively improve the clinical symptoms of recurrent abortion due to prethrombotic status and improve the coagulation factors in patients with kidney deficiency and blood stasis.

A case report on pneumonia and pleural effusion resulted from brucellosis / 中国职业医学

OBJECTIVE: To investigate the clinical manifestations,chest imaging characteristics and treatment method of pneumonia and pleural effusion resulted from brucellosis. METHODS: The clinical data of a patient who suffered from pneumonia and pleural effusion resulted from brucellosis was collected and analyzed. RESULTS: The patient suffered from pneumonia and pleural effusion because of inhalation of aerosols containing brucella when handling apoblema of sick pigs.The main clinical manifestations included fever,chills,mild cough,mild sputum production,combined with chest congestion and shortness of breath. Chest imaging features were multiple patchy infiltrating shadows and nodules on the right lung combined with right side pleural effusion. Serum rose-bengal plate test was positive, and standard-tube agglutination test resulted in titres of 1 ∶ 200. After combination treatment using oral doxycycline plus rifampicin and intravenous ceftriaxone,the clinical symptom of the patient was relieved,chest patch shadows and pleural effusion were improved. CONCLUSION: Brucellosis with pulmonary involvement is rarely seen. Its clinical manifestations are diverse and non-specific. Pulmonary brucellosis could be easily misdiagnosed as common bacterial pneumonia or tuberculosis.Epidemiological data and occupational exposure history can help the diagnosis.

Mathematical modeling for selecting center locations for medical and health supplies reserve in Hainan Province

OBJECTIVE@#To explore how to choose the center locations to build the medical and health supplies reserve among many island towns.@*METHODS@#The center locations were selected from 18 towns Hainan Province, it's maximum service range (distance) was required to reach the minimum, or to minimize.@*RESULTS@#Three scenarios were considered, the center locations included only one town, two towns, three towns. By the use of graph theory and MATLAB programming, a mathematical model was established to obtain the shortest distance and the shortest path between arbitrary two towns.@*CONCLUSIONS@#We find out the center sites under certain conditions, and determine the specific service ranges of the center sites.

Treatment of osteomyelitis and soft tissue defects at distal region of leg and foot by pedicled peroneus brevis muscle flaps and reverse island flaps with sural nerve and blood supplying vessels / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe the clinical effect of distally pedicled peroneus brevis muscle flaps and reverse island flaps with sural nerve and blood supplying vessels on repairing osteomyelitis and soft tissue defects at distal region of leg and foot.</p><p><b>METHODS</b>Twelve patients with osteomyelitis and soft tissue defects at distal region of leg and foot hospitalized from March 2008 to December 2010. Among them, 7 patients suffered from acute or chronic osteomyelitis and soft tissue defects at the distal end of tibia, 1 patient suffered from chronic osteomyelitis and chronic ulcer in the posterior aspect of achilles tendon, 4 patients suffered from acute or chronic osteomyelitis, soft tissue defects, and exposure of internal fixator in the lateral aspect of calcaneus. After debridement, soft tissue defect sizes ranged from 4 cm×2 cm to 13 cm×9 cm, and bone defect sizes ranged from 3.0 cm×3.0 cm×3.0 cm to 6.0 cm×3.0 cm×4.0 cm. The distally pedicled peroneus brevis muscle flaps with size ranging from 11 cm×3 cm to 16 cm×4 cm were used to fill the wound cavities of bone defects, and reverse island flaps with sural nerve and blood supplying vessels with size ranging from 5 cm×3 cm to 14 cm×10 cm were used for the repair of soft tissue defects. Flap donor sites were closed by direct suture or skin grafting.</p><p><b>RESULTS</b>Muscle flaps and flaps survived in 11 cases, and the wounds healed well. Necrosis appeared in flap and muscle flap at the distal end in one patient, which was repaired with posterior tibial artery perforator myocutaneous flap. Patients were followed up for 6 to 24 months. Osteomyelitis did not recur, and both the texture and shape of flaps were satisfactory.</p><p><b>CONCLUSIONS</b>The distally pedicled peroneus brevis muscle flaps and reverse island flaps with sural nerve and blood supplying vessels are suitable for the repair of osteomyelitis and soft tissue defects at distal region of leg and foot. The operation is simple, safe, reliable, and easy to perform.</p>

Effect of a combination of local flap and sequential compression-distraction osteogenesis in the reconstruction of post-traumatic tibial bone and soft tissue defects / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Treatment of extensive post-traumatic composite bone and soft tissue defects remains a complicated therapeutic problem and a challenge for surgeons. We investigated the application of local flaps and Ilizarov osteogenesis in the reestablishment of severe combined defects of tibial bone and soft tissue.</p><p><b>METHODS</b>Sixteen patients with bone and soft tissue defects were included. The mean age of the patients was 31.5 years. The average time from injury to initial surgery was 14.4 weeks. The average soft tissue and bone defect sizes were 92.9 cm(2) and 8.7 cm, respectively. Local flaps were created to reconstruct the soft tissue defects. The Ilizarov external fixator or the Orthofix Limb Reconstruction System was used to reconstruct bony defects using delayed distraction osteogenesis.</p><p><b>RESULTS</b>Two myocutaneous flaps and 14 reverse island flaps were applied. All transferred flaps survived. Fifteen patients healed with equal leg length, and one healed with a residual leg-length discrepancy of 1.5 cm. One patient with an Ilizarov external fixator developed ankle joint stiffening and a pin-track infection that was successfully treated with oral antibiotics. No patient developed pin loosening. All patients walked without assistance. Fifteen patients returned to their work, and one lost her job. The results were evaluated using the Paley bone and functional assessment scores. The bone assessment results were excellent in 14 and good in two patients. Functional assessment scores were excellent in 13, good in two, and fair in one patient.</p><p><b>CONCLUSION</b>The combination of local flaps and sequential distraction osteogenesis can be used for successful reconstruction of defects of incorporated bone and soft tissue.</p>

Id2 regulates the proliferation of squamous cell carcinoma in vitro via the NF-κB/Cyclin D1 pathway / 癌症

Squamous cell carcinoma(SCC) is a significant cause of cancer morbidity and mortality worldwide, with an incidence of up to 166 cases per 100 000 population. It arises in the skin, upper aerodigestive tract, lung, and cervix and affects more than 200 000 Americans each year. We report here that a microarray experiment comparing 41 SCC and 13 normal tissue specimens showed that Id2, a gene that controls the cell cycle, was significantly up-regulated in SCC. Enforced expression of Id2 in vitro stimulated the proliferation of SCC cells and up-regulated the transcription of nuclear factor kappa B (NF-κB) and cyclin D1. Enhancement of the NF-κB activity with p65 significantly increased the cell proliferation and the transcription of cyclin D1, whereas inhibition of the NF-κB activity with I kappa B alpha mutant (IκBαM) and pyrroline dithiocarbamate (PDTC) abrogated cell proliferation and transcription of cyclin D1. Furthermore, a mutated NF-κB binding site in the cyclin D1 promoter fully abrogated the Id2-induced transcription of cyclin D1. Taken together, these data indicate that Id2 induces SCC tumor growth and proliferation through the NF-κB/cyclin D1 pathway.

Repair of deep burn wound of neck with supraclavicular island flap / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe the therapeutic effect of supraclavicular island flap in repairing deep burn wound of neck.</p><p><b>METHODS</b>Six patients with deep burn of neck hospitalized from January 2009 to June 2011 were enrolled in the study. Their total burn area ranged from 6% to 22% TBSA, of which full-thickness area ranged from 3% to 22% TBSA. The neck wound ranged from 12 cm x 5 cm to 15 cm x 8 cm in area, and they were all full-thickness in depth. One of the neck wounds was covered with granulation tissue. Patients underwent either debridement and escharectomy or excision of granulation tissue for the neck wound, and they were covered with supraclavicular island flap designed with the size corresponding to that of wound area. Four donor sites were sutured directly. The other two donor sites were covered with free skin graft. Survival of flaps and healing of donor sites were observed. The appearance and function recovery of operative regions were followed up.</p><p><b>RESULTS</b>Supraclavicular island flaps of 6 patients survived as a whole. All the donor sites healed well. Flaps with satisfactory appearance and feeling sensation, accompanied by unlimited extension of neck were observed in the follow-up duration from 6 to 12 months. Scars observed in the flap edge and the donor sites were linear, and they did not affect the overall appearance and function of patients.</p><p><b>CONCLUSIONS</b>Supraclavicular island flap is a good choice for repairing deep burn wound of neck, and it gives a good shape and function recovery of the neck.</p>

Early treatment of high-voltage electric burn wound in the limbs / 中华烧伤杂志

<p><b>OBJECTIVE</b>To summarize the experience of early treatment of high-voltage electric burn wounds in the limbs.</p><p><b>METHODS</b>Fifty-four patients (50 males and 4 females, aged from 10 to 56 years) with high-voltage electric burn wounds in 97 limbs (67 upper limbs and 30 lower limbs) were hospitalized in our burn wards from January 2003 to December 2010. A total of 119 burn wounds in wrist-forearm, forearm-elbow-upper arm, shoulder-axillary region, ankle-foot, lower leg, around the knee, thigh-inguinal region were treated with incision for decompression within 10 days after burn. Under the premise of relatively stable systemic condition of the patients, certain surgical operations were performed as follows. (1) Sixteen limbs with 16 wounds were amputated, among them forearm amputation was performed for 5 upper limbs with necrosis, with preservation of elbow joints, and the residual wounds of the elbow and upper arm were repaired with pedicled latissimus dorsi musculo-cutaneous flaps; 1 upper limb with upper arm amputated, with preservation of shoulder joint, was repaired with pedicled latissimus dorsi musculo-cutaneous flap. (2) Ninety-five wounds were covered with various tissue flaps with abundant blood supply after early debridement, in which 3 brachial arteries, 1 vein, 1 brachial artery and vein were reconstructed in 5 wrist wounds, artery reconstruction was performed in elbow wound of 1 case with injured brachial artery. (3) Eight wounds were treated with free skin grafting. Wound healing conditions were observed and followed up.</p><p><b>RESULTS</b>Wounds in 16 limbs healed after amputation and repair. Blood supply and (or) venous return of hands were restored in 5 wrist wounds after vessel reconstruction. After artery reconstruction, abundant blood supply was observed in 1 case with injured brachial artery and amputation was avoided. Necrosis occurred in distal parts of tissue flaps in 5 wounds after grafting, in which 2 wounds healed after removal of necrotic tissue followed by closure with suture, and 3 wounds healed after debridement and free skin grafting. Tissue flap infection occurred in wrist (5 wounds), elbow (1 wound), ankle-foot (2 wounds), and healed after debridement and suture. The other tissue flaps survived after grafting. Six wounds healed after skin grafting. Partial necrosis occurred in 2 wounds after skin grafting, and they were healed after second skin grafting. Thirty-seven patients were followed up for 6 to 12 months, the skin flaps survived with satisfactory appearance and texture.</p><p><b>CONCLUSIONS</b>Early extensive compartment release through fasciectomies and escharectomies, early debridement, early vascular grafting, early wound coverage with contemporary reparative and reconstructive surgical techniques are rational options for the treatment of high-voltage electric burns in the limbs.</p>

Association of XPC and XPG polymorphisms with the risk of hepatocellular carcinoma / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate whether the polymorphism of DNA repair genes XPC (Ala499Val and Lys939Gln) and XPG (His1104Asp) is associated with the susceptibility to hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>A hospital-based case-control study was conducted in 500 cases with HCC and 507 controls. Genotypes of XPC and XPG were determined by real-time polymerase chain reaction with the TaqMan MGB probe.</p><p><b>RESULTS</b>Compared to the CC genotype, the CT genotype and the TT genotype of XPC Ala499Val were not associated with the susceptibility to HCC (adjusted OR = 1.34, 95% CI: 0.85-2.12; adjusted OR = 1.30, 95% CI: 0.68-2.51, respectively). Compared to the AA genotype, the AC genotype and the CC genotype of Lys939Gln were not associated with the susceptibility to HCC (adjusted OR = 1.20, 95% CI: 0.78-1.85; adjusted OR = 1.81, 95% CI: 0.88-3.73, respectively). Compared to the CC genotype, the CG genotype and the GG genotype of XPG His1104Asp were not associated with the susceptibility to HCC (adjusted OR = 0.85, 95% CI: 0.56-1.27; adjusted OR = 1.12, 95% CI: 0.67-1.87, respectively) However, the stratified analysis revealed that the females with the AC+CC genotype of XPC Lys939Gln had increased risk of HCC compared to those with AA genotype (OR = 2.17, 95% CI: 1.01-4.64).</p><p><b>CONCLUSION</b>Our results suggest that XPC and XPG polymorphisms do not independently affect on the susceptibility to HCC, but the joint effect of C allele of XPC Lys939Gln and female may modify the risk of HCC.</p>

Repair of cicatricial contracture in face and neck regions with expanded skin flap / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe the result of repairing deformity due to cicatricial contracture in face and neck regions with expanded skin flap.</p><p><b>METHODS</b>Eighty-three skin expanders with volume ranging from 100 to 600 mL were implanted into 38 patients with scars in face and neck regions after burn. The expansion time ranged from 3 to 5 months. Most expanders were implanted under normal skin. Ten expanders were implanted under stable integrated scars after healing of burn, and flaps therefrom were transplanted; 3 expanders were implanted into deep fascia layer of trapezius, and remote expanded skin flaps with deep branch of transverse cervical artery as the pedicle were formed and transplanted.</p><p><b>RESULTS</b>All flaps survived in 38 cases with satisfactory results. Complications including hematoma and infection after surgery occurred in 8 cases, but they did not affect therapeutic effect after treatment. Thirty patients were followed up for 3 to 24 months. It was found that the color and texture of skin flaps were good; appearance and function were obviously improved.</p><p><b>CONCLUSIONS</b>Expanded skin flap is the best flap for repairing cicatricial deformity in face and neck regions after burn. Expanded cicatricial skin and expanded skin of remote region are good choices when normal skin is not available nearby.</p>

Repair of tissue defect of lower leg and foot with reverse island skin flaps with sural nerve and blood supplying vessels / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe the clinical effect of reverse island skin flaps with sural nerve and blood supplying vessels on repair of tissue defect of lower leg and foot.</p><p><b>METHODS</b>Fifty-six patients with lower leg and foot tissue defects were hospitalized from June 1997 to August 2007. Among them, 10 patients suffered from soft tissue defect of lower leg; 38 patients suffered from wound infection, exposure of fracture of tibia and fibula, and osteonecrosis; 8 patients suffered from heelstick tissue defect, bone adhering scar, and osteomyelitis. The defects were repaired with sural nerve and blood vessel nourished reverse island skin flaps (46 cases) and myocutaneous flaps (10 cases). The size of flaps ranged from 5 cm x 4 cm to 22 cm x 16 cm. Flap donor sites were closed by direct suture or free skin grafting.</p><p><b>RESULTS</b>Flaps in 55 cases survived. Patients were followed up 3-6 months, there was no complication, and they were healed with satisfactory texture and appearance. The patients could walk normally, but with unsatisfactory sensory recovery. In one patient, the flap was broken and ulcerated 1 month after operation on account of leaving behind necrotic tibia. It was healed after second operation.</p><p><b>CONCLUSIONS</b>Sural nerve and blood vessel nourished reverse island skin flap or myocutaneous flap transplantation is an effective treatment for repair of soft tissue defect of lower leg and foot.</p>

Preliminary result of multi-center clinical trial on the docetaxel, 5-Fu and DDP in the treatment of advanced, recurrent or metastatic nasopharyngeal carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>This clinical study was designed to evaluate the efficacy and toxicity of the combined regimen of docetaxel, 5-Fu and DDP (TPF) in the treatment of advanced or relapsed nasopharyngeal carcinoma (NPC).</p><p><b>METHODS</b>Fifty-six patients with newly diagnosed or recurrent/metastatic NPC following chemotherapy or radiotherapy were enrolled. Both docetaxel and DDP were administered intravenously for 6 hours at the dose of 70 mg/m2 on D1. 5-Fu was given at a dose of 400-500 mg/m2 for 6 hours from D1 to D5. Dexamethasone was routinely administered before injection of docetaxel. This combination was repeated every 3 to 4 weeks, and continued for 4-6 cycles or until PD for the responders.</p><p><b>RESULTS</b>Fifty-one (91.1%) patients were evaluable for response assessment. The response rate for whole group was 72.5% (37/51) with a CR rate of 9.8% (5/51). The stable disease accounted for 17.6% (9/51). There were 17(30.4%) chemotherapy-naïve patients. The overall response rate in those was 82.4% with a CR rate of 29.4%. However, the response rate for previously treated patients was 64.7% without CR. Twelve patients had progressed disease, including 5 (8.9%) died of disease progression with a median follow-up of 11 month (ranged from 1 to 19 months). Totally, 196 courses of chemotherapy were administered. The major toxicity was myelosupression, nausea/vomiting. The incidence of leucopenia was 48% with 22.2% of these in NCI grade II or IV. But only 2 patients (3.6%) experienced leucopenia with a fever. Other mild toxicities including alopecia, asthenia, mucositis and diarrhea were also observed.</p><p><b>CONCLUSION</b>Our preliminary outcome shows docetaxel, 5-Fu and DDP combination is effective and safe for the patients with advanced or relapsed nasopharyngeal carcinoma. But further clinical study is warranted.</p>

Treatment of burn cicatricial foot drop with Ilizarov fixator / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the efficacy of Ilizarov fixator on cicatricial foot drop after burn.</p><p><b>METHODS</b>Six patients with cicatricial foot drop after burn were treated with Ilizarov fixator during June 2004 approximately October 2007, the fixator was set on the leg and foot by fixed bone needles. Nuts on the threaded rod were turned from 3 post operation day, 2 approximately 4 rounds per time and 4 times per day in the first week, then 1 approximately 2 rounds per time and 4 times a day, which corrected the deformity of talipes equinus by shortening or lengthening the thread rod in the front and at the back. Ankle joint was maintained in neutral position for 2 approximately 3 months after effective correction. Weight carrying for patients was increased gradually after removal of fixator. Ankle joint was maintained in neutral position with fixator at least three months. Patients were followed up 5 approximately 10 months.</p><p><b>RESULTS</b>Ankle joints from all patients were restored to neutral position after application with fixator for 4 approximately 6 weeks. All patients achieved 0 degrees dorsiflexion in weight carrying for whole planta pedis after use of fixator for 12 approximately 15 weeks with good locomotion function.</p><p><b>CONCLUSION</b>Ilizarov fixator is safe and mini-injury, which is an effective method for treatment of cicatricial foot drop.</p>

Mutational analysis of EGFR and K-RAS in Chinese patients with non-small cell lung cancer / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate gene mutations of the epidermal growth factor receptor (EGFR) and K-RAS in Chinese non-small cell lung cancers (NSCLCs).</p><p><b>METHODS</b>Mutations of exons 18, 19 and 21 of the EGFR and codons 12, 13 of the K-RAS in 101 NSCLCs were detected by PCR-amplifying and gene sequencing, and the relationship between mutations and clinical characters of NSCLCs and response to gefitinib were analyzed.</p><p><b>RESULTS</b>Overall, 26 EGFR mutations (25.7%), 3 K-RAS mutations (2.9%) were detected, and EGFR mutation frequencies in adenocarcinomas, nonsmoker and female were found to be high (44.2%, 65.7% and 48.3% respectively). Nine out of 10 gefitinib treated patients with disease control was found with EGFR mutation.</p><p><b>CONCLUSION</b>The data suggest that mutation frequency of EGFR in NSCLCs from Chinese patients is higher than that of western ethnicities, such mutations are well correlated with tumor response to gefitinib, and gefitinib is more fit for Chinese NSCLC patients.</p>

Evaluation of the consciousness scales in the diagnosis of the severely impaired consciousness / 中华急诊医学杂志

Objective To evaluate the commonly used consciousness scales according to longitudinal study on small-sample patients with minimally conscious state. Method Eleven patients with minimally consciousness, who were scanned using fMRI, were selected and scored by the commonly used consciousness scales in Wujing Hangzbeu Hospital. The 11 patients were classified into 2 groups according to the scores of CRS-R scale couple with the results of the fMRI study. The One-Way ANOVA method was used to analyze the inter-group difference of the commonly used consciousness scales and their subscales. Results Despite the communicative subscale of the CRS-R scales, other iterms lack of statistic significance in classification of the conscious state. Among the commonly used consciousness scales, the Wessex Head Injury Matrix (WHIM) scale presented the highest diagnostic value in consciousness state, whereas the Chinese Vegetative State Scale (CVSS) presented the lowest diagnostic value. Conclusions It indicated that the total scores of the consciousness scales and the scores of subscales of them presented poor diagnostic value in general, and big discrepancy of diagnostic value existed between the iterms of the scales by using objective tools.

Preliminary study on the improvement of wound microcirculation and retrospection on several methods of the management of deep partial thickness burn wound / 中华烧伤杂志

<p><b>OBJECTIVE</b>To analyze several methods of wound repair for deep partial thickness burn wounds retrospectively, so as to evaluate the significance of improvement of wound microcirculation on wound healing.</p><p><b>METHODS</b>(1) 2,976 burn patients admitted to our department were enrolled in the study, among them 614 undertook tangential excision, 32, eschar abrasion, 86 allo-skin coverage after debridement, 1836 tropical application of silver sulfadiazine and 408 with traditional Chinese medicine (Jing Wan Hong ointment) with gauze bandage. The results of the management with different methods were compared. (2) Rat model with deep partial thickness burn was reproduced and topical application of silver sulfadiazine was given. The rats were randomly divided into control (n = 10, with normal saline injected via caudal vein within 5 minutes postburn), and treatment (n = 10, with batroxobin injected via caudal vein within 5 minutes postburn) groups. The blood flow perfusion unit in the wound skin was measured before burn and at 0.5 to 72 postburn hours by Laser Doppler. The wound healing rate, contraction rate and wound healing time in each group were calculated on 14 and 18 postburn days (PBDs). The number of hair follicles after wound healing was observed by histological method.</p><p><b>RESULTS</b>(1) The burn wound treated by tangential excision healed within 2 to 3 post operation weeks (POWs), with the healing rate of 94.8% in patients with burn covering 50% - 70% TBSA and 93.4% in those with burn of 80% approximately 98% TBSA. The healing time of patients with allo-grafts coverage after eschar abrasion was 13.8 +/- 2.1 days without scar formation. The wound healing time was 18.0 +/- 2.3 day in 82 patients with allo-graft coverage after debridement, and it was 26.0 +/- 3.2 days with subeschar healing in 1658 patients with topical application of silver sulfadiazine. Infection in burn wound was encountered in most patients undergoing traditional Chinese medicine bandage treatment with wound healing time of 26.0 +/- 2.8 days in the lower extremities. (2) The blood flow perfusion unit of the rats in the treatment group was significantly higher than that in the control group (P < 0.01). The wound healing rate in treatment group on 14 and 18 PBD was obviously higher than that in the control group (P < 0.01). But the wound contraction rate in the two groups was similar (P > 0.05). The wound healing time in treatment group was much shorter than that in control group (P < 0.01). A few hair follicles remained in the dermis of the rats in the control group on 30 PBD, and the number was evidently smaller than that in the treatment group (P < 0.01).</p><p><b>CONCLUSION</b>Early tangential excision and eschar abrasion remained better methods in the management of deep partial thickness burn wounds, as they could ameliorate burn wound infection, shorten treatment period, raise wound healing rate and quality. Application of batroxobin could accelerate wound healing rate by improving wound microcirculation in deep partial thickness burn wound.</p>

The protective role of hyperoxic Ringer's solution on the hepatic injury in rats with burn shock / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore the dynamic postburn changes in rat hepatic function and the effects of hyperoxic Ringer's solution resuscitation on the function.</p><p><b>METHODS</b>One hundred and ninety Wistar rats of both sexes with body weight of 250 - 300 g were employed as the model and were divided into 6 groups as A, B, C, D, E and F groups as follows: normal control (A, n = 10), early resuscitation with Ringer's solution (B, n = 40), delayed resuscitation with Ringer's solution (C, n = 30), early resuscitation with hyperoxic Ringer's solution (D, n = 40), delayed hyperoxic Ringer's solution resuscitation (E, n = 30) and burn control (F, n = 40). Blood samples were drawn from the injured rats under anesthesia at 6, 12, 24 and 48 postburn hours (PBHs), and the serum contents of ALT, AST and MDA in these blood samples were determined. Hepatic tissue samples were also harvested at the same time and served histologically.</p><p><b>RESULTS</b>The plasma ALT level at 6 PBH in all groups was higher than that in A group (P < 0.05). There was significant difference of plasma ALT levels between hyperoxic Ringer's solution treatment group an other treatment groups (P < 0.05). And there was evident difference of plasma ALT levels between hyperoxic Ringer's solution treatment groups and other treatment groups (P < 0.05). The dynamic change in plasma AST was almost similar to that of ALT. The plasma MDA level was increased obviously after injury, especially in F group (highest level). Furthermore, the MDA level in C group was higher than that in B group. The plasma MDA levels in D and E groups were evidently lower than that in all other groups (P < 0.05). It was revealed by histological examination that there were different degrees of degeneration an necrosis of hepatocytes during early postburn stage, but less so in D group.</p><p><b>CONCLUSION</b>Fluid resuscitation during early postburn stage with hyperoxic Ringer's solution could inhibit the production of oxygen free radicals and blunt lipid peroxidation, and it could also enhance the host tolerance to hypoxia and prevent hepatocytes from injury, thus hepatic function was protected.</p>