TGF-β change in blister fluid of hypertrophic scar and its significance / 中华医学美学美容杂志

Objective To investigate of the tissue TGF-β changes at early stage of hypertrophic scar formation and the value of scar blisters in hypertrophic scar.Methods The TGF-β1 content in the blister fluid and the blood were quantified with ELISA,patients(n=15)with hypertrophy scar after depth burn were included,three time point(each n=5)on early　stage(<3 months)of hypertrophy scar formationwere monitored.and normal skin blister fluid and the blood(n=5)was used as control.Results The serum TGF-β1 in the both hypertrophic scar patients and normal skin group was not elevated(P>0.01),the TGF-β1 in the blister of normal skin was also not elevated(P>0.01),but TGF-β1 level in the scarblisters hypertrophic scar was elevated significantly[<60 d(158.5±69.8)pg/L,60-90 d,(181.1±40.1)pg/L,>90 d,(534.4±125.9)pg/L,P<0.01] and higher than the normal skin blister and the blood(P<15.6 pg/L.P<0.01),the increased TGF-β1 1evel in the hypertrophic scar blisters were persisted for at least three months.the TGF-β1 level of scar blister on the 3th month of hypertrophic scar formation reached a peak [(534.4±125.9)pg/L,P<0.01].Conclusions The data in this study indicates that TGF-β production at the early stage of hypertrophic scar formation is increased and may play an important role in scar formation;scar blisters is a valuable approach in hypertrophic scar study.

The effects of recombinant human growth hormone (rhGH) on the serum levels of cytokines in severely burned patients / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore the effects of recombinant human growth hormone (rhGH) on the serum levels of cytokines in severely burned patients.</p><p><b>METHODS</b>Thirty-six burn patients were enrolled in the study and were randomly divided into 3 groups according to the rhGH dosage used, i.e. small (0.3 IU.kg(-1).d(-1), A), large (0.6 IU.kg(-1).d(-1), B) dose groups and control group (C, with normal saline). The rhGH was administered beginning from 3 postburn days (PBDs) and lasted for 20 days. The dynamic changes in the serum levels of TNFalpha, IL-6, IL-8 and LPS at different time points were observed.</p><p><b>RESULTS</b>When compared with those in C group, the serum levels of TNFalpha, IL-6 in A, B groups were decreased, especially in B group with earlier decrease and bigger range (P < 0.01). Simultaneously, the serum LPS level was decreased accordingly with evident positive correlation with the change in those cytokines (r = 0.9723, P < 0.01). But there was no obvious difference in serum IL-8 level among A, B and C groups (P > 0.05).</p><p><b>CONCLUSION</b>rhGH might decrease the production of postburn inflammatory mediators, especially in higher dose in dose-dependent manner for some degree. The clinical application of rhGH might be a supplementary measure in preventing and ameliorating postburn SIRS and MODS in severely burned patients.</p>

Administration of antibiotics in the treatment of infection of burns based on bacteriological surveillance from burn wound and the analysis of bacterial resistance to antibiotics / 中国医师杂志

Objective To investigate the administration of antibiotics in the treatment of infection of burns based on bacteriological surveillance from burn wound.Methods A retrospective analysis of bacterial culture and drug-sensitivity results from burn wound and subeschar tissues in 581 patients during 1999 to 2004 was carried out.Results Eight hundred and eighty-seven strains of bacteria were isolated from burn wound and subeschar tissues in 581 patients,among which 481 strains were gram negative(54.23%),and 406 strains were gram positive(45.77%).Among the bacteria of gram negative,the most majority was Pseudomonas and then was the Enterobacteriaceae.Among the bacteria of gram positive,Staphylcoccus aureus was the majority,and MRSA accounted for 71.48% in the Staphylcoccus aureus.The resistance of Pseudomonas to Netilmicin was decreased from 20.1% to 4.9%,and the resistance of Enterobacteriaceae to Imipenem was still in a low level.All bacteria of gram positive were sensitive to Vancomycin.Conclusion The majority of the bacteria of burn infection is gram negative.The isolated bacteria show multiple resistance to antibiotic.The analysis of bacteria from burn wound and resistance of bacteria to antibiotic is very important to experiential treatment of antibiotic for burn infection.

Characteristics and Management of Fungal Infection in Severely Burn Patients / 中华医院感染学杂志

OBJECTIVE To study the characteristics and management of fungal infection in severely burn patients.METHODS The clinical data of 51 severely burn patients with fungal infection in our department from 2000 to 2004 were analyzed.RESULTS The infection rate in total 213 severely burn patients was 23.72%.Candidiasis was the most frequent type in fungal infection accounting for 93.98%.The risk factors for fungal infection were the(severity) of burn,tracheal intubations,body catheterizations,long-term use of broad-spectrum antibiotic and(hospitalization).CONCLUSIONS Development and the types of fungi in severely burn patients with fungal infection have their own characterizations and inducing factors.it is important to eluminate the susceptible factors and provide early diagnosis and treatment.