Greeting the new era: reflection on the 60 years of Chinese burn medicine / 中华烧伤杂志

As an initial member of burn medicine in China, I am lucky to participate in the activity of writing paper for the journal to celebrate the 60th anniversary of the founding of burn medicine in China. It is a chance to introduce my clinical work, laboratory study, and teaching. I review the development of burn surgery to make some points in the transformation and development of burn surgery, some suggestions for better coordination between burn surgery and critical care medicine during emergency support for mass burn casualties. Furthermore, I wish that some of the differences in opinions and experience in burn care could be studied and conformed in order to form relatively uniform opinion which might benefit the successors.

Effect of burn injury on relative anaplerosis and gluconeogenesis in rats by 13C magnetic resonance spectrum / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To introduce a safe and specific approach of (13)C magnetic resonance spectrum ((13)C MRS) spectroscopy and investigate the alterations in hepatic anabolism.</p><p><b>METHODS</b>Relative anaplerotic, pyruvate recycling and gluconeogenic fluxes were measured by (13)C MRS isotopomer analysis of blood glucose from rats with 40% body surface area burn injury, and from rats exposed to sham injury. A short chain fatty acid, [U (13)C] propionate which was avidly extracted by the liver, was infused intravenously to deliver (13)C into the citric acid cycle. Proton-decoupled (13)C MRS of deproteinized plasma or extracts of the freeze-clamped liver were used to determine the distribution of (13)C in blood or hepatic glucose.</p><p><b>RESULTS</b>There was no difference in the multiplets detected in the glucose carbon-2 anomer from blood or liver after 45 or 60 minutes of the infusion of the propionate, indicating that steady-state isotopic conditions were achieved. Gluconeogenesis relative to citric acid cycle flux was not altered by burn injury; in both sham and burn groups the rate of glucose production was about equal to flux through citrate synthase. In the sham group of animals, the rate of entry of carbon skeletons into the citric acid cycle was about 4 times than that in the burn group. Similarly, flux through pyruvate kinase (again relative to citrate synthase) was significantly increased after the burn injury.</p><p><b>CONCLUSIONS</b>Since results from analysis of the blood glucose are the same as that of the hepatic glucose, (13)C distribution in the glucose and hepatic metabolism can be assessed based on the (13)C MRS analysis of the blood glucose.</p>

Study on the intra- and extra-hepatocyte distribution of sodium ions in scalded rats during early postburn stage / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the characteristics of the intra- and extra-hepatocyte sodium ions distribution in scalded rats during early postburn stage,with the aim of improving burn shock resuscitation regime and the resuscitation effects.</p><p><b>METHODS</b>Adult Sprague-Dawley rats were randomly divided into sham scalding (C, n = 12) and scalding (S, n = 7) groups. The rats in S group were subjected to 40% TBSA III degree scalding on the back and were catheterized via jugular vein for fluid resuscitation. The rats in C group were catheterized via jugular vein without fluid infusion and were sham scalded by warm water in temperature of 37 degrees. The changes in the intra- and extra-hepatocyte sodium ion contents were determined in vivo by (23)Na-magnetic resonance spectrum technology, while the existing state of the intra- and extra-hepatocyte sodium ion was determined by detecting (23)Na-magnetic resonance horizontal delaying time (T(2)).</p><p><b>RESULTS</b>The extra-hepatocyte sodium content in S group at 24 postburn hours (PBHs) was 17% less than that in C group. In addition, the T(2f) (fast T(2)) in S group remained stable but maintained a higher ratio during the observation time. This suggested that the sodium binding sites in extra-hepatocyte matrix increased relatively and that intra-hepatocyte sodium content increased by 57%. But the T(2) and the fast and slow parts of the T(2) kept stable, which implied that intra-hepatocyte catabolizing products were increased. This led to an increase in the sodium ion binding sites within intra-hepatocyte matrix in proportion to the sodium ion content.</p><p><b>CONCLUSION</b>During early postburn stage, the extra-hepatocyte sodium in a remote organ such as the liver exhibited relative deficiency due to its ingress into hepatocyte cytoplasm and to the increase of sodium combining sites.</p>

The role of Kupffer cells on the postburn production of TNFalpha, IL-1beta and IL-6 in severely scalded rats / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe the role of Kupffer cells in the postburn production of TNFalpha, IL-1beta and IL-6 in severely scalded rats.</p><p><b>METHODS</b>(1) The production of TNFalpha, IL-1beta and IL-6 from rat Kupffer cells stimulated by burn serum was observed. (2) The postburn change in the expression of cytokine mRNA from rat Kupffer cells was monitored. (3) The change in the plasma cytokine contents in scalded rats was determined after the application of gadolinium chloride, a specific inhibitor of Kupffer cells.</p><p><b>RESULTS</b>Kupffer cells could be stimulated by burn serum to release cytokines TNFalpha, IL-1beta and IL-6. The mRNA expression of TNFalpha, IL-1beta and IL-6 from rat Kupffer cells increased significantly after injury. But the postburn plasma levels of TNFalpha, IL-1beta and IL-6 decreased obviously to 34.71%, 36.99% and 33.7% of those in scalding group, respectively, after the Kupffer cell activity was inhibited.</p><p><b>CONCLUSION</b>The plasma cytokines, i.e. TNFalpha, IL-1beta and IL-6, were primarily produced from Kupffer cells after injury in scalded rats, initiated by TNFalpha, IL-1beta and IL-6 mRNA transcription.</p>

Thermal injury induces some protooncogenes expression in wounded skin tissue / 第二军医大学学报

To study the expression of some protooncogenes in burn wounded skin tissue. Methods: The protooncogene expression was analysed by mRNA dot blot hybridization,autoradiography and densitermeter. Results: Thermal injury induced C-myc, C-myb, C-jun and C-sis mRNA expression. How-ever, those four protooncogenes showed different expression models. Expression of C-myc and C-jun in-creased at d 1, and peaked 1 and 3 d postburn, respectively. Expression of C-myb and C-sis increased 3and 5 d, and peaked 10 d after thermal injury. Conclusion: Thermal injury can induce some protooncogeneexpression which sh0wed temporal order and well controlled manifestation. Those results suggest thatthose four protooncogenes are involved with the repair process as a regulator.

Preparation o f Epidermal Growth Factor and Its Effects on Burn Wound Healing: An Experimental Study / 第二军医大学学报

The present article reports the method of preparation of epidermal growth factor (EGF) from mouse submaxillary glands by using a two-step liquid chromatography and the efficacy of EGF in promoting animal wound healing. It was found that combined purification of crude EGF is better with Bio-gel p-10 and DEAE-DE52 ion-exchange chromatographies and purified EGF has a marked enhancement of wound healing and reduction of cicatricial contracture in animals.

The Changes of Serum Myocardial Enzymogram in Bum Patients / 第二军医大学学报

The serum myocardial enzymes and isoenzymes activities were measured in 65 bum patients. The results showed that serum CK, CK-MB, LDH and AST activities, and CK-MB/CK and LDH1/LDH2 ratios were markedly elevated after burn injury. The CK-MB/CK ratio in major bum patients was higher than 0.05 1 -3d and 14d postbum. The results suggest that myocardial cells of serious bum patients are significantly injured in both early period and 14 d postbum.

The Dynamic Changes of Dynorphin in Plasma of Bumed Patients / 第二军医大学学报

The dynamic changes of immunoreactive dynorphin1-13 (ir-Dyn1-13) contents in 18 burned patients were studied by radioimmunoassay. It was found that ir-Dyn began to increase gradually at the onset of burn and remained at a relatively high levels by the time of preliminary wound healing. Plasma ir-Dyn increased gradually after bum and decreased abruptly before death in one severely burned patient who died of respiratory failure at the third week. The results suggest that Dyn may have a protective effect on the burned patients.