Efficacy and safety of Shenyankangfu Tablet, a Chinese patent medicine, for primary glomerulonephritis: A multicenter randomized controlled trial / 中西医结合学报

BACKGROUND@#Shenyankangfu Tablet (SYKFT) is a Chinese patent medicine that has been used widely to decrease proteinuria and the progression of chronic kidney disease.@*OBJECTIVE@#This trial compared the efficacy and safety of SYKFT, for the control of proteinuria in primary glomerulonephritis patients, against the standard drug, losartan potassium.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTION@#This was a multicenter, double-blind, randomized, controlled clinical trial. Primary glomerulonephritis patients, aged 18-70 years, with blood pressure ≤ 140/90 mmHg, estimated glomerular filtration rate (eGFR) ≥ 45 mL/min per 1.73 m@*MAIN OUTCOME MEASURES@#The primary outcome was change in the 24-hour proteinuria level, after 48 weeks of treatment.@*RESULTS@#A total of 735 participants were enrolled. The percent decline of urine protein quantification in the SYKFT group after 48 weeks was 8.78% ± 2.56% (P = 0.006) more than that in the losartan 50 mg group, which was 0.51% ± 2.54% (P = 1.000) less than that in the losartan 100 mg group. Compared with the losartan potassium 50 mg group, the SYKFT plus losartan potassium 50 mg group had a 13.39% ± 2.49% (P < 0.001) greater reduction in urine protein level. Compared with the losartan potassium 100 mg group, the SYKFT plus losartan potassium 100 mg group had a 9.77% ± 2.52% (P = 0.001) greater reduction in urine protein. With a superiority threshold of 15%, neither was statistically significant. eGFR, serum creatinine and serum albumin from the baseline did not change statistically significant. The average change in TCM syndrome score between the patients who took SYKFT (-3.00 [-6.00, -2.00]) and who did not take SYKFT (-2.00 [-5.00, 0]) was statistically significant (P = 0.003). No obvious adverse reactions were observed in any group.@*CONCLUSION@#SYKFT decreased the proteinuria and improved the TCM syndrome scores of primary glomerulonephritis patients, with no change in the rate of decrease in the eGFR. SYKFT plus losartan potassium therapy decreased proteinuria more than losartan potassium therapy alone.@*TRIAL REGISTRATION NUMBER@#NCT02063100 on ClinicalTrials.gov.

Effects of Niaoduqing Particles () on Delaying Progression of Renal Dysfunction: A Post-trial, Open-Label, Follow-up Study / 中国结合医学杂志

OBJECTIVE@#To follow up the participants of the randomized clinical trial "Efficacy and Safety of Niaoduqing Particles () for Delaying Moderate-to-Severe Renal Dysfunction", and assess the long-term effects of Niaoduqing Particles on delaying the progression of renal dysfunction.@*METHODS@#Participants, who had previously been randomly assigned to receive Niaoduqing Particles or placebo for 24 weeks (146 cases in each group), were invited to follow-up and all were administered Niaoduqing Particles 5 g thrice daily and 10 g before bedtime for 24 weeks. The primary endpoints were changes in baseline serum creatinine (Scr) and estimated glomerular filtration rate (eGFR) after completion of the open-label treatment period.@*RESULTS@#After the double-blind period, the median (interquartile range) changes in Scr were 1.1 (-13.0-24.1) and 11.7 (-2.6-42.9) μmol/L for the Niaoduqing Particle and placebo groups, respectively (P=0.008), and the median changes in eGFRs were-0.2 (-4.3-2.7) and-2.21 (-5.7-0.8) mL•min•1.73 m, respectively (P=0.016). There were significant differences in the double-blind period changes in renal function between groups. After the open-label period, the median changes in Scr were 9.0 (-10.0-41.9) and 17.5 (-6.0-50.0) μmol/L for the Niaoduqing Particle and placebo groups according to baseline grouping, respectively (P=0.214), and the median changes in eGFRs were-2.3 (-6.4-1.9) and-3.7 (-7.5-1.1) mL•min•1.73 m, respectively (P=0.134). There were no statistical differences in the open-label period changes in renal function between groups. The eGFR reduction of participants who accepted Niaoduqing Particle treatment for 48 weeks was projected to 2.5 mL•min•1.73 m per year.@*CONCLUSION@#Niaoduqing Particles appear to have long-term efficacy for patients with moderate-to-severe renal dysfunction. Although there was no statistical difference, the early use of Niaoduqing Paticles seems to ameliorate the worsening of renal function. (Trial registration No. ChiCTR-TRC-12002448).

Therapeutic Effects and Mechanism of Chinese Medicine Skin Dialysis for Chronic Renal Failure / 广州中医药大学学报

Objective To observe the influence of Chinese medicine skin dialysis on traditional Chinese medicine (TCM) syndrome scores and microinflammation in patients with chronic renal failure(CRF). Methods A total of 180 patients with CRF were divided into groups A, B and C, 60 cases in each group. All of the 3 groups were given conventional treatment, and additionally, group A was given Chinese medicine skin dialysis, and group B was given pure water dialysis. Meanwhile, 60 healthy volunteers served as normal control group (group D), and had no any medication. The course of treatment lasted for one month. Before and after treatment, we examined the scores of TCM syndromes and the levels of 24-hour urinary protein, serum creatinine (SCr), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), albumin (ALB), immunoglobulin A(IgA), immunoglobulin G (IgG) , immunoglobulin M(IgM), interleukin 6 (IL-6) , interleukin 1(IL-1), hyper-sensitive C reactive protein (hs-CRP), and tumor necrosis factor alpha (TNF-α). Results After treatment, the scores of TCM syndromes and the levels of 24-hour urinary protein, SCr, BUN, eGFR, IL-6, IL-1, hs-CRP, and TNF-α in the 3 groups were decreased (P < 0.05 compared with those before treatment), and were markedly lower in group A than those in group B and group C (P<0.05); serum levels of IgA, IgG, IgM and ALB in the 3 groups were increased(P < 0.05 compared with those before treatment), and the levels in group A were significantly higher than those in group B and group C (P < 0.05). However, the levels of observation indexes did not arrive to the levels of group D(P<0.05). Conclusion Chinese medicine skin dialysis is effective on relieving the symptoms of CRF patients and enhancing the therapeutic effect through decreasing inflammatory mediators, inhibiting micro-inflammation and improving nutritional status.

Biotransformation effect of Bombyx Mori L. may play an important role in treating diabetic nephropathy / 中国结合医学杂志

Compared with herbal drugs, medicine processed from animals (animal medicine) was thought to have more bioactive substances and higher activities. Biotransformation effect often plays an important role in their effect. However, researches about effect of animal medicine on diabetic nephropathy and applying animal medicine as natural bio-transformer were seldom reported. The purpose of this paper was to reveal the use of Bombyx Mori L. on diabetic nephropathy from ancient to modern times. The classical literature indicated that Saosi Decoction (), which contains Bombyx Mori L. or silkworm cocoon, was applied to treat disorders congruent with modern disease diabetic nephropathy from the Ming to Qing Dynasty in ancient China. Modern studies showed that Bombyx Mori L. contains four main active constituents. Among these, 1-deoxynojirimycin (1-DNJ) and quercetin showed promising potential to be new agents in diabetic nephropathy treatment. The concentrations of 1-DNJ and the activities of quercetin in Bombyx Mori L. are higher than in mulberry leaves, because of the biotransformation in the Bombyx Mori L. body. However, these specifific components need further human and mechanistic studies to determine their therapeutic potential for this challenging condition.

Management of chronic kidney disease in China calls for the implementation of expert patient program with traditional Chinese medical interventions / 中国结合医学杂志

Chronic kidney disease was closely related with unhealthy lifestyle; therefore a strategy focused both on daily life and medical process, like the Expert Patients Program, was of great value in the prevention and treatment of chronic kidney disease. In China, however, obstacles still existed in the process of implementing the program. Adding traditional Chinese medical interventions to the program assisted both patients and physicians to understand and to accept this new trend in management of chronic disease better. The combination with traditional Chinese medical interventions showed a solution for successfully implementing the Expert Patients Program and provided a new strategy for prevention and control of chronic kidney disease.

Progress on the application of aquaporins in Chinese medicine / 中国结合医学杂志

Aquaporins are a group of membrane proteins, which are known as the passages of water molecules transforming through the biological membrane lipid bilayer and distributing in almost all of the organs and tissues of living creatures. Aquaporins play important roles in maintaining water balance and internal environment stability. As a new entry point, aquaporins are involved in the researches on water metabolism, physiological regulation and pathological essence in viscera-state more and more widely in recent years. The literature on traditional Chinese medical studies, which related to aquaporins and were published in the last decade, was reviewed and the progress on application of aquaporin in Chinese medicine was summarized in this paper.

Inhibition of the tubular epithelial-to-mesenchymal transition in vivo and in vitro by the Uremic Clearance Granule () / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of the Uremic Clearance Granule (UCG, ), a Chinese patent medicine, on tubular epithelial-to-mesenchymal transition (EMT) in a unilateral ureteral obstruction (UUO) model in vivo and transforming growth factor (TGF)-β1 induced EMT of HK-2 cells in vitro.</p><p><b>METHODS</b>In vivo study, 50 Sprague Dawley rats were divided into three groups: a sham operation group (n=10), a UUO group (n=20), and a UUO with UCG treatment group (n=20). The UCG was given at a dose of 4.5 g/kg body weight per day by gavage after surgery. In vitro study, HK-2 cells were cultured in 10% fetal bovine serum (FBS), 10% healthy rat serum, 10% FBS and TGF-β1 (10 ng/mL), 10% healthy rat serum and TGF-β1, or 10% rat serum containing the uremic clearance granule and TGF-β1. The expression of the epithelial marker E-cadherin and the mesenchymal markers vimentin and α-smooth muscle actin (α-SMA) in kidney tissues and HK-2 cells were investigated by Western blot analysis and immunofluorescence staining.</p><p><b>RESULTS</b>The rats of the UUO group showed obvious tubulointerstitial fibrosis, compared with the sham operation group rats. Tubulointerstitial fibrosis score was reduced by 17.5%±1.1% at day 7 and by 20.0%±1.2% at day 14 in the UCG-treated group, compared with the UUO group. The UCG could maintained expression of E-cadherin and suppressed expression of vimentin and α-SMA in kidney tissues of UUO rats at days 7 and 14, as determined by Western blot analysis and immunofluorescence staining. Rat serum containing the UCG partially inhibited TGF-β1-induced fibroblast phenotype of HK-2 cells and maintained the epithelial morphology of HK-2 cells in vitro. This occurred partially through a reduction of vimentin expression and an increase of E-cadherin expression.</p><p><b>CONCLUSION</b>These results suggest that the UCG prevents tubular EMT and may be a promising agent for treating tubulointerstitial fibrosis.</p>

Advancement in the research of the role of macrophages in wound healing / 中华烧伤杂志

Macrophages play important roles in all stages of wound healing. Changes in micro-environment leads to transformation of macrophages type I and type II, thereby playing a role in wound healing. During the early inflammatory phase, type I macrophages exert pro-inflammatory function such as antigen-presenting, phagocytosis, and the production of inflammatory cytokines and growth factors. While during the wound healing phase, macrophages were transformed into type II, which stimulate the proliferation of fibroblasts, keratinocytes, and endothelial cells by expressing growth factors. This results in the formation of granulation tissue, angiogenesis, and the formation of ECM, so as to promote wound healing. This review summarizes the function and change in phenotype of macrophages in different stages of wound healing.

Colon may provide new therapeutic targets for treatment of chronic kidney disease with Chinese medicine / 中国结合医学杂志

Chronic kidney disease (CKD) has become a worldwide health and social problem. Retarding its progression to end-stage renal disease is beneficial both to the patients and the healthcare system. Plenty of clinical trials have indicated that enema with Chinese medicine could effectively prevent chronic renal failure, and was widely used in the clinical practice. However, studies on mechanism were still nearly blank, which may prevent further improvement of therapeutic efficacy. Recent studies had discovered that colon was an important organ where uremic toxins were generated. The uremic toxins involved could not only promote CKD progression, but also was closely correlated with CKD mortality. Reducing production and promoting excretion of toxins were confirmed to reduce renal tubule interstitial fibrosis and delay renal progression. On the basis of the theory of gut-kidney axis above, we had conducted pilot clinical researches to evaluate the effect of enema with Chinese medicine on the intestinal flora, gut barrier, enterogenous uremic toxins and renal protection. The preliminary results revealed that rheum enema through colon could accelerate intestinal dynamics, improve intestinal barrier function, regulate intestinal flora and reduce production and absorption of intestine-derived uremic toxins such as indoxyl sulfate, which may reduce renal fibrosis and delay renal progression. Further studies could provide more evidence for colon as a new therapeutic target for the treatment of CKD with Chinese medicine.

Current pattern of Chinese dialysis units: a cohort study in a representative sample of units / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Understanding the characteristics of Chinese dialysis patients and the current practice trends is the first step to evaluate the association between practice pattern and outcome in these populations. In the present study, we evaluated the status of medical treatment and characteristic features of chronic dialysis patients in China.</p><p><b>METHODS</b>Through a clustering sampling, we selected 9 centers from the largest dialysis facilities in 6 cities around China. All adult undergoing dialysis in the selected units were screened. A total of 2388 (1775 on hemodialysis (HD) and 613 on peritoneal dialysis (PD)) patients were finally enrolled. All data were collected at enrollment on the bases of review of medical records.</p><p><b>RESULTS</b>In this cohort, 1313 (55.0%) were male. The mean age was 54 years old. The median time for dialysis was 26 months (12 - 51 months). Seventy-five percent of patients were on HD and 25.0% on PD. Among PD patients, about 21% patients did not receive dialysis adequacy. For HD patients, about 14.0% of them did not achieve dialysis adequacy when the target of kt/V was set as 1.2. Only 44.7% of patients achieved blood pressure target of 140/90 mmHg. About 60% of patients did not reach the hemoglobin target of 110 g/L even though 85.0% of them were treated with erythropoietin. In addition, 48.5% of the patients had uncontrolled mineral metabolism revealed by the high calcium-phosphate product. Compared with HD patients, higher level of serum glucose, triglyceride, and total and low density lipoprotein cholesterol were more common in PD patients.</p><p><b>CONCLUSIONS</b>This observational study suggests that many Chinese dialysis patients did not achieve the therapeutic target, particularly in blood pressure control, anemia correction, and mineral balance. PD patients were more likely to suffer metabolic disturbance.</p>

A survey and analysis of Chinese patent medicine for outpatients with chronic kidney disease / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the current state of oral administration of Chinese patent medicine in treatment of chronic kidney disease (CKD) in the Westem medicine hospitals.</p><p><b>METHODS</b>Outpatients of Department of Nephropathy, Peking University Third Hospital with diagnosed CKD confirmed by CKD diagnosis standard were surveyed by questionnaire in May 2009. The following patients' information was collected using the Questionnaire of the Current State of Oral Administration of Chinese Patent Medicine at CKD Clinics. (1) The present symptoms, tongue figure, pulse figure were syndrome typed referring to The Diagnosis, Syndrome Typing, and Efficacy Assessment of Chronic Renal Failure 2006 by Chinese Society of Renal Diseases, Chinese Society of Traditional Chinese Medicine. (2) Names of Chinese patent medicines and Western medicines patients use presently, the dose and dosage, names of hospitals responsible for prescriptions. (3) Patients' basic diseases including diabetes, hypertension, hyperuricemia, and so on at present. Irrational applications of Chinese patent medicines were classified according to the drug instruction and Guiding Principle of Clinical Application of Chinese Patent Medicines (issued by State Administration of Traditional Chinese Medicine). The irrationality was analyzed. Correlated factors such as age, sex, deficiency in origin syndrome, sthenia in superficiality syndrome, the nature and grade of hospitals responsible for prescriptions, total numbers of Chinese patent medicines, and primary diseases, etc. were analyzed using Logistic regression model. These factors might result in irrational application of Chinese patent medicines.</p><p><b>RESULTS</b>102 questionnaires were handed out, with 78 effective ones. Of them, 41 patients (41/78, accounting for 52.6%) were taking Chinese patent medicines. Of the 41 patients, irrational application happened to 24 patients (24/41, accounting for 58.5%), absolute discrepancy of medicines and syndromes to 5 (5/41, accounting for 12.2%), repeated medication to 7 (7/41, accounting for 17.1%), and interaction to 2 (2/41, accounting for 4.9%). Logistic regression model was analyzed. Variables were screened by Enter method. The number of Chinese patent medicines had statistic significance (P<0.05).</p><p><b>CONCLUSIONS</b>The occurrence rate of irrational application of Chinese patent medicines in CKD outpatients in Westem medicine hospitals was higher. They were mainly manifested as absolute discrepancy of medicines and syndromes and repeated medication. Increased numbers of Chinese patent medicines in recipes would increase the occurrence rate of irrational application of Chinese patent medicines.</p>

Analysis of Chinese medicine syndrome types in 156 patients undergoing maintenance peritoneal dialysis / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To analyze the Chinese medicine syndrome types of patients undergoing maintenance peritoneal dialysis to provide some clinical reference for the treatment based on syndromes.</p><p><b>METHODS</b>According to the criterion made by the Nephropathy Branch of China Association of Chinese Medicine in 2006, the syndrome type of 156 patients were differentiated, and the related laboratory parameters, including serum albumin (ALB), C-reactive protein (CRP), hemoglobin (HB), total urea clearance rate (KT/Vt), residual kidney urea clearance (KT/Vr), blood flow mediated vascular endothelial dilatation (FMD) and volume overload (OH) were measured.</p><p><b>RESULTS</b>Syndrome type presented in patients was different. Along with the progress of dialysis, it changed in the root syndromes from qi-deficiency to yang-deficiency and further to both yin-yang deficiency, while in the superficial syndromes it turned from turbid-damp to blood-stasis. ALB in patients with Pi-shen yang-deficiency type and both yin-yang deficiency type was significantly lower than that in patients with Pi-Shen qi-deficiency type and both qi-yin deficiency type (P < 0.05); KT/Vt in both yin-yang deficiency type was the lowest, significantly lower than that in Gan-Shen yin-deficiency type and both qi-yin deficiency (P < 0.05); OH in Pi-Shen yang-deficiency type and both yin-yang deficiency type was significantly higher than that in other types (P < 0.01). Comparison of patients' age showed that group of patients without superficial syndrome was the youngest and the group of patients with damp-heat syndrome type was the oldest (P < 0.01). CRP in damp-heat type was significantly higher than that in other types (P < 0.05); FMD was lower in blood-stasis type than in turbid-damp type and toxic heat type (P < 0.01); and OH was significantly higher in turbid-damp type than in other types (P < 0.01).</p><p><b>CONCLUSION</b>Some rules of syndrome type distribution could be seen in patients undergoing peritoneal dialysis, which is related with some laboratory parameters to a certain extent, so may provide a few references for clinical treatment based on syndrome type.</p>

Influence of macrophages on some biological features of endothelial cells / 中华烧伤杂志

<p><b>OBJECTIVE</b>To establish the co-culture model of human macrophage cell line (U937) with human vein umbilical cell line (ECV304), and to explore the feasibility of using concanavalin A (ConA) as U937 cell stimulator in regulating angiogenesis.</p><p><b>METHODS</b>ECV304 cells were cultured in vitro, and to which were respectively added U937 cells (1 x 10(5)), 25 microg/mL ConA, and U937 cell (1 x 10(5)) + ConA (25 microg/mL) after cell fusion rate reaching 60%, and then co-cultured for 48 hours. ECV 304 cells in conventional culture were used as controls. 3H-TdR incorporation test was employed to determine the DNA synthesis of vascular endothelial cells. Flow cytometry was used to determine the changes in the cell cycle, and RT-PCR was adopted to determine the expression of homeobox (HOXB2) mRNA.</p><p><b>RESULTS</b>After conA stimulation to ECV 304 co-cultured with U937 cells, the percentage of cells in S phase (48.860 +/- 2.290), the DNA synthesis [(5694 +/- 917) min(-1)], and the expression of HOXB2 mRNA (0.947 +/- 0.003) were obviously higher than those in control group [41.590 +/- 2.590 vs (2498 +/- 1109) min(-1) vs 0.646 +/- 0.004, P > 0.01]. There was no obvious difference in apoptosis among above stimulation methods (P >0.05).</p><p><b>CONCLUSION</b>U937 cells activated by ConA can promote the proliferation of ECV304 cells and further regulate angiogenesis. HOXB2 gene is closely related to the endothelial proliferation.</p>

Influence of skin-derived progenitor cell combining with hyaluronic acid on the wound healing of diabetic rat / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the effect of skin-derived progenitor cell (SKP) combined with hyaluronic acid( HA) on the wound healing in diabetic rats.</p><p><b>METHODS</b>SKP of Spraque-Dawley (SD) neonate rats were isolated and cultured and mixed with HA. The differentiation characteristics of SKP in the culture were observed. Sixty SD rats were injected intraperitoneally with 65 mg/kg streptozotocin( STZ) to induce diabetes. Two symmetrical full-thickness cutaneous wounds( 1.0 cm in diameter) were made on the back of each SD rat and randomly divided into A (n = 20, with treatment of 100 mircol SKP-HA) , B (n = 20, with treatment of 100 mirol HA) , and C ( n = 20, with treatment of DMEM/F12 culture medium) groups. Tissue samples from wound in each group were harvested on 1, 2, 3, 4 weeks after the treatment. Wound healing rate, changes in histomorphology, the content of hydroxyproline ( HYP) , and immigration of labelled SKP were determined and analyzed.</p><p><b>RESULTS</b>SKP grew well when cultured with HA. The characteristics of SKP to differentiate into lipocyte, neuron, and neurogliocyte remained in the culture. Compared with that in C group, epithelization in the wounds of A and B groups appeared earlier. The wound healing rate in A group [ (72.1 +/- 2. 8)% ] and B group [ (53.7 +/- 2. 9)% ] were obviously higher at 2 post-treatment weeks(PTW) than that in group C [(42. 5 +/- 1.5)% ( P <0.05) , and that in A group was obviously higher compared with B and C groups at 3 PTW ( P < 0. 05 or 0. 01). The wound healing rates in A and B groups were (100. 00 +/- 0.00) % at 4 PIW, which were obviously higher than that of group C( P <0.01) . There was no obvious difference in the HYP content among the 3 groups at 1 PIW ( P > 0. 05) , but it was obviously higher in A and B groups than that in C group at 2,3,4 PTW( P <0.01) , and that in A group was significantly higher than that in B group at 3 and 4 PTW( P <0. 01). SKP survived well on the wound, and migrated towards the dermis as time elapses.</p><p><b>CONCLUSION</b>SKP-HA composition can promote wound healing in diabetic rats.</p>

The application of artificial dermis and recombinant bFGF afer immersion bath in residual burn wound / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe the effect of application of a new type of artificial biological dressing and recombinant bull fibroblast growth factor( rb-FGF2) after immersion bath in the treatment of residual infected burn wounds at late postburn stage.</p><p><b>METHODS</b>Fifty-six patients with residual wounds at late postburn stage were enrolled in the study, and they were randomly divided into A( n = 28, experimental) and B (n = 28, control) groups. After treatment with immersion bath, the wounds in group A were treated with semi-exposure method. The wound were covered with suitable shape of biological dressings in suitable shape and rb-FGF2 spray twice a day after an immersion bath, and the dressing was changed every other day or every 2 days. To compare the treatment effect, the wounds in group B were only treated with a dressing of monolayer gauze wetted with povidone iodine. The clinical results, the bacteriological state findings, and the corresponding safety indices were determined 10 days after treatment.</p><p><b>RESULTS</b>The wound healing rate, efficacy and the bacterial clearance rate in A group were 64. 3% ,89. 3% ,92. 3% , respectively, and they were obviously higher than those in B group (32. 1% , 67. 9% , 72. 0% , respectively, P < 0. 01 ). No adverse side-effects were observed in either group.</p><p><b>CONCLUSION</b>Application of artificial dermis and bFGF after immersion bath is safe and effective for the elimination of residual wounds at late postburn stage, and it is also beneficial to control wound infection and promote the wound healing.</p>

Multi-center clinical study of acticoat (nanocrystalline silver dressing) for the management of residual burn wounds / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the clinical efficacy and safety of Acticoat (nanocrystalline silver dressing) for the treatment of residual burn wounds.</p><p><b>METHODS</b>Ninety-eight patients with 166 residual burn wounds were enrolled in the multi-center randomized clinical trials. In addition to the routine treatment, Acticoat was applied onto the wounds of the trial group once a day if there was much exudation from the wound, or the dressing change was made every other two days when the wounds were clean. Silver sulfadiazine (SD-Ag) was used in the control group of patients. The healing time was observed up to 20 days. The healing rate on the 15th day after treatment was taken as the percentage of healing.</p><p><b>RESULTS</b>The average healing time was (12 +/- 5) days after the application of Acticoat, which was significantly shorter than that in control wounds with SD-Ag (16 +/- 6) days, (P = 0.005 < 0.01). The total effective rate of the wounds for trial was 97.05%, which was higher than that in control (94.17%) group, but there was no statistically significant difference. The bacterial clearing rate of the Acticoat group on the 6th and 12th post treatment day was 21.7% and 43.5% respectively, which was significantly higher than that in control group. No side-effect was observed in the two groups during the study.</p><p><b>CONCLUSION</b>Acticoat with nanocrystalline silver can promote the healing of residual burn wounds effectively.</p>

Clinical observation of the effects of FE combined enzymes on the infection of the granulation burn wound during late post burns stage / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe the effects of combined FE enzymes on the infection of the granulation burn wound during late postburn stage in controlling burn wound infection caused by common antibiotic resistant bacteria.</p><p><b>METHODS</b>Thirty patients in our burn ward were enrolled and were randomly divided into A [treated with combined FE enzymes (50 ml dissolved in 0-150 ml normal saline to reach the final concentration of 1-3 U/ml)] and B (treated with gentamicin) groups, with 15 patients in each group. Several layers of gauze, either soaked with combined FE enzyme in A or gentamicin in B group, were used to cover the burn wounds once to twice a day. Bacterial culture from the burn wound exudation before and after drug administration was done before the application of the agents. The bacteria in the burn wounds and their susceptibility to antibiotics were identified. The healing time of the burn wounds was recorded. Furthermore, the healing rate of the burn wound was recorded on the 3rd, 5th, 8th, 10th and 12th post skin grafting days (PSGD).</p><p><b>RESULTS</b>The dominating bacteria in the burn wounds in both groups were Pseudomonas aeruginosa, Escherichia coli, Enterobacter cloacae and MRSA. The susceptibility rate of bacteria ( MRSA, Staphylococcus epidermidis, Staphylococcus saprophyte, Pseudomonas aeruginosa, Escherichia coli and Enterobacter cloacae) to combined FE enzyme was 93.8%, 100.0%, 100.0%, 100.0%, 100.0% and 95.0% respectively, which were much higher than those in B group (17.6%, 31.3%, 28.6%, 44.0%, 33.3%, 28.0% respectively, P < 0.1. The wound healing time after skin grafting in A group (10.6 +/- 1.5 days) was significantly shorter than that in B group (15.3 +/- 1.7 days, P < 0.01). The wound healing rate on 10 PSGD in A group was (85.4 +/- 2.4)%, and which was only (51.3 +/- 1.5% in B group (P < 0.01)</p><p><b>CONCLUSION</b>Combined FE enzyme can effectively control burn wound infection, so that the interval between skin grafting and wound healing can be shortened and success rate of skin grafting be improved.</p>

Influence of some topical antibiotics and FGF2, EGF and rhGH on the biological characteristics of fibroblasts in vitro / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the influence of some topically used antibiotics (amikacin, gentamicin, chloromycetin and sulfamylon), basic fibroblast growth factor (FGF2) , epithelial growth factor (EGF) and recombinant human growth hormone (rhGH) on the growth of fibroblasts in vitro.</p><p><b>METHODS</b>Fibroblasts were cultured and passaged. The cultured cells were then divided into control (routine culture of fibroblasts), amikacin (amikacin in respective dose of 0.021, 0.210, 2.100 mg/L), gentamicin (in respective dose of 5, 50, 500 mg/L) , chloromycetin (in respective dose of 0.01, 0.10, 1.00 mg/L), sulfamylon (in respective dose of 5, 10 g/L), FGF2 (2400 U/ml), EGF (2000 U/ml) and rhGH (0.016, 0.160, 1.600 g/L) groups. After the above agents were added to the culture medium respectively, the proliferation of the cultured fibroblasts was determined with MTT method, and the result was expressed as A (absorption) value. The cell cycle was determined with flow cytometry and the morphology of the cells was observed with inverted microscope.</p><p><b>RESULTS</b>(1) MTT method: The A value of fibroblasts cultured with amikacin, gentamicin, chloromycetin and sulfamylon in various doses was obviously lower than that in control group (0.4553 +/- 0.0217, P < 0.05 or 0.01) , and the A value of sulfamylon group was the lowest in two doses (0.1013 +/- 0.0011 for 5 g/L and 0.0950 +/- 0.0041 for 10 g/L, P < 0.01). On the other hand,the A value in FGF2 and rhGH group(0.016 g/L) was much higher than that in the control (P < 0.05). However,theA value in EGF (both doses) and rhGH groups (0.160, 1.600 g/L) was close to that in control (P > 0.05). (2) Cell cycle determination: The proliferation index (PI) of fibroblasts cultured with amikacin in dose of 0.210 mg/L showed no difference compared to that in control (9.63 +/- 0.45)%, (P > 0.05). But the PI of fibroblasts cultured with FGF2, EGF and rhGF in dose of 0.016 g/L was increased significantly (46.76 +/- 2.33)%, (42.30 +/- 1.41)%, and (13.29 +/- 0.47)%, respectively, (P < 0.05 or 0.01). (3) Histological examination of the cells: The number of fibroblasts in elongated or spindle shape was larger, showing a blur contour but high transparency in control as well as in EGF and rhGH groups (both 0.160 and 1.600 g/L doses groups). The number of cells was lower in amikacin, gentamicin, chloromycetin and sulfamylon groups with sharp but irregular contour and lower transparency, and more granule-like materials and vacuoles in the cytoplasm. The cells in the FGF2 and rhGH (in dose of 0.016 g/L) groups exhibited dense with even distribution and slender or spindle shape and with more mitotic figures but blur contour and high transparency.</p><p><b>CONCLUSION</b>Different kinds of the topically used therapeutic agents for burn wounds exert different influence on the biological characteristics of fibroblasts in vitro. The topically used agents for burn wounds should be carefully selected so that wound healing will be promoted and scar formation inhibited.</p>

Influence of macrophages on the expression of vascular endothelial growth factor receptor mRNA, homeobox B2 mRNA, and integrin alpha nu beta3 in vascular endothelial strain / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the influence of macrophages on the expression of the vascular endothelial growth factor (VEGF) receptor (KDR) mRNA, homeobox B2 (HOXB2) mRNA, and integrin alpha nu beta3 in vitro in vascular endothelial strain.</p><p><b>METHODS</b>Human umbilical vein cells (ECV304) were cultured in vitro and divided into 4 groups, i.e. (1) ECV304 group, (2) ECV304 + conA group [with conA (25 microg/ml in culture) added to ECV304], (3) ECV304 + U937 group (with 1 x 10(5)/ml of U937 cells added to 1 x 10(5)/ml ECV 304), (4) ECV304 + U937 + conA group [with 1 x 10(5)/ml of U937 cells and conA (25 microg/ml in culture)] groups. Forty-eight hours after culturing, the expression of integrin receptor alpha nu beta3 and the changes in the expression of KDR mRNA and HOXB2 mRNA in each group were determined by immunofluorescent technique and RT-PCR, respectively.</p><p><b>RESULTS</b>The expression of integrin receptor alpha nu beta3, KDR mRNA, and HOXB2 mRNA in ECV304 group were 6.7 +/- 1.5, 0.633 +/- 0.012, and 0.674 +/- 0.004, respectively, while those in ECV304 + U937 + conA group (10.2 +/- 1.7, 0.879 +/- 0.003, 0.947 +/- 0.003) were obviously more upregulated when compared with those in ECV304 group (P < 0.01). No difference in the above indices was found between ECV304 and ECV304 + conA, ECV304 + U937 groups (P > 0.05).</p><p><b>CONCLUSION</b>Macrophages activated by ConA can accelerate the proliferation, migration and adhesion to the basement membrane matrix of vascular endothelial cells through the influence on the expression of KDR mRNA, HOXB2 mRNA and integrin alpha nu beta3, and through this pathway the angiogenesis is modulated.</p>

Effect of lipopolysacharide on the biological features and growth factor secretion power of U937 cell line / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the effect of lipopolysacharide (LPS) in different concentrations on the biological features and growth factor secretion power of U937 cell line.</p><p><b>METHODS</b>In vitro cultured U937 cells were stimulated by 0 (as control), 0.1, 1.0, 10.0, 50.0 and 100 micro g/ml LPS respectively for 24 hours. Thereafter, the cell proliferation ability was determined by MTT method. The cell apoptosis rate was determined by flow cytometry. The changes in the contents of transforming growth factor beta(1) (TGFbeta(1)) and vascular endothelial growth factor (VEGF) of the supernatant of the cell culture were assessed by ELISA.</p><p><b>RESULTS</b>Apoptosis and TGFbeta(1) secretion could be induced by LPS in dose of 0.1 to 100 micro g/ml when compared with that without LPS challenge (P < 0.05 - 0.01). In detail, LPS in lower dose (0.1, 1.0 and 10.0 micro g/ml) could promote the proliferation of U937 (P < 0.05 - 0.01) but exerted no effect on VEGF secretion. In contrary, LPS in high dose (50 and 100 micro g/ml) could promote VEGF secretion (P < 0.01) but exerted no effects on the proliferation of U937 cells.</p><p><b>CONCLUSION</b>U937 cells could be activated to increase the secretion of TGFbeta(1) by LPS in optimal dose of 0.1 - 10.0 micro g/ml, but the secretion of VEGF could only be promoted by LPS in higher concentration.</p>